NURS FPX 4065 Assessment 2 Sample FREE DOWNLOAD
NURS FPX 4065 Assessment 2
Preliminary Care Coordination Infographic
Student name
Capella University
NURS-FPX4065 Patient-Centered Care Coordination
Professor’s Name
Submission date
Preliminary Care Coordination Infographic
Childhood type 2 diabetes is becoming a serious health concern, particularly among communities that have inadequate access to primary care services and health promotion interventions. The condition also affects not only physical health but also the psychological condition, relations within the family, and social development (Pappachan et al., 2024).
Early-disease management, prevention of complications and promotion of healthy living all require appropriate coordination of care. In this assignment, the author pays attention to determining the strategies to promote health improvement among such populations, the creation of Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) goals in this population, and the evaluation of community resources that can assist in the provision of a safe and effective population continuum.
Analyzing the Selected Health Concern and the Associated Best Practices for Health Improvement
Pediatric type 2 diabetes is an emerging area of concern regarding the population health burden and is especially prevalent in underserved community-based settings where preventative care is not readily accessible (Pappachan et al., 2024). Recent statistics have indicated that the incidence of Type 2 diabetes in US youth aged 10 to 19 rose by about 95 percent between 2001 and 2017, which should be an indication of the necessity to provide specific intervention (Lawrence et al., 2021).
The late outcomes of Type 2 diabetes in children can take the form of cardiovascular disease, kidney failure, and vision loss unless they are managed adequately (Serbis et al., 2021). This condition should be addressed and handled as early as possible and with long-term treatment that entails enhancement of physical and psychological health.
Several practices are effective in the management of children according to the research evidence. First, one needs to observe the glycemic control using the HbA1c level test and conduct regular blood glucose measurements in case of need (Mukonda et al., 2025). Second, physical activity in the form of play or sports during the day is helpful in the regulation of insulin sensitivity and weight (Kanaley et al., 2022).
Third, family-based nutritional counseling promotes good dietary habits since caregivers are motivated and involved in the planning and instruction of food and meals (Runtulalo et al., 2024). Lastly, structured programs on diabetes self-management education (DSME) help children and their families to acquire the skills and confidence to manage their condition over the long term and improve their health status independently (Heise et al., 2022).
Physical and Psychosocial Considerations
The pharmacologic treatment of pediatric Type 2 DM includes the administration of such medications as metformin or insulin in case of need, along with monitoring the level of blood glucose and other comorbidities such as obesity/hypertension (Serbis et al., 2021). Psychosocial factors are also crucial because children can feel anxious, frustrated, or even depressed when they have to learn to manage the disease throughout their lives (Bombaci et al., 2024). It should be encouraged to empower the children emotionally through counseling, peer support, and positive thinking. Families should also be advised on how to support their child’s emotional well-being, thereby promoting an interdisciplinary model of care.
Cultural Considerations
Care coordination in a diverse community environment must be culture-sensitive. The perception of illness, treatment, and dietary modification may be affected by cultural beliefs of a family (Swaleh & Yu, 2020). Therefore, adherence can be influenced by culture, including the consumption of local foods or the inability to trust doctors. It is advisable to consider culture-sensitive nutrition plans, translation of language in case of necessity, and the presence of home health aides familiar with the family. The definition of cultural sensitivity in healthcare presupposes the respect of cultural values and beliefs and a particular manner of communication, which positively influence the level of trust and health outcomes.
SMART Goals
As a means of properly addressing Type 2 diabetes in paediatric patients in a community healthcare setting, it is necessary to set clear and realistic objectives. These objectives must also cover physical, psychosocial, and cultural aspects of the child and the family with respect to the disease. The objectives below are designed to improve long-term health objectives, and all of them are aligned with the SMART goals, which also aim at providing comprehensive family-centred care.
Goal 1: Improve Glycemic Control (Sundberg et al., 2021)
- Specific: To lower the levels of HbA1c in paediatric patients with Type 2 diabetes by an individualized plan of care.
- Measurable: The goal will be to reduce the HbA1c by at least 1 percent relative to the baseline.
- Achievable: Routine blood glucose monitoring and proper medication adherence will help support this.
- Relevant: Better glycaemic control minimises the risks of complications such as kidney or vision problems.
- Time-limited: implement this goal in 6 months of the care coordination plan.
Goal 2: Promote Psychosocial Resilience (Wu et al., 2022)
- Specific: Increase emotional coping abilities of children diagnosed with Type 2 diabetes by providing systematic peer support and counselling.
- Measurable: Monitor the process using self-report scales and therapist measurements, aiming for a 30 percent increase in coping scores.
- Fulfillment: Introduce weekly group work and individual counselling with trained paediatric mental health professionals.
- Relevant: Emotional well-being is addressed and will help in the general management of diabetes and decrease isolation.
- Time-bound: Observe measurable improvements within 12 weeks of initiating psychosocial interventions.
Goal 3: Increase Cultural Engagement in Nutritional Habits (Yusof et al., 2025)
- Specific: Promote culturally appropriate changes in nutrition by engaging families in monthly nutrition classes.
- Measurable: Monitor the rate of participation and do a monthly record of food recall to quantify a 50 percent decrease in processed or sugary food.
- Attainable: Employ community health workers and dietitians who are conversant with the cultural background of the families.
- Relevant: Cultural food preferences will be respected to enhance compliance with healthy eating regimes.
- Time-limited: Obtain specific improvements in dietary patterns in 4 months.
Community Resources
An effective and safe continuum of care of a pediatric patient with Type 2 diabetes is greatly dependent on the community-based resources that can offer continual support that is not limited to the clinic environment. Among the resources, there is the Young Men Christian Association (YMCA) diabetes prevention program that offers age-specific fitness, nutritional education, and physical activities to a group of peers (Andreae et al., 2024).
The Children’s Health Pediatric Endocrinology Clinics in most urban and rural facilities provide the children with diabetes follow-up care, including glucose monitoring, medication control, and individual treatment plans (LePage et al., 2020). Such clinics usually collaborate with the school and family and develop a care plan that would best fit the routine of a child and their medical needs.
The psychosocial and cultural aspects are also vital in the management of diabetes in children. The Juvenile Diabetes Research Foundation (JDRF) Peer Support Program is a program that is aimed at matching children who have type 1 diabetes and their families with volunteers who have already been diagnosed with this condition and can provide them with advice and encouragement based on their own experience of going through a similar situation (Mistry et al., 2022).
Moreover, Women, Infants, and Children (WIC) Nutrition Services not only provide food vouchers but also nutritional education services, which are culturally appropriate to families (Santiago, 2024). Such programs ensure that the teaching/ learning materials and childcare interventions are culturally acceptable and linguistically friendly to the families, which increases cooperation and leads to improved outcomes.
Conclusion
Paediatric patients with Type 2 diabetes require an all-encompassing, culturally aware, and family-centred approach to preliminary care coordination in community healthcare. The present paper shall address how the introduction of evidence-based practices, relevant and attainable health goals, and community resources may contribute to the significant enhancement of the well-being of children and their prognosis in the future.
Attending to physical and psychosocial needs and respecting cultural differences contributes to increasing the participation of patients and the role of families in the process. Through coordinated long-term care, one can manage to deal with the long-term consequences of Type 2 diabetes in children and avoid the harmful consequences to the population that is affected.
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Instruction file for 4065 Assessment 2
Assessment 2
Preliminary Care Coordination Infographic
| Instructions | Resources | Activity 1 | Activity 2 | Attempt 1 available | Attempt 2 |
|---|
Develop infographic of a preliminary care coordination plan for a selected healthcare problem. Include physical, psychosocial, and cultural considerations for this healthcare problem. Identify and list available community resources for a safe and effective continuum of care.
Introduction
The first step in any effective project is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for a particular healthcare problem. Include physical, psychosocial, and cultural considerations for this healthcare problem. Identify and list available community resources for a safe and effective continuum of care.
Note: You are required to complete this assessment before Assessment 5.
Overview
Please watch the following brief video message for an overview of what to keep in mind as you complete your Preliminary Coordination Plan Infographic.
Preliminary Coordination Plan Infographic.
Scenario
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.
Preparation
As you begin to prepare for this assessment, complete the virtual simulation from Sentinel U on Patient Management & Delegation. The goal of this activity is to help familiarize yourself with technology in healthcare, patient acuity, along with assigning and delegating patient care based on the acuity level and skillset of the registered nurse.
You are also encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.
Instructions
Note: You are required to complete this assessment before Assessment 5.
Choose a specific healthcare problem that aligns with your practicum site population and create an infographic that visually represents your care coordination plan.
Select one health concern and a patient population that aligns with your practicum setting. Examples include:
Type 2 diabetes in pediatric patients in a community healthcare setting.
Cognitive impairment in home health of elderly patients.
Mental health in adult patients in an acute health setting.
Pain management in adults in hospice care.
Falls in long-term care adults.
Analyze your selected health concern and the associated best practices for health improvement.
Address the following content elements in your analysis:
Best practices: Summarize evidence-based best practices related to the chosen healthcare problem.
Physical considerations: Address physical aspects of care (for example, medications, treatments, or monitoring).
Psychosocial considerations: Consider mental health, emotional support, and patient coping strategies.
Cultural considerations: Recognize cultural diversity and tailor care accordingly.
Cite supporting evidence for best practices.
Describe two specific SMART (specific, measurable, achievable, relevant, time-bound) goals that should be established to address the healthcare problem and the evidence to support those goals.
For example: “Reduce A1C levels by 10% within 6 months through lifestyle modifications.”
Include physical, psychosocial, and cultural considerations of your specific patient population.
Discuss your SMART goals with your preceptor. Document discussion of SMART goals in Capella Academic Portal.
Identify available community resources for a safe and effective continuum of care.
Compile a list of community resources relevant to the healthcare problem.
Include local clinics, support groups, educational programs, and social services.
Include physical, psychosocial, and cultural considerations of your specific patient population.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
The requirements outlined above correspond to the grading criteria in the Preliminary Care Coordination Plan scoring guide, so be sure to address each point in your infographic. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Format
Create an infographic that visually represents your care coordination plan.
Create the infographic using a PowerPoint infographic template.
Use clear and concise language.
Include relevant icons, graphics, and colors to enhance readability.
Example Infographic
This is an Example Infographic [PPTX]. Feel free to use a PowerPoint infographic template and be creative in your presentation.
Practicum Hours Submission
You have been tracking your completed practicum hours using the Capella Academic Portal. By placing the hours into the Capella Academic Portal, you will ensure you are accumulating all hours that are needed to meet the requirements for your specialization and degree.
Submit your Capella Academic Portal practicum hours tracking log showing a minimum of 10 confirmed hours per assessment. Reminder: Only confirmed hours will be considered for grading.
You will not receive a grade for this assessment without logging practicum hours log. Your faculty will review your hours to date and contact you if there are any questions or concerns.
To summarize:
Use Capella Academic Portal to submit your practicum hours.
You must submit a minimum of 10 confirmed hours with this assessment.
Be sure to discuss your SMART goals with your preceptor.
Failure to complete the required practicum hours and document the discussion around your SMART goals will result in a non-performance for this assessment.
Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.
Completion Checklist
Before you submit your assessment, take a moment to complete the following checklist to ensure your work is ready for submission:
Completion Checklist.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Create a patient centered strategy to achieve desired health outcomes.
Analyze a health concern and the associated best practices for health improvement.
Describe specific goals that should be established to address a selected health care problem.
Identify available community resources for a safe and effective continuum of care addressing a specific healthcare problem.
Competency 5: Apply professional, scholarly communication strategies to lead patient-centered care.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/unctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Complete a minimum of 10 practicum hours, approved by your preceptor. Submit practicum hour documentation to Capella Academic Portal. Document discussion of SMART goals in the Capella Academic Portal under “Activities.”
Scoring Guide for 4065 Assessment 2
Use the scoring guide to understand how your assessment will be evaluated.
Criterion 1
Analyze a health concern and the associated best practices for health improvement.
Distinguished
Analyzes a health concern and the associated best practices for health improvement. Provides credible evidence for best practices and articulates underlying assumptions and points of uncertainty in the analysis.
Proficient
Analyzes a health concern and the associated best practices for health improvement.
Improvement.
Basic
Identifies a health concern and some best practices for health improvement without weighing appropriate physical, psychosocial and cultural considerations.
Non Performance
Does not analyze a health concern and the associated best practices for health improvement.
Criterion 2
Describe specific goals that should be established to address a selected health care problem.
Distinguished
Describes specific goals that should be established to address a selected healthcare problem. Goals are realistic, measurable, and attainable.
Proficient
Describes specific goals that should be established to address a selected health care problem.
Basic
Describes undefined goals that should be established to address a selected health care problem.
Non Performance
Does not describe specific goals that should be established to address a selected health care problem.
Criterion 3
Identify available community resources for a safe and effective continuum of care addressing a specific healthcare problem.
Distinguished
Identifies available community resources for a safe and effective continuum of care addressing a specific healthcare problem. Provides a comprehensive list of resources, with credible evidence of their contribution toward improving community health.
Proficient
Identifies available community resources for a safe and effective continuum of care addressing a specific healthcare problem.
Basic
Identifies available community resources.
Non Performance
Does not identify available community resources for a safe and effective continuum of care addressing a specific healthcare problem.
Criterion 4
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Distinguished
Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Proficient
Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Basic
Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling.
Non Performance
Does not organize content for ideas. Lacks logical flow and smooth transitions.
Criterion 5
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Distinguished
Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Correctly uses quotes and paraphrasing.
Proficient
Applies APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Basic
Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes, and/or paraphrasing.
Non Performance
Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly.
Criterion 6
Complete a minimum of 10 practicum hours, approved by your preceptor. Submit practicum hour documentation to Capella Academic Portal. Document discussion of SMART goals in Capella Academic Portal under “Activities.”
Distinguished
Completes a minimum of 10 practicum hours. Includes detailed description of activities and discussion of SMART goals with preceptor in Capella Academic Portal. Submits all to Capella Academic Portal.
Proficient
Completes a minimum of 10 practicum hours, approved by your preceptor. Submits practicum hour documentation to Capella Academic Portal. Documents discussion of SMART goals in Capella Academic Portal under “Activities.”
Basic
Completes less than 10 practicum hours, approved by your preceptor. Submits practicum hour documentation to Capella Academic Portal.
Non Performance
Does not complete any practicum hours, approved by your preceptor. Does not submit practicum hour documentation to Capella Academic Portal.
References For NURS FPX 4065 Assessment 2
Andreae, S. J., Reeves, H., Casey, T., Lindberg, A., & Pickett, K. A. (2024). A systematic review of diabetes prevention programs adapted to include family members. Preventive Medicine Reports, 39. https://doi.org/10.1016/j.pmedr.2024.102655
Bombaci, B., Torre, A., Longo, A., Pecoraro, M., Papa, M., Sorrenti, L., Mariarosaria La Rocca, Lombardo, F., & Salzano, G. (2024). Psychological and clinical challenges in the management of type 1 diabetes during adolescence: A narrative review. Children, 11(9), 1085–1085. https://doi.org/10.3390/children11091085
Heise, M., Heidemann, C., Baumert, J., Du, Y., Frese, T., Avetisyan, M., & Weise, S. (2022). Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study. Primary Care Diabetes, 16(3), 387–394. https://doi.org/10.1016/j.pcd.2022.03.016
Kanaley, J. A., Colberg, S. R., Corcoran, M. H., Malin, S. K., Rodriguez, N. R., Crespo, C. J., Kirwan, J. P., & Zierath, J. R. (2022). Exercise/physical activity in individuals with type 2 diabetes: A consensus statement from the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 54(2), 353–368. https://doi.org/10.1249/mss.0000000000002800
Lawrence, J. M., Divers, J., Isom, S., Saydah, S., Imperatore, G., Pihoker, C., Marcovina, S. M., Mayer-Davis, E. J., Hamman, R. F., Dolan, L., Dabelea, D., Pettitt, D. J., & Liese, A. D. (2021). Trends in prevalence of Type 1 and Type 2 diabetes in children and adolescents in the US, 2001-2017. Journal of the American Medical Association, 326(8), 717. https://doi.org/10.1001/jama.2021.11165
LePage, A. K., Wise, J. Benjamin, Bell, J. J., Tumin, D., & Smith, A. W. (2020). Distance from the endocrinology clinic and diabetes control in a rural pediatric population. Journal of Pediatric Endocrinology and Metabolism, 34(2), 187–193. https://doi.org/10.1515/jpem-2020-0332
Mistry, S., Tonyushkina, K. N., Benavides, V. C., Choudhary, A., Huerta‐Saenz, L., Patel, N. S., Mahmud, F. H., Libman, I., & Sperling, M. A. (2022). A centennial review of discoveries and advances in diabetes: children and youth. Pediatric Diabetes. https://doi.org/10.1111/pedi.13392
Mukonda, E., van, Dave, J. A., Cleary, S., Hannan, L., Rusch, J. A., & Lesosky, M. (2025). Understanding the relationship between the frequency of HbA1c monitoring, HbA1c changes over time, and the achievement of targets: a retrospective cohort study: bioMed Central Endocrine Disorders, 25(1). https://doi.org/10.1186/s12902-024-01816-w
Pappachan, J. M., Cornelius James Fernandez, & Ashraf, A. P. (2024). Rising tide: The global surge of type 2 diabetes in children and adolescents demands action now. World Journal of Diabetes, 15(5), 797–809. https://doi.org/10.4239/wjd.v15.i5.797
Runtulalo, F. V., Mulyono, S., Rekawati, E. & Sari, I. P. (2024). Family support for healthy dietary changes in children with obesity: A systematic review. International Journal of Nursing and Health Science, 7(3), 304–313. https://doi.org/10.33024/minh.v7i3.318
Santiago, B., & Silveira, C. (2024). Providing culturally responsive nutrition education and food supports: A case study of WIC. Journal of Nutrition Education and Behavior, 56(8), S32–S33. https://doi.org/10.1016/j.jneb.2024.05.079
Serbis, A., Giapros, V., Kotanidou, E. P., Galli-Tsinopoulou, A., & Siomou, E. (2021). Diagnosis, treatment, and prevention of type 2 diabetes mellitus in children and adolescents. World Journal of Diabetes, 12(4), 344–365. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040084/
Sundberg, F., Nåtman, J., Franzen, S., Åkesson, K., & Särnblad, S. (2021). A decade of improved glycemic control in young children with type 1 diabetes: A population‐based cohort study. Pediatric Diabetes. https://doi.org/10.1111/pedi.13211
Swaleh, R. M., & Yu, C. (2020). “A touch of sugar”: The impact of health beliefs on diabetes self-management among Black Canadians. A qualitative study. Canadian Journal of Diabetes, 45(7). https://doi.org/10.1016/j.jcjd.2020.12.002
Wu, Y., Zhang, Y., Zhang, Y.-T., Zhang, H.-J., Long, T.-X., Zhang, Q., Huang, J., & Li, M.-Z. (2022). Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus: A systematic review and meta-analysis. World Journal of Pediatrics. https://doi.org/10.1007/s12519-022-00666-7
Yusof, B.-N. M., Talib, R. A., & Hamdy, O. (2025). Dietary and nutrition education: Type 2 diabetes mellitus. Springer, 1–27. https://doi.org/10.1007/978-3-031-32047-7_49-1
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