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NHS-FPX4000 Assessment 2 Capella

SOCRATIC PROBLEM SOLVING APPROACH 

Create a 3-5-page annotated bibliography and summary based on your research related to best practices addressing a current health care problem or issue of interest to you.

In your professional life you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment.

Being adept at research will help you find the information you need. For this assessment, you will select and research a current health care problem or issue faced by a health care organization.

NHS-FPX4000 Assessment 2 Capella Demonstration of Proficiency

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

1. View the Assessment Topic Areas| Transcript media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

• 1. • Describe the health care problem or issue.
     • Describe your interest in the topic.
     • Describe any professional experience you have with this topic.

2. Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used.

• 1. • You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search.
     • Use keywords related to the health care problem or issue you are researching to select relevant articles.

3. Assess the credibility of the information sources you find.

• 1. • Determine if the source is from an academic peer-reviewed journal.
     • Determine if the publication is current.
     • Determine if information in the academic peer-reviewed journal article is still relevant.

4. Select four current scholarly or academic peer-reviewed journal articles published during the past three to five years that relate to your topic.
5. Explain the relevance of the information sources.

• 1. • Describe how the health care problem or issue is addressed in each source.
     • Discuss what kind of contribution each source provides on your selected topic.

6. Analyze the scholarly literature or academic peer-reviewed journal articles using the annotated bibliography organizational format.

• 1. • The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic.
     • List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
     • Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
     • Follow the reference with the annotation.

7. In your annotation:

• 1. • Identify the purpose of the article.
     • Summarize the source:

• 1. 1. • What are the main arguments?
        • What topics are covered?
     2. Include the conclusions and findings of the article.
     3. Write your annotation in a paragraph form. The annotation should be approximately 150 words (1 to 3 paragraphs) in length.

8. In a separate paragraph or two at the end of the paper, summarize what you learned from your research.

• 1. 1. List the main points you learned from your research.
     2. Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• • Assessment 2 Example [PDF].

NHS-FPX4000 Assessment 2 Capella Additional Requirements

• 1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
  2. Font and font size: Times New Roman, 12 point.
  3. APA Template: Use the APA template linked in the resources. Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOCX] for guidance.
  4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  5. Content: Provide a title page and reference page following APA style.
  6. References: Use at least four scholarly or academic peer-reviewed journal articles.
  7. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
  8. NHS-FPX4000 Assessment 2 Capella

Note: Review the Applying Research Skills Scoring Guide for the grading criteria applied to this assessment.

NHS-FPX4000 Assessment 2 Topic Areas

Selecting a topic for your written assessments can be challenging, but it’s important to make a thoughtful choice.

Choose a topic area of interest to you from the topic suggestions in this media piece. You will use this topic to complete Assessments 2 and 3. Be sure to select a topic that will be manageable for a written assessment.

To explore the chosen topic, you should use the Socratic Problem-Solving Approach, focusing on the sections specifically called out in the assessment guidelines.

NHS-FPX4000 Topic 1: Limited Access to Healthcare

Short Description:

Consumers face barriers to healthcare access for assorted reasons. For example: due to geographic location, provider availability, transportation issues and mobility.

Potential Intervention Approaches:

• Healthcare information online
• Telemedicine
• In–home healthcare services

Keywords for Articles:

online health information seeking, health care access, health information systems, consumer health information, chronic disease, health information search, health seeking behavior, rural nursing

references:

Bhandari, N. (2014). Seeking health information online: does limited healthcare access matter? Journal of the American Medical Informatics Association: JAMIA (1067-5027), 21 (6), p. 1113. https://www-ncbi-nlm-nih-gov.library.capella.edu/pmc/articles/PMC4215038/

Lee, K., Hoti, K., Hughes, J. D., & Emmerton, L. (2014). Dr Google and the Consumer: A Qualitative Study Exploring the Navigational Needs and Online Health Information-Seeking Behaviors of Consumers with Chronic Health Conditions. Journal of Medical Internet Research, 16(12), e262. http://doi.org.library.capella.edu/10.2196/jmir.3706

Ware, P., Bartlett, S. J., Paré, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., … Ahmed, S. (2017). Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interactive Journal of Medical Research, 6(1), e3. http://doi.org.library.capella.edu/10.2196/ijmr.4447

Pratt, D. (2015). Telehealth and telemedicine. Albany Law Journal of Science & Technology. (1059-4280), 25 (3), p. 495. http://www.lexisnexis.com.library.capella.edu/hottopics/lnacademic/?shr=t&csi=148364&sr=TITLE(%22Telehealth+telemedicine+in+2015%22)+and+date+is+2015

Topic 2: Healthcare Disparities

Short Description:

In 2010, the Federal Department of Human and Health Service (DHHS) launched the Healthy People 2020 goals to include a goal to eliminate health inequality/disparity.

Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity;

geographic location; or other characteristics historically linked to discrimination or exclusion” (Office of Disease Prevention and Health Promotion, 2017, p.1).

Potential Intervention Approaches:

• Federal goals
• Community health improvement plans
• Patient advocacy efforts
• “Triple Aim” for populations

Keywords for Articles:

health disparities, community health assessment, community health improvement plan, strategic planning, local health departments, health inequities

References:

Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/disparities

Shah G.H., & Sheahan J.P. (2016). Local health departments’ activities to address health disparities and inequities: Are we moving in the right direction? International Journal of Environmental Research and Public Health. 2016; 13(1):44. http://www.mdpi.com/1660-4601/13/1/44

Institute for Healthcare Improvement. (2017). Triple Aim for Populations. http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx

NHS-FPX4000 Assessment 2 Topic 3: Medication Errors

Short Description:

A medication error is a preventable adverse effect of a patient taking the wrong medication or dosage, whether or not it is evident or harmful to the patient. Medication errors can be a source of serious patient harm, including death.

Potential Intervention Approaches:

• Medical staff education
• Packaging improvements
• Patient medication safety training

Keywords for Articles:

medication administration, medication errors, medication safety

References:

Cohen, M. (2016). Medication errors (miscellaneous). Nursing. 46(2):72, February 2016. DOI: 10.1097/01.NURSE.0000476239.09094.06

Institute for Healthcare Improvement. (2017). Improve Core Processes for Administering Medications. http://www.ihi.org/resources/Pages/Changes/ImproveCoreProcessesforAdministeringMedications.aspx

Agency for Healthcare Research and Quality. (2012). Table 6: Categories of Medication Error Classification. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/match/matchtab6.html

Schmidt, K., Taylor, A., & Pearson, A. (2017). Reduction of medication errors: A unique approach. Journal of Nursing Care Quality. 32(2), April/June 2017, 150–156.

NHS-FPX4000 Assessment 2 Topic 4: Healthcare System Errors

Short Description: 

The health care system in the United States has been the subject of much debate as experts try to determine the best way to deliver high-quality care.

In Crossing the Quality Chasm, the Institute of Medicine (2001) called for the redesign of health care delivery systems and their external environments to promote care that is safe, effective, patient-centered, timely, efficient, and equitable.

Potential Intervention Approaches:

• Systemwide transformation
• Process redesign
• Electronic health records

Keywords for Articles:

multi-stakeholder collaboration, healthcare system redesign

References:

Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US).Agency for Healthcare Research and Quality.

(2017). Hospitals and Health Systems. http://www.ahrq.gov/professionals/systems/index.html

Roberts, B. (2017). Relationship-based care: The institute of medicine’s core competencies in action. Creative Nursing, 05/2016, 22(2).

Credits

1. Subject Matter Expert: Joan Vermillion
2. Interactive Design: Lori Olson
3. Media Instructional Design: Felicity Pearson
4. Instructional Design: Celina Byers
5. Project Manager: Alan Campbell

Resources: Research and Annotated Bibliographies

Top of Form

Bottom of Form

Content

• Print
• How do you approach a problem or issue within your organization? How often do you need credible information to solve a personal or professional problem? Credible information is information that is trustworthy.
• One of the best sources for credible information is the professional literature of the field you are studying; in your case, health care.
• Professional literature is research that has been written and reviewed by other people in your field.

The following resources can help you as you complete your research and seek out professional literature on a health care topic.

• • Gennaro, S. (2016). Why write? Journal of Nursing Scholarship, 48(2), 117.
  • National Institutes of Health, U.S. National Library of Medicine. (2017). Evidence-based practice and health technology assessment. Retrieved from https://www.nlm.nih.gov/hsrinfo/evidence_based_practice.html
  • Rollins, J. A. (2017). Healthcare: It’s “so complicated.” Pediatric Nursing, 43(2), 58, 102.

Each of the following Research Guides is written with a specific program in mind. The one for your program can provide insights about researching topics related to your field.

• • Nursing (BSN) Library Research Guide.
  • Public Health Undergraduate Library Research Guide.
  • Health Care Administration Undergraduate Library Research Guide.

The following resources provide specific information about annotated bibliographies.

• • What Not To Do: Source Material for the Annotated Bibliography | Transcript.
  • Sample Annotated Bibliography [PDF].

NHS-FPX4000 Assessment 2, Healthcare Disparities Sample Approach

Health Disparities

Brief Problem Description

The World Health Organization defines health disparities as “systematic differences in the health status of different population groups” (WHO, 2018). Often, populations portray different factors regarding healthcare services accessibility, where fundamental considerations such as socio-cultural and economic considerations play a significant role in determining how they access quality healthcare.

The World Health Organization (WHO) recognizes social factors like education, employment status, gender, ethnicity, and income levels as essential determinants of how people access healthcare services. In this sense, socioeconomic disparities contribute to the unfairness and exclusion of the population in mainstream healthcare services.

Personal Experience and Interest in the Topic

My interest in the topic relies massively on my working experience with communities facing various socio-economic constraints. I have worked with community-based health organizations targeting to empower rural communities and promote health awareness. I have had opportunities to interact with people struggling with poverty, geographical isolation, low income, and low-level education. Undoubtedly, these disparities affect how people access quality care services. Therefore, I became interested in researching the topic to obtain insights into scientifically proven interventions to reduce inequalities.

Potential Interventions Include:

• Health promotion/advocacy programs
• Quadruple Aims for health equality
• Community improvement strategies
• Multi-disciplinary strategies

Identifying Peer-reviewed Journals

In this section, I leveraged my research knowledge to identify peer-reviewed scholarly publications that I believe should help me develop and support my proposed intervention plan. In addition to using resources that were accessible through the University library portal, I also conducted a search on external databases relevant to nursing, among them Google Scholar, Medline, and CINAHL.

For better search results, I implemented information outlined in the BSN Library Research Guide and learned vital information on how to aggregate and segregate the different internet resources. Once I was conversant with how to navigate through the library and database materials, I managed to refine and filter my search results to obtain only the appropriate scholarly resources.

Further, I used the University Library to access such credible databases as ProQuest and Ebscohost, which also provided some credible resources. By narrowing my search area nursing and health sciences, I was able to obtain only resources relevant to my nursing program.

Assessing Credibility and Relevance of Information Sources

While the University’s portal has specific features that make it easy to access quality scholarly materials on any topic, one must refine the search to obtain the most relevant, recent materials. One can obtain credible resources by simply inputting critical topic words in the University library portal. During my search, some of the keywords I used included health disparities, healthcare access, community health improvement plan, social determinants of health, among others. The search engines have functionalities that enables one to filter the keywords and to tick checkboxes for peer-reviewed and scholarly sources for more refined search results.

To further refine my search outcomes, I sorted the articles based on publication date, from the most recent to the oldest. Additionally, the search engines have a publication date tab that allows one to customize the search range by year of publication, thus making it easier to obtain recent articles. Given the dynamic health environment, only recent peer-reviewed articles with relevant, contemporary nursing and healthcare information must be used in developing an intervention plan. For this reason, I limited my search range to studies published within the last five years.

Peer Reviewed Academic Journals Annotated Bibliography

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

This scholarly article by Garzon-Orjuela et al. (2020) identified and synthesized strategies that facilitate the reduction of health inequalities. The researchers defined healthcare inequalities as differences in health among people or society (Carzon-Orjuela et al., 2020). The background of the study involved reflections on the governments’ interventions or incentives that focus on equity to enhance progress or eliminate health disparities.

One of the strengths of this scholarly journal is that the researchers delved into an in-depth systematic search strategy to select scholarly articles from reputable databases. The researchers indicated many interventions from scientific journals, including multi-disciplinary and team performance, telemedicine, communication between providers, and educational outreach interventions as potential approaches to addressing healthcare inequalities.

Arguably, this research is relevant, up-to-date, and reliable in presenting the various interventions for addressing health inequalities. Firstly, this article is a peer-reviewed scholarly journal and consolidates information from many scholarly articles. Undoubtedly, the study’s findings apply when addressing concerns of inadequate measures to address health inequalities. For instance, the researchers earmarked multi-disciplinary cooperation, multi-sectoral cooperation, technological advancements, and teamwork as scientifically proven approaches to reduce health disparities. As a result, it is possible to apply these interventions in various healthcare contexts.

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, And Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840 

The scholarly article narrowed down health disparities to racial factors that affect how populations access healthcare services. In this sense, the researchers sought to establish the causes of racial inequalities in the US by utilizing quantitative and qualitative data collection and analysis strategies. The study was part of a  sequential mixed-methods study conducted in the US’s Veterans Health Administration (VHA) care system.

The study’s participants were 53 healthcare providers working at three sites in the VHA. The recruitment strategy for the respondents relied on email communication between the researchers and healthcare professionals (potential participants). Essentially, the study identified several patients, providers, healthcare system, and social structural factors that facilitate racial disparities in access to healthcare services. The researchers concluded that understanding racial healthcare disparities is fundamental in informing interventions to addressing health inequalities.

This study is credible because it is peer-reviewed, current, and relies on insights from reputable researchers. Apart from these considerations for determining a reliable scholarly source, the study’s findings apply to inspiring measures to address racial disparities in healthcare. For instance, the investigators suggested openness among healthcare providers as the most profound strategy for reducing racial disparities.

Transparency among healthcare professionals entails various aspects, including effective communication, meaningful relationships, unbiased operations, and positive workplace perceptions. Arguably, these suggestions are vital in addressing workplace stress emanating from racial stereotypes.

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8 

This scholarly journal provides insights into the impact of multi-component community-based health promotion interventions in reducing health discrepancies by focusing on socio-economic status (SES). Therefore, the researchers conducted a comprehensive review to consolidate information about closing the gaps within populations to alleviate healthcare inequalities. The systematic review strategy relied on thorough screening of reputable scholarly article databases such as PubMed and PsycINFO.

Undoubtedly, this research is credible and reliable because it has satisfied peer-review considerations. The systematic review earmarked community-based interventions as vital tools for socio-economic equality in health behavior and status outcomes. The researchers argued that the subsequent community-based interventions for addressing health inequalities should reduce price barriers, promote physical and mental health, and create a healthier environment necessary to support health changes (Nick & von dem Knesebeck, 2020). Arguably, the study’s findings present ideal approaches to address health disparities in different social contexts.

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y 

This scholarly article provides insights into the Quadruple Aim to address the rising economic and social pressures facilitating health inequalities. In this sense, the Quadruple Aim approach includes interventions like improving patient experience, reducing cost, advancing population health, and improving provider’s experiences. For purposeful research, the investigators conducted 10 case studies in three Canadian provinces of Nova Scotia, Ontario, and British Columbia to investigate experiences of primary care and public health collaboration.

The ability to focus articulate current scholarly findings and peer-review criteria render this study credible and reliable. The research identifies provider capacity building, community-based health promotion programs, outreach interventions, and regional immunization management as fundamental approaches for addressing health inequalities in the three Canadian provinces.

Also, researchers identified inadequate collaboration, resource constraints, geographical challenges, and varying organizational goals as barriers to effective strategies for addressing health inequalities. The study concluded that the Quadruple Aims are profound strategies to promote health quality by addressing socio-economic challenges within Canadian populations. The measures presented in the study apply to other nations because they are scientifically proven and tested.

Lessons from the Annotated Bibliography

After preparing an annotated bibliography, I learned that health inequalities pose challenges to countries and communities because they affect how population sections access healthcare services. I realized that the World Health Organization recognizes health disparities as a critical issue in the global health sector.

Some of the causes of health inequalities, as stipulated by the World Health Organization (2018), include economic status, education level, race, ethnicity, gender, and income level. Therefore, governments target alleviating poverty, racial inequalities, illiteracy, and geographical constraints that limit access to health services.

Fortunately, scholarly studies identify community-based strategies, multi-disciplinary cooperation, health advocacy programs, health promotion, capacity building, and fiscal interventions as possible means of realizing health equality. According to Valaitis et al. (2020), these approaches form the basis of the Quadruple Aims for improving patient experience and reducing health costs. Although nations may develop area-specific policies to reduce health disparities, it is crucial to rely on scientific study findings when conceptualizing ideal measures to address causal factors to health inequalities.

References

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y

World Health Organization, WHO. (2018). Health inequities and their causes. Retrieved 25 July 2021, from https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes.

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem

Current Health Problem: Medication Errors

Medication use is undoubtedly the most important aspect of patient care worldwide. With the increased and widespread use of medications comes an increased risk of harm. For instance, there are approximately 6800 prescription medications in the United States, not to mention the countless over-the-counter medications (Tariq et al., 2022).

This, combined with the numerous herbal medications and health supplements used to treat various conditions, raises the risk of harm to consumers. As a result, the Medical Product Safety Commission established goals to focus on overall patient treatment improvement and ensuring the appropriate use of medical products (USDHHS, 2020). According to the Medical Product Safety Commission, medical products include drugs, biological products, and medical devices.

Although there is no universally accepted definition, the National Coordinating Council for Medication Error Reporting and Prevention (2021) defines medication errors as a preventable event that may result in inappropriate medication use or patient harm when the medication is in the control of the healthcare provider, patient, or consumer.

The good news, as suggested by the definition, is that medication error is a preventable action, and thus the go-ahead for all stakeholders to work in unison to integrate and coin preventive interventions. This paper aims to describe the context of a medication error, its causes, the populations affected, and why it is essential. A further discussion of the problem’s potential solutions and ethical implications follows.

Description of Medication Errors and Possible Causes

While interventions have been put in place to reduce the occurrence of medication errors, they have yet to be eliminated. The question that the majority would ask is the reason for the perpetual occurrence of medication errors. Before delving into the causes of medication errors, it is critical to understand their classification.

Medication errors can be classified in a variety of ways, including the stage in the sequence of medication use, the type of errors, the severity, and whether the act is the result of omission or commission (WHO, 2018). Medication errors can occur at any stage of the medication use process, including prescription, transcription, dispensing, administration, and monitoring (WHO, 2018). Based on the type, medication errors are classified as wrong dosage, frequency, route, or patient (WHO, 2018).

A further classification includes acts of commission, such as giving the incorrect dosage of a drug, and acts of omission, such as forgetting to administer a drug (WHO, 2018). Regarding severity, medication errors are classified into levels 0 through 6, with level 0 being a non-medication error and level 6 being a fatal error (Gates et al., 2019). These approaches to categorizing medication errors are mutually exclusive, and there is no strong evidence to support a particular classification criterion, particularly in primary care facilities.

Several studies have delved into examining the factors that contribute to medication errors. According to a Commonwealth Fund International Health Policy Survey, 11% of patients experienced medication errors due to the following risk factors: poor coordination of care, multimorbidity and hospitalization, and cost-related barriers to medical services or medicines (Walsh et al., 2018).

In summary, the survey categorized the key factors associated with medication errors into the following categories: healthcare provider-related, patient-related, work environment-related, and computer system-related. According to the survey, healthcare provider-related factors include a lack of therapeutic training, insufficient knowledge of the patient and the drug, fatigue, emotional burden, inadequate perception of the risk, and poor communication with patients (Walsh et al., 2018).

Patient-related risk factors include, but are not limited to, (1) individual characteristics such as literacy and language barriers and (2) clinical issue complexity such as polypharmacy, multimorbidity, and high-risk medications (Walsh et al., 2018). Work environment-related factors include workload and time pressures, distractions, a lack of standardized protocols, insufficient resources, and physical work environment issues such as lighting.

Medication-related factors such as packaging, labeling, and naming of medicines as well as computerized information system issues such as difficult processes, inadequate design, and lack of accuracy of patient records, are all strongly linked to medication errors (Walsh et al., 2018). While all factors contribute to some degree to the risk of a medication error, some have been shown in studies to play a much larger role in medication error causation than others.

Distractions in the workplace are a significant contributor to the vast majority of medication errors. Tariq et al. (2022) attribute over 75% of medication errors to distraction. Physicians are tasked with many tasks, including history taking, physical examination of patients, ordering laboratory tests, and patient education. Amidst all this, they are asked to write drug orders and prescriptions. A lapse in judgment may occur in the rush to write orders and prescriptions, resulting in medication errors (Tariq et al., 2022).

Physicians may scribble drug orders quickly, not paying attention to dosages, frequency, or route, potentially leading to medication errors. Furthermore, while the percentage of contribution is not known, distortions are a common cause of medication errors. The term “distortions” refers to the physicians’ poor penmanship, abbreviations, and misunderstood symbols. Clearly, these contributing factors are largely avoidable with a little forethought and meticulousness.

The Context of Medication Errors, its Significance, and the Population Affected

Medication error is a worldwide issue that affects all levels of care. Due to the morbidity, mortality, and financial implications of medication errors, it is a significant public health issue that must be addressed. It is estimated that 7000-9000 people die each year in the United States as a result of medication errors (Tariq et al., 2022).

Besides the mortality, hundreds of thousands of patients experience but do not report an adverse reaction or a drug complication (Tariq et al., 2022), suggesting that the problem may be more widespread than statistics indicate. In terms of financial implications, the United States spends approximately $40 billion per year to treat patients who have medication error-associated problems (Tariq et al., 2022). Aside from the monetary cost, medication errors cause significant physical and psychosocial pain, not to mention patient dissatisfaction and growing distrust of healthcare services (Tariq et al., 2022).

In other countries, such as the United Kingdom, a study estimated the prevalence of medication errors to be 12% in all primary care patients, with a higher rate of 38% among patients aged 75 and older (Assiri et al., 2018). A study in Sweden estimated the medication prevalence rate to be 42% nationwide, and in Mexico, it was discovered that 58% of prescriptions contained errors (Assiri et al., 2018). The high prevalence rates and consequences of medication errors provide sufficient impetus for the quest for solutions.

Medication error is an enduring problem for the pediatric and elderly population.  Children who have not reached the talking stage are more likely to suffer medication errors due to their inability to communicate whether they are experiencing any medication side effects, if they have an allergy or when they last took the medication (Nkurunziza et al., 2018).

Furthermore, caregivers, often parents, may be anxious about their children’s deteriorating symptoms or, in some cases, lack knowledge of the medication and may administer higher dosages in the hope of achieving a faster clinical remission (Nkurunziza et al., 2018). In addition, some pediatric drug formulations are sweet, such as Ibuprofen syrup, which has an orange flavor, and risks being consumed in excess, potentially resulting in overdosage.

To assess the severity of the problem in the pediatric population, Feyissa et al. (2020) estimate that 41.8% (n=136) of 325 pediatric patients admitted to the pediatric ward and diagnosed with infectious diseases during the data collection period had at least one medication error during their hospital stay. The elderly are another population group that is at high risk of medication errors. This is due, in part, to the elderly population’s multiple morbidities, which necessitate polypharmacy.

Medication errors occur at varying rates among the elderly population. Most studies, however, assign nearly constant factors associated with medication errors in the elderly, such as age ?65 years, ?7 days of hospital stay, presence of comorbidity, and polypharmacy (Gebre et al., 2021). While medication errors occur in other populations, the elderly and children account for the vast majority of the cases.

Potential Solutions

Several studies have explored ways to improve the quality of medication prescription and administration in primary care settings. Educational programs, computer technology, and clinical pharmacists are common strategies used in multifaceted interventions. The education of healthcare providers and patients about medications has been a key area of research in reducing medication errors.

Educating a care provider about medications leads to improved adherence to clinical guidelines, which reduces errors (Mieiro et al., 2019). Similarly, educating patients about their medications and allowing patients to self-administer medications has been proven to be safe and effective in reducing medication errors (Mieiro et al., 2019). The use of automated information systems, such as computerized provider order entry (CPOE) systems, has the potential to reduce medication errors.

The CPOE systems include alarm devices that detect incorrect dosages, frequency, and routes, as well as reduce medication errors caused by physicians’ poor penmanship (Mieiro et al., 2019). Implementation requires an effective information system, hardware, and software, a health informatics group, and the participation of care providers and patients (Mieiro et al., 2019).

Clinical pharmacists assist with medication reviews and reconciliation, which entails checking for potential drug-drug interactions, correcting medication discrepancies, and developing interventions that lead to increased identification and resolution of medication-related problems. People are shifting to technologizing medication processes to reduce medication errors as technology in healthcare becomes more prevalent. However, these interventions are used in tandem because no study has proven that one strategy is superior to others.

Ethical Implications for the Implementation of Potential Solutions

The interventions used to help reduce medication errors must, at the very least, adhere to four ethical principles: autonomy, beneficence, nonmaleficence, and justice. The concepts of autonomy and right to self-determination recognize patients’ rights to make independent decisions and take actions that they deem appropriate.

Educating patients about the possibility of medication errors allows them to make informed decisions about seeking treatment if a medication error occurs (McMillan, 2019). The concept of beneficence and nonmaleficence may cause a conflict for the caregiver when balancing the projected benefits with the patient’s potential risks. Because medications have the potential to cause harm to patients, caregivers should take the necessary precautions to keep patients safe (McMillan, 2019).

While nonmaleficence refers to not harming the patient, it is difficult to completely assure the patient of no harm because all medications have the potential to cause harm to some degree. Justice, on the other hand, refers to treating patients fairly and equally. All patients, regardless of race or other characteristics, receive the best care possible, and if they have a medication-related problem, they are also treated without discrimination.

Conclusion

While medication error is a serious global health concern, it is potentially avoidable. Every country experiences some level of a medication error, which varies depending on the country’s economic situation and the importance placed on health in that country. Effective interventions to prevent medication errors are available worldwide; however, complete elimination has yet to be achieved. The advancement in technology that has resulted in the revolutionization of healthcare offers great hope for the fight against medication errors. However, it should be noted that a single intervention is rarely sufficient and that multifaceted interventions are frequently required.

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem References

Assiri, G. A., Shebl, N. A., Mahmoud, M. A., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, error-related adverse events, and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8(5), e019101. https://doi.org/10.1136/bmjopen-2017-019101

Feyissa, D., Kebede, B., Zewudie, A., & Mamo, Y. (2020). Medication error and its contributing factors among pediatric patients diagnosed with infectious diseases admitted to Jimma University Medical Center, southwest Ethiopia: Prospective observational study. Integrated Pharmacy Research & Practice, 9, 147–153. https://doi.org/10.2147/IPRP.S264941

Gates, P. J., Baysari, M. T., Mumford, V., Raban, M. Z., & Westbrook, J. I. (2019). Standardizing the classification of Harm Associated with medication errors: The Harm Associated with Medication Error Classification (HAMEC). Drug Safety: An International Journal of Medical Toxicology and Drug Experience, 42(8), 931–939. https://doi.org/10.1007/s40264-019-00823-4

Gebre, M., Addisu, N., Getahun, A., Workye, J., Gamachu, B., Fekadu, G., Tekle, T., Wakuma, B., Fetensa, G., Mosisa, B., & Bayisa, G. (2021). Medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital, West Ethiopia: A prospective observational study. Drug, Healthcare and Patient Safety, 13, 221–228. https://doi.org/10.2147/DHPS.S328824

McMillan, J. (2019). Grounded ethical analysis. Journal of Medical Ethics, 45(1), 1–2. https://doi.org/10.1136/medethics-2018-105272

Mieiro, D. B., Oliveira, É. B. C. de, Fonseca, R. E. P. da, Mininel, V. A., Zem-Mascarenhas, S. H., & Machado, R. C. (2019). Strategies to minimize medication errors in emergency units: an integrative review. Revista Brasileira de Enfermagem, 72(suppl 1), 307–314. https://doi.org/10.1590/0034-7167-2017-0658

Nkurunziza, A., Chironda, G., & Mukeshimana, M. (2018). Perceived contributory factors to medication administration errors (MAEs) and barriers to self-reporting among nurses working in pediatric units of selected referral hospitals in Rwanda. International Journal of Research in Medical Sciences, 6(2), 401. https://doi.org/10.18203/2320-6012.ijrms20180276

Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/

US Department of Health and Human Services. (2020). Medical product safety. Healthypeople.gov. https://www.healthypeople.gov/2020/topics-objectives/topic/medical-product-safety

Walsh, L. J., Anstey, A. J., & Tracey, A. M. (2018). Student perceptions of faculty feedback following medication errors – A descriptive study. Nurse Education in Practice, 33, 10–16. https://doi.org/10.1016/j.nepr.2018.08.017

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem Instructions

• Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
   • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
   • Identify possible causes for the problem or issue.
2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
   • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
     • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
     • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
     • You may find the applicable Undergraduate Library Research Guide helpful in your search.
   • Review the Think Critically About Source Quality to help you complete the following:
     • Assess the credibility of the information sources.
     • Assess the relevance of the information sources.

3. Analyze the health care problem or issue.
   • Describe the setting or context for the problem or issue.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
4. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
5. Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
   • Describe what would be necessary to implement the proposed solution.
   • Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
   • Provide examples from the literature to support the points you are making.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 4 Example [PDF].

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem Additional Requirements

Your assessment should also meet the following requirements:

• Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
• Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
• References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

• Title page. A separate page.
• Introduction. A brief one-paragraph statement about the purpose of the paper.
• Elements of the problem/issue. Identify the elements of the problem or issue or question.
• Analysis. Analyze, define, and frame the problem or issue.
• Considering options. Consider solutions, responses, or answers.
• Solution. Choose a solution, response, or answer.
• Ethical implications. Ethical implications of implementing the solution.
• Implementation. Implementation of the potential solution.
• Conclusion. One paragraph.

Competencies Measured:

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

• • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.

• Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

• • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.

• • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.

• Competency 3: Apply ethical principles and academic standards to the study of health care.

• • Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented

• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

• • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

• • Write following APA style for in-text citations, quotes, and references.

Scoring Guide

Assessment_4_scoring_guide_6398fa1e1fc79.pdf

Capella University NHS FPX6004 Assessment 2 Policy Proposal

NHS FPX6004 Assessment 2 Policy Proposal

Policy Proposal Example

The benchmarking program is being utilized by providers of healthcare all around the world to assist them in identifying areas of inferior performance as well as service inadequacies. When designing a performance standard, the most critical challenges are typically tackled first. Many people come from different backgrounds looking for treatments for chronic illnesses like diabetes. According to the findings of a study by Duan et al. (2021), diabetes was projected to cost the United States $245 billion in the year 2020. Consequently, it is necessary to formulate suitable state, federal, and municipal policies to handle issues such as diabetes. The dashboard benchmarks demonstrate that medical exams, particularly those for diabetes, were not completed at the Mercy Medical Center to the national government’s standards. Mercy Medical Center needs to create regulations and protocols that are both efficient and accurate if they want to improve the effectiveness of its services.

The Need for Organizational Policy

The Mercy Medical Center in Minnesota is a world-class hospital. Between the first and fourth quarters of 2019 and 2020, HgbA1c tests dropped drastically from 60 to 42. Multiple studies have concluded that early diagnosis is the most significant factor in lowering diabetes’s burden since it allows for preventative therapy and, ultimately, better health. Medical facilities that strictly follow all healthcare regulations and guidelines are more likely to accurately identify diabetes by conducting thorough examinations.

To improve the timely use of diabetic foot examination and Hgb A1C screening for early recognition and the prevention of diabetes-related complications, Mercy Medical Center, and other healthcare professionals, need to design appropriate protocols with nurses at the core of the transition. Unfavorable complications such as diabetic foot ulcers, nerve damage, and leg amputations can develop if the condition is not handled promptly. This necessitates establishing procedures for periodic testing of all individuals, particularly those over 40 (Duan et al., 2021). As a result, Hgb A1c testing and evaluation of diabetic foot health will improve at the centers. Individuals who have previously had unfavorable results should still be tested every three months.

Proposed Policy and Guidelines

When developing a strategy to deal with diabetes using the Chronic Care Model, it is essential to keep in mind the six core components outlined in the most recent guidelines from the American Diabetes Association. For Mercy Medical Center’s suggested policies to meet standards for diabetes detection and assessment at the national level, several considerations must be incorporated. Appropriate modes of distribution, patient-specific and population-centered support systems for the medical team, methods for finding and creating resources for developing positive habits, and establishing a quality-oriented environment are all required (Nayeri et al., 2020). Participation from healthcare professionals is also vital for enhancing clinical visits and subsequent therapy, such as diabetic foot inspections and Hgb A1C tests.

The new policy that is being proposed will investigate the possibility of rearranging the scheduling systems for diabetes-related exams to speed up the process of data collection and increase patient engagement. Many patients cannot make appointments at the clinic, and an even lower percentage attend their planned appointments. Patients will be able to schedule appointments online and receive timely reminders so that they may better prepare for their visits as a result of the new policy. As a direct result of these initiatives, more people will seek medical attention at Mercy Medical Center. Patients diagnosed with diabetes should be encouraged to learn about possible treatments by scheduling annual appointments. 

The policy will contain procedures for changing staffing hour shifts and adding additional personnel to ensure that carers are not overwhelmed during these once-yearly checkups. This will ensure that caregivers are not overworked during these once-yearly checkups. A greater emphasis will be placed on patient adherence data and its analysis and use. The evidence needs to be published so that anyone interested can access it whenever they want. This would allow for excellent uniformity in treating diabetes patients and better patient outcomes.

Potential Environmental Effects

To effectively implement organizational policies, it is necessary to consider a diverse range of aspects of the surrounding environment. For example, a sufficient number of qualified personnel capable of carrying out the new testing procedures should be available to avoid employee burnout and unreadiness. Examining a diabetic patient’s feet and performing a Hgb A1c test are necessary skills for nurses and other medical professionals caring for diabetic patients. A competency of this level can only be achieved after formal training. To prevent one department from becoming overburdened with work, the organization needs to do a better job recruiting and educating registered nurses.

It is possible that the adoption and implementation of the proposed policies would be complicated by the limited access that patients have to computers and other digital devices that allow them to book and keep track of their visits. Clients who do not possess essential computer literacy abilities may be unable to access these services and are likely to miss out on them. Because the policies involve using electronic health records (EHRs), which are susceptible to malicious attacks from hackers, the Health Insurance Portability and Accountability Act (HIPAA) requires organizations to conform to standard patient privacy and confidentiality guidelines during this transition. These guidelines must be adhered to protect patient’s privacy and confidentiality. Funding is required to make these portals functional and to manage the anticipated rise in the number of patients visiting the facility. Acquiring and installing necessary tools used in diagnosing and managing diabetes should be prioritized.

Ethical Evidence-Based Strategies

Evidence-based practices (EBP) may improve outcomes and efficiency in diabetic foot exams and Hgb A1c tests. The general public and patients can be educated on diabetes, facts, and standard operating protocols can be updated, alert labels can be added to client files and primary caregivers can be urged to review their patient’s medical records from other healthcare institutions (Yu et al., 2022). Therefore, the multidisciplinary team in charge of conducting the test should be briefed about both the currently used and suggested techniques for diagnosing diabetes, as well as the benefits of doing thorough tests.

Mercy Medical Center intends to achieve this goal by establishing specific programs to educate all relevant employees and setting annual targets to complete these programs. Employees must show the achievement of this competence by passing a test at the end of every module before they can begin delivering patient care. Films, booklets, PowerPoint presentations, and audio recordings will all be used to educate patients on diabetes and the importance of early diagnosis and treatment.

Accurately monitoring diabetic patients also necessitates using a standardized recording method. It may be possible to evaluate the value of the improvements precisely and efficiently if quality data collection methods are used. For example, foot examination instruments will be connected to the EHR system. In this way, only authorized staff members can update patient information, ensuring accurate records. Because their data will only be accessible to them and the healthcare professionals directly involved in their treatment, this strategy will contribute to maintaining patient anonymity. This strategy will also describe the criteria for choosing which exam should be carried out by healthcare staff. The goal of this is to reduce unnecessary spending as much as possible.

Stakeholders’ Involvement in the Policy Implementation

To ensure the strategy is implemented as planned, it is required that all involved stakeholders should play their part. Nurses, physicians, administrators at the hospital, podiatrists, statisticians, wound experts, friends, and family members are all involved in caring for persons with diabetes, alongside the patients themselves and their loved ones. Regular updates about the new policies and clearly defined responsibilities for everyone involved must be regularly updated.

Nurses, for instance, should be able to prepare patients for routine assessments like foot checks and Hgb A1C testing by clarifying their significance, motivating them to come up for the tests, and offering psychological help after the findings are in. Once a sufficient number of individuals come in for foot exams and Hgb A1C tests, medical professionals can collaborate to help the individual manage their condition depending on the outcomes of the tests. The EHR will then be updated with the most recent data by the database administrator.

Clear communication channels between all involved parties are crucial for fostering greater collaboration. Everyone who needs to know about policy changes must be kept up to speed. Employees’ motivation and engagement increase when they feel they contribute to the organization’s success (Silberberg & Martinez-Bianchi, 2019). Everyone must also understand their part to play and the duties under their purview. Similarly, it is essential to give stakeholders a degree of autonomy; it shows assurance that the task can be completed successfully because of the individual’s skills. Additionally, workers should feel at ease performing their jobs by accessing good systems to handle any difficulties or concerns. The support system should encourage stakeholders’ creativity in developing novel solutions to existing problems.

Conclusion

Diabetes and its associated complications are the major contributors to death rates in the United States. To lessen the impact of the condition and establish ways to stop diabetes from becoming an epidemic in the United States, several regulations and requirements have been made mandatory. The importance of early detection and therapy for this condition has been the subject of nursing research. Multiple national guidelines have been produced to promote rigorous diagnostic processes for early disease diagnosis to support the fast implementation of helpful therapies. These guidelines have been developed to facilitate the prompt implementation of beneficial interventions. The findings of the foot inspections and Hgb A1C testing at Mercy Medical Center did not match the requirements set by national agencies, despite the fact that the hospital is widely regarded as among Minnesota’s very best. This paper has made proposals to raise the overall quality of medical care and lessen the financial burden associated with detecting and treating diabetes.

NHS FPX6004 Assessment 2 Policy Proposal References

Duan, D., Kengne, P., & Echouffo-Tcheugui, B. (2021). Screening for diabetes and prediabetes. Endocrinology and Metabolism Clinics of North America, 50(3), 369–385. https://doi.org/10.1016/j.ecl.2021.05.002

Janett, S., & Yeracaris, P. (2020). Electronic medical records in the American health system: Challenges and lessons learned. Ciencia & Saude Coletiva, 25(4), 1293–1304. https://doi.org/10.1590/1413-81232020254.28922019

Silberberg, M., & Martinez-Bianchi, V. (2019). Community and stakeholder engagement. Primary Care, 46(4), 587–594. https://doi.org/10.1016/j.pop.2019.07.014

Nayeri, N., Samadi, N., Larijani, B., & Sayadi, L. (2020). Effect of nurse?led care on quality of care and level of HbA1C in patients with diabetic foot ulcer: A randomized clinical trial. Wound Repair and Regeneration, 28(3), 338-346. https://doi.org/10.1111/wrr.12788

Yu, J., Lee, H., & Kim, K. (2022). Recent updates to clinical practice guidelines for diabetes mellitus. Endocrinology and Metabolism, 37(1), 26–37. https://doi.org/10.3803/enm.2022.105

NHS FPX6004 Assessment 2 Policy Proposal Instructions

I’m working on a Health & Medical exercise and need support.

Write a 4-6-page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1.

Introduction

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care.

This assessment offers you an opportunity to take the lead in proposing such changes. As a master’s-level health care practitioner, you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. NHS FPX6004 Assessment 2 Policy Proposal

Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

Propose organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions NHS FPX6004 Assessment 2 Policy Proposal.

Note: Remember that you can submit all, or a portion of, your draft policy proposal to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

NHS FPX6004 Assessment 2 Policy Proposal Requirements

The policy proposal 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, be sure to note the requirements for document format and length and for supporting evidence.

• • Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
    • What is the current benchmark for the organization and the numeric score for the underperformance?
    • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
    • What are the potential repercussions of not making any changes?
      • What evidence supports your conclusions?
  • Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policy or law.
    • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
    • How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
    • How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting?
    • How can you ensure these strategies are ethical and culturally inclusive in their application?
  • Analyze the potential effects of environmental factors on your recommended practice guidelines.
  • NHS FPX6004 Assessment 2 Policy Proposal
    • What regulatory considerations could affect your recommended guidelines?
    • What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
  • Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
  • NHS FPX6004 Assessment 2 Policy Proposal
    • Why is it important to engage these stakeholders and groups?
    • How can their participation produce a stronger policy and facilitate its implementation?
  • Organize content so ideas flow logically with smooth transitions.
    • Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
  • Use paraphrasing and summarization to represent ideas from external sources.
    • Be sure to apply correct APA formatting to source citations and references.
  • Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
  • Assessment 2 Example [PDF].
  • Policy Proposal Format and Length
    It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Internet. Your policy should be succinct (about one paragraph). Overall, your proposal should be 4–6 pages in length.
  • NHS FPX6004 Assessment 2 Policy Proposal

Supporting Evidence

Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.

• • Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated. NHS FPX6004 Assessment 2 Policy Proposal
  • Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.

Competencies Measured in NHS FPX6004 Assessment 2 Policy Proposal

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• • Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
    • Analyze the potential effects of environmental factors on recommended practice guidelines.
  • Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
    • Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policies or laws.
  • Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, to inform health care laws and policies for patients, organizations, and populations.
  • NHS FPX6004 Assessment 2 Policy Proposal
    • Explain the need for creating a policy to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
  • Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
    • Explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.
  • Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
    • Organize content so ideas flow logically with smooth transitions.
    • Use paraphrasing and summarization to represent ideas from external sources.
    • NHS FPX6004 Assessment 2 Policy Proposal

NHS FPX6004 Assessment 2 Policy Proposal Scoring Guide

NHS-FPX6004 Assessment 4 Training Session for Policy Implementation

Develop a 2-5-page training strategies summary and annotated agenda for a training session that will prepare a role group to succeed in implementing your proposed organizational policy and practice guidelines.

INTRODUCTION

Training and educating those within an organization who are responsible for implementing and working with changes in organizational policy is a critical step in ensuring that prescribed changes have their intended benefit. A leader in a health care profession must be able to apply effective leadership, management, and educational strategies to ensure that colleagues and subordinates will be prepared to do the work that is asked of them.

As a master’s-level health care practitioner, you may be asked to design training sessions to help ensure the smooth implementation of any number of initiatives in your health care setting. The ability to create an agenda that will ensure your training goals will be met, and will fit into the allotted time, is a valuable skill for preparing colleagues to be successful in their practice.

Note: Remember that you can submit all, or a portion of, your draft strategy summary and annotated training agenda to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

To help ensure a smooth rollout and implementation of your proposed policy and practice guidelines, design a training session for one of the role groups in the organization that will be responsible for implementation.

• Write a brief summary of your strategies for working with your chosen role group.
• Explain how this training session will help prepare the group to succeed in implementing your proposed policy and practice guidelines, and why you chose this group to pilot your proposal.
• Prepare an annotated agenda for a two-hour training session.

During this training session, you will want to ensure that the individuals you are training understand the new policy and practice guidelines. You will need them to buy into the importance of the policy in improving the quality of care or outcomes and their key role in successful policy implementation. You must help them acquire the knowledge and skills they need to be successful in implementing the policy and practice guidelines.

As outcomes of this training session, participants are expected to:

• Understand the organizational policy and practice guidelines to be implemented.
• Understand the importance of the policy to improving quality or outcomes.
• Understand that, as a group, they are key to successful implementation.
• Possess the necessary knowledge and skills for successful implementation.

REQUIREMENTS

The strategy summary and annotated training agenda 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, be sure to note the requirements for document format and length and for supporting evidence.

• Summarize evidence-based strategies for working with the role group to obtain their buy-in and prepare them to implement the new policy and apply the associated practice guidelines to their work.
  • Why will these strategies be effective?
  • What measures might provide early indications of success?
• Explain the impact of the new policy and practice guidelines.
  • How they will be implemented?
  • How will they affect the daily work routines and responsibilities of the role group?
• Justify the importance of the new policy and practice guidelines with regard to improving the quality of care or outcomes related to the role group’s work.
  • How will the policy and guidelines help improve the quality of care or outcomes?
• Explain the role group’s importance in implementing the new policy and practice guidelines.
  • Why is the work and buy-in of the role group important for successful implementation?
  • How could you help the group feel empowered by their involvement during implementation?
• Determine appropriate and effective instructional content, learning activities, and materials for the training session.
  • How will each proposed activity on your agenda support learning and skill development?
  • Can you complete the training within the allotted two hours?
• Organize content so ideas flow logically with smooth transitions.
  • Proofread your strategy summary and training agenda, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your strategies.
• Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
  • Be sure to apply correct APA formatting to source citations and references.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 4 Example [PDF].

Strategy Summary and Training Agenda Format and Length

Format your document using APA style.

• Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your strategy summary and agenda. Be sure to include:
  • A title page and references page. An abstract is not required.
  • A running head on all pages.
  • Appropriate section headings.
• Be sure your strategy summary and agenda is 2–5 pages in length, not including the title page and references page.

Supporting Evidence

Cite 2–4 external sources to support your strategies for working with the group you have identified and generating their buy-in, as well as for your approach to the training session, activities, and materials.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: You may choose to save your strategy summary and agenda to your ePortfolio.

COMPETENCIES MEASURED

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
  • Explain the impact of new policy and practice guidelines.
• Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
  • Justify the importance of a new policy and practice guidelines with regard to improving the quality of care or outcomes related to a selected role group’s work.
  • Determine appropriate and effective instructional content, learning activities, and materials for a training session.
• Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
  • Summarize evidence-based strategies for working with a selected role group to promote their buy-in and prepare them to implement a new policy and apply associated practice guidelines to their work.
  • Explain a selected role group’s importance in implementing a new policy and practice guidelines.
• Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
  • Organize content so ideas flow logically with smooth transitions.
  • Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

NHS-FPX6004 Assessment 4 Training Session for Policy Implementation Sample Approach

Sound policy and practice guidelines for managing medication errors are critical for a premier medical center such as Mercy Medical Center. To successfully implement the policy on managing medication errors, members of the nursing staff at the medical center responsible for enacting the policy must thoroughly understand the strategies prescribed by the policy. A training program designed for staff members will ensure effective dissemination of the knowledge and skills required to implement the policy guidelines. The training program outlined in this paper will be conducted for a pilot group of 20 nursing staff members from the pediatric medical center’s pediatric division.

Policy on Management of Medication Errors Policy Guidelines and Strategies

The policy on managing medication errors states the procedure that must be followed in case of a medication error. The scope of the policy extends to the nursing, emergency care, and medical staff employed at Mercy Medical Center (Black County Partnership, 2015). The policy requires that the medical center form a multidisciplinary committee. This committee will assess potential discrepancies and address shortfalls in medication processes (Weant et al., 2014).

The strategies to be implemented at the medical center include installing automated dispensing cabinets and setting up a standardized medication error analysis system. To set up a standardized medication error analysis system, the multidisciplinary committee should classify, prioritize, and regularize the process of reporting medication errors. Understanding the causes of medication errors through medication error analysis becomes simpler with the availability of accurate data.

Automated dispensing cabinets are computerized systems for medication management and are installed in healthcare units. These cabinets are used to manage errors that occur when dispensing medication. The cabinets store and dispense medication and electronically track drug inventory (Weant et al., 2014).

Significance of the Policy

Medication errors are indicative of poor-quality healthcare services in a medical center. The proposed policy can prevent medication errors, ensure patient safety, help the medical center avoid litigation for medical negligence, prevent harm to the medical center’s reputation, and reduce unnecessary expenses (Black County Partnership, 2015). This will increase the efficiency of the nursing staff, thereby decreasing the effort and time spent on medication procedures. Less time spent and more efficiency would increase the job satisfaction of the members of the nursing staff.

Early Indicators of Success

Three types of indicators can project the success of the policy at an early stage: structural indicators, process indicators, and outcome indicators. Structural indicators emphasize the quality of organizational aspects, for example, the availability and effective functioning of equipment such as automated dispensing cabinets. Process indicators focus on the process of care delivery. Efficiency in prescription management and diagnosis management are two process indicators that measure the effectiveness of the policy. Outcome indicators are result oriented.

Reduction in readmission rates, reduction in postsurgical wound infection rates, and patient experience are a few outcome indicators that can measure the success of the policy (Grol et al., 2013).

Concerns Over the Policy

The pilot group selected will be trained on the two strategies: installation and use of automated dispensing cabinets and standardized medication error analysis. Staff members could be apprehensive about reporting errors considering the degree of fatality of the error and the disciplinary action as a consequence of underreporting (Chu, 2016). Such apprehension may cause the nursing staff to object to the establishment of a standardized system for medication error analysis. Implementing the second strategy, the installation of automated dispensing cabinets would be beneficial for medication management and prevention of errors; however, automated dispensing cabinets can potentially cause errors in medication retrieval in case of mismanagement of medical inventory (Weant et al., 2014). This could be a potential concern for the nursing staff.

Nursing Staff and Management of Medication Errors Role of Nursing Staff in Policy Implementation

Nursing staff plays an essential role in the implementation of a medication error management policy because of their proximity to patients and medication processes. A nurse is the last person involved in the administering of drugs. A nurse is responsible for physically administering the right drug to a patient and can, therefore, easily identify and correct any error in the medication process (Ofusu & Jarrett, 2015). In order to ensure that the policy on managing medication errors is implemented efficiently, the nursing staff must focus on maintaining accuracy and regularity in reporting medication errors.

The nursing staff can prevent errors in drug administration by practicing the five rights: right dose, right patient, right time, right drug, and right route. The nursing staff can ensure that there are no medication errors while administering medication. Some ways the nursing staff can contribute positively toward policy implementation include calculating the amount of drugs accurately, reducing distractions while administering medication, informing patients about a drug’s effects, and continuously revising pharmacological knowledge (Chu, 2016).

Importance of Training Nursing Staff on the Policy

Nursing staff is involved in medication processes such as prescription and administration of medication. During drug administration, a nurse is the last person who may be able to rectify errors. While patient safety is a priority for nursing staff, they cause most medication errors because of constant distractions and interruptions in their work routine (Ofusu & Jarrett, 2015). It is crucial to train the nursing staff on the guidelines of the policy, as inexperienced and untrained staff may not be able to anticipate or identify a medication error. The policy on managing medication errors requires that automated dispensing cabinets be set up, and medication error analysis be performed.

For the successful implementation of automated dispensing cabinets, it is crucial that the nursing staff be trained on the safe use of these devices. While automated dispensing cabinets are introduced to reduce errors, their incorrect usage can create problems in dispensing medication (Hamilton-Griffin, 2016). To implement the second strategy, namely medication error analysis, nursing staff must be trained on new procedures that will enable them to accurately and regularly report medication errors. Reinforcing the importance of reporting during training will encourage nurses to adopt the medication error reporting procedures, ensuring the availability of adequate data to perform a medication error analysis.

Training Process

A 2-hour workshop will be conducted to train the nursing staff on using automated dispensing cabinets and medication error analysis. A questionnaire will be circulated to the pilot group a day before the training to assess their understanding of the two strategies. This workshop will be divided into two sessions of an hour each. The first session will be conducted by local opinion leaders, who are individuals recognized as clinical experts in a specific field of medication. The opinion leaders will discuss the technical know-how required to operate automated dispensing cabinets and the steps that must be followed for medication error analysis. This session by local opinion leaders would have an influential impact on the nursing staff because of the presence of a familiar figure whose credentials are known.

The second session will involve simulation-based training. Here, the staff will participate in situations in which they have to operate automated dispensing cabinets and perform a mock medication error analysis. This session will give the staff real-world experience and provide insights into potential complexities they may encounter while using the automated dispensing cabinets or conducting a medication error analysis (Grol et al., 2013).

Training Material for Skill Development

Each participant will be given a handout containing the policy guidelines, a document listing the steps to follow while conducting a medication error analysis, and a user manual for the use of automated dispensing cabinets. In addition, a printed version of the content covered by the opinion leader will also be provided to the staff for future reference. In order to ensure continuous learning, the nursing staff will be given access to a virtual classroom using a log-in ID and password to access lectures and self-learning exercises (Grol et al., 2013). The handouts and the virtual learning material will be designed to help the staff members develop skills such as critical thinking and attention to detail and the confidence required to implement the strategies of the policy.

Interpreting the Policy for Nursing Staff

One of the complexities of implementing the strategies of the policy is deciding to report an event as a medication error. The lack of standard definitions for medication errors leads to unidentified errors because there is uncertainty around whether an error needs to be reported.

The implementation of a standardized system for medication error analysis would require that medication errors be clearly defined. This would help nurses accurately identify and report medication errors (Chu, 2016).

The number of medication errors in Mercy Medical Centre’s medical and surgical units increased by 50% from 2015 to 2016. Most medication errors occur during medication administration by nursing staff (Ofusu & Jarrett, 2015). Therefore, the training program on policy implementation intends to familiarize the nursing staff with complex sections of the policy, such as the repercussions of negligence and the protocol to be followed while addressing medication errors. The nursing staff will also be clearly informed of the chain of command to report errors.

Conclusion

The leadership of Mercy Medical Center proposed the policy on the management of medication errors to reduce and prevent the occurrence of medication errors. For the successful implementation of the policy, it is essential to design a training program for the hospital staff on the various strategies of the policy. The program will help staff members understand the importance of managing medication errors, thereby improving patient safety, the medical center’s reputation, and the staff’s job satisfaction.

NHS-FPX6004 Assessment 4 Training Session for Policy Implementation References

Black County Partnership, NHS Foundation Trust. (2015). Medication error policy. Retrieved from https://www.bcpft.nhs.uk/documents/policies/m/973-medication-errors/file

Chu, R. Z. (2016). Simple steps to reduce medication errors. Nursing 2016, 46(8), 63–65. https://doi.org/10.1097/01.nurse.0000484977.05034.9c

Grol, R., Wensing, M., Eccles, M., & Davis, D. (2013). Improving patient care: The implementation of change in health care. Retrieved from https://ebookcentral-proquest- com.library.capella.edu/lib/capella/reader.action?docID=1153537

Hamilton-Griffin, K. (2016). Developing improvement strategies for using automated dispensing cabinets to reduce medication errors in a hospital setting (Doctoral dissertation). Retrieved from ProQuest. (Order No. 10127834)

Ofusu, R., & Jarrett, P. (2015). Reducing nurse medicine administration errors. Nursing Times, 111(20), 12–14. Retrieved from https://www.nursingtimes.net/Journals/2015/05/10/t/l/q/130515_Reducing-nurse- medicine-administration-errors.pdf

Weant, K. A., Bailey, A. M., & Baker, S. N. (2014). Strategies for reducing medication errors in the emergency department. Open Access Emergency Medicine, 6, 45–55. https://doi.org/10.2147/OAEM.S64174

Noah Sanders Case Study: Dysthymia

Noah Sanders Case Study: Dysthymia

For Noah Sanders, life had never seemed much fun. He was 18 when he first noticed that most of the time he “just felt down.” Although he was bright and studied hard, throughout college he was often distracted by thoughts that he didn’t measure up to his classmates.

He landed a job with a leading electronics firm, but turned down several promotions because he felt that he could not cope with added responsibility. It took dogged determination and long hours of work to compensate for this “inherent second-rateness.” The effort left him chronically tired. Even his marriage and the birth of his two daughters only relieved his gloom for a few weeks at a time, at best. His self-confidence was so low that, by common consent, his wife always made most of their family’s decisions.

“It’s the way I’ve always been. I am a professional pessimist,” Noah told his family doctor one day when he was in his early 30s. The doctor replied that he had a depressive personality.

For many years, that description seemed to fit. Then, when Noah was in his early 40s, his younger daughter left home for college; after this, he began to feel increasingly that life had passed him by. Over a period of several months, his depression deepened. He had worsened to the point that he now felt he had never really been depressed before. Even visits from his daughters, which had always cheered him up, failed to improve his outlook.

Usually a sound sleeper, Noah began awakening at about 4 A.M. and ruminating over his mistakes. His appetite fell off, and he lost weight. When for the third time in a week his wife found him weeping in their bedroom, he confessed that he had felt so guilty about his failures that he thought they’d all be better off without him. She decided that he needed treatment.

Noah was started on an antidepressant medication. Within 2 weeks, his mood had brightened and he was sleeping soundly; at 1 month, he had “never felt better” in his life. Whereas he had once avoided oral presentations at work, he began to look forward to them as “a chance to show what I could do.” His chronic fatigue faded, and he began jogging to use up some of his excess energy. In his spare time, he started his own small business to develop and promote some of his engineering innovations.

Noah remained on his medication thereafter. On the two or three occasions when he and his therapist tried to reduce it, he found himself relapsing into his old, depressive frame of mind. He continued to operate his small business as a sideline.

Evaluation of Noah Sanders

For most of his adult life, Noah’s mood symptoms were chronic, rather than acute or recurring. He was never without these symptoms for longer than a few weeks at a time (criterion C for dysthymia), and they were present most of the day, most days (A). They included general pessimism, poor self-image, and chronic tiredness, though only two symptoms are required by criterion B. His indecisiveness encouraged his wife to assume the role of family decision maker, which suggests social impairment (H).

The way he felt was not different from his usual self; in fact, he said it was the way he had always been. (The extended duration is one of two main features that differentiate dysthymia from major depressive disorder. The other is that the required dysthymia symptoms are neither as plentiful nor as severe as for major depression.) Noah had had no manic or psychotic symptoms that might have us considering bipolar or psychotic disorders (E, F).

The differential diagnosis of dysthymia is essentially the same as that for major depressive disorder. Mood disorder due to another medical condition and substance-induced mood disorder must be ruled out (G). The remarkable chronicity and poor self-image invite speculation that Noah’s difficulties might be explained by a personality disorder, such as avoidant or dependent personality disorder. The vignette does not address all the criteria that would be necessary to make those diagnoses. However, an important diagnostic principle holds that the more treatable conditions should be diagnosed (and treated) first.

If, despite relief of the mood disorder, Noah continued to be shy and awkward and to have a negative self-image, only then should we consider a personality diagnosis.

Now to the specifiers (Table 3.3). Though lacking psychotic symptoms, Noah had quite a number of depressive symptoms (including thoughts about death), which would suggest that he was severely ill. His dysthymia symptoms began when he was young (he first noticed them when he was just 18), so we’d say that his onset was early. Noah’s recent symptoms would also qualify for a major depressive episode, which had begun fairly recently and precipitated his evaluation; DSM-5 notes that a dysthymic patient can have symptoms that fulfill criteria for such an episode (D).

We would therefore give him the specifier with intermittent major depressive episodes, with current episode. None of the course specifiers would apply to Noah’s dysthymia, but the following symptoms would meet the criteria for an episode specifier for the major depression—with melancholic features: He no longer reacted positively to pleasurable stimuli (being with his daughters); he described his mood as a definite change from normal; and he reported guilt feelings, early morning awakening, and loss of appetite.

Once treated, Noah seemed to undergo a personality change. His mood lightened and his behavior changed to the point that, by contrast, he seemed almost hypomanic. However, these symptoms don’t rise to the level required for a hypomanic episode; had that been the case, criterion E would exclude the diagnosis of dysthymia. (Also, remember that a hypomanic episode precipitated by treatment that does not extend past the physiological effects of treatment does not count toward a diagnosis of bipolar II disorder.

It should not count against the diagnosis of dysthymia, either.) I thought his GAF score would be about 50 on first evaluation; his GAF would be a robust 90 at follow-up. In the summary, I’d note the possibility of avoidant personality traits.

My full diagnosis for Noah Sanders would be as follows:

Non-traditional Health Care Practices

Non traditional health care practices that do not fall within the widely recognised domains of modern medicine or conventional health care practices are becoming popular among citizens in America and other western countries (Subramanian & Midha, 2016). Referred to by various nomenclature among them; complementary medicine, traditional medicine and alternative medicine (Balouchi et al., 2018), these forms of therapies are sought by patients and other clients to augment mainstream healthcare for various health conditions.

Survey reports indicate that as high as 60% of American citizens use complementary medicine with half of survey respondents reporting recent use- less than five years ago (Anheyer et al., 2017).  In other continents the use of non-traditional health care practices is also reported to be popular. For example, in Europe, Germany and France were reported to have the highest prevalence of complementary health care where close to half of the population are reported to be consumers of non-traditional health care (Fjær et al., 2020).

In China, the most widely used form of complementary medicine among patients was reported to be Chinese Medicine administered by Chinese medicine doctors, family members and friends of patients (Thirthalli et al., 2016). The authors reported various forms of traditional Chinese therapies including; Acupuncture and moxibustion, Massage, Qigong- a practice of coordinating body, breath, and mind, based on Chinese philosophy, Tai chi- a traditional Chinese martial art in accordance with yin and yang- based mastering five elements; Yi (mind), Qi (breath), Xing (body gesture and movements), and Shen (spirit). Reported by the same study, more than fifty percent of patients reportedly visited their Chinese medicine practitioner more than once in a month while close to thirty percent of patients reportedly visit a Chinese medicine doctor daily. In comparison to China, homeopathic treatment, acupuncture, chiropractic manipulation, and phytotherapy/herbal medicine were the most sought after forms nonconventional therapies in Europe (Fjær et al., 2020).

Though rare, energy medicine was another form of non-traditional form of health care reported in the literature among the European citizens (Germany, Sweden, Norway, UK and France). The implementation of these alternative forms of therapies in Europe was found to be associated with availability of resources both at the individual and country level (Subramanian & Midha, 2016). Individuals were likely to seek these alternative therapies if they had the resources to acquire the services of an alternative care therapist. At the country level, countries with resources at their disposal were found to be more likely to integrate into their health systems these alternative forms of non-traditional health care by formal employment of alternative health care providers such as chiropractors and homeopathic physicians.

In the USA, the use of non-traditional forms of therapies in the management of health conditions as alternative to mainstream forms of treatment has been widely described in literature. In the management of Pediatric Attention Deficit Hyperactivity Disorder for example, Anheyer and colleagues (2017) in a review describing alternative therapies for this condition, reported the use of; Botanicals, Minerals, Essential Fatty Acids, Dietary Restrictions, Homeopathy and Cognitive-Behavioral Interventions as the most widely used therapies. The use of these alternative therapies in this condition is just but a snippet of the use of alternative therapies in a host of other health conditions and is the characteristic of the American patients seeking alternative forms of therapy to supplement modern medicine.

The importance of non-traditional therapies as alternatives to mainstream health care is increasingly being recognised by health care providers and governments in many jurisdictions (Anheyer et al., 2017). The push for integration of non-traditional forms of therapies with mainstream health care services comes with the realisation that this integration enables the achievement of holistic health care for patients. In addition, for most countries, the numbers of mainstream health care providers such as primary care physicians and nurses is not adequate to match patient numbers leading to patients seeking care from alternative therapists.

For some conditions such as asthma, these non- traditional forms of therapies are documented to be offering superior outcomes for some groups of patients though the evidence is still inadequate to draw concrete conclusions (Amaral-Machado et al., 2020).  In the management of communicable conditions such as malaria, the application of alternative medicine has proved its worth.  The major drugs currently being used to treat malaria (quinine and artemisinin) were derived from traditional herbal therapies in Peru and China (Manuel et al., 2020). Non traditional forms of therapies are an important source for several drugs currently being applied in modern modern healthcare especially the treatment of infectious diseases.

In my area, the use of non-traditional forms of healthcare is not uncommon. Many diabetic and hypertensive patients I know are engaged in Yoga meditation, music therapy as a recreational activity and as alternative therapies (Subramanian & Midha, 2016). In addition, diabetic patients also visit chiropractors and homeopaths. Though actual numbers were not easy to come by, majority of users of non-traditional forms of therapy from my area do not only use one form of therapy to manage their conditions but are involved in dual or multiple therapies choosing to concurrently use both traditional and non-traditional alternatives.

World over, the consumption of non-traditional health care is on the increase (Subramanian & Midha, 2016). This increase in the preference for non-traditional health care can be attributed to the following reasons: 1) majority of alternative forms of therapies resonate well with cultural beliefs of patients and are therefore more acceptable. 2) compared to some mainstream forms of treatments, alternative therapies can be affordable to clients and will be preferred basing on the economic standing of the patient (Fjær et al., 2020).  3) though documentation of evidence for alternative forms of therapies is poor, for some conditions such as asthma, patients have reported better outcomes in their health when compared to the modern/traditional forms of treatment (Amaral-Machado et al., 2020).

In conclusion, literature supports the notion that application of non-traditional therapies is increasing in popularity. There is also the increasing recognition of its place in modern health care practice especially in the era of cross-cultural nursing. The emphasis by cross-cultural nursing practice on the principle of respect of patients’ preferences, cultures and beliefs should make the application of non-traditional health care practices more appealing for nurses. In deed, the integration of non-traditional health care into modern health care delivery models offers many benefits and will go a long way in ensuring the patient’s every health need is met as well as furthering the agenda of holistic health care approach.

References

• Amaral-Machado, L., Oliveira, W. N., Moreira-Oliveira, S. S., Pereira, D. T., Alencar, É. N., Tsapis, N., & Egito, E. S. T. (2020). Use of Natural Products in Asthma Treatment. Evidence-Based Complementary and Alternative Medicine. https://www.hindawi.com/journals/ecam/2020/1021258/
• Anheyer, D., Lauche, R., Schumann, D., Dobos, G., & Cramer, H. (2017). Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review. Complementary Therapies in Medicine, 30, 14–23. https://doi.org/10.1016/j.ctim.2016.11.004
• Balouchi, A., Mahmoudirad, G., Hastings-Tolsma, M., Shorofi, S. A., Shahdadi, H., & Abdollahimohammad, A. (2018). Knowledge, attitude and use of complementary and alternative medicine among nurses: A systematic review. Complementary Therapies in Clinical Practice, 31, 146–157. https://doi.org/10.1016/j.ctcp.2018.02.008
• Fjær, E. L., Landet, E. R., McNamara, C. L., & Eikemo, T. A. (2020). The use of complementary and alternative medicine (CAM) in Europe. BMC Complementary Medicine and Therapies, 20(1). https://doi.org/10.1186/s12906-020-02903-w
• Manuel, L., Bechel, A., Noormahomed, E. V., Hlashwayo, D. F., & Madureira, M. do C. (2020). Ethnobotanical study of plants used by the traditional healers to treat malaria in Mogovolas district, northern Mozambique. Heliyon, 6(12). https://doi.org/10.1016/j.heliyon.2020.e05746

National Organization of Nurse Practitioner Faculties NONPF Competencies PRAC 6675

National Organization of Nurse Practitioner Faculties NONPF Competencies PRAC 6675

National Organization of Nurse Practitioner Faculties (NONPF) Competencies

Nursing competencies include incorporating various professional skills, personal principles, knowledge, and values within the scope of nursing. These competencies play a critical role in the nurse performance evaluation. Competent nurses need to address the nine nursing competencies to achieve quality health outcomes.

Scientific Foundation

Competencies reflect on nursing education, ensuring that nurse practitioners have a comprehensive and robust foundation of medical sciences before graduation. The students need to understand pathophysiology and pharmacology in their specialties (Zakhari, 2021). Engaging medical research through evidence-based practice guidelines through scientific competence is easy.

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Assignment 2: Practicum Experience Plan (PEP)

Leadership

Leadership competence allows all practitioners to understand their roles as team leaders and standards of practice while leading a team of healthcare providers (Stewart & DeNisco, 2019). I will be able to gain quality communication skills, solve problems, and make excellent decision-making skills.

Quality

This competency assesses healthcare services’ success in improving patient care and allowing nurses to effectively apply their knowledge and skills (Stewart & DeNisco, 2019). They should be willing to reduce errors and harm.

Practice Inquiry

It involves interpreting research and its application to clinical settings (Zakhari, 2021). Nurses need to understand how to apply research to their parents and improve patient outcomes. I can use the research to improve the health status of communities.

Technology and Information Literacy

This competency aims at the integration of various technologies into the nursing practice. Nurse practitioners need to understand how to use digital communication tools, have network access, and manage and create effective communication during care delivery (The National Organization of Nurse Practitioner Faculties, n.d.). The technology can also be utilized in the maintenance of privacy and confidentiality. I would use social media and media houses to advocate for patient needs.

Policy

Policy refers to the implemented programs at the local, state, national, and global levels to facilitate health resource allocation. In these programs’ advocacy and legislation, however, nurses play a critical role considering that they understand the patient’s primary and complex needs. Nurses are better positioned to address social concerns at the community level, such as violence, poverty, and literacy (Buppert, 2021).

Nursing students also can develop ethical healthcare policies in reference to the existing policies, while others could use the same to provide awareness to members of the community. As a practitioner, I will commit to educating community members on their various health rights using the acquired skills.

Health Delivery Systems

This encompasses developing, planning, and implementing any community and public health program. Nurse practitioners engage in delivery systems through enhancing decision-making, developing major organizational reforms, and creating culturally competent care (Stewart &DeNisco, 2019). They can also implement these skills at the community level to identify existing health concerns.

Ethics

It involves the understanding of ethical issues between nurse-patient interactions that require to be observed. Ethics allows nurse practitioners to improve their decision-making regarding their patients’ health status (Zakhari, 2021). With the help of ethics, the dilemmas in community health can be handled within an appropriate time frame.

Independent Practice

An ability embraces an attendant specialist as an authorized medical care supplier who can freely work with next to no oversight. According to The National Organization of Nurse Practitioner Faculties (2017), expertise like this works with nurture specialists to direct patients’ well-being appraisal, determination, and treatment remedies. Along these lines, nurture specialists are perceived by regulation as experts who have the right stuff and information to oversee both analyzed and undiscovered patients freely. Nursing Competencies Essay.

References

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

The National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies. Retrieved 4th April 2022 from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20170516_NPCoreCompsContentF.pdf

The National Organization of Nurse Practitioner Faculties. (n.d.). National Organization of nurse practitioner faculties. Retrieved 4th April 2022 from https://www.nonpf.org/

Stewart, J. G., &DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Assignment 2: National Organization of Nurse Practitioner Faculties (NONPF) Competencies

The Assignment

For each of the nine NONPF competencies, write one paragraph explaining how the program has prepared you to meet the competency (for a total of at least nine paragraphs). Then, propose how you plan to engage in social change in your community as a nurse practitioner. Finally, describe 1–2 legislative and/or advocacy activities in which your state (California) nurse practitioner organization(s) are involved. Be specific and provide examples.

The National Organization of Nurse Practitioner Faculties (NONPF) has determined nine broad areas of core competence that apply to all nurse practitioners, regardless of specialty or patient population focus. NONPF created the first set of Nurse Practitioner Competencies in 1990; the most recent updates were incorporated in 2017. This course was designed to prepare you to synthesize knowledge gained throughout the program and to apply each of the nine core competencies within your selected areas of practice and your representative communities.

The nine areas of competency are:

Scientific Foundations
Leadership
Quality
Practice Inquiry
Technology and Information Literacy
Policy
Health Delivery System
Ethics
Independent Practice

To Prepare

Review this week’s Learning Resources, focusing on the NONPF Core Competencies Content.

Learning Resources

Required Readings (click to expand/reduce)

American Nurses Credentialing Center. (n.d.). Psychiatric-mental health nurse practitioner (across the lifespan) certification (PMHNP-BC).

https://www.nursingworld.org/our-certifications/psychiatric-mental-health-nurse-practitioner/

Scroll to ANCC Study Aids Free for sample test questions and study guides to help you prepare for your certification exam.
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

Chapter 12, Lawmaking and Health Policy
Chapter 14, Standards of Care for Nurse Practitioner Practice
Chapter 15, Measuring Nurse Practitioner Performance

The National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20170516_NPCoreCompsContentF.pdf

The National Organization of Nurse Practitioner Faculties. (n.d.). National organization of nurse practitioner faculties. https://www.nonpf.org/

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

Chapter 11, Concepts of the Professional
Chapter 12, Health Policy and the Nurse Practitioner
Chapter 14, Mentoring

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Chapter 1, Preparing to Pass the Psychiatric-Mental Health Nurse Practitioner Certification Exam (for review as needed)
Chapter 16, Practice Test
Document: Career Planner Guide

Required Media

APRN Central. (2019, October 27). Goal digger: Test taking strategies [Video]. YouTube. https://www.youtube.com/watch?v=STAT1WpQgSM

DrRegisteredNurse. (2020, February 16). Test-taking strategies to pass the NCLEX in 75 questions part 1 [Video]. YouTube. https://www.youtube.com/watch?v=81E3dAxrO2c

NorQuest NFDN 1002 Professional Portfolio Assignment

Topic: Professional Portfolio Example

Student Name:

Course:

I was keen to bring out several therapeutic tools that the nurse employed. For every non-therapeutic technique used, I had an alternative therapeutic tool that I would have employed. Excellent performance in the assignment made me confident in my communication techniques when interacting with patients.

Su, Jing Jing, Golden Mwakibo Masika, Jenniffer Torralba Paguio, and Sharon R. Redding. Defining compassionate nursing care.” Nursing ethics 27, no. 2 (2020): 480-493. https://doi.org/10.1177%2F0969733019851546

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NFDN 1002 Assignment 2: Teaching Plan

Assignment 1: Professional Portfolio Instructions

Overview

The purpose of a professional portfolio is to demonstrate a commitment to life-long learning through ongoing professional development. The professional portfolio will help you to develop your understanding of the CLPNA competencies as well as ensuring self-assessment and reflection throughout your career in nursing. This will ultimately help you transition from a novice to expert practitioner. This assignment is a total of 14 marks and contributes 5% toward your total course grade.

Instructions

Step 1:

Review the competencies from the CLPNA website

Once you have selected the competency send to your instructor to review the competency number .

NFDN 1002-Check with your Instructor the competency selected from CLPNA site.

Pick the specific competency you would like to focus on.

Step 2:

Reflect on the following areas and provide your information for each area on the template provided.
Competency: Clearly label the competency letter, number, and subcategory (write out the competency).
Significant learning experience: Describe ONE significant learning experience in this course related to the CLPNA competency you have identified. Provide an example.

What you learned: Describe what you learned and how it relates to the competency identified.

Proficiency rating: Use the Proficiency Rating Categories below to rate your own proficiency in the identified CLPNA competency. What did you do to achieve this competency and provide evidence to support your rating?

Significance of learning: Explain how the identified competency enhanced your learning (was meaningful) in this course.

Nursing Practice: Describe how you will apply this learning in your current and future nursing practice (What are your strengths and what are your future learning needs regarding this competency).

Follow APA for references and citations, grammar/spelling

Step 3:

The learner will upload their professional portfolio to the Moodle assignment drop box on the due date specified by your instructor.

Proficiency Categories:

Excellent: Integrates competency theory with other knowledge, skill and attitudes so that it becomes seamless/automatic as part of everyday nursing practice.

Good: Understands the competency in theory and in scenarios and nursing practice.

Fair: Understands the competency in theory; unable to apply it to scenarios or nursing practice.

Poor: Does not understand the content related to the competency

Professional_Portfolio_Marking_Guide_(1).pdf

Professional_Portfolio_Instructions_(1).pdf

Professional_Portfolio_Template_(3)

NR 504 Week 8 Assignment – The Meso Level Leadership

NR 504 Week 8 Assignment – The Meso Level Leadership

Care Clinic Scenario:

The care given to the Summerville, Florida residents is something that the Executive Team of Care Clinic takes great pride in. The Clinic is renowned for its community outreach initiatives and holistic patient treatment.

The Executive Team of Care Clinic evaluates the benchmark results for customer satisfaction with service and quality indicators every year. In the last 12 months, client satisfaction and quality care scores have significantly dropped.

To assist in understanding the quality issues related to client care occurring within the Care Clinic, you are provided with two videos of client situations that have been recorded using Second Life. You must also enter Second Life to observe actions and conversations occurring within the Care Clinic.

When viewing the videos and participating in the Care Clinic in Second Life, consider yourself the manager and identify quality care issues consistent with decreasing client satisfaction scores.

Determine how the declining benchmarks can be addressed and improved from your leadership perspective. Discuss the actions/changes that need to be implemented to improve satisfaction scores and attain Care Clinic quality outcomes.

For NR 504 Week 8 Assignment – The Meso Level Leadership assignment, the Care Clinic Improvement Project must be completed by the end of week six of this course and must address each of the following areas.to

1. Identify ONE satisfaction benchmark you will be addressing and why this benchmark has been selected. Select the ONE client satisfaction benchmark from the following list:
2. Decrease in client satisfaction scores related to courtesy and friendliness of the staff at the Care Clinic.
3. Decrease in client satisfaction scores related to staff explaining discharge instructions in an understandable manner to the client/client.
4. Decrease the quality of nursing care related to interventions provided to clients at the Clinic.
5. Describe the leadership dynamics related to managing the improvement/change project.
6. Identify the change model that will be used in addressing the selected benchmark.
7. Describe the course of action/change.

ORDER THROUGH BOUTESSAY

NR 504 Week 8 Discussion You and Your Leadership Journey Recent

You and Your Leadership Journey

Week 8 has arrived and provides an excellent opportunity to self-reflect on your leadership journey that started eight weeks ago. For the discussion, provide a comprehensive response to each of the following topics:

Based on your learning experiences in NR 504, identify two areas that were new to you regarding leadership and how you will use these two areas in your future professional nursing practice area.
Speculate how to use the leadership concepts presented in NR 504 to guide your final MSN practicum project.

NR-505 NP Advanced Research Methodology : Evidence-Based Practice, Quality-Improvement and Research Methodology:

NR-505 NP Advanced Research Methodology

MY TOPIC: Traditional Research Methodology

NR-505 NP Advanced Research Methodology Purpose

The purpose of this discussion board is to enhance understanding of an evidence-based practice versus quality-improvement versus research methodology (qualitative, quantitative -to include the Randomized Controlled Trial).

This week in discussion board we are going to have a debate-like discussion regarding the following 3 topics:

1. Quality improvement
2. Traditional research methodology 
3. Science of evidence-based practice

Activity Learning Outcomes for NR-505 NP Advanced Research Methodology

Through this assignment, the student will demonstrate the ability to:

1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (CO 1 )
2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes. (CO 2)
3. Analyze research findings and evidence-based practice to advanced holistic nursing care initiatives that promote positive healthcare outcomes. (CO 5)

Due Date for NR-505 NP Advanced Research Methodology:

Initial prompt due by Wednesday, 11:59 PM MT of week 1

One peer and one faculty or two peer posts due by Sunday 11:59 PM MT of week 1

Points:?50 points

Assignment Requirements for NR-505 NP Advanced Research Methodology

1. Your faculty will assign you one of the following three topics: quality improvement, “traditional” research methodology, or evidence-based practice. Watch the Announcements and/or your Chamberlain email for your assigned topic.
2. You will provide rationale as to why your assigned topic is the most important, the best, for the provision of quality care as a nurse practitioner.
3. You will compare the topic you are assigned to one of the other topics you have not been assigned. For example, if you are assigned quality improvement, you may compare to a traditional research method, such as a randomized control trial. When writing this argument, you should provide a compare and contrast approach which highlights the features of the topics, how the topic informs providers and the topic’s importance to quality and safety.
4. Your response to this prompt should be a minimum of two (2) paragraphs of 4-5 sentences which utilize in-text citations (APA).
5. A response to two (2) peers is required with a minimum of one (1) paragraph of 4-5 sentences which utilizes in-text citations (APA).
6. References are required, the use of first person should be avoided.
7. Be sure to integrate one or both of the podcasts of this week into your argument.

NR-505 NP Advanced Research Methodology Discussion Content

Category

Points

%

Description

Scholarly

15

30%

• The student actively stimulates and sustains inquiry by making reflective insightful comments, asking thoughtful questions and/or engaging in a scholarly discussion.
• The student expresses a clear idea of the topic under discussion and sustains inquiry in order to explore relevant issues.
• The student recognizes values or values conflict as things that form the assumption basis of arguments and recognizes when it is important to acknowledge these values. NR-505 NP Advanced Research Methodology
• The student recognizes the accuracy, logic, relevance, or clarity of statements.
• The student asks clarifying questions and knows when clarifying questions need to be asked.
• The student distinguishes fact from opinion.

Application

15

30%

• All components of discussion prompt addressed (met) in initial posting. This includes PowerPoint/Kaltura requirements where indicated.
  • Kaltura video required; a written narrative is not required in addition to the video.
• The student’s writing conveys an understanding of significant ideas relevant to the issue under discussion. This is indicated by integration of course and weekly objectives, as well as readings from text and articles.
• All posts should make correct use of terminology, precise selection of the pieces of information required to make a point, correct and appropriate use of examples and counterexamples, demonstrations of which distinctions are important to make, and explanations that are concise and to the point. NR-505 NP Advanced Research Methodology
• Information and knowledge are accurate.
• The student elaborates statements with accurate explanations, reasons, or evidence from the course and/or weekly objectives.
• All postings integrate scholarly sources to support points consistently.

Interactive Dialogue

10

20%

• Responds to ideas in a way that advances discussion with depth, rigor, and application.
• Interacts with a professional tone and is able to express opinions with ownership and without judgement. NR-505 NP Advanced Research Methodology
• Chooses to include professional experience to the discussion board mindful of appropriateness and boundaries. Experience is integrated as it supports the discussion board topic and utilizes scholarly references to support overall topic.

40

80%

Total CONTENT Points=40 pts

DISCUSSION FORMAT

Category

Points

%

Description

APA (current edition)

5

10%

• In text citations are formatted per APA.
• Reference list is formatted per APA.
• Spelling, grammar, and scholarly tone per APA.

Spelling / Grammar etc.

5

10%

• Posts should utilize correct spelling and grammar (sentence structure and avoidance of slang or casual language). NR-505 NP Advanced Research Methodology

10

20%

Total FORMAT Points= 10 pts

DISCUSSION TOTAL=50 points