Patient Teaching Plan For Medication Safety

To create a Patient Teaching Plan aimed at educating a specific patient population about a specific health topic. This plan will be used to develop a Visual Teaching Tool in a future assignment , recognize the influence that developmental stages have on physical, psycho social, cultural, and spiritual functioning.   Identify teaching/learning needs from the health history of an individual Patient Teaching Plan For Medication Safety.

Community Safety

Summary

A community is a group of individuals with a shared characteristic or interest living together within a larger society. Per Saarloos, D., Kim, J., & Timmermans, over the course of twenty years, the field of health promotion has revealed increased attention for the likely impact of the environment on health. It has become the standard approach to categorizing the various environmental influences on individual health behavior (2009. para. 3). In a community, there are eight subsystems; they are physical, health and social, safety and transportation, education, recreation, politics and government, communication, and economics. In Sentinel City, there are four communities. In this paper, I will continue my window survey and discuss four of the eight subsystems with exploring the different communities Community Safety .

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please read the paper below to find some information to complete the assignment. you can also find more information on the internet.

Physical Environment

The Physical Environment features of communities have been linked to disability, mortality, general health status, chronic conditions, birth outcomes, health behaviors and other risk factors for chronic disease. Along with mental health, injuries, violence, and other important health indicators (Cubbin, Pedregon, Egerter, & Braveman. 2008).

Sentinel City’s first community, Nightingale Square the sidewalks and streets have hardly any rubbish on them and are not in bad shape, buildings are mostly big and bright, there may be some graffiti but it is not much, and it is not that obvious. The trees are nicely trimmed, and beautiful cars line the road. Nightingale Square has tennis courts, a basketball court, and parks, large condominiums, beautiful storefronts for clothing, jewelry, and various other shops. There are a grocery store and a gas station located at the end of the community, where it seems to be not as clean, and a small amount of garbage is outside a few buildings. Buildings are not quite as attractive but are still nice, and there is more graffiti on the buildings. There is a large pharmacy, a dentist office and barber shop in the vicinity. Residents are walking, running biking, and walking dogs. Nightingale Square is a community that has “everything” there is a sense of friendliness and openness to other people towards grocer, but in the other areas, there seems to be a feeling of superiorness to the remainder of the community. At and across from the grocer seems to be a place that people like families, couples and others will stop by and watch the entertainment or come to meet people to “hang-out.”  Community Safety

The second community is Acer Tech Center the sidewalks and streets are mostly clean, buildings are in good shape, there is more garbage outside buildings, sidewalks are nice, and there is a bit more graffiti than Nightingale Square but not too bad. A few loose dogs and cats are running around, the trees are neatly trimmed, and the cars are in good shape. A large hospital, Sentinel City Healthcare Center is one of the first things to see and then there is Acer Center Business Center next to it. In between the hospital and the business center, there is a large fruit stand and courtyard where people are “hanging -out.” There is a small grocer, but the large one is not too far away clothing shops, a barber shop, and trade shops. City Hall is in Acer Tech Center where there is a bunch of protesters (middle-class?) protesting about taxes. There is a Historic Hotel in Acer which is more than likely a tourist attraction or something like that. People are walking, riding bikes and running. There is another “hang-out” area in a courtyard across from the Affordable Housing Project, where there are a small fruit and vegetable stand with people sitting on benches, standing, or walking around. Acer Tech seems to be friendly, and a more pleasant area to welcome strangers because there is a large mixture of people throughout the community in various classes, races, and ages. The third community Casper Park is unlike the first two communities, the streets are dirty, there is, even more, garbage outside buildings, there is more noticeable graffiti, and the buildings need repair, some of them have windows boarded up and some vacant. Low-Income Housing is available, there are fewer cars, and the are not in top working order. The park is in appalling shape with garbage, and crates all around, homeless people, dogs, cats, and rats running around. The trees and grass are overgrown and need some attention. There is a small fruit and vegetable stand and courtyard across from Low-income Housing; people are sitting on benches and walking around. There is a small grocer, a check cashing store, clothing store, pawn shops, and a barber shop. Casper Park at first seems to be welcoming and friendly but going deeper into the community you get a sense of territoriality.

The last community is Industrial Height, the first thing in the community is the school which is nice with a large playground attached. There is a church with a soup kitchen, the streets dirty but not too bad. However, the deeper into the community, the more garbage there is that lines the streets. Graffiti is all over,  from the church with signs of tagging in various buildings like the Better Health Clinic and the building next to it, which seems to be a gang’s hang out due to the massive skull sign out front. There are cars broke down, one on fire, garbage can on fire, buildings have large gang related murals painted on the some of the sides. The Department of Transportation is located here, down the street there is a rundown grocery with not much to choose from, there are boarded up store fronts and one store with busted out windows. Construction for re-development housing with burst sewage pipes with more dogs, cats, and rats running free. There are few cars on the road, an occasional motorcycle every so often and some people walking. This community is not welcoming; it has a feeling of being very unsafe, it is very closed-up and territorial areas Community Safety.

Health and Social Services

“Access to comprehensive, quality health care services is essential for promoting and maintaining health, preventing, and managing the disease, reducing unnecessary disability and premature death, and achieving health equity for all Americans. This topic area focuses on three components of access to care: insurance coverage, health services, and timeliness of attention. When considering access to health care, it is important also to include oral health care and obtaining necessary prescription drugs” (Access to Health Services. n.d.)Community Safety.

Sentinel City Healthcare System has various healthcare and social service facilities in all the diverse communities. There is the main hospital with the Emergency, Inpatient, and ambulatory care. Spread throughout the city are nine primary care clinics with Eighty-two physicians and eight specialty clinics with thirty-three doctors. The dental care there are three orthodontist clinics, one endodontist clinic, three dental hygiene clinics and two pediatric oral surgery clinics which are also spread throughout the city. Mental Health services are also available throughout the city the Mental facilities range from case management service to the State Mental Hospital to have a total of five options. The vision clinics and vision therapy centers are also spread throughout. Depending on the community is the deciding factor to what is available, unfortunately, the communities needing the most healthcare, the poor and impoverished communities have the least available or needs to travel the furthest. Eldercare social services that are available are medical assistance advocates, service animals, Government Entitlement Assistance, Senior Community Centers, Meals on Wheels, and Elder Abuse Prevention Advocates. There are 3472 senior living units, twenty-four Swing bed, thirty-six Long Term Care, and sixty-four Skilled Nursing facilities. More facilities are two hundred forty-eight Assisted Living, 2874 Nursing Home units, and 1048 independent senior living apartments, these are all spread through the city.

Healthy food choices are also of importance there is Jo’s Grocery in Nightingale Square that sells organic food for most their sales, there are three fruit and vegetable carts in two of the communities Acer Tech, and Casper Park placed at the courtyards in the community. The fourth community has a Soup Kitchen at the church that feeds the homeless and hungry healthy meals. Besides the large grocery store, there are many small groceries and one that is moderately sized in Industrial Heights. There are numerous fast food restaurants, Italian, donut shops, Sushi, Pizza shops, to name a few. There are a few of restaurants that are sit down dinners with healthy choices available Community Safety.

Safety and Transportation

Per the website, County Health Rankings, Community Safety considers not only intentional acts in neighborhoods and homes but also injuries caused accidentally. Many injuries are predictable and preventable. Living in unsafe neighborhoods can accelerate aging and harm health because of the chronic stress associated with it. Neighborhoods that are unsafe causes anxiety, depression, and stress, keeping people indoors, away from neighbors, exercise, and healthy foods due to the fear of violence. Jobs are harder to find because companies may be less willing to invest in unsafe neighborhoods (2017).

Sentinel City, has a high rate of violence, depending on the community is greater the risk of being a crime victim, There are Police patrolling in police cars in all communities. The police seem to have the city covered a good as possible, they are at the Grocery Store in Nightingale Square, directing traffic at the hospital in Acer Tech, and the School in Industrial Heights. Other that having an increased amount at City Hall for obvious the obvious reason of the protest there are also increased in Industrial Park for the broken storefront windows and patrolling on foot in Casper Park. Even tough there seems to be somewhat adequate police presence; I feel that it is highly possible for crime to be committed, especially in Industrial Heights and Casper park. Due to gang involvement, low-income and poverty, this makes it a greater chance for there to be crimes and aggravated assault being the top crime.

Transportation in Sentinel City appears to be mostly by taking the bus, the next would be by bicycle, and then by car. Traveling on foot seems to be another means used by the residents. The least costly is bicycling/walking, the riding the bus and last would be by car. Another form of transportation ing Sentinel City that would be to travel from city to city is the train systems; it passes above Pine Street behind City Hall in Acer Tech. There is a highway close by because of there is an overpass over Station Road in Nightingale Square. There are fire hydrants throughout Sentinel city, and there is a Fire Department that responds to the car and garbage can fire in Industrial Heights.

Conclusion

Sentinel City is just like any other city; there are kinds of people with many different situations. These people are rich, poor, or somewhere in between. There are no clear natural boundaries in Sentinel City, but you can see the conditions of the different communities an indication of these limits. The various communities where the people live, work, play, and how they live to affect their health. “Poverty and poor health worldwide are inextricably linked. The causes of poor health for millions globally are rooted in political, social, and economic injustices. Poverty is both a cause and a consequence of poor health” (Key Facts Poverty and Poor Health. n.d.)Community Safety.

References:

Access to Health Services. (n.d.). Retrieved June 05, 2017, from https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Community Safety. (n.d.). Retrieved June 06, 2017, from http://www.countyhealthrankings.org/our-approach/health-factors/community-safety

Cubbin, Pedregon, Egerter, & Braveman. (2008, September). Where We Live Matters for Our Health: Neighborhoods and Health. Retrieved June 5, 2017, from http://www.commissiononhealth.org/PDF/888f4a18-eb90-45be-a2f8-159e84a55a4c/Issue%20Brief%203%20Sept%2008%20-%20Neighborhoods%20and%20Health.pdf

Key Facts Poverty and Poor Health. (n.d.). Retrieved June 05, 2017, from https://www.healthpovertyaction.org/info-and-resources/the-cycle-of-poverty-and-poor-health/key-facts/

Saarloos, D., Kim, J., & Timmermans, H. (2009, June). The Built Environment and Health: Introducing Individual Space-Time Behavior. Retrieved June 05, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705214/ Community Safety

Data Management Plan Discussion Essay

The DNP Project: Data Management, Project Management And Ethical Issues

The data management plan articulates the outcome measure analysis to determine if the translation of the 4AT is effective in impacting restraint usage at the practicum site. The level of data outcome is ratio level (number of restraints). It is ratio level because it contains a true “0” value (no restraints). The planned analysis will include descriptive statistics (n, %) to measure the compliance of nurses and others using the 4AT by gathering daily paper forms of the assessment tool of all the admitted patients. The n, % of admitted patients that were assessed would be computed. To measure the compliance of nurses to document delirium in nursing care plans once associated risks are identified, descriptive statistics (n, %) will be computed. Assess barriers and comfort level of staff using the new 4AT, which will be queried and recorded by the DNP student during scheduled staff meetings and interviews, a qualitative content analysis of the staff statements about barriers will be conducted and categorized into themes. Comfort level will be presented using descriptive statistics (n, %) for the comfort levels of high, moderate, and low comfort regarding using the new 4AT.

To examine restraint use, the average daily restraint episodes will be compared between pre and post using an independent samples t-test. This test allows for a comparison of two independent groups (pre/post) on a continuous outcome (number of daily restraint episodes).  IBM SPSS version 28 will be used to conduct the independent t-test with a significance level of p < .05. Additionally, the restraint use rate per 1,000 inpatient days will be computed and presented for the pre and post intervention. A percentage change calculation will be presented for the rate comparison at pre and post intervention. Descriptive statistics and inferential statistical analyses will be presented in narrative and chart format.

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Project Management Plan and Gantt Chart

The implementation of the 4AT will be implemented over 10 weeks. The detailed project proposal, planning, data management and analysis, and dissemination plan can be found in the 32-week Gant chart (Appendix C).

Pre-Implementation Phase

The 4AT will be part of the daily charting of nursing staff. The DNP student must assess and review the SJMC delirium process and protocols during the pre-implementation phase. The DNP student will meet with stakeholders and unit staff to ensure multidisciplinary involvement for the implementation of the 4AT. The DNP student will also prepare educational resources and set-up meetings with stakeholders for the entirety of the project. Data Management Plan Discussion Essay

Week One of Implementation 

Pre-implementation data collection will consist of restraint usage for patients in 4West within the since January 1st, 2022. Information session on the implementation of 4AT will be held. The DNP student will train the staff and 4AT champions to lead the other staff during the implementation phase. Weekly discussions will be held with hospital leaderships, stakeholders, and members of the multidisciplinary team to ensure effective communication between DNP student and the implementation team related to weekly assessment and updates during the implementation stage. Educational seasons to the implementation staff will also include proper utilization and documentation of the 4AT form, and re-education will be planned as needed.

Week Two through Nine of Implementation

The implementation of the 4AT will occur during weeks two through nine. The DNP student will gather and assure completion of the delirium form daily for eight weeks of all the admitted patients in 4West. The project champions will also ensure the completion of the organizational restraint form per patient per event and online document restraint usage via Google document daily. If identified as at-risk or positive delirium, the DNP student will perform chart audits to ensure utilization of nursing care plans and identification of risk factors or precipitating factors that will prompt a follow-up with hospitalists or specialist providers. The DNP student will meet with the 4AT champions and have weekly discussions every Wednesday to receive feedbacks and modifications as needed. In week nine, the DNP student will conduct scheduled meetings and interviews of nursing staff and supervisors of 4West on barriers encountered with the utilization of the 4AT. In the same week, the DNP student will also gather data regarding the comfort levels of using the 4AT in the unit.

Week Ten through Eleven

Post-intervention data collection and analysis will occur from week ten through eleven. In week ten, the DNP student will compile all the data from week two through nine and provide the Statistician all necessary information for analyzes. Week Eleven will involve dissemination of information to stakeholders and wrap-up with staff. Week Eleven will also involve the discussion for sustainability in the organization.

DNP Project Budget

Expenses

The creation of a detailed budget for the DNP project is an essential strategy for effective progression and risk management of the project. Expenses include salary and benefits, supplies, services, statistician, and project manager. The DNP student will need to allocate 1000 hours with a rate of $0 per hour, which will lead to zero salary and expenses. The project mentor will also allocate around 400 hours for zero cost. The supplies and services are covered by the organization. The statistician will cost around $500 in the analyses and evaluation of data for the project.

Revenue Sources

Revenue sources include hospital sources and the DNP student. The hospital will be covering supplies, services, and overhead costs. The DNP will cover the necessary hours needed for completing the project in addition to paying for the statistician, which will be around $500. The revenue is equal to the total expenses of the project. Data Management Plan Discussion Essay

Table 1

Budget

EXPENSES

REVENUE

Direct

Billing

500

Salary and benefits

0

Grants

0

Supplies

0

Institutional budget support

0

Services

0

Statistician

500

Indirect

0

Overhead

0

Total Expenses

500

Total Revenue

500

Ethical Issues and Considerations

The DNP project proposal will be submitted to Chamberlain University’s IRB for predetermination process, and implementation of the project will commence once the project receives the approval letter. Additionally, the DNP student has obtained permission to conduct the project per facility IRB committee (Appendix D). Patient safety and protection will be the main focus of this project. The participants will be protected during this project, as their 4AT scores and restraint usage will be collected without identifying data, and scores will be reported in cumulative form and will be stored in a password-protected computer file in an encrypted format for seven years. The project does not require any informed consent from the participants and participants are informed of resources available to answer questions or concerns via phone call with confidentially in mind.

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Data Management Plan Discussion Essay