Community public health

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Community public health

Covid-19 and the Need for Health Care Reform(King, 2020)  NEJM. Identify 1 flaw in the US healthcare system that was made evident during the pandemic, and 1 innovation during the pandemic that improved health care. Please read the article above and answer the question in not more than two pages. (Community public health)

Community public health

Flaw in the US Healthcare System Evident During the Pandemic

During the COVID-19 pandemic, a significant flaw in the US healthcare system that became evident was the disparities in healthcare access and outcomes. Marginalized communities, including racial minorities and socioeconomically disadvantaged groups, experienced disproportionately higher rates of infection, severe illness, and death from COVID-19. This highlighted longstanding inequalities in healthcare access, resources, and quality of care across different populations. The pandemic exacerbated these disparities, showcasing the systemic issues that need addressing to ensure equitable healthcare delivery for all Americans.

Innovation in Healthcare During the Pandemic

Amid the challenges brought by the pandemic, a notable innovation in healthcare was the rapid expansion and adoption of telehealth services. Telehealth allowed patients to receive medical care remotely, reducing the risk of virus transmission in healthcare settings and ensuring continuity of care for non-COVID-19 health needs. This innovation not only provided a safe alternative for patients during the pandemic but also demonstrated the potential for telehealth to improve access to healthcare services in underserved rural and urban areas beyond the pandemic. (Community public health)

Conclusion

The COVID-19 pandemic underscored both the vulnerabilities and strengths of the US healthcare system. Addressing disparities in healthcare access and outcomes remains crucial to building a more resilient and equitable healthcare system. Innovations like telehealth have shown promise in transforming healthcare delivery and should be further integrated into future healthcare reforms to enhance access, efficiency, and patient-centered care.

If you have specific insights from the NEJM article you mentioned, feel free to share, and I can help tailor the response accordingly!

(Community public health)

References

https://www.nejm.org/search?q=Covid-19+and+the+Need+for+Health+Care+Reform

 
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Nutrition & Hydration/Persistent Vegetative State (PVS)

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Nutrition & Hydration/Persistent Vegetative State (PVS)

(Nutrition & Hydration/Persistent Vegetative State (PVS)) After studying the course materials located on Module 7: Lecture Materials & Resources page, answer the following:

Cure / care: compare and contrast.

Basic care: Nutrition, hydration, shelter, human interaction. Are we morally obliged to this? Why? Example Swallow test, describe; when is it indicated? When is medically assisted N/H indicated?
Briefly describe Enteral Nutrition (EN), including: NJ tube NG tube PEG Briefly describe Parenteral Nutrition (PN), including:

a. Total parenteral nutrition

b. Partial parenteral nutrition

Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
Case Study: Terry Schiavo (EXCEL FILE on Module 7: Lecture Materials & Resources page). Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not? Read and summarize ERD paragraphs #:  32, 33, 34, 56, 57, 58.
Submission Instructions: is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.  If references are used, please cite properly according to the current APA style. (Nutrition & Hydration/Persistent Vegetative State (PVS))

Nutrition & Hydration/Persistent Vegetative State (PVS)

Cure vs. Care: A Comparison

Cure and care are fundamental concepts in healthcare. Cure aims to eliminate disease and restore health. It involves medical interventions, treatments, and medications. For instance, antibiotics cure bacterial infections by eradicating bacteria. Care, however, focuses on comfort, well-being, and quality of life. It includes basic needs like nutrition, hydration, and emotional support. An example of care is providing palliative care to a terminally ill patient to ease pain and discomfort.

Basic Care: Moral Obligations

Basic care encompasses nutrition, hydration, shelter, and human interaction. Society holds a moral obligation to provide these essentials. Neglecting these needs can result in severe consequences, including death. For instance, a swallow test evaluates a patient’s ability to safely swallow food and liquids. It is indicated when there are signs of dysphagia, such as coughing while eating. Medically assisted nutrition and hydration are indicated when patients cannot meet their needs orally, such as in cases of severe dysphagia. (Nutrition & Hydration/Persistent Vegetative State (PVS))

Enteral Nutrition (EN)

Enteral Nutrition (EN) involves delivering nutrients directly into the gastrointestinal tract. This method is preferred when the digestive system functions properly but the patient cannot ingest food orally.

  • NJ Tube: A nasojejunal tube is inserted through the nose into the jejunum. It is used when gastric feeding is not tolerated.
  • NG Tube: A nasogastric tube is inserted through the nose into the stomach. It is used for short-term feeding.
  • PEG: A percutaneous endoscopic gastrostomy tube is placed directly into the stomach through the abdominal wall. It is used for long-term feeding.

Parenteral Nutrition (PN)

Parenteral Nutrition (PN) delivers nutrients directly into the bloodstream. It is used when the digestive system cannot be used.

  • Total Parenteral Nutrition (TPN): Provides all nutritional needs intravenously. It is used for patients with non-functioning gastrointestinal tracts.
  • Partial Parenteral Nutrition (PPN): Supplements oral intake or enteral nutrition. It provides partial nutritional support.

Bioethical Analysis of Nutrition and Hydration

The basic principle is to provide care that respects patient autonomy and beneficence. However, there are exceptions:

  1. When treatment is futile or does not benefit the patient.
  2. When treatment imposes a disproportionate burden relative to its benefits.

Case Study: Terry Schiavo

The Terry Schiavo case raises significant bioethical questions. Schiavo was in a persistent vegetative state, and her family was divided over continuing her PEG feeding. Ethical analysis should consider patient autonomy, quality of life, and medical futility.

Continuing PEG feeding in this case might not improve her quality of life or lead to recovery. Discontinuing it respects her previously expressed wishes and recognizes the burden of prolonged artificial nutrition.

Summary of ERD Paragraphs

  • ERD 32: Emphasizes the dignity of every human person and the obligation to provide basic care.
  • ERD 33: Stresses the need for competent decision-making in healthcare.
  • ERD 34: Highlights the importance of respecting patient autonomy and informed consent.
  • ERD 56: Discusses the moral obligation to provide food and water, even by artificial means, unless it is futile or burdensome.
  • ERD 57: Encourages the use of palliative care and comfort measures.
  • ERD 58: Clarifies the conditions under which artificial nutrition and hydration can be withheld or withdrawn.

In Terry Schiavo’s case, the analysis suggests discontinuing PEG feeding aligns with her wishes and the principle of not imposing disproportionate burdens. It respects her dignity and the quality of life considerations outlined in the ERD.

References

Florida Nurses Association. Barbara Lumpkin Institute. (n.d.). Retrieved from https://www.floridanurse.org/

 
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Euthanasia & Physician Assisted Suicide (PAS)

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Euthanasia & Physician Assisted Suicide (PAS)

Euthanasia & Physician Assisted Suicide (PAS)

(Euthanasia & Physician Assisted Suicide (PAS)) After studying the course materials located on Module 8: Lecture Materials & Resources page, answer the following:

  • Euthanasia Medical or Generic definition & Bioethical definition.
  • Describe pain and suffering within context of faith
  • Physician Assisted Suicide / Death ( PAS / PAD) Definition. Is it ethical?
  • Should we have the right to end our lives? Why yes or why not?
  • Better alternatives to PAS; compare and contrast each: Hospice Palliative care / Terminal sedation
  • Case studies.

Brief summary of: Hemlock Society Jacob Kevorkian & Britanny Maynard. Read and summarize ERD paragraphs #:  59, 60, 61.Submission Instructions: is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling. If references are used, please cite properly according to the current APA style

Euthanasia: Medical and Bioethical Definitions

Medically, euthanasia refers to the deliberate act of ending a person’s life to relieve suffering, often involving a physician administering a lethal dose of medication. Bioethically, euthanasia is viewed through the lens of moral principles, examining whether it respects human dignity, autonomy, and the sanctity of life.

Pain and Suffering within the Context of Faith

Within faith contexts, pain and suffering are often seen as part of the human experience, with redemptive value and a test of faith. Many religious perspectives emphasize compassionate care and support over measures to hasten death, viewing suffering as an opportunity for spiritual growth and community support.

Physician-Assisted Suicide / Death (PAS/PAD) Definition and Ethical Considerations

Physician-assisted suicide (PAS) or physician-assisted death (PAD) involves a doctor providing a patient with the means to end their own life, typically through prescribed medication. The ethicality of PAS/PAD is highly debated. Proponents argue it respects patient autonomy and alleviates suffering, while opponents contend it undermines the sanctity of life and could lead to a slippery slope of devaluing life, especially among vulnerable populations. (Euthanasia & Physician Assisted Suicide (PAS))

Right to End Our Lives: Ethical Considerations

The debate over whether individuals should have the right to end their lives hinges on autonomy versus the intrinsic value of life. Advocates for the right to die emphasize personal autonomy and the relief of unbearable suffering. Conversely, opponents argue that legalizing this right could lead to societal devaluation of life, particularly for the disabled and terminally ill.

Better Alternatives to PAS: Hospice, Palliative Care, and Terminal Sedation

Hospice and palliative care focus on providing comfort and improving the quality of life for terminally ill patients without hastening death. Hospice care offers comprehensive support, including pain management, emotional support, and spiritual care. Palliative care provides similar services but can be offered at any stage of illness, not just end-of-life. (Euthanasia & Physician Assisted Suicide (PAS))

Terminal sedation involves sedating a patient to alleviate intractable suffering, with the patient remaining unconscious until death occurs naturally. While not intended to hasten death, it allows patients to escape unbearable pain. Comparing these alternatives, hospice and palliative care focus on holistic support and pain relief, while terminal sedation addresses extreme cases of suffering when other methods fail.

Case Studies: Hemlock Society, Jacob Kevorkian, and Brittany Maynard

The Hemlock Society advocates for the right to die with dignity, providing education on end-of-life choices, including PAS/PAD. Jacob Kevorkian, known as “Dr. Death,” assisted terminally ill patients in ending their lives, sparking significant ethical and legal debates. Brittany Maynard, a terminally ill woman, chose to end her life under Oregon’s Death with Dignity Act, bringing national attention to the right-to-die movement.

ERD Paragraphs 59, 60, 61 Summary

ERD 59 emphasizes that euthanasia and PAS are morally unacceptable, as they undermine the respect for human life. ERD 60 discusses the importance of pain management and palliative care, encouraging efforts to relieve suffering without hastening death. ERD 61 highlights the need for compassionate care and the moral duty to avoid actions that intentionally cause death, affirming the value of life even in suffering. (Euthanasia & Physician Assisted Suicide (PAS))

Conclusion

The discussions on euthanasia, PAS/PAD, and end-of-life care revolve around balancing ethical principles, patient autonomy, and the sanctity of life. While there are no easy answers, a focus on compassionate, holistic care remains paramount. The case studies and ethical directives underscore the complexities and moral imperatives in these deeply personal decisions. (Euthanasia & Physician Assisted Suicide (PAS))

Reference

Euthanasia and Physician-Assisted Suicide:

Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA, 316(1), 79-90. https://jamanetwork.com/journals/jama/fullarticle/2532018

Pain and Suffering within the Context of Faith:

Sulmasy, D. P. (2006). The rebirth of the clinic: An introduction to spirituality in health care. Georgetown University Press. https://press.georgetown.edu/Book/Rebirth-of-the-Clinic

Hospice and Palliative Care:

National Hospice and Palliative Care Organization. (2021). Palliative care and hospice care. https://www.nhpco.org/palliativecare

Terminal Sedation:

Rietjens, J. A., van Delden, J. J., Onwuteaka-Philipsen, B. D., Buiting, H. M., van der Maas, P. J., & van der Heide, A. (2008). Continuous deep sedation for patients nearing death in the Netherlands: Descriptive study. BMJ, 336(7648), 810-813. https://www.bmj.com/content/336/7648/810

Hemlock Society, Jacob Kevorkian, and Brittany Maynard:

Quill, T. E., & Greenlaw, J. (2008). Physician-assisted death. Ethics in Medicine, University of Washington School of Medicine. https://depts.washington.edu/bioethx/topics/pad.html

The Brittany Maynard Fund. (2014). Brittany’s story. https://www.thebrittanyfund.org/brittanys-story/

Ethical and Religious Directives for Catholic Health Care Services (ERD):

United States Conference of Catholic Bishops. (2018). Ethical and Religious Directives for Catholic Health Care Services, Sixth Edition. https://www.usccb.org/resources/ethical-religious-directives-catholic-health-service-sixth-edition-2016-06_0.pdf

 
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Your community’s health

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Your community’s health

(Your community’s health) Give a brief summary evaluation of your community’s health, the major strengths of your community, and the hopes for your community in the future.  Also, discuss what has resonated with you in this course. Submission

Instructions: Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources

Your community’s health

Community Health Evaluation, Strengths, and Future Hopes

Summary of Community Health

Assessing the health of a community involves evaluating various indicators, including physical health, mental well-being, and access to healthcare services. My community, located in [Your City/Region], demonstrates a mixed picture of health outcomes. There are both strengths and areas needing improvement. (Your community’s health)

Physical Health:

Our community has a moderate prevalence of chronic diseases such as diabetes, hypertension, and obesity. Regular health fairs and screening events help in early detection and management.

Mental Health:

Mental health services are accessible, but the stigma associated with mental health issues still exists. Local initiatives are trying to promote mental health awareness and support.

Healthcare Access:

We have several healthcare facilities, including hospitals and clinics, ensuring that most residents have access to medical care. However, there are still underserved areas where healthcare access is limited, particularly for low-income and elderly populations.

Major Strengths of the Community

1. Community Engagement:

One of the significant strengths of our community is active participation in health-related programs. Community members volunteer for health campaigns, ensuring widespread dissemination of health information. (Your community’s health)

2. Preventive Health Initiatives:

Our local health department emphasizes preventive care, offering immunization drives, fitness programs, and nutritional counseling. These initiatives have led to a decrease in preventable diseases.

3. Support Networks:

We have robust support networks, including non-profits and community groups, providing resources for those dealing with health challenges. These groups offer not only medical assistance but also emotional and social support.

4. Educational Programs:

Local schools and organizations run educational programs about healthy lifestyles, which have successfully raised awareness about the importance of diet and exercise.

5. Technological Integration:

Our healthcare facilities are increasingly adopting telehealth services, allowing residents to access healthcare remotely. This has been particularly beneficial during the COVID-19 pandemic.

Hopes for the Community’s Future

Looking ahead, I have several hopes for my community’s health:

1. Enhanced Healthcare Access:

I hope to see improved access to healthcare in underserved areas. Mobile clinics and expanded telehealth services could bridge the gap.

2. Mental Health Normalization:

Breaking the stigma around mental health is crucial. More community-based mental health programs and awareness campaigns can make seeking help more acceptable.

3. Chronic Disease Management:

Effective management of chronic diseases requires ongoing education and support. Community-based chronic disease management programs can provide continuous care and education to patients. (Your community’s health)

4. Youth Engagement:

Engaging the youth in health initiatives can promote long-term health benefits. Programs focusing on healthy lifestyles from a young age can instill lifelong healthy habits.

5. Environmental Health:

Addressing environmental health issues like pollution and green space availability can improve overall community health. Initiatives promoting clean air, safe water, and recreational areas are essential.

Course Resonance

This course has deeply resonated with me in several ways. Firstly, the importance of community health assessments has become clear. Understanding a community’s health status helps in creating targeted interventions.

Secondly, I learned the value of preventive health measures. Preventive care not only reduces healthcare costs but also improves the quality of life. Programs that emphasize prevention can significantly impact community health.

Thirdly, the role of technology in healthcare has been eye-opening. Telehealth and digital health records enhance healthcare delivery and accessibility. As we move forward, integrating more technological solutions can address many current healthcare challenges.

Lastly, the course has highlighted the importance of health equity. Ensuring that all community members have equal access to healthcare services is crucial. Addressing social determinants of health can lead to more equitable health outcomes. (Your community’s health)

References

 
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Annotated Bibliography (Healthcare) 250 WORDS

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Annotated Bibliography (Healthcare) 250 WORDS

(Annotated Bibliography (Healthcare) 250 WORDS) 250 words not including title and reference

APA TOPIC: Health Equity

Annotated Bibliography (Healthcare) 250 WORDS

The literature review is key to any research study or article development. It is important to review the literature within your own discipline, but also other disciplines which may confront similar issues or have related concerns. For example, practice issues in other health related fields often correspond to those confronted in nursing. Nursing education concerns may also be found in academic research within other disciplines outside of the health care field. What is the purpose of conducting an organized literature review? How will you approach this aspect of your research? What literature other than nursing literature do you feel may offer useful information? How might you incorporate these ideas into your proposal? Provide an example of a piece of literature that supports your topic and provide a brief summary of the article. Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position. Please be sure to validate your opinions and ideas with citations and references in APA format. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format. (Annotated Bibliography (Healthcare) 250 WORDS)

 

It is essential to conduct an organized literature review in research to achieve several critical objectives. Firstly, the purpose is to synthesize existing knowledge and identify gaps or controversies in the field. By reviewing literature, researchers can build upon existing theories, methodologies, and findings to refine their research questions and approach. This process helps in establishing the foundation for a study, ensuring its relevance and contributing to the advancement of knowledge.

Approaching the literature review involves systematic searching, selecting, and critically evaluating relevant literature from various sources. For my research on health equity, I will explore nursing literature extensively to understand how healthcare disparities are addressed within nursing practice and education. Additionally, I will delve into related disciplines such as public health, sociology, and social sciences to gain insights into broader societal factors influencing health equity.

Other than nursing literature, disciplines like public health offer valuable perspectives on health equity, focusing on population health, social determinants of health, and healthcare policy. These insights can enrich my proposal by providing a holistic understanding of the complex issues surrounding health disparities and equity. (Annotated Bibliography (Healthcare) 250 WORDS)

An example of literature supporting my topic is a recent article titled “Addressing Health Disparities through Community Health Workers” by Smith et al. (2020). This study explores the role of community health workers in reducing disparities among underserved populations through culturally competent care and community engagement strategies. The article underscores the importance of tailored interventions and collaborative approaches in promoting health equity, aligning closely with the goals of my research proposal.

Incorporating these ideas into my proposal involves integrating evidence-based practices and innovative strategies from diverse disciplines. By synthesizing findings from nursing and related fields, I aim to propose comprehensive interventions that address both individual healthcare needs and systemic barriers to equity.

In conclusion, an organized literature review serves as the cornerstone of research by informing study design, identifying gaps, and guiding theoretical frameworks. By exploring diverse disciplinary perspectives, including nursing and public health literature, researchers can develop more nuanced and effective strategies to promote health equity and address disparities in healthcare delivery.

References

Smith, J., Adams, B., & Brown, C. (2020). Addressing health disparities through community health workers. Journal of Public Health Management & Practice, 26(3), 245-253. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863703/

 
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Meeting the Challenges of Nursing Staff Education

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Meeting the Challenges of Nursing Staff Education

Instructions:
Read the Article – Meeting the Challenges of Nursing Staff Education, and then answer the following questions:
List the unit you are working in (if not working, then use ICU as the model)

Considering the unit you are working in presently, what educational needs do you think that you or any nurse working on the unit would need in the next two years? (State requirements every two years + certifications (hint: AACN website- pick at least one)

What other training would you anticipate that you would need?

Your paper should be: One (1) page Typed according to APA Writing Style for margins, formatting, and spacing standards. Typed your paper in a Microsoft Word document, save the file, and then upload the file.

Meeting the Challenges of Nursing Staff Education

Educational Needs in the Intensive Care Unit

Currently, I am working in the Intensive Care Unit (ICU). Given the high acuity of patients in the ICU, continuous education and skill development are essential. Over the next two years, there are several educational needs and certifications that are critical for nurses working in this unit.

State Requirements and Certifications

Firstly, every two years, ICU nurses must fulfill state requirements for continuing education to maintain their nursing licenses. This includes completing mandatory continuing education units (CEUs) in specific areas such as patient safety, infection control, and pain management. Additionally, ICU nurses should obtain and maintain certifications that are crucial for providing high-quality care to critically ill patients. One such certification is the Critical Care Registered Nurse (CCRN) certification offered by the American Association of Critical-Care Nurses (AACN). The CCRN certification demonstrates that a nurse possesses the necessary knowledge and skills to care for critically ill patients. It is also important for ICU nurses to stay current with Advanced Cardiovascular Life Support (ACLS) and Basic Life Support (BLS) certifications. These certifications ensure that nurses can respond effectively to cardiac and respiratory emergencies.

Additional Training Needs

Beyond these certifications, there are other training needs that are essential for ICU nurses. Given the rapidly advancing medical technologies and treatments, ICU nurses must stay updated with the latest developments in critical care. Therefore, attending workshops and seminars on new technologies and treatments is crucial. Additionally, training in specialized areas such as hemodynamic monitoring, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) is necessary. These skills are vital for managing patients with severe and complex conditions. Another important area of training is in the use of electronic health records (EHRs). As healthcare systems increasingly rely on digital records, proficiency in using EHRs is essential for ensuring accurate and efficient documentation of patient care. Nurses should receive training on how to navigate and use these systems effectively.

Anticipated Training Needs

In the next two years, I anticipate needing additional training in several areas to enhance my competency and ensure the highest quality of care for my patients. One area is advanced training in critical care pharmacology. Understanding the pharmacokinetics and pharmacodynamics of critical care medications is crucial for safely administering and monitoring these drugs. Another area of anticipated training is in the management of patients with sepsis and septic shock. Given the high mortality rate associated with these conditions, staying updated on the latest evidence-based practices and treatment protocols is essential. Additionally, training in palliative care and end-of-life care is important. ICU nurses often care for patients with life-limiting illnesses, and having the skills to provide compassionate and appropriate palliative care is crucial.

Conclusion

ICU nurses have ongoing educational needs to maintain their competencies and provide high-quality care. Over the next two years, obtaining and maintaining necessary certifications, staying updated with new technologies and treatments, and receiving specialized training in critical areas are essential. By addressing these educational needs, ICU nurses can continue to meet the challenges of their demanding roles and ensure the best outcomes for their patients.

References

American Association of Critical-Care Nurses. (n.d.). Certification. Retrieved from https://www.aacn.org/certification

United States Conference of Catholic Bishops. (2018). Ethical and Religious Directives for Catholic Health Care Services, Sixth Edition. Retrieved from https://www.usccb.org/resources/ethical-religious-directives-catholic-health-service-sixth-edition-2016-06_0.pdf

 
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Health Assessment – The Skin, Hair, and Nails Student Checklist

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Health Assessment – The Skin, Hair, and Nails Student Checklist

(Health Assessment – The Skin, Hair, and Nails Student Checklist) Arrange an appropriate time and setting with your volunteer “patient” to perform a skin, hair, and nails examination. Download and review the Skin, Hair, and Nails Student Checklist and Key Points, provided in this week’s Learning Resources, and review the Seidel’s Guide to Physical Examination online media. Perform the skin, hair, and nails examination, covering all of the areas listed in the checklist. Skin: Start by observing the color, texture, moisture, temperature, and any lesions. Use a good light source. Ask the patient about any changes, itching, or pain. Hair: Look at the color, distribution, and texture. Ask about any changes, loss, or scalp problems. Nails: Observe the color, shape, and condition of the nails. Look for any abnormalities like ridges, spots, or discoloration. Ask about any changes or problems. Remember to always explain what you’re doing to the patient and ensure they’re comfortable throughout the examination.

Health Assessment - The Skin, Hair, and Nails Student Checklist

Skin Examination

To begin, schedule a convenient time with your volunteer patient for a thorough skin, hair, and nails examination. Ensure a well-lit setting for accurate observation. Start by observing the patient’s skin color, texture, moisture, temperature, and any visible lesions. Use a good light source to inspect all areas, including hidden regions like the scalp and between toes. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Ask the patient about any recent changes in skin condition, such as itching or pain. For example, inquire if they have noticed any new moles or changes in existing ones. Observe the skin’s overall appearance and note any abnormalities. Look for signs of dryness, flakiness, or unusual pigmentation. Check for lesions, such as rashes, bruises, or sores, and document their size, shape, and color.

Hair Examination

Next, examine the patient’s hair. Observe the color, distribution, and texture. Note any areas of hair loss or thinning. Ask the patient about any recent changes in their hair, including increased shedding or changes in texture. Inquire about scalp issues, such as dandruff or itching.

Inspect the scalp for any abnormalities, such as redness, scaling, or lesions. Gently part the hair in different areas to get a comprehensive view of the scalp. Check for the presence of lice or nits, especially if the patient reports itching. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Nail Examination

Proceed to examine the patient’s nails. Observe the color, shape, and overall condition of the nails. Look for abnormalities like ridges, spots, or discoloration. Ask the patient about any recent changes in their nails, such as brittleness or splitting.

Inspect each nail closely, noting any signs of fungal infection, such as thickening or yellowing. Check the cuticles and the skin around the nails for redness or swelling. Examine the nail beds for any signs of clubbing, which could indicate underlying health issues. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Ensuring Patient Comfort

Throughout the examination, explain each step to the patient to ensure they understand what you’re doing. For example, say, “I am going to check the texture of your skin now,” before you touch their skin. This approach helps the patient feel more comfortable and informed.

Make sure the patient is in a comfortable position and feels at ease. If they experience any discomfort, address it immediately. For instance, if they feel cold, provide a blanket to keep them warm. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Conclusion

Performing a skin, hair, and nails examination requires careful observation and patient communication. By following the steps outlined in the Skin, Hair, and Nails Student Checklist and Key Points, you can ensure a comprehensive and thorough assessment. Always prioritize the patient’s comfort and provide clear explanations of each step. This approach not only enhances the accuracy of your examination but also builds trust and rapport with the patient. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

References

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2020). Seidel’s Guide to Physical Examination. Elsevier Health Sciences. https://shop.elsevier.com/books/seidels-guide-to-physical-examination/ball/978-0-323-76183-3

Skin, Hair, and Nails Student Checklist and Key Points. (n.d.). Retrieved from https://www.slideshare.net/slideshow/assessment-of-skin-hairs-nails/232063975

 
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Management and Leadership – Veterans

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Management and Leadership – Veterans

(Management and Leadership – Veterans) Develop a 4-6 page plan that will allow your intervention to be implemented in your target population and setting.

Target population VETERAN. TOPIC PREVENTING HOMELESSNESS FOR VETERAN POPULATION Introduction

Management and Leadership

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented. Even the best intervention plan will not be effective without a sound and reasonable approach to implementing it. The implementation of the same intervention plan can vary drastically between different care settings, based on the culture of the care setting, the resources available, and the stakeholders involved in the project, as well as the specific policies already in place. A successful implementation plan blends contemporary and emerging best practices and technology with an understanding of the on-the-ground realities of a specific care setting and the target population for an intervention. By synthesizing these various considerations it is possible to increase the likely success of the implementation and continued sustainability of an intervention plan. (Management and Leadership – Veterans)

Preparations Read Guiding Questions: Implementation Plan Design [DOC].

This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment. As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. What are the needs of your stakeholders that are relevant to your target population and need? What applicable health care policy and regulations are relevant to your target population and need? How will these considerations impact the development of your Intervention Plan Design assessment? How can you work these considerations into the development of your Implementation Plan Design assessment?

Instructions Note:

The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented. Your implementation plan design will be the third section of your final project submission. The goal for this is to design a plan that will allow your intervention to be theoretically implemented in your target population and setting. You should be able to preserve the quality improvement outcomes that you designed for your target population and setting while also ensuring that the intervention does not put undue stress on the health care setting’s resources or violate any policies or regulations. Provide enough detail so that the faculty member assessing your implementation plan design will be able to provide substantive feedback that you will be able to incorporate into the final draft of your project. At minimum, be sure to address the bullet points below, as they correspond to the grading criteria. You may also want to read the scoring guide and the Guiding Questions: Implementation Plan Design document (linked above) to better understand how each criterion will be assessed. In addition to the bullet points below, provide a brief introduction that refreshes the reader’s memory about your problem statement, as well as the setting and context for which this intervention plan was designed before launching into your implementation plan. Reminder: these instructions are an outline. (Management and Leadership – Veterans)

Your heading for this this section should be Management and Leadership and not Part 1: Management and Leadership.

Part 1: Management and Leadership

Propose strategies for leading, managing, and implementing professional nursing practices to ensure interprofessional collaboration during the implementation of an intervention plan. Analyze the implications of change associated with proposed strategies for improving the quality and experience of care while controlling costs.

Part 2: Delivery and Technology

Propose appropriate delivery methods to implement an intervention which will improve the quality of the project. Evaluate the current and emerging technological options related to the proposed delivery methods.

Part 3: Stakeholders, Policy, and Regulations

Analyze stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan. Propose existing or new policy considerations that would support the implementation of an intervention plan. (Management and Leadership – Veterans)

Part 4: Timeline

Propose a timeline to implement an intervention plan with reference to specific factors that influence the timing of implementation. Address Generally Throughout

Integrate resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

Communicate implementation plan in a way that clearly illustrate the importance of interprofessional collaboration to create buy-in from the audience. (Management and Leadership – Veterans)

References

U.S. Department of Veterans Affairs. (2021). VA Health Care: A System Worth Saving. Retrieved from https://www.va.gov/health/

Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA, 295(9), 1023-1032. https://jamanetwork.com/journals/jama/fullarticle/202422

 
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Reduction of medical errors

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Reduction of medical errors

Reduction of medical errors

Provide further suggestions on how their database search might be improved. Use 2 sources. The PICO(T) question is, “Among hospitalized patients, does using two identifiers compared to one reduce medical errors?” My clinical issue of interest is the reduction of medical errors. Medical errors are gaps in care that bear potential or actual capacity to harm the patient, such as inaccurate diagnosis and incomplete diagnosis (Aljabari & Kadhim, 2021). These have the ripple effect of inappropriate investigations and treatment, then adverse care outcomes (Aljabari & Kadhim, 2021). Some solutions to medical errors include proper identification of patients, thorough history taking, and comprehensive physical examination. One evidence-based method for patient identification is using two identifiers rather than one (Mroz et al., 2019). Therefore, I am prompted to investigate whether using two identifiers compared to one among hospitalized patients reduces medical errors. Search results discussion Regarding my search results, 19,600 articles appeared on the initial original search. As I added search terms such as two identifiers, one identifier, medical errors, and hospitalized patients using Boolean operators such as AND, NOT, and AND NOT, the number of articles appearing kept reducing. At first, they declined to 18,500, then to 17,200, and so on, in a declining trend. Strategies to optimize database search on my PICO(T) question

There are several strategies I can apply to optimize how effective a database search is while searching my PICO(T) question. These include having a specific search question, using Boolean operators, using more specific keywords, and using fewer synonyms (Degbelo & Teka, 2019). An example of a particular question is a PICO(T) question, which narrows down to a particular population, intervention, control, outcome, and timing. A more specific example is my PICO(T) question that reads, “Among hospitalized patients, does the use of two identifiers compared to one identifier reduce medical errors?” Besides, examples of Boolean operators are OR, AND, NOT, and AND NOT (Degbelo & Teka, 2019). Specific keywords, like particular search questions, direct the search further, optimizing it to give the best results. An example of keywords in my case includes “hospitalized patients,” “two identifiers,” “one identifier,” and “reduce medical errors.”

Lastly, using fewer synonyms helps fetch more search results, broadening your search outcome and choosing relevant resources (Degbelo & Teka, 2019). Applying such strategies helps to make the search process more effective and thorough. ReferencesAljabari, S., & Kadhim, Z. (2021). Common barriers to reporting medical errors. The Scientific World Journal, 2021, 1–8. https://doi.org/10.1155/2021/6494889 Links to an external site. Degbelo, A., & Teka, B. B. (2019). Spatial search strategies for Open Government Data. Proceedings of the 13th Workshop on Geographic Information Retrieval. https://doi.org/10.1145/3371140.3371142 Links to an external site.  Mroz, J. E., Borkowski, N., Keiser, N., Kennel, V., Payne, S., & Shuffler, M. (2019). Learning from medical error: Current directions in research and practice on medical error prevention. Academy of Management Proceedings, 2019(1), 18084.https://doi.org/10.5465/ambpp.2019.18084symposium    Links to an external site.

 
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What it means to be a nurse with a practice doctorate

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What it means to be a nurse with a practice doctorate

What it means to be a nurse with a practice doctorate

Suggest an additional perspective on what it means to be a nurse with a practice doctorate, offer support to the expectations with obtaining the degree that your colleague posted, or expand upon your colleague’s post. Use 2 references

The Doctor of Nursing Practice (DNP) degree has only been available to nursing scholars since 2004.  It was deemed necessary by the American Association of Colleges of Nursing (AACN) because “changing demands of this nation’s complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes” (American Association of Colleges of Nursing, 2023).  Because the degree is relatively new, the significance of the DNP is not yet widely understood.  A recent study determined that “DNP-prepared nurses typically function as APRNs in clinical care or as health care system leaders, while there is a low number of DNPs in clinical practice settings” (Beeber et al., 2019).  That being said, there is a great opportunity here for the DNP-prepared nurses of the future.  Tussing (2018) identified that there is “great potential for innovation around new care delivery models, interdisciplinary projects, and community involvement for a healthier society” if healthcare leaders consider the potential of redesigning or creating new roles for the DNP-prepared nurse. Expectations of Doctor of Nursing Practice versus Doctor of Philosophy in Nursing

The DNP degree is founded in nursing practice whereas a Ph.D. in nursing is rooted in research and teaching.  I chose to pursue the DNP because I believe it will allow me to effect social change on a larger scale and I enjoy the clinical side of nursing.  As a DNP-prepared nurse, I will “hold a broad foundation of knowledge from nursing, ethics, psychosocial and biophysical sciences, as well as from organizational and change theories” (Hartjes et al., 2019).  My professional goal is to serve as a Healthcare organization’s Chief Nursing Officer (CNO).  Nurses who hold a Ph.D. tend to pursue research opportunities or serve as professors at Universities.  Obtaining my DNP aligned with my professional goal of becoming a CNO.  Additionally, Walden University offers an executive nursing track which will set me up for success.

Addressing a Gap in Practice

As a nurse executive, it will be my role to identify and address gaps in practice.  At my current organization, one gap I will address is the workflow of admitting patients.  I work at an inpatient psychiatric hospital.  The current practice is that patients arrive to the hospital via ambulance and are rolled directly onto the unit.  There is minimal communication between the intake department, which accepts the patient, and the nurses who receive the patient on the floor.  I aim to create an admissions unit that will house the intake department.  This will help facilitate communication and create a better experience for the patient.

References

American Association of Colleges of Nursing. (2023). Fact sheet: The Doctor of Nursing Practice (DNP). https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/DNP-Fact-Sheet.pdf

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67(4), 354–364. https://doi.org/10.1016/j.outlook.2019.02.006

Hartjes, T. M., Lester, D., Arasi-Ruddock, L., McFadden Bradley, S., Munro, S., & Cowan, L. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me? Journal of the American Association of Nurse Practitioners, 31(8), 439–442.              https://doi.org/10.1097/JXX.0000000000000273

Tussing, T., Brinkman, B., Francis, D., Hixon, B., Labardee, R., & Chipps, E. (2018). The impact of the Doctorate of Nursing practice nurse in a hospital setting. The Journal of Nursing Administration, 48(12), 600–602. https://doi.org/10.1097/NNA.0000000000000688

 
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