NURS FPX 6612 Patient Discharge Care Planning Paper Example

NURS FPX 6612 Assessment 3 Patient Discharge Care Planning

NURS FPX 6612 Patient Discharge Care Planning Paper Assignment Brief

Course: NURS-FPX6612 Health Care Models Used in Care Coordination

Assignment Title: NURS FPX 6612 Assessment 3 Patient Discharge Care Planning

Assignment Overview

The Patient Discharge Care Planning Paper assignment in NURS FPX 6612 aims to analyze key issues related to the development of an effective discharge care plan for a hypothetical patient. This assignment underscores the significance of health information technology (HIT) in optimizing care coordination, data reporting, and the overall efficacy of the discharge process.

Understanding Assignment Objectives

The primary objective of this assignment is to demonstrate the student’s proficiency in applying care coordination models, understanding the relationship between care coordination and evidence-based data, utilizing health information technology, and communicating effectively with diverse audiences in an academic format.

The Student’s Role

As a student enrolled in NURS FPX 6612, your role is to assume the position of a senior care coordinator responsible for overseeing a patient’s care. You will lead the discussion on patient’s case during an interdisciplinary team meeting, focusing on the role of informatics in effective discharge care planning. Your task involves analyzing key issues related to HIT support, data reporting, and electronic health record (EHR) data collection to facilitate patient’s transition from the hospital to their home environment.

You Can Also Check Other Related Assessments for the NURS-FPX6612 Health Care Models Used in Care Coordination Course:

NURS FPX 6612 Assessment 1 Triple Aim Outcome Measures Presentation Example

NURS FPX 6612 Assessment 2 Quality Improvement Proposal Example

NURS FPX 6612 Assessment 4 Cost Savings Analysis Example

NURS FPX 6612 Patient Discharge Care Planning Paper Example

Introduction

The focus of this assessment is on the discharge care planning for Marta Rodriguez, who underwent extensive treatment after a severe car accident while on her way to college. Marta spent four weeks in the trauma center, receiving multiple surgeries and antibiotic therapy. As the senior care coordinator, I will lead the discussion on Marta’s discharge plans with the interdisciplinary team. This analysis highlights the importance of health information technology (HIT) in optimizing care coordination, data reporting, and the overall effectiveness of Marta’s transition from the hospital to her home environment.

Longitudinal, Patient-Centered Care Plan

To ensure Marta Rodriguez receives comprehensive, patient-centered care, the interdisciplinary team will harness various components of health information technology (HIT). Electronic health records (EHRs), secure messaging platforms, telehealth technology, and medication reconciliation tools are pivotal in this endeavor (Schwab et al., 2021; Flickinger et al., 2022; Chowdhury et al., 2020). EHRs provide real-time access to Marta’s medical records, facilitating the development of a holistic care plan. Secure messaging platforms enable seamless communication among team members, ensuring timely updates on Marta’s condition, appointments, and medication schedules. Telehealth technology facilitates remote monitoring of Marta’s vital signs, aiding in the early detection of complications. Additionally, medication reconciliation tools ensure accurate medication lists, reducing the risk of errors.

To mitigate the risk of readmission within 48 hours post-discharge, comprehensive education, support, and follow-up care for Marta are paramount (Oksholm et al., 2023). HIT elements, particularly telehealth technology, enable continuous monitoring of Marta’s progress, allowing for timely interventions in case of complications. Secure messaging platforms serve as a conduit for delivering crucial information regarding medication adherence and follow-up appointments.

Furthermore, leveraging HIT elements promotes communication and collaboration among team members, enhancing care coordination for Marta. EHRs serve as a centralized repository of Marta’s health information, ensuring all team members have access to pertinent data. This cohesive approach streamlines care delivery, minimizing redundancies, and maximizing efficiency. Through the strategic use of HIT elements, the interdisciplinary team can deliver a patient-centered, coordinated care plan tailored to Marta’s unique needs.

Data Reporting

Data reporting is integral to optimizing patient care across various dimensions, including coordination, management, efficiency, and innovation within healthcare. Specifically tailored data reporting for patients like Marta Rodriguez holds immense potential to elevate the quality of care and expedite her recovery journey. Firstly, it facilitates seamless care coordination among interdisciplinary team members by offering a unified view of Marta’s condition and progress (Brooks et al., 2020). Real-time access to data on medication adherence, vital signs, and symptoms empowers the team to collaboratively devise personalized care plans, thus minimizing risks of complications or readmissions.

Furthermore, data reporting aids in fine-tuning care management strategies by pinpointing areas necessitating additional support or intervention. By analyzing data on pain levels, mobility, and nutritional status, the team can proactively address emerging issues, thereby optimizing Marta’s path to recovery. Additionally, data reporting serves as a catalyst for interprofessional innovation by providing insights into Marta’s preferences and cultural background, fostering tailored care delivery (Leslie & Paradis, 2018). This patient-centric approach fosters trust and rapport between Marta and her care team, ultimately enhancing health outcomes.

To uphold data integrity, stringent validation protocols and regular audits must be implemented. Ensuring data accuracy, completeness, and timeliness empowers the team to make well-informed clinical decisions confidently. Moreover, aligning data reporting practices with evidence-based guidelines guarantees that interventions are rooted in best practices, thus elevating the overall quality of care provided to Marta.

Client Records Influencing Health Outcomes

Client records play a pivotal role in influencing health outcomes by providing valuable data that guides patient care decisions. Marta Rodriguez’s case exemplifies how health information technology (HIT) can be utilized by healthcare teams to gather, analyze, and disseminate client record data, thereby enhancing patient care and results. Let’s explore how insights derived from patient records positively impact health outcomes and how interdisciplinary teams can synchronize their efforts through collaborative HIT utilization.

HIT facilitates the collection and analysis of patient record data by interdisciplinary teams, enabling the identification of trends, patterns, and care gaps (Leslie & Paradis, 2018). For instance, Marta’s records offer insights into her medical history, medication regimen, and current health status, empowering the team to devise a customized care plan tailored to her specific needs. Moreover, HIT aids in the early detection of potential risks like adverse drug reactions or post-surgery complications, allowing for prompt interventions to prevent unfavorable health outcomes.

Additionally, HIT fosters seamless care coordination among interdisciplinary team members. By sharing information extracted from client records, team collaboration in patient care management is significantly enhanced. HIT tools such as Electronic Health Records (EHRs) and secure messaging platforms facilitate real-time communication among team members, ensuring everyone remains updated on the latest patient information. This reduces the risk of errors and miscommunications, ultimately contributing to improved health outcomes for the patient.

To effectively synthesize their findings, interdisciplinary team members must engage in cohesive collaboration to develop a unified understanding of the patient’s care requirements. This necessitates transparent communication, shared objectives, and a collective commitment to achieving common goals (Rawlinson et al., 2021). HIT tools serve as facilitators of this collaborative approach by providing a centralized platform for data access and exchange among team members. This ensures that all members possess a comprehensive view of the patient’s care needs, enabling them to deliver holistic care addressing all aspects of the patient’s health.

Conclusion

In conclusion, Marta Rodriguez’s discharge care plan requires a holistic, patient-centered approach supported by health information technology (HIT). The interdisciplinary team must leverage HIT elements such as electronic health records (EHRs), telehealth technology, and secure messaging platforms to facilitate seamless communication, data sharing, and care coordination. Effective data reporting is crucial in shaping care management, clinical efficiency, and interprofessional innovation, ensuring that Marta receives personalized, evidence-based care. By harnessing client records and maximizing the potential of HIT tools, interdisciplinary teams can optimize health outcomes and promote Marta’s successful transition from the hospital to her home environment.

References

Brooks, R. G., Steele, S. R., & Wiersma, M. L. (2020). Data reporting: Essential to health care value and quality. Journal of the American College of Surgeons, 231(4), 485–490.

Chowdhury, M. R., Rahman, T., & Khandakar, A. (2020). A review of the state-of-the-art telehealth systems enabling remote monitoring of vital signs—Current status and future challenges. IEEE Reviews in Biomedical Engineering, 13, 107–124.

Flickinger, T. E., Surian, D., Uezono, Y., Kay, A., Amato, M. S., & Bokarius, A. (2022). Longitudinal implementation outcomes and clinical benefits of a secure messaging platform in a large integrated health system. Journal of Medical Internet Research, 24(1), e32123.

Leslie, M., & Paradis, E. (2018). Grooving to the same beat: Healthcare team interactions and adaptive rhythm. Medical Education, 52(6), 590–600.

Oksholm, T., Sandvik, M., & Wangensteen, S. (2023). Factors influencing unplanned readmissions: A qualitative study of hospitalized patients’ experiences. BMC Health Services Research, 23(1), 31.

Rawlinson, F., Morrison, Z., Dhaliwal, N., & Kalra, D. (2021). Self-assessment in health professional education: A meta-synthesis of qualitative research. Medical Teacher, 43(1), 93–103.

Schwab, P., Wilcox, A., Bair, A., Watson, J., Reid, M. W., & Coffey, C. (2021). Creating real-time enhanced patient information displays in the electronic health record: A case study. JAMIA Open, 4(3), ooab072.

Detailed Assessment Instructions for the NURS FPX 6612 Patient Discharge Care Planning Paper Assignment

Description

Assessment 3 Instructions: Patient Discharge Care Planning Paper Assignment

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• Patient Discharge Care Planning
  • Prepare a written analysis of key issues, 6–7 pages in length, applicable to the development of an effective patient discharge care plan.
    The Institute of Medicine’s 2000 report To Err Is Human: Building a Safer Health System identified health information technology (HIT) as one avenue to explore to reduce avoidable medical errors. As a result of the IOM report and suggestions for patient advocacy groups, health care organizations are encouraged to act by utilizing HIT to improve patient quality and safety.

SHOW LESS

• • Health care organizations determine outcomes by how patient information is collected, analyzed, and presented, and nurse leaders are taking the lead in using HIT to bridge the gaps in care coordination. This assessment provides an opportunity for you to analyze the effects of HIT support, data reporting, and EHR data collection on effective care planning.
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
  • Competency 1: Apply care coordination models to improve the patient experience, promote population health, and reduce costs. 
    • Explain how HIT can be used to provide a longitudinal, patient-centered care plan across the continuum of care.
  • Competency 2: Explain the relationship between care coordination and evidence-based data. 
    • Describe ways in which data reporting specific to client behaviors can shape care coordination, care management, clinical efficiency, and interprofessional idea development.
  • Competency 3: Use health information technology to guide care coordination and organizational practice. 
    • Explain how information collected from client records can be used to positively influence health outcomes.
  • Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards. 
    • Write clearly and concisely, using correct grammar and mechanics.
    • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
  • Reference
    Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.
    Competency Map
    CHECK YOUR PROGRESS
  • Use this online tool to track your performance and progress through your course.
• Toggle DrawerResourcesHealth Informatics
  • Mosier, S., & Englebright, J. (2019). The first step toward reducing documentation: Defining ideal workflows. CIN: Computers, Informatics, Nursing, 37(2), 57–59.
  • Yang, Y., Bass, E. J., Bowles, K. H., & Sockolow, P. S. (2019).Impact of home care admission nurses’ goals on electronic health record documentation strategies at the point of care. CIN: Computers, Informatics, Nursing, 37(1), 39–46.
  • SHOW LESSWriting Resources
    You are encouraged to explore the following writing resources. You can use them to improve your writing skills, and as source materials for seeking answers to specific questions.
  • APA Module.
  • Academic Honesty & APA Style and Formatting.
  • APA Style Paper Tutorial [DOCX].
  • Capella Resources
  • ePortfolio.

Research Resources

You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6612: Emerging Health Care Models and Care Coordination Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the navigation menu in your courseroom, provide additional resources to help support you.
As you review these resources, you may want to consider the following questions:

• • How are nurse leaders taking the lead in using HIT to bridge the gaps in care coordination?
  • Why is the consistent use of common HIT terminology important?
  • What is the impact of data reporting in determining health outcomes, the effectiveness of health education, and the ability to predict client behaviors?
• Assessment Instructions

• Preparation
  Marta Rodriguez, a student, recently moved from New Mexico to Nevada to live with her aunt and uncle and was enrolled as a freshman in college. While attending her first semester, Marta was involved in a hit-and-run car accident. She was transported to the nearest shock trauma center where she spent the next four weeks undergoing multiple surgeries and antibiotic treatment for a systemic infection. Spanish is Marta’s first language and English is her second. Marta has a student health insurance plan.
  You are the senior care coordinator overseeing Marta’s care. You will be presenting her case to the interdisciplinary team members who are caring for Marta at an upcoming meeting to consider key aspects of a successful and safe discharge care plan for her. You are expected to lead the discussion, focusing on the role of informatics in effective discharge care planning, and have decided to prepare an analysis of key issues for team members to consider, which you will distribute to the attendees for review prior to the meeting.

Note:

• Remember that you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
  Requirements
  Analyze key issues for consideration at the discharge planning meeting. Determine the effects of HIT support, data reporting, and EHR data collection on effective care planning.
  Use the following template for your written analysis:
  • APA Style Paper Template [DOCX].
  • Analyzing Key Issues
    The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your analysis addresses each point, at a minimum. You may also want to read the Patient Discharge Care Planning Scoring Guide to better understand how each criterion will be assessed.
  • Explain how the interprofessional team will use HIT to provide a longitudinal, patient-centered care plan across the continuum of care that supports Marta in the discharge planning process.
    • What HIT elements will the team members use and why?
    • How can the interprofessional team members utilize the HIT elements to prevent a readmission of this patient 48 hours after being discharged?
    • How will the use of these elements support the coordination of care for this patient?
  • Describe at least three ways in which data reporting specific to client behaviors can shape care coordination, care management, clinical efficiency, and interprofessional innovation in care.
    • How would you evaluate the quality of the data?
  • Explain how information collected from client records can be used to positively influence health outcomes.
    • How will the interprofessional team members coordinate their individual findings in the collaborative use of HIT?
  • Write clearly and concisely, using correct grammar and mechanics.
    • Express your main points and conclusions coherently.
    • Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.
  • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
    • Is your supporting evidence clear and explicit?
    • How or why does particular evidence support a claim?
    • Will your audience see the connection?
  • Additional Requirements
    Written Analysis Format and Length
    Format your written analysis using APA style:
  • Use theAPA Style Paper Template [DOCX]provided. Be sure to include:
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • See also theAPA Style Paper Tutorial [DOCX]to help you in writing and formatting your analysis.
  • Your analysis should be 6–7 pages in length,not includingthe title page and references page.
  • Supporting Evidence
  • Cite at least eight sources of credible scholarly or professional evidence to support your analysis.
  • Apply APA formatting to all in-text citations and references.
  • Portfolio Prompt: You may choose to save your analysis to your ePortfolio.

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