Patient Centered Care Report

Create a patient-centered care report applying the outcomes of the Population Health Improvement Initiative (PHII).

Capella NURS FPX-6011 Assessment 2- Patient-centered Care Report

Your report will be based on the scenario presented in the Evidence-Based Health Evaluation and Application media piece.

Master’s-level nurses need to be able to think critically about the evidence, outcomes data, and other relevant information they encounter throughout their daily practice. Often the evidence or information that a nurse encounters, researches, or studies is not presented in the exact context of that nurse’s practice. A key skill of the master’s-level nurse is to be able to transfer evidence from the context in which it was presented and apply it to a different context in order to maximize the benefit to patients in that new context.

Scenario

For this assessment, you will base your report on the scenario presented in the Evidence-Based Health Evaluation and Application media piece. Some of the writing you completed and exported from the media piece can constitute your prewriting and inform the development of your final submission. Further, even though the media piece was framed within one type of care setting, you can extrapolate the situation into another care setting that is more relevant to you. You will still be able to apply community outcomes data to an individual patient or case. Capella NURS FPX-6011 Assessment 2- Patient-centered Care Report

Instructions

For this assessment, you will apply the outcomes of the Population Health Improvement Initiative (PHII) to a patient-centered care report. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your report addresses all of the bullets below, at a minimum. You may also want to read the Patient-Centered Care Report Scoring Guide and Guiding Questions:

Patient-Centered Care Report [DOCX] to better understand how each criterion will be assessed:

• Evaluate the outcomes of a population health improvement initiative.
• Propose strategies for improving the outcomes of the population health improvement plan, or ensuring that all outcomes are being addressed, based on the best available evidence.
• Develop an individualized personal care approach that incorporates lessons learned from a population health improvement initiative.
• Justify the value and relevance of evidence used as the basis for your personal care approach to your patient.
• Propose a framework that could be used to evaluate desired outcomes of your approach to personalized care for your patients and areas that could be applied to similar situations and patients in the future.
• Write content clearly and logically, with the correct use of grammar, punctuation, and spelling.
  Integrate relevant sources to support assertions, correctly formatting citations and references using APA style. Capella NURS FPX-6011 Assessment 2- Patient-centered Care Report

Example assessment: You may use the Patient-Centered Care Report Example [DOCX] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

APA Resources: You may use the APA Style Paper Tutorial [DOCX] and the APA Style Paper Template [DOCX] to ensure your assessment is formatted in the appropriate APA style. Capella NURS FPX-6011 Assessment 2- Patient-centered Care Report

Submission Requirements

• Length of submission: 4–6 double-spaced, typed pages. Your report should be succinct yet substantive.
• A number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your evaluation, recommendations, and plans.
• APA formatting: Resources and citations are formatted according to APA style.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Apply evidence-based practice to plan patient-centered care.
  Develop an individualized personal care approach that incorporates lessons learned from a population health improvement initiative.
• Competency 2: Apply evidence-based practice to design interventions to improve population health.
  Propose strategies for improving the outcomes of a population health improvement plan, or ensuring that all outcomes are being addressed, based on the best available evidence.
• Competency 3: Evaluate outcomes of evidence-based interventions.
  Evaluate the outcomes of a population health improvement initiative.
  Propose a framework that could be used to evaluate desired outcomes of an approach to personalized care for patients and areas that could be applied to similar situations and patients in the future.
• Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
  Justify the value and relevance of evidence used as the basis for a personal care approach to a patient.
• Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
  Write content clearly and logically, with the correct use of grammar, punctuation, and spelling.
  Integrate relevant sources to support assertions, correctly formatting citations and references using APA style

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Sample Solution

Patient-Centered Care Report

Traumatic brain injury or TBI is a condition that results from events causing trauma to the brain (Hammer & McPhee, 2018). The effects could be diverse and include mental health problems that fall under the category of organic brain syndromes. For patients with TBI, there is a need for them to receive help by way of structured population health improvement initiatives (PHII). This paper is concerned with one such population health improvement initiative and its outcomes.

Outcomes: Achieved and Not Achieved

Patients with TBI require a multifaceted approach in order for them to regain functionality and be able to perform their daily tasks. These include activities of daily living. TBI occurs when a person gets to suffer physical injury that affects their brain. These could range from a fall to road accidents. What happens is that, depending on the extent of the injury, the person who is injured suffers from differing degrees of cognitive deficits and behavioral deficiencies that affect their functioning. There may be memory loss such that the person experiences difficulty in recalling events that either occurred recently (anterograde amnesia) or a long time ago (retrograde amnesia). Studies have shown that three interventions appear to be effective in benefiting persons with TBI. These are exercise, medications, and meditation.

Exercise in all its forms is beneficial to persons who have suffered TBI (Lal et al., 2017). There are two main types of exercise, namely aerobic exercise and resistance training. The aerobic exercise incorporates isotonic exercise which basically means walking. Aerobic exercise is beneficial in improving blood flow to the brain and strengthening the heart muscle. Then there is resistance training which involves training for strength. The most common form of resistance training is weight lifting. In all, exercise helps the body heal itself without outside intervention in the form of other chemical therapies. By improving blood flow to the brain, the healing process is encouraged and the person gets their neurologic circuitry back to proper functionality through repeated episodes of exercising.

The other intervention in traumatic brain injury (TBI) is the use of medications for the accompanying cognitive impairment. Some of the most effective medications in this are dopaminergic drugs that influence the neurotransmission of dopamine (Jenkins et al., 2019). Evidence-based practice (EBP) shows that drug treatment of TBI should be regarded as an adjunct to nonpharmacologic measures such as exercise (discussed above) and diet. Some of the medications used and proven to be efficacious include methylphenidate (which increases cerebral levels of dopamine and noradrenaline), bromocriptine (which reduces dopaminergic release), and amantadine (which improves dopaminergic neurotransmission (Wortzel & Arciniegas, 2012). Lastly, meditation has also been shown to positively affect healing in TBI.

In this case, the outcomes that were achieved with the above interventions were a return to proper cognitive functioning and restoration of some memory. However, the restoration of speech was not fully achieved. The positive effects of the achieved outcomes on community health included improved family bonding and social cohesiveness. Younger persons were seen to be more likely to recover more cognitive functions than older subjects. The extent to which the factors that were not achieved fell short of expectations was not great, community and resource factors that may have contributed to achievement shortfalls included stigma and lack of sufficient financial resources to cover treatment and rehabilitation, despite healthcare coverage.

Strategy for Improving Outcomes

One of the strategies for improving the outcomes that were not achieved would be community sensitization and education about the consequences of TBI and their effect on a person and the community. The other measure would be to harness the support of faith-based organizations and nongovernmental charitable organizations that can help with resources in the form of medications and manpower. There is evidence f the success of these kinds of measures in the developed as well as developing world. The evidence illustrates the likelihood of success if the above measures are implemented in the sense that educating the community changes perceptions. When perceptions are changed, behavior also changes. This is the most important driving force to enabling communities take care of their members who have suffered TBI and have cognitive impairments.

The approach to personalized care that incorporates the lessons learned from the population health improvement initiatives (PHIIs) above would entail coming up with an individualized timetable for exercise therapy for the patient, taking the person affected through several sessions of health education to enable them to internalize the details of a suitable diet as well as the importance of compliance to treatment and medications. Because not all persons affected are able to afford all the care needs for the interventions, it will be within the responsibility of the healthcare worker to advise the affected to use the available resources and get the maximum benefit out of them.

Specifically, the patient and their family will be advised to take advantage of the nonpharmacologic measures which do not require a lot of monetary resources to implement. This includes diet and exercise. Luckily, these are the first-line measures that are effective in achieving the desired patient outcomes. As has been seen above, medications only serve as adjuvant therapy. This evidence is demonstrated by the work of Wortzel and Arciniegas (2012).

The evidence is valuable and relevant to the patients’ cases because it enables the planning of resources that are needed to effect the interventions and achieve the desired outcomes. Most importantly, the evidence is useful in educating the community that interventions for TBI need not necessarily be expensive in order to achieve desirable outcomes. They need to know that simple measures such as exercise and dietary discretion are enough to bring about the outcomes that are required and envisaged. The evidence is appropriate for the issue (TBI) as well as the family situation of the patients who are being assisted to regain functionality. This is because the evidence outlines cost-effective measures that are also evidence-based in terms of efficacy and reliability to bring about desired outcomes.

Criteria for Evaluating Outcomes

The criteria for evaluating outcomes would include memory recovery measurement (taken as the number of events that the patient can remember every week after commencement of therapy), the number of words pronounced correctly with each day of therapy, and the number of personal tasks (activities of daily living) performed without assistance with each successive day of therapy. These criteria are appropriate because they are fashioned from the outcomes that are expected from the PHII taken. All the aspects in the criteria are transferrable to other individuals suffering from the same condition. This is because the measures employed are universally effective, from the research and evidence that is available.

  References

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Jenkins, P.O., De Simoni, S., Bourke, N.J., Fleminger, J., Scott, G., Towey, D.J., Svensson, W., Khan, S., Patel, M.C., Greenwood, R., Friedland, D., Hampshire, A., Cole, J.H., Sharp, D.J. (2019). Stratifying drug treatment of cognitive impairments after traumatic brain injury using neuroimaging. Brain, 142(8), 2367-2379. https://doi.org/10.1093/brain/awz149

Lal, A., Kolakowsky-Hayner, S., Ghajar, J., Vazquez, O., & Balamane, M. (2017). A systematic review and meta-analysis on the role of exercise or rest in patients with concussion and mild traumatic brain injury. British Journal of Sports Medicine, 51(11). http://dx.doi.org/10.1136/bjsports-2016-097270.215

Wortzel, H.S., & Arciniegas, D.B. (2012). Treatment of posttraumatic cognitive impairments. Current Treatment Opinions in Neurology, 14(5), 493-508. http://dx.doi.org/10.1007/s11940-012-0193-6