Developing Accountability for Care Delivery and Self-Care Management

by | Sep 3, 2024 | EDUCATION

 

Develop accountability for care delivery and self-care management.
Background
According to the Agency for Healthcare Research and Quality (AHRQ, 2020), “to provide effective self-management support (SMS), a team of clinicians and administrative staff need to coordinate closely with each other to provide care before, during, and after the patient visit. Successful teams are made up of clinical and administrative staff whose roles are planned in advance (para 7).”
Furthermore, the Joint Commission (Battersby et al., 2010) identified the following principles of patient self-care management:
1. Clinical and health behavior assessments are brief and targeted
2. Evidence-based information is used to guide patient-clinician discussions and shared decisions
3. Clinicians and staff maintain a nonjudgmental approach to patients
4. Patients and clinicians collaboratively prioritize & set goals & action steps
5. Patients and clinicians collaborate, identify and solve goal-related problems
6. Patients work on SMS with several members of the healthcare team; the commitment to SMS is practice-wide
7. SMS interventions are delivered in a variety of formats (in person, by phone, online, via print materials)
8. The focus is patient self-efficacy
9. The healthcare team provides timely, active follow-up
10. Case management is provided for selected patients
11. Patients are linked to evidence-based community programs
12. SMS is delivered and reinforced in numerous multifaceted interventions
Assessment Instructions
Considering what you have learned about APRN roles and the principles of patient self-care management previously, address the following points for this assessment in 4-5 pages not including the title or reference pages:
1. Describe how an APRN would involve themselves in each of the following self-care management activities:
o Gather clinical data before a visit.
o Set agendas for patient visits.
o Help patients set health goals.
o Develop action plans for achieving goals.
o Track health outcomes.
o Refer patients to community programs.
2. What APRN role(s) (i.e., certified nurse educator, nurse practitioner, nurse executive, clinical nurse specialist, certified nurse informaticist, advanced practice case manager, etc), would best fit each of the activities you chose?
3. What intervention(s) would an APRN employ to support patient self-management for each activity you chose? For example, a nurse practitioner may use Motivational Interviewing techniques, a nurse executive may convene a task force, and a nurse educator may track outcomes and tailor educational offerings based on data. List and describe the interventions for each of the activities you chose. The AHRQ site below can support your search.
4. What self-care management principles listed above support the interventions you describe?

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Answer

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Developing Accountability for Care Delivery and Self-Care Management

In an era where patient-centered care is paramount, Advanced Practice Registered Nurses (APRNs) play a crucial role in facilitating effective self-management support (SMS) for patients. According to the Agency for Healthcare Research and Quality (AHRQ), successful SMS requires a coordinated effort among healthcare teams, including clinical and administrative staff. This essay will address how APRNs can involve themselves in specific self-care management activities, identify which APRN roles best fit these activities, outline interventions to support patient self-management, and connect these interventions to the principles of self-care management as identified by the Joint Commission.

Involvement of APRNs in Self-Care Management Activities

1. Gather Clinical Data Before a Visit

Involvement: Prior to a patient visit, an APRN can gather clinical data through electronic health records (EHRs), reviewing previous visit notes, lab results, and any other relevant medical history. They may also utilize patient-reported outcomes and questionnaires to assess current health status and concerns.

APRN Role: Nurse Practitioner (NP)

Intervention: The NP might employ automated pre-visit questionnaires sent via patient portals to enhance data collection efficiency. This allows for a comprehensive understanding of the patient’s health and facilitates targeted discussions during the visit.

2. Set Agendas for Patient Visits

Involvement: APRNs can engage patients in setting the agenda for their visits by asking them what topics or concerns they would like to discuss. This collaborative approach enhances patient engagement and ensures that their priorities are addressed.

APRN Role: Clinical Nurse Specialist (CNS)

Intervention: The CNS may use structured communication tools such as the “Ask-Tell-Ask” method to facilitate discussions about the agenda, ensuring that patients feel heard and empowered to express their needs.

3. Help Patients Set Health Goals

Involvement: APRNs should assist patients in identifying realistic and achievable health goals based on their individual circumstances, preferences, and values. This process involves motivational interviewing techniques to elicit patient motivation and commitment.

APRN Role: Certified Nurse Educator (CNE)

Intervention: The CNE would conduct educational sessions where patients are guided through goal-setting frameworks such as SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound), ensuring that patients understand how to set effective health goals.

4. Develop Action Plans for Achieving Goals

Involvement: Once goals are set, APRNs can help patients develop actionable plans that outline the steps needed to achieve these goals. This includes identifying potential barriers and strategies to overcome them.

APRN Role: Advanced Practice Case Manager

Intervention: The case manager can create a personalized action plan with the patient that includes specific tasks, timelines, and resources needed for success. Regular follow-ups can be scheduled to monitor progress and make adjustments as necessary.

5. Track Health Outcomes

Involvement: APRNs should regularly assess and monitor health outcomes through follow-up appointments, assessments, and patient-reported data to evaluate progress toward health goals.

APRN Role: Nurse Executive

Intervention: The nurse executive can implement a quality improvement initiative that utilizes EHR data analytics to track key performance indicators related to self-management outcomes across the practice. This data can inform strategic decisions for enhancing SMS practices.

6. Refer Patients to Community Programs

Involvement: APRNs can identify local community resources that align with patients’ health goals and refer them accordingly. Building a network of community resources is essential for comprehensive care.

APRN Role: Clinical Nurse Specialist (CNS)

Intervention: The CNS may develop partnerships with community organizations to create a referral directory for available resources such as fitness programs, nutritional counseling, or support groups tailored to specific health conditions.

Supporting Interventions Through Self-Care Management Principles

Each intervention aligns with various self-care management principles outlined by the Joint Commission:

– Gather Clinical Data Before a Visit: Supported by principle 1 (brief and targeted assessments) and principle 10 (case management).

– Set Agendas for Patient Visits: Aligned with principle 4 (collaborative goal-setting) and principle 3 (nonjudgmental approach).

– Help Patients Set Health Goals: Supports principle 8 (focus on self-efficacy) and principle 4 (prioritizing goals collaboratively).

– Develop Action Plans for Achieving Goals: Related to principle 5 (collaborating to identify goal-related problems) and principle 6 (commitment to SMS being practice-wide).

– Track Health Outcomes: Connected to principle 9 (timely follow-up) and principle 12 (multifaceted interventions).

– Refer Patients to Community Programs: Supports principle 11 (linking patients to evidence-based community programs) and principle 6 (practice-wide commitment).

Conclusion

APRNs play an integral role in developing accountability for care delivery and self-care management by actively engaging in various activities that promote patient empowerment and self-efficacy. By utilizing specific interventions tailored to their roles, APRNs can enhance the effectiveness of self-management support, ultimately leading to better health outcomes for patients. Aligning these interventions with established self-care management principles ensures a comprehensive approach that addresses the multifaceted needs of patients in today’s healthcare environment.

 

 

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