The PHII studied outcomes for older patients with TBI and/or PTSD. Exercise showed the strongest improvement in mood, memory and muscle control. Medication and therapy also improved outcomes. A small meditation group saw dramatic improvements. Not all interventions worked - memory exercises and strength training showed limited benefits. The PHII provides lessons that can help develop a personalized care plan for a patient with a history of moderate TBI.

1. Discussion: Traumatic Brain Injury Care Report
Discussion: Traumatic Brain Injury Care ReportDiscussion: Traumatic Brain Injury Care
ReportWrite a 4-6 page evidence-based patient-centered care report on the patient scenario
presented in the Evidence-Based Health Evaluation and Application media piece. Base your
report on the information provided by the traumatic brain injury expert from the
population health improvement initiative (PHII) described in the media activity and your
own evidence-based research on this population health issue.In this assessment, you will
apply evidence-based practice in patient-centered care and population health improvement
contexts. You will be challenged to think critically, evaluate what the evidence suggests is an
appropriate approach for a personalized patient care plan, and determine which aspects of
the approach could be applied to similar situations and patients. Discussion: Traumatic
Brain Injury Care ReportDemonstration of ProficiencyBy successfully completing this
assessment, you will demonstrate your proficiency in the following course competencies
and assessment criteria:Competency 1: Apply evidence-based practice to plan patient-
centered care.Evaluate the outcomes of a population health improvement initiative.Develop
a personalized patient care plan that incorporates lessons learned from a population health
improvement initiative.Competency 2: Apply evidence-based practice to design
interventions to improve population health.Propose a strategy for improving the outcomes
of a population health improvement initiative, or for ensuring that all outcomes are being
addressed, based on the best available evidence.Competency 3: Evaluate outcomes of
evidence-based interventions.Propose an evaluation strategy for the outcomes of
personalized patient care plan and determine what aspects of the approach could be
applied to similar situations and patients.Competency 4: Evaluate the value and relative
weight of available evidence upon which to make a clinical decision.Identify the level of
evidence and describe the value and relevance it brings to personalized care for your
patient.Competency 5: Synthesize evidence-based practice and academic research to
communicate effective solutions.Write clearly and logically, with correct grammar and
mechanics.Integrate relevant and credible sources of evidence to assertions, correctly
formatting citations and references using APA style.ScenarioORDER NOW FOR ORIGINAL,
PLAGIARISM-FREE PAPERSThe charge nurse in your clinic has contacted you to assume
primary care for a patient and develop a plan for follow-up care. The plan should be
personalized for him based on evidence-based research provided by a community expert as
well as your own research on the condition. You will also be challenged to determine which
aspects of the traumatic brain injury (TBI) approach could be applied to similar situations

2. and patients.Your RoleYou are a nurse who has been requested to provide primary patient
care, including a follow-up care plan. You will revisit the interview with the community TBI
expert and prepare a personalized health plan for the patient. Discussion: Traumatic Brain
Injury Care ReportInstructionsReview the Assessment Case Study: Traumatic Brain Injury
Care Report media activity.Review relevant evidence-based research from 3–5 additional
scholarly or professional sources about traumatic head injuries to your evaluation,
recommendations, and plans.The following requirements correspond to the grading criteria
in the scoring guide, so be sure to address each point:Evaluate the expected outcomes of the
population health improvement initiative (PHII) that the community expert reported based
on data.Describe the outcomes that were achieved, their positive effects on the community’s
health, and any variance across demographic groups.Describe the outcomes that were not
achieved, the extent to which they fell short of expectations and any variance across
demographic groups.Identify the factors (for example: institutional, community,
environmental, resources, communication) that may have contributed to any achievement
shortfalls.Propose a strategy for improving the outcomes of the PHII for traumatic head
injuries.Describe the corrective measures you would take in the PHII to address the factors
that may have contributed to achievement shortfalls.Cite the evidence (from similar
projects, research, or professional organization resources) that s the corrective measures
you are proposing.Explain how the evidence illustrates the likelihood of improved
outcomes if your proposed strategy is enacted.Develop a personalized patient care plan for
the patient from the scenario that incorporates lessons learned from the PHII
outcomes.Identify a personalized care approach that addresses the patient’s:Individual
health needs.Economic and environmental realities.Culture and family.Explain how the
lessons learned from the PHII informed the decisions you made in your personalized care
plan for the patient.Incorporate references to the best available evidence from the
population health improvement initiative and other relevant sources.Identify the level of
evidence and describe the value it brings to personalize care for your patient.Identify the
level of evidence for each resource you referenced.Explain why each piece of evidence is
valuable and appropriate for the community health issue you are trying to address and for
the unique situation of your patient and his family.Propose an evaluation strategy to assess
the outcomes of your personalized care approach.Identify measurable criteria that are
relevant to your desired outcomes.Explain why the criteria are appropriate and useful
measures of success.Determine the specific aspects of your approach that are most likely to
be transferable to other individual cases.Additional RequirementsOrganization: Use the
following headingsfor your Traumatic Brain Injury Care Report:Evaluation of Population
Health Improvement Initiative (PHII) Outcomes.Strategies for Improving PHII
Outcomes.Personalized Evidence-Based Patient Care Plan.Analysis of Evidence.Evaluation
Strategy for Personalized Care Approach Outcomes.Application for Other Cases.Length:Your
recommended plan will be 4–6 double-spaced pages, not including title and reference
pages.Font:Times New Roman, 12 points.APA Format:Your title and reference pages must
adhere to current APA format and style guidelines. The body of your paper does not need to
conform to APA guidelines.Do make sure that it is clear, persuasive, organized, and well
written, without grammatical, punctuation, or spelling errors. You also must cite your

3. sources according to APA guidelines. Discussion: Traumatic Brain Injury Care
ReportMaterials:Patient ProfilesFrom: Janie PooleTo: AlexanderGood morning!At last
week’s conference I spoke with Alicia Balewa, Director of Safe Headspace. They’re a
relatively new nonprofit working on improving outcomes for TBI patients, and I
immediately thought of Mr. Nowak. At his last biannual cholesterol screening he mentioned
having trouble with his balance. This may be related to his hypertension, but he believes it’s
related to the time he was hospitalized many years ago after falling out of a tree, and
expressed distress that this might be the beginning of a rapid decline.Ms. Balewa will be on
premises next week, and I’d like to set aside some time for you to talk.— JanieDirector of
Safe Headspace-I have a patient who might benefit from some of the interventions for TBI
and PTSD you recently studied. What populations did your public health improvement
initiative study?My father came home from Vietnam with a kaleidoscope of mental health
problems. That was the 1970s, when treatment options for things like PTSD, TBI, and even
depression were very different. Since then there has been a lot of investment in treatment
and recovery for combat veterans. That’s excellent news for veterans in treatment now, but
they’re not looking at my dad, and how his TBI and PTSD have affected him through mid–
life and now as a senior. That’s why I started Safe Headspace: to focus on older patients who
are years or decades past their trauma, and find ways to help them.Which treatments
showed the strongest improvement?Exercise. We were able to persuade about half of our
participants — that’s around 400 people, mostly men ages 45–80 — to follow the CDC’s
recommendations for moderate aerobic exercise. Almost everyone showed improvement in
mood, memory, and muscle control after four weeks. After that a lot of participants dropped
out, which is disappointing. But of the 75 who stuck with it for another three months,
muscle control improved 15%, mood improved 22%, and short–to–medium term memory
improved 61%. We didn’t specify what kind of exercise, but we did ask them to record what
they did every week, so that data is available.Second was medication and therapy. Most of
our participants didn’t receive any kind of psychotherapy in the years immediately
following their trauma, so we had everyone assessed by a team of psychotherapists. As a
result of those assessments, 40% of participants started on anti–depressant medication and
9% started taking anti–psychotics. Those who started taking medications now have regular
contact with a therapist to manage that care. With some help at home to stick to the
regimen, all but a few have successfully followed their treatment plans. They’ve reported a
26% improvement in mood over six months, and a 6% improvement in memory.The third
treatment I want to mention is meditation. We only had a small group interested in trying it,
but the results were dramatic. We prescribed daily meditation at home, just 10 to 15
minutes, with a weekly hour–long guided group meditation for all 23 participants. After
three weeks we lost two to disinterest, but the other 21 showed improvements of over 70%
in mood and memory, and 32% in muscle control.Have you tried anything that hasn’t
worked?Sure. There are memory exercises for patients in elderly care, and things like
Sudoku and crossword puzzles. We didn’t see any gains with those. Some of our participants
preferred strength training to aerobic exercise, and the only improvement we saw in that
group was in muscle control, but only 4%, which is significantly less than the aerobic
group.I should also say that we were working with a willing group of participants. They

4. knew they needed help, and were motivated to get it. One of the hurdles we see with
veterans, especially in older generations, is an unwillingness to acknowledge that they have
a problem. We haven’t had to wrestle with that because everyone who volunteers to
participate wants to be there.Your organization is intervening with people who have TBI
and PTSD simultaneously. We have a patient with moderate TBI suffered almost 40 years
ago, but no history of PTSD. Have you separated your population and studied each
separately?We haven’t, no. In some cases we could, for those who come in with previous
diagnoses and medical records. But we have participants who either weren’t diagnosed,
were under–diagnosed at the time, or don’t have records to show us.Assessment Case
Study: Traumatic Brain Injury Care Report My QuestionsQuestion: What were the outcomes
of the PHII?Answer: I was able to gather information enough to know how to care for my
patient.Question: How could they have been improved?Answer: I would have asked some
more questions.Question: How do the results of the PHII relate to Mr. Nowak’s
case?Answer: They give me enough information to be able to help the Dr’s better develop a
plan of care.Grading Rubric:1. Evaluate the outcomes of a population health improvement
initiative based on demographic, environmental, and epidemiological data.Passing Grade:
Evaluates the outcomes of a population health improvement initiative based on
demographic, environmental, and epidemiological data. Identifies knowledge gaps,
unknowns, missing information, unanswered questions, or areas of uncertainty (where
further information could improve the evaluation).2. Propose a strategy for improving the
outcomes of a population health improvement initiative, or for ensuring that all outcomes
are being addressed, based on the best available evidence.Passing Grade: Proposes a
strategy for improving the outcomes of a population health improvement initiative, or for
ensuring that all outcomes are being addressed, based on the best available evidence.
Acknowledges challenges in the proposed strategy.3. Develop a personalized patient care
plan that incorporates lessons learned from a population health improvement
initiative.Passing Grade: Develops a personalized care plan that incorporates lessons
learned from a population health improvement initiative, and identifies assumptions on
which the approach is based. Discussion: Traumatic Brain Injury Care Report