Respond 2

discussion: The DNP-Prepared Nurse and Their Communities of practice

· The need for vaccine and immunization clinics for school age children with a school district
· The need for nutritional assistance programs pre-K students in a state-funded early childhood education program
· The need for diabetes education for elderly outpatients in a community health clinic
· The need to reduce the number of re-admits of patients who have had outpatient procedures in freestanding outpatient clinics
· The need to reduce the number of post-operative patient falls on an acute care in-patient hospital unit
These are just a few examples of the needs, challenges, and issues that may exist within a community of practice, and that merit the attention and require the knowledge, experience, and advocacy of a DNP-prepared nurse.
As a DNP-prepared nurse, you will likely belong to multiple communities of practice related to the various contexts and populations with which you are involved. Within each, you may work in a variety of ways to improve health outcomes and catalyze positive social change—at the individual patient level, as well as on increasingly larger scales within your organization, and potentially even at the national or global level.
Resources
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. 
WEEKLY RESOURCES
· Document:  Nursing Communities of Practice Template  Download Nursing Communities of Practice Template(PDF)
· Africa, L., Frantz, J. M., & Mlenzana, N. B. (2023).  Activities to promote interprofessional practice at primary healthcare level: A systematic reviewLinks to an external site..  Social and Health Sciences, Article 12130. https://doi.org/10.25159/2957-3645/12130
· American Association of Colleges of Nursing. (2021).  The essentials: Core competencies for professional nursing educationLinks to an external site. . https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf 
· American Association of Colleges of Nursing. (n.d.).  T he essentials: Domain 6: Interprofessional partnershipsLinks to an external site. . https://www.aacnnursing.org/essentials/tool-kit/domains-concepts/interprofessional-partnerships
· Bradley, C., & Bleich, M. (2024).  The DNP graduate and the potential to advance nursing: An interview with thought leader Michael Bleich, PhD, RN, FAAN, by Carol Bradley, MSN, RN, FAONLLinks to an external site..  Nursing Administration Quarterly, 48(1), 80–82. https://doi.org/10.1097/NAQ.0000000000000621
· Interprofessional Education Collaborative. (2023, November 20).  IPEC core competencies for interprofessional collaborative practice: Version 3Links to an external site. . https://ipec.memberclicks.net/assets/core-competencies/IPEC_Core_Competencies_Version_3_2023.pdf 
· Healthy People 2030. (n.d.).  Healthy people in actionLinks to an external site. . https://health.gov/healthypeople/tools-action/healthy-people-in-action 
· Ho, J. T., See, M. T. A., Tan, A. J. Q., Levett-Jones, T., Lau, T. C., Zhou, W., & Liaw, S. Y. (2023).  Healthcare professionals’ experiences of interprofessional collaboration in patient education: A systematic reviewLinks to an external site..  Patient Education and Counseling, 113, Article 107965. https://doi.org/10.1016/j.pec.2023.107965
· King, R. J., Heisey-Grove, D. M., Garrett, N., Scott, K. A., Daley, M. F., Haemer, M. A., Podila, P., Block, J. P., Carton, T., Gregorowicz, A. J., Mork, K. P., Porter, R. M., Chudnov, D. L., Jellison, J., Kraus, E. M., Harrison, M. R., Sucosky, M. S., Armstrong, S., & Goodman, A. B. (2022). The childhood obesity data initiative: A case study in implementing clinical-community infrastructure enhancements to support health services research and public healthLinks to an external site..  Journal of Public Health Management and Practice, 28(2), E430–E440. https://doi.org/10.1097/PHH.0000000000001419
· McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022).  A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behavioursLinks to an external site..  Healthcare Management Forum, 35(2), 112–117. https://doi.org/10.1177/08404704211063584
· Merriam, D., Wiggs, C., Provencio, R., Goldschmidt, K., Bonnett, P., Valazza, V., Brodhead, J., Scardaville, D., & Stalter, A. (2022).  Concept analysis of systems thinking in the context of interprofessional practice and improved patient outcomesLinks to an external site..  Nursing Education Perspectives, 43(4), E20–E25. https://doi.org/10.1097/01.NEP.0000000000000951
· O’Leary, N., Salmon, N., O’Donnell, M., Murphy, S., & Mannion, J. (2023).  Interprofessional education and practice guide: Profiling readiness for practice-based IPELinks to an external site..  Journal of Interprofessional Care, 37(1), 150–155. https://doi.org/10.1080/13561820.2022.2038551
· Ruebling, I., Eggenberger, T., Frost, J. S., Gazenfried, E., Greer, A., Khalili, H., Ochs, J., Ronnebaum, J., & Stein, S. M. (2023).  Interprofessional collaboration: A public policy healthcare transformation call for actionLinks to an external site..  Journal of Interprofessional Education and Practice, 33, Article 100675. https://doi.org/10.1016/j.xjep.2023.100675
Communities of Practice Resources
· Adler, R. H., & Sickora, C. (2023).  Research, practice and teaching united: Implementing AACN academic guidelines in a community based behavioral health settingLinks to an external site..  Journal of Professional Nursing, 49, 21–25. https://doi.org/10.1016/j.profnurs.2023.08.001
· Bekemeier, B., Kuehnert, P., Zahner, S. J., Johnson, K. H., Kaneshiro, J., & Swider, S. M. (2021).  A critical gap: Advanced practice nurses focused on the public’s healthLinks to an external site..  Nursing Outlook, 69(5), 865–874. https://doi.org/10.1016/j.outlook.2021.03.023
· Corbo, S. A., & Flatekval, A. M. (2022).  An academic-practice partnership to provide community vaccinationsLinks to an external site..  Nursing Management, 53(3), 36–42. https://www.doi.org/10.1097/01.NUMA.0000821704.29642.ee
· Goglio, K., Crespin-Mazet, F., Simon, L., Cohendet, P., & Wenger-Trayner, E. (2023).  Managing with communities for innovation, agility, and resilienceLinks to an external site..  European Management Journal, 41(4), 534–539. https://doi.org/10.1016/j.emj.2023.07.005
· Groff, A. (2023).  Community of practice (CoP)Links to an external site..  Salem Press Encyclopedia. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=ers&AN=90558267&site=eds-live&scope=site&custid=s6527200 
· Shirey, M. R., Bruck, M., Patton, E., Bowers, D., & Watts, P. I. (2022).  COVID-19 telehealth fair partnership for capacity building in primary care nursing.Links to an external site.  Nursing Administration Quarterly, 46(2), 113–124. https://doi.org/10.1097/NAQ.0000000000000517 
· Truax, F. N., Low, J., Mochizuki, T., Asfaha, S., Nguyen, T. N., Carson, M., Katrak, S., Shah, N., & Nguyen, D. (2022).  Latent tuberculosis infection testing and treatment at a federally qualified health center in Southern California: A quality improvement projectLinks to an external site.. J ournal of Nursing Care Quality, 37(2), 155–161. https://doi.org/10.1097/NCQ.0000000000000579 
· UC Davis Health School of Medicine. (n.d.).  Communities of practice: A toolkitLinks to an external site.. https://health.ucdavis.edu/workforce-diversity/What_We_Do/Communities-of-Practice/COPToolkit.html
To prepare:
· Review this week’s Learning Resources, paying special attention to the various examples communities of practice you encounter.
· Use the Communities of Practice template, located in this week’s Learning Resources, to help you identify the various communities of practice with which you are currently involved and those you may want to become involved with in the future.
· Select  one of these communities of practice on which to focus for this Discussion.
· Consider the most important needs, challenges, or issues facing the community of practice you selected.
· Select  one of these needs, challenges, or issues on which to focus for this Discussion.
· Using Walden Library and the internet, search for and identify  three scholarly, peer-reviewed articles (within the last 5 years) that address the need, challenge, or issue you selected.
· Consider the kinds of practice changes you might recommend to address this need, challenge, or issue.
· Consider how your recommendations align with specific Domains from  The Essentials.
Post the following:
· Describe the community of practice and associated need, challenge, or issue you selected for this Discussion.
· From your perspective as a future DNP-prepared nurse, explain why this need, challenge, or issue is important and merits attention. Be specific and provide examples.
· Citing the  three scholarly articles you identified, describe at least  two practice changes you recommend to address the need, challenge, or issue facing the community of practice you selected.
· Explain how your recommendations align with at least  three specific Domains from  The Essentials.
Note: Your posts should be substantial (700 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA Style. Personal anecdotes are acceptable as part of a meaningful post but cannot stand alone as the entire post.
, on different days, by suggesting an additional practice change or other intervention that your colleague might consider to address the need, challenge, or issue facing the community of practice they selected.
Note: Your responses to colleagues should be substantial (250 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA Style. Personal anecdotes are acceptable as part of a meaningful response but cannot stand alone as a response. Your responses should enrich the initial post by supporting and/or adding a fresh viewpoint and be constructive, enhancing the learning experience for all students.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights that you have gained because of your colleagues’ comments.
RESPOND TO THIS DISCUSSION POST
LH
I have had the privilege of participating in our hospital’s community outreach program, which often brings me face-to-face with homeless individuals struggling with mental illness. Accordingly, the community of practice I have chosen to focus on is the homeless population with mental illness in Miami-Dade County. This vulnerable group faces numerous challenges, including limited access to healthcare, inadequate shelter, and the stigma associated with both homelessness and mental illness (Mejia-Lancheros et al., 2020). The need for comprehensive, compassionate care for this population is critical and often overlooked as they are often perceived as a transient population with their numbers increasing and decreasing in different times of the year across the state of Florida (Zhang et al., 2019).
From my perspective as a future DNP-prepared nurse, addressing the healthcare needs of homeless individuals with mental illness is of paramount importance. This population often falls through the cracks of our healthcare system, leading to exacerbation of both physical and mental health conditions (Wadhera et al., 2019). For example, I’ve encountered patients who have gone months without their psychiatric medications, resulting in severe decompensation and hospitalization. Additionally, the lack of consistent care and follow-up means that many chronic physical health conditions go untreated. This further compromises their overall well-being.
To address these challenges, I propose two practice changes based. First, I recommend implementing a mobile outreach program. This program would involve a multidisciplinary team, including PHMNPs, case managers, and social workers, who would provide regular, on-site care to homeless individuals (Kopanitsa et al., 2023). This approach would help overcome barriers to access and build trust with this often-marginalized population. Secondly, I suggest integrating nurse practitioner students into these outreach efforts. This step would not only provide much-needed care to the homeless population but also help develop empathy and cultural competence in future healthcare providers. Exposure to this vulnerable population during training can lead to more compassionate and effective care in the future.
These recommendations align with several Domains from The Essentials of Doctoral Education for Advanced Nursing Practice. Domain 2: Person-Centered Care is addressed by providing tailored, compassionate care to individuals in their own environment (American Association of Colleges of Nursing, 2021). Secondly, Domain 3: Population Health is met by focusing on a specific, underserved population and addressing their unique health needs (AACN, 2021). Finally, Domain 8: Design, Delivery, and Evaluation of Clinical Prevention and Health Promotion Interventions is fulfilled by creating innovative outreach programs that aim to prevent health deterioration and promote wellness among the homeless population with mental illness.
Implementing these changes would require collaboration across various sectors, including healthcare, social services, and education. However, the potential impact on the health and well-being of this vulnerable population makes it a worthwhile effort. I believe that it is our responsibility to advocate for and implement these types of innovative, community-based solutions to address the complex healthcare needs of our most vulnerable populations.
Overall, addressing the healthcare needs of homeless individuals with mental illness goes beyond just providing medical care but also recognizing their humanity and dignity. By bringing care to where they are and training future healthcare providers to be more empathetic and culturally competent, there is a better likelihood of meeting the health needs of this vulnerable population.
References                                           
American Association of Colleges of Nursing. (2021 ). The essentials: Core competencies for professional nursing education.  https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdfLinks to an external site.
Kopanitsa, V., McWilliams, S., Leung, R., Schischa, B., Sarela, S., Perelmuter, S., … & Rosenthal, D. M. (2023). A systematic scoping review of primary health care service outreach for homeless populations.  Family Practice, 40(1), 138-151.   https://doi.org/10.1093/fampra/cmac075Links to an external site.
Mejia-Lancheros, C., Lachaud, J., O’Campo, P., Wiens, K., Nisenbaum, R., Wang, R., … & Stergiopoulos, V. (2020). Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness.  PloS one, 15(2), e0229385.  https://doi.org/10.1371/journal.pone.0229385Links to an external site.
Wadhera, R. K., Choi, E., Shen, C., Yeh, R. W., & Maddox, K. E. J. (2019). Trends, causes, and outcomes of hospitalizations for homeless individuals: A retrospective cohort study.  Medical Care, 57(1), 21-27.  https://doi.org/10.1097/MLR.0000000000001015Links to an external site.
Zhang, M., Garcia, A., & Bretones, G. (2019). Demographics and clinical profiles of patients visiting a free clinic in Miami, Florida.  Frontiers in Public Health, 7, 212.  https://doi.org/10.3389/fpubh.2019.00212Links to an external site.

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