Sample Answer for NURS FPX 4900 CAPSTONE PROJECT 1 Included After Question
Complete this assessment in two parts.
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.
Connect with the patient, family, or group you will 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 hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
In a 5-7 page written assessment, 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. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
A Sample Answer For the Assignment: NURS FPX 4900 CAPSTONE PROJECT 1
Title: NURS FPX 4900 CAPSTONE PROJECT 1
Nurses have a core role in ensuring that individuals and populations have positive healthcare outcomes and improved patient outcomes. The implication is that nurses have to engage in activities designed to foster positive patient outcomes and enhance organizational processes. Therefore, the nurses have to appropriately identify the problems and plan on how to use the most effective intervention for better outcomes. The process requires that nurses engage in the process of determining the best intervention through a comprehensive literature search, and such initiatives may take the form of a change in a process or organizational policy (Perry et al.,2019). As such, the purpose of this assignment is to identify a patient, family, or group to work with during the practicum and focus on a specific health problem. In addition, this write-up will assess the problem from a policy perspective, change management, communication, and collaboration or change management perspective and formulate evidence and research base plan, implement and share specific findings.
Definition of Population Health problem and the Group.
The identified population health problem relevant to the practice is poorly controlled diabetes among the majority of patients receiving diabetes care at the facility. Diabetes is a condition where the body is incapable of producing enough insulin as required, or the body fails to utilize the produced insulin as appropriate (Cole & Florez, 2020). Poorly controlled diabetes is one of the most chronic conditions. In addition, it has been associated with other complications such as diabetic foot ulcers, neuropathy, nephropathy, retinopathy, and hearing problems, among other conditions.
The problem to be explored is poorly controlled glucose levels among patients with diabetes. The main group of focus is African Americans who get diabetes care at the facility. This group of individuals is known to have worse outcomes related to diabetes as compared to other groups of people or racial groups. One of the reasons is that a considerable number come from poor backgrounds; hence they cannot adequately access appropriate care (Cunningham et al.,2018). In addition, other factors such as cultural beliefs and lower levels of education make them prone to not adhering to the medication regimen and healthy lifestyle as prescribed by the practitioners. The result is poor glycemic control and low quality of health.
The Content and Data Showing the Existence of the Problem
Recent research on diabetes in the USA indicates that the prevalence of diabetes is higher among African Americans (11.7%) as compared to only 7.5% among their white counterparts. In addition, African Americans are more likely to experience diabetes complications. For instance, diabetic retinopathy rates are up to 46% higher among African Americans as compared to white (Haw et al.,2021). The end-stage renal disease related to diabetes is also close to three times more prevalent among African Americans. The implication is that this group needs appropriate intervention to help them have better patient outcomes. This problem is relevant to my practice as a baccalaureate-prepared nurse because, as a nurse, I can undertake various nursing interventions to help African Americans have better outcomes.
The Peer-Reviewed Literature and Professional Sources that Describe Nursing Actions.
As earlier indicated, diabetes leads to various adverse complications among the chosen population and a need to control the condition. As such, this area has triggered research that has been carried out to determine nursing actions that can be used to improve the care outcomes among this population. In a systematic review and meta-analysis, Cunningham et al.(2018) sought to investigate the impact of self-management education on HbA1c and quality of life among African Americans. Out of the fourteen articles analyzed, the researchers report that diabetes self-management education has widely been recommended as a nursing intervention and, therefore, widely used. Even though the findings did not show statistical significance, they showed clinical significance, making this one of the most used strategies.
Another source was recently published by Park et al. (2020). The aim of this study was to determine the impact of neighborhood environment on physical activity among patients with diabetes. They found that such an environment has a huge impact as it can either be enabling or disabling to physical activities to impact diabetes outcomes. Another piece of evidence is found in the research done by Young et al. (2020), who did research to determine the impact of nurse coaching and mobile health on diabetes outcomes among African Americans living with diabetes. In a randomized controlled trial, the researchers enrolled a total of 155 patients in the control group, while 132 were enrolled in the intervention group. Upon using nursing coaching and mobile health, the individuals in the intervention group showed better outcomes, such as diabetes self-efficacy and reduced depressive symptoms. The evidence from these sources is in sync with what I observe in practice which is poor diabetes outcomes among the African American population.
It is important to ascertain whether the data is reliable. As such, I would check the author’s profile and see if they have the authority to publish the data and whether they are experts in the field. This is to ensure that they have the knowledge and experience needed to conduct such research and publish the findings. I would also check the author affiliations and find out if they are reputable. The third strategy I would use is to check if the data has been published in a peer-reviewed journal or in an official governmental site authorized to publish such data. I would know that the data is unreliable if the data is not supported by peer-reviewed articles or government-published data.
Barriers to the Implementation of EBP In Addressing The Problem
The literature also details various barriers to the implementation of evidence-based practice in addressing the problem. One of them is inadequate EBP knowledge among nurses. The other barriers include inadequate funding, as EBP implementation may require a considerable amount of funds, while the third barrier is organizational rules which do not favor EBP (Mathieson et al.,2019).
Research Testing the Nursing Standards
One of the research that has tested the effectiveness of nursing standards in improving patient outcomes among patients with diabetes is research done by Azami et al. (2018). These researchers applied a nurse-led diabetes self-management education program among patients with type 2 diabetes. After a period of twelve weeks, the program led to improved HbA1c levels, among other diabetes-related outcomes.
The Role of Nurses in Policy Making
Nurses have a significant role to play in policy-making to reduce hospital readmissions, prevent illnesses and improve care outcomes. One of the roles is being a patient advocate. Nurses also influence the law maker’ opinions through advocacy efforts such as writing letters to them and sharing their views in public forums (Hajizadeh et al.,2021). Nurses also write policy proposals and persuade lawmakers to sponsor the same for adoption.
Theory to Guide the Practicum
Practicum offers an important framework for learning. It gives a chance to interact with patients and obtain first-hand information. One of the theories or conceptual frameworks that might guide my actions during practicum is from novice to expert theory by Patricia Benner. This theory asserts that nurses develop an understanding of patient care and the skills required over a period following a combination of personal experience and a strong educational foundation (Ozdemir, 2019). Therefore, this theory will guide me to learn from the preceptor and senior nurses regarded patient care so that I become an expert professional in the future.
Governmental Policy Impacting the Problem
One of the governmental policies that could impact the problem identified is the affordable care act of 2010. Under this act, providers are prohibited from refusing to cover patients due to underlying conditions such as diabetes. The implication is that patients with diabetes have increasingly accessed care that they could not get appropriately before the passing of this policy (Huguet et al.,2018). In addition, this policy has also enabled access to care by reducing the cost of medical aid; hence many of the patients with diabetes have managed to register, hence improving access.
The Leadership Strategies
Nursing interventions are important in improving patient outcomes. However, these interventions cannot be as effective as required if the leadership strategies in place are not supportive enough. Therefore, various leadership strategies can be used to improve patient experience, patient-centered care, and outcomes. One of the strategies is a collaboration (Perry et al.,2019). Effective diabetes care requires a multi-professional collaboration between physicians, nurses, and pharmacists; as such, leaders should encourage such collaborations. The other strategy is the support of evidence-based practice to improve patient outcomes. Research has shown that the use of collaborations and EBP is key to improving diabetes-related patient outcomes. As such, I anticipate that the leadership must play a role in directing care and encouraging collaboration within the facility to help improve patient outcomes.
Collaboration and communication strategies are in addressing the stated problem. One of the collaboration strategies is the delegation of roles to every team member to ensure that there are no conflicts and that everyone feels responsible and part of the project (Perry et al.,2019). Communication strategies that can be used include encouraging open communication among the team members, passing important messages on time, establishing communication channels, and ensuring that they are always open.
The Change Management Strategy
Offering a solution to the identified problem will need the initiation of a change process hence the need for a change management strategy. Therefore, various strategies will be used. It will be prudent to find the best reason for the change and communicate it in time. The other strategy will be to involve the stakeholders at every level and formulate a change road map for the change initiative (Perry et al.,2019). Again the staff will be motivated, followed by the removal of potential obstacles. These strategies will help in the process of change so that the initiative for improving diabetes management among African Americans with diabetes is a success.
Diabetes is one of the most disabling conditions hence a need for better management. Therefore, during my practicum, I intend to engage African American patients with poorly controlled diabetes. The project will involve using an evidence-based practice initiative to improve diabetes-related patient outcomes such as HbA1c levels and quality of life, among other parameters.
Azami, G., Soh, K. L., Sazlina, S. G., Salmiah, M., Aazami, S., Mozafari, M., & Taghinejad, H. (2018). Effect of a nurse-led diabetes self-management education program on glycosylated hemoglobin among adults with type 2 diabetes. Journal of Diabetes Research, 2018. https://doi.org/10.1155/2018/4930157
Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16(7), 377-390. https://doi.org/10.1038/s41581-020-0278-5
Cunningham, A. T., Crittendon, D. R., White, N., Mills, G. D., Diaz, V., & LaNoue, M. D. (2018). The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis. BMC Health Services Research, 18(1), 1–13. https://doi.org/10.1186/s12913-018-3186-7
Haw, J. S., Shah, M., Turbow, S., Egeolu, M., & Umpierrez, G. (2021). Diabetes complications in racial and ethnic minority populations in the USA. Current Diabetes Reports, 21(1), 1–8. https://doi.org/10.1007/s11892-020-01369-x
Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing, 20(1), 1-9. https://doi.org/10.1186/s12912-021-00648-6
Huguet, N., Springer, R., Marino, M., Angier, H., Hoopes, M., Holderness, H., & DeVoe, J. E. (2018). The impact of the Affordable Care Act (ACA) Medicaid expansion on visit rates for diabetes in safety net health centers. The Journal of the American Board of Family Medicine, 31(6), 905–916. https://doi.org/10.3122/jabfm.2018.06.180075
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20. doi:10.1017/S1463423618000488
Ozdemir, N. G. (2019). The development of nurses’ individualized care perceptions and practices: Benner’s novice to expert model perspective. International Journal of Caring Sciences, 12(2), 1279-1285. https://internationaljournalofcaringsciences.org/docs/81_ozdemir_special_12_2.pdf
Park, S., Zachary, W. W., Gittelsohn, J., Quinn, C. C., & Surkan, P. J. (2020). Neighborhood influences on physical activity among low-income African American adults with type 2 diabetes mellitus. The Diabetes Educator, 46(2), 181-190. https://doi.org/10.1177/0145721720906082
Perry, A. G., Potter, P. A., & Ostendorf, W. (2019). Nursing Interventions & Clinical Skills E-Book. Elsevier Health Sciences.
Young, H. M., Miyamoto, S., Dharmar, M., & Tang-Feldman, Y. (2020). Nurse coaching and mobile health compared with usual care to improve diabetes self-efficacy for persons with type 2 diabetes: randomized controlled trial. JMIR mHealth and uHealth, 8(3), e16665. https://doi.org/10.2196/16665