In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

• Background
• Clinical problem statement.
• Purpose of the change proposal in relation to providing patient care in the changing health care system.
• PICOT question.
• Literature search strategy employed.
• Evaluation of the literature.
• Applicable change or nursing theory utilized.
• Proposed implementation plan with outcome measures.
• Discussion of how evidence-based practice was used in creating the intervention plan.
• Plan for evaluating the proposed nursing intervention.
• Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
• Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

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Topic: Benchmark - Human   Experience Across the Health-Illness Continuum

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

• Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
• Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing.
• Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
• Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

Human Experience Across the Health-Illness Continuum – Outline

Thesis Statement: The health-illness continuum is the integration of all realms of health from the physical, the mental, the emotional, social, and spiritual. This aspect of wellness includes health and general body fitness contributing to the single element of a healthy individual.

Outline

1. Health-Illness Continuum and its Significance to Patient Experience

This perspective of care allows the patient's health to evolve through the different stages of care. Over the time period, the patient moves from preventive care to hospice care, to rehabilitation, and then general medicine, after which they get into a phase of continuous wellness.

2. Its Significance to the Health Care Provider in Promoting Human Flourishing

The continuum has been essential to the creation of a system that brings together all the services provided under the hospice system. Acute care, home care, ambulatory care, extended care, wellness program, and many others have all been interlinked within the same system to encourage health care providers to transition patients through the spectrum with ease.

3. Personal State on the Health-Illness Continuum

Personally, I am within this stage in the paradigm of wellness. I am aware of the requirements posited in the wellness continuum, and I consume further information on a daily basis to educate myself on the benefits and strategies of high-level wellness.

4. Resources Enabling my Personal State to Move Towards Wellness

I am currently in need of self-actualization resources so that I can fully exploit the knowledge I am gaining at the current stage. Therapeutic approaches have been effective in addressing the issue of self-actualization. Through this process, I am able to work on the mental, social, and spiritual aspects of my wholesome wellness.

5. References

Health-Illness Continuum and its Significance to Patient Experience

The health-illness continuum is the integration of all realms of health from the physical, the mental, the emotional, social, and spiritual. This aspect of wellness includes health and general body fitness contributing to the single element of a healthy individual. When Dr John W. Travis coined first coined the concept in 1972, he explained that health could not only be based on physical health alone, but it should span the whole paradigm of wellness with the aim of achieving a higher level of health (Boston-Fleischhauer et al., 2017). This perspective of care allows the patient's health to evolve through the different stages of care. Over the time period, the patient moves from preventive care to hospice care, to rehabilitation, and then general medicine, after which they get into a phase of continuous wellness. The health physician is required to ensure the effectiveness of all these stages by eliminating gaps in the care continuum. The concept posits that there is huge patient vulnerability during these health gaps. By so doing, the patient is able to optimize their health (Boston-Fleischhauer et al., 2017). The long-term results of such a continuum are reducing the instances of meagre illnesses that could have been resolved if the person upheld a continuous wellness approach.

Its Significance to the Health Care Provider in Promoting Human Flourishing

In the continuum, health care providers assume various roles. Essentially, the concept has enabled the creation of a single integrated system that provides a comprehensive spectrum of health services. The continuum has been essential to the creation of a system that brings together all the services provided under the hospice system. Acute care, home care, ambulatory care, extended care, wellness program, and many others have all been interlinked within the same system to encourage health care providers to transition patients through the spectrum with ease ("Different nursing roles in the continuum of care," 2021). Even with the current, seemingly great strides in health care, there is still a large room left in achieving a fully integrated system that has all the mechanisms promoting individual wellness and the continuity of care. All the same, the value and the dignity of individuals are intrinsically brought into application in a bid to enhance the quality-of-care delivery. The continuum works perfectly to stress the importance of the patient's needs to the care providers' services, making it an interdependent association that functions on a collaborative basis.

Personal State on the Health-Illness Continuum

On the health-illness paradigm, I fall on the right side of the neutral point. The continuum is divided into two distinct sections. To the left, in the treatment phase of the continuum, the person is either showing signs and symptoms of a disease or completely immobilized by the disease. In this phase of the continuum, the individual is at risk of being affected chronically by the illness. The care providers focus on administering the appropriate kind of care between acute care, home care, ambulatory care, or extended care. This can be done within preventive care, hospice care, rehabilitation, or general medicine. To the left of the paradigm, the individual looks well from the outside but still remains at risk of illness. Therefore, their body should be on a constant journey towards a high level of wellness. Personally, I am within this stage in the paradigm of wellness. I am aware of the requirements posited in the wellness continuum, and I consume further information on a daily basis to educate myself on the benefits and strategies of high-level wellness. There I am at the education stage of the health-illness continuum.

Resources Enabling my Personal State to Move Towards Wellness

In my journey to high-level wellness, I am currently in need of self-actualization resources so that I can fully exploit the knowledge I am gaining at the current stage. Therapeutic approaches have been effective in addressing the issue of self-actualization. Through this process, I am able to work on the mental, social, and spiritual aspects of my wholesome wellness. The resources provided in therapy shall be effective in improving my spirituality, fulfilment, and heightened significance of the smaller things in life. The intense journey through concentrated psychophysiological experiences will begin to birth ecstasy, awe, wonder, and joy within a self-actualization mind. These common characteristics are essential to the entire being of a person reaching full individual potential. A life designed to pursue self-actualization as an option is never on track to high-level wellness. On the other hand, I am making self-actualization a rule in the pursuit of wellness. It is by making such changes that I can attain full growth, which is the final stage in attaining complete wellness. 

Patient Education – Outline

Thesis Statement: This paper takes evidence-based research steps to create a foundation for educating patients on aspiration. This document shall evaluate literature to settle on applicable ways of disseminating patient education.

Outline

1. Introduction

While treatment procedures can be administered, the most viable response remains patient education on all matters regarding aspiration.

2. Clinical Problem Statement
3. Lack of reliable interventions has been a challenge to providing good care to aged patients in-home care settings. 
4. Purpose of the Change Proposal

The change proposal is motivated by an ethical consideration, just as it is driven by the need for advanced health interventions and outcomes.

5. PICO(T) Question

In adult patients receiving homecare (P), how effective is the education of precautionary measures (I) compared to lack of education by nurses (C) in decreasing the risk of aspiration (O) in perioperative and recovery time? (T).

6. Literature Search & Review

Head-of-bed positioning and the application of small-bowel feeding were found to be effective in lowering occurrences of aspiration. Consequently, reducing the risks of aspiration-related illnesses.

7. Applying Patient Education

The intervention shall always be individualized so as to use patient-specific learning styles. With technology, disseminating information through printed material, videography, and visualized presentations can help to improve the dissemination of information.

8. Evaluating Patient Education

The evaluation shall monitor instances of rehospitalizations due to aspiration complications in already educated patients.

9. Challenges of Implementing Patient Education

The literacy levels are expected to be low hence poor comprehensive abilities. Similarly, this is expected to result in a possibility of language barriers.

10. References

Introduction

Lung abscess and chronic pneumonia are some of the common diseases associated with aspiration of gastric contents. In patients with neurologic deficits causing events such as epileptic seizures, anaesthesia, or trauma, aspiration may be a common incidence: these and other causes of aspiration increase the risk of morbidity, hospitalization, and mortality. However, while treatment procedures can be administered, the most viable response remains patient education on all matters regarding aspiration. This paper takes evidence-based research steps to create a foundation for educating patients on aspiration. This document shall evaluate literature to settle on applicable ways of disseminating patient education. Further, it shall elaborate on the barriers to implementing this intervention plan.

Clinical Problem Statement

The rationale for patient training is to improve or maintain the patients' health, and therefore, training patients is necessary to improve the overall satisfaction of the patient. Aspiration has been noted as one of the main health risks for older adults, and it leads to respiratory infections or sudden bolus death (Chen, Kent, & Cui, 2021). With hospitalized individuals, evidence has been satisfying on the interventions put into reducing aspiration. However, interventions placed to prevent aspirations for patients living in-home care settings have not been as effective. Lack of reliable interventions has been a challenge to providing good care to aged patients in-home care settings. 

Purpose of the Change Proposal

Chen, Kent, & Cui (2021) present a perfect case of person-centered interventions in handling this matter in-home care settings. The degree of risk associated with aspiration among older patients requires the input or rather the awareness and know-how of the patients to effectively handle this matter. Patient education will teach them about oral care, safer eating techniques, drugs to avoid during and after feeding, practices around the nasal gastric tube, and much more. These tips will help the patients monitor their consciousness, positioning, awareness of the nasogastric tube, and tracheal intubation. This information will bring patient consent to another level and better their decision-making process with improved and responsible outcomes (Paterick, Patel, Tajik, & Chandrasekaran, 2017). Therefore, the change proposal is motivated by an ethical consideration, just as it is driven by the need for advanced health interventions and outcomes.

PICO(T) Question

The clinical interventions proposed here will be addressing the risks of aspiration among elderly patients in the home care setting. The interventions are patient education delivered to individuals outside hospice care. Patient education to elderly patients is meant to help reduce the risks of aspiration at home compared to hospitalized patients who have better and more responsive interventions. The PICO(T) questions, therefore, query: In adult patients receiving homecare (P), how effective is the education of precautionary measures (I) compared to lack of education by nurses (C) in decreasing the risk of aspiration (O) in perioperative and recovery time? (T).

Literature Search & Review

The literal investigation conducted an electronic search through Cochrane reviews on the effectiveness of patient education in dealing with risks of aspiration. The search gave several studies comparing hospitalized care and home care in regard to risks of aspiration and interventions surrounding them. Palese et al. (2017) indicate that with an adequate nursing workforce and improved models of care, patient care can reverse the risks of aspiration with elderly individuals in a hospice care setting. On the contrary, the study found that for patients receiving attention from family alone, a patient-centered model of care should be implemented to reduce aspiration risks. Metheny, Davis-Jackson & Stewart (2010) assesses an Aspiration Risk reduction Protocol (ARRP), a three-phased intervention in patients under nasogastric tubing, mechanical ventilation, and chronic nursing ailments. The study intended to find out what methods should be used to effectively implement the protocol and reduce risks of aspiration among these patients. Head-of-bed positioning and the application of small-bowel feeding were found to be effective in lowering occurrences of aspiration. Consequently, reducing the risks of aspiration-related illnesses.

American Academy of Family Physicians (2000) provides guidelines to ensure effective patient education. This body suggests that physicians should help patients master effective practical skills. They need to find out the educational needs of the patients before they can begin disseminating the knowledge. Secondly, there is a need to identify the barriers to this process and mitigate them. The physicians ought to ensure that there is constant counseling through written, non-written, and computerized materials. In addition, the American Academy of Family Physicians (2000) guidelines recommend incorporating routine office visits into the protocol of patient education.

Applying Patient Education

Various studies have cited patient education as an effective person-based and collaborative intervention in reducing the risks of aspiration in older patients. To effectively apply this intervention, nurses need to embark on a number of activities. The intervention intends to make patient education a continuous process where nurses begin educating patients on every encounter. The process shall always enquire to see what the patient already knows and, by so doing, correct any instances of misinformation. The education process shall be conducted in layman's language while employing a great use of visual aid. When administering care, question the patient's understanding and, through repetition, enquire about the same information on repeated occasions (Davis & Zuber, 2013). The intervention shall always be individualized so as to use patient-specific learning styles. With technology, disseminating information through printed material, videography, and visualized presentations can help to improve the dissemination of information. Additionally, the patient's family members shall always be involved to improve the chances of having the instructions implemented. This is also important since home care depends on the initiative of family members in taking care of the patient (Davis & Zuber, 2013).

Evaluating Patient Education

To find out the effectiveness of patient education, the program creates measurable outcomes that can be monitored. Data on these measurable outcomes shall be systematically collected, analyzed, and reported. This shall be an impact evaluation where the outcome measured shall be the impacts of increased awareness and knowledge as well as changes in attitudes and beliefs on matters relating to aspiration and its risks. The evaluation shall monitor instances of rehospitalizations due to aspiration complications in already educated patients. The monitoring shall follow a cohort format to observe whether the rate of aspiration in home-based elderly patients changes. The target is to have the events of aspiration begin to reduce.

Challenges of Implementing Patient Education

The expectation is that the process of implementation will not be a smooth one. Working with aging patients by itself can present a considerable number of challenges. To begin with, the literacy levels are expected to be low hence poor comprehensive abilities. Similarly, this is expected to result in a possibility of language barriers (Gattullo & McDevitt, 2013). These challenges can be mitigated by changing the design of the education through a simplification of content. Family members can be involved to help enhance the patient's comprehensiveness. Translators can also be employed in instances of language barriers. 

However, the applications face further problems when the issues become lack of patient motivation, unwillingness to open up to the problems they are facing, or psychological and psychomotor impairments. These considerations are necessary when designing the individualized patient education content (Gattullo & McDevitt, 2013). Family involvement becomes crucial to enhancing the patient's attitude towards accepting and concentrating on the life-saving skills being passed on through patient education. The collaborative nature of this intervention approach will trigger alternative solutions to resolve some of the arising challenges, whether foreseen or not. For instance, if the patient exhibits signs of psychomotor impairment such as a decline in muscle strength and coordination, the education can teach them how to alert their caregivers in an emergency instance. This can be through pressing a panic button which notifies the family.