Practicum Project: Suggesting Interventional Solution to the Problem

Practicum Project: Suggesting Interventional Solution to the Problem

Patient Health Problem Solution

This practicum project was about a health issue involving a 12-year-old female who was admitted with acute asthmatic exacerbation. The patient also had childhood obesity and chronic GERD. The last session with the patient and the mother evaluated how technology would impact their healthcare. An intervention of choice to improve their health promotion and maintenance was a health educational brochure.

Practicum Project: Suggesting Interventional Solution to the Problem

The purpose of this paper is to summarize and substantiate this patient’s health problem; elaborate on the impact of nursing leadership and change management on the problem; explain how the quality of care, cost, and patient safety impacted the intervention; explain the role of the state board of nursing standards in improving the management of the problem; and explain the potential role of technology, utilization of community resources, and care coordination in developing the educational brochure.

Problem Summary and Justification

The patient was Annie (not her actual name), a 12-year-old black female patient accompanied by her mother on a brief inpatient hospital admission due to acute asthmatic exacerbation. However, during this admission, she was diagnosed with chronic GERD and childhood obesity.

Annie has been using her Ventolin inhaler whenever needed for asthma attacks. However, this time, the inhaler did not control her symptoms even after half an hour of treatment. This was her second admission due to asthma. The first admission was four years ago when she was being evaluated for symptoms of GERD.

Recently, asthma attacks have increased in frequency and are triggered not only by cold weather but also by certain body sprays and strong smells from foods and fresh paints. Annie lives with her parents and is the only child in her family. I selected this patient because her case represents a patient health problem with various socioeconomic determinants, a need for care coordination, and nursing care and patient exudation.

At the first point of our interaction, I desired to learn more in-depth about the reasons for her recent increase in attacks and offer care where possible and necessary. Therefore, her care would offer me the opportunity to exercise my quality improvement skills and nursing care coordination skills.

Role of Leadership and Change Management in Addressing the Health Problem

Good nursing leadership qualities and skills enable a nurse leader to inspire, influence, and motivate patients, care stakeholders, and other healthcare professionals in the nursing process. Nursing leadership helped inspire the patient and her family to take the initiatives to prevent future attacks through knowledge empowerment by using the educational brochure.

The educational brochure contained self-explanatory information that informed the patient’s caregiver about emergency awareness and prevention strategies for future attacks. According to van Diggele et al. (2020), effective nursing leadership influences patient education through attitude and behavior change. Nursing leadership ensured that the resource was influential by keeping it simple, direct to the point, and only including the need-to-know elements that would enhance understanding and health literacy.

Change management concepts learned from undergraduate education influenced the development of the intervention. This patient’s health problem was not an ordinary case of pediatric asthma. It was complicated by comorbidities and socioeconomic issues. One key change management concept applied in this intervention’s development was stakeholder involvement (Harrison et al., 2021).

Key stakeholders in this patient health problem were family caregivers, doctors, and community resource managers. This intervention aimed at engaging these stakeholders by promoting awareness in the patient and her family caregiver (the mother) in seeking these services by providing necessary contacts and links to essential community resources

The role of nursing ethics was not overlooked in the development of this intervention. Patient privacy, confidentiality, and data security ethics ensured that no direct patient identifiers were included in the interventions. The need to promote justice and equity in resource allocation, utilization, and access ensured that sample community resources for social and material support were included in the intervention.

This intervention also attempted to ensure that the patient’s caregiver makes informed decisions in future health-related endeavors regarding the child’s health. Therefore, the information included in the brochure was evidence-based and adapted from current guidelines and reputable sources.

Strategies for Communicating and Collaborating with The Patient and the Family

Patient collaboration and communication improved collaboration. To enhance collaboration with this patient and her family, patient and family-centered communication is an evidence-based strategy that ensures their engagement and quality outcomes (Park et al., 2018).

Patient- and family-centered communication will include a discussion of factors specific to this patient and their relevant determinants of health, such as income and health insurance in healthcare resource utilization. Communicating strategies that promote self-management and behavior improvement will improve their engagement and self-care. Change communication is another strategy that enhances cooperation and engagement of the patient’s family and their effective self-planning in the process of enhancing self-management.

Effective collaboration with the patient and her family could be enhanced through shared decision-making. In this process, the patient and the nurse collaborate to make patient-specific decisions. The selection of community resources will enhance the uptake and utilization of these resources. Patient engagement is vital in promoting compliance to care interventions and adherence to treatment plans.

This engagement also promotes self-management and positive behavior change. Therefore, working closely with the patient through the above communication and collaboration strategies will prevent future unplanned hospitalizations and complications of her health problem.

Patient engagement in their care will also prevent ethical problems related to decision-making (Lantos, 2020). An example is a situation where the clinician requests interventions and the patient or family declines, or the patient suggests intervention, but the clinician declines it as inappropriate without communicating.

The Role Played by Practice Standards and Policies in the Intervention Development

The state boards of nursing standards regulate my scope of intervention. Therefore, it determent what I could legally perform or explain as a baccalaureate nurse. This scope included assessment, diagnosis, planning, implementation, evaluation, and coordination of care.

Therefore, the contents of this intervention were limited to health problem assessment, diagnosis of complications, planning interventions, implementing prevention strategies, evaluation of outcomes, and coordinating care between different stakeholders. Therefore, the intervention was within the boundaries of the practice authority of a baccalaureate nurse.

Effective policies such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) ensured that no protected health information (PHI) of the patient was included I n this intervention. This upheld the privacy and confidentiality between the patient and the care coordinator. This intervention also borrowed concepts from another influential policy – the affordable care act (ACA).

As part of mitigating the health disparities that affected this patient, the provision of ACA that allows pediatric patients to be eligible to use their parents’ insurance covers was used as the basis of influencing the patient family to use available insurance to plan for their future health activities and expenditures.

According to Suri et al. (2022), ACA improved outcomes for patients from low socioeconomic status at the individual level. However, this credible research still reported the existence of cost barriers even in those individuals who used insurance.

The Quality of Care, Patient Safety, and Cost Outcomes of the Intervention

Educational brochures have been used in health care to communicate health risks and interventions and educate patients to improve health literacy (Malliarou et al., 2022). The reforms by recent policies such as ACA have shifted patient care from hospital-based care to patient and family-based care to save care costs and improve the quality of care. Using this intervention would improve the quality of care, enhance safety, and minimize the costs of care.

Quality of care has six domains: safety, equity, timeliness, effectiveness, efficacy, and patient-centered care (Harrison et al., 2021). This intervention incorporated patient-centered communication, planning, and collaboration that included specific social determinants of health, such as income and health insurance, to propose specific preventive interventions.

This intervention used evidence-based information from scholarly sources to recommend health prevention and monitoring. Prevention of hospitalization was a key theme discussed in this intervention. This strategy would improve patient safety. By enhancing the use of community resources and coordinated communication through technology, this intervention would ensure that the patient’s family spends less on hospitalizations due to emergencies.

Technology, Care Coordination, and The Utilization of Community in Addressing the Patient Health Problem

Potentially useful technologies impacting this patient’s health problem are smartphone application technologies, digitally-enabled technologies, phone message service technologies, and social media. These technologies would connect the patient remotely with her primary doctor and nurse, enhance remote monitoring, improve the doctor-patient relationship, improve patient satisfaction, and prevent emergency hospitalizations (Poowuttikul & Seth, 2020).

Smart inhalers will enhance self-management and self-monitoring. According to a study by Homaira et al. (2022), care coordination for asthma patients integrates acute care and primary care. This coordination also enables these families with resources that have the potential to prevent emergency hospitalizations. Community resources such as community pharmacies, online support groups, and respiratory rehabilitation facilities ensure care continuity, restore health, and reduce the risk of hospitalizations.

Conclusion

The educational brochure has the potential to positively impact the quality of care, care costs, and patient safety. Nursing leadership, change management, and nursing ethics determined the scope and contents of the intervention. State board of nursing standards were applied to ensure the intervention’s scope did not go beyond the level of practice and education.

National policies such as ACA and HIPAA formed the basis of patient education and outline of information in the intervention. These policies also ensured ethics of care, such as data safety, community resource utilization and equity, and patient confidentiality.

Patient-centered communication, shared decision-making, and change communication is strategies to enhance patient and family communication and collaboration by promoting patient engagement and involvement in their care. The potential role of various technologies, care coordination, and community resources cannot be overlooked in this patient’s health problem.

References

  • Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership13, 85–108. https://doi.org/10.2147/JHL.S289176
  • Homaira, N., Dickins, E., Hodgson, S., Chan, M., Wales, S., Gray, M., Donnelly, S., Burns, C., Owens, L., Plaister, M., Flynn, A., Andresen, J., Keane, K., Wheeler, K., Gould, B., Shaw, N., Jaffe, A., Breen, C., Altman, L., & Woolfenden, S. (2022). Impact of integrated care coordination on pediatric asthma hospital presentations. Frontiers in Pediatrics10, 929819. https://doi.org/10.3389/fped.2022.929819
  • Lantos, J. D. (2020). Ethical problems in decision making in the neonatal ICU. Obstetrical & Gynecological Survey75(4), 214–216. https://doi.org/10.1097/ogx.0000000000000793
  • Malliarou, M., Pappa, V., Papathanasiou, I., Andreanidis, I., Nikolentzos, A., Apostolakis, I., & Sarafis, P. (2022). The effect of an information brochure on patients undergoing cardiac catheterization on their anxiety, knowledge, and fear: A randomized controlled study. Health Psychology Research10(3), 35640. https://doi.org/10.52965/001c.35640
  • Park, M., Lee, M., Jeong, H., Jeong, M., & Go, Y. (2018). Patient-and family-centered care interventions for improving the quality of health care: a review of systematic reviews. International Journal of Nursing Studies, 87, 69–83. https://doi.org/10.1016/j.ijnurstu.2018.07.006
  • Poowuttikul, P., & Seth, D. (2020). New concepts and technological resources in patient education and asthma self-management. Clinical Reviews in Allergy & Immunology59(1), 19–37. https://doi.org/10.1007/s12016-020-08782-w
  • Suri, R., Macinko, J., Inkelas, M., & Needleman, J. (2022). The relationship between insurance status and the Affordable Care Act on asthma outcomes among low-income US adults. Chest161(6), 1465–1474. https://doi.org/10.1016/j.chest.2022.01.011
  • van Diggele, C., Burgess, A., Roberts, C., & Mellis, C. (2020). Leadership in healthcare education. BMC Medical Education20(Suppl 2), 456. https://doi.org/10.1186/s12909-020-02288-x

Practicum Project Instructions: Suggesting Interventional Solution to the Problem

LC4002A: Healthcare Quality
LC4002A Assessment Instructions
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Review the details of your assessment including the rubric. You will have the ability to submit the assessment once you submit your required self-assessments and engage with your Faculty Subject Matter Expert (SME) in a substantive way about the competency.

Overview
In this Performance Task Assessment, you will consider healthcare quality issues that you observe in practice. You will also locate evidence that relates to the issue from scholarly sources.

Looking Ahead
Over the course of Competencies LC4002A – LC4005A, you will be going through the steps of your Quality Improvement Project which will be submitted in LC4005A. During each Competency, you will complete one or more parts of the final project, and in LC4005A, you will use these parts to create the final project.

This practice experience project has six parts:

Analyze available evidence and identify a quality improvement practice problem;
Conduct a literature search finding data and evidence-based solutions/interventions to support the importance of the quality improvement practice problem;
Identify the quality improvement tools (Fishbone diagram, Pareto Chart, Process Flow Chart, etc.) that will display the data supporting the need for the Quality Improvement Project;
Apply the PDSA process to the development of the Quality Improvement Project;
Develop an evidence-based plan to address the quality improvement practice problem; and
Present the final Quality Improvement Project as a comprehensive paper and quality improvement storyboard.
The practice experience is an active learning process that provides you with the opportunity to apply your nursing knowledge by addressing a quality improvement practice problem. The practice experience is comprised of selected onsite experiences and completion of a Quality Improvement Project with guidance from your subject matter expert. For additional information on the practice experience, follow this link: https://academicguides.waldenu.edu/fieldexperience/son/home

The practice experience guide can also be found here: https://academicguides.waldenu.edu/ld.php?content_id=45642029

Instructions
To complete this Assessment, do the following:

Be sure to adhere to the indicated assignment length.
Download the Academic Writing Expectations Checklist to review prior to submitting your Assessment.
Before submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.


All submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided where appropriate. Submissions that do not meet these expectations will be returned without scoring.

This Assessment requires submission of one (1) document, a 3–4-page paper. Save this file as: LC4002A_firstinitial_lastname (for example, LC4002A_J_Smith)

You may submit a draft of your assignment to the Turnitin Draft Check area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.

Addressing Quality Issues in Healthcare
As a practicing nurse, you probably see falls, CLABSI, CAUTI, MRSA infections, and other such issues arise from time to time. No facility is immune to safety issues, and, as a nurse leader, it is your job to identify these issues and work to address them using evidence.

In this Performance Task Assessment, you will discuss healthcare quality and the pioneers that shaped current practices. You will also consider a practice problem that might be present in your practicum facility and locate evidence surrounding the problem.

In a 3- to 4-page paper, address the following:

Define healthcare quality in your own words and apply it to the work of one major quality pioneer as listed in the Spath (2018) textbook (Shewhart, Deming, Juran, Ishikawa, Crosby, Feigenbaum, etc.).
Describe a healthcare practice problem that you have had some experience with as a consumer or as a practitioner in healthcare. The practice problem you identify must be supported by data that is available to you in your practice setting and justifies that a problem exists. This problem will be the basis for your quality improvement practicum project you will complete in the upcoming competencies (LC4003, LC4004 and LC4005). Explain how your definition of healthcare quality might apply to your selected practice problem and your experiences with it.
Locate 5 sources of scholarly evidence published within the last five years that describe potential solutions or interventions that you can implement as part of your practicum quality improvement plan. A scholarly piece of evidence could be a journal, government agency, white paper, or professional organization. Synthesize the information in the 5 articles. Note that a synthesis of information is not a summary of each source. A synthesis involves critical reading to make connections between sources, compare the similarities and differences, highlight important information, and present new ideas based on your interpretation of the information.
Note: You will use this practice problem in your practicum project that you will work on throughout this area of expertise. Your faculty SME will provide approval for your practicum project topic in the feedback for this Assessment. Be sure to review it and address any comments in subsequent assessments.