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Capella 4900 Assessment 1

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    Capella 4900 Assessment 1

    Capella 4900 Assessment 1 Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

    Student Name

    Capella University

    NURS-FPX 4900 Capstone Project for Nursing

    Prof. Name

    Date

    Introduction to the Identified Problem and its Relevance

    This report aims to probe into the problem of a high incidence and ineffective management of Chronic Obstructive Pulmonary Disease (COPD) among the middle-aged population in a particular urban neighborhood, examining this issue through the lenses of leadership, collaboration, communication, change management, and policy. These perspectives are integral to fostering effective transformations within the healthcare environment.

    Consider Mr. John, a 45-year-old resident of the aforementioned neighborhood. Mr. John, who has a high school education and works as a construction supervisor, is currently uninsured due to the recent loss of his job. He lives with his wife and two school-aged children, who offer him emotional support. In addition to COPD, Mr. John also has comorbidities of hypertension and obesity. The patient, Mr. John, became under my care after his recent hospitalization for a severe exacerbation of COPD. Following his discharge, he was referred to me as his primary nurse for ongoing management and support.

    Capella 4900 Assessment 1

    Despite numerous interventions and adjustments to his medication regimen, Mr. John’s COPD management remains suboptimal, leading to frequent hospital visits and readmissions that impose significant physical, emotional, and financial burden on him and his family. This situation highlights the need to critically evaluate the current COPD management strategies and interventions employed in our healthcare setting, taking into account Mr. John’s specific circumstances.

    Inappropriate management of COPD can result in severe complications such as respiratory failure, heart diseases, and even death. This issue not only affects the individual’s quality of life and overall well-being, but also impacts the healthcare organization’s performance and reputation, owing to increased hospital admissions (Ebrahimi et al., 2022). John was an active smoker until a decade ago, which has greatly contributed to his COPD. Even though he has quit smoking, the damage done remains significant and exacerbates his health condition (Fan Chiang et al., 2022). His last admission to our hospital was just two weeks ago and, despite medication adjustments and planned follow-ups, his health condition has not significantly improved since the previous visit.

    As a baccalaureate-prepared nurse, it is my responsibility to facilitate care for patients suffering from chronic conditions like COPD and ensure they receive comprehensive and effective care (Ebrahimi et al., 2022). This duty involves working with the interdisciplinary team to develop and implement evidence-based interventions aimed at reducing hospital admissions, improving patient outcomes, and enhancing the overall COPD management (Fan Chiang et al., 2022). By addressing this issue, my goal is to assist patients like John to better manage their chronic conditions, promote healthier lifestyle choices, and improve their quality of life while simultaneously reducing the strain on our healthcare system.

    Literature and Professional Evidence Analysis

    Consistency with Literature and Practice: Numerous peer-reviewed studies affirm the efficacy of several interventions such as smoking cessation programs, pulmonary rehabilitation, and targeted health education in managing COPD effectively, thus improving patients’ quality of life. For example, studies have established that personalized pharmaceutical care and patient counseling significantly enhance medication adherence and health-related quality of life among COPD patients (Rompicharla & Swaroop, 2021). This evidence resonates with my experience in nursing practice where similar interventions have proven effective.

    Data reliability can be gauged through several factors. Reliable data is usually characterized by large and diverse sample sizes, consistent findings across multiple studies, the presence of control groups, clear and unbiased methodologies, and peer-reviewed sources. Conversely, unreliable data may present with inconsistent or contradicting results, small or homogeneous sample sizes, absence of control groups, unclear or biased methodologies, lack of peer-review, or information obtained from outdated or non-credible sources (Izquierdo et al., 2021).

    The literature delineates numerous barriers impeding effective COPD management. These include inadequate patient awareness and understanding of the disease, limited access to rehabilitation programs, unavailability or inaccessibility of healthcare services, particularly in rural or underserviced areas, and environmental factors such as air pollution and second-hand smoke exposure (Rompicharla & Swaroop, 2021). Financial constraints and socio-cultural factors can also limit the adoption of evidence-based practices.

    Capella 4900 Assessment 1

    Research indicates that strict adherence to guidelines such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) standards leads to significant improvement in patient outcomes (Chinai et al., 2019). These standards encompass diagnostic measures, pharmacological management, and non-pharmacological strategies such as pulmonary rehabilitation and self-management interventions, all of which are vital for comprehensive COPD management. 

    Barriers to effective COPD management could also extend into policy-making. A lack of representation or advocacy for the specific needs of COPD patients could exist. However, the active role of nurses in this area can play a transformative role. As front-line healthcare providers, nurses can advocate for patient needs, contribute to the development of preventive measures, and facilitate improved health literacy. Their unique insights into patient experiences can also aid in reducing hospital readmissions and enhancing overall COPD management, directly influencing the outcomes for COPD patients (Czira et al., 2023).

    Within this context, the Self-Care Deficit Theory by Dorothea Orem can serve as a valuable guiding framework. This theory emphasizes the patient’s self-care capabilities and highlights the role of nursing in educating and empowering the patient. This theoretical perspective can guide the implementation of self-management strategies and educational interventions for COPD patients. By focusing on improving patients’ abilities to manage their condition, we can address some of the barriers to effective COPD management and aim for improved health outcomes (Jeddi et al., 2023).

    Impact of Nursing Practice Standards and Policies on the Problem

    The American Nurses Association (ANA) has standards that significantly influence the management of COPD. For instance, ANA’s Standard of Professional Performance emphasizes that nurses must evaluate their practice to ensure it is consistent with professional standards (Pleasants et al., 2019). This guideline could affect COPD management as it encourages nurses to continuously review and update their knowledge about COPD management strategies, ensuring they provide care aligned with current evidence-based practices.

    Governmental policies such as the Clean Air Act, enforced by the Environmental Protection Agency (EPA), can also have a substantial effect on COPD management. This legislation focuses on controlling air pollution, a significant risk factor for COPD. By improving air quality, the prevalence and exacerbation of COPD can be reduced, impacting the volume and complexity of cases nurses manage (Carlsten et al., 2020).

    These standards and policies directly influence the scope of nursing practice. ANA’s standards prompt nurses to consistently self-evaluate and improve their COPD management approaches, thereby affecting nursing practice by enforcing regular knowledge updates and adherence to best practices. On the other hand, the Clean Air Act influences the environmental determinants of health, altering the incidence and progression rate of COPD, which in turn affects nursing workload, practice, and required competencies in managing the disease. These standards and policies, therefore, guide and shape nursing practice in COPD management, pushing for high-quality, evidence-based care while creating an environment conducive to better respiratory health.

    Leadership Strategies to Improve Outcomes and Patient-Centered Care

    Transformational leadership within nursing can significantly improve health outcomes for COPD patients. By fostering a team environment that encourages ongoing learning and adherence to evidence-based practices, leaders can drive improved patient outcomes. For example, nurse leaders can champion the adoption of protocols such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, which have been linked with fewer exacerbations and improved patient function in COPD patients. As a nurse leader, my role will be to encourage a culture that emphasizes the importance of these guidelines, leading to better adherence and thus improved health outcomes (Reinhardt et al., 2022).

    Patient-centered care involves understanding and responding to the unique needs of each patient, a key aspect of managing COPD effectively. A transformational nurse leader can foster this by promoting open communication, leading by example in delivering personalized care, and advocating for patients’ rights and needs within the healthcare system. By doing so, we ensure that COPD management strategies are tailored to each patient’s specific circumstances and preferences, enhancing patient satisfaction and engagement in their care (Stellefson et al., 2022).

    Capella 4900 Assessment 1

    The overall patient experience can be significantly elevated by leadership strategies that prioritize clear communication, patient involvement, and empathetic care. For instance, facilitating patient education sessions to improve patients’ self-management skills, leveraging technology to improve patient-provider communication, and leading healthcare teams in delivering compassionate, understanding care can all enhance the patient experience (Czira et al., 2023). In my leadership role, I will strive to cultivate a healthcare environment where these strategies are not just encouraged, but embedded in our practice.

    Efficient management of COPD requires strong collaboration, open communication, and effective change management, all of which can be facilitated by transformational leadership. In addition to discussing COPD with a patient group for two hours, I also spent an hour consulting a pulmonologist specializing in COPD, gaining deeper insights into the condition and its management strategies. These hours have been recorded in the Core Elms Volunteer Experience Form.

    Conclusion

    In conclusion, addressing the high prevalence of COPD among middle-aged residents requires a comprehensive approach that intertwines evidence-based practices, adherence to nursing standards, and transformational leadership. As a baccalaureate-prepared nurse, my roles extend beyond patient care to advocating for policy changes, instigating evidence-based interventions, and facilitating effective collaboration. The lessons drawn from this exercise will invariably inform my practice and contribute to the broader efforts of improving public health outcomes in the community.

    References

    Carlsten, C., Salvi, S., Wong, G. W. K., & Chung, K. F. (2020). Personal strategies to minimise effects of air pollution on respiratory health: Advice for providers, patients and the public. European Respiratory Journal, 55(6), 1902056. https://doi.org/10.1183/13993003.02056-2019 

    Chinai, B., Hunter, K., & Roy, S. (2019). Outpatient management of chronic obstructive pulmonary disease: Physician adherence to the 2017 global initiative for chronic obstructive lung disease guidelines and its effect on patient outcomes. Journal of Clinical Medicine Research, 11(8), 556–562. https://doi.org/10.14740/jocmr3888 

    Czira, A., Purushotham, S., Iheanacho, I., Rothnie, K. J., Compton, C., & Ismaila, A. S. (2023). Burden of disease in patients with mild or mild-to-moderate chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease Group A or B): A systematic literature review. International Journal of Chronic Obstructive Pulmonary Disease, 18, 719–731. https://doi.org/10.2147/copd.s394325 

    Ebrahimi, A., Ahmadi, M., & Mahmoudi, S. (2022). The Impact of self-efficacy and health literacy on medication adherence and health-related quality of life in patients with heart failure: A systematic review. Journal of Clinical Research in Paramedical Sciences, 11(2). https://doi.org/10.5812/jcrps-118666 

    Fan Chiang, Y., Lee, Y., Lam, F., Liao, C., Chang, C., & Lin, C. (2022). Smoking increases the risk of postoperative wound complications: A propensity score‐matched cohort study. International Wound Journal, 20(2), 391–402. https://doi.org/10.1111/iwj.13887 

    Capella 4900 Assessment 1

    Izquierdo, J. L., Morena, D., González, Y., Paredero, J. M., Pérez, B., Graziani, D., Gutiérrez, M., & Rodríguez, J. M. (2021). Clinical management of COPD in a real-world setting. A big data analysis. Archivos de Bronconeumología (English Edition), 57(2), 94–100. https://doi.org/10.1016/j.arbr.2019.12.023 

    Jeddi, H., Aghebati, N., Ghavami, V., & Rezaeitalab, F. (2023). The effect of self-care nurturance using the theory of modeling and role-modeling on self-efficacy in stroke patients. Holistic Nursing Practice, 37(2), E24–E35. https://doi.org/10.1097/hnp.0000000000000567 

    Pleasants, R. A., Radlowski, P. A., & Davidson, H. E. (2019). Optimizing drug therapies in patients with COPD in the US nursing home setting. Drugs & Aging, 36(8), 733–745. https://doi.org/10.1007/s40266-019-00680-x 

    Reinhardt, A., Leon, T., & Summers, L. (2022). The transformational leader in nursing practice – an approach to retain nursing staff. Administrative Issues Journal, 12(1). https://dc.swosu.edu/aij/vol12/iss1/2/ 

    Rompicharla, S. S., & Swaroop, A. M. (2021). Impact of clinical pharmacist intervention on the management of health related quality of life in chronic obstructive pulmonary disease. International Journal of Research in Engineering, Science and Management, 4(8), 327–332. https://journal.ijresm.com/index.php/ijresm/article/view/1272 Stellefson, M., Kinder, C., Boyd, I., Elijah, O., Naher, S., & McFadden, N. (2022). COPD self-management for adults living in rural areas: Systematic review of telehealth and non-telehealth interventions. American Journal of Health Education, 53(5), 269–281. https://doi.org/10.1080/19325037.2022.2100525

    Capella 4900 Assessment 1