Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations
School of Nursing and Health Sciences, Capella University
NURS-FPX4900 Capstone Project for Nursing
April 29, 2022
Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations
To be successful in achieving objectives, effective communication and management of change are essential. Most medical projects fail due to ineffective change management, even though change theories may improve patient satisfaction and medical system efficiency (Braithwaite et al., 2020). Public health is a national concern, and policy analysis is a major factor in achieving this aim. The prevalence of hypertension is increasing in the United States. According to recent research (Ramos-Vera et al., 2023), hypertension is the most common mental health disease impacting patients today and is directly related to a patient’s lifestyle. This capstone project includes a case study of a patient with hypertension, which is shown here.
Part 1
A 42-year-old female patient Kamille who was just admitted to the hospital, is now undergoing evaluation and treatment. She is the only provider for her two children, a son, 14, and a daughter, 12. Her emotional condition indicates that she went through a traumatic divorce a year ago. She admits to excessive alcohol consumption, tobacco use after divorce and being overweight. When our nurses took a patient’s blood pressure, a reading above 140 mmHg indicated hypertension. Paranoia and hypertension have plagued the patient, a Caucasian American, for the last decade. Her diastolic blood pressure has been 100 mm Hg as of late. According to the Seventh Report of the Joint National Committee on the Prevention and Detection of High Blood Pressure (Burnier & Egan, 2019), hypertension is defined as a blood pressure reading of more than 140/90 mmHg in adolescents and greater than 150/180 mmHg in adults. The patient’s hypertension (HTN) is likely attributable to the pressures of their personal and professional life.
Kamille also took medicine for her hypertension, but her frequent headaches persisted despite this. After two hours of counselling, I learned that Kamille was taking 100 milligrams of amlodipine and 12 milligrams of chlorthalidone daily. However, she has a harder time keeping track of her medications than she would like. While using anti-HTN medicine, the patient’s blood pressure may fluctuate between 155 to 160 over 115 to 120 mmHg, causing her some concern. The patient also used nicotine-related medicines twice daily and drank alcohol regularly. Her workout routine was over the place, and she never stuck to it long enough to see results. The patient’s diet has to be drastically altered, and she must give up snacking and foods high in cholesterol if she is to be saved from heart attacks and type II diabetes. After making a quick diagnosis, the patient received prompt treatment from expert nurses.
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My responsibility as a licensed nurse is to help the group improve patients’ health via successful treatment results. I discussed this issue with prominent physicians and business leaders for six hours of my practicum. The aim is to lessen the prospect of complete healing from hypertensive and cardiovascular problems. For my senior thesis, I want to investigate a pressing problem in public health. To ensure that patients get cost-effective care, I will analyze the situation from the perspectives of leadership and collaborative strategies. Safeguards for diabetic patients will also consider communication, change management, and policy.
Part 2
Evidence from peer-reviewed literature and professional sources
Hypertension-specific treatments and information the nursing team provides may help patients successfully manage HTN. Educating and training healthcare workers is the best way to ensure that patients with hypertension have their blood pressure at the appropriate values and that nurses can check these patients frequently. If hypertension is diagnosed and treated promptly, it may be easier to manage and control (El Kadri et al., 2022). With an ever-increasing patient load, nurses have taken on an increasingly critical role in managing hypertension during the past few years. Observing and managing hypertension is a significant task requiring nurses to follow set rules. Since this approach aims to improve patients’ capacity for self-management and knowledge of hypertension, patient education is particularly crucial. Regular checkups and follow-ups should include specialized nurses. Nurses may improve care coordination with the help of diagnostic tests and therapies (Reist et al., 2022).
Roles of nurses
According to Kes & Polat (2022), nurses are responsible for developing individualized care strategies that improve the advantages provided to patients undergoing treatment for high blood pressure. Patients’ health may improve with the help of effective treatments and therapies, as well as a good diet. Therefore, the nurse must monitor the patient’s blood pressure (B.P.) and remind them when to take their medication. Patients might be given the diet plan and encouraged to exercise for 30 minutes every day by nurses. The nurses must check the activity chart once a week. According to the study’s authors, the nurse’s role is to help patients set up social support systems in their communities so that they may get the advice, direction, and emotional support they need (Kes & Polat, 2022). Evidence suggests that trained nurses further minimize their patients’ risk of developing hypertension by counselling them on nutrition and exercise.
Barriers to the Implementation of Evidence-Based Practice
Many factors may create roadblocks in the way of treating and managing hypertension. Technology in hospitals, staffing challenges in healthcare facilities, and patient readmissions are all contributing factors (Storey et al., 2019). Several barriers prevent the widespread use of evidence-based approaches to HTN. In addition, the group needs a pharmacist with more advanced training. Further challenges include a lack of telehealth and inadequate information technology infrastructure (Hirko et al., 2020). Psychologists and nurses are not working together on HTN management because they do not want to. This barrier may lessen the efficacy of your treatment or change management plan. The organization’s requirement for extra-qualified human resources stems from the worry that its current staff needs to be more skilled. Creating a large medical library with all the latest books and journals is also possible. By expanding recruiting efforts, guaranteeing dependable internet connection, and minimizing technical issues, nurses will soon be able to avoid fatigue.
Nurses and Policy Making
Nurses have significant policymaking responsibilities, particularly in-patient outcomes, hypertension prevention, and readmission reduction. The growth of the healthcare industry depends on the nurses’ efforts to expand their responsibilities to encompass the creation of health policy. Experience-wise, they could be entrusted with advocacy tasks. Because of their vital role in the development of their profession, the influence that policies have on nurses, and their direct contact with patients. As part of these efforts, nurses can participate in advocacy organizations and associations and learn more about policy services. The American Nurses Association’s code of ethics states that nurses should encourage others to work together to provide the best care possible for patients (Starke et al., 2022).
Theoretical Approach to Nursing
From the scholarly articles I read before starting my practicum, I knew that the needs of my patients had to come first. I like showing my patients that I am an accomplished nurse. The chronic care model is the nursing theory or conceptual framework that may guide nursing actions in hypertension management. This model focuses on managing chronic conditions such as hypertension through patient-centred care, self-management support, and care coordination. According to Berwick (2019), the model emphasizes the importance of a collaborative approach to care, with the patient at the centre of the care team. As I formulate a treatment and medication plan, I consider their choices, feelings, and abilities and choose the best approach to assure their safety and care.
How do state board nursing practice standards and organizations affect HTN patients?
If Kamille needs medical attention, she may be able to get it via the Medicare system and the Patient Protection and Affordable Care Act (ACA). The state board, local, and national regulations are all geared toward helping nurses, and other healthcare workers learn more about the best practices for treating hypertension. With an ever-increasing patient load, nurses have taken on an increasingly critical role in managing hypertension during the past few years. Observing and managing hypertension is a significant task requiring nurses to follow set rules.
More than a thousand research publications and medical journals were used to compile these recommendations, with the help of nine more U.S. institutions. It also suggests that hypertensive patients treated according to state and federal recommendations will successfully reduce their heart rate within three months. According to the American College of Cardiology, those with hypertension have an increased chance of acquiring cardiovascular disease if it runs in their family (Maimaitiaili et al., 2022).
Nursing guidelines for maintaining patient health using the ISH’s 135/90 mmHg criteria are also available (Sudharsanan et al., 2022). High blood pressure poses a risk to the cardiovascular system, and the organization advises nurses to keep their patients’ readings below 130/85 mmHg to prevent liver and heart failure. Patients should have their goal blood pressure reduced from 140/85 mmHg to 130/80 mmHg within three months after beginning hypertension treatment.
In addition, the WHO and the International Society of Hypertension (ISH) (Campbell et al., 2022) gave the most current hypertension therapy and management recommendations. The World Health Organization’s recommendations for managing hypertension were developed with input from medical experts in more than 24 nations. Following the advice and implementing measures like medications and lifestyle adjustments may help HTN patients achieve optimum and good B.P. readings of up to 120/80 mmHg (Bell et al., 2021). The number of Americans losing their lives due to hypertension will decrease due to this.
Leadership strategies
Finally, nurses and other healthcare providers benefit greatly from learning about leadership strategies for increasing the effectiveness of therapies for lowering hypertension in patients. These tactics, together with empathy, originality, vigilance, foresight, and a commitment to the success of others, are what make up exceptional nursing leadership. Leaders in the nursing profession are crucial in all areas of healthcare, from direct patient care to the formulation of policy. The new and seasoned nursing staff turn to the more seasoned nurses for guidance and support. Nurse leaders are being pushed to their limits by the simultaneous factors of the impending retirement of many long-serving nurses in administrative roles and the rapid evolution of the healthcare system. Among the studies recommending that nurse leaders provide revolutionary leadership in healthcare is the National Academy of Sciences (NAS). Doctors’ and nurses’ commitment to public healthcare metrics reveals an interest in macroeconomic health indicators. Nurses’ leadership skills are essential to any healthcare institution’s success because societies benefit from intellectual health when their leaders promote it and raise public awareness of mental health issues. According to the company’s new strategic strategy, nurse managers were required to become transformational leaders to increase the efficiency of innovative activities (Kraus et al., 2021). Nurses play a significant role in our company, making crucial managerial and problem-solving decisions.
Nurses’ leadership skills may be essential in reducing racial disparities in the quality management of HTN remotely and in person, thus suggesting that nurses with leadership skills can better alleviate HTN by addressing critical sociocultural and cost-based issues. The results show that advanced practice nurses who hold leadership roles make substantial efforts to lower their patients’ hypertension and cardiovascular risk factors. Acquiring leadership skills in nursing, such as compassion, understanding, spiritual management, and direction setting, allows managers to instil those same qualities in their employees. These leadership practices may be useful to healthcare organizations regarding consumer loyalty and customer satisfaction. Hypertension treatment priorities may be influenced by nursing organizations that convene semi-annual and monthly conferences with stakeholders and provide instructional seminars (DesRoches et al., 2022). In order to encourage patients to make lifestyle changes and control their hypertension, nurses might employ evidence-based methods and leadership skills.
Conclusions
Hypertension has recently surpassed tobacco usage as the greatest killer worldwide. As a result, nurses need to participate in collaborative efforts to educate the public and shape legislation. The greatest barriers to evidence-based nursing practice are financial and cultural. Nurses can solve certain problems by educating the public and offering solutions. Patients of American ancestry who have trouble maintaining stable blood sugar levels may benefit from the Patient Protection and Affordable Care Act (ACA) and the National Diabetes Prevention Program (NDPP). Improved outcomes for diabetes patients have been linked to various leadership practices, including open communication, stakeholder cooperation, education, and training. The following suggestions may assist Kamille in saving expenditures on her medical care. I am a registered nurse, so I can advise her on how to get the most out of her healthcare dollars.
References
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