Instructions

Deliverable: Develop an evidence-based plan for health care delivery.

Scenario:

The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.

As a member of the nurse team, you have been asked to develop one component of the clinic.

The hospital leadership established these objectives for the clinic services:

Evaluate and maximize proper medication therapy.

Conduct regular diet, exercise, and stress management classes for the patients.

Monitor physiological indicators for the patients (lab work, weights, vital signs, ECGs).

Provide a case management system for patients in the program post-discharge.

The overall goals for the heart failure clinic are to:

Enroll greater than 90 percent of the patients with a primary or secondary diagnosis of HF prior to discharge.

Facilitate discharge planning to achieve 100 percent compliance with patient education prior to discharge (discharge planning).

Decrease readmission rates in this population by 5 percent over the next year.

The leadership team has asked you to provide them with an evidence-based plan for one of the components of the clinic. You may use any combination of documents (for example, a spreadsheet or a table) in addition to explanatory information to convey information clearly and succinctly.

Develop one: an Orientation Course Plan, a Discharge Education Plan, or a Care Coordination Plan.

An Orientation Course Plan:

Develop an evidence-based plan for health care delivery.

Include a comprehensive schedule of topics, objectives, key points, and patient resources for the orientation course.

What are the components of an evidence-based education plan?

How will you know that patients will understand what to do?

What modalities will you use to deliver information?

How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?

Identify specialized and supplementary material needs.

Apply professional and legal standards in support of a care plan.

Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.

Describe the accountability tools and procedures used to measure effectiveness.

How will you know if the patient education plan is successful?

What are the indicators of success or effectiveness?

A Discharge Education Plan:

Develop an evidence-based plan for health care delivery.

Develop a discharge plan with objectives and resources, and tools for patients to monitor their progress.

How will you know that patients understand what to do?

What modalities will you use to deliver information?

How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?

Apply professional and legal standards in support of a care plan.

Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.

Describe accountability tools and procedures used to measure effectiveness.

How will you know if the discharge plan is successful?

What are the indicators of success or effectiveness?

Care Coordination Plan:

Develop an evidence-based plan for health care delivery.

Develop a procedure for coordinating services.

Consider the needs of “outliers.” For example, someone with lung disease may need extra resources.

Who should be on the team?

When would the team be activated?

How would it be activated?

What is the time frame required to coordinate services?

How would the intervention plan be monitored for effectiveness?

Apply professional standards in support of a care plan.

Explain the alignment to the most recent heart failure guidelines and specific professional standards.

Describe accountability tools and procedures used to measure effectiveness.

How will you know if the care coordination plan is successful?

What are the indicators of success or effectiveness?

How will information be collected or communicated?

Additional Requirements

Written communication: Written communication should be free of errors that detract from the overall message.

APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.

Length: The report should be 3 pages in content length, double-spaced.

Font and font size: Times New Roman, 12 point.

Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.

Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.

Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.

To Prepare

· Review this week’s media presentation on the gastrointestinal system.

· Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.

· Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.

· Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.

· Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.

ASSIGNMENT:

Write a 2- to 3-page paper that addresses the following:

· Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.

· Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

· Chapter 35, “Structure and Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

· Chapter 36, “Alterations of Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

· Chapter 37, “Alterations of Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

· Chapter 13, “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

· Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

· Chapter 15, “Disorders of the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.

Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”

Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.

Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

1.4 Participate in health care policy development to influence nursing practice and health care.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.

Create a problem statement.

Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.