NURS-FPX4905 - NURS FPX 4000 Assessment

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