I need help Building on my preliminary plan

4050 A4 instructions

For this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.

Note: You are required to complete Assessment 1 before this assessment.

Introduction

This assessment provides an opportunity to research the literature and apply evidence to support what communication, teaching, and learning best practices are needed for a hypothetical patient with a selected health care problem.

Preparation

You are encouraged to complete the Vila Health: Cultural Competence activity prior to completing this assessment. Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.

In this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.

To prepare for your assessment, you will research the literature on your selected health care problem. You will describe the priorities that a care coordinator would establish when discussing the plan with a patient and family members. You will identify changes to the plan based upon EBP and discuss how the plan includes elements of  Healthy People 2030 .

For this assessment:

· Build on the preliminary plan, developed in Assessment 1, to complete a comprehensive care coordination plan.

Document Format and Length

Build on the preliminary plan document you created in Assessment 1. Your final plan should be a scholarly APA-formatted paper, 5–7 pages in length, not including title page and reference list.

Supporting Evidence

Support your care coordination plan with peer-reviewed articles and Healthy People 2030 resources. Cite at least three credible sources.

Grading Requirements

The requirements outlined below, correspond to the grading criteria in the Final Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

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

· Address three health care issues.

· Design an intervention for each health issue.

· Identify three community resources for each health intervention.

· Consider ethical decisions in designing patient-centered health interventions.

· Consider the practical effects of specific decisions.

· Include the ethical questions that generate uncertainty about the decisions you have made.

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

· Cite specific health policy provisions.

· 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 explain the need for changes to the plan.

· 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.

· Use the literature on evaluation as guide to compare learning session content with best practices.

· Align teaching sessions to the Healthy People 2030 document.

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

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

Additional Requirements

Before submitting your assessment, proofread your final care coordination plan to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan.

Context

Care coordination is the process of providing a smooth and seamless transition of care as part of the health continuum. Nurses must be aware of community resources, ethical considerations, policy issues, cultural norms, safety, and the physiological needs of patients. Nurses play a key role in providing the necessary knowledge and communication to ensure seamless transitions of care. They draw upon evidence-based practices to promote health and disease prevention to create a safe environment conducive to improving and maintaining the health of individuals, families, or aggregates within a community. When provided with a plan and the resources to achieve and maintain optimal health, patients benefit from a safe environment conducive to healing and a better quality of life.

Course Competencies

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 1: Adapt care based on patient-centered and person-focused factors.

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

· Competency 2: Collaborate with patients and family to achieve desired outcomes.

· 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.

· Competency 3: Create a satisfying patient experience.

· 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.

· Competency 4: Defend decisions based on the code of ethics for nursing.

· Consider ethical decisions in designing patient-centered health interventions.

· Competency 5: Explain how health care policies affect patient-centered care.

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

· Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.

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

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

4050 A4 - Activity

Vila Health: Cultural Competence

I. Introduction

II. The Patient Comes to the ER

III. Treatment

IV. Treatment Plan Goes Badly

V. Treatment Plan Revisited

VI. Conclusion

I. Introduction

Providing care for patients means more than diagnosing them and coming up with a plan for their treatment. It means communicating with the patient, explaining what they need to know to understand why the treatment has been chosen, what the treatment will accomplish, and what their role will be in that treatment—taking medications, doing home therapy, changing diet, or other actions.

When working with patients whose cultural background is different from the practitioner’s, cultural competence becomes a necessary skill. Cultural competence does not mean knowing everything about every patient’s culture. But it does mean learning about that culture so that treatment decisions, communications, and other actions take that culture into account.

In this activity, you will explore a patient situation that calls for cultural competence: explaining the proposed treatment plan to the patient. You will observe a practitioner performing this task both with, and without, cultural competence.

II. The Patient Comes to the ER

A few days ago, Camila Flores came to the emergency room with acute stomach pain, nausea, and vomiting. Her breathing was deep and rapid.

Dr. Lawrence greets Camila.

Dr. Lawrence: Hi, Camila, my name is Dr. Lawrence, and I hear you’ve been having some trouble.

Camila My stomach is killing me!

Dr. Lawrence: Well, we’re going to get you fixed up. Nurse, let’s get an A1C and gluCose level.

Emilio Boggio: Will do. Camila, we’re going to take good care of you, okay?

III. Treatment

The results come in from Camila’s tests. Her A1C is 7.5 and her glucose level is 330. That confirms what Dr. Lawrence suspected: Camila has diabetes mellitus type 2. She’s going to have to make some significant lifestyle changes, and she’s going to have to adhere to a medication regimen. She may even have to have insulin injections.

Dr. Lawrence meets with Emilio Boggio.

Dr. Lawrence: All right, diabetes mellitus type 2 diagnosis is confirmed. Let’s get that glucose level stabilized first, and some IV fluids.

Emilio Boggio: On it. I’ll make a plan to meet with her later for some education and a plan for her ongoing treatment. And a referral to the diabetes educator, of course.

IV. Treatment Plan Goes Badly

The next morning, Emilio meets with Camila to talk about next steps. Lucas Branch, the hospital’s diabetes educator, sits in to observe.

Emilio starts the conversation.

Emilio: [slightly condescending tone] Well, good morning, Mrs. Flores, how are you feeling today?

Camila: A lot better. But I don’t know what I’m going to do now. I have diabetes? I have to change everything I eat?

Emilio: Now, don’t you worry, we’ll help you. It’s not as hard as it sounds. You will have to pay more attention to what you eat, and that might be hard at first, but you’ll get used to it.

Camila: I already pay attention to what I eat.

Emilio: Oh, of course you do. But this is different. Let’s take an example. Have you heard of the Mediterranean diet?

Camila: Of course.

Emilio: Well, it’s not important that you know why it’s the Mediterranean diet. But you’ll learn more, and basically when you follow that diet you’ll have a good deal of success with managing your glucose levels.

Camila: [irritated] It’s because it’s based on foods found in countries on the Mediterranean coast.

Emilio: Well, look at you! See, you’ll have no trouble with this. You’ll just have to count calories like you’ve never counted before! I’m sure you like rice and beans, right?

Camila: No, I don’t.

Emilio: So that’s going to help. Rice and beans are both good carbohydrates that raise your blood sugar in a predictable fashion.

Camila: I said I don’t like them. I need different options.

Emilio: [at the same time] Now, I’ve got all kinds of educational materials that will help you get going on this. We’ll talk more later, but right now we should probably talk about how you’ll be checking your sugars!

V. Treatment Plan Revisited

After the meeting, Emilio asks Lucas Branch, the diabetes educator, how he thought it went. “Well, it could have gone better,” he says. “Here’s how I would have gone about it.”

Lucas starts the conversation

Lucas: Hello, Ms. Flores, how are you feeling?

Camila: A lot better. But I don’t know what I’m going to do now. I have diabetes? I have to change everything I eat?

Lucas: Well, that’s what I’m here to talk with you about. It’s true, you’re probably going to have to make some lifestyle changes. But I’m here to give you the information you need and work with you so that you can make those changes without too much effort. And I don’t just mean today; we’ll be talking more in the days ahead, and I’ll be available until you feel like you’ve got a good handle on your diet and checking your sugars and so on.

Camila: Okay. So what are we talking about?

Lucas: So how much do you feel like you already know about diabetes?

Camila: I’ve gotta give up sugar, right?

Lucas: I’d say it’s more like your job now is going to be to monitor the carbohydrates you take in. Diabetes is when your body doesn’t use insulin properly. Have you heard of insulin?

Camila: Sure, it’s what I’ll have to inject, right?

Lucas: Not necessarily. What you’ll be doing is eating in such a way that your blood sugar doesn’t go up so high. Insulin is a hormone that your body produces to process blood sugar. When you have diabetes, your body releases more and more but it still can’t keep your blood sugar at the right level. So when you eat a diet that keeps your blood sugar a little more steady, you’ll also avoid having too much insulin in your system—or not enough.

Camila: Okay. That makes sense.

Lucas: So what do you like to cook?

Camila: I like steak! And potatoes. I know, not a very good Latina, right? I should eat all rice and beans.

Lucas: [laughs] Well, rice and beans are good, in moderation. But vegetables are also really good. And again, you don’t have to give up anything or only eat one thing. We’ll work together to create a diet that works for you, that you like, and that also just happens to manage your insulin better.

Reflection Questions

Now that you have reviewed what happened after Camila was diagnosed, consider the following reflective questions. Your answers may help in developing your assignment.

1. What did you notice about the difference between how Emilio Boggio and Lucas Branch related to Camila?

2. In what ways did Emilio Boggio demonstrate insensitivity to Camila?

This question has not been answered yet.

3. In what ways did Lucas Branch demonstrate cultural competence with Camila?

4. How can you apply these lessons to your practice to provide culturally-competent care?

5. How does this scenario translate to culturally-competent care coordination?

VII. Conclusion

Congratulations! You have completed this activity.

As you’ve seen, interactions with patients can be productive, but they can also be counterproductive and leave the patient feeling less informed and more uncertain than before. Developing cultural competence can help prevent these counterproductive interactions and bridge cultural gaps between nurse and patient, resulting in better evidence-based care.

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