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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

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Student Name Capella University NURS-FPX 5005 Introduction to Nursing Research, Ethics, and Technology Prof. Name Date Application of Evidence-Based Practice Nurses play a pivotal role in assessing and evaluating patient care quality within the healthcare setting. Operating in a constantly evolving environment, nurses adapt to changes in patient conditions and advancements in medical practices. Evidence-Based Practice (EBP) serves as the framework for assessing recent innovations, best practices, and emerging literature to ensure state-of-the-art patient care (Alatawi et al., 2020). Analysis of Criteria and Process for Implementing EBP EBP follows a four-step process to address clinical challenges: Nurses formulate clinical problem statements based on assessments and diagnoses, conduct comprehensive literature reviews, and implement identified treatment protocols (Alatawi et al., 2020). Barriers to Implementing EBP Alatawi et al. (2020) identify individual and organizational barriers to EBP adoption. Individual barriers include healthcare providers’ professional competence and communication with patients. Organizational barriers relate to resource allocation and budget constraints within healthcare institutions. Importance of Scholarship for EBP Research Programs like Magnet® support evidence-based nursing practice and research, contributing to staff development and healthcare enhancement (Wentland & Hinderer, 2020; Whalen et al., 2020). Criteria for Conducting Evidence-Based Nursing Practice Saunders et al. (2019) outline inclusion and exclusion criteria for EBP research, emphasizing the importance of addressing biases, evaluating study quality, and focusing on multiple outcomes. Clinical Questions Related to EBP Speroni et al. (2020) highlight the prevalence of EBP adoption in Magnet-recognized hospitals, with the Iowa Model being commonly employed. Chiwaula et al. (2021) demonstrate the Iowa Model’s effectiveness in managing fever in ICU patients through technology-driven interventions. Knowledge Gap in Study Chiwaula et al. (2021) acknowledge a knowledge gap regarding patient consent in ICU settings, emphasizing the need to adapt EBP guidelines to individual patient needs. Ethical and Regulatory Concerns for EBP Ethical considerations include patient consent and adherence to ethical principles such as respect for autonomy and beneficence (Tu & Gao, 2021). Regulatory compliance with FDA recommendations is essential for implementing evidence-based technologies (Chipps et al., 2020). Conclusion EBP offers solutions to emerging healthcare challenges but requires rigorous research efforts and adherence to ethical standards. Nurses must prioritize patient confidentiality and autonomy while implementing EBP practices. References Alatawi, M., Aljuhani, E., Alsufiany, F., Aleid, K., Rawah, R., Aljanabi, S., & Banakhar, M. (2020). Barriers of implementing evidence-based practice in nursing profession: A literature review. American Journal of Nursing Science, 9(1), 35. Chipps, E., Tucker, S., Labardee, R., Thomas, B., Weber, M., Gallagher-Ford, L., & Melnyk, B. M. (2020). The impact of the electronic health record on moving new evidence-based nursing practices forward. Worldviews on Evidence-Based Nursing, 17(2). Chiwaula, C. H., Kanjakaya, P., Chipeta, D., Chikatipwa, A., Kalimbuka, T., Zyambo, L., Nkata, S., & Jere, D. L. (2021). Introducing evidence-based practice in nursing care delivery, utilizing the Iowa model in the intensive care unit at Kamuzu Central Hospital, Malawi. International Journal of Africa Nursing Sciences, 14, 100272. Liu, Y., Liu, C., Gao, M., Wang, Y., Bai, Y., Xu, R., & Gong, R. (2020). Evaluation of a wearable wireless device with artificial intelligence, iThermonitor WT705, for continuous temperature monitoring for patients in surgical wards: A prospective comparative study. BMJ Open, 10(11), e039474. Saunders, H., Gallagher‐Ford, L., Kvist, T., & Vehviläinen‐Julkunen, K. (2019). Practicing healthcare professionals’ evidence‐based practice competencies: An overview of systematic reviews. Worldviews on Evidence-Based Nursing, 16(3), 176–185. Speroni, K. G., McLaughlin, M. K., & Friesen, M. A. (2020). Use of evidence‐based practice models and research findings in magnet‐designated hospitals across the united states: National survey results. Worldviews on Evidence-Based Nursing, 17(2), 98–107. Tu, J., & Gao, W. (2021). Ethical considerations of wearable technologies in human research. Advanced Healthcare Materials, 10(17), 2100127. Wentland, B. A., & Hinderer, K. A. (2020). A nursing research and evidence-based practice fellowship program in a magnet®-designated pediatric medical center. Applied Nursing Research, 151287. Whalen, M., Baptiste, D.-L., & Maliszewski, B. (2020). Increasing Nursing Scholarship Through Dedicated Human Resources. JONA: The Journal of Nursing Administration, 50(2), 90–94. NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Implementing evidence-based practice for promoting a healthy lifestyle Hey everyone, this is ______, and my topic of presentation is the implementation of evidence-based practices for diabetes type 2 patients to promote a healthy lifestyle. Diabetes is one of the most prevalent problems that is often worsened by an unhealthy lifestyle. The core deficit in diabetes type 2 is the insulin resistance that is often built up due to unhealthy lifestyles such as lack of exercise and obesity. Due to insulin resistance, the body’s insulin cells become restrained, eventually reducing insulin secretion. According to the Centers for Disease Control and Prevention (CDC, 2022), around 37.3 million Americans have diabetes, which makes up around 11.3% of the overall American population. From this population, almost 37.1 million patients are adults or 18 years old and older. Furthermore, other statistical reports have highlighted that out of all the diabetic cases within the country, 90.9% are of diabetes type 2, making up 21 million of all the cases (Julia, 2022). Studies have highlighted that diabetes and obesity often increase the future risk of cardiovascular diseases, making it more difficult to treat either of the conditions (Sharma et al., 2020). Also, other studies have highlighted that an unhealthy lifestyle and diabetes increase the risk of developing other coronary heart diseases, which may include vascular problems, issues in electrical mechanisms, and arrhythmias (Piché et al., 2020). There are studies that have linked the worsening condition of the heart with uncontrolled diabetes as well (Zareinu et al., 2020). PICOT Question  In adults with Type 2 diabetes, a healthy diet and regular exercise have a more significant impact as compared to standard diabetes management without a specific focus on lifestyle changes, which leads to lower blood glucose levels and weight management within a year. Population: Adults  Intervention: Implementation of comprehensive lifestyle changes (dietary modification and regular exercise) Comparison: Standard Diabetes Management without Lifestyle Changes Outcome: lower levels of blood glucose and weight reduction Time: 1 year. Action Plan to Implement an Evidence-Based Plan Physical activities are associated with an increased risk of type 2 diabetes as the sedentary lifestyle works on the insulin resistance in the body, leading to overweight and other health-related issues (Li et al., 2022). whereas the World Health Organization (2023) has reported that a healthy diet, regular exercise, and maintaining a normal body weight have been linked with prevention and delay in the onset of diabetes type 2. Considerable evidence supports the idea that weight management has been identified as the cornerstone of metabolic health, while the quality of the diet is significantly more important (Forouhi et al., 2018). The lifestyle intervention has significantly reduced the risk of onset of type 2 diabetes to 36% in an RTC trial experimental study as compared to the control group (Pot et al., 2020). The study revealed that the effects of the lifestyle intervention were greater for intensive interventions that combine dietary and physical activity as compared to single-component interventions. The program was developed within the course of 1 year, where the patients who have a lack of glycemic control and obesity were introduced to lifestyle changes such as a healthy diet, such as control food and low-carb and fat-free food options, along with regular exercise such as walking and low-paced exercise, helping people to reduce and maintain weight. The current plan was developed to ensure that people who are overweight are encouraged to regulate and change their lifestyle choices to encourage them to have long-term sustainable lifestyles and healthy habits. Studies have highlighted that lifestyle changes have significant positive impacts on diabetes management and tend to provide long-term and persistent results (Pot et al., 2020). NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice The action plan will be based on Stakeholders and Potential Barriers to Project Implementation The stakeholders in this intervention project are: NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice Similarly, the following are the potential barriers to the implementation of the project: NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice Outcome Measures  The targeted action plan based on evidence-based practice should be assessed through certain set parameters, which can help evaluate the outcomes of the intervention plan. The outcome measures were aligned with the quadruple aims of the Thai action plan, which have an impact on controlling and reducing blood sugar levels. This plan is significantly effective for the organization and the professionals while managing the overall financial burden of supporting and providing medication to diabetic patients. The expected outcomes are: All of these outcomes align with the aim of patient outcomes, satisfaction, cost reduction, and well-being through improved blood glucose levels, a reduction in weight, healthy eating habits, patient satisfaction, and increased physical activity. Search strategies and databases The search strategies and databases utilized for the current assessment were PubMed, the National Library of Medicine (NIH), and Google Scholars. Other sources that aided in providing statistical and trend-based information were the Centers for Disease Control and Prevention (CDC), the Centre for Food and Animal Health (CFAH), and the World Health Organization (WHO). Diabetes has a significant role in the healthcare system as it is one of the leading illnesses around the globe, with a prevalence of more than 90.9% among adults older than 18. Studies have highlighted that it is important for the diabetic patient to focus on lifestyle changes as they can help in better glycemic control and reduce the risk of comorbid diseases, while the sedentary lifestyle has been linked as a potential perpetuator of the high blood glucose level (Golovaty et al., 2022). Similarly, a systematic review highlighted that increasing adherence to health behaviors significantly lowers the risk of cardiovascular and cerebrovascular diseases (Zyriax & Windler, 2022). Conclusion  With the high prevalence of type 2 diabetes in the American population, it is important to develop programs that aim to address the issue of lifestyle changes and incorporate healthy lifestyles such as a
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NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Slide 1:  Hey everyone, my presentation topic for today is an evidence-based population health improvement plan. Slide 2:  Choose a health problem: diabetes type 2 Diabetes is a chronic health disease that alters the human body’s ability to convert food into energy. It is a metabolic disease that may impact the blood glucose levels in one’s bloodstream. According to the World Health Organization, it  occurs either due to the inability of the pancreas to process the desired amount of insulin or due to the inability of the body to utilize the insulin. Type 1 diabetes, type 2 diabetes, and pregnancy-related diabetes are the three most common forms of diabetes. Type 1 diabetes is an autoimmune disease, which means that the body’s immune system attacks the cells in the pancreas that make insulin. This type of diabetes is rather common in children. Lifestyle factors like obesity, inactivity, and unhealthy eating habits have been linked to the development of type 2 diabetes. Type 2 diabetes is characterized by insulin resistance and can manifest at any age, though it is typically diagnosed in adults. Whereas gestational diabetes usually occurs during pregnancy and resolves after giving birth, Our focus for the presentation is type 2 diabetes. The following statistics show the trends in diabetes among US citizens. Slide 3:  Environmental Determinants.  Epidemiological determinants  Slide 4  Ethical Health Improvement Plan: Promoting a Healthy Lifestyle and Diabetes Prevention  Goals Interventions  Outcomes Slide 5 Communication Strategies (Malikhao, 2020) NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan Slide 6:  Value and Relevance Slide 7  In conclusion, the aim of developing an ethical health improvement plan for diabetes type 2 was to establish a community with a reduced incidence of health issues and enhanced quality of life, with the key goal of encouraging training and awareness, diversity and community engagement, health lifestyle changes, and access to preventive care. While the communication strategies that were designed were based on effective and collaborative communication strategies such as two-way communication, cultural inclusivity and diversity, and technology integration such as using telehealth mediums. However, the aim is to provide a long-lasting commitment to healthcare quality improvement initiatives. Reference  Bonini, M. G., & Sargis, R. M. (2018). Environmental Toxicant Exposures and Type 2 Diabetes Mellitus: Two Interrelated Public Health Problems on the Rise. Current opinion in toxicology, 7, 52–59. https://doi.org/10.1016/j.cotox.2017.09.003 Center for Disease Control and Prevention. (2022). National diabetes statistics report. CDC. https://www.cdc.gov/diabetes/data/statistics-report/index.html CDC. (2022). The Facts, Stats, and Impacts of Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/spotlights/diabetes-facts-stats.html Julia, N. (2022, November 30). Diabetes Statistics: Facts & Latest Data in the US (2023 Update). CFAH. https://cfah.org/diabetes-statistics/ Malikhao P. (2020). Health Communication: Approaches, Strategies, and Ways to Sustainability on Health or Health for All. Handbook of Communication for Development and Social Change, 1015–1037. https://doi.org/10.1007/978-981-15-2014-3_137 NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan Mayo Clinic. (2022, June 3). Diabetes management: How lifestyle, daily routine affect blood sugar. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20047963 Li, D., Yang, Y., Gao, Z., Zhao, L., Yang, X., Xu, F., Yu, C., Zhang, X., Wang, X., Wang, L., & Su, J. (2022). Sedentary lifestyle and body composition in type 2 diabetes. Diabetology & Metabolic Syndrome, 14(1). https://doi.org/10.1186/s13098-021-00778-6 Scottish Government. (2021, February 25). Diabetes care – Diabetes improvement plan: commitments – 2021 to 2026. Www.gov.scot. https://www.gov.scot/publications/diabetes-improvement-plan-diabetes-care-scotland-commitments-2021-2026/pages/4/ Skoglund, G., Nilsson, B. B., Olsen, C. F., Bergland, A., & Hilde, G. (2022). Facilitators and barriers for lifestyle change in people with prediabetes: a meta-synthesis of qualitative studies. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-12885-8 NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

Student Name Capella University NURS 4900 Capstone Project for Nursing Prof. Name Date Intervention Presentation and Capstone Video Reflection Hi, my name is Cindy and I am a Baccalaureate nurse. Today I am presenting a capstone reflection video on the management of type II diabetes for chronic diabetics. Type II diabetes is one of the chronic diseases which is characterized by persistent uncontrolled blood sugar levels especially hyperglycemia or raised blood sugar levels after the intake of carbohydrates. This is non-insulin-dependent diabetes because hyperglycemia persists despite high insulin levels in the body, which is termed insulin resistance (Westman, 2021). According to CDC’s statistics, more than 37 million Americans are diagnosed with diabetes and about 95% of these people have type II DM (CDC, 2022). This statistic develops room for bringing reforms in the population related to the management of diabetes. These reforms involve the education and reinforcement of behavioral changes in the patients who are diagnosed with the condition. Healthy People 2030 defines health behavioral modification as a key objective in terms of decreasing the global burden of diseases (U.S. Department of Health and Human Services, n.d.).  Some of the non-pharmacological interventions for the management of diabetes include lifestyle modification (dietary changes, stress management, and physical activity) and self-management of diabetes through blood glucose monitoring and tracking the records. NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection  For this capstone project, I have been working with a patient, John, who has been a chronic type II diabetes patient. He is also suffering from obesity, blurred vision, and extreme fatigue. He has a family history of the same condition and his uncle and father have been suffering from the disease already. John has certainly been trying various lifestyle modification techniques and medicinal treatments to control his blood sugar levels. Despite his efforts, he still encounters uncontrolled sugar levels. In this capstone project, I have developed several interventions for John which included the introduction of Continuous Glucose Monitoring (CGM) devices for self-management and record keeping, a smartphone app for live coaching, some pharmacological advancements, and consultation with a multidisciplinary team through telehealth.   Contribution of the Interventions to the Patient’s Satisfaction and Quality of Life Next, I will present the contribution of these interventions to John’s quality of life and satisfaction. Evidence-based interventions are proven to be effective in improving patients’ satisfaction levels and quality of life. Self-management of diabetes has been considered an effective intervention for chronic diabetics. This includes self-monitoring of blood glucose levels, ensuring a healthy diet, engaging in physical activities, complying with medication, and preventing further complications (Adhikari & Santosh, 2021). The successful ways of performing these actions are through monitoring blood glucose levels, keeping track of the readings, medicines, eating a healthy diet, and exercising, and consulting with the healthcare team for effective management. For this purpose, a CGM device was introduced for John. The CGM is a device that provides continuous glucose readings for patients and healthcare providers, which helps in the identification of hypo/hyperglycemia events with no symptoms and tracking the record (Miller, 2020). He was given complete training about the use of this device and how to report his blood glucose levels to healthcare providers. This device was connected to his smartphone app, where as soon as he entered the glucose reading, he received live health coaching from the providers. This coaching included immediate actions (medicine and rest) if needed, short-term actions (coping from stress, physical activity, and diet changes), and/or long-term actions (medicine modifications, nutritional consultation, physical rehabilitation, doctors’ visit, etc.).  Moreover, on his appointments with doctors, his medicines were also changed so that effective results can be checked. For monitoring and evaluation of these outcomes, telehealth was used for constant updates, and for healthcare providers to ensure that interventions introduced for John are effective and successful.  NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection These interventions were presented to the patient in person while providing the CGM device, the use of the device was demonstrated to John, and a re-demonstration was asked at the end. I developed an individualized smartphone app for him which was set up for immediate coaching and I also came prepared with some posters related to diet and exercise for his self-awareness. John, really appreciated my efforts for him as I arranged a CGM device for him and developed an app with the help of the IT department in my hospital. He was so excited to use these applications as they looked really fun to him and he thought it would be a great way for him to manage his diabetes. Besides this, he felt assured that even if he is apart from the hospital, he will timely receive his consultation and coaching using telecommunication methods.  We also discussed some of the lifestyle modification methods and his compliance with his medication. We did not only discuss dietary changes and physical activities but also discussed with him the ways he can control his sugar cravings, like going for natural sugar in fruits, eating regularly, and maintaining quality over quantity. He was also recommended adding short time-period exercises to his routine. Furthermore, he was given advice on medication compliance like keeping reminders. This part thrilled him as he has been trying lifestyle changes but couldn’t improve because of a lack of consistency and compliance.  Use of Evidence and Peer-Reviewed Literature for Implementation of Capstone Project Next, I will discuss how the evidence and peer-reviewed literature were used throughout the capstone project. So, from the start of the project, every intervention, strategy, policy, and implementation were conducted based on evidence-based literature. The Healthy People 2030 objectives for the management of diabetes advocated the need for planning and implementing this project. Some of these objectives include the reduction of diabetes cases and mortality associated with the condition, enhancement of formal diabetes education for adults, an increase in the number of people receiving type II diabetes prevention programs, and increasing the number of people who monitor their
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NURS FPX 4050 Assessment 4 Final Care Coordination Plan

Student Name Capella University NURS4050 Coord Patient-Centered Care Prof. Name Date Final Care Coordination Plan This care coordination plan is based on evaluating the preliminary care coordination plan developed in Assessment 1 for mental health issues in the Lodi Community. This plan focuses on developing patient-centered interventions considering ethical implications, health policy provisions, and Healthy People 2030 objectives using evidence-based research. Mental health is the psychological and emotional well-being of individuals that assists them in addressing stressful life situations and recognizing their abilities to contribute positively to the community (WHO, 2022).  Patient-centered Health Interventions and Timelines for Mental Health  Various issues under the domain of mental health must be eradicated using patient/population-centered interventions. These issues are; limited mental health literacy, inadequate community support programs, and mental health issues in school-going children and adolescents. Mental Health Literacy/Education A patient-centered intervention to address this concern is the implementation of educational campaigns. The purpose of these campaigns is to disregard the stigma associated with mental health conditions and promote sharing and discussions related to mental well-being. These campaigns will be conducted in the form of awareness sessions. Social media applications will be used for a wider spread of information, as they are considered effective in promoting mental health awareness (Latha et al., 2020). The timeline for this intervention is divided into two sections – 1) development of the application, which will be done within three months, and 2) awareness sessions, which will be continuously conducted once per month. Furthermore, community resources like mental health advocates, community care centers, and psychological well-being clinics will be utilized to achieve the desired objectives.  Community Support Networks Another important healthcare challenge is inadequate community support resources. The establishment of community support groups can address this challenge. The goal is to create at least five support groups within the year’s timeline. Effective mobilization of community stakeholders such as leaders, faith-based organizations, financial resources, healthcare organizations, and governmental support is essential for fulfilling the community-based initiative (Siddiqui et al., 2022).  School-based Mental Health Programs A patient-centered intervention is establishing a school-based mental health curriculum to address the rising prevalence of mental health issues in children and adolescents. This educational intervention is vital to minimize the risks of mental health issues in the concerned population, early detection of signs, which is important for early intervention, and improve mental health literacy from an early age (Richter et al., 2022). The timeline for this intervention is that the planning should begin within a month, the course should be developed in 3 months, and the execution of the curriculum should begin within six months. Initially, a pilot project should be undertaken for 3-6 months, which after evaluation and modification, should be implemented in all schools. Educators, school administrators, and healthcare professionals in the mental health domain are major community resources required for this project.  Ethical Decisions Related to Patient-centered Health Interventions Ethical considerations are crucial when designing patient-centered health interventions related to mental health issues due to the associated stigma. Cultural sensitivity and acceptance of diversity are two major ethical concepts that must be considered while developing educational/awareness campaigns for the community. It is imperative to develop culturally sensitive content that recognizes the unique mental health challenges faced by various racial/ethnic groups within the community. Besides, using social media applications raises ethical concerns about privacy and confidentiality (Ahmed et al., 2020). NURS FPX 4050 Assessment 4 Final Care Coordination Plan In this regard, it is crucial for healthcare providers to adhere to the rules of maintaining patients’ privacy and confidentiality during the implementation of social media for information-sharing purposes. Establishing community support networks comes with the ethical principle of justice whereby every individual member should receive equitable community resources and fair treatment. A study by Creary (2021) suggests that applying justice and efficiency in terms of the allocation of resources can lead to health equity and minimize disparities. Lastly, developing a school-based mental health curriculum involves the ethical principles of autonomy and informed choices. Students/parents should be given the autonomy to decide what is best for their healthcare based on the curriculum’s evidence-based informed risks and benefits.  Coordination and Continuum of Care Related to Mental Health – Healthcare Policies Several policies significantly impact care coordination related to addressing mental health issues in communities.  Mental Health Parity and Addiction Equity Act (MHPAEA) This health policy was developed in 2008 to reduce inequalities and disparities in accessing mental health services. Further amended under the Affordable Care Act (ACA) policy, this act instructs health insurance providers to give equal coverage to mental health and substance abuse concerns as provided for other physical health conditions (CMS, n.d.). The provisions of this policy improve healthcare accessibility for patients with mental health illnesses reducing financial barriers, leading to early interventions and improved quality of life through coordination of care.  21st Century Cures Act The Cures Act aims to enhance health outcomes for individuals with mental health and substance abuse issues, especially in the criminal population. This act reduces racial disparities and provides equal opportunities for the concerned population so that the continuity of care is maintained and individuals receive equitable access to healthcare (Cole et al., 2018). Furthermore, this legislation also provides funding for mental health initiatives, encouraging coordination and integration of mental health services within primary care settings. Priorities and Evidence-based Changes in Care Coordination While engaging in discussions with patients and their families, the care coordinator must establish the priorities to ensure effective communication of the care plan. Comprehensive assessment and goal-setting is an initial priority where the care coordinator will assess patients’ physical, mental, and psychosocial needs. Engaging the patient and their family member in dialogue allows the coordinator to gain valuable insights into the patient’s medical history, current symptoms, and personal preferences. This approach is essential for providing patient-centered care and establishing realistic and meaningful goals. The need for changes to the plan arises from evidence-based practice. These practices emphasize the importance of individualized care plans targeting specific goals to optimize health outcomes (Bolton
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NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Student Name Capella University NURS4040 Managing Health Information and Technology Prof. Name Date Introduction Hello, my name is Alex, today I welcome you all to my presentation about nursing-sensitive quality indicators and how technology can help us collect data and report. The session is organized based on an interview with the director of the quality control department. The topic of the conversation was the prevalence of pressure ulcers and the collection and reporting of data. This presentation is based on the same topic. Before I discuss pressure ulcers and how their prevalence is a quality indicator for nursing practice, I would like you to understand the purpose of establishing quality indicators and their importance.  Nursing-Sensitive Quality Indicators The American Nursing Association developed the National Database of Nursing Quality Indicators (NDNQI) in 1998, to collect data on specific quality indicators to evaluate and monitor nursing care. These indicators are subdivided into three categories, a) structural indicators, b) process indicators and c) outcomes indicators. This database provides quarterly and yearly reports on various indicators which are helpful for healthcare organizations to improve their nursing practices and care (Barchielli et al., 2022). The goal of NDNQI is to bring together interprofessional teams to work to achieve positive outcomes for patients by improving the quality of care. These measures also indicate the importance of nurses and nursing practices for patients’ well-being and positive healthcare results. Thus, they are highly important for you people as new nurses to understand your role in patients’ lives and this will help you improve your practices in clinical settings.  Quality Indicator – Prevalence of Pressure Ulcers in Adult Patients As mentioned earlier, out of several quality indicators, today’s discussion is about pressure ulcers and how incidences of pressure ulcers are related to poor nursing care. Furthermore, we will discuss the importance of improving nursing care for the prevention of these ulcers. Pressure ulcers are confined skin and tissue injuries that are usually caused by friction or pressure that occurs between an object and the surface of the skin. Globally, the progression and deaths related to pressure ulcers have increased by 60% in elderly patients. NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators A report developed in an ulcer summit revealed that around 60,000 people die due to complicated pressure ulcers. Moreover, approximately 700,000 patients develop pressure ulcers and most of them occur due to inadequate care (Tesfa Mengist et al., 2022). Some of the causative factors for pressure injuries are older age, bladder incontinence, a bedridden state, lack of proper nutrition and water intake, neurological deficiency, pressure on the skin due to medical devices, and multiple secondary diagnoses. As frontline care staff, nurses are primarily responsible healthcare providers with the major responsibility to prevent pressure ulcers by enhancing their knowledge and practices. Caring for patients’ pressure areas is an imperative element of nursing practices. The nurses must maintain patients’ skin integrity and prevent complications. This is done by early recognition of high-risk patients and providing special attention to them for which nurses must be knowledgeable and have an insight into their poor practices (Ebi et al., 2019). These positive outcomes are better achieved when multidisciplinary teams work together.  Interdisciplinary Teams’ Role in Collecting and Reporting Data  Healthcare facilities function with the help of interdisciplinary teams; thus, data collection and establishing an organizational report on quality indicators also require a team of individuals from various professions. Nurses play an important role in this regard. The process of data collection for pressure ulcers (PU) and the knowledge of nurses related to PU include nurses, nurse instructors, the quality control department, the IT department, and administrators if the incidences are high and require hospital management to be involved. To collect effective data two things are required; a) a pressure ulcer reporting system and b) a questionnaire for nurses. Some of the hospitals in the US have this in-built software called Medicare Patient Safety Monitoring System (MPSMS), which is developed for various patient safety indicators (Smith et al., 2018). The purpose of this software is to report every new hospital-acquired incidence of PU or any old pressure ulcers which get complicated during the hospital stay. This reporting system is then audited by the quality control department to identify the high-risk units in the hospital. Then, data is disseminated among the stakeholders of each patient unit to identify the risk factors in nursing care.  NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators Another approach to data collection and reporting is by analyzing nurses’ knowledge related to PU. For this purpose, nurses are given a survey questionnaire which is then submitted to the nurse instructors. The data collected from surveys is then transmitted in the statistical software on the computers. It is then compiled in mean and percentages which help to identify the average of nurses who lack knowledge about pressure ulcers and give an idea to instructors for conducting educational training (Ebi et al., 2019).  The data collected helps in improving patients’ safety through various unit-level and organizational-level interventions thus improving the quality indicators of the organization. Interprofessional team members when working together in their areas of expertise will be able to collect the data effectively, analyze it using various technologies, prepare organizational reports, and bring successful reforms in the organization to improve patients’ safety.  Nursing-Sensitive Quality Indicators for Healthcare Organizations So as we discussed earlier, nursing-sensitive quality indicators are essential to improve the results of the data collected, eventually enhancing quality care. Healthcare organizations use these indicators for three purposes, 1) improving patients’ safety, 2) enhancing patient care outcomes, and 3) improving organizational performance reports.  Like other hospitals, our organization is also interested in providing quality care to the patients, especially in terms of decreasing the incidences of  pressure ulcers. Nurses being the frontline care providers have this responsibility to ensure care quality and patients’ safety (Vaismoradi et al., 2020). The data received from NDNQI about the prevalence of pressure ulcers helps nurses and nurse leaders to
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NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Student Name Capella University NURS4030 Making Evidence-Based Decisions Prof. Name Date Remote Collaboration and Evidence-Based Care Hello, my name is ________, and I am here to propose an evidence-based plan geared at improving the results of our Vila Health patients. I will thoroughly explore the topic of remote collaboration and its broad implications in the setting of providing effective and beneficial healthcare services. In addition, we shall look at the benefits and drawbacks of remote cooperation, which is critical in today’s healthcare environment. I will also provide observations from relevant research outcomes essential in building our evidence-based care approach. Ultimately, we shall look at some of the issues that interdisciplinary teams face when working remotely and techniques for successfully navigating and overcoming these challenges. Initially, I would like you to develop a firm knowledge of remote collaboration and its crucial importance in healthcare procedures. Remote collaboration is a dynamic and repetitive process that includes several stages, such as exchanging and perceiving collaborative information, user interactions for expressing collaborative goals and manipulating physical elements. Its interdisciplinary nature distinguishes it and frequently necessitates considerable resources and time investment. This strategy can transcend geographical boundaries, allowing users to embrace flexible lifestyles and assuring equal access to resources (Wang et al., 2021). Moving forward, I will illustrate a scenario from Vila Health Organization, wherein a diverse team of medical professionals is involved in remote collaboration to ensure patients receive adequate care and management through various telecommunication methods. The Scenario Behind Evidence-based Care Plan In this particular scenario, a two-year-old girl called Caitlynn is taken to the emergency room due to breathing problems. Virginia, a certified nurse, and Dr. Copeland, a physician, oversee her care. Her physician examination reveals she has respiratory issues, including Rhonchi and shortened breathing noises at the right base. Virginia, a certified nurse, and Dr. Copeland, a physician, oversee her care at 32 per minute and malabsorption of nutrients. According to Caitlynn’s medical history, she had meconium ileus at birth and had previously been admitted for similar conditions. A laboratory sweat chloride test is used to confirm the cystic fibrosis diagnosis. A respiratory therapist provides aerosol nebulizers and chest physical therapy. The medical staff notes several obstacles to Caitlynn’s care, including her home’s distance from the hospital, her parents’ separation, and the need to educate Caitlynn’s family on managing her cystic fibrosis. To handle the emotional and logistical challenges faced by the family, the hospital healthcare staff consulted with a local social worker where the family resides. Moreover, the healthcare professionals consulted with Dr. Benjamin, Caitlynn’s pediatrician, to coordinate her care. NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care They decided to implement remote cooperation to improve the outcomes of patients’ health.  They talked about telemedicine access, vaccinations, and the treatment plan. To explain nebulization and chest physiotherapy to Caitlynn’s parents, the respiratory therapist conducts Skype consultations. The healthcare professionals also connected via Skype with parents to guide them regarding Caitlynn’s physical chest therapy by giving advice and emphasizing the significance of monitoring for symptoms of respiratory trouble, as Cystic fibrosis is a chronic condition.  Evidence-based Care Plan for Vila Health Patients The presented scenario is a straightforward guide for healthcare specialists to improve patient outcomes through evidence-based knowledge exchange, telemedicine, and optimizing healthcare delivery in a time when distant healthcare is becoming increasingly important. With the help of the following evidence-based research articles, I would like to present an Evidence-based care plan for Caitlynn to help her cystic fibrosis achieve the desired healthcare outcomes. These guidelines of the care plan are: Because of the patient’s young age, it is especially crucial to emphasize family involvement to promote successful long-term self-management. Controlling infections is crucial to treating CF. Caitlynn’s risk of respiratory infections will be reduced by hand cleanliness, and she will obtain all advised vaccinations and screening (Barben et al., 2021). Secondly, educating her family about the airway clearance technique and observing her oxygen level is essential. A study by Terlizzi et al. (2021) explains that due to the risk of respiratory infections, it is important for CF patients to have an airway without any secretions. NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care Thus, suctioning and giving adequate oxygen support is necessary. Next, I will discuss the importance of nutrition for CF patients. A specific meal plan for Caitlynn will be developed as part of our treatment strategy in close collaboration with a nutritionist. With the help of this strategy, she will be able to manage the difficulties caused by CF-related malabsorption while receiving the nutrients she needs for growth and development (Bailey et al., 2022). Further in our care plan, Caitlynn will have access to a local dedicated pediatric-focused care team, including a pediatric pulmonologist, respiratory therapist, dietitian, and social worker with experience treating cystic fibrosis children. Pediatric experts will help develop individualized care plans based on the patient’s needs and preferences. Lastly, the pediatric-focused care team will regularly monitor Caitlynn’s medication schedule. This entails seeing to it that she takes her prescription drugs as directed, checking on their efficacy, and making necessary modifications (Pinto et al., 2019). Integration of Evidence-based Care Model   As the presentation goes on, I will discuss the evidence-based care model that is, Iowa model that was applied to creating this care plan. The IOWA model is a well-established model that leads nurses through the EBP process, integration of professional knowledge, experiences, and preferences; assessment of clinical practice needs and available research; selection, implementation, and evaluation of evidence-based therapies; benchmarking and re-assessment when necessary (Chiwaula et al., 2021). With the help of the IOWA model, I started with a thorough assessment to develop an efficient care plan for Caitlynn with cystic fibrosis. I started the process by thoroughly analyzing the state of the research, assessing the needs for CF control, and identifying specific challenges. Based on the assessment, I chose and implemented evidence-based therapies designed explicitly for CF control. Being able to continuously assess the efficacy of my efforts to control CF. I ensured that my
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NURS FPX 4030 Assessment 3 PICO(T) Questions And An Evidence Based Approach

Student Name Capella University NURS4030 Making Evidence-Based Decisions Prof. Name Date PICO(T) Questions and an Evidence-Based Approach Nurses utilize the PICO(T) question strategy to find evidence for a healthcare problem. The PICO(T) stands for Patient/Population/Problem, Intervention, Comparison of Potential Interventions, Outcomes, and Time frame. With the help of this strategy, nurses can conduct research and gather evidence on a particular problem related to patients to serve them with the best evidence-based care. For this purpose, a healthcare issue is selected, followed by choosing a potential intervention and comparing it with another possible strategy. Lastly, the outcomes are evaluated based on the current evidence, which directs nurses to deliver evidence-based care treatments.  Healthcare Issue to be Explored by PICO(T) Strategy The PICO(T) question to be explored in this assessment is as follows: Do hypertensive patients (P) have better-regulated blood pressure levels (O) through medication therapy (I) or lifestyle modifications (C)? Hypertension is a chronic healthcare issue often encountered by elderly people. According to the World Health Organization, a patient is hypertensive if the blood pressure exceeds 140/90 mmHg. The patients do not experience significant symptoms, requiring regular blood pressure check-ups to diagnose hypertension (World Health Organization, 2023). Timely management of hypertension helps prevent conditions such as angina, heart attack, heart failure, and sudden death. The existing treatment strategies include pharmacological therapy of ACE inhibitors, ARB blockers, Calcium channel blockers, and diuretics.  NURS FPX 4030 Assessment 3 PICO(T) Questions And An Evidence Based Approach Furthermore, lifestyle changes and healthy eating also regulate blood pressure. Many healthcare providers deem pharmacological therapy more effective than lifestyle modification. In contrast, others consider that pharmacological treatment should not be prioritized and a healthier lifestyle can regulate patients’ blood pressure levels. Therefore, nurses need to treat patients with a more practical approach. The PICO(T) strategy can evaluate this, and nurses can deliver evidence-based interventions that are more suitable for patients. With this strategy, nurses can resolve existing conflicts in hypertension management and draw conclusions based on substantial data. Evidence-Based Sources to Answer PICO(T) Question  The sources of evidence that can be potentially effective in solving a PICO(T) question include several databases, relevant journals, and websites on hypertension. The databases available for searching evidence on the above PICO question are PubMed, CINAHL, Google Scholar, Capella University Library, MEDLINE, BioMed Central, and Cochrane Library. The journals that can be sought to obtain evidence-based data on hypertension are the Journal of Hypertension, Hypertension Research, International Journal of Hypertension, and American Journal of Hypertension. Moreover, the American Heart Association, Centers for Disease Control and Prevention, World Health Organization, and Preventive Cardiovascular Nurses Association are websites that highlight hypertension and treatment strategies. These sources are chosen because they align with the CRAAP criteria, ensuring their credibility and relevance when answering PICO questions on hypertension. NURS FPX 4030 Assessment 3 PICO(T) Questions And An Evidence Based Approach CRAAP stands for Currency, Relevance, Authority, Accuracy, and Purpose. All the referred sources are credible and relevant to hypertension and can provide valuable insights into hypertension management as they are up to date. Nurses can integrate these two approaches, i.e., the CRAAP test and PICO question, to obtain meaningful and authentic information on hypertension that can improve patient health outcomes.  Findings From the Relevant Sources Decision-Making on PICO Question Using Findings Considering the findings from evidence-based research data, the decision derived is that prehypertensive patients should first be guided towards non-pharmacological interventions, such as the DASH diet and lifestyle modifications, before considering pharmacological therapy. However, hypertensive patients with BP exceeding 140/90mmHg or with comorbidities are advised to follow physicians’ initial antihypertensive medication. Hypertension can be well regulated by adjuvant therapy of lifestyle modifications and antihypertensive drugs. Nurses must provide patient-centered care tailored to the health needs of hypertensive patients based on the frailty degree, comorbidities, and relevant psychosocial factors.  Conclusion As a chronic health issue, hypertension requires intricate management and long-term care. To implement the best evidence-based care strategy, nurses must look for credible data on hypertension. For this purpose, nurses can use the PICO(T) approach to make the right decisions. Here, the PICO question is whether hypertensive patients have regulated blood pressure via pharmacological therapy or lifestyle modifications. The right decision was based on relevant findings, including lifestyle modification for pre-hypertensives and pharmacological or adjuvant therapy for older people with hypertension and comorbidities.  All the findings are based on CRAAP criteria and offer credible solutions. References  Al-Makki, A., DiPette, D., Whelton, P. K., Murad, M. H., Mustafa, R. A., Acharya, S., Beheiry, H. M., Champagne, B., Connell, K., Cooney, M. T., Ezeigwe, N., Gaziano, T. A., Gidio, A., Lopez-Jaramillo, P., Khan, U. I., Kumarapeli, V., Moran, A. E., Silwimba, M. M., Rayner, B., & Sukonthasan, A. (2021). Hypertension pharmacological treatment in adults: A world health organization guideline executive summary. Hypertension, 79(1). https://doi.org/10.1161/hypertensionaha.121.18192  Fu, J., Liu, Y., Zhang, L., Zhou, L., Li, D., Quan, H., Zhu, L., Hu, F., Li, X., Meng, S., Yan, R., Zhao, S., Onwuka, J. U., Yang, B., Sun, D., & Zhao, Y. (2020). Nonpharmacologic interventions for reducing blood pressure in adults with prehypertension to established hypertension. Journal of the American Heart Association, 9(19). https://doi.org/10.1161/jaha.120.016804  NURS FPX 4030 Assessment 3 PICO(T) Questions And An Evidence Based Approach Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2019). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303  Portillo, I. A., Johnson, C. V., & Johnson, S. Y. (2021). Quality evaluation of consumer health information websites found on google using DISCERN, CRAAP, and honcode. Medical Reference Services Quarterly, 40(4), 396–407. https://doi.org/10.1080/02763869.2021.1987799  World Health Organization. (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension#:~:text=Hypertension%20(high%20blood%20pressure)%20is 

NURS FPX 4030 Assessment 2 Determining The Credibility of Evidence and Resources

Student Name Capella University NURS4030 Making Evidence-Based Decisions Prof. Name Date Determining the Credibility of Evidence and Resources Hypertension, commonly known as high blood pressure, is a prevalent health issue affecting millions globally. Its management requires consistent monitoring, accurate treatment protocols, and a deep understanding of patient needs. The ever-evolving medical research landscape necessitates an evidence-based approach to ensure the most effective and contemporary interventions are utilized. In the subsequent sections, we will delve into the importance of evidence-based practices, methodologies to evaluate credibility, and the role of nursing models in the holistic management of hypertension. Evidence-Based Approach for Hypertension Management  Hypertension is a chronic condition of high blood pressure exceeding 140/90 mmHg. This chronic healthcare issue predominantly affects older segments of the population, but younger adults can also be susceptible. Hypertension accounted for causing 691,095 deaths in the U.S. in 2021. Moreover, 45 % of U.S. natives have uncontrolled hypertension, making a population of 37 million U.S. adults with hypertension (CDC, 2023). Hypertension is considered a silent killer as it shows no significant symptoms and can only be diagnosed by measuring blood pressure. Therefore, routine blood pressure examination is essential to diagnose hypertension in patients. Hypertension treatment requires implementing protocols and guidelines to decide the therapeutic plan for patients. Considering the plethora of information available on hypertension, nurses must determine the credibility of evidence and resources. Additionally, they must practice the evidence-based guidelines on hypertension to ensure patients acquire adequate treatment at the required time. Hypertension management is needed to prevent the onset of lethal cardiovascular diseases such as stroke, heart attack, and kidney disorders. Therefore, it is essential to consider evidence-based practices (EBP) for effective and timely management of hypertension that saves patients from life-threatening conditions (Fuchs & Whelton, 2019).  Criteria to Determine Credibility of Resources The CRAAP methodology is a criterion to evaluate the authenticity and credibility of journals, websites, and article resources. The CRAAP criterion is an acronym for Currency, Relevance, Authority, Accuracy, and Purpose. This methodology shares valuable pieces of information on the credibility of resources. For instance, it describes whether the source has been updated and published lately and if it shares insights on the topic under consideration, showing its relevance. Moreover, it tells about the authors and their credibility, the accuracy of claimed points with scholarly references, and the purpose of the journal and article under study, if it brings valuable data or results for the audience. One way to apply this criterion can be done by considering the following bibliography as an example: Li, R., Liang, N., Bu, F., & Hesketh, T. (2020). The effectiveness of self-management of hypertension in adults using mobile health: Systematic review and meta-analysis. JMIR MHealth and UHealth, 8(3), e17776. https://doi.org/10.2196/17776  NURS FPX 4030 Assessment 2 Determining The Credibility of Evidence and Resources Currency: The article mentioned above was published in 2020, falling in the category of the latest articles within the past five years. Relevance: This journal article is specifically related to hypertension and its self-management. Authority: The authors are well-equipped with scientific knowledge of hypertension and have scientific and medical backgrounds in their fields. Accuracy: The claims are well-supported by evidence-based references in this journal article. Purpose: This study aims to provide the audience with results on whether self-management is effective for hypertension using mobile health. Analysis of Credibility and Relevance of Evidence and Resources This section entails some evidence-based resources on hypertension to analyze their credibility and relevance with the CRAAP test. One study on hypertension management was conducted by Timpel et al. (2020) on managing hypertension through telemedicine. This source was published within the last five years, showing its currency and relevance to hypertension. Moreover, the authors share their knowledge on treating hypertension by using technology where patients can acquire consultation on managing hypertension remotely. The article is published in the Journal of Medical Internet Research, which publishes peer-reviewed papers. The authors are specifically from medical backgrounds, where they presented accurate results and findings. Lastly, this study aims to brief the audience on managing hypertension using telehealth and telemedicine.  NURS FPX 4030 Assessment 2 Determining The Credibility of Evidence and Resources Another literature study by Mostafa et al. (2022) highlights antihypertensive effectiveness in controlling hypertension, i.e., Perindopril and Amlodipine. This study was first published in 2022 and fulfills the criterion of currency in the CRAAP test. Moreover, the study mainly talks about hypertension management, showing its relevance to the topic of discussion. The authors are acquainted with medical background and furnished information substantiated sufficiently with scholarly references. The purpose is to manage hypertension using anti-hypertensive agents and their efficacy. Based on the analysis, the most helpful resource is the study conducted by Mostafa and colleagues, as it directly mentions pharmacological ways to control hypertension and prevent lethal cardiovascular diseases. Importance of Evidence-Based Practice Model Nurses use evidence-based practice models to incorporate credible evidence to address various healthcare issues. Several evidence-based practice models exist in the literature, including Johns Hopkins, Stetler, and Iowa. These EBP models help nurses make informed decisions based on the evidence available. Moreover, integrating evidence-based data into these models promotes the delivery of effective care treatments by identifying relevant interventions. This will lead to better patient health outcomes and efficient use of resources. Additionally, this will result in cost-effective care treatments as healthcare providers make informed decisions based on evidence incorporated into EBP models.  NURS FPX 4030 Assessment 2 Determining The Credibility of Evidence and Resources The Johns Hopkins Nursing Model comprises three key steps: identification of practice question (effective hypertension management), gathering evidence (literature on hypertension treatment), and Translation (plan hypertension treatment, implement them and evaluate results, and communicate with an interdisciplinary team for managing hypertension) (Rice, 2023). The literature will be located for hypertension management, and evidence will be gathered. After gathering data on the treatment of hypertension, the plan for hypertension management is developed, considering various factors such as patient health needs and preferences and cultural sensitivity while merging clinical expertise. The extended plan for hypertension management
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NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Root-Cause Analysis and Safety Improvement This report delves into a significant medication administration error at Tampa General Hospital (TGH), a prevalent issue that critically impacts patient safety. As a backdrop, medication errors rank as a leading cause of preventable harm in healthcare settings. Through this assessment, we will systematically explore the root causes behind such errors at TGH using Root-Cause Analysis (RCA). Subsequently, we will propose best practice strategies to mitigate these challenges, devise an evidence-based safety improvement plan, and identify organizational resources to bolster this plan’s success. Analysis of the Root Cause  Several medication administration errors occurred at Tampa General Hospital, but the incident with a 45-year-old patient, Hannah, instigated the use of RCA. Hannah underwent appendix surgery and was admitted for her post-surgery recovery. In one of the nurses’ rounds for medication administration, Hannah was administered the wrong medication by nurse Olivia. Hannah’s doctor had prescribed her morphine, ciprofloxacin, and heparin. The nurse examined her prescribed medications and went to the dispensing unit. Meanwhile, she received a phone call and started talking casually while dispensing medication from the automated dispensing system (ADS). The ADS system faced glitches and dispensed the wrong medicines. Olivia was momentarily distracted by a phone call and paid no attention to the dispensed drug. She administered a double dose of heparin instead of morphine. This resulted in massive bleeding in the patient. This problem was detected by the nurse, Olivia, as she saw her patient bleed significantly. She immediately reported to an emergency, and Hannah’s bleeding was controlled. NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan This adverse event affected Hannah, her family, the organization, and the nursing staff. The patient’s recovery period was extended, and she had to undergo further procedures to control her bleeding. Moreover, her healthcare expenditures increased, and family members were distressed seeing her endure pain all over again. Healthcare organizations faced problems as their healthcare costs were further ameliorated due to additional treatments. The nursing staff was struck with fear and sadness as their poor attention toward patient care led to significant incidents, posing safety risks to patients’ lives. The root causes identified in this particular scenario were as follows: The RCA revealed these underlying causes, which contributed to the onset of the unfortunate adverse event. Considering these root causes, medication errors in the future can be prevented. Moreover, patient safety can be enhanced by implementing strategies that solve the above-mentioned issues. Application of Evidence-Based Practice Strategies  After conducting a thorough root-cause analysis, it is crucial to implement evidence-based strategies considering the underlying causes of medication administration errors at TGH. These evidence-based strategies can improve patient safety and reduce medication errors. Moreover, they will reduce the costs incurred by patients and healthcare organizations. One study shows that about 62.1 % of nurses make medication errors due to a lack of training on safe and effective medication administration (Wondmieneh et al., 2020). Another study finds that external interruptions during medication administration, such as bedside conversations and taking phone calls, account for 18.8 % of medication errors (Manias et al., 2021). Another study highlights how healthcare information technologies also lead to medication administration errors due to poor maintenance and flaws in designing the technology to mitigate human errors (Ambwani et al., 2019).  NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan The best practices include training nurses on safe medication administration, where nurses can be educated on protocols regarding medication administration. Nurse leaders can play a vital role in training young nurses on the five rights of medication administration and how this strategy can address medication safety issues. As the five rights of medication administration include the right patient, the right drug, the correct dose, the right time, and the right route of administration, nurses can prevent medication administration errors due to the wrong medicine and the wrong patient (Manias et al., 2021). Moreover, healthcare organizations can integrate a new technology of medication administration, i.e., Bar Code Medication Administration. This will enable double-checking with accuracy through barcode scanning of the label on the drug and matching it with the barcode mentioned on the patient’s bedside or wrist. This will ensure the patient is acquiring the medication prescribed to him with the help of Barcode (Owens et al., 2020). Healthcare organizations can revise policies for nursing staff to carefully provide care treatments to patients and avoid external interruptions such as bedside communications, distracting conversations, and taking unnecessary phone calls. Any violation of these policies should instigate disciplinary actions and penalties. This will enhance a culture of careful administration of drugs without external interruptions (Yang et al., 2022).  Evidence-Based Safety Improvement Plan  Considering the alarming situation of TGH, where medication administration errors impact patients’ safety, developing a safety improvement plan for safe medication administration is imperative. This improvement plan accounts for the factors contributing to patient safety risks and can potentially lessen medication administration error rates. The plan consists of establishing training and educational sessions for nurses that guide nurses on safe medication administration. Nurses will learn about medication administration techniques, protocols, and interdisciplinary collaboration to promote a safe medication administration culture (Manias et al., 2021). Moreover, the hospital will revise its standard SOPs for nurses, who must abide by the stringent policies on mindful medication administration. The guidelines will include penalties for inappropriate bedside communication during medication administration and no cellphone use during working hours (Yang et al., 2022). Lastly, the plan provides for integrating BCMA technology into safe medication administration (Owens et al., 2020).  Desired Goals of Actions Timeline of Development and Implementation of Plan The safety improvement plan will be developed in two months, requiring resource estimation and budget management. Moreover, the practical implementation will be executed within three months after development. For instance, the plan will be implemented on a small scale in one hospital department. After three months of implementation and evaluation, revision of the
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NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Enhancing Quality and Safety The primary purpose of the healthcare system is to provide improved quality of care that enhances patient safety and satisfaction. This paper explains the factors involved in patient safety risks due to Medication Administration Errors (MAEs) that lead to adverse events or sometimes cost a patient’s life. MAEs occur due to violating the five medication administration rights, including incorrect drug, patient, dose, frequency, and time. Further in the paper, evidence-based practices and solutions are provided to improve patient safety by reducing MA errors. Moreover, the nurse’s role and collaboration with different stakeholders are also explained, which reduces the cost and enhances the quality of care within the healthcare system.   Factors Leading to Specific Patient Safety Risks  The patient, Jiliana, is a 60-year-old woman with anaphylactic symptoms who came to the emergency room in the community hospital. The patient’s medical history revealed hypertension and obesity. Upon the examination, the doctor prescribed a handwritten prescription which mentioned to “administer Epinephrine 1mg” only. The duty nurse without further probing into the correct route, administered her Epinephrine to aid with allergic symptoms through an intravenous route, which immediately caused an intense, crushing pain that made her lose consciousness. The resuscitation team in the hospital was called. Through supplemental oxygen and other resuscitation methods, the patient was reverted. However, this incident was a life-threatening situation for the patient. Hence, a comprehensive case investigation was performed. The case investigation revealed several factors involved in this incident that led to the mild but reversible condition. One of the factors is the negligence of healthcare professionals while prescribing and administering medications. While the physician neglected to consider the patient’s hypertensive history before ordering a drug and did not mention the route in the prescription, the nurse neglected to double-check with the doctor and the pharmacist before administering the drug. NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Another factor is the communication gap among the healthcare professionals as there was a lack of collaboration among the physician, pharmacist, and nurses which led to the adverse drug event, eventually causing complications for the patients. According to the literature, most MAEs occur due to negligent behaviour and lack of communication among healthcare professionals. This negligence and communication gap leads to several preventable adverse events which are harmful to patient safety (Tariq & Scherbak, 2023). Health literacy is another important factor. Like in the given scenario the doctor did not check the patient’s medical history as she has hypertension, and prescribed medication that could be harmful to the patient. Health literacy of healthcare providers related to medication and risk factors associated with medication administration is an essential component of preventing patients’ safety (Mueller et al., 2019). Lastly, the lack of technological involvement in the medication management process led to a significant issue in Jiliana’s case. If the hospital had the Electronic Health Records (EHR) and Electronic Medication Administration Records (EMAR) system, there would be minimal chances of medication errors as a shared portal would have improved communication and alerted every healthcare professional for potential errors. Evidence-Based and Best Practice Solutions  Incidences like the one described above may bring various challenges related to patient safety which can be addressed using several evidence-based and best practices.  Standardized Guidelines: The Joint Commission International Accreditation (JCIA) body has helped healthcare organizations and healthcare professionals to create a safer evidence-based practice and environment for patients and healthcare providers to enhance patient safety by providing standardized patient safety goals (patient identification and medication management). These goals are related to medication administration as, which will help in preventing errors if followed adequately in the healthcare settings (ElLithy et al., 2023).  Effective Communication: The communication between healthcare professionals, such as physicians, pharmacists, and nurses, helps to improve patient safety in the healthcare setting. Effective Communication of the healthcare providers is enhanced when the experienced professional provide training and session to the novice nurse about medication administration. Effective communication during novice nurse training reduces the hospital’s cost to hire experienced or registered nurses for patient safety. Moreover, double-checking of prescriptions will also save the cost of medication patient and hospital. This will enable the nurses to give the right medication to the right patient with a correct route (Rodziewicz et al., 2023).  Technological Integration: Technical integration such as Barcode Medication Administration (BCMA) and Electronic Health Records (EHR) improve patient safety and is practical to adopt. BCMA helps to fulfil the five rights of medication administration, which enhances hospital efficacy and prevents MAEs. It enables the pharmacist to avoid mistakes in look-alike-sound-alike medication. BCMA reduces the rates of MAEs, ultimately reducing the cost of the patient’s stay at the hospital. Moreover, it also saves the patient’s cost of transportation due to the correct administration of the medicine (Shermock et al., 2023). Nurse Role in Care Coordination and Cost Reduction  Nurses are the frontline force that helps the healthcare system provide quality care and improve patient safety. MAEs are the leading cause of hospitalization and disability worldwide, which include multiple factors; one of them is mainly due to novice nurses and their negligence. The training of the nurses in medication administration helps them to understand the five rights of medication administration, which include the correct dose, route, patient, timing, and frequency. Training young nurses with registered nurses will improve patient safety as they discuss the patient cases during training. NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Moreover, this training session enables them to communicate and collaborate with healthcare professionals such as pharmacists to get information about the new and LASA drugs (Luokkamäki et al., 2020). Care coordination involves a multidisciplinary team, which helps the patient receive an improved quality of care and enhances patient safety. The nurses will collaborate with the physician and pharmacist in a team to provide care at the right time to the right patient. The incidence reporting system within the healthcare setting will help the
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NURS FPX 4010 Assessment 4 Stakeholder Presentation

Student Name Capella University NURS4010 Leading in Intrprof Practice Prof. Name Date Stakeholder Presentation Hi! My name is Georgia; today I will present a stakeholder presentation that will help the organization bring change to achieve its goal in improving communication among the interdisciplinary team. The presentation consists of the organization issue on which the interdisciplinary plan is based.  The evidence-based plan includes the practices that help the interdisciplinary team bridge the team’s communication gap. The allocation of human and financial resources and implementing the plan will be part of the presentation. Finally, criteria will be presented to help evaluate the change proposal plan’s efficacy. Organizational Issue  The organizational issue faced by the emergency department (ED) at the United Hospital is the communication gap in the interdisciplinary team. This communication gap leads to more errors in information flow and clarity. Moreover, team members are confused and disrupted, which hinders work completion due to a lack of collaboration and communication. These results in more patient visits and long stays in ED and risks to patient safety and quality of care. Effective communication skills training helps healthcare professionals practice active listening during the information flow, gathering and sharing it with team members. The shared decision-making approach will improve the communication and collaboration of the interdisciplinary team and improve patient outcomes (Buljac-Samardzic et al., 2020). The organizational goal is to improve the communication gap of the interdisciplinary team, which helps them to achieve patient outcomes.  Potential Consequences If this collaborative interdisciplinary approach is not implemented in the hospital, more errors in information flow and clarity will occur. The confusion among the team members will impact their performance when they do not participate in decision-making. The lack of communication and collaboration will increase patient visits and stays, affecting patient satisfaction. Moreover, the hospital budget will also be affected due to patient stays, ED visits, and wrong treatment.  Relevance of Interdisciplinary Team Approach The healthcare professionals working in the United Hospital ED lack communication; however, this interdisciplinary team approach, which includes the effective communication skills workshop and shared decision-making, is the best and most relevant approach that will bridge the gap in the team. Shared decision-making and effective communication skills interventions are specific to the team’s requirements. These two approaches include team characteristics like shared leadership, interdependence, and responsibilities of the team members. NURS FPX 4010 Assessment 4 Stakeholder Presentation This team characteristic manages collaboration in the team to reduce the gap and improve patient safety errors. Thus, focusing on interdisciplinary team communication reduces errors in information flow and gathering (Dietl et al., 2023). Interdisciplinary communication gap issue faced by the general hospital in Solvenia, which leads to medical errors and a reduction in patient safety. 70% of the errors in this hospital were due to communication in the team. However, after analysis of the issue, the hospital implemented effective communication training to enhance the communication among team members, which helped the hospital to improve the performance of the team and improve the quality of care and patient safety (Erjavec et al., 2022). This approach will help achieve the organisation’s goal of communicating effectively in the team and achieving patient outcomes through reduced errors in information gathering and flow.  Evidence-Based Interdisciplinary Plan Summary The objective of an interdisciplinary plan to improve and achieve the organizational goal to bridge the communication gap in the team. The plan objective is based on evidence-based practices such as effective communication skills workshops and shared decision-making of the team. The interdisciplinary team have nurses, health educator, IT technician and logistics. The resources projector and screen along with experienced health educators for training. The health educators will train healthcare professionals in effective communication skills, such as active listening and engagement in the hospital meeting room. The head nurse ensures the availability of all professionals for the training by adjusting their duty schedule. The logistics department and IT team will ensure that resources such as projectors, computers, and information materials are adequately available and appropriately working in the meeting room during training. Implementing evidence-based practices involves the organizational will, team cooperation, and personal dedication of the team, which is the ultimate objective for nurses, clinicians, and healthcare organizations (Shayan et al., 2019).  NURS FPX 4010 Assessment 4 Stakeholder Presentation In North America, there are ten thousand deaths of patients due to medical errors, and the communication gap is the leading cause of these errors. The Institute of Medicine (IOM), in the report ‘Err to Human, has provided the adverse effect of the communication gap in an interdisciplinary team along with evidence-based practices to bridge the team’s gap. Effective communication skills include listening to other team members, giving feedback, assessing the information, sharing information, and participating in shared decision-making. These practices are also identified by the World Health Organization (WHO) (Lateef, 2022). Interdisciplinary team decision-making depends on personal skills such as responsibility and active listening and team management skills such as collaboration and communication with other members (Khodeir & Nessim, 2019). The evidence for the plan is from the IOM, WHO, and the WileyonlineLibrary. These sources specifically defined the importance of the communication and decision-making power of the interdisciplinary and its impact on organizational and patient outcomes.   Implementation of Interdisciplinary Plan The plan will be implemented according to the Plan-Do-Study-Act (PDSA) model. Effective communication skills workshops and decision making is the plan for the team, which is necessary to achieve the organizational goal and patient outcomes. Shared decision-making will help the healthcare professional share information, impacting team coordination and communication. The training of communication skills is provided to healthcare professionals, and their results will be checked through the assessment. NURS FPX 4010 Assessment 4 Stakeholder Presentation The evaluation of the plan’s effectiveness is made through the assessment of the team members. The plans will be made to achieve the organization’s goal and enhance communication and collaboration (Katowa-Mukwato et al., 2020). The human and financial resources will be managed by collaborating with external stakeholders such as policymakers, human resource specialists and organization administrators. The
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