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Patient, Family, or Population Health Problem Solution

Maureen

Patient, Family, or Population Health Problem Solution

My practicum hours have been spent on a patient, Emily, diagnosed with depression, who was also on hypertension management. In this case, the knowledge of the complex connection between mental health and physical disorders is key. Depression symptoms, which include constant low mood, loss of interest in activities, energy depletion, decision-making difficulties, memory lapses, and changes in appetite, were explained, hence emphasizing the multifaceted nature of the condition.

The selected patient provides a chance to solve cultural competency problems in nursing practice, acknowledging that care should be provided per the cultural backgrounds of patients. Moreover, the analysis shows the importance of a multidisciplinary approach to the treatment of depression, especially when it is associated with other medical diseases like hypertension (Flaubert et al., 2021). Through the combination of the knowledge of various healthcare specialties, a treatment plan that is more complete and effective can be created.

Proposed Intervention for Depression

In my proposed intervention aimed at addressing Emily’s depression, the primary focus is on enhancing the quality of care she receives. By actively involving Emily in decision-making processes and tailoring the intervention to her unique needs and preferences, I will ensure that the care provided is patient-centered. Through the implementation of evidence-based practices such as cognitive-behavioral therapy (CBT) and medication management, I anticipate a significant reduction in Emily’s depressive symptoms, ultimately leading to an improvement in her overall well-being and quality of life. Pinho et al. (2021) indicate that patient-centered care contributes to better treatment outcomes and patient satisfaction.

Regarding patient safety, my intervention prioritizes mitigating the risks associated with untreated mental health conditions. By effectively managing Emily’s depressive symptoms through evidence-based therapies and regular monitoring, I aim to reduce the likelihood of adverse outcomes such as self-harm or hospitalization. Studies by Wiedermann et al., 2023 show that active engagement in care coordination ensures timely identification and management of any safety concerns that may arise, thereby promoting a safe care environment for Emily.

In terms of cost reduction, my intervention strategy focuses on optimizing resource utilization and preventing costly complications associated with untreated depression. By leveraging telehealth services, community resources, and evidence-based practices, I anticipate a decrease in the overall cost of care for Emily. Preventing relapses, reducing hospital readmissions, and empowering Emily to actively participate in her care contribute to cost savings for both her and the healthcare system.

Role of Leadership and Change Management in Addressing Depression

The fundamental element for the successful resolution of this kind of health problem would be a competent leadership and change management system. I intend to embrace the transformational leadership style of giving inspiration, motivation, and involvement, which results in positive outcomes. By creating a common mission that focuses on success and by encouraging team members to collaborate in the implementation of the care program, I will serve patients with consideration of their individual needs.

The change management principles will provide the implementation guidelines for interventions, which will largely be done with a focus on communication, stakeholder engagement, and continuous evaluation. I intend to engage with the critical stakeholders, combat resistance to change and offer continued help and training to ensure that new processes and procedures geared towards improving Emily’s outcome are smoothly adopted.

Ethics in nursing will serve as the foundation for all nursing action plans during the length of the project; the intervention will be performed ethically while respecting the patient’s rights, dignity, and well-being. Adhering to ethical principles like beneficence, non-maleficence, autonomy, and justice, I will ensure that the interventions will bring good to the patient and will be in her best interest (Kuo et al., 2021).

An education brochure on the management of depression involving Emily’s needs is going to be part of the intervention. The brochure will fulfill an important role, providing Emily with the necessary information, advice, and support to help embrace her active role in the management of her mental health and achieve a mutual decision between her and the healthcare team.

Communication and Collaboration Strategies with the Patient to Improve Depression Outcomes

To achieve the best results concerning Emily’s depression and hypertension, I will use several communication and collaboration techniques between Emily, her relatives as well as the healthcare team professionals. My proposal has elements of scheduled moments together and the application of digital means for continuous conversation. First, I will offer weekly face-to-face or telehealth sessions with Emily that will help manage her progress; any concerns/issues will be discussed, and the treatment plan will be altered accordingly. Another critical strategy is the involvement of family members in the care plan. I will have a scheduled meeting with the family monthly for education purposes, which will include her condition, treatment process, and how they can support her. Notably, family engagement may lead to treatment compliance and emotional support, which is necessary for depression self-management (Ong et al., 2021). Through their deployment, I intend to build a nurturing home that reinforces Emily’s abidance by the treatment plan. Besides, support from family has been proven to boost patients’ motivation to participate actively in their treatment, leading to better health outcomes (Ong et al., 2021).

Involving Emily in the process by consulting with a multidisciplinary team of her physicians and mental health professionals is imperative. I will employ a shared care coursework, which is accessible through a secure online website, as an important tool to update the treating team on her treatment progress and any modifications. This process is outlined in several findings demonstrating that shared care directions boost the practitioners’ communication and patient outcomes (Babione et al., 2022). Aligning treatment with several providers will eliminate seams in care and help Emily receive comprehensive and solid care. Furthermore, the medical health team can quickly solve all emerging issues and conveniently amend the care plan using our sustained and clear communication plan, which will ultimately be the best way to improve her health (Boice et al., 2022).

State Board Nursing Practice Standards and Governmental Policies in Guiding Intervention Development

In my proposed intervention for Emily’s depression, I complied with state board nursing practice standards and various organizational and governmental policies, which were my guide as I undertook my decision-making process. These standards guarantee that my intervention falls into my scope of practice and complies with legal and ethical requirements. The State Board of Nursing standards highlight the significance of patient-centered care, evidence-based practice, and interdisciplinary collaboration, which are all fundamental to the intervention plan.

The Nursing Practice Act (NPA) has provided the guidelines within which I will make my decisions, ensuring that all the tasks and functions that I undertake are legally permissible. This principle is of great importance to me since it was a starting point for formulating a plan that incorporates CBT and medication management because this is within the realm of nursing. In addition, Boehning and Haddad (2023) emphasize that maintaining these standards is essential for quality care and patient safety. They contend that such benchmarks must be met to ascertain the effectiveness and safety of the interventions provided.

Organizational policies, such as those from the American Nurses Association (ANA) and The Joint Commission, also informed my approach. These policies advocate for high standards of patient care and the use of best practices in nursing interventions. Additionally, I considered governmental policies like the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA). The ACA expands access to mental health services, supporting the feasibility of my intervention, while HIPAA ensures the confidentiality and security of Emily’s health information.

Studies like Novilla et al.’s (2023) research conclude that these standards and policies improve care quality and patient results. For instance, the ACA has brought mental health closer to the population, resulting in better treatment of disorders such as depression (Tully et al., 2021). Still, some critics point at some flaws, like the complexity and rigidness of the regulations, which can decrease the flexibility that is needed for patient-centered care (Novilla et al., 2023). Nevertheless, these difficulties are manageable, provided the adoption of detailed planning and data-driven strategies.

Through the comparison of care quality, patient safety, and costs, medical providers will have the opportunity to use many sources for data collection, like the hospital data medical archives, reports, and national agencies such as the Centers for Medicare Services, the Agency for Healthcare Research and Quality (AHRQ), and the American Psychological Association.

Improving Quality of Care and Reducing Costs

The theme of the capstone project I have selected is Emily’s depression and hypertension, which will be addressed through a holistic and patient-centered intervention. For her, I will do CBT therapy and consult with her doctors to manage her medication and use technology and community amenities as well. Rendering these different techniques will consume most of my time, and I will dedicate it to monitoring Emily’s progress and adjusting her treatment plan when necessary. Thus, telehealth check-ups and mobile health apps will be necessary to continuously monitor the care provided and offer personalization. The idea is based on studies revealing that an integrative care approach improves patient outcomes (Kusec et al., 2023). One of the key issues that I will keep in mind is patient safety, and by treating Emily’s symptoms in an evidence-based way, I will minimize the risk of creating further complications like the ones that are related to untreated depressed people.

Telehealth and mobile apps will enable ongoing control and quick resolution of any arising challenges. Similarly, by implementing telehealth services and community initiatives, we as medical care providers can lower healthcare costs by reducing the number of necessary in-person visits and hospital readmissions. Giving Emily the power to participate in her treatment and teaching her how to choose value-priced treatment options will be the reason for responsible healthcare usage. As a research-based intervention, it will be designed to provide evidence-based, safe, and low-cost optimal care.

Applying Technology, Care Coordination, and Community Resources in Addressing Depression

To combat Emily’s depression and hypertension, I chose technology, care coordination, and community resources to be the crucial elements of my nursing plan. I shall make use of telehealth services to conduct scheduled virtual check-ups with Emily so that her treatment plan can be monitored and adjusted without her having to attend in-person visits. Telehealth is a great tool for chronic conditions and mental health care management as it expands access to care and allows professionals to intervene promptly (Idris et al., 2024). In addition, I will use a mobile health app that will monitor Emily’s mood, medication adherence, and lifestyle modifications. This software will provide real-time data that I can use to make wise choices when treating her medical condition.

Moreover, developing community resources is another indispensable part of my intervention. I will link Emily with nearby counseling centers and therapy services that can give her continuous emotional support. Such community resources can be helpful for patients as they offer social support and lessen the feeling of isolation, which has been proved by Kuo et al. (2021). Through the incorporation of these resources into Emily’s treatment plan, I seek to build a comprehensive care system that integrates her emotional and cognitive health challenges. This way, Emily gets the treatment that supports her physically and mentally. She needs this type of care because of her comorbid conditions of depression and hypertension.

Care coordination is crucial to make sure that all aspects of Emily’s treatment are unified and competently supervised. I will assume the role of the main coordinator, facilitating communication between Emily’s primary care physician, mental health specialist, and community service providers. These collaborations will be facilitated by a common EHR system that allows all team members to access and update Emily’s care plan in real-time. Recent studies indicate the positive effect of coordinated care on health outcomes by avoiding over-utilization of services, decreasing medical errors, and guaranteeing continuity (Kusec et al., 2023). Through technology and community resource utilization and clear communication between all stakeholders, Emily’s health care will be managed smoothly and integrated.

References

Babione, J., Panjwani, D., Murphy, S., Kelly, J., Van Dyke, J., Santana, M., Kaufman, J., Sargious, P., & Rabi, D. (2022). Alignment of patient‐centredness definitions with real‐life patient and clinician experiences: A qualitative study. Health Expectations, 26(1). https://doi.org/10.1111/hex.13674

Boehning, A. P., & Haddad, L. M. (2023, July 17). Nursing Practice Act. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559012/

Boice, E. N., Berard, D., Gonzalez, J. M., Hernandez, S. I., Knowlton, Z. J., Avital, G., & Snider, E. J. (2022). Development of a modular tissue phantom for evaluating vascular access devices. Bioengineering, 9(7), 319–319. https://doi.org/10.3390/bioengineering9070319

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). Supporting the health and professional well-being of nurses. In www.ncbi.nlm.nih.gov. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573902/

Idris, H., Nugraheni, W. P., Rachmawati, T., Kusnali, A., Yulianti, A., Purwatiningsih, Y., Nuraini, S., Susianti, N., Faisal, D. R., Arifin, H., & Maharani, A. (2024). How is telehealth currently being utilized to help in hypertension management within primary healthcare settings? A scoping review. International Journal of Environmental Research and Public Health, 21(1), 90. https://doi.org/10.3390/ijerph21010090

Kuo, S., Ye, W., de Groot, M., Saha, C., Shubrook, J. H., Hornsby, W. G., Pillay, Y., Mather, K. J., & Herman, W. H. (2021). Cost-effectiveness of community-based depression interventions for rural and urban adults with type 2 diabetes: Projections from program ACTIVE (Adults Coming Together to Increase Vital Exercise) II. Diabetes Care, 44(4), 874–882. https://doi.org/10.2337/dc20-1639

Kusec, A., Murphy, F. C., Peers, P. V., Bennett, R. M., Carmona, E., Aleksandra Korbacz, Lawrence, C., Cameron, E., Bateman, A., Watson, P., Allanson, J., Dutoit, P., & Manly, T. (2023). Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): Results from a randomized controlled pilot feasibility trial for low mood in acquired brain injury. BMC Medicine, 21(1). https://doi.org/10.1186/s12916-023-03128-7

Novilla, M. L. B., Goates, M. C., Leffler, T., Novilla, N. K. B., Wu, C., Dall, A., & Hansen, C. (2023). Integrating social care into healthcare: A review on applying the social determinants of health in clinical settings. International Journal of Environmental  Research and Public Health, 20(19), 6873. https://doi.org/10.3390/ijerph20196873

Ong, H. S., Fernandez, P. A., & Lim, H. K. (2021). Family engagement as part of managing patients with mental illness in primary care. Singapore Medical Journal, 62(5), 213–219. https://doi.org/10.11622/smedj.2021057

Pinho, L. G. de, Lopes, M. J., Correia, T., Sampaio, F., Arco, H. R. do, Mendes, A., Marques, M. do C., & Fonseca, C. (2021). Patient-centered care for patients with depression or anxiety disorder: An integrative review. Journal of Personalized Medicine, 11(8), 776. https://doi.org/10.3390/jpm11080776

Wiedermann, C. J., Barbieri, V., Plagg, B., Marino, P., Piccoliori, G., & Engl, A. (2023). Fortifying the foundations: A comprehensive approach to enhancing mental health support in educational policies amidst crises. Healthcare, 11(10), 1–11. https://doi.org/10.3390/

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Question 

Develop a 2-3 page intervention (your capstone project), as a solution to Emily’s problem which is the depression you’ve defined. In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. 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:

Patient, Family, or Population Health Problem Solution

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:

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