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NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

Student Name

Capella University

NHS-FPX 6004 Health Care Law and Policy

Prof. Name:

Date

Training Session for Policy Implementation 

Greetings, nurses. My name is ______, and I welcome you all to today’s training session on policy implementation. Today’s session focuses on presenting the policy and practice guidelines proposed for Mercy Medical Center (MMC) to address the underperforming benchmark of foot examinations for diabetic patients. This session is essential for you as nurses to ensure the successful development and implementation of the policy and practice guidelines, improving clinical outcomes and organizational performance. 

Session Objectives 

The objectives of the presentation are as follows:

  1. Discuss the proposed policy and practice guidelines. 
  2. Elaborate on evidence-based strategies to collaborate with nurses for successful implementation. 
  3. Describe the implementation process and the impact on nurses’ roles and responsibilities. 
  4. Discuss the importance of the policy and practice guidelines to improve the quality of care and clinical outcomes. 
  5. Explain nurses’ role in successful implementation. 
  6. Determine effective learning content, activities, and materials for the training session. 

Proposed Policy and Practice Guidelines 

Evaluating MMC metrics against established benchmarks revealed an underperformance in all diabetic screening tests – eye, foot, and HBA1c. However, our proposal specifically covered foot examination as a significant aspect of diabetic screening to prevent diabetic neuropathy and leg amputation. We developed a succinct policy based on guidelines established by the Centers for Medicare & Medicaid Services (CMS) and the American Diabetes Association (ADA). The proposed policy is as follows: 

“The organization must conduct annual comprehensive foot examinations for type I and type II diabetic patients to recognize the predictive factors for foot ulcers and diabetic neuropathy. These examinations should include foot inspection, checking for the pulses, and testing foot sensations” (CMS, n.d.). 

Furthermore, some practice guidelines are developed to ensure healthcare providers have a blueprint for successful comprehensive foot examinations. These practice guidelines include patients’ history and general exam, neuropathy assessment, vascular assessment, and referral/follow-up. Patient history and general examination involved healthcare professionals (physicians and nurses) in gathering sufficient data about past ulcerations and leg amputations, along with gathering data about previous incidences of peripheral vascular disease.

NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

Moreover, assessing patients’ renal function is imperative to recognize the signs of disease progression and examine patients’ feet to identify deformities. Neuropathy assessment checks foot sensations using tuning fork vibration, ankle reflexes, and Vibration Perception Threshold (VPT). Next, the vascular assessment involves the evaluation of foot pulses to identify the signs of diabetic neuropathy and lack of tissue perfusion (ADA, n.d.). 

Based on these assessments, healthcare providers should decide whether the patient needs a referral or a follow-up according to the risk categories (RC). While RC 0 indicates zero risk of diabetic neuropathy, which means an annual examination will manage patients’ health condition, RC 1 is defined as losing protective sensation. Patients must receive an examination every three to six months. Additionally, RC 2 reflects sensation loss, deformities, and peripheral vascular disease.

This situation requires healthcare professionals to conduct tests every two to three months and refer patients to a vascular specialist. Lastly, RC 3 demonstrates that the patient has a previous history of ulceration or amputation and must get a foot examination by experts every 1-2 months (ADA, n.d; Nduati et al., 2022).

Evidence-based Strategies to Gauge Nurses’ Buy-in

Let us discuss the evidence-based strategies to actively involve nurses in successfully implementing the policy and practice guidelines. These strategies effectively garner nurses’ buy-in, improving clinical outcomes and organizational performance. Open communication channels, peer mentorship programs, and recognition and incentives programs are three distinct and effective strategies to achieve desired outcomes. 

  • Open Communication Channels: Skumsnes et al. (2023) claim the effectiveness of open communication channels, such as regular meetings and technological mediums, to enhance care coordination and promote providers’ engagement in the process. These channels will encourage nurses to voice their concerns and provide feedback on the policy and practice guidelines, ensuring they feel valued. This strategy promotes trust and reduces resistance, allowing nurses to participate actively to make the initiative successful and sustainable. 

NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

  • Peer Mentorship Programs: Mentorship brings several benefits, such as enhancing collaboration, accelerating information exchanges, creating supportive networking, and enhancing staff commitment (Gong et al., 2022). Mentors providing practical insights, addressing concerns, and guiding their peers facilitate a smooth transition into the newly proposed changes. This strategy promotes a successful understanding of the policy and practice guidelines, influencing successful implementation through peer support. 
  • Recognition and Incentives Program: Providing recognition through incentive programs involves rewarding nurses for constant compliance with the policy and practice guidelines. According to Gadsden et al. (2021), positive recognition motivates behavioral change and improves practices, enhancing staff commitment to the change. These incentives can range from acknowledgment to tangible rewards such as certificates, tokens of appreciation, and salary bonuses. 

Several indicators demonstrate the early achievement of nurse engagement and successful plan implementation. These include augmented adherence rate and positive feedback on policy and practice guidelines. Furthermore, improved clinical outcomes and increased employee satisfaction indicate that policy and practice guidelines are successfully implemented to achieve desired outcomes. Moreover, the organization’s maintenance of regulatory compliance, preserving accreditation, and minimal variation of MMC’s dashboard metrics to established benchmarks show that interprofessional teams collaborate and work productively to improve efficiency. 

Implementation and Impact of Policy and Practice Guidelines

Implementing the proposed policy and practice guidelines is a multifarious process influencing nurses’ unique roles, responsibilities, and daily work routines. The key steps involved in the implementation process are education and training, open communication channels, peer mentorship programs, and monitoring and evaluation of the progress. 

  • Training and Education: Training sessions based on the importance of policy and practice guidelines, the shared objectives, and the process of conducting comprehensive foot examinations will positively impact nurses’ engagement and qualify them to perform these tests competently. According to Jose et al. (2023), staff engagement and skill development are the primary results of effective educational training and clinical exposure. The organization must conduct training and education sessions to implement the changes successfully. 
  • Open Communication Channels: Another step is establishing transparent and open communication channels to address questions and provide ongoing support to the nurses. These channels include introducing technology and regular meetings (Skumsnes et al., 2023), which are essential to fostering transparent information exchange and a beneficial implementation environment. 
  • Peer Mentorship Programs: Another critical step that fosters collaboration among the nurses, advocated in the study by Gong et al. (2022). Establishing peer mentorship programs facilitates information exchanges, addresses nurses’ concerns, and creates a supportive network for the practical application of comprehensive foot examinations. 

NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

  • Monitoring and Evaluation: Lastly, monitoring and evaluation are essential to identify loopholes and make timely modifications to ensure seamless progression of the change implementation plan. The mechanisms to monitor and evaluate include gathering staff feedback, monitoring clinical outcomes, assessing adherence rates, and evaluating patient satisfaction scores. 

On the other hand, this implementation process profoundly impacts nurses’ daily work routines and responsibilities. Workflow, for instance, is an integral element that requires adjustment to incorporate the new practices for diabetic patients seamlessly. Nurses must change assessment protocols for diabetic patients, add to the documentation process, and collaborate with other healthcare professionals to make sound clinical decisions and positively impact patient outcomes (Rawlinson et al., 2021). Furthermore, new practices require nurses to manage their time effectively, especially when performing foot assessments for diabetic patients, to integrate the steps of comprehensive foot examination into daily routines. Lastly, the new policy and practice guidelines may necessitate skill development in specific areas.

Nurses must undergo training and education to ensure proficiency in executing the guidelines effectively, which is an additional task for nurses. Yet, there is a need to interpret the complex policy and practice guidelines into smaller steps for easy and successful implementation. Thus, effective communication is essential to share clear explanations and answer nurses’ concerns. 

Importance of Proposed Policy and Practice Guidelines 

Addressing underperforming foot examinations in diabetic patients is essential to prevent diabetic neuropathy, which is a common complication of diabetes. This results in foot ulcerations, pain, and leg amputation. According to Yang et al. (2020), approximately 50% of the diabetic population suffers from diabetic peripheral neuropathy, ultimately causing mortality. The proposed policy and practice guidelines emphasize proactive measures of regular and comprehensive foot examinations, leading to the early detection of complications. This early detection is imperative to prevent disease progression, improve the clinical outcomes of diabetic patients, and enhance the quality of care (Carmichael et al., 2021).

Another essential rationale behind these practice guidelines is establishing standards to ensure consistency in the delivery of healthcare services. This consistency reduces variations from established benchmarks, improving the quality of care and patient outcomes. Lastly, the proposed policy and practice guidelines ensure compliance with the regulatory standards. Non-adherence to these standards may risk an organization’s accreditation and affect financial viability (Hussein et al., 2021), thus indicating the importance of these policies and practice guidelines. Therefore, the anticipated result of implementing the policy and practices is improving the quality of care and health outcomes for diabetic patients.  

Nurses’ Importance in Implementing the Policy and Practice Guidelines

The nurses are pivotal in successfully implementing the new policy and guidelines. As the frontline staff, nurses play a central role in patient care. Their active involvement ensures that comprehensive foot examination guidelines are seamlessly integrated into daily practices. Nurses’ engagement in policy-making and implementation influences the adherence to the guidelines due to a sense of ownership. This commitment improves organizational performance and positive patient outcomes (Inayat et al., 2023). Another influential role that nurses play is fostering interprofessional collaboration. With the support of nursing staff, we anticipate that other healthcare will be encouraged for successful implementation of the initiative, leading to compliance with established benchmarks. 

To empower nursing staff during the implementation, we envision nursing staff becoming the drivers of the change, demonstrating a commitment to evidence-based practice guidelines and patient-centered care. The nursing staff is well-known for their clinical expertise and collaborative spirit. This collaboration fosters a culture of continuous improvement and mounting patient satisfaction with healthcare services. Thus, the dedication and commitment from nurses not only influence patient outcomes but also hoists the organization’s reputation, positioning it as a beacon of quality healthcare services in the region.

Educational Resources for Training Sessions

In the last part of our presentation, we will discuss the educational resources to develop training sessions related to learning and skill development for nurses about implementing the policy and practice guidelines. 

  • Instructional Content: We plan to include a comprehensive overview of the new policy, practice guidelines, and their implications for nursing practice. This overview is essential for informed decision-making, fostering a sense of ownership, and instilling relevance in nursing practice. We will include case studies to relate the practice to real-life scenarios and theoretical understanding. These case studies are essential to enhance the practical application of knowledge and internalization of current practices to improve patient outcomes (Liu et al., 2020). 
  • Learning Activities: Activities include role-playing exercises and mentorship programs. Role-playing activities will foster effective communication skills and teamwork to navigate interpersonal challenges and develop skills to perform comprehensive foot examinations competently. Similarly, mentorship programs will help nurses learn from each others’ experiences and receive ongoing support during the implementation (Gong et al., 2022).
  • Materials: Training manuals and handbooks are necessary as reference material to guide nurses after training sessions in their clinical areas. Moreover, visual aids and infographics enhance understanding and retention of information and work as ongoing support. 

Conclusion 

In conclusion, Mercy Medical Center requires the successful execution proposed policy and practice guidelines related to foot examinations. We discussed the proposal and effective strategies to gauge nurses’ buy-in for these policies and practices throughout the presentation. Then, we elaborated on the implementation plan and the impact of the change proposal on nurses’ daily routines and roles. Next, we covered the importance of these policies and practice guidelines and nurses’ role in successful implementation. Lastly, we included the learning materials, content, and resources for the training sessions. I hope this session was informative for you all. You may ask your questions now. 

References 

ADA. (n.d.). The American Diabetes Association Comprehensive Diabetic Foot Exam Guidelines | American Diabetes Association. Professional.diabetes.org. https://professional.diabetes.org/webcast/american-diabetes-association-comprehensive-diabetic-foot-exam-guidelines-0 

Carmichael, J., Fadavi, H., Ishibashi, F., Shore, A. C., & Tavakoli, M. (2021). Advances in screening, early diagnosis and accurate staging of diabetic neuropathy. Frontiers in Endocrinology12, 671257. https://doi.org/10.3389/fendo.2021.671257 

CMS (n.d.). Diabetes: Foot Exam. Qpp.cms.gov. https://qpp.cms.gov/docs/ecqm-specs/2017/EC_CMS123v5_NQF0056_Diab_Foot/CMS123v5.html#:~:text=The%20foot%20examination%20should%20include 

Gadsden, T., Mabunda, S. A., Palagyi, A., Maharani, A., Sujarwoto, S., Baddeley, M., & Jan, S. (2021). Performance-based incentives and community health workers’ outputs, a systematic review. Bulletin of the World Health Organization99(11), 805–818. https://doi.org/10.2471/BLT.20.285218 

Gong, Z., Van Swol, L. M., & Wang, X. (2022). Study on the relationship between nurses’ mentoring relationship and organizational commitment. International Journal of Environmental Research and Public Health19(20), 13362. https://doi.org/10.3390/ijerph192013362 

Hussein, M., Pavlova, M., Ghalwash, M., & Groot, W. (2021). The impact of hospital accreditation on the quality of healthcare: A systematic literature review. BMC Health Services Research21(1), 1057. https://doi.org/10.1186/s12913-021-07097-6 

NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

Inayat, S., Younas, A., Andleeb, S., Rasheed, S. P., & Ali, P. (2023). Enhancing nurses’ involvement in policy making: A qualitative study of nurse leaders. International Nursing Review70(3), 297–306. https://doi.org/10.1111/inr.12828 

Jose, A., Tortorella, G. L., Vassolo, R., Kumar, M., & Cawley, A. F. M. (2023). Professional competence and its effect on the implementation of healthcare 4. 0 technologies: Scoping review and future research directions. International Journal of Environmental Research and Public Health20(1). https://doi.org/10.3390/ijerph20010478 

Liu, L., Li, M., Zheng, Q., & Jiang, H. (2020). The effects of case-based teaching in nursing skill education: Cases do matter. INQUIRY: The Journal of Health Care Organization, Provision, and Financing57, 004695802096442. https://doi.org/10.1177/0046958020964421 

Nduati, J. N., Gatimu, S. M., & Kombe, Y. (2022). Diabetic foot risk assessment among patients with type 2 diabetes in Kenya. The East African Health Research Journal6(2), 196–202. https://doi.org/10.24248/eahrj.v6i2.698 

Rawlinson, C., Carron, T., Cohidon, C., Arditi, C., Hong, Q. N., Pluye, P., Peytremann-Bridevaux, I., & Gilles, I. (2021). An overview of reviews on interprofessional collaboration in primary care: Barriers and facilitators21(2), 32. https://doi.org/10.5334/ijic.5589 

Skumsnes, R., Thygesen, H., & Groven, K. S. (2023). Facilitators and barriers to communication in rehabilitation services across healthcare levels: A qualitative case study in a Norwegian context. BMC Health Services Research23(1), 1353. https://doi.org/10.1186/s12913-023-10222-2 

NHS FPX 6004 Assessment 3 Training Session for Policy Implementation

Yang, H., Sloan, G., Ye, Y., Wang, S., Duan, B., Tesfaye, S., & Gao, L. (2020). New perspective in diabetic neuropathy: From the periphery to the brain, a call for early detection, and precision medicine. Frontiers in Endocrinology10https://www.frontiersin.org/articles/10.3389/fendo.2019.00929 

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