NURS-FPX 4050 Assessment 4: Final Care Coordination Plan

Capella University NURS-FPX 4050 Assessment 4: Final Care Coordination Plan-Step-By-Step Guide

This guide will demonstrate how to complete the Capella University NURS-FPX 4050 Assessment 4: Final Care Coordination Plan    assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for  NURS-FPX 4050 Assessment 4: Final Care Coordination Plan                                                                                  

Whether one passes or fails an academic assignment such as the Capella University  NURS-FPX 4050 Assessment 4: Final Care Coordination Plan    depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS-FPX 4050 Assessment 4: Final Care Coordination Plan                                                                                

The introduction for the Capella University NURS-FPX 4050 Assessment 4: Final Care Coordination Plan   is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS-FPX 4050 Assessment 4: Final Care Coordination Plan                                                                                

After the introduction, move into the main part of the  NURS-FPX 4050 Assessment 4: Final Care Coordination Plan   assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS-FPX 4050 Assessment 4: Final Care Coordination Plan                                                                                

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for  NURS-FPX 4050 Assessment 4: Final Care Coordination Plan                                                                                  

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS-FPX 4050 Assessment 4: Final Care Coordination Plan

Hypertension is a major global concern due to its complications like stroke, heart disease, and chronic kidney disease. The purpose of this paper is to present my final care coordination plan for hypertension by identifying three healthcare issues and interventions to address them. The paper will also address ethical decisions in these interventions, the impact of health policy on care coordination, and the priorities of the care coordination plan.

Patient-Centered Health Interventions

The identified healthcare issues related to hypertension that will be addressed in the care coordination plan are Poor BP control, High risk of stroke, and Poor lifestyle practices. This section will address each issue by proposing an intervention for each and community resources for the interventions.

Poor BP Control

Poor BP control is defined as BP of ≥140/90 mm Hg for patients without diabetes and ≥150/90 mm Hg for patients >80 years without diabetes. Various factors have been attributed to poor BP control, including lack of early detection of high BP, inadequate treatment, and poor adherence to treatment (Carey et al., 2021). Besides, poor BP control is identified as a major risk factor for cardiovascular diseases.

Educating patients on medication adherence is the proposed intervention to address poor BP control. Various factors are associated with poor adherence, including little hypertension knowledge and ignorance of the need for long-term treatment, high medication cost, religious practices, cultural beliefs, and complementary medications and practices. The nurse will assess these factors to determine how to design the patient education plan to increase patient’s knowledge and change their attitude toward long-term treatment for hypertension (Carey et al., 2021). The community resources that will foster the intervention include support groups for hypertensive patients, Community-based medication delivery programs, and Hypertension Community Outreach programs.

High risk of stroke

Stroke is one of the complications of poor BP control. Reduction of BP is associated with significant benefits in stroke risk and related mortality risk in older persons. Gorelick et al. (2020) explain that stroke is the second most common cause of death globally and the second leading cause of disability-adjusted life years. Proper BP management is fundamental to the prevention of stroke and acute treatment. The proposed intervention to lower the risk of stroke is intensive BP-lowering therapy via pharmacological and non-pharmacological therapy. Funakoshi et al. (2022) found growing evidence showing that BP-lowering therapies based on renin-angiotensin system (RAS) blockers, calcium blockers, and diuretics effectively prevent recurrent strokes among patients with a history of stroke or transient ischemic attack (TIA).

Patients who fail to achieve optimal BP control will have their medication therapy modified per the current hypertension treatment guidelines and their lifestyle practices reviewed to identify gaps and address them. Community resources facilitating the BP-lowering therapy intervention include Stroke Prevention Programs, Community Health Worker Stroke Prevention programs, and Community stroke and TIA education programs.

Poor lifestyle practices

Hypertension control often becomes challenging due to poor lifestyle practices like smoking, unhealthy dietary habits, physical inactivity, and excessive alcohol drinking. Ojangba et al. (2023) explain that maintaining healthy lifestyle factors can lower systolic BP by 3.5 mm Hg and decrease the risk of CVD by roughly 30%, notwithstanding genetic susceptibility to hypertension. The proposed intervention will be to provide health education on lifestyle modification to improve lifestyle factors. Patients will be empowered to modify behavior like reducing sodium, salt, and fat intake, eating habits to include more fruits and vegetables, cessation of smoking, less alcohol intake, maintaining healthy body weight, exercising regularly, and reducing stress.

Furthermore, lifestyle changes will be recommended in hypertensive patients as an initial therapy before initiating medication and as an adjunct to pharmacologic therapy in those receiving it. Lifestyle changes can support the withdrawal of medication and reduce the number of hypertensive patients with medication-controlled BP if highly motivated patients successfully adopt and maintain lifestyle changes (Ojangba et al., 2023). Community resources for this intervention will include support groups, a CDC-approved curriculum containing lessons and handouts, and community programs that support healthy eating and active living.

Ethical Decisions in Designing Patient-Centered Health Interventions

The decision to educate patients on medication adherence and behavior modification will promote better health outcomes that uphold beneficence. However, there is a need to engage patients in lifestyle changes and allow them to make dietary changes that align with their preferences and cultural diet practices rather than imposing the changes on them (Clark III et al., 2020). This promotes autonomy and increases the likelihood of the patient adhering to the lifestyle changes. In addition, the intervention in intensive BP-lowering therapy promotes beneficence by improving BP control as well as nonmaleficence by protecting patients from complications of uncontrolled BP (Clark III et al., 2020). Patients will be closely monitored for adverse effects to prevent causing more harm. Furthermore, consent will be obtained before initiating new treatments to respect the patient’s right to autonomy. These interventions promote social justice by ensuring that resources for hypertension management are available to the persons who need them most, that is, hypertensive patients.

Nonetheless, ethical questions have surfaced, which has created some level of uncertainty about the decisions I have made above. One of the questions is: Does driving the concept of medication adherence go against the patient’s right to refuse treatment? What if the medications used in intensive BP therapy put the patients at risk of adverse effects from medication errors? How will clinicians establish that a certain drug will promote the best BP control in a specific patient?

Relevant Health Policy Implications for the Coordination and Continuum of Care

The Affordable Care Act (ACA) mentions that care coordination is under sections on payment reform, quality improvement, and monitoring savings. It also mentions it under full Medicare Medicaid beneficiaries, special considerations of patients with diabetes and depression, and health home members (Natkin et al., 2023). Section 3502 of the ACA establishes Community Health Teams, which link clinical and community settings to support Patient-Centered Medical Homes. The act outlines the role of the Community Health Teams as coordinating disease prevention and chronic illness management, creating interdisciplinary care plans, and engaging patients and caregivers (Natkin et al., 2023). Furthermore, they support PCPs by coordinating access to preventive services and services that are cost-effective, quality-driven, culturally appropriate, and patient- and family-centered.

Section 2703 of the ACA requires the CMS to establish health home services for Medicaid beneficiaries with chronic illnesses. This is a Medicaid State Plan Option that provides a comprehensive care coordination system for Medicaid beneficiaries (De Marchis et al., 2023). The services include: Comprehensive care management, Care coordination, Health promotion, Comprehensive transitional care, patient and family support, and Referral to community and social support services

Priorities That a Care Coordinator Would Establish When Discussing the Plan with a Patient and Family Member

The care coordinator discussing the above plan with a patient and family members will identify the priorities as attaining optimal BP control, managing weight, and treatment adherence. The care coordinator will inform the patient and family that achieving optimal BP control will be a vital step in reducing the risk of complications. Besides, one has to control the BP to <140/90 to lower the risk of stroke (Gorelick et al, 2020). A controlled BP is an indicator of effective pharmacological and non-pharmacological measures. Weight management is another priority the care coordinator should point out. Overweight and obesity are linked with high BP. Thus, the patient should be informed that changing lifestyle practices will be fundamental to promoting weight loss. Treatment adherence should be emphasized for both pharmacological and non-pharmacological measures. This will be key to lowering BP and maintaining it at optimal levels.

Aligning Teaching Sessions to the Healthy People 2030 Document

Best practices on hypertension management should be the foundation of patient education on measures to control BP and prevent complications like stroke. One of the Healthy People 2030 goals is to improve cardiovascular health and decrease mortalities from heart disease and stroke (ODPHP, n.d.). One of the objectives of preventive care is to increase the proportion of adults with hypertension whose BP is under control. Thus, teaching sessions can be aligned with Healthy People 2030 by educating individuals on measures to control or lower BP. This can help reduce chronic kidney disease, heart failure, heart attack, and stroke. Furthermore, individuals can be educated on the importance of screening for high BP and adopting measures to lower it through lifestyle modification.

Conclusion

The identified healthcare issues related to hypertension are Poor BP control, High risk of stroke, and Poor lifestyle practices. The proposed interventions are educating patients on medication adherence, intensive BP- BP-lowering therapy, and health education on lifestyle modification. The proposed healthcare interventions align with medical ethical principles of autonomy, beneficence, nonmaleficence, and social justice.

References

Carey, R. M., Wright, J. T., Jr., Taler, S. J., & Whelton, P. K. (2021). Guideline-Driven Management of Hypertension: An Evidence-Based Update. Circulation Research, 128(7), 827–846. https://doi.org/10.1161/CIRCRESAHA.121.318083

Clark III, D., Hall, M. E., & Jones, D. W. (2020). Dilemma of blood pressure management in older and younger adults. Hypertension, 75(1), 35–37. https://doi.org/10.1161/HYPERTENSIONAHA.119.14125

De Marchis, E. H., Doekhie, K., Willard-Grace, R., & Olayiwola, J. N. (2019). The Impact of the Patient-Centered Medical Home on Health Care Disparities: Exploring Stakeholder Perspectives on Current Standards and Future Directions. Population health management, 22(2), 99–107. https://doi.org/10.1089/pop.2018.0055

Funakoshi, S., Kawazoe, M., Tada, K., Abe, M., & Arima, H. (2022). Blood Pressure Lowering for the Secondary Prevention of Stroke. Cardiology Discovery, 2(01), 51-57. doi/full/10.1097/CD9.0000000000000048

Gorelick, P. B., Whelton, P. K., Sorond, F., & Carey, R. M. (2020). Blood Pressure Management in Stroke. Hypertension (Dallas, Tex.: 1979), 76(6), 1688–1695. https://doi.org/10.1161/HYPERTENSIONAHA.120.14653

Natkin, L. W., van den Broek-Altenburg, E., Benson, J. S., & Atherly, A. (2023). Community Health Teams: a qualitative study about the factors influencing the decision-making process. BMC health services research, 23(1), 466. https://doi.org/10.1186/s12913-023-09423-6

ODPHP. (n.d.). Increase control of high blood pressure in adults — HDS‑05. Home of the Office of Disease Prevention and Health Promotion – health.gov. https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke/increase-control-high-blood-pressure-adults-hds-05

Ojangba, T., Boamah, S., Miao, Y., Guo, X., Fen, Y., Agboyibor, C., … & Dong, W. (2023). Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review. The Journal of Clinical Hypertension. https://doi.org/10.1111/jch.14653

Sample Answer 2 for NURS-FPX 4050 Assessment 4: Final Care Coordination Plan

In the US, family and domestic violence is a common problem that affects around 10 million people a year. Research suggests that domestic violence involves a significant proportion of the population, with approximately one in four women and one in nine men experiencing such violence (Grillo et al., 2019). Healthcare practitioners often encounter patients who have suffered from family or domestic abuse. Abuse of any kind, including financial, physical, sexual, mental, and psychological, may be classified as domestic or family violence and can affect people of all ages, including adults, children, and the elderly. Domestic violence hurts one’s physical and mental health, as well as productivity, quality of life, and, in some cases, fatality. This paper aims to outline the key priorities for a care coordinator when discussing a plan to address domestic violence with a patient and their family members.

Patient-Centered Health Interventions

The Healthy People 2030 initiative, which addresses domestic violence, aims to lower various forms of violence, including physical assaults, sexual assaults, and gun-related injuries (Rauhaus et al., 2020). When the victim is afraid, it may be difficult to identify domestic violence, especially when they go to the ER or a doctor’s office. Creating an evaluation process and being aware of the possible connection between domestic and family abuse and the symptoms and indications that the patient is presenting with is essential. More than 80% of victims of family and domestic abuse go to hospitals for treatment; other victims may see therapists, dentists, and other medical professionals (Grillo et al., 2019). Patient-centered care for these individuals primarily focuses on assessing and managing physical injuries, pain, and psychological trauma.

All healthcare practitioners, such as nurses, physicians, doctor’s assistants, dental practitioners, nurse practitioners, and pharmacists, should conduct routine screening. Interdisciplinary screening coordination is crucial for safeguarding victims and reducing adverse health outcomes within 24 hours (Lutgendorf, 2019). Proving the correlation between injuries and domestic abuse poses a significant challenge. The primary focus is on injuries that significantly risk one’s life or physical well-being. Following stabilization and physical assessment, laboratory tests and imaging modalities such as X-rays, CT scans, or MRI scans may be necessary. Healthcare professionals should prioritize addressing the root cause of the patient’s condition upon their arrival at the emergency department.

After confirming the patient’s stability and absence of pain, it is essential to conduct a comprehensive assessment of individuals who have disclosed experiencing abuse. The primary focus is on evaluating safety. Utilizing a set of predetermined questions can assist in reducing ambiguity during the patient’s assessment. In imminent peril, it is advisable to promptly seek assistance from an advocate, a shelter, a victim hotline, or legal authorities within 24 hours (Lutgendorf, 2019). In the absence of imminent peril, the evaluation should prioritize the examination of mental and physical well-being while also ascertaining the presence of any prior or ongoing instances of abuse. The responses determine the suitable intervention.

Survivors of intimate partner violence demonstrate elevated rates and severity of depression, with symptoms potentially enduring for up to five years following the cessation of violence (Grillo et al., 2019). Survivors of intimate partner violence (IPV) also experience higher rates of anxiety, posttraumatic stress disorder (PTSD), and issues related to alcohol and substance abuse. In an ideal world, the hospital would allow patients to speak privately with a medical professional, be prepared to handle emergencies, offer consolation measures like information, support, and emotional support, and be able to connect patients with local social service organizations. The Institute of Medicine (IOM) and the U.S. Preventive Services Task Force recommend IPV screening and counseling for all adolescent and adult women as part of preventive care. The Department of Health and Human Services has also adopted these recommendations as part of the preventive care provided through the Affordable Care Act.

Ethical Decision

Obtaining authorization promptly is crucial when providing treatment to clients affected by domestic violence. Specific individuals who engage in domestic violence may exhibit psychological defense mechanisms, such as prematurely terminating an interview or refusing to cooperate in various ways. If the therapist communicates with the probation officer who referred the client without obtaining proper authorization, it could violate the law and ethical standards that safeguard the client’s right to confidentiality (Lutgendorf, 2019). Therapists must obtain signed consent before conducting the assessment interview to mitigate this vulnerable situation. A limited release enables the therapist to acknowledge the client’s participation in the assessment process (Rauhaus et al., 2020). After obtaining limited authorization, the therapist can legally contact the referring agency. After the client consents to the assessment process or treatment program, a more extensive approval will enable the clinician to disclose specific information about the diagnosis or treatment.

Relevant Health Policy Implications

            Global policies emphasize the imperative to address abuse and domestic violence promptly. An authorizing legal or societal framework can reinforce organizational-level policies and procedures. These policies enhance awareness of abuse, including routine discussions of the issue in clinical settings. Each state has specific child abuse statutes as mandated by the Federal Child Abuse Prevention and Treatment Act (CAPTA) (Iverson et al., 2022). Federal legislation establishes criteria for determining what actions qualify as child abuse. According to the guidelines, child abuse encompasses an act or recent failure that poses a significant and immediate threat of severe harm. Child maltreatment refers to any recent action or inaction by a parent or carer that leads to the death, emotional or physical harm, sexual assault, or exploitation of a child. The Elder Justice Act aims to reduce elder neglect, exploitation, and abuse by implementing various strategies (Hegarty et al., 2020). The Patient Safety and Abuse Act, a component of the Violence Against Women Act, establishes a federal offense for individuals who engage in interstate stalking, harassment, or physical harm against their partners. It also criminalizes the violation of a protective order when crossing national borders.

Making Changes Based Upon Evidence-Based Practice

Care coordinators should prioritize addressing domestic violence victims by providing treatment that acknowledges the impact of trauma and abuse on their health. They should also ensure that patients are connected to appropriate specialists for comprehensive recovery. Care coordinators should make adjustments based on evidence-based practices when discussing the care plan with patients and their family members. Exiting an abusive relationship or living situation presents significant difficulties, encompassing both emotional and practical aspects. The process entails recognizing the presence of abuse, seeking assistance to exit the position safely, and addressing the emotional and psychological aftermath (Iverson et al., 2022). Survivors can engage in a gradual process of self-esteem reconstruction following the detrimental effects experienced in the relationship. Survivors may benefit from self-care routines, professional mental health counseling, and the establishment of a nonjudgmental support network to effectively manage the fallout from the relationship. Society can support abuse victims by providing access to resources, affordable mental health care, and effective prevention programs. Workplaces can mitigate the impact of intimate partner violence on employees by implementing policies that provide protection and support, particularly about financial strain.

Conclusion

Domestic and family violence encompasses various forms of abuse, such as economic, sexual, physical, emotional, and psychological, targeting individuals across different age groups, including children, adults, and elders. Domestic and family violence poses challenges in terms of identification, with a significant number of cases remaining unreported to healthcare providers and legal authorities. Healthcare professionals, such as psychologists, nurses, chemists, dentists, doctor’s assistants, registered nurses, and physicians, are responsible for assessing and potentially providing care to individuals involved in domestic or family violence, given its widespread occurrence in our society. Healthy People 2030 aims to decrease various forms of violence, such as physical assaults, sexual assault, and gun-related injuries.

References

Grillo, A., Danitz, S. B., Dichter, M. E., Driscoll, M., Gerber, M. R., Hamilton, A. B., Stirman, S. W., & Iverson, K. M. (2019). Strides toward Recovery from Intimate Partner Violence: Elucidating Patient-Centered Outcomes to optimize a brief counseling intervention for women. Journal of Interpersonal Violence, 36(15–16), NP8431–NP8453. https://doi.org/10.1177/0886260519840408

Hegarty, K., McKibbin, G., Hameed, M., Koziol‐McLain, J., Feder, G., Tarzia, L., & Hooker, L. (2020). Health practitioners’ readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLOS ONE, 15(6), e0234067. https://doi.org/10.1371/journal.pone.0234067

Iverson, K. M., Danitz, S. B., Driscoll, M., Vogt, D., Hamilton, A. B., Gerber, M. R., Stirman, S. W., Shayani, D. R., Suvak, M. K., & Dichter, M. E. (2022). Recovering from intimate partner violence through Strengths and Empowerment (RISE): Development, pilot testing, and refinement of a patient-centered brief counseling intervention for women. Psychological Services, 19(Suppl 2), 102–112. https://doi.org/10.1037/ser0000544

Lutgendorf, M. A. (2019). Intimate partner violence and women’s health. Obstetrics & Gynecology, 134(3), 470–480. https://doi.org/10.1097/aog.0000000000003326

Rauhaus, B. M., Sibila, D., & Johnson, A. F. (2020). Addressing the increase of domestic violence and abuse during the COVID-19 pandemic: a need for empathy, care, and social equity in collaborative planning and responses. The American Review of Public Administration, 50(6–7), 668–674. https://doi.org/10.1177/0275074020942079