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NURS FPX 4905 Assessment 5 Reflective Journal
NURS-FPX4905, Capella University, RN-TO-BSN

NURS FPX 4905 Assessment 5 Reflective Journal

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NURS FPX 4905 Assessment 5 Reflective Journal Student Name Capella University NURS-FPX4905 Capstone Project for Nursing Professor Name Submission Date   Reflective Journal Wellness and Disease Prevention The major experiences I’ve had in connection with the practicum practice in mental health psychiatry have involved the use of preventive methods in treating patients, most of whom are over 65 years of age, with anxiety disorders. Some of the following measures are usually used to prevent the occurrence of the problems that are discussed in this section: Examination of anxiety symptoms that patients show when they go to hospitals. The patients, the nurses, and other mental health workers would be assessed on their behavior. This would involve restlessness, difficulty in falling asleep, worrying, being unable to concentrate on anything, and many other things. It is important to help these patients in so many different ways because they must form positive relations and social connections. The key determinants of the health status of patients were poverty, poor transport provision, and low-income family systems support. During this experience, I had the realization of the importance of the role that nurses play in the prevention of disease in susceptible people. The following observations were made: many of the psychological issues encountered by elderly patients can be easily missed by their families, requiring diagnosis. As a future BSN nurse, I found learning about the need for a nurse to have the skills to communicate with a patient, be able to relate to a patient, and act as an advocate for a patient who suffers from anxiety disorders to be extremely important. The importance of social determinants of health was obvious. Chronic Disease Management During the practicum, I found it very important to know how to work in teams when dealing with patients who suffer from anxiety disorders. That was because patients who had anxiety disorders also had some problems with hypertension, diabetes, heart disease, and depression. For this reason, it was necessary for the whole team, comprising the psychiatric nurse, psychiatrist, psychologist, social worker, and geriatrician, to work hand in hand. This would allow nurses to see patient behaviors and emotional responses during the psychiatrist’s medication adjustments. Teamwork was an excellent approach to solving patients’ issues, but it also presented some challenges due to poor communication. Besides, I found that in some instances, due to poor documentation and reassessment, I was not able to determine the poor health status of the patient with anxiety disorders. Such experiences help develop the requirement for communication and coordination in dealing with patients who have chronic illnesses. Through my experience as a nursing student, I have come to understand that nurses are very crucial in the medical team. Nurses are the ones who conduct assessments and immediately make decisions based on the patient’s health condition. As a future nurse, I hope to contribute to the change that will take place among those who suffer from chronic mental diseases. Regenerative and Restorative Care At times when someone’s signs and symptoms appeared to require immediate referral to a health care provider during my internship at the Psychiatry Department, I have been in these kinds of situations. Signs and symptoms here are defined with conditions such as anxiety, behavioral changes, emotional disturbance, and high risk of falling by virtue of aging. In this case, the patient will experience several psychological ailments such as panic attacks, confusion, insomnia, instability, and frailty. The responsibility of the nurses will be to watch over patients and give them drugs. During the practicum period, I have been able to learn more about psychiatric nursing practice and the importance of restoring the health of the patient. The importance of critical thinking, decision making, and teamwork is a major feature of the members of the healthcare team, as at some stage, they needed to make rapid decisions for the safety of the patient in question. From knowing how nurses made their fast actions in these scenarios, it has become apparent to me that the significance of clinical reasoning and communication skills cannot be undermined. As a future BSN-prepared nurse, it is quite evident that fast actions and safety measures should not be overlooked when it comes to restoring the health status of the patient. Hospice and Palliative Care During my time in the practicum setting, I observed some patients who had been suffering from different types of psychological problems, such as depression and anxiety disorders, chronic illness, mental health disorders, and physical disabilities. The location of the practicum experience was, indeed, related to psychiatry, but oftentimes the nurses used a palliative approach to make the clients more comfortable. This has been observed when emotional, symptom, medication, and therapeutic interventions have been used to help patients cope with anxiety disorders, depression, chronic conditions, and social isolation. I have experienced hospice nursing care where not only was a patient’s health problem addressed, but also issues related to spiritual, emotional, psychological, and sociological factors were addressed. As observed, nurses’ empathic care with patients by listening and communicating with patients has helped to alleviate anxiety and build trust between patients and nurses. From experience, I have learned that as a BSN nurse in the future, it is important to respect the dignity and the wishes of the patient in making decisions for them in times of difficulty. In addition, it has been my learning that nurses act as leaders in soothing their patients. References References coming soon.

NURS FPX 4905 Assessment 1 BSN Practicum Conference Call Template
NURS-FPX4905, Capella University, RN-TO-BSN

NURS FPX 4905 Assessment 1 BSN Practicum Conference Call Template

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NURS FPX 4905 Assessment 1 BSN Practicum Conference Call Template Student Name Capella University NURS-FPX4905 Capstone Project for Nursing Professor Name Submission Date BSN Practicum Conference Call Template Date: 09/04/2025 Attending: (Student), Professor, Preceptor Meeting objectives:   What is going well during your practicum? What are some of the challenges you are facing? What are your practicum objectives? Topic Notes Action Item •What is going well during your practicum? Creating a desirable rapport. Contributing to the team of caring medical specialists. Promoting high-level open communication. Approved •What are some of the challenges you are facing? Handling appointment times likely to take a longer period than what was scheduled. Approved •What are your practicum objectives? Use the knowledge and skills acquired during my BSN education to provide excellent and life-changing care and influence patient outcomes in a positive way. Approved Practicum Hours The course will require 50 practicum hours; however, not more than 6 hours per day. Approved Conclusion This practicum conference call ensures effective communication, goal alignment, and continuous professional development in nursing practice. For more details about this class, visit NURSFPX4905Assessment. References References coming soon.

NURS FPX 4905 Assessment 2 Define and Analyse Your Healthcare Process Problem or Issue of Concern
NURS-FPX4905, Capella University, RN-TO-BSN

NURS FPX 4905 Assessment 2 Define and Analyse Your Healthcare Process Problem or Issue of Concern

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NURS FPX 4905 Assessment 2 Define and Analyse Your Healthcare Process Problem or Issue of Concern Student Name Capella University NURS-FPX4905 Capstone Project for Nursing Professor Name Submission Date Define and Analyze Your Healthcare Process Problem or Issue of Concern Affecting older adults, anxiety disorders often turn into a serious mental and physical illness and a life-threatening condition for their emotional and physical well-being. It is, therefore, essential for the psychiatric nurse not only to identify and intervene in the problem safely and effectively but also to track the patient and ensure that there are no further risks or detrimental outcomes. Furthermore, nurses need to identify potential problems associated with the process of healthcare that may occur when delivering care, which can be identified by analyzing the healthcare process itself. The focus of this assessment will be on the problem of healthcare processes related to anxiety issues in elderly patients and the repercussions that will follow patient safety, quality of patient care, costs, and process efficiency in the delivery of care. Practicum Setting Description The practicum will be conducted in the Mental Health Psychiatry Department, where emphasis will be placed on caring for older adults who have anxiety disorders. This setting offers an excellent opportunity to undertake the evaluation and management of anxiety disorders, as well as other potentially age-related concerns, such as loneliness, decreased independence, and health complications. Many senior citizens suffer from anxiety, with symptoms including worry, restlessness, fatigue, trouble sleeping, and not being able to focus, which can impact day-to-day activities. The WHO (2023) estimates that 10–20% of older people develop some form of anxiety disorder, and many who suffer from the condition are not diagnosed or treated. Here, the patients’ age is above 60 years, socioeconomic status is varied, and they lack family and social support systems. The population of older people is growing rapidly, and in the near future, most of the world’s population will consist of older individuals (Feyzabadi et al., 2025). By 2023, it was estimated that one out of six people in the world would be 60 years or older. By 2050, however, the number of people would be around 2.1 billion, representing 20% of the population (World Health Organization, 2023). This highlights the importance of mental health intervention for the older population, not least in the way their anxiety disorders can be managed. The ward follows an interprofessional approach, which involves psychiatrists, psychiatric nurses, geriatricians, psychologists, social workers, and many more. Nursing practice involves assessment of symptoms, medication administration, psychological support, and patient safety. They regularly communicate with the patients to enhance their health outcomes. Regarding the mental health team of patients with anxiety disorder, some decisions have been taken towards the delivery of treatment efficiently for my practice placement. These include selecting the appropriate anti-anxiety medication, determining dosage based on reaction to the prescribed medication, and determining whether a self-directed psychoeducation program would be required for the treatment. Deep breathing exercises, progressive muscle relaxation, and other techniques that promote relaxation may be included in this program. When treating elderly patients, it is important to take into account their predispositions to health problems, which can make them vulnerable to the side effects of their treatment in addition to the side effects of the drugs (Srifuengfung et al., 2023). Moreover, the decision had to be made at some point when the patient can be released, in collaboration with social workers, and the provision of follow-up services to prevent re-hospitalization and relapse. As far as my participation in the decision-making process, I will be evaluating the patient, reporting any changes in symptoms, and monitoring how well the medication is working. The outcome or outcomes of the decision-making process would be to have less anxiety, a better sleep pattern, perform more effectively in daily activities, and have fewer anxiety disorders. Identification of Process Issue The process problem that I encountered in my practicum was screening and follow-up of anxiety disorders in older adults. This problem has major impacts on the treatment and health of the patients. Although some of the older people are identified as having anxiety disorders due to symptoms of anxiety, such as worry, not much has been done to develop screening and follow-up systems. According to Atchison et al. (2024), 10-20% of older adults suffer from anxiety disorders. They can, however, be difficult to diagnose as their symptoms can be confused with normal aging symptoms and associated with other medical conditions. Patients who have been admitted to hospitals during my practicum have also been screened for anxiety disorders. However, at present, there is no follow-up done after admission to the hospital that may exacerbate the patients’ anxiety symptoms. As a result, the psychological state of the patient will deteriorate; they will become socially isolated, will not be able to adhere to the treatment, will develop other diseases, and will be admitted to the hospital several times. If left untreated, anxiety disorders can lead to major deterioration of the patient’s quality of life. Analysis of Process Impact on Quality, Safety, and Cost Periodic monitoring and follow-up of anxious elderly can have a major impact on patient outcomes, the quality, safety, and cost-effectiveness of the health care system. From a quality perspective, the wrong evaluation leads to a wrong treatment plan, inadequate symptom management, and patient dissatisfaction. Anxiety disorder is a chronic condition for many older patients, meaning that they will continue to suffer from the symptoms again and again, impact their day-to-day functioning, and cause health problems (Atchison et al., 2024). As far as safety is concerned, irregular monitoring is related to a worsening of the patient’s condition, incorrect therapy, and side effects. The other difficulty encountered in this case is the reluctance of some elderly patients to disclose to health care professionals that they have some symptoms, and therefore, the assessment of their current health status is not conducted. Finally, from a financial perspective, poorly managed anxiety is more expensive for healthcare providers and patients’ families. Moreover, if not periodically

NURS FPX 4905 Assessment 3 Technology and Professional Standards
NURS-FPX4905, Capella University, RN-TO-BSN

NURS FPX 4905 Assessment 3 Technology and Professional Standards

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NURS FPX 4905 Assessment 3 Technology and Professional Standards Student Name Capella University NURS-FPX4905 Capstone Project for Nursing Professor Name Submission Date Technology and Professional Standards The issue of depression screening and ineffective screening in CareTeam Health is pretty bad because, without being picked up or screened properly, depression can have a significant impact on a person’s physical health, safety, quality of life, and mental health. For example, the elderly with depression might feel lonely or isolated, not take the prescribed medications, struggle to manage a pre-existing disease, be admitted to a hospital, or even consider suicide. However, the key role of psychiatric nurses and other healthcare workers in the identification and management of the above-mentioned issue cannot be ignored, as they should help their patients receive prompt treatment, monitoring, and follow-up visits (Russell, 2025). Therefore, the paper will explore the role of the BSN-prepared nurse in the process of process improvement, the importance of collaboration amongst health care workers, recommendations from governing bodies, technologies to solve the problem discussed, and the potential barriers for implementation. Clarifying Role in Change Process I observed and participated in the process of assessing patients, documented patient information, kept track of changes in behavior, and provided the supervising nurses with information related to the patient during the practicum period at CareTeam Health as a nursing student. I was not given the autonomy to make clinical decisions by myself. Still, I did see the potential for psychiatric nurses to assist in the treatment of depression in older adults by observing patients, administering medications, offering psychological support, educating patients, and organizing the work of various experts. This made me realize how much of a difference nurses make in achieving positive patient outcomes and areas that need to be improved. Essential for the BSN-prepared RN to make changes to the processes, because BSN education focuses on leadership, evidence-based practice, quality improvement, communication, and healthcare informatics. Nurses are in frequent contact with patients and hence are good at identifying problems in the processes used and suggesting changes that should improve the process. One of the most frequent problems I observed during my practicum was that not all patients were measured with the same depression scale; there was also no reassessment of the patients’ depression status after they were admitted to the facility. In this health care setting, as a BSN-prepared nurse, I would be a part of the process of implementing the screening procedure for depression in the elderly. If this were the case, I would do my utmost to ensure that standard assessments of depression in older people are implemented (including the use of the GDS and PHQ-9 in initial and ongoing assessment sessions). I would also back efforts to enhance documentation and reporting, inter-professional working, and post-work-up assessments. Also, the reminders (in the EHR system) for reassessment and surveillance can be utilized by the nurse. All of these would help to enhance the effectiveness of symptom detection and the continuity of care, and overall patient safety. The professional standards of nursing totally support the concept of nurses’ involvement in quality improvement efforts and change. Nurses should showcase evidence-based practice, advocacy, collaboration, leadership, and accountability in their practice as outlined by the ANA’s Standards of Practice (American Nurses Association, 2022). Also, nurse practice acts define the boundaries of practice of registered nurses. The role of nursing assessment, advocacy, documentation, communication, and involvement in quality improvement activities is typically emphasized in nurse practice acts. The standards make the assumption that nurses have the required knowledge and skills in judgment and leadership. Interprofessional Collaboration Implementation Overview Interprofessional working is also of critical importance in relation to depression and the elderly, as mental disorders may be complex and require a range of perspectives from the different health and social care professionals. Interprofessional working between psychiatrists, psychiatric nurses, psychologists, therapists, social workers, geriatric specialists, and case managers can be seen in the case of CareTeam Health. The various healthcare professionals bring different specialties, which will contribute to the holistic treatment of the elderly suffering from mental disorders (Chu et al., 2025). The doctors of psychiatry, for instance, have the responsibility to diagnose the mental disorders and prescribe appropriate medicines. The psychiatric nurse’s role is to watch for the patient’s symptoms and response to the medication. Here are some things that I think would have benefited my practicum experience if I had collaborated better with others. Communication was a significant factor in this case, and at times, communication issues led to poor communication, monitoring, or follow-up. Communication can be enhanced with patient care conferences and huddles between healthcare personnel and/or effective communication tools like the SBAR tool (Situation, Background, Assessment, and Recommendations) (Shrivastava et al., 2025). Enhanced teamwork will make sure that everyone is on the same page about the patient’s condition, whether or not there has been a change in medication, and the patient’s psychology. As an RN with BSN preparation, I will be able to enhance interprofessional working by arranging interdisciplinary meetings relating to patients who are deteriorating and frequent admissions. Benefits Collaborating with other professionals has many benefits when working with older adults with depression at CareTeam Health. First, with interprofessional collaboration, there is better communication between health care partners and less fragmentation of care. Information regarding the client’s recovery, treatment, and/or behavioral changes can be shared with one another to offer clients unified and coordinated care (Dietl et al., 2023). Secondly, by treating interprofessionally, all factors that could impact the client’s physical, psychological, emotional, and social well-being can be taken into account. For instance, some of the reasons for older adults becoming depressed are due to chronic disease, bereavement, limited mobility, social isolation, and financial problems. Third, interprofessional care enhances adherence to medication and follow-ups, and identifies early signs of problems. Psychiatric nurses and social workers are the key workers who can identify any obstacles that may prevent patients from making follow-up visits or taking prescribed medication. This interprofessional care is supported by research studies, which report

NURS FPX 4905 Assessment 4 Proposal for Intervention
NURS-FPX4905, Capella University, RN-TO-BSN

NURS FPX 4905 Assessment 4 Proposal for Intervention

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NURS FPX 4905 Assessment 4 Proposal for Intervention Student name Capella University NURS-FPX4905 Capstone Project for Nursing Professor Name Submission Date Proposal for Intervention To fill the gap between the continuity of care provided to patients during detox and long-term recovery at Immersion Residential Center, a properly designed intervention is needed. Those who are released with substance use disorders (SUDs) do not have a personalized follow-up plan, and this exposes them to the risk of relapse and unfavorable health outcomes. To enhance the effectiveness of post-detox transitions, the suggested intervention would introduce a standardized discharge protocol comprising a coordinated referral, use of technology to facilitate follow-up, and an increase in the level of interprofessional collaboration. This practice is compliant with evidence-based practices and effective in the provision of patient-centered care, which is safe for this high-risk population. Practice Issue of Concern The practice problem of concern identified is the absence of structured continuity of care for people who have left detoxification at Immersion Residential Center (The Immersion Program, 2025). Detox is a vital initial intervention in the treatment of SUD. Still, most patients are being discharged without a specific follow-up plan or referral to outpatient or long-term rehabilitation programs (David et al., 2022). Such a gap leads to an increased risk of relapse or hospital readmission or even lack of engagement with treatment altogether. Although there are electronic health records (EHRs) and multidisciplinary teams, the quality and safety of patient outcomes are undermined because there is no universal standard that should be followed to facilitate a smooth transition among levels of care.  The problem is especially relevant to nursing leadership and practice as the BSN-prepared nurses are supposed to contribute to the quality promotion and represent other vulnerable groups. The Code of Ethics of the American Nurses Association helps nurses to avoid falling through the systemic gaps, particularly at high-risk moments such as post-detox discharge (American Nurses Association, 2025). A solution to this issue is not all about clinical care. It also involves integrative planning, communication, and incorporating a supportive technology to facilitate the inpatient-outpatient services transition. Nurses will be able to take the forefront in creating and sustaining care continuity and better long-term recovery outcomes among persons with SUDs by identifying and addressing this problem. Current Practice In Immersion Residential Center, the existing procedure is the delivery of medically supervised detoxification and discharge without the use of structured and individual transition plans, but general verbal instructions or pamphlets (The Immersion Program, 2025). Even though the staff consists of a multidisciplinary team, consisting of nurses, physicians, therapists, and case managers, the process of providing follow-up care is not formalized and standardized (Sheehan et al., 2021). Discharge planning depends on the provider, and even though EHRs are utilized in recording patient data, they are not always utilized to organize referrals or communicate with outpatient services. Simple telehealth services, along with case management assistance, are present, though these services are not part of a system that ensures that each patient has a clear and confirmed way to the next level of care. Consequently, a large portion of the patients leave the detox without a recorded referral, outpatient appointment, or a personalized plan of relapse prevention (David et al., 2022). This chaotic habit leads to poor integration of care, diminished compliance with treatment, and a high risk of relapse in SUD patients. Strategy to Improve Current Practice To overcome the problem of discontinuity between the post-detox care at Immersion Residential Center, a transition-of-care protocol is suggested. This plan is dedicated to the delivery of a personalized and well-coordinated follow-up plan to every client who is discharged during detox (Incze et al., 2024). This involves booking appointments with outpatients, mental health care, and connecting patients to support systems of recovery like peer groups. Nowadays, a large number of persons are discharged with no continuation plan, which exposes them to the risk of recidivism or readmission to hospitals. The new protocol would entail an increased level of interprofessional collaboration among nurses, addiction counselors, and case managers with a standardized discharge checklist and improved EHR documentation procedures (Incze et al., 2024). This would not only make follow-up care a planned process but also a procedure that must be ensured with a patient before they walk out of the facility. Changes Needed for People and Processes In order to introduce this enhancement, the functions and work processes of the staff members need to be reconsidered. The discharge would be initiated early during the detox stay by the nurses, and case managers would deal with the coordination with the external providers and community programs (Patel and Bechmann, 2023). The introduction of weekly interdisciplinary huddles to evaluate the discharge preparedness and to get the team aligned on the progress of every patient would be implemented. The changes in the EHR system would involve the implementation of automatic suggestions, referral documentation templates, and post-discharge tracking communication (Alexiuk et al., 2023). The strategy enables quality improvement as it helps to facilitate continuity of care, improve patient safety due to proactive relapse prevention, and lower the healthcare costs due to minimal emergency readmissions. Moreover, it promotes the use of technology in communication and decreases the amount of pressure on emergency services and crisis centers. Assumptions The plan takes the assumption that employees like nurses, therapists, and case managers will be willing to use a standardized discharge workflow with the necessary training. It also assumes that the EHR system used in the facility is capable of supporting the discharge coordination custom templates and discharge alerts. It is also subject to the availability and responsiveness of the outpatient providers to receive referrals on time. Lastly, it presumes that patients with SUDs will tend to remain in the recovery process when they leave the hospital with systematic follow-up and direct assistance. Such assumptions are in line with the evidence that coordinated care enhances the post-detox outcomes. Enhancing Quality, Safety, and Cost-Effectiveness Varying discharge planning strategies among different patients with SUDs would greatly enhance the quality and continuity of patient care at Immersion

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