Tag: Clinical-Nursing

DNP Project Proposal – Management and prevention of type 2 diabetes

INSTRUTIONS:  
DNP Project Proposal (20–35 pages, plus references) is a detailed plan for carrying out the DNP Project. The Proposal builds on the approved Premise and will be presented to the DNP Project Committee in written form .

1.Abstract

2.Table of contents

3. Section 1: Nature of the Problem

4:Introduction

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5:Background

6:Problem Statement

Provide a one- to two-paragraph statement that establishes the relevance of this problem:

1.     Summarize preliminary, supporting evidence that provides justification that this problem is meaningful and relevant to the local setting as well as the broader field of nursing practice, citing key scholarly sources.

2.     Explicitly state the gap in nursing practice or problem that will be your focus of this doctoral project

7: Problem Statement

8: Purpose Statement; 

9: Project Question

10: Framework for the Project

11: Implications for Social Change

How this will impact social change? Does this project support the mission of Walden University to promote positive social change?

12: Definition of Terms

13: Assumptions

14: Scope and Delimitations

15: Limitations

16: Significance

17: Summary

18: References

Use APA format for this prospectus. Include a minimum of five APA-formatted peer-reviewed references for all citations in the Doctoral Project Prospectus.

DNP Project Proposal – Management and prevention of type 2 diabetes

Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example

Introduction

Dementia is not a disease but a general term for the decline in mental ability which is severe enough that it could interfere in daily life, amongst all other types of dementia Alzheimer’s is the most common. At least 47.5 million people are living with dementia around the world, which is more than the population of Canada. (Alzheimer’s Association, 2015) As nurses, we work in different fields of health care and one of them is dementia care where we get to interact with older adults as well as their families. Using evidence-based practice is one of the competencies a nurse need to follow in their career. Critiquing a research can help us to be sure about the evidence and to find its weakness and strengths of the study. The purpose of this paper is to critique the research study, Mental and Physical Activities Delay Cognitive Decline in Older Persons with Dementia. This paper will be critiqued in various sections like title and abstract, literature review, framework, research question and method. (Cheng, Chow, Song, Edwin, Chan, Lee & Lam, 2014)

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Title and Abstract

The title and the abstract clearly reflects on the study. The title mentions that the age group is older adults with dementia. It also indicates the purpose being mental and physical activities delaying cognitive decline which reflects the research study. The abstract was organized and had subheadings. The first subheading was the objective of the research followed by design, setting, participants, interventions, measurements, results and conclusion.(Cheng et al., 2014) All the subheadings of the study had a summarised detail which makes it easier for the readers to know what to expect in the research. The title and abstract are short, clear, to the point and also provides an overview of the research.

Purpose

The purpose of the paper was “to examine the effects of cognitive stimulation (mah-jong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia”. (Cheng et al., 2014) The purpose of the study was clearly stated in the abstract with a heading; objective which was easy to identify. The objective of the paper does fit our case scenario of dementia with an appropriate age range. This research study has significance to nursing as future nurses working with older adults can propose to involve older adults in physical as well as mental activities that can delay cognitive decline. The introduction further elaborates on researches which involved different physical and mental activities that did not test the long-term effects.

Literature Review

The study has reviewed up to date researches and articles relevant to the paper which range from 1995 to 2012. (Cheng et al., 2014) The literature was adequately covered. The introduction refers to the different article that used similar objective of cognitive decline through physical and mental activities but the different outcome and the time period varied, some were long term were as others were short term. Further, it mentions two leisure activities conducted for this study including rationale from the reviewed articles. The introduction doesn’t have any statistical information provided. The referred articles are used to support this study and initiate a different design and method to get better results. The study refers to the latest research and also provides the rationale to the selected activities showing some delay in cognitive decline. The study hypothesized d that mah-jong and tai chi (TC) would lead to enhanced cognitive performance relative to simple handicraft as a control. (Cheng et al., 2014) The rationale and literature justify the study and is covered fair-minded.

Framework

There is no definition provided for conceptual or operation. The dependable variable is cognitive decline and the independent variable is mental and physical activity. There is three leisure activity in the study, mah-jong, tai chi (TC) and simple handicrafts. (Cheng et al., 2014) All the activities took place for one hour three times per week. Considering the population, tai chi was performed in seated position in 12 form of yang style. All the three activities are briefly explained in the subheading intervention. The section includes obtaining informed consent from the family members with an assent of the participants as well as considering ethical observations. (Cheng et al., 2014)

Method

Population and sample

The population used in this study were residents from nine nursing homes. The sampling method used was clustering and rationale to using cluster design was provided. The rationale provided was to avoid contamination within the nursing homes. (Cheng et al., 2014) The study has three experimental conditions i.e. the leisure activities conducted in all nine houses which are provided in the form of a flow diagram to make it easy to understand. There are an inclusion and exclusion criteria for the study. For the inclusion criteria assessment, Mini Mental State Examination (MMSE) was used and a score of 10 to 24 and suffering from at least mild dementia with a score of 0.5 or more by Clinical Dementia Rating. (Cheng et al., 2014) The exclusion criteria were being bedridden, someone with audio or visual impairment, and someone with participation in any of the three activities in previous 3 months or having conflicts to participate in exercise activities. (Cheng et al., 2014) The sampling and population used were appropriate for this study given the purpose of the study and the research design being randomized controlled trail. Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example.

Research Design

This is a quantitative study. This study was randomized controlled trail with clustering method and open-label design. The open-label design was not avoidable as the activities couldn’t be masked and it was not possible to prevent the participants from talking to the interviewer about the activities. (Cheng et al., 2014)  The sample population being from nine nursing home the selection was random. The research design was appropriate for this study as Cheng et al. mentions in the introduction “a randomized controlled trial is necessary for conclusions about causal effects to be made.”

Measures and data collection

Data collection for this study was done through the various tests mentioned above and through the nursing home staff that recorded on a daily log sheet measuring their participation. The participants were free to participate in activities for the other group. Mini Mental State Examination (MMSE) was used as a primary outcome. Forward and backward digit sequence, digit span, 15-word immediate and 30-minute delayed recall and categorical verbal fluency were the secondary outcomes. (Cheng et al., 2014)  The cognitive assessments and 15-item Geriatric depression scale were administered by trained interviewers. Total cholesterol, high-density lipoprotein, triglycerides, and glucose were measured by a registered nurse using calibrated portable devices. (Cheng et al., 2014) Low- density lipoprotein cholesterol was measured using the Friedewald formula. The home staff provided information on cholinesterase inhibitor use and diagnosed coronary heart disease, stroke, hypertension, diabetes and chronic obstructive pulmonary disease. (Cheng et al., 2014) The study also measured APOE4; a genetic predisposition for Alzheimer disease along with depression and chronic illness. (Cheng et al., 2014) All the outcome measures were obtained at baseline for 3, 6, and 9 months. Throughout the study, the assessment was thoroughly done and presented in a flow chart. The flow chart presents data about the study and also mentions the sample size at baseline, at 3, 6 and 9 month. The above-mentioned test, scale and method for measurement were appropriate and suitable for the study.

Data Analysis

As mentioned before, the study hypothesized mah-jong and tai chi (TC) would lead to enhanced cognitive performance relative to simple handicraft as the control. (Cheng et al., 2014) The subheading “statistical analysis” in the study has clear steps of proving the hypothesis. The steps are easy to follow and do prove the hypothesis. The data used statistical methods to prove the hypothesis and provided 95% confidence interval to support their data. The data was analyzed using the computer program called Stata version 11.1. (Cheng et al., 2014) Since the nursing home staff were recording the participant’s activities bias should be eliminated. Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example.

Results

Findings

The subheading results in this study is easy to follow and clearly states the findings from the study. At baseline, all the all the groups had no difference, but as time progressed people with lower APOE4 had lower word list recall and MMSE. By 6 and 9 months, there were  significant difference among the group. (Cheng et al., 2014) At 9-month assessment, tai chi showed significantly difference on the forward digit span measure. (Cheng et al., 2014)There were no effects measured for verbal memory and digit backward memory for tai chi as well as mah-jong. The findings are further summarized into a table which provides clear and easy to understand information. The table has all the various assessment, tests, method and scales and the scores which makes it easy to refer and find the results. The primary outcome measuring MMSE score showed difference between mah-jong, tai chi and simple handicraft. Over the 9-month period time, the simple handicraft group dropped scores whereas mah-jong and tai chi gained points resulting in proving the hypothesis true. (Cheng et al., 2014)

Discussion

There is a table in the discussion section which displays results of mixed effect regression which is grouped into columns of MMSE, verbal immediate recall, verbal delayed recall, categorical fluency, digit forward span, digit forward sequence, digit backward span and digit backward sequence. (Cheng et al., 2014) The regression shows 95% interval confidence and the p-value. This makes it easy to guess if the hypothesis is true or not. There are boxplots presenting information regarding forward digit sequence, forward digit span, and MMSE. The discussion was clear and to the point, and summarized the result finding without numbers. The discussion further discusses the results comparing with another research study to establish the importance of this study. Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example.

Recommendations and study limitation

There are no recommendations given in the study, but the subheading following results is study limitation which gives the readers an insight of the study limitations faced during the study. Few of the limitations faced during the study were lack of blinding, participants being recruited for activities leading to a possible selection bias. (Cheng et al., 2014) Even after having all these limitations, the nursing homes were dedicated and helped towards the study. The study limitations basically summarize barriers they faced during the study. Even though the study was not conducted in Canada or U.S it is relevant to the topic as the method and techniques were appropriate.

Conclusion

The study is clear and precise to the point, there are a lot of things that could be added to the study to enhance the information like statistics of dementia, global issues, implication, and recommendations. The lack of these sections doesn’t make the study weak in any manner. The information provided in this study can be used to support a presentation and also used as a credible resource to back up the presentation. After critically analyzing this study, the paper can be used as a source of evidence as the findings are logical and clearly presented that is easily understandable. The paper does provide a lot of information regarding physical and mental exercise to delay cognitive decline.

Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example

 

 

 

References

Alzheimer’s Association (2015) What Is Dementia? (n.d.). Retrieved from http://www.alz.org/what-is-dementia.asp#

Cheng, S-T., Chow, P., Song, Y-Q., Edwin, Y., Chan, A., Lee, T., & Lam, J., (2014) Mental and physical activities delay cognitive decline in older persons with dementia. American Journal of Geriatric Psychiatry. 22, 63-74. Retrieved from: http://dx.doi.org.login.ezproxy.library.ualberta.ca/10.1016/j.jagp.2013.01.060

Effects of cognitive stimulation and physical exercise on cognitive performance in persons with dementia essay article review example

Free Evidence-Based Practice Model Example Essay Paper

Evidence-Based Practice Model Selection

Evidence-based practice (EBP) is a process of taking knowledge and converting it into the delivery of care (Schaffer, Sandau, & Diedrick, 2013).  Most nurses know that EBP improves the quality of patient care in a cost-effective manner.  Most nurses want to base their patient care decisions on the best evidence available (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012).  It takes more than this knowledge and desire, however, to implement EBP into clinical nursing practice.  Multiple barriers exist that make the realization of EBP challenging.  These roadblocks include inadequate financial support, limited resources, inadequate computer skills, dissatisfaction with supervisors’ assistance in participating in EBP, absence of an academic degree, and unclear and unrealistic workplace goals (Kajermo et al., 2008; Melnyk et al., 2004).  More recently, Melnyk et al. (2012) identified other barriers such as lack of education, inadequate access to information, and time to implement and use EBP.  In 2001, the Institute of Medicine estimated that translating research evidence into clinical practice takes over 17 years.  Even 13 years later, the process is lengthy and full of hurdles (Brown, 2014).  Evidence-based practice models are tools that health care organizations can use to overcome the challenges.

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Evidence-Based Practice Model Selected

Multiple theoretical models have been developed to help turn research discoveries into clinical practice and assist organizations to implement evidence-based practice into their routines. In organizational settings, leadership must decide which evidence-based changes to make and how to do it.  These models present a methodical approach and break the complex process into smaller steps.  Using these models enhances the chance of success, promotes complete implementation, improves resource allocation, and provides a mechanism to evaluate outcomes (Schaffer, Sandau, & Diedrick, 2013).

The Iowa Model of Evidence-Based Practice to Promote Quality Care (Titler et al., 2002) is one such conceptual model that has been used in numerous academic and organizational settings to facilitate the implementation of EBP (Gawlinski & Rutledge, 2008).  Multiple facilities have documented its success and value.  The Iowa Model utilizes an algorithm with decision points and feedback loops (Schaffer, Sandau, & Diedrick, 2013).  Within the algorithm is a feedback mechanism that helps question current practices and determine if evidence exists that can improve those practices.  The model can focus efforts based on either observed problems or new knowledge (White & Spruce, 2015).

After reviewing other EBP models, the Iowa Model was chosen as the best way to explore new triage methods that could improve patient flow through the emergency department.  Many reasons support this decision.  First, the Iowa Model works well with organizational change (White & Spruce, 2015).  Second, it focuses on an interdisciplinary approach.  The Iowa Model uses input from a team that represents the system in question and collaborates to implement EBP (Schaffer, Sandau, & Diedrick, 2013).  Emergency department processes involve multiple disciplines that work closely together- physicians, nurses, ancillary departments, and administration.  A model that depends on the collaboration of many is a logical choice.  Third, Gawlinski and Rutledge (2008) describe the Iowa model as being intuitively understandable or, in other words, user-friendly.  Finally, the Iowa model is attractive because it allows a trial run of the proposed change before final implementation (White & Spruce, 2015).

The Iowa Model and Improving Emergency Department Patient Flow

Applying the Iowa Model will facilitate the implementation of an evidence-based triage system in the emergency department.  The algorithm in the model has three decision points.  The first decision point is to determine whether the topic is a priority for the organization.  Some topics are triggered by knowledge while some are triggered by problems.  Implementing a new, evidence-based triage model is a priority for the organization, which has been brought to light because of the emergency department crowding issue.  Therefore, the next step is to form an interdisciplinary team (Titler et al., 2002; White & Spruce, 2015).

The team should consist of all interested stakeholders, representatives of every discipline that is directly involved in the EBP implementation (Titler et al., 2002).  It is well documented that change is more successful when initiated by frontline practitioners rather when management imposes it on them (Doody & Doody, 2011).  For the emergency department, the team will include direct patient care nurses, the nurse manager, the nurse educator, a physician, a nurse practitioner, nurses’ aide, and a patient registrar.

According to the Iowa Model, the team is first tasked with searching for evidence (Titler et al., 2002).  They should brainstorm together and determine key words for database searches regarding triage models.  This literature search should include research evidence and existing evidence-based guidelines.  For emergency medicine, there are multiple professional organizations and governmental agencies that have studied triage models.  After evidence has been gathered, the team needs to critique and synthesize the evidence.  If members of the team are not experienced with literature searches and assessing the strength of evidence, they should enlist the help of someone in their organization who is (Titler et al., 2002).  Ideally, the team will find pre-appraised research, systematic reviews, and even guidelines that have already been developed for triage systems.  Existing guidelines will help the team identify gaps in knowledge (White & Spruce, 2015).  This work brings the team to the next decision. Free Evidence-Based Practice Model Example Essay Paper.

The second decision point in the algorithm is whether there is enough evidence to guide evidence-based practice.  If the team believes there is a sufficient amount of quality research evidence on triage models, they can move on to piloting an evidence-based change.  If they do not have a solid research base, they may decide to proceed using other types of evidence, such as case studies, expert opinion, scientific principles, or theory.  Alternatively, the team may choose to conduct the research that is lacking (Titler et al., 2002).

If the team proceeds with the development of a new triage model, the next phase is to pilot the change in practice.  There are six steps to follow at this stage.  First, the desired outcomes should be determined (Titler et al., 2002).  Modifying triage is an attempt to improve patient flow through the emergency department; therefore, potential outcomes to measure might be length of stay, time it takes until a patient sees a physician, or number of patients who leave without a physician assessment.  The second step is to obtain baseline data; measure the outcomes before implementing change (Titler et al., 2002).

The third step is to develop the written guidelines that establish the new process and protocols for triage.  The fourth step involves testing the new process on a sample of patients.  In the emergency department, the team could decide to test the new triage process for two weeks, or they could use the new process on alternate days for a month.  Regardless, this step involves training all of the personnel involved and communicating the expectations well.  The fifth step is to evaluate the new process by comparing the outcome measures to the baseline data obtained in step two.  This establishes if the new process affected patient flow positively.  Finally, the last step includes modifying the guidelines based on the outcomes.  It is possible that the team needs to tweak the process based on an unexpected factor or a specific need of this particular emergency department that was not foreseen (Titler et al., 2002).

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Conclusion

In today’s health care environment, it has never been more important to practice evidence-based care.  Nurse leaders have a responsibility to ensure that high-quality care is delivered in a cost effective way, and EBP leads to improved health care and lower costs.  The Iowa Model of Evidence-Based Practice to Promote Quality Care “serves as a guide for nurses and health care providers to use research findings for improvement of patient care” (Titler et al., 2002, p. 498).  The Iowa Model will be especially useful in directing the implementation of a new triage process to improve emergency department patient flow. Free Evidence-Based Practice Model Example Essay Paper.

 

 

 

 

 

 

References

Brown, C. G. (2014). The Iowa model of evidence-based practice to promote quality        care: An illustrated example in oncology nursing.
Clinical Journal of Oncology Nursing, 18
(2), 157-159. Retrieved from            
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Gawlinski, A., & Rutledge, D. (2008). Selecting a model for evidence-based practice   changes: A practical approach.
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, 291-300.       doi:10.1097/01.AACN.0000330380.41766 .63

Doody, C. M., & Doody, O. (2011). Introducing evidence into practice: Using IOWA      model.
British Journal of Nursing, 20
(11), 661-664. Retrieved from            
http://www.researchgate.net/publication/51466031_Introducing_evidence_into_n
            ursing_practice_Using_the_IOWA_model

Institute of Medicine. (2001).
Crossing the quality chasm: A new health system for the       21st century
(pp. 8-25). Washington, DC: National Academies Press. Retrieved        from http://www.nap.edu/read/10027/chapter/1

Kajermo, K. N., Undén, M., Gardulf, A., Eriksson, L. E., Orton, M. L., Arnetz, B. B., & Nordström, G. (2008). Predictors of nurses’ perceptions of barriers to research         utilization.
Journal of Nursing Management, 16
(3), 305-314. Retrieved from    10.1111/j.1365-2834.2007.00770.x

Melnyk, B. M., Fineout-Overholt E., Fischbeck, F. N., Li, H., Small, L., Wilcox, L., &      Kraus, R., (2004). Nurses’ perceived knowledge, beliefs, skills, and needs         regarding evidence-based practice: Implications for accelerating the paradigm   shift.
Worldviews on Evidence-Based Nursing, 1
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Melnyk, B.M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state   of evidence-based practice in US nurses: Critical implications for nurse leaders  and educators.
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Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models    for organizational change: Overview and practical applications.
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Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., …    Goode, C. J. (2002). The Iowa Model of evidence-based practice to promote  quality care.
Critical Care Nursing Clinics of North America, 13
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White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice    guidelines using the Iowa Model of Evidence-Based Practice.
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White, B. A., Brown, D. F., Sinclair, J., Chang, Y., Carignan, S., McIntyre, J., &   Biddinger, P. D. (2012). Supplemented triage and rapid treatment (START)   improves performance measure in the emergency department.
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Sample Older Adult Assessment and Comparison Essay – Alzheimer’s Disease and Chronic Obstructive Pulmonary Disease (COPD) Paper

Older Adult Assessment and Comparison Paper

Introduction

Pushing limits in health care, creating awareness, educating the community of older persons and the setting of goals by
Healthy People 2020
we are going to see a tremendous number of people over the age of 65 living longer.  With the increased life expectancy comes greater demand of care for this population due to the increased needs that are going to be identified.  Not only does this put increased burden on health care to find the resources, knowledge and expertise to care for this population, but it makes this population more vulnerable to adverse outcomes.  The older population when looking at authors Flaskerud and Winslow’s Vulnerable Populations Conceptual Model addresses this population’s increased risk of vulnerability related to their health status, relative risk factor, and resource availability (Allender, Rector, & Warner, 2014).

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            As one ages they are typically exposed to more risk factors that may negatively impact their health.  Their health may suffer from those risk factors or lack of care related to the availability of resources or lack of that they have had throughout their life thus far.  As one’s health declines not only do they need resources to be treated, but they need transportation, support, financial means, and so forth.  These resources are scarcer due to the increased demand there are just not enough, and the older population in many cases are retired with little knowledge of how to access the resources that are available to them.  This population is only growing and needs education on primary, secondary, and tertiary prevention methods, in addition to resources available and help accessing them.

 

Older Adult Assessment Tools

With my Grandpa John we went through a few of the Older Adult Assessment Tools to establish what additional resources that he might need and interventions that we could implement together to better keep him safe.  Upon completion of the UW Elder Initiative Basic Older Needs Assessment I established that my grandpa is in need of many resources and is putting a lot of strain on my grandma to care for him.  From the assessment I found that grandpa was diagnosed with late onset Alzheimer’s disease and COPD which he has had for years and is taking a few new medications that my grandma is administering.  Neither of them are educated on what they are or how these medications work.  Currently he is becoming more frail and deteriorating quickly.  Now he is functioning like he is 20 years old, which was when he was an alcoholic.  So he has experienced many personality changes recently, which is very upsetting to grandmother.   He has become more violent, with outbursts; he is angry and often restless.

His functional limitations are starting to waiver from day to day.  Occasionally my grandfather needs assistance using the restroom and ambulating, but it is not a constant thing, neither are his outbursts.  When it comes to meal preparation, house work, paying bills, and transportation my grandfather is not able to do any of that.  He is still able to feed himself, dress, bath and participate in his normal hygiene routines it just takes him longer than it used to.  My grandpa is retired and has been for about 15 years, my grandparents are just above the poverty line, but our family just helped them pay off their house.  They are on Medicare and my family assists them with food and any other bills.  Overall my grandpa said that my grandma does everything, but my grandma stated that she does that now but knows she can’t do it forever.  My aunts have been taking turns going over during the week and driving my grandparent’s places, helping with chores, and making meals.  From this assessment though my grandpa needs more help than what my grandma can give him, it is starting to take a toll on her health.

After completing the Fulmer SPICES: An Overall Assessment Tool for Older Adults with my grandfather I noticed it was more vague than the UW Eldercare Needs Assessment.  Going through it with my grandpa I found that he occasionally has problems with eating and feeding, incontinence, and confusion.  So from this understanding my grandpa is experiencing a few geriatric syndromes according to authors Inouye, Studenski, Tinetti, and Kuchel (2007).  Urinary incontinence and functional decline are both present currently which are predicted to only become more of an issue in time because of his Alzheimer’s diagnosis and rapid progression.  Furthering that notion he has been experiencing minor issues with mobility that may become major problems increasing his risks for falls, which is another geriatric syndrome (Inouye, et al, 2007). This area of prevention has been discussed with my grandmother and my aunts.  My grandpa told me that his confusion comes with change in his patterns and new people.  So all of these limitations are not an everyday thing, but are beginning to happen more frequently.  He told me that he had no evidence of skin breakdown after I explained what that was to him.  This is a potential geriatric syndrome to watch for due to his decreasing mobility that may eventually lead to limited or no mobility (Inouye, et al, 2007).  We talked about that and how to avoid it, my grandma was present when we talked about this.  He has also had no falls and is not experiencing any sleeping issues that he only gets up at night if he has to use to restroom.  This is also where the incontinence comes from he does not always make it to them bathroom in time or at all at night.  So we talked about not drinking any fluids about an hour before bedtime and using the bathroom before getting into bed to help with this.

Next I went over the Family Assessment Tool while talking with my grandpa John.  I included my grandpa and grandma in the family constellation because they are living together within the home and my grandma is doing most of the care for my grandpa as needed.  I answered the questions based on my own judgments from the conversations that we had throughout the day.  The first category is Facilitative Interaction among Members, overall there communication with one another is good, but I would say that they need work on resolving conflicts and being supportive of one another.  My grandma is trying to be very supportive, but is struggling from caregiver strain which is causing the conflicts.  She just needs help; it is getting too overwhelming for her to do most of the care by herself.

In the Enhancement of Individual Development I noticed that my grandma is not quite accepting of my grandfather’s total diagnosis and neither is he.  Due to this lack of acceptance my grandpa is not always acknowledging certain tasks he should not be involved in because they stir up confusion and my grandma is then over bearing trying to do too much and taking away the autonomous activities that he should be doing to keep them intact as long as he can.  In the Effective Structuring of Relationships decision making is being allocated to appropriate members for the most part, but my grandma is not distributing tasks to my grandpa flexibly.  Both of my grandparents are not actively coping properly.  They are not making all the necessary changes due to lack of acceptance of the change being needed; they are not utilizing resources neither are they accepting new ideas and proposals from others about help.  The living conditions are safe and hygienic my aunts have gone over to the house and organized the house for clear paths and to help prevent falls.  They also take turns cleaning the home.  The emotional climate is unsteady at times though with my grandpa’s outburst and my grandma’s caregiver strain.

Overall my grandpa likes to take walks, but my grandma is not always accepting of this because she is afraid something bad will happen.  This is an intervention that we discussed is healthy for both of them, but that could be done with my aunts or other neighbors if she does not feel comfortable walking with him by herself.  Overall my grandparents have very little links with the community the moved from Florida two years ago and have not connected with the community where they live now.  They also lack any information and education about community resources and involvement.  My aunts and I have discussed the importance of them getting involved especially my grandma so she makes some connections and friends to cope better if my grandpa does pass away soon.

When I got to the CDC Check for Safety A Home Fall Prevention Checklist my grandparents recognized it already.  I told them that we were going to go over it and they said that my aunt got it from the doctor and went over it with her.  So we talked about and checked to make sure everything was still up to date on it.  All of their rooms are very open, the floors are clear and the furniture is out of the way of their paths.  They do have non-skid rugs on the floor because they have wood floors, which I discussed that they should be wearing non-skid socks or non-slip shoes if they are walking around the house then.  They only have steps on the outside of their home; the house is a one story.  The stairs outside are in good condition, cement newly poured, with no debris, and two handrails on either side.

My grandma does utilize the high shelves in her kitchen, but said she just got a new stepping stool.  I still discussed with her possibly moving the common items that are up high to move down to lower areas.  They already have non-slip rugs in the bathroom, but are in need of grab bars for the shower and the toilet.  We discussed this with my Aunt Julie and her husband was going to come over and install those.  They have night lights all over the house and both of my grandparents have easy to reach lighting near the head of their bed.  As we already discussed walking is important and my grandpa likes doing that so having my aunts come over and help them do that a few times a week if not every day is important.  Both of my grandparents have glasses and get their vision checked yearly, and I discussed medication with my grandma for better understanding.  I am glad we went over this because they were in need of grab bars, but other than that they were up to date with everything else.  This did prompt our family also though to consider looking into getting them an alarm device in case they fall and are not able to get up and call anyone.  I left a copy of this checklist with them in case, so that they could go over it whenever they had any changes just to be safe. Sample Older Adult Assessment and Comparison Essay – Alzheimer’s Disease and Chronic Obstructive Pulmonary Disease (COPD) Paper.

Next I went through the Improving Independence in the Home Environment: Assessment and Intervention Tool and discussed possible interventions with my grandpa.  In the bathroom potential problems are the toilet getting up and in the shower not having railings so increasing the risk of falls.  As discussed before my uncle is going to come over to the house and install grab bars in the shower and in front of the toilet.  In the bedroom and throughout the house the flooring is wood, so non-slip rugs have been placed, but wearing non-slip shoes with rubber soles or socks with rubber grips needs to be done as well.  Medications are also an issues with my grandpa he can’t read the bottles because the print is too small and he has some memory loss.  He gets confused when it comes to his medications so my grandma usually deals with that. However I wrote out the instructions of his medications, common side effects, and when to take them so that he could read it.  I also instructed him that he could use a magnifying glass, which they already have.  I educated my grandma on his medications as well as hers because including the caregiver is just as important, especially since she is able to explain his medications to him whenever he may be confused and forgets about his medications (Marck, et al, 2010).  I made sure that they both were aware of what they were taking, why they were taking it and the side effects of their medications.  After the assessment I was able to identify where the main medication issues were and found that it was when to take each medication (Marck, et al, 2010).  To make it easier for my grandma and help my grandpa be more independent of his care I organized a weekly pill box and sorted of his medications for days and times to ensure they were taken properly.  I talked with my aunts and they are going to refill the medication box when they go over every week.  My grandma was also instructed on how to do this if one of my aunts wasn’t able to make it over during the week.

In the kitchen when carrying items I instructed my grandpa to slide stuff across the counter as much as possible.  If they have anything really heavy or hard to manipulate I instructed my grandparents to call someone to come and help them not to move it themselves.  There is also one very low chair located in the living room that my grandpa loves to sit in.  I put pillows on the seat of it to raise it up to make it easier for him to sit and get up.  He said this helped him; he is over six feet tall so I’m sure it helped a little.  I also explained to him to use the armrests to help him when he is getting up.  My grandpa has some hearing loss so it is hard for him to hear everything; the phone, television, and alarms.  So I talked with my grandpa and aunts about getting him hearing aids and in the meantime found a ringtone that he could hear better than others.  We also preset numbers on the phone for my aunts, emergency numbers, and my dad to make it easier when they need to call someone.  For the alarms we also discussed having my uncle install alarms that have lights to help alert my grandpa.  We talked about the front door being difficult for my grandpa to identify people, but my grandma said this was due to confusion and memory loss and that an intercom wouldn’t help.

From the information gathered in the Assessment Tools my grandpa is in need of a few referrals and attention to CDC guideline regarding physical activity was addressed.  I recommended that my grandpa get his hearing checked out, I definitely believe that he would benefit from hearing aids and I collaborated with family to get this done.  In addition according to the Center for Disease Control people over the age of 65 years old need 150 minutes of moderate exercise (ie. walking) a week and need muscle strengthening 2 or more times a week. Throughout the assessments we did discuss walking with neighbors or my aunts when they come each week to get this exercise in.  My grandpa likes doing it; it is just a matter of coordinating it with someone who is able to walk with him safely.  The muscle strengthening could be done with a trainer at a gym in the community.  My aunts attend the YMCA so I discussed possibly taking him twice a week, he would need to take it slow so working with someone who is trained would be safer for him (CDC, 2014).  According to
Healthy People 2020
maintaining social relationships and interactions is very important for elderly with Alzheimer’s in order to keep them functioning optimally for as long as they can.  Keeping the client engaged in their activities of daily living is also very important so I discussed this with my grandma so that she will allow him to do as much as he can on his own (
Healthy People 2020)
.  I asked my grandparents to think about hobbies or something that they liked that they would be interested in doing in the community and they both stated they would rather just go to the gym as previously discussed.  My grandpa was recently in the hospital and at that time he received the pneumococcal and influenza vaccines.  He is up to date on his immunizations according to the CDC however; my grandma is not up to date which could put both of my grandparents at an increased risk.  I educated my grandma on this and she told me she doesn’t like needles.  I explained they didn’t hurt much and that it is more important to get vaccinated then not.  So she agreed to get her vaccinations the next chance she got, so I then discussed this with my Aunt Julie who usually takes my grandparents to the doctors.

Compare and Contrast

           
PACE, Transition, and NICHE are all Models of care aimed at improving persons over the age of 65’s care.  They all established resources to help the older population with chronic diseases receive care in the community and set goals to make sure that care was more than adequate.  All of the Models focus on innovative evidence based clinical practices and have continued education opportunities as well as continued research efforts in geriatric care.  In addition all of the Models are in different stages of operation and are paid for differently.  The PACE Model is paid for by Medicaid, Medicare, and grant funding (National PACE Association, 2002).  The NICHE Model is paid for by hospitals that chose to use incorporate this education model into their practice and the Transitional Care Model is paid for individually or few through the Affordable Care Act’s Pilot funding (Initiative on the Future of Nursing, 2011).  These Models focus on different care providers in specific.  PACE discusses more physicians as providers, whereas the other two models focus more on nurse’s role in geriatric care.

The PACE Model of care is an all-inclusive approach that looks at all aspects of care that the older population may need while still in the home, or in facilities within the community.  In addition this model focuses on keeping the client within the home although they must qualify for needing nursing home care in order for PACE to work with collaborating community services for the client (National PACE Association, 2002).  The PACE Model focuses on preventative care versus acute care so that the client may stay within the home for as long as possible.  Whereas NICHE is a model aimed at patient centered care of the older population in the hospital setting.  NICHE established the Geriatric Resource Nurse model to educate staff nurses on geriatric cases so that they can be the resource nurse for their entire floor (NICHE, 2014).  This is the most frequently used NICHE Model, which has helped improve the older population’s patient outcomes and satisfaction with their hospital stay.

In addition NICHE also developed the Acute Care of the Elderly Patient on a Medical Surgical Unit model.  This model commonly known as ACE focuses on patient centered care of older populations trying to prevent further geriatric syndromes and educate nurses on geriatric care to improve the elderly client’s outcomes (NICHE, 2014).  While the NICHE Model focuses on hospital care of the older population the Transitional Care Model focuses on the discharging and reintegration of the older client going home from the hospital. This model identifies what needs the client has when transitioning from the hospital to home collaborating care within the community to meet these patients’ needs so that they can stay out of the hospital.

While all three models PACE, NICHE, and Transitional Care focus on education of the older population and meeting the diversity of their needs, each of these models focuses on education within certain ranges of care.  The PACE Model focuses on care of the older population prior to hospitalization or chronic health issues flaring up, thus this is primary prevention.  This model though also focuses on secondary and tertiary prevention when clients are admitted to nursing homes or hospitals.  The NICHE Model focuses on education during the acute phase of the disease, or while the older client is in the hospital receiving care so this is secondary prevention.  Then the Transitional Model focuses on tertiary prevention through educating the client and family on recognizing symptoms that may lead to further complications.  This is done to prevent further readmissions to the hospital while encouraging active participation and compliance with the designed plan of care.  Each of these Models discussed promote transitions into care of the next model.  The PACE Model if necessary transitions those older populations to move into the nursing home or be hospitalized, then provides the collaboration of care within those settings. Whereas the older population receiving care within the hospital moves out of the NICHE Model into the Transitional Care Model upon discharge.  Those Models at the end of care overlap tasks with one another.

Each of the models focuses on different guidelines that suite there area of implementation.  The PACE Model focuses on guidelines and recommendations for common chronic issues that the geriatric population experiences.  The PACE Model Practices are; diabetes mellitus, chronic heart failure, chronic kidney disease, and obstructive pulmonary disease (National PACE Association, 2002).  These model practices have guidelines for PACE physicians to use when planning treatment and prevention strategies.  Guiding Principles for the NICHE Model are hospital focused which include; geriatric evidenced based bedside care, patient family centered environments, healthy and productive practice environment, and metrics of quality.  Then the Transitional Care Model focuses on a continuum of care from screening, managing symptoms, then collaborating and coordinating care of these clients (Initiative on the Future of Nursing, 2011).

After reviewing the different models the one that I find most appropriate in using with my older adult is the PACE Model.  I found that this would be the most affordable, but would also provide more benefits for my older adult because it is an all-inclusive approach.  This model focuses on keeping the client within the home for as long as possible, which I feel would be best for my older adult overall.  Providing primary prevention to prevent further complications would be important to prevent my older adult from being admitted to the hospital.  These include staying hydrating, eating healthy and avoiding falls as we discussed during our assessment.  It would focus on the health issues that he currently is experiencing with his Alzheimer’s.  This would be beneficial in ensuring medication compliance and that my older adult is getting his medications and medication box refilled as needed every week.  It would also follow through with his care if he transitions to a nursing home at some point, which I do believe will happen at some point due to the caregiver stress and inability to care for his increasing health demands.

Conclusion

Upon using the multiple assessment tools with my older adult I was able to find which assessment tool yielded better information from my older adult.  The UW Eldercare Needs Assessment Tool helped me identify all of the issues that were established within the other assessment tools.  From the open ended questions used in the UW Eldercare Needs Assessment my older adult went more in depth than with the other assessment tools.  However the other assessment tools were beneficial in identifying interventions appropriate for my older adult.  In addition from doing the comparison of the three models of care; PACE, NICHE, and Transition I found that the PACE Model best met the needs of my older adult.  This assignment helped me identify priority safety issues that needed to be addressed immediately with my older adult.  It also brought up educational opportunities and made me aware of the future care needs that my grandfather is going to need.  Overall this assignment furthered my knowledge on older adult assessments, needs and resources available to them.

Sample Older Adult Assessment and Comparison Essay – Alzheimer’s Disease and Chronic Obstructive Pulmonary Disease (COPD) Paper

 

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References

Centers for Disease Control (CDC). (2014).
Adult Immunization Schedules.
Retrieved from http://www.cdc.gov/vaccines/schedules/hcp/adult.html

Centers for Disease Control (CDC). (2014).
How much physical activity do older adults need?
Retrieved from http://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

Healthy People 2020. (2011b).
Dementias, including Alzheimer’s disease.
Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=7

Initiative on the Future of Nursing. (2011).
The Transitional Care Model.
Retrieved from http://www.thefutureofnursing.org/resource/detail/transitional-care-model

Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept.
Journal of American Geriatric Society, 55
(5), 780-791. doi: 10.1111/j.1532-5415.2007.01156.x

Marck, P. B., Lang, A., Macdonald, M., Griffin, M., Easty, A., & Corsini-Munt, S. (2010). Safety in home care: A research protocol for studying medication management.
Implementation Science
,
5
43-51. doi:10.1186/1748-5908-5-43

National PACE Association. (2002).
What is Pace?
Retrieved from http://www.npaonline.org/website/article.asp?id=12&title=Who,_What_and_Where_is_PACE?

NICHE. (2014).
The NICHE Program.
Retrieved from http://www.nicheprogram.org/program_overview

Sample Older Adult Assessment and Comparison Essay – Alzheimer’s Disease and Chronic Obstructive Pulmonary Disease (COPD) Paper

Walden NURS6501 Quiz Questions and Answers

Question 1

A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

Question 2

A 4-month-old female is diagnosed with atopic dermatitis (AD). Which of the following assessment findings by the nurse will most likely support this diagnosis?

Question 3

A patient has chicken pox. How does the varicella replicate?

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Question 4

A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?

Question 5

When bacterial pathogens enter a patient’s body, they can defend themselves from an immune response by:

Question 6

In discoid lupus erythematosus, skin lesions may be accompanied by Raynaud phenomenon, which is manifested by:

Question 7

When trying to distinguish between an infectious disease and noninfectious disease, what is the hallmark symptom for most infectious diseases?

Question 8

When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers this disease is an example of:

Question 9

The incidence of fractures of the pelvis is highest in:

Question 10

A 5-year-old female was diagnosed with seropositive juvenile rheumatoid arthritis (RA). The treatment option for this disease is termed:

Question 11

A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?

Question 12

A 4-month-old female develops white spots and shallow ulcers in her mouth. Her pediatrician diagnoses her with thrush. This condition is caused by:

Question 13

The pathophysiology student would correctly identify the etiologic agent of smallpox as:

Question 14

Copy of A 5-year-old female was diagnosed with seropositive juvenile rheumatoid arthritis (RA). The treatment option for this disease is termed:

Question 15

For a patient with candidiasis, which factor will exacerbate the condition?

Question 16

A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:

Question 17

An 8-year-old female presents with edema of the cutaneous and mucosal tissue layers. Her mother reports that the condition is recurrent and seems to occur more often during stressful situations. The child is diagnosed with hereditary angioedema. Which of the following is deficient in this child?

Question 18

Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:

Question 19

When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

Question 20

A 35-year-old male is diagnosed with a hormone-secreting tumor of the adrenal medulla. He experiences elevated blood pressure, pupil dilation, “goose bumps,” and increased anxiety. Which of the following hormones is the predominant one released by the tumor?

Question 21

A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

Question 22

A 35-year-old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response?

Question 23

After teaching about stress, which information indicates a correct understanding of stress?

Question 24

0 out of 1 points

While planning care, a nurse recalls seasonal allergic rhinitis is expressed through:

Question 25

Which of the following individuals would be at greatest risk for an opportunistic infection?

Question 26

A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?

Question 27

A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the following is of concern for this patient?

Question 28

During inflammation, the liver is stimulated to release plasma proteins, collectively known as:

Question 29

A 3-year-old is making play cakes in a sandbox and is eating the play cakes. The sand was also being used by cats as a litter box and was contaminated with toxoplasmosis. Which of the following would most likely also be present?

Question 30

A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

Question 31

A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have spread to local lymph nodes. A nurse realizes this cancer would be documented as stage:

Question 32

A child fell off the swing and scraped the right knee. The injured area becomes painful. What else will the nurse observe upon assessment?

Question 33

A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child’s parents suffer from allergies. Which of the following terms would be used to classify the child?

Question 34

A nurse recalls an example of an immune-complex-mediated disease is:

Question 35

A 65-year-old female is diagnosed with metastatic breast cancer. She has developed muscle wasting. Which of the following substances would be produced in large quantities to eliminate the tumor cells and cause muscle wasting?

Question 36

When histamine is released in the body, which of the following responses would the nurse expect?

Question 37

An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?

Question 38

A 30-year-old female presents to her primary care provider reporting fatigue, excessive sweating, and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into the category of type _____ hypersensitivity.

Question 39

Which of the following patients would be at greatest risk for basal cell carcinoma?

Question 40

A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?

walden nurs6501 quiz questions and answers

Seasonal allergies and congestive heart failure essay

Consider this scenario:

Mr. Johnson is a 70 year male patient who is seen in your office for seasonal allergies
and congestive heart failure. He denies chest pain, but does admit to tightness when he breathes. Mr. Johnson says he was admitted to the hospital last month with pneumonia.

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Today, he is complaining of chest congestion with a productive cough. His vital signs are BP-168/100, P-120, R-24, T-101.3F.

Mr. Johnson has an Albuterol inhaler he uses for his asthma and he takes an ACE inhibitor for congestive heart failure.

What are some of your concerns for this patient? What may be causing his chest congestion? Do you think he has an infectious illness? Why or why not? Make sure you include sources in APA format in your response. Include sources in APA citation in your response.

NURS561 Essay Assignments Week 1 discussion

Discussion 1

This discussion prompt refers to the Pathways to Safer Opioid Use simulation.

After participating in the Pathways to Safer Opioid Use simulation exercise, reflect on the following.

Have you empowered a patient to believe they could make needed lifestyle modifications irrespective of the barriers that exist in their environment? Please provide examples. If so, you were engaged in health promotion activities as part of your nursing role.

Where there any strategies used in this simulation exercise that you use to improve patient health literacy? Are there any that you use that were not mentioned here? In your experience, how effective are these strategies?

What are some of the biggest challenges you encounter when trying to improve health literacy? What solutions can you offer to manage these challenges?

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Discussion 2

Choose two emerging populations, such as Latino/Hispanic Americans, Asian Americans/Pacific Islanders, or Black/African Americans. How do health issues differ between the two populations?

Week 2 discussion

Discussion 1

How should you respond if your health promotion values conflict with a client’s values?

Discussion 2

What ethical issue have you recently encountered when teaching health promotion strategies to a patient? What ethical decision-making process did you use?

Week 3 discussion

Discussion 1

How should you use Gordon’s Functional Health Patterns to assess individual health? What health screening interventions do you regularly participate in?

Discussion 2

What family characteristics may contribute to potential or actual dysfunctional health patterns?

Week 4 discussion

Discussion 1 Watch the Ted Talk video,

What if our health care system kept us healthy?

Watch Video

Rebecca Onie: What if our healthcare system kept us healthy?

Duration: (16:35)

User: TED – Added: 6/12/12

What role does your facility play in keeping people healthy? Would the Health Leads program work in your facility? Why or why not?

Discussion 2

How do the nutrition and fitness goals in Healthy People 2010 compare to those in Healthy People 2020?

Week 5 discussion

Discussion 1

What resources do you use to determine safety and effectiveness of complementary and alternative medicine?

Discussion 2

Discuss some of the psychophysiological aspects of stress. Which evidence-based stress management interventions do you apply to clinical practice? How effective are they?

Week 6 discussion

Discussion 1

What methods can nurses use to actively influence health policies and legislation?

Discussion 2

Discuss the controversy regarding childhood immunization and the potential affect on community health.

Week 7 discussion

Discussion 1

What essential elements should be included in a health teaching plan addressing physical, emotional, social, and spiritual challenges in adolescents?

Discussion 2

Discuss factors that contribute to risk-taking behaviors and situations during adolescence. What impact might stress play on this age group? Do you see any connection between stress and common adolescent risk factors? Consider the findings from the 2013 APA report Stress in America on millennials (pages 19-21 of the report).

Week 8 discussion

Discussion 1

Please watch the film, And the Band Played On.

This film may be available on the Internet through free sites such as Youtube and Vimeo (please note: accessing these sites is at your own risk). You may also view the film for purchase online through sites such as Amazon or HBO.

What factors inhibited the early war against acquired immunodeficiency syndrome (AIDS)? Do you believe the AIDS outbreak could have been stopped? Why or why not? What role does advocacy play in the film? How much publicity does HIV/AIDS receive today? What’s the story of HIV/AIDS in the 21st century? Explain.

Discussion 2

How do occupation and culture influence psychosocial stressors that affect middle-aged adults? How does your occupation influence psychosocial stressors?

Week 2 Ethical Health Promotion Paper

Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue. Use the WCU library databases to search for appropriate articles.

In your paper:

Briefly summarize the presented issue.

Describe your thoughts on the role health care professionals should play in resolving the ethical issue.

Provide specific theories and refer to specific ethical codes to support your position.

Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.

Week 3 Community Strategic Plan: Part A, Community Assessment

For this assignment, identify an area of focus in community health within your own community.

Using Gordon’s Functional Health Patterns framework (p. 130 in your e-text), assess the health risks in your community.

In your community assessment paper, include the following:

Identify resources in your community that would enable you to complete a community assessment and submit a summary of your findings (1–2 paragraphs).

Refer to Table 8-2: Examples of Community Strengths and Concerns, and assess the strengths and concerns of your community (2–3 paragraphs).

Identify potential barriers to implementing community health plans in your community and brainstorm ways of addressing these barriers (2–3 paragraphs).

Plan ahead: Next week, as Part B of this assignment, you will select one (1) identified risk from this assessment to develop a community-focused strategic plan to address that health risk. It is recommended that you look ahead to next week’s assignment so that you can begin framing your chosen community health focus.

Your paper should be 2–3 pages in length, not including the cover and reference pages. Use APA throughout.

You must include 2–3 sources that are APA cited and referenced in your paper. (Sources may include community resources such as flyers, brochures, interviews, news stories, and local research data from credible sources.)

Review the rubric for further information on how your assignment will be graded.

Week 4 Community Strategic Plan: Part B, Strategic Plan

For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.

Potential topics may include:

• Using prenatal and infancy home visits to prevent child abuse and neglect

• Preventing falls in the elderly

• Reducing population salt intake

• Reducing tobacco use among adults

• Preventing risky sexual behavior among youth and young adults

• Reducing drug experimentation among young adults

Include the following in your paper:

Introduction:

Provide an overview of the community health issue as described in Part A with identified causes and influences, including knowledge gaps.

Detail the prevalence of the issue inside and outside the United States.

Describe potential monetary costs associated with the issue in the United States.

You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).

Describe advance practice roles and management strategies that affect change at the community level.

Identify key community and social resources that negatively and positivelyaffect the selected issue.

Identify changes or enhancements in community-related services for your selected topic.

Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.

Conclusion:

A summary of the goals and challenges

An assessment of the outlook for action/progress

Appendix A: Include your community assessment from Week 3 as Appendix A.

Your paper should be 3–5 pages in length (not including the cover or reference pages). Use APA throughout.

Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 110

Review the rubric for further information on how your assignment will be graded.

Before you begin, review some strategic plans to garner ideas for developing your own strategic plan.

ACL strategic plan (2013–2018)

A strategic plan to make improvements in the network of community-based long term care and supportive services for older adults and adults with disabilities in San Francisco

Week 5 Disease Analysis Paper

For this assignment, you will select a disease of your choice and conduct a detailed analysis of that disease, exploring it from a balanced traditional and alternative health perspective.

Begin by searching the Center for Disease Control (CDC) website Diseases and Conditions Index to choose a disease or condition of interest to you.

Next, review the website for Healthy People 2020 for information related to the disease or the disease category (e.g., mental health for ADHD).

In your paper, discuss the following:

Prominent aspects of this disease

Current data and statistics related to the disease

Health disparities related to the disease

Prevention strategies including complementary and alternative health therapies

Contemporary research and clinical studies related to the disease

An analysis of the pathophysiologic effects of stress related to the disease

Evidence-based stress management interventions that might help with prevention or cure

The paper should be between 3–4 pages.

Incorporate at least three scholarly sources within the paper. Sources should be no more than three years old.

Use proper APA format to cite and reference sources.

Review the rubric for further information on how your assignment will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Week 7 Adolescent Health Risk Seminar

For this assignment, you will develop and deliver a 10–15 minute seminar/workshop aimed at the teen or young adult audience on a specific health risk associated with the population. you will submit your presentation using the Kaltura recording tool within Blackboard. See the Getting Started with Kaltura link listed under the Resources area in your course menu to learn how to use this tool.

* If you predominantly work with a specific population and would like to present a relevant health risk seminar to that population, you must seek instructor approval in advance. Email your instructor through the Virtual Office.

1. Choose a health risk associated with adolescence. Some categories to consider may include:

Suicide

Pregnancy

Substance use and abuse

Motor vehicle crashes

Tobacco use

Sexually transmitted disease

Domestic violence

Mental health issues

Sexual identity issues

Eating disorders

Nutrition and fitness

2. As the health care advocate, you will present the following to the target audience (adolescents or young adults)in 10-15 slides or screens:

An overview of the risk factor

Contributing factors

Prevalence of the health risk (meaningful data)

Explain your role with the issue as a health care practitioner/advocate

Ways to identify a problem and address the issue

Present an activity or project or exercise for the audience to engage in related to the topic

Help and support resources

3. In your research materials, incorporate 3–4 current sources with one containing the most current statistics.

4. Use age-appropriate creativity to ensure the message gets across to the selected audience.

As you plan your seminar, consider:

How will you initiate a conversation (rather than give a lecture)?

How will you keep the attention and respect of this audience?

5. Use APA for citing and referencing your sources.

6. Keep your design and audio appropriate to the audience, yet professional. Your presentation must include both audio and visual components and be professional in nature.

What is a seminar?

See this week’s Resource folder for curriculum and topic ideas.

Review the rubric for further information on how your assignment will be graded.

Submit your final presentation here for grading and post a copy in the discussion board to share with your peers

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 300

Week 7 Final Adolescent Health Risk Seminar Presentation

Click the link above to post a copy of your final presentation to the discussion board to share with your classmates no later than Sunday, 11:59 p.m. (Pacific time).

(You must also submit it to the assignment folder above for grading.) In the final presentation discussion board, review and comment on at least four presentations by the end of the course (for a total of 4 comments, minimum). You are encouraged to view and comment on as many peer projects as you can.

Week 8 Global Health Risk Paper

Choose a global health issue. For this assignment, you will introduce the health issue and discuss the interventions necessary to prevent the issue and promote health.

Some topics to consider may include:

Anthrax

Bioterrorism

Cholera

Clostridium botulinum infection

Community-associated methicillin-resistant Staphylococcus

Ebola virus disease

Escherichia coli

Human immunodeficiency virus disease

Malaria

Plague

Severe respiratory distress syndrome

Small pox

Suicide

Tuberculosis

Vancomycin-resistant enterococcus infection

West Nile virus

Include the following in your paper:

Introduction/overview of the health issue and the prevalence in the United States and worldwide

Contributing factors

Prevention strategies

Signs and symptoms

Diagnostic tests (if applicable)

Advanced practice nursing role and management strategies

Medical/pharmacological management (if applicable)

Follow-up care

Conclusion

Write a 3–4 page paper following APA format. You must include 2–3 scholarly sources in your citations and references.

Review the rubric for further information on how your assignment will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 100

The patient, a 32-year-old woman, was referred for headaches that had begun in her teens. 

Her headaches were described as a throbbing or pressure sensation that began behind one eye and then rapidly spread to the ipsilateral temple. Although the headaches usually occurred on the left side, on rare occasions they were right-sided.

The severity of pain ranged from moderate to severe, and the pain often began within 1 hour of waking.

The headaches were associated with photophobia and phonophobia and tended to worsen with movement.

What is your list of differential diagnoses at this point and what additional questions might you ask or testing might you do. Please answer with evidence based sources within 5 years of publication. Include in text citations.

nurs561 Global Health Risk Essay Paper

Choose a global health issue. For this assignment, you will introduce the health issue and discuss the interventions necessary to prevent the issue and promote health.

Some topics to consider may include:

Anthrax

Bioterrorism

Cholera

Clostridium botulinum infection

Community-associated methicillin-resistant Staphylococcus

Ebola virus disease

Escherichia coli

Human immunodeficiency virus disease

Malaria

Plague

Severe respiratory distress syndrome

Small pox

Suicide

Tuberculosis

Vancomycin-resistant enterococcus infection

West Nile virus

Include the following in your paper:

Introduction/overview of the health issue and the prevalence in the United States and worldwide

Contributing factors

Prevention strategies

Signs and symptoms

Diagnostic tests (if applicable)

Advanced practice nursing role and management strategies

Medical/pharmacological management (if applicable)

Follow-up care

Conclusion

Write a 3–4 page paper following APA format. You must include 2–3 scholarly sources in your citations and references.

Review the rubric for further information on how your assignment will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 100

The Medicare Part D donut hole can be a difficult situation for a Medicare beneficiary.

Discuss this situation and the impact to Medicare beneficiaries. (150 words )