Overview

· Develop a data table that illustrates one or more underperforming clinical outcomes in a care environment of your choice. Write an assessment (3 pages) in which you set one or more quantitative goals for the outcomes and propose a change plan that is designed to help you achieve the goals.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.

Knowing what is the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients.

The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For, if we cannot effectively implement changes in practice or procedure, than our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.

This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.

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

· Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.

· Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.

· Competency 2: Develop change strategies for improving the care environment.

· Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.

· Justify the specific change strategies used to achieve desired outcomes.

· Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care.

· Explain how change strategies will lead to quality improvement with regard to safety and equitable care.

· Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.

· Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.

· Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.

· Communicate change plan in a way that makes the data and rationale easily understood and compelling.

· Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Assessment Instructions

· Scenario

Consider the current environment. This could be your current care setting, the care settings presented in the Vila Health: Using Evidence to Drive Improvement or Vila Health: Concept Maps as Diagnostic Tools media, or a care setting in which you are interested in working.

For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course (Vila Health: Using Evidence to Drive Improvement), a relevant data set that already exists (a data set from the case study you used as a basis for your Concept Map assessment, or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)

After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal.

Potential topics for this assessment could be:

· Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your Concept Map assessment. As a starting point you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”

· Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point you could ask yourself, “How could the care environment be changed to enhance coping?”

Once you determine the change you would like to make, consider the following:

· What data will you use to justify the change?

· How can the team achieve this change with a reasonable cost?

· What are the effects on the workplace?

· What other implementation considerations do you need to consider to ensure that the change strategy is successful?

· How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals?

· Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?

Instructions

Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation to better understand how each grading criterion will be assessed.

· Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.

· Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.

· Justify the specific change strategies used to achieve desired outcomes.

· Explain how change strategies will lead to quality improvement with regard to safety and equitable care.

· Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.

· Communicate the change plan in a way that makes the data and rationale easily understood and compelling.

· Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Additional Requirements

· Length of submission: 3 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.

· Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.

· APA formatting: Use the APA Paper Template linked in the Resources. An APA Template Tutorial is also provided to help you in writing and formatting your analysis. No abstract is required.

TRANSITION EVE CARE PLAN INSTRUCTIONS

· 3 Nursing diagnoses in priority from highest to lowest

· The highest priority nursing diagnosis is required to be broken down for the care plan.

· The highest priority nursing diagnosis should include:

· 3 interventions

· 3 goals

· 2 short-term

· 1 long-term

· Evaluation of Goals/Outcomes

· 2 met goals

· 1 unmet goal

· Stimuli

· 1-focal

· 1-conceptual/contextual

· 1-residual

· Subjective

· 2-3 verbal statements

· Objective

· 3-4 observable

· Teaching and Discharge Needs Related to Behaviors and Stimuli

· Please include all the teaching to help the patient transition from a facility, hospital, or even agency back to home. The point of teaching and discharge needs are to prevent patients from being re-hospitalized for the same issues. Think “disease management and preventing exacerbation”.

· Include: referrals for medical social worker, physical therapy, occupational therapy Etc.…if you think the patient will need additional rehab assistance while at home to become more stable.

· The first page of the care plan document is mainly data collection (assessment).

· On the second page you have a psychosocial section.

· Self-concept

· You must include any of the three: body image/religion/Erikson’s stages (Exp. Erikson’s stages are located in your Fundamentals book). At least one of the items has to be addressed.

· Role function

· What role did the patient most likely will need to transition to after diagnosis or impairment. (Exp. If the patient had a right lower leg amputation and his full-time job was a roofer. What adaptations will be needed for him to eventually function in day-to-day life such as: physical therapy, prosthetic, and/or infection management?

· Interdependence

· What are the patient’s support systems

· Community, family, spouse, job Etc.…

· Stimuli ( Review pages 5-6 of the Application of Roy’s Adaptation Modal {RAM} to get examples of what are needed for each of these categories). This paper was handed out on the first day of class.

· Focal

· Conceptual/contextual

· Residual

· Medications

· Name, dose, frequency, route, and nursing considerations (must be included).

· Laboratory and Diagnostic Studies.

· List abnormal values only.

· Teaching and Discharge Needs Related to Behaviors and Stimuli (examples given on page 1).

· On the third page focal, conceptual/contextual, and residual stimuli is mentioned again.

· Use the same information you entered on the second page for focal, conceptual/contextual and residual.

· This page should list your three priority diagnoses and break down the highest priority one.

· REMEMBER:

Enter all of the medications

· Do not forget the nursing considerations for each medication.

· Enter all of the abnormal labs or diagnostic test only used on the patient in the case study.

· Please make sure your name, instructor name, site name, and date are on all of the forms.

· You may use Jersey College for the clinical site and the next class date for the care plan date, which is 9/4/19.

· If you do not have the information from the case study or additional information page on the patient to enter in the data collection portion on page 1. Please place an N/A in the space. There should be no blank areas on the care plan.