Paper: Innovative Nursing Care Delivery (750 words min)
Innovative Nursing Care Model; Development/Implementation Team for Innovative Nursing Care Model; Evaluation of Model: Outcome Measurement
Read the two (2) articles below:
- Norlander, L. (Ed.). (2011). Transformational models of nursing across different care settings. Report: The future of nursing: Leading change, advancing health (Appendix G). Washington, DC: National Academy of Sciences, Institute of Medicine.
NOTE: For this assignment, ignore curriculi/nurse education models
- Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53, 94-101.
Baccalaureate-prepared nurses are expected to function as managers, educators, collaborators, advocates, and leaders within a variety of settings. These articles describe a variety of innovative or “transformational” models in nurse-managed care across various care settings. Another source of ideas are the vignettes and case studies found in: Global Health 101 Richard Skolnik Burlington, MA: Jones & Bartlett Learning, 3rd Edition, 2016.
For this paper, you will develop an innovative nursing care delivery model for a vulnerable population, care specialty, and setting in the United States OR a low income global country that reflects nurse managed care, collaboration, care across settings, and technology.
For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease, and one (1) type of setting within a country. Be specific. If you use a low income country, name your low income country (see list at the end of this) and adjust your model to the disease(s) and conditions found within that country. Consider that low income countries will not have access to the same level of facilities, technology related to diagnostics and communication, medications, and the health care professionals found in the U.S.
–A vulnerable population include low income children & adults; elderly; homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health or terminal conditions/diseases (or any group at risk for obtaining appropriate health care).
-A care specialty include preventative care; primary care; acute care; chronic care; palliative or end-of-life care (including the targeting of any disease or condition that results in a health risk).
-A setting include rural or urban community housing and/or clinic; school; specialty unit in a hospital; emergency room; health provider office; armed services facility; rehabilitation facility; hospice facility; ambulatory health care center; client home; nursing home; short term stay housing (or any setting where a vulnerable client/patient population is available for care).
LIST OF SELECTED COUNTRIES
African Republic Algeria
Dem Rep of Congo Ethiopia
Ghana Madagascar Malawi Mozambique Niger Senegal Sierra Leone South Africa Uganda Zambia Zimbabwe
Bolivia Ecuador Guatemala Haiti Nicaragua Peru
Iraq Morocco Somalia Sudan Yemen
Bangladesh North Korea Myanmar Nepal
OUTLINE OF EXACTLY HOW THE PAPER NEEDS TO BE:
Title of Paper (top of page 2, centered) Innovative Nursing Care Delivery: [Name of Your Model]
PAPER HEADING: Introduction [Level 1] What is your model’s population, setting, care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you targeting a particular group or disease/condition? Choose a name for your model and include it in your paper title.
PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are welcome to use your creativity in the model–develop your own or base it on an existing model. For ideas, start with the articles found with the assignment, textbook (Global Health 101) scenarios, or do literature searches on the internet. However, be sure that the model is nurse-led or nurse-managed. Registered nurses have authority to make decisions regarding nursing diagnoses, interventions, and referrals. Registered nurse practitioners have additional authority related to medical diagnoses and interventions (prescriptions).
Be sure to include the themes crucial to meeting the challenges of the future: nurse- managed care, collaboration, continuity of care and technology in describing your model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models, but no one would consider implementing it because the cost would be too high.
Nurse led and nurse managed health care. [Level 3] How is your model nurse managed? Were nurses instrumental in the development and implementation of your model? Are nurses consulted and/or make decisions re: budget, personnel, and the communication, referral, and evaluation processes?
Partnerships and collaboration. [Level 3] What partnerships and collaborations exist for your model? Are they at the professional level (i.e., social workers, nutritionists, community leaders) and/or the organizational level (home health care agencies, public health departments, hospitals)?
Continuity of care across settings. [Level 3] What happens when a patient/client moves to a different setting, i.e., home, hospital, hospice, clinic, emergency room, etc. How is communication handled so the patient/family needs are consistently met when moved across settings?
Technology. [Level 3] What technology is used? Is it low-technology (basic assessment tools, screening tests) or high-technology (i.e, patient diagnostic, monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on your model and setting, your team may include other registered nurses, nurse practitioners, community workers, nurse assistants, licensed practical nurses, nutritionists, physical therapists, occupational therapists, dentists, social workers, community leaders, psychologists, clergy, administrators, informatics technicians, physicians (if physicians are part of the team, they should function as consultants, not “captain of the ship”). Include your team members and briefly discuss their functions in carrying out the model goal(s)/purposes(s). How would communication and referrals be handled? Again–think about the cost effectiveness–could ancillary staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement [Level 2] After implementation of the model, what outcomes would you measure Would you look at cost comparisons and/or savings? Patient satisfaction? Staff satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a particular disease/condition? Increased number of therapies? Increased knowledge of a disease or intervention?
For outcomes, be specific on what, who, when and how. For example, if you do a survey:
What type of survey is it (i.e., satisfaction, data gathering)?
Who would you survey (i.e., staff, patients, administrators)?
When would you do the survey (i.e., time period; pre/post tests)?
How would you conduct the survey (handout, mailing, computer analysis)?
- b) An example of a nurse-managed model:
Below is an idea for a nurse-managed model. Your paper would be organized per the assignment instructions and more detailed regarding the health care delivery (nurse-led, collaboration/partnerships, continuity of care, and technology), and the functions of each of the team members, etc., but this is the start of an idea:
Let’s say you are a nurse working in community health and you are aware of three large migrant communities located in the rural areas around Homestead, Florida. The migrant workers who reside in these communities include their families–from infants to elderly. The communities are isolated and lack transportation and the ability to pay for and access local health care facilities.
You develop a model named Bus Stop for Health. You obtain funding (donor and/or grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care organization. The bus will include an examination room (with assessment devices, such as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes, cholesterol, pap smears, etc.), and two rooms for consultation.
The purpose of the bus is to provide primary health care (preventative care, such as immunizations and well child exams), monitor chronic diseases, such as hypertension and diabetes), diagnose and treat minor illnesses, and provide health-related education for this population. A referral system will be established for specialty care, such as obstetrics. An informatics technician (IT) will establish a computerized (e-tablet) system to input, store, and access data in the field. Smart phones will be used for real time communication.
After consultation with and permission from the local community leaders in the migrant communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant community. Some folding chairs and a tarp will be carried in the bus so small covered outdoor or indoor health education sessions can be provided.
Regular team members on the bus will consist of a nurse practitioner, registered nurse, and receptionist/translator. Other team members will rotate in and out of the scheduled bus times on a regular basis. For example, you could include a social worker, dentist, and psychologist (describe their specific functions/purposes for this migrant population) as rotating team members. A nurse midwife could also be included in the bus rotation for managing low risk pregnancies. A consultant and referral relationship with a physician or physicians could be established for more complicated health care problems. Commonly prescribed medications can often be obtained through pharmacies at reduced costs or free from donors.
Evaluation? Some outcomes looked at could be increased immunization rates, increased knowledge related to common chronic diseases, child safety, etc. (by using pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal care, or other outcomes of interest. You could also use surveys to determine patient and community leader satisfaction with the model.
Critical Thinking Skills (15 pts); Content Development (15 pts); Organization (15 pts) References (15 pts); Format (15 pts); Computer/Technology Skills (25 pts)
Writing the Paper
The standard for writing and evaluating papers in the FIU Nursing Unit is APA formatting/style as reflected in the Nursing Student Writing Guide, APA Format Quiz, and the APA Manual. Per the assignment, APA formatting/style is 40% of your grade. UPLOAD EARLY; This is a hard deadline, and missed or late papers will receive a failing grade. Before you begin writing your paper:
1) Read the assignment instructions in module 4: I am always perplexed when students do not follow assignment instructions (you must have a discussion under ALL the assignment headings in your paper) or “forget” the information on the APA Format Quiz they recently passed by 100%. If you do not address the required content (see assignment instructions), you risk significant point deductions, including a failing score. The students who earn the best scores are those who follow assignment instructions re: content and APA formatting (headings, citations, references), and use the Student Writing Guide checklist before submissions.
2) Review the APA-formatted paper example on Content Page: The example provides a “visual” of the topical headings in a finished paper, and the citations and references are in APA format. If it visually helps you, print out the paper example and keep it for future reference.
3) Headings/subheadings levels/positions. APA style is very specific as to the heading/subheading levels/positions in a professionally written paper. Note the positions, font bolding, and capitalization of words in the paper example. To assist you, I indicated the headings and levels/positions for each paper in the Writing Guide and/or assignment instructions. Note that if there are level 3 headings, a short introductory paragraph (at least 2 sentences) must introduce the level 3 headings.
Pay special attention to the level 3 heading format–the heading title is indented, only the first word in the heading is capitalized unless a proper noun, there is a period at the end of the heading, and the discussion begins immediately after the period. Up to fifteen (15) points are taken off if headings are not APA style.
4) Abbreviations. APA style is very specific as to how to deal with abbreviations, such as World Health Organization (WHO). If you insert an abbreviation into your paper at any time, ask yourself—Have I first “spelled out” this abbreviation in a previous sentence or citation?
5) Citations. APA style expects all thoughts from another author/publisher to be cited in the text–to not do so is considered plagiarism (student misconduct). Citations that are missing or formatted incorrectly decrease a paper score significantly. There are lots of examples in the documents and the APA Manual–remember that you can cite at the end of a paragraph if you used the same source throughout the paragraph. It is better to “over” cite than “under” cite. Up to fifteen (15) points are taken off if citations and/or references are not APA style.
6) References. APA style expects references to be formatted correctly. There are lots of examples in the documents and the APA Manual. The author for a citation/reference must match exactly. References that are formatted incorrectly decrease a paper score significantly. Up to fifteen (15) points are taken off if citations and/or references are not APA style. The most common errors are in web page references:
- If an author’s name isn’t found, use the publisher, agency, or organization name as author. The name or a lower case abbreviation (such as “who” — World Health Organization) is often found within the URL link/web address in your browser or somewhere on the web page.
- If you used the abbreviation for an agency/organization in your paper, spell out the full name of the agency/organization with the abbreviation in the reference.
- Include a publication year; it is often found at the bottom of the web page.
- A web page title MUST be included in the reference. If the web page does not have a title, create a short title (in italics) based on the content of the page.
- ONLY the first word of the web page title is capitalized (unless a proper noun).
- NOTE: References found in NUR 4667 modules are formatted in APA style.