NURS4050 Coordinating Patient-Centered Care – Superior

Learners in this course apply the knowledge and skills needed to respond to the unique biopsychosocial attributes and situational context of each individual patient while recognizing the patient as full partner in all health care decision making. Learners collaborate and adapt practices to support patient-centered care and defend decisions based on the code of ethics for nursing.  For BSN learners only.
Develop a 3-4 page preliminary care coordination plan for a hypothetical individual in your community. Identify and list available community resources for a safe and effective continuum of care.
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 an individual in your community as you consider the 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.
You are encouraged to complete the Care Coordination Planning activity as you begin to prepare this assessment. Completing this will provide valuable practice, especially for those of you who do not have experience with care coordination in community settings. The knowledge gained from completing this activity will assist you in passing the assessment. Completing formatives is another way to show engagement.
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.Analyze a health concern and the associated best practices for health improvement.Competency 2: Collaborate with patients and family to achieve desired outcomes.Establish mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient.Competency 3: Create a satisfying patient experience.Identify available community resources for a safe and effective continuum of care.Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.Write clearly and concisely in a logically coherent and appropriate form and style.PREPARATIONImagine 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.


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