NURS FPX 4905 Assessment 4 Proposal for Intervention

Student Name

Capella University

NURS FPX 4905

Professor Name

Submission Date

Proposal for Intervention

The inconsistencies in the use of non-pharmacological methods to treat anxiety disorders among patients in LTCFs in New York can be seen as an important practical problem that can result in increased financial burden for patients and a decrease in their safety and quality of health care. The reason for that lies in the fact that anxiety disorders are common both among elderly patients suffering from several diseases and cognitive disorders upon their admission to LTCFs and among those who do not have any contact with the outside world and thus are very likely to face troubles related to anxiety disorders. According to the findings of the World Health Organization (2023), about 14% of people older than 70 suffer from psychological disorders with anxiety being the most widespread.

Practice Issue of Concern

In the LTCF care setting, the nursing practice problem that was identified as a problem of inconsistency in the application of non-pharmacological interventions in the management of anxiety symptoms that nurses deal with. Based on the observation carried out in the course of the practicum, the anxiety symptoms of patients in the LTCF care setting were only addressed through pharmacological means. Some of these symptoms can include irritability, restlessness, agitation, insomnia, withdrawing from others, and emotional expression (Penninx et al., 2022). Despite having various non-pharmacological interventions based on evidence, there seems to be inconsistency in the application.

The nursing practice problem mentioned above is quite important as far as BSN-prepared nurses are concerned, since they will have to make a significant contribution so that patients can have a more promising outcome. According to the American Nurses Association (2023), these nurses must make sure that patient outcomes of patients are improved, that evidence-based practice is implemented, and that change is provided. Healthcare professionals do not regularly apply non-pharmacological interventions in the current situation. The consequences of such a scenario can be numerous, some of which can be emotional disturbances, fall risk, and overmedication.

Current Practice

Currently, assessment of nursing, administration of drugs, behavioral observation, and multidisciplinary care planning are employed in the LTCF as mechanisms for managing the anxiety problem experienced by the patients. The observations of the patients’ behavior and feelings are documented in the patient’s electronic health record by the nurses. The main strategy used in managing excessive anxiety is drug administration. Nurses will probably face situations when they will use relaxation and communication techniques and music therapy. On the other hand, there are no guidelines for the nurses on how to use these strategies in the various departments of the LTCF. Moreover, the electronic patient records, which are employed in this LTCF, do not mention whether or not the interventions, which should be aimed at reducing the anxiety of the patients, should be documented. Lastly, there are no training programs aimed at addressing the problem of anxiety of elderly people.

Strategy to Improve Current Practice

The following measures will help in achieving the intervention strategy through the use of the structured nursing intervention program by use of technology. The following is the approach that will be used when realizing the anxiety management intervention strategy. This method involves the use of a combination of different strategies such as mindfulness methods, relaxation, breathing exercises, music therapy, therapeutic communication, and counseling, among others. To measure anxiety, it will be necessary to employ several evidence-based tools that will aid the assessment of the anxiety, and one of these tools will be the use of the Generalized Anxiety Disorder-7 Scale (GAD-7) (Casares et al., 2024). Speaking of the integration of reminders and alerts within EHRs, both the reminders and alerts will assist nurses in determining the level of anxiety of their patients. Nurses will be trained on the assessment and other processes such as therapeutic communication through workshops.

Changes Needed for People and Processes

The application of the intervention will call for radical change in terms of the role that healthcare practitioners will play and the processes that will have to be altered to enable them to manage anxiety issues among the residents. This implies that the role of nurses and mental health professionals will be expanded to include dissemination of evidence-based practices in dealing with anxiety among the residents (Tushe, 2024). It implies that the functions of the nurses will concern evaluation of the state of the patients, offering them non-pharmacological therapy, recording the outcomes and reporting them to the other health workers in case of some alterations of behavior. Such roles will imply the development of the required skills, therapeutic communication, emotional assessment of the patients, documentation, and CDSS/EHR use. Rather than being reactive in response to the anxiety problem among their patients, health professionals will adopt proactive approaches to deal with the problem. The SBAR model will help in enhancing communication across disciplines.

Assumptions

It is believed that this strategy will be easier to implement by using LTCF by educating employees and enhancing technology and processes. The proposed strategy assumes that the assumption will be fulfilled, which means that nurses and other professionals will be engaged in learning and applying evidence-based approaches in dealing with anxiety (Singh et al., 2025). Furthermore, another of the assumptions related to the strategy implementation would be the involvement of older people and their caregivers in the non-pharmacological anxiety treatment.

Enhancing Quality, Safety, and Cost-Effectiveness

The outcome of the intervention is the improvement of the quality of care by adopting evidence-based practice to address the problem of anxiety experienced by a patient. The mindfulness practice will stabilize the patient’s emotions and allow him to rest in a calm environment. Additionally, the use of mindfulness exercises will allow the patient to get more social and improve their quality of life (Alvarado-Garcia et al., 2025). It will be clear sooner than later that the situation in the patient is worsening and, accordingly, the corresponding reaction to the issue will be prompt. It will also enhance the safety factor as the use of sedatives will be avoided.

In the financial perspective of the question, one has to evaluate the costs regarding training the personnel members and EHR alterations. Nevertheless, simultaneously, some beneficial factors will be present, such as a decrease in the need to use medications among the elderly, decreased chances of falling, hospitalization, and spending on interventions and potential medication adverse effects (Penninx et al., 2022). Furthermore, it will be possible to prevent all psychiatric diseases, which will enable the effective management of healthcare resources. Implementation of the intervention will also have negative consequences. To begin with, there will be the added workload which will be experienced due to evaluation and recording.

Application of Technology in the Strategy

The proper use of technology will help to implement the selected solution. Giving an example, proper assessment, intervention, and documentation of interventions will be easier due to the usage of the EHR reminders and CDSS alerts (Gu et al., 2024). The nurse will be given information regarding the evaluation of patients and recording of interventions at certain points. Regarding the relevance of CDSS alerts, one can say that it will be crucial to decide what interventions are to be offered to patients depending on their conditions.

Apparently, the proposed solution can contribute to resolving most of the issues that were raised in the course of the problem analysis, such as issues related to interventions/assessment documentation, nursing interventions inconsistency, deficiency of adequate communication, etc. Moreover, technologies of telehealth can be applicable during appointments with experts regarding the mental health issues of the patient. In other words, the offered solution has great relevance in situations when the elderly are not able to see specialists due to certain reason.

Implementation of the Improvement Strategy at the Clinical Site

The introduction of the intervention is going to be preceded by a number of steps. Firstly, the planning and organization of those who will take part in the intervention implementation process is important. In the present context, the cooperation of facilities management staff, nurses, physicians, social workers, psychologists, IT professionals will become unavoidable when designing and executing intervention-related objectives and procedures to patients with anxiety disorder (Pinheiro et al., 2025).

Secondly, it is crucial to ensure that the intervention process includes training. During this stage, one needs to acquire the knowledge and skills that one will need to utilize an intervention appropriately. The training might include such aspects of patient assessment, provision of interventions, documentation, interaction with CDSS, and teamwork. Thirdly, the pilot stage will help in deciding how successful the implementation of interventions will be. The pilot intervention application will provide the professionals with at least some practical experience of working with this method, which will also help to identify potential challenges that may arise when implementing it, documenting, and cooperating (Newton et al., 2025).

Site-Specific Challenges and Solutions

The possible barrier that can emerge in respect to the features on the characteristics of LTCFs involves problem of workload. Stated differently, it is necessary to remember about the specificity of nurses that work in LTCFs as individuals that work with a large number of patients. In this manner, it will seem that there are issues related to implementing the proposed intervention. The problem discussed can be addressed with the help of integrating the intervention into the routine activities of the employees. Apart from that, another potential problem may appear, which will refer to healthcare professionals’ perception of the new approach to solving the problem. Healthcare professionals should be made aware of why the intervention needs to be implemented (Singh et al., 2025). Last but not the least, the last obstacle that might arise in the process of implementing the intervention can be related to the use of technologies, such as CDSS, EHR, and telemedicine.

Interprofessional Collaboration to Support Strategy Implementation

Coordination of efforts by different professionals during implementation of the program will be essential to determine the success of the program. What is also worth noting is that every professional will contribute greatly towards ensuring that the mental well-being of the patient is achieved by adopting such programs. Besides the named professionals, nurses, physicians, psychiatrist, psychologist, and therapists, social workers, nursing assistants, and even Information Technology (IT) professionals will be included in this process (Pinheiro et al., 2025). What is also important to add is that the nurses will be key participants in ensuring the success of the program by reviewing and executing the program. Their physicians, as well as psychiatrists will be able to offer the drugs needed by patients.

The people who will enable integration of the alerts provided by CDSS, notifications, EHR system, and telemedicine to the care delivery process will be the ones who will be in charge of regulating application of the technology in the care delivery process. The process of communication about the state of patient and effectiveness of treatment interventions can be implemented through interdisciplinary rounds and use of SBAR technique (Shrivastava et al., 2025). As an illustration, in case anxiety continues even after proper treatment intervention, the issue will have to be raised during an interdisciplinary round coordinated by a nurse and including a psychiatrist and social worker.

In my opinion, the BSN-prepared nurse will contribute to improved collaboration of the healthcare professionals in the following ways: by communicating with the patients and healthcare professionals, organizing interdisciplinary rounds, entering information in EHR system, and offering emotional support to the patient in case of necessity. Collaboration among healthcare professionals is crucial for providing adequate treatment interventions that will reduce patients’ anxiety.

Conclusion

The variations in the manner in which nurses address anxiety in older adults through non-drug means may influence the level of service delivery, safety of patients, mental condition of individuals receiving health care, as well as expenses belonging to the realm of health care. The proposed evidence-based approach assumes a systematic method of dealing with anxiety in the long-term care facilities by means of developing regulations for evaluation of the situation, incorporation of mindfulness techniques, application of electronic health records, as well as conducting interdisciplinary cooperation.

References

Alvarado-García, P. A. A., Soto-Vásquez, M. R., Infantes Gomez, F. M., Guzmán-Rodríguez, N. M., & Castro-Paniagua, W. G. (2025). Effect of a mindfulness program on stress, anxiety, depression, sleep quality, social support, and life satisfaction: A quasi-experimental study in college students. Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1508934

American Nurses Association. (2023). Ways nurses can improve patient care. ANA Nursing Resources Hub. https://www.nursingworld.org/content-hub/resources/nursing-leadership/ways-nurses-can-improve-patient-care/

Casares, M. Á., Díez-Gómez, A., Pérez-Albéniz, A., Lucas-Molina, B., & Fonseca-Pedrero, E. (2024). Screening for anxiety in adolescents: Validation of the generalized anxiety disorder assessment-7 in a representative sample of adolescents. Journal of Affective Disorders, 354, 331–338. https://doi.org/10.1016/j.jad.2024.03.047

Gu, Y., Andargoli, A. E., Mackelprang, J. L., & Meyer, D. (2024). Design and implementation of clinical decision support systems in mental health helpline Services: A systematic review. International Journal of Medical Informatics, 186, 105416–105416. https://doi.org/10.1016/j.ijmedinf.2024.105416

Manera, V., Partos, C., Beauchet, O., Benoit, M., Dupetit, B., Elbaum, J., Fabre, R., Gindt, M., Gros, A., Guerchouche, R., Klöppel, S., König, A., Martin, A., Mouton, A., Pancrazi, M.-P., Politis, A., Robert, G., Sacco, G., Sacconi, S., & Sawchuk, K. (2023). Teleconsultations for mental health: Recommendations from a Delphi panel. Internet Interventions, 34, 100660. https://doi.org/10.1016/j.invent.2023.100660

Newton, N., Bamgboje-Ayodele, A., Forsyth, R., Bruce, L., McPhail, S. M., Shaw, T., Naicker, S., Tariq, A., & Baysari, M. T. (2025). Special issue on CDS failures: Opportunities and challenges associated with the pilot implementation of CDS systems: A qualitative study. Applied Clinical Informatics, 16(4). https://doi.org/10.1055/a-2581-6236

Penninx, B. W. J. H., Pine, D. S., Holmes, E. A., & Reif, A. (2022). Anxiety disorders. The Lancet, 397(10277), 914–927. https://doi.org/10.1016/s0140-6736(21)00359-7

Pinheiro, E., Laranjeira, C., Harmuch, C., Graça, J. M. B., Ali, A. M., Fekih-Romdhane, F., Yıldırım, M., Severo, A. K., & Franco, E. (2025). Collaborative practices in mental health care: A concept analysis. Healthcare, 13(15), 1891. https://doi.org/10.3390/healthcare13151891

Shrivastava, S. R., Chong, S. V., & Bobhate, P. S. (2025). Facilitating effective communication through the adoption of SBAR tool in medical training. Journal of Education and Health Promotion, 14(1). https://doi.org/10.4103/jehp.jehp_1213_24

Singh, S., Degeling, C., Caputi, P., Raftery, D., Montgomery, A., Drury, P., & Deane, F. P. (2025). How do healthcare professionals manage uncertainty in making decisions? Applying theory to nurses’ experiences of uncertainty regarding antibiotics in residential aged-care facilities. Health, Risk & Society, 27(3-4), 1–19. https://doi.org/10.1080/13698575.2025.2492147

Tushe, M. (2024). The role of nurses in mental health management: prevention and support for patients with depression and anxiety. Global Health Synapse, 1(1), 16–19. https://www.researchgate.net/publication/391566922_The_Role_of_Nurses_in_Mental_Health_Management_Prevention_and_Support_for_Patients_with_Depression_and_Anxiety

World Health Organization. (2023). Mental health of older adults. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults

NURS FPX 4905 Assessment 4 Narrative

Student Name

Capella University

FPX 4905 A4

Professor Name

Submission Date

Introduction

Slide 1

Hello, everybody. I am ___, and today I will discuss my intervention plan related to the inconsistent implementation of nurse-led non-pharmacological approaches to anxiety in older people living in long-term care facilities. The idea for this intervention arose from my observations during clinical practice in a long-term care facility located in New York City.

In the course of my clinical practice, I have noticed that medical staff often rely on pharmacotherapy as the main way to deal with anxiety in elderly residents. However, the main challenge is that there are no standardized, systematic guidelines for non-pharmacological interventions like mindfulness practices, relaxation techniques, psychosocial support, and therapeutic communication. My intervention addresses this issue by developing a systematic nurse-led anxiety management program by implementing these evidence-based approaches in practice.

National Data

Slide 2

One of the main health problems that have always subject in the United States, and even in other countries, has always been psychiatric problems such as anxiety disorders. In this case, according to the World Health Organization (2023), around 14% of individuals above 70 years of age are suffering from one form of mental disorder. Anxiety disorders and depression are just some of the common psychiatric diseases experienced by the elderly. Older adults are prone to suffer from anxiety disorders for several reasons, such as unhealthy medical conditions, lack of social activities, cognitive impairment, lack of ability to achieve independence, and mental distress.

Insomnia, heightened vulnerability to falls, occurrence of chronic diseases, non-participation in social activities, and even hospitalization are some of the negative consequences of anxiety disorders among older adults. The results produced by the National Patient Safety Goals and Quality Improvement Guidelines show that healthcare organizations need to employ interventions that will guarantee psychological well-being to their patients (Iorio, 2023). The implementation of evidence-based interventions, particularly pharmacological interventions employed in treating anxiety disorders, is associated with some inconsistency.

Problem Statement

Slide 3

The problem with the introduction of the current procedure of healthcare services delivery in the LTCF is a relevant gap in applying non-pharmacological treatment of anxiety disorders relying on the efforts of nurses. However, despite the participation of nurses in the whole process of caring about the patients’ psychological health on an ongoing basis, there is no way to measure the level of their anxiety before applying the evidence-based practice of non-pharmacological intervention (Tushe, 2024). Additionally, the EHR system utilized to monitor and manage the health conditions of the patients does not entail any features that could assist in informing the nurses about when it was necessary to assess the health condition of the patients and implement non-pharmacological intervention in the presence of the anxiety disorder (Clary et al., 2025). Nevertheless, the teamwork between the nurses, physicians, and other specialists can be affected adversely by certain aspects influencing the collaboration process negatively.

Proposed Solution

Slide 4

The application of the selected intervention will be carried out on the basis of the implementation of the anxiety management protocol, which will imply the use of monitoring devices by the nurses and communication with other health professionals. In that regard, the monitoring of the anxiety of the patients who regularly use the validated methods to measure anxiety, like the GAD-7 test, needs to be carried out continuously (Casares et al., 2024). Additionally, the management of this issue should consider the following measures: mind interventions, relaxation techniques, breathing exercises, music therapy, therapeutic communication, as well as emotional interventions. The clinical decision support system will be used to give recommendations related to problem management and other interventions in the light of evidence-based practice (Gu et al., 2024). The patients will be assessed on anxiety through the prompting of their electronic health records.

Benefits and Rationale for Implementation

Slide 5

There are just a few of the benefits that prove the need for such an intervention. On the one hand, the overall state of the elderly patients will improve since both their well-being and quality of life will increase as a result of appropriate approaches to anxiety disorder treatment. With the implementation of this intervention, the mental well-being of the elderly as well as their sleep and activity patterns will be enhanced. Secondly, the mastery of new methods of communication, documentation and practice by professionals in healthcare that will occur in line with the Clinical Decision Support System will be beneficial (Zhao et al., 2023). Thirdly, the intervention will enhance the safety of the elderly patients because less medication will be administered through this intervention, especially the kind of medication that can have negative effects such as falls, dementia, dizziness and medication errors. Fourthly, elderly individuals will not be hospitalized as frequently because of anxiety disorders. Even though the above intervention will be expensive at the first stage, it will offset this in the long run.

The Need for Change

Slide 6

To effectively treat anxiety disorders in the LTC facility, a number of steps have to be implemented so that the existing process can be enhanced. The current problems associated with the current status quo include the following: dependence on the wrong approach to the documentation process, failure to treat patients properly, and using only pharmacotherapy. This implies that the needs of the patients are not met efficiently, the poor health status of the patients is evident later on, and further risks can arise regarding the health status of the patients. Nowadays, numerous medical institutions aim to implement evidence-based practices and innovative concepts that can address the mental issues of patients (Liu and Schueller, 2023). The lack of attention to the discussed problems leads to the appearance of new mental disorders and medication therapy side effects.

Key Aspects of the Proposal

Slide 7

The following are some of the parts that can be included in the planning of the intervention program. To begin with, screening tools and evidence-based methods of anxiety intervention, including mindfulness, relaxation, therapeutic communication, and music therapy, among others. Secondly, the application of clinical decision-making tools along with reminders from EMR in the management of anxiety (Gu et al., 2024). Thirdly, it will be significant that the nurses be able to detect signs and symptoms of anxiety in the patients, assess, initiate the relevant intervention approaches, assess the outcome of the implementation process by getting responses to interventions implemented, and communicate the same to other health professionals about behavioral change in the patient. Lastly, it will be essential to coordinate and work together with other health professionals in providing quality mental health care services.

Reason to Implement the Proposal

Slide 8

The specified intervention should be implemented to make sure that the patient and the patient’s psychological state of the patient, as well as the health care services provided to the target population, are safe. Patients who contract anxiety disorders but lack access to health care facilities encounter issues like falls, sleeplessness, isolation, aggravation of underlying medical conditions, hospitalizations, and side effects of the prescribed medication. Evidence-based interventions such as the use of anxiety screening as well as the use of non-pharmacological interventions could also aid in addressing the national criteria as far as the health care quality is concerned (Rix et al., 2026). In addition, this intervention may assist in achieving the goals set at the organizational level, such as improvement in patient outcomes, risk management, and development of teamwork among nurses, which can be done by implementing decision support systems, using EHR alerts, and telehealth programs. Finally, the adoption of this intervention will support the adoption of holistic and caring nursing practices.

Conclusion

Side 9

The misuse of non-pharmacological options as a form of addressing anxiety in nurses in the LTCF is a big issue when weighed against the negative connotations associated with it, such as safety, psychosocial status, quality of care services, and quality of healthcare in general. This formulated intervention plan, which encompasses a number of components such as standard strategies, best practices, CDSS, EHR reminders, telehealth care, and collaboration, transforms into an effective intervention plan for the recognized practice issue. The implementation of this approach will improve the quality of patients’ lives and ensure their emotional well-being, collaboration between health care practitioners, as well as prevention of adverse effects caused by medications.

References

Clary, H. M., Alexander, H. B., Gesell, S., Wan, M., Conner, K. R., O’Donovan, C., Boggs, J., Robles, C., Sam, M., Christopher, J., Marini, C., & Snively, B. M. (2025). Implementing electronic health record-based anxiety and depression screening in an epilepsy clinic: Theory-based implementation strategy and pre-post quantitative outcomes using Reach, Effectiveness, Adoption, Implementation, and Maintenance. Journal of Clinical and Translational Science, 9(1). https://doi.org/10.1017/cts.2025.74

Iorio, S. (2023). National patient safety goals: Guide to effective strategies. American Data Network. https://www.americandatanetwork.com/patient-safety/national-patient-safety-goals-guide-to-effective-strategies/

Liu, M., & Schueller, S. M. (2023). Moving evidence-based mental health interventions into practice: Implementation of digital mental health interventions. Current Treatment Options in Psychiatry, 10(333-345). https://doi.org/10.1007/s40501-023-00298-2

Rix, E., Felding, L., Vang, S. I., & Overbeck, G. (2026). Non-pharmacological treatment of anxiety in general practice: A scoping review. Scandinavian Journal of Primary Health Care, 44(1). https://doi.org/10.1080/02813432.2026.2645713

World Health Organization. (2023). Mental health of older adults. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults

Zhao, C., Liang, N., Zhang, H., Li, H., Yang, Y., Zong, X., Chen, Y., Wang, Y., & Shi, N. (2023). Harnessing the power of clinical decision support systems: Challenges and opportunities. Open Heart, 10(2), 1–11. https://doi.org/10.1136/openhrt-2023-002432