NURS FPX 6030 Assessment 6 Final Project Submission

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Final Project Submission

Abstract

This project implements nurse-led transitional care programs for postpartum mothers of preterm infants to enhance hospital resource management efficiency. Addressing the unique needs of preterm infants and their mothers, who require specialized care and support, aims to reduce hospital readmissions and improve overall health outcomes. The project focuses on organizing workshops to train nurses in care transition processes and effective communication with other healthcare professionals. The project aims to achieve financial efficiencies and maintain high-quality care by enhancing the efficient use of healthcare resources. The intervention is developed and implemented over 10 to 12 months, with continuous evaluation through data collection and analysis, ensuring effectiveness and sustainability.

Introduction

This project addresses the pressing need to implement nurse-led transitional care programs in the postpartum period, particularly following preterm births, to enhance the efficiency of hospital resource management. Without comprehensive transitional care, there is a heightened risk of increased hospital readmissions, which strains healthcare facilities. Mothers of preterm infants, especially those born extremely preterm, require specialized discharge training, as approximately 20% need tailored home care. By implementing nurse-led transitional care programs, hospitals can effectively address the medical, psychosocial, and overall health needs of both mothers and infants, potentially reducing readmission rates and optimizing resource utilization. The target population includes women who have experienced preterm birth and their preterm infants during the postpartum period, particularly in hospital settings where preterm infants are born.

These infants are particularly vulnerable and require specialized care, while mothers face physical and emotional challenges that necessitate adequate postpartum support. Implementing nurse-led care transition programs, especially in Neonatal Intensive Care Units (NICUs), ensures timely and appropriate care, allowing for better allocation and utilization of healthcare resources. The intervention involves organizing nurse-led transitional care workshops to train nurses in care transition processes and effective communication with other healthcare professionals. These programs aim to promote the efficient use of healthcare resources and equip mothers with sufficient postpartum knowledge. However, challenges such as resource constraints and potential confidentiality breaches need to be addressed.

The intervention plan is justified by theoretical models emphasizing adaptive coping mechanisms, interpersonal connections, and strategies like interprofessional collaboration, social support services, and mobile health technologies. Successful implementation hinges on effective leadership, teamwork, open communication, and knowledge sharing. Evaluation aims to enhance resource utilization efficiency, promote coordinated care delivery, achieve cost savings, boost patient satisfaction, and drive better health outcomes while balancing potential challenges such as staff resistance and sustainability concerns.

Problem Statement (PICOT)

Need Assessment

This project aims to implement nurse-led transitional care programs during the postpartum period, specifically after preterm births, to enhance hospital resource management efficiency. Efficient resource management is crucial for delivering high-quality healthcare. Without comprehensive transitional care, there is a higher risk of increased hospital readmissions, leading to unplanned hospital visits and additional strain on healthcare facilities (Weber et al., 2020). Additionally, standard care practices often overlook the emotional and mental health needs of mothers who have experienced preterm births, which can exacerbate stress and anxiety (Mutua et al., 2020). Mothers of preterm infants, especially those born extremely preterm, require discharge training, as about 20% need specialized home care (Molina et al., 2019).

Effective care transitions, led by nurses, are essential to ensure these mothers receive adequate home care training and reduce hospital readmission rates. Nurse-led transitional care programs can effectively address patients’ medical, psychosocial, and overall health needs (Liss et al., 2019). This analysis assumes that nurse-led care transitions help mothers manage their health and their infants’ needs. Educating mothers through nurse-led care transition programs can improve the quality of care for mothers and infants, potentially lowering readmission rates. Additionally, such programs can help hospitals allocate resources more efficiently, as nurses are well-equipped to educate patients based on their specific health needs (Mileski et al., 2020).

Population and Settings

The quality improvement project focuses on women who have experienced preterm birth and their preterm infants during the postpartum period. Addressing the needs of this population is crucial for several reasons. Preterm infants are particularly vulnerable due to their underdeveloped physiological systems, necessitating specialized care (Molina et al., 2019). Nurse-led transitional care programs during the postpartum period can ensure optimal health outcomes for these infants, promoting their growth and development and preventing complications. Additionally, mothers of preterm infants face physical and emotional challenges, requiring adequate postpartum care to monitor and address specific health concerns, including postpartum complications and mental health support (Ma et al., 2021). This project targets hospital settings where preterm infants are born. Implementing nurse-led care transition programs in the Neonatal Intensive Care Unit (NICU) ensures that these infants receive timely and appropriate care. Furthermore, addressing this need within the hospital setting allows for better allocation and utilization of healthcare resources (Mileski et al., 2020).

Intervention Overview

The success of implementing nurse-led care transition programs hinges on adopting specific interventions tailored to postpartum mothers who have given birth to preterm infants in hospitals. One key intervention involves nurse-led care transition programs that offer postpartum support. By organizing nurse-led transitional care workshops, nurses can be trained effectively in care transition processes and in communicating with other healthcare professionals, such as gynecologists, pediatricians, and pharmacists (Rush et al., 2019). These programs should focus on practices that promote the efficient use of healthcare resources for preterm infants and their mothers during the postpartum period. This approach is well-suited for the target population within the healthcare setting as it provides hands-on experience for nurses working with this group. Furthermore, it addresses the need for efficient healthcare resource utilization by equipping mothers of preterm infants with sufficient knowledge postpartum. However, the intervention’s weaknesses include the need for significant resources to organize workshops, ongoing reinforcement and support, and the potential risk of confidentiality breaches of protected health information (Torrens et al., 2020).

Comparison of Approaches

An interprofessional alternative to address the project’s needs involves interprofessional team training and collaboration for postpartum care of mothers who have given birth to preterm infants. This approach includes training sessions and collaborative meetings to enhance postpartum care and provide timely interventions for preterm infants. These sessions will emphasize teamwork, shared meetings, and care coordination, ultimately aiming to improve the use of healthcare organizational resources (Walker et al., 2019). However, this approach requires dedicated time for training, which could disrupt regular clinical schedules. Healthcare professionals might face time management challenges due to their complex schedules, potentially causing them to miss meetings. Additionally, team members may resist workflow changes, necessitating effective change management strategies (Torrens et al., 2020).

Initial Outcome Draft

The primary goal of the proposed quality improvement project is to enhance hospital resource management efficiency through the implementation of nurse-led care transition programs. This goal aims to optimize the use of available hospital resources, preventing waste and avoiding the overuse caused by unnecessary hospital stays. As a result, resources can be more effectively allocated to meet the specific needs of patients, particularly postpartum mothers and their preterm infants (Bartsch et al., 2020). Additionally, by reducing hospital readmission rates and unnecessary resource utilization, hospitals can achieve financial efficiencies while maintaining high-quality care through these nurse-led programs. The success of this outcome will be evaluated using criteria such as hospital readmission rates, patient satisfaction surveys from the target population, financial stability or efficiency estimates, and improved quality of care for all patients through effective resource allocation (Bartsch et al., 2020).

Time Estimate

The proposed intervention, a nurse-led care transition program through workshops, is expected to be developed and implemented over a period of 10 to 12 months. This timeline is divided into several phases: a development phase lasting 3-6 months, a pilot testing phase from 6-9 months, a refinement phase of 3-6 months, and a scaling-up phase from 9-12 months. During the development phase, a literature review on nurse-led transition care programs will be conducted to identify evidence-based practices for efficient resource utilization. The next three months will focus on pilot testing, where the program’s feasibility, acceptability, and impact on resource efficiency will be evaluated. In the three-month refinement phase, data from the pilot study will be analyzed, and feedback from healthcare professionals, mothers, and families will be gathered to improve the program. Finally, the program will be expanded to other departments to enhance resource management and efficiency. Participants will receive training during this phase, and the program’s impact on a larger scale will be monitored, considering variations in patient populations and care settings. Continuous evaluation will be carried out through ongoing data collection and analysis.

While the timeline is specific, there are uncertainties in the process. External factors, such as changes in healthcare policies or introducing new technologies, could influence the program’s success. Additionally, the state of existing digital infrastructure and accessibility may impact implementation. The program’s long-term sustainability and effect on healthcare resource efficiency depend on these external factors, necessitating ongoing monitoring and continuous evaluation.

Literature Review

 The literature review validates the need for addressing the improvement in resource efficiency of healthcare resources by implementing nurse-led care programs for mothers in post-partum after giving birth to pre-term babies. The literature review suggests and supports the significance and demand for efficient use of hospital resources. In an evidence-based article by Ann et al. (2019), the power of nurses to improve the efficiency of hospital resources and create opportunities for nurses to impact healthcare quality positively is discussed. The authors state that healthcare resources are scarce in number, and by harnessing the power of nurses to use these limited resources efficiently, healthcare can be improved, and costs to organizations can be reduced. In another study by Anwar and Abdullah (2021), hospital resources, including human resources, and their impact on organizational performance are highlighted. The study shows that efficient management of hospital resources through decentralization can improve the efficiency of organizational performance.

Similarly, the comparison of advanced nurse-led care with usual care is conducted in an evidence-based study along with its efficacy. The study also evaluated its impact on costs and critical care environments such as NICU. This approach reduced costs and wait times, efficiently using available healthcare resources (Htay & Whitehead, 2021). Another study by Li et al. (2021) evaluated the effects of nurse-led transitional care on healthcare utilization, particularly for patients who have experienced heart failure. The results showed that hospital readmission risks were reduced along with shortening hospital stay length. Ultimately, healthcare resources were efficiently and equitably utilized.

NURS FPX 6030 Assessment 6 Final Project Submission

The evidence-based systemic review study by Mileski et al. (2020) improved the understanding of the nurse’s role in alleviating patient hospitalization risks and improving their health outcomes. The study showed that the valuable contribution of nurse practitioners resulted in decreased extra hospitalization and enhanced access to healthcare by adequate education and guidance. This resulted in a better allocation of resources and improved healthcare access to other patients. The article by (Mizukawa et al., 2019) studied the effectiveness of nurse-led collaborative management through telemonitoring domains. It was evaluated that this approach improved psychosocial status and prevented hospital readmissions. The prevented hospital readmission highlights the hospital’s better and more effective resource utilization. 

Another resource by Morkisch et al. (2020) suggests that implementing the care transition models by integrating interprofessional intervention can reduce rehospitalization rates in geriatric patients. This is done by implementing nurses’ appropriate and adequate contribution to education and self-management promotion. Moreover, reducing hospital readmission rates without increasing costs shows effective management of hospital resources. The article by Green et al. (2020) reviews the transition process of preterm babies. The authors suggest that pre-term babies require the intensive participation of nurses in transition to meet the unique needs of their health condition. Moreover, nurses’ roles also support maternal mental health during the care transition.

NURS FPX 6030 Assessment 6 Final Project Submission

This will improve healthcare outcomes for babies and mothers, with the secondary outcome of locating limited healthcare resources appropriately. The resource by Ma et al. (2021) shares the caregivers’ experiences on the care transition of pre-term babies to guide nurses on their required role of smoothing the care transition process for the target population and improving their care transition while mediating the healthcare resources effectively. These needs include intensive care after discharge to prevent infections and complications, tackling the emotional needs of mothers, and negative psychological pressure. According to Spall et al. (2019), with the help of nurse-led interventions, patient-centered transitional care services did not significantly improve the quality-of-care transition effectively in patients with heart failure. 

 This evidence supports the implementation of nurse-led care transition programs to improve the efficiency of healthcare resources in hospitals for mothers in their post-partum with pre-term babies. These pieces of evidence are evaluated based on CRAAP criteria of Currency, Relevance, Accuracy, Authority, and Purpose (Muis et al., 2022). All resources are current and published within the last five years. Moreover, the articles are relevant to the identified need for efficient healthcare resource management. The articles are accurate and substantiated by references. The authors are relevant to nursing and healthcare to improve healthcare resources (Muis et al., 2022).

Evaluation and Synthesis of Relevant Health Policies

The American Nurses Association (ANA) policies on care coordination and care transition help address the identified need to improve healthcare resources and efficiency by implementing nurse-led care transitions. The ANA policy on care coordination in the transition process guides them on performing patient-centered care transitions to facilitate smooth care transitions (ANA, 2023). Moreover, it guides nurses on communication transitions during nursing care transitions. It ensures patients like mothers with preterm babies during transition procedures acquire adequate education on post-transition care at home (Figueiredo & Potra, 2019). These health policies guide nurses on the correct procedure of care coordination during care transitions and help them ensure the hospital readmission rates are prevented and healthcare resources are effectively managed  (Htay & Whitehead, 2021).

Interventional Plan

Intervention Plan Components

The intervention designed to improve hospital resource management is nurse-led care transition programs. This intervention is based on various components and elements, each essential for effective implementation and achieving the desired outcome. The population’s health needs are thoroughly examined to tailor the care transition plans accordingly. Mothers who have given birth to pre-term babies require physical healthcare along with the challenges they encounter after pre-term birth. These can be varied from patient to patient, and a deeper analysis can help nurses develop transition care plans accordingly (Phillips et al., 2023). Another significant intervention component is creating customized care plans that consider patients’ medical history, post-partum recovery, and psychosocial needs.

Moreover, the nurses are expected to educate mothers about post-partum care and caring for pre-term infants, such as recognizing signs of complications, monitoring infants’ development, and self-care strategies. The nurses must foster interdisciplinary collaboration with relevant team members such as physicians, neonatologists, lactation consultants, and social workers to create a holistic care transition plan for mothers and their pre-term babies (Haemmerli et al., 2021).  These components will help nurses promote effective care strategies during care transition procedures, ultimately reducing hospital readmission rates and the need for emergency visits. This will improve the efficiency of healthcare resources and their effective allocation for other patients, fulfilling the identified need described in the previous assessment. The criteria that can be utilized to evaluate the success of this intervention plan are measuring the patient satisfaction scores through mothers’ surveys, analyzing reduction in hospital readmission rates, and better allocation of resources without complaints of resource scarcity in gynecology and neonatology wards (Seltzer et al., 2022).

Cultural Needs and Characteristics of Population and Setting

The intervention plan’s components greatly depend on the cultural needs and the features of the population and setting. Considering the given population of mothers post-partum after giving birth to pre-term babies in hospitals, the cultural needs can vary due to diverse cultural backgrounds and their varied beliefs about health and illness. They all have different knowledge, perspectives, and beliefs in healthcare practices after childbirth and post-partum. Therefore, nurse-led care transition programs will require culturally competent care plans that consider the patients’ cultural considerations and their impact on care transitions (Hanssen et al., 2021). The educational materials must be in a language understandable by culturally diverse mothers who use cultural language.

Moreover, the nurse practitioners will require additional training in providing care transition guidance and education in a culturally competent manner (Kamau et al., 2022). The hospital will require culturally competent nursing staff to address these cultural needs and specific health policies to implement a patient-centered care culture. These cultural needs will require training, additional recruitment of qualified staff, and fostering collaboration among interprofessional teams to promote communication strategies to address cultural sensitivity among the target population (Srivastava, 2022). The analysis is based on the assumption that culturally diverse populations as patients are prone to dismiss the accomplishment of improving healthcare resource efficiency when their cultural beliefs do not align with healthcare practices (Argyriadis et al., 2022). Therefore, considering the cultural requirements of implementing intervention successfully is essential to manage healthcare resources efficiently.

Theoretical Foundations

Different theoretical nursing models apply to the intervention plan of nurse-led care transition programs for mothers after pre-term births. Roy’s Adaptation Model (RAM) is a nursing theory centralized on individuals adapting to internal and external stimuli to maintain balance and well-being (Kim & Kim, 2023). These stressors can prompt adaptive responses through coping mechanisms. This theory is relevant to the proposed intervention plan, as mothers who have given birth to pre-term babies experience emotional, physical, and psychosocial challenges that are addressed by nurse-led care transition programs and help them adapt to the current difficulties of the health challenges of post-partum and caring for pre-term infants (Tefera et al., 2022).

The strength of this theory is that RAM takes a holistic approach by considering multiple adaptive modes such as physiologic, role function, self-consent, and interdependence, which helps address various aspects of patients’ lives in the subject scenario. Moreover, it integrates the nursing processes such as assessing patients, diagnosing, planning, implementing, and evaluating. Therefore, it provides a systematic approach for nurses to guide their nurse-led care transition program effectively. The weaknesses of RAM are the complex nature of this model for novice nurses and the lack of clarity on residual stimuli, making them practically invalid (Kim & Kim, 2023). 

NURS FPX 6030 Assessment 6 Final Project Submission

Another theory, Peplau’s Interpersonal Relations Theory, focuses on nurse-patient relations. It is relevant to nurse-led care transition programs where nurses must communicate with mothers post-partum after pre-term birth and provide education, support, and guidelines in the care transition process. Through effective interpersonal relations between nurse and patient, the goal of managing healthcare resources is efficiently achieved as patients coordinate with nurses sufficiently (Salvador et al., 2022). The strengths of this theory are a strong emphasis on nurse-patient relations where significant health outcomes can be improved by creating a strong, positive, and healthy relationship. The weaknesses include the need for sufficient time to build deeper interpersonal connections and dependence on practical and therapeutic communication skills to foster connections  (Salvador et al., 2022). 

The strategies from other disciplines that can be adopted related to nurse-led care transition programs are social work support services such as connecting families with community resources and providing emotional support that can promote comprehensive care for mothers in post-partum with preterm babies. Other strategies include psychological strategies to promote positive behaviors and reinforcements to encourage desired behaviors and outcomes in maternal self-care and infant care (Mazza et al., 2021). These strategies significantly influence intervention plan components in enhancing care and adherence to the care plan. The healthcare technologies relevant to the intervention plan of a nurse-led care transition program include mobile health applications. These apps can provide accessible resources, educational materials, and reminders to support mothers of pre-term babies in improving self-care and managing preterm infant care. This technology influences the design of nurse-led care program components as the education nurses provide can be practically applied with the help of these apps that promote consistency and adherence to care plans (Phagdol et al., 2021).

Justification of Major Components of the Intervention Plan

The subsequent section justifies the intervention plan using theoretical models, strategies, and technology. The RAM theoretical model suggests that the adaptive nature of humans to external stimuli can provide them with better coping mechanisms and help them adapt to the surrounding situations. This theory justifies the intervention plan, including educating mothers of pre-term infants to manage the health challenges effectively and adjust to the current healthcare scenarios with wisdom and correct knowledge (Kim & Kim, 2023). Similarly, the intervention’s component of interprofessional collaboration is justified by Peplau’s theory, which emphasizes the need for interpersonal connections and relations to enhance care coordination (Salvador et al., 2022).

The strategies of social support services and reinforcing psychological behaviors also justify the customized care plans based on health needs, such as mothers requiring social and community resources and psychological support. These strategies also justify the intervention’s component of thorough assessment to delve into specific patients’ needs and provide social and psychological support accordingly. The mobile health technologies justify the nurse-led care transition programs as the mothers can implement knowledge nurses share effectively through these apps, providing alarms, educational resources, and self-care support to mothers (Phagdol et al., 2021). The conflicting data from the earlier perspectives exist in literature where nurse-led care transition programs are not supported with strategies from other disciplines due to the need for extensive resources and time for collaboration (Dyess et al., 2023).

Stakeholders, Policy, and Regulations

The relevant stakeholders of this intervention plan are nurses, mothers in post-partum with pre-term infants, social supporters, and psychologists. The needs of these stakeholders are vital to consider as they directly impact the nurse-led care transition programs. For instance, nurses must educate mothers, communicate with interprofessional team members, and manage the care transition process (Hays et al., 2022). The mothers must be adequately guided on post-partum and pre-term infant care with sufficient knowledge of the baby’s future follow-ups and managing challenges associated with pre-term infant care. The social supporters must coordinate with mothers, nurses, and community resources to deliver emotional and social support (Brazil et al., 2022). Psychologists are needed to provide mental health support to mothers. These needs must be adequately met to successfully implement the intervention plan components (Dyess et al., 2023). 

The American Nurses Association is the governing body that guides nurses through healthcare policies. The health policies on care coordination necessary for care transition provide nurses with authentic guidelines for performing care transition plans for mothers having given pre-term births (ANA, 2023). The Health Insurance Portability and Accountability Act (HIPAA) regulations are vital to implement when mobile health apps are used. The HIPAA regulatory guidelines emphasize the importance of securing patients’ protected health information to prevent privacy breaches (Choi & Williams, 2022).

Compliance with these policies and regulations promotes the effective implementation of intervention plans such as interprofessional collaboration, which requires the practice of care coordination policies where nurses are adequately communicating with multidisciplinary team members and creating care transition plans according to shared decisions of team members and the health needs of mothers and pre-term infants. The underlying assumptions of this analysis are grounded in theoretical perspectives that health policies by governing bodies and stakeholders’ collaboration can effectively direct the nurses to make the nurse-led care transition successful. Moreover, health policies are meant to guide nurses by paving the way for them to perform corrective steps in light of sound literature (ANA, 2023).

Ethical and Legal Implications

The ethical issues identified in this project are related to mothers’ autonomy in post-partum for creating care-transition plans according to their preferences and health needs. Moreover, privacy and security issues are raised during mobile health apps and interprofessional team collaboration. These ethical issues affect the intervention plan’s educational component and interprofessional collaboration element. Moreover, legal issues can arise when the nurses must practice the state nursing board policies and accreditation standards. Adherence to these legal standards and policies ensures nurses customize care transition plans accordingly (Iversen et al., 2021). These legal issues impact the nurse-led care transition plans. Failure to implement these health policies by the American Nursing Association can lead to incorrect and illegal healthcare practices and require organizational change to revise the guidelines and take stringent measures.

Implementation Plan

Management and Leadership

Visionary leadership is essential for implementing nurse-led care transition programs for postpartum mothers with preterm infants. This vision underscores the significance of these programs in boosting nurse satisfaction and enhancing patient care quality. Leaders should exemplify dedication and cultivate a culture of innovation. A detailed plan with specific goals, deadlines, and transparent stakeholder communication is necessary to ensure successful change management. Involving frontline staff, especially nurses, in decision-making and providing training opportunities is crucial for effectively implementing these programs. The practical application of nurse-led care transition programs in hospital settings aims to improve nurse well-being and patient care outcomes. This relies on innovative leadership, change management, and staff empowerment. Effective implementation also depends on interprofessional teamwork. Interdisciplinary teams, including nurses, gynecologists, pediatricians, managers, and other relevant healthcare professionals, should be formed to establish collaborative frameworks. Assigning specific roles and responsibilities to each team member during the implementation phase encourages accountability and cooperation (Ruderman et al., 2021).

Open communication is vital in this process. Encouraging open dialogue and mutual respect allows healthcare providers to freely share ideas, concerns, and suggestions (Moirano et al., 2019). Regular interdisciplinary meetings and communication channels should be established to foster collaboration and information exchange among team members. Additionally, promoting knowledge sharing is key. Facilitating interdisciplinary workshops and knowledge-sharing sessions enables healthcare professionals to learn from each other’s perspectives and expertise. Initiatives to enhance understanding and appreciation of the diverse roles within healthcare disciplines are also encouraged, including cross-training efforts (Wei et al., 2022).

Implications of Change

These strategies can ultimately contribute to the successful implementation of the intervention plan, positively impacting the quality of care provided to mothers and their preterm infants while controlling costs through efficient teamwork and resource utilization. Firstly, emphasizing interprofessional collaboration will likely improve patient outcomes by providing more integrated and comprehensive care, leading to enhanced health outcomes and increased patient satisfaction while reducing the likelihood of readmissions (Carron et al., 2021). Secondly, focusing on effective teamwork and collaboration can improve care efficiency by streamlining processes, minimizing redundancies, and maximizing resource utilization, ultimately resulting in cost savings for healthcare organizations (Kaiser et al., 2022). Furthermore, nurturing a collaborative work environment can boost staff morale, increase job satisfaction, and foster staff retention, contributing to consistently delivering high-quality care (Wei et al., 2022). 

Delivery and Technology

One appropriate delivery method to implement a nurse-led care program for mothers in the postpartum period after giving birth to preterm infants could involve establishing a virtual telehealth platform. This platform could enable remote consultations, education, and support for mothers from the comfort of their homes, allowing nurses to offer guidance on infant care, breastfeeding, emotional support, and monitoring of both the mother and baby’s health. This approach can improve access to care, reduce the need for in-person visits, and enhance overall efficiency in healthcare resource management by optimizing nurse scheduling, reducing travel time, and increasing patient engagement (Sarik & Matsuda, 2023). Another effective delivery method could involve developing a mobile app specifically designed for mothers of preterm infants.

This app could offer educational resources, personalized care plans, symptom-tracking tools, and a communication channel for direct interaction with nurses and other healthcare providers. By leveraging mobile technology, this delivery method can empower mothers to actively participate in their own care and enhance the continuity of support beyond the hospital setting (Lyu et al., 2021). Assumptions underlying the proposal of these delivery methods include the availability of reliable internet connectivity and access to technology for both healthcare providers and patients. Additionally, it is assumed that nurses are adequately trained to deliver care through telehealth platforms and mobile apps and that appropriate measures are in place to ensure data security, privacy, and regulatory compliance when using digital tools for patient care (Sarik et al., 2022).

Evaluation of Technological Options

Virtual telehealth platforms offer secure video conferencing and data sharing capabilities, while emerging technologies, such as AI-driven analytics and blockchain, hold the potential to enhance remote patient monitoring and data security. Similarly, mobile apps provide features like educational resources and symptom tracking, with advancements in AI-driven chatbots and augmented reality, further enhancing user experience and support for mothers (Oyeniyi, 2024). However, critical knowledge gaps exist in data security, user experience, integration with existing systems, regulatory compliance, and effectiveness. Further research and collaboration are needed to address these uncertainties, ensuring the successful implementation and optimization of these technologies to improve healthcare resource management and enhance outcomes for mothers and preterm infants.

Stakeholders, Policy, and Regulations

The successful implementation of a nurse-led care program for mothers of preterm infants hinges on the collaboration and support of various stakeholders, including healthcare providers, hospital administration, IT professionals, insurance providers, regulatory bodies, technology vendors, and patient advocacy groups. Engaging with healthcare providers is crucial as their clinical expertise and experience are essential in designing and implementing effective transition care programs for mothers of preterm infants. Collaborating with hospital administration is vital to secure institutional support, resources, and alignment with organizational goals. Involving IT professionals is necessary for implementing technology solutions, ensuring data security, and optimizing digital platforms (Depla et al., 2021).

Engaging with insurance providers is critical to navigating reimbursement policies and ensuring financial sustainability for the proposed program. Regulatory bodies are crucial in guiding compliance with healthcare regulations, such as HIPAA, and ensuring ethical care delivery. Technology vendors provide the necessary tools and support for integrating telehealth solutions and mobile apps into the program. Finally, involving patient advocacy groups is essential for promoting awareness, education, and acceptance of virtual care services among post-partum mothers of preterm infants, ultimately enhancing patient engagement and outcomes (LaDonna et al., 2020). 

Assumptions underlying this analysis include the willingness of stakeholders to collaborate, adequate training of healthcare providers on virtual care technologies, compliance with regulations, favorable reimbursement policies from insurance providers, and commitment from hospital administration. By addressing these assumptions and actively engaging stakeholders while considering regulatory implications and potential sources of support, the nurse-led care program can be effectively implemented to provide high-quality care to mothers of preterm infants, ultimately improving health outcomes in this vulnerable population (Scott et al., 2021).

Policy Considerations

The Health Information Technology for Economic and Clinical Health (HITECH) Act is a crucial policy consideration that can support nurse-led care programs for postpartum mothers of preterm infants. The HITECH Act promotes the adoption and meaningful use of electronic health records (EHRs) and secure health information exchange. By complying with HITECH requirements, healthcare providers can enhance the efficiency, quality, and safety of care delivery and facilitate care coordination among multidisciplinary teams involved in postpartum care. EHR systems can enable nurses to document and track patient data, monitor outcomes, and communicate with other healthcare providers seamlessly, thereby supporting the continuity of care for mothers of preterm infants (Pye et al., 2024).

Additionally, leveraging telehealth technologies integrated with EHRs in nurse-led care programs can enhance remote monitoring, virtual consultations, and patient education, aligning with the goals of the HITECH Act to improve healthcare outcomes and patient engagement through the use of health information technology. By aligning nurse-led care programs with HITECH policy requirements, healthcare organizations can leverage technology to optimize care delivery, enhance communication, and promote patient-centered care for postpartum mothers of preterm infants (Pye et al., 2024).

NURS FPX 6030 Assessment 6 Final Project Submission

The Health Insurance Portability and Accountability Act (HIPAA) is critical for safeguarding patient privacy and data security. Still, it may also pose challenges that could potentially impair the implementation of nurse-led care transition programs for postpartum mothers of preterm infants. HIPAA regulations require strict adherence to standards for protecting the confidentiality of patient information, which can impact the sharing of sensitive data among healthcare providers involved in the intervention plan. This may create barriers to seamless communication and care coordination, particularly in a nurse-led model that relies on multidisciplinary collaboration. Additionally, HIPAA compliance requirements necessitate secure technology infrastructure to ensure data encryption, access controls, and audit trails (Szalados, 2021).

This may entail significant financial and logistical investments for healthcare organizations implementing telehealth solutions or digital platforms for remote monitoring and patient engagement. Furthermore, navigating HIPAA regulations concerning telehealth services and remote consultations can add complexity to the documentation and consent processes, potentially leading to administrative burdens and delays in care delivery. Addressing these challenges requires careful consideration of HIPAA implications, training healthcare providers on compliance protocols, implementing robust data security measures, and leveraging technology solutions that adhere to HIPAA standards while enabling efficient and effective communication among providers and engagement with patients in nurse-led care programs for postpartum mothers of preterm infants (Szalados, 2021).

Timeline

Our nurse-led transition care program for mothers of preterm infants will span over twelve months. The initial two months will focus on establishing the groundwork, such as allocating resources and contacting participants. The subsequent six months will involve actively implementing the program, conducting regular training sessions for participants, and collecting ongoing feedback. The final four months will be dedicated to evaluating the program, analyzing data, and refining our approach based on feedback received. The availability of resources, participant engagement, and external factors will influence the success of our timeline. Feedback from both mothers and healthcare providers will play a crucial role in shaping the pace and potential adjustments to our program. Flexibility is key; we will adapt to address unforeseen challenges and prioritize the well-being of the preterm infant and mother community.

Evaluation Plan

Defining the Outcomes of the Intervention Plan

The outcomes that serve as the goals of an intervention plan of a nurse-led care transition program focusing on improving resource management efficiency are multifaceted and interrelated. The overarching aim is to enhance the utilization of healthcare resources effectively. By optimizing the allocation of staff time, equipment, and supplies, the program strives to ensure that the right resources are available at the right time to meet the needs of postpartum mothers of preterm infants. This improved resource management is expected to lead to a more coordinated approach to care delivery (Depla et al., 2021). Streamlining communication and collaboration among healthcare providers involved in the care of these vulnerable populations can facilitate seamless transitions between care settings, ultimately enhancing the overall patient experience.

In addition to improving coordination and resource allocation, the intervention plan also targets cost efficiency (Lyu et al., 2021). By identifying waste areas, reducing unnecessary expenditures, and optimizing resource utilization, the program aims to generate cost savings for healthcare organizations and payers. Simultaneously, the goal is to increase patient satisfaction by improving access to care, minimizing wait times, and enhancing the quality of services provided to mothers of preterm infants. This focus on patient-centred care aims to ensure that the needs and preferences of patients and their families are met throughout the care delivery process (Kaiser et al., 2022).

On the positive side, the program is promising in enhancing resource utilization efficiency, promoting coordinated care delivery, achieving cost savings, boosting patient satisfaction, and driving better health outcomes for mothers and infants. These outcomes can transform care delivery processes, optimize resource allocation, and elevate the overall experience of patients and healthcare providers. However, implementing such interventions may encounter obstacles such as resistance from staff, resource constraints, sustainability concerns, increased staff workload, and data management complexities (Depla et al., 2021). Striking a balance between the benefits and challenges of these alternative outcomes is crucial in assessing the effectiveness and sustainability of the intervention program in achieving its overarching goal of enhancing resource management in the care of postpartum mothers of preterm infants.

Discussion

Advocacy

Nurses play a crucial role as catalysts for positive change in healthcare. Positioned at the forefront of patient care, they are adept at identifying areas for enhancement and driving improvements. Through their close interactions with patients, nurses are uniquely positioned to lead initiatives that enhance the overall patient experience. When implementing new care approaches, nurses ensure that interventions are clinically effective and address patients’ holistic needs (Lyu et al., 2021). In multidisciplinary teams, nurses act as connectors, bridging diverse healthcare perspectives to deliver integrated care for patients. This collaborative approach, guided by the nurse’s expertise, forms the foundation of high-quality care where all healthcare professionals work together towards a shared goal (LaDonna et al., 2020). The underlying assumption is that nurses know current best practices and have the authority to advocate for and enact necessary changes.

Future Steps

Integrating emerging technology and advanced care models is crucial to enhancing nurse-led care transition programs’ impact on preterm mothers of preterm infants. Incorporating telehealth and remote monitoring systems can establish continuous connections between caregivers and healthcare professionals, enabling real-time assessment and support for preterm infants (Sarik & Matsuda, 2023). Furthermore, comprehensive education programs focusing on the unique needs and behaviors of preterm babies, as well as peer support networks for mothers, can provide holistic support. However, these improvements are based on assumptions regarding the accessibility and acceptance of technology by preterm mothers and the effectiveness of early detection systems in predicting complications and improving outcomes (Scott et al., 2021).

Reflection on Leading Change and Improvement

Leading the nurse-led care transition program for post-partum mothers of preterm infants has significantly impacted my ability to lead change in my practice and future leadership positions. The experience has allowed me to develop a deeper understanding of the complex needs of preterm infants and their mothers, the importance of holistic care, and the integration of technology in healthcare. This has empowered me to advocate for innovative and patient-centered care models, driving positive change within my practice and inspiring a vision for future leadership roles.

My goals for future personal growth include furthering my knowledge of emerging healthcare technologies and their application in improving patient outcomes. Additionally, I aim to enhance my leadership and communication skills to influence stakeholders and effectively drive meaningful change within healthcare organizations. Furthermore, I aspire to expand my expertise in patient education and support programs, focusing on empowering caregivers and improving the overall experience of preterm infant care.

References

Ahmed, F., Zhao, F., Faraz, N. A., & Qin, Y. J. (2020). How inclusive leadership paves way for psychological well‐being of employees during trauma and crisis: A three‐wave longitudinal mediation study. Journal of Advanced Nursing, 77(2), 819–831. https://doi.org/10.1111/jan.14637 

ANA. (2023, December 21). Care coordination and the essential role of nurses | American Nurses Association (ANA). ANA. https://www.nursingworld.org/practice-policy/health-policy/care-coordination/ 

ANA. (2023, December 21). Care coordination and the essential role of nurses | American Nurses Association (ANA). ANA. https://www.nursingworld.org/practice-policy/health-policy/care-coordinatio

Ann, C. K., Tracey, M., & Yvonne, S. (2019). Affordable care: Harnessing the power of nurses – proquest. Www.proquest.com. https://search.proquest.com/openview/e725593146ca4406b5812a2fa6721948/1?pq-origsite=gscholar&cbl=43860 

Anwar, G., & Abdullah, N. N. (2021, January 15). The impact of human resource management practice on organizational performance. Papers.ssrn.com. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3824689 

Argyriadis, A., Patelarou, E., Paoullis, P., Patelarou, A., Dimitrakopoulos, I., Zisi, V., Northway, R., Gourni, M., Asimakopoulou, E., Katsarou, D., & Argyriadi, A. (2022). Self-Assessment of health professionals’ cultural competence: Knowledge, skills, and mental health concepts for optimal health care. International Journal of Environmental Research and Public Health, 19(18), 11282. https://doi.org/10.3390/ijerph191811282 

Bartsch, S. M., Ferguson, M. C., McKinnell, J. A., O’Shea, K. J., Wedlock, P. T., Siegmund, S. S., & Lee, B. Y. (2020). The potential health care costs and resource use associated with COVID-19 in the United States. Health Affairs, 39(6), 10.1377/hlthaff. https://doi.org/10.1377/hlthaff.2020.00426 

Brazil, V., McLean, D., Lowe, B., Kordich, L., Cullen, D., De Araujo, V., Eldridge, T., & Purdy, E. (2022). A relational approach to improving interprofessional teamwork in post-partum haemorrhage (PPH). BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08463-8 

Brummett, A. (2021). Improving quality and efficiency of postpartum hospital patient education delivery. Thescholarship.ecu.edu. https://thescholarship.ecu.edu/handle/10342/9325 

NURS FPX 6030 Assessment 6 Final Project Submission

Carron, T., Rawlinson, C., Arditi, C., Cohidon, C., Hong, Q. N., Pluye, P., Gilles, I., & Peytremann-Bridevaux, I. (2021). An overview of reviews on interprofessional collaboration in primary care: Effectiveness. International Journal of Integrated Care, 21(2). https://doi.org/10.5334/ijic.5588 

Choi, Y. B., & Williams, C. E. (2022). A HIPAA security and privacy compliance audit and risk assessment mitigation approach. Research Anthology on Securing Medical Systems and Records. https://www.igi-global.com/chapter/a-hipaa-security-and-privacy-compliance-audit-and-risk-assessment-mitigation-approach/309023 

Cui, X., Zhou, X., Ma, L., Sun, T.-W., Bishop, L., Gardiner, F., & Wang, L. (2019). A nurse-led structured education program improves self-management skills and reduces hospital readmissions in patients with chronic heart failure: A randomized and controlled trial in China. Rural and Remote Health, 19(2). https://doi.org/10.22605/rrh5270 

Depla, A. L., Crombag, N. M., Franx, A., & Bekker, M. N. (2021). Implementation of a standard outcome set in perinatal care: A qualitative analysis of barriers and facilitators from all stakeholder perspectives. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06121-z 

Dyess, N. F., Keels, E., Myers, P., French, H., Reber, K., LaTuga, M. S., Johnston, L. C., & Scala, M. (2023). Optimizing clinical care and training in the neonatal intensive care unit: The relationship between front line providers and physician trainees. Journal of Perinatology, 43(12), 1513–1519. https://doi.org/10.1038/s41372-023-01749-7

Figueiredo, A. R., & Potra, T. S. (2019). Effective communication transitions in nursing care: A scoping review. Annals of Medicine, 51(sup1), 201–201. https://doi.org/10.1080/07853890.2018.1560159 

Green, J., Fowler, C., Petty, J., & Whiting, L. (2020). The transition home of extremely premature babies: An integrative review. Journal of Neonatal Nursing, 27(1). https://doi.org/10.1016/j.jnn.2020.09.011 

NURS FPX 6030 Assessment 6 Final Project Submission

Haemmerli, N. S., Gunten, G. von, Khan, J., Stoffel, L., Humpl, T., & Cignacco, E. (2021). Interprofessional collaboration in a new model of transitional care for families with preterm infants – the health care professional’s perspective. Journal of Multidisciplinary Healthcare,14, 897–908. https://doi.org/10.2147/jmdh.s303988 

Hanssen, I., Mkhonto, F. M., Øieren, H., Sengane, M. L., Sørensen, A. L., & Tran, P. T. M. (2021). Pre-decision regret before transition of dependents with severe dementia to long-term care. Nursing Ethics, 29(2), 344–355. https://doi.org/10.1177/09697330211015339 

Hays, K., Denmark, M., Levine, A., de Regt, R. H., Andersen, H. F., & Weiss, K. (2022). Smooth transitions: Enhancing interprofessional collaboration when planned community births transfer to hospital care. Journal of Midwifery & Women’s Health, 67(6), 701–706. https://doi.org/10.1111/jmwh.13441 

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances, 3(3), 100034. https://doi.org/10.1016/j.ijnsa.2021.100034 

Iversen, A.-M., Stangerup, M., From-Hansen, M., Hansen, R., Sode, L. P., Kostadinov, K., Hansen, M. B., Calum, H., Ellermann-Eriksen, S., & Knudsen, J. D. (2021). Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors. American Journal of Infection Control, 49(6). https://doi.org/10.1016/j.ajic.2020.11.007 

NURS FPX 6030 Assessment 6 Final Project Submission

Kaiser, L., Conrad, S., Neugebauer, E. A. M., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: a systematic review. Systematic Reviews, 11(1). https://doi.org/10.1186/s13643-022-02027-x 

Kamau, S., Koskenranta, M., Kuivila, H., Oikarainen, A., Tomietto, M., Juntunen, J., Tuomikoski, A.-M., & Mikkonen, K. (2022). Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review. International Journal of Nursing Studies, 136, 104377. https://doi.org/10.1016/j.ijnurstu.2022.104377

Kim, J., & Kim, H. (2023). A structural equation model on social re-adjustment of stroke patients: Based on Roy’s adaptation model. Journal of Korean Academy of Nursing, 53(4), 480–480. https://doi.org/10.4040/jkan.22140 

LaDonna, K. A., Watling, C. J., Cristancho, S. M., & Burm, S. (2020). Exploring patients’ and physicians’ perspectives about competent health advocacy. Medical Education. https://doi.org/10.1111/medu.14408 

Li, M., Li, Y., Meng, Q., Li, Y., Tian, X., Liu, R., & Fang, J. (2021). Effects of nurse-led transitional care interventions for patients with heart failure on healthcare utilization: A meta-analysis of randomized controlled trials. PLOS ONE, 16(12), e0261300. https://doi.org/10.1371/journal.pone.0261300 

Liss, D. T., Ackermann, R. T., Cooper, A., Finch, E., Hurt, C., Lancki, N., Rogers, A., Sheth, A., Teter, C., & Schaeffer, C. (2019). Effects of a transitional care practice for a vulnerable population: A pragmatic, randomized comparative effectiveness trial. Journal of General Internal Medicine, 34(9), 1758–1765. https://doi.org/10.1007/s11606-019-05078-4 

NURS FPX 6030 Assessment 6 Final Project Submission

Lyu, Q., Huang, J., Li, Y., Chen, Q., Yu, X., Wang, J., & Yang, Q. (2021). Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes: A randomized controlled trial. International Journal of Nursing Studies, 119, 103929. https://doi.org/10.1016/j.ijnurstu.2021.103929 

Ma, R. H., Zhang, Q., Ni, Z. H., & Lv, H. T. (2021). Transitional care experiences of caregivers of preterm infants hospitalized in a neonatal intensive care unit: A qualitative descriptive study. Nursing Open, 8(6). https://doi.org/10.1002/nop2.899 

Mazza, M., Caroppo, E., Marano, G., Chieffo, D., Moccia, L., Janiri, D., Rinaldi, L., Janiri, L., & Sani, G. (2021). Caring for mothers: A narrative review on interpersonal violence and peripartum mental health. International Journal of Environmental Research and Public Health, 18(10), 5281. https://doi.org/10.3390/ijerph18105281 

Mileski, M., Pannu, U., Payne, B., Sterling, E., & McClay, R. (2020). The impact of nurse practitioners on hospitalizations and discharges from long-term nursing facilities: A systematic review. Healthcare, 8(2), 114. https://doi.org/10.3390/healthcare8020114 

Mizukawa, M., Moriyama, M., Yamamoto, H., Rahman, M. M., Naka, M., Kitagawa, T., Kobayashi, S., Oda, N., Yasunobu, Y., Tomiyama, M., Morishima, N., Matsuda, K., & Kihara, Y. (2019). Nurse-led collaborative management using telemonitoring improves quality of life and prevention of rehospitalization in patients with heart failure. International Heart Journal, 60(6), 1293–1302. https://doi.org/10.1536/ihj.19-313

NURS FPX 6030 Assessment 6 Final Project Submission

Molina, J. G., Medina, I. M. F., Sola, C. F., Padilla, J. M. H., Lasserrotte, M. del M. J., & Rodríguez, M. del M. L. (2019). Experiences of mothers of extremely preterm infants after hospital discharge. Journal of Pediatric Nursing, 45, e2–e8. https://doi.org/10.1016/j.pedn.2018.12.003 

Morkisch, N., Upegui-Arango, L. D., Cardona, M. I., van den Heuvel, D., Rimmele, M., Sieber, C. C., & Freiberger, E. (2020). Components of the Transitional Care Model (TCM) to reduce readmission in geriatric patients: A systematic review. BMC Geriatrics, 20(1), 1–18. https://doi.org/10.1186/s12877-020-01747-w 

Muis, K. R., Denton, C., & Dubé, A. (2022). Identifying CRAAP on the internet: A source evaluation intervention. Advances in Social Sciences Research Journal, 9(7), 239–265. 

Mutua, J., Kigamwa, P., Ng’ang’a, P., Tele, A., & Kumar, M. (2020). A comparative study of postpartum anxiety and depression in mothers with pre-term births in Kenya. Journal of Affective Disorders Reports, 2, 100043. https://doi.org/10.1016/j.jadr.2020.100043 

Phagdol, T., Nayak, B. S., Lewis, L. E., Margaret, B., & George, A. (2021). Designing a mobile health intervention for preterm home care: Application of conceptual framework. Public Health Nursing, 39(1), 296–302. https://doi.org/10.1111/phn.13020 

Phillips, S. E. K., Celi, A. C., Wehbe, A., Kaduthodil, J., & Zera, C. A. (2023). Mobilizing the fourth trimester to improve population health: Interventions for postpartum transitions of care. American Journal of Obstetrics and Gynecology, 229(1), 33–38. https://doi.org/10.1016/j.ajog.2022.12.309 

NURS FPX 6030 Assessment 6 Final Project Submission

Salvador, J. T., Al‐Madani, M. M., Al‐Hussien, A. M., Alqahtani, F. M., Alvarez, M. O. C., Hammad, S. S., Sudqi, A. I., Cabonce, S. G., Reyes, L. D. V., Sanchez, K. B., Rosario, A. B., Agman, D. D., & Al‐Mousa, A. A. (2022). Revisiting the roles of neonatal intensive care unit nurses towards vision 2030 of Saudi Arabia: A descriptive phenomenological study. Journal of Nursing Management, 30(7), 2906–2914. https://doi.org/10.1111/jonm.13637 

Sarik, D. A., & Matsuda, Y. (2023). Baby steps: Improving the transition from hospital to home for neonatal patients and caregivers through a nurse-led telehealth program. Springer EBooks, 25–50. https://doi.org/10.1007/978-3-031-22152-1_3 

Sarik, D. A., Matsuda, Y., Terrell, E. A., Sotolongo, E., Hernandez, M., Tena, F., & Lee, J. (2022). A telehealth nursing intervention to improve the transition from the neonatal intensive care unit to home for infants & caregivers: Preliminary evaluation. Journal of Pediatric Nursing, 67, 139–147. https://doi.org/10.1016/j.pedn.2022.09.003 

Scott, I. A., Carter, S. M., & Coiera, E. (2021). Exploring stakeholder attitudes towards AI in clinical practice. BMJ Health & Care Informatics, 28(1), e100450. https://doi.org/10.1136/bmjhci-2021-100450 

Seltzer, E. K., Guntuku, S. C., Lanza, A. L., Tufts, C., Srinivas, S. K., Klinger, E. V., Asch, D. A., Fausti, N., Ungar, L. H., & Merchant, R. M. (2022). Patient experience and satisfaction in online reviews of obstetric care: Observational study. JMIR Formative Research, 6(3), e28379. https://doi.org/10.2196/28379 

Spall, H. G. C., Lee, S. F., Xie, F., Oz, U. E., Perez, R., Mitoff, P. R., Maingi, M., Tjandrawidjaja, M. C., Heffernan, M., Zia, M. I., Porepa, L., Panju, M., Thabane, L., Graham, I. D., Haynes, R. B., Haughton, D., Simek, K. D., Ko, D. T., & Connolly, S. J. (2019). Effect of patient-centered transitional care services on clinical outcomes in patients hospitalized for heart failure. JAMA, 321(8), 753. https://doi.org/10.1001/jama.2019.0710 

NURS FPX 6030 Assessment 6 Final Project Submission

Srivastava, R. H. (2022). The health care professional’s guide to cultural competence – e-book. In Google Books. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=FgxvEAAAQBAJ&oi=fnd&pg=PP1&dq=culturally+competent+care+and+communication+for+care+transition&ots=4iDgH3lV-_&sig=TlhCfBXP9WJWAv2kAvF2krqGr2M 

Swanson, N. M., Elgersma, K. M., McKechnie, A. C., McPherson, P. L., Bergeron, M. J., Sommerness, S. A., Friedrich, C., & Spatz, D. L. (2022). Encourage, assess, transition (EAT) A quality improvement project implementing a direct breastfeeding protocol for preterm hospitalized infants. Advances in Neonatal Care, 23(2), 107–119. https://doi.org/10.1097/anc.0000000000001037 

Tefera, M., Assefa, N., Roba, K. T., Gedefa, L., Brewis, A., & Schuster, R. C. (2022). Women’s hospital birth experiences in Harar, eastern Ethiopia: A qualitative study using Roy’s adaptation model. BMJ Open, 12(7), e055250. https://doi.org/10.1136/bmjopen-2021-055250

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104(104), 103443. https://doi.org/10.1016/j.ijnurstu.2019.103443 

Walker, R., Olander, E. K., Hill, B., Willey, S., & Skouteris, H. (2019). Weight management across pregnancy and postpartum care: The need for interprofessional education and collaboration. Nurse Education in Practice, 41, 102651. https://doi.org/10.1016/j.nepr.2019.102651 

NURS FPX 6030 Assessment 6 Final Project Submission

Weber, L. A. F., Lima, M. A. D. da S., & Marques Acosta, A. (2020). Quality of care transition and its association with hospital readmission. Aquichan, 19(4), 1–11. https://doi.org/10.5294/aqui.2019.19.4.5 

Wei, H., Horns, P., Sears, S. F., Huang, K., Smith, C. M., & Wei, T. L. (2022). A systematic meta-review of systematic reviews about interprofessional collaboration: Facilitators, barriers, and outcomes. Journal of Interprofessional Care, 36(5), 735–749. https://doi.org/10.1080/13561820.2021.1973975 

NURS FPX 6030 Assessment 5 Evaluation Plan Design

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Evaluation of Plan

Defining the Outcomes of the Intervention Plan

The outcomes that serve as the goals of an intervention plan of a nurse-led care transition program focusing on improving resource management efficiency are multifaceted and interrelated. The overarching aim is to enhance the utilization of healthcare resources effectively. By optimizing the allocation of staff time, equipment, and supplies, the program strives to ensure that the right resources are available at the right time to meet the needs of postpartum mothers of preterm infants. This improved resource management is expected to lead to a more coordinated approach to care delivery (Depla et al., 2021). Streamlining communication and collaboration among healthcare providers involved in the care of these vulnerable populations can facilitate seamless transitions between care settings, ultimately enhancing the overall patient experience. In addition to improving coordination and resource allocation, the intervention plan also targets cost efficiency (Lyu et al., 2021).

By identifying waste areas, reducing unnecessary expenditures, and optimizing resource utilization, the program aims to generate cost savings for healthcare organizations and payers. Simultaneously, the goal is to increase patient satisfaction by improving access to care, minimizing wait times, and enhancing the quality of services provided to mothers of preterm infants. This focus on patient-centred care aims to ensure that the needs and preferences of patients and their families are met throughout the care delivery process (Kaiser et al., 2022).

On the positive side, the program is promising in enhancing resource utilization efficiency, promoting coordinated care delivery, achieving cost savings, boosting patient satisfaction, and driving better health outcomes for mothers and infants. These outcomes can transform care delivery processes, optimize resource allocation, and elevate the overall experience of patients and healthcare providers. However, implementing such interventions may encounter obstacles such as resistance from staff, resource constraints, sustainability concerns, increased staff workload, and data management complexities (Depla et al., 2021). Striking a balance between the benefits and challenges of these alternative outcomes is crucial in assessing the effectiveness and sustainability of the intervention program in achieving its overarching goal of enhancing resource management in the care of postpartum mothers of preterm infants.

Designing the Evaluation Plan for the Intervention

Our comprehensive evaluation plan for assessing the impact of the nurse-led transition care program on health promotion and quality improvement is designed to provide a clear and detailed assessment of the intervention’s effectiveness. Combining quantitative and qualitative measures, we aim to capture a holistic view of how the program influences staff and mothers’ satisfaction and well-being. The quantitative aspect of the evaluation will focus on tracking improvements in health outcomes post-intervention by comparing data against a baseline. Hospital resource efficiency and cost-effectiveness will be measured to assess the program’s impact on healthcare utilization (Depla et al., 2021).

Qualitative feedback sessions will offer valuable insights into staff and mothers’ perceptions of the program and overall satisfaction with the intervention. By incorporating both data types, we seek a nuanced understanding of the program’s success. Utilizing specialized software for data analysis will aid in interpreting quantitative data accurately and efficiently, while qualitative data analysis tools will help derive patterns and insights from feedback (Samardzic et al., 2021). Through this evaluation plan, we aim to showcase the meaningful impact of the intervention, demonstrating improvements in health promotion, quality improvement, hospital resource efficiency, and cost-effectiveness (Depla et al., 2021). Assumptions guiding this plan include active participation in feedback sessions by staff and mothers, the reliability of monitoring tools, and effective communication among healthcare providers throughout the evaluation process.

Discussion

Advocacy

Nurses play a crucial role as catalysts for positive change in healthcare. Positioned at the forefront of patient care, they are adept at identifying areas for enhancement and driving improvements. Through their close interactions with patients, nurses are uniquely positioned to lead initiatives that enhance the overall patient experience. When implementing new care approaches, nurses ensure that interventions are clinically effective and address patients’ holistic needs (Lyu et al., 2021). In multidisciplinary teams, nurses act as connectors, bridging diverse healthcare perspectives to deliver integrated care for patients. This collaborative approach, guided by the nurse’s expertise, forms the foundation of high-quality care where all healthcare professionals work together towards a shared goal (LaDonna et al., 2020). The underlying assumption is that nurses know current best practices and have the authority to advocate for and enact necessary changes.

Impact of the Intervention on Nursing, Collaboration, and Healthcare

 The proposed intervention plan profoundly affects nursing and interprofessional collaboration within the healthcare system. Empowering nurses to lead these programs enhances their practice by allowing them to provide comprehensive care, education, and emotional support to mothers of preterm infants. Expanding their role improves the quality of care and utilizes their expertise in maternal and neonatal health more effectively. Moreover, implementing nurse-led care transition initiatives strengthens interprofessional collaboration by fostering communication, coordination, and understanding among healthcare team members caring for preterm infants and their mothers (Carron et al., 2021). Nurses act as facilitators, bridging the gap between professionals and ensuring that care is well-coordinated, holistic, and patient-centered.

This collaborative approach enhances the overall care experience and optimizes patient outcomes by addressing the diverse needs of both the mother and the infant. The healthcare field benefits significantly from nurse-led care transition programs through improved patient outcomes, reduced readmission rates, better resource management,  and enhanced well-being for postpartum mothers and preterm infants. Additionally, these programs contribute to cost-effectiveness by promoting efficient care transitions, preventing complications, and minimizing healthcare utilization. By emphasizing evidence-based practices, patient-centered care, and continuous quality improvement, nurse-led care transition programs elevate the standard of care delivery and drive innovation in healthcare settings (Samardzic et al., 2021).

Future Steps

Integrating emerging technology and advanced care models is crucial to enhancing nurse-led care transition programs’ impact on preterm mothers of preterm infants. Incorporating telehealth and remote monitoring systems can establish continuous connections between caregivers and healthcare professionals, enabling real-time assessment and support for preterm infants (Sarik & Matsuda, 2023). Furthermore, comprehensive education programs focusing on the unique needs and behaviors of preterm babies, as well as peer support networks for mothers, can provide holistic support. However, these improvements are based on assumptions regarding the accessibility and acceptance of technology by preterm mothers and the effectiveness of early detection systems in predicting complications and improving outcomes (Scott et al., 2021).

Reflection on Leading Change and Improvement

Leading the nurse-led care transition program for post-partum mothers of preterm infants has significantly impacted my ability to lead change in my practice and future leadership positions. The experience has allowed me to develop a deeper understanding of the complex needs of preterm infants and their mothers, the importance of holistic care, and the integration of technology in healthcare. This has empowered me to advocate for innovative and patient-centered care models, driving positive change within my practice and inspiring a vision for future leadership roles.

My goals for future personal growth include furthering my knowledge of emerging healthcare technologies and their application in improving patient outcomes. Additionally, I aim to enhance my leadership and communication skills to influence stakeholders and effectively drive meaningful change within healthcare organizations. Furthermore, I aspire to expand my expertise in patient education and support programs, focusing on empowering caregivers and improving the overall experience of preterm infant care.

Integration of Intervention Insights into Broader Practice

The knowledge gained from this intervention plan goes beyond its original context and holds significant value for diverse settings. Combining established practices and advanced technology ensures the plan’s flexibility in different healthcare scenarios. This adaptable approach, which prioritizes personalized care supported by evidence-based practices and strong interprofessional collaboration, can act as a model for interventions in various healthcare environments. However, it is essential to consider conflicting evidence and perspectives impartially, recognizing the challenges and limitations outlined in the literature, such as the necessity for well-designed studies to demonstrate the effectiveness of quality improvement practices. This balanced approach will facilitate the seamless integration of intervention, implementation, and evaluation plans into my practice while remaining receptive to diverse viewpoints and evidence.

References

Carron, T., Rawlinson, C., Arditi, C., Cohidon, C., Hong, Q. N., Pluye, P., Gilles, I., & Peytremann-Bridevaux, I. (2021). An overview of reviews on interprofessional collaboration in primary care: Effectiveness. International Journal of Integrated Care, 21(2). https://doi.org/10.5334/ijic.5588 

Depla, A. L., Crombag, N. M., Franx, A., & Bekker, M. N. (2021). Implementation of a standard outcome set in perinatal care: A qualitative analysis of barriers and facilitators from all stakeholder perspectives. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06121-z 

Kaiser, L., Conrad, S., Neugebauer, E. A. M., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: A systematic review. Systematic Reviews, 11(1). https://doi.org/10.1186/s13643-022-02027-x 

LaDonna, K. A., Watling, C. J., Cristancho, S. M., & Burm, S. (2020). Exploring patients’ and physicians’ perspectives about competent health advocacy. Medical Education. https://doi.org/10.1111/medu.14408 

Lyu, Q., Huang, J., Li, Y., Chen, Q., Yu, X., Wang, J., & Yang, Q. (2021). Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes: A randomized controlled trial. International Journal of Nursing Studies, 119, 103929.  https://doi.org/10.1016/j.ijnurstu.2021.103929 

Sarik, D. A., & Matsuda, Y. (2023). Baby steps: Improving the transition from hospital to home for neonatal patients and caregivers through a nurse-led telehealth program. Springer EBooks, 25–50. https://doi.org/10.1007/978-3-031-22152-1_3 

NURS FPX 6030 Assessment 5 Evaluation Plan Design

Sarik, D. A., Matsuda, Y., Terrell, E. A., Sotolongo, E., Hernandez, M., Tena, F., & Lee, J. (2022). A telehealth nursing intervention to improve the transition from the neonatal intensive care unit to home for infants & caregivers: Preliminary evaluation. Journal of Pediatric Nursing, 67, 139–147. https://doi.org/10.1016/j.pedn.2022.09.003 

Scott, I. A., Carter, S. M., & Coiera, E. (2021). Exploring stakeholder attitudes towards AI in clinical practice. BMJ Health & Care Informatics, 28(1), e100450. https://doi.org/10.1136/bmjhci-2021-100450 

Wei, H., Horns, P., Sears, S. F., Huang, K., Smith, C. M., & Wei, T. L. (2022). A systematic meta-review of systematic reviews about interprofessional collaboration: Facilitators, barriers, and outcomes. Journal of Interprofessional Care, 36(5), 735–749. https://doi.org/10.1080/13561820.2021.1973975 

NURS FPX 6030 Assessment 4 Implementation Plan Design

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Implementation Plan Design

The assessment extensively examines the integration of nurse-led transition care programs for mothers in post-partum of pre-term infants to improve hospital efficiency. It evaluates the current and emerging technological tools, identifies their potential impact on delivery methods and efficacy, and addresses associated challenges. This thorough exploration highlights the technological complexities of improving hospital efficiency by streamlining smooth care transitions and the resulting policy implications. The aim is to comprehend the current scenario and anticipate future changes to ensure that strategies remain pertinent and feasible

Management and Leadership

Visionary leadership is essential for implementing nurse-led care transition programs for postpartum mothers with preterm infants. This vision underscores the significance of these programs in boosting nurse satisfaction and enhancing patient care quality. Leaders should exemplify dedication and cultivate a culture of innovation. A detailed plan with specific goals, deadlines, and transparent stakeholder communication is necessary to ensure successful change management. Involving frontline staff, especially nurses, in decision-making and providing training opportunities is crucial for effectively implementing these programs.

The practical application of nurse-led care transition programs in hospital settings aims to improve nurse well-being and patient care outcomes. This relies on innovative leadership, change management, and staff empowerment. Effective implementation also depends on interprofessional teamwork. Interdisciplinary teams, including nurses, gynecologists, pediatricians, managers, and other relevant healthcare professionals, should be formed to establish collaborative frameworks. Assigning specific roles and responsibilities to each team member during the implementation phase encourages accountability and cooperation (Ruderman et al., 2021).

Open communication is vital in this process. Encouraging open dialogue and mutual respect allows healthcare providers to freely share ideas, concerns, and suggestions. Regular interdisciplinary meetings and communication channels should be established to foster collaboration and information exchange among team members. Additionally, promoting knowledge sharing is key. Facilitating interdisciplinary workshops and knowledge-sharing sessions enables healthcare professionals to learn from each other’s perspectives and expertise. Initiatives to enhance understanding and appreciation of the diverse roles within healthcare disciplines are also encouraged, including cross-training efforts (Wei et al., 2022).

Implications of Change  

These strategies can ultimately contribute to the successful implementation of the intervention plan, positively impacting the quality of care provided to mothers and their preterm infants while controlling costs through efficient teamwork and resource utilization. Firstly, emphasizing interprofessional collaboration will likely improve patient outcomes by providing more integrated and comprehensive care, leading to enhanced health outcomes and increased patient satisfaction while reducing the likelihood of readmissions (Carron et al., 2021). Secondly, focusing on effective teamwork and collaboration can improve care efficiency by streamlining processes, minimizing redundancies, and maximizing resource utilization, ultimately resulting in cost savings for healthcare organizations (Kaiser et al., 2022). Furthermore, nurturing a collaborative work environment can boost staff morale, increase job satisfaction, and foster staff retention, contributing to consistently delivering high-quality care (Wei et al., 2022). 

Conflicting Data and Other Perspectives 

Acknowledging that varying viewpoints and conflicting evidence may arise while implementing proposed strategies to enhance interdisciplinary collaboration is essential. While clear communication channels and team building are proposed as key strategies, it is necessary to recognize that healthcare professionals may have diverse experiences, expertise, and opinions on how best to collaborate effectively. This diversity of perspectives can present challenges and opportunities for growth and innovation within the interdisciplinary team (Samardzic et al., 2021). By fostering an environment that values open dialogue, active listening, and respectful discussion, conflicting data and perspectives can be addressed constructively to reach a consensus and find common ground.

Embracing these differing viewpoints with an impartial lens can enrich the collaboration process, leading to more robust decision-making, improved patient outcomes, and vital unity among team members. In navigating conflicting data and perspectives, maintaining a balanced and inclusive approach is paramount to ensuring the successful implementation of the intervention plan and promoting a culture of interprofessional teamwork and excellence in care delivery (Ahmed et al., 2020).

Delivery and Technology

One appropriate delivery method to implement a nurse-led care program for mothers in the postpartum period after giving birth to preterm infants could involve establishing a virtual telehealth platform. This platform could enable remote consultations, education, and support for mothers from the comfort of their homes, allowing nurses to offer guidance on infant care, breastfeeding, emotional support, and monitoring of both the mother and baby’s health. This approach can improve access to care, reduce the need for in-person visits, and enhance overall efficiency in healthcare resource management by optimizing nurse scheduling, reducing travel time, and increasing patient engagement (Sarik & Matsuda, 2023).

Another effective delivery method could involve developing a mobile app specifically designed for mothers of preterm infants. This app could offer educational resources, personalized care plans, symptom-tracking tools, and a communication channel for direct interaction with nurses and other healthcare providers. By leveraging mobile technology, this delivery method can empower mothers to actively participate in their own care and enhance the continuity of support beyond the hospital setting (Lyu et al., 2021). Assumptions underlying the proposal of these delivery methods include the availability of reliable internet connectivity and access to technology for both healthcare providers and patients. Additionally, it is assumed that nurses are adequately trained to deliver care through telehealth platforms and mobile apps and that appropriate measures are in place to ensure data security, privacy, and regulatory compliance when using digital tools for patient care (Sarik et al., 2022).

Evaluation of Technological Options

Virtual telehealth platforms offer secure video conferencing and data sharing capabilities, while emerging technologies, such as AI-driven analytics and blockchain, hold the potential to enhance remote patient monitoring and data security. Similarly, mobile apps provide features like educational resources and symptom tracking, with advancements in AI-driven chatbots and augmented reality, further enhancing user experience and support for mothers (Oyeniyi, 2024). However, critical knowledge gaps exist in data security, user experience, integration with existing systems, regulatory compliance, and effectiveness. Further research and collaboration are needed to address these uncertainties, ensuring the successful implementation and optimization of these technologies to improve healthcare resource management and enhance outcomes for mothers and preterm infants.

Stakeholders, Policy, and Regulations

The successful implementation of a nurse-led care program for mothers of preterm infants hinges on the collaboration and support of various stakeholders, including healthcare providers, hospital administration, IT professionals, insurance providers, regulatory bodies, technology vendors, and patient advocacy groups. Engaging with healthcare providers is crucial as their clinical expertise and experience are essential in designing and implementing effective transition care programs for mothers of preterm infants. Collaborating with hospital administration is vital to secure institutional support, resources, and alignment with organizational goals. Involving IT professionals is necessary for implementing technology solutions, ensuring data security, and optimizing digital platforms (Depla et al., 2021).

Engaging with insurance providers is critical to navigating reimbursement policies and ensuring financial sustainability for the proposed program. Regulatory bodies are crucial in guiding compliance with healthcare regulations, such as HIPAA, and ensuring ethical care delivery. Technology vendors provide the necessary tools and support for integrating telehealth solutions and mobile apps into the program. Finally, involving patient advocacy groups is essential for promoting awareness, education, and acceptance of virtual care services among post-partum mothers of preterm infants, ultimately enhancing patient engagement and outcomes (LaDonna et al., 2020). 

Assumptions underlying this analysis include the willingness of stakeholders to collaborate, adequate training of healthcare providers on virtual care technologies, compliance with regulations, favorable reimbursement policies from insurance providers, and commitment from hospital administration. By addressing these assumptions and actively engaging stakeholders while considering regulatory implications and potential sources of support, the nurse-led care program can be effectively implemented to provide high-quality care to mothers of preterm infants, ultimately improving health outcomes in this vulnerable population (Scott et al., 2021).

Policy Considerations

The Health Information Technology for Economic and Clinical Health (HITECH) Act is a crucial policy consideration that can support nurse-led care programs for postpartum mothers of preterm infants. The HITECH Act promotes the adoption and meaningful use of electronic health records (EHRs) and secure health information exchange. By complying with HITECH requirements, healthcare providers can enhance the efficiency, quality, and safety of care delivery and facilitate care coordination among multidisciplinary teams involved in postpartum care.

EHR systems can enable nurses to document and track patient data, monitor outcomes, and communicate with other healthcare providers seamlessly, thereby supporting the continuity of care for mothers of preterm infants (Pye et al., 2024). Additionally, leveraging telehealth technologies integrated with EHRs in nurse-led care programs can enhance remote monitoring, virtual consultations, and patient education, aligning with the goals of the HITECH Act to improve healthcare outcomes and patient engagement through the use of health information technology. By aligning nurse-led care programs with HITECH policy requirements, healthcare organizations can leverage technology to optimize care delivery, enhance communication, and promote patient-centered care for postpartum mothers of preterm infants (Pye et al., 2024).

NURS FPX 6030 Assessment 4 Implementation Plan Design

The Health Insurance Portability and Accountability Act (HIPAA) is critical for safeguarding patient privacy and data security. Still, it may also pose challenges that could potentially impair the implementation of nurse-led care transition programs for postpartum mothers of preterm infants. HIPAA regulations require strict adherence to standards for protecting the confidentiality of patient information, which can impact the sharing of sensitive data among healthcare providers involved in the intervention plan. This may create barriers to seamless communication and care coordination, particularly in a nurse-led model that relies on multidisciplinary collaboration. Additionally, HIPAA compliance requirements necessitate secure technology infrastructure to ensure data encryption, access controls, and audit trails (Szalados, 2021).

This may entail significant financial and logistical investments for healthcare organizations implementing telehealth solutions or digital platforms for remote monitoring and patient engagement. Furthermore, navigating HIPAA regulations concerning telehealth services and remote consultations can add complexity to the documentation and consent processes, potentially leading to administrative burdens and delays in care delivery. Addressing these challenges requires careful consideration of HIPAA implications, training healthcare providers on compliance protocols, implementing robust data security measures, and leveraging technology solutions that adhere to HIPAA standards while enabling efficient and effective communication among providers and engagement with patients in nurse-led care programs for postpartum mothers of preterm infants (Szalados, 2021).

Timeline

Our nurse-led transition care program for mothers of preterm infants will span over twelve months. The initial two months will focus on establishing the groundwork, such as allocating resources and contacting participants. The subsequent six months will involve actively implementing the program, conducting regular training sessions for participants, and collecting ongoing feedback. The final four months will be dedicated to evaluating the program, analyzing data, and refining our approach based on feedback received. The availability of resources, participant engagement, and external factors will influence the success of our timeline. Feedback from both mothers and healthcare providers will play a crucial role in shaping the pace and potential adjustments to our program. Flexibility is key; we will adapt to address unforeseen challenges and prioritize the well-being of the preterm infant and mother community.

References

Ahmed, F., Zhao, F., Faraz, N. A., & Qin, Y. J. (2020). How inclusive leadership paves way for psychological well‐being of employees during trauma and crisis: A three‐wave longitudinal mediation study. Journal of Advanced Nursing, 77(2), 819–831. https://doi.org/10.1111/jan.14637 

Carron, T., Rawlinson, C., Arditi, C., Cohidon, C., Hong, Q. N., Pluye, P., Gilles, I., & Peytremann-Bridevaux, I. (2021). An overview of reviews on interprofessional collaboration in primary care: Effectiveness. International Journal of Integrated Care, 21(2). https://doi.org/10.5334/ijic.5588 

Depla, A. L., Crombag, N. M., Franx, A., & Bekker, M. N. (2021). Implementation of a standard outcome set in perinatal care: A qualitative analysis of barriers and facilitators from all stakeholder perspectives. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06121-z 

Kaiser, L., Conrad, S., Neugebauer, E. A. M., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: a systematic review. Systematic Reviews, 11(1). https://doi.org/10.1186/s13643-022-02027-x 

LaDonna, K. A., Watling, C. J., Cristancho, S. M., & Burm, S. (2020). Exploring patients’ and physicians’ perspectives about competent health advocacy. Medical Education. https://doi.org/10.1111/medu.14408 

Lyu, Q., Huang, J., Li, Y., Chen, Q., Yu, X., Wang, J., & Yang, Q. (2021). Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes: A randomized controlled trial. International Journal of Nursing Studies, 119, 103929. https://doi.org/10.1016/j.ijnurstu.2021.103929 

NURS FPX 6030 Assessment 4 Implementation Plan Design

Oyeniyi, N. J. (2024). The role of AI and mobile apps in patient-centric healthcare delivery. World Journal of Advanced Research and Reviews, 22(1), 1897–1907. https://doi.org/10.30574/wjarr.2024.22.1.1331 

Pye, J., Rai, A., & John Qi Dong. (2024). How hospitals differentiate health information technology portfolios for clinical care efficiency: Insights from the HITEACH act. Information Systems Research. https://doi.org/10.1287/isre.2021.0260 

Ruderman, R. S., Dahl, E. C., Williams, B. R., Davis, K., Feinglass, J. M., Grobman, W. A., Kominiarek, M. A., & Yee, L. M. (2021). Provider perspectives on barriers and facilitators to postpartum care for low-income individuals. Women’s Health Reports, 2(1), 254–262. https://doi.org/10.1089/whr.2021.0009 

Samardzic, M. B., Clark, M. A., Exel, N. Job. A., & Wijngaarden, J. D. H. (2021). Patients as team members: Factors affecting involvement in treatment decisions from the perspective of patients with a chronic condition. Health Expectations, 25(1). https://doi.org/10.1111/hex.13358 

Sarik, D. A., & Matsuda, Y. (2023). Baby steps: Improving the transition from hospital to home for neonatal patients and caregivers through a nurse-led telehealth program. Springer EBooks, 25–50. https://doi.org/10.1007/978-3-031-22152-1_3 

Sarik, D. A., Matsuda, Y., Terrell, E. A., Sotolongo, E., Hernandez, M., Tena, F., & Lee, J. (2022). A telehealth nursing intervention to improve the transition from the neonatal intensive care unit to home for infants & caregivers: Preliminary evaluation. Journal of Pediatric Nursing, 67, 139–147. https://doi.org/10.1016/j.pedn.2022.09.003 

Scott, I. A., Carter, S. M., & Coiera, E. (2021). Exploring stakeholder attitudes towards AI in clinical practice. BMJ Health & Care Informatics, 28(1), e100450. https://doi.org/10.1136/bmjhci-2021-100450 

NURS FPX 6030 Assessment 4 Implementation Plan Design

Szalados, J. E. (2021). Medical records and confidentiality: Evolving liability issues inherent in the electronic health record, HIPAA, and cybersecurity. The Medical-Legal Aspects of Acute Care Medicine, 1(1), 315–342. https://doi.org/10.1007/978-3-030-68570-6_13 

Wei, H., Horns, P., Sears, S. F., Huang, K., Smith, C. M., & Wei, T. L. (2022). A systematic meta-review of systematic reviews about interprofessional collaboration: facilitators, barriers, and outcomes. Journal of Interprofessional Care, 36(5), 735–749. https://doi.org/10.1080/13561820.2021.1973975 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Intervention Plan Design

This assessment continues the discussion on the intervention designed for the Population, Intervention, Comparison, Outcome, and Time( PICOT) question developed and discussed in the previous two assessments. The PICOT question analyzes the strategic management of nurse-led care transition and how it impacts the efficiency of healthcare resource management compared to standard care provided for mothers in post-partum after giving birth to pre-term infants. This assessment delves into the intervention plan and the relevant theoretical, ethical, and legal perspectives.

Intervention Plan Components

The intervention designed to improve hospital resource management is nurse-led care transition programs. This intervention is based on various components and elements, each essential for effective implementation and achieving the desired outcome. The population’s health needs are thoroughly examined to tailor the care transition plans accordingly. Mothers who have given birth to pre-term babies require physical healthcare along with the challenges they encounter after pre-term birth. These can be varied from patient to patient, and a deeper analysis can help nurses develop transition care plans accordingly (Phillips et al., 2023).

Another significant intervention component is creating customized care plans that consider patients’ medical history, post-partum recovery, and psychosocial needs. Moreover, the nurses are expected to educate mothers about post-partum care and caring for pre-term infants, such as recognizing signs of complications, monitoring infants’ development, and self-care strategies. The nurses must foster interdisciplinary collaboration with relevant team members such as physicians, neonatologists, lactation consultants, and social workers to create a holistic care transition plan for mothers and their pre-term babies (Haemmerli et al., 2021). 

These components will help nurses promote effective care strategies during care transition procedures, ultimately reducing hospital readmission rates and the need for emergency visits. This will improve the efficiency of healthcare resources and their effective allocation for other patients, fulfilling the identified need described in the previous assessment. The criteria that can be utilized to evaluate the success of this intervention plan are measuring the patient satisfaction scores through mothers’ surveys, analyzing reduction in hospital readmission rates, and better allocation of resources without complaints of resource scarcity in gynecology and neonatology wards (Seltzer et al., 2022).

Cultural Needs and Characteristics of Population and Setting

The intervention plan’s components greatly depend on the cultural needs and the features of the population and setting. Considering the given population of mothers post-partum after giving birth to pre-term babies in hospitals, the cultural needs can vary due to diverse cultural backgrounds and their varied beliefs about health and illness. They all have different knowledge, perspectives, and beliefs in healthcare practices after childbirth and post-partum. Therefore, nurse-led care transition programs will require culturally competent care plans that consider the patients’ cultural considerations and their impact on care transitions (Hanssen et al., 2021). The educational materials must be in a language understandable by culturally diverse mothers who use cultural language. Moreover, the nurse practitioners will require additional training in providing care transition guidance and education in a culturally competent manner (Kamau et al., 2022).

The hospital will require culturally competent nursing staff to address these cultural needs and specific health policies to implement a patient-centered care culture. These cultural needs will require training, additional recruitment of qualified staff, and fostering collaboration among interprofessional teams to promote communication strategies to address cultural sensitivity among the target population (Srivastava, 2022). The analysis is based on the assumption that culturally diverse populations as patients are prone to dismiss the accomplishment of improving healthcare resource efficiency when their cultural beliefs do not align with healthcare practices (Argyriadis et al., 2022). Therefore, considering the cultural requirements of implementing intervention successfully is essential to manage healthcare resources efficiently.  

Theoretical Foundations

Different theoretical nursing models apply to the intervention plan of nurse-led care transition programs for mothers after pre-term births. Roy’s Adaptation Model (RAM) is a nursing theory centralized on individuals adapting to internal and external stimuli to maintain balance and well-being (Kim & Kim, 2023). These stressors can prompt adaptive responses through coping mechanisms. This theory is relevant to the proposed intervention plan, as mothers who have given birth to pre-term babies experience emotional, physical, and psychosocial challenges that are addressed by nurse-led care transition programs and help them adapt to the current difficulties of the health challenges of post-partum and caring for pre-term infants (Tefera et al., 2022).

The strength of this theory is that RAM takes a holistic approach by considering multiple adaptive modes such as physiologic, role function, self-consent, and interdependence, which helps address various aspects of patients’ lives in the subject scenario. Moreover, it integrates the nursing processes such as assessing patients, diagnosing, planning, implementing, and evaluating. Therefore, it provides a systematic approach for nurses to guide their nurse-led care transition program effectively. The weaknesses of RAM are the complex nature of this model for novice nurses and the lack of clarity on residual stimuli, making them practically invalid (Kim & Kim, 2023). 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Another theory, Peplau’s Interpersonal Relations Theory, focuses on nurse-patient relations. It is relevant to nurse-led care transition programs where nurses must communicate with mothers post-partum after pre-term birth and provide education, support, and guidelines in the care transition process. Through effective interpersonal relations between nurse and patient, the goal of managing healthcare resources is efficiently achieved as patients coordinate with nurses sufficiently (Salvador et al., 2022). The strengths of this theory are a strong emphasis on nurse-patient relations where significant health outcomes can be improved by creating a strong, positive, and healthy relationship. The weaknesses include the need for sufficient time to build deeper interpersonal connections and dependence on practical and therapeutic communication skills to foster connections  (Salvador et al., 2022). 

The strategies from other disciplines that can be adopted related to nurse-led care transition programs are social work support services such as connecting families with community resources and providing emotional support that can promote comprehensive care for mothers in post-partum with preterm babies. Other strategies include psychological strategies to promote positive behaviors and reinforcements to encourage desired behaviors and outcomes in maternal self-care and infant care (Mazza et al., 2021). These strategies significantly influence intervention plan components in enhancing care and adherence to the care plan.

The healthcare technologies relevant to the intervention plan of a nurse-led care transition program include mobile health applications. These apps can provide accessible resources, educational materials, and reminders to support mothers of pre-term babies in improving self-care and managing preterm infant care. This technology influences the design of nurse-led care program components as the education nurses provide can be practically applied with the help of these apps that promote consistency and adherence to care plans (Phagdol et al., 2021).

Justification of Major Components of the Intervention Plan

 The subsequent section justifies the intervention plan using theoretical models, strategies, and technology. The RAM theoretical model suggests that the adaptive nature of humans to external stimuli can provide them with better coping mechanisms and help them adapt to the surrounding situations. This theory justifies the intervention plan, including educating mothers of pre-term infants to manage the health challenges effectively and adjust to the current healthcare scenarios with wisdom and correct knowledge (Kim & Kim, 2023). Similarly, the intervention’s component of interprofessional collaboration is justified by Peplau’s theory, which emphasizes the need for interpersonal connections and relations to enhance care coordination (Salvador et al., 2022).

The strategies of social support services and reinforcing psychological behaviors also justify the customized care plans based on health needs, such as mothers requiring social and community resources and psychological support. These strategies also justify the intervention’s component of thorough assessment to delve into specific patients’ needs and provide social and psychological support accordingly. The mobile health technologies justify the nurse-led care transition programs as the mothers can implement knowledge nurses share effectively through these apps, providing alarms, educational resources, and self-care support to mothers (Phagdol et al., 2021). The conflicting data from the earlier perspectives exist in literature where nurse-led care transition programs are not supported with strategies from other disciplines due to the need for extensive resources and time for collaboration (Dyess et al., 2023).

Stakeholders, Policy, and Regulations

The relevant stakeholders of this intervention plan are nurses, mothers in post-partum with pre-term infants, social supporters, and psychologists. The needs of these stakeholders are vital to consider as they directly impact the nurse-led care transition programs. For instance, nurses must educate mothers, communicate with interprofessional team members, and manage the care transition process (Hays et al., 2022). The mothers must be adequately guided on post-partum and pre-term infant care with sufficient knowledge of the baby’s future follow-ups and managing challenges associated with pre-term infant care. The social supporters must coordinate with mothers, nurses, and community resources to deliver emotional and social support (Brazil et al., 2022). Psychologists are needed to provide mental health support to mothers. These needs must be adequately met to successfully implement the intervention plan components (Dyess et al., 2023). 

The American Nurses Association is the governing body that guides nurses through healthcare policies. The health policies on care coordination necessary for care transition provide nurses with authentic guidelines for performing care transition plans for mothers having given pre-term births (ANA, 2023). The Health Insurance Portability and Accountability Act (HIPAA) regulations are vital to implement when mobile health apps are used. The HIPAA regulatory guidelines emphasize the importance of securing patients’ protected health information to prevent privacy breaches (Choi & Williams, 2022).

Compliance with these policies and regulations promotes the effective implementation of intervention plans such as interprofessional collaboration, which requires the practice of care coordination policies where nurses are adequately communicating with multidisciplinary team members and creating care transition plans according to shared decisions of team members and the health needs of mothers and pre-term infants. The underlying assumptions of this analysis are grounded in theoretical perspectives that health policies by governing bodies and stakeholders’ collaboration can effectively direct the nurses to make the nurse-led care transition successful. Moreover, health policies are meant to guide nurses by paving the way for them to perform corrective steps in light of sound literature (ANA, 2023). 

Ethical and Legal Implications

The ethical issues identified in this project are related to mothers’ autonomy in post-partum for creating care-transition plans according to their preferences and health needs. Moreover, privacy and security issues are raised during mobile health apps and interprofessional team collaboration. These ethical issues affect the intervention plan’s educational component and interprofessional collaboration element. Moreover, legal issues can arise when the nurses must practice the state nursing board policies and accreditation standards. Adherence to these legal standards and policies ensures nurses customize care transition plans accordingly (Iversen et al., 2021). These legal issues impact the nurse-led care transition plans. Failure to implement these health policies by the American Nursing Association can lead to incorrect and illegal healthcare practices and require organizational change to revise the guidelines and take stringent measures.

Conclusion

This assessment studied the intervention plan to discuss ethical, legal, and regulatory considerations. The nurse-led care program is based on interprofessional collaboration, educating postpartum mothers with preterm babies, and thorough health analysis. Moreover, theoretical models, strategies, and technologies, such as RAM and Peplau’s theory, are highlighted. Ethical, legal, and regulatory issues must be considered while designing the intervention.

References

ANA. (2023, December 21). Care coordination and the essential role of nurses | American Nurses Association (ANA). ANA. https://www.nursingworld.org/practice-policy/health-policy/care-coordinatio

Argyriadis, A., Patelarou, E., Paoullis, P., Patelarou, A., Dimitrakopoulos, I., Zisi, V., Northway, R., Gourni, M., Asimakopoulou, E., Katsarou, D., & Argyriadi, A. (2022). Self-Assessment of health professionals’ cultural competence: Knowledge, skills, and mental health concepts for optimal health care. International Journal of Environmental Research and Public Health, 19(18), 11282. https://doi.org/10.3390/ijerph191811282 

Brazil, V., McLean, D., Lowe, B., Kordich, L., Cullen, D., De Araujo, V., Eldridge, T., & Purdy, E. (2022). A relational approach to improving interprofessional teamwork in post-partum haemorrhage (PPH). BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08463-8 

Choi, Y. B., & Williams, C. E. (2022). A HIPAA security and privacy compliance audit and risk assessment mitigation approach. Research Anthology on Securing Medical Systems and Records. https://www.igi-global.com/chapter/a-hipaa-security-and-privacy-compliance-audit-and-risk-assessment-mitigation-approach/309023 

Dyess, N. F., Keels, E., Myers, P., French, H., Reber, K., LaTuga, M. S., Johnston, L. C., & Scala, M. (2023). Optimizing clinical care and training in the neonatal intensive care unit: The relationship between front line providers and physician trainees. Journal of Perinatology, 43(12), 1513–1519. https://doi.org/10.1038/s41372-023-01749-7

Haemmerli, N. S., Gunten, G. von, Khan, J., Stoffel, L., Humpl, T., & Cignacco, E. (2021). Interprofessional collaboration in a new model of transitional care for families with preterm infants – the health care professional’s perspective. Journal of Multidisciplinary Healthcare,14, 897–908. https://doi.org/10.2147/jmdh.s303988 

Hanssen, I., Mkhonto, F. M., Øieren, H., Sengane, M. L., Sørensen, A. L., & Tran, P. T. M. (2021). Pre-decision regret before transition of dependents with severe dementia to long-term care. Nursing Ethics, 29(2), 344–355. https://doi.org/10.1177/09697330211015339 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Hays, K., Denmark, M., Levine, A., de Regt, R. H., Andersen, H. F., & Weiss, K. (2022). Smooth transitions: Enhancing interprofessional collaboration when planned community births transfer to hospital care. Journal of Midwifery & Women’s Health, 67(6), 701–706. https://doi.org/10.1111/jmwh.13441 

Iversen, A.-M., Stangerup, M., From-Hansen, M., Hansen, R., Sode, L. P., Kostadinov, K., Hansen, M. B., Calum, H., Ellermann-Eriksen, S., & Knudsen, J. D. (2021). Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors. American Journal of Infection Control, 49(6). https://doi.org/10.1016/j.ajic.2020.11.007 

Kamau, S., Koskenranta, M., Kuivila, H., Oikarainen, A., Tomietto, M., Juntunen, J., Tuomikoski, A.-M., & Mikkonen, K. (2022). Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review. International Journal of Nursing Studies, 136, 104377. https://doi.org/10.1016/j.ijnurstu.2022.104377

Kim, J., & Kim, H. (2023). A structural equation model on social re-adjustment of stroke patients: Based on Roy’s adaptation model. Journal of Korean Academy of Nursing, 53(4), 480–480. https://doi.org/10.4040/jkan.22140 

Mazza, M., Caroppo, E., Marano, G., Chieffo, D., Moccia, L., Janiri, D., Rinaldi, L., Janiri, L., & Sani, G. (2021). Caring for mothers: A narrative review on interpersonal violence and peripartum mental health. International Journal of Environmental Research and Public Health, 18(10), 5281. https://doi.org/10.3390/ijerph18105281 

Phagdol, T., Nayak, B. S., Lewis, L. E., Margaret, B., & George, A. (2021). Designing a mobile health intervention for preterm home care: Application of conceptual framework. Public Health Nursing, 39(1), 296–302. https://doi.org/10.1111/phn.13020 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Phillips, S. E. K., Celi, A. C., Wehbe, A., Kaduthodil, J., & Zera, C. A. (2023). Mobilizing the fourth trimester to improve population health: Interventions for postpartum transitions of care. American Journal of Obstetrics and Gynecology, 229(1), 33–38. https://doi.org/10.1016/j.ajog.2022.12.309 

Salvador, J. T., Al‐Madani, M. M., Al‐Hussien, A. M., Alqahtani, F. M., Alvarez, M. O. C., Hammad, S. S., Sudqi, A. I., Cabonce, S. G., Reyes, L. D. V., Sanchez, K. B., Rosario, A. B., Agman, D. D., & Al‐Mousa, A. A. (2022). Revisiting the roles of neonatal intensive care unit nurses towards vision 2030 of Saudi Arabia: A descriptive phenomenological study. Journal of Nursing Management, 30(7), 2906–2914. https://doi.org/10.1111/jonm.13637 

Seltzer, E. K., Guntuku, S. C., Lanza, A. L., Tufts, C., Srinivas, S. K., Klinger, E. V., Asch, D. A., Fausti, N., Ungar, L. H., & Merchant, R. M. (2022). Patient experience and satisfaction in online reviews of obstetric care: Observational study. JMIR Formative Research, 6(3), e28379. https://doi.org/10.2196/28379 

Srivastava, R. H. (2022). The health care professional’s guide to cultural competence – e-book. In Google Books. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=FgxvEAAAQBAJ&oi=fnd&pg=PP1&dq=culturally+competent+care+and+communication+for+care+transition&ots=4iDgH3lV-_&sig=TlhCfBXP9WJWAv2kAvF2krqGr2M 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Tefera, M., Assefa, N., Roba, K. T., Gedefa, L., Brewis, A., & Schuster, R. C. (2022). Women’s hospital birth experiences in Harar, eastern Ethiopia: A qualitative study using Roy’s adaptation model. BMJ Open, 12(7), e055250. https://doi.org/10.1136/bmjopen-2021-055250

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Problem Statement

The management of sepsis, a condition that can be fatal, in adult patients admitted to intensive care units depends significantly on the timing of antibiotic administration. The question arises: In adult patients admitted to intensive care units (Population), is the early usage of broad-spectrum antibiotics (Intervention) compared to delayed usage (Comparison) interconnected with a lower mortality rate (Outcome) within the first 72 hours of sepsis diagnosis (Time)? Understanding this temporal relationship is essential for refining clinical protocols, potentially leading to more effective interventions and improved outcomes for patients grappling with sepsis in intensive care settings.

Needs Assessment

The project seeks to lead organizational change by addressing a critical need in the healthcare setting, specifically focused on adult patients admitted to intensive care units diagnosed with sepsis. Compared to delayed usage, the intervention centers around implementing an early usage of broad-spectrum antibiotics to lower mortality rates within the first 72 hours of sepsis diagnosis. This intervention aligns with health promotion and quality improvement objectives, aiming to enhance the overall experience of care, improve population health outcomes, and optimize the work life of healthcare professionals. The identified need is urgent as sepsis is a time-sensitive condition, and evidence strongly supports the notion that early administration of broad-spectrum antibiotics is interconnected with a lower mortality rate.

Delayed treatment can significantly worsen patient outcomes and increase mortality rates, making timely intervention imperative. The urgency is underscored by studies demonstrating that a prompt response within the crucial 72-hour window is associated with improved survival rates and reduced healthcare costs (Martínez et al., 2020). By implementing this intervention, the project addresses a vital health promotion and quality improvement need by emphasizing the importance of timely and effective sepsis management. The assumptions underlying this analysis include the belief that proactive measures in sepsis care, like early antibiotic intervention, will positively impact patient outcomes and decrease overall healthcare costs. Furthermore, it assumes that organizational changes supporting timely interventions will lead to a more efficient, cost-effective, and patient-centered healthcare system by contributing to improved experiences of care, population health, and the work life of healthcare professionals (Rhee et al., 2020).

Population and Settings

The project targets adult patients admitted to intensive care units (ICUs) diagnosed with sepsis as the specific population, given the urgency and severity of sepsis cases. The ICU setting is chosen for its specialized resources, skilled healthcare professionals, and advanced monitoring capabilities by aligning with the critical requirements of sepsis management. The identified need within this setting focuses on improving patient outcomes through the early use of broad-spectrum antibiotics within the first 72 hours of sepsis diagnosis. Effectively addressing this need is crucial for positively impacting mortality rates and aligns with health promotion and quality improvement objectives. Challenges in this initiative may include navigating the intricate nature of ICU care, overcoming potential resistance to protocol changes, and ensuring seamless coordination among healthcare teams. Despite these challenges, the specialized environment of ICUs provides an opportunity for focused and intensive implementation of the quality improvement method (Al-Sunaidar et al., 2020).

The importance of this project lies in its potential to enhance patient outcomes in a time-sensitive condition, supported by evidence linking early antibiotic intervention to lower mortality rates. The initiative aligns with broader goals of improving the patient experience, population health outcomes, and optimizing the work life of healthcare professionals within the critical ICU setting. Assumptions guiding this initiative include the belief that proactive measures, like early antibiotic intervention, will positively impact patient outcomes and decrease healthcare costs. The project aligns with the overarching goal of leading organizational change to enhance the quality of care while being mindful of cost-effectiveness and the professional well-being of healthcare practitioners within the targeted ICU population and setting (Gauer et al., 2020).

Intervention Overview

A multifaceted intervention strategy is proposed to improve sepsis management in adult ICU patients. Firstly, evidence-based clinical protocols will guide healthcare professionals in early broad-spectrum antibiotic administration within the critical first 72 hours of sepsis diagnosis. Tailored to the urgent needs of the target population, these protocols aim to streamline decision-making and ensure timely interventions, directly addressing the identified need for prompt sepsis management. Secondly, educational initiatives will enhance healthcare professionals’ knowledge and awareness of the importance of early antibiotic intervention in sepsis cases. Designed to fit the ICU setting, these programs consider the challenges of ICU care, fostering a culture of continuous learning and awareness. This intervention promotes a proactive approach to sepsis management among healthcare professionals (Sendak et al., 2020). While both interventions effectively address the identified need, potential challenges such as changing established protocols and the need for ongoing education will be systematically addressed through stakeholder engagement, continuous training, and quality improvement processes. The combined strategy aims to comprehensively address the identified need by integrating clinical protocols and educational initiatives tailored to the unique characteristics of the target population and setting (Sendak et al., 2020).

Comparison of Approaches

An alternative approach to improving sepsis management in adult ICU patients involves establishing a dedicated rapid response team comprising various healthcare professionals, including physicians, nurses, pharmacists, and respiratory therapists. This interdisciplinary team collaborates to ensure swift and coordinated responses to sepsis cases within critical hours by fostering a complete and interprofessional approach to patient care. Unlike the initial intervention, this alternative promotes interprofessional care by leveraging the collective expertise of diverse healthcare professionals, enabling a comprehensive strategy that addresses timely antibiotic administration and critical aspects of sepsis management, such as continuous monitoring and immediate adjustments to the care plan (Uffen et al., 2021).

This alternative aligns well with the adult ICU population’s specialized and complex medical needs, addressing unique challenges associated with ICU care through team members’ diverse skill sets and expertise. In the ICU setting, the rapid response team seamlessly aligns with the time-sensitive nature of critical care, facilitating prompt mobilization and responses to sepsis cases within the crucial 72-hour window. This alternative proves favorable in addressing the identified need for prompt and effective sepsis management. The collaborative efforts of the rapid response team offer a holistic and timely approach, potentially enhancing patient outcomes and reducing sepsis-related mortality rates. Acknowledging potential challenges, such as efficient coordination and consistent availability of diverse professionals, emphasizes the importance of proactive management through effective communication, ongoing training programs, and continuous quality improvement processes for successful implementation (Wulff et al., 2019).

Initial Outcome Draft

The defined outcome is a substantial reduction in sepsis-related mortality within the first 72 hours through early broad-spectrum antibiotic administration in adult ICU patients. Aligned with the intervention’s purpose of health promotion, quality improvement, and patient safety, this outcome reflects a targeted and measurable goal. Focusing on lowering mortality rates underscores the urgency of timely intervention, emphasizing the potential life-saving impact of early antibiotics. This outcome serves an apparent objective by establishing a framework for enhancing the quality and safety of care for septic patients in ICUs. It highlights the pivotal role of swift and effective interventions in mitigating the risk of fatal outcomes, illustrating the project’s intent to make a tangible impact.

To assess achievement, criteria include a statistically significant decrease in mortality rates, a comparative analysis of outcomes between early and delayed antibiotic administration, and adherence to established protocols within the 72-hour window. These criteria provide a robust evaluation framework by ensuring that the intervention’s success is objectively measured and contributes to health promotion, quality improvement, and preventing adverse outcomes. The outcome signifies the purpose and intended accomplishments of the intervention. It establishes a meaningful benchmark for evaluating success in enhancing the overall care experience for septic patients in intensive care settings.

Time Estimate

The development of the intervention focusing on the early usage of broad-spectrum antibiotics in adult ICU patients to lower sepsis-related mortality would span approximately 12-18 months. This time frame allows for a comprehensive review of existing literature by consultation with experts and the design of evidence-based protocols. While realistic, potential challenges such as navigating regulatory approvals, coordinating multidisciplinary input, and addressing unforeseen obstacles in protocol development may impact this timeframe. The implementation phase, involving the integration of the intervention into ICU practices, is estimated to require an additional 18-24 months. This period includes training healthcare staff, modifying existing workflows, and establishing a robust monitoring and feedback system. While deemed realistic, challenges may arise from resistance to change among healthcare professionals, logistical issues in implementing new protocols, and the need for ongoing adjustments based on real-world feedback. Identifying and proactively addressing these challenges will be crucial to ensuring the successful development and implementation of the intervention within the proposed time frames.

Literature Review

Investigating the early usage of broad-spectrum antibiotics in adult patients admitted to intensive care units (ICUs) and its potential correlation with lower mortality rates within the initial 72 hours of sepsis diagnosis involves an in-depth analysis of current evidence. Evaluating this evidence validates the identified need and explores its appropriateness within the target population and setting by considering relevance, currency, sufficiency, and trustworthiness. The Surviving Sepsis Campaign Guidelines, a cornerstone in sepsis management, consistently undergo updates based on the latest meta-analyses and expert consensus. The evidence within these guidelines robustly underscores the significance of early antibiotic intervention in adult ICU patients diagnosed with sepsis (Suh et al., 2023).

In another study, the guidelines validated the identified need and established its relevance within a comprehensive approach to improving patient outcomes in diverse healthcare settings (Schorr et al., 2022). The evidence supporting the appropriateness of early antibiotic intervention within the target population. The evidence validates the identified need and showcases its currency and relevance in contemporary ICU settings by demonstrating a clear association between early, goal-directed therapy (including antibiotic usage) and reduced mortality rates. The study’s impact has led to the worldwide integration of early interventions into sepsis management protocols (Rothrock et al., 2020).

A study by Kollef et al. (2021) further contributes to the comprehensive validation of the identified need. By highlighting the critical role of timely initiation of effective antimicrobial therapy in improving survival rates among adult ICU patients with septic shock, this evidence emphasizes the relevance and sufficiency of early antibiotic administration within the specified timeframe. The study of Al-Kader et al. (2022) findings has influenced sepsis treatment guidelines, emphasizing the importance of prompt antibiotic intervention. The study provides valuable insights of sepsis, especially within the unique setting of ICUs. The evidence robustly validates the appropriateness of addressing the identified need in ICU settings by emphasizing the crucial role of timely interventions.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

The observed impact of time to treatment on sepsis mortality rates underscores the relevance and trustworthiness of this evidence, further reinforcing the identified need for early antibiotic administration (Im et al., 2022). The study explores the impact of rapid antibiotic administration on patient outcomes in ICUs. By delving into the time-sensitive nature of antibiotic delivery, the evidence provides insights into the practical implications of early intervention, further substantiating the identified need. The study’s findings contribute to the ongoing discourse on optimizing antibiotic administration in critical care settings (Asner et al., 2021).

Focusing on patient-centered outcomes, this study evaluates the impact of early sepsis interventions, including antibiotic administration, on patients’ overall experiences and satisfaction. By considering the holistic effects of early interventions, the evidence enhances our understanding of the identified need’s appropriateness in promoting patient-centered care and improving the quality of the overall healthcare experience in ICUs (Artigas et al.,2022). Focusing on antibiotic timing in the setting of emerging resistant strains, this evidence addresses a critical aspect of appropriateness within the evolving landscape of sepsis management. The study’s findings contribute valuable insights into adapting early antibiotic intervention strategies to mitigate the challenges of emerging antibiotic resistance, thereby enhancing the overall relevance and currency of the identified need (Arulkumaran et al., 2020). The extensive evidence analysis solidifies the need for early use of broad-spectrum antibiotics in adult ICU patients within the first 72 hours of sepsis diagnosis. This analysis validates the need and elucidates its appropriateness within the target population and setting, considering multiple dimensions of evidence quality, relevance, and currency ( Busch & Kadri, 2020).

Evaluation and Synthesis of Relevant Health Policy

The Centers for Medicare & Medicaid Services (CMS) Sepsis Management Guidelines are pivotal in shaping healthcare practices for diagnosing, treating, and reporting sepsis cases. These guidelines emphasize the critical aspects of early recognition, timely interventions, and adherence to evidence-based practices in sepsis management. The policy’s impact on addressing the identified need is substantial, given that CMS guidelines hold sway over reimbursement structures and quality ratings for healthcare facilities. Compliance with these guidelines is necessary for regulatory adherence and financial viability (Kempker et al., 2019). Incorporating evidence-based clinical protocols aligned with CMS recommendations for sepsis care is a crucial consideration for the project. Continuous monitoring and documentation of sepsis care practices will be essential to meet reporting requirements mandated by CMS. However, challenges emerge in balancing strict adherence to guidelines and the need for flexible intervention approaches. Modifications may become necessary to strike a balance that ensures policy compliance while addressing the unique needs of the target population and setting (Pakyz et al., 2020).

The National Institute for Health and Care Excellence (NICE) provides evidence-based guidelines that significantly influence healthcare practices, including those related to sepsis. The NICE Sepsis Guidelines offer comprehensive recommendations for healthcare professionals recognizing, diagnosing, and managing sepsis, emphasizing early intervention and the prompt administration of antibiotics. This policy is particularly relevant to the identified need as it contributes additional perspectives and standards to guide effective sepsis care (Goel et al., 2019). Incorporating NICE guidelines into the project is imperative for enhancing the evidence-based approach to sepsis management. Aligning the project interventions with NICE recommendations will enhance patient outcomes and contribute to quality improvement goals. Staying informed about updates or revisions to NICE guidelines is crucial to ensuring the project remains current and aligned with evolving standards. Collaboration with healthcare professionals is essential to implement interventions that align with CMS and NICE guidelines, considering any variations or intersections between the two recommendations (Hershkovich–Shporen et al., 2021).

Conclusion

In conclusion, this assessment highlights the urgency of addressing sepsis in adult ICU patients through early broad-spectrum antibiotic intervention. The proposed strategy, aligning with health promotion objectives, seeks to reduce mortality rates within 72 hours. The alternative rapid response team approach offers an interdisciplinary solution, addressing challenges in the complex ICU setting. With a clear outcome of lowering sepsis-related mortality, this comprehensive assessment provides a robust foundation for a timely, evidence-based intervention, promising significant improvements in patient care within intensive care settings.

References

Al-Kader, D. A., Anwar, S., Hussaini, H., Jones Amaowei, E. E., Rasuli, S. F., Hussain, N., Kaddo, S., & Memon, A. (2022). Systematic review on the effects of prompt antibiotic treatment on survival in septic shock and sepsis patients in different hospital settings. Cureus. https://doi.org/10.7759/cureus.32405 

Al-Sunaidar, K. A., Prof. Abd Aziz, N., & Prof. Hassan, Y. (2020). Appropriateness of empirical antibiotics: Risk factors of adult patients with sepsis in the ICU. International Journal of Clinical Pharmacy, 42(2), 527–538. https://doi.org/10.1007/s11096-020-01005-4 

Artigas, R. M, Ferrando, C., Martino, F., Delbove, A., Ferreyro, B. L., Darreau, C., Jacquier, S., Brochard, L., & Lerolle, N. (2022). Early intubation and patient-centered outcomes in septic shock: A secondary analysis of a prospective multicenter study. Critical Care, 26(163). https://doi.org/10.1186/s13054-022-04029-6 

Arulkumaran, N., Khpal, M., Tam, K., Baheerathan, A., Corredor, C., & Singer, M. (2020). Effect of antibiotic discontinuation strategies on mortality and infectious complications in critically ill septic patients. Critical Care Medicine, 48(5), 757–764. https://doi.org/10.1097/ccm.0000000000004267 

Asner, S. A., Desgranges, F., Schrijver, I. T., & Calandra, T. (2021). Impact of the timeliness of antibiotic therapy on the outcome of patients with sepsis and septic shock. Journal of Infection, 82(5), 125–134. https://doi.org/10.1016/j.jinf.2021.03.003 

Busch, L. M., & Kadri, S. S. (2020). Antimicrobial treatment duration in sepsis and serious infections. The Journal of Infectious Diseases, 222(2), S142–S155. https://doi.org/10.1093/infdis/jiaa247 

Hershkovich–Shporen, C., Guri, A., Gluskina, T., & Flidel‐Rimon, O. (2021). Centers for disease control and prevention guidelines identified more neonates at risk of early‐onset sepsis than the Kaiser‐Permanente calculator. Acta Paediatrica. https://doi.org/10.1111/apa.16232 

Gauer, R., Forbes, D., & Boyer, N. (2020). Sepsis: Diagnosis and management. American Family Physician, 101(7), 409–418. https://www.aafp.org/pubs/afp/issues/2020/0401/p409.html?utm_medium=email&utm_source=transaction 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Goel, N., Shrestha, S., Smith, R., Mehta, A., Ketty, M., Muxworthy, H., Abelian, A., Kirupaalar, V., Saeed, S., Jain, S., Asokkumar, A., Natti, M., Barnard, I., Pitchaikani, P. K., & Banerjee, S. (2019). Screening for early onset neonatal sepsis: NICE guidance-based practice versus projected application of the Kaiser Permanente sepsis risk calculator in the UK population. Archives of Disease in Childhood – Fetal and Neonatal Edition, 105(2), 118–122. https://doi.org/10.1136/archdischild-2018-316777 

Im, Y., Kang, D., Ko, R.-E., Lee, Y. J., Lim, S. Y., Park, S., Na, S. J., Chung, C. R., Park, M. H., Oh, D. K., Lim, C.-M., Suh, G. Y., Lim, C.-M., Hong, S.-B., Oh, D. K., Suh, G. Y., Jeon, K., Ko, R.-E., Cho, Y.-J., & Lee, Y. J. (2022). Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: A prospective nationwide multicenter cohort study. Critical Care, 26(1). https://doi.org/10.1186/s13054-021-03883-0 

Kempker, J. A., Kramer, M. R., Waller, L. A., Wang, H. E., & Martin, G. S. (2019). State-level hospital compliance with and performance in the centers for medicaid & medicare services’ early management severe sepsis and septic shock bundle. Critical Care, 23(1). https://doi.org/10.1186/s13054-019-2382-0 

Kollef, M. H., Shorr, A. F., Bassetti, M., Timsit, J.-F., Micek, S. T., Michelson, A. P., & Garnacho-Montero, J. (2021). Timing of antibiotic therapy in the ICU. Critical Care, 25(1). https://doi.org/10.1186/s13054-021-03787-z 

Martínez, M. L., Plata-Menchaca, E. P., Ruiz-Rodríguez, J. C., & Ferrer, R. (2020). An approach to antibiotic treatment in patients with sepsis. Journal of Thoracic Disease, 12(3), 1007–1021. https://doi.org/10.21037/jtd.2020.01.47 

Pakyz, A. L., Orndahl, C. M., Johns, A., Harless, D. W., Morgan, D. J., Bearman, G., Hohmann, S. F., & Stevens, M. P. (2020). Impact of the centers for medicare and medicaid services sepsis core measure on antibiotic use. Clinical Infectious Diseases, 72(4), 556–565. https://doi.org/10.1093/cid/ciaa456 

Rhee, C., Kadri, S. S., Dekker, J. P., Danner, R. L., Chen, H.-C., Fram, D., Zhang, F., Wang, R., & Klompas, M. (2020). Prevalence of antibiotic-resistant pathogens in culture-proven sepsis and outcomes associated with inadequate and broad-spectrum empiric antibiotic use. JAMA Network Open, 3(4), e202899. https://doi.org/10.1001/jamanetworkopen.2020.2899 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Rothrock, S. G., Cassidy, D. D., Barneck, M., Schinkel, M., Guetschow, B., Myburgh, C., Nguyen, L., Earwood, R., Nanayakkara, P. W. B., Nannan Panday, R. S., & Briscoe, J. G. (2020). Outcome of immediate versus early antibiotics in severe sepsis and septic shock: A systematic review and meta-analysis. Annals of Emergency Medicine, 76(4). https://doi.org/10.1016/j.annemergmed.2020.04.042 

Sendak, M. P., Ratliff, W., Sarro, D., Alderton, E., Futoma, J., Gao, M., Nichols, M., Revoir, M., Yashar, F., Miller, C., Kester, K., Sandhu, S., Corey, K., Brajer, N., Tan, C., Lin, A., Brown, T., Engelbosch, S., Anstrom, K., & Elish, M. C. (2020). Real-world integration of a sepsis deep learning technology into routine clinical care: Implementation study. JMIR Medical Informatics, 8(7), e15182. https://doi.org/10.2196/15182 

Schorr, C. A., Seckel, M. A., Papathanassoglou, E., & Kleinpell, R. (2022). Nursing implications of the updated 2021 surviving sepsis campaign guidelines. American Journal of Critical Care, 31(4), 329–336. https://doi.org/10.4037/ajcc2022324 

Suh, G. J., Shin, T. G., Kwon, W. Y., Kim, K., Jo, Y. H., Choi, S. H., Sung Phil Chung, & Kim, Y.-J. (2023). Hemodynamic management of septic shock: Beyond of the SSC guidelines. Clinical and Experimental Emergency Medicine. https://doi.org/10.15441/ceem.23.065 

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NURS FPX 6030 Assessment 1 Conference Call Scheduling and Notes

Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

MSN Practicum Conference Call Template

Date:

Attending:

Meeting objectives: Consolidate clinical data documentation protocols, initiate the research study on broad-spectrum antibiotic timing and mortality rates, secure approval for dedicated clinical hours, and conduct a comprehensive literature review.

NURS FPX 6030 Assessment 1 Conference Call Scheduling and Notes