Assessing the Problem: Leadership, Communication, Change Management and Policy

Assessment 1: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Strategies for Fall Prevention in Older Adults

Introduction

This capstone project aims at addressing the health issue of medication nonadherence among older adults living with chronic conditions. Drug nonadherence refers to the inability to accept prescriptions as endorsed by medical care experts, which can prompt chronic weakness results, expanded hospitalizations, and higher medical care costs (Mittaz Hager et al., 2019). This issue is especially predominant among the older populace, who frequently have complex medication regimens and may confront provokes in dealing with their prescriptions because of mental deterioration, actual impediments, or absence of help (Blum et al., 2021). According to a leadership perspective, nurse leaders need to perceive the effect of prescription nonadherence on understanding results and go to proactive lengths to resolve this issue. Promoting a culture of medication safety, providing patients and healthcare providers with education and resources, and implementing evidence-based interventions to improve medication adherence are all components of effective leadership (Blum et al., 2021).

Cooperation is fundamental in handling medicine nonadherence, as it requires the contribution of various partners, including patients, relatives, medical services suppliers, and local area associations. By cultivating joint effort, attendants can work with shared navigation, empower open correspondence, and foster extensive consideration designs that think about patients’ singular necessities and inclinations. Communication is crucial when dealing with medication nonadherence (Mittaz Hager et al., 2019) Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations . To assess patients’ understanding of medication regimens, identify obstacles to adherence, and provide appropriate education and support, nurses must communicate effectively with patients. Clear and succinct correspondence between medical care suppliers is additionally urgent to guarantee exact medicine compromise and forestall prescription mistakes (Blum et al., 2021).

Population health problem

Fall prevention in older adults is a population health issue that is relevant to my practice. Because they can result in severe injuries, decreased quality of life, increased healthcare utilization, and even death, falls are a significant public health concern among the elderly population (Mittaz Hager et al., 2019). As a medical nurse, I have seen the negative effect of falls on older adults and perceive the significance of carrying out systems to forestall falls and limit their results.

Summary of the problem

The issue I will investigate is older adults’ fall prevention. Falls among older people have critical outcomes, including wounds, diminished personal satisfaction, and increased medical services costs (Mittaz Hager et al., 2019). I will analyze techniques to forestall falls and limit their effect through authority, joint effort, correspondence, change the executives, and strategy drives (Dalgaard et al., 2019). This research aims at developing evidence-based interventions, advancing interdisciplinary coordinated efforts, promoting communication among older adults and their families, and promoting strategies that help fall anticipation. The goal is to make older adults’ environments safer, lessen the number of injuries caused by falls, and improve their overall health.

The group to work with

I intend to collaborate with a group of elderly residents of a senior living community during my practicum. The group will consist of people over 65 who are at risk for falling or who have fallen before. I will team up with the occupants, their families, and the medical services suppliers locally to evaluate their fall gambles, teach them about fall avoidance techniques, and execute mediations to lessen the occurrence of falls (Blum et al., 2021). By working with this group, I hope to better the safety and well-being of older adults living in residential settings by addressing their particular requirements and challenges.

Information substantiating the presence of falls

Fall prevention among older people is a vast and significant issue upheld by convincing information and proof. As the Centers for Disease Control and Prevention (CDC) indicates, falls are the primary source of injury-related passings and nonfatal wounds among more established grown-ups. Many older adults experience falls every year, bringing about breaks, head wounds, and decreased versatility. The economic impact is significant, as healthcare costs related to falls are estimated to cost $50 billion annually in the United States. Moreover, falls significantly affect the personal satisfaction of elderly citizens and their families, prompting dread of falling, loss of freedom, and diminished social commitment. This issue highlights the critical requirement for robust fall anticipation systems to work on understanding results, decrease medical care use, and improve the general prosperity of older adults and their families.

Relevance of the problem

The issue of fall prevention among elderly citizens is profoundly pertinent to my training as a baccalaureate-arranged nurse. As a medical attendant, I’m focused on advancing careful consideration and improving the well-being results of people across life expectancy. More established grown-ups are a weak majority with novel medical care needs, and falls represent a critical gamble to their prosperity (Pieruccini‐Faria et al., 2020). By tending to fall anticipation, I can apply my insight into proof-based practice, authority, joint effort, correspondence, change the executives, and strategy to create and carry out mediations that advance security, upgrade patient results, and work on the general nature of care. As a healthcare leader, advocate, and caregiver, fall prevention enables me to have a significant impact on the lives of older adults and their families Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

Evidence-based literature

Numerous studies and guidelines offer helpful insights and suggestions for nursing practice in this area. A study by Pieruccini‐Faria et al. (2020) did a meta-analysis and systematic review of fall prevention programs for older adults who live in the community. The creators distinguished different viable methodologies, including exercise programs, multifactorial intercessions, and home well-being adjustments. These results are in line with my nursing practice because I have observed that exercise programs designed to improve strength, balance, and gait stability reduce the risk of falling among elderly people. Another study by Dalgaard et al. (2019) emphasized the significance of complete fall risk appraisals, including assessing various factors, such as medicine use, vision, and natural perils. Their findings align with how I practice nursing because I frequently conduct in-depth fall risk assessments that consider both intrinsic and extrinsic factors that can lead to falls.

Proficient sources, like the American Geriatrics Society (AGS) and the Public Committee on Maturing (NCOA), give proof-based rules to fall prevention among older adults (Pieruccini‐Faria et al., 2020). The AGS/British Geriatrics Society’s fall prevention guideline emphasizes interventions like individualized exercise programs, medication reviews, and environmental changes. Similarly, the Falls Free Initiative of the NCOA recommends methods for multifactorial fall risk assessment and management (Pieruccini‐Faria et al., 2020). The significance of interdisciplinary collaboration in fall prevention is consistently emphasized in the literature. For instance, Chew et al.’s study (2021) emphasizes interdisciplinary teams’ role in reducing hospital fall rates through targeted interventions and staff training. Since I frequently collaborate with physical therapists, occupational therapists, and other healthcare professionals to develop comprehensive fall prevention plans, this finding is consistent with my nursing practice.

Assuming the information needs validity and straightforwardness or depends on a defective approach, conflicts with laid-out research discoveries, or is not upheld by trustworthy sources, it might show that the information is questionable.

Effect of Nursing Practice Norms and Approaches on Fall Avoidance among the elderly citizens

Nursing practice norms laid out by state sheets and hierarchical and legislative strategies are essential in resolving the issue of fall counteraction among older people (Pieruccini‐Faria et al., 2020). The nursing scope of practice is shaped by these standards and policies, which also have an impact on the outcomes for patients, families, and populations (Mittaz Hager et al., 2019). We can learn more about how these standards and policies affect fall prevention efforts by looking at the most recent research. State board nursing practice standards establish the requirements for nursing practice in a given jurisdiction (WHO, 2021). These principles give a structure to attendants to convey protected and capable consideration, including fall counteraction intercessions. State boards may, for instance, specify the specific assessment tools or protocols that nurses should use to identify elderly fall risks. By sticking to these guidelines, medical attendants can guarantee that extensive fall risk appraisals are led, empowering early distinguishing proof and designated intercessions (Chew et al., 2021).

Hierarchical strategies likewise assume a fundamental part in fall prevention. Medical services offices frequently foster approaches that lay out normalized conventions for fall risk distinguishing proof, anticipation techniques, and reaction to falls (Chew et al., 2021). These strategies might incorporate rules for carrying out bed cautions, utilizing assistive gadgets, or establishing a protected climate. By following authoritative arrangements, medical attendants can guarantee reliable and proof-based fall avoidance rehearses across care settings. For example, medical caretakers can work with interdisciplinary groups to execute these strategies, advancing a culture of security and decreasing the rate of falls among more seasoned grown-ups. Fall prevention efforts may also be impacted by government policies, such as reimbursement or quality improvement initiatives (Pieruccini‐Faria et al., 2020). Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations For example, government offices might carry out arrangements that boost medical services offices to focus on fall anticipation by binds repayment to fall rates or executing quality improvement programs. Patients’ outcomes may improve due to healthcare organizations investing in resources and implementing interventions supported by evidence. Medical caretakers can use these strategies to advocate for assets, carry out accepted procedures, and drive change at the authoritative level (Pieruccini‐Faria et al., 2020).

Proposing Administration Systems to Further Develop Fall Avoidance Results and Patient Involvement with older adults

Viable authority methodologies are fundamental to further develop results, patient-focused care, and the patient experience connected with fall prevention in older adults. Change, collaboration, communication, and the implementation of evidence-based practices all rely heavily on leadership (Pieruccini‐Faria et al., 2020). Here are some suggested leadership strategies:

Develop a Fall Prevention Task Force- Lay out a multidisciplinary group comprising of medical caretakers, doctors, actual specialists, word-related advisors, and other crucial medical care experts. The team can team up to foster normalized conventions, rules, and informational materials for fall avoidance. A comprehensive and coordinated approach to addressing fall hazards is guaranteed by this strategy (Pieruccini‐Faria et al., 2020).

Promote Staff Education and Training- Give progressing instruction and prepare projects to improve the information and abilities of medical care suppliers concerning fall anticipation techniques. This incorporates teaching attendants about proof-based evaluation devices, mediation, and correspondence methods for connecting with patients and families in fall prevention endeavors.

Implement Quality Improvement Initiatives- Participate in fall prevention-focused quality improvement projects. This might entail carrying out routine audits, looking over data from the fall, and figuring out where things can be improved. Through ongoing evaluation and feedback, leadership can facilitate incorporating evidence-based practices into daily workflows and monitor progress.

Advocate for Policy Changes- Work with authoritative pioneers and policymakers to advocate for strategies focusing on fall counteraction. Participating in healthcare committees, collaborating with government agencies, and supporting initiatives that promote safe environments and fall prevention resources are all examples of this.

Implementing these leadership strategies can help healthcare providers to improve and upgrade the patient experience connected with fall avoidance in more established grown-ups. Compelling administration is crucial in driving joint effort, advancing correspondence, and overseeing change, eventually creating a security culture and diminishing fall gambles (Dalgaard et al., 2019). To ensure accurate record-keeping and demonstrate the practical application of the proposed strategies in a real-world setting, the practicum hours spent with the individuals or group will be documented in the Capella Academic Portal Volunteer Experience Form per the requirement.

Conclusion

In conclusion, this project has examined fall prevention in older adults, a significant patient, family, or population health issue. Through evaluating the issue according to different viewpoints, including administration, coordinated effort, correspondence, change the board, and strategy, we have acquired experiences in the intricacies and difficulties included. The literature review has guided nursing actions to address the issue by providing a foundation of evidence-based knowledge. We have investigated the effect of nursing practice guidelines, arrangements, and authority systems on other developing results and upgrading patient-focused care. The significance of powerful administration, coordinated effort, and correspondence in driving change and advancing patient security has been accentuated. By carrying out the proposed methodologies and consolidating nursing hypotheses or systems, we can progress toward accomplishing improved results, forestalling falls, and giving a positive patient encounter. Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Through the practicum hours enjoyed with the distinguished people or gatherings, true application and encounters have advanced the undertaking’s degree. This project has laid the groundwork for the capstone experience, giving baccalaureate-prepared nurses the tools they need to become leaders in problem identification, strategy implementation, and planning, ultimately leading to improved patient care and organizational efficiency.

References

Abraham, J., Kupfer, R., Behncke, A., Berger-Höger, B., Icks, A., Haastert, B., … & Möhler, R. (2019). Implementation of a multicomponent intervention to prevent physical restraints in nursing homes (IMPRINT): A pragmatic cluster randomized controlled trial. International journal of nursing studies , 96 , 27-34.

Blum, M. R., Sallevelt, B. T., Spinewine, A., O’Mahony, D., Moutzouri, E., Feller, M., … & Rodondi, N. (2021). Optimizing therapy to prevent avoidable hospital admissions in multimorbid older adults (OPERAM): cluster randomised controlled trial. bmj , 374 .

Chew, S. M., Lee, J. H., Lim, S. F., Liew, M. J., Xu, Y., & Towle, R. M. (2021). Prevalence and predictors of medication nonadherence among older community‐dwelling people with chronic disease in Singapore. Journal of Advanced Nursing , 77 (10), 4069-4080.

Dalgaard, F., Pallisgaard, J. L., Numé, A. K., Lindhardt, T. B., Gislason, G. H., Torp‐Pedersen, C., & Ruwald, M. H. (2019). Rate or rhythm control in older atrial fibrillation patients: risk of fall‐related injuries and syncope. Journal of the American Geriatrics Society, 67(10), 2023-2030.

Mittaz Hager, A. G., Mathieu, N., Lenoble-Hoskovec, C., Swanenburg, J., de Bie, R., & Hilfiker, R. (2019). Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. BMC geriatrics , 19 , 1-11.

Pieruccini‐Faria, F., Sarquis‐Adamson, Y., Anton‐Rodrigo, I., Noguerón‐García, A., Bray, N. W., Camicioli, R., … & Montero‐Odasso, M. (2020). Mapping associations between gait decline and fall risk in mild cognitive impairment. Journal of the American Geriatrics Society, 68(3), 576-584.

World Health Organization. (2021). Step safely: strategies for preventing and managing falls across the life-course.

SCORE GUIDE – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Define a patient, family, or population health problem that’s relevant to personal and professional practice.

Clearly and succinctly defines a patient, family, or population health problem that’s relevant to personal and professional practice. Fully substantiates the presence and relevance of the problem.

Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.

Analyzes evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem. Applies relevant, unambiguous criteria for evaluating the evidence, and exhibits clear insight into potential barriers to evidence-based practice and theoretical guiding frameworks.

Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.

Provides an explanation, with examples, of how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem, based on a perceptive and coherent synthesis of current literature. Provides clear insight into how policy affects the nursing scope of practice.

Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Proposes leadership strategies, supported by examples, to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem. Exhibits clear insight into the necessary role of leadership and the need for collaboration, communication, and change management in addressing the problem. and Documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

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

In a 5-7 page written assessment, define the patient, family, or population health problem. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective.

Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

oo often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

Develop a problem statement for a patient, family, or population that’s relevant to your practice.

Begin building a body of evidence that will inform your approach to your practicum. Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.

In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.

Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.

Part 1

Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.

Part 2

Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice.

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Define a patient, family, or population health problem that’s relevant to your practice.

Summarize the problem you’ll explore.

Identify the patient, family, or group you intend to work with during your practicum.

Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.

Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.

Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.

Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.

Explain how you would know if the data are unreliable.

Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.

Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.

Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.

Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.

Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.

Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.

Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.

Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.

Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.

Discuss research on the effectiveness of leadership strategies Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

Define the role that you anticipate leadership must play in addressing the problem.

Describe collaboration and communication strategies that you anticipate will be needed to address the problem.

Describe the change management strategies that you anticipate will be required to address the problem.

Organize content so ideas flow logically with smooth transitions.

Apply APA style and formatting to scholarly writing.

Additional Requirements

Format: Format your paper using APA style.

Length: Your paper should be approximately 5–7 pages in length, not including the reference page.

Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.

Competencies Measured – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

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

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.

Define a patient, family, or population health problem that’s relevant to personal and professional practice.

Competency 2: Make clinical and operational decisions based upon the best available evidence.

Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.

Competency 5: Analyze the impact of health policy on quality and cost of care.

Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.

Competency 7: Implement patient-centered care to improve quality of care and the patient experience.

Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Competency 8: Integrate professional standards and values into practice.

Organize content so ideas flow logically with smooth transitions.

Apply APA style and formatting to scholarly writing.

Practicum Focus Sheet – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Assessment 1

Note: Expect to spend at least 2 hours with the patient, family, or group you’ll be working with

during this portion of your practicum, assessing the health problem you’ve defined from a

leadership, collaboration, communication, change management, and policy perspective. This

includes the time you may elect to spend in consultation with the subject matter or industry experts.

You’ll report on the results of this work as part of your next assessment.

Identify the patient, family, or group you intend to work with:

The subject is a 55-year-old retired peace officer. In 2002 was diagnosed with Diabetes and hypertension. He was a range master in charge of qualifying and re-qualifying peace officers. The subject lived and worked in Las Vegas, Nevada, where temperatures can easily reach 110-115 degrees in the peak of summer. H trained 8-10 hours in an outside desert shooting range to qualify both experienced and new officers. Many of the officers did not bring water to the range. The subject would give out his water to the officers who did not bring water. After about a month, he developed vision problems, a pounding rapid pulse, profuse sweating, great thirst, and frequent urination and went to his primary care provider.

When he presented with an elevated blood pressure of 250-260’s over 120’s heart rate of 125 beats per minute. The medical assistant immediately called the physician, who advised that EMS would be called for transport to the nearest hospital. Ultimately, he spent one week in the hospital and received the diagnosis of heat exposure, heat exhaustion, diabetes, elevated triglycerides, and hypertension.

Think about what you hope to learn?

o What’s your rationale for choosing this particular patient, family, or group?

Rationale is that Diabetes affects about 1 in 10 Americans, approximately 37 million, 90 to 95% are type 2.

Consider how you’ll present your ideas about the problem to the patient, family, or group

and convince them of its significance Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Which leadership, collaboration, communication, and change management skills will you

need to apply in order to work successfully with your chosen patient, family, or group?

Which potential barriers do you foresee in presenting the problem to this patient, family,

or group?

Which change management strategies might you employ to overcome these barriers?

o For example, you might consider creating a sense of urgency supported by data or

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