Capella 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: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

In this assessment, I will assess the population health problem of smoking cessation. This paper will mainly discuss the leadership necessary for promoting smoking cessation and the need for collaboration and communication to obtain desired results. Additionally, the change management strategy will be highlighted to drive smoking cessation among tobacco smokers. Lastly, the policies that impact tobacco use and improve health outcomes are emphasized.

Tobacco Use and Smoking Cessation: A Population Health Concern

This capstone project will delve into a population health concern of smoking cessation due to the significant use of tobacco products. A group of young boys who have been using tobacco products for a long time are admitted to the Dignity Health- California Hospital Medical Center due to emphysema. I approached these boys as it was my regular duty in the respiratory ward, and they all had a strong history of tobacco use in the past. Now, as their health condition is worsening, they are willing to quit smoking and have a healthier lifestyle.

Their keen interest in smoking cessation led me to work with this group to improve their health and restore lung function. The group of boys informed that they indulged in smoking tobacco in their teenage and got addicted, resulting in significant damage to their lungs. When their respiration was severely impacted, and their cough worsened due to continuous smoking for years, the group of boys wanted to get rid of this addiction and improve their health.

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

Tobacco smoking is a global issue that kills almost 8 million people every year. About 22.3 % of the entire world population is engaged in the use of tobacco products, with 7.8 % of women and 36.7% of men being active users (World Health Organization, 2023). Tobacco smoking causes significant damage to the immune system, enhances inflammation, Chronic Obstructive Pulmonary Disease (COPD), and emphysema. This increases their chances of bacterial and viral infections (Cattaruzza et al., 2020). It is also the driving factor of lung cancer in people due to consistent damage to the lungs.

It has caused 610,000 deaths due to lung cancer in China and contributed to 17% of the incidence of cancer due to smoking (Parascandola & Xiao, 2019). These data show the presence and relevance of this healthcare issue and its significance in reducing prevalent tobacco use rates. This problem is particularly relevant to my practice because I see people in my hospital suffering from the harmful impacts of smoking, such as lung cancer cases, COPD cases, and cardiovascular cases. Moreover, this issue is relevant to me personally as my father was an active smoker, and I lost him due to lung cancer as a result of continuous smoking. Therefore, I am responsible for working with this group to promote smoking cessation and improve their health outcomes.

The Guiding Nursing Actions for Smoking Cessation

Nurses play a broad role in promoting health within hospitals and communities. Nurses can be the right leaders for supportive care and inspiring patients to improve their health. One significant nursing action can be smoking cessation training by nurses in promoting smoking cessation. This training, along with smoking cessation interventions by nurses, such as self-efficacy, can promote smoking cessation among smokers (Li et al., 2021).  The interventions for nurse-led smoking cessation training programs will include implementing the 5As (Ask, Advise, Assess, Assess, and Arrange) approach to address smoking and its cessation (Grech, 2021).

Nurses can also provide online courses on smoking behaviors and how to promote smoking cessation through cognitive behavior management. The course will comprise four lessons on smoking, its cessation plan, and interventions.  In the last lesson, the nurse will introduce pharmacological and non-pharmacological treatments for nicotine addiction (La Torre et al., 2019). Additionally, nurses can also connect smokers with smoking cessation programs through community support groups where they can implement smoking cessation interventions (Tsoh et al., 2022).

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

These evidence-based resources describe the practices consistent with our nursing practices within our healthcare organization. The hospital has appointed nurses to educate smokers on the harms of tobacco smoking and ways to overcome addiction. These sources of evidence are authentic and reliable as they were published in recent years and provide accurate information substantiated by results and appropriate references. The unreliability of these sources can be estimated by using CRAAP criteria. It stands for Currency, Relevance, Authority, Accuracy, and purpose. When the evidence-based source meets all these metrics, it showcases its credibility and authenticity (Muis et al., 2022).

The potential barriers to the application of these evidence-based practices can be as follows:

• Lack of adequate training on promoting smoking cessation education.
• Lack of resources to enable smoking cessation practices.
• Lack of motivation and consistency.
• Inadequate collaboration due to negative nurses’ attitudes and perceptions regarding smoking and quitting. 
• Negative social influences include peer pressure to smoke (Li et al., 2021).

Effect of Nursing Board Standards, Organizational/ Governmental Policies  

The American Nursing Association (ANA) has proposed its statement on preventing tobacco use and promoting a tobacco-free community. For nurses, it is imperative to be tobacco-free role models for their patients, workplaces, homes, and overall communities. This will motivate others to stick to healthy habits and quit smoking (American Nurses Association, n.d.). Moreover, they should be trained on culturally competent strategies to prevent tobacco use and claim leadership roles to provide enhanced access to quality care.

They must assess the tobacco users in their nursing practices and address their concerns by implementing the five A’s strategy. They must also contribute to research tobacco control and advocate for prospective continuous funding and research (American Nurses Association, n.d.). These nursing standards can reduce the rates of tobacco use and promote smoking cessation among young boys.

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

The American Lung Association (ALA) has developed specific policies that can reduce smoking rates and improve smoking cessation efforts. The policy on increased tobacco excise taxes helps deter the consumption of tobacco products, including cigarette smoking and can show less purchasing due to high costs. Furthermore, the policy on the sale of tobacco products starts from age 21, which will prevent adolescents from smoking addiction (American Lung Association, n.d.). The ALA has supported funding of evidence-based tobacco prevention programs, including smoking cessation programs, which promote enhanced access to these programs and promote quitting among young groups.

These policies can significantly reduce tobacco use among the community’s young population and also promote the use of smoking cessation programs among active smokers (American Lung Association, n.d.). The ANA and ALA policies positively impact the scope of practice in nursing. Nursing scope of practice is defined as the range of activities and duties a nurse is expected to perform after adequate education, training, and certification (McMichael & Markowitz, 2022). These policies expand the nursing scope of practice as they can educate more tobacco users through enhanced access to smoking cessation programs and reduce the number of smokers in the community.  

Improving Health Outcomes, Patient-Centered Care, and Patient Experience through Leadership Strategies

The leadership strategies that can improve health implications, patient-targeted care, and patient experiences can include transformational leadership. In this leadership style, the leaders motivate others to attain the desired goals by instilling a vision (Chua & Ayoko, 2019). The group of active smokers can be led by this leadership strategy and promote smoking cessation among them by providing support and inspiration in overcoming addiction. Moreover, it promotes self-efficacy and empowerment, improving behaviors toward quitting smoking (Wunderlich, 2020).

Ultimately, it results in improved health outcomes. Similarly, by motivating the affected individuals, healthcare professionals can promote patient-centered care as their preferred care treatment, such as pharmacological or non-pharmacological interventions to overcome smoking addiction (Manning & Mattio, 2022). This leadership also improves the patient experience as the affected people will enable self-care behaviors and receive patient-centered care, such as customized smoking cessation plans and supportive care (Nnate et al., 2021).

Need for Leadership, Communication, Collaboration, and Change Management

Smoking cessation is a challenging population health problem that requires an interdisciplinary team of physicians, nurses, psychologists, and counselors to establish a tobacco-free community. Therefore, healthcare organizations must adopt a leadership style that best suits their interest (Wunderlich, 2020). Likewise, smoking cessation requires open communication and collaboration on behavior changes and overcoming cravings. With open and transparent communication, active smokers can be able to share their struggles and efforts on smoking cessation. Furthermore, teaching a change management strategy such as Kotters’ 8-step Change Model (KCM) can drive a sense of urgency among patients to quit smoking and improve their healthy lifestyle to prevent future deadly complications (Moyo et al., 2023).

I have documented the two practicum hours spent with the group of boys in the Capella Academic Portal Volunteer Experience Form.

Conclusion

A group of young boys were admitted to the hospital due to emphysema, and their history of smoking tobacco was revealed. However, the group wanted to quit smoking and improve health outcomes. The nursing interventions substantiated by evidence included training programs on smoking cessation, online education and support, and connecting smokers with smoking cessation programs by community support groups. The ANA and ALA have provided standards for preventing tobacco use and promoting smoking cessation programs. Transformational leadership is vital to improving health outcomes, delivering patient-centered care to smokers, and enhancing their experience.

References

American Lung Association. (n.d.). Public policy position – tobacco and health. Www.lung.org. https://www.lung.org/policy-advocacy/public-policy-positions/public-policy-position-tobacco 

American Nurses Association. (n.d.). Prevention and cessation of tobacco and other nicotine products statement of ANA position. Nursingworld.org. https://www.nursingworld.org/~49b0b0/globalassets/practiceandpolicy/work-environment/health–safety/tobacco-cessation/ana-position-statement-on-tobacco-products-03202020.pdf 

Cattaruzza, M. S., Zagà, V., Gallus, S., D’Argenio, P., & Gorini, G. (2020). Tobacco smoking and COVID-19 pandemic: Old and new issues. A summary of the evidence from the scientific literature. Acta Bio Medica : Atenei Parmensis, 91(2), 106–112. https://doi.org/10.23750/abm.v91i2.9698 

Chua, J., & Ayoko, O. B. (2019). Employees’ self-determined motivation, transformational leadership and work engagement. Journal of Management & Organization, 27(3), 1–21. https://doi.org/10.1017/jmo.2018.74 

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

Cooper, S. L., Kovar, V., & Levinson, A. H. (2022). Developing a collaborative, team-based smoking cessation treatment program in an outpatient oncology setting. JCO Oncology Practice, 19(1). https://doi.org/10.1200/op.22.00273 

Grech, J. (2021). Impact of a nurse‐led brief tobacco cessation training program for healthcare professionals. Public Health Nursing, 38(5). https://doi.org/10.1111/phn.12925 

La Torre, G., D’egidio, V., Patrissi, R., Chiarini, M., De vivo, G., Mannocci , A., & Grassi , M. C. (2019). Effectiveness of a training course on smoking cessation knowledge and behaviour for health profession students: The SISMA project. Journal of Preventive Medicine and Hygiene, 60(2), E119–E123. https://doi.org/10.15167/2421-4248/jpmh2019.60.2.1178 

Li, M., Koide, K., Tanaka, M., Kiya, M., & Okamoto, R. (2021). Factors associated with nursing interventions for smoking cessation: A narrative review. Nursing Reports, 11(1), 64–74. https://doi.org/10.3390/nursrep11010007 

Manning, J. M., & Mattio, P. (2022). Educating bachelor of science in nursing students in leadership strategies needed for care management and disease management for the heart failure patient population. Critical Care Nursing Clinics of North America, 34(2). https://doi.org/10.1016/j.cnc.2022.02.007 

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

McMichael, B. J., & Markowitz, S. (2022). Toward a uniform classification of nurse practitioner scope of practice laws. Medical Care Research and Review, 80(4), 107755872211267. https://doi.org/10.1177/10775587221126777 

Moyo, S., Hefler, M., Carson‐Chahhoud, K. V., & Thomas, D. (2023). Research translation to improve carer smoking cessation support in a paediatric ward of a regional hospital in the northern territory. Health Promotion Journal of Australia, 34(4). https://doi.org/10.1002/hpja.698 

Muis, K. R., Denton, C., & Dubé, A. (2022). Identifying CRAAP on the internet: A source evaluation intervention. Advances in Social Sciences Research Journal, 9(7), 239–265. https://doi.org/10.14738/assrj.97.12670 

Nnate, D. A., Barber, D., & Abaraogu, U. O. (2021). Discharge plan to promote patient safety and shared decision making by a multidisciplinary team of healthcare professionals in a respiratory unit. Nursing Reports, 11(3), 590–599. https://doi.org/10.3390/nursrep11030056 

Parascandola, M., & Xiao, L. (2019). Tobacco and the lung cancer epidemic in China. Translational Lung Cancer Research, 8(S1), S21–S30. https://doi.org/10.21037/tlcr.2019.03.12 

Tsoh, J. Y., Hessler, D., Parra, J. R., Bowyer, V., Lugtu, K., & Potter, M. B. (2022). Addressing tobacco use in the context of complex social needs: A new conceptual framework and approach to address smoking cessation in community health centers. PEC Innovation, 1, 100011. https://doi.org/10.1016/j.pecinn.2021.100011 

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

World Health Organization. (2023, July 31). Tobacco. Www.who.int. https://www.who.int/news-room/fact-sheets/detail/tobacco#:~:text=Around%2080%25%20of%20the%20world 

Wunderlich, K. (2020). Running to quit? : Exploring predictors of attendance in an exercise and smoking cessation intervention. Open.library.ubc.ca. https://open.library.ubc.ca/soa/cIRcle/collections/ubctheses/24/items/1.0389777