Author name: NURS FPX 4000 Assessment

NURS FPX 4035 Assessment 3 Improvement Plan In-Service Presentation
Capella University, NURS-FPX4035, RN-TO-BSN

NURS FPX 4035 Assessment 3 Improvement Plan In-Service Presentation

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NURS FPX 4035 Assessment 3 Improvement Plan In-Service Presentation Student Name Capella University NURS FPX 4035  Instructor Name Submission Date In-Service Session Slide 01: Hi, everyone, I am……,. Thank you for coming. This In-Service will cover a patient safety concern, Healthcare-Associated Infections (HAIs), and resources that are available for the nursing staff related to HAIs. I will give clinically-based information that is based on the prevention of infections, early assessment of risk, and escalation of threats to safety. The following resources assist the healthcare team to improve post-operative care, prevent infection and optimise outcomes safely and effectively for all patients in all healthcare environments. Slide 02: Scenario Mr. Jones Carey, 62, was recently transferred to the Riverdale Medical Institute (RMI) from outside the healthcare system. In this transfer, Mr. Carey did not receive Post-Operative Infection Prevention or Post-Operative Infection Surveillance. This transfer was then complicated by a severe Healthcare- Associated Infection (HAI) developed by Mr. Carey. This led to longer hospital stays and extra workload for other health care personnel in caring for the infected person and providing extra supervision. This is an example of how a patient can suffer from an avoidable bad outcome when there is not sufficient attention paid to infection control and quick resolution of clinical problems. Slide 3: Agenda and Outcomes The prevention of Healthcare- Associated Infection (HAI) occurs as a result of a combination of traditional infection control practices, proactive surveillance, and timely management of clinical needs during the recovery process. Purpose Statement This will empower nurses with an understanding of risks and precautions associated with the presence of Healthcare-Associated Infection risk in surgical patients. This meeting will be an introduction to new methods of maintaining the safety of patients with support of the infection prevention bundle. This will aid in the identification, recording, and enhancement of the infection markers and documentation of infection. Proper assessment and recording of infection control and prevention is part of a safe health care system. Infection prevention and control is an evidence-based practice of repeated use that encourages collaboration, decreases the risk to patients, and makes the health care system safer. Slide 04: Goals The first goal is to demonstrate the connections between poor patient outcomes, increasing Healthcare Associated Infections, and the lack of Infection Prevention and Control. If the patients are not identified and monitored for signs of infection, and if Infection Prevention, Control and Care is not implemented, they are likely to have poor outcomes, stay in hospital longer and have an increased number of unnecessary interventions. Sartelli et al. (2024) identified a clear relationship between the regular use of IPC and enhanced IPC and a decrease in the number of infections. The second objective is to foster good collaboration between nurses, doctors, infection control, and the other post-op team members through best practice. Effective and timely reporting of clinical information and concerns to staff and other health care providers supports the provision of safe and effective care. Collaboration is the best method to embed a proactive approach to patient deterioration and IPC across the healthcare system, Katantha et al. (2025) state. Finally, consider promoting early detection and action on early indicators of postoperative infection, and the evidence-based approach of less emphasis on individual team members’ assignments, and more emphasis on the responsibility of the team as a whole. Garcia et al. (2022) state that an integrated infection monitoring and control system, plus educating and preparing the entire post-operative team, will improve the systems in monitoring and controlling infection in post-operative patients. Slide 05:   Safety Improvement Plan Overcoming two challenges: the failure to detect the clinical decline in patients and the limited uptake of infection prevention has resulted in poorer care for patients and for the prevention of ‘Healthcare Associated Infections’ (HAI). The most challenging aspect of Mr. Jones Carey’s case was the ongoing surveillance and care of infection prevention measures following the surgery. The infection prevention measures and their monitoring were inconsistently provided after the operation. Documenting of care, escalation, and monitoring processes continued to fail. The first step in response to the failures was to formally establish an infection prevention measures bundle. The development of the bundle was a specialized checklist for electronic infection prevention measures; the development of an infection prevention and clinical deterioration training was also created; and a monitoring framework was developed that included engagement audits to assess the care team’s adherence with monitoring and documentation of clinical care. The measures proposed are mainly focused on organising clinical care activities to remove safety and infection risks, from a post-surgical status and avoidable. Importance of Addressing This Issue This is a major step forward for patients and hospitals as infection prevention programs are introduced. We do care for the psychological well-being of a patient, but we feel that it is more important now, given the patients who have to undergo long and painful rehabilitation. Each and every rehabilitation is not just about the physical recovery of the patient but also about his/her psychological recovery as well. We mention, however, that infection prevention and control is crucial during the rehab process. Incorporation of infection prevention in the clinical environment and the systemization of clinical activities will allow harmful activities to be stopped and patient safety to be guaranteed (Sandu et al. 2025). The primary concern of this system is patient safety and the intentional design and ordering of an activity for the caregiver in a thoughtful, systematic, and purposeful way. Slide 06: Process for Safety Improvement We are working towards reducing infections associated with health care. It will be achieved by sustaining a process of embedding the care quality standards throughout routine care of all postoperative patients. The introduction of an electronic infection prevention checklist is a large changeable component of this plan and will then allow for the infection prevention bundle. This plan intends to reinforce the critical aspects of hand hygiene, aseptic technique, and reporting and control of infection in a timely fashion. This plan aims to protect care standards

NURS FPX 4035 Assessment 2 Root-Cause Analysis and Safety Improvement Plan
Capella University, NURS-FPX4035, RN-TO-BSN

NURS FPX 4035 Assessment 2 Root-Cause Analysis and Safety Improvement Plan

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NURS FPX 4035 Assessment 2 Root-Cause Analysis and Safety Improvement Plan Student Name Capella University NURS FPX 4035   Instructor Name Submission Date   Understanding What Happened   1. What happened?: Begin by understanding the sequence of events leading up to the sentinel event. Gather detailed information about the incident, including the timeline, people involved, and context. o Who did the problem/event affect, and how? Mr. Jones Carey, 62, was transferred to Rivera del Medical Institute following a surgical procedure at another hospital. At the time Mr. Carey was in the post-surgical unit, infection control measures were not being performed and he did not know how to identify early signs and symptoms of an infection. Mr. Carey contracted a serious Healthcare-associated Infection (HAI), extending his hospital stay and causing an increased risk of injury to other hospital patients and a decrease in quality of care for other patients. This case illustrates how, if prevention fails or the response to patient injury is inadequate, additional healthcare resources are lost. 1. Why did it happen?: o Human Factors: Investigate whether communication breakdowns, staff fatigue, or lack of training contributed. o System Factors: Examine workflow processes, equipment failures, and environmental factors. o Organizational Culture: Assess if there are cultural issues, lack of safety culture, or inadequate leadership support. o Society/Culture: What role might cultural assumptions or backgrounds play? The development of infection in staff of the hospital was related to several factors, especially individual factors. It is possible that staff have become fatigued from feeling overwhelmed by the volume of work they are responsible for and that this perception of being overwhelmed has led to a lack of compliance with the infection prevention measures, which may have been ignored or implemented less strictly and with less attention to detail. Nantsupawat et al. (2021) pointed out that gaps in infection prevention and control are linked to inadequate staffing and failure to recognize that the patient’s condition is declining. There were several design defects, too. This monitoring system did not provide any protection against staff identifying and responding to early signs of infection. Training and infection control and prevention practices would likely help to strengthen infection prevention within an organization. After a little while, the culture, which sometimes has been disrespectful to compliance with IP&C, may be another reason for the increased disruption to injury to the patient, however, once the systems and processes are in decline. 1. Was there a deviation from protocols or standards?: o Procedures and Policies: Determine if established protocols were followed or if there were deviations. o Were there any steps that were not taken or did not happen as intended? o Documentation: Review medical records, nursing notes, and other relevant documentation. From the information available, it is clear that there was no regard for infection control after Mr. Carey’s surgery. Infection control policies and practices were probably used, but were not necessarily implemented often. Appointed staff were most likely to have completely ignored the infection control practices. An infection control assessment is very likely not to have been performed, or it was not performed in an unreasonable timeframe. Probably some of the necessary Infection control assessments were not completed. There is likely to be some missing data from Infection control assessment records. Records of monitoring and evaluation of vital signs and Mr. Carey’s post-operative status may not have been completed. No monitoring was done of Infection control. Sartelli et al (2024) state that the Infection control system, standards and policies have likely been breached, and that multiple system failures have likely occurred, but the omissions/violations by staff were isolated and likely manual. 1. Who was involved?: o Staff: Identify the roles of individuals directly involved in the event. o Supervisors and Managers: Investigate The nurses, qualified doctors, infection prevention and nursing leadership team members were many of the members of Mr. Carey’s healthcare team. The nursing supervisors, managers, and frontline staff had the closest contact with infection control procedures, as this team was the most involved with monitoring the patient and reporting any significant changes in the patient’s condition. The environment was mostly influenced by the supervisors and managers, while the direction of infection prevention and control was primarily reliant on the staff control and support. No policies existed that had a very clear structure to establish and define accountability, and no support for the ongoing implementation of control in the various shifts. Lack of leadership control and lack of policy reinforcement are directly related to lack of consistency in operational processes and are likely to lead to unnecessary adverse outcomes, according to Cappelli et al. (2024). 1. Was there a breakdown in communication?: o Interdisciplinary Communication: Assess how well different teams communicated. o Patient-Provider Communication: Explore whether patients were informed and understood their care. The poor communication caused the infection to get worse. The clinical issues that developed were not well communicated to the remainder of the health care staff, causing delays in the evaluation of the patient and critical care. There was informal communication at this stage, and critical information to enable a time-sensitive intervention was not available. The staff also failed to communicate to the patient the degree of importance of the need for him to verbally report the worsening infection. Barriers to care coordination and timely interventions to protect the patient will be best removed through consistent communication (Howick et al., 2024). The breakdown of communication rendered the surveillance of infections totally unhelpful and caused additional harm to Mr. Carey’s already poor condition. 1. What were the contributing factors?: o Physical Environment: Consider facility layout, equipment availability, and workspaces. o Staffing Levels: Evaluate if staffing was adequate. 2. Training and Competency: Assess staff’s knowledge and skills. There were many bad conditions, primarily environmental and personnel, which resulted in a negative outcome. Resource constraints caused a shortage of staff to the point where it was not even possible to monitor the patients and adhere to the infection-control standards. Also, standards of infection control may have been overlooked because we have been excessively busy, working outside of normal working hours, and lacking validated competency in infection control and early recognition of infections. If continuous education services and training are limited, staff performance and safety standards are likely to be negatively impacted in a healthcare facility,

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety
Capella University, NURS-FPX4035, RN-TO-BSN

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

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NURS FPX 4035 Assessment 1 Enhancing Quality and Safety Student Name Capella University NURS FPX 4035  Professor Name Submission Date   Enhancing Quality and Safety Improving the quality and safety is a key goal of healthcare, with a particular focus on patient safety & quality in nursing. One such effort to accomplish this goal – and promote the health and safety of military veteran – is the prevention of suicide. Military veterans with post-traumatic stress disorder (PTSD), depression, substance abuse, and social isolation are at higher risk of suicidal behavior and require rapid, comprehensive coordinated care due to evidence of their significant impact on suicide risk among military veterans (Hoffmire et al., 2024). In this paper, this paper will examine the role nurses can play in assisting patients in identifying their risks and then implementing effective intervention strategies and coordinating multidisciplinary care will be examined with the case study of Mr. James Carter, who is a patient at an outpatient mental health clinic for Veterans Affairs (VA). Scenario Mr. James Carter is a 42-year-old veteran who is being treated at a VA outpatient mental health clinic. Mr. Carter has had several deployments overseas and was medically discharged due to physical injuries, as well as developing signs of PTSD. Mr. Carter indicates he’s struggling with insomnia, withdrawal from friends and family, hopelessness, and an increasing consumption of alcohol at a follow-up visit. Mr. Carter has seen some counseling previously, but has had a lack of regular follow-up visits and appointments. At the time of the nursing assessment, other factors suggest that Mr. Carter has a greater risk of self-harm, such as his recently losing his job, distancing himself from family members, and uncertainty about his future. Factors Leading to the Patient Safety Risk in Healthcare Setting Numerous factors related to veteran suicidal risk could be potentially hazardous if the patient’s time is not spent in prevention and treatment. In this case, multiple and easily identifiable risk factors are evident within the client, Mr. James Carter, that put him at greater risk of suicidal ideation and behavior. These risk factors encompass his PTSD, depression symptoms, alcohol use, unemployment, and disconnection from his civilian community in his post-service life. The stress of this interconnection is compounded and places a greater strain on his resources to cope, with the potential for suicide. Study evidence suggests that veterans with comorbid mental illness, co-occurring mental illness, and adverse life events are at higher risk for suicide compared to veterans with only a single or none of these factors (Hoffmire et al., 2024). Mr. Carter’s sporadic and brief visits make it more likely that his psychological condition will deteriorate without his parents even noticing. It can be impossible to overemphasize the significance of routine monitoring of suicide risk in all veterans, continuity of comprehensive and consistent treatment, and regular follow-up of veterans (Saulnier et al., 2025); these should be the pillars of treatment for veterans. If one of these comprehensive and complex evaluations is not conducted, there is a risk of missing suicide warning signs. Evidence-Based Practice Solutions to Improve Patient Safety and Reduce Costs The most effective way to reduce veteran suicide is to implement evidence-based interventions that facilitate better identification, engagement and maintenance of veterans in care within health care settings. One of the first interventions is to implement universal suicide risk screening to identify at-risk veterans before they engage in suicidal behaviours, and allow the health care team to be notified of mental status changes before self-harm occurs (Powsner et al., 2023). For Mr. James Carter, the same nurses who conducted suicide risk assessments at each outpatient encounter would be used to detect early signs of distress and make mental health referrals to specialists before the crisis, avoiding the event. It will also save costs linked to suicidal activities, which include crisis avoidance, an absence of visits to the emergency department, and hospitalization. Intervention two was personalized safety planning (PSI), in which a veteran discussed with them practical strategies, emergency contacts, and resources to help them manage and mitigate acute suicidal ideation. Regarding Mr. James Carter, if he is experiencing symptoms of depression, he can use his personal safety plan, list the people available to him and/or his health care team, and call on one of those people to avoid a situation leading to crisis. This will lessen the need for costly emergency services and treatment associated with an acute psychiatric emergency. The third intervention is the use of cognitive behavioural therapy (CBT). Besides bolstering coping behaviors, CBT addresses patients’ thinking patterns and the connection between the thinking patterns and maintenance and development of negative behaviors (Nakao et al., 2021). CBT will help Mr. James Carter to replace thoughts of hopelessness due to unemployment and his experience of trauma during his time of service. Avoidable hospitalization and costs of treatment will be reduced by effective treatment, which will prevent future recurrences. Fourth is the prompt follow-up of any missed appointments or after patient discharge from the hospital, where veterans face a greater risk of suicide (Ee et al., 2023). A quick follow-up with Mr James Carter will provide good information about why he is not in the appointment and will thereby help to maintain continuity of his treatment, thus minimizing unnecessary emergency care and hospitalizations. Fifth is the collaboration of multidisciplinary healthcare where nurses would be part of a collaborative care team consisting of a psychologist, primary care provider, addiction counselor, social worker, and a psychiatrist (Isaacs & Mitchell, 2024). The nurse will collaborate with the multidisciplinary health team that cares for Mr. James Carter to help him with his PTSD, alcohol abuse, lack of employment, and family problems. Better coordination will help with treatment outcomes and lower the costs of duplication of services, prevent complications, reduce unnecessary emergency department visits, psychiatric hospitalization, and suicidal behavior. Role of Nurses in Improving Patient Safety The combined efforts of a nurse at different levels of the health system can have a significant impact on Mr.

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers
Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

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NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers Student Name Capella University FPX4025 Professor’s Name Submission Date   Sharing Your PICO(T) Process Results with Your Colleagues Good morning, my name is and I am going to present you with an evidence-based plan which will prove to be helpful to the patients with acute decompensated heart failure (ADHF) and particularly those who could be at risk of having an ischemic stroke during their hospitalization. The concept of evidence-based practice (EBP) is extremely important in the work of nurses since EBP involves the application of clinical skills, personal preferences of the patient, as well as the most relevant research findings, which results in better patient outcomes. The application of the PICOT model in this scenario is a big assist as it assists nurses in developing the appropriate questions about clinical practice. The aim of the given presentation is to elaborate on the diagnosis, formulate a PICOT question, locate the evidence concerning the topic in the academic literature, and outline key stages in EBP. Diagnosis According to the Outcomes, Risks, and Complications The ADHF is the extreme weakening of the power of the heart to convey sufficient portions of oxygenated blood in support of the metabolism of the organism. ADHF is linked to a large amount of fluid in the body, leading to congestion of the lungs and inadequate supply of blood to different body organs. According to a report by the Centers for Disease Control and Prevention (2024), almost 14.6% of deaths are caused by ADHF in adults aged 20 or older, resulting in 6.7 million adults with heart diseases in the United States. Shortness of breath, weakness, leg edema, and poor tolerance to physical activity are the most prevalent symptoms of ADHF. ADHF is characterized by high morbidity and mortality rates and is considered one of the most urgent clinical issues that hospitalized patients have. The presence of ADHF leads to long hospital stays, cardiac dysfunction, and low quality of life. The hemodynamic abnormalities, heart rhythm disorders including atrial fibrillation, clot formation, and end-organ perfusion dysfunction are some of the complications of ADHF (Milhem et al., 2025). One of the possible complications of ADHF, which is evident in practical situations, is ischemic stroke. It could also happen that the heart can develop blood clots, and the blood supply cannot reach the brain. Some of the complications that might arise as a result of ADHF include cardiogenic shock and respiratory failure as a result of pulmonary edema. Examples The problems of ADHF can be explained by a situation when a patient gets admitted to the hospital due to a case of congestive heart failure, and finds out that he is experiencing irregular heartbeats, which is known as atrial fibrillation. Atrial fibrillation complication also causes the accumulation of blood in the atrium of the heart. Thus, there is the possibility of the formation of blood clots. The clots of blood move to the brain, resulting in a stroke. Finally, the patient also acquires a neurological problem in the form of hemiplegia and aphasia. One more problem that can be identified with ADHF is evident when people experience fluid retention and decreased cardiac output, thereby resulting in hypoxemia due to pulmonary congestion. PCIO(T) Question In adult patients with acute decompensated heart failure (P), how does nurse-led early stroke risk assessment and prevention (I), compared to standard care with no risk assessment (C), influence the incidence of ischemic stroke (O) in the hospital (T)? PICOT Breakdown P (Population): adults with acute decompensated heart failure. I (Intervention): Preventive risk assessment and intervention in stroke at an early age. C (Comparison): Standard care in the absence of stroke risk assessment. O (Outcome): Affect the occurrence of ischemic stroke T (Time): In hospitalization (within 30 days) Alignment with PICOT Framework All the elements of the PICOT question apply to the particular clinical issue of ADHF. In relation to the first element, the population would be comprised of patients with ADHF who are at risk of developing thromboembolism. The intervention element entails the identification of the various risk factors that lead to stroke among patients. The comparisons would be between the status quo, where the risks have not been detected before the onset of stroke, and where the risk has been detected before the stroke has occurred. The outcome element would be geared towards ensuring that no ischemic stroke takes place as this could be lethal. Overview of Content of More Than Three Sources of Evidence Multiple quality scientific papers have been reviewed to identify the effectiveness of early risk assessment of ischemic stroke in ADHF patients. In their research, Iguchi et al. (2021) carried out an observational study among more than 4,000 patients and concluded that ischemic stroke is one of the main complications that occur during hospitalization for ADHF. The study found that BNP, atrial fibrillation, and acute coronary syndrome are significant predictors of the condition of a patient. Yamazaki et al. (2026), in their turn, have conducted an observational study involving over 5,000 participants. They came to the conclusion that ischemic stroke occurs the most in the first 30 days of hospitalization and the onset of the sickness. Also, the alterations of hemoglobin and the cardioembolic mechanism are the factors that are believed to raise the chance of having a stroke considerably. Ran et al. (2025) included 2,994 people and systematically reviewed and analyzed 11 clinical studies. The authors of this paper found NT-proBNP to be an excellent biomarker in assessing the patient’s outcome, including ischemic stroke. This article is extremely important because a number of sources are analyzed. Therefore, this research paper presents high-level evidence, and the role of biomarkers in assessing risks should be taken into account in medical practice. In Lucki et al. (2025), the study was an observational one that focused on the hospitalization outcomes of ADHF patients. The authors concluded that the more serious nature of the disease and long-term hospitalization are risk factors

NURS FPX 4025 Assessment 3 Using the PICO(T) Process
Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 3 Using the PICO(T) Process

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NURS FPX 4025 Assessment 3 Using the PICO(T) Process Student Name Capella University NURS FPX 4025 Professor’s name Submission Date   Using the PICO(T) Process The acute decompensated heart failure (ADHF) is one of the most problematic cardiovascular issues due to its rapid progression, during which the amount of accumulated fluid, cardiac output, and the ability to supply tissues sufficiency increase. The issue in question is a healthcare emergency that has a high morbidity and mortality. Hence, evidence-based practice (EBP) can be used for the treatment of ADHF since EBP enables specialists to merge the experience of the health care provider, preferences of the patient, and empirical data (Ghorpade & Salvi, 2024). EBP tools are numerous, but PICO(T) is the most potent tool. This approach is based on population, intervention, comparison, outcomes, and time. By using PICO(T), clinicians will have the ability to generate pertinent questions, conduct a literature review, and make a decision regarding the treatment actions. Using the PICO(T) model to address the problem of ADHF will assist nurses in preventing such complications as ischemic stroke. ADHF Acute decompensated heart failure is said to be a potentially fatal complication as they do not produce enough output of the heart that, in turn, is incapable of supplying the body with the necessary oxygen in the form of tissue perfusion, resulting in systemic and pulmonary edema. Shortness of breath, exhaustion, fluid overload, and inability to maintain good physical performance are some of the common symptoms that are experienced in ADHF. More so, ADHF today needs emergency medical care since it is highly likely to be put into the hospital. The untreated ADHF is associated with numerous health issues, including prolonged hospitalization, frequent hospitalization, low quality of life, and mortality (Milhem et al., 2025). In addition, ischemic stroke is among the numerous diseases that are regularly observed with ADHF. This can be attributed to the fact that ADHF is surrounded by such hemodynamic changes as stagnation of blood, hypercoagulability, and inadequate cerebral perfusion. The impacts of ADHF and the risks associated with the complexities of ADHF are tremendous to certain population segments. The elderly, underprivileged individuals, and those with no easy access to healthcare services are more likely to be affected by ADHF and its complications. For example, the poor can face issues such as delayed diagnosis and treatment of their conditions, as well as poor prevention techniques, such as anticoagulation treatment (Milhem et al., 2025). Such disparities might be the reasons why individuals have bigger opportunities of experiencing complications, including strokes. Secondly, minority groups are usually confronted with various issues when they receive appropriate medical attention. Formulating a PICOT Question The clinical question should be developed during the EBP practice as it will help the professionals to determine the most effective interventions in improving patient outcomes. Regarding ADHF patients, the most significant problem that arises in this group of patients when dealing with complications encountered during hospitalization is an escalation in the risk of ischemic stroke, which is associated with serious outcomes, including morbidity, mortality, and disabilities. Using PICOT to generate the clinical question can be helpful since it offers valuable guidelines for creating the right question (Jahanshahlou et al., 2024). The clinical question formulated using this process involves aspects of the problem that need to be solved, the population of patients, the intervention used, the comparative intervention, desirable outcomes, and time. As for the issue in question, it may be worthwhile for nurses to focus on early risk assessments of stroke among ADHF patients in order to prevent stroke. Based on this, it is clear that nurses will be very important in effecting the suggested interventions. PICOT-Formatted Research Question In adult patients with acute decompensated heart failure (P), compared to standard care with no risk assessment (C), how does nurse-led early stroke risk assessment and prevention (I) versus standard care (C) influence the incidence of ischemic stroke (O) in the course of hospitalization (T)? PICOT Breakdown · Population: Non-communicable, acutely decompensated heart failure in adult patients. · I (Intervention): EPS (Early stroke risk assessment and prevention) · C (Comparison): Standard care: no stroke risk assessment. · O (Outcome): Have an impact on the prevalence of ischemic stroke. · T (Time): In hospital (in 30 days) The Effect of the PICOT Approach on the ADHF Management Evidence-based practice will necessitate the use of the PICOT model, and through it, the healthcare professionals will be in a position to test various interventions in order to give the patients sufficient treatment. When it comes to the treatment of ADHF, it is rather clear that early detection of the risk of stroke along with adequate response is required. Assessing the risks of strokes, nurses and other medical workers will be empowered to identify risky patients and make the right recommendations related to their care (Milhem et al., 2025). For instance, monitoring of at-risk patients and administration of anticoagulants in case it is needed will be the two steps that should be undertaken. Evaluation of the risks of stroke can be regarded as the most prominent difference between evidence-based practice and standard practice. Eventually, through the PICOT model, health care professionals will be in a position to enhance the outcomes of the patients. Search of the Literature Noting Search Engines, Key Words, and Factors of Credibility The literature was extensively searched with the help of scholarly sources that can be used in this PICOT question. The databases like PubMed, CINAHL, Google Scholar, and ScienceDirect were used. The selected databases have been used due to their credibility of information since they consist of only evidence-based and peer-reviewed information regarding health care. Some of the keywords that will be used during the search procedure are: acute decompensated heart failure, risk of ischemic stroke, stroke prevention in heart failure patients, BNP monitoring, and complications of heart failure. To make sure that valuable evidence is presented, the search procedure included certain filters such that all sources whose content has not been reviewed by peer reviewers or was

NURS FPX 4025 Assessment 2 Applying an EBP Model
Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 2 Applying an EBP Model

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NURS FPX 4025 Assessment 2 Applying an EBP Model Student Name Capella University NURS-FPX4025  Professor’s Name Submission Date   Applying an EBP Model Sickle cell disease (SCD) is a hereditary blood disorder that causes the red blood cells to stiffen into a sickle shape. This leads to obstruction in the blood vessels, pain crisis, organ damage, and a drop in the quality of life (QOL) (D’Costa et al., 2023). Children such as a 10-year-old with a pain crisis require holistic and lifetime care. Evidence-based practice (EBP) in nursing is an effort to improve patient safety and care. This takes into account evidence, practitioner and patient values/preferences in order to realize the intended results. The paper discusses the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to resolve problems in the SCD child’s care and enhance his pain control experience. Description of the Diagnosis and Associated Issue Sickle cell anemia is a long-lasting condition that is commonly experienced by children. Pain (pain crises) has been noted to be a common symptom of the disease in childhood, with multiple hospital visits and requiring a multidisciplinary team for their management (Jain et al., 2026). A problem with SCD is that there is a gap between the development of the disease and symptoms and complications (pain crisis). In addition, care can be influenced by problems with the coordination of services and access to health services, including transportation problems, lack of knowledge and skills in health care providers. These affect the quality of life and complications. It is here that an EBP approach can assist, where care can be provided in a different way compared to the typical care approach and not based on the best available evidence. Without the availability and consistency of using evidence-based approaches, there’s a potential for a delay in timely pain and supportive care interventions. The EBP model assists health care practitioners in planning care, avoiding delays in care, and enhancing quality and outcomes with the top and current evidence at their fingertips (Connor, 2023). This means that an EBP model will need to be adopted to aid in alleviating these problems and health outcomes in children with SCD. Selection of the Evidence-Based Practice Model   The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was chosen for this discussion as it is an easy way to integrate and use to support decision-making (Bissett et al., 2025). This model is divided into three general steps: Practice Question (P), Evidence (E), and Translation (T). The model provides a framework that nurses can use to recognize evidence problems, seek evidence, and transform practice to utilize evidence. The JHNEBP model is suitable to tackle issues related to sickle cell disease as it is practice-focused. It assists nurses in forming practice questions and finding and utilizing evidence. This structured process also encourages consistent engagement between clinical staff and the evolving body of research. It also results in better patient outcomes and the added advantages of standardisation and uniformity of nursing care (Gaber et al., 2025). The simplicity of the models enables them to be used in complicated issues, including delays in the treatment and care of SCD kids. Description of the Evidence-Based Practice Model Steps The JHNEBP model’s first step is the Practice Question (P), and it starts with recognising a problem and developing an evidence question. This may be achieved by taking into account Population (P), Intervention (I), Comparison (C), Outcome (O), and Time (T) factors (PICOT). Again, with regard to sickle cell disease, the practice question is to coordinate care and expedite treatment for pain in children. The second step is Evidence (E), as nurses apply evidence by searching for studies and analysing the validity and applicability of the studies. The nurses search credible databases (for example, PubMed, CINAHL, and Google Scholar) for peer-reviewed evidence in the area. And the nurses also critique the evidence for validity, reliability, and strength to ensure that the evidence used to guide our practice is reliable. The third step is Transformation (T), or putting the evidence into our practice. This is when we introduce strategies to facilitate change, such as improved communication between health care providers, education of the patient, and removing these barriers to treatment (Ainslie et al., 2024). These strategies are tested to assess the impact it has on the patient. Steps are important as they outline the strategic approach of the model by using best practices in health care. Application of the Evidence-Based Practice Model to the Issue A particular issue impacted by using the JHNEBP model was the delayed treatment and lack of coordination of care in the case of childhood sickle cell disease. In the Practice Question phase, a PICOT question was developed: What is the effect of enhanced care on the prevention and treatment of pain crises, and on patient outcomes in kids who suffer from sickle cell disease compared to usual care? This question was applied in searching for literature. In the Evidence phase, peer-reviewed literature from the past 5 years was identified using search engines PubMed, CINAHL, and Google Scholar. We conducted a search based on the following terms: Sickle cell disease, children, childhood, pain crisis, coordination of care, and barriers to care. Articles we have chosen were based on the research findings within the past few years, with results in children and barriers to care. We identified barriers to care, with few studies focused on children, and problems getting the full text of certain studies. We had the opportunity to search a couple of studies. At the Translation stage, we formulated care improvement strategies based on the data in the research. These strategies involve communication with the health care team and families, support services like transport services, and protocol use to manage pain (Baker et al., 2024). The goals of these strategies are to reduce delays in care as well as enhance treatment. Analysis of Evidence The first one – Schlenz et al. (2025) – is a qualitative study that explains the impediments and enablers of care in children with

NURS FPX 4025 Assessment 1 Analyzing a Research Paper
Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 1 Analyzing a Research Paper

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NURS FPX 4025 Assessment 1 Analyzing a Research Paper Student Name Capella University NURS-FPX4025 Professor’s Name Submission Date Analyzing a Research Paper Criteria Analysis Type of Study This is a qualitative descriptive study because it conducts semi-structured interviews with parents of children who have sickle cell disease, and then describes their experiences using content analysis. Using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, this study has a Level VI rating on the evidence pyramid. That means it is almost on the bottom of the pyramid (and Level I is the top and Level VII the bottom). It is Level VI because it doesn’t involve experiments, control groups, or statistical tests, nor does it include scientific measurements. This is still valuable, despite its placement at Level VI, because it informs us of the problems people face and how to make health care more patient-centered. Credibility Peer-reviewed journal. NIH-funded. IRB approved. Conducted by healthcare researchers. Importance of Diagnosis Focuses on sickle cell disease in children. Identifies barriers and facilitators to care. Application to Patient (Jamie) Applies to Jamie’s pain crisis. Highlights care barriers (access, delays) and supports better care coordination and education. Sickle cell disease (SCD) is a genetic condition causing red blood cells to be in a sickle shape and affecting the mobility of the blood cells. This leads to complications that cause pain, organ damage, and loss of quality of life. It is an early childhood disease diagnosed early on, and the child should undergo specialist care to avoid complications in later life. Children with SCD need tailored care, as this allows children to have a better quality of life and reduces complications (Schieve et al., 2022). This assignment will elaborate on one of the journal articles on barriers and facilitators of holistic care in children with sickle cell disease, to treat a 10-year-old boy, Jamie Hampton, with SCD pain. Abstract of the Research Article Our chosen article is Barriers and facilitators to paediatric sickle cell care: a qualitative descriptive study, Schlenz et al (2025), a qualitative descriptive study that provides the barriers and facilitators to holistic care of children with sickle cell disease. The authors analysed data from semi-structured interviews of 27 parents of sickle cell children. The Conceptual Framework of the Access to Care Model was used to do a directed content analysis. Such qualitative studies provide a detailed account of what it is like as a patient or a carer to go through an issue; they can be helpful in determining access barriers. This kind of insight often reveals nuances that quantitative measures alone may fail to capture. Qualitative research isn’t as rigorous as quantitative research, but it does provide you with some knowledge of the problem, and you can learn from this to better care. The study provides Level VI evidence, which is especially helpful in patient experience and enhancing patient-centered care, albeit being lower on the hierarchy of evidence. Article Credibility It is a plausible article for a few reasons. First, because they have published their article in a peer-reviewed journal about the topic, Pediatric Blood & Cancer. First, since it is a study sponsored by NIH, and thus a measure of the quality of the study (Schlenz et al., 2025). Two, it has been endorsed by the Institutional Review Board (IRB). The authors of the study have published other studies on pediatrics or hematology. In addition, the research contains information on various locations, thereby rendering the study genuine. Significant Results of the Research This paper has brought out the fact that there were a number of factors that supported and hindered sickle cell care. This was by way of positive parent-provider relations, support, and education. This led to greater health care satisfaction and engagement (Schlenz et al., 2025). The support and support services (e.g., appointments, transport). There were problems, the study found. The lack of knowledge of health care providers, waiting times, and appointments was the issue in the health system. The individual issues were transportation, money, no-show (failure to attend), and employment/studying opportunities (Sang et al 2025). These may have an influence on health and health care. The most prevalent power outage in health care was in public transport. Relevance to Sickle Cell Disease The work is also relevant in coming up with innovative solutions to tackle sickle cell disease since sickle cell disease needs to be handled on a long-term and comprehensive basis. The disease symptoms and signs without effective treatment are pain, complications, and hospitalizations. The identified children with SCD have various quality of life (QoL) needs and complications, which necessitate a variety of health care services (Schlenz et al 2015). They underscored the health care barriers and facilitators to enhance the quality of life of SCD. Application to Patient The presented study can be used in the case of the crisis of sickle cell disease in a 10-year-old child of Jamie Hampton. Jamie has pain crises that require treatment. Jamie may face delays and difficulty coordinating and getting care. He might have problems getting to appointments. The experiment demonstrates ways to enhance care. These are communication, education, and coordination. He has nurses who are looking after him. They can make sure that he is free of pain, educate, and coordinate (Ge et al, 2023). Therefore, with education, removing barriers, and offering enablers, we can enhance the care and experience of Jamie. Application to Practice This study can provide us with an idea. This can assist in empowering health care providers, including nurses, so as to overcome the health barriers. That is, parents will be assisted in transportation and well-informed and supported in their healthcare journey. Health-care professionals can also be more humble and practice cultural humility to care for the patient by being reflective of the patient or family (Hernandez et al., 2021). Barriers and facilitators will ensure that the health-care system can offer the most efficient health and well-being to the child with sickle cell disease. Conclusion The article looks at the barriers and facilitators of health

NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation
Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation

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NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation Student Name Capella University NURS-FPX4015 Professor Name Submission Date   Head-to-Toe Assessment on a Volunteer Presentation Hello, everyone! Immaculate Durvil is my name and I will perform a head-to-toe examination of my patient, Ms. Aiyana Tehanata today. During this evaluation, I will monitor the overall appearance, check her vital signs, perform focused physical examination, and examine her neurological, cardiovascular, respiratory, and musculoskeletal systems. I will also explain my process of doing every component of the assessment in order to be comprehensive and precise. The demonstration relies on the health status of Ms. Tehanata and its impact on her overall care plan, which deals with the short-term and long-term health requirements. Comprehensive and Professional Assessment I started the overall examination of Ms. Aiyana Tehanata and talked about the reason behind the examination and her medical history, including her chief complaint, which is tingling in her feet. I also insisted on the role of communication during the process to make her feel at ease and collaborate. I began by general assessment to note her overall look with alertness and demeanor and whether she was experiencing distress or not. I then did a physical examination, specifically looking at the color and texture of the skin including any edema or other abnormalities of her extremities. I proceeded to the cardiovascular assessment, which involved hearing heart sounds, where S1 and S2 were normal without any murmur, gallops, and rubs. I proceeded to have an examination of the 4 th intercostal space where I identified the presence of stenotic turbulence. The above finding indicates that there are potential vascular abnormalities that could be explored (Selvaraj et al., 2022). The vital signs were taken, with temperature (98.4degF), heart rate (75 bpm), blood pressure (130/72 mmHg), and SpO2 (98%), which were normal. The respiratory examination was also accompanied by the fact that the lungs were clear and clear in the five lobes of the lungs, which was a sign that the lungs were free of respiratory distress or abnormalities. Next, I proceeded to the genitourinary examination and the abdominal examination, which were both free of distress and abnormalities. Her stomach was tender, non-tender, and stool was normal. I would then examine the musculoskeletal system to determine whether a person has joint pain, stiffness or restricted movements. I detected complete movement in all the extremities, and no external swelling or pain in joints. The neuro-assessment also involved a rudimentary ocular nerve appraisal, where Ms. Tehanata was attentive and oriented, as well as had intact cranial nerves. She was tested using the Snellen chart, and the outcome was 20/30 in the right eye and 20/40 in the left one, which is compatible with her reported problems in focusing. The next examination was the peripheral vascular system. I inspected both legs of the fibula to determine whether it is swollen, or altered in skin color or whether it has an ulcer. Symmetrical and palpable pulses in lower extremities were +2 bilaterally, and Capillary refill was less than 3 seconds. A single 10-point monofilament examination revealed reduced sensation in both feet, specifically 1, 2, 3, and 6 on the right foot, 4, 5, 6, and 9 on the left foot, which may be a sign of a possible neurological problem, such as peripheral neuropathy. In the process of the assessment, I shared the results with Ms. Tehanata and clarified to her the importance of her symptoms regarding the possibilities of diabetes and peripheral neuropathy. I also talked about the following steps of additional diagnostic tests and treatment, and made sure she had the idea of the consequences of her current health condition. Discussion of Diagnosis and Findings   Following the examination, I told Ms. Tehanata that she had the signs of peripheral neuropathy, which is one of the common complications usually observed in persons with diabetes or hypertension. One of the main findings that can be used to diagnose this diagnosis is reduced sensation in both feet that is reflected by the 10-point monofilament test (Parveen et al., 2025). These findings suggest that she may have nerve damage in the lower extremities which may be secondary to long term hyperglycemia or vascular problems. I highlighted that peripheral neuropathy is a severe disease, and unattended to, it may cause other complications like ulcers, infection and even amputations. I told her that the elevated level of blood sugar might be causing the damaging of the nervous system, and managing her blood sugar levels is the only way to avoid the amplification of the situation. This observation suggests that, possibly, stricter management of her diabetes and an assessment of her medications, including Metformin and Gabapentin, is needed to make her treatment plan optimal (Dave et al., 2025). The vascular sufficiency may be compromised as caused by constriction of her blood vessels that appears in her cardiovascular examination with stenotic turbulence in the 4th intercostal space. This might be a root cause of the numbness in her feet. I promised her that I would be watching her heart and her circulatory system very closely and would take into consideration other diagnostic procedures to determine the vascular health. This collaborative approach reassured her that her care would remain consistent and closely monitored moving forward. Finally, I addressed the topic of the need to have regular follow-up visits and tight blood glucose control. Reduced sensation exposes Ms. Tehanata to more risks of injuries, wounds, and infections that can remain undetected because her feet have impaired sensation (Baig et al., 2022). I focused on the importance of good feet care, frequent checking of her blood sugar levels and lifestyle changes (eating healthy and exercising). These measures are critical in ensuring that there is no more damage to the nerve and that her quality of life is enhanced. Understanding of Pharmacological Needs As the assessment and evaluation show, Gabapentin is prescribed to Ms. Tehanata to control peripheral neuropathy and reduce tingling in her feet. Gabapentin acts by decreasing nerve activity related to nerve-related

NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation
Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation

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NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation Student Name Capella University NURS FPX 4015 A4 Professor’s Name Submission Date   Caring for Special Population Teaching Presentation Slide 1 Hi, my name is……., Today I’m going to speak about special populations, homeless/housing insecure populations. Slide 2 The care of culturally competent nursing care is still essential for delivering appropriate health care solutions to homeless and housing-insecure individuals. Homelessness affects individuals’ health care access, leading to higher prevalence of chronic diseases, mental health problems, and infectious diseases (Sleet & Francescutti, 2021). Nurses have the opportunity to address health disparities by utilizing evidence-based patient-centered strategies that center on trust and providing accessible, compassionate care. In this presentation, we will explore homeless healthcare needs, their inequitable treatment, and cultural needs, and will showcase some helpful nursing practices for the delivery of fair and effective healthcare. Slide 3 Population Group and Their Healthcare Needs Homelessness and housing insecurity are made up of a diverse population of people with mental illness, financial problems, families, and veterans. People experiencing homelessness can be defined as those who do not have a fixed, regular nighttime residence while staying in a shelter, transitional housing, or in a car, a bus or train, an abandoned building, or a public building or place, such as a hospital or mental health facility (Sleet & Francescutti, 2021). Housing insecurity is a term used to describe people who are at risk of becoming homeless due to financial issues, moving frequently, or living too close together. The constant switching of housing from shelters to other insecure environments negatively impacts access to care and exacerbates acute and chronic health issues. Slide 4 Because of their lack of coverage, homeless people often suffer from chronic health problems, such as high blood pressure, diabetes, and respiratory diseases. Non-compliance with drugs and medication and harsh weather conditions are combined with poor nutrition, which hastens the progression of the disease (Mejia-Lancheros et al., 2020). Diabetic ketoacidosis (DKA), peripheral neuropathy, and lower extremity amputation are some examples of complications of uncontrolled diabetes, while stroke and heart failure are some examples of complications of uncontrolled Hypertension. Environmental pollution, smoking, and exposure to repeated cold weather worsen chronic obstructive pulmonary disease (COPD), leading to increased hospital admissions and premature death. Shelter overcrowding increases homeless persons’ vulnerability to infectious diseases due to insufficient sanitation. Homeless individuals suffer more from tuberculosis, hepatitis, and COVID-19 infection than other people, resulting in higher death rates (Tsai & Wilson, 2020). Homeless individuals are often affected by depression, anxiety, post-traumatic stress disorder (PTSD), and substance abuse disorders. Homeless people have been less likely to use medical services because of their experience of trauma, abuse, and systemic neglect. Integrated prevention programs and early detection with person-centered coordinated services are needed to address the healthcare needs of this population. Slide 5 Culturally Sensitive Nursing Strategies To provide culturally competent nursing care to homeless people, it is necessary to know about the unique challenges and cultural experiences of these individuals. Trauma-informed care is beneficial for equitable care delivery as it allows healthcare providers to be more aware of how past trauma can impact patient behaviors and medical service engagement. Trauma-informed care practices create safe environments that are open for patients, as well as active listening techniques and experiences validation (Barry et al., 2023). Nurses should not use stigmatizing language as they assess patients’ barriers to care, such as issues of medication storage and survival being more important than health management. Creating trust and showing empathy between nurse and patient is a practice that increases patients’ involvement in their treatments. Medication access and management are a substantial challenge for homeless people due to financial, cognitive, and storage issues. To advocate for the use of long-acting medications, nurses will support monthly injectable antipsychotics in individuals with schizophrenia, and extended release antihypertensive in those with unstable living conditions (Adams et al., 2020). Healthcare providers who make medications easier to take and do not require refrigeration, and simplify medication regimens, enhance treatment adherence. Properly educated patients can become active players in their healthcare management during periods of instability if they are informed of and educated about the various treatment options and ways of risk reduction. Street medicine services are useful strategies to improve healthcare services for homeless people when they are mobile, moving between multiple locations. Those living in homelessness prefer to avoid traditional health care settings due to adverse experiences, extended wait times, and challenges with transportation (Gutman et al., 2024). Mobile health units deliver health care services at encampments, drop-in centers, and shelters, where individuals receive services focused on chronic disease management, wound care, and substance use counseling in addition to preventive services. Boston Health Care for the Homeless program has been a successful model whose primary care is delivered in community-based settings, resulting in better health outcomes (Koh et al., 2020). Healthcare models that offer flexibility in appointment times, such as walk-in clinics and same-day appointments, offer medical care convenience for individuals who experience homelessness by meeting ongoing medical care needs. Slide 6 Physical Assessment Findings Physical evaluations must be conducted since people who are homeless are more likely to delay health care until their condition is serious. Nurses should examine for skin infections, wounds, frostbite, and foot problems that are caused by long hours of walking and possibly wearing inappropriate footwear. A patient’s overall health needs can be understood by assessing their dehydration and malnutrition. Mental health assessments are equally critical because homeless people often have depression, PTSD, and substance use disorders that can compromise their capacity to take care of themselves and follow instructions (Adams et al., 2020). Establishing a consistent point of contact can further strengthen the therapeutic relationship over time. No judgement builds trust between healthcare providers and patients, resulting in disclosure of health concerns. Wound care, hydration, and mental health referrals are key activities that nurses conduct in health care settings as they perform physical and mental health screenings that will have a positive impact on

NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map
Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map

Leave a Comment / Capella University, NURS-FPX4015, RN-TO-BSN /

NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map Student Name Capella University NURS FPX 4015 Professor Name Submission Date Mental Health Diagnosis Concept Map References Bandelow, B. (2020). Current and novel psychopharmacological drugs for anxiety disorders. Advances in Experimental Medicine and Biology, 1191, 347–365. https://doi.org/10.1007/978-981-32-9705-0_19 Bains, N., & Abdijadid, S. (2020, July 10). Major depressive disorder. Europepmc.org. https://europepmc.org/article/nbk/nbk559078 Chand, S. P., Arif, H., & Kutlenios, R. M. (2023, July 17). Depression (Nursing). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK568733/ Huang, X.-J., Ma, H.-Y., Wang, X.-M., Zhong, J., Sheng, D.-F., & Xu, M.-Z. (2022). Equating the PHQ-9 and GAD-7 to the HADS depression and anxiety subscales in patients with major depressive disorder. Journal of Affective Disorders, 311, 327–335. https://doi.org/10.1016/j.jad.2022.05.079 Walter, H. J., Abright, A. R., Bukstein, O. G., Diamond, J., Keable, H., Ripperger-Suhler, J., & Rockhill, C. (2022). Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 62(5), 479–502. https://doi.org/10.1016/j.jaac.2022.10.001

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