NURS FPX 4050 Assessment 4 Final Care Coordination Plan
Phillip April 19, 2024 No Comments

Final Care Coordination Plan

NURS FPX 4050 Assessment 4 Final Care Coordination Plan


Capella university

NURS-FPX 4050 Coord Patient-Centered Care

Prof. Name


Final Care Coordination Plan

Stroke remains a significant cause of long-term disability and mortality rates in the United States. Care coordination plays a pivotal role in enhancing patient outcomes and quality of life post-stroke. This process involves the seamless transfer of care across different healthcare settings. Nurses are central to care coordination, providing patient education, facilitating communication among healthcare providers, and connecting patients with community resources. This evaluation aims to assess the initial care coordination plan from Assessment 1 using evidence-based approaches from the literature.

Strategies for Ensuring Patient-Centeredness in Stroke Care Coordination

Stroke can lead to various health issues, including physical disability, cognitive impairment, and depression. The care coordination plan for stroke should address these health issues through:

Physical Rehabilitation:

Physical therapy is vital in restoring function and mobility post-stroke. Rehabilitation interventions should include therapeutic exercises, fine motor skills rehabilitation, and speech therapy. Community resources such as the American Stroke Association and the National Stroke Association offer support groups and rehabilitation programs.

Cognitive Rehabilitation:

Cognitive impairment after stroke requires tailored rehabilitation interventions, including cognitive therapy and memory training. Community resources like the Alzheimer’s Association and the Brain Injury Association of America provide support for stroke survivors with cognitive impairments.

Depression Management:

Stroke survivors are at risk of depression, which can hinder recovery. Screening and treatment interventions are crucial. Community resources such as the National Alliance on Mental Illness and the Substance Abuse and Mental Health Services Administration offer support for individuals with depression.

Ethical Considerations for Designing Patient-Centered Interventions in Stroke Care

Ethical considerations are essential in designing patient-centered interventions for stroke care. It is crucial to ensure interventions are safe, effective, and respectful of patient autonomy. This includes tailoring interventions to individual needs, maintaining confidentiality, and obtaining informed consent.

Identify Relevant Health Policy Implications for The Coordination and Continuum of Care

The Patient Protection and Affordable Care Act (PPACA) have significant implications for stroke care coordination. Provisions such as Accountable Care Organizations (ACOs) and coverage for preventive services support care coordination and patient-centered care in stroke management.

Priorities for Care Coordinator in Discussing and Modifying Care Plan

When discussing and modifying a care plan, care coordinators should prioritize patient-centered care, medication management, chronic disease management, preventive care, and coordination of care across different healthcare settings.

Stroke Care Education with Healthy People 2030

Stroke care education should align with guidelines such as Healthy People 2030, focusing on promoting physical activity, maintaining a healthy weight, and addressing rehabilitation needs.


Effective care coordination is essential for improving health outcomes in stroke patients. By prioritizing evidence-based practices and aligning care plans with policies and guidelines, healthcare providers can ensure optimal care for stroke survivors.


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