Response to peers

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Response to peers

Running head: AFRICAN AMERICAN CULTURE AND AMISH HERITAGE Roxana Tejera Florida National University Nursing Department BSN Program Nur 4636 01/22/2019 Professor Cassandre Milien MSN 1 AFRICAN AMERICAN CULTURE AND AMISH HERITAGE 2 1. Discuss the cultural development of the African American and Amish heritage

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in the United States. African American refers to the African people who were forced to slavery in America during the slavery era. The United States constitution had given a period during which the forced slave trade will be eradicated in all the States. Therefore, after eradication of slave trade in America, the black slaves could not go back to their countries but settled in America as African Americas. African American culture has its roots in Africa. Due to the reasons that most slaves were from western Africa, African American culture is a deep blend of their practices. However, their culture was in the blink of destruction as the slavery roles did not allow African slaves to practice their culture in America. Although some of the cultural traits were lost, the African culture survived and it is now blended in the American culture. For a long period, racial discrimination prevented the growth and mixing of African culture with that of American culture (Purnell, 2013). However, African American descendants liked to maintain and have their own culture embedded in their tradition. Even if this faced stiff opposition from American Racists, they later succeeded, and today African culture dominate most parts of South America. The Amish people came from Europe to America in early 1600 to free from the religious persecution by the state church in Europe. Being white, they never faced racial discrimination as their African counterparts but were allowed to settle and even to own land at the area near Pennsylvania. AFRICAN AMERICAN CULTURE AND AMISH HERITAGE 2 They are viewed as the people who have great conservative culture. Even though the Americans did not oppose or force them to abandon their culture, Amish culture remains one of the littleknown cultures in the United States. This is mainly because it is a more of religious kind of culture which most people view to be conservative. Amish culture though not famous remains in the United States up to date but only among the Amish people. 2. What are the cultural beliefs of the African American and Amish heritage related to health care and how they influence the delivery of evidence-based healthcare? Both African American and Amish heritage culturally believe that things happen because they have been designated by fate to happen in that matter. For instance, an African American believes that good health is a result of luck and success while bad health is as a result of bad omen (Asiodu et al 2015). Therefore, an African American will consult a doctor only after all the home remedies’ have failed. On the same note, an Amish believes that good health is a reward from God and illness can just come as the punishment from God. Therefore, he will not seek the intervention of the doctor unless prayers have not worked at the right time. It is therefore advisable for the nurse dealing with the case of people from these cultures to exhibit high levels of tolerance. Also, the African American culture is characterized by mistrusts from the health caregivers. This is because of the past discriminations they received in the hands of health cares during and after the slave trade period. So unless the health care provider is friendly, they will be very reluctant to share family or personal information (Burkett, 2015). On the same note, Amish had been persecuted in Europe due to their strict believe in God and therefore they fear that they can be persecuted again for believing in God. Thus, in order to give evidence-based healthcare, it is advisable for the health care provider to build a trust relationship with the patients. AFRICAN AMERICAN CULTURE AND AMISH HERITAGE 2 Reference Asiodu, I. V., Waters, C. M., Dailey, D. E., Lee, K. A., & Lyndon, A. (2015). Breastfeeding and use of social media among first‐time African American mothers. Journal of Obstetric, Gynecologic, & Neonatal Nursing, Burkett, K., Morris, E., Manning-Courtney, P., Anthony, J., & Shambley-Ebron, D. (2015). African American families on autism diagnosis and treatment: The influence of culture. Journal of autism and developmental disorders, 45(10), Purnell, L. (2013). Transcultural health care. Philadelphia: F.A. Davis. Running head: PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 1 People of African American Heritage and Amish Heritage Karen Echenique Culture in Nursing Florida National University Prof. Cassandre Milien, MSN PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 2 People of African Heritage and Amish Heritage The African American culture which is also known as the Black culture in America is the mix of African descent in Americans in our society. The African American culture is the most influential culture in the United States to this day. Owing to slavery, African Americans were restricted of many of their ethnic practices including, values and traditions. Several of these customs were blended and influenced with the white culture in America. Although Black culture was reshaped due to slavery, it is one of the most unique cultures that have impacted the American culture immensely. Subsequently after the emancipation of slaves in the United States, the traditions of black culture continued to surpass other cultures especially in literature, music, religion, food and art. On the other hand, Amish, also known as Amish Mennonite began emigrating to North American from Europe around the 18th Century. They originally Settled in the east side of Pennsylvania, where there is still great amount of residents. A separation between the religion occurred after 1850 which created two groups amongst the religion: “New Amish” which accepted technological innovation and believed in social change and “Traditional Amish” who abided to the older ways of the religion. The main aspects of the Amish church is that family and community is separated from the rest of society. Their language is a mix of German and English dialects. The Amish are best known for their old-fashioned aspects; plain clothing, furniture, transportation etc. and the use of electricity and technology is avoided. Originally, patients of African American descent were defined as “Blacks” however, most recently this is not the best terminology to describe these persons because people of African descent may have light complexion. African Americans in our society today have bleneded PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 3 heritages and it is important not to generalize race with skin color in the health care setting. Families may be matriarchal, although the role may be shared in some families. Health and Diet disparities studies have showed that residents in low-income neighborhoods of AfricanAmericans are at increased risks for health disparities. A lack of access to health care and health insurance contributes to the prevalence of chronic illnesses. African Americans have strong connections with religion, especially Christianity, however, many follow Islam. Moreover, many African Americans are becoming health conscious recently, where they seek treatments and health screenings. Healthcare for the Amish may vary from family to family but most are less likely to seek medical attention because they believe God is the ultimate healer. The Amish turn to alternative forms of treatment for minor illnesses like: folk remedies and herbal teas. Most Amish patients reject health insurance coverage and shame birth control. Abortions are forbidden by the religion even if the mother is enduring a life-threatening pregnancy. They do not rule out immunizations but only 16-26% of Amish children have actually received preventive immunizations. Nurses must be extra careful not to over educate Amish women to practice contraception and instructions must be given in a simple manner; higher education is not allowed. References Britannica, T. E. (2018, December 14). Amish. Retrieved from https://www.britannica.com/topic/Amish LibGuides: Celebrating African American Culture & History: Home. (2018, January 25). Retrieved from https://guides.hmcpl.org/AfricanAmericanHistory
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Response to peers

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Response to peers

Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. Discussion # 3 Melvys Barrios Florida National University Culture In Nursing Prof. Cassandre Milian, MSN 1 Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. 2 Ohio, Indiana and Pennsylvania nest religious and cultural groups in large and smaller communities , also in other states including Wisconsin. These communities with this type of religion and culture are called Amish. The Amish population grows every day because they are large families with enough members. Studying the Amish culture is very important to be able to offer health care correctly. The knowledge that a nurse can acquire in terms of beliefs and understanding of this religion will make it easier for health professionals to provide the best possible care as well as gain confidence from these Amish patients. At another point, AfricanAmericans have generally adopted the cultures of the general population of the United States, but they will still also assume certain customs and cultures, such as; in an African-American family it could be matriarchal, although the father or mother can acquire the role of the decision. African-American women tend to be single longer than men and have done more university than men. African-Americans are increasingly aware in the field of health and research treatments and examinations for their health although sometimes the knowledge or education about health in this population tends to vary according to their generations. Those who are older tend to be suspicious of health professionals because of what has been rumored about the Tuskeege experiments on African-Americans, which makes them more untrustworthy until they realize that health care providers are friendly and can be counted with them in a positive way letting them know that they are truly interested in them and their health. It is clear that AfroAmericans depend on a relationship of trust, patient vs health care provider since it is crucial for them. The African-Americans are very religious people mainly affiliated to the Baptist religion as well as the church of God in Christ but in spite of this many follow the Islam. Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. 3 Many times they maintain good health corresponds with a very good religious practice. Also many of their churches or parishes maintain a health ministry through which nurses provide their health support , like with flu vaccines, blood pressure control, and health education in general. The rich population on the other hand tend to move away from these communities and become less traditional, while the poor choose to practice traditional cultures and religions. the elderly particularly practice and experience many home and natural remedies. It is more part of the African-American culture, going through an herbalist to reach remedies because this is part of the African-American culture since the era of slavery. In general, it is very difficult for African-Americans to divide the use of medicinal herbs from their African religions, including Igbo, Yoruba and others. As we all know medical treatments during slavery were rejected for Africans so they had no choice but to resort to home remedies and natural since then continue to affect their cultural communities and religions. Most African-Americans today have tried home remedies before seeking professional help in health or a treatment from a doctor. In 1700 a group of Anabaptists emigrated from Europe to the United States called the Amish. These groups called Amish are extremely religious and hard-working people who believe in their beliefs that worldliness prevents humans from being closer to God. These communities choose to have a simple life by evading all technological use or even modern comforts by supporting their conservative thinking. The Amish are governed by their personal code of conduct called Ordnung which shows their way of dressing, their behavior and their way of expressing themselves or talking in order a link of relationships and rules to follow correspond to the Amish faith. There are many differences between the Amish and the non-Amis. For example, Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. 4 the Amish do not believe in birth censorship. Therefore, their level of infant mortality is low, which leads to overpopulation in a rapid increase. The Amish Loaf and its beliefs are unique, in their style and practice in difference to the English. Healthcare providers benefit in many ways by applying the power of cultural competence, since by gaining knowledge they can select clues that lead to positive diagnoses where the patient appreciates the care of cultural support by establishing a familiarity or trust between the patient and the patient’s health care professional. The Amish also expose themselves to try remedies before asking for medical help. Maybe these remedies could mask the problem a bit in the first place. The Amish for example do not receive immunizations so in this way it is obvious that diseases that are not common to English, will be more common in the Amish. Also taking into account that the Amish tend to prefer natural treatments instead of prescriptions as a cause in consideration of the cost. The Amish ‘s patient will accept a treatment at a lower cost since their does not have health insurance. Bearing in mind that due to their way of transporting themselves to places, such as the horse and the buggy, it limits them to continue correctly with a follow-up of any treatment that is ordered by their doctor. In conclusion, that is why it is very important to maintain and learn more about the different cultures of our patients in order to develop a plan of care that fits their needs and beliefs, to build a relationship of trust between the patient and caregivers of the health care provider. Relating quickly guarantees effective communication between patient and providers. Making connections with the members of the community is another very important fact in order to recognize the conditions of the communities. In addition to learning and learning a little more Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. about different cultures and beliefs, the health professional can educate the different communities more in confidence about the well-being of each patient. 5 Running head: AFRICAN AMERICAN AND AMISH HERITAGE IN THE U. S. 6 References Health Care for African American Patients/Families. (2011, May 16). Retrieved May 15, 2018, from dimensionsofculture.com/2011/05/health-care-for-african-americanpatientsfamilies/ Smith, M. (2001). Writing a successful paper. The Trey Research Monthly, 53, 149-150. Weyer, S. M., Hustey, V. R., Rathbun, L., Armstrong, V. L., Anna, S. R., & Ronyak, J. et al. (2003). A look into the Amish culture: What should we learn? Journal of Transcultural Nursing, 14(2), 139-145. World Health Organization (2007). Mental health: Strengthening mental health promotion Retrieved 7/30/09, from www.who.int/entity/mediacentre/factsheets/fs220/en/nn Running head: PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 1 People of African American Heritage and Amish Heritage Karen Echenique Culture in Nursing Florida National University Prof. Cassandre Milien, MSN PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 2 People of African Heritage and Amish Heritage The African American culture which is also known as the Black culture in America is the mix of African descent in Americans in our society. The African American culture is the most influential culture in the United States to this day. Owing to slavery, African Americans were restricted of many of their ethnic practices including, values and traditions. Several of these customs were blended and influenced with the white culture in America. Although Black culture was reshaped due to slavery, it is one of the most unique cultures that have impacted the American culture immensely. Subsequently after the emancipation of slaves in the United States, the traditions of black culture continued to surpass other cultures especially in literature, music, religion, food and art. On the other hand, Amish, also known as Amish Mennonite began emigrating to North American from Europe around the 18th Century. They originally Settled in the east side of Pennsylvania, where there is still great amount of residents. A separation between the religion occurred after 1850 which created two groups amongst the religion: “New Amish” which accepted technological innovation and believed in social change and “Traditional Amish” who abided to the older ways of the religion. The main aspects of the Amish church is that family and community is separated from the rest of society. Their language is a mix of German and English dialects. The Amish are best known for their old-fashioned aspects; plain clothing, furniture, transportation etc. and the use of electricity and technology is avoided. Originally, patients of African American descent were defined as “Blacks” however, most recently this is not the best terminology to describe these persons because people of African descent may have light complexion. African Americans in our society today have bleneded PEOPLE OF AFRICAN AMERICAN HERITAGE AND AMISH HERITAGE 3 heritages and it is important not to generalize race with skin color in the health care setting. Families may be matriarchal, although the role may be shared in some families. Health and Diet disparities studies have showed that residents in low-income neighborhoods of AfricanAmericans are at increased risks for health disparities. A lack of access to health care and health insurance contributes to the prevalence of chronic illnesses. African Americans have strong connections with religion, especially Christianity, however, many follow Islam. Moreover, many African Americans are becoming health conscious recently, where they seek treatments and health screenings. Healthcare for the Amish may vary from family to family but most are less likely to seek medical attention because they believe God is the ultimate healer. The Amish turn to alternative forms of treatment for minor illnesses like: folk remedies and herbal teas. Most Amish patients reject health insurance coverage and shame birth control. Abortions are forbidden by the religion even if the mother is enduring a life-threatening pregnancy. They do not rule out immunizations but only 16-26% of Amish children have actually received preventive immunizations. Nurses must be extra careful not to over educate Amish women to practice contraception and instructions must be given in a simple manner; higher education is not allowed. References Britannica, T. E. (2018, December 14). Amish. Retrieved from https://www.britannica.com/topic/Amish LibGuides: Celebrating African American Culture & History: Home. (2018, January 25). Retrieved from https://guides.hmcpl.org/AfricanAmericanHistory
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Discussion Post Emotional Intelligence

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Discussion Post Emotional Intelligence

Students will be required to post answers to discussion questions posted in BrightSpace. The initial post must between 250-350 words with at least one scholarly reference. Students will respond to two other members of their group with a response of at least 150 words. The posts must be meaningful, respectful and substantive. You are the nurse manager on a busy medical-surgical unit. You have been requested to attend a hospital administration meeting with your Chief Nursing Officer (CNO) and the hospital Chief Financial Officer. The CNO explains that nurse−patient staffing ratios on every unit are being increased, and your ratios must also increase by 1-2 patients on both the day and night shift. The CNO assures you this is a temporary issue due to the seasonal high census, and this decision is not open for debate. You are shocked and don’t know how to respond initially. Related question #1 Using the Theory of Emotional Intelligence: a) Describe how you will demonstrate self-management and social competence to regulate your emotions in this scenario? b) Discuss how you will respond to your CNO by using this leadership theory.
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The scientific management theory

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The scientific management theory

Please respond with a paragraph to the following post, add citations and references:

The scientific management theory seeks to improve an organizations efficiency by systematically improving the efficiency of task completion by utilizing scientific, engineering and mathematical analysis. Some of the routines that seem to be inefficient is communication. It’s vital to have open communication between management and front-line staff. The front-line staff is the professionals that provides direct patient care. With poor communication skills common mistakes and errors get missed and a floor or unit doesn’t function on safe levels. This will cause poor patient outcomes and safety hazards for staff and patients. When staff can’t communicate with their management they feel unappreciated and over worked. Its imperative for management to actively listen, follow up with staff and evaluate the unit. Staff retainment is also an issue in the profession of nursing. Many nurses are leaving their jobs due to burn out, poor pay scales, poor management and feeling not valued. New nurses begin their careers excited and eager to learn, however there isn’t enough seasoned nurses on the unit to properly train them. This creates a barrier for learning and the new nurses loose interest or become afraid for their licensed. Many new nurses leave their jobs within a year. Currently, I work in a nineteen bed ICU, we have a leadership committee for our unit. This consist of ICU nurses, nursing assistants, doctors and our manager. They meet once a month to discuss the current issues and complaints made by our staff and patients. During each meeting interventions are created to improve our patient outcomes and address complaints from staff. I feel that this encourages staff to get involved in decision making and improve the standards of care for our patients. I have seen positive outcomes since this committee was started. For example, staff complained of feeling unappreciated. Now we have a comment box on our unit to recognize staff member for their dedication and hard work. Each quarter a staff member is recognized on our star board and rewarded with a gift card. Our manager also meets with the entire unit once a month to discuss educational classes offered, any current or unresolved issues and she gives everyone a chance to speak. It’s important to have great management and leadership skills. Without this the whole team will fail because there isn’t any one to lead.

Reference:

Marquiz, B.L. & Huston, C.J. (2009). Leadership Roles and Management Functions in Nursing: Theory and Application (6th ed.). Philadelphia, PA. Wolters Kluwer Lippincott Williams and Wilkins.

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Global developmental delay Assignment

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Global developmental delay Assignment

The Assignment

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Topic : Global developmental delay

 

  • Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

  • Signs and symptoms according to the DSM-5
  • Differential diagnoses
  • Incidence
  • Development and course
  • Prognosis
  • Considerations related to culture, gender, age
  • Pharmacological treatments, including any side effects
  • Nonpharmacological treatments
  • Diagnostics and labs
  • Comorbidities
  • Legal and ethical considerations
  • Pertinent patient education considerations

By Day 7 of Week 8

Submit your Assignment to the forum as an attachment. Although no responses are required, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study. Global developmental delay Assignment

 

Part 3 Topic 1 DQ 1-2 Leadership ability

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Part 3 Topic 1 DQ 1-2 Leadership ability

Please respond with a paragraph to the following post, add citations and references:

Leadership is both a research area and a practical skill encompassing the ability of an individual or organization to “lead” or guide organizations. Management includes the activities of the strategy of an organization and coordinating the efforts of its employees to accomplish objectives and goals through available resources. Both management and leadership should be open minded and visionary thinkers. For example, they both need to have positive influences on staff through their motivation, morals and values. They need to have appropriate problem-solving skills and can cope with multi-tasking. One way to expand influence as a leader is to do the right thing the right way. As a nurse leader, it’s important to implement critical thinking skills, listen actively and to have great coping skills. These skills are essential in the high stress and fast paces environments that nurses work in day to day. Some ways to make a difference in nursing is to be politically aware and actively involved with the current issues of nursing. Reading professional journals and attending continuing education classes that are relevant to our practice may also improve leadership and management skills. One would describe a great nursing leader/manager as one that keeps staff motivated to perform a top quality of patient care. Its someone who can inspire others to work together in pursuit of a common goal, such as enhanced patient care.

Reference:

 

Huber, D. (2014). Leadership and Nursing Care Management. (5th ed.). Retrieved from http://pageburst.elseiver.com/#blocks/978145574071…

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the question is below and all details are below

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the question is below and all details are below

Diabetes Case Study

Chief Complaint

“My left foot feels weak and numb. I have a hard time pointing my toes up.”

History of Present Illness

D.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently.

Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone.

Past Medical History

  • Seasonal allergic rhinitis (since her early 20s)
  • Breast biopsy positive for fibroadenoma at age 30
  • Gestational diabetes with second child 10 years ago
  • Multiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bath
  • Hypertension for 10 years

Past Surgical History

C-section 14 years ago

OB-GYN History

  • Menarche at age 11
  • Last pap smear 3 years ago

Family History

  • Type 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots.
  • Mother alive and well
  • Father has COPD
  • Two other siblings alive and well
  • All three children are alive and well

Social History

  • Married 29 years with 3 children; husband is a school teacher
  • Family lives in a four bedroom single family home
  • Patient works as a seamstress
  • Smokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per week
  • Denies illegal drug uses
  • Never exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars.

Allergies

NKDA

Medications

  • Lisinopril 10 mg daily
  • Loratadine 10 mg daily

Review of Systems

General

Admits to recent onset of fatigue

HEENT

Has awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speaking

Cardiac

Denies chest pain, palpitations, and difficulty breathing while lying down

Lungs

Denies cough, shortness of breath, and wheezing

GI

Denies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipation

GU

Has experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinence

EXT

Denies leg cramps or swelling in the ankles and feet; has never experienced weakness, tingling or numbness in arms or legs prior to this episode

Neuro

Has never had a seizure and denies recent headaches

Derm

Has a rash under her bilateral breast and in groin area

Endocrine

Denies a history of goiter and has not experienced heat or cold intolerance

Vital Signs

BP 165/100, T 98 F, P 88 regular, HT 5 feet 4 inches, RR 20 non labored, WT 210 lbs

What you need to 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).

Format

The paper should be no more than 3–5 pages (not including the title page and reference pages.

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) 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 American English (correct grammar, punctuation, etc.);

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  • 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.

Module 5 Discussion Culturally Competent Care For African Americans

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Module 5 Discussion Culturally Competent Care For African Americans

 

Culturally Competent Care for African Americans

Based on the readings, viewing on the Module 5: Lecture Materials & Resources page, and your own experience, what strategies would you recommend encouraging culturally competent care of African Americans?

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

African American, Hispanic, and Latino Populations’ Health Beliefs & Practices

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Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s). Module 5 Discussion Culturally Competent Care For African Americans

(Note: The citations below are provided for your research convenience. Students should always cross reference the current APA guide for correct styling of citations and references in their academic work.)

Read
Ritter, L.A., Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and Bartlett Learning.
ISBN: 9781284021028
Chapters 7 and 9

Online Materials & Resources

Visit the CINAHL Complete under the A-to-Z Databases on the University Library’s website, locate and read the article(s) below:
Abbott, L. S. (2015). Evaluation of nursing interventions designed to impact knowledge, behaviors, and health Outcomes for rural African-Americans: An integrative review. Public Health Nursing, 32(5), 408-420. doi:10.1111/phn.12174
Price, M., Williamson, D., McCandless, R., Mueller, M., Gregoski, M., Brunner-Jackson, B, et al. (2013). Hispanic migrant farm workers’ attitudes toward mobile phone-based telehealth for management of chronic health conditions. Journal of Medical Internet Research, 15(4), e76. http://doi.org/10.2196/jmir.2500 (Links to an external site.) Module 5 Discussion Culturally Competent Care For African Americans

Watch the YouTube videos below:
LarryStephenRobb. (2011, November 16). African Americans’ Distrust in the Health Care System: Past and Present [Video file]. Retrieved fromAfrican Americans’ Distrust in the Health Care System: Past and Present (Links to an external site.)African Americans’ Distrust in the Health Care System: Past and Present
Mpuentes05. (2013, December 5). Health Disparities in African American populations [Video file]. Retrieved fromHealth Disparities in African American populations (Links to an external site.)Health Disparities in African American populations
TEDx Talks. (2014, February 28). Tackling ethnic health disparities: Lisa Cooper at TEDxBaltimore 2014 [Video file]. Retrieved fromTackling ethnic health disparities: Lisa Cooper at TEDxBaltimore 2014 (Links to an external site.)Tackling ethnic health disparities: Lisa Cooper at TEDxBaltimore 2014
Sahar Consulting, LLC. (2013, June 27). Barriers to Healthcare for Latino/ Hispanic patients[Video file]. Retrieved fromBarriers to Healthcare for Latino/ Hispanic patients (Links to an external site.) Module 5 Discussion Culturally Competent Care For African Americans

Case Study

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Case Study

A 60-year-old male patient is admitted with chest pain to the telemetry unit where you work. While having a bowel movement on the bedside commode, the patient becomes short of breath and diaphoretic. The ECG waveform shows bradycardia.

  • What other assessment findings should you anticipate?
  • Why does this patient probably have bradycardia?
  • Does this dysrhythmia need treatment? Why or why not? What intervention would you implement first?
  • What is the drug treatment and dosage of choice for symptomatic bradycardia? How does this drug increase heart rate?

Please use complete sentences to answer the questions. Ensure that you are using correct grammar. In additions, support your answers by using your textbooks, scholarly journals, and credible Internet sources. All citations must be in APA format.

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A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit

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A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit

The discharge process remains a significant hurdle for most healthcare organizations who want to improve patient satisfaction scores and reduce readmissions.  One of the issues is mostly in part because patients do not understand the medication regimen ordered at the time of discharge.  Currently at Mercy Fairfield Acute Rehab Unit (MFARU), the discharge process consists of the registered nurse (RN)printing the after-visit summary, reviewing the written information with the patient, providing prescriptions for any new medications from the current stay, answering any questions, and calling for transport to get the patient to the lobby for discharge.

According to Stricker (2018), two of the most common reasons for readmissions are misunderstanding and miscommunication regarding medications.  The discharge process at MFARU does not take into count that most of the patients have been in the hospital for several weeks and may have missed routine appointments with primary care physicians to receive prescriptions of home medications; possibly leaving the patient with minimal amounts of the medicines.“Hospital admissions and discharges are complex events, characterized by multiple handoffs among health care providers and numerous changes to the patient’s therapeutic plan” (Poon, 2017, para. 2).  Having a well-thought-out discharge process personalized to the individual patient population on the MFARU may bring about an increase in patient satisfaction.  Reported patient satisfaction surveys for the MFARU have shown poor scores when it comes to discharging.  The unit has also noted a rise in patient calls requesting prescriptions for required home medications that were not provided upon discharge.A new discharge process protocol for the MFARU is needed.  A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit

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Background Discussion

“Dhruv Khullar, M.D., a resident physician at Massachusetts General Hospital and Harvard Medical School recommends incorporating the attention to detail in the admissions process into the discharge process” (Cambridge Management Group, 2016, para. 3).The problem with the current discharge process used on MFARU is directly related to the medication reconciliation process upon admission and during the patients stay. “Medication reconciliation is the process of comparing a patient’s new medication orders with all the medications the patient had been taking prior to changing levels of care” (Hennen & Jorgenson, 2014, p. 72).Most of the admissions to the MFARU are patients coming from within the hospital.  The patient is discharged from the medical unit then readmitted to the acute rehab unit.  The difference from an internal transfer and readmission is that Epic will recognize medications in the system that the patient discharged on, as now being the home medications for the patient.  “The nurse can help prevent rehospitalization by assessing the patient at discharge and reviewing the plan of care, including medication reconciliation, to ensure the patient understands medications he or she will be taking and the plan for furtherfollow-up and home care” (Fredricks, 2018, p. 330).  It is the responsibility of the admitting nurse to differentiate between medicines that are new to the patient from the current hospitalization and the medications the patient was taking at home.  The process will consist of an accurate medication reconciliation that involves the patient, family, pharmacy, and other health care providers.“Measurement and understanding of the patient, caregiver, and family experience of healthcare provides the opportunity for the reflection and improvement of nursing care and patient outcomes” (Berkowitz, 2016, p. 1). A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit

In the end, the key purpose of discharge medication reconciliation is to avoid readmissions and unintentional medication errors created by hospitalization.In the long run, some form of discharge reconciliation needs to be present.  The biggestchallengefaced by discharge reconciliation is incorporating it into the over-all discharge process, which already includes multiple actions on the part of all the health care professionals involved.

Stakeholders

            The stakeholders from within the MFARU that will be directly impacted through this strategic plan are as follows:Mercy Hospital, the medical director, clinical coordinators, registered nurses, patients, patient’s familyor caregiver, and the unit-based educator.  The unit-based educator’s knowledge and experience will serve as an essential resource to the project leader in providing support and guidance on the creation of the new discharge process protocol.

Outcome Statement and Evaluation Plan

A strategic plan can be implemented to achieve the following result:  To improve the patient satisfaction scores related to discharge on the MFARU from three stars to five stars, after implementation of a new discharge process protocol, by April 30, 2019.  This plan will involve a 5-star discharge paper that provides detailed information regarding the patients’ updated medication regimen.  The sheet will be provided in the patients’ room upon admission and reviewed with the patient with each medication change and then at the weekly care conferences.  Upon discharge, the paper will have a final review between the patient and nurse, ensuring that the patient has the needed prescriptions for ordered medications, then signed by both, stating understanding of the information provided on the sheet. A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit

TheThe charge nurse will monitor and ensure the new procedure is followed by staff involved.  After the analysis of the data, it will be determined whether the 5-star discharge paper increased patient satisfaction scores related to discharge from the current three stars to the desired five stars.

Conclusion

            The initiation of a new discharge process will benefit the hospital, MFARU,and the patients served.  “As reimbursement and performance policies have become more normative within healthcare, the patient experience has become a metric to measure payment systems for quality” (Berkowitz, 2016, p. 1).  Patients have more choices when it comes to where they receive their care so the better the patient satisfaction scores,the more likely this will be the provider of choice for patients.

 

References

Berkowitz, B. (2016). The patient experience and patient satisfaction:Measurement of a             complex dynamic. OJIN: The Online Journal of Issues in Nursing 21(1,                                Manuscript 1).https://doi.org/10.3490/articleJet21089676767

Cambridge Management Group. (2016). More strategies to reduce readmissions. http://cmg625.com/strategies-reduce-readmissions/

Fredericks, T. (2018). Medication reconciliation.  MEDSURG Nursing 27(5),329-330.

Hennen, C., & Jorgenson, J. (2014). Importance of medication reconciliation in the continuum of care. The American Journal of Pharmacy Benefits,6(2), 71-75. https://www.ajpb.com/journals/ajpb/2014/ajpb_marapr2014/importance-of-medication-reconciliation-in-the-continuum-of-care

Stricker, P.(2018). Best practice strategies to reduce hospital readmission rates.https://www.tcshealthcare.com/clinical-corner/best-practice-strategies-and-interventions-to-reduce-hospital-readmission-rates/ A Strategic Plan for Improving the Discharge Process on the Acute Rehab Unit