Assessment 4 : Patient, Family, or Population Health Problem Solution
Assessment 4: Patient, Family, or Population Health Problem Solution
Assessing the Problem
Part 1
The proposed intervention that is recommended for providing high quality, safe, and efficient care to the patient with stroke is offering coordinated care via telehealth. Telehealth is a digital technology in healthcare that facilitates the provision of patient care remotely. The technology enables patients and their healthcare providers to interact and share ideas on ways of ensuring the optimum management of their health problems (Lawson et al., 2020). Telehealth has proven effective in use in patients suffering from chronic and acute illnesses. Evidence shows that besides providing effective care coordination remotely in stroke, telehealth also enhances the care outcomes for patients suffering from conditions such as asthma, depression, heart disease, and chronic obstructive pulmonary disease among others (Rutledge et al., 2017).
The effectiveness of telehealth in providing coordinated care to the patient is that it enhances the safety, quality, and efficiency of care. The improvement in safety of care is attributable to continuity in care provision to patients even after discharge from the hospital. The patient is also assured of timely care and attention when needed, minimizing the risk of adverse events due to recurrent strokes and associated complications. Telehealth promotes cost-effectiveness by reducing the costs that the patient could have incurred travelling for unnecessary assessments (Hubert et al., 2021). It also prevents adverse events such as complications that would result in high costs of care, hence, cost efficiency. Therefore, the use of telehealth is anticipated to improve the safety, quality and efficiency of care given to the patient and burden of the disorder to the healthcare system (Bashir, 2020). Each of the following considerations shaped my understanding of the problem (stroke) and need for telehealth to address the care needs of the patient.
Leadership: Leadership in nursing is important for the promotion of the health and wellbeing of the patient with stroke. Nurses have to demonstrate their leadership skills in proposing and implementing evidence-based interventions that will minimize the burden of stroke to the patient, family and healthcare system. Nurses also demonstrate leadership by strengthening teamwork, active stakeholder collaboration, and open communication in addressing the care needs of the patient (Morley & Cashell, 2017). Therefore, leadership informed my understanding of the severity of the problem and the needed interventions that could enhance the health outcomes of the patient and his family.
Collaboration: The realization of optimum outcomes for the patient with stroke requires effective inter-professional collaboration. Healthcare providers from different specialties are needed to work together in the assessment, planning, implementation, monitoring, and evaluation of the care needs of the patients. They also have to work together in determining the advanced care needs of the patient that should be met to prevent and minimize complications. Having the different healthcare providers working together from the same setting may be a challenge in healthcare organizations (Morley & Cashell, 2017). As a result, telehealth for care coordination is an effective alternative to achieve the desired collaboration in patient care.
Communication: Communication is an important aspect in ensuring the provision of high quality, efficient and safe care to the patient. Communication strategies such as open communication, consistency, and conciseness in communication should be encouraged in working with the patient in the project. Through open communication, healthcare providers involved in the care process will understand the needs, views, and concerns of the others and patient in the care process (Lawson et al., 2020). The consideration of communication therefore shaped my understanding of the vital aspects of communication that should be incorporated into care coordination for the patient.
Change management: The effective management of stroke using interventions such as technology, care coordination and community resources is a change initiative on its own. Healthcare providers involved in the care process have to transform their existing systems and processes to ensure the optimum health outcomes of the patient. They also need to have the desired competencies in utilizing technologies to address the care needs of the patient. Therefore, change management interventions such as training, open communication, and active stakeholder involvement are needed to increase the success rate of the approaches to patient care (Lawson et al., 2020). The consideration of this aspect increased my understanding of the requirements that should be met for the effective use of telehealth for care coordination.
Policy: Healthcare policies will influence the care given to the patient. Policies related to the use of healthcare technologies, care coordination and utilization of community resources must be adhered to in the implementation of the proposed intervention. Policies will also influence the scope of nursing practice in providing care to the stroke patient (Haddad & Geiger, 2021). Therefore, policies shaped my understanding of the dynamic roles that each of the healthcare providers and resources play in ensuring the realization of the optimum care outcomes for the patient with stroke.
Quality of care: Quality of care in stroke management is important. Nurses and other healthcare providers have the responsibility of ensuring that the care interventions use promote quality, safety and efficiency. Healthcare providers utilized evidence-based interventions to achieve this care outcome (Carrigan & Livesay, 2018). The focus on quality in stroke management informed the decision to propose telehealth for care coordination to achieve optimum outcomes of care.
Patient safety: Patient safety is important in the provision of care. Nurses and other healthcare providers ensure that the care that patients receive has minimal harm but optimum benefits to promote recovery from their health problems. Stroke patients require safe care to accelerate their recovery process. The consideration of patient safety informed the recommendation of telehealth, as it has optimum benefits such as enhanced quality and efficiency of care and minimal harms (Rutledge et al., 2017). Patients also develop their desired competencies in self-management, hence, safety and quality outcomes.
Costs to system and individual: The care given to patients with stroke should aim at reducing the cost burden of managing the condition. The cost implications of stroke to patients and healthcare system are enormous. The adopted interventions should targeted at ensuring the provision of optimum and high quality care at the lowest cost possible. Telehealth technologies provide cost-effective and efficient solutions to lowering the costs incurred by patients and healthcare systems. The technology eliminates unnecessary hospital visits and hospitalizations, hence, cost-efficiency in the treatment process (Gorelick, 2019). Therefore, the cost benefits of the solution informed its adoption for the patient in this project.
Technology: Healthcare technologies have transformed the provision of healthcare in the modern world. The technologies are used to ensure safety, efficiency and quality in patient care. Healthcare technologies are also applicable in stroke management to enhance the care outcomes. Review of the existing literature showed that digital technologies such as telehealth are effective hence, its recommendation for use in coordinating the care needed by the patient in this practicum experience (Bashir, 2020).
Care coordination: Care coordination is important for the realization of optimum outcomes in the care of the patient. Care coordination also promotes the realization of other outcomes such as patient and provider satisfaction, patient empowerment, increase in the quality of care, and enhanced access to specialized care (Kitzman et al., 2017). As a result, this concept informed the decision to incorporate telehealth for the provision of coordinated care to the patient.
Community resources: Community resources should be utilized optimally to achieve the desired outcomes of care for the patient with stroke. Community resources such as social support systems are important in facilitating the coping of the patient and his family. Nurses and other healthcare providers will work with the patient and his family to explore the available resources in the community that can be used to achieve the set goals of treatment (Mackie et al., 2019).
Part 2
Healthcare problems such as stroke have immense effects on the affected populations, their significant others and healthcare systems. Nurses and other healthcare providers play the responsibility of ensuring the adoption of responsive interventions to address the care needs of the affected populations. They explore the best practice interventions that can be adopted to ensure efficiency, quality, and safety in case management. They also explore evidence-based technologies that are applicable in optimizing care outcomes for their populations. Therefore, this section of the project explores the proposed solution that would be used to meet the care needs of the patient with stroke.
Summary of the Patient Problem
The selected patient problem is stroke. Stroke is a condition that develops due to the occlusion of blood flow to the brain. It also occurs due to the bursting of the blood vessels in the brain. The occlusion or bursting of blood vessels impairs the supply of oxygen to different parts of the brain leading to death of brain cells. The patient used in the practicum experience is a male patient in my neighborhood who was diagnosed with stroke a year ago. The patient has partial paralysis and requires moderate assistance in undertaking most of his activities of the daily living. The patient enjoys ready support from his family members and community members who provide the support he needs to live a healthier life and wellbeing.
Reason for Selection
Stroke was selected for the practicum project because of a number of reasons. Firstly, stroke is the leading cause of disability and mortality in the USA. The CDC reports that about 795000 people are diagnosed with stroke in the US on an annual basis. It further reports that one person gets stroke after every 40 seconds in America. Stroke is a preventable condition. Modifiable factors such as obesity, hypertension, heart disease, diabetes, and cigarette smoking contribute to it (Gorelick, 2019). Nurses can therefore play a proactive role in leading the implementation of interventions that will promote the health and wellbeing of patients affected or at risk of developing stroke. Stroke was also selected due to the effect it has on the affected populations and healthcare systems. As a result, it was important to explore the ways in which the burden associated with it can be reduced in families and healthcare systems (Carrigan & Livesay, 2018).
Relevance to Professional Practice and to the Patient and Family
Stroke is relevant to professional practice. As noted above, stroke is a preventable condition. Nurses have a critical role in the promotion of health and prevention of illnesses. As a result, the relevance of stroke can be seen from the increased need for nurses to ensure creation of awareness among the community members on the prevention and minimization of burden of stroke (Ouriques Martins et al., 2019). Stroke also has enormous burden to the patients, their families and healthcare systems. Issues such as the high costs of managing stroke, loss of productivity due to disability, and increased utilization of healthcare resources in addressing the complex needs of stroke patients evidence the burden of the condition (Gorelick, 2019). Nurses play an important role in easing the burden of disease for patients, their significant others and healthcare systems. Consequently, stroke is relevant to their professional practice, as they have to identify efficient and effective interventions needed to lower the disease burden and improve the quality of health and lives of the affected populations.
Influence of Leadership and Change Management Strategies on the Development of Proposed Intervention
As noted, the proposed intervention entails the use of telehealth to enhance care coordination for the patient with stroke. Leadership and change management strategies had an influence on the development of the proposed intervention. Leadership in nursing entails influencing others to act in ways that contribute to the realization of the desired outcomes. Nurses influence others using interventions such as active participation, open communication, and modeling the desired behaviors (Berra et al., 2019). The use of effective leadership approaches contribute to change management in managing health problems including stroke. Therefore, I used the concepts of leadership such as innovation to propose the use of telehealth to enhance the quality, safety and efficiency of care given to the patient (Carrigan & Livesay, 2018). I also utilized the concepts of change management such as open communication and active stakeholder participation to propose the use of telehealth, as it will increase the engagement of those involved and ownership of the care process by the patient and healthcare providers.
How Nursing Ethics Informed the Development of the Proposed Intervention
Nursing ethics also informed the development of the proposed intervention. Ethics in nursing entails universal rules that guide the motives, actions, and intentions of the nurses. Several ethics in nursing informed the development of the intervention. One of them is my primary commitment to the patient and his family. According to nursing ethics, nurses must prioritize the patients and their significant others. The prioritization includes implementation of interventions that enhance the realization of their actual and potential needs. The need for advocacy in my role also informed the development of the intervention. Nurses have critical roles to play in ensuring the protection of the rights, safety, and health of their patients. Patients have a right to equity in healthcare irrespective of their health problems. As a result, the incorporation of telehealth into the coordination of the care the patient needs will ensure equity in access to high quality care by the patient, hence, my role in advocacy. The ethical principles of benevolence, non-maleficence, justice, and veracity also informed the development of the intervention. Accordingly, the use of telehealth in care coordination for chronic conditions is safe, efficient and effective (Haddad & Geiger, 2021). It also ensures that healthcare providers demonstrate their commitment and professional responsibility in promoting continuity in the care given to the patient remotely.
Patient Identification
The patient for the practicum activity is a male diagnosed with stroke. The patient was diagnosed with stroke a year ago and has been on home-care management. He lives with his family that assists him in meeting his daily needs. The patient has partial paralysis. The aim of the project is therefore to propose the use of telehealth to enhance the coordination of care given to the patient. Telehealth will also promote the realization of care outcomes that include safety, quality and efficiency.
Benefits of Gathering Patient and Family Input
Patient and their families play an important role in the development and implementation of care interventions used to achieve the desired care outcomes. As a result, nurses should prioritize gathering their input as a way of improving care associated with the identified health problem. Input from the patient with stroke and his family should be obtained in the treatment process because of a number of reasons. Firstly, gathering input from them promotes ownership of the adopted interventions. The patient and family can implemented the interventions with ease to achieve their desired outcomes (Morel & Cano, 2017). Gathering their input also ensures relevance of the adopted interventions. Healthcare providers will implement interventions that align with the expectations of the patients and healthcare providers. Relevance of the adopted interventions is important, as it ensures sustainability in the treatment process. Gathering the inputs of the patient and his family members also promotes their empowerment. They are empowered to play a proactive role in the implementation of care interventions that will optimize their care outcomes. Lastly, gathering the inputs of the patient and his family promotes their satisfaction with the care process (Mackie et al., 2019). By gathering their inputs, values, needs, and preferences of the patient and his family are prioritized in the decision-making processes, hence, their satisfaction with the care given to them.
Best Practice Strategies for Effective Communication and Collaboration
Effective communication and collaboration are important for the realization of the optimum care outcomes for the patient and his family. One of the communication strategies that would be used to achieve the desired outcomes is open communication. Open, transparent communication between the patient, his family and healthcare providers will be promoted to ensure trust in the adopted interventions. The involved stakeholders will have the freedom to express their concerns, ideas, and views on the ways in which the treatment plans can be improved to address the care needs of the patient and his family. The communication will also be concise and consistent. Concise and consistent communication is essential to underpin the information needed to enhance the care outcomes of patients, their families and healthcare systems (Wang et al., 2018). One of the collaboration strategies that will be adopted is defining and assigning roles to the different healthcare providers. Defining and assigning roles will prevent duplication of tasks, hence, efficiency in care provision. Active stakeholder involvement will also be used as a collaboration approach. Active involvement will aim at ensuring that the healthcare providers, patient and his family develop the desired competencies for the effective management of the health problem (Morley & Cashell, 2017). Therefore, the above strategies will ensure the realization of optimum outcomes for the patient and the family in the treatment process.
Standards or Policies that Guided the Work
Nursing practice standards and government policies guided the development of the intervention. The nursing practice standards that influenced the development of the intervention included health information technology, quality and efficiency competencies in the provision of patient care. Nurses have the responsibility of promoting the meaningful use of health information data in their practice. They ensure privacy and confidentiality in the access and use of patients’ data. The competencies related to efficient and quality use of data in healthcare informed the selection of telehealth for care coordination (Park & Jeong, 2021). The existing evidence has shown that telehealth systems are safe and efficient in use in coordinating care given to patients suffering from chronic illnesses. Government regulations including HIPAA also guided the development of the intervention. Accordingly, HIPAA requires healthcare providers to adopt efficient technologies for patient care that offer adequate security for private and confidential data of the patients. The meaningful use of health information data should also be promoted in patient care (Rutledge et al., 2017). Through it, technologies such as telehealth will enhance the care outcomes for the diverse patient populations.
Effectiveness of the Proposed Intervention
The proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the patient, his family and the system in a number of ways. Firstly, it will improve quality of care by ensuring the patient accesses specialized care remotely. The system will incorporate care interventions from different healthcare providers to optimize the treatment outcomes (Hubert et al., 2021). The intervention will also facilitate the early identification and management of any complications. Through it, the system will promote safety in patient care (Lawson et al., 2020). The intervention will also reduce the costs of care to the patient and healthcare system. For instance, telehealth will enable the patient to address his care concerns remotely without having to travel to the hospital. It will also eliminate any complications through their early identification and management. As a result, costs incurred by the patient and healthcare system will decline significantly (Bashir, 2020). Therefore, the adoption of telehealth for use in care coordination should be prioritized. The available sources of benchmark data that can be used include those reported in journals and institutions that have implemented telehealth for chronic disease management.
Application of Technology, Care Coordination and Utilization of Community Resources
Technology can be applied in addressing the care needs of the stroke patients. As seen from this project, technologies such as telehealth are effective in enhancing the care outcomes such as quality, safety, efficiency and patient satisfaction with care. Care coordination can also be applied in addressing the problem. Nurses can coordinate inter-professional care to ensure the realization of optimum care outcomes of the patient and the family. Care coordination can also be used to enhance patient satisfaction and empowerment with care. Community resources can also be applied in addressing the problem. Community resources such as social support systems can be used to promote coping in the patient and his family with the functional changes due to stroke.
Conclusion
Overall, the proposed intervention for the project is the use of telehealth to provide coordinated care to the patient. Telehealth is appropriate, as it reduces costs of care and enhances care outcomes such as safety and quality. Board of nursing standards and government policies informed the development of the intervention. Therefore, an effective use of change management practices will be considered to achieve the optimum outcomes of the intervention.
References
Bashir, A. (2020). Stroke and Telerehabilitation: A Brief Communication. JMIR Rehabilitation and Assistive Technologies, 7(2), e18919. https://doi.org/10.2196/18919
Berra, K., Fletcher, B., Hayman, L. L., & Miller, N. H. (2019). Global Cardiovascular Disease and Stroke Prevention: A Call to Action for Nursing. Journal of Cardiovascular Nursing, 34(3), 197–198. https://doi.org/10.1097/JCN.0000000000000578
Carrigan, T. M., & Livesay, S. (2018). Mapping a Strategy for Success: A Case Study in Nursing Engagement as a Strategic Imperative at a Comprehensive Stroke Center. Nurse Leader, 16(2), 112–117. https://doi.org/10.1016/j.mnl.2017.12.010
Gorelick, P. B. (2019). The global burden of stroke: Persistent and disabling. The Lancet Neurology, 18(5), 417–418. https://doi.org/10.1016/S1474-4422(19)30030-4
Haddad, L. M., & Geiger, R. A. (2021). Nursing Ethical Considerations. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK526054/
Hubert, G. J., Corea, F., & Schlachetzki, F. (2021). The role of telemedicine in acute stroke treatment in times of pandemic. Current Opinion in Neurology, 34(1), 22–26. https://doi.org/10.1097/WCO.0000000000000887
Kitzman, P., Hudson, K., Sylvia, V., Feltner, F., & Lovins, J. (2017). Care Coordination for Community Transitions for Individuals Post-stroke Returning to Low-Resource Rural Communities. Journal of Community Health, 42(3), 565–572. https://doi.org/10.1007/s10900-016-0289-0
Lawson, D. W., Stolwyk, R. J., Ponsford, J. L., Baker, K. S., Tran, J., & Wong, D. (2020). Acceptability of telehealth in post-stroke memory rehabilitation: A qualitative analysis. Neuropsychological Rehabilitation, 0(0), 1–21. https://doi.org/10.1080/09602011.2020.1792318
Mackie, B. R., Mitchell, M., & Marshall, A. P. (2019). Patient and family members’ perceptions of family participation in care on acute care wards. Scandinavian Journal of Caring Sciences, 33(2), 359–370. https://doi.org/10.1111/scs.12631
Morel, T., & Cano, S. J. (2017). Measuring what matters to rare disease patients – reflections on the work by the IRDiRC taskforce on patient-centered outcome measures. Orphanet Journal of Rare Diseases, 12(1), 171. https://doi.org/10.1186/s13023-017-0718-x
Morley, L., & Cashell, A. (2017). Collaboration in Health Care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207–216. https://doi.org/10.1016/j.jmir.2017.02.071
Ouriques Martins, S. C., Sacks, C., Hacke, W., Brainin, M., de Assis Figueiredo, F., Marques Pontes-Neto, O., Lavados Germain, P. M., Marinho, M. F., Hoppe Wiegering, A., Vaca McGhie, D., Cruz-Flores, S., Ameriso, S. F., Camargo Villareal, W. M., Durán, J. C., Fogolin Passos, J. E., Gomes Nogueira, R., Freitas de Carvalho, J. J., Sampaio Silva, G., Cabral Moro, C. H., … Feigin, V. L. (2019). Priorities to reduce the burden of stroke in Latin American countries. The Lancet Neurology, 18(7), 674–683. https://doi.org/10.1016/S1474-4422(19)30068-7
Park, H.-K., & Jeong, Y.-W. (2021). Impact of Nursing Professionalism on Perception of Patient Privacy Protection in Nursing Students: Mediating Effect of Nursing Informatics Competency. Healthcare, 9(10), 1364. https://doi.org/10.3390/healthcare9101364
Rutledge, C. M., Kott, K., Schweickert, P. A., Poston, R., Fowler, C., & Haney, T. S. (2017). Telehealth and eHealth in nurse practitioner training: Current perspectives. Advances in Medical Education and Practice, 8, 399–409. https://doi.org/10.2147/AMEP.S116071
Wang, Y.-Y., Wan, Q.-Q., Lin, F., Zhou, W.-J., & Shang, S.-M. (2018). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81–88. https://doi.org/10.1016/j.ijnss.2017.09.007
Patient Problem Solution
The successful management of health problems facing different patient populations requires the use of evidence-based interventions or solutions. Nurses and other healthcare providers play an essential role in determining the most effective and efficient treatment interventions for their patients. They utilize evidence-based interventions to ensure that optimum outcomes of care are achieved in the care given to their patients. Therefore, this project examines the proposed solution that will be utilized in addressing the issue of hypertension and pre-diabetes affecting the selected patient for the project.
You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:
- Minority Health: http://www.cdc.gov/minorityhealt/index.html
- Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html
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Solution/Intervention
The proposed solution or intervention that will be used in managing hypertension and pre-diabetes is the use of web-based self-management interventions. Web-based self-management entails empowering patients on the effective interventions that can be used to improve their outcomes of treatment. The interventions are delivered virtually via health technologies such as m-health and telehealth. Self-management interventions in hypertension and pre-diabetes entail the education of the patient on the importance of lifestyle and behavioral modifications alongside medication adherence. Patients should be educated about the self-management interventions to increase their level of awareness about the ways in which the adverse outcomes associated with their conditions can be minimized. Patients also require coaching on the ways in which the interventions are implemented in practice. The effective use of self-management interventions in hypertension and pre-diabetes contribute to care outcomes such as patient satisfaction, empowerment, and cost-efficiency in care (Alessa et al., 2019).
Studies have been conducted to examine the effectiveness of web-based self-management interventions in hypertension and pre-diabetes. One of the studies is the research by Li et al., (2020) that investigated the effectiveness of self-management of hypertension in adults using the mobile health technology. The results obtained from a systematic review of quantitative and qualitative studies showed that self-management using mobile health technology led to effective blood pressure control, improvement in self-management behaviors and adherence to medication among the participants. The study showed that the use of tailored messages, multifaceted functions, and interactive communication were the most effective features of the technology in promoting the desired behavioral change (Li et al., 2020). A study by Morrissey et al., (2018) sought to obtain the perspectives of the general practitioners on the effectiveness of health technologies for hypertension and diabetes self-monitoring. The data of the study showed that the use of health technologies for self-management of hypertension was cost-effective and provided accurate data on blood pressure and glucose monitoring. The consequence was that general practitioners were able to identify and manage potential adverse events earlier, promoting safety and quality of health (Morrissey et al., 2018). The research by (Aminuddin et al., 2019) showed that the use of smartphone-based self-management interventions in patients with diabetes improved self-care, self-efficacy activities, and health outcomes. The technology also contributed to improved glycemic control in patients with diabetes mellitus type 2 (Aminuddin et al., 2019). Therefore, the use of web-based self-monitoring interventions may prove effective for the patient in this case study.
Leadership
Effective leadership is important for the management of hypertension and pre-diabetes using web-based self-management interventions. Nurses and other healthcare providers involved in the implementation of the solution should demonstrate effective leadership styles such as active listening, promotion of patient-participation, and respect for diversity. There is also the need to coach and mentor the client to embrace the desired interventions delivered via the web-based health solutions. The healthcare providers should also encourage innovation in the identification and implementation of best practices for the optimum management of hypertension and pre-diabetes.
Collaboration
Effective collaboration is required for the realization of the desired outcomes of care using web-based self-management interventions for hypertension and pre-diabetes. Collaboration entails ensuring that the patient and other stakeholders are actively involved in the assessment, planning, implementation, monitoring, and evaluating the effectiveness of the selected interventions. Collaboration contributes to the realization of care outcomes such as patient satisfaction, empowerment, lifestyle and behavioral modification, and ownership of the self-management interventions that are used in hypertension and pre-diabetes management. Therefore, active collaboration will be promoted in the use of the web-based self-management interventions in addressing the health needs of the patient in the case study.
Communication
Communication is an essential component that will determine the realization of lifestyle and behavioral change by the patient. Effective communication skills such as open communication, active listening, and use of non-verbal cues are needed to be embraced in working with the patient in the case study. The communication should foster positive consultation between the stakeholders involved in the care process. The values, needs and preferences of the patient should be prioritized for the realization of the optimum goals of care. Therefore, open and transparent communication will be embraced to promote patient outcomes in the case delivered to the patient.
Change Management
The successful implementation of the proposed solution will require the adoption of new lifestyle and behaviors by the client. The client will therefore require support in ensuring successful implementation of change. Interventions such as active patient participation, patient education, and aligning the interventions with the aims of disease management will be embraced. Responsive strategies to address any potential resistance to change by the patient will also be embraced.
Policy
Nurses play a critical role in shaping policies that relate to the use of technologies in providing patient care. Nurses advocate for the utilization of care technologies that promote safety, efficiency, and quality of patient care. The technologies used should also align with policy provisions such as the protection of data integrity and continuous quality improvement in nursing. Therefore, the existing evidence will be reviewed to ensure that the selected web-based self-management interventions promote the provision of value-based care to the patient.
Quality of Care
Nurses strive to promote high quality care provision to their diverse patient populations. The care given should be patient-centered and evidence-based to ensure that the quality outcomes are achieved. Healthcare technologies for self-management of hypertension and pre-diabetes promote quality of care by ensuring reduction of adverse events, minimization of hospitalization rates and lifestyle and behavioral modification. Therefore, the effectiveness of the technologies informs their selection for use in the case study.
Patient Safety
The aim of any intervention in nursing is to promote patient safety in care. The care given to patients should predispose them to minimal harm and optimize its benefits in disease management and promotion of recovery. Evidence-based technologies used in self-management of chronic conditions promote patient safety by increasing the accuracy of disease monitoring and management. Therefore, the proposed solution is anticipated to contribute to positive outcomes of treatment and patient safety in hypertension and pre-diabetes management.
Costs to the System and Individual
The care provided to the patient should be cost-effective in nature. The costs incurred by the healthcare system should also be minimal. The use of web-based self-management interventions for hypertension and pre-diabetes are cost effective for the patient and system. The interventions minimize the need for unnecessary hospital visits and hospitalization rate. They also facilitate the early identification and management of potential adverse events in the care process. Patients are also empowered to take responsibility for their health. Cumulatively, the above benefits reduce healthcare spending by the patient and the utilization of healthcare resources.
Technology
Nurses and other healthcare providers have the responsibility of selecting healthcare technologies that will promote value-based care in the management of the disease. The healthcare technology should promote safety, quality, efficiency, and patient-centeredness in care. Web-based interventions for self-management of hypertension and pre-diabetes promote safety, quality, and efficiency in disease management. As a result, they are desirable for use in addressing the health concern of the patient.
Care Coordination
Care coordination entails the utilization of carefully planned inter-professional interventions to provide care to the patient. Web-based interventions for self-management of hypertension and pre-diabetes incorporate the concepts and principles of care coordination. The web-based interventions incorporate the inputs from different healthcare providers on the management of the health problems affecting the patient. The interventions also seek to ensure optimum participant involvement in the provision of the care needed by the patient for the promotion of the effective management of the health problems.
Community Resources
The available community resources should be utilized optimally to promote the effective management of hypertension and pre-diabetes. Besides the web-based interventions, the patient should be linked to the existing community resources such as social support groups for patients with hypertension and other chronic illnesses. Social support from the community members will promote the coping of the client with his health problems.
Part 2
Summary of the Patient Problem
The selected patient problem for the project is a 42-year-old male who has hypertension and is pre-diabetic. The patient has been hypertensive for the last two years. He has been managing hypertension by taking anti-hypertensive medication. The patient is also pre-diabetic. He has been using lifestyle and behavioral modifications to manage it. Some of the interventions that he uses to manage pre-diabetes include engaging in active physical activity on a regular basis and dietary modification. Despite the above interventions, hypertension has been poorly controlled, hence, the use of the patient for the project.
Reason for Selecting the Problem and Its Relevance
The health problems of hypertension and pre-diabetes were selected for the project because of a number of reasons. Firstly, hypertension and diabetes are among the health problems with increasing prevalence in the modern world. According to the Center for Disease Control and Prevention (CDC), about half of the adults in the US have hypertension with 24% of them having controlled hypertension. About 37 million adults in the US also have uncontrolled hypertension. Hypertension was also ranked as the primary cause of death of at least 494873 people in the US in the year 2018. Hypertension accounts for a significant proportion of the budget of the US. For example, about $131 billion is used on a yearly basis to treat the condition (CDC, 2020b). Similar statistics are seen in pre-diabetes and diabetes. The CDC also reports that about 88 million adults in America were pre-diabetic in 2018. The rate of pre-diabetes was found to be higher in males than in females (37.4% v. 29.2% respectively) (CDC, 2020a). Poor management of pre-diabetes can lead to disease progression to diabetes. Consequently, population awareness on the effective management of diabetes and pre-diabetes is important.
Hypertension and pre-diabetes are relevant to nursing practice because of a number of reasons. Firstly, hypertension is one of the health issues that contribute to considerable complications if left untreated or poorly controlled. Accordingly, patients with poor controlled or untreated hypertension are predisposed to complications that include stroke, renal failure, heart failure, and aneurism among other complications. The cost of treating hypertension and its complications is also high. For example, evidence shows that individuals with hypertension face approximately $2000 higher annual expenditure in health when compared to people without hypertension. In addition, the annual expenditure attributed to hypertensive patients in the US is estimated to be $9089 (Kirkland Elizabeth B. et al., 2018). The high cost of treatment is attributed to increased utilization of healthcare services, hospital admissions, emergency visits, loss of productivity, and purchase of the essential medications needed for the management of the disease. Similar effects of pre-diabetes may be experienced if poorly managed (Li et al., 2020). Nurses and other healthcare providers have a crucial role to play in promoting the effective management of hypertension and pre-diabetes. They embrace interventions that promote the health of the patients and minimize their risk of developing complications. Based on the above, it was essential to use this patient to inform the role of the nurse in promoting health and wellbeing of patients affected by chronic conditions.
Role of Leadership and Change Management in Addressing the Problem
Leadership and change management have critical roles to play in addressing the health problems of hypertension and pre-diabetes. Effective leadership is needed to ensure the implementation of interventions that promote the health of the patient. The leadership should promote patient empowerment to play a proactive role in the management of his health problems. The leadership styles embraced should also facilitate the adoption of care interventions that align with the diverse needs, values and preferences of the patients (Spies, Gray, et al., 2018). The effective management of hypertension and pre-diabetes requires the adoption of healthy lifestyle and behavioral interventions by the patient. As a result, change management should be enhanced through the provision of opportunities that increase the adoption of healthy lifestyles and behaviors. In addition, forces that pull the patient away from embracing the desired behaviors should be limited to increase the implementation of interventions that optimize the management of hypertension and pre-diabetes (Spies, Bader, et al., 2018). Therefore, leadership and change management informed the selection of the intervention for use in addressing the patient problem in the case study.
Influence of Leadership and Change Management Strategies on the Development of the Proposed Intervention
Leadership and change management strategies influenced the development of the proposed solution. The influence of leadership can be seen from the fact that the intervention seeks to strengthen inter-professional collaboration in the provision of care to the patient. The use of web-based interventions for self-management incorporates inputs from different healthcare stakeholders to achieve the desired outcomes of care. The other way in which leadership influenced the development of the intervention is its role in shaping the patient-centered initiatives that will be used in the provision of care. The technology will promote safety, high quality and continuity in nursing care, hence, excellence in service provision. Change management strategies also influenced the development of the intervention. The selection of the intervention took into consideration the need for behavioral modification by the patient (Harvin et al., 2020). The use of the web-based interventions is likely to promote the adoption of healthy behaviors by the patient, for effective management of his health problem.
How Nursing Ethics Informed Development of the Proposed Intervention
Nursing ethics also informed the development of the proposed intervention. The development of the proposed solution took into consideration the safety needs of the patient. It was important to ensure that the selected web-based interventions do not predispose the patient to any form of harm. As a result, evidence-based interventions will be used to promote the effective management of hypertension and pre-diabetes. The development of the intervention also took into consideration the need for the promotion of data integrity. The selected intervention should safeguard the privacy and confidentiality of the patient’s data. The intervention should also empower the patient to play a proactive role in promoting the sustainability of the effective management strategies for his health problem (Zhu et al., 2018). The ethical aspect of promoting the autonomy of the patient was also considered in the development. Technologies that are familiar to the patient will be used to increase their usability and ease of use. Lastly, the ethical aspect of informed consent was considered. Informed consent will be obtained from the patient prior to his utilization of the selected web-based technologies. Informed consent will imply the understanding of the patient about the aims and benefits of the different web-based interventions for self-management of hypertension and pre-diabetes (Hailu et al., 2018).
Strategies for Communication and Collaboration
A number of communication and collaboration strategies will be utilized in the implementation of the intervention. One of the communication strategies that will be embraced in the implementation process is open communication. Open communication between the patient and healthcare providers will be promoted to improve the quality of care. The patient will be encouraged to express his concerns, views and fears on the aspects related to the care he will be receiving. Open communication will promote trust and honesty between the patient and the healthcare providers. The other strategy for open communication that will be utilized is being objective. A focus will be placed on ensuring the existence of alignment between the strategies being adopted and aims of the intervention. Active participation in the implementation of the intervention will be encouraged. The patient will be encouraged to play an active role in the assessment, planning, implementation, monitoring and evaluation of the effectiveness of the selected solutions for managing his health problems. The patient and his significant others will also be involved in making decisions related to the care that he needs. Shared and participative decision-making will empower the patient to implement solutions that align with his needs, values and preferences (Granheim et al., 2018). The consideration of the above strategies will promote sustainability in the use of the developed solutions.
Benefits of Gathering Their Inputs
Gathering inputs from the patient and significant others will be important in facilitating the effective management of hypertension and pre-diabetes. Gathering inputs from them will provide the healthcare team with insights into the values, preferences and beliefs of the patient and the family. The development of care plans will incorporate the identified values, preferences and beliefs, hence, the realization of optimum outcomes of care. Gathering inputs from the patient and his family will also encourage their active involvement in the care process. Accordingly, the patient and the family will develop a sense of ownership of the solution. The implication will be the empowerment of the patient and his family to explore the effective ways in which their care needs can be achieved further. Gathering the inputs of the patient and his family will also contribute to the sustainability of the interventions of the solution (Bishop & Macdonald, 2017). Through it, the patient and his family will be encouraged to embrace long-term use of the interventions to promote their health and wellbeing.
Influence of State Board Nursing Practice Standards and Organizational Policies
The state board nursing practice standards influenced the development of the intervention. Accordingly, the state board nursing standards identify that nurses have a critical role to play in the promotion of health of their populations. Nurses employ interventions such as health education, diagnosing, treating, case finding, and provision of supportive care to patients to promote recovery and alleviate suffering. State board of nursing such as the New York State Board of Nursing recognizes the fact that nurses have to utilize healthcare technologies to promote the health and wellbeing of their populations. Nurses should ensure that the selected healthcare technologies promote safety, quality, and efficiency in hypertension and pre-diabetes management. Organizational policies could have also influenced the selection of web-based intervention to promote the health and wellbeing of the patient (Morrissey et al., 2018).
How the Intervention Improves Quality of Care, Enhance Patient Safety and Reduce Costs to System and Individual
The proposed intervention improves the quality of care given to the patient in the case study. The use of web-based self-management interventions for hypertension and pre-diabetes minimize the risk of adverse events. The reduction in risk is attributed to blood pressure and glycemic control. The interventions also promote the provision of patient-centered care. The use of web-based interventions ensures that the patent is in constant interaction with the healthcare providers. The interaction ensures continuity in the care provision for the patient, hence, enhanced wellbeing and health outcomes. The proposed intervention also aims at promoting patient safety. The intervention promotes the safety of the patient by minimizing any harm due to complications of hypertension and pre-diabetes (Aminuddin et al., 2019). The intervention also promotes cost-effectiveness in care. As noted in the earlier analysis, web-based interventions minimize visits to the emergency department and hospital admission among patients with chronic illnesses. The use of the interventions also reduces healthcare spending due to the reduction in adverse events related to hypertension and pre-diabetes. The intervention also promotes efficiency in resource utilization in health organizations. The reduction in hospital re-admission rates and visits to the emergency department minimize the resources that could have been used in health organizations to provide care to patients with hypertension and pre-diabetes (Li et al., 2020).
Conclusion
Overall, web-based interventions are effective for the self-management of hypertension and pre-diabetes. Web-based interventions promote safety and quality in the care that would be given to the patient. The interventions minimize the risk of complications as well as the increased need for intensive utilization of healthcare services. The interventions also promote cost-effectiveness in care. Therefore, the implementation of the solution will be done with a consideration of the policies, guidelines and ethics that govern nursing practice.
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