Evaluate the preliminary care coordination plan you developed in Assessment 1
using best practices found in the literature.
NOTE: You are required to complete this assessment after Assessment 1 is successfully completed.
Care coordination is the process of providing a smooth and seamless transition of care as part of the health
continuum. Nurses must be aware of community resources, ethical considerations, policy issues, cultural
norms, safety, and the physiological needs of patients. Nurses play a key role in providing the necessary
knowledge and communication to ensure seamless transitions of care. They draw upon evidence-based
practices to promote health and disease prevention to create a safe environment conducive to improving and
maintaining the health of individuals, families, or aggregates within a community. When provided with a plan
and the resources to achieve and maintain optimal health, patients benefit from a safe environment conducive
to healing and a better quality of life.
This assessment provides an opportunity to research the literature and apply evidence to support what
communication, teaching, and learning best practices are needed for a hypothetical patient with a selected
health care problem.
You are encouraged to complete the Vila Health: Cultural Competence activity prior to completing this
assessment. Completing course activities before submitting your first attempt has been shown to make the
difference between basic and proficient assessment.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies
through the following assessment scoring guide criteria:
Competency 1: Adapt care based on patient-centered and person-focused factors.
Design patient-centered health interventions and timelines for a selected health care problem.
Competency 2: Collaborate with patients and family to achieve desired outcomes.
Describe priorities that a care coordinator would establish when discussing the plan with a patient and family
member, making changes based upon evidence-based practice.
Competency 3: Create a satisfying patient experience.
Use the literature on evaluation as a guide to compare learning session content with best practices, including
how to align teaching sessions to the Healthy People 2020 document.
Competency 4: Defend decisions based on the code of ethics for nursing.
Consider ethical decisions in designing patient-centered health interventions.
Competency 5: Explain how health care policies affect patient-centered care.
Identify relevant health policy implications for the coordination and continuum of care.
Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation,
word choice, and spelling.
Preparation
In this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1
using best practices found in the literature.
To prepare for your assessment, you will research the literature on your selected health care problem. You will
describe the priorities that a care coordinator would establish when discussing the plan with a patient and
family members. You will identify changes to the plan based upon EBP and discuss how the plan includes
elements of Healthy People 2020.
Note: Remember that you can submit all, or a portion of, your plan to Smarthinking Tutoring for feedback,
before you submit the final version for this assessment. If you plan on using this free service, be mindful of the
turnaround time of 24–48 hours for receiving feedback.
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