Write a report on the application of population health
improvement initiative outcomes to patient-centered care, based
on information presented in an interactive multimedia scenario.
In this assessment, you have an opportunity to apply the tenets
of evidence-based practice in both patient-centered care and
population health improvement contexts. You will be challenged
to think critically, evaluate what the evidence suggests is an
appropriate approach to personalizing patient care, and
determine what aspects of the approach could be applied to
similar situations and patients.
SHOW LESS
By successfully completing this assessment, you will
demonstrate your proficiency in the following course
competencies and assessment criteria:
Competency 1: Apply evidence-based practice to plan patient-
centered care.
Evaluate the outcomes of a population health improvement
initiative.
Develop an approach to personalizing patient care that
incorporates lessons learned from a population health
improvement initiative.
Competency 2: Apply evidence-based practice to design
interventions to improve population health.
Propose a strategy for improving the outcomes of a population
health improvement initiative, or for ensuring that all outcomes
are being addressed, based on the best available evidence.
Competency 3: Evaluate outcomes of evidence-based
interventions.
Propose a framework for evaluating the outcomes of an
approach to personalizing patient care and determining what
aspects of the approach could be applied to similar situations
and patients.
Competency 4: Evaluate the value and relative weight of
available evidence upon which to make a clinical decision.
Justify the value and relevance of evidence used to support an
approach to personalizing patient care.
Competency 5: Synthesize evidence-based practice and
academic research to communicate effective solutions.
Write clearly and logically, with correct grammar and
mechanics.
Integrate relevant and credible sources of evidence to support
assertions, correctly formatting citations and references using
APA style.
Evidence-Based Practice
Devine, D. A., Wenger, B., Krugman, M., Zwink, J. E.,
Shiskowsky, K., Hagman, J., . . . Reeves, C. (2015).
Part 1: Evidence-based facility design using transforming care
at the bedside principles [PDF]
.
JONA: The Journal of Nursing Administration
,
45
(2), 74–83.
Jeffs, L., Beswick, S., Lo, J., Campbell, H., Ferris, E., &
Sidani, S. (2013).
Defining what evidence is, linking it to patient outcomes, and
making it relevant to practice: Insight from clinical nurses
.
Applied Nursing Research
,
26
(3), 105–109.
Krugman, M., Sanders, C., & Kinney, L. J. (2015).
Part 2: Evaluation and outcomes of an evidence-based facility
design project
.
JONA: The Journal of Nursing Administration
,
45
(2), 84–92.
Rice, M. J. (2013).
Evidence-based practice: A model for clinical application
.
Journal of the American Psychiatric Nurses Association
,
19(
4), 217–221.
Evidence-Based Practice in Nursing & Health Sciences: Review
Levels of Evidence
.
Evidence-Based Practice in Nursing & Health Sciences
.
Research Guides
Nursing Masters (MSN) Research Guide
.
Database Guide: Ovid Nursing Full Text PLUS
.
Kaplan, L. (n.d.).
Framework for how to read and critique a research study
. Retrieved from
https://www.nursingworld.org/~4afdfd/globalassets/practiceand
policy/innovation--evidence/framework-for-how-to-read-and-
critique-a-research-study.pdf
Assessment InstructionsPreparation
In this assessment, you will base your Patient-Centered Care
Report on the scenario presented in the Evidence-Based Health
Evaluation and Application media piece. Some of the writing
you completed and exported from the media piece should serve
as pre-writing for this assessment and inform the final draft of
your report. Even though the media piece presented only one
type of care setting, you can extrapolate individualized care
decisions, based on population health improvement initiative
outcomes, to other settings.
Requirements
Note:
The requirements outlined below correspond to the grading
criteria in the scoring guide, so be sure to address each point. In
addition, you may want to review the performance level
descriptions for each criterion to see how your work will be
assessed.
Writing, Supporting Evidence, and APA Style
Write clearly and logically, using correct grammar and
mechanics.
Integrate relevant evidence from 3–5 current scholarly or
professional sources to support your evaluation,
recommendations, and plans.
Apply correct APA formatting to all in-text citations and
references.
Attach a reference list to your report.
Report Content
Address the following points in a 4–6 page report:
Evaluate the expected outcomes of the population health
improvement initiative that were, and were not, achieved.
Describe the outcomes that were achieved, their positive effects
on the community's health, and any variance across
demographic groups.
Describe the outcomes that were not achieved, the extent to
which they fell short of expectations, and any variance across
demographic groups.
Identify the factors (for example: institutional, community,
environmental, resources, communication) that may have
contributed to any achievement shortfalls.
Propose a strategy for improving the outcomes of the population
health improvement initiative, or ensuring that all outcomes are
being addressed, based on the best available evidence.
Describe the corrective measures you would take to address the
factors that may have contributed to achievement shortfalls.
Cite the evidence (from similar projects, research, or
professional organization resources) that supports the corrective
measures you are proposing.
Explain how the evidence illustrates the likelihood of improved
outcomes if your proposed strategy is enacted
Develop an approach to personalizing patient care that
incorporates lessons learned from the population health
improvement initiative outcomes.
Explain how the outcomes and lessons learned informed the
decisions you made in your approach for personalizing care for
the patient with a health condition related to the population
health concern addressed in the improvement initiative.
Ensure that your approach to personalizing care for the
individual patient addresses the patient's:
Individual health needs.
Economic and environmental realities.
Culture and family.
Incorporate the best available evidence (from both the
population health improvement initiative and other relevant
sources) to inform your approach and actions you intend to take.
Justify the value and relevance of evidence you used to support
your approach to personalizing care for your patient.
Explain why your evidence is valuable and relevant to your
patient's case.
Explain why each piece of evidence is appropriate for both the
health issue you are trying to correct and for the unique
situation of your patient and their family.
Propose a framework for evaluating the outcomes of your
approach to personalizing patient care.
Ensure that your framework includes measurable criteria that
are relevant to your desired outcomes.
Explain why the criteria are appropriate and useful measures of
success.
Identify the specific aspects of your approach that are most
likely to be transferable to other individual cases.
Note
: Faculty may use the
Writing Feedback Tool
when grading this assessment. The Writing Feedback Tool is
designed to provide you with guidance and resources to develop
your writing based on five core skills. You will find writing
feedback in the Scoring Guide for the assessment, once your
work has been evaluated.
Has to be based on the scenario below:
Introduction
Public health improvement initiatives (PHII) provide invaluable
data for patient–centered care, but their research is often
conducted in a context different from the needs of any
individual patient. Providers must make a conscious effort to
apply their findings to specific patients' care.
In this activity, you will learn about a PHII, and explore its
application to a particular patient's care plan.
Back to top
Overview
You continue in your role as a nurse at the Uptown Wellness
Clinic. You receive an email from the charge nurse, Janie Poole.
Click the button to read it.
Good morning!
At last week's conference I spoke with Alicia Balewa, Director
of Safe Headspace. They're a relatively new nonprofit working
on improving outcomes for TBI patients, and I immediately
thought of Mr. Nowak. At his last biannual cholesterol
screening he mentioned having trouble with his balance. This
may be related to his hypertension, but he believes it's related to
the time he was hospitalized many years ago after falling out of
a tree, and expressed distress that this might be the beginning of
a rapid decline.
Ms. Balewa will be on premises next week, and I'd like to set
aside some time for you to talk.
— Janie
Back to top
Alicia Balewa
Director of Safe Headspace
Overview
Interview Alicia Balewa to find out more about a public health
improvement initiative that might apply to Mr. Nowak's care.
Interview:
I have a patient who might benefit from some of the
interventions for TBI and PTSD you recently studied. What
populations did your public health improvement initiative
study?
My father came home from Vietnam with a kaleidoscope of
mental health problems. That was the 1970s, when treatment
options for things like PTSD, TBI, and even depression were
very different. Since then there has been a lot of investment in
treatment and recovery for combat veterans. That's excellent
news for veterans in treatment now, but they're not looking at
my dad, and how his TBI and PTSD have affected him through
mid–life and now as a senior. That's why I started Safe
Headspace: to focus on older patients who are years or decades
past their trauma, and find ways to help them.
Which treatments showed the strongest improvement?
Exercise. We were able to persuade about half of our
participants — that's around 400 people, mostly men ages 45–80
— to follow the CDC's recommendations for moderate aerobic
exercise. Almost everyone showed improvement in mood,
memory, and muscle control after four weeks. After that a lot of
participants dropped out, which is disappointing. But of the 75
who stuck with it for another three months, muscle control
improved 15%, mood improved 22%, and short–to–medium term
memory improved 61%. We didn't specify what kind of
exercise, but we did ask them to record what they did every
week, so that data is available.
Second was medication and therapy. Most of our participants
didn't receive any kind of psychotherapy in the years
immediately following their trauma, so we had everyone
assessed by a team of psychotherapists. As a result of those
assessments, 40% of participants started on anti–depressant
medication and 9% started taking anti–psychotics. Those who
started taking medications now have regular contact with a
therapist to manage that care. With some help at home to stick
to the regimen, all but a few have successfully followed their
treatment plans. They've reported a 26% improvement in mood
over six months, and a 6% improvement in memory.
The third treatment I want to mention is meditation. We only
had a small group interested in trying it, but the results were
dramatic. We prescribed daily meditation at home, just 10 to 15
minutes, with a weekly hour–long guided group meditation for
all 23 participants. After three weeks we lost two to disinterest,
but the other 21 showed improvements of over 70% in mood and
memory, and 32% in muscle control.
Have you tried anything that hasn't worked?
Sure. There are memory exercises for patients in elderly care,
and things like Sudoku and crossword puzzles. We didn't see
any gains with those. Some of our participants preferred
strength training to aerobic exercise, and the only improvement
we saw in that group was in muscle control, but only 4%, which
is significantly less than the aerobic group.
I should also say that we were working with a willing group of
participants. They knew they needed help, and were motivated
to get it. One of the hurdles we see with veterans, especially in
older generations, is an unwillingness to acknowledge that they
have a problem. We haven't had to wrestle with that because
everyone who volunteers to participate wants to be there.
Your organization is intervening with people who have TBI and
PTSD simultaneously. We have a patient with moderate TBI
suffered almost 40 years ago, but no history of PTSD. Have you
separated your population and studied each separately?
We haven't, no. In some cases we could, for those who come in
with previous diagnoses and medical records. But we have
participants who either weren't diagnosed, were under–
diagnosed at the time, or don't have records to show us.
Back to top
Conclusion
As you've seen, a PHII can apply to a patient under your care.
But it's not always a perfect fit, and it's important to think
carefully about how your patient's condition, symptoms,
background, and experience compare to that of participants in a
PHII.
Write a report on the application of population health improveme.docx

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Write a report on the application of population health improveme.docx

  • 1. Write a report on the application of population health improvement initiative outcomes to patient-centered care, based on information presented in an interactive multimedia scenario. In this assessment, you have an opportunity to apply the tenets of evidence-based practice in both patient-centered care and population health improvement contexts. You will be challenged to think critically, evaluate what the evidence suggests is an appropriate approach to personalizing patient care, and determine what aspects of the approach could be applied to similar situations and patients. SHOW LESS By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Competency 1: Apply evidence-based practice to plan patient- centered care. Evaluate the outcomes of a population health improvement initiative. Develop an approach to personalizing patient care that incorporates lessons learned from a population health improvement initiative. Competency 2: Apply evidence-based practice to design
  • 2. interventions to improve population health. Propose a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence. Competency 3: Evaluate outcomes of evidence-based interventions. Propose a framework for evaluating the outcomes of an approach to personalizing patient care and determining what aspects of the approach could be applied to similar situations and patients. Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision. Justify the value and relevance of evidence used to support an approach to personalizing patient care. Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions. Write clearly and logically, with correct grammar and mechanics.
  • 3. Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Evidence-Based Practice Devine, D. A., Wenger, B., Krugman, M., Zwink, J. E., Shiskowsky, K., Hagman, J., . . . Reeves, C. (2015). Part 1: Evidence-based facility design using transforming care at the bedside principles [PDF] . JONA: The Journal of Nursing Administration , 45 (2), 74–83. Jeffs, L., Beswick, S., Lo, J., Campbell, H., Ferris, E., & Sidani, S. (2013). Defining what evidence is, linking it to patient outcomes, and making it relevant to practice: Insight from clinical nurses . Applied Nursing Research , 26 (3), 105–109. Krugman, M., Sanders, C., & Kinney, L. J. (2015). Part 2: Evaluation and outcomes of an evidence-based facility design project . JONA: The Journal of Nursing Administration
  • 4. , 45 (2), 84–92. Rice, M. J. (2013). Evidence-based practice: A model for clinical application . Journal of the American Psychiatric Nurses Association , 19( 4), 217–221. Evidence-Based Practice in Nursing & Health Sciences: Review Levels of Evidence . Evidence-Based Practice in Nursing & Health Sciences . Research Guides Nursing Masters (MSN) Research Guide . Database Guide: Ovid Nursing Full Text PLUS . Kaplan, L. (n.d.). Framework for how to read and critique a research study . Retrieved from https://www.nursingworld.org/~4afdfd/globalassets/practiceand policy/innovation--evidence/framework-for-how-to-read-and- critique-a-research-study.pdf Assessment InstructionsPreparation
  • 5. In this assessment, you will base your Patient-Centered Care Report on the scenario presented in the Evidence-Based Health Evaluation and Application media piece. Some of the writing you completed and exported from the media piece should serve as pre-writing for this assessment and inform the final draft of your report. Even though the media piece presented only one type of care setting, you can extrapolate individualized care decisions, based on population health improvement initiative outcomes, to other settings. Requirements Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance level descriptions for each criterion to see how your work will be assessed. Writing, Supporting Evidence, and APA Style Write clearly and logically, using correct grammar and mechanics. Integrate relevant evidence from 3–5 current scholarly or professional sources to support your evaluation, recommendations, and plans. Apply correct APA formatting to all in-text citations and references. Attach a reference list to your report.
  • 6. Report Content Address the following points in a 4–6 page report: Evaluate the expected outcomes of the population health improvement initiative that were, and were not, achieved. Describe the outcomes that were achieved, their positive effects on the community's health, and any variance across demographic groups. Describe the outcomes that were not achieved, the extent to which they fell short of expectations, and any variance across demographic groups. Identify the factors (for example: institutional, community, environmental, resources, communication) that may have contributed to any achievement shortfalls. Propose a strategy for improving the outcomes of the population health improvement initiative, or ensuring that all outcomes are being addressed, based on the best available evidence. Describe the corrective measures you would take to address the factors that may have contributed to achievement shortfalls. Cite the evidence (from similar projects, research, or professional organization resources) that supports the corrective measures you are proposing.
  • 7. Explain how the evidence illustrates the likelihood of improved outcomes if your proposed strategy is enacted Develop an approach to personalizing patient care that incorporates lessons learned from the population health improvement initiative outcomes. Explain how the outcomes and lessons learned informed the decisions you made in your approach for personalizing care for the patient with a health condition related to the population health concern addressed in the improvement initiative. Ensure that your approach to personalizing care for the individual patient addresses the patient's: Individual health needs. Economic and environmental realities. Culture and family. Incorporate the best available evidence (from both the population health improvement initiative and other relevant sources) to inform your approach and actions you intend to take. Justify the value and relevance of evidence you used to support your approach to personalizing care for your patient.
  • 8. Explain why your evidence is valuable and relevant to your patient's case. Explain why each piece of evidence is appropriate for both the health issue you are trying to correct and for the unique situation of your patient and their family. Propose a framework for evaluating the outcomes of your approach to personalizing patient care. Ensure that your framework includes measurable criteria that are relevant to your desired outcomes. Explain why the criteria are appropriate and useful measures of success. Identify the specific aspects of your approach that are most likely to be transferable to other individual cases. Note : Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.
  • 9. Has to be based on the scenario below: Introduction Public health improvement initiatives (PHII) provide invaluable data for patient–centered care, but their research is often conducted in a context different from the needs of any individual patient. Providers must make a conscious effort to apply their findings to specific patients' care. In this activity, you will learn about a PHII, and explore its application to a particular patient's care plan. Back to top Overview You continue in your role as a nurse at the Uptown Wellness Clinic. You receive an email from the charge nurse, Janie Poole. Click the button to read it. Good morning! At last week's conference I spoke with Alicia Balewa, Director of Safe Headspace. They're a relatively new nonprofit working on improving outcomes for TBI patients, and I immediately thought of Mr. Nowak. At his last biannual cholesterol screening he mentioned having trouble with his balance. This may be related to his hypertension, but he believes it's related to the time he was hospitalized many years ago after falling out of a tree, and expressed distress that this might be the beginning of a rapid decline.
  • 10. Ms. Balewa will be on premises next week, and I'd like to set aside some time for you to talk. — Janie Back to top Alicia Balewa Director of Safe Headspace Overview Interview Alicia Balewa to find out more about a public health improvement initiative that might apply to Mr. Nowak's care. Interview: I have a patient who might benefit from some of the interventions for TBI and PTSD you recently studied. What populations did your public health improvement initiative study? My father came home from Vietnam with a kaleidoscope of mental health problems. That was the 1970s, when treatment options for things like PTSD, TBI, and even depression were very different. Since then there has been a lot of investment in treatment and recovery for combat veterans. That's excellent news for veterans in treatment now, but they're not looking at my dad, and how his TBI and PTSD have affected him through mid–life and now as a senior. That's why I started Safe Headspace: to focus on older patients who are years or decades past their trauma, and find ways to help them. Which treatments showed the strongest improvement?
  • 11. Exercise. We were able to persuade about half of our participants — that's around 400 people, mostly men ages 45–80 — to follow the CDC's recommendations for moderate aerobic exercise. Almost everyone showed improvement in mood, memory, and muscle control after four weeks. After that a lot of participants dropped out, which is disappointing. But of the 75 who stuck with it for another three months, muscle control improved 15%, mood improved 22%, and short–to–medium term memory improved 61%. We didn't specify what kind of exercise, but we did ask them to record what they did every week, so that data is available. Second was medication and therapy. Most of our participants didn't receive any kind of psychotherapy in the years immediately following their trauma, so we had everyone assessed by a team of psychotherapists. As a result of those assessments, 40% of participants started on anti–depressant medication and 9% started taking anti–psychotics. Those who started taking medications now have regular contact with a therapist to manage that care. With some help at home to stick to the regimen, all but a few have successfully followed their treatment plans. They've reported a 26% improvement in mood over six months, and a 6% improvement in memory. The third treatment I want to mention is meditation. We only had a small group interested in trying it, but the results were dramatic. We prescribed daily meditation at home, just 10 to 15 minutes, with a weekly hour–long guided group meditation for all 23 participants. After three weeks we lost two to disinterest, but the other 21 showed improvements of over 70% in mood and memory, and 32% in muscle control. Have you tried anything that hasn't worked? Sure. There are memory exercises for patients in elderly care,
  • 12. and things like Sudoku and crossword puzzles. We didn't see any gains with those. Some of our participants preferred strength training to aerobic exercise, and the only improvement we saw in that group was in muscle control, but only 4%, which is significantly less than the aerobic group. I should also say that we were working with a willing group of participants. They knew they needed help, and were motivated to get it. One of the hurdles we see with veterans, especially in older generations, is an unwillingness to acknowledge that they have a problem. We haven't had to wrestle with that because everyone who volunteers to participate wants to be there. Your organization is intervening with people who have TBI and PTSD simultaneously. We have a patient with moderate TBI suffered almost 40 years ago, but no history of PTSD. Have you separated your population and studied each separately? We haven't, no. In some cases we could, for those who come in with previous diagnoses and medical records. But we have participants who either weren't diagnosed, were under– diagnosed at the time, or don't have records to show us. Back to top Conclusion As you've seen, a PHII can apply to a patient under your care. But it's not always a perfect fit, and it's important to think carefully about how your patient's condition, symptoms, background, and experience compare to that of participants in a PHII.