Patient, Family, or Population Health Problem Solution
Asthma is a chronic condition that affects millions worldwide, requiring ongoing management to prevent exacerbations and maintain a high quality of life. The patient in focus is a young male family member diagnosed with asthma, facing seasonal exacerbations that often disrupt his daily activities. Despite adherence to his medication regimen, his symptoms tend to worsen during certain times of the year. Managing asthma effectively requires an integrated approach that involves education, proper medication use, lifestyle modifications, and continuous monitoring. The proposed intervention aims to enhance his understanding of asthma, promote self-management, and improve his long-term health outcomes by addressing key areas like leadership, communication, change management, and policy considerations.
Role of Leadership and Change Management in Addressing the Problem
Successful leadership is critical in the management of health issues, and this is true for asthma. Transformational leadership helped explain to the patient and his family the need for medication adherence and lifestyle modifications. As a nurse, this meant that I should inspire and motivate the patient toward ownership of health, ensuring the benefit of better management of asthma is long-lasting (Seljemo et al., 2020). Subsequently, such motivation transforms patients into taking an active role in their care as recommended in chronic disease management.
Change management strategies, particularly Kotter’s Change Management Model, were applied to motivate the patient toward assuming new behaviors that would alleviate his asthmatic symptoms. According to Kotter’s model, establishing urgency for change among patients is critical to bringing about change (Carman et al., 2019). In this case, past asthma exacerbations, including visits to the emergency room, have been used to help demonstrate the need for the patient to follow his asthma action plan. Another intervention in the change management process was the provision of an enabling environment in which the client and his family felt competent and motivated to make proper decisions about his health. For example, the gradual steps he needed to take in treatment, starting with changes in lifestyle, such as avoiding known allergens, made the process of change more palatable.
Nursing Ethics in the Development of the Intervention
Nursing ethics have a foundational role in the development of patient-centered interventions. In this case, ethical principles of autonomy, beneficence, and non-maleficence were given priority during the intervention’s design. The patient’s autonomy was ensured by informing him about his condition and treatment alternatives, including the essence of compliance with the asthma action plan (Haddad & Geiger, 2023). This was achieved through clear communication, thus enabling the patient to decide upon his care while fully understanding the implications of his non-concordance.
The intervention has also been based on the principle of beneficence, given that its core has been the interest of the patient through the improvement in the quality of his life by being able to self-manage his asthma. It has also concurrently conformed to the principle of non-maleficence, given the assurance that the intervention has indeed minimized risks relative to the medication use errors and, equally, incorrect techniques used for inhalers. Notably, education on proper inhalation and dosing was an important highlight in preventing adverse events. By aligning the intervention with nursing ethics, the patient’s rights and safety were protected, fostering a trusting nurse-patient relationship that is essential for long-term health management.
Communication and Collaboration Strategies
Effective communication and collaboration will make a difference in this patient’s outcome. The intervention that was implemented was a developed structured communication plan that included follow-up on a regular basis with the patient’s healthcare team, which comprised the primary care physician, pulmonologist, and pharmacist. Follow-ups were made so as to continually reassess the patient’s current medication and make necessary adjustments, especially in a timely manner.
Reinforcing the asthma action plan was done in collaboration with the patient and family. The involvement of the patient’s family created a supportive environment in the home by addressing the child’s asthma triggers and medication adherence. With this collaboration, the family can easily identify warning signs early on, which is a prompt response if hospitalization needs to be avoided.
Motivational interviewing was used to communicate with him regarding personal health goals in relation to asthma. This is a best practice in patient-centered care, where it is most useful to enable patients to be involved in their health decision-making process. Hartney (2023) shows that motivational interviewing works by encouraging a sense of ownership and responsibility in patients, leading to improved treatment adherence and health outcomes. Further, collecting data from the patient and the family through intervention assisted in tailoring the education materials. For instance, with knowledge of the family’s concerns regarding the side effects of some drugs, I was directly able to address them and make necessary adjustments to the teaching plan, input that quality care needs to be improved in order to meet all the patient’s needs.
Policy, Nursing Standards, and Organizational Guidelines
State board nursing practice standards and organizational policies mainly guided the proposed intervention. In the management of asthma, the ANA standards of practice emphasize patient education, advocacy, and commitment to the application of evidence-based guidelines. These guided the construction of the asthma education brochure and use of the asthma action plan in treating the patient with asthma, as allowed for best practices for chronic disease management.
In addition, the Affordable Care Act (ACA) also informed the intervention. The ACA increases preventive care services, such as asthma education programs, without financial barriers for the patient. These value-based purchasing policy levers focus on the reduction in hospital readmissions, which aligns with the goal of this intervention—to avoid exacerbation and facilitate improved self-management.
The studies indicate that the asthma education programs, based on nursing standards and organizational policies, benefit the patient in that they lead to an overall improvement in the patient’s status, bringing in positive change in self-management and reduction in hospital emergency use, as suggested by (Rehman et al., 2020). Based on the above policies, interventions should be patient-centered, evidence-based, and responsive to national health priorities.
Improving Quality of Care, Enhancing Patient Safety, and Reducing Costs
The proposed intervention directly enhances the quality of care by providing the patient with the tools and knowledge to manage his asthma. Education about the proper use of medication, avoidance of triggers, and breathing exercises empowers the patient to manage his symptoms better and, hence, reduces the chances of severe exacerbation of the disease. This fits into the quality improvement strategies that focus on preventive care and management of chronic diseases.
Regarding patient safety, the intervention ensures that the patient understands how to use his medications correctly, particularly inhalers and corticosteroids. Poor use of corticosteroid medications can result in poor outcomes, sometimes including respiratory distress or a future readmission to the hospital. The goal of this intervention is to allow the asthma patient to understand the dosage and common side effects of medications and when he has to seek help for safe medication practices.
This intervention indirectly results in savings due to the avoidance of expensive admissions and visits to the emergency departments, a common phenomenon in poorly controlled asthmatic patients. According to Barnes et al. (2016), patients who adhere to closely structured asthma action plans are admitted to hospitals less and have lower healthcare costs. The intervention decreases the economic burden on the patient and also the healthcare system by enhancing the self-management skills of the patient and decreasing exacerbation.
Application of Technology, Care Coordination, and Community Resources
Technology is significant in the management of chronic diseases such as asthma. In this regard, the proposed intervention also relies on a mobile health application the patient can utilize to monitor his symptoms, medication use, and environmental triggers. The app is also to be used to remind the patient when he should take medication and when appointments are due for follow-up so that he may maintain his interest in self-care.
The intervention also includes care coordination as an integral element. Continuous contact with the providers ensures that the patient’s treatment plan is consistently reviewed and updated whenever appropriate. Communication is further enhanced through the use of electronic health records (EHRs), which enable all providers involved in the care and treatment of the patient to have access to his medical history and treatment plan in real-time.
The intervention will also involve community resources, including local asthma support groups and education programs. Such resources extend support to the patient even out of clinical settings through aides in helping him connect with others experiencing similar struggles to deal with his condition. Evidence supports the implementation of interventions at the community level to achieve positive asthma outcomes through social support and continued education (Haldane et al., 2020).
Conclusion
The proposed intervention will make it possible to address the main issues pertaining to asthma management in various ways through education, technological support, care coordination, and linkages to relevant community resources. Leadership, change management, and collaboration guarantee that the patient can take full charge of his health in addition to the professional support from his healthcare team. This is a patient-sensitive approach based on the principles of the nursing profession in light of current nursing ethics, policies, and standards. It enhances expenditure for health care delivery so as to ensure safe and quality care of patients. The intervention is further supported by integration through technology and community resources in an effort to provide the patient with the best chance possible for potential long-term health management.
References
Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). A change-management approach to closing care gaps in a federally qualified health center: A rural Kentucky case study. Preventing Chronic Disease, 16(E105). NCBI. https://doi.org/10.5888/pcd16.180589
Haddad, L. M., & Geiger, R. A. (2023, August 14). Nursing ethical considerations. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/
Haldane, V., Chuah, F. L. H., Srivastava, A., Singh, S. R., Koh, G. C. H., Seng, C. K., & Legido-Quigley, H. (2020). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLoS One, 14(5).
Hartney, E. (2023, November 14). Understanding motivational interviewing. Verywell Mind. https://www.verywellmind.com/what-is-motivational-interviewing-22378
Rehman, N., Morais-Almeida, M., & Wu, A. C. (2020). Asthma across childhood: Improving adherence to asthma management from early childhood to adolescence. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1802-1807.e1. https://doi.org/10.1016/j.jaip.2020.02.011
Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: A cross-sectional Study. BMC Health Services Research, 20(1), 1–8. https://doi.org/10.1186/s12913-020-05671-y
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Question
Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to 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. In a separate written deliverable, write a 5–7 page analysis of your intervention.
Introduction
In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of 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), as a solution to the problem.
Preparation
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
- 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 that you understand the work you will be asked to complete and how it will be assessed.
- Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.
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: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.
Part 1
Develop an intervention, as a solution to 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.
In a separate written deliverable, write a 5–7 page analysis of your intervention.
- 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 and length and for 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 individual.
- Cite evidence from the literature that supports your conclusions.
- Identify relevant and available sources of benchmark data 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 in addressing 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 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.
- Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.
Patient, Family, or Population Health Problem Solution
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
- Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
- Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/
professional product.
- Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/
- Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
- Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
- Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
- Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health 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 guided the development of a proposed intervention.
- Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
- Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
- Competency 8: Integrate professional standards and values into practice.
- Write concisely and directly, using active voice.
- Apply APA formatting to in-text citations and references.
Please submit both your solution/intervention and the 5–7 page analysis to complete Assessment 4.