Final Care Coordination Plan

You did a fine job evaluating the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature. You described the priorities that a care coordinator would establish when discussing the plan with a patient and family members. You identified changes to the plan based upon EBP but DID NOT discuss how the plan includes elements of Healthy People 2030. Overall, this is a very good effort on this final care coordination plan addressing the health care problem of trauma; and I value your time and professionalism and creativity in preparing this. I made a few recommendations on how some criteria might achieve a higher performance score. I hope you will take the information you learned on creating this final care coordination plan back to your facility to identify opportunities to improve health outcomes. This would be a great way to share nursing knowledge.  I look forward to seeing what you do in your future educational endeavors.  

All my best, 

Dr. Elina

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COMPETENCY 1

Adapt care based on patient-centered and person-focused factors.

CRITERION

Design patient-centered health interventions and timelines for a selected health care problem.

Your result: Distinguished

Distinguished

Designs patient-centered health interventions and timelines for a selected health care problem that includes community resources.

Proficient

Designs patient-centered health interventions and timelines for a selected health care problem.

Basic

Designs patient-centered health intervention for a selected health care problem.

Non-Performance

Does not design patient-centered health interventions and timelines for a selected health care problem.

Faculty Comments:

I like that you designed a care plan that provides a comprehensive and patient-centered patient centered health interventions and timelines for a selected health care problem that includes community resources.

COMPETENCY 2

Collaborate with patients and family to achieve desired outcomes.

CRITERION

Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.

Your result: Proficient

Distinguished

Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice. Clearly explains the need for changes to the plan.

Proficient

Describes priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.

Basic

Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member but does not use evidence-based practice to make changes to the plan.

Non-Performance

Does not describe priorities that a care coordinator would establish when discussing the plan with a patient and family member.

Faculty Comments:

I see you described priorities that a care coordinator would establish when discussing the plan with a patient and family member and made changes based upon evidence-based practice. To earn distinguished in this criterion, you need to clearly explain changes to the plan based upon evidence-based practice. 

COMPETENCY 3

Create a satisfying patient experience.

CRITERION

Use the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2030 document.

Your result: Non-Performance

Distinguished

Uses the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2030 document. Clearly explains the need for any revisions.

Proficient

Uses the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2030 document.

Basic

Discusses evaluation but does not use the literature as a guide to compare learning session content with best practices, or does not include how to align teaching sessions to the Healthy People 2030 document.

Non-Performance

Does not use the literature on evaluation as a guide to compare learning session content with best practices, and does not include how to align teaching sessions to the Healthy People 2030 document.

Faculty Comments:

The paper does not use the literature on evaluation as a guide to compare learning session content with best practices and does not include how to align teaching sessions to the Healthy People.

COMPETENCY 4

Defend decisions based on the code of ethics for nursing.

CRITERION

Consider ethical decisions in designing patient-centered health interventions.

Your result: Distinguished

Distinguished

Considers insightful ethical decisions in designing patient-centered health interventions. These decisions are supported by the literature.

Proficient

Considers ethical decisions in designing patient-centered health interventions.

Basic

Considers ill-defined or ambiguous ethical decisions in designing patient-centered health interventions.

Non-Performance

Does not consider ethical decisions in designing health interventions.

Faculty Comments:

I see that you considered insightful ethical decisions in designing patient-centered health interventions supported by the literature.

COMPETENCY 5

Explain how health care policies affect patient-centered care.

CRITERION

Identify relevant health policy implications for the coordination and continuum of care.

Your result: Proficient

Distinguished

Identifies relevant health policy implications for the coordination and continuum of care, based on precise and accurate interpretations of relevant policy provisions. Makes valid, insightful inferences.

Proficient

Identifies relevant health policy implications for the coordination and continuum of care.

Basic

Identifies health policy implications that are inconsistent with the goals and objectives for the coordination and continuum of care.

Non-Performance

Does not identify relevant health policy implications for the coordination and continuum of care.

Faculty Comments:

I like that you identified relevant health policy implications for the coordination and continuum of care. To earn distinguished in this criterion, I recommend that you base this on precise and accurate interpretations of relevant policy provisions and support this with valid and insightful inferences.

COMPETENCY 6

Apply professional, scholarly communication strategies to lead patient-centered care.

CRITERION

Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Your result: Distinguished

Distinguished

Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.

Proficient

Applies APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Basic

Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes and/or paraphrasing.

Non-Performance

Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly.

Faculty Comments:

Your application of APA formatting was flawless. You used quotes and paraphrased appropriately.

CRITERION

Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Your result: Distinguished

Distinguished

Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.

Proficient

Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Basic

Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling.

Non-Performance

Does not organize content for ideas. Lacks logical flow and smooth transitions.

Faculty Comments:

I like that your writing was very clear and logical.  You organized content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.