NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Name

Capella university

NURS-FPX4905 Capstone Project for Nursing

Prof. Name

Date

Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Alcoholism, also known as Alcohol Use Disorder (AUD), signifies a disorder described by the inability to regulate alcohol intake, resulting in adverse effects on personal health (Wang et al., 2020). Alcohol addiction stands as a prominent risk factor for both mortality and disability. Those grappling with AUD face elevated susceptibility to anxiety, depression, cognitive impairment, and illicit substance misuse (Wang et al., 2020). Healthcare professionals can address alcoholism problems by assessing leadership approaches, collaboration, effective change management strategies, and pertinent policies. The capstone project seeks to delve into the widespread issue of alcoholism, a family health issue and aims to offer insights for improvement and intervention.

Alcoholism as a Family Health Problem

Henry, a 38-year-old former smoker, battles alcohol addiction, a challenge that also affects his family. The case of Henry and his family explains the intricate nature of AUD and its widespread effects. With a history of smoking, Henry’s prior habit exacerbates his health risks, stressing respiratory issues, cancer susceptibility, and cardiovascular concerns. I professionally navigate alcoholism, enhancing clinical skills and interdisciplinary collaboration, which are vital for holistic patient care, understanding its impacts, and offering recovery support.

 In addition to the physical and psychological impact, AUD strains interpersonal relationships, leading to family conflicts, social isolation, and financial strain. Henry’s challenging relationships with his spouse and children underscore AUD’s emotional and social toll. I dedicated two hours to meeting with Henry and his family to discuss their health condition and assess potential risks impacting their well-being and quality of life. The objective was to observe and evaluate factors contributing to alcoholism. This capstone project presents an opportunity to identify critical elements influencing Henry and his family’s health improvement, as this matter relates to my professional responsibilities. As a nurse, addressing alcoholism improves patient care and fosters personal growth, empathy, and a deeper connection to the human experience.

Relevance to Practice

The profound influence of the family health issue of alcoholism makes it a pertinent concern. Recent data represents the broader impact of alcoholism, indicating that 10.4% of Americans aged 13 and above struggle with AUD. In comparison, 24.2% of adults engage in binge drinking within a month (National Center for Drug Abuse Statistics, 2023). Expenses linked with alcohol illness, such as liver disease in the United States (US), come to $33.4 billion, with two-thirds of these expenses attributed to hospitals (Guido et al., 2024). Physically, alcoholism triggers liver damage, cardiovascular ailments, and neurological impairments.

Psychologically, it triggers mood swings, cognitive decline, and depression, significantly impacting overall well-being. It underscores concerning trends in alcohol-related behaviors. AUD presents multifaceted challenges affecting individuals, families, and society, as well as its relevance to nursing practice (Rehm et al., 2021). These alarming statistics underscore the urgency of addressing adult alcoholism, demand awareness campaigns, policy reforms, and treatment initiatives. Nurse-led interventions combining Cognitive Behavioral Therapy (CBT), medications, mindfulness, and peer support offer a comprehensive approach to managing AUD (Celik et al., 2024).

As a nurse, my goal is to support and empower Henry and his family to overcome their challenges of alcoholism. This opportunity allows me to implement evidence-based pharmacological and non-pharmacological interventions with my expertise and skills. In guiding AUD treatment with Henry and his family, I develop a deeper understanding and resilience through embracing diverse viewpoints. This capstone project serves as a platform to refine communication skills for patient-centered care.

Analysis of Evidence-Based Literature to Guide Nurses’ Actions

Scholarly literature offers valuable insights into Evidence-Based Practices (EBP) nursing interventions for AUD, which can benefit Henry and his family. For instance, Fairbanks et al. (2020) highlight the significance of pharmacotherapies such as naltrexone in managing alcoholism. These medications aid in the reduction of cravings and promote self-denial, which is particularly valuable for Henry’s family, who grapple with intense urges due to addiction. Another analysis by Magill et al. (2020), underscores the efficiency of CBT in addressing substance use disorders, including AUD.

CBT provides Henry’s family with coping mechanisms and behavioral strategies essential for managing triggers and cravings while striving for abstinence. Educational interventions have also proven effective in raising awareness about the risks of excessive drinking, providing coping strategies, facilitating access to support groups, and promoting medication adherence to control AUD (Nagy et al., 2022). Furthermore, the collaborative care model, involving nurses, patients’ families, and other healthcare experts, has demonstrated efficacy in improving conditions related to alcoholism (Beichler et al., 2023). This model enhances monitoring, follow-ups, and medication adherence and ensures consistent care for Henry and his family.

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

When assessing these interventions, nurses must consider critical criteria such as effectiveness, safety, patient-centeredness, and feasibility. Utilizing the CRAAP test (Currency, Relevance, Authority, Accuracy, Purpose) ensures the reliability of sources guiding nurses for Henry and his family in AUD management (Muis et al., 2022). Sources are considered current (C) as they stem from publications within the past five years.

For instance, Fairbanks et al.’s (2020) study underscores the significance of pharmacotherapies like naltrexone in managing alcoholism. They are also relevant (R) to the issue of alcoholism, providing essential insights into improved patient outcomes. Furthermore, I verified that the information from sources was authoritative (A) and accurate (A). For instance, Magill et al.’s (2020), study, led by expert field authors, employed thorough research practice. Lastly, all sources align with the purpose (P) of managing AUD for Henry and his family through both pharmacological and non-pharmacological interventions.

Potential Barriers and Guiding Framework

Numerous obstacles hinder the application of EBP in managing AUD. Among these is insufficient awareness among healthcare providers and patients regarding effective alcoholism management. Conflict and resistance to change pose challenges concerning unconventional approaches like behavioral therapies and medication adherence. Limited access to resources, including education programs, complicates EBP implementation (Nagy et al., 2022).

The Iowa Model for promoting quality care is a guiding framework to address these barriers. This model integrates research findings, professional expertise, and organizational resources to facilitate evidence-based decision-making and change in practice. By systematically identifying and evaluating challenges, the Iowa model enables nurses to implement evidence-based alcoholism management practices effectively (Cullen et al., 2022). This approach ensures sustained improvements, promoting excellence in care for Henry and his family through CBT and other best practices.

National Standards or Policies Affecting Nursing Practice

The American Association of Nurse Practitioners (AANP) policies are pivotal in shaping nurse roles and responsibilities in addressing AUD. These policies underscore the importance of integrating EBP, patient-centered care, and interdisciplinary collaboration in managing AUD. Following AANP guidelines, nurse practitioners conduct comprehensive assessments operating authorized means like the Alcohol Use Disorders Identification Test (AUDIT) and provide brief interventions and counseling to specialized addiction treatment programs or mental health services for families like Henry and his family (Paulus et al. 2023). 

The Affordable Care Act (ACA) and Mental Health Parity and Addiction Equity Act (MHPAEA) have significant implications for AUD management by promoting access to psychological well-being and addicted substance facilities, including AUD management. These policies ensure that insurance coverage includes AUD screening, counseling, behavioral therapies, and medication management without biased limitations (Kantawong et al., 2023). Consequently, Henry and his family can access evidence-based interventions and comprehensive care for AUD under ACA- insurance plans. 

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

The American Association of Colleges of Nursing (AACN) establishes guidelines for nursing instruction that prepare nurses to address complex health issues such as AUD. These standards emphasize EBP, interprofessional collaboration, and leadership in healthcare delivery. Nurses under AACN guidelines are equipped with skills to screen for AUD, provide education, and collaborate with other healthcare specialists to facilitate holistic care for families like Henry and his family within their scope of practice (Wolfson & Poole, 2023).

State legislative policies outline specific protocols and guidelines for AUD screening, intervention, and referral processes in healthcare settings. These policies ensure that healthcare providers, including nurses, follow standardized procedures for identifying AUD and offering appropriate interventions to specialized services (Wolfson & Poole, 2023). By adhering to state-level policies, nurses like those caring for Henry and his family can ensure consistency and quality in AUD management practices across different healthcare facilities.

Leadership Strategies and Change Management

Leadership is crucial in implementing AUD management techniques for families like Henry and his family. The transformational leadership approach efficiently guides nurses to adopt best practices within the healthcare system by inspiring and motivating team members for better outcomes. Strategies include forming interdisciplinary care teams, implementing family education programs, utilizing technology for remote monitoring, and initiating quality improvement initiatives. Healthcare leaders will establish and lead multidisciplinary teams comprising nurses, physicians, pharmacists, and others to ensure comprehensive and coordinated care for patients with alcoholism (Huang & Liu, 2023). This personalized approach will benefit Henry and his family through tailored care plans, regular follow-ups, and shared decision-making, leading to improved outcomes. 

Leaders will oversee the implementation of education programs focusing on AUD management, empowering families like Henry’s family with self-care and CBT strategies to enhance their health literacy and engagement in self-management. This approach facilitates accessibility and care continuity for Henry and his family through virtual follow-ups and real-time communication, fostering open communication, mutual respect, and patient-centered care. Thus, transformational leadership ensures enhanced care quality, better outcomes, and a positive impact on patient experience and satisfaction (Beichler et al., 2023). Furthermore, leaders can effectively manage change and implement EBPs for AUD management, providing patient-centered care for families like Henry and his family. 

The ADKAR model is instrumental in managing alcoholism and driving organizational change. Leaders ensure healthcare providers are aware (A) of the need for change in AUD management. It fosters a desire (D) among team members to embrace change, provide necessary knowledge (K) and skills through training and education, and empower healthcare providers to implement change effectively (Racine et al., 2021). The model reinforces (R) and sustains change through recognition, feedback, support, and barrier resolution. The ADKAR framework addresses resistance to change, drives behavior change, and improves practices that benefit families like Henry and his family in managing AUD (Racine et al., 2021).

Part Two

Documentation of the Practicum Hours

During my practicum, I spent two hours with Henry and his family, conducting assessments, discussing treatment options, and providing emotional support. These interactions offered valuable insights into Henry and his family’s needs, informing a patient-centered care plan. Tailored leadership strategies significantly supported Henry and his family throughout their treatment journey, enhancing patient care and healthcare leadership in AUD management.

Conclusion

The capstone project discusses alcoholism’s effects, nursing interventions, and their application to patient Henry and his family, emphasizing leadership, collaboration, and policy relevance in AUD management. It advocates for tailored care and effective change strategies to enhance patient well-being, stressing the significance of comprehensive, patient-centered approaches and healthcare leadership in AUD management.

References

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Celik, M., Gold, M. S., & Fuehrlein, B. (2024). A narrative review of current and emerging trends in the treatment of alcohol use disorder. Brain Sciences, 14(3), 294. https://doi.org/10.3390/brainsci14030294

Cullen, L., Hanrahan, K., Edmonds, S. W., Reisinger, H. S., & Wagner, M. (2022). Iowa implementation for sustainability framework. Implementation Science, 17(1). https://doi.org/10.1186/s13012-021-01157-5

Fairbanks, J., Umbreit, A., Kolla, B. P., Karpyak, V. M., Schneekloth, T. D., Loukianova, L. L., & Sinha, S. (2020). Evidenced-based pharmacotherapies for alcohol use disorder. Mayo Clinic Proceedings, 95(9). https://doi.org/10.1016/j.mayocp.2020.01.030 

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NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

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Paulus, D. J., Rogers, A. H., Capron, D. W., & Zvolensky, M. J. (2023). Maximizing the use of the Alcohol Use Disorders Identification Test (AUDIT) as a two-step screening tool. Addictive Behaviors, 137, 107521. https://doi.org/10.1016/j.addbeh.2022.107521

Racine, N., Ereyi-Osas, W., Killam, T., McDonald, S., & Madigan, S. (2021). Maternal-child health outcomes from pre- to post-implementation of a trauma-informed care initiative in the prenatal care setting: A retrospective study. Children, 8(11), 1061. https://doi.org/10.3390/children8111061

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NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

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