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Prompt: Clinical change and quality improvement projects are implemented with an aim to make healthcare systems safer and more efficient. How do you know that your specific clinical change project will have this type of an effect on the organization?*at least 1 page, minimum 2 scholarly references, APA 7 citations, no plagiarism, no AI.
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Intervention for Proposed Clinical Change Project
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The Issue Under Study
In this research project paper, Tai Chi is presented as an alternative pain-relieving
physical activity among older adults suffering from chronic Rheumatoid Arthritis (RA). In order
to address the shortcomings in conventional pharmaceutical interventions, which are
accompanied by adverse effects and skyrocketing costs, this project will adopt nonpharmacological methods like Tai Chi. Such may make the general health provision cheaper and
the grounds on which patients may be well taken care of (Sánchez-Flórez et al., 2022). The study
provides evidence that, just as with elderly patients, physical exercises meet the requirements
and limitations inherent to the general approach to RA treatment. Acts of such kind may decrease
discomfort and increase the level of mental comfort one enjoys in life. The effect of tai chi
exercise on pain and physical function in patients with rheumatoid arthritis is supported by
evidence. According to Smolen et al. (2020), a more extensive treatment plan should be
organized for geriatric patients with RA in addition to conventional therapy.
The paper has numerous major purposes, such as investigating the adequacy of Tai Chi
for pain management and good health. The paper highlights the value of a qualitative data
collection method, such as thorough in-depth interviews and focus groups for understanding
pain, pain experience, and functional limitations associated with this technique. This paper
studies the community benefits of adopting a cheap, available pain relief system and
modification in medical problems addressing unbearable lifestyles under general pain
management (Mudano et al. 2019). Additionally, to establish the requirement of budgeting and
financial analysis for any program of such nature, one should understand it to consider economic
necessities like training expenses and equipment purchases. This project, therefore, offers a basis
for the inclusion of alternative interventions in the usual care of RA, recognizing its limitations
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and noting that quality studies are necessary in order to ensure better pain relief among elderly
patients with RA.
Solutions Or Interventions
This literature review suggests that several solutions and interventions can be
recommended to incorporate alternate physical activities, especially Tai Chi, into the pain control
management of aged RA patients. Such interventions aim to improve patient’s health, decrease
reliance on drugs, and foster a better livelihood. One possible solution is to create specialized Tai
Chi programs for elderly persons with RA, considering their physical limitations and unique
requirements. Therefore, Tai Chi and rheumatology specialists should design these programs to
avoid exposing senior patients to any risks with uncontrolled or unmonitored practices. The
exercises should include non-strenuous activities to enhance flexibility, balance, and muscle
tone.
The second approach involves the training of instructors. Such training should comprise
the knowledge of the disease, limitations in these patients, and possibilities to adjust Tai Chi
exercises. As such, it is a high-quality training that must be under healthcare professionals.
Thirdly, the collaboration with healthcare providers. It will involve partnering with
rheumatologists, physiotherapists, and other healthcare providers to determine the inclusion of
Tai Chi in the general RA patients’ management scheme. This will ease full patient management,
which includes medical therapy and physical exercise.
The fourth solution is to run awareness programs on Tai Chi therapy for patients and
health practitioners. Such campaigns could involve organizing workshops, developing
informational brochures, and presenting in healthcare contexts to increase awareness of the use
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and benefits of Tai Chi. Another potential solution is to undertake research to determine whether
Tai Chi can be prescribed as a substitute for pain treatment initiated by RA among the elderly.
The impact of qualitative quality tools on chronic pain intensity, physical functionality,
psychosocial issues, and quality of life should be assessed through a quantitative approach to
evaluate the studies.
Other Views on The Problem and Solutions
This paper suggests a non-pharmacological intervention of Tai Chi to control RA pain in
elderly patients. However, the literature offers differing opinions on the issue of RA pain
management and strategies for solving it. Although Tai Chi is emphasized for its low-impact,
gentle movements that favor RA patients, certain studies also recommend yoga, Pilates, and aqua
therapy. For example, Tai Chi and similar alternatives may enhance flexibility, strength, and
general mental health, among other benefits that may be preferred over traditional forms
(Mudano et al., 2019). For example, yoga focuses on breath control and meditation, which can
contribute to stress reduction even more.
However, this paper highlights non-pharmacological approaches in opposition to some
researchers and physicians who have emphasized traditional medical interventions as the key
role in the management of RA. They include disease-modifying antirheumatic drugs (DMARDs),
biologics, and corticosteroids (Hanly & Lethbridge, 2021). Proponents of this perception think
that while alternative treatments can be supplemental, they should not substitute medical
interventions known to inhibit disease progression and protect the joints. As the literature
indicates, a broader concept calls for a combination of pharmacological and nonpharmacological treatments. The model argues for an individualized treatment strategy
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comprising medication, physical activity, and lifestyle changes, a patient-centered approach
where the patients have some input in planning for their treatment.
Other studies favor digital solutions and telemedicine as pain management technologies
in the advanced technological arena. These include wearables for monitoring physical activity,
telerehabilitation, and self-management mobile applications for exercise adherence. The
supporters of this notion suggest that technology can enhance patients’ involvement, immediate
feedback, and greater accessibility, especially to people with mobility issues. Other researchers
highlight mind-body techniques such as mindfulness, meditation, cognitive-behavioral therapy
(CBT), and formal practices. According to Sánchez-Flórez et al. (2022), these efforts address the
psychological components of chronic pain and RA life, such as stress, anxiety, and depression
related to the condition.
In addition, numerous pieces of literature emphasize the significance of patient education
and self-management in relieving pain for RA. In this regard, patients are taught about their
disorder, treatment choices, and how to deal with different symptoms. As such, the literature
offers various viewpoints, from traditional medicine perspective to whole-person care practices.
These consist of technological interventions, mind-body therapies, and patient education that will
help in the management of RA pain in geriatric patients. Such diversity of perceptions highlights
the heterogeneity of pain-management programs and advocates for an individualized patientcentered strategy that considers every patient’s specific needs, preferences, and circumstances.
The APRN’s Role in The Intervention
Advanced practice registered nurses have diverse and integral roles in the provision of
interventions such as Tai Chi for the management of RA pain in their elderly population. These
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interventions can only be led by APRNs because they possess the skills of a great clinician,
operate in holistic caring modes, and can function independently. The latter regards their role and
has many clinical consequences. The first role is assessing and developing a person-centered
pain care plan. According to Urbanowicz (2019), APRNs are mainly responsible for checking a
patient’s physical capabilities, level of pain, and general health. Such assessment allows them to
adapt to specific patient requirements, making these interventions secure and advantageous, like
Tai Chi. When planning care, APRNs can make care plans unique to each patient, ready to
combine alternative therapies with traditional RA treatments by incorporating comorbidities,
physical limitations, and patient preferences.
The second responsibility is that of educating and counseling. Education is also the
cornerstone of APRN practice. APRNs should offer education on the utility, health, and care to
be taken when undergoing Tai Chi for RA, including Tai Chi in the self-management of patients
with the disease. They can also aid APRNs in providing teaching regarding lifestyle
modifications, pain relief mechanisms, and self-care maneuvers so that patients are educated and
can participate in the management of the disorder (Urbanowicz, 2019). Thirdly, APRNs
encourage the connection and continuum of care. APRNs are usually the primary care providers
in the healthcare sector. In this role, they collaborate with other health care practitioners such as
rheumatologists, physiotherapists, and Tai Chi trainers to offer an integrated interdisciplinary
approach to taking care of patients. It would not be possible to include non-pharmacological
interventions in the patient’s treatment plan without this collaboration.
The fourth role entails monitoring and follow-up. Evaluating the effectiveness of Tai Chi
for pain is an ongoing monitoring and follow-up. The treatment plan should be adjusted in these
cases, and APRNs should periodically assess the dynamics of pain, physical functioning, and
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quality of life. Continuous appraisal enables the early identification of issues or difficulties
concerning patient safety and treatment outcomes. The fifth role is as a researcher and evidencebased practitioner. They take part in the studies to develop their research and keep up-to-date
with the latest evidence when implementing Tai Chi interventions. This input makes the care
provided more meaningful and furthers the body of knowledge regarding RA management.
In addition, APRNs do act as advocates and policy developers. It is, therefore, their role
to act as advocates for patients and change policies regarding care. They could enhance the
availability of alternative therapies such as Tai Chi during RA management, ensure insurance
coverage, and develop integrative pain management guidelines and policies.
Implications for Clinical Practice
Some of the implications of integrating Tai Chi and other such interventions in the
control of RA pain led by APRNs were identified in clinical practice. It enhances patient
outcomes. The involvement of APRNs in holistic, patient-centered care may alleviate physical
and psychological outcomes for elderly RA patients. It also increases accessibility. Especially in
community settings or via telehealth services, APRNs can enhance alternative therapy
accessibility. Tai Chi will advance holistic care. Their participation encourages an integrative
perspective to healthcare, incorporating conventional medicine with alternative treatments.
Third, APRNs educate patients, including self-management support, and this empowers the
patients and enhances patient engagement and self-efficacy. This comprises several important
implications; as it is, the change project concerns the inclusion of Tai Chi as an alternative
physical activity for elderly persons to control rheumatoid arthritis pain.
The Implications of the Change Project
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It is reported that there is a global prevalence of about 18 million people living with
rheumatoid arthritis (Karp et al., 2023). This is an autoimmune disease, accompanied by constant
inflammation and destruction of headlands, more spread among women and increasing with the
age. Offering Tai Chi as a simultaneous rehabilitation program for older people having RA may
lead to significant betterment of the status of one’s health. Such non-pharmacological
interventions might reduce pain intensity, increase mobility, and bring back joint function. In
addition, such patients benefit from positive effects on mental health by lowering stress and
improving mood, which eventually increases their quality of life. As the project mitigates
dependence on costly pharmaceutical-based interventions with health implications, this may
ultimately lower the overall healthcare costs.
This project is a step towards comprehensive treatment of chronic diseases, for instance,
RA. This supports introducing wellness treatment in physical, mental, and emotional health
regimens, moving away from medicine only. Through this project, patients become active
participants in managing their conditions. If a user appreciates Tai Chi, it gives them a sense of
control over their health, enabling them to develop self-efficacy that is essential in the control of
chronic diseases. To make this project operational, a lot has to be done by way of educating the
patients, healthcare personnel, and even the community to fill in knowledge gaps. This type of
education will ease the adoption of Tai Chi and knowledge regarding other alternative methods
in Pain impairment that could affect their attitude toward controlling chronic diseases. This
project presents new directions for exploring how different therapies, such as Tai Chi, can treat
chronic conditions. Evidence-building is also necessary to validate and improve these
interventions, thus contributing to evidence-based practice in health care.
Conclusion
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The integration of Tai Chi with elderly rheumatoid arthritis pain management as a
proposed clinical change is an improvement on the inadequacies of traditional avenues and
embraces holistic non-pharmacological intervention. This initiative is a demand for patientcentered care that can reduce the costs of medical treatment and contribute to physical and
psychological health. In this intervention, Advanced Practice Registered Nurses (APRNs) have
significant roles in patient assessment, education, monitoring, and collaboration. This concept,
therefore, advances the idea of holistic RA management that demonstrates alternative therapies
in improving the quality of life in elderly patients.
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References
Hanks, R. G., Eloi, H., & Stafford, L. (2019). Understanding how advanced practice registered
nurses function as patient advocates. In Nursing Forum (Vol. 54, No. 2, pp. 213-219).
https://doi.org/10.1111/nuf.12319.
Hanly, J. G., & Lethbridge, L. (2021). Use of disease-modifying antirheumatic drugs, biologics,
and corticosteroids in older patients with rheumatoid arthritis over 20 years. The Journal
of Rheumatology, 48(7), 977-984. https://doi.org/10.3899/jrheum.200310.
Karp, N., Yazdany, J., & Schmajuk, G. (2023). Peer Support in Rheumatic Diseases: A
Narrative Literature Review. Patient Preference and Adherence, 2433-2449.
https://doi.org/10.2147/PPA.S391396.
Mudano, A. S., Tugwell, P., Wells, G. A., & Singh, J. A. (2019). Tai Chi for rheumatoid
arthritis. The Cochrane Library. https://doi.org/10.1002/14651858.cd004849.pub2.
Sánchez-Flórez, J. C., Seija-Butnaru, D., Valero, E. G., Acosta, C. D. P. A., & Amaya, S. (2022).
Pain Management Strategies in Rheumatoid Arthritis: A Narrative Review. Journal of
Pain & Palliative Care Pharmacotherapy, 35(4), 291-299.
https://doi.org/10.1080/15360288.2021.1973647.
Smolen, J. S., Landewé, R. B., Bijlsma, J. W., Burmester, G. R., Dougados, M., Kerschbaumer,
A., & Van Der Heijde, D. (2020). EULAR Recommendations for Managing Rheumatoid
Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2019
Update. Annals of the Rheumatic Diseases, 79(6), 685-699.
https://doi.org/10.1136/annrheumdis-2019-216655.
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Urbanowicz, J. (2019). APRN transition to practice: Program development tips. The Nurse
Practitioner, 44(12), 50-55. https://doi.org/10.1097/01.NPR.0000605520.88939.d1.
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Clinical Change Project
Student’s Name
Course
Institution
Date
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Recommendations and Implications for Clinical Practice
The integration of Tai Chi in the management of RA pain among older people has a huge
impact on practice. APRNs are the people who are most likely to institute or implement Tai Chi
programs in RA patients. Therefore, it is prudent to ensure that APRNs are included in Tai Chi
programs for RA patients. While this approach may involve mild exercises, it is expected to help
improve flexibility and strengthen muscles. Moreover, they should be taken through appropriate
training that enables them to tailor Tai Chi exercises specifically for RA cases.
Secondly, working with other health-related experts, such as physiotherapists and
rheumatologists, is also very important. By so doing, comprehensive patient care is provided
since there will be joint prescription of drugs and physical exercises within the same facility. The
presence of intermediaries such as APRNs can facilitate collaboration among different healthcare
workers so that all elements of treatment are considered (Hanly & Lethbridge, 2021). Thirdly,
nurses and health care providers should increase awareness of this type of treatment, which can
only be done through educating the public via workshops and brochures within health facilities.
As part of the education department’s agenda, awareness about tai chi and its use should be
emphasized.
Furthermore, future research should look into whether RA pain management involves Tai
Chi as it relates to the role played by APRNs. APRNs help to put together an extensive
knowledge base by participating in studies and being current with recent evidence. This
evidence-based approach guarantees that Tai Chi interventions are constantly improved by the
mentality of best practices.
Summary of Study and Discussion of Limitations
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This study explores the adoption of Tai Chi as a non-pharmacological intervention for
dealing with RA pain among older patients. The results emphasize how Tai Chi could decrease
pain intensity, increase mobility, and enhance overall well-being for patients with RA. However,
several limitations are also associated with the same. The research mainly describes Tai Chi, thus
there is little attention paid to the investigation of other alternative therapies like yoga, Pilates
and aqua therapy (Karp et al., 2023). Further studies should adopt a comparative approach to
help understand how effective various non-pharmacological interventions are for RA patients.
For this reason, the research has focused on qualitative data collection methods such as
in-depth interviews and focus groups. Thus, while these methods offer rich insights into pain
experiences and functional limitations, using quantitative approaches would have strengthened
its findings. Combining both types of data is necessary to understand the effect of Tai Chi on
chronic pain intensity, physical functionality, and psychosocial aspects.
However, the generalizability of these findings was also limited since most respondents
were old-aged RA patients. Therefore, Future research should examine how such programs apply
across diverse demographic groups to ensure that they apply to everyone. The study does not
extensively address potential barriers to implementing tai chi interventions within several
healthcare systems. Therefore, it is vital to recognize these obstacles and find means by which
they can be overcome so that tai chi becomes part of routine clinical work.
Directions for Future Research
In non-pharmacological pain management for rheumatoid arthritis (RA), there is a need
to consider a trajectory of future research that involves turning towards a more comparative
methodology. The research will examine the effectiveness of Tai Chi in comparison to Pilates,
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Yoga and aqua therapy among other therapies. It will help identify what works best for patients
in different categories. Moreover, from a practical perspective, examining how various HCS
setups can integrate Tai Chi programs is important. Therefore, it will be essential to investigate
issues related to implementation challenges, facilitators’ and patients’ perceptions, and those of
healthcare providers (Mudano et al., 2019). Hence, this study should show how routine clinical
practice can be successfully integrated with Tai Chi.
Finally, another cost-effectiveness area that has to be explored involves comparing Tai
Chi with traditional pharmaceutical interventions. For instance, costs associated with training
and equipment purchase, among others, should be researched and compared to traditional
interventions. As such, this economic scrutiny links decisions that guide the inclusion or
exclusion of such care as part of standard practice for RA patients.
To sum up, the roadmap for future research in non-pharmacologic interventions for RA
pain management underscores comparison lens, emphasis on long-term impacts, examination
into practical implementation challenges, and critical evaluation of cost-effectiveness. These
research avenues are caged to facilitate knowledge of competent interventions, elucidate
practical healthcare methods, and aid the decision-makers in devising appropriate management
strategies for RA pains.
Changes in Theoretical Constructs
In terms of changes in theoretical frameworks, further studies should focus on the
integration of technology, such as telemedicine and wearable devices with non-pharmacological
approaches for RA pain management. The measurement of the potency of digital solutions in
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amplifying patient engagement, monitoring physical activity, and providing real-time feedback
fits into a developing technological landscape.
Secondly, the scholarly research should question the interconnectedness of various
theoretical structures and integrate physical elements, psychological aspects, and social
dimensions. This way, there can be an understanding of pain management in RA through a
holistic approach that takes into account the relationship between mental health, social support
systems, and physical well-being.
Theoretical models must be shifted toward more patient-centric models that promote the
active involvement of individuals in their healthcare. Therefore, there is a need to incorporate
things like patient education, self-management, and individualized treatment plans into
contemporary care systems so as to put the patients at the center of decision-making.
Finally, researchers must examine cultural competence inherent in non-pharmacological
interventions by acknowledging and adapting these interventions to different cultural settings.
Accordingly, adapting theoretical frameworks so that they are culturally sensitive would allow
for inclusivity and efficacy across diverse populations. This is because this cultural
responsiveness helps make interventions easily accessible and effective among people from
diverse cultural backgrounds.
The changes above in theoretical models imply that it is important to have a forwardlooking standpoint that includes technological advances, acknowledges the interaction of
behavioral and social spheres, and promotes patient autonomy and respect for cultural diversity,
which informs non-pharmacologic treatments. Furthermore, these shifts are in line with current
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healthcare philosophies that encourage approaches to dealing with RA pain that are centered on
patients and communities.
Suggestions for Public Policy and/or Changes in Practice
Public policy recommendations should promote the integration of non-pharmacological
interventions, including Tai Chi, into standard care protocols for RA management. This involves
advocating for insurance coverage of such interventions and ensuring equitable access for all
patients. The development of guidelines that incorporate alternative therapies as part of a broader
RA treatment plan should be jointly done by policymakers, healthcare providers, researchers,
and patient advocacy groups. Thus, the practice should change to interdisciplinary team building
for healthcare providers like APRNs, rheumatologists’ physiotherapists, and Tai Chi trainers
(Sánchez-Flórez et al., 2022). The combination of medical therapy with non-pharmacological
interventions not only makes the treatment better but also improves overall patient satisfaction
and results.
In addition, healthcare facilities should invest in scholarly activities that seek to empower
APRNs and other health professionals on how best to integrate non-pharmacological
interventions. This training ensures that the practitioners will be competent in incorporating
alternative therapies into their practice, developing a patient-centered and integrated approach to
managing RA.
Tie the Theoretical Framework to the Overall Product
This study’s theoretical underpinning revolves around the comprehensive management of
RA pain by combining non-pharmacological methods with conventional medicine, especially Tai
Chi. The model under consideration belongs to the group of patient-centered strategies and
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highlights personalized treatment planning developed with various patients’ needs, preferences,
and scenarios in mind. It also promotes multidisciplinary teamwork and cooperation between
health providers in delivering quality service. This corresponds with the role of APRNs as
mediators who improve RA regulation coordination among rheumatologists, physiotherapists,
and Tai Chi trainers.
The constructs from the theoretical side also highlight how healthcare is changing with
technology, cultural competency, and patient empowerment. This is consistent with
contemporary views that see digital solutions, cultural competency, and education as crucial in
improving intervention effectiveness. Thus, the theoretical framework is a guide that connects
various parts to produce one unified and comprehensive approach for integrating Tai Chi in
controlling pain from RA.
Conclusion
The Incorporation of Tai Chi as a non-drug method for supporting old people with RA
pains is one step taken toward patient-oriented holistic healthcare. APRNs play critical roles in
this undertaking by actively developing, implementing, and improving Tai Chi programs. The
clinical significance of this project underscores the importance of specialized programs, highquality training, working closely with healthcare providers, creating awareness through
campaigns, and participating actively in research. These recommendations are intended to
improve patient outcomes and expand access to alternative therapies, thereby promoting holistic
approaches to managing RA.
While recognizing its drawbacks, future research trends will dwell on comparative
studies, long-term effects, applicability, and cost-benefit analysis. Modifications in theoretical
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constructs involve examining the use of technology in practices, holistic approaches to patients’
care, patients being at the center of care, and being competent to deal with different cultures.
Public health policy proposals include insurance for such treatments as well as guidelines for
their use, while changes should be designed around team efforts among practitioners, training
doctors, and public knowledge. Connecting the theoretical framework to the end product
strengthens this study’s patient-centeredness and interdisciplinary approach.
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References
Hanly, J. G., & Lethbridge, L. (2021). Use of disease-modifying antirheumatic drugs, biologics,
and corticosteroids in older patients with rheumatoid arthritis over 20 years. The Journal
of Rheumatology, 48(7), 977-984. https://doi.org/10.3899/jrheum.200310.
Karp, N., Yazdany, J., & Schmajuk, G. (2023). Peer Support in Rheumatic Diseases: A
Narrative Literature Review. Patient Preference and Adherence, 2433-2449.
https://doi.org/10.2147/PPA.S391396.
Mudano, A. S., Tugwell, P., Wells, G. A., & Singh, J. A. (2019). Tai Chi for rheumatoid
arthritis. The Cochrane Library. https://doi.org/10.1002/14651858.cd004849.pub2.
Sánchez-Flórez, J. C., Seija-Butnaru, D., Valero, E. G., Acosta, C. D. P. A., & Amaya, S. (2022).
Pain Management Strategies in Rheumatoid Arthritis: A Narrative Review. Journal of
Pain & Palliative Care Pharmacotherapy, 35(4), 291-299.
https://doi.org/10.1080/15360288.2021.1973647.
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