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Discussion, Nursing, Pages: 1

Cultivating the Advanced Practice Nursing Role through Patient-Centered Care and Population Health

Cultivating the Advanced Practice Nursing Role through Patient-Centered Care and Population Health

Patient-Centered Care in Healthcare Quality

The seminal publication that included patient-centered care (PCC) as a core component of healthcare quality is the National Academy of Medicine’s Closing the Quality Chasm (2001). PCC focuses on respecting and responding to patients’ needs, preferences, and values (Byrne et al., 2020). While both patient-centered care and person-centered care emphasize holistic approaches, PCC is rooted in clinical care delivery, addressing specific health concerns, while person-centered care focuses more broadly on the individual’s lived experience and overall well-being​​: Cultivating the Advanced Practice Nursing Role through Patient-Centered Care and Population Health.

Domains and Updated Definition of PCC

In 1995, Stewart outlined six domains of patient-centered care: exploring the patient’s experience, understanding the whole person, finding common ground, incorporating prevention, enhancing the patient-doctor relationship, and being realistic about resources. Kwame and Petrucka (2021) expanded PCC by emphasizing shared decision-making and therapeutic relationships, aligning closely with nursing’s focus on holistic care and respect for individual patient autonomy.​​

Application of Clinical Reasoning

Clinical reasoning is the systematic process of analyzing and addressing patient needs. I once encountered a patient who presented with symptoms of uncontrolled diabetes. Using Hawkins et al.’s (2018) eight-step framework, I identified abnormal glucose readings, analyzed lifestyle factors, developed hypotheses, prioritized actions, adjusted medications, and provided dietary counseling (Mathew et al., 2023). Evaluating outcomes and reflecting on improvements enhanced care delivery.

Biases and Stereotypes in Nursing

Stereotypes are oversimplified generalizations about a group, while biases are predispositions influencing judgment. Explicit biases are conscious and deliberate, while implicit biases operate unconsciously. Nurses hold an ethical responsibility to challenge biases, as they can perpetuate healthcare inequities. Self-reflection is critical for DNP graduates to identify personal biases, ensuring equitable, patient-centered care and fostering trust​​.

Social Justice and the DNP Role

The American Nurses Association (ANA) defines social justice as the equitable distribution of resources and opportunities. ANA highlights nurses’ responsibility to advocate for policies addressing health disparities. For DNP-prepared nurses, this involves engaging in policy-making to promote inclusivity and access to care ​​(Ernstmeyer & Christman, 2021).

Sustainable Development Goals (SDGs)

The United Nations developed 17 SDGs to address global challenges by 2030. Goal #3, “Good Health and Well-being” (United Nations, 2024)​​​, resonates strongly with my role as a DNP-prepared nurse. Leveraging this role, I aim to promote equitable access to preventive care through community partnerships and education initiatives​​​.

References

Byrne, A.-L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centered care in nursing: An integrative review. PLOS ONE, 15(3). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229923

Ernstmeyer, K., & Christman, E. (2021). Scope of practice. Www.ncbi.nlm.nih.gov; Chippewa Valley Technical College. https://www.ncbi.nlm.nih.gov/books/NBK591808/

Kwame, A., & Petrucka, P. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158), 1–10. https://doi.org/10.1186/s12912-021-00684-2

Mathew, T. K., Tadi, P., & Zubair, M. (2023, April 23). Blood glucose monitoring. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK555976/

United Nations. (2024). Communications materials. United Nations Sustainable Development. https://www.un.org/sustainabledevelopment/news/communications-material/

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Question

Discussion Board Guidelines:

  • The questions from the readings are intended to engage the student and to demonstrate an understanding of the DNP Essentials and how each DNP Essential relates to practice, leadership, and scholarship.
  • You are encouraged to share your worldview from the perspective of a learner-scholar, expert nurse, nurse leader, and/or struggling student in the discussion.
  • Last-minute posts do not demonstrate your best work.
  • Contributions are evaluated on the presentation of a meaningful ‘informed opinion, in which your ideas are supported by literature, and it includes a synthesis of your preparation on the topic, interaction with peers and faculty, and ongoing learning.
  • Substantial posts may include and are not limited to:
    • Posting your ‘take’ on the issue, which is informed by your prep and not a gut reaction.
    • Asking critical thinking questions to the peers and/or faculty.
    • Inviting a collaborative learning experience for the entire group
    • Summarizing a discussion or argument or clarifying a point.
    • Offering alternate interpretations and additional insights.
    • Using at least one reference (i.e., course or outside text/article/resource) to support each posting:
      • Note: A link alone is not a reference. All references must be in APA 7th edition format.

        Cultivating the Advanced Practice Nursing Role through Patient-Centered Care and Population Health

        Cultivating the Advanced Practice Nursing Role through Patient-Centered Care and Population Health

Discussion Board Instructions:

  • The Discussion Board assignment includes all three (3) postings.
    • Initial postings are due by Thursday at midnight (23:59) and the second and third postings must be completed before Sunday by midnight (23:59) of each week.
    • Initial postings should be concise and thorough, in one to two paragraphs per question.
    • Peer Responses should also be concise and offer further insight, ask for clarification, support or challenge a line of reasoning, etc. Length should not exceed one or two paragraphs.
  • Late postings without notice will result in no credit.
  • Failure to post 3 times will result in a grade reduction.
  • As a large part of the final grade, students are expected to participate regularly in Discussion Board assignments.
  • Typically, grading with feedback on discussion boards will be completed within 3 days after the assignment due date.

Discussion Board Prompts:
Please address these prompts in your initial Discussion Board posting:

  1. Which seminal publication included patient-centered care as a core component of healthcare quality? How does patient-centered care differ from person-centered care (PCC)? (CO3, CO4)
  2. Discuss the six domains of patient-centered care as established by Stewart in 1995. How did the updated definition of patient-centered care by Levinson, Lesser, and Epstein in 2010 compare to nursing’s definition of patient-centered care? (CO3)
  3. Define clinical reasoning. Reflect on a patient care scenario in which you applied clinical reasoning. While maintaining patient anonymity, use the eight-step process developed by Hawkins et al. (2018) to illustrate your application of each step of the clinical reasoning process. (CO1,CO3)
  4. Define stereotypes, explicit biases, and implicit biases. How are biases different from stereotypes? What is the nurse’s ethical responsibility concerning biases and stereotypes, and why is self-reflection essential to a DNP graduate’s ability to address healthcare inequities? (CO2, CO2)
  5. According to the American Nurses Association (ANA, 2021), what is social justice? How does the ANA view the relationship between nursing and social justice? How does this relationship shape the DNP-prepared nurse’s responsibility regarding policy development?(CO2, CO3, CO4)
  6. Summarize the background of the 17 Sustainable Development Goals (SDGs) identified for 2030. Which organization is credited with developing the SDGs? View the 17 SDGs (available at https://www.un.org/sustainabledevelopment/news/communications-material/). Choose one SDG that resonates with you. As a DNP-prepared nurse, how will you leverage your professional position to support the achievement of the selected SDG? (CO2, CO4)

Textbook:

  • Schadewald, D.M. (2024). Zaccagnini & White’s core competencies for advanced practice nursing: A guide for DNPs. Jones Bartlett Learning. ISBN-13: 978-1284288391 ISBN-10: 1284288390
  • Module 3 Resources