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Capella 4050 Assessment 4

Capella 4050 Assessment 4: Final Care Coordination Plan

Name

Capella university

NURS FPX 4050 Coordinating Patient-Centered Care

Prof. Name

Date

Final Care Coordination Plan

The prime focus of this assessment is to develop a final care coordination plan by evaluation of preliminary care coordination developed in assessment one. This evaluation will be performed on the basis of evidence-based practices and research-based literature. The final care coordination plan will be focusing on a Hip replacement as selected in assessment one. This plan will highlight patient-centered health intervention along with the ethical decisions in designing patient-centered health interventions, and implications of the health policy for coordinated care. Moreover, the priorities of the care coordinator on discussing plans with patients and evaluation based on Health People 2030 goals are emphasized in this assessment.

Interventions & Timelines for Patient-Centered Health

Hip replacement is one of the major orthopedic health concerns in a community and poses various health issues such as delayed diagnosis of hip joint dislocations, post-hip replacement mobility issues, and post-surgery weight management. This section will demonstrate each of the aforementioned issues with the help of patient-centered health interventions based on the evidence and research data.

Timely Diagnosis of Hip Joint Dislocations and Osteoporosis

Hip replacement can be prevented if the primary cause such as hip joint dislocations or osteoporosis is timely diagnosed and treated with the best possible method. For this purpose, it is imperative to diagnose and detect any hip dislocation in the individuals through X-ray and osteoporosis through bone mineral density (BMD) test with the help of X-ray. The timeline for this intervention is to begin assessing hip joints through various tests such as Ortolani’s Test or Barlow Test after a baby is born to clear the confusion about whether the baby’s hip is healthy or not (Wenger et al., 2019). Any delayed diagnosis increases the severity and complications of dislocation and osteoporosis that may require a hip replacement.

Therefore, to prevent future requirements of hip replacement, early diagnosis at birth is the best practice for newly born babies, and early diagnosis of risk to osteoporosis in elderly people is needed. The community resources that can be used for the timely detection of hip joint dislocation include various laboratories available in the community which can provide X-ray services. Moreover, primary healthcare clinics and community care physicians are required to diagnose and treat patients’ conditions accordingly (Graber & Johnson, 2019).

Initiating Early Mobility Post-Hip Replacement

To speed up the post-hip replacement recovery, it is important to initiate early mobility in patients. This requires help from physical therapists and mobility technicians to facilitate mobilizing the patient with appropriate instructions such as the use of assistive tools to promote walking i.e. crutches or walkers. The timeline for this intervention is initiating mobility within twenty-four hours of surgery as prolonged bed rest and a sedentary lifestyle lead to further complications such as depression, pressure ulcers, and anxiety (None Aprisunadi et al., 2023). 

Moreover, physical therapy is essential to gain muscle strength in hip muscles for the first few months to facilitate walking. The community resources that can be utilized for early mobilization post-hip replacement include rehabilitation centers and community fitness centers to acquire guidance from trained instructors (Madara et al., 2019). Moreover, physical therapists from the primary care clinics must be consulted for appropriate instructions according to patients’ health conditions. Patients can also utilize educational resources from community healthcare organizations for self-management. 

Weight Management to Reduce Strain on Hip Joint Post-Surgery

Patient undergoing hip replacement procedure requires managing weight to prevent from strain on hip joint post-surgery which can further lead to severe complications. This requires lifestyle modifications which include changes in dietary patterns and involvement in physical exercises, which requires constant efforts throughout life. The community resources that can be used in managing weight include gyms and fitness clubs, weight management support groups, and fitness educational centers. Moreover, nutritionists can be consulted so that appropriate dietary pattern is scheduled. 

Ethical Decisions for Patient-Centered Health Interventions

  The designed patient-centered health interventions should be based on ethical principles so that healthcare ethics are profoundly integrated in the care. While diagnosing hip joint dislocation in babies, healthcare professionals must be competent and experienced in their field by practicing within their scope of practice. If the healthcare provider requires additional help, he must consult with his expert colleague to prevent any wrong diagnosis as the patient’s future health procedure will depend on the physician’s diagnosis (Russell et al., 2021). The ethical considerations of seeking a patient’s consent before initiating mobility is necessary and ethically correct.

Patient autonomy gives patients the right in deciding if he is ready to initiate early mobility as hip replacement surgery may pose various emotional challenges like anxiety and become a barrier to early mobility after hip replacement surgery (Pugh, 2020). Therefore, these ethical decisions must be kept under consideration while initiating early mobility in patients with hip replacement. Weight management for hip replacement patients is challenging as their physical burden increases as a result of surgery and obesity and it may become challenging emotionally as well. Therefore, ethical principles of non-discrimination must be observed while guiding individuals with a hip replacement on weight management. Any inappropriate language on body size and judgmental behavior must be prohibited and emphasis should be on body positivity and overall health to avoid any ethically wrong circumstances (Watson et al., 2021). 

Implications of Health Policy for Coordination and Continuum of Care

The health policy of the Affordable Care Act (ACA) has the specific provision of establishing Accountable Care Organizations (ACOs) where various health professionals are in coordination to provide coordinated care to patients (Moy et al., 2022). This policy has implications for patients with hip replacement as they can acquire care from different healthcare professionals such as orthopedic surgeons, physicians, and physical therapists by enabling care coordination through ACOs.

Furthermore, standardized policies and protocols on screening of hip dislocation or risk to osteoporosis must be implemented so that implications such as early detection, the opportunity to decide future care treatment, and care coordination on the basis of screening results are obtained. Health professionals will be able to coordinate effectively in making a care coordination plan for prone individuals when screening protocols are implemented to detect a risk of hip replacement (Gharaibeh et al., 2021). 

Priorities of Care Coordinator and Evidence-Based Changes  

 A care coordinator must have the following priorities while discussing the care coordination plan with the patient, family, or group:

  • A patient-centered care plan that meets the patient’s needs and preferences so that the patient actively listens to the developed care plan as it suits his health needs and preferences (Khanna et al., 2022).
  • Engaging communication by discussing the care coordination plan using open-ended questions so that the patient is equally engaged in communication and understands his care plan well (Chen et al., 2019)
  • Respecting the cultural values and beliefs of the recipient by providing culturally competent care so that discomfort does not arise due to any cultural disrespect (Handtke et al., 2019)
  • Educating the patient, family, or group on early diagnosis of hip joint problems as early diagnosis can prevent hip replacement in the future (Agostiniani et al., 2020)

As a care coordinator, the changes in the final care plan will include raising awareness among patients on hip replacement and how it can be prevented or self-managed in routine life. The need for making these changes is that people have minimal knowledge of bone health particularly the hip joint, factors associated with dislocations, and osteoporosis which lead to hip replacement. Raising awareness of bone health, particularly hip joints can reduce the chances or risk to hip replacement in people.  

Alignment of Learning Sessions with Best Practices and Healthy People 2030

 To compare learning session content with best practices for patients with hip replacement such as early mobility and managing weight to reduce strain, it is imperative to evaluate the literature as a guide. Moreover, the best practices found in the literature should align with the goals and objectives provided by Healthy People 2030. These goals include increasing the proportion of elderly people getting screened for osteoporosis as this condition may lead to hip replacement, reducing the proportion of adults suffering from osteoporosis, and increasing the rate of pregnant women’s abstinence from alcohol as prolonged consumption of alcohol disrupts calcium absorption leading to osteoporosis (U.S. Department of Health and Human Services, n.d.).

To attain these goals, it is crucial that learning sessions comprise early detection and screening of risks of osteoporosis and any dislocations which highlight the abstinence from alcohol to improve bone health so that hip replacement is prevented by reducing risk factors. The required revisions in the learning session can be utilizing telehealth as an intervention to guide patients with a hip replacement on their future treatment and management. Moreover, self-management education programs on hip replacement and its management can be an additional revision in future learning sessions for patients with hip replacement.  

Conclusion

This final care coordination plan highlights the patient-centered interventions, like early detection through x-rays, initiation of early mobility after surgery, and maintenance of weight post-hip replacement. Moreover, relevant timelines for these interventions were shared as well. Furthermore, ethical principles such as scope of practice, non-discrimination, and informed consent must be integrated in designing patient-centered health interventions. There are various healthcare policies like ACA and standard practices policies which are important for the development of care coordinated plans and maintaining a continuum of care. Finally, the care coordinator must prioritize effective communication, patient-centered care, cultural competence, and patient education while delivering the plan, and the goals must align with the objectives of Healthy People 2030 to ensure care coordination and improve patient outcomes. 

References

Agostiniani, R., Atti, G., Bonforte, S., Casini, C., Cirillo, M., De Pellegrin, M., Di Bello, D., Esposito, F., Galla, A., Marrè Brunenghi, G., Romeo, N., Tomà, P., & Vezzali, N. (2020). Recommendations for early diagnosis of developmental dysplasia of the hip (DDH): Working group intersociety consensus document. Italian Journal of Pediatrics, 46(1). https://doi.org/10.1186/s13052-020-00908-2 

Chen, A.-H., Bakar, N.-F. A., & Lam, C. S.-Y. (2019). Comparison of open-ended and close-ended questions to determine signs and symptoms of eye problems among children. Journal of Optometry, 13(2). https://doi.org/10.1016/j.optom.2019.07.002

Gharaibeh, M. A., Al Mohammad, B., Gharaibeh, B., Khasawneh, L., & Al Naser, S. (2021). Guidelines for the orthopedic surgeon in the era of COVID-19. Orthopedic Reviews, 12(4). https://doi.org/10.4081/or.2020.8833  

Graber, M., & Johnson, D. E. (2019, March 31). Anterior hip (femur) dislocation. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507814/ 

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLOS ONE, 14(7), 1–24. https://doi.org/10.1371/journal.pone.0219971 

Capella 4050 Assessment 4

Khanna, A., Fix, G. M., Anderson, E., Bolton, R. E., Bokhour, B. G., Foster, M., Smith, J. G., & Vimalananda, V. G. (2022). Towards a framework for patient-centred care coordination: A scoping review protocol. BMJ Open, 12(12), e066808. https://doi.org/10.1136/bmjopen-2022-066808 

Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni Jr, J., & Raisis, L. (2019). Progressive rehabilitation after total hip arthroplasty: A pilot and feasibility study. International Journal of Sports Physical Therapy, 14(4), 564–581. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670053/ 

Moy, H., Giardino, A., & Varacallo, M. (2022, July 27). Accountable care organization. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK448136/ 

None Aprisunadi, Nursalam Nursalam, Mustikasari Mustikasari, Erlin Ifadah, & Elsi Dwi Hapsari. (2023). Effect of early mobilization on hip and lower extremity postoperative: A literature review. SAGE Open Nursing, 9, 237796082311678-237796082311678. https://doi.org/10.1177/23779608231167825 

Pugh, J. (2020). Informed consent, autonomy, and beliefs. In Oxford University Press. https://www.ncbi.nlm.nih.gov/books/NBK556864/ 

Russell, A., Fromewick, J., Macdonald, B., Kimmel, S., Franke, K., Leach, K., & Foley, K. (2021). Drivers of scope of practice in family medicine: A conceptual model. Annals of Family Medicine, 19(3), 217–223. https://doi.org/10.1370/afm.2669 

U.S. Department of Health and Human Services. (n.d.). Reduce the proportion of adults with osteoporosis — O-01 – healthy people 2030 | health.gov. https://health.gov/healthypeople/objectives-and-data/browse-objectives/osteoporosis/reduce-proportion-adults-osteoporosis-o-01 

Watson, D., Hughes, K., Robinson, E., Billette, J., & Bombak, A. E. (2021). Patient recommendations for providers to avoid stigmatizing weight in rural-based women with low income. Journal of Patient-Centered Research and Reviews, 8(1), 20–30. https://doi.org/10.17294/2330-0698.1752 

Wenger, D., Düppe, H., Nilsson, J.-Å., & Tiderius, C. J. (2019). Incidence of late-diagnosed hip dislocation after universal clinical screening in Sweden. JAMA Network Open, 2(11), e1914779. https://doi.org/10.1001/jamanetworkopen.2019.14779 

Capella 4050 Assessment 4