Quality Improvement
Quality Improvement
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Instructions:
Discuss the roles of the ARNPs or APNs employed by health care organization related to quality improvement activities in your communities.
Are the ARNPs and other APNs the leaders of quality improvement teams?
What significant contributions have occurred as a result of the ARNPs or APNs involvement in Q I teams? What are your thought on it?
Response to below DQ
Need response to the below discussion question response from another student. Will post orginal question for you as well
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APA format 150 words 1 scholarly reference with citation less than 5 years old
Devary posted Jul 28, 2018 1:50 PM
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What questions will you want to ask your patients at every visit in order to get the information needed to provide individualized preventive services?
As a provider I would focus on primary prevention questions to assist me to provide individualized preventive services. The answer to these questions would prompt me to educate, advise, and promote healthier lifestyle and social habits.
Questions that should be asked at every visit include: (Not in any particular order)
Do you tan? Sunbath?
What do you normally eat in a day?
What do you normally drink in a day? How much water do you intake?
Do you smoke? Do you do any narcotics or illegal drugs?
Do you wear a seat belt?
Do you feel safe at home?
Do you Drink alcohol?
Do you wear hearing aids or glasses/contacts?
Do you wear a helmet on a bicycle or motorcycle?
Do you exercise? If so, how many times per week and how long?
Do you feel stressed? What brings on your stress? What do you do for stress?
Do you diet or use weight control methods?
Are you aware of your immunization status? Do you get a flu shot every year?
Are you exposed to any environments hazards?
(Dunphy, Winland-Brown, Porter, & Thomas, 2015).
How does the age and gender of the patient impact your approach to delivering preventive services and providing health education?
Age can impact the approach of a provider when delivering preventive services and providing health education. With a pediatric client the provider has to engage the family with health promotion and educate and advise the family on health education and preventive services. The provider must get the family on board with what is offered at appropriate ages such as immunizations to be able to give the child health services. In this case the child cannot make decision on their own so the provider is solely working with the family. Especially with adolescent and teenage population research suggests that parents influence children through behavior patterns and supportive home environments (Hutchens & Lee, 2018).
How does the patient’s developmental milestones impact their ability to make healthy changes and take charge of their health?
Developmental milestones do impact the patient’s ability to make healthy changes and take charge of their health. The youth of our society have to be taught by parenting or through school and community environments. The Centers for Disease Control and Prevention (2018) discuss the initiative toward youth health promotion called DASH which stands for the division of adolescent and school health. This program has a goal to promote environments where children can be educated on healthy behaviors, connect to health services, and learn how to avoid becoming pregnant or infected with STDs or HIV (CDC, 2018).
What are some risk factors associated with health promotion?
Screening patients for potential known risk factors is vital for effective health promotion and intervention by the advanced nurse practitioner is part of this (Dunphy, Winland-Brown, Porter, & Thomas, 2015). There are modifiable risk factors and non-modifiable. Modifiable risk factors include weight, diet, social habits, lifestyle choices, and stress whereas non-modifiable risk factors include age, sex, and genetics (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The advanced nurse practitioner should be aware of the modifiable and non-modifiable risk factors through a comprehensive health assessment and physical assessment. The information provided by the patient can lead the provider to intervene through education, diagnostic testing, and health promotion and prevention techniques to assist the patient to change the modifiable risk factors and understand the non-modifiable risk factors.
References
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care the art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.
Hutchens, A., & Lee, R. (2018). Parenting practices and children’s physical activity: An integrative review. Journal of School Nursing, 34(1), 68-85.
The Centers for Disease Control and Prevention (CDC). (2018). About the division of adolescent and school health. Retrieved from https://www.cdc.gov/healthyyouth/about/index.htm
Response to below DQ2
response to students response to DQ question 150 words APA format with 1 scholar reference and citation less than 5 years old
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Brittain posted Jul 28, 2018 9:29 AM
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Preventive care is a holistic approach to help keep our communities healthy by being proactive instead of just waiting for our patients to come in sick. (Dunphy, Winland-Brown, Porter & Thomas, 2015). Some questions that we as providers should ask at each office visit include:
Do you smoke or use any tobacco products? If yes, how long have you smoked and how much do you smoke?
Do you drink Alcohol? If yes, how often and how much?
Do you get regular exercise?
Do you eat a balanced diet?
Are your immunizations up-to-date, including flu, pneumonia, tetanus?
Have you been experiencing any depression? (U.S. Department of Health and Human Services, 2017)
Do you have a personal of family history of high blood pressure, high cholesterol, or diabetes?
Have you ever had a colonoscopy?
For women, I would include questions like:
Do you get yearly PAP tests? When was your last PAP test? When was your last menstrual period?
Have you had a mammogram?
Do you conduct monthly self-breast exams?
For men, I would include questions like:
Do you conduct monthly self-testicular exams?
I would offer any immunizations that were needed as per the CDC recommended childhood, adolescent and adult immunization schedules (CDC, 2015). I would also explain that using tobacco products kills 480,000 people per year, causes, lung cancer, cardiovascular disease, chronic obstructive pulmonary disease and is responsible for 30 % of all cancers. (Collins-Bride, Saxe, Duderstadt, Kaplan, 2017). I would explain that having testing for preventable conditions can help prevent costly and deadly conditions or, help catch conditions early that require treatment or lifestyle changes that can help our patients live healthy, longer lives.
References:
Centers for Disease Control and Prevention. (2015). Epidemiology and prevention of vaccine-preventable diseases. 13th edition. Washington D.C. Public Health Foundation.
Collins-Bride, G., Saxe, J., Duderstadt, K., Kaplan, R. (2017). Clinical guidelines for advanced practice nursing. 3rdedition. Jones and Bartlett Learning.
Dunphy, L., Winland-Brown, J., Porter, B., Thomas, D. (2015). Primary care: The art and science of advanced practice nursing. 4th edition. F.A. Davis Company, Philadelphia.
Reflective Journal and Scholarly Activities.
Details:
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Learners are required to maintain a reflective journal integrating leadership and inquiry into current practice.
In your journal, reflect on the personal knowledge and skills gained in the this course and address a variable combination of the following: new practice approaches, intraprofessional collaboration, health care delivery and clinical systems, ethical considerations in health care, population health concerns, the role of technology in improving health care outcomes, health policy, leadership and economic models, and/or health disparities. Outline what you have discovered about your professional practice and the personal strengths and weaknesses that have surfaced. What additional resources and abilities could be introduced to a given situation to influence optimal outcomes? Finally, how did you meet the competencies aligned to this course?
Additional information regarding your reflective journal is found in the DC Network.
Submit your reflective journal both to the instructor and in the Typhon Tracking System under the corresponding course section. Failure to submit your journal in both the classroom and Typhon system may result in a grade of Incomplete for the course.
SCHOLARLY ACTIVITIES DETAILS.
Throughout the DNP program, learners are required to provide a report documenting participation in a minimum of four scholarly activities outside of clinical or professional practice. These reports will be due in specific courses throughout the program, as described below, and must be documented in your Practice Portfolio by the end of each course in which an activity report is due.
Examples of scholarly activities include attending conferences, seminars, grand rounds, participating in policy and quality improvement committees, writing scholarly publications, participating in community planning, serving as a guest lecturer, etc. Involvement in and contribution to interdisciplinary initiatives are also acceptable scholarly activities.
Documentation of these activities is required in DNP-810, DNP-820, DNP-830, and DNP-840.
A summary report of the scholarly activity, including who, what, where, when and take home points, will be submitted as the assignment. Include the appropriate program competencies associated with the scholarly activity and future professional goals related to the activity. Use the “Scholarly Activity Summary” template to help guide this assignment.
Scholarly Activity Summary Template
This document describes the scholarly activity in three or four paragraphs.
Instructions: Read each section and fill it out using the instructions. Once you have completed the section, erase the instructions that appear in italics.
Overview
This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you.
Problem
This section consists of either a short story or a handful of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate us – what is the current state of the activity topic? Tell us – why is this a problem, and for whom is it a problem? Inspire us – what could a DNP-prepared nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more.
Solution
This section consists of either a short paragraph or a handful of bullet points that concisely describes the stated solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section.
Opportunity
This section consists of a short paragraphs that defines the opportunity that the scholarly activity is designed to capture. It is important to cover the GCU Domains and Competencies that were met through this activity. How will attending/participating in this scholarly activity help you grow as a DNP-prepared nurse?
Paragraph 3
Please write a Paragraph answering to this discussion below with your opinion. Please include citations and references in alphabetical order in case of another source.
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The term “at risk” for poor health is made up of a population of people that share common risk factors or are exposed to risks which poses a threat to their health. A vulnerable population consists of “a group or groups that are more likely to develop health-related problems, have more difficulty accessing health care to address those health problems, are more likely to experience a poor outcome or shorter life span because of those health conditions”(Maurer and Smith, 2013). A vulnerable population includes the poor, the homeless, very young, very old, and severely mentally ill and the disabled. Not all individuals that are at risk for poor health are vulnerable because for an individual to be vulnerable, the individual or group suffer from the factors that puts them at the greater risk for on-going poor heath than at-risk people do (Maurer and Smith, 2013). For an example, an individual is regarded as vulnerable, only if he/she suffers from a disease, income below poverty level, has no health insurance and is stressed as a result of their living conditions (Maurer and Smith, 2013). The people in this group cannot advocate for themselves as they are poor and have limited access to resources that they require. The people that are within this population are usually looked down on therefore making them afraid, ashamed and feel like they don’t deserve to be helped. It would be beneficial to advocate for these people because everyone should be able to have access to care irrespective of their level of income as everyone deserves a chance to live a healthy life. As nurses, when taking care of these group of people, we should treat them with same care and respect as other patients, rich or poor, young or old, disabled or homeless, everyone deserves the same treatment and the right to receive care. “Community health nurses can advocate on behalf of vulnerable groups by writing and calling government representatives and speaking to professional and community organizations about the problems and needs of high-risk groups” (Maurer and Smith, 2013).
Homelessness can be seen in people in both urban and rural areas. According to Maurer and Smith (2013), in rural areas, the largest group of homeless persons consist of white, single or married women and their children. In urban areas, the two largest groups of homeless persons include single men and single women with children. Depending on geographical location, racial and ethnic homeless population varies, such as 80% of the homeless population who are white or African American are found in the urban areas. In rural areas, homeless people are more likely to be white, American Indian, or migrant workers (Maurer and Smith, 2013).
Reference:
Maurer, F., Smith, C. (2013). Community/Public Health Nursing Practice, 5th Edition. Retrieved from https://pageburstls.elsevier.com/#/books/978-1-455…
Paragraph 5
Please write a Paragraph answering to this discussion below with your opinion. Please include citations and references in alphabetical order in case of another source.
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Culture Preservation is to preserve the cultural practices within all culture that promote a positive healthy behavior (GCU, 2017). For example, a Polish Catholic family would call the priest when a family member is near death to recite the last rites. This is believed to cleanse the soul. The Catholic priest may lay a hand on the sick and anoints blessed oil on the forehead of the person. This is a special oil that is blessed by the bishop (“When can Last Rites”, 2016). My family called the priest for my grandmother near her death and prayed. My grandmother believed this to be very important. The barrier would be the patient not feeling forgiven for past mistakes or worried about the after life with GOD. As a nurse we could support the positive and reassure any negative thought.
Cultural Accommodation is to accommodate different practices of religion to respect tradition and cultures as long as it is not harmful(GCU, 2017). For example, Shamans, which communicate with the spirit world and help treat illnesses or sickness (What is Shamanism?, n.d.). They believe the Shaman is in between worlds and can be healers, psychics, gurus, and magicians that are set in a trance to communicate to spirits (What is Shamanism?, n.d.). The barrier with this is if the client believes a bad spell has been cast on them. Not being able to fix the spirit world would be an issue.
Cultural Repatterning promotes patients to view and practice safe cultural traditions (GCU, 2017). For example, traditionally Mexican’s have an unhealthy diet with high fat, fried foods that can link to high blood pressure, heart disease and obesity that leads to type 2 diabetes. Changing patterns is difficult but with interventions and preventions of physical activity, nutrition with parent involvement, childhood obesity can decrease (Kaiser et, al., 2018). The barrier is the family not making any changes because of influences from family.
Cultural brokering is to support the client and to ensure they are receiving proper health care with the western health system (GCU, 2018). It is important to value all cultures and to be aware of the needs. Having the knowledge of different culture will help the nurse guide the teaching plan to better health. This will promote positive outcome for patients’.
References
Kaiser, L., Martinez, J., Horowitz, M., Lamp, C., Johns, M., Espinoza, D., & Byrnes, M. (2015, May 24). Adaptation of a Culturally Relevant Nutrition and Physical Activity Program for Low-Income, Mexican-Origin Parents With Young Children. In Centers for Disease Control and Prevention . Retrieved July 30, 2018, from https://www.cdc.gov/pcd/issues/2015/14_0591.htm
Paragraph 6
Please write a Paragraph answering to this discussion below with your opinion. Please include citations and references in alphabetical order in case of another source
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The community health nurse can apply the strategies of cultural competence in their practice by assessing and also accepting the cultural practices and beliefs of each patient. This means that the nurse should be respectful of patient’s cultural diversity as well as the cultural influences influencing their patients by examining how their beliefs impacts their health. It is important that all nurses have cultural awareness since this can improve patient’s outcome.
Cultural Preservation involves a nurse seen as preserving culture when they support the family of Muslim faith to cleanse the body of their deceased family member themselves (Al-Islam, n.d). A possible barrier may conflict between family members who are not accustomed to this tradition because they were born in America.
Cultural accommodation involves the use of practices that have not been proven to be harmful. Example include Acupuncture, a traditional form of Chinese medicine believed that illness occurs when the body’s natural flow of energy or chi is blocked. The insertion of tiny needles in specific points in the body releases the blockage and restores the flow of energy, thus relieving illness (Mayo Clinic, 2016). A possible barrier may be that the patient is still experiencing levels of pain that need further investigation and the patient does not want to see the doctor despite recommendation by the nurse.
Cultural re-patterning involves a nurse working with patients in order to convince them to abandon harmful cultural practices and beliefs. Many cultural practices believe that bedrest is important for healing. Teaching a patient that getting up and moving soon after surgery promotes healing and is an e.g. of repatterning. The barrier here is that many people have been taught and raised in a certain culture from birth. Resistance to change should always be anticipated and the nurse prepared to adjust care as needed
Cultural brokering finally involves mediating between groups or individuals that have different cultural beliefs in order to reach a consensus and effect changes.Many cultures do not make any decisions for health until the entire family is there to agree in the decision making. The Nurse may need to intervene if one family member wants to make decisions before the entire family arrives. A possible barrier may be time constraints. Decisions may need to be made before to the entire family arrives. The Community health nurse then may be able to do a group phone call with all family members.
References
Acupuncture. (n.d.). Retrieved from http://www.mayoclinic.org/tests-procedures/acupunc…
Topic 3 DQ 1
Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question:
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Between ages of 12 to 17 years suicide is the second leading cause of death in the United States (Jarvis, 2015). Some contributing factors are mental disorders like “attention-deficit/hyperactivity disorder [ADHD], behavioral or conduct problems, anxiety, depression, autism spectrum disorders” (Jarvis, 2015, p. 68). According to American Academy of Child and Adolescent Psychiatry (2017), other factors include: “family history of suicide attempts,” “exposure to violence,” “impulsivity,” “access to firearms,” “bullying,” “feeling of hopelessness or helpless,” and “acute loss or rejection” (p. 2). Some signs and symptoms observed in adolescent suicide are illicit drug, alcohol use, and cigarette dependence (Jarvis, 2015). Other signs are “changes in eating or sleeping habits,” “frequent or pervasive sadness,” “withdrawal from friends, family, and regular activities,” “frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue,” and “preoccupation with death and dying” (American Academy of Child and Adolescent Psychiatry, 2017, p. 2). Also many adolescents who are thinking about suicide would make indirect and direct statements. For example, an adolescent could make an indirect statement like “I wish would fall asleep forever.” A direct statement would be “I want to kill myself.”
Suicide is preventable. Primary prevention is reducing events that would lead to suicidal factors. For example promote positive relationship, events, and reduce negative societal conditions. Enhancing parent-child communication through parenting program would help with positive relationship (Caldwell, 2010). Second prevention “involves intervening early when risk factors for suicide have just emerged or are emerging to prevent the onset of suicide related [behavior]” (Caldwell, 2010, p. 4). One example is reducing the sigma around suicide, so adolescents are more likely to seek help. Another example is having timely access for crisis services in the community. Tertiary prevention is about “the care and treatment of those in whom suicide related [behaviors] have already occurred” (Caldwell, 2010, p. 4). For example, have individual and family counseling, provide trainings to primary healthcare provider so they can monitor the survivors, and build support groups.
There are some community and state resources that help with adolescent suicide. One of them is National Alliance of Mental Illness (NAMI). According to the NAMI’s webpage, “NAMI-NYS is the state organization of the National Alliance on Mental Illness…[it is] for people with mental illness and their families. NAMI has affiliates in every state and in more than 1,100 local communities across the country.” NAMI has many different programs like suicide prevention, treatment and support, etc. This is the link to the webpage http://www.naminys.org/nys/about-us/. Mental Health Association in New York State (MHANYS) is another community resource. MHANYS is a non-profit organization that wants to end the stigma against mental illness. This organization promotes mental health wellness in New York. MHANYS has established school mental health resources and training center to help schools provide instruction in mental health to all elementary, middle, and high school students. The link to the website is https://mhanys.org.
There are things nurses can do if they suspect a patient is thinking about suicide. The nurse can screen the patient for suicidal thoughts. First start with general questions and if the nurse receives affirmative answers then ask specific questions like “Have you ever felt that life is not worth living?” and “Have you ever felt so blue that you thought of hurting yourself?” (Jarvis, 2015, p. 73). Also, it is important to build a good rapport with patients, especially if a nurse suspect the patient is thinking about suicide. Building a good rapport with the patient will help the nurse get honest answers. Also, there is a higher chance of the patient listening to the patient.
Reference:
American Academy of Child and Adolescent Psychiatry. (2017). Suicide in Children and Teens. Retrieved July 30, 2018, from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx
Caldwell, D. (2008). The Suicide Prevention Continuum. Pimatisiwin, 6(2), 145–153.
Jarvis, C. (2015). Metal Status Assesmen. Physical Examination and Health Assessment. 7th ed. (pp. 67-87). [Elsevier version]. Retrieved from https://pageburstls.elsevier.com/#/books/978145572…
Topic 3 DQ 1
Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question:
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Depression is a significant problem that can influence every facet of an adolescent’s life. If depression is untreated it can inevitably result in problems within their family and school environment and lead to drug abuse, violence, and suicide. Fortunately, this disease can be treated before irreversible tragedy occurs. Contributing factors that can lead to adolescent depression are peer pressure, sports, hormone imbalance, and body changes. Extreme stressors in home, school, personal, and social life can also contribute to feelings of depression in the adolescent. Signs and symptoms of depression within this age group that can extend into adulthood are irritability, anger, unexplainable aches or pains, extreme sensitivity to criticism, and withdraw from family, friends, and activities. An example of primary prevention that targets this disease would include an adolescent depression awareness program to provide education to individuals within this age group. Secondary prevention can be provided through early detection and treatment if signs and symptoms of depression are present. Tertiary methods may include psychological interventions to treat an individual experiencing active adolescent depression including interpersonal therapy. Depression can be very damaging if left untreated and if warning signs are observed community resources are available such as the Health Care Alliance for Response to Adolescent Depression (HEARD). This resource provides information on disease prevention and promotion, mental health, and local community resources available to the public. In the state of Arizona “You are not alone network,” provides education to families struggling with adolescent depression.
References
Health Care Alliance for Response to Adolescent Depression. (2018). Reach out, Respond, React. Retrieved from http://www.heardalliance.org/
You Are Not Alone Network. (2015). Arizona Resources. Retrieved from http://youarenotalonenetwork.org/resources/state-r…
People of Irish, Italian, and Puerto Rican Heritage
Read chapter 23, 33 and 34 of the class textbook and review the attached PowerPoint presentations. Once done answer the following questions;
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1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.
2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.
The assignment must be presented in an APA format word document, Arial 12 font. A minimum of 3 evidenced-based references must be used (excluding the class textbook). References must be no older than 5 years. A minimum of 700 words is required.
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