Capella University - NURS FPX 4000 Assessment

Capella University, NURS-FPX4065, RN-TO-BSN

NURS FPX 4065 Assessment 3 Ethical and Policy Factors in Care Coordination

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NURS FPX 4065 Assessment 3 Ethical and Policy Factors in Care Coordination Student Name Capella University NURS-FPX 4065 Instructor’s Name October, 2026 Ethical and Policy Factors in Care Coordination Slide: 01 Hi, my name is ……, Today, I will be discussing the factors affecting care coordination, as it relates to addressing gaps in the delivery of health care services at the Sunrise Community Health Center. Hello, I’m Sameera. Today, I will discuss factors that affect care coordination and help fill gaps in health care service delivery at the Sunrise Community Health Center. Slide: 02 In order to properly carry out care coordination, it is important to improve the health outcomes for patients. Care coordination is crucial for vulnerable populations that may face barriers to accessing health care services. Many healthcare policies have an impact on Sunrise Community Health Center’s service delivery, funding, and access to care. Patient Protection and Affordable Care Act (PPACA), Medicaid expansion programs, Patient-Centered Medical Homes (PCMH’s), and Accountable Care Organizations (ACOs) are among the policies that are helpful in supporting care coordination in the community (Baten et al., 2024). These types of health care policies improve the level of coordination among health care providers and also improve patients’ access to care. There are, however, a number of ethical issues that arise, including fairness in the provision of resources, the allocation of limited resources, and providing equitable access to care for those who receive care. Health care providers such as nurses, care coordinators, and the like, will need to evaluate the impact of government policies on the provision of patient-centered care services and report to their organization. Slide: 03 Effect of Governmental Policies on Coordination of Care Healthcare policies affect the way co-ordination is done in community organizations. At my practicum site, in Sunrise Community Health Center, these government healthcare policies greatly impact staffing, referral systems, and preventive care programs. Those with chronic conditions or complex health issues need to be particularly well-coordinated. A systematic review indicates that the coordinated care model can lower hospital readmission rates for high-risk patients by almost 15 – 20 % and enhance health outcomes (Dhaliwal & Dang, 2024). Government policies have an impact on health care delivery, and it is important for health care providers to be aware of and use these policies to ensure timely and appropriate delivery of patient care. Slide: 04 Affordable Care Act The Affordable Care Act (ACA) is one of the most influential healthcare policies that has impacted care coordination in the United States (U.S.). The ACA increased health insurance coverage and introduced a new model of care for health insurance providers, such as the PCMH and ACO that promote collaboration between health care practitioners (Department of Health & Human Services, 2024). Since the law was enacted, the ACA has increased health insurance coverage in the U.S. to over 40 million people, and so has enhanced access to preventive and primary care services (Kaiser Family Foundation, 2024). This approach to care at Sunrise Community Health Center involves working together with the nurse, doctor, and social worker to get better outcomes for the patient and provide seamless care. Slide: 05 Medicaid Expansion Program Medicaid expansion is one of the biggest factors in care coordination affecting low-income care recipients. Since the passage of the ACA, numerous states have started to make a series of changes to their Medicaid eligibility requirements to increase the healthcare coverage of low-income individuals. There are about 90 million people enrolled in Medicaid in the country (Kaiser Family Foundation, 2025). The increased access to care provided by Medicaid has added more pressure to the care delivery teams. With their volume of patients, care coordinators at Sunrise Community Health Center are doing more than ever to coordinate referrals and support the healthcare journey for patients and their families, sometimes with limited resources. Slide: 06 State Immunization Requirements One of the other key considerations in the public health policy realm that can impact care coordination is the existence of state immunization requirements. State immunization requirements under public health policy contribute to the promotion of preventive healthcare and help to prevent the spread of infectious diseases. At the onset of the COVID-19 pandemic, many healthcare providers became key participants in vaccine distribution activities, educating patients, and providing subsequent support and care. According to reports, a total of around 670 million doses of COVID-19 vaccines have been given to people in the United States (Centers for Disease Control and Prevention, 2025). All of these vaccine doses were part of coordinated, effective preventive health care services that were provided by several States and healthcare systems, with the goal of supporting the health of the communities they serve. Effective public health policies work together and effectively, as illustrated, to lead to the provision of effective care coordination systems across the healthcare system. Slide: 07 Ethical and Policy Implications in Care Coordination Healthcare policies often present challenges in the field for workers in care coordination to deliver equitable and efficient care. The ACA, which made health care more available, has set up a scenario where there are still significant service delivery gaps for the most vulnerable groups; for example, it has been well documented that a large number of undocumented immigrants are uninsured. Around 45% are estimated to have no form of health insurance coverage, resulting in extreme concerns over finding equity and justice in access to health services (U.S. Department of Health and Human Services – Office of the Assistant Secretary for Planning and Evaluation, 2021). When making decisions at the patient level, nurses must balance these decisions with the implications of the ethical principles of non-maleficence, beneficence, autonomy, and justice when considering such situations. Care coordination staff are often faced with difficult ethical choices when they have to allocate scarce resources. Likewise, other policy measures such as Medicaid expansion have increased access to health care services, though they have also resulted in problems at a system level, such as provider scarcity and the slow pace of service

Capella University, NURS-FPX4065, RN-TO-BSN

NURS FPX 4065 Assessment 2 Preliminary Care Coordination Infographic

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NURS FPX 4065 Assessment 2 Preliminary Care Coordination Infographic Student Name Capella University Course Code Professor’s Name Submission Date Preliminary Care Coordination Infographic Unsafe home environments and risk for injury among children are a major health problem for those children living in poverty. Many children of low-income parents are often unable to get the necessary resources or training on how to avoid being injured at home. In this case, the patient is a 26-year-old single mother with two children and an ongoing pregnancy, living in a home with many hazards, such as unsecured guns, standing water, and toxic materials that are accessible. Unintentional injuries are still the leading cause of death in children in the United States, with about 9,200 deaths each year as a result of unintentional injuries. Drowning is the second leading cause of unintentional death in children, with almost 1,000 children drowning each year (Wilson et al., 2023). This care coordination plan provides evidence-based strategies, specific, measurable, achievable, relevant, time-bound (SMART) goals, and community resources to reduce injury risk and promote a safe home environment. Analysing the Selected Health Concern and the Associated Best Practices for Health Improvement Community health issues like child injuries from unsafe homes are both preventable and common. There are many environmental hazards in a child’s home, including water-filled bathtubs, unsecured guns, and unsafely stored chemicals, which directly increase risk for potential injury to children. There is research that indicates that children residing in high-risk homes are 40%-50% more likely to be injured when their caregivers lack knowledge about providing safe environments for children or cannot supervise children safely (Alamr et al., 2023). Homes that include domestic abuse often led to potentially dangerous or unstable environments for children when additional risks for injuries exist. When a coordinated approach to care is implemented for victims, they will receive complete supportive care in addressing their medical, mental health, and community resource needs, which can be achieved through a coordinated means of providing care and service delivery as well as through connecting victims to the community resources needed by them. Children encounter multiple forms of danger from unsafe or unhealthy environments. For example, children can sustain physical injuries from unsafe conditions due to drowning, poisoning, burns, or traumatic injuries. One possible concern is that a child can drown in 2 inches of standing water, so even the smallest amount of standing water can create an unsafe environment for them. Also, children exposed to abusive domestic situations may develop longer-lasting emotional problems than children not exposed to domestic violence (Doroudchi et al., 2023). As an example, many children exposed to domestic violence develop anxiety, depression, or behavior problems at double the rate of children who have not been exposed to domestic violence. Utilizing evidence-based interventions is critical in minimizing these risks. Many studies show that home safety education programs can help enhance the likelihood of caregiver safety behaviors by about 25% to 30% when they are combined with follow-up and reinforcement of these behaviors. Environmental changes, e.g., securing firearms, removing standing water, and properly storing chemicals, will reduce the incidence of injuries. Finally, providing trauma-informed care to victims of domestic violence will assist caregivers who have experienced domestic violence within a non-judgmental atmosphere that values their emotional needs and safety (Ewell-Foster et al., 2024). Coordinated effective care requires collaboration between health care providers, social service agencies and community organizations so that they can address both the physical and psychosocial threats. Assumption The coordination of care from a patient-care perspective includes many basic assumptions. One of these assumptions relates to the lack of knowledge regarding in-home safety precautions due to either insufficient financial resources or insufficient information regarding in-home safety precautions. Because there is evidence of domestic violence in patients’ homes that could prohibit them from feeling safe utilizing their surrounding community or seeking help for the purposes of removing themselves from this unsafe environment, e.g., domestic violence, health care providers can anticipate that access to a shelter may be limited (Sabri et al., 2021). Consequently, based on socioeconomic challenges in accessing basic needs, e.g., low-cost & frozen foods, which may impact a patient’s ability to prioritize safety in their home. The health care provider also assumes that they will work closely with other community service providers to identify, educate, and refer their patients regarding home safety. SMART Goals Goal 1: Improve Home Safety and Reduce Injury Risk Specific: The patient will remove or secure all major household hazards, including firearms, standing water, and toxic substances. Measurable: Completion will be verified using a home safety checklist during a follow-up visit. Achievable: Executing this goal will be supported through education, safety tips, and affordable ways that will help implement these changes. Relevant: Environmental modifications can decrease the risk of injury by up to 50% in high-risk households. Time-bound: This will be accomplished within 14 days. Goal 2: Enhance Caregiver Knowledge of Child Safety Practices Specific: The patient will demonstrate at least three safety behaviors, including safe storage of chemicals, draining standing water, and securing dangerous items. Measurable: At follow-up visit, the patient will display and discuss experiences of implementing three safety behaviours. Achievable: Education from a nurse and easy-to-use educational tools will assist the patient’s learning. Relevant: When caregivers are well-informed of a child’s safety, it is proven to decrease the possibility of childhood accidents/injuries. Time-bound: The patient will accomplish this goal within 4 weeks. Goal 3: Improve Access to Support Services and Safe Living Environment Specific: The patient will eliminate or safeguard all major household risks. This includes securing firearms, draining standing water, and disposing of toxic materials in their home environment. Measurable: Completion of this goal will be confirmed at a follow-up home visit, using a home safety checklist. Achievable: Providers will supply resource lists and assist with referrals. Relevant: Access to services that support the victim has been proven to increase their safety and decrease the opportunities to experience violence. Time-bound: All referrals will be completed and evaluated within the following 30 days. Community

Capella University, NURS-FPX4065, RN-TO-BSN

NURS FPX 4065 Assessment 1 BSN Practicum Conference Call Worksheet

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NURS FPX 4065 Assessment 1 BSN Practicum Conference Call Worksheet Student Name Capella University NURS FPX 4065 Professor Name Submission Date BSN Practicum Conference Call Worksheet Learner Name: Student Preceptor Name and Qualification: —– Practicum Location: Full Address of Practicum Site Scheduled Meeting Date: ( Write date ) Attendants: Write names of students, instructors, and preceptor Note: This worksheet is a general template and should be modified to reflect the learner’s specific specialization and practicum principle. Meeting Topic BSN Practicum Conference Call Practicum Goals Goal 1: Create and implement individualized diabetes care plans for each patient. Specify their needs and preferences along with health objectives. Note down their daily lifestyle too. Coordinate these plans with appropriate members of the interdisciplinary team of dietitians, physical therapists, and social workers. Goal 2: Apply safe and ethical approaches to care transitions and discharge planning for diabetic patients. Concentrate on continuing the treatment and maintaining the care plan. Promote medication safety and connect patients with appropriate support services, most importantly community-based. Goal 3: Complete the required 40 practicum hours for the course. Do this by meeting the applicable daily clinical-hour requirements. Assess the effectiveness of care coordination by keeping a check on measures such as glycemic control. Patient satisfaction is a must, and also keep an eye on the hospital readmission rates. Notes: The preceptor will supervise the student’s clinical activities to verify if the completed work meets the course requirements. These supervised activities will support the development of practical skills and should be completed before submitting Assessment 2. Practicum Schedule Notes: I will participate weekly in diabetes education activities/ Other than this, I will also attend interdisciplinary care-planning and community outreach meetings related to chronic disease management. My preceptor will monitor my schedule to assess whether my clinical hours are completed appropriately or not. Action Item: Complete weekly reflection logs. Note down at least three coordinated-care interventions based on diabetic patient cases. Complete the required 40 practicum hours and the maximum of 12 hours per day. Practicum Documentation Notes: Practicum documentation will include relevant EHR entries, communication records from the care team, and patient feedback when applicable. These records will support continuity and quality of care. All clinical activities must be documented accurately, including the conference call hours. No more than 12 hours should be logged in one day, and the required clinical hours should be completed before submitting Assessment 2. Course evaluation requirements and practicum feedback should also be completed at the end of the experience. Action Item: All the documentation should be HIPAA-compliant. The transitions in care should be recorded in a timely manner to provide proof. Recording is necessary during discharge and follow-up care. Expectations Notes: I will have to participate actively in interdisciplinary discussions and use evidence-based approaches to develop a care plan for diabetes patients. I will also explore appropriate digital tools and mobile health applications for better patient engagement and chronic disease management. Action Item: Complete the final evaluation form for preceptor inspection and signature. At the end of the practicum, highlight the problems experienced and talk about the objectives achieved. Also, showcase the skills developed in diabetes care coordination. Summary The practicum will be based on coordinated diabetes care that is ethical and supported by patient and clinical data. The experience will also include consideration of group-based interventions and community resources. Digital tools that can support ongoing chronic disease management should also be studied and used. The conference call will cover clinical-hour verification, SMART goals, required documentation, course evaluation, and the feedback process. Communication with the course instructor, including email correspondence, will also be discussed. The meeting will provide an opportunity to identify any additional academic or practicum support needed while managing the complexities of diabetes care.

Capella University, NURS-FPX4905, RN-TO-BSN

NURS FPX 4905 Assessment 1 BSN Practicum Conference Call Template

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NURS FPX 4905 Assessment 1 BSN Practicum Conference Call Template Student Name Capella University NURS FPX 4905 Professor Name Submission Date BSN Practicum Conference Call Template Date: Meeting Date Attending: Student, Professor & Preceptor Meeting objectives: Discuss the student’s progress and what is going well during the practicum. Identify any difficulties or concerns being experienced during the practicum. Review the student’s goals for the practicum experience. Topic Notes Meeting The student took part in a Zoom conference with the instructor and preceptor to discuss the practicum experience. The student expressed interest in the practicum. The instructor offered useful guidance and encouraged him during the meeting. Action Plan: Arrange more meetings as needed to provide ongoing guidance and assisstance. Practicum Hours Practicum hours should be documented according to the actual dates and hours completed. CEUs and webinars should not be included as practicum hours. A maximum of 12 hours should be recorded for one day. Action item: Enter practicum hours under the correct dates. Record only the actual number of hours completed each day. Hour Logging The format to enter all the practicum hours under one date is inaccurate. Each entry should show the hours completed on the corresponding working date. Action tip: Check each entry carefully. The hours should be recorded against the correct practicum dates rather than combining hours from multiple days. Core Realm Submission The student’s name should be included in the Core Realm while entering practicum hours to identify the submitted hours properly. Action item: Include the student’s name when submitting the recorded practicum hours in Core Realm. Instructor Advice The instructor advised the student to strictly follow the assessment instructions and scoring guides, with particular attention to Assessments 2 and 4. Action Item: Review the assessment instructions and scoring rubrics before starting each assessment, especially Assessments 2 and 4.

Capella University, NURS-FPX4905, RN-TO-BSN

NURS FPX 4905 Assessment 2 Define and Analyze Your Healthcare Process Problem or Issue of Concern

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NURS FPX 4905 Assessment 2 Define and Analyze Your Healthcare Process Problem or Issue of Concern Student Name Capella University NURS-FPX-4905 Professor Name Submission Date A Practicum Analysis: Healthcare Process Issue The problem of antidepressant drug failure has become one of the critical issues in adult care that can be observed at the Mayo Clinic and impacts the overall effectiveness of depression treatment. It is known that antidepressants have proven to be an effective first-line treatment option in major depressive disorder, with the vast majority of patients undergoing such medications failing to stick with them (Unni et al., 2024). This poor adherence results in non-responsive treatment and decreased overall improvement in symptoms. Antidepressants non-adherence leads to the exacerbation of depressive symptoms, increased risk for relapse and recurrence of depression, avoidable hospitalizations, and increasing healthcare costs. In this paper, the researcher seeks to answer the healthcare process question pertaining to the non-adherence of antidepressants medications, the variables behind patient behaviors regarding antidepressant adherence, and the use of nurse-led education and follow-up intervention. Description of the Practicum Site My practicum hours are being completed at a practice site at Mayo Clinic in the United States (US), a community-based ambulatory health care facility that provides services in psychiatric evaluation of adults and provision of psychotropic medications to adults with psychiatric disorders, particularly dementia patients. The study reported that clinics have a great impact on increasing accessibility and assist in long term maintenance treatment by routine monitoring of chronic psychiatric disorders and individual treatment (Gibbons, 2025). The practice of the clinic is regular outpatient care by making regular follow-ups, as opposed to acute care/emergent care. The patient population tends to be 25 and above in age, tends to be diagnosed with major depressive disorder (MDD), and tends to be prescribed an antidepressant to help manage the MDD, given frequent follow-ups for MDD as routine follow-ups. The majority of the patients require complete nursing care, rehabilitation, medications, activities of daily living, and behavioral issues as a result of dementia. At a follow-up, the MDD examines medication, depressive symptoms, Medication compliance and any adverse effects, effectiveness of current treatment, and provides therapeutic support where necessary. The facility has roughly 350 full-time healthcare workers: psychiatrists, psychiatric nurse practitioners, registered nurses, medical assistants, behavioral health counselors, as well as administrative support. Such providers apply an interdisciplinary approach to foster best, client-centered, evidence-based behavioral health care to support depression management and treatment continuity among patients on an antidepressant prescription. Clinical and Operational Decisions at the Practicum Site The operational and clinical choices at my practicum site to enhance antidepressant medication adherence. The process of identifying non-compliant patients; education tailored specifically to the barriers each patient experienced; scheduling follow-up with high-risk patients with a nurse once a week and recording the medication adherence evaluations and nursing interventions into the electronic health records; and discussing concerns with my preceptor and the interdisciplinary team to amend the treatment plan when needed were all part of the clinical decisions. Research has shown that effective care coordination and follow-ups lead to opportunities for reduced patient risk and improved flow of care in outpatient behavioral health services (Leila, 2026). These activities were mentored and directed by my preceptor as a nursing student, with me screening patients on adherence, educating patients individually on their particular barriers to medication adherence, and documenting their assessment in the electronic health record (EHR) as a follow-up. The psychiatric prescriber made the decisions to prescribe; however, my clinical assessment and documentation helped in assisting clinical decision-making. The previous literature confirmed that more follow-up visits, both nurse-led and interdisciplinary collaboration, improved patient medication adherence, quality of care, fewer hospitalizations, and resulted in better patient outcomes, which is linked to better management and suppression of depression symptoms, relapse prevention, and an improved quality of life (Shani, 2024). The severity of depression is measured using the Patient Health Questionnaire-9 (PHQ-9), and adherence to medication was a very important quality indicator in this group of patients. These clinical choices and outcome indicators were consistent with safe and evidence-based care that would perhaps enhance depression management in the long term in this facility. Antidepressant Non-Adherence and Patient Outcomes The healthcare process issue I have assessed at the Practicum site has been non-adherence to the use of antidepressant medication with adult depressed outpatient clients. Many adults prescribed selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) as a group are frequently unable to adhere to the therapy-taking instructions, negatively impacting the effectiveness of the therapy, severity of symptoms, and risks of relapse or hospitalization. A Nurse-led Quality improvement intervention would be responsive to the problem. The interventions include screening medication adherence conducted by a registered nurse (RN), individual patient education, weekly phone calls, visits with an RN, entering all the data into the EHR, and interdisciplinary team collaboration. Existing Evidence: Not all individuals adhere to antidepressant medication, which has been singled out as a common healthcare problem. In one study, Unni et al. (2024) found that the non-adherence rate in the US was 42.9% and in a five-country population in Europe, 46.2%. Their research concluded that the causes of non-adherence that were more frequently mentioned were forgetfulness and concerns about medications. On the same note, another study conducted by Chanie et al. (2025) revealed that the non-adherence rate of a depression treatment group (adults) was 32.9%, and the main factors that influenced the non-adherence rate were based on the fact that they were women, lacked literacy, were unemployed, the duration of treatment, and experienced severe adverse reactions to the medication. Gutirrez-Abejn et al. (2023) also concluded that inadequate medication adherence correlates with an increase in healthcare costs, rate of relapse, visits to the emergency room, and hospitalizations. These results justify the application of an interdisciplinary approach, including a Nurse-led intervention in order to enhance medication adherence. Analysis of Impact on Quality, Safety, and Cost The effects of antidepressant medication non-adherence are harmful to both the health care recipient and the health care system. Poor

Capella University, NURS-FPX4905, RN-TO-BSN

NURS FPX 4905 Assessment 3 Technology and Professional Standards

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NURS FPX 4905 Assessment 3 Technology and Professional Standards Student Name Capella University NURS FPX 4905 Professor Name Submission Date Technology and Professional Standards Quality of life, safety, and continuity of care can be greatly enhanced by technology and professional standards among individuals with a mental health disorder. Cognitive impairment may adversely impact medication adherence in adults with major depressive disorder (MDD) who also have dementia, since they may have difficulty regulating their medications and may miss taking their medication. A systematic review established that cognitive impairment had a significant impact on reduced medication adherence (Harris et al., 2025). This article presents a discussion on the role of registered nurses (RN) prepared to complete a BSN degree as one of the factors in enhancing adherence and outcomes among this group of patients, covering the following areas: process change, interdisciplinary teamwork, governmental recommendations, current and future technology, and the challenges in implementation. Role in Process Change and Professional Standards Evidence-based practice, quality improvement, and professional nursing standards enable the BSN-prepared RN to initiate the process of change. The experience at the Mayo Clinic of an RN working to curb medication barriers and simplify processes. The interdisciplinary group enables the RN to work with other disciplines to improve the treatment of adults with MDD and dementia through a collaborative approach. The Scope and Standards of Practice of the American Nurses Association identify quality improvement and leadership as some of the central areas of practice of the RN (American Nurses Association, 2021). In the capacity of a nursing student, I was part of the observation related to the existing medication reconciliation process and the records of patient medication adherence in the electronic health record (EHR) at Mayo Clinic. In the interactions with the psychiatric nurse practitioner and the clinic RN, I discussed the issue of medication adherence. Nevertheless, as a licensed RN, I will be able to establish systematic adherence screening procedures and assist family caregivers of adults with dementia to be part of the adherence monitoring process. Research has determined that medication reconciliation and adherence monitoring activities are better coordinated, which results in improved medication safety and continuity of care for adult patients with MDD (Fatemi-Nejad et al., 2025). Additionally, Minnesota has given nurses the authority to assess, implement, evaluate, and coordinate care and take part in quality improvement programs by the Minnesota Nurse Practice Act (Minnesota Board of Nursing, 2024). Thus, the role of the BSN-prepared RN is crucial to improving medication adherence for adults with MDD and dementia. Interprofessional Collaboration Effective medication administration of older adults with MDD and dementia can be facilitated by interprofessional collaboration. The interprofessional team at Mayo Clinic comprised a psychiatric nurse practitioner, a registered nurse, a pharmacist, a care coordinator, a primary care provider, and family caregivers, who collaborated to facilitate medication safety and continuity of care. The psychiatric nurse practitioner prescribed and changed medications for the patient. The registered nurse assisted with the patient intake procedure, medication reconciliation, medication education, and medication adherence checks. An observational study suggested that collaboration between nurses, prescribers, pharmacists, and caregivers having proven a positive impact on medication adherence and adverse drug-related events in older adults who use multiple medications (Perron, 2024). More opportunities for collaboration with patients on various psychotropic drugs could be established by expanding regular pharmacist consultations. This collaborative approach might also be enhanced by including family caregivers in medication education and follow-up visits. My practicum experience allowed me to support indirect collaboration with the psychiatric nurse practitioner by including medication adherence problems in the EHR, which would be reported to the nurse. Nevertheless, as a student nurse, I could not make independent decisions to use interprofessional interventions. Assuming that I was a licensed RN who was working in this setting, I would refer to the primary care provider and advise the patient to make a referral to the pharmacist to assist with the polypharmacy. I would also arrange educational activities among caregivers on medication reconciliation meetings and join team case conferences to discuss medication adherence issues. I would also report the progress of the patient to other health care professionals. I would also ensure the advocacy of adherence support services, which are recommended by the evidence-based practice, to enhance medication adherence, safety, and outcomes among older adults with MDD and dementia. Recommendations of Government and Accreditation Agencies Suggestions of different governmental and accreditation agencies strengthen the safe medication handling of adult patients with MDD. The guidelines of the Joint Commission also valued the significance of appropriate medication reconciliation, as well as periodic review of suicide risk, to avoid medication errors and ensure patient safety in behavioral health care contexts (The Joint Commission, 2025). Both practices assist in diagnosing possible medication-related problems at a young age and result in effective treatment in MDD and dementia. The Centers for Medicare and Medicaid Services (CMS) has placed emphasis on the following treatment practices. In particular, they proposed measuring adherence with antidepressants at both the acute and continuation stages of the treatment to enhance patient outcomes and reduce the likelihood of a relapse (Centers for Medicare & Medicaid Services, 2024). Measurement: Quality indicators promoted continuous performance improvement in nursing, fostered by the National Database of Nursing Quality Indicators (NDNQI) (Nelson-Brantley et al., 2026). Another possible quality indicator that enhances accountability in general and could positively affect continuity of care is adherence measurement. These government guidelines will probably ensure safer medication management of patients with MDD and dementia at Mayo Clinic, as shown above. Current Technology Used at the Practicum Site Mayo Clinic uses one enterprise-wide EHR as its primary technology to incorporate medication management in patient care. The system features electronic prescribing, medication reconciliation, clinical documentation, and secure communication features to help clinicians have an up-to-date list of medications the patient is taking and improve continuity of care. Patients can also access their own medication lists and engage in secure communication with their care team using a patient portal. Reconciliation is the best process towards the reduction

Capella University, NURS-FPX4905, RN-TO-BSN

NURS FPX 4905 Assessment 4 Proposal for Intervention

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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.

Capella University, NURS-FPX4905, RN-TO-BSN

NURS FPX 4905 Assessment 5 Reflective Journal

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NURS FPX 4905 Assessment 5 Reflective Journal Student Name Capella University FPX 4905 A5 Professor Name Submission Date Reflective Journal Wellness and Disease Prevention During my practice in a long-term care center in New York, various practices that have been put in place to encourage health and prevent diseases among patients, with the aim of improving their health have been witnessed. Among the practices, which are embraced by medical practitioners in this health facility are health/wellness assessment, medication review, fall risk assessment, nutrition assessment, immunization, and health education to avoid other complications. The disorders were anxiety disorders, depression, and social isolation, where the symptoms were determined and treated accordingly. A number of social factors that influence the health of elderly patients, including absence of social support by family members, loneliness, poor economic status, physical disability, and health conditions were identified. The majority of patients within the facility suffered from anxiety disorders because of some health problems. The presence of inconsistencies in the application of non-medication modalities in the treatment of anxiety disorders was also an interesting observation in this health care setting. Personally, as an advanced nurse practitioner, I have learned the value of promoting the comprehensive care of the patient as a nurse based on the current practicum experience. From the present practicum experience, I have had the chance to appreciate the importance of a nurse’s ability to identify the problems of the patients and suggest solutions that can enhance their wellbeing. Concerning the leadership skills, the current practicum process has enabled me to value the need to motivate patients to adopt prevention measures and shun stress, among others. Chronic Disease Management In my practicum experience, I was taught that a team collaboration approach was the strategy employed in resolving the issues affecting the residents with various illnesses like cardiac illnesses, diabetes, mental problems, and anxiety. An example of this is the fact that the team comprised of nurses, doctors, social workers, therapists, and so on, and the strategy to address the issues of the resident was an individual one. Besides, there were regular interdisciplinary meetings to discuss patient-related problems. Nevertheless, the process could still use some improvements in the areas where it relates to attending to anxious people. Firstly, the majority of the residents suffering from anxiety disorders were medicated, but there were alternative treatments to medicine. Second, even when the residents were given the required medication, some of them were still anxious. The result came out of not satisfying the mental needs of the residents. Practicum is something that should not be neglected due to disclosure that communication and cooperation are the keys to survival of a patient. With my experiences as a nurse, I can say how important it is to have the collaboration of all health care practitioners in managing patients who suffer from chronic conditions. From my experiences as a nurse, I know that nurses contribute to giving treatment and adopting a more holistic approach towards treatment instead of the mere focus on the condition. As a leader, I could easily see the significance of fostering communication among the health care practitioners and using a standard approach for treating anxiety disorders. Regenerative and Restorative Care My practicum session made me learn further about the restorative care in a long-term care facility. As the patients did not encounter any emergency cases, I got to know what is involved in the management of patients in case they fell down, had acute changes in their health conditions, and had behavioral issues associated with being anxious or had a long term problem that had been exacerbated. In these moments, nurses must be an important part in assessing the health status of the patient, on whether they are safe, alerting the doctor and further planning treatment. Patients who had suffered falls, or whose health conditions had acuously changed, were provided with rehabilitation treatments to regain good health. The second observation was the different ways in which the psychological state of a patient influenced the process of recovery. Most often, the patients were provided with pharmacological treatments, but other means of treatment were neglected. Interventions and critical thinking are some of the things that I have learnt during this experience. Some of the issues that I have been learning about my future nursing practice in this experience are that it is necessary that I, as a nurse should seek ways to encourage the practice of restorative so that I will not resort to using medications whenever I can avoid it. The other thing that I have learned about nursing during this experience is that there must be a means of engaging other individuals in practicing restorative therapies, like physiotherapists and doctors. Hospice and Palliative Care Another necessary component of the practical exercise was the hospice and palliative care of the sick residents who had diseases. It involved making sure that the patient not only felt their symptoms relieved but also had a dignified death, not just based on the physical aspect of things, but also the psychological aspect of the things, not just for themselves, but even for the members of their families. The entire process entailed evaluation of the pain and other symptoms and administering drugs to alleviate the symptoms. In the context of the palliative care, one of the first problems arising due to the need of the patients was anxiety. Different kinds of drugs were administered to the patients according to their complaints. This particular experience provided a great opportunity to acquire necessary skills and competencies from a professional perspective in relation to future nursing practice. First, I understood that patient care had to be holistic, both from a physiological perspective as well as from the psychological and spiritual point of view. Being a future leader of nurses, I understood how significant it was to offer holistic care to patients and collaborate with other experts. Second, my experience in the work with patients having terminal disease and their families became a certain important element of

Capella University, NURS-FPX4065, RN-TO-BSN

NURS FPX 4065 Assessment 6 Practicum Hours, Reflection Journal, and Simulation Report Submissions

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NURS FPX 4065 Assessment 6 Practicum Hours, Reflection Journal, and Simulation Report Submissions Student Name Capella University NURS FPX 4065 Professor Name Submission Date NURS FPX 4065 Assessment 6 covers practicum hours, clinical reflections, and simulation reports to demonstrate nursing skills and professional development.

Capella University, NURS-FPX4065, RN-TO-BSN

NURS FPX 4065 Assessment 5 Final Care Coordination Strategy

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NURS FPX 4065 Assessment 5 Final Care Coordination Strategy Student Name Capella University NURS FPX 4065 Professor Name Submission Date Final Care Coordination Strategy Intimate partner violence (IPV), comprising physical wounds, psychological assault, and frequent emergencies, is one of the gravest medical problems adult women in the United States are experiencing (Molina and Matud, 2024). The physically and sexually induced assaults, emotional abuse, and trauma are all part of IPV that ultimately lead to the decline in overall well-being. The women who suffered IPV have chronic body pains, reproductive complications, and mental illnesses, which must be treated through a well-thought-out coordinated care plan. Social instability, inability to purchase housing, and inability to access preventive care are typical consequences associated with these factors. These repercussions conclusively require the design of a competent coordinated care plan that will combine clinical treatments and community support to build a process of healing and long-term recovery. Patient-Centered Health Interventions and Timelines Health Issue I: Acute and Chronic Injuries Linked to IPV Intervention, Community resources, and Timeline Untreated injuries and chronic pain syndrome, gastrointestinal dysfunction, and reproductive health concerns are the most common consequences of IPV in women, and without a systematic screening process, he or she would not realize it. As solutions to these issues, it is necessary to develop a unified set of IPV assessments in the primary care and emergency service setting, an emergency safety plan, and a structured medical follow-up. Trauma-sensitive clinical identification will enable clinicians to be highly careful of documenting injured individuals, with limited re-traumatization and increased confidence (Wathen and Mantler, 2022). Follow-ups are also required beyond acute care to determine the progress and the risk of recurrence, as well as to remind them about the safety measures. The required medical care, temporary housing, and case management of the survivors can be provided by community-based domestic violence shelters, federally qualified health centers, and mobile health outreach programs. The continuity of care, which is a resultant effect of the clinical intervention, is made possible by integrating activities like crisis counselling and avenues of referral to national advocacy groups, including the Domestic Violence Hotline. The corresponding SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goals would be to raise the percentage of reported IPV screening among adult women patients to 80% in nine months, as well as to ensure that all reported survivors are screened and evaluated with regard to their medical history and that every one of them completes individual safety planning within 72 hours after reporting. Health Issue II: Psychological Trauma and Mental Health Disorders Intervention, Community resources, and Timeline Adult women who are subjected to constant abuse are at high risk of such problems as depression, anxiety disorders, substance abuse, and post-traumatic stress disorder. The obstacles to work, taking medication, and following proactive healthcare measures can be psychological distress, which leads to feelings of vulnerability, in turn (Alvarez et al., 2025). The integration of the early behavioural health referral pathway should be coordinated, and systematic risk assessment of suicidality and access to trauma-focused behavioural therapy should be done. By means of identifying IPV, nurse care coordinators can organize the behavioral health follow-up visits within two weeks with the goal of mitigating the symptoms and promptly engaging the symptoms. Mental health clinics within the community, sites of telehealth counselling, and peer support groups that are female-focused are some of the channels that render therapy and emotional support readily available. Stigma among women of varying backgrounds can also be reduced by enhancing the level of trust and religious outreach programs and advocacy in a culturally oriented manner. The desired SMART goal would be oriented towards making sure that no less than 60 percent of the identified survivors start getting mental health services within three months of the referral and at least eight counselling sessions within six months to make sure that there are quantifiable changes in trauma symptoms. Health Issue III: Social Instability, Housing Insecurity, and Safety Obstacles Intervention, Community resources, and Timeline In addition to the physical and emotional damages, IPV is likely to have devastating effects on housing stability, employment stability, and financial independence, which can translate to the likelihood of returning to the clutches of violence. Poverty, which some survivors might have to overcome out of fear, can force them to live in unsecured circumstances, with an absence of transportation and attention to children (Williams et al., 2023). A holistic care coordination plan should comprise social work consultation, legal advocacy referral, and emergency housing placement. The interdisciplinary teams can work together to draw attention to women to services like protective order services, financial counselling services, and reintegration programs within the workforce, and this way women can be empowered to be independent in the long run. The partners in creating safe living conditions and protective laws are community legal assistance services, transitional accommodation, and local shelters against domestic violence. Additional support on the part of community-based services through the assistance of public assistance programs, transportation services, and culturally responsive community agencies can reduce systemic factors that limit access to care. Among the SMART objectives that would be measurable in this context would be the attainment of safe housing for half of the high-risk survivors within 3 months of identifying and registering them, as related to at least 2 supportive community resources within 6 months to lengthen long-term stability and minimize the chance of a recurrence. Ethical Considerations The prime ethical issue in care coordination is to preserve the uniqueness and autonomy in the decision-making of adult females who are subjected to IPV in the United States. Respect for autonomy is the one that obligates all women to be highly informed of the medical, legal, and psychosocial alternatives available to them but leaves the decision of service to seek to the woman. It may involve decisions such as planning safety measures, reporting to a law-enforcement agency, getting a protective order, counselling, or refusing some interventions related to IPV. Another feature of trauma-informed interventions is that an individual cannot be forced