Assessing the Problem-Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Assessing the Problem-Leadership, Collaboration, Communication, Change Management, and Policy Considerations

The efficiency of nursing care in addressing population health problems is based on the efficiency of leadership, collaboration, communication, and management of change, as well as current policies related to the health problem. This paper will explore heart disease in the Black American population as a health problem relevant to my nursing practice and review the population health problem on the basis of current evidence, leadership, communication, collaboration, change management, and current policies on the nursing management of heart disease. Get in touch with us at eminencepapers.com. We offer assignment help with high professionalism.

Population Health Problem Relevant to My Nursing Practice

The population health problem of focus that is relevant to my nursing practice is heart disease among the Black American population. Heart disease, also known as cardiovascular disease (CVD), is an umbrella term for a number of health conditions affecting the heart. The main types of heart diseases include coronary artery disease, heart attack, heart valve diseases, angina, arrhythmias, subclinical atherosclerosis, stroke, and congenital heart defects, among other heart conditions (Tsao et al., 2022).

I will work with a majority of people from the Black American population during my practicum. Contextual data shows that black people are more prone to heart disease and have the highest mortality rates than other American racial groups. Incidence data from the American Heart Association (2022) shows that 60.1 percent of Black male adults and 58.8 percent of females have had heart disease between 2015 and 2018, while in 2019, 57,761 and 54,544 deaths for Black males and Black females were reported, respectively. Coronary heart disease is the most prevalent heart disease among the Black American population, in which 6.7 and 7.2 percent of males and females aged above 20 years have had the disease. Additionally, 3.9 and 2.3 percent of males and females aged above 20 years have heart attacks, from which an estimated 10 percent of those aged above 45 years are expected to die in the first year, and a further 20 percent die within five years (American Heart Association, 2022). The rise in the number of heart disease cases and extreme outcomes across the Black American population is related to high rates of smoking, a poor diet, increased physical inactivity, diabetes, and high rates of overweight and obese individuals across the population (American Heart Association, 2022).

Heart disease is a health problem of significant relevancy to my nursing practice as a baccalaureate-prepared nurse for various reasons. Firstly, heart diseases affect 47 percent of Black Americans and have the highest mortality rates due to the various disparities within the U.S. governance and healthcare structures (CDC, 2022). As a baccalaureate-prepared nurse (BSN-prepared nurse), I can contribute towards reducing and eliminating such disparities. Additionally, the CDC (2022) rates heart health issues as the leading cause of death in the United States, irrespective of gender, race, or ethnicity. In 2020 alone, over 697,000 Americans died due to heart disease, which is expected to be higher by 2025 (CDC, 2022). It is estimated that one individual dies of a heart disease every 34 seconds in the U.S., while 20.1 million adults aged above 20 years are feared to have coronary heart disease, while 805,000 people have hearts annually, of which 1 in 5 heart attacks are silent (Tsao et al., 2022). Another reason heart disease is a population health problem relevant to my nursing practice is due to the costs of care for heart diseases, the economic impact of the disease, and the disparities based on race and gender. Heart disease caused the U.S. economy an excess of $229 billion in care costs and lost productivity (CDC, 2022).

Evidence on Heart Disease that Describes and Guides Nursing Actions

Nurse actions in caring for heart disease patients include collaborating with other specialists, using pharmacotherapeutic options, developing care plans, advising on lifestyle changes, health promotion, caring for patients who have heart surgeries, and using technologies such as telehealth to support patients in coping with heart disease or prevent recurring of the complications after treatment.

Much of the available literature is consistent with current nurse practices and provides guidance to nurses in caring for heart disease. For instance, a study by Jin et al. (2019) provides substantial evidence of the impact of telehealth interventions in the remote delivery of care to patients under cardiac rehabilitation, with notable outcomes in preventing secondary heart disease and improving patient experiences. This study presents telehealth as an alternative to other strategies employed in heart disease rehabilitation. It also provides various modes that telehealth can be used in patient monitoring and rehabilitation for secondary prevention.

To determine the reliability of the data and evidence provided in the study, I considered the authority, relevance, and target audience of the study. I also considered the currency of the paper and the data utilized.

Despite the availability of evidence to support nursing care, nurses face various barriers during the implementation of evidence-based practices, such as the use of telehealth in healthcare when caring for heart disease patients. For instance, in a paper addressing the capabilities, features, applications, and barriers to telemedicine in the adoption of telemedicine in healthcare, Haleem et al. (2021) provide substantial evidence on the barriers to the implementation and adoption of telehealth in healthcare. The study identifies telemedicine as a new technology that is prone to confidentiality and patient privacy concerns, data accuracy issues that can lead to misdiagnosis, and fraud and abuse. Additionally, the complexity of the technology application to some users may be a barrier to the implementation of telemedicine in healthcare (Haleem et al., 2021).

There are various effective nursing standards and policies that help improve population health outcomes for heart disease. One major nursing standard for heart disease is Advance Care Planning (ACP). Available evidence shows the benefits of ACP in improving heart disease outcomes. For instance, a study by Schwerzmann et al. (2020) reviewing evidence on the benefits of and factors for patients’ preferences for ACP found that ACP supported the delivery of structured care for adult patients with coronary heart disease (CHD). The study further proved that ACP allowed the management of CHD on the basis of level and stage of disease progress with improved outcomes and patient experiences. The study also suggests approaches for the implementation of ACP in the process of CHD management.

Nurses are integral in the provision of care for heart disease patients as well as in policy formulations to improve care outcomes, prevent illness, and reduce hospital readmissions. A study by Liljeroos and Strömberg (2019) proposes how nurse-led heart failure clinics in Swedish primary have effectively reduced the need for hospitalizations and improved access to quality patient-centered care. This study highlights the role of nurses in heart disease care and the need to prioritize nurses and professional nurse associations in heart health during the development of related policies to improve outcomes, prevent illness, and reduce hospital readmissions.

A suitable nursing theory or conceptual framework that might frame and guide my nursing actions during my practicum in relation to heart disease management is Roy’s Adaptation Model. The model identifies the recipient and focus of nursing care as well as when nursing care is needed. According to Roy’s Adaptation Model, nursing is an interaction between the person, their health, the environment, and nursing (Mansouri et al., 2019). Based on the model, Mansouri et al. (2019) noted that nurses could detect stimuli and the behaviors of patients with heart failure to develop plans for the adaptation of the patient to the disease and improve their experience and health-related quality of life.

Impact of State Board Nursing Practice Standards and Governmental Policies on Heart Disease

The Nursing Practice Act (NPA) guides nursing practice and actions across the states in the U.S. Although it varies from state to state, the NPA requires nurses to practice within their licensed scope to provide safe and appropriate quality, continually improve their competence, and advocate for their patients. A study by Cousin et al. (2021) found that nurses can improve health disparities in cardio-oncology by addressing the social determinants of health (SDOH) and racial disparities in heart and cancer care for Black breast cancer survivors and exposure to cardiovascular risk factors and barriers to preventive care and cardio-oncology rehabilitation.

As the NPA also requires nurses to improve their competence in patient care, advanced practice nurse competencies are important to address critical issues in health policy by providing a nurse perspective on the health policy agenda (Heinen et al., 2019). As provided by the NPA and the establishment of nursing standards and scope of practice for nurses, the policies determine my authority when it comes to caring for heart disease patients. As a BSN-prepared nurse, I will have an expanded authority to work in both acute and critical care for heart disease patients.

Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience Related to Heart Disease

Leadership and the competencies of the leader are essential in supporting nursing efforts (Heinen et al., 2019). Effective leadership strategies in healthcare ensure open communication in teams, collaboration between interprofessional team members, support personal and professional growth, provide and take feedback, focus on teaching rather than instructing, and focus on the wellbeing of the nurses. The effectiveness of leadership strategies in nurses can be determined by patient outcomes, nurse outcomes, the efficiency of implementing change, reduction, and prevention of errors in nursing, and influence over care strategies employed in patient care. Nurse leaders must be directly involved in policy formulations to reduce the racial disparities in access to resources for heart disease care. This also includes healthcare planning and promotion. Addressing the population health problem in the U.S.’s Black population requires the adoption of a multidisciplinary approach in both patient care and communication.

Reducing the rate of health diseases in the Black American population requires a change of behaviors across the population and other players contributing to the development of heart-related diseases, such as the food industry. The change management strategy I anticipate will be used to address the heart disease problem among Black Americans is the ADKAR (Awareness, Desire, Knowledge, Ability and Reinforcement) Change Management Model. This is because the model adopts a simple approach to implementing and establishing sustainable change.

Conclusion

Heart disease among Black Americans is a health problem majorly related to lifestyle choices. However, addressing the health problem requires the development of population-specific policies guided by evidence. Additionally, effective leadership strategies, including the promotion of interdisciplinary collaboration and communication, are required to fully address the development of heart disease in the Black American population. In conclusion, a lifestyle change encompassing health and food industry change is also required.

References

American Heart Association. (2022). 2022 Heart Disease & Stroke Statistical Update Fact Sheet Black Race & Cardiovascular Diseases. https://professional.heart.org/-/media/PHD-Files-2/Science-News/2/2022-Heart-and-Stroke-Stat-Update/2022-Stat-Update-factsheet-Black-Race-and-CVD.pdf

CDC. (2022). Heart Disease Facts. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/heartdisease/facts.htm

Cousin, L., Roper, N., & Nolan, T. S. (2021). Cardio-Oncology Health Disparities: Social Determinants of Health and Care for Black Breast Cancer Survivors. Number 5 / October 2021, 25(5), 36. https://doi.org/10.1188/21.CJON.S1.36-41

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, 100117. https://doi.org/10.1016/J.SINTL.2021.100117

Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378–2392. https://doi.org/10.1111/JAN.14092

Jin, K., Khonsari, S., Gallagher, R., Gallagher, P., Clark, A. M., Freedman, B., Briffa, T., Bauman, A., Redfern, J., & Neubeck, L. (2019). Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 18(4), 260–271. https://doi.org/10.1177/1474515119826510

Liljeroos, M., & Strömberg, A. (2019). Introducing nurse-led heart failure clinics in Swedish primary care settings. European Journal of Heart Failure, 21(1), 103–109. https://doi.org/10.1002/EJHF.1329

Mansouri, A., Baraz, S., Elahi, N., Malehi, A. S., & Saberipour, B. (2019). The effect of an educational program based on Roy’s adaptation model on the quality of life of patients suffering from heart failure: A clinical trial study. Japan Journal of Nursing Science, 16(4), 459–467. https://doi.org/10.1111/JJNS.12255

Schwerzmann, M., Goossens, E., Gallego, P., Kovacs, A. H., Moons, P., Swan, L., Tobler, D., de Stoutz, N., Gabriel, H., Greutmann, M., Roos-Hesselink, J. W., Sobanski, P. Z., & Thomet, C. (2020). Recommendations for advance care planning in adults with congenital heart disease: a position paper from the ESC Working Group of Adult Congenital Heart Disease, the Association of Cardiovascular Nursing and Allied Professions (ACNAP), the European Association for Palliative Care (EAPC), and the International Society for Adult Congenital Heart Disease (ISACHD). European Heart Journal, 41(43), 4200–4210. https://doi.org/10.1093/EURHEARTJ/EHAA614

Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Ferguson, J. F., Generoso, G., Ho, J. E., Kalani, R., Khan, S. S., Kissela, B. M., Martin, S. S. (2022). Heart Disease and Stroke Statistics-2022 Update: A Report from the American Heart Association. Circulation, 145(8), E153–E639. https://doi.org/10.1161/CIR.0000000000001052

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Practicum Focus Sheet
Assessment 2
Note: Expect to spend at least 2 hours with the patient, family, or group you’ll be working with
during this portion of your practicum, exploring issues of patient safety, quality, and costs
associated with the health problem you’ve defined. This includes time spent in consultation with
subject matter or industry experts. You’ll report on the results of this work as part of your next
assessment.

Assessing the Problem-Leadership, Collaboration, Communication, Change Management, and Policy Considerations

For this portion of your practicum, discuss, in depth, how the problem will affect patient safety,
quality of care, and costs. Consider the following questions to help guide your exploration of
quality, safety, and costs and to make the most of your time:
• Has the patient, family or group experienced any serious safety events because of the
problem?
• How many times have they gone to the emergency department (ED)?
• How many times have they been hospitalized?
• What is the frequency of ED visits or hospitalizations?
• How many medications are needed to manage the problem?
• Does insurance pay for these medications?
• Have the medications caused any side effects?
• How often are doctors’ visits or other therapies needed?
• Does insurance pay for these visits or treatments?

Practicum Focus Sheet
Assessment 1
Note: Expect to spend at least 2 hours with the patient, family, or group you’ll be working with
during this portion of your practicum, assessing the health problem you’ve defined from a
leadership, collaboration, communication, change management, and policy perspective. This
includes time you may elect to spend in consultation with subject matter or industry experts.
You’ll report on the results of this work as part of your next assessment.
For this portion of your practicum, consider the following:
• Identify the patient, family, or group you intend to work with.
• Think about what you hope to learn.
o What’s your rationale for choosing this particular patient, family, or group?
• Consider how you’ll present your ideas about the problem to the patient, family, or group
and convince them of its significance.
• Which leadership, collaboration, communication, and change management skills will you
need to apply in order to work successfully with your chosen patient, family, or group?
• Which potential barriers do you foresee in presenting the problem to this patient, family,
or group?
• Which change management strategies might you employ to overcome these barriers?
o For example, you might consider creating a sense of urgency supported by data or
policy requirements