NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan
Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.
Introduction
NOTE: You are required to complete this assessment before Assessment 4.
The first step in any effective project is planning. This assignment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for a particular health care problem.
Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.
As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.
Preparation
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.
To prepare for this assessment, you may wish to:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
Allow plenty of time to plan your chosen health care concern.
Note: Remember that you can submit all, or a portion of, your draft plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.
Note: You are required to complete this assessment before Assessment 4.
Develop the Preliminary Care Coordination Plan
Complete the following:
Identify a health concern as the focus of your care coordination plan. In your plan, please include physical, psychosocial, and cultural needs. Possible health concerns may include, but are not limited to:
Stroke.
Heart disease (high blood pressure, stroke, or heart failure).
Home safety.
Pulmonary disease (COPD or fibrotic lung disease).
Orthopedic concerns (hip replacement or knee replacement).
Cognitive impairment (Alzheimer’s disease or dementia).
Pain management.
Mental health.
Trauma.
Identify available community resources for a safe and effective continuum of care.
Document Format and Length
Your preliminary plan should be an APA scholarly paper, 3-4 pages in length.
Remember to use active voice, this means being direct and writing concisely; as opposed to passive voice, which means writing with a tendency to wordiness.
In your paper include possible community resources that can be used.
Be sure to review the scoring guide to make sure all criteria are addressed in your paper.
Study the subtle differences between basic, proficient, and distinguished.
Supporting Evidence
Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.
Grading Requirements
The requirements, outlined below, correspond to the grading criteria in the Preliminary Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze your selected health concern and the associated best practices for health improvement.
Cite supporting evidence for best practices.
Consider underlying assumptions and points of uncertainty in your analysis.
Describe specific goals that should be established to address the health care problem.
Identify available community resources for a safe and effective continuum of care.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Write with a specific purpose with your patient in mind.
Adhere to scholarly and disciplinary writing standards and current APA formatting requirements.
Additional Requirements
Before submitting your assessment, proofread your preliminary care coordination plan and community resources list to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan. Be sure to submit both documents.
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: Adapt care based on patient-centered and person-focused factors.
Analyze a health concern and the associated best practices for health improvement.
Competency 2: Collaborate with patients and family to achieve desired outcomes.
Describe specific goals that should be established to address a selected health care problem.
Competency 3: Create a satisfying patient experience.
Identify available community resources for a safe and effective continuum of care.
Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
example:
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
The purpose of this paper is to explain a health concern and then propose a set of reasonable goals that the healthcare industry can pursue to improve the quality of care provided to patients suffering from said health concern. Additionally, the community resources must be enumerated as part of the solution.
Stroke
Globally, strokes are among the leading causes of death. In terms of mortality rate, stroke ranks second, with a yearly death toll of 5.5 million people (Donkor, 2018). The danger of strokes is illustrated not only by the mortality rate, but also by the aftereffects experienced by survivors. 50% of all survivors were observed to develop chronic disabilities (Donkor, 2018).
Two major types of strokes are distinguished. Included in this category are ischemic and hemorrhagic strokes. The obstruction of blood flow to a portion of the brain causes the former. Loss of function is brought on by the interruption of blood flow. Hemorrhagic stroke, on the other hand, is caused by a blood vessel bursting or rupturing (Donkor, 2018).
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
Identification of Stroke Best Practices
The identification of the health concern is now complete. Listed below are a few of the best practices that can be applied to stroke patients.
Patients diagnosed with a large vessel occlusion are to be evaluated for endovascular treatment (Khaki & Tadi, 2021). Patients suspected of having a severe ischemic stroke should undergo a neurological evaluation.
In addition to the specific and specific measures taken for the care and management of strokes, antiplatelet and statin medications are the primary components that serve as the management’s foundation (Khaki & Tadi, 2021).
There are a variety of additional factors that influence the treatment and accommodation of a stroke patient. To facilitate a recovery process devoid of trauma and unhindered by mental distress, the cultural, social, and psychosocial needs must be incorporated into the treatment.
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
The referred-to needs may include the accommodation and consideration of a person’s cultural background’s various peculiarities, etc. People from various cultures typically respond differently to treatments and the various stages of recovery.
Similarly, social and psychosocial needs may necessitate providing the patient with adequate mental support during treatment. This is a psychosocial dynamic because it relates to social factors, such as the individuals, and psychological factors, such as the effects on the mental state of the patient. In light of the importance of psychosocial factors in medication treatments (Xu, Mercury, Zhang, & Xu, 2008), these three areas must be addressed.
Stroke Care Objectives Must Be Established
Certain goals can be established for professionals or the institute to achieve in order to ensure that stroke care is properly administered. Diverse strategies have been proposed in an effort to enhance the quality of care provided to stroke patients. By employing these strategies, we are able to formulate goals and objectives that can serve as a benchmark for everyone. A particular strategy proposed in a medical journal (Baatiema et al., 2020), for instance, was the computerization and digitization of medical practices. Using this strategy, we can establish an organization-wide objective. It can be said that the hospital or professional must digitally enter and store the information and vital details of a particular stroke patient in order to facilitate better care coordination among professionals and transitions between locations.
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
In addition to this objective, namely the computerization of the medical practice, several others can be listed. In order to effectively treat strokes, it is also necessary to increase the number of professionals and the workforce. While the precise number will vary by institution, it is necessary to have a sufficient number of professionals to care for patients (Baatiema et al., 2020).
Moreover, another objective that can be set is the development of a standard set of clinical guidelines and treatment protocols for all professionals in a particular institution to follow (Baatiema et al., 2020). The standardization of protocols improves collaboration and care coordination because all professionals are on the same page regarding the treatment steps.
Community Facilities
Stroke patients’ passive recovery can benefit greatly from community resources. After a stroke, the patient’s recovery and return to a normal way of life can be a challenging process. In this study, however, the purpose of enumerating these community resources is to explain how care can be continued even after discharge from the hospital. In other words, the various community resources aid in the patient’s recovery even after they have left the hospital or medical facility.
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
One reason for recommending community resources to a patient is the deracination of any lingering trauma. Consequently, it was determined that walking groups (White & South, 2012) and other group exercise activities are an effective way to assist patients in recovering from their potential depressive state. Parks and gardens that are accessible to the general public are the community resources at play here.
Similarly, cooking and eating sessions (White & South, 2012) are an additional example of community-based treatment. Participating in these activities with others can be beneficial for patients. People are also a component of community resources; consequently, such activities are justifiably incorporated into community resource-centered treatment.
Classes in literacy (White & South, 2012) are another type of community resource that can aid in the recovery of patients.
NURS FPX 4050 Evaluation 1 Initial Care Coordination Plan
References
Baatiema, L., de‐Graft Aikins, A., Sarfo, F. S., Abimbola, S., Ganle, J. K., & Somerset, S. (2020). Improving the quality of care for stroke patients in low/middleincome countries: A qualitative analysis of the perspectives of healthcare professionals. 450–460 in Health Expectations, 23(2). https://doi.org/10.1111/hex.13027
Donkor, E. S. (2018). A Snapshot of Stroke’s Burden, Epidemiology, and Quality of Life in the 21st Century. Research and Treatment for Stroke, 2018, 1–10. https://doi.org/10.1155/2018/3238165
Khaki, A. S., & Tadi, P. (2021). Cerebrovascular Disease [Statpearls]. Obtainable at https://www.ncbi.nlm.nih.gov/books/NBK430927
White, J., and J. South (2012). The contribution of community resources to clinical practice. British Journal of General Practice, 62(602), pages 454 to 455. https://doi.org/10.3399/bjgp12x653804
Xu, J., Mercury, J., Zhang, Z., & Xu, F. (2008). In clinical pharmacology, psychological, social, and behavioral factors that influence drug efficacy are an important research topic. British Journal of Clinical Pharmacology, volume 66, number 6, pages 901–902. https://doi.org/10.1111/j.1365-2125.2008.03300.x
