Assessing the Problem- Leadership, Collaboration, Communication, Change Management, and Policy Considerations
Part 1
Problem Summary
Alzheimer’s disease (AD) is the problem of concern for this capstone project. The disease is incurable and progressive. It affects an individual’s thought process, language, and ability to recall. Poorly managed AD progresses to the severe form and impedes a person’s ability to execute activities of daily living. ALZ.org (n.d.) reports that AD accounts for about sixty to eighty percent of cases of dementia. Additionally, ALZ.org (n.d.) reports that AD is common among those aged above sixty-five years. However, it should not be characterized by the aging process. Hire our assignment writing services in case your assignment is devastating you.
Patient Identification
The patient is a seventy-four-year-old Hispanic American with AD. She is accompanied by her spouse and two children. According to her family, the patient was diagnosed with AD five years ago. They report that she has struggled with medication adherence for the past five years. Currently, she presents with muscle twitches, confusion, and vocalization of repetitive statements. Further evaluation reveals that the patient experiences difficulty recognizing her children. Her spouse reports that the patient has demonstrated anterograde amnesia over the past two months. Her thought process and impulse control are preserved. As such, the patient is likely to have moderate Alzheimer’s disease.
Context Data
As earlier mentioned, ALZ.org (n.d.) reports that AD accounts for about sixty to eighty percent of cases of dementia. More than five million Americans live with the disease (CDC.gov, 2020). Estimates reveal that the prevalence of AD will triple to more than 14 million cases by 2060 (CDC.gov, 2020). The disease is not a common characteristic of the aging process. However, the risk of getting the disease increases with age. According to CDC.gov (2020), the prevalence of AD among people aged above sixty-five years doubles every five years. AD is the fifth etiology of death among Americans aged sixty-five years and above (CDC.gov, 2020). It has an ethnic predilection. It has the highest prevalence among African Americans (about fourteen percent) than Hispanic whites (about twelve percent) and non-Hispanic whites (about ten percent) (CDC.gov, 2020). The disease has a significant economic impact. CDC.gov (2020) reports that the annual cost of managing AD ranges from about $160 billion to more than $200 billion.
Uncontrolled AD is associated with poor outcomes. Firstly, it worsens the prognosis of the disease and hastens the progress from mild to severe form of the disease. Secondly, it predisposes patients to various mental health problems such as depression, paranoia, and anxiety (Mok et al., 2020). Thirdly, it impedes patients’ ability to complete their activities of daily living, such as feeding and bathing (Mok et al., 2020). Fourthly, it predisposes patients to complications such as pressure ulcers and pneumonia (Mok et al., 2020).
Relevance to a Baccalaureate-Prepared Nurse
Nurses are important stakeholders in the management of AD. They perform various roles such as patient and family education, screening of patients, formulation of nursing care plans, and administration of medication. Patient education focuses on the importance of adherence to the treatment plan and when to seek medical advice. Screening facilitates the diagnosis and staging of AD. Nursing training cultivates a holistic care approach among learners. This enables them to develop patient-centered care plans and administer medication safely. By so doing, they optimize the management of AD and improve patient outcomes.
Peer-Reviewed Literature
Alzheimer’s disease is an incurable disease that requires perpetual patient follow-up. To optimize patient management, nurses perform various roles. Firstly, they conduct patient and family education. In this context, they emphasize adherence to the treatment plan, identifying potential adverse effects, mitigation of these effects, and when to seek urgent medical care (Hope, 2020). Secondly, nurses are involved in patient screening. As a result, they facilitate the diagnosis and staging of AD. This is important because it forms the basis for developing patient-centered care plans. Thirdly, they are involved in safe medication administration. This applies to patients admitted to the hospital and outpatients. Safe medication administration is also associated with optimal patient outcomes and a good prognosis (Hope, 2020). The evidence is harmonious with findings from my current practice. To determine the credibility of the data, I evaluated the currency (published within the past five years), the purpose of the articles, and the authority of the authors.
Various factors impede the implementation of evidence-based strategies to manage AD. Organizational issues such as inappropriate resource allocation impede evidence-based practice (Pitsillidou et al., 2021). Resources should be allocated to recruit more nurses to overcome shortages and to facilitate the training of nurses and other healthcare providers. This facilitates screening patient education, and the safe administration of medication. An organizational culture of lack of motivation and teamwork impedes the implementation of evidence-based practices (Pitsillidou et al., 2021). Motivation ensures or boosts the productivity of nurses, whereas teamwork promotes information sharing.
Nursing standards that impact nursing practice and management of AD can be categorized into three: professional, performance, and practice. Professional standards entail aspects such as diagnosis, formulation of interventions, and patient evaluation (MO.gov, n.d.). These standards are relevant to AD because they enable nurses to perform accurate diagnoses and develop individualized care plans. Performance standards entail aspects such as quality assurance and patient care. These standards enable nurses to provide quality healthcare to patients with AD (MO.gov, n.d.). Lastly, practice guidelines enable nurses to adopt specific protocols when caring for patients with AD (MO.gov, n.d.).
Nurses participate in policy-making by collaborating with other stakeholders. For instance, they can work with elected leaders to sponsor bills that advocate for the safety and well-being of people with AD. Also, nurses collaborate with members of the interdisciplinary team at workplace committees to formulate organizational policies and protocols. Policies that advocate for quality care, cost-effectiveness, and patient safety benefit people with AD.
Abdellah’s 21 Nursing Problems Theory applies to my practicum. The theory explores the competencies and skills that enable a nurse to provide holistic care (Nursingtheory.org, n.d.). The theory identifies patients’ physical, social, and emotional needs that nurses should address (Nursingtheory.org, n.d.). Also, it explores interpersonal relationships that create a therapeutic relationship. The theory promotes patient-centeredness and holistic care.
Standards and Policies
The American Nurses Association provides standards that guide the practice of nurses. These standards impact the care of patients with AD. As earlier stated, the standards have three major themes. Firstly, professional standards entail diagnosis, formulation of interventions, and patient evaluation (MO.gov, n.d.). As such, these standards enable nurses to make accurate diagnoses and develop individualized care plans. Secondly, performance standards entail quality assurance and patient care (MO.gov, n.d.). They will enable nurses to provide quality healthcare to patients with AD. Thirdly, practice guidelines enable nurses to adopt specific protocols when caring for patients with AD (MO.gov, n.d.). As such, the three themes promote quality healthcare and improve patient outcomes.
As earlier stated, nurses participate in policy-making by collaborating with other stakeholders. For instance, they can work with elected leaders to sponsor bills that advocate for the safety of well-being of people with AD. Also, nurses collaborate with members of the interdisciplinary team at workplace committees to formulate organizational policies and protocols. Policies that advocate for quality care, cost-effectiveness, and patient safety benefit people with AD.
The National Alzheimer’s Project Act aims to address AD and other dementias. The act advocates for resource allocation to promote research and care for patients with AD (HHS.gov, n.d.). The ultimate goal of the act is to reduce the economic impact of AD on patients and their families (HHS.gov, n.d.). As a nurse, I should provide patient-centered care to improve patient outcomes, reduce hospitalizations, and reduce healthcare costs.
Leadership Strategies
Nurses should embrace various leadership strategies to improve the quality of healthcare services and patient experience. Open communication will enable them to share their vision and goals (Uzarski & Broome, 2019). Subsequently, this promotes patient and family engagement and optimizes interdisciplinary collaboration. Secondly, nurse leaders should delegate tasks appropriately and motivate other nurses and other members of the interdisciplinary team (Uzarski & Broome, 2019). The delegation will enable them to achieve care coordination and promote teamwork.
Collaboration and communication will be accomplished via therapeutic communication, performance evaluation, and feedback delivery, formulating elaborate goals, and identifying organizational mission and vision. Change management strategies include planning, communication, training sessions, evaluations, and formulating a road map (Uzarski & Broome, 2019). The nursing leadership should delegate effectively, embrace open communication, and advocate for interdisciplinary collaboration in patient management.
Part 2
The patient is a seventy-four-year-old Hispanic American with AD. Her spouse and two children accompany her. According to her family, the patient was diagnosed with AD five years ago. They report that she has struggled with medication adherence for the past five years. Currently, she presents with muscle twitches, confusion, and vocalization of repetitive statements. Additional evaluation reveals that the patient experiences difficulty recognizing her children. The patient’s spouse reports that the patient has demonstrated anterograde amnesia over the past two months. Her thought process and impulse control are preserved. As such, the patient is likely to have moderate Alzheimer’s disease.
I spent four hours with the patient and her family. We explored various aspects of the management of AD. Notably, I educated the patient and her family on the relevance of medication adherence and the prognosis of the disease. We agreed that the family would be actively involved in patient management.
References
ALZ.org. (n.d.). What is Alzheimer’s Disease? https://www.alz.org/alzheimers-dementia/what-is-alzheimers
CDC.gov. (2020). Alzheimer’s Disease and Related Dementias. https://www.cdc.gov/aging/aginginfo/alzheimers.htm
HHS.gov. (n.d.). NAPA – National Alzheimer’s Project Act. https://aspe.hhs.gov/collaborations-committees-advisory-groups/napa#:~:text=The%20National%20Alzheimer’s%20Project%20Act,dementias%20(AD%2FADRD).
Hope, K. (2020). Role of nurses in addressing modifiable risk factors for early Alzheimer’s disease and mild cognitive impairment. British Journal of Nursing, 2020, Vol 29, No 8. http://org/licenses/kevin.hope@stir.ac.ukby-nc/4.0/
MO.gov. (n.d.). Standards of Nursing Practice. https://health.mo.gov/living/lpha/phnursing/standards.php.
Nursing-Theory.org. (n.d.). 21 Nursing Problems by Faye Abdellah. https://nursing-theory.org/theories-and-models/abdellah-twenty-one-nursing-problems.php
Mok, V. C. T., Pendlebury, S., Wong, A., Alladi, S., Au, L., Bath, P. M., Biessels, G. J., Chen, C., Cordonnier, C., Dichgans, M., Dominguez, J., Gorelick, P. B., Kim, S. Y., Kwok, T., Greenberg, S. M., Jia, J., Kalaria, R., Kivipelto, M., Naegandran, K., Scheltens, P. (2020). Tackling challenges in care of Alzheimer’s disease and other dementias amid the COVID-19 pandemic, now and in the future. Alzheimer’s and Dementia, 16(11), 1571–1581. https://doi.org/10.1002/alz.12143
Pitsillidou, M., Roupa, Z., Farmakas, A., & Noula, M. (2021). Factors Affecting the Application and Implementation of Evidence-based Practice in Nursing. Acta Informatica Medica, 29(4), 281–287. https://doi.org/10.5455/aim.2021.29.281-287
Uzarski, D., & Broome, M. E. (2019). A Leadership Framework for Implementation of an Organization’s Strategic Plan. Journal of Professional Nursing, 35(1), 12–17. https://doi.org/10.1016/
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Question 
In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Assessing the Problem- Leadership, Collaboration, Communication, Change Management, and Policy Considerations
Introduction
Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.
Too often, change agents jump to the conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make a case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.
This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:
Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
Preparation
In this assessment, you’ll assess the health problems of the patient, family, or population that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with the subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).
To prepare for the assessment, complete the following:
Identify the patient, family, or group you want to work with during your practicum. The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific healthcare problem.
Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.
In addition, you may wish to complete the following:
Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
Review the Practicum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts.
Part 1
Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.
Part 2
Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. The hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Capella Academic Portal
Complete the NURS-FPX4900 Volunteer Experience Form in the Capella Academic Portal. Include a description of your relationship to the patient, family, or group in the Volunteer Experience comments field.
Requirements
The assessment requirements outlined below correspond to the scoring guide criteria, 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 and length and for supporting evidence.
Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy-making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy-making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.
Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting 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 in length, 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.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define a patient, family, or population health problem that’s relevant to personal and professional practice.
Competency 2: Make clinical and operational decisions based on the best available evidence.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.
Competency 7: Implement patient-centered care to improve the quality of care and the patient experience.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Competency 8: Integrate professional standards and values into practice.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.