Leadership, Collaboration, Communication, Change Management, and Policy Considerations for a Population Health Problem
The pursuit of healthier communities remains an agenda for most global healthcare systems and governments. Care organizations and caregivers play a critical role in this regard. Their role includes but is not limited to identifying high-risk communities and implementing health promotion plans for these communities. The dynamicity of the healthcare landscape sometimes presents management challenges. Lately, the global healthcare landscape has witnessed multiple shocks in its operationalization. The emergence of infectious diseases, antimicrobial resistance, and the growing prevalence of non-communicable diseases are some global population health issues that healthcare systems are grappling with. This paper details antimicrobial resistance as a population health problem with an emphasis on leadership, collaboration, communication, change management, and policy considerations.
Antibiotic Resistance
Antibiotics have highlighted global healthcare provision and disease management since their advent. Antibiotic resistance and recognition of issues surrounding antibiotics have been present since their introduction in the clinical management of infectious diseases. It is slowly gaining recognition as one of the global health concerns. WHO asserts that antibiotic resistance is steadily rising to critically high levels across the globe as new resistance mechanisms continue to emerge and spread. This threatens the effectiveness of infectious disease management. In the U.S. alone, more than 2.8 million cases of antibiotic resistance are documented yearly. Additionally, over 35,000 Americans die every year from antibiotic-resistant strains (Dadgostar, 2019). These grime statistics highlight the need to address this population health issue.
Past global efforts to combat this threat focused on developing newer agents through research and innovations to overcome emerging patterns of bacterial resistance. Dadgostar (2019)asserts that the recently witnessed growth in the prevalence of vancomycin-resistant enterococci and methicillin-resistant strains of Staphylococcus aureus pointed to the limitless patterns of bacterial resistance mechanisms casting the burden of addressing antibiotic resistance on antimicrobial stewardship. Medical professionals and communities need to work concertedly to combat this risk. This practicum intends to work with healthcare providers and patients at high risk of being infected with antibiotic-resistant strains of bacteria, such as hospitalized patients, toward antibiotic stewardship.
The fight against antibiotic resistance draws caregivers from different cadres and communities. Nurses being integral to multidisciplinary healthcare teams is valuable in this regard. This is because they can leverage their knowledge and position in healthcare to effect positive changes that promote antibiotic stewardship. Baccalaureate nursing equips nurses with the prerequisite skills in nursing leadership and collaborative skills necessary to effect positive healthcare changes. This is pivotal in health promotion campaigns that seek to create better antibiotic stewards.
Analysis of a Peer-Reviewed Article on Nursing Role in Antibiotic Stewardship
Nurses play a vital role in antibiotic stewardship. Kirby et al. (2020) assert the criticality of nurses in antibiotic stewardship. The heavy involvement of nurses in infectious disease management, including their roles in prescribing, administering, and preparing antibiotics, makes them invaluable in antibiotic stewardship. They, therefore, play a role in optimizing antibiotic use and encouraging the rational use of these agents. Nurse-centered antimicrobial stewardship has also been perceived as an extension of nursing advocacy, fundamental for all baccalaureate-trained nurses. The author provides sufficient evidence that highlights nursing roles in antibiotic stewardship. These findings are also consistent with the functionalities of a nurse in the contemporary nursing practice field. Nurses are central in infectious disease management and, therefore, bear greater accountability for how antibiotics are used by their patients.
The reliability of this data can be assessed based on the currency, relevance, authority, accuracy, and purpose criteria. The information obtained from this source is current and accurate as it draws its findings and conclusions from scientific research and peer-reviewed evidence. These findings are also relevant as they detail the intrinsic role of nurses in antibiotic stewardship. The author of the article also states the reason this study exists and how it influences nursing practice, highlighting its purpose. This source thus meets the reliability criteria.
Several barriers, however, impede nurses’ efficiency in antibiotic stewardship. McEwen & Burnett (2019) report the inadequacy of some undergraduate nursing training programs in educating learners on antibiotic stewardship. This may lower nurses’ efficiency and accountability in the judicious administration of antibiotics. Resistance to current alteration and modification of prescribing and administration practices of antibiotics has also been implicated in antibiotic resistance. This jeopardizes current efforts to ensure sound antibiotic use. Other barriers to antibiotic resistance that have been identified are limited diagnostic capabilities in healthcare systems across low- and middle-income countries, limited availability of antibiotics, and the high cost of some antibiotics that restrict their access.
Nursing standards of professional practice give specific emphasis on antibiotic stewardship. These standards maintain effectiveness in improving patient and community outcomes by lessening antibiotic resistance (Wiley & Villamizar, 2019). Antibiotic stewardship has long been perceived as an extension of nursing advocacy and educator roles. As health advocates, nurses remain accountable for the judicious use of antibiotics as a measure for ensuring healthy communities. As health educators, nurses play a role in educating their patients on the rational use of antibiotics. This is part of their collective and fundamental responsibilities to ensure safe communities and promote their health.
Nurses also play a critical role in policy-making targeting to lessen antibiotic resistance. Hajizadeh et al. (2021) assert that nurses can leverage their advocacy skills to influence policies that result in positive changes in healthcare. In this regard, nurses can voice for healthcare changes that promote leadership support, caregivers’ accountability, healthcare reporting, and tracking, which are critical for antibiotic stewardship.
Nursing theories are the basis on which nursing practices are grounded. Engagement with transcultural and diverse groups will be key during this practicum. The theory of trans-cultural caring postulates the need for nurses to understand diversity in healthcare and how to engage with different groups. Going to this practicum, the provision of this theory will equip nurses with the prerequisite skills required to engage diverse groups and how they can align their care approaches to the cultural considerations of these groups.
How State Board Nursing Practice Standards and Organizational or Governmental Policies Could Affect Antibiotic Resistance
Nursing standards of practice define the scope of nursing practice. It outlines the responsibilities of professional nurses. The American Nursing Association, various state legislatures, and the Department of Human and Health Services (HHS) emphasize the significance of nurses’ accountability and responsibility towards their patients. Through their advocacy roles, nurses maintain accountability for antimicrobial stewardship by ensuring the judicious use of antibiotics. Wiley & Villamizar (2019) note the effectiveness of nursing standards in antimicrobial stewardship. Through nursing advocacy roles, they can participate in policy-making processes that ensure sound prescribing of antibiotics and maintain their commitment to the prudent use of these agents.
Nursing roles in policy-making and commitment to voicing patient concerns warrant their sustained involvement in policy-making processes. Wiley & Villamizar (2019) emphasize the overall collective mandate of nurses to engage other stakeholders in voicing a specific point of concern. Through intense lobbying and engagement, nurses can successfully oversee the establishment of policies on antibiotic stewardship. These policies can help promote and preserve community lives against resistant strains of bacteria, reduce hospital readmissions, and generally improve outcomes.
Federal policies have also been vital in the fight against antibiotic resistance. The Center for Medicaid and Medicare Services has developed regulations requiring care organizations within the U.S. to develop and implement antibiotic stewardship programs. Under these regulations, all care organizations are required to establish infection prevention and stewardship programs to receive reimbursements from CMS. State and federal policies on antibiotic stewardship also implore caregivers to utilize their knowledge to educate communities on rational antibiotic use. They are also expected to indulge in sound prescribing to promote the prudent use of these agents. In this regard, nurses must maintain accountability when preparing, administering, and prescribing antibiotics.
Leadership Strategies to Improve Outcomes, Patient-Centered Care, and the Patient Experience Related to Antibiotic Resistance
Effective leadership underpins all successful change strategies in healthcare. In the pursuit to lessen antibiotic resistance, healthcare leadership plays an important role. (Akinboyo & Gerber, 2020) reports that leadership commitment to antibiotic stewardship informs the success of all stewardship programs within care organizations. Healthcare leadership, in this regard, plays a role in inspiring their subjects to embrace aspects of antibiotic stewardship. They also inform them of the core elements of antibiotic stewardship, including but not limited to accountability, reporting, tracking, and education. Healthcare leadership also guides healthcare changes that ensure better accountability of caregivers towards embracing best practices in prescribing antibiotic medications.
Healthcare collaborations are integral to antibiotic stewardship. Collaborative stewardship highlights the collective responsibilities of caregivers in implementing measures to lower the likelihood of antibiotic resistance. Collaborative and communication strategies such as clarity in communication, transparency, respect among team members, information sharing, role interdependence, and cooperation may maximize the benefits of this team’s approach to stewardship (Palavecino et al., 2020). Thus, all caregivers involved in antibiotic handling should know these strategies.
Healthcare leadership can utilize several change management strategies to oversee meaningful changes that promote antibiotic stewardship. Effective communication, the creation of a roadmap for any intended change processes, the selection of a change model to be utilized, and the invitation of organizational input on various change processes may considerably enhance the adoption of change processes within an organization. Healthcare leaders should thus be well conversant with these change strategies to ensure the successful implementation of various change processes.
Antibiotic resistance remains a global health concern. It is one of the impediments to the pursuit of healthy communities. Healthcare providers play a role in lessening the hazardous effects of this emerging threat to communities. Through antibiotic stewardship, they can stand to be counted in the fight against antibiotic resistance. Federal and state involvement in this fight has also been evident in policies that promote antibiotic stewardship. A concerted effort from caregivers, communities, and governments is necessary to enhance antibiotic stewardship programs’ success.
References
Akinboyo, I. C., & Gerber, J. S. (2020). Principles, policy, and practice of antibiotic stewardship. Seminars in Perinatology, 44(8), 151324. https://doi.org/10.1016/j.semperi.2020.151324
Dadgostar, P. (2019). Antimicrobial resistance: Implications and costs. Infection and Drug Resistance, Volume 12, 3903–3910. https://doi.org/10.2147/idr.s234610
Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00648-6
Kirby, E., Broom, A., Overton, K., Kenny, K., Post, J. J., & Broom, J. (2020). Reconsidering the nursing role in antimicrobial stewardship: A multisite qualitative interview study. BMJ Open, 10(10). https://doi.org/10.1136/bmjopen-2020-042321
McEwen, J., & Burnett, E. (2019). Antimicrobial stewardship and pre-registration student nurses: Evaluation of teaching. Journal of Infection Prevention, 19(2), 80–86. https://doi.org/10.1177/1757177417726156
Palavecino, E. L., Williamson, J. C., & Ohl, C. A. (2020). Collaborative Antimicrobial Stewardship. Infectious Disease Clinics of North America, 34(1), 51–65. https://doi.org/10.1016/j.idc.2019.10.006
Wiley, K. C., & Villamizar, H. J. (2018). Antibiotic resistance policy and the stewardship role of the nurse. Policy, Politics, & Nursing Practice, 20(1), 8–17. https://doi.org/10.1177/1527154418819251
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Assessment 1 Instructions: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations
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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.
Human Services- From Humanitarian to Human Services Professional Practitioner
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 group 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.
The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.
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 group 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 upon 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 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 group 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.