- Apply professional standards in support of a care plan.
- Explain the alignment to the most recent heart failure guidelines and specific professional standards.
- Describe accountability tools and procedures used to measure effectiveness.
- How will you know if the care coordination plan is successful?
- What are the indicators of success or effectiveness?
- How will information be collected or communicated?
What You'll Learn
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Additional Requirements
- Written communication: Written communication should be free of errors that detract from the overall message.
- APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
- Length: The report should be 3-4 pages in content length, double-spaced.
- Font and font size: Times New Roman, 12 point.
- Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.
Library Resources
Capella Multimedia
Click the links provided below to view the following multimedia pieces:
- Riverbend City: Insurance Issues Mission | Transcript.
- Leadership Styles | Transcript.
- Leadership, Theories, Models, and Styles | Transcript.
The following resources are provided for you in the Capella University Library and are linked directly in this course. These articles contain content relevant to the topics and assessments that are the focus of this unit.
- Mensik, J. S. (2013). Nursing’s role and staffing in accountable care. Nursing Economics, 31(5), 250–253.
- Ganz, F. D., Wagner, N., & Toren, O. (2015). Nurse middle manager ethical dilemmas and moral distress. Nursing Ethics, 22(1), 43–51.
- Ott, J., & Ross, C. (2014). The journey toward shared governance: The lived experience of nurse managers and staff nurses. Journal of Nursing Management, 22(6), 761–768.
- Tait, G. R., Bates, J., LaDonna, K. A., Schulz, V. N., Strachan, P. H., McDougall, A., & Lingard, L. (2015). Adaptive practices in heart failure care teams: Implications for patient-centered care in the context of complexity. Journal of Multidisciplinary Healthcare, 8, 365–376.
- Boyde, M., Song, S., Peters, R., Turner, C., Thompson, D. R., & Stewart, S. (2013). Pilot testing of a self-care education intervention for patients with heart failure. European Journal of Cardiovascular Nursing, 12(1), 39–46.
- Brennan, E. J. (2015). Heart failure care for patients who do not speak English. British Journal of Nursing, 24(20), 1004–1008.
- Coordinating the medical home for heart failure patients; transitioning to palliative care: Adjusting locus of care and focusing on integrated medicine sheds light on best practices and patient-centered care in heart failure clinics. (2010, September 15). PR Newswire.
- Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart failure patients. British Journal of Community Nursing, 18(9), 441–445.
- Limpahan, L. P., Baier, R. R., Gravenstein, S., Liebmann, O., & Gardner, R. L. (2013). Closing the loop: Best practices for cross-setting communication at ED discharge. American Journal of Emergency Medicine, 31(9), 1297–1301.
- Lingle, C. L. (2013). Evidence based practice: Patient discharge education barriers to patient education(Master’s thesis). Available from ProQuest Dissertation Publishing. (UMI No. 1542582)
- Delaney, C., Apostolidis, B., Bartos, S., Morrison, H., Smith, L., & Fortinsky, R. (2013). A randomized trial of telemonitoring and self-care education in heart failure patients following home care discharge.Home Health Care Management and Practice, 25(5), 187–195.
- Wolfson, B. J., & Campbell, R. (2014, February 9). With Medicare watching, hospitals make changes: Orange County medical centers put new focus on discharge practices to reduce patient readmissions. Orange County Register.
- Berry, L. L., Rock, B. L., Houskamp, B. S., Brueggeman, J., & Tucker, L. (2013). Care coordination for patients with complex health profiles in inpatient and outpatient settings. Mayo Clinic Proceedings, 88(2), 184–194.
- Veenstra, W., op den Buijs, J., Pauws, S., Westerterp, M., & Nagelsmit, M. (2015). Clinical effects of an optimised care program with telehealth in heart failure patients in a community hospital in the Netherlands. Netherlands Heart Journal, 23(6), 334–340.
- Aller, M., Vargas, I., Coderch, J., Calero, S., Cots, F., Abizanda, M., … Vázquez, M. L. (2015). Development and testing of indicators to measure coordination of clinical information and management across levels of care. BMC Health Services Research, 15(323), 1–16.
Course Library Guide
A Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the BSN-FP4012 – Nursing Leadership and Management Library Guide to help direct your research.
Internet Resources
- National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved from https://www.ncsbn.org/index.htm
- American Nurses Association (ANA). (2015). Code of ethics for nurses. Retrieved from http://www.nursingworld.org/MainMenuCategories/Eth…
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