NURS FPX 6021 Change Strategy and Implementation Essay Example

NURS FPX 6021 Change Strategy and Implementation Essay Example

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Assignment Brief: NURS FPX 6021 Change Strategy and Implementation Assessment

Course: NURS FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

Assignment Title: Assessment 2 Change Strategy and Implementation in Nursing

Assignment Overview:

In this assignment, you will explore the importance of change strategies and their implementation in nursing practice. Specifically, you will analyze the significance of integrating mental health considerations into the treatment of patients with chronic conditions. Through a comprehensive examination of existing literature and evidence-based practices, you will develop strategies to address both physical and psychological aspects of patient care.

Understanding Assignment Objectives:

The primary objective of this assignment is to deepen your understanding of the holistic approach to patient care within the nursing profession. You will critically evaluate the current gaps in healthcare delivery, particularly regarding the integration of mental health support for patients with chronic conditions. By identifying these gaps, you will develop innovative change strategies aimed at improving patient outcomes and enhancing the quality of care provided.

The Student’s Role:

As a nursing student, your role in this assignment is to act as a proactive advocate for patient well-being. You will analyze existing research literature to identify areas where the current healthcare system may be falling short in addressing the mental health needs of patients with chronic conditions. Using this analysis, you will propose practical and feasible change strategies that can be implemented within clinical settings to bridge these gaps and ensure comprehensive patient care.

You Can Also Check Other Related Assessments:

NURS FPX 6021 Concept Map Nursing Example

NURS FPX 6021 Quality Improvement Presentation Poster Example

NURS FPX 6021 Change Strategy and Implementation Essay Example

Respiratory issues, ranging from difficulty breathing to coughing, are common reasons for patients to seek medical care. Chronic obstructive pulmonary disease (COPD) is a prevalent condition among these patients, often requiring specialized treatment in pulmonary wards. Treatment for COPD typically focuses on improving physical health through interventions like antibiotics, ventilation, and pulmonary rehabilitation programs. However, it overlooks the mental health aspects of patients, despite the strong association between COPD and anxiety and depression (NHS, 2016a; Pooler & Beech, 2014).

Studies show that COPD patients with comorbid anxiety and depression are more likely to be hospitalized, face longer hospital stays, and have higher mortality rates after discharge (Pooler & Beech, 2014). Neglecting mental health can significantly impact treatment adherence and overall health outcomes. Anxiety and depression symptoms often overlap with COPD symptoms, such as dyspnea (shortness of breath), leading to heightened distress and exacerbation of symptoms (Heslop et al., 2013; Pooler & Beech, 2014).

Depression, in particular, is linked to decreased quality of life and physical activity in COPD patients, with potential underdiagnosis and undertreatment (Pooler & Beech, 2014). Patients with COPD and depressive symptoms may struggle to adhere to recommended physical therapy, worsening their COPD symptoms and necessitating further treatment, potentially leading to hospitalization (Dursunoğlu et al., 2016).

Addressing both physical and psychological aspects of COPD is crucial for improving patient outcomes and breaking the cycle of deteriorating health. Integrated interventions targeting mental health alongside physical health can enhance treatment effectiveness and patient well-being (Dursunoğlu et al., 2016). Therefore, implementing change strategies to address COPD patients’ mental health needs within the healthcare system is imperative.

Change Strategies

Both anxiety and depression necessitate attention from mental health professionals to effectively assist patients. Cognitive-behavioral therapy (CBT) stands out as an efficacious approach in managing various mental health conditions, including anxiety and depression (NHS, 2016b). In CBT sessions, patients collaborate with therapists to dissect their problems into manageable parts. They explore thoughts, physical reactions, and behaviors associated with their issues, aiming to identify unhelpful patterns and their impact (NHS, 2016b). Through this process, patients develop strategies to modify counterproductive thoughts and behaviors, eventually applying learned skills to real-life situations. For instance, individuals with COPD and anxiety might learn to dissociate shortness of breath from catastrophic outcomes, enhancing their coping mechanisms (NHS, 2016b).

However, CBT entails challenges. It demands patients’ willingness to confront emotions and anxieties, which may be discomforting (NHS, 2016b). Additionally, patient commitment and cooperation are crucial for successful outcomes, as therapy effectiveness relies on active participation (NHS, 2016b). Yet, hospitals often struggle with limited therapist availability, posing challenges in ensuring an optimal therapist-to-patient ratio.

To address these challenges, a combination of group and one-on-one therapy sessions can be implemented. Group therapy offers a broader access to treatment, potentially reducing intimidation for participants and providing additional support through peer interaction. Furthermore, nurses could undergo training in CBT or specialists could be hired to facilitate individual sessions, ensuring patients have access to diverse treatment modalities (Howard & Dupont, 2014). By integrating these options alongside COPD management, patients can experience an enhanced quality of life and better manage both physical and mental health conditions (Howard & Dupont, 2014).

Pharmacological interventions also play a role in managing anxiety and depression, though they come with potential side effects. Antidepressants, such as selective serotonin reuptake inhibitors, are commonly prescribed, but caution is needed due to potential adverse effects like headaches and gastrointestinal distress (NHS, 2016b). However, these side effects may exacerbate existing conditions in COPD patients. Unlike pharmacological interventions, CBT and group therapy present nonpharmacological alternatives without contraindications (Tselebis et al., 2016). Moreover, implementing pharmacological treatment at a policy level proves challenging due to individualized medication requirements and patient reluctance stemming from mental health stigma (Tselebis et al., 2016).

Expected Outcomes

In the current situation, individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD) often face challenges in accessing mental health support despite experiencing significant anxiety and depressive symptoms. Many COPD patients encounter anxiety due to difficulties in breathing, while others may struggle with depressive symptoms linked to worsening COPD conditions. To address this gap in care, several essential measures need to be implemented. Firstly, it is crucial to ensure that therapists are readily available for COPD patients, allowing them to receive necessary psychological support. Additionally, nurses should undergo training in Cognitive Behavioral Therapy (CBT), or specialized CBT-trained nurses should be recruited to provide tailored assistance. Regular group therapy sessions should also be organized for COPD patients experiencing anxiety, depression, or both, offering them a supportive environment for shared experiences and coping strategies (NHS, 2016b).

Upon the successful implementation of these strategies, COPD patients are expected to have improved access to mental health services, leading to better management of both their physical and psychological well-being. Specifically, patients with comorbid COPD and anxiety would be better equipped to differentiate between anxiety symptoms and exacerbations of their COPD condition (Howard & Dupont, 2014). Similarly, individuals facing COPD and depression would receive enhanced support to effectively manage both their respiratory condition and depressive symptoms (Dursunoğlu et al., 2016).

Conclusion

In conclusion, the management of Chronic Obstructive Pulmonary Disease (COPD) should encompass both physical and mental health aspects to optimize patient outcomes. The strong association between COPD and anxiety/depression underscores the importance of addressing mental health alongside physical treatment. Neglecting mental health can lead to exacerbated symptoms, decreased treatment adherence, and poor overall well-being for COPD patients. Integrated interventions, such as Cognitive Behavioral Therapy (CBT) and group therapy, offer promising avenues for addressing mental health needs alongside COPD management. By ensuring access to mental health professionals and implementing diverse treatment modalities, healthcare systems can significantly improve COPD patients’ quality of life and enhance their ability to manage both physical and psychological conditions effectively.

References

Dursunoğlu, N., Köktürk, N., Baha, A., Bilge, A. K., Börekçi, Ş., Çiftçi, F., … Turkish Thoracic Society-COPD Comorbidity Group. (2016). Comorbidities and their impact on chronic obstructive pulmonary disease. Tüberküloz ve Toraks, 64(4), 289–298.

Howard, C., & Dupont, S. (2014). ‘The COPD breathlessness manual’: A randomised controlled trial to test a cognitive-behavioural manual versus information booklets on health service use, mood and health status, in patients with chronic obstructive pulmonary disease. npj Primary Care Respiratory Medicine, 24.

Heslop, K., Newton, J., Baker, C., Burns, G., Carrick-Sen, D., & De Soyza, A. (2013). Anxiety and depressive symptoms in bronchiectasis: Associations with health-related quality of life. Respiratory Medicine, 107(6), 895–903.

NHS. (2016a). Pulmonary rehabilitation. https://www.nhs.uk/conditions/pulmonary-rehabilitation/

NHS. (2016b). Cognitive behavioral therapy (CBT). https://nhs.uk/conditions/cognitive-behavioural-therapy-cbt/

Pooler, A. M., & Beech, R. (2014). Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: A systematic review. International Journal of Chronic Obstructive Pulmonary Disease, 9, 315–330.

Tselebis, A., Pachi, A., Ilias, I., Kosmas, E., Bratis, D., Moussas, G., & Tzanakis, N. (2016). Strategies to improve anxiety and depression in patients with COPD: A mental health perspective. Neuropsychiatric Disease and Treatment, 12, 297–328.

Detailed Assessment Instructions for the NURS FPX 6021 Change Strategy and Implementation Assignment

Description

• Develop a data table that illustrates one or more underperforming clinical outcomes in a care environment of your choice. Write an assessment (3-5 pages) in which you set one or more quantitative goals for the outcomes and propose a change plan that is designed to help you achieve the goals.

Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented. Knowing what is the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients. The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For, if we cannot effectively implement changes in practice or procedure, then our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals. This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.

Preparation
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. The assessment will be based on one or more outcomes that you would like to see improve. Think about experiences you have had working on setting goals for outcomes or using data to identify areas of need. Part of achieving your goal will be your ability to implement change in pursuit of improving outcomes. The Vila Health: Using Evidence to Drive Improvement simulation may be helpful in this regard.

• • Where do you look for resources and evidence to help you get started when treating a specific condition?
  • Where do you look for resources and evidence to help you get started when setting clinical goals?     
    • When there are no guidelines or policies for setting clinical goals, where do you look for resources and evidence to help you get started?
  • How do you use these resources and evidence to begin constructing evidence-based treatment, or developing evidence-based goals?
  • What data do you plan to use as a basis for setting improved outcome goals?     
    • What care environment do you envision using as the context of your assessment?       
      • How would change models, strategies, or theories need to be applied to help ensure achievement of your outcome goals?
      • Which change models, strategies, or theories seem to be the best fit for your goals and environments. Why?
  • Scenario
    Consider the current environment. This could be your current care setting, the care settings presented in the Vila Health: Using Evidence to Drive Improvement or Vila Health: Concept Maps as Diagnostic Tools media, or a care setting in which you are interested in working.For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course (Vila Health: Using Evidence to Drive Improvement), a relevant data set that already exists (a data set from the case study you used as a basis for your Concept Map assessment, or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal.Potential topics for this assessment could be:
  • Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your Concept Map assessment. As a starting point you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”
  • Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point you could ask yourself, “How could the care environment be changed to enhance coping?”
  • Once you determine the change you would like to make, consider the following:
  • What data will you use to justify the change?
  • How can the team achieve this change with a reasonable cost?
  • What are the effects on the workplace?
  • What other implementation considerations do you need to consider to ensure that the change strategy is successful?
  • How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals?
  • Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?
  • Instructions
    Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation [DOCX] to better understand how each grading criterion will be assessed.
  • Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
  • Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
  • Justify the specific change strategies used to achieve desired outcomes.
  • Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
  • Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
  • Communicate the change plan in a way that makes the data and rationale easily understood and compelling.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
  • Example Assessment
    You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
  • Assessment 2 Example [PDF].
  • Additional Requirements
  • Length of submission: 3-5 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.
  • Number of references: Cite a minimum of 3-5 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.
  • APA formatting: Use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis. No abstract is required.
  • Competencies Measured
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
  • Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.     
    • Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
  • Competency 2: Develop change strategies for improving the care environment.     
    • Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
    • Justify the specific change strategies used to achieve desired outcomes.
  • Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care.     
    • Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
  • Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.     
    • Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.     
    • Communicate change plan in a way that makes the data and rationale easily understood and compelling.

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