NURS FPX 4900 Assessment 1
Phillip September 17, 2023 No Comments

NURS FPX 4900 Assessment 1 – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

NURS FPX 4900 Assessment 1 – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Student Name

Capella University

NURS-FPX4900: Capstone Project for Nursing

Prof.

Date

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

This body of work focuses on a young male named John, aged 10, who was clinically diagnosed with obesity. The project’s framework is thorough, referencing established literature and professional guidelines to present data that elucidate the seriousness of this pediatric health concern. This issue underscores my pivotal role as a nurse prepared at the baccalaureate level, underlining the need to mitigate John’s obesity through proficient leadership, interprofessional coordination, effective communication, managing change, and involvement in policy initiatives. This approach, supported by scholarly research, aims to optimize care planning and implementation and distribute knowledge within the dedicated nursing practice at my facility, Kindred Hospital Los Angeles. 

Patient, Family, and Population Health Problem

The identified patient health problem relevant to my professional practice is pediatric obesity. Specifically, I am focusing on a patient named John, a 10-year-old child who is clinically obese and was recently admitted to Kindred Hospital Los Angeles, where I have been working for around one and a half years. Obesity in children has reached an alarming proportion worldwide and is a significant public health issue. In John’s case, his obesity presents immediate health problems, such as the early onset of type-2 diabetes and hypertension, and overall affects his quality of life, including psychosocial and educational aspects. John is currently categorized under the 95th percentile for BMI in his age group based on his clinical obesity diagnosis. Besides genetic predisposition, unhealthy dietary habits and lack of physical activity contribute to his condition. I intend to work with John and his family during the capstone project.

National Health and Nutrition Examination Survey (NHANES) suggests that approximately 18.5% of children and adolescents in the U.S. are obese. These figures depict the severity and prevalence of the problem within the population segment. Managing childhood obesity is also vital because it can lead to severe health complications in adulthood, like cardiovascular diseases and diabetes. In the U.S., the Centers for Disease Control and Prevention (CDC) notes that obesity was 19.3% among children and adolescents aged 2-19 years in 2019-2020 (CDC, 2021). Pediatric obesity is a significant global public health problem due to its prevalence, associated health risks, and potential for lasting impact into adulthood. According to the World Health Organization, in 2019, more than 41 million children under 5 were overweight or obese (World Health Organization, 2021). Obesity during childhood not only affects the child’s immediate health but impacts their health trajectory into adulthood. Studies have shown that childhood obesity is linked to a higher risk of adult obesity, early onset of type 2 diabetes, cardiovascular disease, and certain types of cancer (Drozdz et al., 2021). 

Furthermore, obesity in children leads to psychosocial issues, including stigma, poor self-esteem, and depression. Risk factors for obesity can be divided broadly into lifestyle factors (poor diet, lack of physical activity), genetic factors (family history of obesity), and environmental factors (socioeconomic status, marketing of unhealthy foods). It is essential to address obesity early in life to prevent its persistence into adulthood (Smith et al., 2020). This problem is particularly relevant to me as a baccalaureate-prepared nurse due to the increasing rates of childhood obesity and the associated health risks. As a nurse, I play an influential role in health education and effecting lifestyle modifications for patients like John and their families. Interventions aimed at weight management, including nutritional guidance and fostering physical activity, could significantly improve John’s health outcomes, making this issue highly pertinent to my professional practice.

Evidence-Based Nursing Actions for Clinical Obesity

Evidence from peer-reviewed literature and professional sources, such as the American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the Journal of Pediatric Health Care, provide guidance on nursing interventions for childhood obesity. The American Academy of Pediatrics (AAP) suggests that healthcare providers, including nurses, have an essential role in preventing childhood obesity through primary prevention and therapeutic interventions. They recommend using motivational interviewing techniques with families, encouraging them to set goals and make small changes in family behaviors (Smith et al., 2020).

According to the World Health Organization (WHO), improving the intake of healthy foods and physical activity while reducing the intake of unhealthy foods and drinks are crucial in preventing pediatric obesity (World Health Organization, 2021). Literature on the role of nurses in policymaking highlights their critical role as advocates for healthy behaviors and initiating change in the healthcare system to improve health outcomes, reduce illness, and decrease hospital readmissions (Flaubert et al., 2021). Finally, the literature supports utilizing nursing theories, such as the Health Belief Model or the Family Systems Nursing theory, for childhood obesity interventions. These models could frame nursing actions by identifying beliefs and perceptions about health, understanding family dynamics and promoting healthy behaviors in the family setting.

Leadership, Collaboration, Communication, Change Management, and Policy Considerations

 Nurses can provide patient education on these topics and encourage healthier lifestyle choices. In a study published in the Journal of Pediatric Health Care, family-centered, school-based interventions involving physical activity and nutrition education were found to reduce BMI in children effectively (Fruh et al., 2021). Nurses can participate in or lead such interventions, thus demonstrating the crucial role of nursing in combating childhood obesity. For instance, it emphasizes the implementation of behavioral modifications, nutritional counseling, and increased physical activity. Evidence is vital, given the multiple high-quality studies conducted worldwide, the consistency of findings, and the direct relevance to John’s situation. However, to ensure the reliability of the data, one should assess the methodology, sample size, and potential biases in these studies (Whitehead et al., 2021). 

 Barriers to evidence-based practice in childhood obesity include insufficient time, resources, or skills for effective counseling. Healthcare professionals, particularly in high-patient volume settings, often struggle to allocate adequate time to complex issues like childhood obesity during clinical visits. Furthermore, effective management of childhood obesity requires access to health promotion and assessment tools, referrals to specialized resources, and training in counseling skills, including motivational interviewing and behavioral modification techniques. However, these resources and training need to be more readily available or utilized.

Additional challenges arise from limited familial involvement and socioeconomic and cultural barriers. Changing lifestyle behaviors necessary for preventing and managing obesity requires the active participation of family members, which might be impeded by factors such as a lack of nutritional knowledge and differing cultural attitudes towards weight and food. Finally, socioeconomic factors such as financial hardships or inadequate access to fitness and dietary resources can also inhibit the successful implementation of interventions. These barriers highlight the need for systemic changes, healthcare professional training, and multi-sector involvement in addressing childhood obesity (Taghizadeh et al., 2023).

Impact of Nursing Practice Standards and Policies on Clinical Obesity

The management of John’s clinical obesity can be significantly influenced by nursing practice standards set by the state board of nursing and the organizations or governmental policies. In California, the state board outlines standards and competencies for managing obesity. The board specifies the scope of practice for registered nurses, which includes nutritional counseling, physical activity promotion, and referrals for advanced care or surgical intervention for obesity (Ogata & Carney, 2022). These practice standards directly impact John’s obesity management by structuring the nursing care he receives. They facilitate effective interventions such as nutritional counseling and physical activity guidance, crucial in managing obesity and improving overall patient health and safety. 

Federal legislation such as the Affordable Care Act (ACA) also has potential implications for obesity management by promoting preventive services, including obesity screening and dietary counseling. Preventive services through ACA policy aim to prevent obesity by encouraging physical activity and nutritional management (Hudak, 2023). Research on the effectiveness of these standards suggests that nursing interventions, underpinned by state board regulations, can result in weight loss and improved metabolic parameters in obese patients. Similarly, studies have shown that ACA’s preventive provisions have the potential to address obesity at a population level by altering lifestyle behaviors (Whitehead et al., 2021).

Nurses play a crucial role in implementing these policies by providing frontline care. Therefore, state board nursing practice standards and governmental regulations play a vital role in patient care, healthcare outcomes, and the nursing scope of practice, significantly impacting how nurses manage clinical obesity in the pediatric population. Their effectiveness lies in prevention, intervention, and policy implementation that influences lifestyle modification, healthcare access, and patient education, essential aspects of obesity management and nursing role. 

Proposed Leadership Strategies for Clinical Obesity

To address John’s obesity, a multifaceted leadership approach is required and can be broken down into several stages. The application of transformational leadership can lead to positive health outcomes. This type of leadership can inspire John and his family to change their lifestyle significantly. A transformational leader goes beyond managing day-to-day operations and crafts strategies for taking care of John’s health in the long run. They can inspire and encourage John to participate actively in physical activities and adhere to a healthier diet (Khan et al., 2020). Moreover, incorporating visionary leadership can affect patient-centered care and patient experience positively. A visionary leader’s role is to set a clear and motivational vision for managing John’s obesity. They set long-term goals by imagining a healthy future for John and creating a strategic plan for achieving this vision (Barden et al., 2020). This approach helps to bridge the gap between current practices and desired health outcomes, thus streamlining efforts and improving patient experience. 

Assessing the Problem

Building collaborations with relevant stakeholders like school authorities, dieticians, and fitness consultants is another part of the leader’s role. A joint effort in this direction can effectively manage and address the problem. Leadership is vital in managing obesity, especially by strategizing personalized care plans and motivating individuals towards a healthier lifestyle. However, this can only be achieved with effort; effective implementation requires collaboration between key entities like healthcare providers, dieticians, and the patient’s family. Fundamental to this is clear and consistent communication, which aids in aligning understanding and expectations and hence fosters adherence to the proposed management plan. Lastly, tackling an issue like obesity requires individuals to modify established habits, necessitating efficient change management.

Here, models like ADKAR can facilitate awareness, desire, NURS FPX 4900 Assessment 1 – Assessing the Problem and ability for change while reinforcing newly developed healthier habits (Sung & Kim, 2021). Regarding the administrative aspect, the two hours spent working with John and his family have already been recorded and submitted using the Capella Academic Portal Volunteer Experience Form. The time was spent in detailed discussions with the family regarding their daily routines, diets, and physical activities. The documentation of these hours formally acknowledges the hard work and time dedicated to helping John improve his health. 

Conclusion

In conclusion, addressing John’s obesity issue requires integrated leadership, collaboration, effective communication, change management, and policy consideration. Leadership will be fundamental in formulating and implementing strategies to improve patient outcomes and patient-centered care. This involves advocating for John, educating the family, and coordinating with other healthcare professionals and school authorities. Successful collaboration and communication among the various stakeholders, including family, school personnel, and dieticians, will streamline efforts and foster an environment conducive to positive change. This collective approach is also anticipated to positively influence John’s dietary habits and physical activity, which are essential to obesity management. Lastly, policy consideration is significant as it can shape the overall environment supporting John’s journey towards a healthier lifestyle. Local, state, and federal policies promoting healthier school food options can significantly impact this problem. All these strategies combined would help mitigate the problem of obesity in John’s case. 

 

References

Barden, A., Giammarinaro, N., & Petrosino, L. (2020). Perspective shifting: Engaging leaders-of-leaders inpatient and caregiver experience. Journal of Patient Experience, 7(6), 237437352094240. https://doi.org/10.1177/2374373520942405 

CDC. (2021, February 5). Products – health e stats – prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2017–2018. \https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/obesity-child.htm

Drozdz, D., Alvarez-Pitti, J., Wójcik, M., Borghi, C., Gabbianelli, R., Mazur, A., Herceg-Čavrak, V., Lopez-Valcarcel, B. G., Brzeziński, M., Lurbe, E., & Wühl, E. (2021). Obesity and cardiometabolic risk factors: From childhood to adulthood. Nutrients, 13(11), 4176. https://doi.org/10.3390/nu13114176 

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health care access and quality. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Fruh, S., Williams, S., Hayes, K., Hauff, C., Hudson, G. M., Sittig, S., Graves, R. J., Hall, H., & Barinas, J. (2021). A practical approach to obesity prevention. Journal of the American Association of Nurse Practitioners, Publish Ahead of Print(11). https://doi.org/10.1097/jxx.0000000000000556

Hudak, M. L. (2022). Scope of health care benefits for neonates, infants, children, adolescents, and young adults through age 26. Pediatrics, 150(3), e2022058881. https://doi.org/10.1542/peds.2022-058881 

Khan, H., Rehmat, M., Butt, T. H., Farooqi, S., & Asim, J. (2020). Impact of transformational leadership on work performance, burnout and social loafing: A Mediation Model. Future Business Journal, 6(1), 1–13. https://doi.org/10.1186/s43093-020-00043-8 

Ogata, B., & Carney, L. N. (2022). Academy of Nutrition and Dietetics: Revised 2022 standards of practice and standards of professional performance for registered dietitian nutritionists (Competent, Proficient, and Expert) in Pediatric Nutrition. Journal of the Academy of Nutrition and Dietetics, 122(11), 2134-2149.e50. https://doi.org/10.1016/j.jand.2022.07.005 

NURS FPX 4900 Assessment 1 – Assessing the Problem

Smith, J. D., Fu, E., & Kobayashi, M. A. (2020). Prevention and management of childhood obesity and its psychological and health comorbidities. Annual Review of Clinical Psychology, 16(1), 351–378. https://doi.org/10.1146/annurev-clinpsy-100219-060201 

Sung, W., & Kim, C. (2021). A study on the effect of change management on organisational innovation: Focusing on the mediating effect of members’ innovative behaviour. Sustainability, 13(4), 2079.. https://doi.org/10.3390/su13042079

Taghizadeh, S., Hashemi, M. G., Zarnag, R. K., Fayyazishishavan, E., Gholami, M., Farhangi, M. A., & Gojani, L. J. (2023). Barriers and facilitators of childhood obesity prevention policies: A systematic review and meta-synthesis. Frontiers in Pediatrics, 10(10). https://doi.org/10.3389/fped.2022.1054133

NURS FPX 4900 Assessment 1 – Assessing the Problem

Whitehead, L., Kabdebo, I., Dunham, M., Quinn, R., Hummelshoj, J., George, C., & Denney‐Wilson, E. (2021). The effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity: A systematic review of randomised trials. Journal of Advanced Nursing, 77(12). https://doi.org/10.1111/jan.14928

NURS FPX 4900 Assessment 1 – Assessing the Problem

World Health Organization. (2021, June 9). Obesity and Overweight. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight