NURS FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Traumatic Brain Injury Case Report: Evidence-Based Practice for Patient-Centered Care and Population Health

Introduction

Personalized care entails taking into account a patient’s unique information as expressed in clinical history, individual complains, and risk factors to provide appropriate treatment. Advances in technology has increased understanding of diseases and improved diagnostic approaches. Some diseases affecting the population are costly to manage due to complexity and chronicity. One of the critical damages caused by trauma to the head is traumatic brain injury (TBI) and can occur to anyone regardless of age. According to Maas et al. (2017), TBI is major cause of mortality and disability in young adults. Patients with relatively mild brain injury may sustain long-term disability if adequate interventions are unavailable. The management of TBI relies heavily on integrated health interventions including medications, rehabilitation, psychotherapeutic approaches or surgery depending on severity.

This paper contains a discussion on the intervention to include in a Population Health Improvement Initiative (PHII) for patients with traumatic brain injury and identifies potential gaps in care. The author describes how these gaps can in incorporated in plan of care using evidence-based practices present in literature. The case involves elderly patients with traumatic brain injury and PTSD who required primary patient care and follow-up care plan. Alicia Balewa, the Director of Safe Headspace reviewed and evaluated outcomes of the PHII. She compared the effectiveness of exercise, medication and therapy. The author describes a personalized health plan for the patients based on evidence-based research provided by a community TBI expert and literature search about the condition.

Evaluation of Population Health Improvement Initiative (PHII) Outcomes

Population Health Improvement Initiative (PHII) guided care provided to patients with TBI and associated PTSD. Some of the evidence-based initiative implement include medication such as diuretics, rehabilitation, counselling psychology, cognitive behavioral therapy, exercise and training on coping mechanisms. In the Safe Headspace, the Director determined that moderate aerobic exercise caused improved mood by 22% among participants. Besides, memory improved by 61% and muscle control by 15%. Among the patients, the use of medication and therapy improved mood by 26% if used over six months. Medication and therapy also improved memory by 6%. Furthermore, daily medication at home provided mood improvement by over 70% and memory with 32% improvement in muscle control. According to the results, daily medication showed most improvement NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

The knowledge gap in this PHII entails the use of surgical measures for severe traumatic head injury. The effectiveness of the surgery in targeted population is unknown because no patient was eligible for the procedure. For a better evaluation, the health organization could consider injury or symptoms based evaluation of patients’ progress. The injury/symptoms approaches would identify unique patient’s needs and priority diagnosis. The approach can also help care providers identify barriers to patient’s self-management plan and facilitate prompt interventions.

Strategy for Improving PHII Outcomes

Long-term quality improvement goals help achieved better population health outcomes. In this strategy, initial steps include identification of most appropriate interventions, desired outcomes and areas of concern. The use of Plan-Do-Study-Act (PDSA) cycle is significant in implementing improvement strategies (Coury et al., 2017). Interventions in this cycle are goal development, identification of strategies to achieve desired goals, instituting implementation plans and action plans.

Personalized Evidence-Based Patient Care Plan

The Patient-Centered Medical Home (PCMH) model could be most suitable for formulating patients’ care plans, which should personalized. The PCMH meets goals of quadruple aim, promotes independence and patient’s autonomy. Besides, the model facilitates the continuity of care from healthcare facility to home. While using the model, healthcare providers establish a long-term therapeutic relation with the patient and family after leaving health facility setting.

The PCMH encourages care providers to formulate short and long-term goals in collaboration with patients and family. The goals are based on unique patient needs and should be congruent to patient’s socio-economic and cultural determinants of health. The care plan defines strategies executed at home and those execute in the healthcare setting. The targeted outcomes of these strategies are increased independence of the patient and better quality of life.

Interventions instituted in plan of care should be supported the best evidence form scientific studies. Care providers handling elderly patients with TBI and PTSD should learn about his condition, needs, and current management based on recent scientific evidence. Evidence from studies shows that educating patient’s family and caregivers on the required treatment modalities. Caregivers would also learn about the use of technology such as electronic programs and telecommunication modalities to facilitate communication with care providers. Using the aforementioned approaches to develop plan of care will promote independence, improve quality of life and prevent frequent hospital visits.

Analysis of Evidence

Healthcare organizations, which bear the vision of best quality of care for their clients, are keen to purse evidence-based practices. Evidence from recent studies help advice practice and address healthcare needs. For patients requiring continuity of care, proper interventions in transiting and managing them are critical for achievement of success. The study by Barman et al. (2016) reveled that management of patient suffering from TBI should involve a combination of rehabilitation techniques and pharmacotherapy. The authors expressed that the interventions help manage ill effects of TBI on patient’s emotions, self-confidence, physical well-being, and behavioral stability NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

The study by Maas et al. (2017) revealed that best practice for managing patients with TBI should encompass the processes between history taking, diagnostic examination until actual treatment modalities. The authors highlighted on the need for advanced radiological examination through MRI as indicated by patient’s presentation. Besides, the study emphasized on use of technology to deliver care even at home settings discharge from hospital. Maas et al. (2017) emphasize on the use of telecommunication advances to ensure continued communication between patients and healthcare providers. The article describes the significance of rehabilitative measures on the patients and follow-up plans assisted by technology.

Evaluation Strategy for Personalized Care Approach Outcomes

A shared-decision making framework is a significant process of working with a client to reach a decision regarding care (Etingen et al., 2020). This framework is applicable in evaluating outcomes of personalized care because it aligns with goals of the care, which include wellness, health promotion and prevention of suffering. In this strategy, care providers and family require training on how to communicate and prompt handling of emergent issues. A shared decision-making improves patient, staff and family satisfaction because all parties are involved in care. Upon implementation, the outcomes of care are compared with desired outcomes NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Application for Other Cases

Good outcomes of personalized care approach encourage care providers to base interventions to patients’ needs and strengths. Similar situation of patients with trauma or post-traumatic stress can be managed by incorporating clients’ choices in care. When patients have control over their plan of care, they easily cooperate and subsequently facilitate healing (Etingen et al., 2020). Beside, allowing the client to make choices in shared decision-making enhances patient’s cooperation in delivery of care.

References

Barman, A., Chatterjee, A., & Bhide, R. (2016). Cognitive impairment and rehabilitation strategies after traumatic brain injury. Indian journal of psychological medicine , 38 (3), 172-181.

Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., D’Agostini, B., … & Coronado, G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC health services research , 17 (1), 1-10. https://link.springer.com/article/10.1186/s12913-017-2364-3

Etingen, B., Hessinger, J. D., & Hunley, H. A. (2020). Training providers in shared decision making for trauma treatment planning. Psychological Services .

Maas, A. I., Menon, D. K., Adelson, P. D., Andelic, N., Bell, M. J., Belli, A., … & Francony, G. (2017). Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. The Lancet Neurology , 16 (12), 987-1048 NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Write a 4-6 page evidence-based patient-centered care report on the patient scenario presented in the Evidence-Based Health Evaluation and Application media piece. Base your report on the information provided by the traumatic brain injury expert from the population health improvement initiative (PHII) described in the media activity and your own evidence-based research on this population health issue.

In this assessment, you will apply evidence-based practice in patient-centered care and population health improvement contexts. You will be challenged to think critically, evaluate what the evidence suggests is an appropriate approach for a personalized patient care plan, and determine which aspects of the approach could be applied to similar situations and patients.

Demonstration of Proficiency

By successfully completing this NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Apply evidence-based practice to plan patient-centered care.

Evaluate the outcomes of a population health improvement initiative.

Develop a personalized patient care plan that incorporates lessons learned from a population health improvement initiative.

Competency 2: Apply evidence-based practice to design interventions to improve population health.

Propose a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence.

Competency 3: Evaluate outcomes of evidence-based interventions.

Propose an evaluation strategy for the outcomes of personalized patient care plan and determine what aspects of the approach could be applied to similar situations and patients.

Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.

Identify the level of evidence and describe the value and relevance it brings to personalized care for your patient.

Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.

Write clearly and logically, with correct grammar and mechanics.

Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Scenario

The charge nurse in your clinic has contacted you to assume primary care for a patient and develop a plan for follow-up care. The plan should be personalized for him based on evidence-based research provided by a community expert as well as your own research on the condition. You will also be challenged to determine which aspects of the traumatic brain injury (TBI) approach could be applied to similar situations and patients.

Your Role

You are a nurse who has been requested to provide primary patient care, including a follow-up care plan. You will revisit the interview with the community TBI expert and prepare a personalized health plan for the patient.

Instructions

Review the Assessment Case Study: Traumatic Brain Injury Care Report media activity.

Review relevant evidence-based research from 3–5 additional scholarly or professional sources about traumatic head injuries to support your evaluation, recommendations, and plans.

The following requirements correspond to the grading criteria in the scoring guide, so be sure to address each point:

Evaluate the expected outcomes of the population health improvement initiative (PHII) that the community expert reported based on data.

Describe the outcomes that were achieved, their positive effects on the community’s health, and any variance across demographic groups.

Describe the outcomes that were not achieved, the extent to which they fell short of expectations and any variance across demographic groups.

Identify the factors (for example: institutional, community, environmental, resources, communication) that may have contributed to any achievement shortfalls.

Propose a strategy for improving the outcomes of the PHII for traumatic head injuries.

Describe the corrective measures you would take in the PHII to address the factors that may have contributed to achievement shortfalls.

Cite the evidence (from similar projects, research, or professional organization resources) that supports the corrective measures you are proposing.

Explain how the evidence illustrates the likelihood of improved outcomes if your proposed strategy is enacted.

Develop a personalized patient care plan for the patient from the scenario that incorporates lessons learned from the PHII outcomes.

Identify a personalized care approach that addresses the patient’s:

Individual health needs NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Economic and environmental realities.

Culture and family.

Explain how the lessons learned from the PHII informed the decisions you made in your personalized care plan for the patient.

Incorporate references to the best available evidence from the population health improvement initiative and other relevant sources.

Identify the level of evidence and describe the value it brings to personalize care for your patient.

Identify the level of evidence for each resource you referenced.

Explain why each piece of evidence is valuable and appropriate for the community health issue you are trying to address and for the unique situation of your patient and his family.

Propose an evaluation strategy to assess the outcomes of your personalized care approach.

Identify measurable criteria that are relevant to your desired outcomes NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Explain why the criteria are appropriate and useful measures of success.

Determine the specific aspects of your approach that are most likely to be transferable to other individual cases.

Additional Requirements

Organization: Use the following headings for your Traumatic Brain Injury Care Report:

Evaluation of Population Health Improvement Initiative (PHII) Outcomes.

Strategies for Improving PHII Outcomes.

Personalized Evidence-Based Patient Care Plan.

Analysis of Evidence.

Evaluation Strategy for Personalized Care Approach Outcomes.

Application for Other Cases.

Length: Your recommended plan will be 4–6 double-spaced pages, not including title and reference pages.

Font: Times New Roman, 12 points.

APA Format: Your title and reference pages must adhere to current APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health sources according to APA guidelines.

Scoring Guide: Please review this assessment’s scoring guide. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance-level descriptions for each criterion to see how your work will be assessed.

Scoring Guide info:

Evaluates the outcomes of a population health improvement initiative based on demographic, environmental, and epidemiological data. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).

Proposes a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence. Acknowledges challenges in the proposed strategy.

Develops a personalized care plan that incorporates lessons learned from a population health improvement initiative, and identifies assumptions on which the approach is based.

Identifies the value and relevance of evidence used to support a personalized patient care plan. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve a personalized patient care plan).

Proposes an evaluation strategy to assess the outcomes of a personalized care approach. Identifies aspects of the approach that could be challenging, with solutions.

Determines aspects of the personalized approach that could be applied to similar situations and patients. Exhibits insight into the broader application of the approach for the community.

Writes clearly, logically, and persuasively; grammar and mechanics are error-free.

Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health