NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Name

Capella university

NURS-FPX 4900 Capstone project for Nursing

Prof. Name

Date

Assessing the Problem: Family Health Issue 

The American Psychological Association describes substance abuse as a pattern of uncontrollable use of illegal drugs, prescription drugs, and alcohol. These actions negatively affect those involved in their social, professional, and interpersonal aspects. It may lead to interferences in family life, including financial burden and trust issues (American Psychological Association, n.d.). The statistics from the National Institute of Drug Abuse (NIDA) reveal that 20.4 million people had substance use disorders in 2019, and around 92,000 people died in 2020 due to drug overdose (National Institute of Drug Abuse, 2022).

Addiction is one of the most significant problems in the world, which affects not only the substance users but also the individuals living around them. A study has shown that the use of drugs and alcohol can expose family members to various problems, such as socio-economic issues, mental health problems, and impaired family structure, and may lead to conflicts and disputes (Mardani et al., 2023). Thus, addressing such issues as healthcare providers to ensure individuals, families, and communities remain protected is significant and relevant. 

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Substance abuse is common among adolescents, and a similar case is selected for this capstone project. This capstone project is based on the issue of substance abuse in a family living in my neighborhood in California. The family comprises four members: two parents, a brother, and a sister. Both parents are working individuals with only enough money to feed their family. John, who is the eldest and the only son of the family, who is 18 years old, has a marijuana addiction. He is a high-school student who acquired this habit from his school friends.

Initially, John used to avoid his friends, but due to peer pressure and fear of social isolation, John began taking drugs. His parents have been recently informed by the school administrator that a packet of marijuana was found in his school bag. This addiction has not only impacted John’s academic performance but has also led to several conflicts between John and his parents. These conflicts are indirectly affecting the mental health of his younger sister, who is just eight years old, as she is facing anxiety and getting bullied by the local children about his brother having a substance use disorder. Besides, his parents are facing societal pressure to leave the house from the proprietor of the community as he qualms that John’s addiction may negatively impact other children within the locality. 

The issue is within my community and related to personal values. Thus, I must address such challenges to protect my family and myself from unhealthy behaviors. Along with this, being a baccalaureate-prepared nurse, substance abuse is a relevant healthcare issue to my practice as it has a significant impact on the overall health and well-being of individuals, families, and communities. As a nurse, I am responsible for promoting healthy behaviors, which include addressing substance abuse. This healthcare issue not only leads to numerous physical and mental health issues but also contributes to accidents, injuries, and social troubles. Therefore, it is fundamental to prevent and manage such issues to maintain the comprehensive well-being of the individuals under my care, aligning with the core values of nursing practice.

Evidence-Based Approach to Guide Nurses

Nurses play an essential role in preventing and addressing the challenges associated with substance abuse as a family health issue. The most critical nursing action is to assess the individuals comprehensively. This includes assessing the patient’s physical and mental health as well as the impact of substance abuse on social relationships. According to the literature, comprehensive assessment as nursing action can lead to early diagnosis of substance use disorders, eventually advancing timely interventions, which creates an opportunity to prevent further complications (Mirlashari et al., 2020). Another vital role that nurses play is through nurse-led cognitive behavioral interventions.

These include providing family-centered therapies such as counseling, promoting self-care, providing education, and assisting family members to build effective communication to resolve conflicts (Joseph et al., 2020). Such interventions result in informed decision-making and minimize family disputes. The strategies mentioned in the literature are consistent with the professional practices I have seen. Counseling and substance abuse prevention are the most common nurse-led interventions integrated into care for addicted patients. However, other strategies like stress management, coping measures, and crisis interventions are also included in nursing practices. These practices ensure that individuals and families receive holistic care and have emergency healthcare options. 

Evaluation of the Resources and Barriers to Evidence-based Practices

The resources utilized above are reliable and credible based on the CRAAP criteria. The CRAAP criteria are defined as currency (the source of information should be up-to-date), relevance (the topic of the sources should be relevant to the issue of research), authority (the author and the journal should be recognized), accuracy (the claims must be accurately presented and supported by evidence), and purpose (the purpose of the study must align with the purpose of the project) (Esparrago-Kalidas, 2021). These criteria are used to examine studies that are credible and reliable for use in research projects. Such criteria help researchers filter out the relevant sources of information from the pool of information available online. Thus, it helps in integrating evidence-based research into patient care. 

There are several barriers to implementing evidence-based practices for substance abuse management. Lack of knowledge and stereotyping among nurses and other healthcare professionals are significant barriers attached to addressing substance abuse. Nurses who keep negative attitudes about people with substance use disorders are unable to implement effective care using evidence-based practices as these thoughts may hamper their perceptions about the management of the condition (Dahl et al., 2022). Other barriers include a lack of training and resources, which nurses may need to implement evidence-based practices such as standardized tools for screening and training on performing family-centered interventions. 

State Board Nursing Practice Standards and Policies Affecting Substance Abuse Issue

State board nursing practice standards are the rules and regulations that direct nursing practices in healthcare settings. For this purpose, most states have developed a Nursing Practice Act (NPA) that provides guidance related to nursing care. These NPAs include professional, ethical, and legal standards for nurses in patient care and management. The California Board of Registered Nursing (BRN) has several standards set under the NPA to provide high-quality care to patients, preserving their safety. These guidelines include practices related to rehabilitation care, preventive education, and supportive care (California Board of Registered Nursing, 2019). These guidelines are impacting nursing care for patients like John with substance abuse disorders, as preventive and supportive care are primarily crucial for such health conditions. 

Similarly, a governmental policy like The Mental Health Parity and Addiction Equity Act (MHPAE) is an expansion of the Affordable Care Act (ACA) that guides insurance providers to cover mental health and substance abuse disorders along with general medical coverage (SAMHSA, 2023). This Act has resulted in patients receiving healthcare services regardless of the financial constraints. A study by Mulvaney-Day et al. (2019) concluded that the establishment of the MHPAE Act led to the significant utilization of outpatient services for mental health as well as substance use disorders, indicating that this Act has been effective in improving healthcare accessibility for survivors. Since John and his family are already facing financial burdens, this Act can help them acquire preventive and rehabilitation healthcare services under insurance coverage. 

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

These nursing practice standards and policies are impacting the nursing scope of practices as they are acting as guidelines for nurses to implement effective care for patients with substance use disorders, such as assisting nurses in providing preventive care using education and awareness strategies, helping nurses to follow ethical principles of practices and avoid discrimination, and directing nurses to maintain the continuum of care by making healthcare services accessible. Such nursing scope of practice also advocates for nurses to engage in policy-making. Since nurses are the primary and frontline healthcare providers, they are well-equipped with patient and family needs and preferences. This enhanced role of nurses enables them to be involved in patient-centered policy development so that effective and coordinated care is provided, improving patient care and diminishing the global burden of the healthcare industry (Inayat et al., 2023). 

Leadership Strategies to Address Substance Abuse as a Family Healthcare Issue 

Interdisciplinary team collaboration is an effective leadership strategy that promotes communication and coordination among healthcare professionals involved in the care and management of patients and families involved in substance abuse (Kools et al., 2022). This team comprises nurses, social workers, counselors, and addiction specialists. This approach helps the team to work for patients’ needs by providing patient-centered care and addressing the challenges effectively. For example, interdisciplinary team meetings established by nurse leaders can bring the team to one platform, discussing treatment plans and addressing the unique needs of John and his family.

By providing patient-centered care through this approach, leadership can improve communication gaps among the team, enhance patient experiences, improve health outcomes, and help families cope with the current situation.  Secondly, leadership should encourage the active involvement of patients and their families in the care process. Involving patients and their families through support groups,  educational workshops, and interdisciplinary meetings empowers substance users to eradicate the problem effectively by maintaining accountability for their healthcare (Wenaas et al., 2021).

For example, nurse leaders can establish a program for our concerned family where they will be provided with resources to understand substance abuse and help John in recovering his health conditions. This will empower his family to participate in his treatment plan actively, improving patient-centered care and overall experience. To address the complex issue of substance abuse within families, the role of leadership is pivotal as it recognizes the need for collaboration, bringing diverse healthcare professionals together to provide comprehensive care.

Moreover, the multifaceted nature of substance abuse demands effective communication, ensuring that team members exchange insights and tailor treatment plans to individual family needs. Additionally,  change management is essential to guide the execution of evidence-based practices and apply ground-breaking approaches to improve patient-centered care. By fostering a culture of collaboration, open and effective communication, and adaptability to change, leaders can facilitate the revolution of healthcare services, enhancing the patient experience and ultimately leading to improved outcomes for families affected by substance abuse. 

Conclusion 

In conclusion, substance abuse is a widespread healthcare issue in the U.S. Several families are facing such issues, out of which one in my neighborhood is the subject of my capstone project. Evidence advocates the effectiveness of comprehensive screening assessments and nurse-led cognitive behavioral interventions practical against the management of substance abuse. However, several barriers, such as stereotyping, lack of knowledge, training, and resources, may prevent implementing such evidence-based practices. On the other hand, nursing practice standards and policies like the MHPAE Act positively impact nursing care for such patients and families. Leadership strategies, effective communication, collaboration, and adaptability to change are crucial factors in preventing and managing family issues related to substance abuse. 

References

American Psychological Association. (n.d.). Substance use, abuse, and addiction. https://www.apa.org/topics/substance-use-abuse-addiction 

California Board of Registered Nursing. (2019). Nursing Practice Act. https://www.rn.ca.gov/practice/npa.shtml 

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Dahl, R. A., Vakkalanka, J. P., Harland, K. K., & Radke, J. (2022). Investigating healthcare provider bias toward patients who use drugs using a survey-based implicit association test: Pilot study. Journal of Addiction Medicine, 16(5), 557–562. https://doi.org/10.1097/ADM.0000000000000970 

Esparrago-Kalidas, A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. https://i-jte.org/index.php/journal/article/view/25 

Inayat, S., Younas, A., Andleeb, S., Rasheed, S. P., & Ali, P. (2023). Enhancing nurses’ involvement in policy making: A qualitative study of nurse leaders. International Nursing Review, 70(3), 297–306. https://doi.org/10.1111/inr.12828 

Joseph, J., Khakha, D. C., & Varkey, B. P. (2020). Nurse-Led Interventions in the De-Addiction Setting: Current State of Evidence. ARC Journal of Nursing and Healthcare, 6(1), 2455-4324. https://doi.org/10.20431/2455-4324.0601002 

Kools, N., Dekker, G. G., Kaijen, B. A. P., Meijboom, B. R., Bovens, R. H. L. M., & Rozema, A. D. (2022). Interdisciplinary collaboration in the treatment of alcohol use disorders in a general hospital department: A mixed-method study. Substance Abuse Treatment, Prevention, and Policy, 17(1), 59. https://doi.org/10.1186/s13011-022-00486-y 

Mardani, M., Alipour, F., Rafiey, H., Fallahi-Khoshknab, M., & Arshi, M. (2023). Challenges in addiction-affected families: A systematic review of qualitative studies. BMC Psychiatry, 23(1), 439. https://doi.org/10.1186/s12888-023-04927-1 

Mirlashari, J., Jahanbani, J., & Begjani, J. (2020). Addiction, childhood experiences and nurse’s role in prevention: A qualitative study. Eastern Mediterranean Health Journal, 26(2), 212-218. https://vlibrary.emro.who.int/wp-content/uploads/2020/09/10203397-2020-2602-212-218.pdf  

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Mulvaney-Day, N., Gibbons, B. J., Alikhan, S., & Karakus, M. (2019). Mental health parity and addiction equity act and the use of outpatient behavioral health services in the United States, 2005–2016. American Journal of Public Health, 109(Suppl 3), S190. https://doi.org/10.2105/AJPH.2019.305023 

National Institute of Drug Abuse. (2022). NIDA IC fact sheet 2023. https://nida.nih.gov/about-nida/legislative-activities/budget-information/fiscal-year-2023-budget-information-congressional-justification-national-institute-drug-abuse/ic-fact-sheet-2023 

SAMHSA. (2023, October 27). Laws and regulations. https://www.samhsa.gov/about-us/who-we-are/laws-regulations 

Wenaas, M., Andersson, H. W., Kiik, R., & Juberg, A. (2021). User involvement in interprofessional team meetings within services for substance use disorders. Nordic Studies on Alcohol and Drugs, 38(2), 190–203. https://doi.org/10.1177/1455072520978353