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NURS FPX 6218 Assessment 4 Advocating for Lasting Change

Student Name Capella University NURS-FPX 6218 Leading the Future of Health Care Prof. Name Date Advocating for Lasting Change Hello everyone, welcome to this presentation on Advocating for Lasting Change, where I will discuss the significant health issues faced by the Jordan community, deteriorating their health badly. The health issues comprised mental health irregularities among school-going youngsters, lack of health insurance, and ill management of chronic health conditions. In this presentation, I highlight the pressing need for a healthcare change proposal based on substantial data that can address these health concerns. This change proposal will improve mental health among children and young adolescents, enhance health insurance coverage, and manage chronic diseases for low-income people by utilizing governmental policy on free treatment for people with pre-existing conditions like chronic health diseases. Target Role Groups or Stakeholders This presentation targets specific stakeholders and role groups that can contribute towards this cause of improving the Jordan community’s health outcomes: Brief Overview of Environmental Analysis of Jordan Community Through Windshield Survey Through a windshield and environmental analysis, we analyzed the environmental condition of the Jordan community, which enhanced our understanding of its positive features and the lacking areas where further improvements are required. Positive Features of Jordan Community: The small town has basic amenities where children and young adolescents can go to school, community dwellers can shop around, go to recreational places, and acquire healthcare services from hospitals. The community members were resilient and eager to tackle health issues collaboratively as they showed an amicable bond with the neighborhood. All members were willing to stand for a change that ensured a sound and healthy community. Areas for Improvements: The Jordan community lacked in certain areas that jeopardized their overall health and impacted their quality of life. The prevailing mental health issues among school students caused havoc as a student committed suicide. Moreover, the scarcity of maximum coverage of health insurance among community members and financial issues in procuring medication for managing chronic conditions were significant health challenges. These areas required intricate attention, which our change proposal is keenly addressing and has the potential to improve these lacking areas. Social Determinants Impacting Community Health Several social determinants of health impact community health, the major factors being education and economic instability. While several school institutions were established for the community’s growing kids and youth, the educational systems lacked health literacy, which impacted students’ mental health. Moreover, the economic instability in most of the population hindered them from acquiring essential health services as they could not get full health insurance coverage and needed to rely on self-financing for treatments. Additionally, the financial constraints burdened populations with chronic diseases who could not manage them as they could not purchase prescribed medications. These social determinants of health are adequately touched upon through our change proposal through appropriate resource allocation and support from local health advocates. Change Proposal Framework Our change proposal was built on the following framework that could improve the lacking areas of the Jordan community where health was profoundly impacted. References Castle, J. T., Levy, B. E., Mangino, A. A., McDonald, H. G., McAtee, E. E., Patel, J. A., Evers, B. M., & Bhakta, A. S. (2023). Impact of the Affordable Care Act on providing equitable healthcare access for IBD in the kentucky appalachian region. Diseases of the Colon & Rectum, 66(9), 1273. https://doi.org/10.1097/DCR.0000000000002942 García-Carrión, R., Villarejo-Carballido, B., & Villardón-Gallego, L. (2019). Children and adolescents mental health: A systematic review of interaction-based interventions in schools and communities. Frontiers in Psychology, 10(918). https://doi.org/10.3389/fpsyg.2019.00918 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 Leadership, 13(13), 85–108. https://doi.org/10.2147/JHL.S289176 Hasbrouck, L. (2021). Healthy people 2030: An improved framework. Health Education & Behavior, 48(2), 113–114. https://doi.org/10.1177/1090198121997812 NURS FPX 6218 Assessment 4 Advocating for Lasting Change Martin, H., Kushner, S., Iles, K., & Montgomery, H. (2021). Advocating for expanded access to medical nutrition therapy in Medicare. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2021.02.024 Myerson, R., & Crawford, S. (2020). Coverage for adults with chronic disease under the first 5 years of the Affordable Care Act. Medical Care, Publish Ahead of Print. https://doi.org/10.1097/mlr.0000000000001370 Rao, M. E., & Rao, D. M. (2021). The mental health of high school students during the COVID-19 pandemic. Frontiers in Education, 6. https://doi.org/10.3389/feduc.2021.719539 Rubim, F., Rubim, L., & Thornton, A. R. (2020). Creating a culture of wellness. POWER, 171–187. https://doi.org/10.1016/b978-0-12-817872-0.00010-0 Soni, A., Wherry, L. R., & Simon, K. I. (2020). How have ACA insurance expansions affected health outcomes? Findings from the literature. Health Affairs, 39(3), 371–378. https://doi.org/10.1377/hlthaff.2019.01436 Zhuang, T., Qian, Q. K., Visscher, H. J., Elsinga, M. G., & Wu, W. (2019). The role of stakeholders and their participation network in decision-making of urban renewal in china: The case of chongqing. Cities, 92, 47–58. https://doi.org/10.1016/j.cities.2019.03.014 NURS FPX 6218 Assessment 4 Advocating for Lasting Change

NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change

Student Name Capella University NURS-FPX 6218 Leading the Future of Health Care Prof. Name Date Planning for Community and Organizational Change Summary To address the persistent health challenges faced by the community of Jordan, located in Minnesota, this proposal outlines strategies aimed at improving mental health support in schools, enhancing health insurance coverage, and better managing chronic health conditions. These measures seek to alleviate issues such as adolescent suicide, inadequate insurance, and poorly managed chronic diseases. Benefits and Implications To mitigate mental health challenges among students, the proposal suggests implementing interaction-based mental health programs in schools. This approach aims to foster emotional well-being and resilience, consequently reducing suicide attempts among adolescents (García-Carrión et al., 2019). Improving health insurance in Jordan involves advocating for policy changes to make coverage more accessible to low-income residents. Additionally, expanding Medicare and Medicaid services can ensure equitable healthcare access for marginalized individuals, thereby improving overall community health (Martin et al., 2021). For better management of chronic conditions, promoting awareness among older adults about available health coverage options under the Affordable Care Act can alleviate financial constraints and reduce mortality and morbidity rates (Myerson & Crawford, 2020). Potential Barriers to Change Implementing mental health programs may face resistance due to social stigma and resource constraints. Accessing adequate healthcare insurance could be hindered by factors such as language barriers and resistance to policy changes. Managing chronic health conditions may be challenging due to stigma, lack of motivation, and resistance to lifestyle changes (Repovš et al., 2019). Strategies for Changing Barriers into Opportunities and Resolving Conflict Overcoming these barriers requires educational campaigns to address stigma, collaboration with external organizations to alleviate resource constraints, and fostering open communication within the community to reduce resistance to change (Schroeder et al., 2020). Stakeholder Communications Effective communication with organizational stakeholders is crucial for implementing proposed changes. A communication plan should outline key messages, provide evidence-based insights, and emphasize the benefits of the proposed changes (Errida & Lotfi, 2021). References AbouAssi, K., Bowman, A. O’M., Johnston, J. M., Bauer, Z., & Tran, L. (2020). Relations, resources, and costs: Exploring cross-sectoral collaboration at the local level in a developing country. International Public Management Journal, 24(5), 646–672. https://doi.org/10.1080/10967494.2020.1853292 Banner, D., Bains, M., Carroll, S., Kandola, D. K., Rolfe, D. E., Wong, C., & Graham, I. D. (2019). Patient and public engagement in integrated knowledge translation research: Are we there yet? Research Involvement and Engagement, 5(1). https://doi.org/10.1186/s40900-019-0139-1 Bracke, P., Delaruelle, K., & Verhaeghe, M. (2019). Dominant cultural and personal stigma beliefs and the utilization of mental health services: A cross-national comparison. Frontiers in Sociology, 4(40). https://doi.org/10.3389/fsoc.2019.00040 Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13(1), 1–15. https://doi.org/10.1177/18479790211016273 García-Carrión, R., Villarejo-Carballido, B., & Villardón-Gallego, L. (2019). Children and adolescents mental health: A systematic review of interaction-based interventions in schools and communities. Frontiers in Psychology, 10(918). https://doi.org/10.3389/fpsyg.2019.00918 NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change Martin, H., Kushner, S., Iles, K., & Montgomery, H. (2021). Advocating for expanded access to medical nutrition therapy in medicare. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2021.02.024 Myerson, R., & Crawford, S. (2020). Coverage for adults with chronic disease under the first 5 years of the affordable care act. Medical Care, Publish Ahead of Print. https://doi.org/10.1097/mlr.0000000000001370 Repovš, E., Drnovšek, M., & Kaše, R. (2019). Change ready, resistant, or both? Exploring the concepts of individual change readiness and resistance to organizational change. Economic and Business Review, 21(2). https://doi.org/10.15458/85451.82 Schroeder, S., Tan, C. M., Urlacher, B., & Heitkamp, T. (2020). The role of rural and urban geography and gender in community stigma around mental illness. Health Education & Behavior, 48(1), 109019812097496. https://doi.org/10.1177/1090198120974963 Appendix A: Grant Proposal Need Statement The community of Jordan, located in Minnesota, faces significant health challenges across various age groups. Mental health issues, particularly among adolescents and adults, are prevalent, often leading to suicide attempts in schools. Additionally, inadequate health insurance coverage and financial constraints hinder access to essential healthcare services, exacerbating the management of chronic diseases requiring extensive medical treatment. The urgency of this change proposal is underscored by the pervasive health issues affecting all age groups in the Jordan community. Anticipated barriers to implementation include resource scarcity, lack of mental health awareness, stigma, and resistance to change. Information sources informing this proposal include environmental analysis, community communication, school surveys, consultations with leaders, and healthcare metrics. Program Description This proposal outlines initiatives to address mental health, expand health insurance coverage, and advocate for improved Medicaid and Medicare services in Jordan. These initiatives will be meticulously planned, resource-allocated, and continuously evaluated. Stakeholder involvement includes health professionals, educators, mental health specialists, community leaders, and governmental and non-profit partners. The program aims to enhance health outcomes in Jordan’s population by addressing financial and mental health challenges. Strategies include educational campaigns, mental health programs, expanding insurance access, and promoting ACA policies for chronic disease care. Goals and Objectives The proposal seeks to improve Jordan’s health by providing mental health support to youth, expanding insurance coverage, and promoting ACA benefits for those in financial need. Objectives include reducing suicide rates among students, increasing insurance coverage, and raising awareness of ACA provisions. Program Evaluation An oversight team comprising health professionals, educators, leaders, and government representatives will bi-annually evaluate progress. Reports will be disseminated to stakeholders, including funders, who will actively participate in data acquisition, progress measurement, and feedback collection. Summary Given the pressing health challenges in Jordan, this proposal aligns with funders prioritizing public health initiatives. The shared goals of improving public health and reducing morbidity and mortality rates present opportunities for funding support. Collaborative efforts foster a sense of meaningful change and gratitude to funding agencies for their support. Appendix B: Project Budget Categories Startup ($) 1st Year ($) Other Sources of Revenue Justification Salary and Wages Project Manager 0 60,000 – Responsible for project organization and planning. Support Staff 0 80,000 – Assist with administrative tasks and report preparation. Mental Health Specialists 0 90,000 – Provide counseling for mental health support. Community Advocates 0 50,000 – Expand health insurance access. Healthcare

NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs

Student Name Capella University NURS-FPX 6218 Leading the Future of Health Care Prof. Name Date Community Healthcare Needs Assessment Executive Summary General Condition and Public Health Needs The assessment conducted a virtual windshield survey to evaluate various aspects of Jordan, Minnesota, including educational systems, health services, and environmental factors. The city exhibited a thriving environment with adequate educational facilities, health services, and recreational amenities. However, challenges such as limited healthcare resources and the vulnerability to diseases due to increased access to restaurants were identified. Limitations of the survey included resource constraints and community members’ reluctance to communicate openly. Environmental Analysis and Social Determinants of Health Environmental factors such as population demographics, educational resources, and healthcare accessibility significantly influence community health. Jordan, with a growing population and robust educational infrastructure, exhibits potential for improved health literacy and overall well-being. Access to healthcare organizations, recreational facilities, and religious institutions further contributes to population health. Challenges include limited transportation infrastructure and uncertainties regarding socioeconomic factors impacting health behaviors. Conclusion The assessment highlights Jordan’s favorable community conditions but underscores the need for expanded healthcare and educational resources to accommodate the growing population. Addressing these needs through enhanced infrastructure and sustainable management strategies is crucial for promoting community well-being. References City of Jordan, Minnesota. (2015, November 30). Economic Development. Retrieved from https://jordanmn.gov/city-departments/economic-development/ Hao, L., Xu, X., Dupre, M. E., Guo, A., Zhang, X., Qiu, L., Zhao, Y., & Gu, D. (2020). Adequate access to healthcare and added life expectancy among older adults in China. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01524-9 Morante-García, W., Zapata-Boluda, R. M., García-González, J., Campuzano-Cuadrado, P., Calvillo, C., & Alarcón-Rodríguez, R. (2022). Influence of social determinants of health on COVID-19 infection in socially vulnerable groups. International Journal of Environmental Research and Public Health, 19(3), 1294. https://doi.org/10.3390/ijerph19031294 NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs Nutbeam, D., & Lloyd, J. E. (2020). Understanding and responding to health literacy as a social determinant of health. Annual Review of Public Health, 42(1), 159–173. https://doi.org/10.1146/annurev-publhealth-090419-102529 Wang, X., Zhou, Q., Zhang, M., & Zhang, Q. (2021). Exercise in the park or gym? The physiological and mental responses of obese people walking in different settings at different speeds: A parallel group randomized trial. Frontiers in Psychology, p. 12. https://doi.org/10.3389/fpsyg.2021.728826 NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs

NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Student Name Capella University NURS-FPX 6218 Leading the Future of Health Care Prof. Name Date Change Proposal Summary Report Introduction The primary objective of this executive summary report is to propose a change in the management of peripheral neuropathy in diabetic patients within healthcare organizations in Colorado. Through comprehensive research on peripheral neuropathy and a comparative analysis of management approaches in non-U.S. healthcare systems, this report aims to suggest effective measures and strategies to enhance the quality of health for individuals with diabetes by reducing complications associated with peripheral neuropathy. Executive Summary Proposed Change Peripheral neuropathy poses significant challenges for individuals with diabetes, leading to pain, sensory loss, and paraesthesia. Diabetic peripheral neuropathy (DPN) affects approximately 50% of diabetics, with a 25% risk of foot ulcers, potentially resulting in leg amputations (Hicks & Selvin, 2019). Given the severe consequences of inadequate care, it is imperative to advocate for aggressive screening and management of diabetes, including regular HbA1c monitoring, foot examination, and pain management. Local healthcare systems in Colorado are grappling with an increasing prevalence of peripheral neuropathy among diabetic patients, resulting in issues such as numbness, foot pain, ulcers, and amputations. Addressing this concerning trend is crucial to improving the health and quality of life for individuals with diabetes. By focusing on enhancing diabetes management through annual foot examinations, glycemic control, and patient education on foot care and self-management behaviors, the onset and progression of peripheral neuropathy can be mitigated (American Diabetes Association Professional Practice Committee, 2021; Alahakoon et al., 2020). Desired Outcomes The proposed changes aim to achieve several desired outcomes: Achieving these outcomes necessitates adequate resources and collaboration among stakeholders. Healthcare organizations must prioritize attentive care, while external resources such as Medicare and Medicaid programs can provide additional support (Duru et al., 2020). Health Care System Comparative Analysis A comparative analysis of healthcare systems in the United Kingdom and Australia reveals valuable insights into managing peripheral neuropathy. Both systems emphasize regular foot examinations, patient education, and preventive measures, offering valuable lessons for improving care in Colorado. Rationale for the Proposed Change The proposed changes are expected to improve outcomes for diabetic patients by preventing complications and promoting self-care. By following established guidelines and recommendations, individuals with diabetes can lead healthier lives with reduced risks of amputations and complications (Selvarajah et al., 2019). Financial and Health Implications Implementing the proposed changes can have significant financial and health implications, including cost savings from early intervention and improved quality of life for patients. Failure to implement these changes may result in increased healthcare costs and reduced productivity due to complications (Kiyani et al., 2020). Conclusion In conclusion, addressing peripheral neuropathy in diabetic patients is crucial for improving health outcomes in Colorado. By adopting strategies from other healthcare systems and prioritizing preventive measures, healthcare organizations can significantly enhance the well-being of individuals with diabetes. References Aalaa, M., Amini, M. R., Delavari, S., Mohajeri Tehrani, M. R., Adibi, H., Shahbazi, S., Shayeganmehr, Z., Larijani, B., Mehrdad, N., & Sanjari, M. (2022). Diabetic foot workshop: A strategy for improving the knowledge of diabetic foot care providers. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16(7), 102543. https://doi.org/10.1016/j.dsx.2022.102543  Agarwal, P., Sharma, B., & Sharma, D. (2019). Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy. Journal of Clinical Orthopaedics and Trauma, 11(3). https://doi.org/10.1016/j.jcot.2019.08.014  Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., & Golledge, J. (2020). Meta‐analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes‐related foot ulcers. Diabetic Medicine, 37(8), 1266–1279. https://doi.org/10.1111/dme.14323 Diabetes Feet Australia. (n.d.). Diabetes feet australia. https://www.diabetesfeetaustralia.org/   NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change Duru, O. K., Harwood, J., Moin, T., Jackson, N. J., Ettner, S. L., Vasilyev, A., Mosley, D. G., O’Shea, D. L., Ho, S., & Mangione, C. M. (2020). Evaluation of a national care coordination program to reduce utilization among high-cost, high-need Medicaid beneficiaries with diabetes. Medical Care, p. 58, S14–S21. https://doi.org/10.1097/mlr.0000000000001315  Hicks, C. W., & Selvin, E. (2019). Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Current Diabetes Reports, 19(10). https://doi.org/10.1007/s11892-019-1212-8  Kiyani, M., Yang, Z., Charalambous, L. T., Adil, S. M., Lee, H.-J., Yang, S., Pagadala, P., Parente, B., Spratt, S. E., & Lad, S. P. (2020). Painful diabetic peripheral neuropathy: Health care costs and complications from 2010 to 2015. Neurology: Clinical Practice, 10(1), 47–57. https://doi.org/10.1212/CPJ.0000000000000671  NICE. (2019, October 11). Overview | Diabetic foot problems: prevention and management | Guidance | NICE. https://www.nice.org.uk/guidance/ng19 Rodríguez-Sánchez, B., Peña-Longobardo, L. M., & Sinclair, A. J. (2019). Cost-effectiveness analysis of the neuropad device as a screening tool for early diabetic peripheral neuropathy. The European Journal of Health Economics, 21(3), 335–349. https://doi.org/10.1007/s10198-019-01134-2   Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology, 7(12), 938–948. https://doi.org/10.1016/s2213-8587(19)30081-6  Zilliox, L. A., & Russell, J. W. (2019). Physical activity and dietary interventions in diabetic neuropathy: A systemic review. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society, 29(4), 443–455. https://doi.org/10.1007/s10286-019-00607-x  NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change