NURS FPX 4900 Assessment 1 Leadership, Collaboration, Communication, Change Management,and Policy Consideration

Sample Answer for NURS FPX 4900 Assessment 1 Leadership, Collaboration, Communication, Change Management,and Policy Consideration Included After Question

Please use stroke as the topic as I will be using stroke patients throughout the remaining assessments.

A Sample Answer For the Assignment: NURS FPX 4900 Assessment 1 Leadership, Collaboration, Communication, Change Management,and Policy Consideration

Title: NURS FPX 4900 Assessment 1 Leadership, Collaboration, Communication, Change Management,and Policy Consideration

Assessing Problem

The promotion of public health is an important role of nurses and other healthcare providers. Nurses and other healthcare providers utilize care interventions such as inter-professional collaboration to ensure the optimum care outcomes for their patients. They also select best practice interventions to ensure the realization of the actual, and potential health needs of their patients. In doing the above, nurses strive to understand the unique needs of their patients, families, and communities as a whole. Therefore, this paper examines the health issue of stroke, influence of state boards of nursing, government and organizational policies on the care given to patients and leadership strategies that will affect care to stroke patients.

Definition of the Problem

The selected health problem for exploring in the project is stroke. According to the Centers for Disease Control and Prevention (CDC), stroke refers to a condition that develops due to the occlusion of blood supply to a region of the brain or due to bursting of the blood vessel in the brain (CDC, 2021b). Stroke is among the leading causes of death and disability in the USA. Individuals are increasingly predisposed to stroke due to risk factors such as hypertension, cigarette smoking, diabetes, and heart disease (CDC, 2019). The severity of stroke in the country is seen from the statistics that 795000 people develop stroke on a yearly basis, with 610000 of them being first or new diagnoses (CDC, 2021a). Nurses and other healthcare providers have a critical role to play in promoting coping in patients and families affected by stroke due to its adverse health effects. They also have a responsibility of creating awareness among the population to promote healthy lifestyles and behaviors.

The patient I will be working with during my practicum is a 65-year-old male who was diagnosed with stroke. He lives with his family. He has left-side paralysis due to stroke. Stroke affected the client’s ability to engage independently in most of the activities of the daily living. Often, his family members assist him in undertaking his daily activities such as bathing, dressing, and feeding. Stroke has had an enormous impact on the patient and the family. For example, the costs incurred in treating the patient have been significantly high. The patient requires frequent hospital visits for assessment and physiotherapy sessions, which are cost intensive. The burden of the disorder to the family can also be seen from the loss of productivity. Accordingly, the family spends most of their productive time in ensuring the needs of the patient are met. The consequences of the above impacts have been high level of emotional and financial stress to the family, increasing the need for me to work with them in identifying the effective ways of coping with the demands of stroke.

The health problem of stroke is relevant to my practice as a baccalaureate nurse because of a number of reasons. Firstly, stroke is considered among the leading causes of disability and mortality in the USA. The CDC reports that 1 in every 6 mortalities due to cardiovascular disease in the US in 2018 was attributed to stroke. It also reports that a person in the US dies from stroke in every four minutes in the US with one person developing it in every 40 seconds. The cost-burden of stroke is high as seen from the fact that the state incurred $46 billion between 2014 and 2015 in the USA (CDC, 2021a).

The other relevance of stroke to my practice is the fact that it is largely attributable to preventable factors. Accordingly, evidence shows that preventable factors cause stroke. They include hypertension, obesity, diabetes, heart disease, smoking, and physical inactivity. It also arises due to other causes such as metabolic syndrome, high levels of lipids and cholesterol, and poor dietary habits (Virani et al., 2021). The population may be predisposed to the risk factors due to their lack of or low level of awareness. Nurses have a critical role to play in creating awareness among the public, promoting the health of those at risk, and providing optimum care to the affected patients and their families, hence, the relevance of the issue to my practice.         

Analysis of Evidence

Nurses have a critical role to play in the prevention and management of stroke in their populations. They utilize national guidelines and evidence-based data in the prevention and management of stroke. The health promotion and prevention strategies they employ in their practice includes the prevention of risk factors through healthy lifestyles and behaviors and treating conditions such as hypertension to reduce the risks of stroke. Nurses also work in collaboration with other healthcare providers to facilitate coping with the demands of stroke among the affected patients and their families. For example, they link patients and families with the existing support groups to ensure their optimum health and coping with demands of stroke. In addition, they adopt care coordination to ensure high quality, safe and efficient care for the affected patients and families. The above interventions align with those I witness in nursing practice in the organization I work.

Evidence-based practice is important in addressing the care needs of patients and families affected by stroke. However, barriers to the use of evidence-based interventions in addressing the problem exist. According to Baatiema et al., (2017), factors such as inadequate institutional support, limited knowledge and skills among healthcare professionals on use of evidence-based therapies, and low level of confidence on the effectiveness of evidence-based therapies act as barriers in practice. The authors further identify that issues such as limited medical facilities to enhance the uptake of evidence, lack of or inadequate peer support among healthcare providers, and complex nature of stroke therapies make it difficult for providers to implement evidence-based interventions in their practice (Baatiema et al., 2017). As a result, it is important for healthcare institutions and providers to examine the enabling factors that will address their above barriers in their practice (Juckett et al., 2020).

Nursing standards are effective in ensuring the realization of the care needs of patients affected by stroke. Accordingly, nursing safeguard the interests of stroke patients and their families by adhering to professional standards that include safety, quality, efficiency, protection of patients’ rights, and advocacy in their practice. Nurses also participate in system design to ensure the needs of stroke patients are met. As seen from the evidence by Adeoye et al., (2019), nurses implement stroke systems of care that focus on aspects such as endovascular therapy, care coordination, and neurocritical care to meet the care needs of stroke patients. Bjartmarz et al., (2017) investigated the effectiveness of nursing standards and guidelines in their research where they found improvement in the consistence, quality, and safety of care given to stroke patients. Bennett (2017) found that nursing standards focusing on patient-centered relationships create a positive culture of care that leads to enhanced emotional wellbeing of the patients and recovery in rehabilitation of stroke patients.

Nurses also have a role to play in policy making to improve outcomes, prevent illness, and reduce hospital readmissions in stroke patients. Accordingly, nurses play a vital role in ensuring the adoption of policies that aim at prevention of stroke and the provision of optimal care to the affected populations. They also advocate for the adoption of interventions to create awareness among the public on the causes, effects and prevention of stroke (Harrington et al., 2020). Through it, the population is motivated to adopted healthy lifestyle and behaviors. Nurses also advocate for policies that enable the use of technologies such as telehealth to reduce hospital visits as well as readmission among stroke patients (Rutledge et al., 2017).

Nursing theories such as Orem’s theory of self-care can be applied in caring for stroke patients. According to Orem, nurses play a vital role in assisting patients meet their self-care needs in cases where they lack power or will to do so. The applicability of the model to stroke is seen from the role that nurses play in helping patients meet their self-care needs. Nurses also help families and patients cope with the increasing demands of stroke (Ghani et al., 2019). Therefore, the model can be used to ensure the provision of optimum care to stroke patients and their families.

Influence of State Board Nursing Practice Standards and Organizational or Government Policies

The state board nursing practice standards influence the care outcomes of patients with stroke. For example, nursing practice standards requiring the utilization of patient-centered models of care have been shown to enhance the safety, quality and efficiency of care given to stroke patients and their families. Patient-centeredness in stroke management increases the confidence of the patients and their significant others in the effective management, rehabilitation, and recovery from stroke.  According to the research by Bennett (2017), the adoption of patient-centered standards in stroke management enhances coping, empowerment, and recovery among stroke patients, hence, their optimal health and wellbeing. National guidelines such as those developed by the American Heart Association also guide the interventions used in stroke prevention and management. Nurses have to ensure that the care interventions align with those provided by the association to ensure optimum care outcomes.

As noted above, nurses have critical roles to play in policy making to improve outcomes, prevent illnesses, and reduce hospital readmissions among patients with stroke. They participate in the formulation and implementation of policies that focus on health promotion and disease prevention. They advocate the implementation of policies that increase the need for creation of public awareness through health education on issues related to stroke. Nurses also implement policies that underpin the use of evidence-based interventions in stroke management to optimize the care outcomes. They also implement policies that encourage innovation through technology use in stroke prevention and management. The local, state and federal legislations influence my scope of nursing practice within the context of stroke prevention and management (Loft et al., 2017). The legislations strengthen the improvement of nursing practices and standards to address the care needs of the patients.

Leadership Strategies

Effective leadership is needed for the prevention and management of stroke. Nurse leaders should demonstrate effective leadership that empowers nurses, patients, and their families to play a proactive role in the prevention, and optimal management of stroke. Leadership strategies such as active collaboration increase the competencies of the nurses in the prevention and management of stroke. Open communication increases trust that nurses, patients, and their families have towards the interventions used in stroke prevention and management (Murray et al., 2018). Effective leadership also creates culture of safety and quality in stroke care for the optimum care needs of the patients.

One of the roles that leadership must play in addressing the issue of stroke is encouraging evidence-based practice in their institutions. Leaders in healthcare must implement interventions that eliminate barriers to evidence-based practice in stroke management and prevention. Nurse leaders must also encourage inter-professional collaboration in their settings to ensure enhanced safety, quality and efficiency of patient care. The collaboration strategies that will be needed to address the problem includes setting realistic goals for treatment, modeling effective behaviors, defining and assigning roles to team members, and promoting creativity and innovation. The communication strategies that will be needed include open communication, clarity and consistency in communicating the strategies needed to promote the health of stroke patients and their families. The change management strategies that are needed to address the health needs of stroke patients and their families includes training, active stakeholder involvement, open communication, and provision of coaching and mentorship opportunities to facilitate change (Jones & Bennett, 2018).

Conclusion

Stroke is a critical public health concern in America, as it is a leading cause of mortality and disability. Evidence-based interventions are needed in stroke prevention and management. Nurses utilize state board standards to ensure optimum health and wellbeing of stroke patients and their families. Effective leadership is needed to ensure the utilization of best practices in stroke prevention and management.

References

Adeoye, O., Nyström, K. V., Yavagal, D. R., Luciano, J., Nogueira, R. G., Zorowitz, R. D., Khalessi, A. A., Bushnell, C., Barsan, W. G., Panagos, P., Alberts, M. J., Tiner, A. C., Schwamm, L. H., & Jauch, E. C. (2019). Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update. Stroke, 50(7), e187–e210. https://doi.org/10.1161/STR.0000000000000173

Baatiema, L., Otim, M. E., Mnatzaganian, G., de-Graft Aikins, A., Coombes, J., & Somerset, S. (2017). Health professionals’ views on the barriers and enablers to evidence-based practice for acute stroke care: A systematic review. Implementation Science, 12(1), 74. https://doi.org/10.1186/s13012-017-0599-3

Bennett, B. (2017). A culture of caring: How nurses promote emotional wellbeing and aid recovery following a stroke. British Journal of Neuroscience Nursing, 13(Sup2), S8–S17. https://doi.org/10.12968/bjnn.2017.13.Sup2.S8

Bjartmarz, I., Jónsdóttir, H., & Hafsteinsdóttir, T. B. (2017). Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: A mixed methods study. BMC Nursing, 16(1), 72. https://doi.org/10.1186/s12912-017-0262-y

CDC. (2019, January 17). Stroke Awareness|Diseases|Resources|Genomics|CDC. https://www.cdc.gov/genomics/resources/diseases/stroke.htm

CDC. (2021a, May 25). Stroke Facts | cdc.gov. https://www.cdc.gov/stroke/facts.htm

CDC. (2021b, August 2). Learn About Stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/about.htm

Ghani, N., Suliman, M., & Fatima, A. (2019). Application of Orem’s Nursing Theory to a Stroke Patient: A Case Study. Journal of Saidu Medical College, Swat, 9(2), Article 2. https://doi.org/10.52206/jsmc.2019.9.2.%p

Harrington, R. A., Califf, R. M., Balamurugan, A., Brown, N., Benjamin, R. M., Braund, W. E., Hipp, J., Konig, M., Sanchez, E., & Joynt Maddox, K. E. (2020). Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association. Circulation, 141(10), e615–e644. https://doi.org/10.1161/CIR.0000000000000753

Jones, L., & Bennett, C. (2018). Leadership for nursing, health and social care students. Lantern Press. https://orca.cardiff.ac.uk/118073/

Juckett, L. A., Wengerd, L. R., Faieta, J., & Griffin, C. E. (2020). Evidence-Based Practice Implementation in Stroke Rehabilitation: A Scoping Review of Barriers and Facilitators. The American Journal of Occupational Therapy, 74(1), 7401205050p1-7401205050p14. https://doi.org/10.5014/ajot.2020.035485

Loft, M. I., Poulsen, I., Esbensen, B. A., Iversen, H. K., Mathiesen, L. L., & Martinsen, B. (2017). Nurses’ and nurse assistants’ beliefs, attitudes and actions related to role and function in an inpatient stroke rehabilitation unit—A qualitative study. Journal of Clinical Nursing, 26(23–24), 4905–4914. https://doi.org/10.1111/jocn.13972

Murray, M., Sundin, D., & Cope, V. (2018). The nexus of nursing leadership and a culture of safer patient care. Journal of Clinical Nursing, 27(5–6), 1287–1293. https://doi.org/10.1111/jocn.13980

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

Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., Elkind, M. S. V., Evenson, K. R., Ferguson, J. F., Gupta, D. K., Khan, S. S., Kissela, B. M., Knutson, K. L., Lee, C. D., Lewis, T. T., … null,  null. (2021). Heart Disease and Stroke Statistics—2021 Update. Circulation, 143(8), e254–e743. https://doi.org/10.1161/CIR.0000000000000950