NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

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Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

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Date

 

Synthesis of Evidence Substantiating a Practice Gap

A practice gap refers to the discrepancies between established best practices and the actual practices implemented in healthcare settings. At We Level Up Treatment Lawrenceville, there is a significant practice gap in the effective communication and collaboration between nursing staff and outpatient care providers during patient discharge. Inconsistent communication and collaboration gap leads to fragmented follow-up care and increases the risk of relapse and hospital readmissions (Louie et al., 2021). Primary goal of this paper is to analyze relevant literature to substantiate the identified practice gap and explore potential interventions that can improve communication and collaboration, ultimately increasing patient outcomes in Substance Use Disorder (SUD) treatment.

Identified Scholarly Articles

Identified practice gap is the inconsistent communication and collaboration between nursing staff and outpatient care providers during patient discharge from substance abuse treatment facilities. Communication and collaboration inconsistency often leads to gaps in follow-up care, which increases the risk of relapse and hospital readmissions. According to Sinclair et al. (2024), “Effective communication between providers is crucial for successful patient outcomes,” underscoring the need to enhance coordination between nursing staff and outpatient providers at our facility. Osilla et al. (2022) found that “Collaborative care models, especially with community health workers, improve communication,” which addresses our practice gap by improving coordination for patients with co-occurring opioid use and mental health disorders.

Kools et al. (2022) concluded that “Interdisciplinary collaboration fosters better care delivery,” which aligns with the need for structured communication in alcohol use disorder treatment at our facility. Hirchak et al. (2020) stated that “Culturally responsive interventions improve communication and coordination in diverse settings,” suggesting strategies to address gaps in communication for our multicultural patient population. Guerrero and Khachikian (2020) asserted that “Leadership plays a pivotal role in enhancing communication and collaboration within substance abuse treatment facilities,” providing insights into how leadership can address our practice gap. Findings from these studies collectively highlight the importance of proper communication to reduce relapse at the drug and alcohol facility.

Critical Review of the Chosen Article

A significant practice gap exists at We Level Up Treatment Lawrenceville, where inconsistent collaboration and communication between nursing staff and outpatient care have led to fragmented protocols in the treatment of drug and alcohol use disorders. Improving patient outcomes and minimizing hospital readmissions are key objectives in addressing the identified issue. Five carefully selected research articles have been reviewed, each offering valuable insights into leadership strategies, cultural responsiveness, interdisciplinary teamwork, and the implementation of evidence-based practices within SUD treatment systems. SORT model, which rates the strength of evidence, will be applied to evaluate the studies reviewed.

Effective discharge planning and recovery-supportive interventions are critical in ensuring continuity of care for individuals with substance use disorders. A well-coordinated discharge process can significantly reduce the risk of relapse by fostering supportive networks and addressing key recovery challenges like housing and employment. An article by Sinclair et al. (2024) supported an effective discharge planning view through a comprehensive scoping review, highlighting the importance of recovery-oriented services. Analysis of 25 studies demonstrated that peer support networks, interagency collaboration, and housing stability are vital in sustaining recovery post-discharge.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Research employed a systematic methodology to examine how recovery-oriented policies and services improve outcomes by promoting trust between service providers and users. Above given article was selected because it aligns with the identified practice gap, offering evidence that enhanced communication and structured discharge planning between inpatient facilities and outpatient services are crucial to maintaining sobriety and preventing hospital readmissions. According to the SORT model, the strength of evidence in Sinclair et al. (2024) is graded as B, reflecting moderate-quality evidence from a comprehensive scoping review that supports the importance of structured discharge planning and communication in improving recovery outcomes.

Co-occurring Opioid Use Disorder (OUD) and mental health conditions like depression and PTSD present significant challenges in treatment due to the complexity of symptoms and the lack of effective care strategies. Osilla et al. (2022) conducted a study in New Mexico, focusing on adapting a collaborative care model named Collaboration Leading to Addiction Treatment and Recovery from Other Stresses (CLARO) to address these intertwined disorders. Utilizing a stakeholder-informed process, the researchers identified 12 fidelity-consistent adaptations to collaborative care aimed at improving treatment accessibility and quality.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Study revealed that integrating community health workers as care coordinators and incorporating measurement-based care enhanced the intervention’s acceptability among patients. Findings from the study underscore the necessity of tailored approaches in addressing treatment gaps, aligning with the need for consistent nursing protocols in managing patients with dual diagnoses, thus supporting evidence-based practices in clinical settings. According to the SORT model, the evidence in Osilla et al. (2022) is graded as B, reflecting moderate-quality evidence supporting tailored collaborative care models for improving treatment outcomes in patients with co-occurring OUD and mental health conditions.

Kools et al. (2022) provided valuable insights into the dynamics of interdisciplinary collaboration in the treatment of Alcohol Use Disorders (AUD) within a hospital setting. Utilizing a mixed-methods approach, they effectively explored the structure and quality of collaboration among healthcare professionals through social network analysis and semi-structured interviews. Grounding the research in the ‘structuration model of collaboration’ provides a robust theoretical framework for understanding communication and collaboration among network partners.

Findings indicated that a project leader plays a crucial role in fostering collaboration, with participants emphasizing the need for structured protocols to enhance care delivery. Selection of this article for review stems from its focus on addressing the clinical practice gap of inconsistent nursing protocols in AUD treatment. By highlighting the importance of collaboration, the research underscored potential strategies for improving patient outcomes and reducing hospital readmissions, aligning with ongoing efforts to communication and collaboration. According to the SORT model, the evidence in Kools et al. (2022) is graded as B, indicating moderate-quality evidence supporting the role of interdisciplinary collaboration in improving AUD treatment outcomes.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Hirchak et al. (2022) explored the intricacies of cultural adaptation and implementation of substance use disorder interventions within an American Indian community, highlighting the significance of collaboration in enhancing treatment efficacy. Interactive Systems Framework was employed to assess three evidence-based treatments, demonstrating how cultural re-centering can facilitate meaningful engagement and improve communication among stakeholders. Methodologically, a pilot feasibility design was utilized, gathering data on recruitment strategies and the sustainability of counselors, which underscores the critical role of community involvement.

Findings indicate that effective collaboration not only addresses barriers but also fosters an environment conducive to shared learning and consistent practices. Insights gleaned from the study are relevant to addressing the identified practice gap of inadequate collaboration and communication in nursing and outpatient settings, showcasing strategies that could enhance interdisciplinary efforts in the treatment of AUDs. Based on the SORT model, Hirchak et al. (2022) is rated as B, reflecting moderate-quality evidence supporting culturally adapted, collaborative interventions to improve substance use disorder treatment outcomes in American Indian communities.

Guerrero and Khachikian (2022) explored how leadership impacts the effectiveness of drug treatment systems, focusing on transformational leadership and organizational climate. Using a case analysis method, the study demonstrated how leadership approaches influence the implementation of culturally responsive, Evidence-Based Practices (EBPs) in SUD treatment programs. Leadership’s role in enhancing collaboration, communication, and engagement among staff, especially in resource-limited settings, is underscored. Findings highlight the importance of fostering an organizational climate where leaders clearly communicate priorities and actively support staff in delivering EBPs.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Grounded in transformational leadership theory, the article emphasizes how such leadership fosters organizational change and improves care quality. Selected for its relevance to the identified practice gap, the article provides valuable insights into how effective leadership can address deficiencies in collaboration and communication within nursing and outpatient care, ultimately improving staff cohesion and patient outcomes. According to the SORT model, Guerrero and Khachikian (2022), would receive a rating of B, indicating moderate-quality evidence that highlights the importance of transformational leadership in enhancing the effectiveness of drug treatment systems and promoting collaboration among staff.

Through the analysis of five carefully selected research articles, several key strategies emerge, including the importance of recovery-supportive interventions, tailored collaborative care models, interdisciplinary teamwork, cultural responsiveness, and transformational leadership. A review of 20 patient charts at We Level Up Treatment Lawrenceville further supports these findings. Analysis of these charts shows that gaps in communication between nursing staff and outpatient services often result in uncoordinated discharge plans, which in turn increase the risk of relapse and hospital readmission. Implementing the strategies outlined in above five research articles can help bridge the identified gap and increase patient outcomes in SUD treatment.

Literature Synthesis Using MEAL Plan

Inconsistent communication and collaboration between nursing staff and outpatient care providers at We Level Up Treatment Lawrenceville significantly hinder effective treatment for SUDs and the ability to overcome relapse at drug and alcohol facilities. Sinclair et al. (2024) highlighted recovery-oriented services that foster trust and improve outcomes, while Osilla et al. (2022), demonstrated that collaborative care models enhance treatment for co-occurring disorders. Kools et al. (2022), illustrated how structured protocols and leadership enhance interdisciplinary collaboration, further supported by Hirchak et al. (2022), who discussed cultural adaptations that improve stakeholder communication.

Guerrero and Khachikian (2022), emphasized the role of transformational leadership in fostering an organizational climate conducive to evidence-based practices. All these studies collectively underscore the necessity of effective communication and structured discharge planning in reducing relapse rates and hospital readmissions. However, unanswered questions persist regarding the practical implementation of these strategies across diverse settings. Future research should investigate specific methods for sustaining effective collaboration and integrating patient feedback into discharge planning processes to enhance post-treatment support.

Integration of Writing Feedback

Writing feedback combined with the assessment process is effective in addressing critical writing problems since it helps the learners to appreciate the core writing skills. Feedback offers more specific details about organization, clarity, and argumentation, which gives students information about the positive and negative aspects of work. Feedback process enhances students’ participation, where they are forced to go over their work and make corrections that enhance the quality of the job. Through feedback, learners improve their skill levels, as well as build up their self-confidence with the skills they have.

Moreover, constant feedback helps to foster an environment for learning where individuals can experiment with their writing. Using the MEAL structure in the feedback can also help explain how expectations should be met by writing further by helping the students understand the expected structure (Lindsay, 2020). Lastly, the introduction of structured writing feedback fosters improved learning and skill inculcation, resulting in improved competence and confidence in the written expression of ideas.

Conclusion

Synthesis of evidence established that there is a noticeable practice breakdown in communication and collaboration between nursing staff and other outpatient caregivers, particularly at the time of discharge from substance use treatment establishments. Lack of standard procedures can slow down follow-up care and contribute to a higher chance of relapse and repeated hospitalization. Studies show that such factors as leadership approaches, teamwork, and cultural sensitivity are vital in closing the gap. Discharge planning and recovery services are important components in the continuity of care and promote better outcomes for patients. Addressing communication and collaboration inconsistency practice gap at drug and alcohol facilities by providing specific interventions will, in the end, result in higher recovery rates for patients with SUD.

References

Guerrero, E. G., & Khachikian, T. (2020). Leadership approaches to developing an effective drug treatment system. Effective Prevention and Treatment of Substance Use Disorders for Racial and Ethnic Minorities, 7. https://doi.org/10.5772/intechopen.91055 

Hirchak, K. A., Vallant, A., Herron, J., Cloud, V., Tonigan, J. S., McCrady, B., & Venner, K. (2020). Aligning three substance use disorder interventions among a tribe in the Southwest United States: Pilot feasibility for cultural re-centering, dissemination, and implementation. Journal of Ethnicity in Substance Abuse, 21(4), 1219–1235. https://doi.org/10.1080/15332640.2020.1836701 

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), e59. https://doi.org/10.1186/s13011-022-00486-y 

Lindsay, D. (2020). Scientific writing = Thinking in words. In Google Books. Csiro Publishing. https://books.google.com/books?hl=en&lr=&id=XMrgDwAAQBAJ&oi=fnd&pg=PP1&dq=proper+structured+argument+and+clarity+in+the+words+&ots=XP1vxw_jyR&sig=iL4BsSVDZ3Kj_v07jl5YQcbfXrQ 

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Louie, E., Barrett, E. L., Baillie, A., Haber, P., & Morley, K. C. (2021). A systematic review of evidence-based practice implementation in drug and alcohol settings: Applying the consolidated framework for implementation research framework. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01090-7 

Osilla, K. C., Dopp, A. R., Watkins, K. E., Ceballos, V., Hurley, B., Meredith, L. S., Leamon, I., Jacobsohn, V., & Komaromy, M. (2022). Collaboration leading to addiction treatment and recovery from other stresses (CLARO): Process of adapting collaborative care for co-occurring opioid use and mental disorders. Addiction Science & Clinical Practice, 17(1), 25.  https://doi.org/10.1186/s13722-022-00302-9 

Sinclair, D. L., Chantry, M., Ruysscher, C. D., Magerman, J., Nicaise, P., & Vanderplasschen, W. (2024). Recovery-supportive interventions for people with substance use disorders: A scoping review. Frontiers in Psychiatry, 15. https://doi.org/10.3389/fpsyt.2024.1352818 

 

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Citation	Conceptual Framework	Design/ Method	Sample/ Setting	Major Variables Studied and Their Definitions	Measurement	Data Analysis	Findings	Appraisal: Worth to Practice
(Sinclair et al., 2024)	Recovery paradigm: Framework emphasizing a holistic, community-based approach that fosters personal recovery.	Scoping review following PRISMA-ScR guidelines	25 studies (2005-2022), primarily from the U.S. Studies included patients with substance use disorders and co-occurring mental health disorders	Recovery-oriented interventions: policies, service-user collaboration, and recovery capital (housing, employment, networks)	Number of studies focusing on specific recovery-supportive interventions and policies. Measures included housing, social networks, employment, relapse rates, and hospital readmissions	Thematic analysis of 25 studies, identifying key recovery-supportive themes such as trust-building between service providers and users, policy alignment, and recovery capital	Recovery-supportive interventions such as coordinated housing and employment services reduced relapse rates and improved social integration and recovery outcomes. Collaboration between service providers, peer support workers, and service users was key to improving outcomes	High relevance: This study highlights the importance of coordinated discharge practices, particularly for housing and community support, directly linking to the practice gap. Interventions that enhance communication between service providers show promise in reducing relapse rates and hospital readmissions
(Osilla et al., 2022)	Collaborative care model adaptation for treating co-occurring OUD, major depressive disorder (MDD), and post-traumatic stress disorder (PTSD).	Qualitative study using the Map of Adaptation Process (MAP) to adapt care.	11 patients from clinics in New Mexico (Health Professional Shortage Areas), primarily Medicaid or uninsured patients with OUD and co-occurring MDD/PTSD.	Adaptations made to collaborative care to address OUD co-occurring with MDD/PTSD. Key variables: care coordination, patient engagement, and intervention acceptability.	Interviews with patients and rapid content analysis to gather feedback on adaptations.	Rapid content analysis of interview data and thematic coding by a team of three coders.	Documented 12 fidelity-consistent adaptations to collaborative care, including the use of community health workers as care coordinators, adapted training protocols for treating OUD with MDD/PTSD, and task-shifting strategies to overcome staffing shortages.	Useful for addressing the practice gap in inconsistent nursing protocols and improving care transitions. Adaptations like care coordination and measuring social needs align with strategies to prevent hospital readmissions.
(Kools et al., 2022)	Study utilizes the “structuration model of collaboration,” focusing on shared goals, internalization, governance, and formalization to evaluate interdisciplinary collaboration.	Mixed-method study, incorporating social network analysis and semi-structured interviews to explore the effectiveness of interdisciplinary collaboration in AUD treatment.	Conducted in a gastroenterology and hepatology department of a top-clinical hospital in the Netherlands; 8 professionals completed the online survey (response rate 66.7%), and 10 participated in interviews.	Interdisciplinary Collaboration: Coordinated efforts between various healthcare disciplines to achieve shared treatment goals for AUD patients. – Network Partners: Healthcare professionals involved in interdisciplinary collaboration.	Social Network Analysis: Measured frequency of contact and degree of collaboration among network partners through an online survey. – Semi-Structured Interviews: Explored experiences of network partners with the collaboration using thematic analysis.	Social network analysis visualized and quantified relationships and collaborations among network partners. Thematic analysis of interview data identified key themes and insights regarding collaboration effectiveness.	Found that a core group of network partners was essential for effective collaboration, and close relationships among partners improved treatment for AUD patients. However, there was a noted gap in the involvement of certain healthcare professionals, which highlights the need for more structured protocols and consistent nursing practices to ensure comprehensive care.	This study highlights the importance of interdisciplinary collaboration in improving AUD treatment rates. With only 10% of individuals with AUD receiving treatment, an interdisciplinary collaborative approach can address the clinical practice gap by increasing engagement and standardizing care protocols, thus potentially reducing hospital readmission rates associated with AUD.
(Hirchak et al., 2020)	Interactive Systems Framework	Mixed-methods approach, including qualitative and quantitative data collection through community partnership	American Indian reservation community, Southwest United States	Cultural re-centering: Adapting interventions to fit cultural contexts; Dissemination: Sharing knowledge and practices within the community; Implementation: The process of putting evidence-based treatments into practice.	Interviews, surveys, and recruitment tracking.	Descriptive statistics and thematic analysis	Successful cultural adaptation and implementation of evidence-based treatments were achieved, identifying facilitators such as community engagement and barriers like recruitment challenges.	Provides essential insights for enhancing culturally relevant interventions for substance use disorders, emphasizing the importance of community involvement and sustainability. Addresses the clinical practice gap by suggesting structured protocols that align with cultural values, potentially leading to improved treatment outcomes.
(Guerrero & Khachikian, 2020)	Study is grounded in transformational leadership theory and implementation science. It emphasizes how leadership, organizational climate, and communication impact the delivery of culturally responsive, EBPs.	Case study analysis along with theoretical exploration of leadership’s role in influencing SUD treatment effectiveness. Key leadership styles, like transformational leadership, are analyzed in the context of improving communication and collaboration within treatment programs.	SUD treatment programs in the United States, with a case study focusing on a program located in a large city on the West Coast. The program consisted of a director, supervisors, counselors, and coordinators dealing with diverse populations.	Leadership Styles: How transformational leadership influences program outcomes.	The interaction between leadership, staff communication, and collaboration.	Qualitative analysis of leadership influence on program outcomes, focusing on communication and collaboration between leaders, supervisors, and counselors. Evaluates how organizational climate facilitates or hinders effective practice implementation.	Leadership plays a critical role in fostering a supportive organizational climate that promotes collaboration and communication. Transformational leaders who prioritize evidence-based practices and cultural competence enhance staff engagement and reduce turnover. Effective leadership trickles down to middle managers and front-line staff, improving patient outcomes and program sustainability.	Highly relevant to addressing the practice gap of collaboration and communication in nursing and outpatient care settings. Strong leadership and an inclusive organizational climate can improve the consistency and quality of care in treating vulnerable populations, including those with SUD. The article provides a framework for applying transformational leadership to bridge gaps in communication and improve interdisciplinary collaboration in healthcare settings.