Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Essay

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Essay

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Essay

Assessment of the Patient Problem

Nurses hold immense value in the healthcare system as they contribute to preventing and treating illnesses. They go beyond providing primary care by actively involving themselves in identifying problems, developing plans, and implementing strategies that help improve patient outcomes and organizational efficiency (Weston, 2022). These dedicated professionals act as powerful change agents by recognizing patient issues, thoroughly assessing their needs, and using evidence-based interventions to address them effectively. Their actions can include direct patient care or initiating policy changes focused on specific aspects of patient management. By utilizing their clinical expertise, sharpened critical thinking skills, and deep understanding of research-supported practices, nurses significantly enhance individual health results and overall healthcare institution effectiveness. This paper will examine the issue of CAUTIs and their consequences through the lenses of leadership, collaboration, communication, change management, and policy.

Definition of the Patient Problem

Summary of the Problem

Catheter-Associated Urinary Tract Infections are not only prevalent but also a highly concerning issue within healthcare. According to Werneburg (2022), CAUTI is the prevailing healthcare-associated infection and the leading contributor to secondary bloodstream infections. The effects of CAUTIs reach far beyond the obvious, seriously jeopardizing patient safety and general well-being. This global problem gets patients in various healthcare settings, from hospitals to long-term care facilities and home care (Werneburg, 2022). CAUTIs occur from urinary catheters – medical devices utilized for many conditions – becoming an unwanted breeding ground for infection. The consequences of such infections should not be underestimated. They can cause severe complications requiring extended hospital stays, resulting in exorbitant healthcare expenditures and, sadly, even mortality. Although CAUTI is possible for anyone using a urinary catheter, it is more concerning for those needing indwelling catheters because of urine retention or incontinence. Among those most susceptible are elderly adults with comorbidities and immune systems compromised by age-related factors. Therefore, CAUTIs pose a severe threat to patients’ lives, and there is a need for urgency in their prevention.

The Patient Problem

During my practicum, I worked closely with Moureen, a 72-year-old adult living in the community who has been diagnosed with urinary retention. Due to her medical condition, Moureen requires a catheter to be inserted and left in place. However, her situation is further complicated by her diabetes which increases the likelihood of complications. Moureen has previously experienced recurring urinary tract infections acquired through the catheter, leading to multiple hospitalizations. To address this ongoing problem and minimize the occurrence of UTIs obtained via the catheter, Moureen has been enrolled in a homecare program provided by the hospital. This program aims to deliver support and care within Moureen’s residence to decrease infection risk. Given Moureen’s history and the challenges associated with managing an indwelling catheter for someone like her, it becomes clear that an all-inclusive approach is necessary. The project will primarily target the reduction of catheter-associated urinary tract infections and their subsequent complications to enhance Moureen’s overall quality of life.

CAUTIs impose a significant weight on patients and the healthcare system. These infections can give rise to different complications and compromise the quality of life for patients. It is approximated that CAUTIs make up a substantial portion of healthcare-associated infections, leading to elevated levels of illness, death rates, and medical expenses (Dadi et al., 2021). Individuals like Moureen who have an ongoing catheter are especially susceptible to CAUTIs. These infections can result in recurring hospitalizations, extended treatment periods, and the possibility of developing resistance to antibiotics. Effectively managing CAUTIs carries considerable financial implications as healthcare resources must be allocated to treating and preventing these infections (Slawomirski & Klazinga, 2022). Reducing the occurrence of CAUTIs and their complications is essential for improving patient outcomes and maximizing healthcare resources. Practical strategies to prevent CAUTIs can improve patient safety, lower healthcare expenses, and enhance patients’ overall quality of life, like Moureen. The significance of addressing the issue of CAUTIs goes beyond individual cases; it supports broader healthcare objectives such as infection prevention and quality improvement. Through leadership, collaboration, communication, change management, and policy considerations, we can develop comprehensive approaches to tackle this problem effectively.

Why is the Problem Relevant to My Practice as a Baccalaureate-Prepared Nurse?

As a nurse with a baccalaureate degree, the issue of CAUTIs is exceptionally pertinent to my practice. I am prepared to handle the difficulties of CAUTIs because of my expertise and abilities in managing patients with complex diseases. Patients who suffer from CAUTIs bear a heavy burden that increases morbidity, lengthens hospital stays, and raises healthcare expenses (Werneburg, 2022). I play a crucial role as a nurse in encouraging appropriate catheter care, implementing evidence-based infection prevention strategies, and keeping an eye out for early indications of infection in patients. I may help to lower the occurrence of CAUTIs and enhance patient outcomes by adopting a proactive stance and working with interdisciplinary teams that include doctors, infection control specialists, and nurse educators. Additionally, I can support guidelines and policies that put patient safety first and encourage an infection prevention culture thanks to my proficiency in leadership, communication, and change management. Through these initiatives, I can significantly influence patient care, raise the standard of healthcare delivery, and ultimately raise the general well-being of those whom CAUTIs impact.

Evidence of the Nursing Actions Related to the Patient

Barriers to the Implementation of Evidence-Based Practice in Addressing the Problem

Nursing interventions aimed at preventing, detecting early, and effectively managing catheter-associated urinary tract infections are demonstrated by the actions taken. Nurses play a vital role in ensuring proper insertion and maintenance of catheters, employing sterile techniques during catheter care, and regularly assessing patients for signs of infection (Alex et al., 2022). Additionally, they educate patients and their families on the significance of maintaining hygiene practices, adequate fluid intake, and the potential risks associated with using a catheter. Nurses collaborate closely with healthcare teams to create evidence-based protocols that minimize the unnecessary use or removal of catheters while implementing alternative strategies for urinary management when appropriate (Alex et al., 2022). By utilizing their clinical expertise and patient-centered care approaches, nurses significantly reduce CAUTI rates, improving patient outcomes and enhancing the quality of life among those with an elevated risk.

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However, despite the substantiating evidence for these nursing actions, there are hurdles to incorporating evidence-based practices in tackling the issue of CAUTIs. One significant obstacle is healthcare professionals’ lack of awareness and adherence to evidence-based guidelines. The resistance to change and reliance on outdated methods can hinder the adoption of recommended strategies for preventing CAUTIs (Parker et al., 2020). Moreover, limited resources like insufficient staff, time constraints, and the absence of necessary equipment can impede the consistent implementation of evidence-based interventions. Insufficient education and training on infection prevention and catheter management might contribute to inconsistent practices leading to suboptimal outcomes. Additionally, an organizational culture that includes hierarchical structures and communication difficulties may act as barriers hindering effective collaboration and interdisciplinary teamwork needed for successful initiatives to mitigate CAUTI occurrences (Clayton, 2019). Acknowledging and tackling these obstacles is essential in promoting the adoption of evidence-based nursing interventions and enhancing outcomes associated with CAUTIs.

Nursing Standards and Policies’ Effectiveness in Improving Population Outcomes for the Issue:

Nursing standards and policies are of utmost importance to improve population outcomes concerning the highlighted patient problem of CAUTIs. According to Connor et al. (2023), adherence to evidence-based standards and regulations guarantees standardized and consistent care practices, enhancing patient safety and lowering the prevalence of infections. Nursing standards emphasize infection prevention measures as they direct healthcare personnel to apply the best catheter insertion, maintenance, and removal practices. Early detection, prompt interventions, and attempts for quality improvement are made possible by policies relating to the surveillance, reporting, and monitoring of CAUTIs. Healthcare organizations may create a safety culture and foster accountability among nursing staff by adhering to these standards and regulations, ultimately enhancing population outcomes and lowering rates of CAUTIs.

The Role of Nurses in Policy Making to Improve Outcomes, Prevent Illnesses, and Reduce Hospital Readmissions:

Nurses play a crucial role in improving patient outcomes, preventing illnesses, and reducing hospital readmissions through their involvement in policy development. As frontline healthcare providers, nurses possess valuable insights and firsthand experience that allow them to advocate effectively for evidence-based practices and patient-centered approaches (Dang et al., 2021). By actively participating in policy-making processes, nurses can ensure that patients’ perspectives are considered and contribute to implementing effective interventions. Additionally, they can promote interdisciplinary collaboration and facilitate dissemination of best practices throughout healthcare systems. Through their expertise, advocacy efforts, and leadership skills, nurses have the power to drive policy changes that result in better patient outcomes, improved quality of care, and decreased rates of hospital readmissions.

Nursing Theory or Conceptual Framework that Frames and Guides Actions during My Practicum:

The theoretical framework that will inform my actions during my practicum is the Person-Centered Care approach. This approach emphasizes seeing individuals as unique beings with varying needs, preferences, and values. It acknowledges the importance of involving patients in their care and tailoring interventions to suit their circumstances (Errasti-Ibarrondo et al., 2022). Throughout my practicum, I will utilize this framework to shape my interactions with patients and develop personalized care plans that address all aspects of their well-being – physical, emotional, and psychosocial. By adopting a person-centered mindset, I strive to empower patients, cultivate a therapeutic nurse-patient relationship, and enhance patient satisfaction while preventing and managing CAUTIs.

Impact of State Board Nursing Practice Standards and Organizational or Governmental Policies on the Defined Patient Problem (Minnesota):

In Minnesota, how patient problems are addressed is heavily influenced by the State Board of Nursing Practice Standards and policies from organizations or government bodies. The Minnesota Board of Nursing standards ensure that nursing actions adhere to safe, competent, and ethical practices(Minnesota Board of Nursing, 2023). These standards cover various aspects of nursing practice related to preventing infections, assessing patients, documenting information, and collaborating with other healthcare professionals. Policies from healthcare facilities and public health agencies also impact how CAUTIs are managed. These policies can include guidelines for inserting and caring for catheters, training staff members, monitoring and reporting infections and considering alternative urinary management methods.

Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience Related to the Patient Problem Identified:

Regarding the highlighted patient concern, effective leadership tactics are crucial for increasing patient experience, encouraging patient-centered treatment, and improving outcomes. A culture of quality and innovation in CAUTI prevention and management can be fostered by transformational leadership, which inspires and motivates healthcare staff (Huang et al., 2023). Leaders may encourage cross-disciplinary cooperation, provide open lines of communication, and support ongoing education and training on catheter management and infection control (Stevenson, 2023). Leaders may facilitate the adoption of evidence-based practices and guarantee patient-centered care by promoting collaborative decision-making and empowering frontline nurses. Leaders can also promote using tools and procedures that assist nurses in providing high-quality care and actively involving patients in their care. Healthcare organizations can improve patient outcomes, raise patient happiness, and foster a culture of continuous improvement by putting these leadership tactics into practice when dealing with the CAUTIs patient problem.

Conclusion

A comprehensive strategy is required to solve the CAUTI issue. The approach includes evidence-based nursing practices, policy development, nursing leadership, and patient-centered care. By following nursing standards and participating in policy-making processes, nurses can help reduce CAUTIs. Additionally, employing person-centered care frameworks can contribute to improved population outcomes. Leadership strategies that promote collaboration, communication, and resource allocation further enhance patient experiences. With these efforts combined with those of other healthcare professionals, promoting a better quality of life for patients by preventing and managing CAUTIs becomes attainable. Therefore, preventing CAUTIs relies on nurses’ understanding, perspective, and adoption of evidence-based practices.

References

Alex, J., Maneze, D., Ramjan, L. M., Ferguson, C., Montayre, J., & Salamonson, Y. (2022). Effectiveness of nurse-targeted education interventions on clinical outcomes for patients with indwelling urinary catheters: A systematic review. Nurse Education Today, 112(105319), 105319. https://doi.org/10.1016/j.nedt.2022.105319

Clayton, W. (2019). Overcoming barriers impeding nurse activation of rapid response teams. Online Journal of Issues in Nursing, 24(3), 1–10. https://doi.org/10.3912/ojin.vol24no03ppt22

Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, P. F., Hole, A., Moore, L., Brown, R., Melnyk, B. M., & Gallagher-Ford, L. (2023). Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6–15. https://doi.org/10.1111/wvn.12621

Dadi, N. C. T., Radochová, B., Vargová, J., & Bujdáková, H. (2021). Impact of healthcare-associated infections connected to medical devices-an update. Microorganisms, 9(11), 2332. https://doi.org/10.3390/microorganisms9112332

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and guidelines, fourth edition. Sigma Theta Tau.

Errasti-Ibarrondo, B., Choperena, A., & Wilson, D. M. (2022). Reading and reflecting on experiential accounts of hospital patients to foster a person-centered care approach: A novel educational method. Teaching and Learning in Nursing, 18(1), 166–175. https://doi.org/10.1016/j.teln.2022.05.012

Huang, A., Hong, W., Zhao, B., Lin, J., Xi, R., & Wang, Y. (2023). Knowledge, attitudes and practices concerning catheter-associated urinary tract infection amongst healthcare workers: a mixed methods systematic review. Nursing Open, 10(3), 1281–1304. https://doi.org/10.1002/nop2.1384

Minnesota Board of Nursing. (2023). Nurse practice act. Minnesota Board of Nursing. https://mn.gov/boards/nursing/laws-and-rules/nurse-practice-act/

Parker, V., Giles, M., King, J., & Bantawa, K. (2020). Barriers and facilitators to implementation of a multifaceted nurse-led intervention in acute care hospitals aimed at reducing indwelling urinary catheter use: A qualitative study. Journal of Clinical Nursing, 29(15–16), 3042–3053. https://doi.org/10.1111/jocn.15337

Slawomirski, L., & Klazinga, N. (2022). The economics of patient safety: From analysis to action. Organization for Economic Cooperation and Development (OECD).

Stevenson, P. (2023). The impact of champion training on a two-clinician indwelling urinary catheter insertion technique to prevent catheter associated urinary tract infection (CAUTI). https://digitalcommons.liberty.edu/doctoral/4364/

Werneburg, G. T. (2022). Catheter-associated urinary tract infections: Current challenges and future prospects. Research and Reports in Urology, 14, 109–133. https://doi.org/10.2147/RRU.S273663

Weston, M. J. (2022). Strategic planning for a very different nursing workforce. Nurse Leader, 20(2), 152–160. https://doi.org/10.1016/j.mnl.2021.12.021

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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 group in the Capella Academic Portal Volunteer Experience Form.

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.

In this assessment, you’ll assess the patient, family, or population health problem 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 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 health care 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.

Practicum Focus Sheet: Assessment 1 [PDF]

Download 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.

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.

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.

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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.

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.

Complete the NURS-FPX4900 Volunteer Experience Form in 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.

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 a 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 the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

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 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.