NURSFPX 4900 ASSESSMENT Problem Identification Template

NURSFPX 4900 ASSESSMENT Problem Identification Template

NURSFPX 4900 ASSESSMENT Problem Identification Template

I need the attached file “Problem Identification Template” completed with Opioid Addiction as the topic.

Please refer to the 2nd file attached called “Assessment 1-3 COPY” for reference to complete this template.

The template entitled ” Problem Identification Template” needs to be in association with the attached file. They should flow together as they are part of a large project.

Below is the competency points that need to be adhered to for a satisfactory answer.

  • Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
    • Define a patient, family, or population health problem that is relevant to personal practice.
  • Competency 2: Make clinical and operational decisions based upon the best available evidence.
    • Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem.
  • Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
    • Propose strategies to improve patient or population outcomes related to a health problem.
  • Competency 8: Integrate professional standards and values into practice.
    • Reflect on state board nursing practice standards relevant to a selected health problem.
    • Communicate professionally with clear, logically organized writing, using correct grammar, spelling, and APA style.

NURSFPX 4900 ASSESSMENT Problem Identification Template Problem Identification Template

The following is a guide to organize your assignment. Please be sure to remove the guiding questions and comments for each section. You are expected to write in a professional and academically appropriate manner throughout. Make sure you are using proper APA style and citations throughout.

Define a patient, family, or population health problem, and realistic goals, that are relevant to personal practice.
  • Introduce a general summary of the health problem that you will be exploring.
  • Provide a brief context for the patient, family, or population struggling with this health problem.
  • Propose one or more goals that you deem appropriate and relevant to the health problem.
  • Briefly state why this health problem is relevant to your personal practice.
Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem. NURSFPX 4900 ASSESSMENT Problem Identification Template
  • Compare and contrast the authors you will be citing, discussing pros and cons of the evidence you are reading about.
  • Note whether the authors provide supporting evidence from the literature that is consistent with what you see in your nursing practice.
  • Assess the quality of the data presented in the articles you are reading.
  • Discuss how you would know if the data were unreliable.
  • Include what the literature says about barriers to evidence-based practice.
  • Describe research studies that present opposing views regarding this health problem.
  • Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your clinical practicum.

Propose potential strategies to improve patient or population outcomes related to a health problem.

  • Cite any known authors who have recommended leadership strategies for nurses to use when providing care to this patient population.
  • Discuss research on the effectiveness of these strategies in improving patient or population outcomes regarding this health problem.
  • Describe what the literature says about patient-centered care, empowering patients to make health care decisions, involving families in patient care, incorporating patient preferences to improve outcomes, prevent illness, and lower readmissions to hospitals.
  • Discuss ways your role as a nurse leader will help improve patient outcomes as described in the literature. NURSFPX 4900 ASSESSMENT Problem Identification Template
Reflect on state board nursing practice standards relevant to a project related to a health problem.
  • Discuss how your state’s nurse practice act will guide your actions in terms of this health problem for this patient or population.
  • Identify the most surprising thing that you found while reading your state’s nurse practice act.
  • Describe the effects of local, state, and federal laws on your nursing scope of practice and care for this patient or population.
  • Explain how nursing ethics will inform your intervention in this clinical practicum.

NURSFPX 4900 ASSESSMENT Problem Identification Template References

Remember to compile your APA-formatted reference list.

Plan Proposal Template Completed with Opioid Topic

The adverse effects of opioids have adverse effects on families, individuals, and American society as a whole. The opioid epidemic is a major problem to the health care system hence the need to address this problem. It leads to poor quality of life and the high cost of medication. NURSFPX 4900 ASSESSMENT Problem Identification Template

Research indicates that the majority of individuals who develop an addiction to opioids are people who, at some point, received the prescription as pain medication (Addiction Center, 2018). In line with the phrase ‘prevention is better than cure,’ the proposed intervention is to increase access to prevention service to people at risk of the opioid epidemic.

Implementation of the proposed plan can help prevent adverse social, health and economic effects associated with opioid abuse, misuse, and addition. Early intervention to people at risk, education to create awareness to people at risk and the public, digital and social media campaigns, community and school-based programs. Patients prescribed opioids as pain relievers and adolescents will be the main target for intervention services.

Collaboration between various agencies such as national health institute, FDA, and NIDA with private sectors are necessary for developing alternative pain relievers and analgesics and analgesics that cannot be abused easily (US Department of Health and Human Services, n. d). Collaboration with state agencies is essential in improving technologies that can detect trafficking and import of illegal opioids.

The interprofessional collaborators will comprise the local caregivers including both clinicians/nurses and behavioural therapists (psychiatrists, social workers, pharmacists, department of justice, training institutions, faith-based organizations, local authority, and community-based organizations NURSFPX 4900 ASSESSMENT Problem Identification Template

The proposal will be submitted to the health staff and collaborators to give their feedback on making the project better. The refined proposal will be submitted by the nurse manager to the facility board members for approval. If approved, the plan will be implemented in the community and hospital with the help of my mentor and the nurse manager as the project managers as well as the support of collaborators.

Technolicical Analysis

Digital and social media technology can be used in the proposed intervention to improve access to prevention services. Chassiakos et al (2016) found a high rate of internet usage among adolescents and young adults than any other demographic groups. Therefore, digital and social media is relevant in disseminating health information about opioid prevention services to our target population. NURSFPX 4900 ASSESSMENT Problem Identification Template

Riley et al (2011 NURSFPX 4900 ASSESSMENT Problem Identification Template) observed that digital health interventions such as eHealth and mHealth are crucial tools in amplifying the public health messages and promoting behavior change to promote healthy living. A study by Årsand et al (2012) found that health services through social media, automated phone, and SMS services (to people with previous opioid prescriptions) prevented potential opioid addiction and misuse.

Overall, these studies indicate that digital and social media technologies are crucial tools in amplifying public health messages and manage health conditions. Hence, literature offers supportive evidence on the use of digital and social media tools in nursing practice. These are evident in the use of eHealth and mHealth in managing diabetes and cardiovascular disorders.

However, given that 23% of Americans do not use a smartphone can hinder the use of digital and social media tools in the prevention of opioid addiction, overdose, and misuse. Instead, combining it with an automatic phone and SMS technology could be most appropriate. Lack of reliability, privacy and confidentiality issues, information overload, and dissemination of false information are other factors that deter the use of digital and social media platforms to disseminate information on opioid prevention services.

However, Murray et al (2011) and Mair et al (2012) argued that digital health interventions are complex and cumbersome to implement due to factors like interoperability, unfit to the current system, high cost, disrupting face-to-face interaction between patients and health professionals.

Governmental & Organizational Policies

Health care policies support projects aimed at preventing, treatment, and recovery of those affected by opioids. Both state and Federal governments have enacted policies to curb increased deaths fro opioids overdose. This includes the collection and dissemination of information on opioids abuse and addiction. These policies seek to promote public education and awareness campaigns- this is consistent with the proposed plan. NURSFPX 4900 ASSESSMENT Problem Identification Template

It also covers community and school-based methods of preventing opioid addiction and misuse (Taft, & Nanna, 2008). Other areas of covered include reducing access and availability of opioids, investing in research to develop less abusive analgesics and alternative pain relievers. Therefore, the design and implementation of the proposed plan are consistent with state and federal policies.

RNs are increasingly influencing health care policies, making to improve patient outcomes and prevention of diseases. With the evolving role of nurses in health care, nurse managers have taken up the role previously reserved for physicians. As a unit manager, nurse managers are tasked with ensuring the safety of patients. The managers should encourage a nurse to engage in research and policy initiatives and changes to improve quality of care.

As a nurse manager, I will seek to propose prevention intervention for opioids through the local government commissions and county health department board. This will be accomplished after the trials at the community and my current facility. The proposed intervention, which based on EBP can then be rolled out to communities and health facilities in the state to help prevent opioid misuse and addiction. NURSFPX 4900 ASSESSMENT Problem Identification Template

Communicating and Collaborating to Improve Health Outcomes

Interprofessional teams communication and collaboration strategies will be fostered through training of doctors, nurses, and other participants together on opioid prevention services. It can be enriched by retraining these participants on how they can work together as a team to prevent, treat, and help in the recovery of patients from opioid disorders.

The other strategies include the use of interdisciplinary rounds consisting of various professionals in health care. Team huddles method can be used to outline the work that is ahead by clarifying issues to be tackled. Effective communication aided by digital and social media and digital platforms will be used to improve interprofessional communication and collaboration.

Communication strategies between patients and health professionals will involve the digital and social media tools targeted youths- the groups at high risk of opioid addiction and misuse. The second strategy is automatic phone and SMS messaging to the potential opioid addicts and abusers.  For one-on-one communication, there is a need to create a rapport with patients and people risk to give them insight regarding the negative effects of opioid addictions. NURSFPX 4900 ASSESSMENT Problem Identification Template

In my clinical practicum environment, a nurse manager, mentor, nurses, patients, physicians, and administrative staff are critical in implementing the proposed plan. Accordingly, I get unwavering support from my mentor and nurse manager to ensure the project succeeds. I also plan to interact with patients on opioid prescriptions and disorders to gain their opinions on how they react to the proposed plan.

Surprisingly, I realized that initially, facility management was unwilling to support education and behavior change in opioid addicts, but rather prefer the use of medications such as naloxone (Narran) as opposed to prevention interventions.

There are benefits of getting input from participants. First, patient input helps to understand their feelings and possible reaction to the intervention. Secondly, input from nurses and doctors will improve the proposed intervention to generate better patient outcomes. NURSFPX 4900 ASSESSMENT Problem Identification Template

NURSFPX 4900 ASSESSMENT Problem Identification Template References

Årsand, E., Frøisland, D. H., Skrøvseth, S. O., Chomutare, T., Tatara, N., Hartvigsen, G., & Tufano, J. T. (2012). Mobile health applications to assist patients with diabetes: lessons learned and design implications. Journal of diabetes science and technology, 6(5), 1197-1206.

Chassiakos, Y. L. R., Radesky, J., Christakis, D., Moreno, M. A., & Cross, C. (2016). Children and adolescents and digital media. Pediatrics, 138(5), e20162593. https://pubmed.ncbi.nlm.nih.gov/27940795/

Mair FS, May C, O’Donnell C, Finch T, Sullivan F, Murray E. Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review. Bull World Health Organ. 2012;90(5):357–64

Murray E, Burns J, May C, Finch T, O’Donnell C, Wallace P, et al. Why is it difficult to implement e-health initiatives? A qualitative study. Implement Sci. 2011;6(1):6.

Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., & Mermelstein, R. (2011). Health behavior models in the age of mobile interventions: are our theories up to the task?. Translational behavioral medicine, 1(1), 53-71.

Taft, S. H., & Nanna, K. M. (2008). What are the sources of health policy that influence nursing practice?. Policy, Politics, & Nursing Practice, 9(4), 274-287.

US Department of Health and Human Services. (n. d) Straegy to Combat Opioid Abuse, Misuse, and Overdose. A framework Based on the Five Point Strategy. Retrieved from https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf

Define a patient, family, or population health problem, and realistic goals, that are relevant to personal practice.

Hypertension is the clinical name for high blood pressure. This condition is a very prevalent patient issue within the healthcare industry. Uncontrolled hypertension can lead to severe health complications. It also increases the risk for cardiovascular disease, stroke, heart failure and death. It is vital to keep blood pressure under to control to reduce the risk of these conditions.

The Centers for Disease Control (CDC) defends that approximately one in four adults with hypertension have it under control and that nearly half of the adults that have hypertension either are not prescribed medication, or they do not take their medication (2020). NURSFPX 4900 ASSESSMENT Problem Identification Template 

It is estimated that every one out of two adults in the United States has hypertension (CDC, 2020). My mother, Mrs. J.M. is one of those adults struggling with hypertension. She is a 66-year-old Italian American woman. She is a former smoker, with a history of diabetes, colon cancer, obesity and hypothyroidism.

Her father who was deceased at the age of 78 suffered from hypertension, diabetes, heart disease and stroke. Her mother who is still living at the age of 89 currently suffers with hypertension and has a history of stroke. Her family history and comorbidities put her at a higher risk for other health related complications if left uncontrolled. NURSFPX 4900 ASSESSMENT Problem Identification Template

Not all individuals with hypertension require medication. One goal offered for patients with hypertension is lifestyle modification and weight loss. These two when combined have been proven to decrease  blood pressure. Lifestyle modifications include; weight loss, exercise, eating a healthy diet, smoking cessation, and stress reduction. In the case of Mrs. J.M. she has admitted that she needs to lose weight, she does not exercise, and her eating habits are not ideal. Given her family history and comorbidities it is important to implement a lifestyle modification plan for her.

This health problem is relevant to my practice because I am an ICU nurse. The majority of my patients come to the ICU with a diagnosis of hypertensive crisis or stroke due to uncontrolled hypertension. Many of my patients have suffered multiple strokes with significant damage due to this problem. Pharmacist intervention can have a substantial impact on knowledge, blood pressure control and medication adherence for hypertensive patients (Saleem et al., 2015). While medication might be the only option for some patients to control their blood pressure, as a nurse it is my duty to seek the least invasive option for my patients.

Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem. NURSFPX 4900 ASSESSMENT Problem Identification Template

Lifestyle modification is an evidence-based strategy designed to eliminate and/or control hypertension. To support this strategy peer-reviewed scholarly journal articles written within the past five years were utilized. This allows for the most up-to-date available evidence-based information.

When using websites to find evidence-based research credible sources are NIH, .gov websites, .org websites, Mayo Clinic and hospital policies. However, blogs, Wikipedia and .com websites are not credible sources of information. Lifestyle modifications include weight loss, exercise, eating a healthy diet, smoking cessation, and stress reduction. NURSFPX 4900 ASSESSMENT Problem Identification Template

In an article written by Yang et al., a study of 1139 adults with hypertension complying with lifestyle modification was conducted. Patients were assessed on their lifestyle, including smoking, alcohol use, salt intake, and physical activity. The purpose of this study was to identify and evaluate life-style modifications associated with blood pressure control in patients diagnosed with hypertension.

The participants checked in at weeks 4, 8, and 12 and discussed drug adherence, weight, physical activity, alcohol and salt consumption, and blood pressure readings. At the conclusion of the study 961 participants (84%) were in the success group. It was discovered that reduced salt intake and increased physical activity were attributed to successful blood pressure control, and increased BMI was associated with uncontrolled blood pressure

The article stated that dietary modifications which are beneficial in reducing hypertension include low sodium intake, alcohol in moderation, weight loss, a diet rich in fruits, vegetables, legumes, low-fat dairy products, and low saturated fat. The researchers also followed up with the participants after 18 months and weight reduction continued to show a trend in reduction of blood pressure (Yang, et al., NURSFPX 4900 ASSESSMENT Problem Identification Template 2017). 

An article written by Magobe et al., stated that the first step in treating hypertension is lifestyle modification and that physical exercise can lower blood pressure and improve quality of life. In the referenced study participants had to engage in physical activity for 10 to 30 minutes a day at least three times a week. The participants varied from ages 41 to 80 years old and had been diagnosed with hypertension for 1 to 10 years. Lifestyle modifications were proven to lower blood pressure and reduce cardiovascular disease by 21% when patients adhered to a healthy lifestyle (Magobe et al.,  NURSFPX 4900 ASSESSMENT Problem Identification Template 2017).

In my current nursing practice evidence from the literature proves to be true. When patients are admitted to the ICU with hypertensive crisis or stroke it is because they have uncontrolled hypertension. When educating them on proper diet, obesity, and exercise it is discovered that they do not practice these lifestyle behaviors. Lack of adequate treatment, reluctance to make lifestyle changes, compliance, and access to healthcare can present barriers to evidence-based practice (Devkota et al., 2016).

The Health Belief Model can be used to assist in behavior change for patients. This model is frequently used in the healthcare setting. In this model goal setting, decision-making, and social learning are integrated for making one’s own decisions, along with the patient’s perceived barriers for the change (Drevenhorn, 2018). This model can be effective in treating patient with hypertension because it allows the individual to make choices and decisions that can be a benefit/detriment to their health. NURSFPX 4900 ASSESSMENT Problem Identification Template

Propose potential strategies to improve patient or population outcomes related to a health problem.

Nurses play a critical role in ensuring safe, effective patient outcomes. Nurses serve as educators and care-coordinators for patients with hypertension. Patient-centered care is an effective approach to hypertension management. “A team-based approach is tailored to meet the patients’ needs and has shown to control hypertension. NURSFPX 4900 ASSESSMENT Problem Identification Template

Currently nurses are leading research teams to examine social, cultural, economic, and behavioral determinants of hypertension outcomes” (Dennison-Himmelfarb et al., 2016). As a nursing leader, patient outcomes can be improved by staying abreast with the most recent evidence-based best practices to improve patient safety. Nurse leaders also educate peers and other subordinate nurses on the importance of quality care and best practices. Nurse leaders play a vital role in providing high-quality patient care and services (Mansel & Einion, NURSFPX 4900 ASSESSMENT Problem Identification Template 2019).

Reflect on state board nursing practice standards relevant to a project related to a health problem.

The Nurse Practice Act was enacted to guide nursing practice. Every state Board of Nursing enforces these rules. The Texas Board of Nursing states that their mission “is to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the state is competent to practice safely” (2019). It is important that nurses know and understand the nurse practice act to ensure we are practicing within the determined scope of practice. NURSFPX 4900 ASSESSMENT Problem Identification Template

In a previous course I had to research my state nursing board standards, and the information has not changed so there were no surprising notations. However, when I first moved to Texas and read about safe harbor that was something, we did not have in Florida which was surprising to me because it protects a nurse’s licensure.

An informed nurse is a competent nurse, competent nurses remain vigilant to keep their patients from harm. To evaluate how nursing ethics apply to this clinical practicum, I consulted the ethical considerations for nursing. Autonomy based on my experience and knowledge as a nurse I am able to provide my mother and my patients with valid advice. NURSFPX 4900 ASSESSMENT Problem Identification Template

In regard to beneficence I am compelled to not turn a blind eye to miseducation on my patients and mothers in regard to their health, as a practicing nurse I have an obligation and a duty for health promotion. Justice denotes that all patients are entitled to equal access of care. NURSFPX 4900 ASSESSMENT Problem Identification Template

NURSFPX 4900 ASSESSMENT Problem Identification Template References

  1. Centers for Disease Control (CDC). (2020Facts About Hypertension. Retrieved from
  2. https://www.cdc.gov/bloodpressure/facts.htm
  3. Dennison Himmelfarb, Cheryl & Commodore-Mensah, Yvonne & Hill, Martha. (2016).
  4. Expanding the Role of Nurses to Improve Hypertension Care and Control Globally. Annals of Global Health, (82) doi:10.1016/j.aogh.2016.02.003.
  5. Devkota, S., Dhungana, R. R., Pandey, A. R., Bista, B., Panthi, S., Thakur, K. K., & Gajurel, R.
  6. (2016). Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal. Frontiers in Cardiovascular Medicine, (3)26. https://doi.org/10.3389/fcvm.2016.00026
  7. Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nurisng in Hypertension Care. International Journal of Hypertension, (11). doi:http://dx.doi.org.library.capella.edu/10.1155/2018/2858253
  8. Magobe, N. B., Poggenpoel, M., & Myburgh, C. (2017). Experiences of patients with hypertension at primary health care in facilitating own lifestyle change of regular physical
  9. exercise. Curationis, 40(1) Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1898593873%3Faccountid%3D27965
  10. Mansel, B., & Einion, A. (2019). “It’s the relationship you develop with them”: emotional intelligence in nurse leadership. A qualitative study. British Journal of Nursing, 28(21), 1400–1408. https://doi-org.library.capella.edu/10.12968/bjon.2019.28.21.1400
  11. Saleem, F., Hassali, M. A., Shafie, A. A., Haq, N. U., Farooqui, M., Aljadhay, H., & Ahmad, F. (2015). Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health-related quality of life: A non-clinical randomized controlled trial. Health Expectations, 18(5), 1270-1281. doi:10.1111/hex.12101
  12. Texas Board of Nursing. (2019). Nurse Practice Act. Retrieved from http://www.bon.texas.gov
  13. Yang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K. Y., Kim, J. S., Oh, H. J., Kang, H. C., & Lee, S. Y. (2017). The Effect of Lifestyle Changes on Blood Pressure Control Among Hypertensive Patients. Korean Journal of Family Medicine, 38(4), 173–180. https://doi.org/10.4082/kjfm.2017.38.4.173. NURSFPX 4900 ASSESSMENT Problem Identification Template
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