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NGR 5700 Decision Making Process Paper Example

NGR 5700 Decision-Making Process Paper – Assignment

NGR 5700 DBX-DL01: Decision Making Course

Florida National University

Course Information

Course Number: NGR 5700

Course Title: Decision Making

Course Credits: 3.0000

NGR 5700 Decision Making Process Paper Assignment Brief

Assignment Instructions Overview

This assignment requires students to craft a 6–8-page scholarly paper exploring a significant and relevant issue in nursing practice. The paper must compare and contrast three different decision-making approaches from a multidisciplinary perspective. Students must examine how various levels of nursing professionals—staff nurses, nurse leaders/managers, and nurse practitioners—would address the chosen issue using these decision-making frameworks. The topic selected should have an impact across all levels of nursing practice and must be approved by the course instructor prior to writing.

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The assignment must follow APA 7th edition formatting, with at least 10 scholarly references (excluding the textbook). The page count does not include the title page or reference list. Students should critically analyze and reflect on their personal decision-making style and identify a funding source applicable to the selected nursing issue.

Understanding Assignment Objectives

The primary objective of this paper is to develop and demonstrate an in-depth understanding of how different decision-making models influence nursing practice across all levels. Students are expected to:

Identify and describe a current, complex issue in nursing that has wide-reaching implications.

Compare and contrast decision-making approaches and analyze how they are applied by various nursing roles.

Evaluate the effectiveness, limitations, and real-world applicability of these approaches.

Reflect on personal decision-making philosophies and how these align with professional practice.

Identify potential funding sources that support initiatives related to the selected issue.

This assignment promotes critical thinking, multidisciplinary awareness, and scholarly writing, preparing students to engage in evidence-based decision-making in complex healthcare environments.

The Student’s Role

Students are expected to take a leadership-oriented, scholarly approach in the development of this paper. This includes:

• Conducting a comprehensive literature review on the selected issue.
• Applying critical reasoning to evaluate and synthesize decision-making frameworks.
• Understanding the nuanced differences in practice scope and authority among nurse leaders, staff nurses, and nurse practitioners.
• Demonstrating advanced communication through clear, coherent, and organized academic writing.
• Ensuring academic integrity by properly citing all sources using APA 7th edition guidelines.
• Engaging in self-reflection to articulate how decision-making models align with their professional values and practice style.

Competencies Measured

This assignment evaluates several graduate-level competencies essential for advanced nursing practice, including:

• Critical Thinking and Clinical Reasoning: Ability to analyze, interpret, and apply complex decision-making models to real-world nursing problems.
• Multidisciplinary Collaboration: Understanding how different nursing roles contribute uniquely to issue resolution using varied decision-making strategies.
• Leadership and Policy Awareness: Evaluation of leadership responsibilities and strategies in addressing systemic nursing issues.
• Professional Identity and Advocacy: Reflection on personal decision-making style and how it integrates with nursing ethics and leadership.
• Scholarly Communication: Proficiency in academic writing, organization, APA formatting, and use of scholarly references.
• Resource Utilization and Financial Literacy: Ability to identify and explain potential funding mechanisms to support practice change or innovation.

NGR 5700 Decision Making Process Paper Example

Introduction

The nursing shortage and high nurse turnover rates are pressing challenges that affect the entire healthcare system. These issues compromise patient safety, overburden existing staff, and reduce overall job satisfaction across all nursing roles. From bedside nurses to nurse managers and advanced practice registered nurses (APRNs), all levels of the profession are impacted. According to the American Association of Colleges of Nursing (AACN), the demand for registered nurses continues to exceed supply, a situation projected to intensify with an aging population and workforce (AACN, 2022). This paper explores various decision-making approaches used to tackle the nursing shortage and turnover, comparing how these strategies differ among staff nurses, nurse leaders, and nurse practitioners. It also includes a reflection on the decision-making model most aligned with personal and professional nursing philosophies, and identifies a potential funding source to support intervention.

Background and Significance

Nurse turnover and workforce shortages are global health issues with profound implications on care quality, healthcare costs, and staff morale. The U.S. Bureau of Labor Statistics (2023) projects over 203,000 openings for registered nurses each year through 2031, mainly due to retirements and the ongoing pandemic aftermath. High turnover is particularly prominent among early-career nurses, with studies reporting rates as high as 27% in the first year of employment (Kelly et al., 2021). The effects are widespread—bedside nurses face increased workloads, nurse leaders struggle to maintain safe staffing ratios, and nurse practitioners experience care delays due to insufficient support staff.

The significance of this issue spans all nursing levels. At the bedside, turnover causes burnout and moral distress, often leading to further resignations (Moss et al., 2022). For nurse managers, frequent departures disrupt team cohesion and continuity of care. APRNs are indirectly affected as they rely on support staff to execute comprehensive care plans efficiently. Addressing this issue requires collaborative and informed decision-making approaches tailored to each role within the healthcare system.

Decision-Making Models: Comparison and Contrast

Several decision-making models can be applied to tackle nurse turnover and shortages, including the Rational Decision-Making Model, Shared Decision-Making Model, and Transformational Leadership Model. Each offers unique benefits and limitations depending on the nursing role involved.

Rational Decision-Making Model

This model involves identifying a problem, gathering data, generating alternatives, evaluating options, choosing the best alternative, implementing it, and monitoring results (Bazerman & Moore, 2019). For nurse managers, this structured approach is ideal for evaluating staffing needs and budget constraints.

• Benefits: It provides a logical, evidence-based framework ideal for administrative decisions involving staffing projections and scheduling algorithms.
• Limitations: The model may not account for emotional or contextual variables such as morale or interprofessional dynamics, making it less useful for bedside nurses under acute stress.

Shared Decision-Making Model (SDM)

The SDM model emphasizes collaboration among stakeholders, incorporating diverse perspectives to reach consensus (Elwyn et al., 2017). Bedside nurses often engage in this model informally, using unit-based councils or staff committees.

• Benefits: It promotes engagement, empowerment, and job satisfaction—key factors in reducing turnover.
• Limitations: The process can be time-consuming and less efficient in urgent staffing crises.

Transformational Leadership Model

Transformational leaders inspire and motivate through vision, individualized consideration, intellectual stimulation, and role modeling (Avolio & Bass, 2004). Nurse practitioners and nurse leaders often adopt this model to foster a positive work culture.

• Benefits: Encourages innovation and morale, aligning with long-term retention goals.
• Limitations: Relies heavily on the leader’s charisma and may not yield immediate, measurable results.

Role-Specific Application of Decision-Making Approaches

Staff Nurse (Bedside)

Bedside nurses deal with the immediate impact of shortages. Their decision-making is often reactive, focused on prioritizing care under pressure. The Shared Decision-Making Model is particularly suitable here, as it involves nurses in discussions about staffing policies, workload balance, and care delivery.

For instance, a hospital with a nurse-led staffing committee that meets monthly to propose solutions can increase retention by allowing bedside nurses to voice concerns and implement changes (Sharma & Rani, 2021).

Nurse Leader/Manager

Nurse managers often rely on the Rational Decision-Making Model. They assess turnover metrics, absenteeism, overtime rates, and productivity data to plan recruitment and retention interventions. For example, they may implement flexible scheduling software after conducting a cost-benefit analysis, balancing staff needs with organizational limitations (Lasater et al., 2021).

Nurse Practitioner (NP)

NPs operate between direct care and leadership, often using a Transformational Leadership Model. As clinical leaders and mentors, they are in a unique position to inspire staff. For example, they may introduce evidence-based practices such as mindfulness sessions or peer-support programs to combat burnout (Wei et al., 2020). Their decisions often blend clinical insight with system-level awareness.

Personal Philosophy and Preferred Decision-Making Approach

As a nursing professional, the Shared Decision-Making Model best aligns with my personal and professional philosophy, which centers on collaboration, mutual respect, and empowerment. I believe effective decisions emerge when all stakeholders are included, especially those directly impacted. Nurses at all levels bring valuable experiential knowledge that can guide practical and sustainable interventions.

In addressing the nursing shortage, this model allows for transparent communication, decentralized leadership, and greater accountability. For instance, involving frontline nurses in discussions about staffing ratios or mental health initiatives ensures that implemented changes are both feasible and well-received. This participatory approach not only improves decision quality but also promotes a culture of trust and shared ownership.

Potential Funding Source

Addressing the nursing shortage requires financial resources for recruitment campaigns, mental health support, retention bonuses, and leadership development programs. One suitable funding source is the Health Resources and Services Administration (HRSA), specifically its Nurse Corps Scholarship Program and Nursing Workforce Diversity (NWD) Grants.

The NWD grant supports educational institutions and healthcare facilities aiming to diversify and expand the nursing workforce. It funds initiatives that promote recruitment and retention of nurses from underserved areas, including mentorship and wellness programs (HRSA, 2024). Facilities could apply for HRSA grants to support resilience training, peer mentoring, and flexible staffing initiatives—all of which reduce turnover.

Another relevant source is the Centers for Medicare & Medicaid Services (CMS) Innovation Center, which funds pilot programs that improve care delivery and workforce outcomes. For example, a nurse-led staffing model aimed at reducing burnout could be submitted as an innovation proposal.

These funding sources align with the national agenda to stabilize and strengthen the nursing workforce, offering financial backing for programs that directly address the chosen topic.

Conclusion

The nursing shortage and high turnover rates are complex issues requiring strategic, evidence-based, and inclusive decision-making. By comparing and applying decision-making models across bedside nurses, nurse leaders, and nurse practitioners, we can appreciate the importance of context, role, and philosophy in shaping decisions. The Shared Decision-Making Model emerges as the most suitable for fostering collaboration and sustainable change. With support from funding bodies like HRSA and CMS, these efforts can be amplified to retain and empower a resilient nursing workforce.

References

American Association of Colleges of Nursing (AACN). (2022). Nursing shortage factsheet. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage

Avolio, B. J., & Bass, B. M. (2004). Multifactor leadership questionnaire: Manual and sampler set (3rd ed.). Mind Garden, Inc.

Bazerman, M. H., & Moore, D. A. (2019). Judgment in managerial decision making (8th ed.). Wiley.

Bureau of Labor Statistics. (2023). Occupational outlook handbook: Registered nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., … & Barry, M. (2017). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 32(6), 675–682. https://doi.org/10.1007/s11606-017-4030-6

Health Resources and Services Administration (HRSA). (2024). Nursing workforce diversity program. https://bhw.hrsa.gov/funding/nursing-workforce-diversity

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96-102. https://doi.org/10.1016/j.outlook.2020.06.008

Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Martin, B., Reneau, K., … & McHugh, M. D. (2021). Chronic hospital nurse understaffing meets COVID-19: An observational study. BMJ Quality & Safety, 30(8), 639-647. https://doi.org/10.1136/bmjqs-2020-011512

Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2022). A critical care societies collaborative statement: Burnout syndrome in critical care health-care professionals. Chest, 161(2), 513-525. https://doi.org/10.1016/j.chest.2021.08.054

Sharma, P., & Rani, R. (2021). Shared decision making and job satisfaction among nurses. International Journal of Nursing Studies, 117, 103882. https://doi.org/10.1016/j.ijnurstu.2021.103882

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2020). Nurse leaders’ strategies to foster nurse resilience. Nursing Management, 51(1), 42-49. https://doi.org/10.1097/01.NUMA.0000610614.58068.93

Detailed Assessment Instructions for the NGR 5700 Decision Making Process Paper Assignment

Decision-Making Process Paper

Instructions

In this assignment, you will be writing a 6–8-page paper identifying, comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing (examples might include nursing shortage and nurse turn- over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation or another current and relevant nursing issue) the topic MUST BE APPROVED by your nursing instructor before writing the paper. . You are required to use APA 7th edition format and the page count does not include title page or reference page. Reflect on your own decision-making practices and the implications this will have regarding differing approaches taken of nursing leaders and staff nurses/clinical practitioners in decision making within to issues in practice. To complete this assignment, do the following:

1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature.
2. Compares and contrast how you would expect a nurse leader/manager, a bedside/staff nurse and a nurse practitioner to address your selected issue using various decision-making approaches. There must be a detailed analysis of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Identify the decision-making approach or approaches that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal inquiry style. How would it help to address your chosen topic if not mentioned or applied in the above description.
4. Identify a possible funding source that addresses your topic. Consider looking at federal, state, and local organizations. For example: There are many grants available through the CDC, HRSA, etc. Again, this need to be specifically applied with sufficient details
5. Use at least 10 references other than your main text. Uses APA 7th edition formatting

CRITERION	STRONG	AVERAGE	WEAK
Identification and description of an issue in nursing that impacts all levels of nursing practice from bedside to advanced practice with a good background and significance (21 pts)	15-21 pts   Identifies, describes and demonstrates a sophisticated understanding of the nursing issue as it relates to all levels of nursing practice with a specific and strong background and significance to nursing	8-14 pts   Identifies, describes and demonstrates an acceptable understanding of the nursing issue as it relates to all levels of nursing practice illustrating some but not explicit background and significance of the topic to nursing	0-7 pts   Identifies, describes and demonstrates an incomplete and vague understanding of the nursing issue as it relates to all levels of nursing practice with a vague and unclear background and significance
Compare and contrast various types of decision-making models that could be utilized to enhance knowledge about your topic (21 pts)	15-21 pts   Presents an insightful and thorough analysis of various decision- making approaches with good comparing and contrasting of the various limitations and benefits of each of the decision-making approaches that specifically addresses the identified problem/topic.	8-14 pts   Presents a somewhat thorough analysis of various decision-making approaches with a somewhat good comparing and contrasting of the various limitations and benefits of each of the decision-making approaches that somewhat but not specific in addressing the identified problem/topic	0-7 pts   Little to no analysis of. various decision- making approaches with a limited and vague comparing and contrasting of the various limitations and benefits of each of the decision-making approaches that is vague and limited in addressing the identified problem/topic
Appropriate and clear application of the selected decision- making approaches from the perspective of a bedside/staff	15-21 pts   Presents an insightful and thorough application of selected decision-making	8-14 pts   Presents a somewhat insightful but not thorough application of selected decision-	0-7 pts   Limited and vague application of selected decision-making approaches from the

 

nurse, nurse leader/manager and nurse practitioner that is realistic and appropriate to the level of nursing practice, the problem and the decision- making approach (21 pts)	approaches from the perspective of 3 levels of nursing practice that is realistic and specific to the level of nursing practice, the decision- making model and the identified problem.	making approaches from the perspective of 2-3 levels of nursing practice that is somewhat realistic but not all together specific to the level of nursing practice, the decision- making model and/or the identified problem.	perspective of less than 2 levels of nursing practice that is unrealistic and vague to the level of nursing practice, the decision making model and/or the identified problem
Identify the decision- making approach or approaches that best fits your personal and professional philosophy of nursing and how would it help to address your chosen topic. (21pts)	15-21 pts   Sophisticated explanation of personal decision-making approach that fits with professional philosophy of nursing. Excellent description of how this decision-making model/theory will address your chosen topic.	8-14 pts   Appropriate explanation of personal decision- making approach that fits with professional philosophy of nursing. Excellent description of how this decision- making model/theory will address your chosen topic.	0-7 pts   Limited explanation of personal decision- making approach that fits with professional philosophy of nursing. Excellent description of how this decision- making model/theory will address your chosen topic.
Identify a possible funding source that addresses your topic (18 pts)	13-18- pts   Integrated and full descriptions of an appropriate funding source that addresses your chosen topic. The description includes real-world examples of fundings sources that include federal, state, and local organizations	7-12 pts   Somewhat integrated but not full description of an appropriate funding source that addresses your chosen topic. The description includes real-world examples of fundings sources but limited with either federal and state or local organizations	0-6 pts   Limited to no description of an appropriate funding source that addresses your chosen topic. The description includes a less than real-world example of only a limited scope of funding and only includes one type of funding either state or federal or local organization.
Writing Mechanics:	13-18- pts	7-12 pts	0-6 pts

 

Language and direction of the paper follows the assignment outline and is clear and easy to follow. (18 pts)	Demonstrates clarity, conciseness and correctness; writing is free of grammar and spelling errors. The assignment outline was followed and guides the paper content appropriately	Somewhat concise and clear grammar and spelling used. Guidelines was mostly used to guide the paper content. Some spelling and grammar issues (less than 3-4 errors within paper)	Many deficiencies in   grammar, spelling, or failure to follow the assignment guidelines. Writing has frequent spelling and grammar errors
APA formatting (paper is formatted per APA 7th edition guidelines including font, level of headings, appropriate number of references, in-text and reference list citations) (18 pts)	13-18- pts   APA formatting is followed throughout the paper with correct citations and includes at least 10 scholarly references that are correctly APA 7th ed. citations.	7-12 pts   APA formatting is mostly followed throughout the paper with mostly correct citations with at least 8 to 9 scholarly references but not required 10 and/or 2-3 incorrect APA 7th ed. referencing or formatting	0-6 pts   Multiple errors in APA formatting throughout the paper identified. Fewer than 8 scholarly references provided in the paper and/or > 3 to 4 errors in APA 7th ed referencing and formatting.
Total: 138 pts

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NGR 5700 Shared Decision Making Paper Assignment Example

NGR 5700 – Shared Decision-Making Paper Assignment

NGR 5700 DBX-DL01: Decision Making Course

Florida National University

Course Information

Course Number: NGR 5700

Course Title: Decision Making

Course Credits: 3.0000

NGR 5700 Shared Decision Making Paper Assignment Brief

Assignment Instructions Overview

This written assignment requires students to explore the implementation of Shared Decision-Making (SDM) as a routine practice in a chosen healthcare setting, such as a clinic or hospital. The paper must be 6–8 pages in length (excluding the title and reference pages) and follow APA 7th edition formatting. A minimum of 8–10 scholarly references (outside of course readings) is required. Students will compare and contrast at least two SDM models, identify a preferred model for implementation, and detail strategies for integration at organizational, professional, and personal levels. The submission must be in Word format only and must comply with SafeAssign similarity index guidelines (<20%).

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Understanding Assignment Objectives

This assignment aims to deepen your understanding of SDM and its essential role in enhancing patient-provider collaboration. The paper will assess your ability to:

• Describe the significance of SDM in clinical decision-making.
• Evaluate and compare two SDM models.
• Propose implementation strategies specific to your healthcare setting.
• Identify the resources, tools, and staff training needs.
• Address potential challenges and benefits of SDM integration.
• Demonstrate scholarly writing, organization, and APA proficiency.

The Student’s Role

As a graduate nursing student and emerging advanced practice nurse (APN), you are expected to critically appraise SDM theory and apply it to a real-world clinical context. Your role includes:

• Independently researching evidence-based SDM frameworks.
• Using your clinical judgment to tailor SDM models to a practice setting.
• Designing strategic approaches for implementation and training.
• Engaging in reflective analysis of barriers and enablers to SDM adoption.
• Writing a unique, plagiarism-free paper that clearly communicates your ideas.

Competencies Measured

This assignment assesses the following advanced nursing competencies:

• Leadership in systems-based practice through proposing organizational-level changes.
• Evidence-based practice by integrating the latest literature on SDM.
• Collaboration and communication in multidisciplinary care planning.
• Clinical decision-making supported by patient-centered models.
• Professional accountability and advocacy through ethical patient engagement.

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NGR 5700 Shared Decision Making Paper Assignment Example

Introduction

Shared decision-making (SDM) is a collaborative process that allows healthcare providers and patients to make health-related decisions together, integrating clinical evidence and patient preferences. In the context of a hospital surgical unit, where patients often face complex choices regarding surgical interventions, the use of SDM is crucial for promoting informed consent, enhancing patient satisfaction, and improving outcomes. Advanced Practice Nurses (APNs) play a vital role in implementing SDM, acting as patient advocates and clinical leaders. This paper explores the significance of SDM in surgical care, compares two leading SDM models, and outlines a comprehensive strategy to integrate SDM at organizational, professional, and personal levels. It also highlights tools, training resources, challenges, and benefits, offering an evidence-based roadmap to strengthen patient-centered care within surgical settings.

Background and Significance of Shared Decision-Making in Healthcare

SDM represents a paradigm shift from the traditional, paternalistic model of care to one that values and incorporates the patient’s voice in clinical decisions. This approach is especially pertinent in surgical units, where patients may be presented with multiple treatment options, each carrying different risks and benefits. Research shows that SDM leads to better alignment between chosen treatments and patients’ values, which subsequently enhances trust, adherence to treatment, and overall satisfaction with care (Stacey et al., 2017).

From the provider’s perspective, SDM fosters meaningful engagement, reduces decisional conflict, and strengthens the therapeutic alliance (Elwyn et al., 2012). For APNs, SDM is a practice-aligned responsibility that intersects with core competencies such as patient education, advocacy, evidence-based practice, and ethical decision-making (American Association of Nurse Practitioners [AANP], 2020).

The importance of SDM is further emphasized in national healthcare policies and standards. The Institute of Medicine advocates for SDM as a critical element of high-quality care (IOM, 2011), while the Agency for Healthcare Research and Quality (AHRQ) promotes its integration across clinical settings. In surgical environments, where high-stakes decisions are common, SDM ensures that patients are not only informed but also actively involved in choosing interventions that align with their values and goals.

Overview and Comparison of Two Shared Decision-Making Models

The Three-Talk Model

The Three-Talk Model, developed by Elwyn et al. (2017), structures the SDM conversation into three phases: team talk, option talk, and decision talk. This model begins with “team talk,” where clinicians invite the patient to be part of the decision-making process. “Option talk” involves the clinician presenting treatment options using clear, balanced information. Lastly, “decision talk” is the collaborative stage where the provider supports the patient in exploring preferences and making a decision.

This model is particularly useful in time-sensitive environments like surgical units because it is concise, adaptable, and easy to implement during pre-operative consultations. It supports active listening and transparency while maintaining the clinical efficiency often required in hospitals.

The SHARE Approach

Developed by the AHRQ, the SHARE Approach is a five-step process: Seek your patient’s participation, Help your patient explore and compare treatment options, Assess your patient’s values and preferences, Reach a decision with your patient, and Evaluate the decision (AHRQ, 2014). Unlike the Three-Talk Model, the SHARE Approach offers a more detailed and structured framework, including tools for documentation, patient education, and decision aids.

This model is best suited for comprehensive, multidisciplinary discussions involving complex or chronic surgical cases. It allows for greater depth in value clarification and can be extended across multiple encounters. However, it may be time-consuming and less suitable for fast-paced surgical assessments.

Comparison and Suitability for Surgical Units

Both models support the principles of patient-centered care, but their structure and focus differ. The Three-Talk Model is streamlined and pragmatic, aligning well with the high-pressure environment of surgical units. It ensures patients are heard without overwhelming the provider with additional procedural steps. In contrast, the SHARE Approach is ideal for elective or non-urgent surgeries, where time permits deeper value exploration.

Given the urgent and procedural nature of hospital surgical units, the Three-Talk Model emerges as the most practical and effective approach for implementation. It aligns with the workflow, accommodates provider constraints, and fosters meaningful patient engagement without disrupting clinical operations.

Implementation of SDM in the Hospital Surgical Unit

Organizational Level

At the organizational level, implementing SDM requires leadership commitment, policy development, and integration into clinical pathways. Hospital administration must prioritize SDM in strategic goals and allocate resources for training, tools, and staffing. Policies should mandate SDM discussions before all surgical procedures, embedded within electronic health records (EHRs) for documentation and quality tracking (Barry & Edgman-Levitan, 2012).

Standardized protocols for informed consent should be updated to include SDM principles, ensuring patients are presented with multiple treatment options and associated outcomes. Multidisciplinary teams—including surgeons, APNs, anesthetists, and patient educators—should collaborate to implement SDM as part of routine preoperative care.

Professional Level

On the professional level, surgeons and APNs need skill development in communication, cultural competency, and evidence presentation. Training programs should include role-playing, workshops, and use of validated decision aids. Continuing education credits can incentivize participation. Interprofessional collaboration must be encouraged to ensure that SDM is not seen as a sole responsibility of the nurse or surgeon but as a shared task across the care team.

APNs, in particular, should take the lead in coordinating SDM conversations, providing patients with reliable information, and clarifying any doubts prior to surgery. Their holistic approach and longer interaction time with patients make them ideal SDM facilitators.

Personal Level

At a personal level, healthcare providers must embrace a mindset shift from being authoritative decision-makers to facilitators of patient choices. Reflective practice, feedback sessions, and peer review can help clinicians evaluate and improve their SDM conversations. Providers must also remain aware of their biases, ensuring that their recommendations are balanced and not coercive.

Personal accountability includes ensuring that every surgical consultation respects patient autonomy and actively seeks their input. For APNs, personal strategies such as using SDM checklists, attending reflective practice groups, and engaging in peer mentoring can reinforce these behaviors.

Tools, Resources, and Patient Engagement Strategies

To ensure successful SDM integration, both staff and patients require appropriate tools and resources. Decision aids are essential, especially in surgical contexts. These include brochures, videos, online platforms, and printed option grids that outline surgical choices, risks, recovery timelines, and alternative therapies (O’Connor et al., 2009).

EHR templates should prompt providers to record SDM discussions and patient preferences. Visual aids and risk communication tools, such as pictographs or risk calculators, can help patients understand statistical information.

Patient engagement is enhanced through structured pre-operative education sessions led by APNs. These sessions can be group-based or individual and should be culturally sensitive and linguistically appropriate. Offering patients printed questions to bring to consultations encourages active participation.

Training for providers must cover the use of these tools, supported by simulation-based learning, e-learning modules, and mentorship programs. These ensure consistent practice and confidence in facilitating SDM.

Strategies to Build Competency Among APNs and Providers

Competency development should begin with formal SDM training included in APN orientation and ongoing professional development. Key strategies include:

• Simulation-based learning: Role-play scenarios with standardized patients improve communication skills.
• Workshops and seminars: Regular educational sessions provide evidence-based updates and practical guidance.
• Peer mentoring: Pairing experienced APNs with novices helps reinforce SDM in real-time settings.
• Audit and feedback: Reviewing SDM documentation in EHRs and providing feedback helps refine practice.
• Online modules: Self-paced programs accommodate busy schedules and ensure theoretical understanding.

APNs should also be involved in research and quality improvement initiatives related to SDM, promoting a culture of inquiry and evidence-based practice. Certification programs and credentialing that recognize SDM competency can further validate these skills.

Challenges and Benefits of Implementing SDM

Challenges

Despite its benefits, implementing SDM in surgical units presents several challenges. These include:

• Time constraints: Surgical consultations are often brief, making it difficult to engage in extended discussions.
• Provider resistance: Some clinicians may be skeptical of SDM, perceiving it as undermining clinical authority.
• Lack of training: Many providers lack formal education in SDM techniques.
• Documentation issues: Integrating SDM into EHRs without adding to administrative burden is challenging.
• Patient variability: Patients differ in their desire and ability to participate, requiring personalized approaches.

Benefits

Conversely, the benefits are significant:

• Enhanced patient satisfaction: Patients feel heard and respected, increasing trust.
• Improved outcomes: Engaged patients are more likely to adhere to postoperative instructions and report better recovery experiences.
• Reduced decisional regret: Patients who participate in decisions are less likely to experience regret or dissatisfaction.
• Professional growth: APNs develop advanced communication and leadership skills.
• Compliance with standards: SDM supports ethical practice, accreditation requirements, and legal standards for informed consent.

Conclusion

Shared decision-making is a vital practice innovation that enhances surgical care delivery by aligning treatments with patient values and preferences. This paper has explored the importance of SDM, compared two leading models, and proposed a comprehensive strategy to implement the Three-Talk Model within a hospital surgical unit. Implementation at the organizational, professional, and personal levels, supported by tools, training, and ongoing reflection, ensures the sustainability of this patient-centered approach. Though challenges exist, the benefits to both patients and providers make SDM an essential standard of care in modern surgical practice.

References

Agency for Healthcare Research and Quality. (2014). The SHARE approach: A model for shared decisionmaking. https://www.ahrq.gov/health-literacy/professional-training/shared-decision/index.html

American Association of Nurse Practitioners. (2020). Standards of practice for nurse practitioners. https://www.aanp.org/practice/clinical-resources/standards-of-practice

Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780–781. https://doi.org/10.1056/NEJMp1109283

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., … & Barry, M. (2012). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6

Elwyn, G., Durand, M. A., Song, J., Aarts, J., Barr, P. J., Berger, Z., … & Frosch, D. L. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891. https://doi.org/10.1136/bmj.j4891

Institute of Medicine (US). (2011). Crossing the quality chasm: A new health system for the 21st century. National Academies Press.

O’Connor, A. M., Bennett, C. L., Stacey, D., Barry, M., Col, N. F., Eden, K. B., … & Thomson, R. (2009). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, 3(3), CD001431. https://doi.org/10.1002/14651858.CD001431.pub2

Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., … & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, 4, CD001431. https://doi.org/10.1002/14651858.CD001431.pub5

Detailed Assessment Instructions for the NGR 5700   Shared Decision Making Paper Assignment

Shared Decision-Making Paper Assignment

The assignment will require you to write a 6-8 page paper formatted using APA 7th edition (this does not include the title or references page). Be sure to review the grading rubric and criteria for the assignment carefully and to include all aspects that are required as part of the assignment grade. It should go without saying that NO two papers should look the same, meaning that the choice of implementation strategies, selection of SDM , the patient and population and specific strategies are unique in every paper AND those papers submitted with numerous similarities will be looked at closely and closely reviewed for any evidence of academic. Students these and all paper assignments need to be original with your own ideas and your individual search of sources and literature to support the paper proposal. Remember the paper must be submitted in a Word formatted APA 7th edition format failure to submit or to submit as a PDF will be returned ungraded. Pay attention when submitting the assignment to SafeAssign that the similarity index is not higher or close to 20% per the Syllabus guidelines.

As an APN working as part of a team, you have been asked by your director to adopt a shared decision-making approach to be used as part of routine practice in your healthcare organization (you may choose if this is a hospital or a clinic setting). This involves describing how shared decision making is implemented from an organizational, professional and personal level to improve the care of patients. What processes are required to implement a successful shared decision-making approach to the current practice environment? Part of this involves determining which SDM of care would be best suited to the selected practice environment and patient population (you are required to describe in- depth at least two different models of SDM comparing and contrasting the two and linking the choice of which model would be best for your practice setting; make sure the description of the practice setting and patients in included in the paper). What is the purpose of SDM, how does it impact patient and provider care? How does SDM help the APN to make decisions in patient care? How does the adoption of the SDM model of care meet the standards of practice for APN/NP?

What resources and training needs would be required both by staff and patients to ensure comprehensive integration of this type of decision making into practice (this needs to be a detailed discussion about specific patient tools and approaches). Additionally, describe specific and detailed strategies that would be implemented to build competency among the APN and provider staff that facilitates adoption of this method. Identify key challenges that you may face in implementing this into the care setting and key benefits to integrating a SDM into care.

Must contain a minimum of 8-10 references not found in your course readings, introduction, summary and be APA formatted.

CRITERION	STRONG	AVERAGE	WEAK
Introduce the overall concepts that will be described in the paper (10 pts)	7-10 pts   Clear and concise introduction of the concepts to be presented in the paper	4-6 pts   Mostly clear but somewhat generic introduction of the concepts to presented in the paper	0-3 pts   Vague, unclear or no introduction of concepts to be presented in the paper
A detailed description of the background and significance of SDM in healthcare and ways it impacts patient and provider care (APN in particular but all levels of care). Description of how	15-21 pts   Detailed and specific background and significance of SDM in healthcare and how it impacts patient and provider clear is thorough and evident. Clear link and description of how the	8-14 pts   Mostly clear but somewhat vague background and significance of SDM in healthcare provided and how it impacts patient and provider is somewhat clear but not specifically evident.	0-7 pts   Vague, unclear, or failure to provide background and significance of SDM in healthcare and how it impacts patient and provider is not clearly evident. Vague or unclear description of

 

SDM meets APN/NP practice standards is described. (21 pts)	SDM meets APN/NP practice standards is described.	Somewhat clear description of how the SDM meets APN/NP practice standards is somewhat described.	how the SDM meets APN/NP practice standards is vaguely or not described.
Detailed description of the processes involved in implementing a shared decision making (SDM) at the organizational, professional and personal level as a way to improve the care of patients. (21 pts)	15-21 pts   Detailed and specific description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is evident.	8-14 pts   Mostly clear but somewhat vague description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is somewhat evident.	0-7 pts   Vague and unclear description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is vague and not clearly evident.
Compare and contrast at least 2 different SDM models of care with the identification of the SDM that would work best in the current practice environment. (21 pts)	15-21 pts   Excellent, specific and detailed comparison and contrast of at least 2 different SDM models with details of how it is used in various practice settings. One of the two described models is prioritized for the selected practice setting and population that serves to clearly link the model with the population.	8-14 pts   Mostly clear but somewhat vague comparison and contrast of at least 2 different SDM models with details of how it is used in various practice settings. One of the two described models is prioritized for the selected practice setting and population that serves to clearly link the model with the population.	0-7 pts   Vague and unclear comparison and contrast of 2 or less SDM models with details of how it is used in various practice settings. One of the two described models may be or is not prioritized for the selected practice setting and population that serves to vaguely or fails to link the model with the population.
Describe and apply resources and tools that will be used to implement SDM models for the selected patient and	15-21 pts   Excellent, detailed and specific description of tools and resources needed to implement the selected SDM model	8-14 pts   Mostly clear but somewhat vague description of tools and resources needed to implement the selected	0-7 pts   Vague and unclear description of tools and resources needed to implement the selected SDM model for the

 

population. Provide	for the select patient	SDM model for the	select patient
sufficient link	population. Strong and	select patient population.	population. Vague
between the tools	clear link is provided	Somewhat strong and	and/or unclear link is
and resources, the	between the tools &	mostly clear link is	provided between the
SDM model chosen	resources, the SDM	provided between the	tools & resources, the
and the patient	model and the patient	tools & resources, the	SDM model and the
population. What will	population. The process	SDM model and the	patient population. The
this process look	is well outlined with	patient population. The	process is either not or
like; justify and	excellent rationale for	process is outlined with	vaguely outlined with
provide the rationale	choice of identified	some rationale for choice	little rationale for choice
for choice of	resources.	of identified resources.	of identified resources.
identified resources.
(21 pts)
Describe strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method (21 pts)	15-21 pts   Describe specific and detailed strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is well informed and realistic to the population and care setting.	8-14 pts   Mostly clear but somewhat vague strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is somewhat clear but not exactly realistic to the population and care setting.	0-7 pts   Vague and unclear strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is missing, unclear or extremely vague and not realistic to the population and care setting.
Identify key challenges and benefits that might be encountered when implementing a SDM into the practice setting at the organization, professional and personal levels of care. (21 pts)	15-21 pts   Identifies and specifically outlines the challenges and benefits that might been countered when implementing the selected SDM model in the practice setting at the organizational, professional and personal levels of care.	8-14 pts   Identifies and somewhat specifically outlines the challenges and benefits that might be encountered when implementing the selected SDM model in the practice setting at the organizational, professional and personal levels of care.	0-7 pts   Vague and unclear outlines the challenges and benefits that might be encountered when implementing the selected SDM model in practice setting at the organizational, professional and personal levels of care.

 

Summary – summarize the key points made throughout the paper is a comprehensive manner (10 pts)	7-10 pts   Summarizes the key points made throughout the paper in a succinct but comprehensive manner	4-6 pts   Somewhat summarizes the key points made throughout the paper in a mostly clear but not entirely comprehensive manner	0-3 pts   Vague and unclear summary of the key points made throughout the paper that is not succinct or comprehensive.
Writing Mechanics: Language and direction of the paper follows the assignment outline and is clear and easy to follow. (18 pts)	13-18- pts Demonstrates clarity, conciseness and correctness; writing is free of grammar and spelling errors. The assignment outline was followed and guides the paper content appropriately	7-12 pts   Somewhat concise and clear grammar and spelling used. Guidelines was mostly used to guide the paper content. Some spelling and grammar issues (less than 3-4 errors within paper)	0-6 pts   Many deficiencies in   grammar, spelling, or failure to follow the assignment guidelines. Writing has frequent spelling and grammar errors
APA formatting (paper is formatted per APA 7th edition guidelines including font, level of headings, appropriate number of references, in-text and reference list citations) (18 pts)	13-18- pts   APA formatting is followed throughout the paper with correct citations and includes at least 10 scholarly references that are correctly APA 7th ed. citations.	7-12 pts   APA formatting is mostly followed throughout the paper with mostly correct citations with at least 8 to 9 scholarly references but not required 10 and/or 2-3 incorrect APA 7th ed. referencing or formatting	0-6 pts   Multiple errors in APA formatting throughout the paper identified. Fewer than 8 scholarly references provided in the paper and/or > 3 to 4 errors in APA 7th ed referencing and formatting.
Total: 182 pts

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NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators

Capella NURS FPX 4040 Assessment 4: Informatics and Nursing-Sensitive Quality Indicators

Assignment Brief: NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators

Course: NURS FPX 4040 Managing Health Information and Technology

Assignment Title: Assessment Informatics and Nursing Sensitive Quality Indicators

Assignment Overview:

This assignment aims to deepen your understanding of informatics and its role in Nursing Sensitive Quality Indicators (NSQIs). Focusing on the National Database of Nursing Quality Indicators (NDNQI) framework, you will explore the significance of nursing-sensitive indicators, their impact on patient outcomes, and the integration of informatics to enhance nursing care.

Understanding Assignment Objectives:

This assignment aims to enhance your comprehension of nursing-sensitive quality indicators, emphasizing the role of informatics in optimizing patient care outcomes. You will explore theoretical frameworks, legal considerations, and the practical application of technology in healthcare settings.

The Student’s Role:

As a student, your role is to engage critically with the NDNQI framework, select a specific nursing-sensitive quality indicator, and analyze its implications for patient care and organizational performance. Investigate the challenges faced by nurses and the potential benefits of informatics in addressing these challenges. Additionally, explore the legal and ethical responsibilities associated with accurate data reporting.

Detailed Assessment Instructions for the NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Assignment

Prepare an 4-5 page paper on the importance of nursing-sensitive quality indicators.

As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality healthcare delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.

The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.

 

NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove, Gray, Jay, Jay, & Burns, 2015).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

The focus of Assessment 4 is on how informatics supports the monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high-quality results.

Reference

Grove, S. K., Gray, J. R., Jay, G.W., Jay, H. M., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). St. Louis, MO: Elsevier.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.

Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.

Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.

Deliver a professional and effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

Follow APA style and formatting guidelines for citations and references.

Preparation

This assessment requires you to prepare a 4-5 page paper on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system.

Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.

Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:

What is your experience with collecting data and entering it into a database?

What challenges have you experienced?

How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?

What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process

Instructions

For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

You determine that you will cover the following topics in your audio tutorial script:

Introduction: Nursing-Sensitive Quality Indicator

What is the NDNQI®?

What are nursing-sensitive quality indicators?

Which particular quality indicator did you select to address in your tutorial?

Why is this quality indicator important to monitor?

Be sure to address the impact of this indicator on quality of care and patient safety.

Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

Collection and Distribution of Quality Indicator Data

According to your interview and other resources, how does your organization collect data on this quality indicator?

How does the organization disseminate aggregate data?

What role do nurses play in supporting accurate reporting and high-quality results?

As an example, consider the importance of accurately entering data regarding nursing interventions.

Additional Requirements

References: Cite a minimum of three scholarly and/or authoritative sources.

APA: Submit along with the recording a separate Reference page that follows APA style and formatting guidelines. For an APA refresher, consult the APA Style and Formatpage on Campus.

NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Example

Introduction

Welcome to this comprehensive tutorial on Nursing Informatics and Nursing-Sensitive Quality Indicators. I’m [Your Name], and in this session, we’ll explore why nursing-sensitive quality indicators are crucial, focusing on patient safety, quality care outcomes, and the essential role of health informatics. Let’s dig into the dynamic relationship between healthcare structures, processes, and outcomes, emphasizing the importance of evidence-based practice and technology in nursing.

Nursing-Sensitive Quality Indicators: A Foundation for Quality Care

Nursing-sensitive quality indicators, as defined by the American Nursing Association (ANA), are crucial measures reflecting the quality of organizational structures, processes, and outcomes in nursing care. These indicators play a vital role in enhancing patient safety and satisfaction while influencing organizational performance. For our tutorial, we will spotlight the nursing-sensitive quality indicator of patient falls.

Importance of Patient Falls as a Quality Indicator

Patient falls are a significant quality indicator due to their impact on patient safety and healthcare outcomes. According to the ANA, patient falls can lead to severe consequences, including extended hospitalization, physical injuries, and, in severe cases, fatalities. The rates of patient falls serve as a barometer for assessing the effectiveness of nursing practices and the overall safety of healthcare environments.

Collection and Distribution of Quality Indicator Data

Data Collection Through Health Information Systems

To monitor and improve patient safety practices, robust data collection mechanisms are crucial. Health information systems, including Electronic Health Records (EHRs), are instrumental in gathering and managing data related to nursing-sensitive quality indicators. During an interview with a senior information system executive, insights were gained into the role of technology in data collection and reporting.

Challenges and Opportunities in Data Collection

While health information systems provide a streamlined approach to data collection, challenges such as unrepresentative samples, lower response rates, and limited follow-up data persist. Our interviewee emphasized the need for continuous improvement in data collection tools, citing the benefits of web-based systems in accessing diverse populations and reducing costs.

Nurse’s Role in Accurate Reporting

Nurses play a pivotal role in supporting accurate reporting and achieving high-quality results. The accuracy of data, especially regarding nursing interventions, is crucial for informed decision-making. Integrating data into electronic medical records and other systems requires precision, and frontline staff’s effectiveness in this process contributes significantly to the reliability of quality indicator data.

Nursing Informatics: Empowering the Interdisciplinary Team

Nursing informatics encompasses the application of information technology in patient care, education, and organizational management. Let’s explore how nursing informatics empowers the interdisciplinary team:

Role of Nursing Informatics in Patient Care

Nursing informatics facilitates efficient data documentation, supports interdisciplinary collaboration, and enhances communication across different healthcare settings. Through electronic systems, nurses can collect, analyze, and report data, contributing to evidence-based decision-making in patient care.

Impact of Patient Care Technologies

Health information systems, including Electronic Health Records, have demonstrated transformative effects on patient care outcomes. Studies show that these systems reduce human errors, improve clinical outcomes, and enhance interdisciplinary coordination. The standardization of documentation procedures in EHRs contributes to positive patient outcomes, reducing information omissions and improving handover processes.

Technology for Quality and Safety: Electronic Health Records

Electronic Health Records (EHRs) are integral to enhancing quality and safety standards for patients. The adoption of EHRs has become widespread, with 96% of U.S. hospitals implementing these systems. The benefits of EHRs include increased organizational productivity, reduced documentation time, and improved access to complete and accurate patient information.

Evidence-Based Practice Guidelines

Nursing-sensitive quality indicators, such as patient falls, serve as a foundation for evidence-based practice guidelines. The systematic collection and analysis of data through EHRs enable organizations to identify areas for improvement. By implementing evidence-based guidelines derived from quality indicators, healthcare leaders can develop targeted interventions to prevent patient falls and enhance overall patient safety.

Conclusion

In conclusion, nursing-sensitive quality indicators are invaluable tools for measuring and improving organizational structures, processes, and outcomes in healthcare. Our focus on patient falls as a quality indicator highlights its significance in assessing patient safety and the effectiveness of nursing practices. Leveraging health informatics, particularly through EHRs, enhances the collection, analysis, and dissemination of quality indicator data, contributing to evidence-based practice and improved patient care outcomes.

Thank you for joining this tutorial on Nursing Informatics and Nursing-Sensitive Quality Indicators. As healthcare professionals, your commitment to understanding and applying these concepts is essential for ensuring the delivery of high-quality and safe patient care.

References

Agency for Healthcare Research and Quality – AHRQ (2019, September 7). Falls. Retrieved from https://psnet.ahrq.gov/primer/falls.

Agency for Healthcare Research and Quality – AHRQ (2013). 5. How do you measure fall rates and fall prevention practices? Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk5.html.

Alotaibi, Y., and Federico, F. (2017). The Impact of Health Information Technology on Patient Safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631.

Dellinger, A. (2017). Older Adult Falls: Effective Approaches to Prevention. Current Trauma Reports, 3(2), 118–123. https://doi.org/10.1007/s40719-017-0087-x.

Health IT. (2019). Improved Diagnostics and Patient Outcomes. Retrieved from https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/improved-diagnostics-patient-outcomes#footnote-1.

NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Example Two

Hello everyone, I’m Rebecca, and I’m excited to welcome you to the RWJBarnabas Health nursing team. In this tutorial, I’ll help you understand how our facility uses Nursing Sensitive Quality Indicators (NSQIs). NSQIs measure and assess the quality of nursing care, capturing elements influenced by nursing interventions. These indicators act as measures of effectiveness and outcomes, aiding in identifying areas for improved patient care.

Importantly, NSQIs, like pressure ulcers and patient satisfaction, help healthcare organizations spot areas of concern and implement targeted interventions to enhance patient care. They also inform evidence-based practice and evaluate the effectiveness of nursing interventions. Analyzing NSQI data reveals patterns, trends, and relationships, advancing nursing knowledge and best practices.

Now, let’s have a look at the National Database of Nursing-Sensitive Quality Indicators (NDNQI).

NDNQI, developed by Press Ganey and the American Nurses Association (ANA), is a comprehensive database collecting data on various nursing-sensitive indicators. It enables facilities to benchmark performance, track progress, and classify information into structure, process, and outcome indicators for standardized assessment.

Here’s how our nursing staff uses NDNQI ratios and an acuity system for staffing. The charge nurse assesses patient complexity using an acuity system, adjusting staffing levels accordingly. NDNQI includes nurse-to-patient ratios, monitored regularly to ensure adherence to guidelines. If ratios indicate inadequate staffing, adjustments are made for effective and safe patient care.

For instance, our facility addresses the increase in pressure ulcers among certain patient groups. Pressure ulcers impact care quality, Medicare reimbursement, and patient satisfaction. They also pose a financial burden on hospitals. Nurses actively engage in prevention through monthly training programs, staff meetings, and reporting data in Press Ganey surveys, contributing to NDNQI.

The interdisciplinary team, including nurses, plays a crucial role in data collection. Using tools like the Braden Scale, they assess patient risk factors, documenting in EHRs for reporting to NDNQI. This data informs quality improvement initiatives, resource allocation, and staff education, promoting a culture of safety.

As nurses, your role is vital. Using the Braden Scale, you assess, document, and report pressure ulcer data. This data drives quality improvement, resource allocation decisions, and staff education, contributing to positive patient outcomes.

Your actions impact healthcare on a broader scale. The data you provide supports research, informs evidence-based practice, and aids in protocols and guideline development. It also influences Medicare reimbursements, helping the facility thrive in the evolving healthcare landscape.

In conclusion, your role in NDNQI contributes to enhanced nursing practice, patient outcomes, and the future of healthcare. Welcome to the organization, and thank you for your dedication to making a difference in patients’ lives.

References:

Afaneh, T., Abu-Moghli, F., & Ahmad, M. (2021). Nursing-sensitive indicators: A concept analysis. Nursing Management, 28(3), 28–33.

Madaris, S. (2023, January 12). Your comprehensive guide to the Press Ganey National Database of Nursing Quality Indicators (NDNQI).

Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital-acquired pressure injuries in the United States. International Wound Journal, 16(3), 634–640.

Paulsen R. A. (2018). Taking nurse staffing research to the unit level. Nursing Management, 49(7), 42–48.

Smith, S., Snyder, A., McMahon, L. F., Jr, Petersen, L., & Meddings, J. (2018). Success in hospital-acquired pressure ulcer prevention: A tale in two data sets. Health Affairs, 37(11), 1787–1796.

NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Example Three

Introduction

Ensuring high-quality care and patient safety is a fundamental goal for healthcare providers, with a focus on nursing staff and hospital administration. The American Nurses Association (ANA) addressed this by establishing the National Database of Nursing Quality Indicators (NDNQI). This database reports unit-level performance data regularly to assist medical facilities in evaluating their nursing care delivery. This paper explores the significance of a specific nursing-sensitive quality indicator (NSI), Nosocomial Infections, in relation to patient safety, care outcomes, and organizational performance. It also examines the role of nurses in supporting accurate reporting and high-quality results, along with the collection and dissemination of nursing-sensitive quality indicator data across healthcare organizations.

Nursing Quality Indicators

NDNQI primarily focuses on collecting and assessing process, structure, and outcome indicators related to healthcare to enable nursing leadership and staff to review their performance regarding patient outcomes. Process indicators involve techniques of nursing interventions and patient assessment, such as nursing job satisfaction or Pediatric Pain Assessment, Intervention, Reassessment (AIR) Cycle. Structural indicators include nursing staff supply and their education, skill, and certification levels. Outcome indicators represent patient results sensitive to nursing care, such as falls and pressure ulcers. This paper specifically examines the nosocomial infections rate as it reflects medical quality and patient safety in hospitals.

Nosocomial Infection Indicator

Nosocomial infections, or Healthcare-associated infections (HCAIs), pose a significant global public health problem due to their impact on mortality and morbidity among hospitalized patients. In the USA alone, the Centers for Disease Control and Prevention reports approximately 1.7 million cases of Healthcare-Acquired infections, resulting in over 98,000 deaths annually. Patients with surgical-associated infections spend an additional average of 6.5 days in the hospital. The outbreak of the COVID-19 pandemic has further emphasized the critical importance of this issue for patient outcomes and safety.

Resilience to antibiotics is a concerning aspect, with about 50 percent of surgical-associated infections, especially Staphylococcus aureus and gram-negative bacilli, being antibiotic-resistant. Various types of HCAIs include Catheter-associated Urinary Tract Infection (CAUTI), Surgical Site Infection (SSI), Central Line-Associated Bloodstream Infection (CLABSI), and Ventilator-Associated Pneumonia (VAP). Nursing staff, at the forefront of patient care, directly contribute to reducing infection transmission by following essential prevention procedures like hand hygiene, surface sanitation, sterilization, and using protective equipment.

Data Collection on the Quality Indicator

To address human factor-related errors, healthcare personnel need advanced technology support, such as the Health Information System (HIS). HIS is a documentation tool designed to manage, collect, store, and transmit healthcare data, including the patient’s electronic medical record (EMR) and Clinical Decision Support Systems (CDSS). EMR replaces traditional paper-based methods, providing accurate patient history, test results, and treatment information. CDSS offers health-related information, clinical guidelines, and diagnostic support, promoting decision-making.

HIS contributes to accuracy in documentation by aggregating information from different sources, selecting required tests for diagnosis, and facilitating clinical workflow. Despite challenges such as usability, interoperability, and scalability, HIS significantly improves staff expertise and computer literacy. It aids in monitoring and obtaining information about nosocomial infections, allowing healthcare organizations to develop a comprehensive picture of potential problem areas and provide excellent service.

Nurse’s Role in Supporting Accurate Reporting and High-Quality Results

An interdisciplinary team, including nurses, physicians, pediatricians, and clinical pharmacists, is crucial for the accurate collection and reporting of NSIs. Nurses play a key role in reporting adverse reactions to medications, changes in patients’ conditions, and entering relevant data into electronic medical records. Other stakeholders, such as office staff, managers, patients, and their families, are also responsible for providing correct information.

In conclusion, this paper emphasizes the importance of collecting and reporting data on nursing-sensitive quality indicators, focusing on Nosocomial Infections. HCAIs have significant implications for patient safety and outcomes, and the Health Information System serves as a vital tool in this context. Nurses, as part of interdisciplinary teams, contribute to accurate reporting, ensuring high-quality results and promoting patient safety.

References

Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Health care-associated infections–an overview. Infection and Drug Resistance, 11, 2321-2333.

Healthcare-Acquired Infections (HAIs). (n.d.). PatientCareLink.

Infection prevention and control (n.d.). WHO.

Oliver, M. (2019). Communication devices and electronic aids to activities of daily living (5th ed.). In Atlas of Orthoses and Assistive Devices (pp. 403-417). Elsevier.

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for success. NPJ Digital Medicine, 3(1), 1-10.

NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Example Four

At Community Hospital, our dedication to continuously assess and enhance patient care is unwavering. We are fortunate to contribute to the Nebraska Hospital Association (NHA), a state organization that collects and analyzes nursing data. Collaborating with other agencies, the NHA strives to develop effective processes for hospital nurses, fostering improvements in patient care. The NHA’s mission is to assist Nebraska hospitals in becoming leaders in the quality of care and safety they provide to patients. Currently, 61 Nebraska hospitals have pledged to lead in healthcare best practices, ensuring the quality and safety of every patient, as per information from Nebraskahospitals.org.

The NHA sends us annual quality surveys, crucial for gathering necessary data. Once obtained, the NHA provides facility-specific reports containing statistics and data. This information empowers us to implement processes that enhance the quality of care, patient safety, and staff performance. For instance, human resources utilizes these reports to assess staff retention, patient satisfaction, and other areas. Subsequently, appropriate departments receive these reports, initiating the development of plans to enhance patient care quality and safety. The data, collected from nurses actively engaged in their work, aids in retaining skilled nurses and ensuring the delivery of quality care.

One notable outcome of these efforts is the increase in patient satisfaction scores in various departments, including outpatient infusion, inpatient services, and the emergency department. Additionally, the focus on reducing 30-day readmission rates, which incur penalties for hospitals, has proven beneficial. Hospitals face reimbursement reductions for readmissions within 30 days, impacting both financials and the quality of care. Nurses, through their research and data analysis, have identified causes of readmissions, emphasizing their crucial role in patient safety.

Nurses, as key contributors, are responsible for collecting and reporting data to the NHA, playing an essential role in the interdisciplinary team. The data collected contributes significantly to improving patient safety and the overall patient experience. The simplicity of survey data entry ensures all team members can easily participate. Community Hospital’s quality team oversees data related to readmission rates, length of stay, incident reports, catheters, infections, and more.

Nurses at Community Hospital are entrusted with providing quality care based on best practices, thorough documentation, patient education, and identifying areas for further education. The impact of their work and data collection is substantial, potentially reducing readmissions and contributing to patients’ longer, healthier lives at home.

The data submitted for surveys provides valuable insights into patient care, influencing interventions and significantly impacting patient outcomes. The hospital’s quality improvement team utilizes this data to create and implement plans that enhance patient outcomes and safety. The team communicates updates to the NHA, outlining their plans for the collected data.

Through the CMS Value-Based Purchasing Program, acute care facilities receive incentive money for higher performance quality measures and improvements in quality and safety. Nurses’ efforts contribute to increased reimbursement and financial benefits for the facility, demonstrating the direct impact of their care.

In conclusion, our collaboration with the NHA offers a unique opportunity to positively influence nursing practices and enhance patient care and safety across the state. Nurses are urged to ensure complete and accurate documentation and timely completion of surveys. Nurse managers are committed to supporting nurses in these efforts, focusing on quality improvement and sharing data received. Every team member plays a crucial role in elevating the quality of patient care and safety, and their contributions are highly valued.

References:

CMS.gov – https://cms.gov

Nebraska Hospital Association – https://nha.org

Upadhyay, S., Stevenson, A., & Smith, D. (2019). Readmission rates and their impact on hospital financial performance. https://ncbi.nlm.nih.gov

NURS FPX 4040 Assessment Informatics and Nursing Sensitive Quality Indicators Example Five

Greetings esteemed members, I am Julian Nkem, and it is a pleasure to welcome some of the brightest minds in this field to contribute to our patients’ well-being. Today, I am excited to discuss our advancements in the healthcare system and how we are leveraging the Nursing Sensitive Quality Indicators (NDNQI) approach to enhance the quality of care at Vila Health Hospital.

The NDNQI, introduced in 1998 by the National Database of Nursing Quality Indicators, serves to track and report quality indicators influencing nurses’ performance in healthcare organizations (Merkley, 2018).

NDQI and Nursing Quality Indicators

At Vila Health Hospital, we utilize the NDNQI framework to assess hospital performance, comparing nursing actions against relevant data. This data aids in establishing evidence-based practice guidelines, enhancing both inpatient and outpatient strategies. Today’s presentation is part of our ongoing efforts to improve nursing care through educational and outreach programs.

Quality indicators under the NDNQI encompass structure, processes, and outcomes. Avedis Donabedian initially integrated these elements into the NDNQI framework. The four types of nursing-sensitive quality indicators include nurse-focused outcomes, patient-focused outcomes, organizational-focused indicators, and nursing-focused interventions and processes.

Chosen Indicator and Its Importance

Addressing the growing issue of medical errors causing stress and fatigue among nurses (Kieft, 2018), our focus is on Outcome Indicators related to the quantity and quality of nursing care. This choice aims to establish a link between nursing outcomes and organizational processes, emphasizing the need for nurses to be informed about these indicators.

Role of Nurses in Accurate Data Reporting

Nurses, integral to accurate data reporting, spend vital time on documentation and reporting. The Data Protection Act of 1988 emphasizes their responsibility to ensure patient safety through accurate record-keeping. Nurses play a crucial role in the legal, ethical, and professional duty of storing patient records accurately in the Electronic Health Record (EHR) system, preventing misunderstandings, and promoting quality care.

Importance of the Indicator

Leveraging technology, such as Electronic Health Records (EHR), enhances nurses’ ability to handle daily tasks efficiently, ensuring error-free work and improved patient care outcomes (Gao, 2018). This nursing-sensitive quality indicator is essential for promoting evidence-based practices at Vila Health Hospital.

Why Nurses Need to Be Aware of This Indicator

Clinical documentation using IT systems, as suggested by Merkley (2018), aids in effective patient information presentation and medication accounting. It significantly contributes to the chosen nursing-sensitive quality indicator, impacting both the quantity and quality of nursing care at our hospital.

Collection and Distribution of Quality Indicator Data

The interview with Dr. Raymond Dallas, in charge of our ICU and psychiatric ward, emphasizes the importance of data collection speed. Nurses play a vital role in collecting and reporting data for NDNQI, ensuring accurate and timely entry through online surveys. Data is then analyzed and entered into the system to improve nursing care in our hospital.

Conclusion

In conclusion, Vila Health Hospital’s adoption of IT informatics positively impacts the quality of nursing care and patient safety. The chosen nursing-sensitive quality indicator, “nursing quality of care outcomes using IT informatics,” highlights the significance of accurate data entry by nurses to drive improvements in quality.

References:

Alharbi, J., Jackson, D., & Usher, K. (2020). Compassion fatigue in critical care nurses and its impact on nurse-sensitive indicators in Saudi Arabian hospitals. Australian Critical Care, 33(6), 553-559.

Gao, J. L., Liu, X. M., Che, W. F., & Xin, X. (2018). Construction of nursing-sensitive quality indicators for haemodialysis using Delphi method. Journal of clinical nursing, 27(21-22), 3920-3930.

Kieft, R. A. M. M., Stalpers, D., Jansen, A. P. M., Francke, A. L., & Delnoij, D. M. J. (2018). The methodological quality of nurse-sensitive indicators in Dutch hospitals: A descriptive exploratory research study. Health Policy, 122(7), 755-764.

Merkley, J., Amaral, N., Sinno, M., Jivraj, T., Mundle, W., & Jeffs, L. (2018). Developing a Nursing Scorecard Using the National Database of Nursing Quality Indicators®: A Canadian Hospital’s Experience. Nursing Leadership (Toronto, Ont.), 31(4), 82-91.

Myers, H., Pugh, J. D., & Twigg, D. E. (2018). Identifying nurse-sensitive indicators for stand-alone high acuity areas: A systematic review. Collegian, 25(4), 447-456.

Start, R., Matlock, A. M., Brown, D., Aronow, H., & Soban, L. (2018). Realizing momentum and synergy: Benchmarking meaningful ambulatory care nurse-sensitive indicators. Nursing Economics, 36(5), 246-251.

Thomas-Hawkins, C., Latham, C. E., & Hain, D. J. (2017). Emphasizing the Value of Nephrology Nursing Through Nursing-Sensitive Indicators: A Call for Action. Nephrology Nursing Journal, 44(4).

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NRSG266 Principles of Nursing Contexts of Ageing Assessments Examples

NRSG266 Principles of Nursing Contexts of Ageing Assessments Assignments

NRSG266 – Principles of Nursing: Contexts of Ageing Course

NRSG266 Principles of Nursing Contexts of Ageing Assessments Assignment Briefs

Assignment Instructions Overview

NRSG266 comprises two key assessments that require students to apply theoretical knowledge to promote best nursing practices for older adults. Assessment One is a written essay focused on analysing the registered nurse’s role in empowering older adults to achieve healthy ageing, drawing on the World Health Organisation’s (2015) framework. Assessment Three is a case-study-based academic essay where students critically respond to six structured questions drawn from three diverse clinical scenarios. Each response must demonstrate integration of pathophysiology, evidence-based nursing care, person-centred principles, and ethical and legal considerations relevant to gerontological practice.

Both assessments are designed to be completed in third-person academic writing, use current and credible references, and be submitted via the designated LEO dropboxes by the due dates outlined. Presentation guidelines are strict, requiring standard academic formatting and adherence to APA 6th Edition referencing.

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Understanding Assignment Objectives

These assessments aim to foster students’ ability to critically reflect on the ageing process and the registered nurse’s pivotal role in supporting ageing populations across various healthcare settings. Students are expected to analyse how the biological, psychological, sociocultural, spiritual, and environmental factors impact older adults and influence care decisions. The assignments encourage critical engagement with current research, application of clinical reasoning, and alignment with national and international aged care standards. Through these tasks, students will develop competencies necessary for delivering respectful, dignified, and evidence-informed care that enhances functional ability and quality of life in older age.

The Student’s Role

Students are expected to demonstrate an evolving understanding of nursing responsibilities through the lens of gerontological care. In Assessment One, students act as advocates for healthy ageing, drawing on evidence to propose practical strategies for promoting independence, dignity, and wellness among older individuals. In Assessment Three, students function as problem-solvers, critically addressing real-world clinical issues such as mobility decline, adverse drug reactions, pain management, labelling, and pressure injury risks. These assessments require students to synthesise learning, research, and professional standards to deliver compassionate, person-centred care solutions tailored to the unique needs of ageing individuals.

Competencies Measured

The NRSG266 assessments are structured to evaluate the following core competencies:

• Critical Analysis: Students must evaluate complex health concepts such as healthy ageing and functional ability, identifying nursing interventions that align with best practice principles.
• Theoretical Application: Demonstrated through integration of the Roper-Logan-Tierney model, students are required to link theory with practical nursing care in ageing contexts.
• Evidence-Based Practice: Each response must be informed by contemporary, peer-reviewed literature to support clinical decisions and health promotion strategies.
• Ethical and Legal Reasoning: Particularly in Assessment Three, students must show awareness of professional standards, autonomy, consent, and ethical care for vulnerable older adults.
• Person-Centred Approach: A recurring focus is maintaining dignity, respecting diversity, and supporting individual values throughout all stages of ageing and care delivery.

These competencies reflect both the learning outcomes of the unit and the graduate attributes of Australian Catholic University—ensuring that nursing graduates are equipped with insight, empathy, and professional impact across gerontological settings.

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NRSG266 Principles of Nursing Contexts of Ageing Assessments Examples

NRSG266 Principles of Nursing Contexts of Ageing Assessment One: Written Assessment

Healthy Ageing and the Role of the Registered Nurse

The World Health Organization (2015) defines healthy ageing as the process of developing and maintaining functional ability that enables well-being in older age. This involves empowering older adults to live a life that they value. The concept of functional ability includes the capacity to meet basic needs, make decisions, remain mobile, build and maintain relationships, and contribute to society. As the global population ages, promoting healthy ageing has become a central public health focus. Registered nurses (RNs) play a vital role in promoting the functional ability and well-being of older adults through evidence-based, person-centred care that addresses physical, psychological, social, cultural, and spiritual dimensions.

Understanding Healthy Ageing

Healthy ageing is influenced by the interplay of genetic, environmental, lifestyle, and social factors throughout a person’s life. It is not simply the absence of disease but a holistic approach to maintaining autonomy, independence, and quality of life (Beard et al., 2016). Functional ability is impacted by intrinsic capacity, including physical and mental capabilities, and the environment in which the individual lives. For nurses, understanding these complex interactions allows for targeted interventions that promote resilience and adaptability in older adults.

The Australian Institute of Health and Welfare (AIHW, 2021) highlights that older Australians are increasingly living longer with chronic illnesses. Therefore, healthy ageing involves managing long-term conditions, reducing risks of disability, and enhancing participation in daily life. A strengths-based approach recognises older adults’ capabilities and supports their decision-making.

The Role of the Registered Nurse in Promoting Healthy Ageing

Registered nurses contribute significantly to healthy ageing through health promotion, disease prevention, early intervention, and coordinated care. Nurses provide education, facilitate access to resources, and advocate for policies that support older adults. Empowerment is central to nursing practice, requiring that care be inclusive, respectful, and collaborative (Australian College of Nursing [ACN], 2020).

One of the primary roles of nurses is to educate older adults about healthy behaviours, such as balanced nutrition, physical activity, smoking cessation, and medication adherence (Kendig et al., 2017). Nurses use motivational interviewing techniques to assess readiness to change and promote autonomy. For example, by involving older adults in goal-setting and care planning, nurses support their sense of control and dignity.

In clinical settings, nurses screen for risk factors like falls, malnutrition, depression, and social isolation. Early identification and intervention can prevent decline in functional ability. The implementation of comprehensive geriatric assessment (CGA) is an evidence-based strategy that allows multidisciplinary teams to tailor care to individual needs (Ellis et al., 2017). Nurses play a crucial role in conducting assessments and coordinating care across services.

Person-Centred and Culturally Responsive Care

Person-centred care is essential to promoting healthy ageing. It involves recognising the values, preferences, and life history of older adults. Nurses must be sensitive to the cultural and spiritual needs of older people, particularly in Australia where there is a diversity of cultural backgrounds, including Aboriginal and Torres Strait Islander communities (Department of Health, 2019).

Culturally responsive care enhances trust and engagement. For instance, incorporating cultural practices into care plans and involving family or community supports can significantly impact outcomes. Registered nurses require ongoing training in cultural safety and communication to effectively engage with diverse populations (Best & Fredericks, 2018).

Promoting Social Participation and Mental Wellbeing

Social engagement is a key determinant of healthy ageing. Loneliness and isolation are associated with poorer health outcomes, including depression and cognitive decline (Holt-Lunstad et al., 2015). Nurses can support older adults by facilitating connections with community resources, support groups, and volunteering opportunities.

Mental health is equally important. The stigma surrounding mental illness in older adults can lead to underdiagnosis and undertreatment. Nurses are in a position to identify signs of depression, anxiety, or cognitive impairment and to refer clients to appropriate services. Cognitive stimulation activities and maintaining meaningful roles in society can preserve mental function and enhance self-worth (Prince et al., 2015).

Supporting Functional Ability and Independence

Maintaining mobility, managing chronic conditions, and supporting self-care are crucial aspects of functional ability. Nurses assess activities of daily living (ADLs), implement mobility plans, and use assistive devices to support independence. They collaborate with physiotherapists, occupational therapists, and dietitians to design care plans that enhance older adults’ physical functioning (WHO, 2015).

Medication management is another area where nurses make a substantial impact. Polypharmacy is common in older adults and increases the risk of adverse drug events. Nurses conduct medication reviews, educate patients on correct usage, and liaise with pharmacists and prescribers to reduce harm (Maher et al., 2014).

Fall prevention strategies are also central to promoting functional ability. These include home safety assessments, exercise programs like tai chi, and vision screening. Registered nurses educate clients and families on risk factors and create safer living environments (Sherrington et al., 2019).

Advocacy and Policy Engagement

Nurses are advocates for older adults, ensuring their rights and preferences are respected in all care settings. Advocacy extends to influencing health policies that support access to aged care services, funding for community programs, and age-friendly urban planning. The voice of nurses is crucial in shaping systems that support healthy ageing at a population level (ACN, 2020).

Ageism remains a significant barrier to healthy ageing. Nurses challenge stereotypes and promote positive images of ageing through their interactions and health promotion efforts. By addressing discrimination and advocating for inclusivity, nurses contribute to social change and improved outcomes for older adults (Officer & de la Fuente-Núñez, 2018).

Conclusion

Healthy ageing is a dynamic process that requires collaboration between individuals, families, communities, and health professionals. Registered nurses are central to this process, using a holistic, evidence-based approach to empower older adults and enhance their functional ability. By addressing physical, psychological, social, cultural, and spiritual factors, nurses promote independence, dignity, and well-being in ageing populations. Continuous education, advocacy, and cultural competence enable nurses to meet the complex needs of older adults and foster environments that support healthy ageing at both individual and societal levels.

References

Australian College of Nursing. (2020). Nurses and healthy ageing position statement. https://www.acn.edu.au

Australian Institute of Health and Welfare. (2021). Older Australia at a glance. https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance

Beard, J. R., Officer, A. M., Cassels, A. K., & Sadana, R. (2016). The World report on ageing and health: A policy framework for healthy ageing. The Lancet, 387(10033), 2145-2154. https://doi.org/10.1016/S0140-6736(15)00516-4

Best, O., & Fredericks, B. (2018). Yatdjuligin: Aboriginal and Torres Strait Islander nursing and midwifery care. Cambridge University Press.

Department of Health. (2019). Aged care diversity framework. https://www.health.gov.au

Ellis, G., Whitehead, M. A., Robinson, D., O’Neill, D., & Langhorne, P. (2017). Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database of Systematic Reviews, (9), CD006211. https://doi.org/10.1002/14651858.CD006211.pub3

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237. https://doi.org/10.1177/1745691614568352

Kendig, H., Wells, Y., O’Loughlin, K., & Heese, K. (2017). Australian perspectives on global ageing. Springer.

Maher, R. L., Hanlon, J., & Hajjar, E. R. (2014). Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety, 13(1), 57-65. https://doi.org/10.1517/14740338.2013.827660

Officer, A., & de la Fuente-Núñez, V. (2018). A global campaign to combat ageism. Bulletin of the World Health Organization, 96(4), 295. https://doi.org/10.2471/BLT.17.202424

Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M., & Karagiannidou, M. (2015). World Alzheimer report 2016: Improving healthcare for people living with dementia. Alzheimer’s Disease International.

Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … & Lord, S. R. (2019). Exercise for preventing falls in older people living in the community: An abridged Cochrane systematic review. British Journal of Sports Medicine, 53(17), 905-911. https://doi.org/10.1136/bjsports-2018-099509

World Health Organization. (2015). World report on ageing and health. https://www.who.int/ageing/events/world-report-2015-launch/en/

NRSG266 Principles of Nursing Contexts of Ageing Assessment Three: Case Study

Question One

Labelling older adults with terms like “acopia”—a non-specific diagnosis implying functional decline without clear pathology—can contribute to ageism and diagnostic overshadowing in clinical settings (McLean, 2015). This label may prevent further investigations into underlying causes of decline, such as infection, delirium, or medication side effects. It can also affect the way nurses and other healthcare professionals perceive and interact with the patient, potentially leading to delayed or inadequate care (Stolz et al., 2021).

When patients like Edith are labelled as having “acopia,” there is a risk that their condition will be treated with less urgency or empathy. This can impact the therapeutic relationship, reduce patient dignity, and negatively influence health outcomes (Royal College of Physicians, 2012). From a nursing perspective, critical thinking is essential to challenge such labels and advocate for comprehensive assessments that explore physical, psychological, and social contributors to functional decline (Boltz et al., 2020).

Additionally, the nurse has a key role in supporting holistic care planning for patients like Edith. Recognising the implications of language used in diagnoses, nurses must champion a respectful, person-centred approach that values older adults’ experiences and supports optimal recovery (De Vries et al., 2021).

Question Two

The ageing process results in physiological changes that significantly increase the risk of pressure injury in older adults, particularly in hospital settings. In Edith’s case, prolonged immobility on an ED trolley, combined with age-related changes such as decreased skin elasticity, reduced subcutaneous fat, and impaired microcirculation, heightens her susceptibility (Jaul & Calderon-Margalit, 2015).

Additionally, muscle atrophy and reduced sensory perception in older adults may delay recognition of discomfort or pressure, increasing the duration of unrelieved pressure on bony prominences (Barakat-Johnson et al., 2020). Skin becomes drier and more fragile with age, further compromising its ability to withstand mechanical stress.

From a nursing perspective, early risk assessment using tools like the Braden Scale is essential (Haesler, 2019). Regular repositioning, use of pressure-relieving devices, and skin inspection are fundamental nursing interventions. Nurses must also advocate for timely ward transfer or ensure appropriate pressure care can be provided in ED, reducing the risk of hospital-acquired pressure injuries and enhancing patient safety (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2020).

Question Three

Chronic pain, such as that experienced by Amita from her venous ulcer, can significantly impair an older adult’s ability to maintain a safe environment. Pain often results in reduced mobility, increased fatigue, sleep disturbances, and impaired concentration, all of which compromise her ability to perform daily activities safely (Molton & Terrill, 2014).

Cognitive effects of persistent pain may include forgetfulness and reduced attention, increasing the risk of accidents such as falls or medication errors (Morlion, 2020). In Amita’s case, isolation and living alone may exacerbate these risks. Pain may also lead to fear of movement (kinesiophobia), which promotes sedentary behaviour and muscle deconditioning.

The nurse’s role includes regular pain assessments using validated tools like the Abbey Pain Scale or Numeric Rating Scale and implementing a multidisciplinary pain management plan. Nurses should provide education on safe home environments, such as removing hazards and ensuring assistive devices are used appropriately. Monitoring for side effects of analgesics, especially opioids like codeine, is critical to prevent falls or cognitive changes that may further threaten safety (Australian Institute of Health and Welfare [AIHW], 2021).

Question Four

Older adults like Amita are more vulnerable to adverse drug events (ADEs) due to physiological changes associated with ageing. Decreased renal and hepatic function affects the metabolism and clearance of medications, increasing the risk of toxicity, especially for drugs like codeine, which can accumulate in the system (Mangoni & Jackson, 2004).

Polypharmacy, which is common in managing multiple chronic conditions, further elevates this risk by increasing the likelihood of drug-drug interactions and medication non-adherence (Maher et al., 2014). Cognitive impairment, visual or hearing deficits, and physical limitations may hinder the correct administration of medications.

Nurses must conduct comprehensive medication reviews regularly and collaborate with pharmacists to identify potential risks. Education for Amita on medication timing, side effects, and safe storage is essential. Strategies such as using pill organisers and medication calendars can enhance adherence and reduce errors. Importantly, nurses must advocate for deprescribing where appropriate, focusing on patient-centred care to enhance quality of life and minimise harm (Scott et al., 2015).

Question Five

Normal age-related changes in the respiratory system predispose older adults like Oliver to pneumonia during hospitalisation. These changes include decreased chest wall compliance, weakened respiratory muscles, and reduced alveolar surface area, which impair effective ventilation and gas exchange (Meyer et al., 2021).

Additionally, ciliary function and cough reflex diminish with age, reducing the clearance of secretions and increasing susceptibility to infection (Ezzie & Parsons, 2020). Immobility, as seen in Oliver’s case due to IVAB therapy and cellulitis, further compromises lung expansion and promotes secretion retention, creating an environment conducive to pneumonia.

Nurses play a crucial role in pneumonia prevention through interventions such as encouraging deep breathing and coughing exercises, administering prescribed incentive spirometry, and facilitating regular repositioning to enhance lung expansion. Monitoring for early signs of infection and collaborating with the interdisciplinary team to optimise hydration and nutrition are also essential nursing responsibilities (AIHW, 2021).

Question Six

Increasing mobility in hospitalised older adults like Oliver has numerous benefits. It reduces the risk of complications such as pneumonia, deep vein thrombosis, constipation, and functional decline (Brown et al., 2004). Mobility supports the maintenance of muscle mass, joint flexibility, and cardiovascular function, thereby promoting faster recovery and reducing hospital length of stay.

From a nursing perspective, promoting incidental exercise—small movements performed during daily activities—can be particularly effective. Nurses should encourage Oliver to sit out of bed for meals, walk short distances with supervision, and perform gentle limb exercises while seated. Incorporating mobility into routine care, such as walking to the bathroom instead of using a bedpan, helps normalise physical activity and supports independence (Boltz et al., 2020).

It is essential for nurses to collaborate with physiotherapists and occupational therapists to tailor mobility plans according to Oliver’s capabilities. Educating the patient and family on the importance of movement and providing reassurance and pain management can enhance adherence to mobility plans, supporting holistic and person-centred care.

References

Australian Commission on Safety and Quality in Health Care. (2020). Preventing pressure injuries. https://www.safetyandquality.gov.au/standards/nsqhs-standards/preventing-and-controlling-healthcare-associated-infection-standard/pressure-injuries

Australian Institute of Health and Welfare. (2021). Older Australians. https://www.aihw.gov.au/reports/older-people/older-australians

Barakat-Johnson, M., Barnett, C., Wand, T., White, K., & Coyer, F. (2020). The role of nurses in preventing pressure injuries in the emergency department. Journal of Wound, Ostomy and Continence Nursing, 47(2), 129-134. https://doi.org/10.1097/WON.0000000000000626

Boltz, M., Capezuti, E., Shabbat, N., & Hall, K. (2020). Going home better not worse: older adults’ views on physical function during hospitalization. International Journal of Nursing Practice, 26(4), e12843. https://doi.org/10.1111/ijn.12843

Brown, C. J., Friedkin, R. J., & Inouye, S. K. (2004). Prevalence and outcomes of low mobility in hospitalized older patients. Journal of the American Geriatrics Society, 52(8), 1263–1270. https://doi.org/10.1111/j.1532-5415.2004.52354.x

De Vries, K., Drury-Ruddlesden, J., & Gaul, C. (2021). Person-centred care in nursing homes: context, practice and outcomes. International Journal of Older People Nursing, 16(1), e12330. https://doi.org/10.1111/opn.12330

Ezzie, M. E., & Parsons, J. P. (2020). Pulmonary issues in older adults. Clinics in Geriatric Medicine, 36(3), 405–417. https://doi.org/10.1016/j.cger.2020.04.004

Haesler, E. (Ed.). (2019). Evidence-based practice in nursing (4th ed.). Elsevier.

Maher, R. L., Hanlon, J. T., & Hajjar, E. R. (2014). Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety, 13(1), 57–65. https://doi.org/10.1517/14740338.2013.827660

Mangoni, A. A., & Jackson, S. H. D. (2004). Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology, 57(1), 6–14. https://doi.org/10.1046/j.1365-2125.2003.02007.x

McLean, A. (2015). The problem with ‘acopia’. BMJ, 350, h1765. https://doi.org/10.1136/bmj.h1765

Meyer, K. C., Franciosi, J. P., & Gibson, K. F. (2021). Pulmonary defense mechanisms and the aging lung. Clinics in Geriatric Medicine, 37(2), 295–312. https://doi.org/10.1016/j.cger.2021.01.004

Molton, I. R., & Terrill, A. L. (2014). Overview of persistent pain in older adults. American Psychologist, 69(2), 197–207. https://doi.org/10.1037/a0035794

Morlion, B. (2020). Chronic pain: The role of the nurse. British Journal of Nursing, 29(5), S16–S22. https://doi.org/10.12968/bjon.2020.29.5.S16

Royal College of Physicians. (2012). Acute care toolkit 3: Acute medical care for frail older people. https://www.rcplondon.ac.uk/guidelines-policy/acute-care-toolkit-3-acute-medical-care-frail-older-people

Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., Jansen, J., & Martin, J. H. (2015). Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Internal Medicine, 175(5), 827–834. https://doi.org/10.1001/jamainternmed.2015.0324

Stolz, K., Mayer, H., & Riedl, D. (2021). Ageism and the nursing care of older people. Journal of Clinical Nursing, 30(1-2), e16–e24. https://doi.org/10.1111/jocn.15525

Detailed Assessment Instructions for the NRSG266 Principles of Nursing Contexts of Ageing Assessments

NRSG266 Principles of Nursing Contexts of Ageing Assessment One: Written Assessment

School of Nursing, Midwifery and Paramedicine

Faculty of Health Sciences Australian Catholic University

NRSG266 Assessment One: Written Assessment

Due Date	Week 5, Wednesday, 26th August 4pm
Weighting	40%
Word limit	1200 words +/- 10%
Assessment Criteria	Appendix 1 of the NRSG266 unit outline
Learning Outcomes	LO1        critically analyse the concept of healthy ageing and its promotion at an individual and community level; (GA4) LO2        understand experiences of ageing and how these are impacted by biopsychosocial, spiritual and cultural factors; (GA1, GA4)
Submission	Assessment 1 dropbox located on your NRSG266 LEO campus tile.
Presentation	1.5 spacing; 11-point Arial or Calibri font. No headings, cover pages, bullets, numbering, tables, or diagrams are to be used. Footer is to include your name, student number and word count This is an academic essay and as such, 3rd person writing is required.
Referencing	APA 6th Edition as per the ACU study guide. References must meet the academic standards of recency, relevance and reliability. Minimum of 12 current (within five years) and credible references are to be used.
Task	The World Health Organisation (2015) states: “Healthy ageing is a process of developing and maintain the functional ability that enables wellbeing in older age. Functional ability is about having the capabilities that enable all people to be and do what they have reason to value” Using the context provided in the statement above, critically analyse your role as a registered nurse in empowering the older adult. In your response discuss current evidence-based approaches to the promotion of healthy ageing.

NRSG266 _ Assessment One: Written Assessment _ Semester Two, 2020 _ Page 1 of 1

NRSG266 Principles of Nursing Contexts of Ageing Assessment Three: Case Study

School of Nursing, Midwifery and Paramedicine

Faculty of Health Sciences Australian Catholic University

NRSG266 Assessment Three: Case Study

Due Date	Week 12, Wednesday, 21st October, 4pm
Weighting	40%
Word limit	1500 words +/- 10% (~250 words per question for six (6) questions)
Assessment Criteria	Appendix 3 of the NRSG266 unit outline
Learning Outcomes	LO2 understand experiences of ageing and how these are impacted by biopsychosocial, spiritual and cultural factors; (GA1, GA4) LO3 demonstrate advanced knowledge of pathophysiology related to the ageing process; (GA5) LO4 critically apply the Roper-Logan-Tierney Model of Nursing to the context of ageing; (GA1, GA4, GA5, GA9) LO6 critically apply legal and ethical principles related to care of the older adult. (GA3)
Submission	Assessment 3 dropbox located on your NRSG266 LEO campus tile.
Presentation	1.5 spacing; 11-point Arial or Calibri font. No cover pages, bullet points, numbering, tables, or diagrams are to be used. Headings are to be used; Question One and Question Two and so on. Footer is to include your name, student number and word count (excluding reference list) This is an academic essay and as such, 3rd person writing is required. Introduction or concluding paragraphs are not to be included.
Referencing	APA 6th Edition as per the ACU study guide. References must meet the academic standards of recency, relevance and reliability. Minimum of 15 current (within five years) and credible references are to be used.

 

Task

The following three (3) case studies are designed to demonstrate the integration of various principles of managing the care of older adults. Each case study has two (2) questions attached. Students are to answer all six (6) questions, remembering to include a critical analysis of the role of the nurse as relevant to the question. Answers are expected to be around 250 words for each, to a total of 1500 words. All answers need to be written as academically structured paragraphs and supported by current, credible research with intext citations.

Case Studies

You are a RN working in ED, looking after Edith, an 87-year-old with an admitting diagnosis of Acopia. All acute interventions have been completed for Edith, but the wards are full, so she will spend the next 8 hours (+) on an ED trolley in a corridor. 1.      What is the impact of a diagnosis based on the labelling of a patient? 2.      How do normal changes of ageing increase the risk of Edith developing a pressure injury in this scenario? You are a RN working in community care, visiting Amita, a 76-year-old with a chronic and painful venous ulcer on her lower leg. She takes multiple medications for chronic illness, and a codeine-based medication for pain. Amita lives alone in her own home. 3.      How would Amita’s chronic pain impact on her ability to maintain a safe environment? 4.      Why is Amita, as an older adult, more vulnerable to adverse drug events? You are a RN working on an acute medical ward, looking after Oliver, an 80-year-old with painful cellulitis from hand to shoulder from a small left hand scratch sustained while gardening. He is admitted for 7 days of QID IVABs via a right cubital fossa PIVC. Because of the cellulitis, PIVC and IVAB regime, Oliver’s mobility is limited. 5.      Outline the normal changes of ageing on the respiratory system in predisposing Oliver to pneumonia during his hospital admission. 6.      What are the benefits of increasing the mobility of an older adult during hospitalisation? How should the RN encourage incidental exercise during Oliver’s admission?

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NRSG372 Chronic Illness and Disability Written Assignment Example

NRSG372 Chronic Illness and Disability Written Assignment

NRSG372 – Principles of Nursing: Chronic Illness and Disability Course

NRSG372 Chronic Illness and Disability Written Assignment Brief

Assignment Instructions Overview:

This assessment task invites students to engage directly with an individual in the community who lives with a chronic illness or disability. The primary goal is to understand the lived experience of managing such a condition and to use that understanding to plan person-centred care. The task requires students to apply two clinical frameworks—the Levett-Jones Clinical Reasoning Cycle and the Roper-Logan-Tierney (RLT) Model of Nursing—to identify and justify two care priorities relevant to the interviewee. Students must also integrate evidence-based practice, demonstrate clinical reasoning, and align their work with national safety and quality standards. The paper is to be written in a formal academic style, adhering to strict formatting and referencing guidelines.

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Understanding Assignment Objectives:

The purpose of this assignment is to develop students’ capacity to critically assess and address the needs of individuals living with chronic illness or disability. It fosters the application of person-centred care principles, encourages engagement with real-world experiences, and promotes safe and ethical nursing practice. Through this process, students will:

• Explore how chronic conditions impact individuals’ lives physically, emotionally, socially, and functionally.
• Use clinical reasoning to assess, plan, and evaluate care in a structured, evidence-based manner.
• Apply theoretical models to support patient autonomy and independence.
• Practice respectful communication, cultural sensitivity, and advocacy through consumer partnership.

The Student’s Role:

Students take on the role of a thoughtful and ethical nurse-in-training who seeks to understand, not diagnose. Their responsibilities include:

• Identifying and gaining informed written consent from a suitable interviewee.
• Conducting a safe and respectful phone or video interview.
• Ensuring strict confidentiality and de-identification throughout the assignment.
• Demonstrating empathy and professionalism during the interview process.
• Analysing data using relevant frameworks and justifying clinical decisions with scholarly literature.
• Submitting both the consent form and the written paper on time, following academic integrity and formatting expectations.

Competencies Measured:

This assessment aligns with several Learning Outcomes (LO1, LO2, LO3, LO6) and evaluates the following core competencies:

• Clinical Reasoning and Critical Thinking: Ability to apply the Clinical Reasoning Cycle to real patient scenarios, justify care priorities, and anticipate outcomes of nursing interventions.
• Person-Centred Care Planning: Demonstrating how to collaborate with the health consumer to create achievable, culturally appropriate goals.
• Application of Theoretical Frameworks: Competently incorporating the Roper-Logan-Tierney model to assess the level of dependence and required support for each care priority.
• Evidence-Based Practice: Integration of current and credible sources (minimum 17) to support arguments and justify nursing interventions.
• Professional Communication: Structuring the assignment according to academic conventions, maintaining clear paragraph logic, and adhering to APA 7th referencing style.
• Ethical and Safe Practice: Maintaining patient confidentiality, securing consent, and showing awareness of professional boundaries.

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NRSG372 Chronic Illness and Disability Written Assignment Example

Introduction

This paper explores the impact of chronic illness on an individual’s life through the lens of a real community interview. Anna (pseudonym), a 49-year-old woman living with multiple sclerosis (MS), shared her lived experience with this progressive neurological condition. MS is a chronic autoimmune disorder affecting the central nervous system, leading to a wide range of symptoms, including fatigue, mobility issues, and cognitive impairment (Moss-Morris et al., 2020). Based on the interview, two care priorities were identified: (1) management of fatigue and (2) support for emotional wellbeing. These priorities were explored using Levett-Jones’ (2018) Clinical Reasoning Cycle and assessed against the Roper-Logan-Tierney (RLT) model of independence to dependence continuum. This paper emphasizes person-centred care and aligns with the National Safety and Quality Health Service (NSQHS) standards, particularly Partnering with Consumers, to ensure evidence-based and collaborative care planning.

Care Priority One: Fatigue Management

Fatigue emerged as Anna’s most debilitating symptom, significantly affecting her quality of life. She described it as “like dragging a lead weight all day,” particularly on warm days or after minimal physical activity. This aligns with the literature, as 80% of MS patients experience chronic fatigue, which is often the most disabling symptom (Branas et al., 2021). Anna reports difficulty completing daily tasks such as cooking, walking short distances, or even concentrating on conversations. On the RLT continuum, she demonstrated partial dependence in the “mobilising” and “maintaining a safe environment” activities of daily living, requiring mobility aids and home modifications to maintain independence (Roper et al., 2001).

Consequences of Not Addressing Fatigue

Failure to address fatigue could lead to increased functional decline, heightened dependence on carers, social isolation, and mental health deterioration (Strober, 2020). Fatigue contributes to reduced participation in physical activity, which in turn can worsen MS symptoms through deconditioning. Moreover, unmanaged fatigue often results in unemployment, as seen in Anna’s case—she had to resign from her role as a schoolteacher, which deeply impacted her sense of identity and purpose. Research highlights a correlation between untreated fatigue and higher healthcare utilisation due to falls, infections, and exacerbations of MS symptoms (Braley & Chervin, 2019).

Goal and Intervention

The nursing goal is to enhance Anna’s functional capacity and improve energy conservation through collaborative planning. A comprehensive fatigue management program incorporating occupational therapy, energy conservation techniques, and physical activity tailored to tolerance levels is essential. Evidence supports graded aerobic exercise and cognitive behavioural strategies for reducing fatigue in MS (Kjølhede et al., 2018). Nurses can coordinate referrals and implement fatigue diaries, promoting patient education on activity pacing. Partnering with consumers (NSQHS Standard 2) ensures that Anna’s goals and preferences are incorporated, empowering her to manage her condition and maintain autonomy in daily life (ACSQHC, 2023).

Care Priority Two: Emotional Wellbeing and Coping

Anna disclosed frequent episodes of low mood, hopelessness, and withdrawal from social activities. She described grieving her pre-diagnosis life and expressed anxiety about disease progression. The emotional toll of MS is well-documented, with over 50% of patients experiencing depression and anxiety (Boeschoten et al., 2017). On the RLT continuum, Anna showed increasing dependence in “communication” and “maintaining social relationships,” withdrawing from previously enjoyed community groups and friendships due to stigma and fatigue.

Consequences of Not Addressing Emotional Health

Ignoring Anna’s emotional wellbeing may worsen her mental health and diminish treatment adherence. Depression is associated with increased MS relapses and greater disability progression (Mohr et al., 2018). Without psychological support, Anna risks social isolation, caregiver burden on her partner, and potentially harmful coping strategies such as substance misuse or neglecting medical appointments. A holistic approach is essential to mitigate these risks, supporting both physical and psychosocial aspects of her condition.

Goal and Intervention

The goal is to promote emotional resilience and coping capacity. Nursing interventions include referral to a clinical psychologist for cognitive behavioural therapy, introduction to peer support groups, and regular mental health screening using the Hospital Anxiety and Depression Scale (HADS). Evidence supports multidisciplinary care models that incorporate mental health professionals into chronic illness management (Gunn et al., 2021). Nurses play a key role in therapeutic communication, normalising emotional responses, and ensuring Anna’s voice is central to decision-making, aligned with NSQHS Standard 2. Collaborative care planning fosters trust and allows Anna to reframe her life with MS from a place of acceptance and empowerment.

Conclusion

This paper has examined the lived experience of Anna, a woman managing the complexities of multiple sclerosis. Two care priorities—fatigue and emotional wellbeing—were explored through the Clinical Reasoning Cycle and contextualised within the RLT model of independence. Interventions were grounded in evidence and aligned with NSQHS standards. Moving forward, the nursing role in ongoing assessment, education, and interprofessional coordination is vital to achieving meaningful, person-centred outcomes. Evaluation of these interventions will help ensure they remain responsive to Anna’s evolving needs, enhancing both her autonomy and quality of life.

References

Australian Commission on Safety and Quality in Health Care (ACSQHC). (2023). NSQHS Standards: Partnering with consumers. https://www.safetyandquality.gov.au/

Boeschoten, R. E., Braamse, A. M., Beekman, A. T., Cuijpers, P., van Oppen, P., Dekker, J., & Uitdehaag, B. M. (2017). Prevalence of depression and anxiety in multiple sclerosis: A systematic review and meta-analysis. Journal of the Neurological Sciences, 372, 331–341.

Braley, T. J., & Chervin, R. D. (2019). Fatigue in multiple sclerosis: Mechanisms, evaluation, and treatment. Sleep, 42(8), zsz117.

Branas, P., Jordan, H., Fry-Smith, A., Burls, A., & Hyde, C. (2021). Treatments for fatigue in multiple sclerosis: A rapid and systematic review. Health Technology Assessment, 7(27), 1-61.

Gunn, J., Palmer, V., Dowrick, C., Herrman, H., Griffiths, F., Kokanovic, R., & Furler, J. (2021). Embedding mental health care in chronic disease management: An Australian case study. The British Journal of General Practice, 71(703), e53–e60.

Kjølhede, T., Vissing, K., & Dalgas, U. (2018). Multiple sclerosis and progressive resistance training: A systematic review. Multiple Sclerosis Journal, 24(6), 703–716.

Levett-Jones, T. (2018). Clinical reasoning: Learning to think like a nurse (2nd ed.). Pearson.

Mohr, D. C., Hart, S. L., Julian, L., Cox, D., & Pelletier, D. (2018). Association between depressive symptoms and clinical outcomes in multiple sclerosis. Multiple Sclerosis Journal, 24(1), 34–41.

Moss-Morris, R., Norton, S., & McCrone, P. (2020). A randomized controlled trial of internet-based cognitive behavioural therapy for distress in people with multiple sclerosis. Journal of Behavioral Medicine, 43(3), 590–602.

Roper, N., Logan, W. W., & Tierney, A. J. (2001). The Roper-Logan-Tierney model of nursing: Based on activities of living. Elsevier Health Sciences.

Detailed Assessment Instructions for the NRSG372 Chronic Illness and Disability Written Assignment

ASSESSMENT INFORMATION
Assessment Title	Written Assignment
Purpose	This assessment will provide students with an opportunity to engage with a health consumer, to gain insight into the impact chronic illness and/or disability has on the consumers life, and to plan person-centered care in partnership with a consumer. Students will have the opportunity to apply specific frameworks to demonstrate critical thinking, clinical reasoning and the principles of caring for people with a chronic illness or disability. Written consent from your interviewee to conduct your interview is required.
Stream A Due Date	Wednesday, 24th March 2021
Stream B Due Date	Wednesday, 5th May, 2021
Time Due	9am
Weighting	50%
Length	1750 words (+/- 10%; includes intext citations, excludes reference list)
Assessment Rubric	Appendix A of the NRSG372 unit outline
LEO Resource	Written Assignment Unpacking video, NRSG372 LEO assessment tile
LOs Assessed	LO1, LO2, LO3, LO6
Task	You are required to conduct a phone or video call interview with a real person in your community who has a chronic illness or disability to discover the impact this has on their life. You will need to prepare for your interview. McGrath, Palmgren & Liljedahl (2019) suggest twelve steps for conducting research interviews; this article is linked on the NRSG372 reading list for Module one.   Identify two (2) care priorities for your interviewee. Present each priority using the Levett-Jones (2018) Clinical Reasoning Cycle, completing the cycle for each priority as outlined in the paragraph structure section of this document. For each priority, identify and rationalise where the person sits on the Roper-Logan- Tierney (RLT) model of nursing independence to dependence continuum. It is expected that appropriate evidence-based literature will be used to support your assignment.
Consent Form	You will need to gain written consent from your interviewee PRIOR to conducting your interview and inform your interviewee they may be called at random by the LIC to confirm consent. There must be evidence that you have interviewed (via phone or video call) a real person in your community, demonstrated by the consent form and unique circumstances outlined in your essay. If there is evidence that students have not conducted a genuine interview an NN grade for the assessment will be awarded.

 

Safety	Confidentiality must be maintained. You must de-identify your interviewee in your paper, by use of a pseudonym, and state this clearly in your paper. Any identifiable location, organisation, or workplace must be deidentified.   This assessment does not encourage you to diagnose conditions or suggest treatments to your interviewee.   Those under 18 years of age, carers, or currently enrolled students at Australian Catholic University, are not to be interviewed.   Students are not to approach strangers for interviews, or to put themselves into situations of risk. Please be aware of the impact of conducting an interview on your interviewee. Should your interviewee become upset, please finish the interview at that point, and contact the LIC for further advice.
Paragraph Structure	Introduction: Introduce the interviewee with a pseudonym (and clearly state it is a pseudonym), their health status and condition(s), introduce your two care priorities, outline the frameworks used, finishing with goals associated with each care priority with a focus on patient centred care. (max 10% of word count). Para 1: What is your first priority? What information have you used to arrive at this? Where on the RLT dependence/independence continuum (by way of equipment, treatments, or interventions) Be specific and explain the priority in depth here. Para 2: What will the consequences be if you do not address this as your priority? This is where you need to justify this being your priority- use evidence to support. Para 3: What is your goal as the nurse in relation to the identified care priority? And what will your intervention be? You will need to substantiate this with evidence and a rationale and bring in the NSQHS partnering with consumers standard. Para 4: What is your second priority? What information have you used to arrive at this? Where on the RLT dependence/independence continuum (by way of equipment, treatments, or interventions) Be specific and explain the priority in depth here. Para 5: What will the consequences be if you do not address this as your priority? This is where you need to justify this being your priority- use evidence to support. Para 6: What is your goal as the nurse in relation to the identified care priority? And what will your intervention be? You will need to substantiate this with evidence and a rationale and bring in the NSQHS partnering with consumers standard. Conclusion: What have you done throughout the paper? What are the next steps? Evaluation of the interventions will demonstrate what? (max 10% of word count).
Submission

 

	1.        Consent Form is to be submitted to the “Assessment One Consent Form” LEO dropbox on your campus tile. Please ensure you submit to the dropbox assigned to your stream.   2.        Written assignment is to be submitted to the “Assessment One Written Assignment” LEO dropbox on your campus tile. Please ensure you submit to the dropbox assigned to your stream.
FORMATTING
File format	.doc or .docx (not .pdf files)
Margins	2.54cm, all sides
Font and size	11-point Calibri or Arial
Spacing	1.5 spacing
Paragraph	Aligned to left margin, indent first line of each paragraph 1.27cm
Title Page	Not to be used
Level 1 Heading	Centered, bold, capitalize each word (14-point Calibri or Arial)
Level 2 Headings	Not to be used
Structure	Introduction, main paragraphs, conclusion, reference list
Direct quotes	Always require page number. No more than 10% of WC in direct quotes
Header	Page number top right corner (9 point Calibri or Arial)
Footer	Name – Student Number – Ax1 – NRG372 – 2021 (in 9 point Calibri or Arial)
REFRENCING
Referencing Style	APA 7th
Minimum References	A minimum of 17 high quality resources are to be used.
Age of References	Published in the last 5 years as this area of knowledge is rapidly developing
List Heading	“References” is centered, bold, on a new page. (in 14 point Calibri or Arial)
Alphabetical Order	References are arranged alphabetically by author family name
Hanging Indent	Second and subsequent lines of a reference have a hanging indent
DOI	Presented as functional hyperlink
Spacing	Double spacing the entire reference list, both within and between entries

ADMINISTRATION

Late penalties will be applied from 9:01am on the due date, incurring 5% penalty of the maximum marks available up to a maximum of 15%. Assessment tasks received more than three calendar days after the due or extended date will receive feedback but will not not be allocated a mark.

Penalty Timeframe	Penalty	Marks Deducted
09:01am Wednesday to 9am Thursday	5% penalty	5 marks
09:01am Thursday to 9am Friday	10% penalty	10 marks
09:01am Friday to 9am Saturday	15% penalty	15 marks
Received after 09:01 Saturday	No mark allocated

Late Penalties

Example:

An assignment is submitted 12 hours late and is initially marked at 60 out of

100. A 5% penalty is applied (5% of 100 is 5 marks). Therefore, the student receives 55 out of 100 as a final mark.

Return of Marks

Marks will be generally returned in three weeks; if this is not achievable, you will be notified via your campus LEO forum.

Final Assignment

Marks for the final assessment (assessment two) of NRSG372 will be withheld until after grade ratification and grade release.

Assessment template project informed by ACU student forums, ACU Librarians and the Academic Skills Unit.

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