Topics- What was the last communicable diseases effecting your community and what were the primary, secondary and tertiary prevention that the community health nurses have undertaken to prevent the spread of the disease?· Must address all of the topics.· 100-word minimum/200-word maximum without the references.· Minimum of two references (the course textbook can be one of the references) in APA format, articles chosen must have been published within last 3-5 years.
Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.Using 200-300 words APA format with references.
POST 1KarineQuality IndicatorsAgency for Healthcare Research and Quality [AHRQ] (2018) defines quality indicators [QI] as measures of healthcare quality that generate data to be utilized by healthcare leaders and administrators. The QI data is used for decisions on quality improvement, staffing, operational budget, and innovations. AHRQ develops QI to provide healthcare leaders along with evaluation tools (AHRQ, 2018). Nash et al. (2019) believe that a variety of QI is needed to achieve six areas for improvement identified by the Institute of Medicine [IOM] committee on safety. The six areas of improvement are; effectiveness, patient-centeredness, timeliness, efficiency, and equity (Institute of Medicine, Committee on Quality of Health Care in America [IOM], 2001). Quality improvement is categorized into three areas of quality of care: structural, process, and outcome (Institute for Healthcare Improvement [IHI], 2020).Two Nurse-Sensitive Indicators of Quality in Ambulatory CareI currently work in the ambulatory care setting in an integrated academic institution as the Senior Manager for Clinical Services and Operations for Neurosurgery, Stroke Neurology, and Neurology & Sleep. The two indicators chosen for this discussion are; pain assessment and follow-up and unplanned transfers to hospital (Start et al., 2018). These two QI are nursing-sensitive QI that relates to ambulatory care for my current practice. The work setting is the Physician Group Practice [PGP] for each of the three departments, with four neurosurgery clinic locations, one stroke clinic, and two sleep centers. The patient population is approximately 60% neurosurgery, 30% stroke, and 10% sleep therapy.Early Quality Improvement Theories and Philosophies on the Development of the Two QIThe emphasis on QIs for ambulatory care became actualized in late 1997, with a committee appointed by the American Nurses Association [ANA] to expand nursing-sensitive quality indicators [NSQI] to ambulatory care (Martinez et al., 2015). The ANA committee aimed to show nursing contributions in the ambulatory practice in improving health outcomes and healthcare delivery cost efficiencies. Despite this push by ANA to expand NSQI to ambulatory care, the process was slowed until 2008 with Swan article that called for nurses to act on NSQI in ambulatory care. The American Academy of Ambulatory Care Nursing [AAACN] in 2013 committee started on the challenge for NSQI in ambulatory care, with the first set of NSQI being published in 2014 (Martinez et al., 2015).The concept of pain assessment and follow-up is embedded in every aspect of patient care. Petiprin (2020) sees the nurse playing the most critical role in assessing and managing the patient’s pain. The evolution of patient pain assessment and management has always had nurses at the forefront. Nursing theories and quality tools have been used over the years by nurses to study and implement pain management (Petiprin, 2020b). Mid-ranged psychological theories such as Kolcaba’s Comfort Theory are used by nursing research in the evolution of pain management in nursing care (Petiprin, 2020a).Marquet et al. (2015) see unplanned admission transfers to hospital, as the marker for patients’ adverse events [AES]. AEs concerns are international health issues for healthcare leaders, professionals, administrators, patients, and their families. Annually AEs lead to unintended injuries or complications, disabilities, deaths, prolongation of hospital stay, and higher healthcare costs rather than the patient’s disease (Marquet et al., 2015).Two Nursing Research Articles that Relate to Two QI Influence on PracticeArticle one: Pain Assessment and Follow-upMeissner et al. (2017) examine the use of QIs in acute postoperative pain management [POPM]. The goal was to use QIs to facilitate caregivers to differentiate between good and poor quality of pain management. The researchers seek to explore the evidence gathered from pain specialists’ experiences in managing patients’ acute pain postoperatively and literature review using QI for acute POPM. The specialist for this study was chosen from Europe and the United States of America [USA]. The inclusion criteria for the participants were a member of a Pain Advisory Board (Meissner et al., 2017). The QIs assessed the healthcare providers’ services and how efficient the interventions were in relieving acute postop pain.The QI measures used were documentation, timeliness of pain assessment, pain reassessment, and timeliness to giving analgesic medication. Pain assessment was done on day one postop using the numerical rating scale of 0 – 10 was used for pain assessment, with 0 being no pain and 10 being the maximum pain experienced. The review found that patients had poor pain management, with pain levels being moderate to severe, 4 – 10 on the numerical scale (Meissner et al., 2017). The data review found that the barriers to acute POPM were; cost to treat acute pain, lack of knowledge on pain management among staff, lack and unclear instructions, inadequate pain assessments, and sub-optimal care (Meissner et al., 2017).Article Two: Unplanned Transfers to HospitalMarquet et al. (2015) view unplanned transfers to the hospital due to preventable adverse patient reactions. The researchers’ research was a three-stage retrospective review on screening, records review, and consensus judgment over six months in Belgium. The study aimed to examine the frequency of preventable adverse reactions and lead to unplanned admission or higher levels of care. A total of 830 medical records were reviewed, 456 of the medical record revealed patient adverse reactions. The review found that 56% of the adverse events were preventable that lead to unplanned hospital admission. This review also revealed that 25% of these adverse reactions required a higher level of care in the intensive care unit. Unplanned transfer to hospital is also a quality standard for The Joint Commission [TJC]. The AHRQ provides a toolkit for healthcare organizations to report and analyze the prevalence and rate of unplanned transfers to hospital (Rahn, 2016).ReferencesAgency for Healthcare Research and Quality. (2018). AHRQ quality indicators.https://www.ahrq.gov/cpi/about/otherwebsites/qualityindicators.ahrq.gov/qualityindicators.htmlInstitute for Healthcare Improvement. (2020). How to improve with the model for improvement. chi.org.https://education.ihi.org/topclass/topclass.do?CnTxT-144791570-contentSetup-tc_student_id=144791570-item=967-view=1Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. ProQuest Ebook Central.https://ebookcentral.proquest.comMarquet, K., Claes, N., De Troy, E., Kox, G., Droogmans, M., Schrooten, W., Weekers, F., Vlayen, A., Vandersteen, M., & Vleugels, A. (2015). One fourth of unplanned transfers to a higher level of care are associated with a highly preventable adverse event. Critical Care Medicine, 43(5), 1053–1061.https://doi.org/10.1097/ccm.0000000000000932Martinez, K., Battaglia, R., Start, R., Mastal, M. F., & Matlock, A. M. (2015). Nursing-sensitive indicators in ambulatory care. Nursing Economic$, 33(1).https://doi.org/https://www.aaacn.org/sites/default/files/documents/news-items/NursingEcARTICLE_NursingSensitiveIndicatorsinAmbulatoryCare.pdfMeissner, W., Huygen, F., Neugebauer, E. A., Osterbrink, J., Benhamou, D., Betteridge, N., Coluzzi, F., De Andres, J., Fawcett, W., Fletcher, D., Kalso, E., Kehlet, H., Morlion, B., Montes Pérez, A., Pergolizzi, J., & Schäfer, M. (2017). Management of acute pain in the postoperative setting: The importance of quality indicators. Current Medical Research and Opinion, 34(1), 187–196.https://doi.org/10.1080/03007995.2017.1391081Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools, fourth edition (4th ed.). Health Administration Press.Petiprin, A. (2020a). Kolcaba’s theory of comfort. Nursing Theory.https://nursing-theory.org/Petiprin, A. (2020b). Pain scale 1-10. Nursing Theory.https://nursing-theory.org/articles/pain-scale.phpRahn, D. J. (2016). Transformational teamwork. Journal of Nursing Care Quality, 31(3), 262–268.https://doi.org/10.1097/ncq.0000000000000173Start, R., Matlock, A. M., Brown, D., Aronow, H., & Soban, L. (2018). Realizing momentum and synergy: Benchmarking meaning ambulatory care nurse-sensitive quality indicators. Nursing Economic$, 36(5), 246–251.https://doi.org/https://www.aaacn.org/sites/default/files/documents/NSI-Measure-Table.pdfPOST 2BilindaQuality IndicatorsNursing-sensitive indicators (NSIs) can be an essential tool in identifying patient care issues that could arise in the healthcare setting. By analyzing the data on specific NSI, the quality of patient care can be optimized, and patient satisfaction can be improved. As a result, NSIs have become a progressively effective and dependable method to support nursing care quality and performance measurement in the healthcare establishment, including evaluating clinical nursing practice (Heslop et al., 2014). The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. Quality indicators refer to clear, measurable items to outcomes and demonstrate the effect on health and population (Rahn, 2016). The different frameworks and theories appeal to care that concentrates on the patients’ individual needs, wishes, and cultural practices.Two Nurse-Sensitive Indicators of QualityPatients with Chronic Kidney Disease (CKD) are at risk for End-Stage Kidney Disease (ESKD), leading to dialysis or transplantation (Manns et al., 2017). To optimize kidney health, health systems should monitor the quality of care provided to patients suffering from CKD (Manns et al., 2017) with specifics quality indicators (QI) such as nosocomial infections and falls. These NSIs affect other aspects of nursing other than renal care, and as a concept, it is effective in developing nursing care implementation (Heslop et al., 2014). However, the conceptual basis, theoretical role, meaning, use, and interpretation of the concept of NSIs tend to differ. Generally, the studies of indicators of nosocomial infections and falls derive from the NDNQI point to facilitate the ability of health organizations to act in response to patient and staff needs (Montalvo, 2007).Article OneAbbasi et al. (2020) described the quality indicator of nosocomial infection in CKD patients. This is a quality assessment for improving patient quality outcomes. Nosocomial infections are classified as NSI because the best practices add to nursing’s knowledge base and help nurses nationwide to advance nursing practice and patient outcomes (Montalvo, 2007). ESRD is one of the leading causes of morbidity and mortality, and more extended hospital stay, prolong catheterization, decrease white blood cell count. Multiple comorbidities are risk factors that reduce quality outcomes and increase dialysis patients for nosocomial infections. Nursing interventions include ways to decrease nosocomial infections, such as pneumonia, urinary tract infections (UTIs), bloodstream infections, and diarrhea (Abbasi et al., 2020, p. 6). Reducing risk factors will enhance the patient’s QoL, a conceptual framework developed by Walker and Avant (Boudreau & Dubé, 2014). Increasing the life expectancy of this patient population is a significant health target, and health care professionals can achieve this by minimizing infection complications (Abbasi et al., 2020). The relationship between ESRD and NSI nosocomial infections is very intriguing.Article TwoGao et al. (2018) identified a group of NSQIs to evaluate the quality of clinical nursing of ESRD patients in the dialysis unit. They utilized the Delphi surveys to collect opinions from independent experts, where 11 NSQIs were identified. One of the NSQIs determined was the incidence of falls among hemodialysis patients. The rate of falls in ESRD is higher compared to the general population. Risk factors identified for falls are diabetic visual impairment, fragile bones, dizziness, fatigue, and cardiopulmonary dysfunctions; thus, making falls an essential NSQI. Therefore, nursing interventions comprise of efforts to prevent falls and associated injuries by intensive monitoring and education.QIs are established and supported by the NDNQI to provide for the need for multifunctional and comprehensible quality measures used to measure healthcare performance. The usage of QI is evidence-based and can be used to differentiate inconsistencies in the eminence of care provided to people at outpatient and inpatient facilities.ReferencesAbbasi, S. H., Aftab, R. A., & Chua, S. S. (2020). Risk factors associated with nosocomial infections among end stage renal disease patients undergoinghemodialysis: A systematic review. PloS One, 15(6), e0234376.https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0234376Boudreau, J. É., & Dubé, A. (2014). Quality of life in end stage renal disease: A conceptanalysis. CANNT Journal, 24(1), 12–20.Gao, J. L., Liu, X. M., Che, W. F., & Xin, X. (2018). Construction of nursing-sensitivequality indicators for haemodialysis using Delphi method. Journal of clinicalnursing, 27(21-22), 3920–3930. https://doi.org/10.1111/jocn.14607Heslop, L., Lu, S., & Xu, X. (2014). Nursing-sensitive indicators: a conceptanalysis. Journal of advanced nursing, 70(11), 2469–2482.https://doi.org/10.1111/jan.12503Manns, L., Scott-Douglas, N., Tonelli, M., Weaver, R., Tam-Tham, H., Chong, C., &Hemmelgarn, B. (2017). A population-based analysis of quality indicators inCKD. Clinical Journal of the American Society of Nephrology, 12(5), 727-733.Montalvo, I., (2007). The National Database of Nursing Quality Indicators. OJIN: TheOnline Journal of Issues in Nursing, 12(3).Rahn, D. J. (2016). Transformational Teamwork. Journal of Nursing CareQuality, 31 (3), 262-268. doi: 10.1097/NCQ.0000000000000173.POST 3VictoriaDescriptive EpidemiologyDescriptive epidemiology is used to characterize the distribution of disease within a population. It describes the person, place, and time characteristics of disease occurrence. Analytical epidemiology is used to test hypotheses to determine whether statistical associations exist between suspected causal factors and disease occurrence. Since disease does not occur randomly but in patterns that reflect the underlying factors, descriptive epidemiology portrays the occurrence of disease with respect to the characteristics of person, place, and time. The person encompasses who is being affected, like males versus females? Rich versus poor? and other factors. Place relates to the geographical location of the problem like in cities or rural areas, in some states more than others, or in the United States versus other countries and time refers to when the problem is occurring like during summer or winter. Descriptive epidemiology is used to discover clues to the causes of health and illness as it helps to recognize patterns of disease and generate hypothesis regarding their underlying causes (Friis, and Sellers, 2021).Prescription Drug OverdoseThe selected health problem for this discussion is prescription drug overdose.Prescription drug abuse and overdoses are a major public health concern. In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses. The misuse of and addiction to opioids including prescription pain relievers, heroin, and synthetic opioids such as fentanyl is a serious national crisis that affects public health as well as social and economic welfare (CDC,2017). Men are more likely than women to engage in illicit drug use but women may be more susceptible to craving and relapse, which are key phases of the addiction cycle. Findings from a recent literature suggests that women 40-64 years are more likely to use prescription opioids compared to men. Seventy-nine percent of individuals who overdose on opioids are non-Hispanic White, 10% are Black and non-Hispanic, and 8% are Hispanic (Silver and Hur, 2020).Opioid addiction, such as heroin and prescription pain medication, is a growing problem in the United States and internationally. Knowledge and respect for the epidemiology of opioid abuse and addiction, its consequences, and the role of the prescriber and nurse in reducing the risk of opioid abuse and addiction is critical to reduce the incidence of adverse outcomes and deaths (Green, 2017). Drug poisoning deaths involving opioid analgesics have more than tripled since 1999, with more than 16,000 deaths in 2013 alone. The CDC has been focused on boosting resources for State prevention efforts in conjunction with other Federal efforts to help States expand and intensify their work to address this growing problem (CDC,2017).The United States have seen an epidemic of opioid misuse and abuse that has been called the deadliest drug crisis in American history. Opioid addiction includes the abuse of prescription, nonprescription, and illegal pain relievers The misuse of and addiction to opioids, including prescription opioids, heroin, and synthetic opioids such as fentanyl, is a serious problem that affects not only the health of many Americans but also the social and economic welfare of the country (Mattson et al., 2021).Data Sources with Strengths and LimitationsData sources utilized for this discussion are secondary or use of existing data from hospital outpatient statistics. The strength of this data source is that clinics and outpatient departments provide a large volume of care for this population. The limitations are that hospital records are not well developed sometimes, and diagnostic data may be incomplete. Another data source is data from public health clinics. A strength of this data source is that the data can be used for possible identification of cases for disease study and the limitation is that the population denominator is unknown (Friis, and Sellers, 2021).Two Methods to Use in Collecting Raw Data For descriptive epidemiology of Prescription Drug OverdoseTo determine the descriptive epidemiology of prescription drug overdose, it is important to identify and classify which types of drugs are involved in an overdose, how often they are involved, and how that involvement changes over time. Data can be collected from two methods, primary and secondary data sources. Primary data is original data collected by interviewing people while secondary data is data collected by other individuals or organization.How Methods Would Influence the Completeness of Case IdentificationIdentifying the type of drug and the drug involvement will help to determine appropriate prevention and response activities.ReferencesCenters for Disease Control and Prevention. (2017). Opioid overdose. https://www.cdc.gov/drugoverdose/states/state_prevention.htmlFriis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.Green, J. (2017). Epidemiology of Opioid Abuse and Addiction. Journal of Emergency Nursing, 43(2), 106–113. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jen.2016.09.004Mattson, C. L., Tanz, L. J., Quinn, K., Kariisa, M., Patel, P., & Davis, N. L. (2021). Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths – United States, 2013-2019. MMWR. Morbidity and Mortality Weekly Report, 70(6), 202–207. https://doi-org.ezp.waldenulibrary.org/10.15585/mmwr.mm7006a4Silver, E. R., & Hur, C. (2020). Gender differences in prescription opioid use and misuse: Implications for men’s health and the opioid epidemic. Preventive Medicine: An International Journal Devoted to Practice and Theory, 131. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ypmed.2019.105946POST 4MelanieIntroductionObesity is a global challenge. Many adverse events are related to obesity. The purpose of this discussion is to explore obesity and its relation to descriptive epidemiology.Descriptive EpidemiologyThe field of descriptive epidemiology depicts the occurrence of a health concern considering characteristics of person, place, and time (Friis & Sellers, 2021). Furthermore, defining features within these characteristics can help outline patterns and possible underlying causes (Friis & Sellers, 2021). By doing this, descriptive epidemiology is a valuable tool to prevent disease and plan for a satisfactory response to a health concern.Obesity is a population health concern as it can have serious health, economic, and social consequences (Centers for Disease Control and Prevention (CDC), 2021a). Health complications include hypertension, dyslipidemia, diabetes, coronary heart disease, stroke, sleep disturbances, mental illness, and body pain (CDC, 2021). Due to obesity, health care costs increase. For obesity-related reasons, affected individuals may not be able to participate in certain activities or work.Person, Place, and TimeObesity can result from various factors, including genetics, environmental influences, and behaviors (CDC, 2021). By utilizing descriptive epidemiology methods, preventative measures and pertinent interventions can be applied to susceptible populations. Person, place, and time are determining characteristics.Determinants of place include international, geographic variations, urban or rural differences, and localized occurrences (Friis & Sellers, 2021). In a nationally representative cross-sectional sample study, Wen et al. (2017) found that the odds of obesity were greater in rural areas compared to urban areas. Educational and environmental factors are relevant to the disparity (Wen et al., 2017). Globally, 61% of the population of Nauru is obese (Procon.org, 2020).Aspects of time include cyclic fluctuations, point epidemics, secular time trends, and clustering (Friis & Sellers, 2021). Robinson et al. (2021) suggest that the Covid-19 pandemic may have had a disproportionately sizeable and negative influence on weight-related behaviors among adults with a higher BMI.Characteristics defining person include race, sex, and age. In 2017, 42.5% of adults over 20 years of age had obesity (CDC, 2021b). According to the CDC (2021b), 34 states and the District of Columbia had an obesity prevalence of 35% among non-Hispanic Black adults. In most countries, females are more obese than males (Ameye & Swinnen, 2019). In a Brazilian study, Araujo et al. (2018) conclude that racial disparities in obesity are socioeconomic status level and sex dependent.Data Sources and Associated Strengths and LimitationsMost of the data sources from this discussion utilized the PubMed database. Strengths from this database include a wide variety of baseline data and information. A limitation may be that the representative sample in an article may not accurately portray the whole population. Most of the articles utilized secondary data as it was derived from existing surveys. One of the articles utilized primary data as participants completed a questionnaire. A strength is that the data is from the original source, but a limitation may be that the participant may falsely answer. Another data source utilized was the National Center for Health Statistics by the CDC. This is a federal government website that provides various health statistics. This source is valuable as there is a great deal of health statistics that are easily accessible.Raw Data CollectionTwo methods to collect raw data are wearable technologies and hospital data. Public health professionals can utilize hospital data on to determine if obesity is present. However, hospital statistics lack the representation of a specific population (Friis & Sellers, 2021). Wearable technologies can provide data on vital signs and physical activity. However, this can present challenges as devices may not be consistently utilized to provide accurate data for the completeness of a study. Furthermore, public health professionals must respect privacy and data sharing principles.ReferencesAmeye, H., & Swinnen, J. (2019). Obesity, income and gender: the changing global relationship. Global Food Security, 23, 267-281.Araujo, M. C., Baltar, V. T., Yokoo, E. M., & Sichieri, R. (2018). The association between obesity and race among Brazilian adults is dependent on sex and socio-economic status. Public Health Nutrition, 21(11), 2096–2102. https://doi-org.ezp.waldenulibrary. https://www.cdc.gov/obesity/index.htmlorg/10.1017/S1368980018000307Centers for Disease Control and Prevention. (2021a). Overweight and obesity. Overweight and obesity. https://www.cdc.gov/nchs/fastats/obesity-overweight.htmCenters for Disease Control and Prevention. (2021b). Obesity and overweight. National center for health statistics. https://www.cdc.gov/nchs/fastats/obesity-overweight.htmFriis, R. H., & Sellers, T.A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.Procon.org. (2020). Global obesity levels. https://obesity.procon.org/global-obesity-levels/Robinson, E., Boyland, E., Chisholm, A., Harrold, J., Maloney, N. G., Marty, L., Mead, B. R., Noonan, R., & Hardman, C. A. (2021). Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults. Appetite, 156. https://doi-org.ezp.waldenulibrary.org/10.1016/j.appet.2020.104853Wen, M., Fan, J. X., Kowaleski-Jones, L., & Wan, N. (2018). Rural-urban disparities in obesity prevalence among working age adults in the United States: Exploring the mechanisms. American Journal of Health Promotion, 32(2), 400–408. https://doi-org.ezp.waldenulibrary.org/10.1177/0890117116689488
Assignment: Final Paper: Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health ProblemThroughout this course, you have been applying an epidemiological approach to analyze a population health problem. In previous weeks, you have developed distinct sections of your paper; it isnow time to finalize and submit a cohesive, polished version of work. This paper serves as your Major Assessment for this course and must be uploaded by Day 2 Tuesday 5/8/18 6pm of this week.To prepare:Finish incorporating any feedback from the submitted sections of your paper.To complete:Write a12- to 15-pagepaper that includes an introduction and a conclusion as well as the following:Section 1: The Problem (See attached paper)1) A brief outline of the environment you selected (i.e., home, workplace, school)2) A summary of your selected population health problem in terms of person, place, and time, and the magnitude of the problem based on data from appropriate data resources (Reference the data resources you used.)3) Research question/hypothesisSection 2: Research Methods (See attached Paper)1) The epidemiologic study design you would use to assess and address your population health problem2) Assessment strategies (i.e., if you were conducting a case-control study, how would you select your cases and controls? Regarding the methods and tools, you would use to make these selections, how is it convenient for you as the researcher or as the investigator to use this tool?)3) Summary of the data collection activities (i.e., how you would collect data—online survey, paper/pen, mailing, etc.)Section 3: The Intervention (See attached Paper for section 3 & 4 together)1) An outline of an intervention you would implement to address the population health problem with your selected population based on the results of the study in Section 2 (Note: If you selected a descriptive study design, you are still required to outline an intervention that might be developed based on future research.)2) A review of the literature that supports this interventionSection 4: The Impact (See attached Paper for section 3 & 4 together)1) An explanation of the health outcome you would be seeking and the social impact of solving this issueSection 5: Evaluation (See attached Paper)1) An evaluation plan based upon the health outcome that you have chosen and your anticipated resultsYour written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct.See all previous 4 papers attached in the file area and use them to form one cohesive paper of 12 to 15-page. Incorporate the comment made by the teacher in each paper.
APA format, references, 300 wordShare a case study from your clinical practice or from the literature on an endocrine disorder. Discuss the pathophysiology of the disorder, including the effects on the endocrine feedback system, and the role of the hypothalamic-pituitary axis. Identify the pharmacologic agent(s) used to treat the disorder and how the pharmacologic agent(s) alters the pathophysiology.
This week, you will write a mini-systematic literature review. It is mini because you will only be reviewing two sources.For this literature review assignment, we are going to give you a choice of three topics to choose from. Choose one for this assignment.Myasthenia GravisHodgkin’s LymphomaHIV/AIDSRemember, for a systematic review, focus your analysis on the treatments, causes, diagnosis, and prognosis presented in the literature.Next, conduct your research of scholarly articles. Use the WCU Online Library databases. You will need to choose two sources to include in this mini-literature review.For this review, be sure to:Select two relevant and appropriate scholarly articles that address the topic you chose.Present a thorough literature review of both articles by summarizing, synthesizing, and evaluating the materials.Demonstrate understanding of the content presented in the articles.Include a critical assessment of the sources. Do not simply include a summary of what you have read.Incorporate citations into your body paragraphs; incorporate the essential and most relevant supporting evidence eloquently and appropriately.Present your writing in a clear, organized manner.Provide a strong introduction and conclusion, including further questions for research.Use proper APA format with proper citations.Review APA Citations HereYour literature review should be 1–2 pages in length. Remember, you will need to use APA formatting in your literature review and include a title page and a reference page.
The Assignment:Complete the Focused SOAP Note Template provided for the patient in the case study. Be sure to address the following:Subjective: What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate. Provide a review of systems.Objective: What observations did you note from the physical assessment? What were the lab, imaging, or functional assessments results?Assessment: Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned.Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. Follow APA 7th edition formatting.Week 4 Case 2CC: My wife seems to be having trouble hearing me when I talk. She is turning the TV up loud.HPI: Mary is an 88-year-old African American (AA) female married for 50 years to Albert. Albert complains that Mary cannot hear or hears but does not understand (especially in a group); turns up radio or television louder to hear (also noted by family, friends, and neighbors); Mary complains of tinnitus; and she feels like people are “mumbling.”PMH: Mary takes ramipril for hypertension (HTN), a baby aspirin for cardio protection, and a statin for hypercholesterolemia.Vital signs are 120/88 P: 88 P02: 96% WT: 156 HT: 5’6” BMI:_____ROS: Ask if Mary has had any exposure to ototoxic drugs or other otic damage in the past. Describe at least three.PE: What examinations will you perform on the ear? Describe the areas of the ear you will evaluate and what you will expect to find.Diagnostic Testing: Please describe at least three (3) methods to test for hearing.You determine that Mary has a hearing deficit and tinnitus. What differential diagnoses do you want to consider? Describe at least three.What will your treatment plan for this patient be?What other recommendations will you make (i.e., screening)?What referrals will you make?Education: Name at least two things you will educate your patient about regarding their hearing.Choose the ROS, PE, and DD and final diagnosis for this patient, and then write up your focused SOAP note.
Case Study: Frameworks for Nursing ResearchA group of nurses working in a hospital observed that some patients with chronic renal insufficiency were less cooperative due to being anxious and unable to think clearly. They also noted that these patients were less likely to ambulate and actively participate in their care, unless there was a family member present. Through reviewing the literature, the nurses identified a lack of knowledge about the effects of renal insufficiency on ambulation. The nurses collaborated with an educator with a doctoral degree and developed a proposal for a descriptive, longitudinal study of ambulation and family presence of patients with chronic insufficiency. The framework of the study was synthesized from physiological principles and a theory of family presence and presented as a model.The study was designed to answer the following questions:a. How do renal insufficiency, ambulation, and family presence change over the course of hospitalization?· b. What are the relationships among renal insufficiency, ambulation, and family presence?Question 1In your own words, describe the physiological theory that supports the relationship between renal insufficiency and ambulation.Question 2The second research question elicits information about relationships, what type of statistical analysis will be done if the data meets the assumptions for a parametric test?
I am interest in the care of diabetic patients. As diabetes is on the rise it is important that nurses have the knowledge and skills to care for those who live with diabetes and its treatments. My clinical issue of interest specifically, it to address whether patients being treated with metformin are at risk for vitamin B12 deficiency. Metformin is frequently prescribed to diabetic patients. Vitamin B12 is important to the health of the nervous system and nerve cells (Mayo Foundation for Medical Education and Research, 2021). My PICO question will be developed around the idea of prescribing a vitamin B12 supplement to diabetic patients on metformin.Using database resources to search key words such as, metformin, vitamin B12 deficiency, and diabetes, I was able to retrieve lots of information. According to McGonigle & Mastrian (2018), for best patient care healthcare workers must be able to retrieve evidence-based information to achieve best practices.The first data base I used was CINAHL & Medline Combined search and the Boolean/phrase used was metformin and vitamin B12, this search resulted in 238 articles. Next, I used the filters to limit results by limiting information to peer-reviewed, full-text resources published between 2017-2021. This resulted in 92 resources. With filters still activated I also used the Boolean, diabetes and vitamin B12 and metformin, this further reduced findings to 64 results.The second database I used was PubMed. I used the same Boolean words, diabetes and vitamin B12 and metformin which resulted in 313 articles. One thing I really enjoyed about PubMed filters is that you can check mark the randomized control trial. After, I filtered the PubMed database to the randomized control trial information, I had 5 results.Strategies one may use to increase the rigor and effectiveness of a database search is to search for evidence by level of evidence, for example, the best evidence design is a systematic review that includes a randomized control trial (McGonigle & Mastrian, 2018). An example of a lower-level evidence would be a descriptive study (i.e., a qualitative study). Another strategy to increase effectiveness of a database search in MEDLINE database is to use the subject set box and select systematic reviews (Walden University, 2020).
1) Describe an effective transformational leader that you know and an effective servant leader. How does these leaders exemplify the principles of each leadership style and French and Raven’s sources (bases) of power (influence)?2) Evaluate the strengths/limitations of the specific leadership style of that person in the situation they were in.3) Based on this analysis, what leadership style will be most effective for you in the role you are preparing to do and why?Answer should be one page long, cite references (APA), use in-text citation
