Skip To Content  COURSES  RESOURCES  MY MEDIA  TUTORIALSSUPPORTLOG OUT   Lynne Brush7     COURSE NAVIGATION  9SUPPORT  Assessment 4 Instructions: Final Care Coordination Plan  â€¢ PRINT  â€¢ For this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.  NOTE: You are required to complete this assessment after Assessment 1 is successfully completed.  Care coordination is the process of providing a smooth and seamless transition of care as part of the health continuum. Nurses must be aware of community resources, ethical considerations, policy issues, cultural norms, safety, and the physiological needs of patients. Nurses play a key role in providing the necessary knowledge and communication to ensure seamless transitions of care. They draw upon evidence-based practices to promote health and disease prevention to create a safe environment conducive to improving and maintaining the health of individuals, families, or aggregates within a community. When provided with a plan and the resources to achieve and maintain optimal health, patients benefit from a safe environment conducive to healing and a better quality of life.  This assessment provides an opportunity to research the literature and apply evidence to support what communication, teaching, and learning best practices are needed for a hypothetical patient with a selected health care problem.  You are encouraged to complete the Vila Health: Cultural Competence activity prior to completing this assessment. Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.  Demonstration of Proficiency  By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:  â€¢ Competency 1: Adapt care based on patient-centered and person-focused factors.  â€¢ Design patient-centered health interventions and timelines for a selected health care problem.  â€¢ Competency 2: Collaborate with patients and family to achieve desired outcomes.  â€¢ Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.  â€¢ Competency 3: Create a satisfying patient experience.  â€¢ Use the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2020 document.  â€¢ Competency 4: Defend decisions based on the code of ethics for nursing.  â€¢ Consider ethical decisions in designing patient-centered health interventions.  â€¢ Competency 5: Explain how health care policies affect patient-centered care.  â€¢ Identify relevant health policy implications for the coordination and continuum of care.  â€¢ Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.  â€¢ Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.  â€¢ Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.  Preparation  In this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.  To prepare for your assessment, you will research the literature on your selected health care problem. You will describe the priorities that a care coordinator would establish when discussing the plan with a patient and family members. You will identify changes to the plan based upon EBP and discuss how the plan includes elements of Healthy People 2020.  Note: Remember that you can submit all, or a portion of, your plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.  Instructions  Note: You are required to complete Assessment 1 before this assessment.  For this assessment:  â€¢ Build on the preliminary plan, developed in Assessment 1, to complete a comprehensive care coordination plan.  Document Format and Length  Build on the preliminary plan document you created in Assessment 1. Your final plan should be a scholarly APA formatted paper, 5–7 pages in length, not including title page and reference list.  Supporting Evidence  Support your care coordination plan with peer-reviewed articles, course study resources, and Healthy People 2020 resources. Cite at least three credible sources.  Grading Requirements  The requirements, outlined below, correspond to the grading criteria in the Final Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.  â€¢ Design patient-centered health interventions and timelines for a selected health care problem.  â€¢ Address three health care issues.  â€¢ Design an intervention for each health issue.  â€¢ Identify three community resources for each health intervention.  â€¢ Consider ethical decisions in designing patient-centered health interventions.  â€¢ Consider the practical effects of specific decisions.  â€¢ Include the ethical questions that generate uncertainty about the decisions you have made.  â€¢ Identify relevant health policy implications for the coordination and continuum of care.  â€¢ Cite specific health policy provisions.  â€¢ Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.  â€¢ Clearly explain the need for changes to the plan.  â€¢ Use the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2020 document.  â€¢ Use the literature on evaluation as guide to compare learning session content with best practices.  â€¢ Align teaching sessions to the Healthy People 2020 document.  â€¢ Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.  â€¢ Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.  Additional Requirements  Before submitting your assessment, proofread your final care coordination plan to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan.  Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course.  â€¢ SCORING GUIDE  Use the scoring guide to understand how your assessment will be evaluated.  VIEW SCORING GUIDE    

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I will do the video presentation.

 

Develop a 20-minute presentation for nursing colleagues highlighting the fundamental principles of care coordination. Create a detailed narrative script for your presentation, approximately 4-5 pages in length, and record a video of your presentation.  Nurses have a powerful role in the coordination and continuum of care. All nurses must be cognizant of the care coordination process and how safety, ethics, policy, physiological, and cultural needs affect care and patient outcomes. As a nurse, care coordination is something that should always be considered. Nurses must be aware of factors that impact care coordination and of a continuum of care that utilizes community resources effectively and is part of an ethical framework that represents the professionalism of nurses. Understanding policy elements helps nurses coordinate care effectively.  This assessment provides an opportunity for you to educate your peers on the care coordination process. The assessment also requires you to address change management issues. You are encouraged to complete the Managing Change activity.  Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.  Demonstration of Proficiency  By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:  â€¢ Competency 2: Collaborate with patients and family to achieve desired outcomes.  o Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.  â€¢ Competency 3: Create a satisfying patient experience.  o Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.  â€¢ Competency 4: Defend decisions based on the code of ethics for nursing.  o Explain the rationale for coordinated care plans based on ethical decision making.  â€¢ Competency 5: Explain how health care policies affect patient-centered care.  o Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.  â€¢ Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.  o Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation. Script and reference list are not submitted.  Preparation  Your nurse manager has been observing your effectiveness as a care coordinator and recognizes the importance of educating other staff nurses in care coordination. Consequently, she has asked you to develop a presentation for your colleagues on care coordination basics. By providing them with basic information about the care coordination process, you will assist them in taking on an expanded role in helping to manage the care coordination process and improve patient outcomes in your community care center.  To prepare for this assessment, identify key factors nurses must consider to effectively participate in the care coordination process.    Complete the following:  â€¢ Develop a video presentation for nursing colleagues highlighting the fundamental principles of care coordination. Include community resources, ethical issues, and policy issues that affect the coordination of care. To prepare, develop a detailed narrative script. The script will be submitted along with the video.  Note: You are not required to deliver your presentation.  Presentation Format and Length  Create a detailed narrative script for your video presentation, approximately 4–5 pages in length. Include a reference list at the end of the script.  Supporting Evidence  Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your video. Include your source citations on a references page appended to your narrative script. Explore the resources about effective presentations as you prepare your assessment.  Grading Requirements  The requirements outlined below correspond to the grading criteria in the Care Coordination Presentation to Colleagues Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.  â€¢ Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.  o Provide, for example, drug-specific educational interventions, cultural competence strategies.  o Include evidence that you have to support your selected strategies.  â€¢ Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.  â€¢ Explain the rationale for coordinated care plans based on ethical decision making.  o Consider the reasonable implications and consequences of an ethical approach to care and any underlying assumptions that may influence decision making.  â€¢ Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.  o What are the logical implications and consequences of relevant policy provisions?  o What evidence do you have to support your conclusions?  â€¢ Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recordePortfolioed presentation.  o Fine tune the presentation to your audience.  o Stay focused on key issues of import with respect to the effects of resources, ethics, and policy on the provision of high-quality, patient-centered care.  o Adhere to presentation best practices.  Additional Requirements  Submit both your presentation video and script. The script should include a reference page. See Using Kaltura for more information about uploading multimedia files. You may submit the assessment only once, so be sure that both assessment deliverables are included.

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