NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution

Name

Capella university

NURS-FPX 4900 Capstone project for Nursing

Prof. Name

Date

Patient, Family, or Population Health Problem Solution

Heart disease, particularly Coronary Artery Disease (CAD) occurs when the coronary arteries become obstructed due to plaque accumulation, reducing blood flow to the heart. According to the Centers for Disease Control and Prevention (CDC), heart disease claimed the lives of 695,000 persons in 2021 (Khalid et al., 2024). This case study emphasizes my maternal uncle, Paul Eagle, a 58-year-old with CAD. His condition worsened, leading to myocardial infarction and subsequent stent placement. Contributing factors such as a sedentary lifestyle, poor dietary habits and unreliable medication adherence exacerbate his condition. This scenario underlines the critical need for timely and effective interventions to improve his quality of life.

I selected CAD because it is a major global cause of illness and death. It exerts a significant burden on individuals, families and healthcare systems. Throughout my career, I have witnessed how personalized measures such as promoting medication adherence, healthy lifestyle adjustments and utilizing virtual care tools can improve patient recovery and quality of life. This endeavor aligns with my goal to provide integrated, patient-oriented care. For Paul Eagle, addressing these factors is dynamic to alleviating his risk of complications. It enhances disease control and restricts redundant medical expenses. Through this project, I seek to develop CAD management methods that center on patient priorities and long-term health.

The Leadership Role, Management of Change, and Values in Nursing

Transformational leadership efficiently addresses the difficulties of managing CAD by inspiring patients to support change and actively participate in transformative efforts. This leadership approach nurtures teamwork. It drives motivation and encourages creativity to achieve patient-focused aims (Hamdan et al., 2024). For Paul Eagle, transformational leadership shaped the creation of the planned approaches by fostering a collective vision for improved health outcomes through consistent medication use, healthy lifestyle modifications and the integration of advanced technologies. It reinforced interdisciplinary collaboration in making personalized interventions by growing trust and devotion among team members.

Lewin’s change management model provided the basis for the interventions employed in managing Mr. Paul’s CAD. The unfreezing phase involved identifying organizational barriers and developing awareness of the need for change (Hospodková et al., 2021). Challenges include uneven medication use and unhealthy lifestyle habits. During the moving phase, initiatives like telehealth education platforms, Remote Patient Monitoring (RPM) and awareness programs were executed to promote behavioral change and empower Paul Eagle. The refreezing phase highlighted embedding these changes into his daily life through constant follow-ups and strong support networks to safeguard long-term efficiency. This outline presented an organized approach to overcoming resistance and integrating current practices into the care plan.

The principles of nursing ethics aided as the basis for designing interventions that supported autonomy, beneficence and justice. Respecting Paul Eagle’s autonomy involved creating tactics aligned with his preferences and actively engaging him in decision-making. The principle of beneficence directed the adoption of practical methods like RPM, telehealth education and mobile health applications to enhance his health and support positive health outcomes. Justice is maintained by promoting fair access to these resources and tailoring them to suit his needs. Adhering to these ethical principles safeguarded the interventions, which remained patient-centered and aligned with professional nursing standards.

The Proposed Intervention for Health Problem

The proposed interventions for Paul Eagle focus on managing his CAD through strategies that enhance medication adherence and promote lifestyle changes through RPM, mobile health tools and telehealth services. Medication adherence support includes personalized reminders, educational sessions, pill organizers, mobile health apps like MyFitnessPal and regular follow-ups to safeguard consistent medication use (Candelaria et al., 2025). Research has shown that educational interventions enhanced medication adherence by 94% in older adults with CAD (Xu et al., 2024).

Lifestyle modifications involve personalized educational sessions to encourage heart-healthy eating habits, suitable exercise plans and smoking cessation. It aims for lasting behavioral transformation. Furthermore, mobile health applications and RPM have been shown to enhance adherence to prescribed treatments (Candelaria et al., 2025). Telehealth services provide Paul easy access to healthcare consultations, remote monitoring of his condition, and timely advice. These strategies create an inclusive, patient-centered care model to recover Paul’s health and reduce readmissions.

Methods for Interacting and Working Together with the Patient

Effective communication and collaboration with Paul Eagle are vital for improving outcomes in his management of CAD. Key strategies include motivational interviewing. It maintains a professional dialogue, uses teach-back methods to ensure he fully understands the prescribed treatments and schedules regular telehealth check-ins. The research underscores the value of culturally competent communication, personalized education approaches, and involving patients in collaborative decision-making to increase participation and compliance with care (Schellenberg et al., 2020). Creating a multidisciplinary care team comprising cardiologists, nutritionists and nurses certifies a unified approach and consistent messaging and reinforces the patient’s health aims.

It is important to seek Paul Eagle’s input, encourage his contribution, and provide opportunities for him to participate actively in shaping his healthcare plan. His feedback is vital in identifying obstacles to adherence like time limitations or misunderstandings and can inform personalized intentions to overcome these challenges. Involving patients in their care enhances their knowledge, adherence and health outcomes. Patients gain confidence in the care plan through a collaborative approach. It aligns with their lifestyle, preferences and values.

Nursing Practice Guidelines and Policies

The American Nurses Association (ANA) accreditation standards prioritize evidence-based, patient-centered care. It emphasizes the best cardiovascular management at every stage and enhances patient outcomes (American Nurses Association, 2020). These principles were contributory in shaping the proposed interventions. ANA standards support professional responsibility, clear communication and teamwork. These are essential for employing strategies like medication adherence support, lifestyle modifications and integrating mobile apps like MyFitnessPal and telehealth platforms. The ANA code of ethics upholds values prioritizing patient autonomy. It ensures that Paul Eagle’s care plan is custom-made to his needs.

The Affordable Care Act (ACA) offered a solid foundation for the intervention by promoting the delivery and coordination of affordable RPM and telehealth services. This improves patient access to care. It overcomes travel limitations or time constraints. The ACA’s Medicaid expansion enables access to telemedicine, particularly benefiting vulnerable groups like Paul Eagle, who could gain from remote monitoring and community support resources (Centers for Medicare & Medicaid Services, n.d.). These policies interpret the intervention into practice, addressing the identified gaps in care.

The Health Insurance Portability and Accountability Act (HIPAA) is vital in shaping the intervention, particularly safeguarding Paul Eagle’s health data through RPM and mobile health applications. Adhering to HIPAA standards helps build trust by ensuring the confidentiality of patient data during virtual consultations and the sharing of information (Edemekong et al., 2024). HIPAA compliance has been shown to increase patient involvement with digital health tools when privacy and security are assured. These regulations provide a solid outline for delivering ethically responsible, patient-focused care.

Quality, Safety, and Cost Considerations of Proposed Interventions

The proposed interventions aim to improve the financial burden on patients and healthcare costs. It reduces risks and improves care quality. Medication adherence supports that Paul Eagle constantly takes his prescribed medications. It is essential for managing his CAD and preventing severe complications like strokes. Studies indicate medication adherence interventions can reduce hospital admissions and healthcare costs by enhancing disease management and halting disease progression (Xu et al., 2024). Lifestyle changes cover dietary adjustments and increased physical activity. It lowers the risk of CAD-related complications, promotes better long-term health, and reduces the need for urgent care facilities. The use of RPM technologies offers both clinical and financial advantages in managing CAD.

Research shows that integrating RPM improves health outcomes for CAD patients like Paul Eagle. According to Schellenberg et al. (2020), cardiac telerehabilitation, a form of RPM, is cost-effective. It yields a return of €1.42 for every €1 spent. This cost-saving results in fewer hospitalizations and reduced clinical visits. It proves the long-term financial benefits of RPM. Insurance coverage and reimbursement policies are key factors shaping the adoption of telemedicine and RPM. For Paul, having access to an insurance plan that covers telehealth platforms and RPM services is crucial in reducing his out-of-pocket expenditures. It lowers disease prevalence and diminishes costs for both individuals and the healthcare system.

Achieving benchmark data will offer insights into the efficiency of care quality, patient safety and financial outcomes through specific indicators. The World Health Organization (WHO) recommends 600 MET minutes of weekly physical activity to maintain optimal health. The WHO’s Global Physical Activity Survey will be used to evaluate. The patients meeting this threshold are classified as physically active. It reflects successful lifestyle modifications. Medication adherence will be assessed using the Morisky Green Levine scale. It measures the degree of compliance with prescribed treatments among individuals with heart conditions (Padilha et al., 2021). Moreover, weight measurements will determine whether patients fall within the normal body mass index range defined by the WHO.

Considerations for Technology, Care Coordination, and People Support Resources

Mobile applications like MyFitnessPal, RPM and telemedicine have shown the potential to improve patient engagement. It supports medication adherence, which is a crucial concern for Mr. Paul. RPM permits continuous tracking of patients’ vital signs and health data outside clinical settings. It provides healthcare providers with real-time insights into a patient’s condition. Mobile health platforms monitor key health metrics. It includes medication adherence and physical activity, offering patients and healthcare providers real-time insights. Telemedicine facilitates healthcare access, particularly for individuals with mobility challenges or remote locations. Research has emphasized the efficacy of mobile apps and telehealth interventions in managing CAD. It demonstrates their ability to lower hospital readmission rates and enhance patient outcomes (Candelaria et al., 2025).

Effective coordination in managing care is crucial to overcoming the challenges associated with CAD, particularly for patients like Mr. Paul. A collaborative multidisciplinary team of cardiologists, nurses, dietitians, pharmacists and other healthcare experts confirms broad and constant treatment. This team works collaboratively to address various aspects of CAD, from lifestyle adjustments to medication optimization and modifying care to meet the patient’s needs. The value of an integrated team approach improved patient outcomes. It reduces the risk of complications and provides a patient-centered treatment plan (Khalid et al., 2024).

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution

Various community-based resources, like the American Heart Association (AHA), are essential in supporting CAD patients. The AHA offers a range of educational tools, peer support groups and initiatives designed to improve heart health by promoting lifestyle modifications. It includes physical activity, nutrition, and stress management (American Heart Association, n.d). These resources equip patients like Paul Eagle with the information and inspiration to manage their health better. Additionally, it is crucial to support increased funding for community-driven support programs to safeguard patients’ access to continuous care.

National Heart, Lung, and Blood Institute (NHLBI) and CDC are other vital community resources that provide valuable support for CAD patients. The NHLBI offers educational materials and resources on preventing, treating and managing heart disease. It provides tools for lifestyle changes that promote cardiovascular health (National Heart, Lung, and Blood Institute, n.d.). The CDC offers many resources and programs to prevent and manage heart disease. It includes initiatives focusing on lifestyle changes such as physical activity, nutrition, and smoking cessation to support patients like Paul Eagle manage his cardiovascular health (CDC, 2024).

Conclusion

The management of CAD requires a patient-centered approach to improve health outcomes and reduce healthcare costs. Patients like Paul Eagle can better manage their condition and achieve long-term health improvements by integrating strategies such as medication adherence support, lifestyle modifications, and telehealth. The proposed interventions, grounded in nursing ethics, evidence-based practices, and healthcare policies, offer a holistic model for CAD management that emphasizes collaboration, technology, and personalized care. This approach enhances patient quality of life and ensures efficient use of healthcare resources.

References

American Heart Association. (n.d). Cardiac rehabilitation tools and resources. www.heart.org. https://www.heart.org/en/health-topics/cardiac-rehab/cardiac-rehabilitation-tools–resources

American Nurses Association. (2020). Cardiovascular nursing: Scope and standards of practice, 2nd Ed. nursingworld.org. https://www.nursingworld.org/nurses-books/cardiovascular-nursing-scope-and-standards-of-practice-2nd-ed/?srsltid=AfmBOopCfJHCKmlllMlp1C2GrPcmqYnl0lHyAkHyicP12XFV0Br3XcpI

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution

Candelaria, D., Cacciata, Serafica, R., Reyes, T., Lee, J.-A., Hildebrand, J. A., Maria, A. S., Strömberg, A., & Evangelista, L. S. (2025). Patient activation improves with a multi-component personalized mHealth intervention in older patients at risk of cardiovascular disease: a pilot randomized controlled trial. European Journal of Cardiovascular Nursing. https://doi.org/10.1093/eurjcn/zvae159

Centers for Disease Centers for Medicare & Medicaid Services. (n.d.). Home. Centers for Medicare & Medicaid Services. https://www.cms.gov/

CDC. (2024, May 20). Preventing Heart Disease. Heart Disease.

 https://www.cdc.gov/heart-disease/prevention/index.html

Edemekong, P. F., Haydel, M. J., & Annamaraju, P. (2024). Health Insurance Portability and Accountability Act (HIPAA). National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500019/

Hamdan, M., Jaaffar, A., Khraisat, O., Issa, M., & Jarrar, M. (2024). The association of transformational leadership on safety practices among nurses: The mediating role of patient safety culture. Risk Management and Healthcare Policy, Volume 17, 1687–1700. https://doi.org/10.2147/rmhp.s458505

Hospodková, P., Berežná, J., Barták, M., Rogalewicz, V., Severová, L., & Svoboda, R. (2021). Change management and digital innovations in hospitals of five European countries. Healthcare, 9(11), 1508. https://doi.org/10.3390/healthcare9111508

Khalid, N., Haider, S., Abdullah, M., Asghar, S., Laghari, & Rajeswaran. (2024). Trends and disparities in coronary artery disease prevalence among U.S. adults from 2019 to 2022. Current Problems in Cardiology, 49(8), 102645–102645. https://doi.org/10.1016/j.cpcardiol.2024.102645

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution

National Heart, Lung, and Blood Institute. (n.d.). Heart disease prevention and management. U.S. Department of Health & Human Services. https://www.nhlbi.nih.gov/

Padilha, J. C., Santos, V. B., Lopes, C. T., & Lopes, J. de L. (2021). Prevalence of pharmacological adherence in patients with coronary artery disease and associated factors. Revista Latino-Americana de Enfermagem, 29. https://doi.org/10.1590/1518-8345.4554.3464

Scherrenberg, M., Falter, M., & Dendale, P. (2020). Cost-effectiveness of cardiac telerehabilitation in coronary artery disease and heart failure patients: Systematic review of randomized controlled trials. European Heart Journal – Digital Health, 1(1), 20–29. https://doi.org/10.1093/ehjdh/ztaa005

Xu, M., Lo, S. H. S., Miu, E. Y. N., & Choi, K. C. (2024). Educational programmes for improving medication adherence among older adults with coronary artery disease: A systematic review and meta-analysis. International Journal of Nursing Studies, 104924. https://doi.org/10.1016/j.ijnurstu.2024.104924