NURS FPX 8006 Assessment 1 Forming an Innovative Healthcare Team to Promote a New Approach to a Current and Ongoing Healthcare Issue
NURS FPX 8006 Assessment 1 Forming an Innovative Healthcare Team to Promote a New Approach to a Current and Ongoing Healthcare Issue Student Name Capella University NURS-FPX8006 Nursing Research and Evidence-Based Practice Professor Name Submission Date Forming an Innovative Healthcare Team to Promote a New Approach to a Current and Ongoing Healthcare Issue The principles of evidence-based practice require interprofessional working to solve complex health-care problems. One-third of the patients with heart failure are readmitted to the hospital within 30 days (Khan et al., 2021). It results in billions of dollars in healthcare system costs each year and identifies gaps in healthcare (Kwok et al., 2021). The traditional care model does not seem to be able to meet the complex needs, especially in transition, of the heart failure patient. Lack of care coordination and fragmented healthcare are among the biggest drivers of re-hospitalization. Care continuum gaps can be filled with comprehensive interventions that require multiple disciplines to be involved. A new type of interprofessional team can be used as an effective solution to the persistent problem. Assessment is used primarily to discuss how a team can be developed so that they can work together to improve the care provided to patients. Healthcare Issue Complex problems require a multidisciplinary approach, which involves health care organizations coordinating care, to improve patient outcomes. The prevalence of heart failure is estimated to be about 6 million adults in the United States every year (Osenenko et al., 2022). The national range of 30-day readmission rates is 13-20% (Foroutan et al., 2023). The cost of these problems will impact $70 billion annually by 2030 (Gillet & Stewart, 2025) and these high rates of readmission will place a significant financial burden on the health system as a whole. The model of the intervention requires an orchestrated working together of various health care professionals with a shared goal of benefiting the patients. Medication non-adherence, poor discharge planning, and inaction on their social determinants of health are among the factors that contribute to high readmission rates in health care. The interprofessional collaborative practice has been shown to reduce hospital readmission rates among HF patients. The researcher found that systematic transitional care interventions are able to decrease 30-day readmissions (Pollak et al., 2025). Organized interprofessional team approaches that focus on the medical, pharmaceutical, and psychosocial needs were shown to be associated with better outcomes for patients (Shirey et al., 2018). The application of wide-reaching strategies using teams is a very critical opportunity to achieve the quality of care and reduce health care costs. Roles and Perspectives Effective healthcare interventions presuppose the collaboration of professionals who can offer unique knowledge to the work with patients. Nurse practitioners also have a significant role in providing transitional care coordination as well as patient education with regard to heart failure. The team also provides medication titration, symptom management, and seven-day early post-discharge follow-up. Cardiologists can offer specific expertise in optimizing guideline-based medical treatment and managing complicated cardiovascular comorbidities (Pedretti et al., 2022). The doctors go through an evidence-based pharmacotherapy, which is divided into four types of medication for heart failure with reduced ejection fraction. The coordination of the different health representatives is relevant, in order to create a complete network of care provision for patients. Pharmacists offer vital care to patients with heart failure during the care continuum in terms of medication management. The pharmacists also perform admission and discharge medication reconciliation, provide drug interaction services, and provide patient education. Transitional care interventions led by pharmacists have shown a high level of readmission reductions in 30 days and medication adherence or use (Weber et al., 2024). A non-medical recovery barrier is addressed using a social determinant of health assessment by case managers and social workers. Interprofessional roles combine to provide a holistic approach to patient support, covering clinical and social needs for recovery. Critical Appraisal of Studies Quantitative Study Evidence-based healthcare innovations need to be research-based to provide a sound foundation of evidence-based practice across a range of contexts. The study conducted by Williams et al. 2021 is a quantitative comparative study with 384 patients with heart failure who were categorized into three groups: those who engaged in interprofessional collaborative practice clinics on a low, medium or high level. The engaged group (n=170) had a significant decrease in inpatient hospital days (p<0.001) and overall cost savings of 1,987,379 compared to the not-engaged (n=103) and not-established groups (n=111), respectively. Limitations of the study were a non-random design, a single academic center, and the need to have continuous care in one health system. Such strengths as prospective data collection with the use of standardized instruments, cost analysis blinded, and considering social determinants in a systematic way were mentioned. The evidence-based interventions should be rigorously assessed to capture the impact of the interventions on patient outcomes in a comprehensive way. Qualitative Study Qualitative research can help explain the realities of individuals facing health care transitions and interventions with a chronic condition. The applied thematic analysis technique was used, and semi-structured interviews with 10 heart failure patients who were readmitted to the hospital within 30 days were conducted by Turrise et al. (2023). There are two main themes – one involving measures which can be taken to manage heart failure (dietary intake, self-advocacy, symptom management, support) and one involving obstacles to heart failure management (healthcare system, professional relationships, personal traits, knowledge gaps). Limitations of the study were that it was small (predominantly males, 80 per cent) in size, with data collected from one geographical location, and with possible interviewer bias. The strong points of the research were a purposeful sampling, checking of data saturation, a thorough coding process consisting of several researchers, and using the homes of participants as a place to hold interviews. The knowledge of patient experiences improves an organization’s implementation strategies for sustainable models of interprofessional collaborative practice. Outcomes and Solutions Synthesis of quantitative outcomes and qualitative patient experiences results in evidence-based recommendations that can be used to make clinical practice better. The
