Describe ways to help a child develop a sense of accomplishment.

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Describe ways to help a child develop a sense of accomplishment.

Describe ways to help a child develop a sense of accomplishment.

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Response to below DQ

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Need a response to the below DQ 150 words. APA format 1 scholarly reference less than 5 years old with 1 citation. Will post original question.

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L Charles posted Aug 1, 2018 12:07 PM

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Helping and Healing Relationships

When patients seek the services of their health care provider, they believe that they possess the capabilities to help them restore their health and improve their well-being. It is the perception that informed the growing demand for healthcare services and series of reforms to modify the system into a patient-centered one. One of the ways that healthcare provider can develop a healing and helping relationship between them and their patients is the recognition of the emotional, physical and spiritual needs of their patients and families. According to Pullen and Mathias (2014), a trusting and mutually beneficial patient-provider relationship can be established through the use of effective verbal and nonverbal communication methods for the interactions between the parties. They stated that the information that is derived from this approach would help patients and their relatives understand the complexity and severity of the condition, its implications on their resources, and their role in the processes for achieving wellness.

Similarly, practitioners can use effective communication practices to develop the cooperative and collaborative partnerships with other members of the clinical team involved in the care of their patients. Babiker et al. (2014) noted that one of the advantages of effective teamwork is the increased level of patient safety and outcomes regarding their health condition. As empirical evidence of several studies has shown, the level of efficiency achieved by clinical teams in the care of their patients plays a significant role in the reduction of the rate co-morbidities of diseases. An additional method for developing partnerships with other members of the clinical team is through the sharing of the culture and principles of patient-centered care, which involves placing the needs of the patient above the professional status of the team. Babiker et al. (2014) stated that it is one of the keys for forming teams that provide exceptional care to their patients.

Finally, some of the personal behaviors and attitudes that need to be changed for effective team collaboration include the use of subjective language when addressing colleagues from other disciplines and disregard for the perspective of other team members on the appropriate approaches for patient care. Also, cultural bias is another aspect of the behavior and attitude of healthcare practitioners that should be addressed for working with others to deliver the expected level of services (Berger, 2014). For example, these changes are important when resolving conflicts because they would prevent the practitioner from focusing on who is right or wrong but on what is right for the patient. So far in my profession, I have never judge anyone on their religious beliefs, cultural values, or sexual orientation. I believed that everyone is entitled to their personal and medical privacy.

References

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., … & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese Journal of Paediatrics, 14(2), 9.

Berger, C. R. (2014). Interpersonal Communication. Berlin: De Gruyter Mouton.

Pullen Jr, R. L., & Mathias, T. (2014). Fostering therapeutic nurse-patient relationships. Nursing Made Incredibly Easy 8 (3),

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Response to below DQ 150 words apa format with 1 scholarly reference with citation less than 5 years old

Del Valle posted Aug 4, 2018 9:32 PM

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Helping and Healing Relationships- Discussion 9

Many believe that nursing is easy. The human body is an amazing thing, it is constantly changing, cells in motion. One of the main things for anyone in healthcare is the capability of not just learning how the human body works and how to treat it when is not working right but also to handle that body as an individual person. The human body consist also of someone with a personality unique to each that at times comes with fears and doubts, with questions, with tears and pain, and as a healthcare providers it is your responsibility to treat the body as a whole.

Relationships with my patients

Therapeutic communication is something that nurses learn in school, with the main goal of provide holistic and quality care (Abdolrahimi, Ghiyasvandian, Zakerimoghadam, & Ebadi, 2017). With experience this type of communication becomes very familiar. Listening to patient’s needs, their stories about their families, what they like or don’t like builds a trust rapport in where they feel secure in your care. I have personally enjoyed asking patients a little about themselves, their family or their personal habits of entertainment. At times with something that you can relate, makes you approachable and this is something that I plan to continue practicing. With patient and time management I will commit in giving patients education on their health care individual needs by also making sure that I know the most up to date information will also help me in delivering good care and maintain trust in the healthcare patient-provider relationship (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

Professional Partnerships

In healthcare it is imperative to cultivate good partnerships with all healthcare disciplines. As technology keeps advancing and more developments in medical applications, treatment, medications and guidelines keep growing it is impossible for one practitioner to be able to know or maintain knowledge to every detail, therefore there is a need to maintain inter-professional team based health care collaborations (Babiker et al., 2014). Courtesy and respect for those in their field is something that goes a long way. For those that specialized in a particular field, their time and knowledge they can provide to a patient’s health needs should not be taken for granted. Professional courtesy should always be present to maintain good effective communication.

Personal behaviors, Biases, Attitudes

There is a saying that states “be nice to everyone because you do not know when in life you will cross paths again and needs from them”. This is most true and applicable when it comes to partnerships with health care teams. Something that I am guilty of is not wanting to waste people’s time and therefore trying to do too many things by myself. I have worked in this behavior for years and improvement has come slow but proactively. Collaboration with others is a necessity to apply quality care to patients. With good manner, being respectful and thankful to those that participate in the healthcare teams excellent long lasting partnerships are forged and maintained. Making the commitment to deliver good information in healthcare with recommendations and education is a continuous process in which I plan to perform with a positive, professional and respectful approach.

References

Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M., & Ebadi, A. (2017, Aug). Therapeutic communication in nursing students: A Walker & Avant concept analysis [Article]. Electronic Physician, 9(8), 4968-4977. https://doi.org/10.19082/4968

Babiker, A., Husseini, M., Al Nemri, A., Al Frayh, A., Juryyan, N., Faki, M., Saadi, M. (2014). Health care professional development: Working as a team to improve patient care [Article]. Sudanese Journal of Paedriatics, 14(2), 9-16.

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: The art and science if advances practice nursing (4th Ed.). Philadelphia, PA: F.A. Davis

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Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded) • Due Sunday by

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11:59pm • Points 175 • Submitting a file upload Capstone Project Milestone 1: Practice Issue and Evidence Summary Guidelines Updated 7/10/2017 Purpose Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project. Course Outcomes This assignment enables the student to meet the following course outcomes: • • CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4) CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8) Due Dates Milestone 1 consists of the completion of ONE form with two worksheets called the Practice Issue and Evidence Summary Worksheets. (Links to an external site.)Links to an external site. Complete both worksheets and submit the form by Sunday, 11:59 p.m. MT at the end of Week 3. Points Milestone 1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary). Practice Issue Worksheet Directions 1. A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site. 2. Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the List of Approved Systematic Reviews (Links to an external site.)Links to an external site.. 3. Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected. 4. Use the worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions. 5. Your practice issue will be the same for all three Milestone assignments in this course. 6. Please type your answers directly into the worksheet. Evidence Summary Worksheet Directions 1. Develop an evidence summary by following the grading criteria below. 2. Document this on the evidence summary portion of the worksheet. 3. You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment. 4. Please type your answers directly into the worksheet. **Academic Integrity Reminder** Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments. By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page. NR451_Milestone1 Criteria This criterion is linked to a Learning OutcomePratice issue statement, scope of practice, practice area view longer description This criterion is linked to a Learning OutcomePractice issue identification, rationale for selections view longer description This criterion is linked to a Learning OutcomeTypes of evidence to gather, rationale for selections view longer description This criterion is linked to a Learning OutcomePractice problem view longer description Ratings Practice issue is identified based on the systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is fully described. Practice area identified. 20.0 pts Practice issue is identified but is not clear, however it is based on the systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is described in simple terms. Practice area identified. 18.0 pts Documents how the practice issue was identified. Rationale for responses is logical and described thoroughly. 35.0 pts Documents how the practice issue was identified. Rationale for responses is logical and briefly described. 33.0 pts Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected. 20.0 pts -Practice problem is in own words, with reference to the population of Practice issue is identified but is not clearly related to a nursing practice issue, however it is based on the systematic review topic chosen. Practice issue is not an independent nursing decision. Scope of practice issue is described but is not logical in comparison to Practice Issue described. Practice area identified. 16.0 pts Documents how the practice issue was identified. Rationale for responses is somewhat logical and vaguely described. 30.0 pts Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected. 18.0 pts -Practice problem is in own words, with reference to the population of Pts Practice issue is unclear. Practice issue is not based on the systematic review topic. Practice Issue is not an independent nursing decision. Scope of practice issue is not described. Practice area identified. 8.0 pts Vaguely describes how the practice issue was identified. Rationale for responses is somewhat logical and vaguely described. 15.0 pts Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence. 16.0 pts -Practice problem is in own words, with reference to the population of Practice issue is not identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified. 0.0 pts Does not document how the practice issue was identified. Rationale is not completed. This section of the form is blank. 0.0 pts Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence. 8.0 pts -Practice problem is in own words, with reference to the population of Does not document types of evidence or rationale. 0.0 pts -Practice problem is not in own words -There are no references to the 20.0 pts 35.0 pts 20.0 pts 10.0 pts interest. -Setting of the problem is identified Magnitude of problem is discussed. -The practice issue is stated in measurable terms. 10.0 pts interest. -Setting of the problem is not discussed. Magnitude of problem is discussed. -The practice issue is stated in measurable terms. 9.0 pts interest. -Setting of the problem is not discussed. Magnitude of problem is not discussed. -The practice issue is stated in measurable terms. 8.0 pts -Source is a Systematic Review article chosen from the approved list. -A reference is given, but it has APA formatting errors. The source must be relevant to the practice issue identified. 18.0 pts -Source is a Systematic Review article chosen from the approved list. No reference is provided. -The source must be relevant to the practice issue identified. 16.0 pts interest. -Setting of the problem is not discussed. Magnitude of problem is not discussed. -The practice issue is stated but not measurable. 4.0 pts This criterion is linked to a Learning OutcomeSource of evidence view longer description -Source is a Systematic Review article chosen from the approved list. Complete APA formatted reference is given for Systematic Review article with no errors. -The source must be relevant to the practice issue identified. 20.0 pts This criterion is linked to a Learning OutcomeObjectives of the article/Statement of questions view longer description -Objectives of article are identified. Questions addressed by author/s are thorough. Relationship to your practice issue is explained. 20.0 pts -Objectives of article are identified. Questions addressed by author/s are explained but not thorough. Relationship to your practice issue is explained. 18.0 pts -Objectives of article are identified. Questions addressed by author/s are not thorough. Relationship to your practice issue is vague. 16.0 pts -Objectives of article are identified. Questions addressed by author/s is missing. Relationship to your practice issue is not explained. 8.0 pts This criterion is linked to a Learning -Thoroughly summarized (in their -Briefly summarized (in -Vaguely summarized (in their -Summary of interventions is population of interest. -Setting and magnitude of problem is not discussed -The practice issue is not stated in measurable terms. 0.0 pts -Source of evidence is a research article or systematic review no on the approved list. -A reference for the article or systematic review is given. -The source is not relevant to the practice issue identified. 8.0 pts -Source of evidence is not provided, or is not a research article or systematic review. Reference is missing. 0.0 pts -Objectives of article are not identified. Questions addressed in article and relationship to own practice is not identified. 0.0 pts -Summary of the interventions the 20.0 pts 20.0 pts 30.0 pts OutcomeInterventions/Main own words) the findings summary interventions the view longer description author(s) suggest to improve patient outcomes. Thoroughly summarized main findings of the author/s. -Included strength of evidence for each main outcome. 30.0 pts This criterion is linked to a Learning OutcomeEvidence-based solutions and limitation view longer description -Outline of evidence-based solutions considered for project is documented and clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project. 20.0 pts their own words) the interventions the author(s) suggest to improve patient outcomes. -Briefly summarized main findings of the author/s. -Included strength of evidence for each main outcome. 27.0 pts -Outline of evidencebased solutions being considered for project is documented but not clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project. 18.0 pts own words) the interventions the author(s) suggest to improve patient outcomes. -Vaguely summarized main findings of the author/s. -Included strength of evidence for most of main outcomes. 25.0 pts not in own words. -Summarized main findings of the author/s is not apparent. -Did not include strength of evidence for any of the main outcome. 12.0 pts -Outline of evidencebased solutions considered for project is documented but not clear. Discussed most limitations to the studies performed. Documents limitations believed may impact use in project. 16.0 pts Total Points: 175.0 NOTE: Please use your browser’s File setting to save or print this page. NR451_Milestone1 author(s) suggest to improve patient outcomes is missing. -Summary of the main findings of the author is missing. -The strength of the evidence for outcomes are missing. 0.0 pts -Outline of evidencebased solutions being considered for project is not documented. Discussed most limitations to the studies performed. Documents limitations believed may impact use in project. 8.0 pts -Outline of evidencebased solutions, limitations of studies and potential impact to project is missing. 0.0 pts 20.0 pts Chamberlain College of Nursing NR451 RN Capstone Course Capstone Project Milestone 1: Practice Issue and Evidence Summary Worksheets For Use July 2018 Student Name: Date: DIRECTIONS 1. 2. 3. 4. Refer to the guidelines for specific details on how to complete this assignment. Type your answers directly into the worksheets below. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response. Practice Issue Worksheet List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support): What is the nursing practice issue you have identified related to the topic you have chosen? Fully describe the scope of the practice issue: What is the practice area? ___ Clinical ___ Education ___ Administration ___ Other (List): How was the practice issue identified? (check all that apply) NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 7/2018 DP 1 Chamberlain College of Nursing NR451 RN Capstone Course ___ Safety/risk management concerns ___ Difference between hospital and community practice ___ Unsatisfactory patient outcomes ___ Clinical practice issue is a concern ___ Wide variations in practice ___ Procedure or process is a time waster ___ Significant financial concerns ___ Clinical practice issue has no scientific base __ Other: Describe the rationale for your checked selections: What evidence must be gathered? (check all that apply) ___ Literature search ___ Clinical Expertise ___ Guidelines ___ Financial Analysis ___ Expert Opinion ___ Standards (Regulatory, professional, community) ___ Patient Preferences ___ Other Describe the rationale for your checked selections: EVIDENCE SUMMARY WORKSHEET Directions: Please type your answers directly into the worksheet. Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms: Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 7/2018 DP 2 Chamberlain College of Nursing NR451 RN Capstone Course reference for any additional optional supplemental scholarly source related to the review you wish to use. Identify the objectives of the article: Provide a statement of the questions being addressed in the work and how these relate to your practice issue: Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes. Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper. (If an optional supplemental source is also used, include a statement of relevance to it as well.) Outline evidence-based solutions that you will consider for your project. Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project. NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 7/2018 DP 3
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The Conflict

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The Conflict

Nurse leaders need to be familiar with conflict management styles and the impact these styles can have on

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interpersonal dynamics, and, ultimately, patient care. For this Discussion, you evaluate a situation marked by conflict and consider how conflict management strategies could be applied to promote positive results.

To prepare:

Consider a conflict situation you witnessed or were engaged in within your practice setting. Then, proceed as follows:
Think about who was involved, how it was resolved (if it was), and how it might have been handled more effectively.
Identify the conflict management style(s) employed by various individuals, including ineffective responses or no response to the situation.
Evaluate your personal response to this conflict.
What do your thoughts and actions in this and other conflict situations reveal about your typical approach to conflict?

Post a description of how you handled or avoided a conflict, as well as the results of your approach. Explain how would you respond to this conflict today and/or what steps you would take to improve your comfort level and skill for managing conflict in the future (including specific conflict management strategies you would use). Explain how conflict management relates to your effectiveness as a leader.

APA and references please

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Understandably, there are mixed opinions in regard to the effectiveness of the current healthcare system; because it

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has worked well for some, but not all. It may not be perfect, but it is’t a total loss. Unfortunately,the cost of healthcare does not equal the quality, and with or without health insurance, it is creating financial hardships for common society (Dudek, 2017); thus leading to sustainability concerns. With the cost of healthcare continuing to rise and without equal increases in the average American income, many individuals are at risk of losing coverage, and therefore not having access to needed care.

Secondary to the financial evaluation, is the concern in the quality of care provided (Rice, et.al, 2014), one way the quality of care is measured, is by life expectancy (Etehad & Kim, 2017). In 2016, the life span in the U.S. was 78.5 years, whereas the longest is 84.2 years, representing the people of Japan (World Health Organization, 2018). The number of people that die from complications or conditions that could have been avoided with timely and effective care, is referred to as mortality amenable to healthcare (Nolte & McKee, 2012). In 2007, the rate was the highest in the United States and doubled that of France, which was the lowest of the four countries researched (Nolte & McKee, 2012).

However, despite these drawbacks, there have been advancements made as well. For instance, increasing the availability of electronic medical records so that multiple providers have the capability to always have current information to safely care for their patients, as well as implementing evidence-based policies to prevent hospital admissions and readmissions.

That being said, this shows that our healthcare system posses both positive and negative elements, proving a fair score when compared globally. Nevertheless, we still have mountains to climb in order to improve issues such as the economics and quality of care.

References

Dudek, A. (2017, October 14). U.S. Health Care System: American Taxpayers Paying A Lot, Getting Little In Return–A German-American Perspective. Retrieved from https://www.huffingtonpost.com/alev-dudek/us-health-care-system-ame_b_12431960.html.

Etehad, M., & Kim, K. (2017, July 18). The U.S. Spends More on Healthcare Than Any Other Country — But Not With Better Health Outcomes. LA Times. Retrieved from http://www.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.html#

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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 United States was trying to improve the health care system by passing the Affordable Care Act through legislation so they could provide healthcare to the rich and the poor person. According to Amadeo (2018), four reasons that we needed healthcare reform in the United States. The reasons included health care costs were increasing, improve the quality of life, lack insurance and decrease fraud. According to American Public Health Association, the Affordable Care Act (ACA) was needed because over 16% people did not have insurance in the US. The ACA has assisted more than twenty million people with health insurance coverage but over twenty nine million still need health insurance. We have a long way to go to improve health insurance for all the people. The ACA has assisted by reducing spending but health insurance is still high for some families. Even though the ACA has been available for the patients but our health outcomes are poor. The ACA has shifted its focus from treatment to prevention and maintenance. Many insurance companies encourage and have requisites to obtain insurance the member has to complete health surveys for prevention. Many people buy insurance from their work companies because health care is so expensive. Insurance companies charge the employer premiums and still charge the member monthly dues and co-payments. There is a charge of co-payment due to the member every time you see the primary care physician, consulting physicians, laboratory, radiology procedures, urgent care or emergency care for each member of your family.

The ACA will need time to improve the patient outcomes and make further progress because not many people like change. There are both positive and negatives to ACA. The areas that need improvement for the patients who are not employed have difficulty paying the out-of-pocket costs. Some patients have to pay thousands of dollars and are unable to pay if they need care. People who are illegally here are not able to obtain insurance. If the illegal patient comes to Emergency Department, as healthcare workers we cannot refuse care if they need assistance.

According to Institute of Medicine (IOM) (2018), nursing will be driving force of primary care and prevention to assist the patients. Nursing has the ability to collaborate with other disciplines to obtain positive outcomes for the patient. Nursing is the largest work force in America who will be primary people to assist the patients in prevention of diseases.

References:

Amadeo, K. (2018). Why reform health care. Why we need health care reform. Retrieved from https://www.thebalance.com/why-reform-health-care-3305749.

American Public Health Association (APHA). (2016). Why do we need the Affordable Care Act? Making progress on critical health system problems facing the United States. Retrieved from https://www.apha.org

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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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For the past four decades, healthcare spending has skyrocketed as well as their costs. With the changes in health care coverage or the lack of having coverage has prompted families to delay health care. The increase in average mortality rate has increased the number of chronic illness the practitioners are attempting to manage at clinics. The more people that need to be seen the less appointment spaces that are available, forcing patient to seek medical treatment from the Emergency Rooms. This leads to overcrowding and extended wait periods to be seen.

Rising health care costs in the private sector have translated into significant insurance premium increases, unemployment, and stagnant real wages. The hourly wage growth of health benefits has stalled since 2000; while inflation adjusted family health insurance premiums have increased 58% according to the Senator Whitehouse report.

When we take a look at the health care system today, the overpriced and unnecessary services, excessive administrative costs, inefficiently delivered care, not using preventative measures, and Medical fraud cases all
are contributing to the excessive health care costs. Taking all of these things into consideration could be used to improve health care without increasing the cost and bettering the quality of care that American receives.

Reference:

Health Care Delivery System Reform and the Patient Protection & Affordable Care Act (2012, March). Found at: http://www.amia.org/sites/amia.org.files/senator-whitehouse-report.pdf.

Power Point to be Fixed

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Power Point to be Fixed

THE HISPANIC COMMUNITY OF MIAMI DADE COUNTY Grand Canyon University: NRS-427VN Instructor: Alma

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Celaya Aug 12, 2018 Lorena Hernandez, Idongesit Akazue, Jennifer Thomas, Ace Rodriguez, Maria Salas. Introduction • The Hispanic community refer to the Spanish speaking group of people in America. • The community comprise of Hispanic Americans and Latino Americans. • The community holds the second fastest growing community in the U.S. • The communities live in places like California, Arizona, and Nevada. Community And Community Boundaries • The community boundaries comprise some parts of the original Republic of Mexico in 1821. • The Hispanic community comprises 16.7% of the American population. • More than 50% of the community lives in the Southwest region of the U.S. • Community includes Mexicans, Puerto Ricans, Dominicans, Salvadorans, and Cubans. The Geographic And Geopolitical Nature Of The People • The Hispanic community is a young community in the U.S. • Huge populations in the country immigrate to the U.S. with university degrees. • The Hispanic community has contributes to demographic changes in America. • The community is increasing its political power in the U.S. The Financial & Education Level Of The Hispanic People • The U.S. born among the community recorded increased financial literacy as compared to the immigrants. • Low levels of understanding of financial concepts among the community. • The community is making large attempts to increase its college enrollment rate. • The dropout rate of the communnity is dropping significantly. The Ethnic And Phenomenological Features Of The Community • The Hispanic community comes from different backgrounds. • The major religion of the community is Christianity. • The cuisine of the community is famous across the country. • The community is growing its consciousness levels in the U.S. Types Of Social Interactions, Common Goals, And Interests Of The Community. • Most of the community members are very diverse from one another. • The community has limited common goals. • The community holds a lot of interest in the family unit. • Most of the community support their families in their countries through remittances. Barriers And Challenges Faced By The Community. • • • • Immigration. Low SES and education. Acculturation Language Conclusion • The Hispanic community’s growth keeps expanding exponentially. • The community comprises many diverse groups. • The community’s political power is increasing. • Challenges like language and education remain unsolved for the community. Interview with Angie Ngoc B. L. Interview performed on July 28th, 2018, by Lorena Hernandez • Doctor of Medicine (M. D.), Internal Medicine Larkin Community Hospital • Main role / responsibilities of interviewee : advice and diagnosis for patients, follow-up and monitoring of treatment adherence, regular check-ups, emergencies. => Mostly secondary and tertiary prevention. Population and Diseases of Interest • – Profile of patients: Children (5-17 years) Emergencies (including those in need of surgery) Elderly (check-ups and treatment adherence) • – Most frequent medical conditions : Diabetes (obesity, unhealthy lifestyles) Liver disease (excessive drinking, sometimes addiction) HIV (increasing prevalence, transmission mostly through sexual intercourse) Challenges in the local/state healthcare system • Understaffing in hospitals and clinics • Prohibitive cost of treatment (poverty, raise of healthcare costs, insurance insufficient / absent) • Also problem for hospitals’ finances (unpaid bills) => Heavily burdened medical care delivery system Health Assessment • High prevalence of obesity and diabetes, esp. among the Hispanic community (Davis, Taitel et al, 2017). • Explained by unhealthy lifestyle habits • Poor diet combined with heavy drinking (since young age) also explaining high prevalence of liver diseases. • Inaccessibility of treatment bec. of lack of insurance (Qato, Wilder, et al, 2017). In Miami-Dade County, the uninsured rate in 2017 is 67.7%(“FLHealthCHARTS Data Viewer”, 2017) Lifestyle habits – Data for Miami Dade County (Florida Department of Health, 2007) (CDC, 2007) Miami-Dade County adults are much less physically active than Americans overall. Lack of Insurance • In places like South Florida’s (Dade County) the immigrant population likely contributes to the high uninsured rate. • Some don’t make enough money to quality for tax-subsidized Affordable Care Act polices. • Many are accustomed to going to emergency rooms or public health clinics when they get sick • It’s not part of their culture to have health insurance • When they do obtain insurance, they do not understand how to use is or even how to make an appointment. Diabetes • Unhealth lifestyles (high fats and high carb (“Latino Health Disparities”, n.d.) • Hispanic youth population consumes a total 40 % of their calories from solid fats and added sugar (“Latino Health Disparities”, n.d.) • Low income neighborhoods have limited access to healthy foods and an abundance of fast food and low cost convenience store. (“Latino Health Disparities”, n.d.) • In Miami-Dade County the 2017 Death Rate for Diabetes was 19.7% for the Hispanic population. This is compared to the entire Florida population that was at 20.7%. (“FLHealthCHARTS Data Viewer”, 2017) Liver Disease • Chronic liver disease is the leading cause of death in Hispanic communities • In Miami-Dade County the 2017 Death Rate for Chronic Liver Disease and Cirrhosis was 5.8% for the Hispanic population. This is compared to the entire Florida population that was at 11.4%.(“FLHealthCHARTS Data Viewer”, 2017) HIV • HIV (increasing prevalence, transmission mostly through sexual intercourse) • In Miami-Dade County the 2017 Death Rate HIV/AIDS was 2.1% for the Hispanic population. This is compared to the entire Florida population that was at 3.2%.(“FLHealthCHARTS Data Viewer”, 2017) Recommendations on Improvement Opportunities • Lack of Insurance • Provide help in filling out forms and explaining benefits • Diabetes • Provided educational cooking classes for alternative Hispanic meals • Liver Disease • Providing AA groups tailored to the Hispanic population • Hosting “dry” social events to increase awareness and demonstrate that fun can be had with the use of ETOH • HIV • Education tailored to the Hispanic population • Distributing free condoms at social gatherings Existing Health Initiatives and Partnerships in Miami Dade County • RX4HEALTH PROGRAM (HTTP://WWW.MIAMIDADE.GOV/PARKS/RX4HEALTH.ASP) – Public: Adult, Youth, Children • Main objectives : live longer and healthier, prevent heart diseases, high blood pressure, prevent type 2 diabetes, prevent weight gain. – Activities: Walk for Life, Enhance Fitness, Yoga, Zumba, Pilates, Tai Chi, Water Aerobics – Walk with Ease : program aimed at teaching how to incorporate physical activity in everyday life. Possibility to participate in a sixweek group program led by a trained leader. – Developed by the Miami-Dade County Parks, Recreation and Open Spaces Department Initiatives funded by United Way of Miami-Dade (2018) • Family Christian Association of America [FCAA] “Healthy Kids Miami”: education and awareness activities + physical assessment to create lifelong healthy eating and wellness habits in children. Funding: $99,502 • Open Door Health Center Health Promotion, Disease Prevention Program: medical services + selfmanagement education & support groups for uninsured people with diabetes & other chronic health conditions. Funding: $29,851 Promotion of healthy eating and cooking programs for children in school settings Grants’ total value: $25,000. References (1) • Daviglus, M. L., Pirzada, A., Durazo‐Arvizu, R., Chen, J., Allison, M., Avilés‐Santa, L., … & Sorlie, P. D. (2016). Prevalence of low cardiovascular risk profile among diverse Hispanic/Latino adults in the United States by age, sex, and level of acculturation: The Hispanic Community Health Study/Study of Latinos. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 5(8). • CDC (2007). Nutrition, Physical Activity, and Obesity: Data, Trends and Maps- Nutrition. Retrieved from : https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.Expl oreByLocation&rdRequestForwarding=Form • Davis, A. M., Taitel, M. S., Jiang, J., Qato, D. M., Peek, M. E., Chou, C. H., & Huang, E. S. (2017). A national assessment of medication adherence to statins by the racial composition of neighborhoods. Journal of racial and ethnic health disparities, 4(3), 462471. References (2) • FLHealthCHARTS Data Viewer. (2017). Retrieved from http://www.flhealthcharts.com/charts/DataViewer/DeathVie wer/DeathViewer.aspx?indNumber=0091 • Florida Department of Health (2007). . Retrieved from: http://www.floridacharts.com/charts/mapp_report.aspx • Hurtibise, R. (2016). Sun Sentinel – We are currently unavailable in your region. Retrieved from http://www.sunsentinel.com/business/consumer/fl-uninsured-rate-falls-20160913story.html • Patel, S. R., Sotres-Alvarez, D., Castañeda, S. F., Dudley, K. A., Gallo, L. C., Hernandez, R., … & Redline, S. (2015). Social and health correlates of sleep duration in a US Hispanic population: results from the Hispanic Community Health Study/Study of Latinos. Sleep, 38(10), 1515-1522. References (3) • Qato, D. M., Wilder, J., Zenk, S., Davis, A., Makelarski, J., & Lindau, S. T. (2017). Pharmacy accessibility and costrelated underuse of prescription medications in lowincome Black and Hispanic urban communities. Journal of the American Pharmacists Association, 57(2), 162-169. • United Way of Miami-Dade (2018). Health Programs. Retrieved from: https://unitedwaymiami.org/what-wedo/our-work-in-health/health-programs/
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In March of 2010 the Affordable Care Act was enacted, this was designed to ensure that everyone had access to health care and more affordable health care. It original design was to realign and encourage collaboration between health and healthcare system (Public Health, n.d.). One of the initiatives was a Public Health Workforce Loan Repayment Program. This was to attempt to make sure that there were enough nurses to care for these patients. The incentive of having loan repayment would cost the participant three year commitment to public health agency, the Health & Human Service Department offers a repayment program (American Nurses Association, 2014).

With the scholarships and loan repayment programs, this encourages primary care providers, dentists, mental health care providers and nurses to commit to communities that are in need of their services. We are familiar with this with Native Health and is now bridging over to other public health offices.

As a nurse with a role in providing health care to the population they are able to support the long term care for these patients. Many of the patients that benefit from public health assistance are the mentally ill, the low income, mothers and babies, and the elderly. I have personally noticed an increase in the number of public health nurses and they are getting out into the community teaching and caring for the community.

Reference:

American Nurses Association. (2014). Health care transformation: The Affordable Care Act and more. Found at: www.nursingworld.org/MainMenuCatagories.Policy-Advocacy/HealthSystemReform/AffordableCareAct.pdf.