Category: Nursing

Healthy People 2020 and Evidence-Based resources

As a healthcare professional, understanding where to locate evidence-based resources in order to help your patients benefit from that knowledge will be useful in your career. One such resource is The National Center for Health Statistics. The Center has established Healthy People 2020 for tracking the nation’s health. In this assignment, you will begin from the topic you selected and propose a culturally competent, as defined by SAMHSA, community based health program.

Go to the Healthy People 2020 website and find the Topics & Objectives. Once you have located the 42 topic areas discussed on the website, choose a topic in which you are interested.

Write a 1,500-1,750-word paper in which you propose a community health program related to the topic you selected. Include the following in your proposal:

An overview of the program you are proposing. What is it? Who are the population(s) it will serve?

A rationale for the program.

A discussion of how the program will be established as and will remain culturally competent.

A discussion of how the program could be affected if budgetary restraints limited research in that field.

Staphylococcus aureus (MRSA) and Vancomycin

To comment…

Hi, Staph Aureus has become so strong and resistant over the years of treatment, now there is MRSA, MSSA, and more to come. I have always kept the communication lines wide open with the pharmacists I work with, asking all types of questions and they are so resourceful to us as nursing staff. I have also heard over many years of the over use of antibiotics and the fact these super bugs are growing stronger every year and more and more infected patient’s and also the public, are driving antibiotic immunity to a scarce level. Now you may agree that VRE (Vancomycin Resistant Enterococcus) scares us all more than MRSA…lol..but true… In the little ED I am working in right now I like to say to my co-workers, there is a sepsis craze going on around us and we laugh yet we get annoyed with the insane amount of blood cultures we draw and lactic acids we run… But the most common antibiotic we give is 1st line Zosyn, then Vancomycin and our pharmacy is sometimes slack getting us the medications on time and the vancomycin is often becomes the first dose we have to give, I would be asking that physician an awful lot of questions about why vancomycin??? And unfortunately they have almost no other choice but to administer it….on and on the medical field goes…

Vancomycin may be overused for the treatment of hospital-acquired pneumonia, perhaps because of physicians’ perceptions that patients are at high risk for methicillin-resistant Staphylococcus aureus (MRSA). The MRSA-culture-negative patients continued to receive vancomycin for a varying duration after the culture results were known (ICAAC, 2006). Staphylococcus aureus (MRSA) and Vancomycin.

Advance Practice Registered Nurse (APRN) Role

Overview of the APRN Role

• Advance Practice Registered Nurse (APRN) Role as a teacher:

o Understanding the three domains of learning:

 Cognitive Domain: “… contextualizing and consolidating exiting theoretical knowledge….” (Hayes, 2016, p.861)

 Psychomotor Domain: the learner has retained safe practice skills when the demonstrated through repetition or “… becomes ‘second nature’….” (Hayes, 2016, p. 861).

 Affective Domain: The teacher must gage whether the learner has gained realization of the values and ethical beliefs associated with their practice

o The advanced practice nurse is trained to provide patients and families with the education and skills needed understand their health/treatment, take control of their care and to be more autonomous (Joel, 2013, p. 327)

o Provide students or new graduates with the education and skills needed to feel confident, safe and practice safely/independently

o The APRN must understand the components of teaching (Gaberson & Oermann, 2010) –

 Assess the learner (i.e. student, patient or family member/s)

 Assess the learner’s readiness to learn

 Identify the individual’s needs

 Set obtainable goals (with learners’ participation in planning)

 Monitoring the learner’s progression

 Determine if further education/teaching is indicated

• Ultimate goal:

o Gain an understanding, trusting and professional relationship with learner to better facilitate knowledge retention

o “… patients gain an understanding of their health problems and treatments, how to care for themselves at home, and health-promoting behaviors”

o Promote safe and ethical practices for new graduates/students

Advance Practice Registered Nurse (APRN) Role References

Gaberson, K., & Oermann, M. H. (2010). Clinical teaching strategies in nursing (3rd ed.) New York: Springer.

Hayes, C. (2016). Approaches to continuing professional development: putting theory into practice. British Journal Of Nursing, 25(15), 860-864.

Joel, L.A. (2013) Advanced practice nursing: essential for role development. (3rd Ed). Philadelphia: F.A. Davis, 327-330.

Hypogonadism

Draft … My original question in PICOT format was: In men, ages 45-65, with low testosterone levels, how does using intramuscular testosterone alone compare to using intramuscular testosterone in combination with subcutaneous human chorionic gonadotropin (hCG) in increasing serum testosterone levels after a 6-month treatment period. However, since creating it last week, I have decided to redefine it to: In men, ages 45-55 who present with symptoms of hypogonadism, how does using intramuscular testosterone alone compare to using intramuscular testosterone in combination with subcutaneous hCG in reducing reported symptoms after a 6-month treatment period.

Symptoms associated with hypogonadism are fatigue, loss of muscle mass, increased body fat, depression, decreased libido, and loss of night time erections. Granted, these symptoms alone may not result in a diagnosis of hypogonadism as comorbidities, such as obesity, hypertension and diabetes, must be considered (Lawrence, Stewart, & Larson, 2017).

Background questions are looking to answer general knowledge questions that often can be located in textbooks. They typically have a root question of who, what, when, where, how and why followed by the outcome of the intervention or area of interest (Colorado State University, n.d.). Foreground questions, as defined by Lawrence, Stewart, & Larson (2017), are “those that can be answered from scientific evidence about diagnosing, treatment, oe assisting patients in understanding their prognosis” (p.27).

Background questions would likely deal with the type of symptoms the patient initally reported that encouraged them to seek medical attention. Examples would be what causes fatigue and loss of energy in the aging man? What are the symptoms of low testosterone? What causes low testosterone? The symptoms associate with hypogonadism are easily located in textbooks and on the internet. The foreground questions pose the more clinical questions. An example may be, what other diagnoses may cause similar symptoms as hypogonadism? What does hCG do in the role of treating low testosterone?

Much of the evidence located initially was related to infertility in younger men. As I varied my key words for the searches, my results began to increase. The additional results were more specific to testosterone replacement in various ages and several were specific to older men. There are even fewer results that discuss the use of hCG with testosterone. The most specific article was “A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older men with Partial Age-Related Androgen Deficiency”, but it was from 2002 and did not use testosterone in combination with the hCG (Liu, Wishart, & Handelsman, 2002). I feel confident that with time and varying the key words in the searches that I will generate more appropriate results…

How management role interacts with colleagues and employees

In two or three paragraphs, assess how each management role interacts with colleagues and employees: Nursing, social services and patient care director.

Community health assessments

Needs Assessment

Community health assessments are used by health planners to identify, and prioritize health problems within a given community. To prioritize health programs and their development, a needs assessment is used. There are four types of needs that should be considered in a needs assessment. Although there is no single way to conduct a needs assessment, the basic steps to conducting a needs assessment can be identified.

Using the South University Online Library or the Internet, research about needs assessments and the types of health needs in your community. Based on your research, create a 2- to 3-page Microsoft Word document that:

Describes the four types of needs and compares them. Explains the interaction of the four types and the role of each type of need in the community assessment process.

Selects one of the four needs and provides an example of how this need can be applied to a health issue in your community. Describes the potential pitfalls of focusing a needs assessment on a single need. Provides examples to support your assertions.

Identifies and describes the basic steps of conducting a needs assessment and also explains the importance of each.

Describes any additional steps that should be considered in the assessment process.

Support your responses with examples.

Cite any sources in APA format.

Maximum Points

Described the four types of needs and compares them. Explained the interaction of the four types and the role of each type of need in the community assessment process.

15

Selected one of the four needs and provides an example of how this need can be applied to a health issue in the community. Described the potential pitfalls of focusing a needs assessment on a single need. Provided examples to support assertions.

10

Identified and described the basic steps of conducting a needs assessment and also explained the importance of each.

10

Described any additional steps that should be considered in the assessment process.

10

Presented a structured document free of spelling and gram

Evolution and Adoption of Health Information Systems

For this assignment, you are asked to perform the following tasks:

1. Describe the evolution of healthcare information technology by identifying key technological advancements in each decade, beginning with the 1960s, that had a direct impact on healthcare administrative and clinical functions.

2. Which decade do you feel was most significantly related to advances in health information systems? Please discuss.

3. Based on your own personal views, which specific law or act had the most significant advances for health information systems. Please discuss.

4. Discuss what the American Health Information Management Association (AHIMA) is and its significance to health information technology.

Your response should be at least three pages in length.

You are required to utilize your textbook and peer-reviewed journal articles from the University Online Library to complete this assignment. Make sure that you support any claims with proper sources, and appropriately cite your sources in APA format.

Public Health Problem

Understanding the health problem. A problem statement is one of the most crucial parts of your concept paper. This is the first section your audience will read, and it will set the tone for your proposed program. A well-written problem statement should include the nature of the problem, who the problem affects, the current impact of the problem, and future consequences of the problem, if left unaddressed.

Continuing with the Microsoft Word report you created in W1 Assignment 3, add 2–4 pages to the report covering the following:

Explain the public health problem your program will address using factual information.

Define the public health problem.

Describe the adverse effects of the problem on public health and well-being.

Provide detailed and specific data on the problem and the community in which the project will be implemented.

Explain the anticipated improvements in health outcomes upon successful implementation of the program.

Support your responses with examples.

Cite any sources in APA format.

Submission Details

Name your report SU_PHE4070_W2_A2_LastName_FirstInitial.doc.

Submit your report to the W2 Assignment 2 Dropbox by Week 2, Day 6.

Assignment 2 Grading Criteria

Maximum Points

Explained the public health problem to be addressed using factual information.

15

Described the adverse effects of the problem on public health and well-being.

10

Identified specific data on the problem and provided the details on the data and the community in which the project will be implemented.

10

Identified and explained the anticipated improvements in health outcomes upon successful implementation of the program.

10

Used correct spelling, grammar, and professional vocabulary. Cited all sources using APA format.

5

Total:

50

dysuria, urinary frequency and urgency

LN is a twenty-six-year-old married woman who presents at the clinic with symptoms of dysuria, urinary frequency and urgency. Further history yields two days of these symptoms but no fever, chills, or flank pain. She describes a burning discomfort during and immediately following urination and feeling the need to void every half hour. There is no vaginal discharge, itching, or odor. She is not using birth control at this time. She requests “a urine culture and some sulfa pills.” When asked to explain, she says she has had many “bladder infections” over the past three years and “sulfa pills usually work.” She was evaluated approximately five years ago with an IV pyelography and cystogram, and “nothing was wrong.” All her vital signs are normal. Answer the following questions:

What additional information would you like to collect?

What is your working diagnosis?

What are the contributing factors to this potential diagnosis?

What treatment would you implement and why?

What type of follow-up would you recommend?

Standardized Healthcare Data Set

1. Describe what a standardized healthcare data set is.

2. Compare and contrast at least three data sets used in electronic health records.

a. What are the data sets used for?

b. Where are the data sets stored/housed?

c. Are the standards governing the data sets used as part of the Department of Health and Human Services meaningful use regulations?

3. Analyse and compare administrative based data and clinical based data.

Your Standardized Healthcare Data Set response must be at least three pages in length, double spaced. You are required to use at least one outside source. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying APA citations.