Self Care Orem's Nursing Theory in Practice Capstone Project

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Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy ConsiderationsIntroductionThe patient health problem I will explore during my practicum is the challenges faced by individuals with quadriplegia and co-morbidities who are medically fragile. These individuals often rely heavily on others for assistance with daily activities and may require the use of heavy medical equipment, making travel and mobility difficult. This can also place a strain on their families, who may need to provide ongoing care and support.This problem is relevant to my practice as a baccalaureate-prepared nurse as many of my clients are total quads with co-morbidities and are medically fragile. I have seen firsthand the challenges they face in terms of mobility and reliance on others, as well as the strain this can place on their families. One of the key challenges faced by quadriplegic patients is their complete reliance on others for their daily needs. This can be physically and emotionally draining for both the patient and their caregivers, leading to strain on the family.Related Nursing ActionsAccording to peer-reviewed literature and professional sources, nursing actions related to this patient population should focus on promoting independence and self-management, as well as providing education and support to both the patient and their caregivers. It is important for nurses to assess the patient's needs and goals, and to work with the patient and their caregivers to develop a plan of care that addresses these needs and goals. I would know if this data were unreliable if it came from unreliable sources—but peer-reviewed sources are generally reliable because they reduce the risk of bias.Challenges and Ways to Address ThemOne potential barrier to the implementation of evidence-based practice in this patient population is the lack of accessibility to resources and support. For example, many individuals with quadriplegia may not have access to adapted transportation or specialized equipment, which can make it difficult for them to participate in rehabilitation or other therapeutic activities.There is evidence from peer-reviewed literature and professional sources that supports the importance of addressing these challenges in order to improve the quality of life for quadriplegic patients and their families. For example, a study published in the peer-reviewed journal Disability and Rehabilitation found that patients with spinal cord injuries who received specialized nursing interventions had improved self-care abilities and increased independence (Conti et al., 2022). Another study published in the same journal found that the use of assistive technology, such as voice-controlled devices, can improve the ability of quadriplegic patients to perform daily activities and reduce their reliance on caregivers (Jafar & Nagesh, 2021).There is also research that has tested the effectiveness of nursing standards and policies in improving outcomes for patients with quadriplegia. For example, a study published in the Journal of Spinal Cord Medicine found that a multidisciplinary team approach, including input from a rehabilitation nurse, was effective in improving functional outcomes and quality of life for patients with spinal cord injuries.

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Nurses have a role in policy making to improve patient outcomes, prevent illness, and reduce hospital readmissions. This can include advocating for policies that improve access to resources and support for patients with quadriplegia, such as adapted transportation and specialized equipment.Nursing TheoryOne nursing theory that may be relevant to the care of patients with quadriplegia is the Self-Care Deficit Theory, developed by Dorothea Orem, which emphasizes the importance of helping patients develop the skills and knowledge they need to manage their own care and maintain their…

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…outcomes, policies and protocols must be developed or updated to better suit the requirements of this patient population. Additionally, processes may need to be altered in order to ensure optimal levels of care and assistance for these individuals. As such, implementing appropriate change management measures is an essential step in providing quality healthcare for quadriplegic patients.Local, State, and Federal Polices/LegislationLocal, state, and federal policies and legislation can have a significant impact on the nursing scope of practice in the context of caring for quadriplegic patients with comorbidities and who are medically fragile. For example, policies related to reimbursement for specialized nursing interventions or the use of assistive technology may vary from one jurisdiction to another. In addition, policies related to the provision of home health services or the availability of long-term care facilities may impact the ability of quadriplegic patients to receive care in the community.To improve outcomes, patient-centered care, and the patient experience for quadriplegic patients, I propose several leadership strategies.Change management strategies will also be important in addressing the challenges faced by quadriplegic patients. This may involve developing and implementing protocols for the use of specialized nursing interventions or assistive technology, and providing education and training to staff on the use of these interventions.ConclusionDuring my practicum, I will spend a significant amount of time working with quadriplegic patients and their families to address the challenges they face. This will include providing direct patient care, as well as working with other healthcare providers and stakeholders to develop and implement strategies to improve patient outcomes and the patient experience. Based on the Leadership, Collaboration, Communication, Change Management, and Policy Considerations discussed in this paper, it is evident that time will need to be given to each….....

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