NR 452 CCN Nursing Health Maintenance and Promotion Capstone Assignment

NR 452 CCN Nursing Health Maintenance and Promotion Capstone Assignment

NR 452 CCN Nursing Health Maintenance and Promotion Capstone Assignment

Basic Care and Comfort

Basic Care and Comfort is the priority topic selected from the Individual Student Comprehensive Assessment Trends. Elements in basic care and comfort are assistive devices, elimination, mobility/immobility, nutrition and oral hydration, non-pharmacological comfort interventions, and post-mortem care (RegisteredNursing, 2022). The NCLEX-RN examination blueprint state that the concept entails helping patients with activities of daily living (ADL). Comfort encompasses physical, social, emotional, and spiritual support for patients and their families. The purpose of this paper is to discuss the importance of basic care and comfort, related healthcare disparities, legal and ethical considerations, and an interdisciplinary approach.

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Importance

The goal of basic care and comfort is to alleviate pain and other symptoms to ensure the patient is comfortable as possible. Assisting patients with ADLs and promoting their comfort benefits the patient and the nurse. Basic care and comfort are important to nursing practice because they improve nurses’ job satisfaction when they see patients comfortable and enjoying their hospital experience (Brown & Ashcraft, 2019). It also improves the image of nursing practice since patients with great experiences with nurses significantly promote a better PR for the profession. Basic care and comfort benefit patients by promoting quick recovery and better health outcomes. Nevertheless, failing to address basic care and comfort can increase nurses’ workload causing fatigue and burnout due to delayed healing and prolonged hospital stays (Brown & Ashcraft, 2019). A negative environment that does not promote patient comfort suppresses the immune system leading to delayed healing. Thus, failing to address basic care and comfort can cause morbidities, disease complications, prolonged hospitalization, and poor patient health outcomes.

Healthcare Disparities, Inequalities, and Interventions

Unresolved basic care and comfort can negatively impact patients with dementia. Shuman et al. (2018) explain that as dementia advances, patients eventually need assistance with ADLs like grooming, eating, and mobility, as well as instrumental ADLs like shopping, meal preparation, and financial and medication management. Supplementary medical and nursing care is usually needed to manage coexisting medical disorders, incontinence, polypharmacy, and mobility devices. Since persons with dementia need more help to meet their daily needs, their quality of life (QoL) is often negatively impacted (Shuman et al., 2018). Furthermore, persons with dementia living alone are at risk for self-neglect, which occurs when a vulnerable adult cannot carry out basic self-care, including obtaining food, shelter, or clothing and managing their physical needs. They have more unmet needs than those who have caregivers.

Person-centered care is a proposed evidence-based solution to address the healthcare disparities in basic care and comfort in dementia patients. Moon et al. (2022) explain that person-centered care comprises four key elements: value, individuality, perspective, and social support. Person-centered care values the patient with dementia and their carers (value) and perceives persons with dementia as individuals (individuality) instead of defining them by the diagnosis. It also aims to recognize the person’s perspective (perspective) and fosters positive social interactions that improve QoL (social support) (Moon et al., 2022). In addition, person-centered care for dementia patients focuses on caring for all elements of an individual’s well-being, including mental, social, emotional, and spiritual needs, alongside their diagnoses and physical needs.

Patient education should be provided during person-centered care to empower dementia patients and their families to engage in decision-making. Burgstaller et al. (2018) assert that family involvement is fundamental in attaining person-centered care in dementia patients. One of the integral elements of person-centered care is shared decision-making. However, many families and providers fail to integrate dementia patients into decision-making and care planning effectively. Besides, the lack of inclusion occurs even with dementia patients being able to convey their preferences regarding their daily care and health care.

Legal & Ethical Considerations and Intervention Challenges

            Nurses should consider legal consequences that can occur while providing basic care and comfort, like breach of duty. Acts of breach of duty that can be perceived as negligence include inadequate patient monitoring for fall risk, confusion, and self-injury; failure to assess patients for potential nursing problems; lack of documentation; failure to adhere to protocols (Suhonen et al., 2018). Patient confidentiality is a major ethical consideration for nurses when providing basic care and comfort to patients. Ethical consequences can arise if the nurse breaches patient confidentiality by sharing patient information with unauthorized persons, including social media or mishandling patient records, or leaving them unsecured, particularly when using technology devices. Nurses can avoid ethical dilemmas by following the American Nursing Association (ANA) Code of Ethics for Nurses, which guides nursing practice (Suhonen et al., 2018). The code of ethics gives a framework for ethical nursing care and guides decision-making. Furthermore, they can avoid legal consequences by adhering to the scope and standards of practice care laid down by the Nurse Practice Act in their state and following the organization’s procedures, policies, and protocols.

            A potential barrier to successfully preventing the challenges in ADLs and comfort in professional practice is a high nursing workload. A high nurse-to-patient ratio makes nurses have inadequate time to meet a patient’s basic needs, including providing sufficient comfort measures. Consequently, a high nursing workload is associated with poor patient outcomes and low patient satisfaction (Brown & Ashcraft, 2019).. Besides, the success of addressing basic care and comfort can be hindered by a lack of insurance to enable patients to access healthcare services where they are assisted with ADLs and provided with interventions to improve their comfort.

Participants and Interdisciplinary Approach

Patients’ basic care and comfort will be facilitated by an interdisciplinary team comprising nurses, therapists, specialists, and nutritionists. Nurses will implement non-pharmacological comfort interventions, including palliative care and pain management. The nurse will also provide nutrition and hydration, assist patients with elimination and mobility, and assist patients in performing personal hygiene activities like bathing and oral, hair, and nail care (RegisteredNursing, 2022). Speech and language therapists will evaluate patients with speech and oral communication deficits and prescribe assistive devices. Besides, physical therapists will promote patients’ mobility and prevent immobility, prescribe assistive devices for mobility, and instruct the nurse on the proper use and maintenance.  

Specialists will include an ophthalmologist to assess patients with actual or potential visual deficits and an audiologist to manage patients with auditory deficits. The nutritionist will assess patients’ nutritional status, identify nutritional deficits, calculate and recommend daily nutritional intake, and recommend special diets to meet nutritional needs (RegisteredNursing, 2022). The team has professionals outside nursing, including therapists and nutritionists. This is essential since they have specialized knowledge and skills in speech, hearing, physical therapy, and clinical nutrition. As a result, they help the team provide evidence-based care that promotes better patient outcomes.

Quality Improvement

Providing patients with basic care and comfort measures reduces morbidities and prevents safety issues like falls and pressure ulcers. This promotes better patient outcomes, prevents mortalities, reduces hospital stays, improves patients’ QoL, and reduces healthcare costs (Brown & Ashcraft, 2019). This, in turn, benefits nurses since reduced hospital stays and better patient outcomes lower their workload preventing ensuing fatigue and burnout. Besides, nurses are more satisfied when patients are comfortable in the clinical setting (Brown & Ashcraft, 2019). Patient outcomes in the clinical environment can be improved by adopting technology systems like the Clinical decision support systems (CDSS), which improves medical decisions with targeted patient information and clinical knowledge, and CPOE, which addresses errors that occur in the medication process.

Conclusion

Basic care and comfort are important to nursing practice since it impacts job satisfaction and the public image of the nursing profession. It is also essential to patients since comfortable patients generally have better healing and recover faster. Dementia affects an individual’s cognitive function and ability to carry out routine activities and results in healthcare disparities relating to basic care and comfort. A person-centered approach for dementia patients can support individual identity, improve comfort, foster inclusivity, incorporate meaningful occupation, and promote attachment. Nurses should consider legal and ethical consequences associated with breach of duty and patient confidentiality when providing basic care and comfort measures.

References

Brown, K. L., & Ashcraft, A. S. (2019). Comfort or Care. Journal of Trauma Nursing, 26(1), 2–9. doi:10.1097/jtn.0000000000000410

Burgstaller, M., Mayer, H., Schiess, C., & Saxer, S. (2018). Experiences and needs of relatives of people with dementia in acute hospitals—A meta‐synthesis of qualitative studies. Journal of Clinical Nursing, 27(3-4), 502-515. https://doi.org/10.1111/jocn.13934

Moon, F., McDermott, F., & Kissane, D. W. (2022). Supporting families of patients with dementia at end-of-life in hospital. Collegian, 29(1), 31-37. https://doi.org/10.1016/j.colegn.2021.03.007

RegisteredNursing. (2022). NCLEX-RN exam guide. https://www.registerednursing.org/nclex/

Shuman, S. B., Hughes, S., Wiener, J., & Gould, E. (2018). Research on care needs and supportive approaches for persons with dementia. Background Paper. Research Summit on Dementia Care: Building Evidence for Services and Supports. Washington.

Suhonen, R., Stolt, M., Habermann, M., Hjaltadottir, I., Vryonides, S., Tonnessen, S., … & Scott, P. A. (2018). Ethical elements in priority setting in nursing care: A scoping review. International Journal of Nursing Studies, 88, 25-42. https://doi.org/10.1016/j.ijnurstu.2018.08.006

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Purpose

The student previously analyzed their performance on the integrated comprehensive assessments and reflected on areas of opportunity and strategies to promote NCLEX-RN success and transition into practice. The student will now apply the priority concept (topic) to evidence-based professional practice upon which nurses have the ability to resolve or have a positive impact. There is a focus on the healthcare disparities of the individual, as well as ethical and legal implications to professional practice. The student will discuss how an interdisciplinary approach promotes quality improvement for the patient and evidence-based professional practice, driving positive outcomes.

Course outcomes:  This assignment enables the student to meet the following course outcomes:

CO # 1: Synthesize knowledge from sciences, humanities, and nursing in managing the needs of humans as consumers of healthcare in a patient-centered environment. (PO#1)

CO # 2: Integrate communication and relationship skills in teamwork and collaboration functioning effectively with health team members and consumers of care. (PO#3)

CO # 3: Utilize information technology to manage knowledge, mitigate error, and support decision making with health team members and consumers of care. (PO# 8)

CO # 4 Integrate critical thinking, clinical reasoning skills, best current evidence, clinical expertise, and patient/family preferences/values in the implementation of the nursing process. (PO# 4)

CO # 5: Explore the impact of professional standards, legislative issues, ethical principles, and values on professional nursing, using data to monitor outcomes and improve quality and safety. (PO# 5, 6)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 230 points

Preparing the assignment: Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

In this paper the student will provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint, the priority concept (topic) selected based on assessment performance, and professional practice.

• Write a 4-6 page paper (not including the title page or reference page) using APA format
• Include the following sections:
  1. Introduction- 20 points/8%
• Offer a detailed description of the purpose statement for the
• Identify the priority concept (topic) from the Individual Student Comprehensive Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint:
• Assurance of a safe and effective care environment
• Health promotion and maintenance of health
• Preservation of the patient population’s psychosocial integrity
• Preservation of the patient population’s physiological integrity
• Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).
  1. Importance – 20 points/8%
• Describe the importance of the priority concept (topic) to professional practice.
• Describe the importance of the priority concept (topic) to the health status of a patient population.
• Include the potential negative effect(s) to professional practice if the priority concept (topic) is unresolved.
• Include the potential negative effect(s) to the patient population if the priority concept (topic) is unresolved.
  1. Healthcare Disparities, Inequalities, and Interventions- 70 points/28%
     • Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.
     • Identify healthcare resources to support evidence-based professional practice related to the priority concept (topic).
     • Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.
     • Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.
     • Identify three (3) evidence-based practice interventions.
     • Prioritize the identified evidence-based practice interventions and provide rationale.
     • Discuss two (2) patient education considerations related to the priority concept (topic).
  2. Legal & Ethical Considerations and Intervention Challenges- 40 points/16%
     • Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.
     • Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.
     • Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.
     • Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.
     • Identify one (1) anticipated challenge to the success of resolving the priority concept (topic) in professional practice.
  3. Participants and Interdisciplinary Approach – 20 points/8%
     • Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.
     • Discuss the role of each member in the intervention implementation for the priority concept (topic).
     • Identify a minimum of two (2) members of a discipline outside of nursing.
     • Discuss the benefit of including the identified interdisciplinary members from disciplines outside nursing to promote evidence-based professional practice.
  4. Quality Improvement– 20 points/8%
     • Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.
     • Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.
     • Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.
     • Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.
  5. Conclusion – 20 points/8%
     • Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.
     • Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).
     • Include a complete statement describing why addressing the priority concept (topic) matters for patient outcomes and evidence-based professional practice.
  6. APA Style and Organization– 20 points/8%
     • References are submitted with paper.
     • Uses current APA format and is free of errors.
     • Grammar and mechanics are free of errors.
     • At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.

For writing assistance (APA, formatting, or grammar) visit the APA Citation and Writing page in the online Chamberlain library.

Grading Rubric

Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance		High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance		Section not present in paper
Introduction (20 points/8.7%)	20 points			16 points	8 points	0 points
Required criteria 1.       Offer a detailed description of the purpose statement for the paper. 2.       Identify the priority concept (topic) from the Individual Student Comprehensive Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint: a.        Assurance of a safe and effective care environment b.       Health promotion and maintenance of health c.        Preservation of the patient population’s psychosocial integrity d.       Preservation of the patient population’s physiological integrity 3.       Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).	Includes all 3 requirements for section.			Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Importance (20 points/8.7%)	20 points		18 points	16 points	8 points	0 points
Required criteria 1.       Describe the importance of the priority concept (topic) to professional practice 2.       Describe the importance of the priority concept (topic) to the health status of a patient population. 3.       Include the potential negative effect(s) to professional practice if the priority concept (topic) is unresolved. 4.       Include the potential negative effect(s) to the patient population if the priority concept (topic) is unresolved.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Healthcare Disparities, Inequalities, and Interventions (70 points/30.4%)	70 points		63 points	54 points	21 points	0 points
Required criteria 1.       Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved. 2.       Identify healthcare resources to support evidence-based practice related to the priority concept (topic). 3.       Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations. 4.       Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities. 5.       Identify three (3) evidence-based practice interventions. 6.       Prioritize the identified evidence-based practice interventions and provide rationale. 7.       Discuss two (2) patient education considerations related to the priority concept (topic).	Includes all 7 requirements for section.		Includes no fewer than 5-6 requirements for section.	Includes no fewer than 3-4 requirements for section.	Includes no fewer than 1-2 requirements for section.	No requirements for this section presented.
Legal & Ethical Considerations and Intervention Challenges (40 points/17.4%)	40 points		36 points	31 points	12 points	0 points
Required criteria 1.       Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice. 2.       Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice. 3.       Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice. 4.       Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice. 5.       Identify one (1) anticipated challenge to the success of resolving the priority concept (topic) in professional practice.	Includes all 5 requirements for section.		Includes no fewer than 4 requirements for section.	Includes no fewer than 3 requirements for section.	Includes no fewer than 1-2 requirements for section.	No requirements for this section presented.
Participants and Interdisciplinary Approach (20 points/8.7%)	20 points		18 points	16 points	8 points	0 points
Required criteria 1.       Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions. 2.       Discuss the role of each member in the intervention implementation for the priority concept (topic). 3.       Identify a minimum of two (2) members of a discipline outside of nursing. 4.       Discuss the benefit of including the identified interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Quality Improvement (20 points/8.7%)	20 points		18 points	16 points	8 points		0 points
Required criteria 1.       Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment. 2.       Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice. 3.       Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment. 4.       Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.		No requirements for this section presented.
Conclusion (20 points/8.7%)	20 points			16 points	8 points		0 points
Required criteria 1.       Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency. 2.       Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic). 3.       Include a complete statement describing why addressing the priority concept (topic) matters for patient outcomes and evidence-based professional practice.	Includes all 3 requirements for section.			Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.		No requirements for this section presented.
APA Format, Grammar, and Punctuation (20 points/8.7%)	20 points	18 points		16 points	8 points	0 points
Required criteria 1.       References are submitted with paper. 2.       Uses current APA format and is free of errors. 3.       Grammar and mechanics are free of errors. 4.       At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.	Includes all 4 requirements for section.	Includes no fewer than 3 requirements for section.		Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Total Points Possible = 230 points