NURS FPX 4065 Assessment 5 Final Care Coordination Strategy

NURS FPX 4065 Assessment 5 Final Care Coordination Strategy 

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Student Name

University

FPX4065

Professor’s Name

Submission Date

Final Care Coordination Strategy

One of the ongoing significant public health issues is the fact that anxiety disorders are still present and may have developed due to the ongoing stress of factors such as poverty and unstable environments, as well as family dysfunction. The data collected at the time of the initial care coordination plan show that people living in economically and socially disadvantaged communities are more likely to suffer from mental issues, be less able to function, and have poor health status. In our society today, over 1 billion people suffer anxiety and other mental illnesses. . . A care coordination approach might have a positive effect on some social and psychological determinants of health that play a role in the onset of anxiety disorders. In contrast to the preliminary infographic created to show the proposed care coordination plan, the plan contains a number of components: ethics, evidence-based practice, policies that impact the problem, and patients’ needs.

Patient-Centered Health Interventions and Timelines 

When dealing with anxiety disorders within vulnerable populations, an integrated approach needs to be applied to handle the problems psychologically and socially. The first challenge that the healthcare system is facing is that people’s ability to cope with their activities is highly impacted by symptoms of persistent anxiety, insomnia, exhaustion, and difficulties in concentration. A solution to this problem is to consider using Cognitive Behavioral Therapies (CBT) in combination with Mindfulness-Based Stress Reduction techniques. From the literature review conducted, it can be seen that CBT is an effective way to manage the problems, as it helps to identify and change one’s thoughts causing anxiety. There are also several other stages that should be taken into consideration for this intervention: diagnosis and referrals (within 2 weeks); weekly intervention (8 weeks); and assessment of progress using GAD-7 scales (after 3 months).

Economic and environmental stress is one of the big problems that can occur with chronic anxiety. Financial / housing problems and socialization issues increase the challenge to the patient’s mental health. Care coordination here will be about helping patients to access additional services either financed by assistance or through housing and family counseling. Community involvement and needs met through Medicaid and/or ACA services likely would have had a significant effect on patients and their needs. These measures should take place during the first month, and the identification of at least two community resources should be ensured within three months.

Finally, lack of knowledge about health and the importance of mental health services and limited access to services are a third issue that should be considered in this project and may pose a barrier to service use. These go hand-in-hand with stigma and lack of awareness. Education that is culturally sensitive, addressing anxiety disorders, and multiple resources for caregivers are possible strategies to handle this challenge (Arahanthabailu et al., 2024). The program will begin with an initial evaluation (after 1 week).

Ethical Decisions in Designing Patient-Centered Interventions   

Some of the ethical issues associated with people with anxiety disorders, as they relate to care co-ordinating approaches, are autonomy, beneficence, nonmaleficence, and justice. To begin with, autonomy is critical since a significant number of individuals tend to be shy about getting involved in treatment due to stigmatization and culture. Second, nurses have to exhibit beneficence and nonmaleficence by making sure that the process is least harmful and most advantageous to the patient. Thirdly, justice is a key requirement as many of the vulnerable are not able to receive medical attention because of inequity. Access to health services is limited in certain groups of people, for a variety of reasons.

The ethical questions that come out in this case scenario are:

What can nurses do if the patient refuses treatment when he or she has significant anxiety disorders?

The problem of correct allocation of limited resources in the community?

If a patient’s family does not wish to share information, should nurses include the family?

To solve such problems, it appears that ethical thinking and inter-disciplinary thinking are required. Research has shown that it is essential to use a welcoming approach if treatment is to be successful.

Health Policy Implications for Care Coordination 

Policy in health care affects the access to and quality of coordination strategies that could be available for anxiety disorders. The Affordable Care Act (ACA) will make the coordination strategies more available, given provisions for behavioral health treatment and the use of medication and psychotherapy treatments.

 It’s important to diagnose the anxiety disorder early on so that the appropriate treatment can be provided. Another resource that can help cover patients concerning their care coordination and mental health is Medicaid. Medicaid provides benefits to individuals who cannot afford insurance and even provides services to such individuals.

Socially, they have an impact on the social care that is provided in the form of housing support and financial assistance through care coordination. The social determinants are regarded as one of the key factors associated with patients’ poor mental health. So, their physical and psychological health are going to be affected by social policies, as they’ll be presented with a favorable environment.

Priorities for Care Coordination Discussions 

These priorities will be crucial in the conversation when discussing the care co-ordinated approach to the patient and family. Firstly, the need to enhance the understanding of the causes of anxiety and what triggers it is important. Educate patients and/or their families about the psychological nature of these disorders associated with financial, environmental and/or social stressors. This awareness will help the patient to take initiative towards solutions. In addition, enhancing communication and the decision-making process with patients’ participation must be deemed an important priority. Patients’ needs and preferences, and their willingness to change, all need to be considered when planning interventions. This way, autonomy and a proper implementation of interventions will be assured. Lastly, community services would have to be considered as a priority as they would have an impact on a number of aspects of patients’ psychological health.

Revisions and Adaptations to the Care Plan

During care coordination sessions, all changes and modifications to the care plan should be coordinated as a priority, as these changes in the plan need to be completed correctly for the care plan intervention to be completed.

The duty of the care coordinator is to evaluate the patient’s progress and obstacles in the interaction between the patient/patient’s family and the Care plan. Some of the obstacles might be related to the lack of resources, culture, and health literacy skills, which can help support the modification of the interventions. If there appears not to be adherence to the treatment plan, e.g., if patients are not taking it, another intervention method can be used, e.g., teleconferencing.

Aligning Teaching Sessions with Best Practices and Healthy People 2030 

Evaluation is fundamental to ensure the success of care coordination, as interventions/learning should lead to good outcomes. Care coordination becomes part of this care plan and aligns with the goals of Healthy People 2030 as it involves the use of strategies to address health disparities, increase access to health services, and improve mental wellness. Standardized instruments (e.g., GAD-7) are helpful to look at changes in level of anxiety. Educational interventions and any other activities should be assessed with the client’s satisfaction survey in order to evaluate the client’s satisfaction with the activities. The proposed intervention is effective, demonstrated by utilizing community resources.

Good patient education should include provision for variations that will cater to individual differences in clients. For example, implementation of an interactive communication model is crucial, depending on the client’s learning style. Furthermore, a culturally competent approach to health care delivery has to be included, as some people might have difficulty getting the needed health care information. The results from the review process could highlight the need to review the care plan. Some clients may be less health literate than others, and the education information on health must be modified to be easily understood.

Revisions and Adaptations

The care co-ordinated plan(s) will always be amended to ensure they are effective in meeting the needs of the patients. The changes that occurred for the patients, adherence to interventions, and the patients’ outcomes compared to intervention effectiveness will be evaluated to modify interventions as appropriate. If there are problems patients might encounter in accessing interventions because of geographical location, then using telemedicine as a way of providing interventions could solve the problems. In addition, the education offered will also be adjusted depending on the patients’ literacy level and culture.

Conclusion

Treatment of people with stress-related anxiety should be delivered with a treatment approach that considers the psychological and social aspects of health issues. Seeing evidence-based practices, ethical principles, and health policies integrated into this approach allows for identifying health problems from an empowering perspective that helps to benefit disadvantaged patients. This will enable the right care to be taken for patients. Lastly, the strategy incorporates Healthy People 2030 objectives in the areas of health equity and decreasing health inequities.

References

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