Write a 3 page evidence-based health care delivery plan for one component of a heart failure clinic.

Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.

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

• Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
  • Describe accountability tools and procedures used to measure effectiveness.
• Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
  • Develop an evidence-based plan for health care delivery.
• Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
  • Apply professional and legal standards in support of a care plan.
• Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
  • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

 

In an effort to improve the patients’ health literacy concerning heart failure, it is important that the clinic staff and the hospital staff present a consistent, evidence-based message on self-care to these patients and their families in order to decrease acute exacerbation and re-admissions. Review current evidence for clinical practice guides or protocols when developing your patient teaching plans and materials. Consider the following:

• What does the patient know about the disease process as a baseline?
• What does the patient need to do understand as far as the best self-care processes?
• Can the patient identify proper medication compliance?
• Is there a financial issue that affects compliance?
• Who buys and prepares the food in the home?
• Can the patient verbalize when to seek medical assistance?

 

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.

 

 

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ASSIGNMENT: Prepare for Joint Commission  CAHIIM Competency: Interpret health information standards

You are the Health Information Director of a hospital, and your hospital has hired a consultant to help determine major issues with the hospital’s information technology. The consultant submitted the following report:

City Hospital has a variety of hardware and software that is used in its departments. Computer workstations are widely used across the organization, but in many departments the computer workstations are too old to provide an adequate platform for the later versions of software that would most effectively support departmental reporting responsibilities.

There is no organization-wide network in place. Software applications and versions are not standardized across the organization, and so members of different departments cannot share data and information in electronic formats. This forces members of the organization to duplicate report generation efforts when reports contain the same or similar data.

An office suite application available to users on a local­ area network could help solve this problem. The absence of a local­ area network and an administrative database accessible to department managers means that reports must be prepared in the generating department, output on paper, and then input again in administrative departments to be utilized in administrative applications. An administrative database served by a network to all departments would require data to be gathered only once and then would be made available for subsequent users and purposes without reprocessing.

All of the logs that the organization currently generates, many of which are on an hourly or daily basis, could be more effectively administered and accessed if they were in electronic formats. In addition, interviews with data users state that even with the existing software, they had not been trained well enough to use it.

You are now preparing for a Joint Commission visit that will be in about 6 months. Here are the Joint Commission standards that you are concerned about:

• IM. 01.01.01 The [healthcare organization] plans for managing information.
• IM. 01.01.03 The [healthcare organization] plans for continuity of its information management processes.
• IM. 02.01.01 The [healthcare organization] protects the privacy of health information.
• IM. 02.02.01 The [healthcare organization] effectively manages the collection of health information and retrieves, disseminates, and transmits health information in usable formats.
• IM. 04.01.01 The organization maintains accurate health information.

INSTRUCTIONS: You need to prepare a memo for the CEO to tell him what you recommend be done before the visit. Tell the CEO why you are concerned about the findings. At the end of your memorandum to the CEO (as an annex, or table), create a table to map each concern to the related standard to show your interpretation of each of the standards that are not being met. Match the appropriate Joint Commission standard listed above to the each of the consultant’s findings. 

Prepare you memo as if you were working at the hospital.  The format should look like you are the HIM Director, addressing the Hospital CEO.  It does not have to be in APA format, but you must list your references in APA format at the very end, as it is an academic assignment.

PLEASE NOTE:  You will have to do research to determine the intricacies of each standard listed above, in order to complete the third column.  Here is one sample site to get you started https://foh.psc.gov/tjc/im/standards.pdf

Here is a sample of a table to get you started:

ISSUE

JOINT COMMISSION STANDARD

IMPORTANCE/ JOINT COMMISSION CRITERIA

Computer workstations are too old to provide an adequate platform for the later versions of software

IM.01.01.01  The organization plans for managing information

 

 

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a..Pain that continues even after healing has occurred.

b..Pain associated with the musculoskeletal system may impair this function.

c..Pain of a short duration.

d..The fat layer beneath the dermis that provides support and insulation.

e..Largest organ of the body that performs many vital roles as both a barrier and as a regulator.

f..A collagen-based matrix with minerals laid upon it.

g..Controlled by blood vessels within the dermis.

h..Secretions of the eccrine glands in response to heat.

i..Controls bone formation.

j..Pain that is severe and associated with a sudden onset.

k..Outer layer of skin, prime function is to provide a physical and biological barrier to the environment.

l..Responsible for bone destruction.

m..Superficial pain is easy to locate because the skin has a higher concentration of these.

n..Have 300 bones primarily made up of cartilage.

o..Have 206 bones of various shapes and sizes.

Matching words

Bone

Osteoblasts

Osteoclasts

Adults

Babies

Skin

Subcutis

Sweat

Epidermis

Thermoregulatio

QUESTION 2

Discuss the relationship that pain and other factors can have on a person’s ability to mobilize independently.

Your response should be at least 500 words in length.

 

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QUESTION 6

1. Explain the purpose of the blood-brain barrier and how it functions. Include discussion of the types of substances that can pass through and effect the brain.

   Your response should be at least 500 words in length.

CASE STUDY:

Joe Devlin, a 32-year-old graphic artist, has been admitted to the neurology ward for further investigations. Mr. Devlin has a history of fatigue and numbness to his left lower leg and foot, and has recently experienced falls because of this. He is now also complaining of numbness to his hands. He is very anxious because his maternal grandmother also experienced similar symptoms and was found to be suffering from multiple sclerosis.

On neurological examination, he has absent abdominal reflexes with brisk tendon jerks and bilateral extensor plantar responses. Blood investigations are normal including hemoglobin (spelled “haemoglobin” in your textbook) and white cell count. A lumbar puncture is carried out. The cerebrospinal fluid (CSF) investigation results show oligoclonal lgG bands that are not found in normal CSF, but are found in 90% of patients with multiple sclerosis. In the absence of clinical signs of infection, this test is almost diagnostic of multiple sclerosis.

1. Discuss the signs and symptoms that Mr. Devlin is experiencing.
2. Discuss the role of pharmacological interventions in managing Mr. Devlin’s condition.
3. Outline the immediate care that Mr. Devlin will require.
4. Discuss the health promotion advice Mr. Devlin may require to remain safe.

Save your answers as a word document and submit for grading.

MATCHING:

 
a.

Consists of the brain and spinal cord.

b.

Have a lifespan of around 120 days.

c.

Part of PNS responsible for muscle contractions and conscious activities.

d.

Have a life span of a few days to a few years.

e.

Responsible for the fight or flight response.

f.

The main function of leucocytes.

g.

Makes up 25% of white blood cells.

h.

The hormone that controls the production of red blood cells.

i.

Divided into two major sections, central and peripheral.

j.

Responsible for regulation of the body’s involuntary functions.

k.

The main function of erythrocytes.

l.

Small blood cells that seal holes in the blood vessels.

m.

Controls internal responses associated with a state of relaxation.

n.

Breakdown of old red blood cells carried out by macrophages.

o.

Consists of the nerves that carry impulses to and from the spinal cord.

 

Nervous System

Central Nervous System

Peripheral Nervous System

 

Autonomic Nervous System

Sympathetic division

 

Somatic Nervous System

Parasympathetic division

 

Erythropoietin

 

Lymphocytes

Platelets

 

Haemolysis

 

Red blood cells

 

White blood cells

Transportation

Protection

 

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Match words with definitions 

Connective tissue

Reticular fibers (fibres: UK)

Tendons

White blood cells

Immune system

Thrombosis

Muscle

Blood

Endogenous

Sweat

   

a.

An infection that comes from within the body.

   

b.

Lymphocytes, phagocytes that destroy infectious organisms.

   

c.

Tissue is concerned with movement.

   

d.

An example of a liquid connective tissue.

   

e.

During tissue repair platelets promote this.

   

f.

Connects body parts to one another.

   

g.

Stringy structures within dense connective tissue.

   

h.

A chemical barrier against infection.

   

i.

Forms the internal skeleton of soft organs such as the spleen.

   

j.

Integrated collection of organs and cells that protect the body from disease.

QUESTION 2

More than 70 micro-organisms have been identified as capable of causing serious disease in man. List and describe the four types of micro-organisms that cause disease. Your response should be at least 75 words in length. 

QUESTION 3

Describe the processes of cell reproduction. List and provide brief explanations of the stages and phases that are involved.

Your response should be at least 300 words in length.
 

 

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