NURS 6051 Advocating for the Nursing Role in Program Design and Implementation

NURS 6051 Advocating for the Nursing Role in Program Design and Implementation

NURS 6051 Advocating for the Nursing Role in Program Design and Implementation

Osteoporosis and low bone density affect approximately 54 million Americans making it a growing health issue in the United States. Osteoporosis affects a significant proportion of the aged American population, according to statistics. The implication is that a sizable proportion of the population is predisposed to increased rate of bone fractures and breakage that might not be easy to heal. Osteoporosis prevention and reduction programs have been implemented in the United States (Lieberman et al., n.d.). This paper aims at looking in nursing role in osteoporosis reduction program implemented in my practice.

What is the Cost and Projected Outcome of the Program?

The Osteoporosis Prevention Program is a program that has been implemented in my practice to address high incidences of post knee and hip bone surgeries. The Texas government created the OPP program with the goal of preventing and reducing osteoporosis rates in the state. Implementation of the OPP program was necessitated by the fact that close to one-third of the population in Texas was suffering from recurrent bone fractures in 2015. This program is guided by a number of principles. They include addressing the social determinants of health that contribute to osteoporosis, increasing resource availability, and transforming environments to promote physical activity and healthy eating.

In order to meet the program’s objectives, a number of activities have been implemented.

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They include expanding possibilities for healthy eating, encouraging active living through the construction of healthy settings, and providing community and clinical preventive interventions for people who are at risk of becoming bone fractures. The initiative also improves the chances of children and elderly populations at risk having a healthy lifestyle, as well as public health efforts aimed at preventing osteoporosis (Osteoporosis Treatment & Prevention in Houston, Texas, n.d.). The program’s implementation costs are paid for with public funds. Projected outcomes include a decrease in the state’s bone fracture rate, a decrease in morbidity and mortality rates, and increased access to healthy foods and environments for the population (des Bordes et al., 2020). It is also expected to improve Texans’ health and well-being, as evidenced by increased awareness, lifestyle, and behavioral changes on health-related issues.

What is the target Population?

According to the research, the program targets all of the populations in Texas that are at risk of or affected by osteoporosis and low bone density associated with post knee and hip bone surgeries. The state’s population includes children, adults, and the elderly. The program addresses the social inequalities that contribute to the state’s osteoporosis problem. It also broadens the population’s access to healthy living options, regardless of background.

What is the role of the nurse in providing input for the design of this healthcare program? What are the examples?

My experience and research have taught me that nurses play a variety of roles in providing input for the design of the OPP program. The first role they play is to ensure that the program’s strategies align with the expected goals and objectives. They ensure, for example, that the strategies adopted are relevant to the needs of the populations affected and at risk of bone fractures and osteoporosis. The nurses’ other role in contributing to the design of OPP is to ensure that the needs of the target population are incorporated into the program.

For example, they conduct needs assessments to identify health-related aspects that should be prioritized in the project, thereby increasing the project’s relevance to the population (Curry et al., 2018). Another way nurses influence the design process is by assisting in determining the program’s resource requirements. Adequate resources, such as financial and human resources, are required for the program’s successful implementation. As a result of their experience with public health programs, nurses can contribute insights into the resources that are required.

What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

My responsibilities as an advocate for populations at risk of or affected by the OPP program are diverse. One of them is to ensure that adequate public awareness of the program’s importance and use of its strategies is generated. Health education is required to ensure that those at risk of or affected by osteoporosis understand the lifestyle and behavioral interventions required for their health and well-being. My other role as an advocate is to ensure that all members of the community have equal access to and use of the program initiatives. I ensure that all affected and at-risk populations have improved access to program resources to promote their health. I address issues such as costs associated with the population’s use of the program. I also connect people with the resources they require. For example, I assist them in gaining access to community support groups where they can obtain the assistance, they require in managing and preventing osteoporosis and bone fractures. I had a say in the design. I collaborate with other program stakeholders to define the program’s goals, strategies, and objectives. In addition, I help to determine the program’s resource requirements.

What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

Nurses play a variety of roles in healthcare program implementation. One of the roles of nurses in the implementation of healthcare programs is that of implementers. Nurses help to carry out the program’s strategies. They put the strategies developed to bring the program to life into action. Another role of nurses in program implementation is to coordinate the process. Nurses can help ensure that the program’s strategies are followed as planned. They also make certain that the allocated resources are used to their full potential in order to achieve the program’s objectives. Working with the project management team to evaluate resource utilization versus plan to identify any deviations and implement changes is one example (Pinheiro et al., 2020). However, the roles differ in program design and implementation. Nurses are involved in the development of program plans. During the implementation phase, they carry out the plans.

The design phase is also hands-off because it includes strategy development, whereas the implementation phase is hands-on because it includes the actual use of strategies in practice.

Who are the members of a healthcare team that you believe are the most needed to implement a program? Can you explain why?

Registered nurses, dieticians, and physicians are the members of the healthcare team I believe are most needed to implement the OPP program. Registered nurses perform tasks such as screening, health education, and follow-up on patients. Dieticians perform tasks such as nutritional assessment and counseling for the at-risk patients. Finally, doctors diagnose and treat these patients.

Conclusion

The osteoporosis prevention program is a successful one to help curb the increased incidences of post knee and hip bone surgeries. The program aims to educate those who are impacted by osteoporosis and those who are at risk of developing the condition in future life about how to live a better lifestyle. Nurses are vital in the planning and implementation of programs. All stakeholders involvement is crucial to the success of the program.

References

Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Kemper, A. R., Kubik, M., Landefeld, C. S., Mangione, C. M., Phipps, M. G., Pignone, M., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2018). Screening for Osteoporosis to Prevent Fractures. JAMA, 319(24), 2521. https://doi.org/10.1001/jama.2018.7498

des Bordes, J., Prasad, S., Pratt, G., Suarez-Almazor, M. E., & Lopez-Olivo, M. A. (2020). Knowledge, beliefs, and concerns about bone health from a systematic review and metasynthesis of qualitative studies. PLOS ONE, 15(1), e0227765. https://doi.org/10.1371/journal.pone.0227765

Lieberman, I. H., MD, MBA, & FRCSC. (n.d.). Osteoporosis Prevention Plan. SpineUniverse. https://www.spineuniverse.com/conditions/osteoporosis/how-start-your-osteoporosis-prevention-plan-today

Osteoporosis Treatment & Prevention in Houston, Texas. (n.d.). Texas Endocrinology Group. Retrieved October 24, 2021, from https://www.txendocrine.com/services/osteoporosis/

Pinheiro, M. B., Oliveira, J., Bauman, A., Fairhall, N., Kwok, W., & Sherrington, C. (2020). Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity, 17(1). https://doi.org/10.1186/s12966-020-01040-4

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Nurses collaborate with other health professionals from various specialty areas to design effective programs. Nurses bring various specialties in designing and implementing programs that make them effective partners to professionals in such undertaking. Their involvement through leadership positions in the healthcare system allows them to deliver highly successful programs that meet set goals and objectives (Evripidou et al., 2019). The purpose of this essay is to demonstrate through an interview with a nurse leader the type of leadership required for nurses to advocate for a healthcare program. Based on a transcript of the interview, the assignment illustrates the critical role of these healthcare providers in design and implementation of programs.
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?

Nurse Interviewee

Nurses play a vital role that include linking healthcare professionals and patients to offer effective treatment interventions, especially in mental and behavioral health areas. Caring for adults with mental health issues is challenging for families and even healthcare providers. The implication is that these challenges require stakeholders, especially healthcare providers like nurses, to design and implement effective programs that can lead to optimal care and better outcomes. An effective program that is being implemented in my practice is the use of home-based care interventions like meditation and dance therapy to enhance the psychological aspects of individuals with mental health issues. The program that was designed by the nursing team in the facility involves using meditation and dancing therapy as ways of helping the mentally sick individuals to enhance their cognitive functioning.
The facility implemented this program due to elderly patients over 60 years presenting with different types of mental disorders like Alzheimer’s disease, Parkinson disease, Schizophrenia, and dementia (Chiesi et al., 2021). The program aims at improving memory for this individuals, enhancing their cognition and coordination of activities. Mental health benefits of meditation are broad and include better focus and concentration, improved self-awareness and self-esteem as well as a reduction in stress and anxiety and fosters kindness. Dance movement therapy (DMT) is used in nursing care and practice as way of reducing symptoms linked to different mental health conditions. The average cost of the program whose duration is two hours; one hour for meditation and one hour for dance therapy, is $80. The program’s projected outcomes include enhancing coordination and cognition and reducing the adverse symptoms of mental health conditions.


Who is your target population?

Interviewee


The program targets mainly all individuals who are 60 years and above and have some form of mental health challenges, especially those presenting in the facility with dementia, and Alzheimer’s disease.
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
Interviewee
The nurse plays a significant role in offering input for designing the healthcare program. Nurses possess extensive and hands-on knowledge about patient needs than other healthcare practitioners as they provide care and interact with more. Nurses’ input in the program is founded on using best practices from research findings. The implication is that nurses suggests the different aspects of the program. Nurses design communication approaches and strategies, different ways to implement the program, and various aspects of the initiative to enhance its effectiveness on the target population (Evripidou et al., 2019). Nurses are also critical in the program as they encourage patients to develop positive body image, have self-esteem and self-concept to ensure that they benefit from its approaches. For example, the nurses propose different approaches to implementing the program with the aim of meeting patient needs and expectations on outcomes.

What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

Interviewee

Nurses are patient advocates in all their settings or practice environment as they seek better ways to help improve care outcomes. As an advocate for the target population, my role is to ensure that these individuals get quality care at their convenience. The care does not need to be hospital-based but can be private in the comfort of their homes. My role is to ensure that these individuals feel free and can express their feelings. Further, I ensure that they get sufficient resources and interact well with the providers for effective care delivery. I believe that their involvement in the program is critical to both the facility and communities where they live. Secondly, I have significant input in the design decisions as I am part of the team that recommended and developed the program for the target population. My suggestions include integrating the dance movement therapy with the meditation process that has proved successful for the target population based on positive outcomes attained since implementation. I impact the design by ascertaining that the program can also run in patients’ homes for those who cannot move to the facility.

What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples.

Interviewee

The nurse plays a critical role in implementation of healthcare programs, not just this one. The initial role is program coordination that involves the monitoring of various patients and their care needs to ensure effective and quality performance of the expected outcomes. Nurses also link different healthcare professionals in their teams to provide a common approach to the health situation at hand. In this program, nurses are the pivot of the implementation as they execute the suggested strategies for patients in different settings, including at home and in the facility Innes et al., 2018). Nurses incorporate the proposed program into their clinical practices and offer patient-centered care to meet the individual needs of a patient. Nurses incorporate the individual specifications of the initiative to like personal or customized plans for different patients with mental health issues.

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nurs 6051 advocating for the nursing role in program design and implementation
NURS 6051 Advocating for the Nursing Role in Program Design and Implementation

The role of nurses in implementation differs from the design as implementation entails executing aspects of the program and ascertaining that they meet patient’s needs. In design, a nurse suggests different approaches to the program that include scope and size and sustainability. However, in implementation, the nurse incorporates these specifications into clinical practice and hands-on execution to ascertain expected outcomes.

Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Interviewee

Effective design and implementation of healthcare intervention programs requires collective efforts from different stakeholders and players. These include healthcare professionals, nurses in the practice, organizational managers and leaders and patients. In this case of this program and its implementation, the members of the healthcare team include nurse practitioners in the facility, the mental health professionals like psychologists, psychotherapists, and psychiatrists. The nurse practitioners and the mental health experts are essential for this program because of their role and experience in its overall success (Singh et al., 2019). As members of the team, they will ensure that all components of the program succeed and are tailored to meet the needs of the different patients in the facility and even those in home-based settings.

Conclusion


Nurses like other healthcare providers, play a critical role in the design and implementation of healthcare programs or initiatives focused on enhancing target populations based on their suggested interventions. The need to enhance mental health among elderly patients is essential since many suffer from mental health disorders. The program in this case will enhance their mental cognition and functions leading to better lifestyle experience for the target population.

References


Chiesi, F., Gori, E., Collini, F., Palfrader, A., Galli, R., Guazzini, A., … & Bonaccorsi, G. (2021).
Biodanza as a Nonpharmacological Dance Movement–Based Treatment in Older People with Alzheimer’s Disease: An Italian Pilot Study in 2 Tuscan Nursing Homes. Holistic Nursing Practice, 35(5), 264-272. DOI: 10.1097/hnp.0000000000000470
Evripidou, M., Charalambous, A., Middleton, N., & Papastavrou, E. (2019). Nurses’ knowledge
and attitudes about dementia care: Systematic literature review. Perspectives in psychiatric care, 55(1), 48-60. doi: 10.1111/ppc.12291.
Innes, K. E., Selfe, T. K., Brundage, K., Montgomery, C., Wen, S., Kandati, S., … & Huysmans,
Z. (2018). Effects of meditation and music-listening on blood biomarkers of cellular aging and Alzheimer’s disease in adults with subjective cognitive decline: An exploratory randomized clinical trial. Journal of Alzheimer’s Disease, 66(3), 947-970.
doi: 10.3233/JAD-180164.
Singh, N. N., Lancioni, G. E., Medvedev, O. N., Sreenivas, S., Myers, R. E., & Hwang, Y. S.
(2019). Meditation on the soles of the feet practice provides some control of aggression for individuals with Alzheimer’s disease. Mindfulness, 10(7), 1232-1242. https://digitalcommons.kennesaw.edu/facpubs/4362
Swan, B. A., Haas, S., & Jessie, A. T. (2019). Care coordination: roles of registered nurses
across the care continuum. Nursing Economics, 37(6), 317-323. https://jdc.jefferson.edu/nursfp/101

Thorough planning and designing of healthcare programs are essential for success. Program design entails determining the program’s scope, including the population it will serve and the health issue of focus. It also includes defining the roles of different individuals in implementation, outlining short- and long-term goals and targeted outcomes, making an evaluation plan, and identifying suitable evaluation measures. This assignment aims to present an interview transcript about a healthcare program in my current practice.

Interviewer: Tell us about a healthcare program in your practice.

Me: Our organization established an ADHD program five years ago, which seeks to help children with ADHD and their parents/guardians to manage the condition. The program focuses on teaching parents the skills required to address and prevent behavioral and emotional problems in their children. The program was informed by the growing need to improve the management of children diagnosed with ADHD to improve their mental and overall health outcomes and lower the risk of the disorder progressing to adolescence and adulthood (Bahraini et al., 2022). Besides, it was observed that many parents/guardians with ADHD children were not well-versed in managing their children at home due to inadequate parental training.

            The program offers a range of services, including:

  • Parenting interventions such as individual and group-based therapy to empower caregivers to manage their children’s attention and behavior successfully.
  • Adolescent education support for adolescents 11 to 18 years to help them be successful in school by improving time management, organization, and academic performance.
  • Family therapy with caregivers and children where they receive personalized training to manage ADHD and behavior issues.
  • Group therapy for children and adolescents to enable them to develop skills and practice them with their peers.
  • Education on frustration management for children 8 to 11 years for effective coping with disappointment and negative emotions.

Interviewer: What are the costs and projected outcomes of this program?

Me: The ADHD program was established at the cost of $ 450,000, which was inclusive of screening tools, training healthcare providers, and health education materials. The program’s average yearly operational cost is $ 150,000. The projected outcomes are improved health outcomes for ADHD patients, reduced ADHD comorbidities, and improved management of ADHD symptoms at home (Kleve et al., 2022).   

Interviewer: Who is your target population?

Me: The target population is children and adolescents with ADHD and their caregivers.

Interviewer: What is the role of the nurse in providing input for the design of this healthcare program?

Me: Nurses were involved in the design of the ADHD program. They acted as consultants on the services that should be incorporated into the program to meet the desired outcomes. This is because they are well-versed in the challenges ADHD patients and their caregivers encounter and the services that can be offered to address them (Gerber, 2018). Besides, nurses provided input on how the services should be programmed for the different age groups, children and adolescents, and the interventions that should be provided in individual and group therapy.

Interviewer: What is your role as an advocate for your target population for this healthcare program?

Me: My role as an advocate for children and adolescents with ADHD includes evaluating the quality of the services to ensure they adequately meet their health needs. I educate individuals about ADHD to lower the stigma associated with the condition and encourage parents with ADHD children to enroll in the program (Gerber, 2018). Besides, I create awareness about cultural sensitivity to the healthcare providers to ensure services provided align with patients’ cultures. 

Interviewer: Do you have input into design decisions? How else do you impact design?

Me: I contribute to the program’s design decisions owing to my knowledge and experience in mental health. I propose evidence-based interventions that can be implemented in the program, including various therapy approaches counselors can employ when handling ADHD patients (Baweja et al., 2021). Besides, I offer input on how the services should be implemented to meet the individual patient’s and family’s needs and encourage patients to continue attending the therapy sessions.

Interviewer: How does this role vary between the design and implementation of healthcare programs?

Me: My role in ADHD program design and implementation is relatively different. In program design, I propose solutions that can optimize the program and help attain the program’s goals. The proposed solutions are usually analyzed for viability and often modified before implementation. However, my role in implementation is to put the interventions into action as per the program’s policy and ensure quality and patient safety are considered. Besides, I evaluate the impact of the interventions during implementation, which guides the solutions I propose to improve the program. For example, I proposed including behavioral parenting training in the program’s design. However, I evaluated how the counselors delivered the training in the implementation phase and recommended solutions to improve it.  

Interviewer: Who are the members of a healthcare team that you believe is most needed to implement a program? Can you explain why?

Me: The ADHD program healthcare team comprises child psychiatrists, PMHNPs, registered nurses, counseling therapists, and social workers. I believe that no team member is more important than the other, and each professional equally contributes to the success of the ADHD program. Each member brings their unique knowledge and expertise in the design and implementation of the program. All team members contribute to continually optimizing the program and implementing the interventions to improve the health outcomes of our target population (Kleve et al., 2022). For instance, the psychiatrist and PMHNP have specialized knowledge in assessing, diagnosing, and providing ADHD treatment. In contrast, counselors have specialized skills in providing psychosocial interventions, and social workers are skilled in providing social support.

References

Bahraini, S., Maisoneuve, A. R., Liu, Y., Samson, A., Ying, Q., Li, F., Yang, L., & Robaey, P. (2022). Implementing a Canadian shared-care ADHD program in Beijing: Barriers and facilitators to consider prior to start-up. BMC Psychiatry22(1), 321. https://doi.org/10.1186/s12888-022-03955-7

Baweja, R., Soutullo, C. A., & Waxmonsky, J. G. (2021). Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care. World journal of psychiatry11(12), 1206–1227. https://doi.org/10.5498/wjp.v11.i12.1206

Gerber, L. (2018). Understanding the nurse’s role as a patient advocate. Nursing202048(4), 55-58. https://doi.org/10.1097/01.NURSE.0000531007.02224.65

Kleve, L., Vårdal, L., & Elgen, I. B. (2022). The Nurse Role in the Management of ADHD in Children and Adolescent: A Literature Review. Frontiers in psychiatry13, 676528. https://doi.org/10.3389/fpsyt.2022.676528

Nurses consistently influence health-related decisions and affairs through their political knowledge, effective communication, and collaboration with other members of various health organizations, thereby improving their working environment and the quality of their services to patients. Due to organizational issues, participation in such policy-making processes may need to be revised. Registered nurses and Advanced Practice Registered nurses have opportunities to participate in policy formulation actively through: 

  1. Professional groups. The American Nurses Association, Emergency Nurses Association, and others represent RNs and APRNs today. Nurses join these groups to change policies that may harm their working environment and safety. Professional organizations empower nurses to voice their work problems and create changes that benefit them.

2) Employment/ Community 

 RNs and APRNs can shape healthcare initiatives in organizations by being active in their community. Nurses are the first face the patient and family see. Nurses can gain the patient’s trust and families’ trust. They may impact management policy review decisions. Policies improve patient care and nurse safety at work. 

Opportunities have drawbacks. These include

1. Joining professional groups takes time. Nurses must join these organizations to be licensed. Some nurses may work unlicensed due to the complicated registration process or illness. Nurse licenses are also expensive. 

2 . Working in healthcare during the pandemic has caused nurses to lose compassion and experience burnout. When a lack of respect for the individual’s dignity is present in human interactions, the stress induced and perpetuated consistently negatively affects health and healthcare providers(Muntean,2013). Voicing their concerns and advocating is becoming less and less. Great nurses have become calloused and leave nursing because of the responsibility and liability of nursing. 

Solution

1. By simplifying the membership registration process, anyone can join the organization or allow the community to elect members on the professional nursing boards.

2. Employers may need to inform nurses of new policies. Employers need to show new nurses more support and also listen to the frustrations of nurses. Poor leadership also hinders nurse voices and places strain on patient care. This prevents nurses from contributing to patient-benefitting decisions. Active listening and improved verbal and nonverbal communication build trust( Shanhan, 2021). Nurses could get nominated when the local candidates run for office. 

Board of directors. ANA. (2017b, October 14). https://www.nursingworld.org/ana/leadership-and-governance/board-of-directors/

Links to an external site.

Muntean, A., Tomita, M., & Ungureanu, R. (2013). The Role of the Community Nurse in Promoting Health and Human Dignity-Narrative Review Article. Iranian Journal of Public Health, 42(10), 1077-1084. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436534/

Shanahan, T., & Cunningham, J. (2021). Keys to Trust-Building with Patients. Journal of Christian nursing : a quarterly publication of Nurses Christian Fellowship38(2), E11–E14. https://doi.org/10.1097/CNJ.0000000000000823

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