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NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

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    NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan


    Capella university

    NURS FPX 4050 Coordinating Patient-Centered Care

    Prof. Name


    Preliminary Care Coordination Plan

    The development of a preliminary care coordination plan for a health care problem is an essential responsibility of a staff nurse in a community care center. Preliminary care coordination refers to the initial steps taken in the care coordination process. These steps involve identifying the healthcare problem, assessing the patient’s needs, and developing a comprehensive plan of care. Physical, psychosocial, and cultural considerations are essential components of a comprehensive plan of care (Marimuthu et al., 2022).

    Patients have unique experiences, beliefs, and values that influence their perceptions of illness and health, and incorporating these aspects into the plan of care is critical to achieving positive outcomes. The emotional and mental health of patients play a significant role in determining the overall health status of an individual. Therefore, it is important to integrate psychosocial support services into the plan of care to address any psychological or emotional barriers that may hinder the patient’s recovery (Kuhney et al., 2023). Furthermore, recognizing the influence of cultural values and beliefs is essential to delivering culturally competent care. Patients’ cultural backgrounds can impact their perceptions of illness and treatment, and this can affect their willingness to adhere to the plan of care (Marimuthu et al., 2022).

    This assessment aims to present a perceptive analysis of a selected health concern, establish realistic and attainable goals, and identify significant community resources to ensure a safe and effective continuum of care. Furthermore, the plan is the foundation for delivering complete and efficient patient treatment that addresses not only their physical needs but also their psychosocial and cultural elements.

    Perceptive Analysis of a Health Concern and Evidence-Based Practice

    Heart disease is a significant health concern that affects a large number of individuals. It includes conditions such as high blood pressure, stroke, and heart failure. Cardiovascular diseases are the primary worldwide cause of death, responsible for 17.9 million fatalities annually, as per the “American Heart Association.” To combat this serious health issue, various research studies have suggested that adopting healthy lifestyle habits and participating in health education programs can considerably lower the possibility of getting heart illness.

    The research published in the “American College of Cardiology Journal” in 2019 concluded that engaging in regular physical activity, including activities like walking, jogging, swimming, or cycling for a minimum of 30 minutes per day, can enhance heart function, decrease blood pressure, and improve cholesterol levels (Finocchiaro et al., 2023).In addition to lifestyle modifications, medication therapy is also critical for managing heart disease. Several types of medications are available to help manage heart disease risk factors, including those that lower cholesterol levels, control blood pressure, prevent blood clots, and reduce the risk of heart failure. These medications include statins, “Angiotensin-converting Enzyme Inhibitors (ACE)”, and “Angiotensin Receptor Blockers (ARBs)”.

    NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

    For instance, a case study published in the “Journal of Cardiology” Cases in 2019 reported the successful management of heart disease in a patient with a history of myocardial infarction using a combination of high-dose statin therapy and beta-blockers. The individual showed a substantial reduction in their Low-Density Lipoprotein (LDL) cholesterol levels and successfully attained the targeted blood pressure levels. The combination therapy resulted in improved symptoms and overall quality of life for the patient (Chen et al., 2023). Although these best practices have demonstrated efficacy, the analysis is subject to underlying assumptions and areas of uncertainty. For instance, medication therapy may not be well-tolerated by certain patients due to adverse effects, and lifestyle modifications, such as weight loss, may be unattainable for some patients (Marimuthu et al., 2022).

    Attainable Goals to Address Selected Health Care Problems

    To address the health concern of heart disease, it is essential to establish specific goals. An impactful objective would be to increase physical activity levels by incorporating at least 30 minutes of activity of moderate intensity into everyday schedules. The number of days per week the individual engages in physical activity, as well as the duration and intensity of the activity, can be tracked to measure progress towards the goal (Chen et al., 2023).An additional goal to avoid heart disease is to consume foods that are good for the heart, such as vegetables, fruits, whole carbohydrates, and protein sources in moderate amounts.

    Specific targets for the number of servings of each food group to be consumed per day or week can be set to achieve this goal. For instance, at least five servings of fruits and vegetables every day and choosing lean protein sources such as chicken, fish, or legumes instead of red meat. Moreover, incorporating whole grains into the diet by replacing refined grains can further promote heart health. Choosing brown rice instead of white rice is an excellent way to incorporate more whole grains into the diet. These changes should be made gradually, and progress can be tracked by keeping a food diary or using a tracking app to ensure the goals are attainable (Maddox et al., 2021).

    NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

    In addition to lifestyle changes, smoking is a major contributor to cardiovascular disease, thus quitting smoking can significantly reduce the likelihood of getting heart disease. Setting a specific goal to quit smoking within a specified timeframe, such as 6 months, can be effective. Progress can be monitored by keeping track of the number of cigarettes smoked per day and the number of quit attempts.While these goals have been shown to be effective, it’s essential to recognize underlying assumptions and points of uncertainty in the analysis. For example, medication therapy may not be well-tolerated by some patients due to side effects, and some lifestyle modifications such as weight loss may not be achievable for some patients (Maddox et al., 2021).  Thus, it’s important to tailor goals to individual needs and capabilities to achieve the best outcomes.

    Community Resources for Individuals at Risk of Heart Disease

    Identifying significant and available community resources is crucial for providing a safe and effective continuum of care for individuals at risk of heart disease. Community resources can include a range of healthcare facilities, support groups, rehabilitation programs, and educational resources. By identifying and utilizing these resources, individuals with heart disease can receive the care and support they need to improve their health outcomes and reduce the risk of future heart events.

    Healthcare Facilities

    Hospitals and clinics are essential community resources that provide diagnostic testing, medication management, and other critical services for individuals with heart disease. For example, cardiac catheterization labs can perform tests to diagnose blockages in the arteries, while cardiac rehabilitation programs can help patients recover from heart attacks and other cardiac events. Research has demonstrated that individuals who engage in cardiac rehabilitation programs have a decreased likelihood of hospital readmissions and a lower mortality risk (Mhmoud, 2022).

    Support Groups

    Support groups can offer emotional support and practical advice for coping with the challenges of managing a chronic condition such as heart disease. Many organizations offer online and in-person support groups for individuals with heart disease and their families. For example, the “American Heart Association” provides digital assistance groups, and the “Mended Hearts Association” furnishes peer-to-peer support gatherings for individuals and their families affected by heart ailments. (Maddox et al., 2021).

    Rehabilitation Programs

    Participating in rehabilitation programs can aid in enhancing an individual’s physical capabilities while diminishing the possibility of subsequent heart-related incidents. These programs usually consist of exercise training, instruction on heart-healthy lifestyles, and guidance on how to manage stress and other lifestyle factors that can impact heart health. Studies have shown that cardiac rehabilitation programs can reduce the risk of future cardiac events by up to 50%.

    Educational Resources

    Educational resources can provide information about heart-healthy lifestyles, medication regimens, and other important topics related to heart disease management. These resources can be accessed through healthcare providers, community organizations, and online sources. For example, the National Heart, Lung, and Blood Institute provides online resources on heart disease prevention, while the “American College of Cardiology” offers patient education resources on heart conditions and treatments (Zheng et al., 2019).

    In conclusion, a comprehensive list of community resources can be compiled to help individuals with heart disease access the resources they need to manage their condition. By working with healthcare professionals to develop personalized plans for accessing these resources, individuals can receive the care and support they need to improve their health outcomes and reduce the risk of future heart events.


    Chen, B., Dou, Y., Yu, X., & Ma, D. (2023). Influence of Internet-Based Health Management on Control of Clinical Parameters in Patients With Hypertension: Four-Year Longitudinal Study. Journal of Medical Internet Research25, e42896. 

    Finocchiaro, G., Radaelli, D., D’Errico, S., Papadakis, M., Behr, E. R., Sharma, S., … & Sheppard, M. N. (2023). Sudden cardiac death among adolescents in the United Kingdom. Journal of the American College of Cardiology81(11), 1007-1017. 

    Kuhney, F. S., Miklowitz, D. J., Schiffman, J., & Mittal, V. A. (2023). Family-Based Psychosocial Interventions for Severe Mental Illness: Social Barriers and Policy Implications. Policy Insights from the Behavioral and Brain Sciences10(1), 59-67. 

    Maddox, T. M., Januzzi Jr, J. L., Allen, L. A., Breathett, K., Butler, J., Davis, L. L., … & Youmans, Q. R. (2021). 2021 update to the 2017 ACC expert consensus decision pathway for optimization of heart failure treatment: answers to 10 pivotal issues about heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology77(6), 772-810. 

    NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

    Marimuthu, M., Taghizadeh, S. K., & Kandampully, J. (2022). Understanding the process of patient empowerment and their well-being in the context of outpatient services. The TQM Journal. 

    Mhmoud, N. I. A. (2022). A Study of Coronary Arteries Diseases by Cardiac Catheterization (Doctoral dissertation, Sudan University of Science and Technology). 

    Zheng, X., Zheng, Y., Ma, J., Zhang, M., Zhang, Y., Liu, X., … & Yu, B. (2019). Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: a systematic review and meta-analysis. Heart & Lung, 48(1), 1-7.