NURS FPX 6610 Assessment 1

NURS FPX 6610 Assessment 1

NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment

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This comprehensive assessment of Mr. Decker’s needs considers his initial care and the factors that define the care coordination process. It also involves gathering additional assessment data, conducting a gap analysis of the patient’s care and needs, and considering evidence-based practice recommendations from specialists for effective care coordination. By examining these various aspects, we aim to develop a nuanced understanding of Mr. Decker’s healthcare needs and the benefits of a collaborative, multidisciplinary approach to his care.

Current Gaps in the Patient’s Care

Evaluation of Mr. Decker’s current care needs is done through a comprehensive examination by applying patient-reported data and expert observations. A lengthy interview with Mr. Decker brought indispensable information on his health status, concerts, and the healthcare system. Medical records and corresponding documentation were examined to develop well-rounded health information about the patient’s medical history, treatments, and all past healthcare facilities he had encountered (Lorkowski & Pokorski, 2022). During the data analysis process concerning the patient-reported data, it became apparent that there are several gaps in care that he needs to receive. First, the guidance clinician, your role, complained of limited communication between the primary care physician and specialists. Thus, the therapy plan needs to be more precise. Here, it was shown that the healthcare providers involved in his care, including you, must enhance communication and collaboration.

Assessment observations while attending to Mr. Decker revealed the problem of therapeutic management. The client regularly admitted needing to be more mindful about prescriptions and sometimes needing more financial resources to buy the necessary drugs. Additionally, more health literacy was needed, as Mr. Decker needed help grasping the challenging healthcare terms and instructions, which could lead to wrong interpretations and incomplete self-care of his health.

Strategy for Gathering Additional Necessary Data

To have more information than can be gathered from the initial patient interview and the different specialists, a strategy based on interdisciplinary collaboration is the most suitable. This will run among the many health professionals such as doctors, nurses, social workers, and allied health professionals to fully understand the patient’s needs and limitations (Moudatsou et al., 2020). Each team member has their view and specific abilities that, in turn, allow them to raise valuable questions that cannot occur during standard patient encounters.

Besides, that multimodal evaluation approach is another integral part of the approach. This is when the healthcare provider carries out diverse processes, including physical examinations, lab tests, screenings, and psychosocial evaluation, to have a total overview of the patient’s health status and needs. Running lab tests on measurable agents like biomarkers or performing functional assessments targeting the patient’s physical capacities can also be a significant contributing variable in addition to what is gathered from the first interview.

Technologies act as catalysts for data strengthening and scaling databases throughout health facilities. Integrating electronic health records (EHRs) and health information exchange (HIE) systems ensures the flow of information that applies to patients’ health status, books an appointment, or finds a person’s record (Reegu et al., 2023). Telehealth platforms and remote monitoring gadgets may efficiently gather accurate data and the patient’s adherence to the treatment operation in diagnosing and treating.

The active participation of the patient and his caregivers, including you, is essential to the assessment process, providing reliable information. Involvement in interaction, the dynamic of attention, and agreement between doctors and patients will allow the patient to realize themselves and voice their needs, expectations, and concerns, generating a patient-centered approach to care (Kwame & Petrucka, 2021). Also, access to caregivers’ feedback, your feedback, opens a new window on the patient’s social relationships, home setting, and compliance with the treatment standards, thereby supplementing the diagnosis data from all kinds of settings.

Societal, Economic, and Interdisciplinary Factors Affecting Patient Care

Health education services for people with low literacy levels on health topics are known to be connected with worse health outcomes. Patients with a vague grasp of their illnesses, treatment plans, and medicine instructions are prone to medication errors, treatment neglect, and severe health issues. Based on the articles published in the Journal of General Internal Medicine, it was found that low-literacy health helped people to be hospitalized more, stay in hospital for a long time, and caused more health care costs.

Specific socioeconomic factors, such as income, education, and resource availability, significantly impact patients’ health. Individuals from low socioeconomic backgrounds often face numerous healthcare barriers, primarily due to their lack of insurance coverage, limited access to transportation, and more. Research published by JAMA Network Open underscores the clear links between socioeconomic status and health disparities, including higher rates of chronic diseases and mortality in lower social classes (Pérez-Stable & Webb Hooper, 2023). This highlights the need for a comprehensive healthcare approach that addresses these underlying socioeconomic issues.

NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment

A personal story about the role of strong social networks in patients’ recovery and positive health outcomes. Having a close circle of family, friends, or healthcare workers reduces the likelihood of patients having poor emotional health, poor treatment adherence, or bad health outcomes. On the other hand, social isolation and lack of support, in turn, are found to be significant factors for the higher risk of depression, anxiety, and poor overall physical health. Health Psychology journal articles have been found to point to the advantages of social relations in combating physical and mental health, thus underscoring the part of social support in developing authenticity and healing.

NURS FPX 6610 Assessment 1

Professional Standards Influence on Patient Care and Care Coordination Outcomes

The case is also about the most desirable patient outcome metrics that reflect their ability to follow their doctor’s treatment plan, which strongly aligns with healthcare standards that encourage patient engagement and cooperation. According to ANA’s standards and professional organizations that employ nurses, nurses are accountable for educating and empowering patients in such a way that there is therapeutic compliance with the prescription (Ernstmeyer & Christman, 2022). Adhering to patients’ monitoring shows how effectively the care coordination is performed, ensuring adherence to the treatment guidelines and patient understanding. With compliance with the set principles and standards, proper patient education, and backing, the teams for care coordination can increase the eventual outcomes of the setting and lower the risk of adverse events.

The second essential measure to be considered is the success of care transitions. According to the standards that focus on the continuity of care, this measure means a seamless flow of a patient’s care throughout health facility settings. The prosed of professional standards, for example, by the Agency for Healthcare Research and Quality (AHRQ), emphasize better caring transition to reduce hospital readmissions and patients’ safety (Young & Smith, 2022). Watching outcome care transitions, care coordination staff can guarantee that patients experience seamless transitions between diverse levels of care; as a result, the chance of intervention in treatment, which may lead to mistakes, will be significantly reduced. Sticking to these criteria enables patients to receive practical, thorough, and synchronized treatment, restricted to better health outcomes and patient satisfaction.

Evidence-Based Practices for Successful Implementation of Patient Care Coordination

Interprofessional collaboration is one crucial evidence-based strategy for effectively delivering a care plan from a population’s perspective. An article published in the Journal of Interprofessional Care notes that the joint work of healthcare professionals ensures better patient outcomes and financial cut down on healthcare costs. In which different fields of professionals are involved, there is a chance for care teams to provide more efficient services to vulnerable populations than in those that affect only nurses, doctors, social workers, and community health workers (Alderwick et al., 2021). As a result, health outcomes and resource utilization are improved.

Besides, community engagement is also helpful. This means that community members are actively involved in planning and implementing healthcare interventions. Studies show that community involvement reflects the growth of trust in the health systems, better observance of health procedures, and improved health rates. The research published in the American Journal of Public Health emphasizes community work in providing the next level of health care by fighting the social determinants of health and promoting health equity. Through joint action with public health agencies and utilizing local resources, healthcare institutions can customize interventions to address populations’ individual needs, culminating in better population health actions.

Benefits of Multidisciplinary Approach to Patient Care

Multi-disciplinary patient care, as long as a pro-active care coordination process, causes improvement in patient care. Several studies published in the Journal of General Internal Medicine attest to improved clinical outcomes, sparing hospitals a burden of readmissions and increased patient contentment that resulted from the consolidation of various disciplines within the healthcare sphere. This care coordination program is provided by a team of experts from many disciplines like nursing, medicine, social work, and allied professionals to answer patients’ healthcare needs in all directions and be more efficient.

An integral approach helps improve care coordination, including constantly moving forward among healthcare sectors and providers. It revealed that care that is not multidisciplinary and seen mainly in the absence of medical cooperation between professionals usually leads to medical errors, duplication of services, and lack of care. On the contrary, an interoperable system of the healthcare industry promotes communication and information sharing among team members, consequently permitting a more integrated approach to delivering care that is not disrupted in the care continuum. According to a study published in the Journal of Nursing Administration, effective inter-disciplinary communication is crucial in better coordination of care plans and preventing adverse incidents (Dietl et al., 2023). Accepting an interdisciplinary approach implies that risks associated with the process are mitigated and the purpose of care is fulfilled in safer and more integrated settings.

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Indeed, enhancing the detected flaws in the care pathway implemented through a multidimensional strategy could bring to the surface a significant partner in crime in Mr. Decker’s well-being and all-around healthcare satisfaction. Using evidence-based practices and adhering to the code of ethics, healthcare providers can proffer cohesive care coordination and have no gaps in care transitions between different settings. Finally, patient-centered care and integrated teamwork are vital to providing better and less expensive health services for Mr. Decker and others with such a condition.


Alderwick, H., Hutchings, A., Briggs, A., & Mays, N. (2021). The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: A systematic review of reviews. BMC Public Health, 21(1).

Dietl, J. E., Derksen, C., Keller, F. M., & Lippke, S. (2023). Interdisciplinary and interprofessional communication intervention: How psychological safety fosters communication and increases patient safety. Frontiers in Psychology, 14(6).

Ernstmeyer, K., & Christman, E. (2022). Chapter 6 – Ethical Practice.; Chippewa Valley Technical College.

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158), 1–10. BMC Nursing.

Lorkowski, J., & Pokorski, M. (2022). Medical records: A historical narrative. Biomedicines, 10(10), 2594.

Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The role of empathy in health and social care professionals. Healthcare, 8(1), 1–9.

Pérez-Stable, E. J., & Webb Hooper, M. (2023). The pillars of health disparities science—race, ethnicity, and socioeconomic status. JAMA Health Forum, 4(12).

Reegu, F. A., Abas, H., Gulzar, Y., Xin, Q., Alwan, A. A., Jabbari, A., Sonkamble, R. G., & Dziyauddin, R. A. (2023). Blockchain-based framework for interoperable electronic health records for an improved healthcare system. Sustainability, 15(8).

Young, M., & Smith, M. A. (2022, December 13). Standards and evaluation of healthcare quality, safety, and person-centered care. PubMed; StatPearls Publishing.

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