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NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Student Name

Capella University

NURS-FPX 4900 Capstone project for Nursing

Prof. Name:

Date

Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Globally, chronic bronchitis and emphysema are respiratory conditions that progress gradually over time (Adeloye et al., 2022). Chronic Obstructive Pulmonary Disease (COPD) is an obstruction ventilatory pattern and frequently shows signs of partial reversibility. Chronic respiratory failure can arise from COPD, a condition often linked to tobacco use. Smoking is a common hazard for the development of COPD (Ruvuna & Sood, 2020).

Indications of COPD include difficulty in breathing, coughing, and sputum production. An estimated 10.3 million clinic visits, 685,000 hospital admissions, and 1.6 million emergency department visits occur annually among adults with COPD in the US (Adeloye et al., 2022). Within 30 days of discharge, 25% of hospitalized COPD cases result in re-admission. By carefully analyzing leadership, cooperation, interaction, management change, and guidelines, medical personnel can identify barriers to COPD care (Zafari et al., 2020). This capstone project examines COPD issues and their effects on the elderly.

Problem Defining and its Significance

During a two-hour practicum session for this capstone project, I am assessing the issue of COPD. Robert’s COPD serves as the focal point of this project and holds significance for equally individual and skilled aspects in the healthcare setting. Robert, a 54-year-old patient with COPD, is the central focus. He has been readmitted to Wilmington Hospital, where I serve as a registered nurse. The patient’s admission is attributed to insufficient COPD management and exacerbations prompted by respiratory infections. Robert has severe COPD, classified as GOLD 3, with FEV in one second (FEV1) 40% of the predicted value, indicating significant airflow limitation. According to Robert’s family, he struggles to manage his respiratory levels due to inadequate lifestyle habits.

He typically engages in activities that exacerbate his COPD, such as exposure to respiratory irritants and smoking. He desires more complete support for his condition, making him careless with his lifestyle choices. To better understand his condition, I will contribute two practicum hours to monitoring his daily life, interacting with him, and examining his lifestyle choices and respiratory habits. This capstone project was created on Robert’s disease, as COPD is relevant to my practice.

Relevance of Problem

COPD is currently one of the leading causes of death globally, and in the years to come, its impact is projected to increase. Patients encounter sudden worsening of their indications, known as an exacerbation, which demands extra handling (Vogelmeier et al., 2020)Exacerbations of COPD and inadequate management significantly impact patients’ well-being, contributing to over 25% of lung function decline. These events result in insistent consequences like muscle weakness, reduced fitness, and limited outdoor activities, leading to patients becoming housebound and needing pulmonary rehabilitation. The burden of exacerbations is more pronounced in patients with multiple health issues, elevating the risks of heart attack, stroke, pulmonary embolism, and death (MacLeod et al., 2021). 

This emphasizes the significance of COPD as a considerable health concern in professional practice, emphasizing the need for early identification for improved treatment and prevention of COPD-related complications. Nurses play a vital role in patient care for COPD, offering awareness, education, and complete support. They provide patients with information on lifestyle changes, medication adherence, and self-management.

Timely intervention is aided by routine monitoring of lung function, vital signs, and symptoms (Baqdunes et al., 2021). As a baccalaureate nurse, I would treat patients with this health issue because it is relevant to my professional objectives. Nurses develop personalized care plans with interdisciplinary teams to enhance patient health. Nurses in complex community settings put into practice specialized evidence-based practices for COPD patients, understanding varied family dynamics and using caregiving abilities in demanding situations (Baqdunes et al., 2021).

Proof from Peer-Reviewed Literature and Qualified Sources

The main goal of nursing education initiatives is to provide COPD patients with the ability to recognize contaminants and evaluate the risk factors that lead to exacerbations. Interventions include alerts for outdoor activity and advice on avoiding allergens indoors (Mohler et al., 2020). Nurse-coordinated programs, like the Particulate Matter Education initiative (PME), showed long-term benefits for COPD patients by improving their knowledge of air pollution, managing symptoms, and indoor air quality. Improved COPD assessment test scores demonstrate how the program improved participants’ awareness of air quality and their knowledge of self-prevention, which positively impacted their surroundings (Sebastião et al., 2023).

Through effective self-management techniques, nurses play a critical role in improving the social, physical, and overall care experience for patients with COPD (Baker & Fatoye, 2019). Nurses instruct patients on symptom monitoring, customized exercise regimens, and inhaler techniques as part of nurse-led self-management for COPD. They lead support groups and offer advice on changing one’s lifestyle and quitting smoking. Nurses enable patients to exercise regimens to encourage more physical activity, which enhances lung function and general well-being. With expertise in information technology, nurses are essential to implementing and improving telerehabilitation. They also help to prevent COPD exacerbations and promote patient well-being (Syakura et al., 2020).

The Credibility of Resources and Barriers

The CRAAP criteria about Currency, Relevance, Authority, Accuracy, and Purpose provide a framework for evaluating evidence-based sources. All nursing actions referenced in recent research materials published within the last five years are reputable and authored by medical professionals. They deliver reliable insights into COPD disease management (Ghai et al., 2022). Measuring the consistency of possessions and understanding obstacles in nursing, particularly in Robert’s health, requires the application of the CRAAP criteria. Nurses use the CRAAP test to ensure the data they use to guide their interventions is up-to-date, relevant, and sourced from reliable sources. It is easier to avoid misinformation and customize interventions to the needs of patients when the accuracy and purpose of resources are evaluated (Ghai et al., 2022). 

The CRAAP test helps nurses manage COPD by helping them distinguish evidence-based practices and obstacles to providing adequate care. It guarantees that data on medication schedules, lifestyle advice, and respiratory therapies are current and backed by respected industry experts (Banayat et al., 2023). By implementing the CRAAP criteria, nurses can improve the standard of patient education, encourage treatment adherence, and reduce potential obstacles to effective COPD care. Outdated guidelines, uneven reimbursement policies such as Medicaid and Medicare policy, and a lack of integration of evidence-based practices into healthcare protocols can hinder the implementation of nursing theoretical frameworks for COPD, impeding optimal patient care. Nurses use this framework to inform evidence-based policies that support efficient healthcare procedures (Banayat et al., 2023). 

State Board Nursing Practice Standards

The American Nurses Association sets COPD care guidelines in compliance with state nursing practice acts. To treat COPD patients safely and effectively, nurses adhere to protocols. They address symptoms, encourage lifestyle management, and guarantee the best possible quality of life through interdisciplinary teamwork (Robert, 2019). The US Medicaid and Medicare programs, combined with the Affordable Care Act (ACA), substantially impact the nursing care provided to Robert COPD. The ACA promotes care coordination and improves access to preventive services (McGee & Breslin, 2020).

Medicare covers older people’s medical expenses, while Medicaid covers those with low incomes, including COPD patients. Through their influence on nursing roles in patient education, lifestyle modification, care coordination, and preventive measures such as stopping smoking, these programs help to shape healthcare policies and ensure that people with COPD receive comprehensive and easily accessible care (McGee & Breslin, 2020).

Effect of Policies on Nursing Practice

Policies like ACA, Medicaid, and Medicare enable nurses to manage COPD exacerbations. These regulations allow Robert to access prescription drugs, specialized care, and preventive services. To prevent exacerbations, nurses are essential in care coordination, education, and monitoring (Helvaci & Gok Metin, 2020). The policy framework directs nursing interventions, minimizing the incidence of exacerbations, promoting proactive COPD management like lifestyle modification, wearing masks, quitting smoking, and improving patient outcomes. These regulations are vital for nurses to comply with the recognized rules and ensure patients receive evidence-based, legitimate, and active treatment (Helvaci & Gok Metin, 2020)

Leadership Strategies

Leadership skills are essential for improving treatment results and patient satisfaction in the medical field. Regarding Robert’s COPD, a transformational leader can maximize the positive effects on his health by providing customized care and raising his level of satisfaction. Nurses and physiotherapists oversee COPD treatment plans (Nnate et al., 2021). 

Transformational leadership facilitates multidisciplinary team meetings and individualizes strategies for the disease’s physiological and emotional aspects. Healthcare professionals are taught evidence-based COPD management, cultural sensitivity, and practical interpersonal skills by leaders, including nurse leaders (Labrague et al., 2020). Robert’s healthcare experience is improved through individualized and improved care, which is ensured by regular training based on the most recent evidence. Because COPD affects people emotionally, medical professionals need to be careful when dealing with these people (Moon et al., 2019).

Role of Change Management Strategies

 Lewin’s model, a change management tactic, can be used in the medical field to manage Robert’s COPD. Improving clinical practice involves three steps. First is unfreezing, where nurses emphasize the value of COPD management while preparing patients for change through education and awareness campaigns. Change is the second part in which nurses apply evidence-based interventions, including lifestyle adjustments, medication adherence techniques, and individualized care plans (Saleem et al., 2019). This phase’s goals are to change how patients behave and promote teamwork.

Finally, refreezing and achieving COPD care goals such as promoting smoking cessation, maintaining healthy body weight, and improving airway clearance by breathing techniques necessitates changing management techniques and the cultural framework of traditional COPD therapy. Robert and I have spent the last two hours discussing the best way to manage Robert’s COPD based on his routines, circumstances, and medical history.

Conclusion

In conclusion, managing Robert’s severe COPD requires a comprehensive approach involving complete care, including indication nursing, lifestyle direction, medicine adherence, and interdisciplinary teamwork. Nurses play a crucial role in promoting patient well-being and preventing exacerbations. By applying Lewin’s model and considering evidence-based practices, nurses can address barriers and enhance COPD care, emphasizing the importance of personalized and proactive interventions for better patient outcomes.

References

Adeloye, D., Song, P., Zhu, Y., Campbell, H., Sheikh, A., & Rudan, I. (2022). Global, regional, and national prevalence of, and risk factors for, Chronic Obstructive Pulmonary Disease (COPD) in 2019: A systematic review and modelling analysis. The Lancet Respiratory Medicine10(5). https://doi.org/10.1016/s2213-2600(21)00511-7

Baker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: A systematic review of qualitative research. International Journal of Nursing Studies91(1), 22–34. https://doi.org/10.1016/j.ijnurstu.2018.12.004

Banayat, A. C., Challinor, J., & Sniderman, E. (2023). An expert evaluation of oncology website resources for use in pediatric oncology clinical nursing education in low-resource settings. Journal of Pediatric Hematology/Oncology Nursinghttps://doi.org/10.1177/27527530231190370

Baqdunes, M. W., Leap, J., Young, M., Kaura, A., & Cheema, T. (2021). Acute exacerbation of chronic obstructive pulmonary disease. Critical Care Nursing Quarterly44(1), 74–90. https://doi.org/10.1097/cnq.0000000000000341

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Ghai, T., Das, A., & Patel, R. (2022). The investigation of the effect of antibody recruiting molecules on various antigenic markers (cancer, bacteria, viruses): A literature review. Undergraduate Research in Natural and Clinical Science and Technology Journal6, 1–7. https://doi.org/10.26685/urncst.341

Helvaci, A., & Gok Metin, Z. (2020). The effects of nurse‐driven self‐management programs on chronic obstructive pulmonary disease: A systematic review and meta‐analysis. Journal of Advanced Nursinghttps://doi.org/10.1111/jan.14505

Labrague, L. J., Nwafor, C. E., & Tsaras, K. (2020). Influence of toxic and transformational leadership practices on nurses’ job satisfaction, psychological distress, absenteeism, and turnover intention. Journal of Nursing Management28(5), 1104–1113. https://doi.org/10.1111/jonm.13053

MacLeod, M., Papi, A., Contoli, M., Beghé, B., Celli, B. R., Wedzicha, J. A., & Fabbri, L. M. (2021). Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact. Respirology26(6), 532–551. https://doi.org/10.1111/resp.14041

McGee, B. T., & Breslin, S. E. (2020). The Affordable Care act 10 years in. Nurse Leader19(1). https://doi.org/10.1016/j.mnl.2020.03.022

Moon, S. E., Van Dam, P. J., & Kitsos, A. (2019). Measuring transformational leadership in establishing nursing care excellence. Healthcare7(4), 132. https://doi.org/10.3390/healthcare7040132

Nnate, D. A., Barber, D., & Abaraogu, U. O. (2021). Discharge plan to promote patient safety and shared decision-making by a multidisciplinary team of healthcare professionals in a respiratory unit. Nursing Reports11(3), 590–599. https://doi.org/10.3390/nursrep11030056

Robert, N. (2019). How artificial intelligence is changing nursing. Nursing Management (Springhouse)50(9), 30–39. https://doi.org/10.1097/01.numa.0000578988.56622.21

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Ruvuna, L., & Sood, A. (2020). Epidemiology of chronic obstructive pulmonary disease. Clinics in Chest Medicine41(3), 315–327. https://doi.org/10.1016/j.ccm.2020.05.002

Saleem, S., Sehar, S., Afzal, M., Jamil, A., & Gilani, Dr. S. A. (2019). Accreditation: Application of Kurt Lewin’s theory on private health care organizational change. Saudi Journal of Nursing and Health Care02(12), 412–415. https://doi.org/10.36348/sjnhc.2019.v02i12.003

Schmid-Mohler, G., Clarenbach, C., Brenner, G., Kohler, M., Horvath, E., Spielmanns, M., & Petry, H. (2020). Advanced nursing practice in COPD exacerbations: The solution for a gap in Switzerland? ERJ Open Research6(2). https://doi.org/10.1183/23120541.00354-2019

Sebastião, B. F., Hortelão, R. M., Granadas, S. S., Faria, J., Raquel, J., & Helga Rafael Henriques. (2023). Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbations. International Journal of Nursing Scienceshttps://doi.org/10.1016/j.ijnss.2023.12.003

Syakura, A., Nursalam, N., & Sw, A. (2020). Self-care management to prevent exacerbation for Chronic Obstructive Pulmonary Disease (COPD) patients: A systematic review. International Journal of Nursing and Health Services (IJNHS)3(3), 391–401. https://doi.org/10.35654/ijnhs.v3i3.228

Teguh, A., Sri Hariyati, Rr. T., & Muhaeriwati, T. (2019). Applicability of Lewin’s change management model for an optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS)2(2), 66–74. https://doi.org/10.35654/ijnhs.v2i2.136

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Vogelmeier, C. F., Román-Rodríguez, M., Singh, D., Han, M. K., Rodríguez-Roisin, R., & Ferguson, G. T. (2020). Goals of COPD treatment: Focus on symptoms and exacerbations. Respiratory Medicine166(1), 105938. https://doi.org/10.1016/j.rmed.2020.105938

Zafari, Z., Li, S., Eakin, M. N., Bellanger, M., & Reed, R. M. (2020). Projecting long-term health and economic burden of COPD in the United States. Chesthttps://doi.org/10.1016/j.chest.2020.09.255



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