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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Student Name Capella University NURS-FPX 6218 Leading the Future of Health Care Prof. Name Date Change Proposal Summary Report The focus of this change proposal summary report is to explore the shortage of healthcare professionals in the local healthcare system in Minnesota. The executive summary report clearly explains the issue, elaborates on the desired outcomes and factors hindering the achievement of those outcomes, a compelling comparison with non-U.S based healthcare systems is described, and the report identifies the financial and health implications of these proposed changes. Through this assessment, we aim to communicate a practical strategy for minimizing the shortage of staff and improving the quality of care and health outcomes for patients. Executive Summary Proposed Change The local healthcare system in Minnesota is recently facing a significant shortage of healthcare professionals, especially nurses, and doctors, which is becoming a considerable challenge for healthcare organizations to deliver quality healthcare services to the patient population. These shortages lead to a high-patient-to-provider ratio, resulting in longer waiting times for consultations, delayed treatment, increased workload, and compromised care. Another important aspect that should be considered here is the aging workforce. A substantial component of the current healthcare workforce is nearing retirement age, leading to a potential migration of experienced professionals. Thus, the shortage of healthcare professionals is a leading problem in the healthcare system and change strategies must be initiated to address the challenge (Tamata & Mohammadnezhad, 2022). The expectations for improvements include increasing recruitment efforts, whereby the healthcare system should focus on efforts to recruit healthcare professionals, both from within the region and outside. These efforts should include competitive salaries, added benefits, and work-life balance programs which will enable the organization to attract expert individuals (Abelsen et al., 2020). Another strategy for improving outcomes is establishing dual education opportunities for students interested in the healthcare sector. This can be done by collaborating with medical and nursing schools to deliver both academic and practical knowledge and establish study loan programs, and hands-on training initiatives to prepare students for pursuing jobs in healthcare careers. Integration of telemedicine technologies bridges the gap of staff shortages in rural and underserved areas, making healthcare accessible and resulting in positive outcomes for the population living in these areas (Hoffman, 2020).  Desired Outcomes The proposal to minimize the shortage of staffing using recruitment efforts, expanding educational opportunities, and integrating telehealth will result in several desired outcomes that we plan to achieve through this change proposal.  Enhanced Healthcare Accessibility Increasing the workforce is essential to attain the desirable outcome of providing equitable access to healthcare for every individual, which means decreasing waiting times, increasing access to adequate nursing care, and addressing inaccessibility factors in remote and underserved areas.  Improved Health Outcomes  Another anticipated outcome is to improve overall health outcomes of the concerned population, which includes reduction of mortality rates, minimizing the risk of morbidities, enhancing preventive care, and promoting measures to enhance health and well-being (Cometto et al., 2020).  Cost Effectiveness The delivery of cost-effective healthcare while maintaining the quality of care is a desirable outcome for every healthcare organization. Increasing the healthcare workforce through aforementioned change strategies is purposed for the optimization of resources and reducing unnecessary costs which may lead to long-term cost savings in the healthcare sectors.  Adequate Workforce  The major purpose of this change proposal is to ensure an adequate and well-trained healthcare workforce is available within the region to meet the population’s needs, leading to better patient care and reducing the strain on existing healthcare providers. Although these are imperative changes required within the healthcare sectors, organizations must have a balanced approach to funding the implementation of the change proposal. An organization’s financial reserves should be used along with the arrangement of external funding from governmental programs like taxation, subsidies, and insurance programs. Moreover, some funds should be gathered from private insurance companies, as it can assist in reducing the burden on the public healthcare system and offer faster access to healthcare. Despite striving efforts, the implementation and achievement of these outcomes can be impeded by various factors such as financial constraints, a fragmented healthcare system whereby, lack of care coordination and reduced interprofessional collaboration can lead to poor results, resistance to change, and lack of commitment from administrative leaders (Labrague et al., 2022; Warrick, 2023). The optimal healthcare solutions to achieve these desirable outcomes are the implementation of an integrated healthcare model which will improve care coordination, integration of health information technology, establishing partnerships between public and private organizations, promoting interdisciplinary collaboration, and making regulatory reforms. These solutions will help organizations address the major concern of staffing shortage and achieve desired outcomes as mentioned earlier.  Health Care System Comparative Analysis To find a more operational and successful approach to reduce staffing shortages in Minnesota’s local healthcare systems, we have performed an analysis with two non-U.S; Germany’s Dual Education System and Australia’s Rural Health Workforce Strategy (Appendix, Table 1). Germany has a prosperous dual education system for nurses and other allied healthcare professionals. This education program combines practical training and academic education to ensure a constant supply of well-trained healthcare workers. They also provide scholarships, and loans to the students so that they are attracted towards the profession, preparing students for jobs after their graduation. Fundings are arranged by the collaboration of the government and healthcare institutions (Seizinger & Brunner, 2023). On the other hand, Australia’s rural health strategy is focused on the recruitment and retention of staff agreeing to work in the rural areas of the country by offering them financial enticements, scholarships, and grants. Additionally, it provides support for continuing education and training opportunities (Australian Government Department of Health and Aged Care, 2021). This in return increases healthcare access for underserved populations and cost-effective care using existing community resources. Our healthcare system could develop a similar dual education system as proposed in this change proposal to address healthcare professional shortages. We can also establish policies for offering financial incentives to attract more individuals into the healthcare workforce. We could also work

NURS FPX 6414 Assessment 3 Tool Kit for Bioinformatics

Student Name Capella University NURS-FPX 6414 Advancing Health Care Through Data Mining Prof. Name Date Toolkit for Bioinformatics in Health Security In light of the COVID-19 virus, heightened concerns about health security have emerged, particularly among individuals who visited hospitals during the outbreak and feared contracting the virus in the healthcare setting (Wu et al., 2020). Rapid identification and treatment of COVID-19 infections are crucial for enhancing people’s sense of security. Health Information Technology, including Clinical Decision Support Systems (CDSS) and Best Practice Advisory (BPA) alerts, plays a vital role in achieving this objective (Wu et al., 2020). This paper aims to provide a comprehensive toolkit for the implementation of CDSS and BPA alerts. Evidence-Based Policy for Healthcare The burden imposed by the COVID-19 pandemic has escalated the workload for healthcare workers and significantly inflated healthcare costs. Failure to control the spread of the illness could lead to substantial challenges for patients, care providers, and health systems due to a shortage of medical professionals and equipment (Moulaei, 2022). Monitoring early signs of COVID-19 infections is essential, and the optimized use of CDSS can assist physicians in making informed decisions, resulting in quicker and more accurate diagnoses and outbreak containment (Moulaei, 2022). In the realm of health information technology, the Affordable Care Act mandates healthcare providers to adopt and fully utilize technology to improve quality, patient outcomes, and reduce healthcare costs (Fry, 2021). A fully developed Electronic Health Record (EHR) with Clinical Decision Support (CDS) is crucial for a learning health system capable of navigating the complex healthcare landscape. Integrated clinical decision support technologies, such as Best Practice Advisory (BPA) alerts, enhance clinical decision-making by providing relevant information to clinicians (Fry, 2021). Guidelines for Effective Policy Implementation Successful policy implementation requires the support of key stakeholders. Communicating guiding principles, norms, and policies to the entire healthcare workforce is essential (Akhloufi et al., 2022). Regular meetings involving physicians, nurses, hospital administrators, nurse informaticists, and information technology specialists should be conducted to develop an efficient CDSS and BPA alert system. These meetings aim to improve technology user-friendliness, minimize errors, and provide training on efficient technology usage (Akhloufi et al., 2022). Following meetings and training sessions, the implementation planning may commence, with the development team defining project goals. Collaboration with system vendors is essential for effective technology integration, with vendors potentially introducing a beta version or minimum viable product for testing and feedback, leading to system adjustments tailored to the needs of patients and healthcare professionals (Akhloufi et al., 2022). Practical Recommendations Stakeholders Education Successful technology implementation necessitates buy-in from all relevant stakeholders. Healthcare organizations can educate their staff on maximizing technology potential through weekly training sessions, seminars, and webinars, while also addressing staff concerns (Lukowski et al., 2020). Classroom-based team training interventions and simulation have been shown to be beneficial for assessing technical competence and addressing training gaps in healthcare technology use (Bienstock & Heuer, 2022). Monitor Data to Evaluate Outcomes After successfully implementing CDSS and BPA alert systems, evaluating their impact on COVID-19 patient outcomes is crucial. The potential of the CDSS system to enhance health outcomes through rapid and accurate disease detection can reduce its spread, lower healthcare costs, and increase patient safety (Karthikeyan et al., 2021). Saegerman et al. (2021) demonstrated that the CDSS system facilitated the rapid identification of COVID-19 patients, aiding triage efforts in understaffed diagnostic labs during the pandemic. This clinical decision support tool plays a crucial role in managing the pandemic (Saegerman et al., 2021). A Specific Example of Bioinformatics in Action Clinicians can significantly reduce the time required to evaluate patients with COVID-19 symptoms by using a clinical decision support tool for diagnostic assessments (Gavrilov et al., 2021). Effective quarantine of patients with COVID-19 symptoms is essential to prevent further virus spread in healthcare facilities. The CDSS system guides practitioners through a standardized COVID-19 diagnostic workup based on the latest recommendations, streamlining the process (Gavrilov et al., 2021). The integration of CDSS systems with Best Practice Advisory (BPA) alerts offers several advantages, including improved patient and staff safety, rapid virus detection, and time-saving benefits (Gavrilov et al., 2021). Process: Before and After CDSS Implementation Metric Before CDSS Implementation After CDSS Implementation Time to make an accurate diagnosis of COVID-19 1-2 days 5-6 hours Healthcare costs $9500 $2000 Unidentified patients in quarantine 10-20 patients 5 patients False Negative Results 7-8 false negatives 3-4 false negatives Conclusion This study explored the feasibility of utilizing CDSS systems in the administration and management of COVID-19. The CDSS system’s ability to swiftly diagnose COVID-19 patients assists healthcare professionals in containing its spread, reducing complications, lowering unnecessary treatment costs, shortening diagnostic procedures, and improving clinical performance and patient outcomes. References Akhloufi, H., van der Sijs, H., Melles, D. C., van der Hoeven, C. P., Vogel, M., Mouton, J. W., & Verbon, A. (2022). The development and implementation of a guideline-based clinical decision support system to improve empirical antibiotic prescribing. BMC Medical Informatics and Decision Making, 22(1). Bienstock, J., & Heuer, A. (2022). A review on the evolution of simulation-based training to help build a safer future. Medicine, 101(25), e29503. Fry, C. (2021). Development and evaluation of best practice alerts: Methods to optimize care quality and clinician communication. AACN Advanced Critical Care, 32(4), 468–472. NURS FPX 6414 Assessment 3 Tool Kit for Bioinformatics Gavrilov, D., Kuznetsova, T., Gusev, A., Korsakov, N., & Novitskiy, R. (2021). Application of a clinical decision support system to assess the severity of the new coronavirus infection COVID-19. European Heart Journal, 42(Supplement_1). Karthikeyan, A., Garg, A., Vinod, P. K., & Priyakumar, U. D. (2021). Machine learning-based Clinical Decision Support System for early COVID-19 mortality prediction. Frontiers in Public Health, 9. Lukowski, F., Baum, M., & Mohr, S. (2020). Technology, tasks and training – Evidence on the provision of employer-provided training in times of technological change in Germany. Studies in Continuing Education, 1–22. Moulaei, K. (2022). Diagnosing, managing, and controlling COVID-19 using Clinical Decision Support systems: A study to introduce CDSS applications. Journal of Biomedical Physics and Engineering,

NURS FPX 6616 Assessment 1 Community Resources and Best Practices

Student Name Capella University NURS-FPX 6616 Ethical and Legal Considerations in Care Coordination Prof. Name Date Slide 1: Community Resources and Best Practices Welcome esteemed leaders. Today, we delve into a pressing issue that has been confronting our healthcare organization – high readmission rates. This deep dive will include a thorough review of our current practices, a dissection of the legal and ethical implications of these readmission rates, and a proposal for a potential solution through an evidence-based intervention known as the “Transitional Care Model”. Our goal is not just to highlight the challenges but also to explore collaborative strategies to enhance the quality of care, improve patient outcomes, and uphold our ethical responsibilities while minimizing legal risks. Thank you for embarking on this crucial journey of innovation and improvement with us. Slide 2: Purpose of the Presentation The purpose of this presentation is to comprehensively examine and address the pressing issue of high readmission rates within our healthcare organization. Through this presentation, we aim to illuminate the severity and implications of this problem, including its legal and ethical ramifications. Moreover, we will introduce an evidence-based intervention strategy – the “Transitional Care Model” – that has the potential to significantly improve these outcomes. This presentation will serve as a collaborative platform to discuss and devise actionable strategies that can enhance the quality of our healthcare services, improve patient outcomes, reduce readmission rates, and thereby fulfill our legal and ethical responsibilities more effectively. We strive for this dialogue to lead us to a pathway that ensures the best possible care for our patients and a stronger, more efficient, and more ethically sound healthcare organization. Slide 3: Description of the Current Situation and Issues In the past year, our hospital discharged 10,000 patients, of which 2,000, or 20%, have been readmitted within 30 days. A closer look at the data reveals a high readmission rate among patients with chronic conditions, particularly heart disease and diabetes, which constitute 50% of our total readmissions. Specifically, heart disease patients show a readmission rate of 35%, while for those with diabetes, the rate stands at 30%. This readmission trend indicates potential inefficiencies in the care delivery system and post-discharge procedures, as each readmission points to a distressing return to the hospital for the patients and their families (Zumbrunn et al., 2022). The use of healthcare information systems (HCIS) in care coordination presents various ethical issues. One of the most significant issues is the potential violation of patient privacy. Although HCIS are designed to be secure, the risk of breaches, whether unintentional or through cyber-attacks, is a pressing concern. Healthcare data is highly sensitive, and any violation could result in severe emotional, social, and even financial harm to the patients. Furthermore, the ethical issue of informed consent arises, particularly in relation to how and when patients’ data is used or shared. Although systems often require patients to sign broad consent forms for the use of their information, there are debates about the extent to which patients fully understand the implications of this consent  (Wright et al., 2023). NURS FPX 6616 Assessment 1 Community Resources and Best Practices Moreover, health inequities may also be amplified with the use of HCIS. These systems are more likely to benefit patients who are literate, have access to technology, and possess the ability to manage their health information online. This could potentially marginalize certain patient populations, such as the elderly, low-income individuals, and those living in remote areas, which raises questions about the ethical principles of justice and equality (Zumbrunn et al., 2022). Lastly, the reliance on algorithmic decision-making tools within these systems also presents ethical issues. While these tools can assist in diagnosis and treatment decisions, they may inadvertently introduce bias, reducing the individualized care each patient should receive  (Wright et al., 2023). The ultimate challenge is to find a balance that allows the utilization of HCIS to improve care coordination while upholding ethical principles such as autonomy, privacy, justice, and beneficence. Slide 4: Legal and Ethical Implications Legally, our elevated readmission rates could expose the hospital to increased malpractice lawsuits due to perceived negligence. For instance, a failure to provide adequate post-discharge instructions could potentially lead to a patient’s condition worsening and subsequent legal actions could ensue. The cost of these lawsuits is not merely financial; they could also significantly harm the hospital’s reputation and trust among the community we serve (Bianco et al., 2023). Moreover, we are subject to the Hospital Readmissions Reduction Program (HRRP) by the Centers for Medicare and Medicaid Services (CMS). Under this program, hospitals with high readmission rates face financial penalties which, given our current situation, could translate into a significant reduction in our annual Medicare reimbursements. Ethically, the high readmission rates call into question our responsibility and commitment to providing the best care for our patients. As a healthcare provider, we have a moral obligation to ensure that our patients receive comprehensive, effective treatment and supportive post-discharge care. Our current readmission rates suggest a potential failing in this duty. This not only impacts our patients’ health outcomes but also affects their trust in our healthcare services (Wright et al., 2023). Thus, it’s essential to view these readmission rates as a reflection of our care quality, and make improvements to fulfill our ethical obligation to our patients. Slide 5: Best Practices and Comparison to Current Practices Upon a thorough review of available literature and benchmarking against best-performing hospitals, several interventions emerge as promising strategies to curb high readmission rates. The two most compelling strategies involve improved care coordination and enhanced patient education. Our current care coordination practices are primarily confined to the hospital setting. A discharge plan is formulated by the healthcare team, and the patient or their caregiver receives these instructions at the time of discharge. The current outcomes of the plan indicate that it’s not effective in maintaining long-term patient adherence, there is insufficient post-discharge support and follow-up, and overall patient satisfaction scores remain moderate.  However, it seems that the impact of

NURS FPX 6614 Assessment 1 Defining a Gap in Practice

Student Name Capella University NURS-FPX 6614 Structure and Process in Care Coordination Prof. Name Date Proposing Evidence-Based Change Clinical Priorities and Information Gaps for the Elderly Elderly patients (65+) in urban healthcare settings with multiple chronic conditions require a holistic, person-centered approach. This means understanding their comprehensive needs, from medical to psychosocial. Seamless transitions between in-patient and home care are essential to prevent health complications and readmissions. Given their complex medication regimes, proper medication management and adherence are vital. Educating patients and caregivers enhances at-home care and eases the healthcare system’s burden (Vareta et al., 2022). However, there are challenges. A significant hurdle is the inconsistency in electronic health records (EHR). Accurate, up-to-date EHRs are pivotal for effective care coordination. Further, communication gaps between primary and specialty care providers can lead to inefficient care, like redundant testing or conflicting treatments. Additionally, not adequately addressing the patient’s socioeconomic context can negatively impact health outcomes (Fjellså et al., 2022). Addressing these barriers is crucial for improved care coordination for this group. PICOT Question Related to Care Coordination Gap The proposed PICOT question – “In elderly patients with multiple chronic conditions in urban healthcare settings (P), how does implementing a coordinated interprofessional care plan (I) compared to standard care without active coordination (C) influence the number of hospital readmissions (O) over 6 months (T)?” – stems from evident gaps in current care models. Studies have consistently shown that fragmented care, often typical of the standard model, correlates with increased hospital readmission rates, decreased patient satisfaction, and an uptick in preventable complications for the elderly. For instance, a study found that elderly patients with uncoordinated care had a 50% higher chance of being readmitted to the hospital within 30 days of discharge (Hovsepian et al., 2023). Another study highlighted that lack of care coordination for elderly patients led to increased hospital stays and escalated healthcare costs by approximately 30% (Wolff et al., 2023). Thus, a care coordination approach is considered beneficial for the concerned population.  Evaluation of Potential Services and Resources for Care Coordination Elderly patients with multiple chronic conditions in urban settings require specialized care services and resources, such as geriatric assessment units, which provide in-depth evaluations of medical, psychosocial, and functional health insights. Comprising a team of diverse specialists, these units yield a comprehensive grasp of patients’ health needs. Furthermore, home care services, from daily assistance to specialized nursing care, are vital for these patients, ensuring their independence (Liu et al., 2023). Telehealth consultations, enabled by technology, have also emerged as a beneficial tool, especially for those facing mobility challenges. However, several barriers hinder optimal care coordination. Service fragmentation remains a significant challenge, often leading to miscommunications and inefficiencies. Limited health literacy complicates their understanding of health information and optimal care paths. Financial constraints also pose a considerable barrier; despite insurance, the costs associated with various services can be prohibitive (Arain et al., 2022). It’s essential to employ a patient-focused approach, leveraging scholarly insights to refine care coordination, ensuring accessibility and effectiveness in serving this vulnerable demographic. Optimal Care Coordination Intervention To enhance evidence-based practice for elderly patients in urban healthcare settings, an Interprofessional Collaborative Care Team (ICCT) is suggested. The ICCT, including physicians, nurses, pharmacists, social workers, and patient navigators, would ensure comprehensive care coordination (Gao et al., 2023). Key responsibilities of this team would encompass consistent patient evaluations, formulating and revising individualized care plans, enlightening patients and caregivers through dedicated educational sessions, and ensuring medication reconciliation to prevent potential drug-drug interactions and bolster medication compliance. By integrating these multifaceted professionals, the intervention addresses the intricate needs of the population in a streamlined and effective manner. Nursing Diagnosis and Collaborative Care Approach The primary nursing diagnosis pinpointed is the risk for ineffective health management. This risk stems from the multifaceted nature of the health issues experienced by elderly patients and the tendency for healthcare services to be fragmented, potentially causing care gaps. Regular nursing-led educational sessions will be initiated to counteract this risk, focused on enhancing patient and caregiver understanding of health conditions and treatment modalities. Furthermore, prioritizing collaborative care meetings that incorporate the voices of patients, caregivers, and the entire healthcare team can ensure cohesive care planning and delivery. Additionally, the optimal utilization of Electronic Health Records (EHR) is a cornerstone strategy. It ensures that all care team members have real-time access to patient data, fostering effective communication and coordination (Innab, 2022). Structuring the Intervention and Anticipating Outcomes The initial phase entails the recruitment and meticulous training of dedicated ICCT members. Subsequently, clear protocols for routine patient assessments and evaluations will be developed and institutionalized. A robust system that facilitates seamless communication and ensures consistent EHR updates will also be implemented (Strachna et al., 2022). Through these interventions, several measurable outcomes are projected. There’s an anticipation of a marked reduction in hospital readmissions by approximately 25% over six months. Concurrently, feedback mechanisms like patient satisfaction surveys should reflect improved scores, particularly in areas of care coordination. A pivotal metric would be observing a pronounced increase in medication compliance among our target population. This approach is predicated on several assumptions, such as unwavering commitment and active participation of all ICCT members, sustained resource allocation and support from the overarching healthcare entity, and proactive engagement from patients and their caregivers throughout the care continuum. As this care coordination model is operationalized, it’s imperative to maintain a feedback loop for regular assessment of the process, continuous professional development, and invaluable insights to drive iterative refinements in the care process. References Arain, S., Al Shakori, M., Thorakkattil, S. A., Mohiuddin, S. I., & Al-Ghamdi, F. (2022). Implementation of pharmacist-led telepsychiatry services: Challenges and opportunities in the midst of COVID-19. Journal of Technology in Behavioral Science, 7, 468–476.  Fjellså, H. M. H., Husebø, A. M. L., & Storm, M. (2022). eHealth in care coordination for older adults living at home: Scoping review. Journal of Medical Internet Research, 24(10), e39584.  Gao, H., Yous, M.-L., Connelly, D., Hung, L., Garnett, A., Hay, M., &

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Implementing Evidence-Based Practice for Promoting Exercise Among Cancer Survivors Hey everyone.. I am Jessica. Cancer is one of the most lethal diseases that prevails in our society, with a low mortality and survival rate. Usually, cancer is diagnosed in the late stages, when radiation and chemotherapy become evident for the patient’s survival. The American Cancer Society has just recently announced the updated cancer incidence and death rates in the United States, which revealed a significant decline in the overall cancer mortality trend from 1991 to 2017 by a total of 29% (Siegel et al., 2019). There were an expected 19.3 million new instances of cancer (18.1 million excluding non-melanoma skin cancer) and roughly 10.0 million (9.7–10.2 million) deaths from cancer (9.9 million excluding non-melanoma skin cancer) globally in 2020. The uncertainty interval for this estimate is from 19.0 to 19.6 million (Hanahan, 2022). The term “cancer” refers to a wide variety of diseases, each of which has its own set of symptoms, approach to therapy, and outlook on survival. Cancer has a tremendous effect on the physical, emotional, and social well-being of individuals who are affected by it, beginning at the moment a diagnosis is made and continuing through the road of treatment and survival. The prognoses of a large number of cancer patients have greatly improved as a result of recent developments in research, prevention methods, diagnostic procedures, and treatment modalities. NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice On the other hand, there is still a continuous need for additional research, early detection, effective medications, and extensive support systems in order to further improve cancer prevention and management and, ultimately, to improve the quality of life for people whose lives have been damaged by this disease. The aim of this poster presentation is to fill the gap between evidence-based practice and clinical practice and help the clinician have information that is embedded in the scientific findings and based on background information. PICOT Question  Cancer requires a lifestyle change that helps manage a cancer-free life. Dietary habits, exercises, medications, and food choices have to be changed to manage bodily counts and spaces. The PICOT question seeks to investigate the impact of the exercise programs on the quality of life of cancer survivors as compared to standard care or non-exercise programs within 6 months of the intervention. If we open up the PICOT, The population in question is the cancer survivors, while the intervention that is being implemented is an exercise program, which is being compared to standard care or no exercise program, and the outcome is an improvement in the quality of life within the timeline of 6 months. Action plan  Exercise has a significant role in bringing about active change in our lives. Similarly, incorporating exercise programs into the regimen of a cancer patient gives the ultimate hands-on assistance in bringing about change in one’s life. This program is based on a course of six months where the recently cancer-free patients were given a regimen of walking and doing low-paced exercises that would help them feel energetic and active. The action plan for this was to ensure that people who have recently survived cancer were encouraged to engage in physical activities such as walking and low-pace exercise to encourage them to develop healthy habits. Studies have highlighted that exercise has a significantly positive impact on cancer survivors and has been characterized as one of the most frequently advised activities to have in the patients’ regimen. Also, a study based on a breast cancer survivor revealed that exercise in the follow-up routine had a significantly positive response among patients. Similarly, a systematic review aggregated information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature (Stout et al., 2017). The review came to the conclusion that exercise is useful before, during, and after treatment for cancer, for all different forms of cancer, and for a range of impairments that are associated with cancer. When it comes to enhancing physical function and reducing the negative effects of cancer-related impairments, the optimal degree of exercise intensity is moderate to vigorous physical activity (Cormie et al., 2017). NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice An additional systematic review was conducted to provide a thorough summary of the information that is currently available from epidemiologic and randomized controlled trials evaluating the function of exercise in the management of cancer. Patients who exercised following a diagnosis of cancer were found to have a decreased relative risk of cancer mortality and recurrence in comparison to patients who engaged in no exercise or less exercise. Furthermore, patients who exercised following a diagnosis of cancer were reported to have experienced fewer or less severe adverse effects (Ferioli et al., 2019). NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice Stakeholders and Potential Barriers  The following stakeholders would hold an important place in the implementation of the project: Similarly, the following are examples of potential barriers to the implementation of the project: Outcome Assessment:  The outcome criteria can be evaluated through multiple sources, such as: Value and relevance  The evidence that supports the necessity for a practice change to incorporate exercise into the treatment of cancer survivors is compelling and extremely pertinent. Exercise has been shown to offer numerous benefits for cancer survivors, including better physical function, quality of life, and cancer-related outcomes, and these benefits have been the subject of a number of systematic reviews and meta-analyses (Czosnek et al., 2021). As such, the findings of one systematic review indicated that exercise is beneficial before, during, and after therapy for cancer, for each and every form of cancer, and for a range of impairments that are associated with cancer (Campbell et al., 2019). Patients who exercised following a diagnosis of cancer were shown to have a decreased relative risk of cancer mortality and recurrence, and they reported fewer or less severe

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Evidence-Based Population Health Improvement Plan – Type 2 Diabetes Type-2 Diabetes Mellitus is a prevalent health problem among the adult community of Florida. It often develops in people over 45 and impacts their physical, emotional, and mental health (CDC, 2019). This chronic condition can be well-managed within the older community by implementing evidence-based interventions. In this presentation, I will discuss the environmental and epidemiological data on diabetes in the adult community of Florida and the healthcare issues they encounter. Furthermore, I will develop an ethical health improvement plan followed by a communication plan to encourage the implementation of the plan within the community. Lastly, I will explain the value and relevance of resources utilized in developing a health improvement plan and how they are appropriate to improve the community’s health. Community Data Evaluation Indicators Findings Prevalence of Diabetes in Florida About 2,164,009 people in Florida are diabetics, which makes up 12.5 % of the adult population. Every year, 148,613 people in Florida are diagnosed with diabetes (ADA, 2018). Type 2 diabetes accounts for 90-95 % of total diagnosed cases (Florida Department of Health, 2022).  Costly Treatment Diabetics have 2-3 times higher medical expenses than non-diabetics. The direct medical costs involved in treating diabetes in Florida are $19.3 million (ADA, 2018). Complications Chronic kidney disease cases nationally (37 million)Vision loss cases (5,57,000) NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan Environmental factors such as access to unhealthy food, poor socioeconomic status, and lack of adequate parks and recreational areas for physical activity impact the health of community residents. The population with diabetes will be unable to maintain a healthy lifestyle when they have access to processed food and a diet rich in carbohydrates. Moreover, the lack of knowledge and awareness on diabetes care and its potential consequences due to poor health literacy also contributes to poor management of diabetes, leading to secondary complications such as chronic kidney disease and vision loss. Additionally, low socioeconomic status among community members deprives them of accessing basic medical facilities to monitor their blood glucose levels and control them by complying with prescribed medication therapy (Bodhini et al., 2023). The lack of appropriate parks also leads to a sedentary lifestyle with no physical activity, essential to maintaining a healthy lifestyle and managing diabetes. About 30.6 % of the older population above 65 has been reported to do no physical activity or exercise in Florida (America’s Health Rankings, n.d.). Lastly, geographic disparities persist within Florida with low participation rates in the Diabetes Self-Management Education and Support (DSMES) program (Khan et al., 2021). The sources referred are reliable and validated as they were published within the last five years, showing the current studies and derived from databases like Google Scholar and Governmental websites like CDC, the Florida Department of Health, and the American Diabetes Association (ADA) and American Health Rankings. Health Improvement Plan – Meeting Community Needs Considering the community challenges in Florida, the health improvement plan comprises expanding the DSMES program, where people from diverse cultural backgrounds with culturally sensitive diabetes education and self-management guidelines will be provided in multiple languages to ensure the culturally diverse population of Florida equally acquires diabetes management care (Goff et al., 2020). This is done by developing diabetes education materials in culturally appropriate ways, free of stereotypes, and providing culturally competent training to healthcare providers to rule out any misunderstandings that may arise due to a lack of knowledge of different cultures.  Furthermore, the improvement plan involves enhancing the medical coverage of diabetes self-management education and support (DSMES) by collaborating with Medicaid health insurance coverage. This will reduce health inequities experienced by people from low socioeconomic backgrounds (Powers et al., 2020). By providing diabetes self-management education and support in a culturally competent and ethically correct way, diabetics can improve their health outcomes and quality of life by acquiring healthy lifestyles and medication adherence. Furthermore, it will reduce the onset of diabetes-related complications and mortalities as the population with diabetes has adequately controlled their blood glucose levels. To overcome geographic disparities, integrating telehealth-based DSMES programs is another strategy for health improvement plans (Litchman et al., 2022). This will ensure the diabetic community of Florida with high diabetes prevalence rates acquires this service at home and overcomes the geographical barriers that cause geographical disparities. Implementing DSMES will consider an ethical code of conduct where patient privacy and confidentiality will be taken into account, along with informed consent and honesty in delivering patient-centered care.  Criteria to Evaluate Achievement of Plan’s Outcomes The criteria to evaluate the achievement of the plan’s outcomes are as follows: The proposed criteria are helpful and appropriate ways of measuring the success of our proposed plan as they directly estimate the efficacy of the health improvement plan. These criteria are directly relevant to the goals of our health improvement plan. When the plan is successfully implemented, the criteria of improved health outcomes, reduced diabetes prevalence, enhanced access to care, and cultural inclusivity will be fulfilled.  Communication Plan To effectively apply the strategies for communicating with community stakeholders and community members in an ethical, culturally sensitive, and inclusive way about the development and implementation of a health improvement plan for diabetics of Florida, it is essential to devise a communication plan and implement it. The communication plan is as follows:  Identification of Key Stakeholders  The critical stakeholders for developing and implementing this health improvement plan include the Diabetes Advisory Council of Florida’s Department of Health, community health centers, healthcare providers, physicians, pharmacists, nurses, and relevant organizations such as the Florida Diabetes Alliance. These specific stakeholders must collaborate to ensure diabetes prevalence in Florida can be diminished and health outcomes of diabetes in adults and older populations. They can effectively develop and implement the proposed plan with valuable resources and skillful expertise in managing the community health of diabetics.  Communication Strategy The communication strategy is so devised that it covers ethical, cultural,

NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Evidence-Based Patient-Centered Concept Map Patient Scenario: Winnie is a 45-year-old Asian American Woman. Winnie was diagnosed with heart disease 4 years ago. She reported that she was diagnosed with coronary heart disease when she went to the hospital with complaints of pain in the shoulder, heavy breathing and pain in the back. She reported when she was diagnosed with heart disease, she was in shock and thought her life had ended. Winni got too serious regarding her health and started monitoring her diet and used to take all of her medication on time to avoid anything happening to her. Recently, Winni’s husband had a stomach issue due to which she had to go to the hospital with him and she started having anxiety associated with being ill and being admitted to the hospital again. After being discharged, Winnie got anxious regarding her husband’s health and got too preoccupied with taking care of him. She said she “used to manage all the work by herself without asking for anyone’s help”, and “had to take care of her husband’s health”. Due to being too preoccupied with her husband’s medication and care, she often forgets her medication and at times eats excessive junk food as she does not have the energy to cook diet food for herself. She also stated that “I feel so overwhelmed that I eat whatever is in front of me as I don’t have the energy to cook” and “I get too tired taking care of my husband therefore, I often oversight my health” NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map As per her medical records, Winnie has missed her last two appointments has not administered her pending blood tests that were requested by the doctor, and is avoiding her hospital appointments as she feels too anxious. She also reported that she feels too tired and often feels breathless and has shared this with her husband and now he’s very concerned and has led her to visit her doctor but due to her daily routine she is unable to. Her medical records have indicated high levels of stress, high blood pressure, and muscle ache. She is being treated for her constant high blood pressure and has been given medication to manage her blood pressure.  The last time she visited the hospital, doctors advised her to reduce her stress or else it would be harmful to her.  References  Chauvet-Gelinier, J. C., & Bonin, B. (2017). Stress, anxiety, and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of physical and rehabilitation medicine, 60(1), 6-12. Hersberger, L., Dietz, A., Bürgler, H., Bargetzi, A., Bargetzi, L., Kägi-Braun, N., … & Schuetz, P. (2021). Individualized nutritional support for hospitalized patients with chronic heart failure. Journal of the American College of Cardiology, 77(18), 2307-2319. Hotopf M. (2002). Psychological stress and cardiovascular disease. Rose’s questionnaire is not what it seems. BMJ (Clinical research ed.), 325(7359), 337. NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map Jaarsma, T., Hill, L., Bayes‐Genis, A., La Rocca, H. P. B., Castiello, T., Čelutkienė, J., … & Strömberg, A. (2021). Self‐care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. European journal of heart failure, 23(1), 157-174. Pah, A. M., Buleu, N. F., Tudor, A., Christodorescu, R., Velimirovici, D., Iurciuc, S., Rada, M., Stoichescu-Hogea, G., Badalica-Petrescu, M., Georgescu, D., Nutiu, D., Iurciuc, M., & Dragan, S. (2020). Evaluation of Psychological Stress Parameters in Coronary Patients by Three Different Questionnaires as Pre-Requisite for Comprehensive Rehabilitation. Brain sciences, 10(5), 316.