Patient, Family, or Population Health Problem Solution

Patient, Family, or Population Health Problem Solution

I have continued to work with patients and community members of the Black American community, focusing on heart disease among Black Americans as the population health problem of interest. In this assignment, I will present a Lifestyle Change Program as an appropriate intervention to help Black American patients and the community reduce, prevent, and manage the risks associated with heart disease. In this paper, I will discuss the roles of leadership and change management in heart disease management and the consideration of policies in developing the intervention. I will also present the proposed intervention, the strategies for communication and collaboration with the patients and other participants, and how I will incorporate technology, care coordination practices, and community resources in managing heart disease among Black Americans. I will also identify how the proposed intervention will impact the quality of care, patient safety, and costs to the system and individuals.

Role of Leadership and Change Management in Addressing Heart Disease among Black Americans

I have considered how leadership through empowerment influences disease management and helps manage the expected changes during the implementation of the intervention. Leadership is central to successfully managing healthcare interventions that require a change of behavior. Successful change in population behavior, the system, and its operations require promoting behaviors and system-wide practices that align with the changes. Firstly, leaders ensure that infrastructure supports coalitions, collaborations, and pooling of aid necessary to address health disparities that impact health (Domínguez et al., 2020). Additionally, leaders support changes in health systems during difficult times (Sriharan et al., 2022). Leaders promote effective communication and positive attitudes for developing a healthy environment supporting change (Robbins & Davidhizar, 2020). In this case, to improve heart disease outcomes in the Black American community, I will promote and motivate the desired changes across the patient group. Evidence shows that health-promoting leadership initiates and motivates changes that grow an individual’s health awareness, health motivation, development of values and behaviors for health, and help remodel and manage behaviors for sustainable well-being (Yao et al., 2021).

Role of Nursing Ethics in Informing the Development of Proposed Intervention

Nursing actions and interventions are guided by the principles of ethics, which include autonomy, beneficence, justice, and non-maleficence. Nurses must align the delivered care and interventions with these principles and base their decisions on ethical dilemmas (Yıldız, 2019). Ethics in nursing help recognize that each individual has their own beliefs, values, views, preferences, and concerns about health that guide health decisions (Haddad & Geiger, 2022). In consideration, nursing ethics dictate that nurses must allow patients to make decisions regarding their health and healthcare plans based on their personal systems of belief, values, and wishes. This means that regardless of the proposed intervention’s expected effectiveness if implemented, it must be developed on the basis of the Black community’s beliefs and values to help understand and overcome dilemmas and make the right judgments and decisions to help achieve the intervention’s goals.

Proposed Intervention as a Solution

I have proposed a program that focuses on lifestyle change as an intervention solution to heart disease among Black Africans. Through the lifestyle change program, I will focus on teaching a group of patients on approaches to making healthy changes as an intervention to reduce the impact of heart disease while preventing new cases. I will use a narrated PowerPoint presentation for patient education purposes. Other materials to promote a healthy lifestyle will include handouts and brochures. I will also organize the patients at the facility to have a support group within the hospital and in the community to discuss and develop solutions to overcoming their lifestyle change challenges. In the lifestyle change program, I also include physical activity, improving the consumption of nutritious foods, reducing the consumption of processed foods, and reducing the consumption of foods with high sodium content. I will also use technology, including social media, telehealth, and live podcasts, to improve care coordination and collaboration between the team members, including the healthcare professionals, the patients, and the community members.

Strategies for Communicating and Collaborating with the Black American Community to Improve Heart Disease Outcomes

My group of focus with regard to heart disease is the Black American population. Communicating and collaborating with the local community is essential to successfully implementing the proposed intervention. First, gathering input from the population group is important as it ensures the nurses remain accountable to the local community. I will collect data and input from the target group to help me meet the intervention’s information needs, understand the health needs of the community, their preferred channels of communication, health beliefs, health views, existing community-level risk factors for heart disease, and their experiences with heart disease, the available resources within the community, and the existing difficulties to access care and other resources necessary for managing and preventing heart disease among the Black American community. Community input will also help me gather first-hand input to support decision-making for improving the intervention, care, and community outcomes related to heart disease. I have selected strategies to facilitate communication and collaboration with Blacks in the U.S. by creating an environment that supports open communication with opportunities for giving and receiving feedback. The intervention will also employ technology to improve communication and facilitate multiple lines of communication. Evidence from the use of technology in managing the COVID-19 pandemic proved to be useful in communication and contact tracing (Alo et al., 2021). Additionally, technology, when used as an alternative channel for communication, has been found to improve the efficiency of communication and overcome complex communication needs during emergencies (Light et al., 2019).

Role of State Board Nursing Practice Standards and Governmental Policies in Guiding the Development of Proposed Intervention

The State Board of Nursing Practice and governmental standards guided the development of the intervention. I considered three policies during the development of the intervention for heart disease among the Black American population: the Nursing Practice Act (NPA), the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy act, and the Affordable Care Act (ACA). I will use the NPA to ensure that I assign the nurses roles that are in line with their level of education and competence to avoid errors or role conflicts. I will also use the HIPAA to ensure that I maintain the privacy and confidence of patients during and after implementing the intervention and ensure that all activities and actions comply with the HIPAA’s Privacy rule on the use of technology and handling of health information. I will also use the ACA to ensure that the intervention is not costly, adequately meets the community’s needs, and improves access to cardiac care services. The evidence shows that the ACA has significantly improved access to care for CVD adult patients across the general patient despite the existing gaps in care for patients from minority backgrounds with CVD and faced with multiple cardiovascular risk factors (CVRFs)  (Barghi et al., 2019).

Impact of Proposed Intervention on the Quality of Care, Patient Safety, and Costs to the System and Individual

I expect the proposed intervention to positively impact and improve the cost of care, patient safety, and the costs to the system and the individual. I will focus on ensuring that the lifestyle change intervention reduces the risk of heart disease among the Black American population and improves access to quality and safe care, ultimately reducing cases and related expenditures. Evidence from research shows positive links between lifestyle modifications and risk reduction with an impact on patient safety and care costs. For instance, lifestyle modifications have notable risk reduction and maximized patient outcomes (Franklin et al., 2020), including positive outcomes in patients with resistant hypertension (Blumenthal et al., 2021). The American Diabetes Association (2019) notes that CVD and CVD risk management reduces the burden of treatment and care, and the management costs have been educated about added treatment burden, side effects, and costs, as discussed below. The benchmark data for the intervention will be drawn from existing administrative data, total insurance, Medicare and Medicaid claims, patient medical records, patient assessments, total expenditure on heart disease on a monthly basis, heart disease survey data, and electronic clinical data.

How Technology, Care Coordination, and the Utilization of Community Resources can be applied in addressing Heart Disease in the Black American Community

As noted earlier, I will utilize technology to improve communication, coordinate care teams, and improve the utilization of community resources. Besides communication, I will innovatively utilize technology to link patients and the community with peers and available resources for care. With patients’ authorization, I will acquire and track patient health data using health monitoring applications such as mobile health (mHealth) applications. The use of m-Health in interventions among young African-American women has been shown to lead to improved risk reduction with benefits that help overcome common barriers to CVD care (Kathuria-Prakash et al., 2019).

Conclusion

In conclusion, healthcare leadership is an integral part of motivating lifestyle changes, creating and leading collaborative teams, and coordinating care toward combating the impact of heart disease on Black Americans. The application of technology to lifestyle changes as an intervention can improve communication, collaboration, and coordination of care and the utilization of community resources with an impact on risk reduction.

References

Alo, U. R., Nkwo, F. O., Nweke, H. F., Achi, I. I., & Okemiri, H. A. (2021). Non-Pharmaceutical Interventions against COVID-19 Pandemic: Review of Contact Tracing and Social Distancing Technologies, Protocols, Apps, Security and Open Research Directions. Sensors 2022, Vol. 22, Page 280, 22(1), 280. https://doi.org/10.3390/S22010280

American Diabetes Association. (2019). 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2019. Diabetes Care, 42(Supplement_1), S103–S123. https://doi.org/10.2337/DC19-S010

Barghi, A., Torres, H., Kressin, N. R., & McCormick, D. (2019). Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study. Journal of General Internal Medicine, 34(9), 1797. https://doi.org/10.1007/S11606-019-05108-1

Blumenthal, J. A., Hinderliter, A. L., Smith, P. J., Mabe, S., Watkins, L. L., Craighead, L., Ingle, K., Tyson, C., Lin, P. H., Kraus, W. E., Liao, L., & Sherwood, A. (2021). Effects of Lifestyle Modification on Patients with Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial. Circulation, 144, 1212–1226. https://doi.org/10.1161/CIRCULATIONAHA.121.055329

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

Domínguez, D. G., García, D., Martínez, D. A., & Hernandez-Arriaga, B. (2020). Leveraging the power of mutual aid, coalitions, leadership, and advocacy during COVID-19. American Psychologist, 75(7), 909–918. https://doi.org/https://doi.org/10.1037/amp0000693

Franklin, B. A., Myers, J., & Kokkinos, P. (2020). Importance of Lifestyle Modification on Cardiovascular Risk Reduction: COUNSELING STRATEGIES TO MAXIMIZE PATIENT OUTCOMES. Journal of Cardiopulmonary Rehabilitation and Prevention, 40(3), 138–143. https://doi.org/10.1097/HCR.0000000000000496

Haddad, L. M., & Geiger, R. A. (2022). Nursing Ethical Considerations. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Hasson, R., Sallis, J. F., Coleman, N., Kaushal, N., Nocera, V. G., & Keith, N. (2021). COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity. American Journal of Lifestyle Medicine, 16(4), 420–433. https://doi.org/10.1177/15598276211029222

Kathuria-Prakash, N., Moser, D. K., Alshurafa, N., Watson, K., & Eastwood, J. A. (2019). Young African American women’s participation in an m-Health study in cardiovascular risk reduction: Feasibility, benefits, and barriers. European Journal of Cardiovascular Nursing, 18(7), 569–576. https://doi.org/10.1177/1474515119850009

Light, J., McNaughton, D., Beukelman, D., Fager, S. K., Fried-Oken, M., Jakobs, T., & Jakobs, E. (2019). Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs. Augmentative and Alternative Communication, 35(1), 1–12. https://doi.org/10.1080/07434618.2018.1556732

McClellan, M., Brown, N., Califf, R. M., & Warner, J. J. (2019). Call to Action: Urgent Challenges in Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation, 139(9), E44–E54. https://doi.org/10.1161/CIR.0000000000000652

National Heart Lung and Blood. (2021). Study: Blacks in U.S. remain at higher heart disease risk than whites | NHLBI, NIH. Nhlbi.Nih.Gov. https://www.nhlbi.nih.gov/news/2021/study-blacks-us-remain-higher-heart-disease-risk-whites

Robbins, B., & Davidhizar, R. (2020). Transformational leadership in health care today. Health Care Manager, 39(3), 117–121. https://doi.org/10.1097/HCM.0000000000000296

Sriharan, A., Hertelendy, A. J., Banaszak-Holl, J., Fleig-Palmer, M. M., Mitchell, C., Nigam, A., Gutberg, J., Rapp, D. J., & Singer, S. J. (2022). Public Health and Health Sector Crisis Leadership During Pandemics: A Review of the Medical and Business Literature. Medical Care Research and Review : MCRR, 79(4), 475–486. https://doi.org/10.1177/10775587211039201

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

U.S. Department of Health and Human Services. (2022). Heart Disease and African Americans. The Office of Minority Health. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19

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Yıldız, E. (2019). Ethics in nursing: A systematic review of the framework of evidence perspective. Nursing Ethics, 26(4), 1128–1148. https://doi.org/10.1177/0969733017734412

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Develop an intervention (your capstone project) to solve the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution must be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. Write a 5-7 page analysis of your intervention in a separate written deliverable.

Please submit your solution/intervention and the 5-7 page analysis to complete Assessment 4.

Introduction
In your first three assessments, you applied new knowledge and insight gleaned from the literature, organizational data, and direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your problem assessment. You’ve examined the problem from leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now, it’s time to turn your attention to proposing an intervention (your capstone project) to solve the problem.

Preparation
In this assessment, you’ll develop an intervention to solve your defined health problem. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:

Creating an educational brochure.
Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
Creating a teaching plan for your patient, family, or group.
Recommending work process or workflow changes addressing your topic.
Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.

In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete and how it will be assessed.
Conduct sufficient scholarly and professional literature research to inform your work and meet scholarly expectations for supporting evidence.
Note: As you revise your writing, check out the resources on the Writing Center’s Writing Support page.

Instructions
Complete this assessment in two parts: (a) develop an intervention to solve the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.

Part 1
Develop an intervention to solve the problem based on your assessment and supported by data and scholarly, evidence-based sources.

Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:

• Leadership.
• Collaboration.
• Communication.
• Change management.
• Policy.
• Quality of care.
• Patient safety.
• Costs to the system and individual.
• Technology.
• Care coordination.
• Community resources.

Part 2
Submit your proposed intervention to your faculty for review and approval.

Write a 5–7 page analysis of your intervention in a separate written deliverable.

Summarize the patient, family, or population problem.
Explain why you selected this problem as the focus of your project.
Explain why the problem is relevant to your professional practice and to the patient, family, or group.
In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format, length, and supporting evidence.

Define the role of leadership and change management in addressing the problem.
Explain how leadership and change management strategies influenced the development of your proposed intervention.
Explain how nursing ethics informed the development of your proposed intervention.
Include a copy of the intervention/solution/professional product.
Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
Identify the patient, family, or group.
Discuss the benefits of gathering their input to improve care associated with the problem.
Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
Cite the standards and/or policies that guided your work.
Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individuals.
Cite evidence from the literature that supports your conclusions.
Identify relevant and available benchmark data sources on care quality, patient safety, and costs to the system and individual.
Explain how technology, care coordination, and the utilization of community resources can be applied to address the problem.
Cite evidence from the literature that supports your conclusions.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Additional Requirements
Format: Format the written analysis of your intervention using APA style. APA Style Paper Tutorial [DOCX] is provided to help you write and format your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages long, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Portfolio Prompt: Save your intervention to your ePortfolio. After completing your program, you may want to consider leveraging your portfolio as part of a job search or demonstrating your academic and professional competencies.