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Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion – Preliminary Care Coordination Plan Example Paper

Selected Health Concern

Mental health has become a global concern in recent years. Despite the increasing incidence of this illness, stakeholders have not given it the necessary attention. The National Institute of Mental Health (2022) reports that one in five adults in the United States lives with a mental illness, representing about 52.9 million people in 2020. These people are afflicted with incapacitating impairments that substantially impact their daily lives.

As a result of this insurmountable, afflicted persons believe that their difficulties lack legitimacy because they are uncommon in contrast to other illnesses. Sufferers with apparent health impairments in their ability to accomplish numerous errands are treated with derision, whereas the general public views mental health patients as having irrelevant worries.

Despite the fact that mental health conditions and invulnerable health concerns may not be indicative of a successful life, success is frequently associated with the availability of community resources and treatment alternatives. In low-income countries, more than 75% of mental health patients go untreated, while 35 to 50 % of high-income patients do not seek medical care and go untreated (Qin & Hsieh, 2020). This trend has a negative impact on the fight against mental illness.

Additionally, more than $280 billion are lost annually in the United States providing services and treating mental health issues (The White House, 2022). Furthermore, according to the National Alliance on Mental Illness (2021), major depressive episodes, anxiety disorders, posttraumatic stress disorder, and bipolar disorder are leading causes of hospitalization for adults. Consequently, mental health problems remain a global hazard.

In addition, these diseases influence numerous social and economic areas. Among other aspects of life, mental health illnesses affect a person’s schooling abilities, work chances, and ability to maintain healthy interpersonal relationships. Therefore, seeking medical care and utilizing available community services is essential to living a mentally healthy life. In this view, the purpose of this project is to focus on a community member with a mental health disorder. The study’s primary objective is to design a care coordination plan.

The case patient has a mental illness (a depressive episode). During the evaluations, it becomes apparent that his family and acquaintances are willing to care for him. However, their assistance is insufficient, and they fail to comprehend the patient’s financial constraints in meeting his family’s demands. In addition, the patient sets unrealistic ambitions to conserve most of his resources, leaving his family with inadequate financial assistance. He desires to spend as little as possible on his healthcare. The patient’s worries necessitate discussing with mental health care specialists and developing a treatment plan appropriate to the community’s existing resources.

Community Resources Available for Effective and safe Care Continuum

The patient can benefit from a variety of support services aimed to help patients achieve mental health. First, Mental Health America (MHA) is committed to promoting mental health wellness by providing early identification and interventions for people at risk, integrating support, care, and services, with the sole goal of mental wellness recovery. It provides an affiliate network of mental health organizations to influence public policy and ensure access to reasonable and effective care for the vast number of mental health patients in the United States.

Operating in 42 states and with more than 200 affiliates, the MHA’s affiliate network is committed to providing assistance and advocacy to all individuals affected in all communities throughout the United States (Mental Health America (MHA), 2022).  The affiliates provide outstanding programs and services specifically designed to address the needs of an area. The case patient can access information, mental health care, and a rehabilitation program through the affiliate network of the Mental Health Association.

Other resources include Substance Abuse Treatment Facility Locator, which assists individuals in locating programs with affordable payment options and links to support institutions. In addition, the National Suicide Prevention Lifeline provides vital support to those with mental health by connecting them to a local crisis center where they can seek emergency care. There is a toll-free number for this service. Therefore, one can select the choice that best meets their needs from among these options. However, he needs assistance in recognizing the existence of such resources and gaining access to them.

The Care Coordination Plan

Given the delicate nature of mental health issues, it is crucial to utilize effective and evidence-based approaches supported by the best clinical expertise, evidence, and research to give the highest possible level of care. A suitable intervention must be effective, well-defined, consider the patient’s goals, and comply with society norms (Lyon & Bruns, 2019). In addition, it should not be prohibitively expensive and should be adaptable to changing demands from patients and the community. According to this point of view, the healthcare professional and the patient need to work together to establish health goals that both parties are comfortable with.

The patient identified for this case resides within New York City. We planned an interview in two weeks and identified several objectives. One of them is to identify individuals who can offer unconditional support. Since his family is reluctant to provide support, the patient is encouraged to engage in social activities to help him identify new persons who can offer invaluable support.

Nevertheless, the relatives are also encouraged to adopt a more accepting and supportive attitude towards the patient. This would go a long way in enhancing the patient’s mental health and general well-being. Treating a patient in isolation from his family is doomed to fail. Therefore, incorporating the family members in the care coordination plan is vital.

Moreover, the patient is encouraged to value himself, avoid negative self-evaluation and criticism, and treat himself respectively. The patient should also be able to live without undue fear or guilt, work more productively and provide positive input to his family and community, establish more meaningful and healthy interpersonal relationships, accurately appraise reality, and attain a self-defined spiritual view.

These goals are all realistic and achievable. After identifying them, the patient should gradually focus on how to achieve them. Whenever he encounters unprecedented or considerably weighing down challenges, the patient should seek the available support from resources and personnel. He should also adhere to any prescribed treatment and therapeutic activities. Lastly, the patient should adopt healthy coping mechanisms to stress to avoid relapses and further deterioration of his state.

Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion References

Lyon, A. R., & Bruns, E. J. (2019). From Evidence to Impact: Joining Our Best School Mental Health Practices with Our Best Implementation Strategies. School Mental Health. https://doi.org/10.1007/s12310-018-09306-w

Mental Health America (MHA). (2022). About Mental Health America. Mental Health America. https://mhanational.org/about

National Alliance on Mental Illness. (2021). Mental health by the numbers. Nami.org; National Alliance on Mental Illness. https://www.nami.org/mhstats

National Institute of Mental Health. (2022, January). Mental Illness. https://www.nimh.nih.gov/health/statistics/mental-illness

Qin, X., & Hsieh, C.-R. (2020). Understanding and Addressing the Treatment Gap in Mental Healthcare: Economic Perspectives and Evidence From China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 57, 004695802095056. https://doi.org/10.1177/0046958020950566

The White House. (2022, May 31). Reducing the Economic Burden of Unmet Mental Health Needs. The White House. https://www.whitehouse.gov/cea/written-materials/2022/05/31/reducing-the-economic-burden-of-unmet-mental-health-needs/

Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion Instructions

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.

NOTE: You are required to complete this assessment before Assessment 4.

The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for a hypothetical individual in your community as you consider the hypothetical patient’s unique needs; the ethical, cultural, and physiological factors that affect care; and the critical resources available in your community that are the foundation of a safe plan for the 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.

Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion – DEMONSTRATION OF PROFICIENCY

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.

PREPARATION for Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion

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.

Capella University NURS FPX 4050 Caring for Alzheimers Patient Discussion
INSTRUCTIONS

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.

Capella University BUS4802 Organizational Team Development Analysis

Integrate your understanding of change management and the use of the five disciplines for team development, based on your findings from your two team development sessions, to write an analysis of what you learned about change as a facilitator, and about yourself as a facilitator.

Include the following sections:

1. Theory of the five disciplines as a method of change: Describe a relevant theory of change management and two of the five disciplines. (You are not required to choose the same two theories that you used in your team sessions, but you may use them if you wish.)
   • Consider your audience as you choose your theory, and decide how to discuss it and what to present. Ideally, this audience would be the larger organization in which the team functions, but it could also be to the session team itself, members of an educational forum, or another group. Make judgment calls about the audience’s needs and setting. Note: After successfully completing this assessment, you may wish to actually present your paper to a professional audience at your organization, in order to demonstrate your own development.
   • Invent your own unique metaphor and use it to explain your chosen theory. That is, develop a graphic or verbal image of something familiar to explain an unfamiliar thing or process. An important part of considering an audience is to provide a powerful metaphor to help audience members understand and remember the relevant information. Causal loops and the ladder of inference are examples of graphic metaphors.
   • Capella University BUS4802 Organizational Team Development Analysis

1. Team development summary findings: Present your summary findings from the two team development sessions, in which you completed the team exercises.
   • Use the best stories and quotes from your session experiences to illustrate the disciplines and how they support change.
   • Synthesize your learning from the sessions about team dynamics and the value of the five disciplines for team development.
   • Illustrate some action statements made by your team and the subsequent changes you observed.
   • Capella University BUS4802 Organizational Team Development Analysis

1. What you have learned from facilitating both team-development sessions:
   • Write a section on your learning as a facilitator for the team development sessions. What worked? What did not work? What would you do differently next time?
   • How would you change your contract, your explanation of change management, the disciplines, the exercises, your exercise choices, or your behavior during the team sessions, in order to enhance the quality of the team learning?

1. Recommendations: Provide your recommendations for enhancing team development in the future in a way that is practical, justified, memorable, and actionable for your team and your audience (ideally, the larger organization to which the team belongs).
   • Include some of your best quotes and stories from your session experiences as examples.
   • Show how your recommendations for building more effective teams will help the audience move closer to its preferred future.
   • Capella University BUS4802 Organizational Team Development Analysis
   • Include some models from your learning about disciplines that support team learning.
   • Describe the potential power of using the five disciplines to support team learning.

1. Learning resources: To assist your team in learning more about the change management process, list a selection of books, articles, Web resources, and organizations containing the most important resources you would recommend.

Capella University BUS4802 Organizational Team Development Analysis ADDITIONAL REQUIREMENTS

• Written communication: Written communication is free of errors that detract from the overall message.
• APA formatting: References and citations are formatted according to current APA style and formatting guidelines.
• Length of paper: 10 to 15 typed, double-spaced pages.
• Font and font size: Arial, 12 point.
• Capella University BUS4802 Organizational Team Development Analysis

K.

P. J.

user-friendly tool kit for knowledge and process documentation.

Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session

Capella University NURS-FPX4020 Assessment 4 Quality Improvement Initiative Tool Kit Essay Example Approach

Medication administration errors are undesirable in healthcare facilities. The safety improvement plan of interest will focus on introducing barcode medication administration technology and a staff education program. The focus is reducing medication administration errors’ prevalence, thus improving patient safety and ensuring quality patient outcomes.

This improvement plan kit is divided into four themes: Evidence-Based Medication Error Prevention Strategies, Utilization of Healthcare Technologies, Education and Training, Communication and collaboration. The tool kit provides and explains how various resources under these themes will help implement and sustain a safety improvement plan initiative in a medical unit in a healthcare facility.

Evidence-Based Medication Error Prevention Strategies Annotated Bibliography 

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: a systematic review. Therapeutic Advances in Drug Safety, 11, 2042098620968309. https://doi.org/10.1177/2042098620968309

The article explores literature for interventions to reduce medication errors in healthcare facilities. The article supports the assertion that medication errors are the leading causes of death and harm globally, and the researchers compared the different activities in reducing medication errors with prescribing, administering, and supplying medication. The researchers analyzed results from six libraries and used statistical analysis to determine the success of these activities. The study results show that the most effective interventions include pharmacist-led reconciliations, prescriber education, medication reconciliation by trained mentors, and computerized physician order entry.

The study also showed that combined interventions such as CPOE and automated distribution systems have better outcomes than single technology interventions. Combining interventions is thus potentially effective, and thus, the result supports the safety improvement plan. The resource will help the nurses understand the importance and effectiveness of the chosen interventions in addressing medication errors and improving patient safety. The resource will also help the nurses select the best interventions to propose in addition to the selected safety improvement plan.

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. https://doi.org/10.1016/j.ijans.2020.100235

The study was conducted in Iran to identify the best interventions in medication error prevention in a hospital ward. The study was conducted using 16 nurses and one physician selected using purposive sampling, and data were collected using semi-structured interviews. The study results were categorized into acting professionally and presenting technical strategies.

In the ‘acting professionally theme,’ themes that appeared include reading the drug label, continuous training on medication administration, preventing errors, and awareness of the legal implications. Under the theme of ‘presenting technical strategies,’ themes most prominent were distinguishing high-risk drugs, medication safe-keeping, and skilled nurses administering drugs. The resource will help the nurses understand their responsibility and collaborative efforts in preventing medication errors. 

It will also help identify areas in their practices that require improvement and help them address these areas. It will also help them appreciate and select technical interventions to help reduce medication administration errors. The resource will also help us understand the importance of mixing technical strategies and professionalism in minimizing medication errors. The resource is vital to safety improvement because change begins with an individual, and understanding the basic activities that prevent errors can help nurses advance to better patient outcomes.

Ciapponi, A., Nievas, S. E. F., Seijo, M., Rodríguez, M. B., Vietto, V., García-Perdomo, H. A., Virgilio, S., Fajreldines, A. V., Tost, J., Rose, C. J., & Garcia-Elorrio, E. (2021). Reducing medication errors for adults in hospital settings. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.cd009985.pub2

This article evaluated the effectiveness of various interventions in preventing medication administration errors among adults admitted in a hospital setting. The researchers conducted a systematic review of studies investigating interventions aimed at medication error prevention. The study also evaluated other outcome measures such as adverse drug events, length of hospital stays, quality of life, mortality, and morbidity in all hospital care units. The research analyzed 65 studies and showed that medication reconciliation was the most common and effective intervention in medication administration error prevention. 

Other interventions with high efficacy included electronic prescribing systems, barcode medication administration, professional education, improved medication dispensing systems, and organizational policy changes. The study results show that interventions such as medication reconciliation, CPOE, CDSS, barcoding, and feedback and dispensing systems reduce medication administration errors and adverse drug events. The resource supports the safety improvement plans interventions, professional education, and BCMA are evidence-based interventions that are viable in preventing medication errors.

The resource compares the effectiveness of the various interventions in different studies. It helps determine their effectiveness based on the identified evaluation parameters. Using the information provided, nurses can analyze interventions and select the best intervention(s) based on their success in achieving the desired goals. This resource can be helpful to nurses who wish to evaluate an intervention to prevent medication administration errors in the hospital. The areas evaluated and discussed above can serve as a guideline to determine the impact of the intervention besides its effectiveness in medication administration error prevention. The resource can also be sued to help determine the compatible interventions required to produce quality outcomes among patients.

Utilization of Healthcare Technologies

Saleem, M. (2023). Barcode Medication Administration Technology to Prevent Medication Errors. Journal of the College of Physicians and Surgeons–Pakistan: JCPSP, 33(1), 107-108. https://doi.org/10.29271/jcpsp.2023.01.107

The study is a viewpoint proposing BCMA implementation to avoid adverse drug events. The resource gives an overview of BCMA, studies its effectiveness, and evaluates challenges associated with its implementation of BCMA. The article aims to improve BCMA awareness and oversee its implementation in care facilities. The literature review in the study shows that BCMA improves patient safety by decreasing the rate of adverse drug events and transcription errors.

BCMA requires the institution to implement supporting technologies, particularly CPOE, to ensure all medications are available in the system and any errors between prescription and administration are easily discovered. Barcode medication administration is a viable technology for reducing mortality and morbidity related to preventable medication administration errors.

The resource is crucial to the safety improvement plan. It has vast information on the state of the art of BCMA and its application to improve medication administration safety in healthcare facilities. The study depicts BCMA as a clinical decision support system that will assist nurses in administering medications flawlessly. One of the technology’s limitations is detecting errors that occurred before the entry of the CPOE.

The technology also requires a functional health information system and other medication error prevention technologies such as CPOE and CDSS. Given the protocol outlined in this study, the resource can be used to educate nurses on how to implement the BCMA technology in the facility. Thus, this resource is crucial to ensuring the successful implementation of the safety improvement plan.

Naidu, M. & Alicia, Y. L. (2019). Impact of barcode medication administration and electronic medication administration record system in clinical practice for an effective medication administration process. Health, 11(05): 511. https://doi.org/10.4236/health.2019.115044 .

The study notes that change interventions are directed toward creating a new norm in healthcare facilities. The study was implemented to determine the outcomes of using BCMA and electronic medication administration systems (e-MAR), as well as clinical practices, policies, and processes that affect nurses’ medication administration processes in clinical settings.

A literature review during the study revealed that provision guidelines increase compliance with BCMA implementation. Studies also reported significant improvement in medication error reduction during the period. In addition, adding e-MAR to BCMA increased its efficiency and efficacy in error prevention. The study also explores the advantages and disadvantages of BCMA and e-MAR, strategies for developing BCMA and e-MAR systems, and the implementation process and potential challenges and their management.

This resource will be crucial to the team in implementing the BCMA technology and considering other backup technologies for increased efficiency. The study supports implementing BCMA as a viable technology for preventing medication errors. The study will be an integral resource for the nurses as it will help them evaluate the BCMA critically before implementation. Reviewing the advantages and disadvantages and weighing them in the organizational context will help determine if it is a viable innovation for the healthcare facility.

In addition, the resource will provide nurses with a step-by-step process for developing, implementing, and evaluating the BCMA intervention. In addition, it will provide vital information that will help predict and identify challenges and address them for the successful implementation of the project. Thus, the resource supports the safety improvement plan and will help implement the plan.

Broome, R. G., Thomas, M., Jones, C., & Sneha, S. (2020). Exploring BCMA compliance in an acute care community hospital. Nursing Management, 51(11), 32-38. https://doi.org/10.1097/01.NUMA.0000719412.67108.17

The researchers note that it has been established in earlier studies that BCMA is a viable technology for eliminating medication administration errors. However, few studies address the rates of care providers’ adherence to the technology or strategies to ensure adherence and ensure facilities reap the maximum benefits of the technologies. The study evaluated a BCMA implementation project developed to ensure that all six medication rights are appropriately implemented in medication administration. The project’s adherence rate was 99.77 compared to the 99 national benchmarks.

Many factors affect the adherence rate, and the rate varies significantly in other healthcare facilities. The researchers noted that the significant factors affecting adherence to the technology include unscannable QR codes, patients with several risk assessment wristbands, drained batteries, patient PIB removal or damage to the PIB, medications without barcodes, damaged barcodes, unreadable barcodes and improper barcode placement by the pharmacy department.

Recommended change interventions include adding drop-down menu options in the HER, implementing a handheld wireless scanner, improving maintenance of the AMU machine, and other strategies to address these issues. The study is thus resourceful and can help predict barriers to compliance success and present their management options. The resource provides vital information that can be used to help improve the proposed change interventions. The resource will enhance the nurses’ knowledge of barriers to BCMA technology compliance and success and strategies to address the barriers. The resource will thus help implement and comply with the safety improvement plan.

Nurses Education and Training

Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2022). Nursing interventions to reduce medication errors in pediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62, e139-e147. https://doi.org/10.1016/j.pedn.2021.08.024

There are numerous organizational, systematic, technological and personal interventions to prevent medication errors. They all have varying degrees of success and compatibility based on the organization, unit, or need (causal factors). The study aimed to identify nursing interventions to reduce medication administration errors. The systematic review analyzed 18 studies that met the predetermined inclusion criteria. The studies analyzed were from various countries, the majority being from the US, thus providing a better representation of global perspectives and interventions in preventing medication errors.

An analysis of the studies showed that the primary interventions include education programs, medication information services, pharmacists’ involvement/medical reconciliation, double checking, and smart pumps. Education interventions were identified in 13 out of 18 of the studies, showing that they are the most common interventions in healthcare. A meta-analysis showed that education programs have an associated sixty-four percent reduction in medication administration errors after implementation.

The study notes that medication administration safety is a multifaceted problem, and medication safety education is essential to care interventions. According to the study, care providers must identify the causes of errors before implementing care interventions. The resource supports the implementation of a staff education program and the implementation of care interventions based on the causes of errors being addressed. The resource will allow nurses to compare the effectiveness of various care methods against staff education. It will also lead nurses to evaluate the causes of medication errors before implementing the best care interventions.

Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Farha, R. A., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: a focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78-86. https://doi.org/10.1093/jphsr/rmaa025

Medication administration is a primary nursing role, and the government endeavors to ensure individuals remain healthy and free from physical and psychological suffering, such as that associated with medication administration errors. Thus, a deep understanding of medication errors and clinical practices is vital for their management/ prevention. The researchers reviewed studies on medication errors from Google Scholar and other search engines. The review explores various areas of medication errors, such as classification, types, outcomes, reporting processes, and strategies to prevent medication errors.

The study is instrumental to the staff education program because it highlights the factors vital to preventing medication errors. The study also explains the evidence-based strategies that can be used to address the problem, such as independent double checks, standardizing procedures, documentation, keeping communication lines open, patient engagement, avoiding distraction, creating a blame-free culture, and organizational support in error reporting.

This resource will be integral to informing the content of the educational program. The resource is extensive and covers many domains of medication administration and its interception with the nursing profession. The themes discussed. An analysis of the best practices provided in this study will help determine which practices to include in the safety improvement plan besides the proposed changes. The resource will also form a vital framework that will guide how the two interventions in the safety improvement plan will be implemented. The resource will also provide interventions for continuous organizational improvement.

Lilley, L. L., Collins, S. R., & Snyder, J. S. (2022). Pharmacology and the nursing process E-Book. (10th Ed.) Elsevier health sciences.

The book is a resourceful intervention that explores the state of the art of pharmacology in nursing. The book has a topic dedicated to medication error prevention and response. The book also explores medication administration for the various systems and also routes. The book explores the various types of errors and their detection. It also explores the use of healthcare technologies such as BCMA, CDSS, CPOE and e-MAR in detecting and correcting medication errors.

The chapter also explores the significance of interprofessional collaboration in medication error prevention. It discusses in depth the steps nurses can take to address medication errors in various circumstances, such as overdose and medication side effects. Unlike studies, the book examines the concepts in depth. For example, it explains stepwise interventions such as administering antidotes, including their doses.

The book also presents a stepwise implementation of a preventive intervention for preventing medication errors. The book also discusses the ethical and legal issues in medication administration and issues hardly addressed by studies. The book notes that medication errors are undesirable and have legal implications for the patients, care providers and the facility. It also presents best practices in medication administration, such as utilizing medication administration companions and proper documentation to avoid the legal and ethical issues associated with medication administration. Thus, this resource will be significant to the nurses and help implement the safety improvement plan.

Interprofessional Education and Collaboration

Grimes, T. C., & Guinan, E. M. (2022). Interprofessional education focused on medication safety: A systematic review. Journal of Interprofessional Care, 1-19. https://doi.org/10.1080/13561820.2021.2015301

The study’s main aim was to evaluate interprofessional collaboration interventions’ design, delivery, and evaluation. The systematic review describes medication safety-focused interprofessional education. The focus themes were the learners’ opinions, satisfaction, and attitude towards interprofessional work. The most common groups identified in the study were nurses, physicians, and pharmacists. These professionals view medication safety from different perspectives but with the patients’ interests and hearts. The study shows that learners accept and adopt early medication safety interventions focused on an interprofessional team.

The study recommendations could be used in the safety improvement plan. The recommendations include the development of a standard curriculum, learner engagement, and quality and drive development. The care professionals working together must also have the skill set necessary before engaging in the interprofessional team. In addition, the education program should have a learning outcome and assessment approach predefined pre-implementation.

The resource will help the role group in various ways. The nurses can utilize the recommendations of this resource to implement the desired safety improvement plan. It will also help them prepare to implement the desired interventions. For example, the outcomes of the education plan and the assessment plan should be determined before and well-curated to ensure they measure the effectiveness of the education intervention. Thus, this resource will help implement the interventions and meet the desired goals.

Irajpour, A., Farzi, S., Saghaei, M., & Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of Education and Health Promotion, 8. https://doi.org/10.4103/jehp.jehp_200_19

Medication administration is a primary nursing role, but nurses are not the only professionals administering medications. Other care providers, such as pharmacists, physicians, and nurses, are also crucial in medication administration and error prevention. The study evaluated the effectiveness of an interprofessional education program on medication safety for nurses and physicians.

The study results showed a decrease in medication error rate post-implementation compared to pre-implementation. Interprofessional education helps improve interprofessional collaboration, which positively impacts care outcomes. Interprofessional teams bring different perspectives that ensure high-quality decisions, represent the interests of all healthcare professions, and holistically achieve patients’ needs. Thus, interprofessional education programs on medication safety can help reduce medication errors and improve patient safety.

The resource will help oversee the safety improvement plan implementation. The resource will help incorporate change interventions in the safety improvement plan. It will help the nurses incorporate other care providers to ensure quality outcomes. The nursing profession cannot be independent and must rely on other professionals’ input. The resource will help the nurses seek input from other professionals and use it to improve and implement the safety improvement plan.

Kim, S., Kim, H., & Suh, H. S. (2022, March). Priorities in the Prevention Strategies for Medication Error Using the Analytical Hierarchy Process Method. In Healthcare (Vol. 10, No. 3, p. 512). MDPI. https://doi.org/10.3390/healthcare10030512

The study was conducted to prioritize medication error prevention strategies. Various strategies cut across various units and have varying effectiveness and compatibility with the organization/institution wishing to implement them. The hierarchy structure implemented had three stages;’ goals of decisions, criteria, and alternatives. Ten experts were involved in the process.

In the decision criteria, the most selected criteria were system improvement over cultural and system improvement in the counterplan. The preferred alternative was a counterplan by facilities and culture change from a blame culture to a safety and reporting culture. A sensitivity analysis shows that priorities are robust based on organizational needs. The study recommends an analytical hierarchy process in selecting and prioritizing preventive strategies to address current needs and implement evidence-based strategies and policies to improve patient safety.

The resource will be vital in prioritizing interventions that involve creating effective interventions to manage the medication administration problem. Organizational needs may differ based on the settings of interest and the services offered by a facility. For example, this safety improvement plan focuses on medical units, and the needs in the medical units may differ from those in intensive care units hence the need for prioritization. The analytic hierarchy process will help prioritize the two priorities based on organizational needs or available resources. Healthcare resources are scarce, and the tool will help the nurses prioritize implementing the safety improvement plan initiatives based on their effectiveness.

Conclusion

Medication safety is an essential concept in the nursing profession and healthcare. Medication administration errors occur at the point of care and are caused by various factors that should be promptly addressed. Medication administration errors can be prevented using various interventions, and the selected interventions in this safety improvement plan are BCMA and an education program. The above resources support the interventions selected in the safety improvement plan and will guide the nurses in designing, implementing, and evaluating them. Healthcare institutions should focus on such improvement interventions to improve patient safety, satisfaction and ensure quality care outcomes.

Capella University NURS-FPX4020 Assessment 4 Quality Improvement Initiative Tool Kit Essay References

Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Farha, R. A., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: a focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78-86. https://doi.org/10.1093/jphsr/rmaa025

Broome, R. G., Thomas, M., Jones, C., & Sneha, S. (2020). Exploring BCMA compliance in an acute care community hospital. Nursing Management, 51(11), 32-38. https://doi.org/10.1097/01.NUMA.0000719412.67108.17

Ciapponi, A., Nievas, S. E. F., Seijo, M., Rodríguez, M. B., Vietto, V., García-Perdomo, H. A., Virgilio, S., Fajreldines, A. V., Tost, J., Rose, C. J., & Garcia-Elorrio, E. (2021). Reducing medication errors for adults in hospital settings. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.cd009985.pub2

Grimes, T. C., & Guinan, E. M. (2022). Interprofessional education focused on medication safety: A systematic review. Journal of Interprofessional Care, 1-19. https://doi.org/10.1080/13561820.2021.2015301

Irajpour, A., Farzi, S., Saghaei, M., & Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of Education and Health Promotion, 8. https://doi.org/10.4103/jehp.jehp_200_19

Kim, S., Kim, H., & Suh, H. S. (2022, March). Priorities in the Prevention Strategies for Medication Error Using the Analytical Hierarchy Process Method. In Healthcare (Vol. 10, No. 3, p. 512). MDPI. https://doi.org/10.3390/healthcare10030512

Lilley, L. L., Collins, S. R., & Snyder, J. S. (2022). Pharmacology and the Nursing Process E-Book. (10th Ed.). Elsevier health sciences.

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: a systematic review. Therapeutic Advances in Drug Safety, 11, 2042098620968309. https://doi.org/10.1177/2042098620968309

Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2022). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62, e139-e147. https://doi.org/10.1016/j.pedn.2021.08.024  

Naidu, M., & Alicia, Y. L. Y. (2019). Impact of barcode medication administration and electronic medication administration record system in clinical practice for an effective medication administration process. Health, 11(05), 511.https://doi.org/10.4236/health.2019.115044

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. https://doi.org/10.1016/j.ijans.2020.100235

Saleem, M. (2023). Barcode Medication Administration Technology to Prevent Medication Errors. Journal of the College of Physicians and Surgeons–Pakistan: JCPSP, 33(1), 107-108. https://doi.org/10.29271/jcpsp.2023.01.107

Capella University NURS-FPX4020 Assessment 4 Quality Improvement Initiative Tool Kit Essay Instructions

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.

Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard, Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical.

Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).

You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.

DEMONSTRATION OF PROFICIENCY for Capella University NURS-FPX4020 Assessment 4 Quality Improvement Initiative Tool Kit Essay

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

• Competency 1: Analyze the elements of a successful quality improvement initiative.
  • Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.
• Competency 2: Analyze factors that lead to patient safety risks.
  • Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.
• Competency 3: Identify organizational interventions to promote patient safety.
  • Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
  • Present compelling reasons and relevant situations for resource tool kit to be used by its target audience.
  • Communicate in a clear, logically structured, and professional manner, using current APA style and formatting.

References

Chard, R., Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329-342.

Kaminski, J. (2016). Why all

CAPS 400 The Deadly Bloom Sample Paper

Abstract

Alzheimer’s patients are suspected to have an increase level of Beta-methyl-amino-L-alanine (BMAA). BMAA is an environmental toxin produced by cyanobacteria and is linked to algae blooms. Found in sea creatures such as sharks, fish and shellfish that ingest algae, the neurotoxin is believed to trigger the neurodegenerative disease Alzheimer’s. The examiners performed an autopsy and removed the entire bran from forty deceased bodies. The deceased were separated into a control and experimental group. The experimental group consisted of twenty of the deceased who had diagnoses of Alzheimer’s while living and the remaining twenty had not victims of Alzheimer’s disease.

The brains were then placed in a cylinder filled with fluid to distinguish the average volume between the control and experimental group. The results came back to the experimental group suffering from brain atrophy and the control group having no brain atrophy. Medical examiners also used an enzyme-linked immonosorbent assay (ELISA) to disclose the presence of the toxin in the brain tissue of Alzheimer’s patients. The ELISA test proved that BMAA was present in eighteen of the brains of the deceased diagnosed with Alzheimer’s while living.

The findings also showed that BMAA was present in three of the healthy brains. To further understand the relation between Alzheimer’s and BMAA scientist should further investigate BMAA. More funding will go towards investigation. The safety information for seafood will contain both a safety summary and a complete toxicological profile. Exposure to BMAA should also decrease to reduce the cost of health care cost to Alzheimer’s.

Literature Review

Alzheimer’s disease is an illness that affects the brain and includes memory loss causing individuals to forget about loved ones and interfering with social skills. The disease attacks nerve cells of the brain, which then weakens a person’s ability to recall certain aspects of lives (Alzheimer’s Association, n.d). Having this complex illness interferes with daily routines, eating and taking medications have to be reminded by an aid or a family member. Impaired judgments, personality changes, annoyance are some of the symptoms (Web Md, n.d). Pictures, sticky notes are placed on items for remembrance.

Ranked number sixth leading cause of death in the United States, Alzheimer’s is irreversible (National Institute on Aging, 2016). Early onset Alzheimer’s occurs in people as young as thirty years old. Late onset Alzheimer’s occurs after sixty years old (NIH Senior Heath, 2015). The disease progresses slowly for some and faster for others. Mental abilities become compromised. Conversations are challenging as a result of compromised mental abilities (Alzheimer’s Association, n.d). It is categorized into three stages, mild, moderate and severe Alzheimer’s.

Individuals are diagnosed with the illness during mild Alzheimer’s. Driving and working are capable, however, during this stage a person is experiencing memory lapses. Family members start to take notice of struggles (Alzheimer’s Association, n.d). Close relatives notice difficulties with paying bills handling money and personality changes (National Institute on Aging, 2016). Doctors also detect problems in concentration and memory in this stage (Alzheimer’s Association, n.d).

The second stage is moderate Alzheimer’s. “Damage occurs in areas of the brain that control language, reasoning, conscious and sensory processing” (National Institute on Aging, 2016). Individuals require more help than the previous stage. There is an increase in memory loss, an urgency and uncontrollable time use the bathroom. Remembering names, faces and multitasking worsens. “At this stage people have hallucinations, delusions and paranoia” (National Institute on Aging, 2016). More time is spent with family members and not alone.

The final stage called severe Alzheimer’s is where assistance is needed at all times. Memory is compromised; people do not remember where they live or family member names, most times are spent in bed  “Plaques and tangles spread throughout the brain and brain tissue shrinks” (National Institute on Aging). Joining in conversations does not happen and personalities change dramatically (Alzheimer’s Association, n.d).

The ultimate way to diagnose Alzheimer’s is to perform an autopsy. Doctors look at the brain tissues of the deceases to out find whether plaques and tangles exist (NIH Senior Health, 2015). Neurologists can make a diagnosis by asking patients and family members a series of questions about past health; conduct a test to measure memory and a brain scan to look for any abnormalities in the brain (NIH Senior Health, 2015).

A person diagnosed with Alzheimer’s can live between ten or twenty years. Depending on the severity some can remain alive for less than three years (Holland, 2016). The cause of Alzheimer’s is genetic for most and idiopathic for others. . “Late-onset Alzheimer’s arises from a complex series of brain changes that occur over decades” (National Institute on Aging, 2016). Alzheimer’s can be inherited from a parent. A child with one parent carrying the gene has a 50/50 chance of inheriting the mutation and develop early onset Alzheimer’s (National Institute of Aging, n.d).

A major determinant for late onset Alzheimer’s is the apoliprotein E gene (APOE). “APOE is a cholesterol carrier that supports lipid transport and injury repair in the brain” (Nature Reviews Neurology, 2013). Patients who carry copies of APOE e4 have a higher risk of developing Alzheimer’s disease than patients who are carry APOE 3 (UC Irvine Institute n.d). “APOE lipoproteins bind to several cell-surface receptors to deliver lipids and also to hydrophobic amyloid-B peptide which is thought to initiate toxic events that lead to synaptic dysfunction and neurodegeneration in Alzheimer’s disease” (Nature Reviews Neurology, 2013).

Health and lifestyle factors induce the risk of Alzheimer’s. “Researcher suggests that a host of factors beyond genetics may play a role in the development of Alzheimer’s disease” (National Institute on Aging, 2016). Researchers mention that heart disease, stroke, high blood pressure and diabetes could play a role in increasing the risk of developing Alzheimer’s disease (National Institute on Aging, 2016).

Beta-methyl-amino-L-alanine (BMAA) can also increase the risk of Alzheimer’s disease. BMAA is an amino acid produced by cyanobacteria (Ethno Medicine, n.d). The toxin is found in sea creatures such as sharks, fish and shellfish that ingest algae. “BMAA is inserted into human proteins, causing them to misfold replaces amino acid serine in the protein sequence” (Ethno Medicine, n.d). Beta-methyl-amino-L-alanine replaces the amino acid serine. Serine is an amino acid that is important in the functioning of the brain and central nervous system (Vitamins stuff, n.d). Replacing serine causes protein aggregation and apoptosis (Ethno Medicine, n.d). BMAA is a trigger for Alzheimer’s in some people.

An estimated 5.5 million Americans are diagnosed with Alzheimer’s in 2017 (Alzheimer’s Association, n.d). 200,000 are estimated to be under the age of 65 and 5.3 million are 65 and over (Alzheimer’s Association, n.d). Two thirds of Alzheimer’s patients are women (Alzheimer’s Association, n.d). African Americans are twice as likely to have Alzheimer’s as Caucasians (Alzheimer’s Association, n.d). Hispanics are one and one-half as likely to have Alzheimer’s as older Caucasians (Alzheimer’s Association, n.d). “Today, someone in the United States develops Alzheimer’s every 66 seconds” (Alzheimer’s Association, n.d).

Alzheimer’s disease does not have a cure, however, individuals can take medications and participate in non-drug therapy (Alzheimer’s Association, n.d). Cholinesterase and memantine are used to stabilize the symptoms of Alzheimer’s temporarily (Alzheimer’s Association, n.d).

Cholinesterase inhibitors are used to help delay mild to moderate Alzheimer’s (National Institute on Aging, 2016). These medications include donespezil and galantamine. These medicines help reduce the symptoms and prevent them from getting worst for an amount of time (National Institute on Aging, 2016). Although taking inhibitors is helpful, cholinesterase may lose effects as a result of the disease progressing (National Institute on Aging, 2016).

To help moderate to severe Alzheimer’s doctors prescribe Namenda (memantine) (National Institute on Aging, 2016). These medications help maintain functions longer. While this can be helpful for most, medications and non-drug therapy do not reverse the damage Alzheimer’s has caused in the brain. The prescriptions provide a temporary relief from the symptoms (Alzheimer’s Association, n.d).

Doctors’ usually prescribed three different types of cholinesterase inhibitors; donespezil, is used to treat all stages of Alzheimer’s, Rivastigmine is used to treat mild to moderate Alzheimer’s and finally Galantamine is used to treat mild to moderate Alzheimer’s (Alzheimer’s Association, n.d).

Caring for someone with Alzheimer’s is estimated to be $60,000 a year. Depending on the family of the patients, a nursing home or private care is used. The cost of living in a nursing home is around $82,000 per year. Coverage is not always covered by insurance. Family members cover some of the cost (Hanes, 2012).

Alzheimer’s causes damage between the nerve cells in the brain and death of the nerve cells (National Institute on Aging, n.d). In the brain of a person with Alzheimer’s, the cortex and hippocampus shrink which injures the part of the brain that controls memory and thinking and the ventricles enlarge (Alzheimer’s Association, n.d). A magnetic resonance imaging (MRI) shows on average 0.44 percent of whole brain volume is lost in Alzheimer’s patients (ALZFORUM, n.d).

In a brain of an Alzheimer’s patient, amyloid plaques are piled up between the nerve cells. “Amyloid is a general term for protein fragments that the body produces normally” (Bright Focus Foundation, n.d). Someone with a healthy brain can eliminate them, however, in a brain of an Alzheimer’s person, these fragments become insoluble plaques (Bright Focus Foundation, n.d).

The brains also contain nerve cells containing tangles. “They primarily consist of a protein called tau, which forms part of a structure called microtubule” (Bright Focus Foundation, n.d). These proteins are not normal and the microtubule die out where tangles form (Bright Focus Foundation, n.d). Plaques do not stay in one place as Alzheimer’s progresses; they spread throughout the brain’s cortex. Depending on the stage at which a person is, the changes in the brain’s cortex very. (Alzheimer’s Association, n.d)

Methods and Materials

BMAA is a neurotoxin that has been linked to Alzheimer’s and other neurological diseases. To investigate the presence of BMAA and its correlation to Alzheimer’s diagnosis a research study was conducted. With the permission of family members doctors at the National Institute of Neurological Disorders and Stroke gathered forty brain tissue samples to complete their experiment. Twenty of the samples came from people that had been diagnosed with Alzheimer’s, were deceased and were named the experimental group the other twenty who died of other causes, were named the control group. To find out if BMAA is an underlying cause of Alzheimer’s autopsy was performed to the forty patients who were diagnosed with Alzheimer’s as well as the controls.

Standard procedures were used to remove the brains, which include “cutting the nerves to the blood vessels to the brain, the fibrous attachment to the skull and the nerves to the eyes,” (Encyclopedia, n.d). Twenty of the deceased had diagnoses of Alzheimer’s while living and the remaining twenty had not victims of Alzheimer’s disease. After obtaining the brains, pilling the lining of the surface of the brain from both the experimental and control group, data collection for both was obtained.

To confirm a correlation between the presence of BMAA and Alzheimer diagnoses medical examiners performed an autopsy and removed the entire brain from forty deceased bodies. Examining the external features of the brain to identify atrophy. The brains were then placed in a cylinder filled with fluid to distinguish the average volume between the control and experimental group. Using a knife, the examiner cut each brain in half to evaluate the difference between a healthy brain and an Alzheimer brain. Each brain was cut into smaller pieces to identify any similarities and differences (Gentleman, 2012).

The medical examiners used enzyme-linked immunosorbent assay (ELISA), which are used to detect the presence of antigen antibody in a sample (ELISA-antibody, n.d). The first step the examiners took in determining the presence of BMAA in the brain tissue was the use of standard solution. The medical providers added fifty microliters of solutions to the control and experimental group’s wells of the test strips. Secondly, the medical attendant added fifty microliters of enzyme conjugate to each wells using a pipette. Following, the addition of the enzyme conjugate, addition of fifty microliters of antibody solution was added to the individual wells. After the solution was added, tape was used to cover the wells then mixture of the contents was done, along with incubation for sixty minutes.

The fourth step in determining the presence of BMAA was removing the tape and disposing the contents into a sink. 250 microliters of washing buffer was used to clean the wells. Next, 100 microliters of substrate color solution was added to each wells. During this step, the examiners covered the wells with tape and mixed the contents together, then incubated for thirty minutes. The sixth step for the examiners was adding 100 microliters of stop solutions using a multi-channel pipette. The final step in determining the presence was to calculate the results” (Abraxis, n.d).

Health examiners were able to determine if BMAA was truly present in the brain of the experimental group. Also if its present in the brains of some of the control group.

Results

Upon Medical examiners could see obvious brain atrophy in the experimental group and the brains of the control group remained with no atrophy. “Neurofibrillary tangles and B-amyloid plaques are the neurological hallmarks of Alzheimer’s” (Cox, 2016). The doctors concluded that BMAA replaced the amino acid serine in human proteins and it led to the death of motor neurons (Ethno Medicine, n.d). The control group brain maintained the average length and volume associated with normal size while the experimental group had a decrease in brain volume.

Once the doctors placed the healthy brains in the cylinder, the liquid in rose approximately to 2800 centimeters cube on one of the tries. Using this number, examiners were able to subtract the brain volume, which is 1500 from 2800 (Shcupak, 2001). The lowest the water rose up to be 2600 cm3. The highest the fluid elevated to be 2900 cm3, which gave examiners the highest number.

The medical examiners used the same method to determine the volume of the experimental group. Since the brains of the experimental group were smaller, than those of the control group, the fluid in the cylinder did not rise as high. The health providers simply took the volume of a healthy brain and subtracted the level at which the fluid reached. The water rose up to 800 cm3 on the first try and the doctor subtracted 1500 from 800 to determine the volume. On the second try the water rose up to 770 cm3, on another try the water raised to 599 and the highest the fluid and brain rose up to 2501

Capstone Experience Assignment 4

Being a global health concern, nosocomial infection is a relevant topic. Factors contributing to its relevance include its impact on the general quality of life, mortality and morbidity (Ban et al., 2017). Despite various attempts to reduce the infections, the prevalence and incidences are still overwhelming. Recently, the World Health Organization projected that about 10% and 7% of all patients in developed and developing countries, respectively, will acquire at least one health-associated infection (HAI) in their lifetime (Meng et al., 2019).

The statistics have spurred worldwide efforts to reduce the occurrences of the infections. A common preventative intervention towards infections includes hand washing. Technology has been used to improve the efficacy of hand washing, such as through behavior monitoring systems (Meng et al., 2019). The paper addresses the main issue (HAI), interventions and expected outcomes in a PICO format.

Impact of Topic on Nursing Practice and Profession

Due to limited surveillance systems, the epidemiology of nosocomial infections is not well established. However, existing studies provide estimates of the burden of the infections, indicating a global health concern. The impact of the infections on nursing practice and the profession is evident. Studies have shown nearly the same 30-day mortality rate of about 10% in patients with the infections (Sikora & Zahra, 2020). Further, Sikora and Zaha (2020) note that critically ill patients tend to have an even greater mortality rate of 25% compared to other patients. The deaths cause dysphoria and demoralization of healthcare workers (Zheng et al., 2017).

Additionally, studies in German hospitals have confirmed that patients with HAI spend a lot more time in hospitals as compared to other patients (Sikora & Zahra, 2020). The prolonged hospital stay causes an increased burden on the healthcare sector and increased associated costs in managing infections (Sikora & Zahra, 2020). In the United States adult inpatient hospitals, circa $9.8 billion is estimated to be incurred in managing the infections. In addition to the associated complications, it is evident that the infections impact the nursing practice negatively. However, the subtle positive impact cannot be undermined since the burden of the infections has inspired increased efforts in the search for effective preventative strategies.

PICO Format

            The probable PICO question in this case is as follows: Does the contribution of behavior monitoring systems in hand washing, compared to direct observation methods, reduce nosocomial infections in a critical adult care unit among healthcare workers and patients? PICO is an evidence-based practice format used in framing and answering clinical questions. The P refers to the population or the problem. In this case, the issue is nosocomial infections, while the populations at risk are the healthcare workers and the patients.

I refer to the intervention in place to treat or mitigate the problem. The use of behavior monitoring innovations to improve hand hygiene adherence is the intervention studied. C is the comparison or the control intervention. In this case, a direct observation method is compared with the behavior monitoring systems. Further, O refers to the expected outcome. The intent of the interventions is to reduce the rate of nosocomial infections within the critical care unit. In this case, the PICO question helps explore the advantage behavior monitoring systems have over directly observed hand washing techniques.

According to Meng et al. (2019), direct observation is the gold standard for hand hygiene monitoring. However, it is costly and biased and the adherence or compliance rates are underwhelming. Therefore, technological innovations that are aimed at improving the adherence rates, such as behavior monitoring devices, are crucial. An example of such behavior monitoring systems include electronic sensors that counts, observe, and report hand hygiene adherence actions (Meng et al., 2019). Various studies have also proven the impact of technology in improving hand hygiene adherence and, ultimately, patient outcomes.

Conclusion

The quest for preventative interventions towards HAI is in progress. A commonly practiced preventative intervention includes hand washing; however, reports of adherence rates are underwhelming. To increase the efficacy of hand washing in the prevention of HAI, technology can be applied. Currently, addressed in the study are the behavior monitoring systems to improve hand washing adherence in a bid to increase the fight against nosocomial infections.

References

• Ban, K., Minei, J., Laronga, C., Harbrecht, B., Jensen, E., Fry, D., Itani, K., Dellinger, E., Ko, C., & Duane, T. (2017). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. Journal Of The American College Of Surgeons, 224(1), 59-74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029
• Meng, M., Sorber, M., Herzog, A., Igel, C., & Kugler, C. (2019). Technological innovations in infection control: A rapid review of the acceptance of behavior monitoring systems and their contribution to the improvement of hand hygiene. American Journal Of Infection Control, 47(4), 439-447. https://doi.org/10.1016/j.ajic.2018.10.012
• Sikora, A., & Zahra, F. (2021). Nosocomial Infections. Ncbi.nlm.nih.gov. Retrieved 19 January 2021, from https://www.ncbi.nlm.nih.gov/books/NBK559312/#_NBK559312_pubdet.
• Zheng, R., Lee, S., & Bloomer, M. (2017). How nurses cope with patient death: A systematic review and qualitative meta-synthesis. Journal Of Clinical Nursing, 27(1-2), e39-e49. https://doi.org/10.1111/jocn.13975

Capstone Experience Topic Sample Paper

Capstone Experience Topic (Nosocomial Infections)

            Infections and infectious diseases are some of the common conditions healthcare professionals deal with on a day-to-day practice. Within the hospital, patients can acquire infections that were not present during admission. Similarly, in the course of their work, healthcare providers can also contract infections. These infections are known as nosocomial infections or health associated infections (HAI). Sikora and Zahra (2020) define HAI as the infections that are acquired after admission and typically manifest 48-hours post hospitalization. The settings where the infections are acquired include hospitals, ambulatory settings and long-term care facilities (Sikora & Zahra, 2020). In modern care, the risk factors associated with the infections are indwelling devices, invasive surgical procedures, prosthetic devices and susceptible host such as immune compromised patients. Various pathogens implicated in the etiology of HAI are broadly classified into bacterial, viral and fungal.

Significance of the Topic

            The infections affect a massive number of patients worldwide making it a global healthcare concern. Healthcare settings in both the developed and developing countries face the burden of the HAI. Due to its associated prolonged hospital stay, morbidity, mortality and financial burden, it remains an unresolved predicament. A study by Khan, Baig and Mehboob, (2017) report that huge number of patients, approximately 15% of all hospitalized individuals, end up acquiring the infections. The infections cause adverse consequences particularly in neonates, with a mortality rate of 4%-56% (Khan et al., 2017). Studies from South East Asia and Sub Saharan Africa indicate an incidence rate of 75% among the neonates (Khan et al., 2017).

Further studies on the economic burden of HIA provide evidence that management of the infections is expensive. For instance, a study in the United States reveal that medical costs incurred towards management of surgical site infections due to Vancomycin resistant enterococci are about $12,766 (Puchter et al., 2018). Even though the statistics are available, worldwide burden is unknown due to the unavailable surveillance systems for nosocomial infections. The worldwide prevalence is however likely to be higher with greater burden as compared to the impact on the specific countries. The burden of the HAI is an adequate impetus for the quest of preventive strategies spearheaded by the World Health Organization.

References

• Khan, H., Baig, F., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal Of Tropical Biomedicine, 7(5), 478-482. https://doi.org/10.1016/j.apjtb.2017.01.019
• Puchter, L., Chaberny, I., Schwab, F., Vonberg, R., Bange, F., & Ebadi, E. (2018). Economic burden of nosocomial infections caused by vancomycin-resistant enterococci. Antimicrobial Resistance & Infection Control, 7(1). https://doi.org/10.1186/s13756-017-0291-z
• Sikora, A., & Zahra, F. (2020). Nosocomial Infections. NCBI. Retrieved 15 January 2021, from https://www.ncbi.nlm.nih.gov/books/NBK559312/#_NBK559312_pubdet

Capstone Reflection Scoring Guide Rubric

CRITERIANON-PERFORMANCEBASICPROFICIENTDISTINGUISHEDReflect on use of evidence and the literature to plan and implement a capstone project, and compare project outcomes to initial predictions based on a review of the literature.Does not reflect on use of evidence and the literature to plan and implement a capstone project nor compare project outcomes to initial predictions based on a review of the literature.Reflects on use of evidence and the literature to plan and implement a capstone project, or compares project outcomes to initial predictions based on a review of the literature but not both.Reflects on use of evidence and the literature to plan and implement a capstone project, and compares project outcomes to initial predictions based on a review of the literature.Reflects on use of evidence and the literature to plan and implement a capstone project, and compares project outcomes to initial predictions based on a review of the literature. Explains how evidence-based practice principles informed this aspect of the capstone project.Reflect on the degree to which health care technology was leveraged successfully to improve outcomes or communication to relevant stakeholders in a capstone project.Does not reflect on the degree to which health care technology was leveraged successfully to improve outcomes or communication to relevant stakeholders in a capstone project.Identifies, but does not reflect on success of, health care technology leveraged to improve outcomes or communication to relevant stakeholders in a capstone project.Reflects on the degree to which health care technology was leveraged successfully to improve outcomes or communication to relevant stakeholders in a capstone project.Reflects on the degree to which health care technology was leveraged successfully to improve outcomes or communication to relevant stakeholders in a capstone project. Notes opportunities to improve health care technology use in personal practice.Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project, as well as any contributions of the project to policy development.Does not reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project, nor on any contributions of the project to policy development.Identifies but does not reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project, nor on contributions of the project to policy development.Reflects on how organizational and governmental health policy influenced the planning and implementation of a capstone project, as well as any contributions of the project to policy development.Reflects on how organizational and governmental health policy influenced the planning and implementation of a capstone project, as well as any contributions of the project to policy development. Notes specific observations related to the BSN-prepared nurse’s role in policy implementation and development.Reflect on personal and professional growth throughout the capstone project and the BSN program, addressing the provision of ethical care and demonstration of professional standards.Does not address personal and professional growth throughout the capstone project and the BSN program.Describes but does not reflect on personal and professional growth throughout the capstone project and the BSN program or does not fully address the provision of ethical care and demonstration of professional standards.Reflects on personal and professional growth throughout the capstone project and the BSN program, addressing the provision of ethical care and demonstration of professional standards.Reflects on personal and professional growth throughout the capstone project and the BSN program, addressing the provision of ethical care and demonstration of professional standards. Notes specific growth areas of personal or professional pride.Communicate professionally in a clear, audible, and well-organized presentation, with correct grammar, spelling, and use of APA style.Does not communicate professionally in a clear, audible, and well-organized presentation, with correct grammar, spelling, and use of APA style.Communicates in a presentation that is unclear or inaudible, poorly organized, and/or contains errors in grammar, spelling, and/or use of APA style.Communicates professionally in a clear, audible, and well-organized presentation, with correct grammar, spelling, and use of APA style.Communicates professionally in an exceptionally clear, audible, and well-organized presentation, with flawless grammar, spelling, and use of APA style.

 

Resources:

Inter-professionalism

• Consider exploring the interprofessional collaboration video scenarios in this resource:
  • Interprofessional Professionalism Collaborative. (2018). IPA tool kit. Retrieved from http://www.interprofessionalprofessionalism.org/toolkit.html

Critical Reflection

• This article presents a framework for incorporating theory and evidence-based practice into reflection activities:
  • Kuennen, J. K. (2015). Critical reflection: A transformative learning process integrating theory and evidence-based practice. Worldviews on Evidence-Based Nursing, 12(5), 306–308.

Program and Library Resources

·         Writing Resources

Refer to the writing resources in the NHS Learner Support Lab, linked in the courseroom navigation menu, as you prepare your assessment.

APA Style and Format

The Writing Center’s APA Module can help you cite your references in correct APA style and format.

Library Resources

• BSN Program Library Research Guide.
• Databases A-Z: Nursing & Health Sciences.
• Evidence-Based Practice in Nursing & Health Sciences.
• Get Critical Search Skills.
• Library Research and Information Literacy Skills.