In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

As a master's-level health care practitioner, you have a valuable viewpoint and voice on policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

QUESTION

Propose an organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions.

The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

• Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
  • What is the current benchmark for the organization and the numeric score for the underperformance?
  • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
  • What are the potential repercussions of not making any changes?
    • What evidence supports your conclusions?
• Summarize your proposed organizational policy and practice guidelines.
  • Identify applicable local, state, or federal health care policy or law that prescribes relevant performance benchmarks that your policy proposal addresses.
  • Keep your audience in mind when creating this summary.
• Analyze the potential effects of environmental factors on your recommended practice guidelines.
  • What regulatory considerations could affect your recommended guidelines?
  • What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
• Explain ethical, evidence-based practice guidelines to improve targeted benchmark performance and the impact the proposed changes will have on the targeted group.
  • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
  • How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
  • How can you ensure that these strategies are ethical and culturally inclusive in their application?
  • What is the direct impact of these changes on the stakeholders’ work setting and job requirements?
• Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
  • Why is it important to engage these stakeholders and groups?
  • How can their participation produce a stronger policy and facilitate its implementation?
• Present strategies for collaborating with the stakeholder group to implement your proposed policy and practice guidelines.
  • What role will the stakeholder group play in implementing your proposal?
  • Why is the stakeholder group and their collaboration important for successful implementation?
• Organize content so ideas flow logically with smooth transitions.
  • Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4–5 page report.

Health care systems around the world provide useful models for analysis. Familiarity with different models and approaches to health care enables leaders to identify what works and what does not, as the basis for proposing a change. As we continue to evaluate the complex and fragmented system in the United States, it is important for nurse leaders to become familiar with the programs and systems that provide evidence-based quality care that is affordable and focused on continual improvement.

This assessment provides an opportunity to examine a local or regional health care issue from a global perspective.

Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study.

You know that an examination of other countries' health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes.

In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine. In addition, you may wish to:

REQUIREMENT

Complete this assessment in three steps:

1. Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.
2. Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change.
3. Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.

The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

• Identify an aspect of a local or regional health care system or program that should be a focus for change.
• Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
• Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.
  • Choose one of the following options for selecting the two systems or programs:
    • Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
    • Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
  • Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
• Explain why specific changes will lead to improved outcomes.
• Determine the financial and health implications associated with the proposed changes.
  • Address the implications of making the changes.
  • Address the implications of not making the changes.
• Write clearly and concisely in a logically coherent and appropriate form and style.
• Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

1.  Are you a part of a professional organization? If so, which one? If not, which professional organization might you be interested in joining?
2. What type of civic engagement have you participated in, or what type of civic engagement might you be interested in participating in? 

 Which of the culture and caring theories most resonates with you for your practice as an NP? How does the theory integrate the nursing paradigm?  What parts of the theory do you identify with? How does the theory help to meet CLAS standards to advance health equity?  

Theory of Caring and Healing

#1

My presentation was about fall prevention technology. We have three different sensitivities: repositioning, moves to edge of bed, and left the bed. Personally, I don’t like using the “left the bed” sensitivity because if a patient is a bad enough fall risk to put on the bed alarm, that sensitivity is not going to help much. The bed alarm does me no good if it’s just telling me “hey, your patient just fell.” Bed alarms may help improve response times in order to prevent a fall but a bed alarm will not prevent a fall on its own. (Patient Safety Authority, 2004). Another point I mentioned is that bed alarms are not integrated into EHR and has to be manually documented. I feel like if the bed boards at the charge desk can show which room has bed alarms engaged, it should translate into the chart as well.

Pennsylvania Patient Safety Authority (2004, September 1). Bed exit alarms to reduce fall risk: Advisory. Https://patientsafety.pa.gov/ADVISORIES/Pages/200409_14.aspx

 #2

Sepsis is an overwhelming infection that can lead to total body failure. Approximately 270,00 Americans die from it each year. Symptoms of Sepsis are similar to many other illnesses, diagnosing it can be very challenging; however, studies have shown with early recognition, followed by aggressive treatment could have a better outcome (Perlin, 2019). When it comes to Sepsis, minutes matter and just as we have improved safety in our homes with smoke detectors that sniff out a possible fire. HCA uses a new technology called S-P-O-T Sepsis Prediction and Optimization of Therapy. The S-P-O-T technology works by using AI algorithm to monitor patients 24/7 and to sniff out and detect the first signs of sepsis by observing labs, vitals and symptoms as well as risk factors. Early diagnosis of sepsis allows prompt lifesaving treatment to save lives that can include but not limited to fluids, broad spectrum antibiotics and pressors if needed these treatments are called sepsis bundles (Perlin, 2019).

Reference: Perlin, J.B. (2018). HCA sepsis protocol: Improving patient outcomes through early detection and treatment. Presented at 2018 Investor Conference, Nashville, T.N. HCA

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