During this week, you will identify a population at risk in your community. This population will be the basis for your Practicum Discussions and your individual presentations over the next 6 weeks, as well as the focus of your final PowerPoint presentati

Identification of a Population in Your Community

 During this week, you will identify a population at risk in your community. This population will be the basis for your Practicum Discussions and your individual presentations over the next 6 weeks, as well as the focus of your final PowerPoint presentation in Week 6. To review, a population is a group of individuals who share a common environmental or personal characteristic, such as obese individuals who are at risk for diabetes or cardiovascular disease (populations at risk) or those individuals who are otherwise healthy and could stay healthy if they do not develop risky behaviors (populations of interest). An example of this is teenagers who don’t yet smoke but might consider it due to peer pressure (Stanhope & Lancaster, 2016). Some of the topics you might consider are vaccination compliance, obesity rates among children and adults, teenage pregnancy, or infectious diseases such as Norwalk virus, genital warts, or sexually transmitted diseases/infections. You might look also at emerging public health problems such as Chagas or the Zika virus. Some of the places you might consider looking for information to substantiate and support your ideas about populations at risk in your communities are your local health department, the CDC, and the many evidence-based websites that the CDC supports, such as the CDC Wonder (http://wonder.cdc.gov/). You may also review the work of other community groups that focus on improving health care outcomes for your community. You should begin to support your selection of population and ideas about their health care problems through the use of health data and scholarly literature.

Please address the following points in your Practicum Discussion:

• Briefly describe your community and then describe your practice setting.
• What are the determinants of health in your community? (https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health)
• What are the most prevalent health problems in your community or in your practice?
• Choose a population at risk and describe the health problem specific to that population. Remember that you will have to define the population’s age, culture, religious beliefs, foods, and traditions eventually as your project progresses.

As a community of practice your task for this week is to collaborate with professionals across the health care system and with your community of practice in the discussion in order to find a gap in care or social determinant that often results in poor health care outcomes. You will begin to take the lead in advocating for and collaborating with others to improve the health care outcomes for populations at risk.

What health issue, problem, or disparity in health outcomes is of concern to you as a scholar practitioner in your community? What gaps in knowledge and care do you see as possible causes for the health issue? What does the health data tell you about the health issue? What does the literature tell you about the health issue? How can you learn about the health issue and about possible solutions from the viewpoint of families, community as a whole, and health professionals in your community? What evidence is there to support your proposal? What is one avenue you could advocate for improved health outcomes and know when a change has taken place?

• Develop an intervention plan in collaboration with other professionals that takes into account determinants of health, available resources, and activities that contribute to health and the prevention of illness or injury
• Provide culturally competent care, i.e., health promotion, disease and injury prevention interventions in collaboration with other health care professionals in a community health care setting
• Analyze data pertaining to a specific community health issue
• Evaluate how cultural competence improves nursing practice and health outcomes
• Evaluate current evidence-based practices for your selected population
• Analyze evidence-based practices
• Evaluate programs aimed at solving health problems
• Evaluate local disaster plans and contemplate collaborative efforts in problem solving
• Analyze effectiveness of practicum proposal through practice presentations
• Present practicum presentation to colleagues

Hypertension Case StudyC.D is a 55-year-old African American male who presents to his primary care provider with a 2-day history of a headache and chest pressure.PMHAllergic RhinitisDepressionHypothyr

Hypertension Case Study

C.D is a 55-year-old African American male who presents to his primary care provider with a 2-day history of a headache and chest pressure.

PMH

Allergic Rhinitis

Depression

Hypothyroidism

Family History

Father died at age 49 from AMI: had HTN

Mother has DM and HTN

Brother died at age 20 from complications of CF

Two younger sisters are A&W

Social History

The patient has been married for 25 years and lives with his wife and two children. The patient is an air traffic controller at the local airport. He has smoked a pack of cigarettes a day for the past 15 years. He drinks several beers every evening after work to relax. He does not pay particular attention to sodium, fat, or carbohydrates in the foods he eats. He admits to “salting almost everything he eats, sometimes even before tasting it.” He denies ever having dieted or exercised.

Medications

Zyrtec 10 mg daily

Allergies

Penicillin

ROS

States that his overall health has been fair to good during the past year.

Weight has increased by approximately 30 pounds in the last 12 months.

States he has been having some occasional chest pressure and headaches for the past 2 days. Shortness of breath at rest, headaches, nocturia, nosebleeds, and hemoptysis.

Reports some shortness of breath with activity, especially when climbing stairs and that breathing difficulties are getting worse.

Denies any nausea, vomiting, diarrhea, or blood in stool.

Self treats for occasional right knee pain with OTC Ibuprofen.

Denies any genitourinary symptoms.

Vital Signs

B/P 190/120, HR 73, RR 18, T. 98.8 F., Ht 6’1”, Wt 240 lbs.

HEENT

TMs intact and clear throughout

No nasal drainage

No exudates or erythema in oropharynx

PERRLA

Funduscopy reveals mild arteriolar narrowing without nicking, hemorrhages, exudates, or papilledema

Neck

Supple without masses or bruits

Thyroid normal

No lymphadenopathy

Lungs

Mild basilar crackles bilaterally

No wheezes

Heart

RRR

No murmurs or rubs

Abdomen

Soft and non-distended

No masses, bruits, or organomegaly

Normal bowel sounds

Ext

Moves all extremities well

Neuro

No sensory or motor abnormalities

CN’s II-XII intact

DTR’s = 2+

Muscle tone=5/5 throughout

What you should do:

• Develop an evidence-based management plan.
• Include any pertinent diagnostics.
• Describe the patient education plan.
• Include cultural and lifespan considerations.
• Provide information on health promotion or health care maintenance needs.
• Describe the follow-up and referral for this patient.
• Prepare a 3–5-page paper (not including the title page or reference page).

Assignment Requirements:

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

• follow the conventions of Standard English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th Edition format as outlined in the APA Progression Ladder.

Preventing Disease in Communities: The Role of Public Health, the Silent SentinelOur “world” starts with our own community, county, and state, then moves out in concentric rings from that point to

Preventing Disease in Communities: The Role of Public Health, the Silent Sentinel

Our “world” starts with our own community, county, and state, then moves out in concentric rings from that point to include our country and eventually the world. Disease is transmitted from person to person through direct contact, or from a source such as a vector or contaminated water through a variety of means, such as flood waters or even terrorist actions. Individuals with limited or no knowledge of safe sex methods may have unprotected sexual relations and knowingly or unknowingly transmit disease to their partners, then to their partners’ partners, and on and on. Often it is the role of the public health nurse to investigate a disease outbreak, contain it, and then educate others so that the same situation doesn’t happen again.

In this Discussion, you will visit a site and interview people who work there about risks for disease transmission, then report on your findings.

To prepare, select which site you will visit from the following options:

• High school nurse’s office
• Water treatment plant
• Public health department
• Pediatrician’s office

Create a brief description of your setting, providing some context; for example, how many patients are seen, size or capacity of the facility as applicable, and/or the location of the office or organization.

Take pictures of the building and surrounding area/neighborhood to provide context. You do not have to include the interior/s of the building/s or people/clients who may be there.

Then, during your site visit, pose the questions listed in the following chart:

High school nurse

• What is the school’s policy on giving students advice about birth control?
• How often do you get requests for information about birth control or how to protect oneself from an STD?
• How do you track vaccination compliance, and what happens to students who fall out of compliance?

Local water treatment plant

• Where does your community’s water come from?
• Where is it stored?
• How often is it tested for purity?
• What safeguards are in place to prevent tampering with the water supply?

Local public health department

• Does this department have an STD clinic?
• In addition to testing, does the department offer treatment of one party or both parties?
• What is the most frequently diagnosed STD?

A pediatrician’s office

• What is your policy on accepting patients who refuse vaccinations?
• What are the most common reasons parents decline vaccinations for their children in this particular office?
• What is the policy at this office for giving antibiotics to treat viral syndromes?

Now, look at the site you visited through the eyes of the public health nurse (PHN). Imagine you are the PHN and have been asked to investigate an outbreak at this facility.

• What questions would you ask?
• What suggestions could you make to avoid a disease outbreak at the facility?
• What would your role as a change agent be for any deficiencies you find in your on-site inspection?

By Day 3

Post your brief description and pictures of the site you visited. Share the answers you were given to the questions you posed. Then, respond to the above prompts through the eyes of a PHN asked to investigate an outbreak at this facility.

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

NURS 6221: MANAGING HUMAN RESOURCES – Discussion 10 (Grading Rubic and Media Attached)

Discussion: Creating, Developing, and Leading Effective Teams

Coming together is a beginning. Keeping together is progress. Working together is success.

—Henry Ford

A critical skill for all nurse managers is the ability to create, develop, and lead effective teams. When people are part of an effective and well-functioning team, they are more productive and have a stronger commitment to the organization. Nurse managers have a responsibility to create teams that fulfill functional needs within their units or departments. These can include leadership teams, ad hoc project teams, or primary work teams.

As a nurse manager, there is a variety of ways that you can enhance team functioning. The first step is developing the structural elements of the team and then designing the team with the appropriate membership. Just as you must critically examine each application during the employment process, so will you critically examine the skills and attributes of each employee before appointing him or her to a collective team.

In this week’s Discussion, you lay the groundwork for creating and developing a team for your unit, department, or health care setting. You also identify leadership strategies that you could employ to increase the team’s organizational effectiveness.

To prepare

Review Chapter 5, “The Art of Effectively Facilitating Processes” from the course text, From Management to Leadership: Strategies for Transforming Health Care. Carefully examine the section, “Essential Elements of a Team” to identify the six steps of creating an effective team.

Consider a team you might create for your current organization or one with which you are familiar. For example, is there a project to be accomplished or a problem to be solved? Perhaps there is a need for a leadership team within your unit or department?

Identify the purpose or goal for your team. Then, reflect on the following questions:

What type of team would you create (leadership, ad hoc, or primary work team) to accomplish this purpose or goal? What are the benefits or disadvantages of creating this type of team?

What staff members would you want on this team? Why? How could their skill sets and positions make them effective team members?

Explore this week’s Learning Resources to identify leadership strategies you might employ before, during, and after the team-building phase. For example, what leadership strategies might influence synergy among team members while also increasing the effectiveness of the team?

Post a description of the team you would create, including the purpose or goal the team would serve, the team type, and the specific skills each member would contribute as well as their job positions. Describe at least two leadership strategies you could implement to help this team effectively achieve its purpose or goal.

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Critically appraise a colleague’s team description. Provide an additional leadership strategy he or she could use to further improve the effectiveness of the team.

Find a colleague who would like to implement a team similar to one that has been implemented in your workplace. Share an insight into how your organization benefited from this type of team and the leadership strategies management employed to support the work of the team.

Required Readings

Manion, J. (2011). From management to leadership: Strategies for transforming health care (3rd ed.). San Francisco, CA: Jossey-Bass.

Chapter 5, “The Art of Effectively Facilitating Processes” (pp. 179–242)

This chapter describes the many components that make up the facilitating process. Some of these elements include empowerment, authority, resolutions, and negotiation.

Chapter 6, “Getting Results” (pp. 243–282)

The main points of this chapter are the components that contribute to effective teamwork. The author lists the benefits and pitfalls of proactive behavior, group decision making, and problem solving.

Beeson, J. (2011). Build a strong team. Leadership Excellence, 28(2), 15. 

Retrieved from the Walden Library databases.

Beeson’s article focuses on the importance of building a structured team. He provides five steps that leaders can implement in the workplace to create a strong team that benefits the whole workplace.

Calendrillo, T. (2009). Team building for a healthy work environment. Nursing Management, 40(12), 9–12. 

Retrieved from the Walden Library databases.

In this article, Calendrillo states that skilled communication is the foundation for strong team building in clinical settings. When skilled communication has been mastered and used, quality patient care and healthy work environments are among the many results.

Pentland, A. (2012). The new science of building great teams. Harvard Business Review, 90(4), 60–70. 

Retrieved from the Walden Library databases.

This article addresses how communication is a key to team efficiency. The author provides three communication dynamics that were used by the teams that were most communicative.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Team building. Baltimore, MD: Author. 

Note:  The approximate length of this media piece is 8 minutes.

This week’s presenter, Jo Manion, provides effective team-building strategies nurse managers can employ when initiating teams in units, departments, and organizations. She also reviews the three types of teams that are generally found in health care settings: leadership, ad hoc, and primary work teams.

Accessible player  

 The following document gives credit for Laureate-produced media in this course: Credits (PDF)

Optional Resources

Ramsay, S., Troth, A., & Branch, S. (2011). Work-place bullying: A group processes framework. Journal of Occupational & Organizational Psychology, 84(4), 799–816.

Respond to this post with a positive response :Ask a probing question, substantiated with additional background information, evidence or research.Share an insight from having read your colleagues’

 Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use at least 3 references

                            The Accountability and Affordable Care Act of 2010

            A public policy that is impacting my workplace along with the rest of the nation’s healthcare is the Accountability and Affordable Care Act of 2010 (ACA).  Overall, this policy expanded eligibility for Medicaid to millions of Americans (Frank, Beronio, & Glied, 2014).  Before the ACA, the mentally ill was a population who struggled to gain access to care.  Fortunately, now the mentally ill can get insurance coverage which has impacted the facility in which I work.  We are always full with a waiting list of patients trying to get admitted.  

The ACA was designed to improve access, cost, and quality to care for all Americans.  According to the Substance Abuse and Mental Health Services Administration (2018), it has dramatically impacted the number of Americans who have access to mental health care.  According to Laureate Education (2012a), 32 million Americans who did not have coverage before this act will have coverage.  In conjunction with the Mental Health Parity and Addictions Equity Act, about 60 million Americans will have access to mental health services (Frank et al., 2014).  Also, the ACA was designed to help the cost of healthcare.  Unfortunately, this cost was initially expensive for our nation (Laureate Education, 2012a).  However, in the long run, the Affordable Care Act will hopefully save the nation money (Laureate Education, 2012a).  Lastly, quality was a goal of the ACA.  The ACA prompted changing payment models so that facilities are held accountable for quality care, and value of delivered care effects reimbursement rates (Knickman & Kovner, 2015).  Overall, the ACA is still a work in progress to improve access, cost, and quality of care.

As a nurse in a psychiatric facility, the ACA has impacted my daily life.  Due to the increase in access to care, my facility is always busy.  We are continuously full, and there are always patients waiting to get in.  Next week, our new building will be opening which will more than double our beds.  The ACA has also affected the quality of care given in my facility.  High importance is placed on care coordination to make sure the patient has follow-up care to avoid readmission.  Also, leadership is focused on monitoring incidences and near misses to avoid errors as errors are expensive.  The ACA has, unfortunately, added much stress to the daily lives of healthcare professionals in my facility.

Staffing in Healthcare

An enormous struggle we are facing in our facility, and one I would like to see change through public policy, is staffing of nurses and patient care techs.  This issue seems to come up in every conversation among nurses no matter where they work.  Soon, my facility will have the supply of rooms along with the demand of patients, but we do not have the staff.  This staffing crisis makes me nervous.

Kingdon’s model identifies four influential factors to get issues on the public agenda (Milstead, 2019).  First, the problem stream is the staffing crisis that hospitals and agencies face all over our nation (Milstead, 2019).  In my 11 years of nursing in three different hospitals, staffing ratios have only worsened.  Second, the policy stream attaches a solution to the problem (Milstead, 2019).  The answer to the staffing crisis may be to implement policy not allowing hospitals to admit patients if they can’t maintain a specific staffing ratio of nurses to patients.  Third, the political stream includes getting the problem and solution government attention (Milstead, 2019).  As nurses, we could set up a campaign to get the word out regarding staffing and could notify our local representatives.  The fourth factor that influences getting issues on the public agenda is the window of opportunity (Milstead, 2019).  This concept is about the timing of introducing a problem.  A good time may be close to an election year when it is vital for local representatives to get votes from their constituents (Laureate Education, 2012b).  

Due to the ACA, millions of Americans, especially the mental health population, were given access to more affordable and quality healthcare.  Unfortunately, the healthcare industry is not ready.  Staffing is the next problem needing to be addressed by our government.   

References

Frank, R.G., Beronio, K., & Glied, S.A. (2014). Behavioral health parity and the affordable care act. J Soc Work Disabil Rehabil, 13, 31-43. doi: 10.1080/1536710X.2013.870512

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

Laureate Education (Producer). (2012a). Introduction to healthcare delivery, part II: Healthcare reform. Baltimore, MD: Author.

Laureate Education (Producer). (2012b). Health policy and politics. Baltimore, MD: Author.

Milstead, J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones and Bartlett Publishers.

Substance Abuse and Mental Health Services Administration. (2018). Laws and Regulations. Retrieved from https://www.samhsa.gov/about-us/who-we-are/laws-regulations