Patient, Family, or Population Problem Solution Essay

Patient, Family, or Population Problem Solution Essay

Patient, Family, or Population Problem Solution  Essay

The focus of this project is Catheter Acquired Urinary Tract Infection (CAUTI) in a community-dwelling elderly patient. The patient is a 72-year-old lady with an indwelling urinary catheter after being diagnosed with urinary retention. In addition, she has diabetes. She was recently hospitalized following a recurring urinary tract infection, despite being enrolled in the hospital’s homecare program aimed at reducing CAUTI prevalence. The CAUTI issue considerably impacts patient safety and quality of care and increases costs for the patient and the healthcare system. However, leadership, collaboration, effective communication, and care coordination between the necessary stakeholders impact the prevalence and management of the issue. This paper aims to analyze the proposed solution for the issue and describe how factors of Leadership, Collaboration, Communication, Change management, Policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources influenced the development of the intervention.

Patient Problem Summary

The patient problem, in this case, is CAUTI. The patient has been having recurrent CAUTI after being diagnosed with urinary retention. The reason for selecting this problem as the focus of the capstone project is because it is a prevalent issue, one of the most prevalent hospital-acquired infections that pose major patient safety issues among patients. In addition, community-dwelling elderly diabetic patients are at a greater risk of infection since diabetic patients’ infections are usually severe and take time. The problem is relevant to my professional practice since it is our role to promote patient safety. Since the infection is a safety issue, it is vital to determine solutions for the problem. The proposed intervention is an educational brochure to educate the patient on proper catheter care and management practices. The intervention will increase the patient’s knowledge of catheter care, thus preventing infections and promoting her quality of life.

Role of Leadership and Change Management in Addressing the Problem

Leadership and change management significantly impacted the development of the proposed solution intervention. The leadership strategies used include developing a clear vision and goals for the interaction with the patient. We developed an agreed-upon goal with the patient, which helped us stay focused and avoid deviations. The goal was to gain knowledge on catheter care, thus preventing recurrent CAUTIs. Additionally, the clear vision and goal promoted participation from the patient’s side since the focus of the intervention was clear.

Furthermore, there was shared decision-making, whereby we collaborated with the patient to get their insights and decide on other interaction issues, including meeting time and what the patient would like to know about catheter care and urinary tract infections. Wehking et al. (2023) note that shared decision-making promotes success by promoting participation. Shared decision-making also encouraged participation, and adherence to the plan, thus promoting the success of the intervention.

Nursing ethics also helped shape the selection and development of the intervention to address the problem. Autonomy and respect for nursing ethical principles were maintained. The patient participated in deciding on the best intervention and agreed to adhere to whatever would be taught, thus maintaining the principle of autonomy. Additionally, involving the patient in all parts of the intervention is a form of respect.

Proposed Communication and Collaboration Strategies

Effective communication and collaboration are vital in improving outcomes associated with the problem. Therefore, communication and collaboration with the patient focus is essential. The communication strategies included using a common and understandable language to the patient and allowing the patient to seek clarification when needed. According to Keutchafo et al. (2020), effective communication with older adults requires simple and clear language. Simple and straightforward language enhances understanding and adherence to the teaching.

The other communication best practice applied in the intervention is visual aids. Glaser et al. (2020) note that visual aids improve communication with elderly patients. Therefore, visual aids enhanced the message taught and improved understanding. The overall benefit of getting the patient’s input in developing an intervention is encouraging participation and adherence, thus improving outcomes.

Nursing Board Practice Standards and Policies’ Impact on the Intervention

The development of the intervention considered the nursing practice standards in the state. The board of nursing in every state has the standards and scope of practice that guide nurses’ work. The intervention was developed in line with the nurse’s scope of practice in the state. Additionally, institutional nursing practice standards for interacting with the patient were followed. For instance, the protocols to reach community-dwelling patients through the homecare section were followed.

The Affordable Care Act (ACA) is a government policy that influenced the development of the intervention. According to Cleveland et al. (2019), the ACA has stipulations that support home healthcare services. In this case, the patient is community-dwelling, and since she is insured, the policy supports her home health service. Policies and nursing standards enhance intervention outcomes since they provide a robust support base for the intervention.

Impact of the Proposed Intervention on Care Quality, Costs, and Patient Safety

The proposed intervention aims to improve care quality, reduce patient and healthcare system costs, and promote patient safety. The patient will be educated on proper catheter handling and management practices to prevent CAUTI. Desirable quality of care meets the patient’s needs, including providing the patient with the necessary education (AHRQ, n.d.). Therefore, educating this patient will improve care quality. In addition, the patient will then be able to prevent CAUTIs, which are costly to treat. Hence, the intervention will reduce the related costs to the patient and the healthcare system. CAUTIs are a major patient safety issue and a common hospital-acquired infection (AHRQ, n.d.). The AHRQ identifies the low prevalence of CAUTIs as a benchmark for quality care. Additionally, Ling et al. (2021) note that CAUTIs increase the costs of care, which mainly falls on the patient and the healthcare system. Thus, helping patients prevent recurrent CAUTIs will enhance their safety, reduce costs, and promote good care quality.

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Technology, Care Coordination, and the Utilization of Community Resources in Addressing the Problem

Technology, care coordination, and community resources can play a significant role in addressing the issue of CAUTIs among community-dwelling elderly patients. Specific healthcare technologies such as telehealth, electronic health records, and patient portals can significantly address the issue. Telehealth minimizes the hustle of visiting the hospital physically. Since the focus patient is in the community, telehealth applications can access follow-up services, such as direction on catheter care, thus preventing infections. In addition, electronic health records can be used to maintain checklists, which can be used to check whether a patient is safe for catheter insertion, thus helping prevent related infections. According to Pérez-Roman (2020), patient portals can also be used to personalize care and provide the necessary information to enable patients to take appropriate care for themselves. Care providers can also access patient information from the portals, identifying the patients whose catheters should be removed, thus preventing infections.

Different care providers are required to work together in coordination to address the CAUTIs issue. These professionals include nurses, physicians, caregivers, infection control nurses, and nurse Informaticists. Care coordination among these professionals can ensure smooth infection control and prevention. In addition, community resources such as community centers and groups can take the initiative to educate community-dwelling patients on catheter care and prevent CAUTIs. The community resources can also provide social and emotional support to patients with recurrent urinary tract infections.

Conclusion

Patient education is the proposed intervention to address the CAUTI issue in the focus patient. The patient will be taught about proper catheter care and management, including the related risk factors. Leadership and management strategies such as shared decision-making greatly influenced the development of the intervention. The communication strategy applied includes the use of simple and clear language. The policies and collaboration strategies identified above also impacted the development of the intervention. In addition, technology care coordination and community resources can be used to address the CAUTIs problem, especially among community-dwelling patients.    

                                              

References

Agency for Healthcare Research and Quality (n.d.). Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide: Technical Interventions To Prevent CAUTI. Accessed 1^st July 2023 from  https://www.ahrq.gov/hai/cauti-tools/guides/implguide-pt3.html

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing the Power of Nurses. Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man02

Glaser, J., Nouri, S., Fernandez, A., Sudore, R. L., Schillinger, D., Klein-Fedyshin, M., & Schenker, Y. (2020). Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review. Medical Decision making: an international journal of the Society for Medical Decision Making, 40(2), 119–143. https://doi.org/10.1177/0272989X19896348

Ling, R., Giles, M., & Searles, A. (2021). Administration of indwelling urinary catheters in four Australian Hospitals: cost-effectiveness analysis of a multifaceted nurse-led intervention. BMC Health Services Research, 21(1), 897. https://doi.org/10.1186/s12913-021-06871-w

Pérez-Roman, E., Alvarado, M., & Barrett, M. (2020). Personalizing healthcare in smart cities. Smart Cities in Application: Healthcare, Policy, and Innovation, 3-18. https://doi.org/10.1007/978-3-030-19396-6_1

Keutchafo, E. L. W., Kerr, J., & Jarvis, M. A. (2020). Evidence of nonverbal communication between nurses and older adults: a scoping review. BMC Nursing, 19, 53. https://doi.org/10.1186/s12912-020-00443-9

Wehking, F., Debrouwere, M., Danner, M., Geiger, F., Buenzen, C., Lewejohann, J. C., & Scheibler, F. (2023). Impact of shared decision making on healthcare in recent literature: a scoping review using a novel taxonomy. Journal of Public Health, 1-12. https://doi.org/10.1007/s10389-023-01962-w

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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.

Please submit both your solution/intervention and the 5–7 page analysis to complete Assessment 4.

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.

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.

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.

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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.

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.

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.

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.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

View Scoring Guide

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