Healthy People 2020

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Healthy People 2020

Discuss aspects of a health concern not being addressed despite the efforts of services and partnerships involved and describe the ultimate outcome(s) or goal(s) from Healthy People 2020 relating to that specific health concern.
Answer the following questions to assist in data interpretation:
What similarities are apparent between the data that were gathered and the data that were generated?
What differences are apparent between the data that were gathered and the data that were generated?
What are the weakness and strengths of this community?
In what areas is improvement needed in this community?

The assignment should be written in an APA-formatted essay. The essay should be between 1500 and 2000 words in length and include at least two scholarly sources other than provided materials.
Healthy People 2020

Health Concern Not Being Addressed and Healthy People 2020 Goals

Obesity is a major public health concern that continues to affect communities despite the efforts of healthcare services, educational programs, and community partnerships. While many services promote healthy eating and exercise, certain aspects, such as socioeconomic factors and access to affordable healthy food, remain inadequately addressed.

Healthy People 2020 has set clear goals to reduce the proportion of adults and children who are obese and to improve overall nutrition and physical activity. The ultimate outcomes focus on reducing obesity-related health conditions like diabetes and heart disease, increasing public awareness of healthy lifestyles, and promoting environments that support physical activity and access to nutritious foods.

Similarities Between Gathered and Generated Data

When data were gathered from community assessments, both the gathered and generated data indicated high rates of obesity within the population. Both types of data identified poor diet and physical inactivity as major contributing factors. Community surveys and focus groups echoed national statistics, showing that a significant portion of the population was either overweight or obese. Additionally, both sets of data demonstrated the community’s general awareness of obesity as a problem, with residents expressing concern over their weight and health.

Differences Between Gathered and Generated Data

While the gathered data reflected general trends in obesity rates, the generated data highlighted more specific local factors. For example, the generated data from local surveys and focus groups revealed that while many community members understood the importance of a healthy diet, limited access to affordable healthy food and few opportunities for physical activity were substantial barriers.

In contrast, gathered data from broader sources might suggest general solutions such as dietary education, whereas the generated data indicated that addressing socioeconomic barriers, improving local infrastructure (e.g., parks, walking paths), and providing better access to affordable fresh produce were more specific community needs.

Weaknesses and Strengths of the Community

One of the strengths of the community is the presence of active local partnerships, including schools, community centers, and healthcare providers, which work together to promote health. Many community members are willing to participate in health programs, and there is awareness of the obesity issue.

However, the weaknesses include limited access to healthcare services, especially preventive services like nutritional counseling, and economic disparities that prevent some residents from adopting healthier lifestyles. In some parts of the community, “food deserts” exist, where fresh fruits and vegetables are hard to find, and residents may rely on fast food and convenience stores for meals.

Areas for Improvement

Improvement is needed in infrastructure to support physical activity, such as creating more parks, walking paths, and community fitness programs. Additionally, efforts should be made to improve access to healthy foods by encouraging grocery stores to carry fresh produce, supporting local farmers’ markets, and offering subsidies or food assistance programs for low-income families. Another area for improvement is in health education, specifically targeting the younger population to instill healthier eating habits and the importance of physical activity early on.

Conclusion

The issue of obesity in the community reflects a complex interplay of factors that extend beyond simple education and awareness campaigns. Addressing the root causes, such as socioeconomic barriers and access to healthy food, will require a more targeted approach. Healthy People 2020 goals emphasize reducing obesity and improving access to health-promoting resources, and to meet these goals, more comprehensive strategies will need to be employed at both local and national levels.

By understanding the data differences, community weaknesses, and areas for improvement, better strategies can be designed to tackle obesity and improve overall health outcomes.

References

Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017–2018. National Center for Health Statistics Data Brief, (360), 1-8. https://www.cdc.gov/nchs/products/databriefs/db360.htm

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187-192. https://doi.org/10.4103/2249-4863.154628

 
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Coding Project

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Coding Project

Page one will include the title “Coding Project” your name, class name, and date of the project, centered on the page.

Each topic will have its own page with the topic name at the top and center, followed by your 250 to 300 words summary of your research (word count does not include references), and the references used for each topic.

As you have noticed, guidelines vary for different modalities of coding. Outpatient has a set of guidelines, and Inpatient has their own guidelines. For each of the following topics, I want you to research each one to see if coding differs or if there are specific coding guidelines. Compare and contrast coding from inpatient/outpatient coding guidelines.

The topics are as follows:

Home Health
Long-term Acute Care (LTAC)
Outpatient Rehabilitation
Inpatient Rehabilitation
Skilled Nursing Facility (SNF)

The last page you will write a summary (100 to 150 words) of what you learned about your research for each topic and state if you would consider working in one of the fields of coding. This section is worth 5 points for content, spelling, and grammar.
(Coding Project)

Coding Project
Home Health Coding

Home health services involve providing medical care to patients in their homes. Coding for home health follows guidelines set by the ICD-10-CM system and involves documenting diagnoses and treatments provided during home visits. Outpatient home health coding requires attention to specific codes for services such as wound care, physical therapy, and medication administration. Since patients are not formally admitted to a hospital, coding focuses more on the services provided rather than procedures.

In inpatient settings, home health is less common as patients are admitted to facilities like hospitals. However, when home health services are part of discharge planning, codes must reflect ongoing care, ensuring a smooth transition from inpatient to outpatient care. Coding guidelines in outpatient settings are typically more detailed and nuanced because of the variety of services provided at home.

Long-term Acute Care (LTAC)

Long-term acute care (LTAC) hospitals provide specialized treatment for patients with serious medical conditions requiring extended hospitalization. Inpatient coding for LTAC hospitals involves using the ICD-10-CM and ICD-10-PCS for procedures. LTAC hospitals follow inpatient coding guidelines, focusing on detailed documentation of long-term care needs, including ventilator management and complex wound care.

In outpatient LTAC, coding focuses on follow-up appointments or procedures provided to patients discharged from LTAC hospitals. Outpatient codes tend to cover post-care services like rehabilitation or continued therapy sessions. Although LTAC services are predominantly inpatient, outpatient coding plays a role in managing continuity of care.

Outpatient Rehabilitation

Outpatient rehabilitation services, such as physical, occupational, or speech therapy, rely on CPT (Current Procedural Terminology) codes in conjunction with ICD-10-CM. Outpatient rehabilitation coding is straightforward, often focusing on specific therapy sessions, consultations, and follow-up visits. Each session or therapy type is coded separately, and the documentation is service-based.

In inpatient rehabilitation, coding focuses on a broader range of procedures and the use of ICD-10-PCS to document therapeutic interventions. Inpatient rehab coding is more complex because it includes both diagnoses and procedures within a long-term care setting, and often deals with comprehensive treatment plans that involve multiple therapy modalities.

Inpatient Rehabilitation

Inpatient rehabilitation, often found in dedicated rehabilitation hospitals or units within hospitals, focuses on patients who require intensive therapy following surgery or illness. Inpatient rehabilitation coding uses ICD-10-PCS codes to document the various procedures and therapies patients receive, including physical therapy, occupational therapy, and speech-language pathology.

In contrast, outpatient rehabilitation coding relies on CPT and ICD-10-CM codes for services rendered in a clinic or outpatient setting. The codes for outpatient rehabilitation are generally more specific to the type of therapy and session length, whereas inpatient codes cover comprehensive care.

Skilled Nursing Facility (SNF)

Skilled Nursing Facilities (SNFs) provide medical and nursing care in a residential setting. Inpatient SNF coding relies heavily on ICD-10-CM and ICD-10-PCS codes. The complexity of coding in a SNF stems from the need to document long-term care services, such as wound management, physical therapy, and medication administration over an extended period.

Outpatient SNF coding, though less common, might apply to follow-up visits for patients discharged from a SNF. In these cases, outpatient coding guidelines are similar to those of other outpatient settings, focusing on specific treatments and services rendered during follow-up care.

Summary

Throughout my research, I’ve learned that coding guidelines vary significantly between inpatient and outpatient settings. Inpatient coding tends to be more complex, covering long-term care, surgical procedures, and multidisciplinary treatment plans, while outpatient coding is more service-based and focused on short-term treatments and follow-up care. For example, outpatient rehabilitation services are coded individually for each session, whereas inpatient rehabilitation requires coding for the entire care process, including therapy and medical procedures.

I would consider working in Outpatient Rehabilitation Coding, as it allows for a more specific focus on procedures and services rendered on a per-visit basis, which may be more manageable compared to the complexity of inpatient coding. Additionally, outpatient coding offers opportunities to work with diverse therapy services, making it an engaging field to pursue.

(Coding Project)

References

uhn, M. & Levit, K. (2015). Understanding the Basics of Inpatient and Outpatient Coding. Journal of AHIMA, 86(6), 38-43. https://library.ahima.org/doc?oid=301987#.XzVCQU9KjIU

American Hospital Association. (2019). Coding for Inpatient and Outpatient Services: What’s the Difference? American Hospital Association Coding Clinic, 36(4), 1-10. https://www.ahacentraloffice.org/coding/

 
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Discussion- POC and Hypertension

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Discussion- POC and Hypertension

The advanced practice nurse is updating the plan of care of nursing home patients with hypertension. Briefly describe the therapeutic actions of drugs affecting blood pressure (diuretics, ACE inhibitors, ARBs, CCB, sympathetic nervous system drugs).

What important teaching points should be addressed for patients receiving antihypertensive drugs?

Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
(Discussion- POC and Hypertension)

Discussion- POC and Hypertension

Therapeutic Actions of Antihypertensive Drugs

Managing hypertension is crucial, particularly in nursing home patients, where medication management can significantly impact overall health outcomes. The main classes of antihypertensive medications include diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and sympathetic nervous system drugs. Each class functions through different mechanisms to lower blood pressure effectively.

Diuretics
Diuretics, commonly referred to as “water pills,” help lower blood pressure by promoting the excretion of sodium and water from the body through urine. This reduction in fluid volume decreases blood pressure. Thiazide diuretics, such as hydrochlorothiazide, are often first-line agents for treating hypertension. They are effective in reducing both systolic and diastolic blood pressure and are especially beneficial for elderly patients (Whelton et al., 2018).

ACE Inhibitors
ACE inhibitors, such as lisinopril and enalapril, work by blocking the enzyme that converts angiotensin I to angiotensin II, a potent vasoconstrictor. By inhibiting this conversion, ACE inhibitors promote vasodilation, reducing peripheral vascular resistance and lowering blood pressure. Additionally, these medications have renal protective effects, making them particularly beneficial for patients with diabetes or chronic kidney disease (Mancia et al., 2018).

Angiotensin Receptor Blockers (ARBs)
ARBs, including losartan and valsartan, block the action of angiotensin II at its receptor sites. This blockade also leads to vasodilation and decreased blood pressure. ARBs are often used as alternatives for patients who experience cough or angioedema with ACE inhibitors. They provide similar renal protective effects, making them suitable for patients with comorbid conditions (Whelton et al., 2018).

Calcium Channel Blockers (CCBs)
CCBs, such as amlodipine and diltiazem, prevent calcium from entering heart and blood vessel cells. By doing so, these medications reduce heart contractility and promote vasodilation, leading to lower blood pressure. CCBs are especially effective for patients with angina or arrhythmias and can be used in combination with other antihypertensives (Mancia et al., 2018).

Sympathetic Nervous System Drugs
Drugs affecting the sympathetic nervous system, such as beta-blockers and alpha-2 agonists, also play a role in managing hypertension. Beta-blockers, such as metoprolol, decrease heart rate and contractility, reducing cardiac output. Alpha-2 agonists, like clonidine, reduce sympathetic outflow from the central nervous system, leading to vasodilation and lowered blood pressure. These agents may be useful in patients with concurrent conditions like heart failure or anxiety (Whelton et al., 2018).

Important Teaching Points for Patients

Effective patient education is essential for individuals receiving antihypertensive medications. Several key teaching points should be addressed:

  1. Medication Adherence: Patients should understand the importance of taking medications as prescribed. Skipping doses can lead to blood pressure fluctuations and increase the risk of complications.
  2. Potential Side Effects: Patients should be informed about common side effects associated with their medications. For example, diuretics may cause increased urination, while ACE inhibitors may lead to a persistent cough. Understanding these side effects can help patients manage them effectively and report any severe reactions to their healthcare provider.
  3. Lifestyle Modifications: Emphasizing the role of lifestyle changes in managing hypertension is vital. Patients should be encouraged to adopt a heart-healthy diet, engage in regular physical activity, limit sodium intake, and manage stress.
  4. Monitoring Blood Pressure: Patients should be taught how to monitor their blood pressure at home and maintain a log to share with their healthcare provider. This monitoring can help assess the effectiveness of treatment and make necessary adjustments.
  5. Regular Follow-up: Patients should be encouraged to attend regular follow-up appointments to monitor their blood pressure and assess their treatment regimen. This follow-up is essential for making timely adjustments based on individual responses to therapy.
  6. Recognition of Symptoms: Educating patients about recognizing symptoms of hypotension (such as dizziness, lightheadedness, or fainting) is crucial, especially for older adults who may be more susceptible to these effects.

Conclusion

The therapeutic actions of antihypertensive medications vary by class, each working through distinct mechanisms to lower blood pressure. Proper patient education on medication adherence, potential side effects, lifestyle modifications, blood pressure monitoring, and the importance of regular follow-up can enhance treatment outcomes in nursing home patients with hypertension. By equipping patients with knowledge, advanced practice nurses can significantly improve the management of hypertension and enhance patients’ quality of life.
(Discussion- POC and Hypertension)

References

Mancia, G., Fagard, R., Narkiewicz, K., et al. (2018). 2018 Guidelines for the management of arterial hypertension. European Heart Journal, 39(33), 3021-3104. https://doi.org/10.1093/eurheartj/ehy339

Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). Guideline for the management of high blood pressure in adults: 2017. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065

 
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Argument Analysis

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Argument Analysis

Instructions

Read the following argument examples in this activity.

Argument 1
Dick and Jane have insured their house and cars with Farmer’s Mutual for 10 years. During this time, they filed only one claim for $500, and the premiums have risen 100%. Two weeks ago, while backing out of the garage, Jane damaged the right fender. They didn’t fix it, and yesterday, while Jane was parked at the supermarket, someone hit the right side of the car, damaging everything but the right fender. When Jane checks the insurance policy, she discovers that while the supermarket accident is covered, the damaged right fender is not. Jane says, “Let’s claim that all the damage happened at the supermarket. It’s only fair. The insurance company has made thousands of dollars from our premiums alone, not to mention all the other people they insure, so they’ll hardly miss the few thousands that their repairs will cost. Many of their friends have done the same – included items that were not part of actual collision damage. It’s unlikely that they will be discovered, because the fender could easily have been damaged in the collision.”

Argument Analysis
Argument 2
In a world where medical resources are in ever-shorter supply, allocation of those resources is becoming an issue. Critical care units (ICU) put heavy demand on hospital resources. Adult medical intensive care units (MICU’s) are often occupied by elderly patients in the final stages of chronic illnesses. Neonatal ICU’s, however, are reserved for premature infants that need critical care in the first few days of life. Surveys of mortality rates in relation to the amount of care for both units show that on a cost/benefit basis, outcomes for NICU patients are statistically better than those for MICU patients. Since hospitals should prioritize outcomes, it is clear that resources should be allocated more heavily to the NICU.

Using the examples in the introduction of this activity, address the following:

Briefly analyze each argument as follows:
State the issue and the conclusion.

For each argument, analyze the argument:
State if it is deductive or inductive.
Explain how the argument follows the form of an inductive or deductive argument.
Reference words, phrases, the structure of the argument, or any other facts or observations you believe support your claim.
Diagram the argument.

Writing Requirements (APA format)

Length: 1-2 pages total (not including title page or references page)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
(Argument Analysis)

 
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Evidence-based practice (EBP)

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Evidence-based practice (EBP)

Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of evidence-based practice (EBP) is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time.

Name two potential barriers that may prevent your EBP change proposal (based on after discharge follow-up) from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers.

Evidence-based practice (EBP)

Sustaining Evidence-Based Practice Change in After-Discharge Follow-Up

Sustaining change within healthcare organizations, particularly regarding evidence-based practice (EBP) proposals, can be challenging. As organizations implement changes, various barriers may arise that hinder the desired outcomes over time. In the context of an EBP change proposal focused on after-discharge follow-up, two significant barriers can be identified: staff resistance to change and inadequate patient engagement.

Barrier 1: Staff Resistance to Change

One potential barrier that may prevent the EBP change proposal from achieving sustained results is staff resistance to change. Healthcare staff may be hesitant to adopt new practices or workflows due to comfort with established routines, skepticism about the efficacy of the proposed changes, or concerns regarding additional workload. Resistance can stem from a lack of understanding of the benefits associated with the change, insufficient training, or inadequate leadership support.

Strategies for Overcoming Staff Resistance
To address this barrier, it is essential to engage staff early in the change process. Involving team members in discussions about the importance and expected outcomes of the EBP change can foster a sense of ownership and investment. Providing comprehensive training sessions that highlight the benefits of the new follow-up practices, along with how they can enhance patient outcomes, is crucial. Additionally, ongoing support from leadership and the establishment of feedback mechanisms can help staff voice concerns, thereby promoting a culture of open communication and collaboration.

Barrier 2: Inadequate Patient Engagement

Another significant barrier that could hinder the sustainability of the after-discharge follow-up proposal is inadequate patient engagement. If patients do not actively participate in their follow-up care, the effectiveness of the interventions may diminish. Factors contributing to this issue may include lack of understanding about the importance of follow-up appointments, barriers to accessing healthcare services (such as transportation issues), or low health literacy.

Strategies for Enhancing Patient Engagement
To overcome this barrier, it is vital to implement strategies that enhance patient engagement. Providing educational resources that explain the significance of follow-up care and what patients can expect during their appointments can empower them to take an active role in their healthcare. Additionally, employing various communication methods, such as reminder calls, texts, or emails, can help reinforce the importance of follow-up visits. Collaborating with community organizations to address transportation barriers and promote accessible healthcare services can also increase patient participation.

Conclusion

In conclusion, sustaining the EBP change proposal focused on after-discharge follow-up requires addressing potential barriers such as staff resistance and inadequate patient engagement. By actively involving staff in the change process and enhancing patient education and access to follow-up care, organizations can foster a culture of continuous improvement. Ensuring that the practice change is integrated into the organizational culture is essential for maintaining positive outcomes over time. Through these strategies, healthcare organizations can work towards achieving long-lasting impacts in patient care and outcomes.

References

McCormack, B., McCance, T., & McGhee, S. (2017). Developing evidence-based practice: A guide for nurses and health care professionals. John Wiley & Sons. https://www.wiley.com/en-us/Developing+Evidence+Based+Practice%3A+A+Guide+for+nurses+and+health+care+professionals-p-9781119266586

Ogrinc, G., et al. (2016). Transforming care: A multidisciplinary approach to improving patient outcomes. American Journal of Medical Quality, 31(5), 429-436. https://journals.sagepub.com/doi/full/10.1177/1062860616632454

 
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Therapeutic Communication

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Therapeutic Communication

Therapeutic communication is important to ensure patients are part of treatment planning.

Provide discussion (250-350 words) of the following:

How would you evaluate a patient’s ability to understand your instruction and their current knowledge base about their problem?

What characteristics of the patient would be helpful?

How would you be certain that the patient understands your medication instruction?

What methods of therapeutic communication would be useful in advanced practice?

Therapeutic Communication

Evaluating Patient Understanding and Knowledge Base

Evaluating a Patient’s Understanding

To evaluate a patient’s ability to understand instructions and their current knowledge base about their health problem, healthcare providers can employ various strategies. One effective approach is to use open-ended questions, allowing patients to express their understanding. Questions such as “Can you explain what you know about your condition?” or “What do you believe is important about your treatment plan?” can reveal their existing knowledge and any misconceptions. Additionally, the teach-back method is valuable, where patients are asked to repeat the instructions in their own words. This technique confirms comprehension and clarifies any misunderstandings.

Helpful Patient Characteristics

Certain characteristics of the patient can significantly aid in this evaluation process. For instance, age, educational background, and cognitive ability influence how patients interpret and retain information. Younger patients or those with higher educational levels may comprehend complex medical jargon more easily. In contrast, elderly patients or those with cognitive impairments may require simpler explanations and more visual aids. Furthermore, understanding a patient’s emotional state is essential, as anxiety, stress, or depression can hinder their ability to absorb and process information.

Ensuring Understanding of Medication Instructions

To ensure that a patient fully understands medication instructions, it is essential to use clear and concise language, avoiding medical jargon when possible. Visual aids, such as charts, diagrams, or written instructions, can enhance understanding. Encouraging questions and creating a supportive environment where patients feel comfortable expressing concerns is critical. Additionally, validating understanding through the teach-back method, where patients explain their medication regimen in their own words, is particularly effective in confirming comprehension.

Methods of Therapeutic Communication in Advanced Practice

In advanced practice, several therapeutic communication methods can be employed to enhance patient understanding and foster collaboration. Active listening is fundamental, as it demonstrates empathy and helps build a trusting relationship. Non-verbal communication, including maintaining eye contact and using appropriate body language, plays a crucial role in conveying support and understanding. Moreover, reflective statements can help clarify feelings and thoughts, further facilitating patient engagement.

By integrating these strategies, healthcare providers can significantly improve patient outcomes and promote active involvement in their treatment planning. Overall, effective therapeutic communication is essential in ensuring patients are informed, engaged, and empowered in their care journey.

References

McCoy, L., & Theeke, L. A. (2019). Enhancing patient education and therapeutic communication in chronic illness management: An integrative review. Journal of Nursing Education and Practice, 9(9), 55-63. https://www.sciedupress.com/journal/index.php/jnep/article/view/14788

Bagnasco, A., et al. (2017). The role of communication in promoting patient empowerment and improving health outcomes. Health and Social Care in the Community, 25(1), 143-152.

 

 
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UNIT 1: PRINCIPLES OF EPIDEMIOLOGY

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UNIT 1: PRINCIPLES OF EPIDEMIOLOGY
UNIT 1: PRINCIPLES OF EPIDEMIOLOGY

DQ1
Define endemic, epidemic, and pandemic, and provide an example of each. Describe a current epidemic. Describe one example of each of the prevention types (primary, secondary, and tertiary) that could be applied to control the epidemic.

DQ2
Discuss the role the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report plays in conveying public health information and recommendations. Describe the type of data and information provided by the Morbidity and Mortality Weekly Report. Choose a report posted within the last 2 years from the “Publications – Weekly Report” tab. Provide a brief summary of the disease report, including the natural history and mode of transmission, and whether the report is an example of descriptive epidemiology or analytical epidemiology.
(UNIT 1: PRINCIPLES OF EPIDEMIOLOGY)

RESOURCES
Read Chapters 1, 2, and 6 in Gordis Epidemiology.
Read “Smoking and Carcinoma of the Lung,” by Doll and Hill, from British Medical Journal (1950). URL: Smoking and Carcinoma of the Lung
Read “The Training of Epidemiologists and Diversity in Epidemiology: Findings from the 2006 Congress of Epidemiology Survey,” by Carter-Pokras et al., from Annals of Epidemiology (2009). URL: Epidemiologists and Diversity
Watch “Epidemiology the Backbone of Public Health,” by Greg Martin (2017), located on the YouTube website. URL: Epidemiology the Backbone of Public Health
Read “The Framingham Study: ITS 50-Year Legacy and Future Promise,” by Kannel, from Journal of Atherosclerosis and Thrombosis (2000). URL: Framingham Study Legacy
Read “Epidemiological Background and Design: The Framingham Study,” located on the Framingham Heart Study website. URL: Framingham Study Background
Read “Epidemiological Approaches to Heart Disease: The Framingham Study,” by Dawber, Meadors, and Moore, from American Journal of Public Health (1951). URL: Epidemiological Approaches to Heart Disease
Read “Global Disease Detectives,” by the Center for Global Health (2013), located on the Centers for Disease Control and Prevention website. URL: Global Disease Detectives
Read “Section 2: Historical Evolution of Epidemiology,” from Lesson 1 of the Centers for Disease Control and Prevention self-study course, Principles of Epidemiology in Public Health Practice (2012), located on the CDC website. URL: Historical Evolution of Epidemiology
Explore the CDC Current Outbreak List page of the Centers for Disease Control and Prevention website. URL: CDC Current Outbreak List
Explore the Epidemic Intelligence Service page of the Centers for Disease Control and Prevention website. URL: Epidemic Intelligence Service
Explore the Morbidity and Mortality Weekly Report, located on the Centers for Disease Control and Prevention website. URL: Morbidity and Mortality Weekly Report

UNIT 2

DQ1
Disease surveillance is a necessary public health role. Passive surveillance relies on individuals and local authorities “pushing” information to national agencies who then compile, analyze, and disseminate the information. Unfortunately, significant gaps occur in reporting. Review your textbook and the Centers for Disease Control and Prevention’s National Notifiable Disease Surveillance System. Discuss the strengths of the current surveillance systems, the gaps you identified, and why these gaps occur. Discuss the global challenges of coordinating surveillance between multiple countries and provide an example highlighting the challenges. What could other governments and agencies, such as the World Health Organization and the Centers for Disease Control and Prevention, do to strengthen global disease surveillance systems?
(UNIT 1: PRINCIPLES OF EPIDEMIOLOGY)

DQ2
Explain the importance of validity and reliability in diagnostic testing or research. Describe how validity relates to sensitivity and specificity in diagnostic testing. Identify a health screen specific to a diagnostic test that is currently being debated regarding its use, recommended ages, or frequency, and discuss how validity and reliability play into this debate. What other factors should you consider when you assess the recommendations for a diagnostic test or screen?

STUDY MATERIALS
Read Chapters 3-5 and 18 in Gordis Epidemiology.
Read “Types of Surveillance,” located on the London School of Hygiene and Tropical Medicine website. URL: Types of Surveillance
Read “WHO Report on Global Surveillance of Epidemic-Prone Infectious Diseases – Introduction,” located on the World Health Organization website. URL: WHO Report on Global Surveillance
Read “CDC 24-7 Fact of the Week,” located on the Centers for Disease Control and Prevention website. URL: CDC 24-7 Fact of the Week
Read “Two by Two Tables,” by Sullivan, Dean, and Pezzullo, from OpenEpi: Open Source Epidemiologic Statistics for Public Health (2013), located on the OpenEpi website. URL: Two by Two Tables
Read “Goodness of Measurement: Reliability and Validity,” by Bajpai and Bajpai, from International Journal of Medical Science and Public Health (2014). URL: Goodness of Measurement
Use the “Compendium of Acute Foodborne and Waterborne Diseases,” located on the Centers for Disease Control and Prevention website, to assist in completing the Oswego Outbreak Case History assignment. URL: Compendium of Acute Foodborne and Waterborne Diseases
View “How to Create an Epidemic Curve,” by Martin (2016), located on the YouTube website. URL: How to Create an Epidemic Curve
View “Know How to Interpret an Epidemic Curve?” by Martin (2017), located on the YouTube website. URL: Know How to Interpret an Epidemic Curve?
Explore the National Notifiable Diseases Surveillance System page of the Centers for Disease Control and Prevention website. URL: National Notifiable Diseases Surveillance System
Explore the Public Health Surveillance and Data page of the Centers for Disease Control and Prevention website. URL: Public Health Surveillance and Data

UNIT 3

DQ1
Differentiate between bias and confounding. Discuss the criteria necessary to establish a factor as a confounder and provide an example applying these criteria. What is one way to adjust for a confounding relationship in the study design or the analysis?

DQ2
Explain the two major types of bias. Identify a peer-reviewed epidemiology article that discusses potential issues with bias as a limitation and discuss what could have been done to minimize the bias (exclude articles that combine multiple studies such as meta-analysis and systematic review articles). What are the implications of making inferences based on data with bias? Include a link to the article in your reference.
(UNIT 1: PRINCIPLES OF EPIDEMIOLOGY)

STUDY MATERIALS
Read Chapters 14 and 15 in Gordis Epidemiology.
Read “Association or Causation: Evaluating Links Between ‘Environment and Disease,'” by Lucas and McMichael (2005), located on the World Health Organization website. URL: Association or Causation
Read “Weak Associations in Epidemiology: Importance, Detection, and Interpretation,” by Doll, from Journal of Epidemiology (1996). URL:

 
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Journal Entry

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Journal Entry

Learning From Experiences

Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.

Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each? What did you learn from this experience? What resources were available? What evidence-based practice did you use for the patients? What would you do differently?

How are you managing patient flow and volume? How can you apply your growing skillset to be a social change agent within your community?
(Journal Entry)

Communicating and Feedback

Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor. Answer the questions: How am I doing? What is missing?

Reflect on the formal and informal feedback you received from your Preceptor.
Journal Entry

Journal Entry: Learning From Experiences

Goals and Objectives Achievement

During my practicum experience, I revisited the goals and objectives outlined in my Practicum Experience Plan. I aimed to enhance my clinical skills, improve patient communication, and learn about interdisciplinary collaboration. I achieved these objectives to a significant degree. I was able to perform various nursing procedures under supervision, which bolstered my confidence. Additionally, I actively engaged with patients, which improved my communication skills. Finally, I collaborated with different healthcare professionals, understanding the importance of teamwork in patient care.

Challenging Patients Encountered

I encountered three particularly challenging patients during my practicum.

The first patient, an elderly woman with chronic obstructive pulmonary disease, struggled with breathlessness. The most challenging aspect was her anxiety regarding her condition. Despite my attempts to reassure her, she remained visibly distressed, which made it difficult to administer care.

The second patient, a young man with diabetes, faced issues with medication adherence. The challenge lay in his lack of understanding of his condition and treatment plan. I realized that my explanations were not resonating with him, which hindered effective communication.

The third patient was a middle-aged man with hypertension who had multiple comorbidities. The complexity of his medical history made it challenging to devise a straightforward treatment plan.

From these experiences, I learned the importance of empathy and tailored communication. I also recognized the need for patience and creativity in patient education.

Resources and Evidence-Based Practices

Several resources were available during my practicum, including access to clinical guidelines, patient education materials, and supportive staff. I utilized evidence-based practices, such as motivational interviewing with the young diabetic man, to enhance his understanding of his condition. I also applied the use of breathing exercises to help the elderly woman manage her anxiety.

Reflecting on Improvements

If I could approach these situations differently, I would incorporate more visual aids and analogies to explain medical concepts better. For the anxious elderly patient, I would prioritize creating a calm environment before attempting any clinical procedures.

Managing Patient Flow and Volume

I managed patient flow and volume by prioritizing tasks and ensuring effective communication with the healthcare team. Utilizing a triage system allowed me to address the most urgent needs first while maintaining a steady workflow.

Applying Skills for Social Change

As I continue to develop my nursing skills, I aspire to become a social change agent within my community. I plan to engage in health promotion initiatives that focus on chronic disease prevention and management. By utilizing my growing skillset, I aim to educate patients and their families about healthy lifestyle choices and the importance of regular medical check-ups.

(Journal Entry)

Communicating and Feedback

To improve my skills and knowledge, I will actively seek feedback from my preceptor and colleagues. Regular discussions will help me identify areas for improvement and learn from their experiences.

Reflecting on my progress, I am doing well but recognize that I need to enhance my understanding of complex medical conditions. The informal feedback I received indicated that I should focus more on patient education strategies, while formal feedback highlighted my strengths in technical skills.

 

References

Benner, P. (2001). From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Pearson Education. https://www.pearson.com/store/p/from-novice-to-expert-excellence-and-power-in-clinical-nursing-practice/P100000294013

Kinnunen, J., & Haatainen, K. (2020). The role of clinical placements in nursing education: A literature review. Journal of Nursing Education and Practice, 10(5), 112-121. https://www.sciedupress.com/journal/index.php/jnep/article/view/18696

 
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School Health Practices

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School Health Practices

Frameworks and Models for School Nursing Practice, Levels of Prevention, Legislature

In an essay of 1500 to 2000 words, using at least 2 APA style cited references, write an essay in APA style on the following topics.

Three Levels of Prevention

Discuss the three levels of prevention. Of the examples given in your textbook, describe how one of each would be different based on the age of the individual.

Collaboration of School Nurses

School nurses are called upon to collaborate with many different groups. Chapter 9 describes various laws pertaining to the school nurse. School nurses are impacted by the Centers for Disease Control and Prevention more than any other agency. Discuss why that statement is true.

HIPAA vs. FERPA

Describe the difference between the Health Insurance Portability and Accountability Act and the Family Educational Rights and Privacy Act, and how they affect a school health practice.

CAPTA and School Health Practice

Discuss the Child Abuse Prevention and Treatment Act and how it affects a school health practice.

Connection Between School Health and Public Health

Discuss the connection between School Health and Public Health, giving examples from both chapters 4 and 9.

School Health Practices

School Health Practices

The role of school nurses is pivotal in promoting the health and well-being of students. This essay discusses the three levels of prevention, the collaboration of school nurses with various groups, the implications of specific laws affecting school health practices, and the connection between school health and public health. By analyzing these components, we can understand how they contribute to a holistic approach to student health.

Three Levels of Prevention

Prevention in healthcare is categorized into three levels: primary, secondary, and tertiary prevention.

Primary Prevention aims to prevent disease before it occurs. For example, administering vaccinations to elementary school children serves as a primary prevention strategy to protect against infectious diseases.

Secondary Prevention focuses on early detection and treatment of diseases. For instance, screening for vision or hearing problems in middle school students exemplifies secondary prevention.

Tertiary Prevention is concerned with managing and rehabilitating individuals with established diseases. In high school students with asthma, providing education about managing their condition effectively represents tertiary prevention.

The approach to each level of prevention may vary based on age. For young children, preventive measures might involve parent education and community vaccination drives. In contrast, for adolescents, prevention may focus on sexual health education and mental health resources, illustrating the need for age-appropriate strategies.

Collaboration of School Nurses

School nurses collaborate with various stakeholders, including parents, teachers, healthcare providers, and local health agencies. Chapter 9 outlines different laws that impact school nursing practice, such as the Individuals with Disabilities Education Act and the Family Educational Rights and Privacy Act. The Centers for Disease Control and Prevention (CDC) significantly influences school nursing through guidelines and policies designed to promote student health. The CDC provides resources on immunization, nutrition, and mental health, making it a vital agency for school nurses. Its influence is particularly relevant during public health crises, such as the COVID-19 pandemic, where school nurses play a crucial role in implementing health protocols.

HIPAA vs. FERPA

The Health Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA) are two critical laws affecting school health practices. HIPAA protects the privacy of individuals’ health information, applicable to healthcare providers and plans. It ensures that students’ medical records are kept confidential. Conversely, FERPA protects the privacy of student education records and grants parents and eligible students certain rights regarding those records. While both laws safeguard privacy, HIPAA focuses on health information, whereas FERPA encompasses educational records, highlighting the importance of understanding their implications in school health practice.

CAPTA and School Health Practice

The Child Abuse Prevention and Treatment Act (CAPTA) plays a significant role in school health practices. CAPTA provides federal funding to improve the prevention, identification, and treatment of child abuse and neglect. It mandates that school personnel report suspected cases of child abuse. Consequently, school nurses must be trained to recognize signs of abuse and understand the reporting process. By doing so, they can contribute to the safety and well-being of students, emphasizing the intersection of health and child welfare.

Connection Between School Health and Public Health

The connection between school health and public health is evident in various initiatives and programs aimed at improving community health. School health programs often align with public health goals by promoting health education, physical activity, and mental health services. For example, initiatives that encourage physical education in schools contribute to public health efforts to combat childhood obesity. Additionally, vaccination programs in schools help achieve public health objectives by increasing herd immunity within the community. Both chapters 4 and 9 illustrate how school health practices are essential for fostering a healthy population.

Conclusion

In conclusion, the role of school nurses encompasses various responsibilities that directly impact student health. Understanding the three levels of prevention, the influence of laws, and the relationship between school health and public health are essential for effective nursing practice in educational settings. Through collaboration and adherence to regulations, school nurses can contribute to the overall well-being of their students and promote a healthier future for the community.

References

Bureau of Health Workforce. (2023). School Health Services. Retrieved from https://bhw.hrsa.gov/health-workforce-analysis/school-health-services

Centers for Disease Control and Prevention. (2024). School Health Policies and Practices Study. Retrieved from https://www.cdc.gov/healthyyouth/data/shpps/index.htm

 
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Health Policy Analysis and Recommendations

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Health Policy Analysis and Recommendations

Select Health Policy on a local, state, or federal policy that you have explored along with recommendations based upon the analysis.
• Analyze and evaluate the Health Policy
• Identify application of health policy into clinical practice.
➢ Your upper must have an Introduction and a Conclusion
➢ Maximum of 6 pages (not including Title and Reference page).
➢ APA format
➢ At least 5 references within 5 years

Health Policy Analysis and Recommendations

Health Policy Analysis and Recommendations

Health policies play a crucial role in shaping the healthcare landscape and directly impact clinical practice. This paper selects a specific health policy, evaluates its effectiveness, and offers recommendations for improvement. Additionally, the application of this policy in clinical practice will be examined. The analysis will draw on current research and provide a comprehensive understanding of the selected health policy.

Selected Health Policy

For this analysis, the focus is on the Affordable Care Act (ACA), a significant federal health policy aimed at increasing access to healthcare, reducing costs, and improving health outcomes for individuals in the United States. Enacted in 2010, the ACA has transformed the healthcare system by expanding Medicaid, establishing health insurance marketplaces, and mandating coverage for essential health benefits.

Analysis and Evaluation of the Health Policy

The Affordable Care Act has had a profound impact on healthcare access. According to a report by the U.S. Department of Health and Human Services (2021), the ACA has contributed to a reduction in the uninsured rate, providing millions of Americans with health coverage. However, challenges remain, including rising premiums and gaps in coverage for certain populations.

One significant strength of the ACA is its emphasis on preventive care. The policy mandates coverage for preventive services without cost-sharing, encouraging individuals to seek necessary health services early. This proactive approach can lead to improved health outcomes and reduced long-term healthcare costs. However, critics argue that the ACA’s complexity and administrative burden may hinder its effectiveness, particularly for small healthcare providers.

Recommendations

Based on the evaluation of the Affordable Care Act, several recommendations can be made to enhance its effectiveness:

  1. Simplify Enrollment Processes: Streamlining the enrollment process for health insurance coverage can improve access for individuals, particularly those with limited health literacy.
  2. Enhance Support for Small Providers: Providing additional resources and support for small healthcare providers can help them navigate the complexities of the ACA, ensuring that they can effectively deliver care to their patients.
  3. Expand Outreach Efforts: Increasing outreach efforts to underserved communities can help raise awareness about available resources and coverage options under the ACA.
  4. Address Cost Issues: Implementing measures to control rising premiums and out-of-pocket costs can improve affordability and access to care for individuals and families.
  5. Evaluate and Adapt: Regularly evaluating the ACA’s impact on health outcomes and access can help identify areas for improvement and adapt the policy as needed to address emerging challenges.

Application of Health Policy into Clinical Practice

The Affordable Care Act has several implications for clinical practice. Healthcare providers must navigate the insurance landscape to ensure their patients have access to necessary services. The ACA’s emphasis on preventive care requires clinicians to prioritize health screenings and vaccinations, aligning their practice with the policy’s goals.

Additionally, the ACA has incentivized the use of electronic health records and data sharing among providers, enhancing care coordination and improving patient outcomes. Clinicians must also remain informed about the ACA’s provisions, as changes in policy can impact reimbursement rates and the services covered.

Conclusion

In conclusion, the Affordable Care Act represents a significant health policy that has reshaped the U.S. healthcare system. While it has successfully increased access to care and emphasized preventive services, challenges remain that require ongoing evaluation and adaptation. By implementing the recommended strategies and integrating the ACA into clinical practice, healthcare providers can better serve their patients and contribute to a healthier population.

References

U.S. Department of Health and Human Services. (2021). The Affordable Care Act: Impact on Health Insurance Coverage. https://www.hhs.gov/about/news/2021/07/01/aca-impact-health-insurance-coverage.html

Kaiser Family Foundation. (2022). Health Reform: Summary of the Affordable Care Act.  https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/

National Institute for Health Care Management. (2023). The Affordable Care Act: Impacts on Healthcare Access and Quality. https://www.nihcm.org/publications/the-affordable-care-act-impacts-on-healthcare-access-and-quality

American Hospital Association. (2023). The Affordable Care Act: What it Means for Hospitals. https://www.aha.org/affordable-care-act

Centers for Medicare & Medicaid Services. (2024). 2024 Marketplaces Open Enrollment Period.  https://www.cms.gov/health-insurance-marketplaces

 
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