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Clinical and Healthcare Discussion

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Application of the DNP Essentials V-V111 to your CSP.

Please respond to these five discussion board posts with substantive responses. the 5 responses will be 5, do not combine them into one post, they have to be five total with at least one reference for each.

1.

V. Health Care Policy for Advocacy in Health Care

The health care policy for advocacy creates the framework for patient care and creating policies to meet the needs of the patients (AACN, 2006). For my project I will be educating providers on the importance of screening for concussions in the primary care setting. I will be initiating a provider education and a pre/post-intervention quiz. The goal of the project is to make screening for concussions a standard of practice in primary care. If the project goes as planned and there is an increase in the number of patients screened for concussions, I hope to initiate a policy at my place of employment. The policy will require providers to ask each patient about recent head injury and document the patient was screened in the chart. The number of concussions sustained far outnumbers the percentage of concussions that are reported to a health care provider (Veliz, 2017). This future policy will be a quality improvement and hopefully reduce the number of patients who go undiagnosed and/or treated with a concussion. In my future practice I will follow procedures, evidence-based practice, and contribute my knowledge to further health care policies.

VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes

Essential VI focuses on individuals of various practices coming working together to provide quality patient care (AACN, 2006). I will be collaborating with several members of the health care team, including, medical doctors, doctors of osteopathic medicine, naturopathic doctors, nurse practitioners, and physician’s assistance. I will start by initiating provider education with the assistance of my mentor. I will then present my educational piece to various providers within the organization and from there we will work together to provide quality care to patients by screening from concussions. In my future practice I will utilize interprofessional collaboration to care for my patients, refer my patients to other specialize, and consult with my colleagues.

VII. Clinical Prevention and Population Health for Improving the Nation’s Health

The goal of Essential VII is to reduce patients’ risk of illness through preventative care (AACN, 2006). My project is about quality improvement and highly meets the recommendations of essential VII. My project will educate providers on the importance of screening patients for concussions to promote early diagnosis and subsequent treatment. In addition, this gives the providers the opportunity to educate patients on the risk of repeat injury that can lead to second impact syndrome, post-concussive syndrome, morbidity, and mortality. A high priority of my project is prevention, awareness, and overall health improvement. In my future practice I will utilize my extensive education, knowledge, and the collaboration of my peers to provide quality patient education for preventative health care measures.

VIII. Advanced Nursing Practice

The purpose of essential VIII is to grow and perform to the full capacity of out skills as nurse practitioners (AACN, 2006). My project fulfills these goals as I will be utilizing my knowledge and evidence-based practice to educate a group of highly trained providers. In addition, I will be utilizing my education to implement a change that has the potential to enhance the quality and safety of patient care. In my future practice I will stay up to date on current evidence-based practices to ensure I am proving my patients with the best care possible.

References

American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. https://www.aacnnursing.org/Portals/42/Publication…

Veliz, P., McCabe, S. E., Eckner, J. T., & Schulenberg, J. E. (2017). Prevalence of Concussion Among US Adolescents and Correlated Factors. JAMA, 318(12), 1180. https://doi.org/10.1001/jama.2017.9087

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Essential V: Health Care Policy for Advocacy in Health Care

This essential focuses on the creation of health care policy that may serve as a framework for facilitating the delivery of health care services identifying and addressing the health care need through advocacy. Health care policies and political activism could be used to address health disparities, cultural issues, access to health care, quality of care, finance, equity, and other aspects of health care delivery (aacn.org, 2006). It also focuses on advocating for health, the nursing profession, social justice, and other policies that could promote the overall wellbeing of individuals in the community. My project could be used by policymakers and congressional groups to address health disparity especially among minority women with PPD. There may be a focus on programs that will address maternal depression during the prenatal period to prevent negative consequences of PPD (Abdollahi et al., 2011). There may be a need to reach out to community leaders and or partners for support in health promotion.

Essential V1: Interprofessional Collaboration for Improving Patient and Population Health Outcomes.

The focus is on interprofessional collaboration for better health outcomes. It also involves the application and utilization of collaborative skills in the delivery of health care. Consulting with other members of the health care team, effective communication, and utilization of leadership skills in the development of models, guidelines that could improve the standard of care (aanc.org, 2006). My CSP will utilize a tested instrument, the Edinburgh Postnatal Depression Scale (EPDS) for early identification of women with PPD and refer to a Psychiatrist and/or therapist for treatment as needed (Smith-Nielson et al., 2018). Collaborating with the rest of the health team, fully participating in teamwork, and utilization of leadership skills in the community clinic may improve the client’s response to the plan of care and reduce the negative outcomes of PPD (Mozhgan et al., 2021).

Essential V11: Clinical Prevention and Population Health for Improving the Nation’s Health.

This primarily focuses on ways to promote health, reduce risk and prevent illnesses among individuals, their families, and the community. It also evaluates the various dimensions of health such as environment, occupational, cultural, and socioeconomic (aanc.org, 2006). My CSP will focus on early identification and treatment of PPD, untreated PPD could be a health population issue that may result in disability and/or mortality (Hahn-Holbrook et al, 2018). My CSP will be at a clinic that serves a large minority population with the low-income majority who are below the Federal Poverty level, also women who are at risk for PPD. Addressing PPD in this community will include the implementation of clinical preventive measures such as prenatal assessment for risk factors of PPD, early assessment at initial postpartum visit, and referral for treatment if they met the criteria (Abdollahi e al., 2011). Preventing PPD could improve the health status of the community and an overall improvement of population health. Recommendations will focus on the determinants of health, cultural diversity, and disease prevention for the improvement of population health.

Essential V111: Advanced Nursing Practice

This essential incorporates the foundation and core competencies of nursing practice. The sustenance of partnership, mastery, and advanced knowledge will be the basis of practice during the period of my project. Conducting thorough and comprehensive health assessment such as during the initial postpartum assessment for identification of PPD, referral for treatment for those who met the criteria (aanc.org, 2006; Mozhgan et al., 2021). My CSP will utilize advanced skills that will promote effective communication among team members, use the EPDS for better assessment and identification of PPD. The findings of my CSP could be published in peer review journals to exemplify authorship and transformation of knowledge. Furthermore, an evaluation of the interventions to ascertain the outcomes. The findings of my CSP could be incorporated into programs that focus on cultural awareness and policies that focus on women’s health.

References

Abdollahi, F., Lye, M., Zain, A., Ghazali, S., & Zarghami, M. (2011). Postnatal depression and

it’s associated factors in women from different cultures. Iranian Journal of Psychiatry &

Behavioral Sciences, 5(2): 5-11. PMCID:PMC3939973: PMID:2464441.

Hahn-Holbrook, J., Cornwell-Hinrichs, T., & Anaya, I. (2018). Economic and health predictors

of national postpartum depression prevalence: A systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Frontiers in Psychiatry, 1:2. https:/.doi:10.3389/fpsyt.2017.00248.

Martin, C., & Redshaw, M. (2018). Establishing a coherent and replicable measurement model

of the Edinburgh postnatal depression scale (2018). Journal of Psychiatry Research, 264: 182-191. https://doi: 10.1016/j.psychres.2018.03.062.

Mozhgan, R., Paymaneh, S., Elahe, S., & Farkhondeh, S. (2021). Exploring the necessity of

establishing a Doctor of Nursing proactive program from experts’ views: a qualitative study. BMC Medical Education, 21:328(2021). https://doi.org/10.1186/s12909-021-02758-w

Smith-Nielsen, J., Matthey, S., Lange, T., & Vaever, M., S. (2018). Validation of the Edinburg postnatal depression scale against both DSM-5 and ICD-10 diagnostic criteria for depression. BMC Psychiatry, 18(1):393. https://. doi:10.1186/s12888-018-1965-7

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The Essentials of Doctoral Education for Advanced Nursing Practice V-VIII

Essential V: Health Care Policy for Advocacy in Health Care.

The process of advocacy in health will continue to require the support of health care policy. Health care policy is the stand-alone reference for all entities in the care of patients and their families. The nursing care concept has exceptional outcomes in terms of research and evidence-based practices, and the policy making process is certainly the means of that reference point. My CSP will effectively support health care policy in the role of improving preventative maintenance measures by advocating for healthier lifestyles and full compliance while taking part in physical activity regimens. Also, the use of physical activity will improve wellbeing of participant’s overall health status as well as help to improve any co-morbidities that exist.

Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes.

Interprofessional collaboration for improvement of patient outcomes is important in that the achievement of shared governance is key to creating an effective and efficient patient-centered care. In the development of practice models, peer reviews, and practice guidelines, interprofessional collaboration help to communicate the overall realm of what should collectively be advocated for and put into practice for the health care of each patient. The Robert Wood Johnson Foundation addresses the inherent power struggles and necessary culture changes in its definition of interprofessional collaboration in healthcare: “Effective interprofessional collaboration promotes the active participation of each discipline in patient care, where all disciplines are working together and fully engaging patients and those who support them, and leadership on the team adapts based on patient needs … It fosters respect for the disciplinary contributions of all professionals” (O’Connor, 2019). In the multi-tiered, complex health care environment of today, nursing practice experts, in collaboration with other healthcare professionals, can assume leadership roles. By achieving this significant role when appropriate and employing effective communication skills, DNPs can overcome interprofessional impediments to practice and assure timely, effective, and efficient patient-centered care (Helem, 2020).

Essential VII. Clinical Prevention and Population Health for Improving the Nation’s Health.

In support of the Healthy People 2020 Promotion, the Essential VII represents the nation’s view of capturing the highest of health continuum levels and empowering protectionary practices for individuals and their families. My CSP will help to promote preventative maintenance by encouraging physical activities in the community settings as will help to support other communities and out-reach centers to adapt the same premise of clinical prevention and public health. Clinical preventive services, such as routine disease screening and scheduled immunizations, are key to reducing death and disability and improving the Nation’s health. These services both prevent and detect illnesses and diseases from flu to cancer in their earlier, more treatable stages, significantly reducing the risk of illness, disability, early death, and medical care costs (HealthyPeople.gov, 2020). This project relates to embarking on what is most important to our nation which in part is to educate and propose methods to attain and achieve the goal of improving the health status of our nation.

Essential VIII. Advanced Nursing Practice.

The DNP Essential VIII capitalizes on the foundational study of different competencies that represent the varied specialties within the nursing profession. The area of study also embodies the clinical experience in the different patient settings beyond the baccalaureate level of study. My CSP will support the education and specialization curriculum of the DNP preparation and systemic alignment with facilitating preventative measures for larger populations and community groups for optimal healthcare and patient outcomes. This essential focuses on the goal of DNP education; that the advanced nursing curriculum will prepare advanced practice nurses for leadership across complex healthcare systems. Evidence of the DNP Essentials is realized when graduates perceive themselves as equal to other leaders and capable of driving change using evidence and effective collaboration (Bowie et al., 2019).

References

Bowie, B., DeSocio, J., Swanson, K. (2019). The DNP degree: are we producing the

graduates we intended. Retrieved from https://journals.lww.com/jonajournal/Abstract/2019…

HealthyPeople.gov (2020). Clinical preventative services. Retrieved from

https://www.healthypeople.gov/2020/leading-health-…

Helem, T. (2020). DNP Essential VI. Interprofessional collaboration for improving patient and population health outcomes. Retrieved from

https://tanshanickahele-4bc472317e76d9b19ac9c29.we…

O’Connor, W. (2019). Five benefits of interprofessional collaboration in healthcare. Retrieved from tigerconnect.com/blog/5-benefits-of-interprofessional-collaboration-in-healthcare/

4.

Essential V: Health Care Policy for Advocacy in Health Care

Health care policy helps the provider to address health care needs. These policies can be created through governmental actions, institutional decision-making, or organizational standards (AACN, 2006). Engaging in in-policy development is vital in creating a health care system that meets the constituents’ needs. The DNP graduate has the knowledge and education to design, implement and advocate for health care reforms that address social justice issues and equity in health care. Some of the nurses involved in political activity have been elected or appointed as officials involved in policymaking (Wilson et al ., 2020). I am a member of the American Academy of Nurse Practitioners (AANP) and the Maryland Academy of Advanced Practice Clinicians (MAACP). MAACP is one of the leading associations in Maryland that have made legislative and regulatory changes that benefit Maryland Advanced Practice Clinicians since 2005. MAACP was instrumental in influencing many laws in the state of Maryland. In 2015, MAACP’s Full Practice Authority bill for NPs was passed into law in Maryland. As a DNP graduate, I have found that belonging to a nursing organization provided me with invaluable experience in understanding the profession’s problems and contacting policymakers about some of the crucial issues facing nurse practitioners. I intend to join other interest groups to help influence the community leaders, other prominent people, and the media. Some of the meetings are held via zoom and email communications.

Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes

The health care system is complex and providing high-quality care depends on highly skilled and knowledgeable clinicians from different professions. In order to provide care that is equitable, effective, efficient, and patient-centered, health care professionals must work collaboratively

as a team ( AACN, 2006). This essential prepares DNP graduates as team leaders in the multifaceted environment as team leaders who can participate in quality improvement and assume leadership positions when needed. My CSP is on decreasing the risk factors of obesity using a mobile app. This essential will be met as I will be the team leader that will guide the project with collaboration with my CSP chair and other experts in the field. I will provide education to the study participants and provide follow-up calls each week to discuss progress which will help them to stay on track with their goals. This essential will also be applied in my daily practice by screening each patient for obesity with every patient encounter and providing education as needed to help reduce risk factors of obesity.

Essential VII: Clinical Prevention and Population Health for Improving the Nation’s Health

Clinical prevention and population health activities are vital in achieving the national goal of improving the population’s health. Preventable deaths due to unhealthy lifestyles can be managed by providing education and creating initiatives to increase awareness. DNP-prepared nurses can use their leadership position to create and integrate evidence-based clinical preventive health services for the population. This essential focuses on providing equitable and patient-centered care that will guide all clinical decision-making. This essential is linked to my CSP, which includes reviewing the obesity epidemic in my community and state epidemiological data for several hours. The preparation for this CSP has helped me identify the extent of the problem for the local community where the project will take place. It has influenced my practice by looking at obesity in a new light.

Essential VIII: Advanced Nursing Practice

The goal of DNP VIII Essential is to improve patient outcomes with the skills acquired. It emphasizes using advanced clinical judgment, systems thinking and providing evidence-based care. This essential ultimately emphasizes the DNP graduate’s role in assimilating nursing science and practice with the complex needs of humankind (AACN, 2006). The role of the advanced practice nurse is geared towards providing high-quality care and improving patient outcomes. Consulting with my mentor and other experts in the field of obesity has helped me to understand the obesity epidemic and the burden on health care, which added another dimension to the project. Completing my CSP and sharing the knowledge with other providers and patients will add to their knowledge and hopefully transcend to changes in the provision of health care and individual habits.

References

American Association of College of Nursing (2006). The essentials for doctorate education for advanced nursing practice. Washington DC

Maryland Academy of Advanced Practice Clinician (MAAPC) (2021): Navigating your government. https://maapconline.enpnetwork.com

Wilson, D. M., Anafi, F., Kusi-Appiah, E., Darko, E. M., Deck, K., & Errasti-Ibarrondo, B. (2020). Determining if nurses are involved in political action or politics: A scoping literature review. Applied Nursing Research, 54. https://doi-org.libproxy.chapman.edu/10.1016/j.apn…

5.

Essential V: Health Care Policy for Advocacy in Health Care

Essential V acknowledges the crucial role in shaping health care policies. Goudreau and Smolenski (2018) said that health care providers influence policy. DNP graduates are prepared to design, impact, and implement health care policies that set health care funding, practice regulation, access, safety, quality, and efficacy (Institute of Medicine, 2001). Furthermore, they take part in these practice skills with two more sets: the competence to evaluate the policy process and engage in political action (Stanley, 2004). The DNP essential will relate to the project as we see trends in the behavior of new graduate nurse practitioners. There might be a change in some policies that can help new practice transition or regulation. It may also help with NP retention, solving the primary care provider deficiency. The California Health Care Foundation (2019) stated that an additional 10,500 primary care providers are needed in California to match the need of its population by 2030.

Essential VI: Interprofessional Collaboration for Improving Patient and Population

Health Outcomes

Collaboration is one of the core competencies of the advanced practice nurse (Tracy & O’Grady, 2019). Interprofessional collaboration occurs when one or more professional focuses on a particular health problem or concern. It requires mutual respect and commitment for the sake of a response to a problem (Tracy & O’Grady, 2019). Effective interprofessional collaboration is obtained when communicating a readiness to work together is initiated (Interprofessional Education Collaborative, 2011). Communication competencies aid professionals prepare for collaborative practice. According to Gluyas (2015), teamwork entails communication, cooperation, and coordination to accomplish goals and outcomes. Quality patient care and ethical imperative are the goals to provide care and resolve conflicts. It essentially relates to the DNP project since it needs collaboration and networking from various people. This project builds an interprofessional team since the project aims to recruit novice nurse practitioners from California in any setting or specialty. The project also entails effective communication in platforms to gather the right people and connections.

Essential VII: Clinical Prevention and Population Health for Improving the Nation’s

Health

The seventh essential talks about health promotion and disease prevention, and it is related to Healthy People 2020 (Office of Disease Prevention and Health Promotion, n.d.). The project aligns the healthy people movement regarding educational and community-based programs to increase the core clinical prevention and population health content in training nurse practitioners. It states that these educational and community-based programs are for people outside traditional health care settings; thus, it also indicated that they could overlap depending on settings (Office of Disease Prevention and Health Promotion, n.d.). Since the schools and institutions are included in this setting, improving the existing systems regarding policy and programs can promote better health. It also relates to health care access, provider shortage in the future, and filling the gaps of caring for the population.

Essential VIII: Advanced Nursing Practice

The last DNP essential challenges the learning experiences in the DNP program that should be enough to inform practice decisions and their consequences (American Association of Colleges of Nursing [AACN], 2006). The DNP essential VIII specifies the foundational competencies to practice, and role preparation is part of every DNP curricula (AACN, 2006). The post-master DNP-APRNs are distinguished to have the highest engagement in this DNP essential (Christiansen & Champion, 2018). The nurse practitioner role transition can be difficult due to the inconsistency between school and practice expectations. The stress in the first year of practice comes from the lack of residency programs for the nurse practitioners, unlike other providers (Faraz, 2016). Therefore, the DNP essential is associated with the project as the central theme is role transition.

References

American Association of Colleges of Nursing (2006). The essentials of doctoral education

for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publication…

California Health Care Foundation (2019). Five ways to cure California’s doctor shortage. https://www.chcf.org/publication/cure-californias-…

Christiansen, B., & Champion, J. D. (2018). Examining doctor of nursing practice clinical competency. The Journal for Nurse Practitioners, 14(5). https://doi.org/10.1016/j.nurpra.2018.02.006

Faraz, A. (2016). Novice nurse practitioner workforce transition and turnover intention in primary care. Journal of the American Association of Nurse Practitioners, 29(1), 26-34. https://doi.org/10.1002/2327-6924.12381.

Gluyas, H. (2015). Effective communication and teamwork promotes patient safety. Nursing

Standard, 29(49), 50–57., https://doi.org/10.7748/ns.29.49.50.e10042.

Goudreau, K. A., & Smolenski, M. C. (2018). Health policy and advanced practice nursing: impact and implications (2nd ed.). Springer Publishing Company, LLC

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press.

Interprofessional Education Collaborative. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. https://www.aacom.org/docs/default-source/insideom…

Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2020. U.S. Department of Health and Human Services. https://www.healthypeople.gov/2020

Stanley, J. (2004). Advanced practice nursing: Emphasizing common roles (2nd ed.). F.A. Davis.

Tracy, M. F., & O’Grady, E. T. (2019). Advanced practice nursing: an integrative approach (6th ed.). Elsevier Saunders

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