Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Heart disease is one of the leading causes of death among individuals in the United States. According to the Centers for Disease Control (CDC), every 33 seconds, someone dies from cardiovascular disease in the U.S. According to statistical data from 2021, 80 million people had a heart attack (Centers for Disease Control, 2022). As it is one of the major causes of death in the U.S., it affects millions of people and requires leadership collaboration, communication, policy considerations, and change management strategies. This assessment discusses heart disease, evidence-based research, leadership strategies, and community management to enhance the outcomes and prevention of this disease. Implementing the strategies that bring change in the health results and treatment interventions is a crucial part of the change. 

The Health Problem

Heart disease is one of the major causes of death among people in the U.S. That is why, this health problem is selected because it has a global impact. Heart disease is a vast term used for all the heart diseases that come under it. These diseases include coronary artery disease, arrhythmia, and heart failure (Shao et al., 2020). The heart is the source of the whole body’s blood functioning and that is why its diseases cause critical conditions and fatal consequences in patients. Treatment interventions are crucial for the management of heart disease but what’s more important is to implement prevention strategies so people do not suffer from this disease. The prevention strategies can include lifestyle changes, patient, education, and community support (Sattar et al., 2020). The need for reducing healthcare costs, and improving patient care and health outcomes are all the goals that highlight the relevance of this health problem. 

Presence and Relevance of The Problem

Every 33 seconds, someone dies from cardiovascular disease in the US. Globally, one-third of deaths occur due to heart disease according to the Centers for Disease Control (CDC). This disease arises from unhealthy diets, sedentary lifestyles, an aging population, and less availability of disease prevention programs and strategies. From a leadership perspective, it is crucial to prioritize cardiovascular health by developing healthcare collaboration teams, improving communication between healthcare providers and patients, and also to bring policy changes (Kazemi et al., 2022). Bringing such changes is required to improve the heart disease treatments and prevention strategies that can result in reducing the heart disease rates. 

Analysis of Evidence for Nursing Actions in Managing Heart Disease 

Incorporating up-to-date evidence-based strategies is crucial for the prevention and management of heart disease. Several researches show that nurses play an important role in implementing these strategies. One of these evidence-based strategies is motivational interviewing which focuses on increasing patients’ motivation based on their motivating factors to bring behavioral change (Bischof et al., 2021). Furthermore, this technique helps patients to become aware of their ambivalence and bring out their motivation to build healthy habits. This technique is effective in bringing lifestyle changes to a patient’s life. Another strategy is health coaching which helps improve motivational interviewing as it provides regular follow-ups to bring lifestyle changes that help prevent and manage heart disease (Breckon, 2023). To help patients learn about their condition and treatments, the American Heart Association organizes self-management educational workshops for them. The health coaching technique allows patients to adhere to the treatment plans and develop and maintain healthy habits. 

To evaluate the interventions, nurses must utilize the method used, the evidence of the interventions, and their relevance to the clinical practice. One major tool for nurses to evaluate the credibility of studies used for evidence-based strategies is the Joanna Briggs Institute (JBI) critical appraisal tool (Munn et al., 2020). Randomized controlled trials (RCTs) have validated the reliability of motivational interviewing in improving heart disease management (Zabor et al., 2020). Furthermore, peer-reviewed articles by Suen et al. (2020) have provided evidence for health coaching to be beneficial in improving cardiovascular diseases, such as blood pressure and cholesterol levels. All these strategies are evaluated for their evidence and thus provide nurses to implement evidence-based practices. 

Barriers and Theoretical Frameworks

The application of evidence-based strategies is prohibited by some barriers that stand in the way. One of the most prominent barriers is the patient’s resistance to change (Santos, 2022). Patients have been following sedentary lifestyles for a long period and that is why adhering to lifestyle changes is a big challenge for healthcare providers. Such a large number of patient and limited time and resources creates another big challenge for healthcare providers to provide efficient treatment to patients with heart diseases (Santos, 2022). Another barrier is the lack of training in healthcare providers about motivational interviewing and its application. As motivational interviewing is an updated evidence-based treatment strategy many healthcare providers may not be aware of it. Thus, it is important to overcome these barriers by providing skills training to the nurses and organizational support such as resources of evidence base practices to improve heart diseases treatment. 

One of the major theoretical frameworks that guides nurses to apply evidence-based interventions is the Health Belief Model (HBM). This model allows nurses to become aware of patient’s perceptions of the risks and benefits associated with the treatment of heart diseases. Nurses can use this model to apply motivational interviewing as they are better able to understand patient risks and benefits. So, they can bring out the patient’s motivational factors that are beneficial to the heart disease treatment. The second theoretical framework is called the transtheoretical model which serves as a guide for nurses to apply and sustain evidence-based interventions in their clinical practice. This model has 5 stages of change that provide nurses with a structured plan to help patients identify their motivation behind changing their behavior and adapting newly learned lifestyle habits (Pennington, 2021). These models are helpful for nurses to apply evidence-based practices and will also allow them to establish theoretical principles that improve heart disease management. 

Nursing Practice Standards and/or Organizational or Governmental Policies

All the policies have a major role in the management of heart disease because these policies determine the actions of nurses in providing care to patients. Such as, the American Heart Association guidelines are focused on patient education and prevention of heart disease. So, it allows nurses to apply evidence-based practices for the management of cardiovascular conditions. To reduce the rate of rehospitalization for heart disease patients the Medicare and Medicaid policies allow nurses to engage in a theoretical care model that focuses on the quality of the care treatment for heart disease patients rather than the quantity (Flaubert et al., 2021). Such policies prioritize patient-centered care and enable nurses to engage in educational workshops that improve their professional development and also to be up to date with new evidence-based strategies. During the COVID-19 pandemic telehealth policies were introduced to the nurses that allowed them to increase access to cardiac care to patients remotely, assess their progress, and improve their health outcomes. This example shows how policies have a huge impact on disease management and it also highlights the role of practicing nurses in gaining updated knowledge and providing them resources through educational workshops. 

Policy Affects Nursing Scope of Practice

The responsibilities of a nurse are directed by ethical guidelines and also the policies enforced especially for cardiac care. Policies that allow Advanced Practice Registered Nurses (APRNs) to provide medications and care coordination treatment plans can help improve the treatment of heart diseases. Many states of the US allow APRNs, backed by the Nurse Practice Act, to take over cardiovascular disease management by providing heart care initiatives and awareness campaigns (Hughes, 2024). Other than that, the Affordable Care Act is a federal policy that prioritizes prevention care and helps nurses reduce the risk factors of heart disease. This goal is achieved by bringing lifestyle coaching and awareness campaigns for patients with heart diseases. Thus, policies impact nurses’ actions and also encourage them to take initiatives to prevent and manage cardiovascular diseases to improve treatment results. 

Leadership Strategies to Improve Outcomes of Heart Disease

Transformational  Leadership Strategy

The values of this type of leadership strategy are inspiration and motivation for the nurses (Manu, 2022). It focuses on inspiring and motivating nurses so that they can improve patient-centered techniques to manage heart diseases. Moreover, it allows nurses to develop trust with their patients and enables them to make better-informed decisions. 

Shared Governance Models 

This leadership strategy improved patient satisfaction and care coordination by ensuring that multidisciplinary healthcare professionals are involved in decision-making that is centered on patient care. This strategy ensures that healthcare providers closest to the patients can share their perspectives to make health outcomes better for the treatment of cardiovascular diseases. 

Interdisciplinary Collaboration

When an interdisciplinary collaboration forms between healthcare providers, it requires a team leader to facilitate the process of how all healthcare providers will work in collaboration (Zhou & Li, 2021). Cardiologists, nurses, dietitians, and others come together to provide better care coordination plans to address all aspects of cardiovascular disease management. That is why, having a leader who promotes open communication and cooperation among all healthcare providers is essential for the success of a heart disease management plan. 

Quality Improvement Through Evidence-Based Decision-Making

Utilizing evidence-based interventions is the backbone of improving the quality of patient care and heart disease management. Evidence-based strategies enable leaders to identify the gaps the management and make improvements to provide better quality of treatment. 

Role of Leadership in Collaboration, Communication, and Change Management of Heart Disease 

Every leader prioritizes open communication, collaboration, inspiration, and change management strategies to improve the system. Leaders must implement effective communication strategies. To improve the flow of collaboration, digital platforms should be established by leaders as well. Leaders can also engage in a co-leadership model to make the process of collaboration smoother. To bring change within the organization and all its departments, the five stages of change can be implemented to guide the process of change easier. 

Documentation of Practicum Hours

A group of patients with heart diseases was involved in a 2-hour meeting for the practicum. The topic of the session was based on giving patients awareness about the condition and improving their existing knowledge, addressing fears and thoughts about heart diseases. The session also addressed the barriers that the patients face in accessing preventive care. A local cardiologist was also a part of the session to increase access of the community to heart disease interventions. The detailed, key takeaways and the 2-hour meeting are documented in the Capella Academic Portal Volunteer Experience Form. 

Conclusion

Heart disease is the common cause of death among United States residents. The prevention and treatment of cardiovascular diseases is crucial. The prevention strategies can include lifestyle changes, patient, education, and community support. Incorporating up-to-date evidence-based strategies is crucial for the prevention and management of heart disease. Addressing the barriers to providing exceptional heart disease management is crucial to providing access to the interventions to the communities. Leadership strategies also play a huge role in improving access to healthcare for heart disease patients.

References

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Breckon, J. (2023). Supporting physical activity lifestyle change: The application of motivational interviewing. ACSM’s Health & Fitness Journal, 27(5), 15-19. https://doi.org/10.1249/fit.0000000000000901

Flaubert, J. L., Le Menestrel, S., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health care access and quality. In the future of nursing 2020-2030: Charting a path to achieve health equity. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Hughes, S. (2024). Leveraging the power of nursing’s voice for cardiovascular health. in preventive cardiovascular nursing: Resilience across the lifespan for optimal cardiovascular wellness (719-736). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-53705-9_27 

Kazemi, A., Sasani, N., Mokhtari, Z., Keshtkar, A., Babajafari, S., Poustchi, H., & Malekzadeh, R. (2022). Comparing the risk of cardiovascular diseases and all-cause mortality in four lifestyles with a combination of high/low physical activity and healthy/unhealthy diet: a prospective cohort study. International Journal of Behavioral Nutrition and Physical Activity, 19(1), 138. https://doi.org/10.1186/s12966-022-01374-1 

Manu, A. (2022). Transformational leadership. In The Philosophy of Disruption: From Transition to Transformational Change (pp. 67-77). Emerald Publishing Limited. http://dx.doi.org/10.1108/978-1-80262-849-420221006 

Munn, Z., Barker, T. H., Moola, S., Tufanaru, C., Stern, C., McArthur, A., & Aromataris, E. (2020). Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evidence Synthesis, 18(10), 2127-2133. https://doi.org/10.11124/jbisrir-d-19-00099 

Pennington, C. G. (2021). Applying the transtheoretical model of behavioral change to establish physical activity habits. Journal of Education and Recreation Patterns, 2(1). http://dx.doi.org/10.53016/jerp.v2i1.6 

Santos, L. (2022). The impact of nutrition and lifestyle modification on health. European Journal of Internal Medicine, 97, 18-25. https://doi.org/10.1016/j.ejim.2021.09.020 

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