NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Patient-Centred Care 

 

Programs aimed at improving the health of large populations are becoming increasingly essential to health care organizations in the United States. PHIIs, or population health improvement initiatives, were created with the dual objectives of reducing overall health care costs and improving the lives of different population segments, such as pregnant women and older residents. In addition, PHIIs give critical information on patient-centred Care and expenditure per capita in the form of verifiable clinical, humanistic, procedural, economic, and utilization outcomes (Kazdin, 2019). A PHII’s findings are considered by medical experts when creating treatment plans customized explicitly to the needs of patients treated by a health institution.

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Changing patient demographics, illnesses, and care environments might lead to evidence not being presented in the context of a health care professional’s practice (Anglin et al., 2021). Experts in the health care sector do an evidence evaluation of a PHII and choose just those factors relevant to the specific patient care plan when presented with such situations. When discussing evidence-based practice, the story of Mr. Nowak, an Uptown Wellness Clinic (UWC) patient who fell and had a traumatic brain injury (TBI), is presented as an example. Mr. Nowak voiced worry about his increasing shakiness during his cholesterol screening. In his view, a person’s inability to maintain their balance indicates brain injury.  NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Mr. Nowak’s treatment plan should be based on evidence from Safe Headspace, according to a charge nurse at UWC. One of Safe Headspace’s goals is to enhance the results for those who have. The evidence from the PHII will be included in Mr. Nowak’s treatment plan once thoroughly examined. As a starting point for Mr. Nowak’s therapy, the assessment will seek to uncover any knowledge gaps within the PHII. It will then provide viable remedies to those gaps. A new framework for evaluating the patient care plan will be created in light of the results.

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Evaluation of Population Health Improvement Initiative (PHII) Outcomes

Seeing some of the PHII Outcomes results in promising research discoveries was uplifting. It was pretty encouraging to see these goals come to fruition. Participants aged 45 to 80 who engaged in cardiac exercise saw improvements in short-term memory, mood, and muscle control, to name a few of the results they identified as promising. Studies have shown that meditating significantly improves one’s mood and lessens the symptoms of depression. When treating traumatic brain damage, an intervention like word puzzles or games failed to provide any positive results (TBI). Safe Headspace PHII has significantly improved the health outcomes of older adults who have PTSD due to head trauma since its inception (Rahill et al., 2020).

NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Physical movement, talk therapy, and meditation are just a few of the methods used by the PHII to help people with mental health difficulties. Regular exercise was the most beneficial intervention this program provided. More than 70 percent of the participants in the intervention were men in their late 40s and early 50s. Four months of aerobic exercise were required of each of the participants. One in 15 men showed an increased ability to control muscles, while 22 percent showed an increase in mood, and 61 percent showed an increase in their short- to medium-term memory capacity. Despite this, the data presented here does not offer a comprehensive picture of the problem. People diagnosed with post-traumatic stress disorder and traumatic brain injury were the first to benefit from the PHII (Rodney et al., 2020).

Individuals with PTSD or TBI cannot be studied independently. Thus, the outcomes of cases like Mr. Nowak’s, who has a history of TBI but no record of PTSD, remain ambiguous and need more investigation. Safe Headspace’s findings do not explain why patients were unable to follow the self-management plans they were given, nor do they analyze whether or not this lack of motivation was connected to factors such as high medical costs or insufficient therapy. Evaluation of these previously unresearched outcomes increases the evidence base and assists doctors in devising treatments for individual patients that are fit for the symptoms, history and experiences.

Evaluation of Population Health Improvement Initiative (PHII) Outcomes and Strategies for Improving Outcomes

One way to improve the overall findings of the PHII research is to expand the number of participants. Considering how few people participated in the meditation experiment, any positive results are likely to have more weight than results from research with larger sample size. There is no harm in asking family members for their thoughts as well. The patient’s family must be invited whether they have seen any changes in their loved one since persons with traumatic brain injuries may not be aware of certain behaviours they participate in (Mikolić et al., 2019). This is why it is so important to inquire. One member of the family may be the only one who recognizes anything. There may be a need for surveys. NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Furthermore, there was a lack of a randomised control study during the PHII activity. In addition, everyone who took part was a native of the same region. Attrition and recruitment are considered when determining the necessary number of participants for a study to be genuine. The utilization of a wide range of media and collaborations with various disciplines and organizations, as well as the expansion of the demographics of the participant community, were critical to the project’s success (Ord et al., 2022). In addition, it explains how to pick a population to study in combination with a specific intervention. Once the results have been compared to the outcomes of a control group, the researchers will publish their findings. PHII community studies did not seem to reach groups who did not get the studied therapies. The observation was the primary method employed in this study. Despite my diligent searching, the comparisons of interventions in terms of therapy were nowhere to be found. By filling in the holes in the Safe Headspace programs, the PHII’s methodology may be included in the treatment plan the UWC has prepared for individuals like Mr. Nowak.

Bellin Health, a Wisconsin-based integrated healthcare delivery system, demonstrates the Triple Aim’s effectiveness. Bellin enhanced the health of its employees and Medicare beneficiaries by using the approach (Wallace et al., 2022). To achieve this, the health care specialists at Bellin could provide cost-effective, patient-satisfying and comprehensive treatment for both large-scale health initiatives and individual patients. Despite its many triumphs, the Triple Aim continues to confront various challenges. “The Phantom Aim,” which refers to the health and happiness of individuals who work in the health care profession, is a second impediment.” It’s a challenging work environment that can lead to employee burnout as a consequence of the three objectives (Wallace et al., 2022). Because of this, quality improvement programs must include measures to enhance the working circumstances of medical workers. It’s essential to consider the benefits and limitations of every effort to improve quality. In designing a treatment plan for Mr. Nowak, the medical personnel at UWC should consider both the advantages and disadvantages of employing the Triple Aim framework. Similar to the PHII results, the plan must consider the findings and alter them to compensate for shortcomings.

Personalized Evidence-Based Patient Care Plan

Only if the treatment regimens are adjusted to each patient following the above statement can a high degree of evidence-based medicine (EBM) be accomplished by employing any or all of the PHII treatments. This should be kept in mind while considering using any or all PHII treatments. This patient does not live in the same environment as the research participants. Therefore, consider additional therapies that have been proved to assist patients with traumatic brain injury (Talal et al., 2020). Further treatment is required as a result. I’ll meet with the patient again after I’ve explained that problems with balance are the second most common symptom of traumatic brain injury so that we can talk about the patient’s worries about the connection. I’ll let him know that I understand his concerns about balance, which is the second most common symptom of a traumatic brain injury.

NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

After he tells me about his friendships in their entirety, I’ll begin questioning him. TBI sufferers may find themselves alone due to their condition, which may lead to feelings of loneliness. According to the report, someone with mental or physical health concerns may experience sensations of loneliness even when they are not alone. In the month after his departure, I will ask him to restore touch with at least one friend from a list I will provide or go to a support group (Marra et al., 2020). Reconnecting with old friends or conversing with people going through similar hardships may help him feel less anxious if this has been a problem for him. I think it is feasible for him to reconnect with old friends or others who are going through something similar to what he is; if this has been an issue for him, In the following 30 days, I advise him to attempt a new exercise regimen and then get in touch with me through our electronic patient connection platform on our online platform for new patient connections.

A helpful intervention would be to utilize the Xbox Kinect function to monitor patients with cardiovascular health and balance issues participating in video games powered by Microsoft’s sensor technology (Tremblay et al., 2021). An excellent and beneficial study was carried out. The voice-activated feature of the Xbox Kinect was my initial thought. I opted to utilize the function because of my view that it would be an effective intervention in this situation. It was shown that using motion capture gaming technology may restore dynamic balance and provide cardiovascular exercise to someone who has suffered a severe traumatic brain injury (TBI). To achieve this, they had to be able to track their movements accurately.

Analysis of Evidence

The PHII interventions taught me a lot, and Mr. Nowak has high cholesterol, so I knew I had to add some physical exercise to his treatment plan. Having both of us do this seemed like a good idea to me. There are no downsides to doing this, in my opinion, and just great rewards. The Patient-Centered Medical Home has had a lot of success in increasing the quality of interactions between primary care physicians, patients, and their families (Barone Gibbs et al., 2021). Over three years of research, the PCHM was effectively incorporated into the Pennsylvania Chronic Care Initiative. Compared to non-PCMH practices, the PCMH pilot year’s adjusted expenditures were 17.5% lower.

Consequently, fewer people are being admitted to hospitals, going to the ER, and visiting outpatient clinics. mHealth, or mobile health, has a lot of promise in metropolitan regions, where there are a lot of clinical and financial pressures to deal with. Urban and working-class neighborhoods, notably in Chicago, Illinois, are the primary focus of UCM, an academic medical facility (Granger et al., 2018). The mobile health program includes messaging services, appointment reminders by email and text, and follow-up contact via phone calls, emails, and readers for self-management. Patients were encouraged to continue practicing self-management as a consequence of this. However, there are drawbacks to these methods. PCMHs are often employed to treat chronic illnesses, but little is known about their potential use in treating mental conditions.  NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Patients who use mHealth platforms want to feel like they are engaging in the project by seeing a natural face (Rashidi et al., 2020). As a result, UCM employees have been tasked with keeping tabs on the mHealth participants. In addition, due to the complicated and heavily controlled structure of the technology and health care sectors, there are numerous unresolved challenges with adopting mHealth. UWC’s PCMH and mobile health studies can better serve public health. There are several ways in which a clinic might use this research to enhance its treatment choices. Establishing a practical evaluation framework may help ensure adherence to the patient care plan’s requirements.

Evaluation Strategy for Personalized Care Approach Outcomes

The breadth of the medical examinations I can undertake is more limited since this treatment plan focuses on the patient performing particular duties at home while going about his daily life (Rashidi et al., 2020). Gait index and qualitative remarks will be given on the patient’s friendships and energy level as part of the evaluation approach that I will utilize for this patient every three months. In a monthly questionnaire based on cognitive and Behavioural questions, which he will complete once a month, I will search for themes of reconnecting with people and initiating new interests. We’ll also check on him every three months to determine whether his cholesterol levels have dropped. These evidence evaluation levels aren’t particularly compelling, but for the sake of this strategy, I think they’re appropriate. People with neurological conditions such as multiple sclerosis and stroke may benefit from the dynamic gait index, which is an effective tool for monitoring gait, balance, and the risk of falling.

Conclusion 

This patient’s treatment plan includes concepts from PHII and other support groups, combined with the novel use of an X-Box for an innovative intervention. I was pleased to read that gaming and exercise might improve cardiovascular health and balance. With friends, family, or even alone oneself, I feel this is a safe exercise that may enhance mood, overall health, and balance. These treatments may be used with a broad range of people who suffer from various chronic mobility issues.

References

Anglin, D. M., Orshansky, S., Kluang, M. J., Bridgewater, M. A., Niendam, T. A., Ellman, L. M., Deviled, J., Thayer, G., Bolden, K., Musket, C. W., Grattan, R. E., Lincoln, S. H., Schiffman, J., Lipner, E., Bachman, P., Corcoran, C. M., Mota, N. B., & van der Ven, E. (2021). From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States. American Journal of Psychiatry, 178(7), 599–610. https://doi.org/10.1176/appi.ajp.2020.20071091

NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Barone Gibbs, B., Hiver, M.-F., Jerome, G. J., Kraus, W. E., Rosenkranz, S. K., Schorr, E. N., Spartan, N. L., & Lobelo, F. (2021). Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How? A Scientific Statement From the American Heart Association. Hypertension. https://doi.org/10.1161/hyp.0000000000000196

Granger, C. L., Parry, S. M., Ed Brooke, L., Abo, S., Leggett, N., Dwyer, M., & Denehy, L. (2018). Improving the delivery of physical activity services in lung cancer: A qualitative representation of the patient’s perspective. European Journal of Cancer Care, 28(1), e12946. https://doi.org/10.1111/ecc.12946

Kazdin, A. E. (2019). Annual Research Review: Expanding mental health services through novel models of intervention delivery. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 60(4), 455–472. https://doi.org/10.1111/jcpp.12937

Marra, D. E., Hamlet, K. M., Bauer, R. M., & Bowers, D. (2020). Validity of tele neuropsychology for older adults in response to COVID-19: A systematic and critical review. The Clinical Neuropsychologist, 1–42. https://doi.org/10.1080/13854046.2020.1769192

Mikolić, A., Polinder, S., Retell Helmrich, I. R. A., Haagsma, J. A., & Cnossen, M. C. (2019). Treatment for posttraumatic stress disorder in patients with a history of traumatic brain injury: A systematic review. Clinical Psychology Review, 73, 101776. https://doi.org/10.1016/j.cpr.2019.101776

Ord, A. S., Epstein, E. L., Shull, E. R., Taber, K. H., Martindale, S. L., & Rowland, J. A. (2022). Factors associated with recovery from posttraumatic stress disorder in combat veterans: The role of deployment mild traumatic brain injury (mob). Rehabilitation Psychology. https://doi.org/10.1037/rep0000400

Rahill, G. J., Joshi, M., Zlotnick, C., Lamour, S., Beech, H., Sutton, A., Burris, C., & Paul, P. (2020). “Give Me Proof”: A Covert but Coercive Form of Non-partner Sexual Violence Contributing to Teen Pregnancy in Haiti and Opportunities for Biopsychosocial Intervention. Journal of Aggression, Maltreatment & Trauma, 29(7), 835–855. https://doi.org/10.1080/10926771.2020.1738616

Rashidi, A., Kaisha, P., Whitehead, L., & Robinson, S. (2020). Factors that influence adherence to treatment plans amongst people living with cardiovascular disease: A review of published qualitative research studies. International Journal of Nursing Studies, 110, 103727. https://doi.org/10.1016/j.ijnurstu.2020.103727

Rodney, T., Taylor, P., Dunbar, K., Perrin, N., Lai, C., Roy, M., & Gill, J. (2020). High IL-6 in military personnel relates to multiple traumatic brain injuries and post-traumatic stress disorder. Behavioural Brain Research, 392, 112715. https://doi.org/10.1016/j.bbr.2020.112715

Talal, A. H., Solicitous, E. M., Jaanimägi, U., Kerenski, M., Tobin, J. N., & Marcato, M. (2020). A framework for patient-centered telemedicine: Application and lessons learned from vulnerable populations. Journal of Biomedical Informatics, 112, 103622. https://doi.org/10.1016/j.jbi.2020.103622

Tremblay, S., Castiglione, S., Audet, L.-A., Desmarais, M., Horace, M., & Peláez, S. (2021). Conducting Qualitative Research to Respond to COVID-19 Challenges: Reflections for the Present and Beyond. International Journal of Qualitative Methods, 20, 160940692110096.

https://doi.org/10.1177/16094069211009679

NURS FPX 6011 Assessment 2 Traumatic Brain Injury Care Report GCU

Wallace, T., Morris, J. T., Glickstein, R., Anderson, R. K., & Gore, R. K. (2022). Implementation of a Mobile Technology–Supported Diaphragmatic Breathing Intervention in Military mob with PTSD. The Journal of Head Trauma Rehabilitation, 37(3), 152–161. https://doi.org/10.1097/HTR.0000000000000774