| Course | NUR 5063 Patient-Centered Care |
|---|---|
| Module | Module 4 |
| Paper type | Patient and family engagement program |
| Length | 1,200 words, about 4 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NUR 5063 Module 4
The Daughter-in-Law Learns the Pen Too: A Patient and Family Engagement Program for Bhutanese Nepali Adults Going Home on New Insulin
Student Name
American College of Education
NUR5063: Patient-Centered Care
Module 4 Assignment
Instructor Name
February 2, 2027
The Transition and Why It Fails
Patients from the composite diabetes center described in earlier modules are admitted to the hospital's medical units for problems such as severe hyperglycemia, infections of the foot and heart failure. A review of the past year's records found 38 admissions of Bhutanese Nepali adults during which insulin was started or its regimen changed. Of those patients, 11 returned to the emergency department within 30 days, seven for low or high blood sugar, and only 15 were seen at the diabetes center within two weeks of discharge.
Chart review and interviews with staff and families showed why. Insulin teaching was done by the day nurse with the patient alone, often through a telephone interpreter, while the family member who would give the insulin at home was at work. Discharge instructions were printed in English. Follow-up was booked by letter. The Module 2 assessment found that in this community, adult children and daughters-in-law usually manage medicines and appointments, and that help-seeking begins within the family. The hospital was teaching the person who would not give the insulin, in a language the household could not read, and then writing to a house where no one opened English mail.
The Engagement Framework
Carman et al. (2013) describe patient and family engagement along two dimensions. The first is a continuum running from consultation, in which patients receive information and are asked for their views, through involvement, to partnership and shared leadership, in which patients and families share power and responsibility. The second is the level at which engagement happens: direct care, organizational design and governance, and policy making. The framework is useful here because it shows that the hospital's current practice sits at the consultation end of the continuum and only at the level of direct care, and that a program limited to better handouts would stay there.
The program aims to reach involvement and partnership at the level of direct care, where families will share the work of learning and deciding, and involvement at the level of organizational design, where patients and families from the community will shape the program itself.
Program Components at the Bedside
Identifying the family partner. On admission, the nurse asks the patient, through a trained interpreter, who helps with medicines and appointments at home and whether that person should be part of the care plan. The answer is recorded in a family partner field in the record, and the patient's choice is respected if the patient prefers not to involve family.
A family teaching session. When insulin is started, the nurse schedules a teaching session at a time the family partner can attend, including evenings, with an in-person or video interpreter. Both the patient and the family partner practice with the pen, demonstrate a glucose check and explain back the plan for low blood sugar, using the picture-based materials and recorded Nepali audio developed in Module 3. Discharge does not proceed until at least one person in the household has demonstrated the injection correctly.
A community health worker across the transition. A Nepali-speaking community health worker from the community meets the patient and family before discharge, helps them set one or two goals for the first weeks at home, visits the home within 72 hours and stays in contact for at least four weeks. The model follows the randomized trial by Kangovi et al. (2014), in which community health workers built action plans with low-income inpatients around the patients' own recovery goals; patients in the intervention group were more likely to see a primary care clinician within 14 days, reported better discharge communication and were less likely to have repeated readmissions. Yun et al. (2016) found that Bhutanese refugees readily sought out community navigators and preferred helpers who could model how to deal with the health system, which suggests the role fits this community particularly well.
Coaching the family to speak up. The Care Transitions Intervention trained a coach to help adults aged 65 and older and their caregivers take charge of their own transition, and its patients were readmitted less often at 30 and 90 days than those in usual care (Coleman et al., 2006). Borrowing that idea, the community health worker will help the family keep a simple record of readings and medicines, recognize warning signs and prepare two questions for the follow-up visit, which the center will schedule by telephone in Nepali before discharge.
Engagement in Program Design and Governance
The program will be overseen by a working group that includes two Bhutanese Nepali patients or family members, recruited through the community association and paid for their time, alongside the nurse manager, a diabetes educator, the community health worker and a hospital interpreter. The working group will review the teaching materials each quarter, hear from families whose transitions went badly and decide on changes. The hospital's patient and family advisory council, which has no member from this community, will also be asked to add one. These steps reach involvement at the organizational level; true shared leadership would mean families helping to set the program's budget and priorities, and the working group will be asked after the first year whether that is wanted.
Anticipated Barriers
Three barriers are likely. First, evening teaching sessions compete with the day's workload on units that are already short of staff at shift change, so the program will start on one unit and add the second only when the first unit's nurses report that sessions are running without delaying other care. Second, some patients will not want a family member involved, or will name a grandchild who is too young to carry the responsibility; the nurse will respect the first choice and, in the second case, ask whether an adult can share the role, with the community health worker helping to find one. Third, a single community health worker is a fragile resource. If that worker is ill or leaves, the home visits stop. The working group will therefore train a second community member as a part-time backup during the first six months, and the program will keep a short written guide so that the role does not live only in one person's memory.
Roles, Resources and First Measures
The program needs one full-time community health worker, funded for the first year from the hospital's community benefit budget, and protected time for nurses on the two medical units to teach in the evening. The diabetes educator will train unit nurses in family teaching and teach-back, and the interpreter service will add evening video coverage in Nepali. The nurse manager of the medical units is accountable for the program, and the community health worker reports to the diabetes center's nurse manager so that the role belongs to the setting patients return to.
Early measures will include the percentage of eligible patients with a family partner recorded, the percentage of households with a demonstrated injection before discharge, diabetes center visits within 14 days and emergency visits within 30 days. Module 5 will add measures of how patients and families experience the transition in their own words and scores.
References
Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223-231. https://doi.org/10.1377/hlthaff.2012.1133
Coleman, E. A., Parry, C., Chalmers, S., & Min, S.-J. (2006). The care transitions intervention: Results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 1822-1828. https://doi.org/10.1001/archinte.166.17.1822
Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., Shannon, R. P., & Long, J. A. (2014). Patient-centered community health worker intervention to improve posthospital outcomes: A randomized clinical trial. JAMA Internal Medicine, 174(4), 535-543. https://doi.org/10.1001/jamainternmed.2013.14327
Yun, K., Paul, P., Subedi, P., Kuikel, L., Nguyen, G. T., & Barg, F. K. (2016). Help-seeking behavior and health care navigation by Bhutanese refugees. Journal of Community Health, 41(3), 526-534. https://doi.org/10.1007/s10900-015-0126-x
The NUR 5063 Module 4 assignment instructions
In many sections, the fourth module of NUR 5063 asks you to design a program that engages patients and families, usually around a care transition such as discharge. Expect to define the transition and why it fails, choose an engagement framework, describe program components at the direct care level and at the organizational level, anticipate barriers, and name roles, resources and measures. Many prompts ask how patients and families will help design or govern the program. The program paper commonly runs five pages, sometimes with a budget or timeline. The Canvas page shows whether the program must serve the population from earlier modules.
How the NUR 5063 Module 4 example is put together
The program paper starts with the transition and its failures in the center's numbers, then uses interviews to explain why patients struggled after discharge, linking the reasons to language and family roles. The framework section summarizes Carman's two dimensions, depth and level, and places current practice and the target on them. The bedside section describes each component closely enough to implement: a bilingual worker, a family teaching session, a home visit, and a discharge rule that a household member must demonstrate the injection, each tied to a trial or to community findings. The governance section creates paid advisor roles with recruitment and support. Barriers are paired with responses, including a backup worker, and the last section names staff, funding, reporting lines and measures.
NUR 5063 Module 4 rubric: what full marks look like
For the engagement program the rubric typically follows the design from problem to measures. The problem row wants the transition's failures shown with data. Framework credit requires a named model used to locate current practice and set the program's target, not merely cited. The components usually weigh heaviest and reach the top band when each is specific enough to implement and linked to evidence or local findings. Governance points reward patients and families with defined roles, recruitment and support, along with an honest statement of how much power they hold. Barrier and resource rows reward realistic plans with named responses. Measures that lead into the next module finish the rubric, with APA 7 throughout.
NUR 5063 Module 4 help: mistakes that cost points
Engagement programs most often consist of education handouts with a new name. A second weakness is engagement only at the bedside, with no role for patients in design or review. Students also forget who actually gives care at home, so the patient is taught and the family member is not. Make one component a real requirement, such as a demonstration before discharge. Pay advisors and say how they are recruited. Name the person who covers when the community worker is away. Avoid claiming partnership when the program reaches consultation. If your transition is from the emergency department, a skilled nursing facility or a clinic, the desk can draft an engagement program for that move.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 5063 and MSN sample papers
- NUR 5063 Module 1: Concept Analysis
- NUR 5063 Module 2: Cultural Needs Assessment
- NUR 5063 Module 3: Health Literacy and Decision Tool
- NUR 5063 Module 5: Patient Experience Measures
- NUR 5063 Module 6: Patient-Centered Care Proposal
- NUR 5053 Module 5: Measurement Plan and Run Chart
- NUR 5053 Module 2: Root Cause Analysis
- NUR 5023 Module 4: Evidence Synthesis
- NUR 5023 Module 2: Documented Literature Search
NUR 5063 Module 4 questions, answered
Which engagement framework should I use?
Any framework your course materials name. The Carman framework is widely used because it separates how deeply patients are engaged, from consultation to partnership, from the level where engagement happens, from bedside care to governance and policy.
Does the program need patients in its governance?
A strong program usually includes them. Show how patients or family members will help design or review the program, how they will be recruited and supported, and be honest about how much decision-making power they will hold.
Where can I find a free NUR 5063 Module 4 sample paper?
The insulin discharge engagement program is open to read above without payment, covering the failing transition, the Carman framework, bedside components, governance roles, barriers, resources and first measures.
What is the Carman framework for patient engagement?
Carman and colleagues describe engagement along two dimensions: how deeply patients take part, from consultation to partnership, and at what level, from direct care to organizational design to policy. It helps a program state where it sits and where it is aiming.
Why teach a family member during discharge?
In many households the person who will give insulin or manage meals is not the patient. Teaching that person, and asking them to demonstrate the skill, makes the plan work at home and reflects the family roles found in the cultural assessment.