Preliminary Care Coordination Plan
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Preliminary Care Coordination Plan
Introduction
A preliminary care coordination plan is a blueprint designed to provide collaborated care for a specific condition. We will develop a coordinated care plan for a patient with obesity and mental health-related issues for this task. Obesity is a common and complex disease involving an excessive amount of body fat. It is a widespread medical condition that contributes to increased risks for other conditions such as hypertension, cardiac ailments, and strokes. The care plan involves cultural coordination, physical and psychosocial interventions through utilizing the available community resources. Some of the physical interventions include dietary changes, physical exercise in the community, and school facilities. Psychosocial services will be used through a community counselor to assist the target patient with mental health counseling. Most crucially, the care plan will be patient-centered and consist of family collaboration to provide the patient’s complete wellbeing.
Overview and Analysis of the Selected Condition
Obesity is a condition whereby the individual has body fat that is above the normal BMI. The situation is caused by poor dietary lifestyles, lack of exercise and a combination of genetic factors. For the target patient, the condition has been primarily contributed to by a sedentary lifestyle coupled with poor feeding habits (Di Cesare et al., 2019). This has resulted in increased body fat concentration and weight. The condition started from an early age and has since developed throughout the young adulthood phase. In America, most of the adults with obesity occasionally have a history of early childhood obesity. The parents cite that the condition has led the adolescent to develop physiological challenges and mental health issues associated with body image and low self-esteem. As reported, they have been victims of body shaming in the educational facilities and the community setting. As a result, the care plan is focused on promoting a lifestyle change through collaboration with the parents and making the entire program patient-centered. Improved nutrition and physical exercise will contribute to positive outcomes for the patient, as explained in the coordinated care plan’s strategic goals or objectives below.
The Objectives of the Care Plan
The coordinated care plan for the patient will be focused on achieving several outcomes. First of all, the physical interventions aim to improve the patient’s nutrition to promote beneficial foods that do not enhance the condition. The plan’s design will involve the patient’s parents and or guardians as matters such as nutrition lifestyles and decisions occasionally lie in the parents’ hands. For instance, there are propositions to increase fruit and vegetable intake and minimize starchy fatty and junky foods. The main aim will be to initiate a nutritional culture change that will reduce the patient’s susceptibility to obesity. Secondly, the program aims to improve the patient’s involvement in physical activities such as outdoor games. Utilization of the gyms and community and educational setting resources such as recreation parks will be highly encouraged (Foster et al., 2018).
The psychological interventions done by the community counselor is aimed at improving the psychological wellbeing of the patient. Most crucially, the counselor will carry out a detailed patient assessment to get an objective overview of the conditions. By coordinating with the nurse and parents, behavioural therapy improves confidence, improves dieting habits, and promotes social cohesion with others.
Cultural Conditions
In pursuing the set objectives for this coordinated care plan, several cultural and ethical considerations need to be addressed. For instance, the nurse and the counselor need to make the entire program patient-centered and must be done with a priority to the patient’s interests. Additionally, the program also needs to comply with coronavirus measures such as social distancing during the counseling sessions and recreation parks. During counseling, the language used should be polite and avoid bias in weight loss or stereotyping the patient, which worsens the psychosocial challenges (Christison et al., 2018). It is also essential to respect the patient and family’s culture and norms, especially in nutritional therapy. The parent’s need to be approached to enable them to see the essence of altering some behavioral trends that promote obesity.
The Incorporation of Family-Based Interventions
In the care plan, the main stakeholders involved are the patient, the nursing practitioner, the counselor, and the patient’s family. One of the most critical components of this proposed care plan is the patient’s family. It is essential to incorporate family to address and minimize the unhealthy eating habits, lifestyles and deter the adverse psychological outcomes. Family-based interventions will empower the entire household to minimize sedentary lifestyles and enhance good nutritional choices. I plan on using family-based lifestyle intervention, nutrition intervention, parent education and awareness, family therapy coupled with psychotherapy. The parent provides the nutritional resources and is responsible for maintaining the environment the adolescent will thrive in. Thus, they are responsible for developing healthy eating lifestyles and instilling healthy behaviors in the patient (Wilfley et al., 2019). Therefore, they will be trained in patient monitoring, setting objectives, preventing relapse, and behavioral contracting. Lifestyle modification is necessary, and it involves dietary changes, physical exercise programs, and reducing sedentary activities such as videogames and watching television. Parent participation in physical exercise and taking fruits and vegetables dramatically influences the patient’s adoption. Numerous researches show that family-based behavioral weight control programs were effective in losing weight in multiple obese patients. Also, psychosocial challenges, such as depression and anxiety, were reduced significantly. Therefore, in this program, the family-based behavioral therapies will promote a change of harmful habits such as normalizing poor eating habits. The program aims to alter negative obesity-enhancing thought patterns. Thus the patient will be forced to re-learn behaviors related to eating habits and physical exercise. Family dysfunction may often contribute to the inhibition of the patient’s recovery and contribute to further depression.Therefore, a parent is advised to avoid making negative remarks about themselves as the child learns or models the same on their body image and nutrition (Tripicchio et al., 2018).
Available Community Resources
In managing the condition, there are available community resources that may be utilized to achieve the desired outcomes. The primary resources that will be used in this program are the community park and recreation center. Also, the patient will use the school gym to initiate useful physical exercises aimed at weight loss. The community recreation park consists of several resources that may be used to aid in physical exercises. Moreover, to promote better psychosocial wellbeing, the patient will be exposed to interactions with other adolescents engaging in recreational activities. This is aimed at reducing the sedentary lifestyles that contribute to the development of obesity.
Conclusion
Despite the high prevalence of obesity and the reported budgetary constraints in its management, a well-coordinated community-based family and patient-centered care plan will effectively manage the condition: The utilization of community facilities such as recreation and fitness centers aids in physical exercise and reduced sedentary lifestyles to aid in weight loss. On the other hand, to counter the associated psychosocial problems, the counselor will mentor the patient and offer support. Through family-based psychoeducation, many adverse obesity enhancing behaviors will be tackled to promote a holistic, healthy household that promotes healthy nutrition, physical exercise, and reduced sedentary lifestyles.
References
Christison, A. L., Vaidya, S., Tinajero-Deck, L., & Hampl, S. E. (2018). Application of the medical neighborhood to children with severe obesity. Childhood Obesity, 14(7), 461-467.
Di Cesare, M., Sorić, M., Bovet, P., Miranda, J. J., Bhutta, Z., Stevens, G. A., … & Bentham, J. (2019). The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC medicine, 17(1), 212.
Foster, C., Moore, J. B., Singletary, C. R., & Skelton, J. A. (2018). Physical activity and family‐based obesity treatment: a review of expert recommendations on physical activity in youth. Clinical obesity, 8(1), 68-79.
Tripicchio, G. L., Ammerman, A. S., Ward, D. S., Faith, M. S., Truesdale, K. P., Burger, K. S., & Davis, A. (2018). Clinical-community collaboration: A strategy to improve retention and outcomes in low-income minority youth in family-based obesity treatment. Childhood Obesity, 14(3), 141-148.
Wilfley, D. E., Staiano, A. E., Altman, M., Lindros, J., Lima, A., Hassink, S. G., … & Improving Access and Systems of Care for Evidence‐Based Childhood Obesity Treatment Conference Workgroup. (2017). Improving access and systems of care for evidence‐based childhood obesity treatment: Conference key findings and next steps. Obesity, 25(1), 16-29.
Preliminary Care Coordination Plan
Question
TOPIC: Preliminary Care Coordination Plan
Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.
NOTE: You are required to complete this assessment before Assessment 4.
The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for a hypothetical individual in your community as you consider the hypothetical patient’s unique needs; the ethical, cultural, and physiological factors that affect care; and the critical resources available in your community that are the foundation of a safe plan for the continuum of care.
As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
• Competency 1: Adapt care based on patient-centered and person-focused factors.
o Analyze a health concern and the associated best practices for health improvement.
• Competency 2: Collaborate with patients and family to achieve desired outcomes.
o Describe specific goals that should be established to address a selected health care problem.
• Competency 3: Create a satisfying patient experience.
o Identify available community resources for a safe and effective continuum of care.
• Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
o Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
o Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Preparation
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.
To prepare for this assessment, you may wish to:
• Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
• Allow plenty of time to plan your chosen health care concern.
Note: Remember that you can submit all, or a portion of, your draft 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 this assessment before Assessment 4.
Develop the Preliminary Care Coordination Plan
Complete the following:
• Identify a health concern as the focus of your care coordination plan. In your plan, please include physical, psychosocial, and cultural needs. Possible health concerns may include;
o Mental health.
• Identify available community resources for a safe and effective continuum of care.
Document Format and Length
• Your preliminary plan should be an APA scholarly paper, 3–4 pages in length.
o Remember to use active voice, this means being direct and writing concisely; as opposed to passive voice, which means writing with a tendency to wordiness.
• In your paper include possible community resources that can be used.
• Be sure to review the scoring guide to make sure all criteria are addressed in your paper.
o Study the subtle differences between basic, proficient, and distinguished.
Supporting Evidence
Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.
Grading Requirements
The requirements, outlined below, correspond to the grading criteria in the Preliminary 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.
• Analyze your selected health concern and the associated best practices for health improvement.
o Cite supporting evidence for best practices.
o Consider underlying assumptions and points of uncertainty in your analysis.
• Describe specific goals that should be established to address the health care problem.
• Identify available community resources for a safe and effective continuum of care.
• Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
• Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
o Write with a specific purpose with your patient in mind.
o Adhere to scholarly and disciplinary writing standards and current APA formatting requirements.
Additional Requirements
Before submitting your assessment, proofread your preliminary care coordination plan and community resources list to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan. Be sure to submit both documents.
Preliminary Care Coordination Plan Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Analyze a health concern and the associated best practices for health improvement. Does not identify a health concern and the associated best practices for health improvement. Identifies a health concern and the associated best practices for health improvement. Analyzes a health concern and the associated best practices for health improvement. Provides a perceptive analysis of a health concern and the associated best practices for health improvement. Provides credible evidence for best practices and articulates underlying assumptions and points of uncertainty in the analysis.
Describe specific goals that should be established to address a selected health care problem. Does not describe specific goals that should be established to address a selected health care problem. Identifies undefined goals that should be established to address a selected health care problem. Describes specific goals that should be established to address a selected health care problem. Describes specific goals that should be established to address a selected health care problem. Ensures that the goals are realistic, measurable, and attainable.
Identify available community resources for a safe and effective continuum of care. Does not identify available community resources. Identifies available community resources. Identifies available community resources for a safe and effective continuum of care. Identifies significant and available community resources for a safe and effective continuum of care. Provides a comprehensive list of resources, with credible evidence of their contribution toward improving community health.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes and/or paraphrasing. Applies APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.
Preliminary Care Coordination Plan