SlideShare a Scribd company logo
Discussion: Heart Failure Clinic Care Plan
Discussion: Heart Failure Clinic Care PlanORDER HERE FOR ORIGINAL, PLAGIARISM-FREE
PAPERS ON Discussion: Heart Failure Clinic Care PlanAssessment
InstructionsPREPARATIONRefer to the Capella library and the Internet for supplemental
resources to help you complete this assessment.INSTRUCTIONSDeliverable: Develop an
evidence-based plan for health care delivery.Scenario:The hospital where you work has an
issue with increased readmissions within 30 days of discharge. After examining the core
measures, it was found that heart failure was the most common core measure disease
process experiencing the highest rate of readmissions. The leadership team has given your
team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of
this clinic is to ensure that discharge education is presented to the patient in an orderly,
consistent manner and complies with evidence-based practice protocols. Since these
patients may be discharged from a variety of areas in the facility, having the heart failure
clinic staff take ownership of the process will improve both consistency and compliance.
There are cardiologists that interact with the staff and patients, but the day-to-day
operations of the clinic are designed and supported by the nurses as they interact with
appropriate members of the other health care team disciplines promoting the best care for
the heart failure patients. Discussion: Heart Failure Clinic Care PlanAs a member of the
nurse team, you have been asked to develop one component of the clinic.The hospital
leadership established these objectives for the clinic services:Evaluate and maximize proper
medication therapy.Conduct regular diet, exercise, and stress management classes for the
patients.Monitor physiological indicators for the patients (lab work, weights, vital signs,
ECGs).Provide a case management system for patients in the program post-discharge.The
overall goals for the heart failure clinic are to:Enroll greater than 90 percent of the patients
with a primary or secondary diagnosis of HF prior to discharge.Facilitate discharge planning
to achieve 100 percent compliance with patient education prior to discharge (discharge
planning).Decrease readmission rates in this population by 5 percent over the next year.The
leadership team has asked you to provide them with an evidence-based plan for one of the
components of the clinic. You may use any combination of documents (for example, a
spreadsheet or a table) in addition to explanatory information to convey information clearly
and succinctly.Develop one: an Orientation Course Plan, a Discharge Education Plan, or a
Care Coordination Plan.An Orientation Course Plan:Develop an evidence-based plan for
health care delivery.Include a comprehensive schedule of topics, objectives, key points, and
patient resources for the orientation course.What are the components of an evidence-based
education plan?How will you know that patients will understand what to do?What
modalities will you use to deliver information?How will you adapt the plan to meet the
needs of patients from diverse cultural and language backgrounds?Identify specialized and
supplementary material needs.Apply professional and legal standards in support of a care
plan.Explain the alignment to the most recent Heart Failure Guidelines and specific
professional standards.Describe the accountability tools and procedures used to measure
effectiveness.How will you know if the patient education plan is successful?What are the
indicators of success or effectiveness?A Discharge Education Plan:Develop an evidence-
based plan for health care delivery.Develop a discharge plan with objectives and resources,
and tools for patients to monitor their progress.How will you know that patients
understand what to do?What modalities will you use to deliver information?How will you
adapt the plan to meet the needs of patients from diverse cultural and language
backgrounds?Apply professional and legal standards in support of a care plan.Explain the
alignment to the most recent Heart Failure Guidelines and specific professional
standards.Describe accountability tools and procedures used to measure effectiveness.How
will you know if the discharge plan is successful?What are the indicators of success or
effectiveness?Care Coordination Plan:Develop an evidence-based plan for health care
delivery.Develop a procedure for coordinating services.Consider the needs of “outliers.” For
example, someone with lung disease may need extra resources.Who should be on the
team?When would the team be activated?How would it be activated?What is the time frame
required to coordinate services?How would the intervention plan be monitored for
effectiveness?Apply professional standards in support of a care plan.Explain the alignment
to the most recent heart failure guidelines and specific professional standards.Describe
accountability tools and procedures used to measure effectiveness.How will you know if the
care coordination plan is successful?What are the indicators of success or
effectiveness?How will information be collected or communicated?ADDITIONAL
REQUIREMENTSWritten communication: Written communication should be free of errors
that detract from the overall message.APA formatting: Resources and in-text citations
should be formatted according to current APA style and formatting.Length: The report
should be 3-4 pages in content length, double-spaced.Font and font size: Times New Roman,
12 point.Number of resources: Support your plan with a minimum of three peer-reviewed
resources, in addition to professional standards.Library ResourcesCapella MultimediaClick
the links provided below to view the following multimedia pieces:Riverbend City: Insurance
Issues Mission | Transcript.Leadership Styles | Transcript.Leadership, Theories, Models, and
Styles | Transcript.The following resources are provided for you in the Capella University
Library and are linked directly in this course. These articles contain content relevant to the
topics and assessments that are the focus of this unit.Mensik, J. S. (2013). Nursing’s role and
staffing in accountable care. Nursing Economics, 31(5), 250–253.Ganz, F. D., Wagner, N., &
Toren, O. (2015). Nurse middle manager ethical dilemmas and moral distress. Nursing
Ethics, 22(1), 43–51.Ott, J., & Ross, C. (2014). The journey toward shared governance: The
lived experience of nurse managers and staff nurses. Journal of Nursing Management, 22(6),
761–768.Tait, G. R., Bates, J., LaDonna, K. A., Schulz, V. N., Strachan, P. H., McDougall, A., &
Lingard, L. (2015). Adaptive practices in heart failure care teams: Implications for patient-
centered care in the context of complexity. Journal of Multidisciplinary Healthcare, 8, 365–
376.Boyde, M., Song, S., Peters, R., Turner, C., Thompson, D. R., & Stewart, S. (2013). Pilot
testing of a self-care education intervention for patients with heart failure. European
Journal of Cardiovascular Nursing, 12(1), 39–46.Brennan, E. J. (2015). Heart failure care for
patients who do not speak English. British Journal of Nursing, 24(20), 1004–
1008.Coordinating the medical home for heart failure patients; transitioning to palliative
care: Adjusting locus of care and focusing on integrated medicine sheds light on best
practices and patient-centered care in heart failure clinics. (2010, September 15). PR
Newswire.Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart
failure patients. British Journal of Community Nursing, 18(9), 441–445.Limpahan, L. P.,
Baier, R. R., Gravenstein, S., Liebmann, O., & Gardner, R. L. (2013). Closing the loop: Best
practices for cross-setting communication at ED discharge. American Journal of Emergency
Medicine, 31(9), 1297–1301.Lingle, C. L. (2013). Evidence based practice: Patient discharge
education barriers to patient education(Master’s thesis). Available from ProQuest
Dissertation Publishing. (UMI No. 1542582)Delaney, C., Apostolidis, B., Bartos, S., Morrison,
H., Smith, L., & Fortinsky, R. (2013). A randomized trial of telemonitoring and self-care
education in heart failure patients following home care discharge.Home Health Care
Management and Practice, 25(5), 187–195.Wolfson, B. J., & Campbell, R. (2014, February
9). With Medicare watching, hospitals make changes: Orange County medical centers put
new focus on discharge practices to reduce patient readmissions. Orange County
Register.Berry, L. L., Rock, B. L., Houskamp, B. S., Brueggeman, J., & Tucker, L. (2013). Care
coordination for patients with complex health profiles in inpatient and outpatient
settings. Mayo Clinic Proceedings, 88(2), 184–194.Veenstra, W., op den Buijs, J., Pauws, S.,
Westerterp, M., & Nagelsmit, M. (2015). Clinical effects of an optimised care program with
telehealth in heart failure patients in a community hospital in the Netherlands. Netherlands
Heart Journal, 23(6), 334–340.Aller, M., Vargas, I., Coderch, J., Calero, S., Cots, F., Abizanda,
M., … Vázquez, M. L. (2015). Development and testing of indicators to measure coordination
of clinical information and management across levels of care. BMC Health Services
Research, 15(323), 1–16.Course Library GuideA Capella University library guide has been
created specifically for your use in this course. You are encouraged to refer to the resources
in the BSN-FP4012 – Nursing Leadership and Management Library Guide to help direct your
research.Internet ResourcesNational Council of State Boards of Nursing (NCSBN). (n.d.).
Retrieved from https://www.ncsbn.org/index.htmAmerican Nurses Association (ANA).
(2015). Code of ethics for nurses. Retrieved
from http://www.nursingworld.org/MainMenuCategories/Eth…Bookstore ResourcesThe
resources listed below are relevant to the topics and assessments in this course. Unless
noted otherwise, these materials are available for purchase from the Capella University
Bookstore. When searching the bookstore, be sure to look for the Course ID with the
specific –FP (FlexPath) course designation.Kelly, P., & Tazbir, J. (2014). Essentials of nursing
leadership and management (3rd ed.). Clifton Park, NY: Delmar.Chapter 2.Chapters 11–
15.heart_failure_clinic_care_plan_scoring_guide.pdfleadership__theories__models_and_styles
.pdfDiscussion: Heart Failure Clinic Care Plan

More Related Content

Similar to Heart Failure Clinic Care Plan.docx

Msn fp6011 concept map template instructionsyou may use the t
Msn fp6011 concept map template instructionsyou may use the tMsn fp6011 concept map template instructionsyou may use the t
Msn fp6011 concept map template instructionsyou may use the t
MARRY7
 
Heart Failure Clinic resourcing Plan.docx
Heart Failure Clinic resourcing Plan.docxHeart Failure Clinic resourcing Plan.docx
Heart Failure Clinic resourcing Plan.docx
bkbk37
 
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnar
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnarUeda2015 tupelo.nurses role in dm prevention dr.martyn molnar
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnarueda2015
 
Write 3–4 pages describing the effective use of patient-care techn.docx
Write 3–4 pages describing the effective use of patient-care techn.docxWrite 3–4 pages describing the effective use of patient-care techn.docx
Write 3–4 pages describing the effective use of patient-care techn.docx
sleeperfindley
 
Patient Centered Medical Home; The Army Medical Department Experience
Patient Centered Medical Home; The Army Medical Department ExperiencePatient Centered Medical Home; The Army Medical Department Experience
Patient Centered Medical Home; The Army Medical Department ExperienceMadigan Healthcare System
 
Rainbow Clinic Staff Education
Rainbow Clinic Staff EducationRainbow Clinic Staff Education
Rainbow Clinic Staff EducationTanisha Davis
 
DN 703 Unit 8 Identifying a Target Population.docx
DN 703 Unit 8 Identifying a Target Population.docxDN 703 Unit 8 Identifying a Target Population.docx
DN 703 Unit 8 Identifying a Target Population.docx
write5
 
Assessment 3PRINTLetter to the Editor Population Health P.docx
Assessment 3PRINTLetter to the Editor Population Health P.docxAssessment 3PRINTLetter to the Editor Population Health P.docx
Assessment 3PRINTLetter to the Editor Population Health P.docx
galerussel59292
 
Documenting Your Clinical Efforts In a Way that Counts
Documenting Your Clinical Efforts In a Way that CountsDocumenting Your Clinical Efforts In a Way that Counts
Documenting Your Clinical Efforts In a Way that Counts
tatetomika
 
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docxMARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
alfredacavx97
 
Running head Critical Appraisal of ResearchCritical Appraisal o.docx
Running head Critical Appraisal of ResearchCritical Appraisal o.docxRunning head Critical Appraisal of ResearchCritical Appraisal o.docx
Running head Critical Appraisal of ResearchCritical Appraisal o.docx
healdkathaleen
 
Innovation in Care Delivery: The Patient Journey
Innovation in Care Delivery: The Patient JourneyInnovation in Care Delivery: The Patient Journey
Innovation in Care Delivery: The Patient JourneyJane Chiang
 
evidence based practice, EBP
evidence based practice, EBPevidence based practice, EBP
evidence based practice, EBP
pankaj rana
 
Write a 3 page evidence-based health care delivery plan for one co.docx
Write a 3 page evidence-based health care delivery plan for one co.docxWrite a 3 page evidence-based health care delivery plan for one co.docx
Write a 3 page evidence-based health care delivery plan for one co.docx
owenhall46084
 
Care Coordination - Northwest Medical Partners
Care Coordination - Northwest Medical PartnersCare Coordination - Northwest Medical Partners
Care Coordination - Northwest Medical Partners
pedenton
 
New microsoft office power point presentation
New microsoft office power point presentationNew microsoft office power point presentation
New microsoft office power point presentation
Emani Aparna
 
WhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingWhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingPhilippa Göranson
 
WhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingWhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingSuzanne Parsons
 
Population health improvement plan.docx
Population health improvement plan.docxPopulation health improvement plan.docx
Population health improvement plan.docx
sdfghj21
 
Primary Health Care Strategy
Primary Health Care StrategyPrimary Health Care Strategy
Primary Health Care Strategy
Health Informatics New Zealand
 

Similar to Heart Failure Clinic Care Plan.docx (20)

Msn fp6011 concept map template instructionsyou may use the t
Msn fp6011 concept map template instructionsyou may use the tMsn fp6011 concept map template instructionsyou may use the t
Msn fp6011 concept map template instructionsyou may use the t
 
Heart Failure Clinic resourcing Plan.docx
Heart Failure Clinic resourcing Plan.docxHeart Failure Clinic resourcing Plan.docx
Heart Failure Clinic resourcing Plan.docx
 
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnar
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnarUeda2015 tupelo.nurses role in dm prevention dr.martyn molnar
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnar
 
Write 3–4 pages describing the effective use of patient-care techn.docx
Write 3–4 pages describing the effective use of patient-care techn.docxWrite 3–4 pages describing the effective use of patient-care techn.docx
Write 3–4 pages describing the effective use of patient-care techn.docx
 
Patient Centered Medical Home; The Army Medical Department Experience
Patient Centered Medical Home; The Army Medical Department ExperiencePatient Centered Medical Home; The Army Medical Department Experience
Patient Centered Medical Home; The Army Medical Department Experience
 
Rainbow Clinic Staff Education
Rainbow Clinic Staff EducationRainbow Clinic Staff Education
Rainbow Clinic Staff Education
 
DN 703 Unit 8 Identifying a Target Population.docx
DN 703 Unit 8 Identifying a Target Population.docxDN 703 Unit 8 Identifying a Target Population.docx
DN 703 Unit 8 Identifying a Target Population.docx
 
Assessment 3PRINTLetter to the Editor Population Health P.docx
Assessment 3PRINTLetter to the Editor Population Health P.docxAssessment 3PRINTLetter to the Editor Population Health P.docx
Assessment 3PRINTLetter to the Editor Population Health P.docx
 
Documenting Your Clinical Efforts In a Way that Counts
Documenting Your Clinical Efforts In a Way that CountsDocumenting Your Clinical Efforts In a Way that Counts
Documenting Your Clinical Efforts In a Way that Counts
 
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docxMARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
MARKETING PRINCIPLESMKTG 305SWOT Assignment – CSUSB.docx
 
Running head Critical Appraisal of ResearchCritical Appraisal o.docx
Running head Critical Appraisal of ResearchCritical Appraisal o.docxRunning head Critical Appraisal of ResearchCritical Appraisal o.docx
Running head Critical Appraisal of ResearchCritical Appraisal o.docx
 
Innovation in Care Delivery: The Patient Journey
Innovation in Care Delivery: The Patient JourneyInnovation in Care Delivery: The Patient Journey
Innovation in Care Delivery: The Patient Journey
 
evidence based practice, EBP
evidence based practice, EBPevidence based practice, EBP
evidence based practice, EBP
 
Write a 3 page evidence-based health care delivery plan for one co.docx
Write a 3 page evidence-based health care delivery plan for one co.docxWrite a 3 page evidence-based health care delivery plan for one co.docx
Write a 3 page evidence-based health care delivery plan for one co.docx
 
Care Coordination - Northwest Medical Partners
Care Coordination - Northwest Medical PartnersCare Coordination - Northwest Medical Partners
Care Coordination - Northwest Medical Partners
 
New microsoft office power point presentation
New microsoft office power point presentationNew microsoft office power point presentation
New microsoft office power point presentation
 
WhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingWhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMaking
 
WhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMakingWhereArePatientsinDecisionMaking
WhereArePatientsinDecisionMaking
 
Population health improvement plan.docx
Population health improvement plan.docxPopulation health improvement plan.docx
Population health improvement plan.docx
 
Primary Health Care Strategy
Primary Health Care StrategyPrimary Health Care Strategy
Primary Health Care Strategy
 

More from bkbk37

Range of.docx
Range of.docxRange of.docx
Range of.docx
bkbk37
 
Ralph Waldo Emerson.docx
Ralph Waldo Emerson.docxRalph Waldo Emerson.docx
Ralph Waldo Emerson.docx
bkbk37
 
Raising Minimum An explanation of the its.docx
Raising Minimum An explanation of the its.docxRaising Minimum An explanation of the its.docx
Raising Minimum An explanation of the its.docx
bkbk37
 
Rail Project A goal of the Obama administration.docx
Rail Project A goal of the Obama administration.docxRail Project A goal of the Obama administration.docx
Rail Project A goal of the Obama administration.docx
bkbk37
 
Racism toward Indigenous peoples in Canada.docx
Racism toward Indigenous peoples in Canada.docxRacism toward Indigenous peoples in Canada.docx
Racism toward Indigenous peoples in Canada.docx
bkbk37
 
Race and.docx
Race and.docxRace and.docx
Race and.docx
bkbk37
 
R2P and Syria.docx
R2P and Syria.docxR2P and Syria.docx
R2P and Syria.docx
bkbk37
 
Racial Disparities.docx
Racial Disparities.docxRacial Disparities.docx
Racial Disparities.docx
bkbk37
 
Race and Technology.docx
Race and Technology.docxRace and Technology.docx
Race and Technology.docx
bkbk37
 
QuickBooks uses windows API to follow orders to get updates.docx
QuickBooks uses windows API to follow orders to get updates.docxQuickBooks uses windows API to follow orders to get updates.docx
QuickBooks uses windows API to follow orders to get updates.docx
bkbk37
 
Questions What are the purposes of Just.docx
Questions What are the purposes of Just.docxQuestions What are the purposes of Just.docx
Questions What are the purposes of Just.docx
bkbk37
 
Questions to Each group you read about is.docx
Questions to Each group you read about is.docxQuestions to Each group you read about is.docx
Questions to Each group you read about is.docx
bkbk37
 
Questions that must be answered in your plus other.docx
Questions that must be answered in your plus other.docxQuestions that must be answered in your plus other.docx
Questions that must be answered in your plus other.docx
bkbk37
 
Questions for Brief Explicit Spiritual.docx
Questions for Brief Explicit Spiritual.docxQuestions for Brief Explicit Spiritual.docx
Questions for Brief Explicit Spiritual.docx
bkbk37
 
Question Libya recently announced that it is claiming a.docx
Question Libya recently announced that it is claiming a.docxQuestion Libya recently announced that it is claiming a.docx
Question Libya recently announced that it is claiming a.docx
bkbk37
 
Question Use the Internet or the IGlobal Resource.docx
Question Use the Internet or the IGlobal Resource.docxQuestion Use the Internet or the IGlobal Resource.docx
Question Use the Internet or the IGlobal Resource.docx
bkbk37
 
Question Please define motivation and discuss why it is.docx
Question Please define motivation and discuss why it is.docxQuestion Please define motivation and discuss why it is.docx
Question Please define motivation and discuss why it is.docx
bkbk37
 
Question share your perspective on personal data as a.docx
Question share your perspective on personal data as a.docxQuestion share your perspective on personal data as a.docx
Question share your perspective on personal data as a.docx
bkbk37
 
QEP Assignment Death Penalty.docx
QEP Assignment Death Penalty.docxQEP Assignment Death Penalty.docx
QEP Assignment Death Penalty.docx
bkbk37
 
Question In your what are the main workforce.docx
Question In your what are the main workforce.docxQuestion In your what are the main workforce.docx
Question In your what are the main workforce.docx
bkbk37
 

More from bkbk37 (20)

Range of.docx
Range of.docxRange of.docx
Range of.docx
 
Ralph Waldo Emerson.docx
Ralph Waldo Emerson.docxRalph Waldo Emerson.docx
Ralph Waldo Emerson.docx
 
Raising Minimum An explanation of the its.docx
Raising Minimum An explanation of the its.docxRaising Minimum An explanation of the its.docx
Raising Minimum An explanation of the its.docx
 
Rail Project A goal of the Obama administration.docx
Rail Project A goal of the Obama administration.docxRail Project A goal of the Obama administration.docx
Rail Project A goal of the Obama administration.docx
 
Racism toward Indigenous peoples in Canada.docx
Racism toward Indigenous peoples in Canada.docxRacism toward Indigenous peoples in Canada.docx
Racism toward Indigenous peoples in Canada.docx
 
Race and.docx
Race and.docxRace and.docx
Race and.docx
 
R2P and Syria.docx
R2P and Syria.docxR2P and Syria.docx
R2P and Syria.docx
 
Racial Disparities.docx
Racial Disparities.docxRacial Disparities.docx
Racial Disparities.docx
 
Race and Technology.docx
Race and Technology.docxRace and Technology.docx
Race and Technology.docx
 
QuickBooks uses windows API to follow orders to get updates.docx
QuickBooks uses windows API to follow orders to get updates.docxQuickBooks uses windows API to follow orders to get updates.docx
QuickBooks uses windows API to follow orders to get updates.docx
 
Questions What are the purposes of Just.docx
Questions What are the purposes of Just.docxQuestions What are the purposes of Just.docx
Questions What are the purposes of Just.docx
 
Questions to Each group you read about is.docx
Questions to Each group you read about is.docxQuestions to Each group you read about is.docx
Questions to Each group you read about is.docx
 
Questions that must be answered in your plus other.docx
Questions that must be answered in your plus other.docxQuestions that must be answered in your plus other.docx
Questions that must be answered in your plus other.docx
 
Questions for Brief Explicit Spiritual.docx
Questions for Brief Explicit Spiritual.docxQuestions for Brief Explicit Spiritual.docx
Questions for Brief Explicit Spiritual.docx
 
Question Libya recently announced that it is claiming a.docx
Question Libya recently announced that it is claiming a.docxQuestion Libya recently announced that it is claiming a.docx
Question Libya recently announced that it is claiming a.docx
 
Question Use the Internet or the IGlobal Resource.docx
Question Use the Internet or the IGlobal Resource.docxQuestion Use the Internet or the IGlobal Resource.docx
Question Use the Internet or the IGlobal Resource.docx
 
Question Please define motivation and discuss why it is.docx
Question Please define motivation and discuss why it is.docxQuestion Please define motivation and discuss why it is.docx
Question Please define motivation and discuss why it is.docx
 
Question share your perspective on personal data as a.docx
Question share your perspective on personal data as a.docxQuestion share your perspective on personal data as a.docx
Question share your perspective on personal data as a.docx
 
QEP Assignment Death Penalty.docx
QEP Assignment Death Penalty.docxQEP Assignment Death Penalty.docx
QEP Assignment Death Penalty.docx
 
Question In your what are the main workforce.docx
Question In your what are the main workforce.docxQuestion In your what are the main workforce.docx
Question In your what are the main workforce.docx
 

Recently uploaded

Palestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptxPalestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptx
RaedMohamed3
 
The geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideasThe geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideas
GeoBlogs
 
Biological Screening of Herbal Drugs in detailed.
Biological Screening of Herbal Drugs in detailed.Biological Screening of Herbal Drugs in detailed.
Biological Screening of Herbal Drugs in detailed.
Ashokrao Mane college of Pharmacy Peth-Vadgaon
 
"Protectable subject matters, Protection in biotechnology, Protection of othe...
"Protectable subject matters, Protection in biotechnology, Protection of othe..."Protectable subject matters, Protection in biotechnology, Protection of othe...
"Protectable subject matters, Protection in biotechnology, Protection of othe...
SACHIN R KONDAGURI
 
Polish students' mobility in the Czech Republic
Polish students' mobility in the Czech RepublicPolish students' mobility in the Czech Republic
Polish students' mobility in the Czech Republic
Anna Sz.
 
1.4 modern child centered education - mahatma gandhi-2.pptx
1.4 modern child centered education - mahatma gandhi-2.pptx1.4 modern child centered education - mahatma gandhi-2.pptx
1.4 modern child centered education - mahatma gandhi-2.pptx
JosvitaDsouza2
 
The approach at University of Liverpool.pptx
The approach at University of Liverpool.pptxThe approach at University of Liverpool.pptx
The approach at University of Liverpool.pptx
Jisc
 
Chapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptxChapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptx
Mohd Adib Abd Muin, Senior Lecturer at Universiti Utara Malaysia
 
Acetabularia Information For Class 9 .docx
Acetabularia Information For Class 9  .docxAcetabularia Information For Class 9  .docx
Acetabularia Information For Class 9 .docx
vaibhavrinwa19
 
Embracing GenAI - A Strategic Imperative
Embracing GenAI - A Strategic ImperativeEmbracing GenAI - A Strategic Imperative
Embracing GenAI - A Strategic Imperative
Peter Windle
 
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
EugeneSaldivar
 
Language Across the Curriculm LAC B.Ed.
Language Across the  Curriculm LAC B.Ed.Language Across the  Curriculm LAC B.Ed.
Language Across the Curriculm LAC B.Ed.
Atul Kumar Singh
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
DeeptiGupta154
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
EverAndrsGuerraGuerr
 
Honest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptxHonest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptx
timhan337
 
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
Levi Shapiro
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
kaushalkr1407
 
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdfUnit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Thiyagu K
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
MysoreMuleSoftMeetup
 
The basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptxThe basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptx
heathfieldcps1
 

Recently uploaded (20)

Palestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptxPalestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptx
 
The geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideasThe geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideas
 
Biological Screening of Herbal Drugs in detailed.
Biological Screening of Herbal Drugs in detailed.Biological Screening of Herbal Drugs in detailed.
Biological Screening of Herbal Drugs in detailed.
 
"Protectable subject matters, Protection in biotechnology, Protection of othe...
"Protectable subject matters, Protection in biotechnology, Protection of othe..."Protectable subject matters, Protection in biotechnology, Protection of othe...
"Protectable subject matters, Protection in biotechnology, Protection of othe...
 
Polish students' mobility in the Czech Republic
Polish students' mobility in the Czech RepublicPolish students' mobility in the Czech Republic
Polish students' mobility in the Czech Republic
 
1.4 modern child centered education - mahatma gandhi-2.pptx
1.4 modern child centered education - mahatma gandhi-2.pptx1.4 modern child centered education - mahatma gandhi-2.pptx
1.4 modern child centered education - mahatma gandhi-2.pptx
 
The approach at University of Liverpool.pptx
The approach at University of Liverpool.pptxThe approach at University of Liverpool.pptx
The approach at University of Liverpool.pptx
 
Chapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptxChapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptx
 
Acetabularia Information For Class 9 .docx
Acetabularia Information For Class 9  .docxAcetabularia Information For Class 9  .docx
Acetabularia Information For Class 9 .docx
 
Embracing GenAI - A Strategic Imperative
Embracing GenAI - A Strategic ImperativeEmbracing GenAI - A Strategic Imperative
Embracing GenAI - A Strategic Imperative
 
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
 
Language Across the Curriculm LAC B.Ed.
Language Across the  Curriculm LAC B.Ed.Language Across the  Curriculm LAC B.Ed.
Language Across the Curriculm LAC B.Ed.
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
 
Honest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptxHonest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptx
 
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
 
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdfUnit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdf
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
 
The basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptxThe basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptx
 

Heart Failure Clinic Care Plan.docx

  • 1. Discussion: Heart Failure Clinic Care Plan Discussion: Heart Failure Clinic Care PlanORDER HERE FOR ORIGINAL, PLAGIARISM-FREE PAPERS ON Discussion: Heart Failure Clinic Care PlanAssessment InstructionsPREPARATIONRefer to the Capella library and the Internet for supplemental resources to help you complete this assessment.INSTRUCTIONSDeliverable: Develop an evidence-based plan for health care delivery.Scenario:The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients. Discussion: Heart Failure Clinic Care PlanAs a member of the nurse team, you have been asked to develop one component of the clinic.The hospital leadership established these objectives for the clinic services:Evaluate and maximize proper medication therapy.Conduct regular diet, exercise, and stress management classes for the patients.Monitor physiological indicators for the patients (lab work, weights, vital signs, ECGs).Provide a case management system for patients in the program post-discharge.The overall goals for the heart failure clinic are to:Enroll greater than 90 percent of the patients with a primary or secondary diagnosis of HF prior to discharge.Facilitate discharge planning to achieve 100 percent compliance with patient education prior to discharge (discharge planning).Decrease readmission rates in this population by 5 percent over the next year.The leadership team has asked you to provide them with an evidence-based plan for one of the components of the clinic. You may use any combination of documents (for example, a spreadsheet or a table) in addition to explanatory information to convey information clearly and succinctly.Develop one: an Orientation Course Plan, a Discharge Education Plan, or a Care Coordination Plan.An Orientation Course Plan:Develop an evidence-based plan for health care delivery.Include a comprehensive schedule of topics, objectives, key points, and patient resources for the orientation course.What are the components of an evidence-based
  • 2. education plan?How will you know that patients will understand what to do?What modalities will you use to deliver information?How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?Identify specialized and supplementary material needs.Apply professional and legal standards in support of a care plan.Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.Describe the accountability tools and procedures used to measure effectiveness.How will you know if the patient education plan is successful?What are the indicators of success or effectiveness?A Discharge Education Plan:Develop an evidence- based plan for health care delivery.Develop a discharge plan with objectives and resources, and tools for patients to monitor their progress.How will you know that patients understand what to do?What modalities will you use to deliver information?How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?Apply professional and legal standards in support of a care plan.Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.Describe accountability tools and procedures used to measure effectiveness.How will you know if the discharge plan is successful?What are the indicators of success or effectiveness?Care Coordination Plan:Develop an evidence-based plan for health care delivery.Develop a procedure for coordinating services.Consider the needs of “outliers.” For example, someone with lung disease may need extra resources.Who should be on the team?When would the team be activated?How would it be activated?What is the time frame required to coordinate services?How would the intervention plan be monitored for effectiveness?Apply professional standards in support of a care plan.Explain the alignment to the most recent heart failure guidelines and specific professional standards.Describe accountability tools and procedures used to measure effectiveness.How will you know if the care coordination plan is successful?What are the indicators of success or effectiveness?How will information be collected or communicated?ADDITIONAL REQUIREMENTSWritten communication: Written communication should be free of errors that detract from the overall message.APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.Length: The report should be 3-4 pages in content length, double-spaced.Font and font size: Times New Roman, 12 point.Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.Library ResourcesCapella MultimediaClick the links provided below to view the following multimedia pieces:Riverbend City: Insurance Issues Mission | Transcript.Leadership Styles | Transcript.Leadership, Theories, Models, and Styles | Transcript.The following resources are provided for you in the Capella University Library and are linked directly in this course. These articles contain content relevant to the topics and assessments that are the focus of this unit.Mensik, J. S. (2013). Nursing’s role and staffing in accountable care. Nursing Economics, 31(5), 250–253.Ganz, F. D., Wagner, N., & Toren, O. (2015). Nurse middle manager ethical dilemmas and moral distress. Nursing Ethics, 22(1), 43–51.Ott, J., & Ross, C. (2014). The journey toward shared governance: The lived experience of nurse managers and staff nurses. Journal of Nursing Management, 22(6), 761–768.Tait, G. R., Bates, J., LaDonna, K. A., Schulz, V. N., Strachan, P. H., McDougall, A., & Lingard, L. (2015). Adaptive practices in heart failure care teams: Implications for patient-
  • 3. centered care in the context of complexity. Journal of Multidisciplinary Healthcare, 8, 365– 376.Boyde, M., Song, S., Peters, R., Turner, C., Thompson, D. R., & Stewart, S. (2013). Pilot testing of a self-care education intervention for patients with heart failure. European Journal of Cardiovascular Nursing, 12(1), 39–46.Brennan, E. J. (2015). Heart failure care for patients who do not speak English. British Journal of Nursing, 24(20), 1004– 1008.Coordinating the medical home for heart failure patients; transitioning to palliative care: Adjusting locus of care and focusing on integrated medicine sheds light on best practices and patient-centered care in heart failure clinics. (2010, September 15). PR Newswire.Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart failure patients. British Journal of Community Nursing, 18(9), 441–445.Limpahan, L. P., Baier, R. R., Gravenstein, S., Liebmann, O., & Gardner, R. L. (2013). Closing the loop: Best practices for cross-setting communication at ED discharge. American Journal of Emergency Medicine, 31(9), 1297–1301.Lingle, C. L. (2013). Evidence based practice: Patient discharge education barriers to patient education(Master’s thesis). Available from ProQuest Dissertation Publishing. (UMI No. 1542582)Delaney, C., Apostolidis, B., Bartos, S., Morrison, H., Smith, L., & Fortinsky, R. (2013). A randomized trial of telemonitoring and self-care education in heart failure patients following home care discharge.Home Health Care Management and Practice, 25(5), 187–195.Wolfson, B. J., & Campbell, R. (2014, February 9). With Medicare watching, hospitals make changes: Orange County medical centers put new focus on discharge practices to reduce patient readmissions. Orange County Register.Berry, L. L., Rock, B. L., Houskamp, B. S., Brueggeman, J., & Tucker, L. (2013). Care coordination for patients with complex health profiles in inpatient and outpatient settings. Mayo Clinic Proceedings, 88(2), 184–194.Veenstra, W., op den Buijs, J., Pauws, S., Westerterp, M., & Nagelsmit, M. (2015). Clinical effects of an optimised care program with telehealth in heart failure patients in a community hospital in the Netherlands. Netherlands Heart Journal, 23(6), 334–340.Aller, M., Vargas, I., Coderch, J., Calero, S., Cots, F., Abizanda, M., … Vázquez, M. L. (2015). Development and testing of indicators to measure coordination of clinical information and management across levels of care. BMC Health Services Research, 15(323), 1–16.Course Library GuideA Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the BSN-FP4012 – Nursing Leadership and Management Library Guide to help direct your research.Internet ResourcesNational Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved from https://www.ncsbn.org/index.htmAmerican Nurses Association (ANA). (2015). Code of ethics for nurses. Retrieved from http://www.nursingworld.org/MainMenuCategories/Eth…Bookstore ResourcesThe resources listed below are relevant to the topics and assessments in this course. Unless noted otherwise, these materials are available for purchase from the Capella University Bookstore. When searching the bookstore, be sure to look for the Course ID with the specific –FP (FlexPath) course designation.Kelly, P., & Tazbir, J. (2014). Essentials of nursing leadership and management (3rd ed.). Clifton Park, NY: Delmar.Chapter 2.Chapters 11– 15.heart_failure_clinic_care_plan_scoring_guide.pdfleadership__theories__models_and_styles .pdfDiscussion: Heart Failure Clinic Care Plan