Leadership, Collaboration, Communication, Change Management

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Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective.

• Define a patient, family, or population health problem that’s relevant to your practice.
o Summarize the problem you’ll explore.
o Identify the patient, family, or group you intend to work with during your practicum.
o Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
o Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
• Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
o Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
o Explain how you would know if the data are unreliable.
o Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
o Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
o Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
o Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
• Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.

 

Sample Solution

1. Defining the Problem:

Summarize the problem you’ll explore:

Medication non-adherence in older adults with chronic diseases is a significant public health problem. Poor adherence leads to worsened health outcomes, increased healthcare costs, and decreased quality of life for both patients and their families.

Identify the patient, family, or group you intend to work with during your practicum:

I will work with older adults diagnosed with chronic diseases (e.g., hypertension, diabetes, heart failure) in outpatient settings like community health centers or senior living facilities. Additionally, I will collaborate with their families and caregivers, healthcare providers, and pharmacists to implement and evaluate interventions aimed at improving medication adherence.

Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population:

  • Prevalence: Studies estimate that non-adherence rates among older adults with chronic diseases range from 30% to 60%.
  • Consequences: Non-adherence can lead to disease progression, increased hospitalizations, and premature death. It also burdens the healthcare system with unnecessary costs.
  • Patient impact: Poor adherence negatively affects the quality of life for older adults, leading to increased disability, pain, and anxiety.
  • Family impact: Families and caregivers often bear the burden of managing medications and monitoring adherence, adding to their own stress and workload.

Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse:

  • Promoting patient safety and well-being: Nurses play a crucial role in educating patients about their medications, identifying barriers to adherence, and implementing interventions to overcome them.
  • Holistic care: Addressing medication adherence aligns with the holistic approach of nursing, considering both physical and psychosocial factors influencing health outcomes.
  • Advocacy and collaboration: Nurses can advocate for patients and families, collaborating with other healthcare professionals to develop and implement patient-centered interventions.

2. Analyzing Evidence from the Literature:

Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your practice:

Yes, the literature heavily supports the observations in practice. Numerous studies confirm the high prevalence of non-adherence in older adults and its detrimental consequences. Additionally, research identifies various barriers to adherence that I encounter regularly, such as complex medication regimens, cognitive decline, financial constraints, and lack of understanding about medications.

Explain how you would know if the data are unreliable:

I will critically evaluate the sources I use, considering factors like publication date, author qualifications, methodology, and potential biases. I will also look for consistency across multiple studies published in reputable journals and organizations like the Agency for Healthcare Research and Quality (AHRQ) or the CDC.

Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined:

Common barriers include:

  • Lack of awareness and knowledge: Healthcare providers may not be fully aware of the extent of the problem or the most effective interventions for their patients.
  • Time constraints and workload: Busy clinic schedules may limit the time for comprehensive medication adherence assessments and interventions.
  • Resource limitations: Limited access to pharmacists, specialized counseling services, or technology-based solutions can hinder implementation.
  • Resistance to change: Existing routines and practices within healthcare systems may not be conducive to incorporating new patient-centered interventions.

2. Continued Analysis (Word Count ~ 900):

Here are some additional sections you can expand on to reach the 2000-word target:

  • Describe current evidence-based interventions that have shown promise in improving medication adherence in older adults with chronic diseases.
  • Discuss the role of nurses in leading and implementing change initiatives within healthcare systems to address medication non-adherence.
  • Analyze policy and regulatory factors that can influence medication adherence, such as access to affordable medications and insurance coverage for behavioral interventions.
  • Describe specific research questions you intend to explore through your capstone project related to improving medication adherence in this population.
  • Explain how you will collaborate with stakeholders (patients, families, providers, pharmacists) to design and implement your interventions.
  • Discuss ethical considerations involved in your project, such as informed consent, patient privacy, and potential conflicts of interest.

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