Assessment 4 Instructions Final Care Coordination Plan

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 this assessment after Assessment 1 is successfully completed.

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.

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.

Demonstration of Proficiency

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

  • Competency 1: Adapt care based on patient-centered and person-focused
    • Design patient-centered health interventions and timelines for a selected health care
  • Competency 2: Collaborate with patients and family to achieve desired
    • 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
    • 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 2020
  • Competency 4: Defend decisions based on the code of ethics for
    • Consider ethical decisions in designing patient-centered health
  • Competency 5: Explain how health care policies affect patient-centered
    • Identify relevant health policy implications for the coordination and continuum of
  • Competency 6: Apply professional, scholarly communication strategies to lead patient-centered
    • Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA
    • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and

Preparation

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 2020.

Instructions

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

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

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, course study resources, and Healthy People 2020 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.

  • Consider the practical effects of specific
  • Include the ethical questions that generate uncertainty about the decisions you have
  • Identify relevant health policy implications for the coordination and continuum of
    • 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 2020 document.
  • Use the literature on evaluation as guide to compare learning session content with best
  • Align teaching sessions to the Healthy People 2020
  • 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.