*Please note that in NR531 students must use at least three scholarly sources and keep all  assignments to a maximum of three pages, excluding the title page and reference list.

Purpose

The purposes of this assignment are to: (a) identify and articulate key concepts of one of the following: either your future pathway to excellence or your shared-governance model you wish to initiate at one of the three areas: 1. Saint Louis Medical Center (SLMC)/community or critical access hospital, 2. Home health/community transition, or 3. Long term care/skilled nursing facility (SNF) or memory care (CO 5), (b) provide empirical, scholarly evidence to support your proposed project (CO 4), and (c) communicate your information in a clear, succinct, and scholarly manner (CO 5).

Note: You are completing this assignment as if you are the nurse executive. You are to decide whether you wish to focus on implementing your pathway to excellence or a shared governance model. You will choose one of the areas to implement either your pathway to excellence or your shared governance model. What elements would like to adopt and implement for your organization?

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

(CO4) Apply the use of research in the evaluation of healthcare outcomes, utilizing critical thinking skills, and interprofessional research strategies. (PO4)

(CO5) Examine effective verbal and written communication; utilizing communication skills of the professional role to promote and improve quality and safety in healthcare. (PO1, 2, 5)

 

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Within 20 miles of our facility, there will be a new hospital that is opening up in the summer of 2020. Leading to lots of opportunities for the healthcare environment. One of the concerns with this includes how many staff members will leave to go to the new and upcoming hospital. Our human resource department estimates that we risk approximately ten percent of our staff to this new facility. At this time, we do not know what their benefits package will entail for the team. Benefits that include sign-on bonuses and tuition reimbursement may not be readily available to them, as this will be an entirely new business. Our facility has invested about 7 percent of the start-up, and another more extensive hospital system from 100 miles away has spent forty-five percent. One of the expectations of this new hospital is that it will be locally owned and ran. The physicians are fed up with big business from Colorado and California trying to run multiple hospitals.

Benefits such as tuition reimbursement and sign-on bonuses can attract new employees to an organization. What happens when they are unknown as of this a new facility and cooperation? As a nurse executive on the things that I would continue to reinforce is that the grass is not always greener on the other side. Several years ago, I worked part-time in a new hospital organization, and they severe growing pains. They did not have any formal recognition for the length of services and financial and retirement planning programs (Moon, Beck, & Laudicinia, 2014). They did not offer tuition reimbursement for those that wished to advance their degrees. As a transformational leader, one would want to have a general idea of what the staff member’s hopes and dreams are for work.

 

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• CO 2: Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)
• CO 4: Identify teaching/learning needs from the health history of an individual. (PO #2)

Due Date

Patient Teaching Plan assignment is due Sunday of Week 4 at 11:59 MT.

Points

This assignment is worth 125 points.

Background Information

NR305 focuses on nursing assessment, and the identification of opportunities to prevent disease and improve health of patients. An important professional role for nurses is to provide teaching to patients based on knowledge deficits identified during assessment.

Prior to beginning this assignment, follow the link to read the article below. The information related to adult learning and barriers to understanding will be helpful when planning how to best educate your selected population.

Beagley, L. (2011). Educating patients: Understanding barriers, learning styles, and teaching techniques. Journal of Paranesthesia Nursing, 26(5), 331-337. permalink (Links to an external site.)

Directions

Please read all directions carefully before you begin.

1. Click to download the Patient Teaching Plan Form (Links to an external site.).
   Type your answers directly into this Word document and submit. The use of correct terminology, grammar, and spelling is important! Any references and citations used should be written in APA format. Please utilize in-text citations when appropriate, and list all references in the space provided at the end of the worksheet.
2. You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.). Click on the envelope at the top of the page.
3. Health Topic: Decide WHAT you would like to teach. Describe in detail why this is an important topic for patient education. Use evidence from the textbook, lesson or an outside scholarly source to support your rationale. Select from the following health topics to complete your Patient Teaching Project:

    

   • Stress and Time Management
   • Self-Care (can choose a specific self-care activity)
   • Prevention of Hazards at Work
   • Bicycle Safety
   • Ergonomics (related to work, posture)
   • Skin Cancer Prevention
   • Healthy Eating
   • Exercise/Physical Activity
   • Suicide
   • Human Trafficking
   • Eating Disorders
   • Substance Abuse (Opioid, Alcohol, Nicotine)
   • Depression
   • Palliative Care/Hospice Care
4. Population and Setting: Once you have selected a topic, you must decide WHO you will be teaching and WHERE the education will take place. (i.e., teaching a classroom of middle school students; teaching community members at a local health fair)
5. Learning Barriers: Refer to the assigned article: Educating patients: Understanding barriers, learning styles, and teaching techniques for information related to learning barriers and other teaching considerations. Barriers might be cultural, physical, educational, or environmental. You may also want to consider the developmental stages of your selected population. Example:
    
   • The population in this community is known to have a low-literacy level, therefore clear pictures and graphics will be utilized to assist with understanding.
6. Learning Objectives: Write three specific learning objectives your Visual Teaching Tool will address. Begin each objective with “At the end of this education, the learner will …” Use an action verb to finish the sentence (i.e., list, demonstrate, describe, define, identify). Example:
    
   • At the end of this education, the learner will be able to demonstrate the proper way to wear a bike helmet.
   • At the end of this education, the learner will be able to describe how to perform a breast self-exam.
   • At the end of this education, the learner will be able to list three benefits of regular physical activity.
7. Evaluation: Write a paragraph describing how you could evaluate whether your visual teaching tool was successful and met the learning objectives. Consider the population’s abilities and the setting.

 

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The case of Jim is a great example of how value based reimbursement structures are driving improvements in healthcare.

With fee for service, or volume based reimbursement, the hospital will receive reimbursement for providing care on two separate admissions, despite the fact that the second admission could possibly have been avoided.  Additionally, with fee for service, there is  no incentive to return the patient to the community or recover health in a timely manner.  Physicians and hospitals receive more benefit from greater length of stay and additional tests and consults.  With volume based reimbursement, there is no incentive to reduce costs or improve quality which negatively impacts patient satisfaction.   While this form of reimbursement provides maximum profits for providers, it results in epidemic unaffordable and inaccessible healthcare for populations. 

With value based reimbursement, the hospital will receive a flat fee for Jim’s diagnosis regardless of how care is provided.  The hospital will also be penalized for readmission additionally reducing reimbursement.  In the case of value based reimbursement, the hospital is incentivized to diagnose, treat, and recover the patient as quickly and efficiently as possible.  This reduces the chances of imposed unnecessary costs to the patient and improves the likelihood of quality care and thereby patient satisfaction, which is known as the Triple Aim (Martin, 2017).

With nearly 50% of the payer mix at my institution coming from government funded healthcare, value based reimbursement has a significant impact on how we deliver care with a large focus on quality and cost reduction improvement strategies.  One of the ways our hospital has tried to reduce cost is through merger.  Advocate merged with Aurora Healthcare last year and the large volume of providers has allowed us to negotiate lower contracts with vendors and suppliers.  Additionally, they are reducing costs by partnering with physician groups to provide services to patients and employees at reduced costs under a large HMO.

 

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This sounds very complicated and intensive. It is good that the employees have an understanding of the final budget so they can know their responsibility.

Dr. Strong

 

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