Presidential Healthcare Agendas

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Initial Post

The population health concern that I have selected in the opioid crisis.  The opioid crisis affects all people regardless of socio-economic class.  Addiction to opioids, especially illegal, can occur with as little as one dose.  According to Berman (2018), factors that contribute to the opioid crisis include “short-term effectiveness, lack of education and the unavailability of prescription medications”.

Administration Agenda

President Bush’s agenda was largely focused on stopping drug use before it started, healing America’s drug dealers and disrupting the illegal drug market (“The President’s National Drug Control Strategy” (n.d.).  President Bush was also an advocate for securing the countries borders to discourage illegal drugs from entering the country.

President Obama’s agenda focus was through the Affordable Care Act (ACA), commonly called “ObamaCare” which label substance abuse .  One of the main goals of the ACA was to improve access to health care.  Other key Agenda items were monitoring of prescription drugs, enabling safe disposal of needles, increasing access to naloxone and accelerating research on pain management.  President Obama was able to get the Comprehensive Addiction and Recovery Act passed.  The Bill was aimed at improving prevention and education, expanding naloxone availability, launching evidence-based opioid and heroin education and treatment programs (“Comprehensive Addiction and Recovery Act” (CARA) (n.d)) Presidential Healthcare Agendas.

President Trump has a three part plan to address the opioid epidemic.  Part one of the plan is aimed at reducing the demand for opioids and targeting over prescriptive practices.  Part two of the plan is aimed at reducing the amount of drugs that enter the country illegally as well as addressing illegal drugs domestically.  Part three of the plan focuses on evidenced-based treatment for addiction (“Ending America’s Opioid Crisis, The White House”, 2020).

The opioid crisis is a complex problem.  I believe that all of the approaches previous presidents have had can be effective.  Unfortunately, as with most problems there is a political divide that limits the effectiveness of the programs established.  I think one measure that could be effective is improving low income communities and creating jobs that allow for improved self-esteem.  I feel that uplifting communities as well as individuals could be an effective tactic for reducing illegal opioid use.  Prescriptive practices still need to be monitored.  In Michigan we have the Michigan Automated Prescription Service (MAPS), which monitors the amount of drug that is being prescribed and filled for the patient.  One of the causes listed by Berman (2020) was short-term effectiveness of the medication.  With that in mind, it may be a good idea to research non-opioid medications that have longer half-lives

References

Berman, D.,(2020). https://www.pharmacentra.com/three-factors-led-opioid-epidemic-america/. [Blog].

“Comprehensive Addiction and Recovery Act” (CARA).  (n.d.).  Retrieved June 2, 2020, from https://cadca.org/comprehensive-addiction-and-recovery-act-cara

“Ending America’s Opioid Crisis, The White House”, (2020). The White House. Retrieved June 1, 2020, from https://www.whitehouse.gov/opioids/

Response

Based on your discussion post it sounds like Bush, Obama, and Trump have all addressed the seriousness of the opioid epidemic during their presidential term(s).  As the new presidential election approaches, I think it is important for health care providers to review and understand what our current president has implemented in response to this ongoing issue.  As you mentioned in your post, the Trump Administration’s Strategy to fight the opioid epidemic consists of three elements: prevention, treatment and recovery, and reducing the availability of drugs.

Two ways health care providers can help prevent the opioid epidemic from growing are by utilizing safe prescribing practices and expanding the use of prescription drug monitoring programs (Office of Nation Drug Control Policy, 2019, pp. 5-6).  Following clinical guidelines and best practices when prescribing opioids is one way to ensure safe prescribing practices are being utilized by providers (Office of National Drug Control Policy, 2019, pp. 5).  Developing a universal drug monitoring program for the United States would be another beneficial way of preventing over-prescribing of opioids.  Some of the issues with the current Prescription Drug Monitoring Programs (PDMP) are that not all states require this tool to be used, certain electronic health records (EHR) are not able to be integrated into the PDMPs, and some providers feel their patient’s confidentiality will be compromised if they use PDMPs (Office of National Drug Control Policy, 2019, pp. 6).

I think it is important for all advanced care providers with prescribing rights to be educated and up to date on the national and state recommendations for opioid prescribing.  “The Minnesota Prescription Monitoring Program (PMP) was established to promote public health and safety by detecting diversion and misuse of prescriptions for controlled substances” (Minnesota Department of Health, n.d.).  In 2017, enrollment into the PMP was made mandatory for all prescribing providers (Minnesota Department of Health, n.d.).

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Resources

Minnesota Department of Health. (n.d.). Prescribing practices: Prescription monitoring program. Retrieved June 4, 2020, from https://www.health.state.mn.us/communities/opioids/mn

response/pmp.html

Office of National Drug Control Policy. (2019, January). National Drug Control Policy. Retrieved June 4, 2020, from https://www.whitehouse.gov/wp-content/uploads/2019/01/

NDCS-Final.pdf Presidential Healthcare Agendas.

Discussion: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

  • Review the Resources and reflect on the importance of agenda setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

 

Teenage Pregnancy

The United States has one of the most pregnancy rates of all industrialized countries (Solomon-Fears, 2015). Nonetheless, there have been improvements in the way this public issue is being handled to lead to a significant reduced rate. Scholars have been divided on the approach to tackle this health issue with no compromise on either side. One group prefers the abstinence-only education program, while the other favors the comprehensive approach to sex education.

The Bush Administration leaned toward the abstinence-only method, which led to increased federal money allocated for this approach to reduce and or prevent teenage pregnancy. This administration favored education to stop teenage sex as opposed to teaching safe sex which aides in encouraging teenagers and or giving them a sense of false security. An eight-point federal definition of abstinence education was established as the Welfare Reform Act of 1996 by this administration (Ballaro and Ginsburg, 2019).

The Obama Administration favored evidence-based approaches to broaden the interventions to reduce teenage pregnancy. This administration used rigorous evaluation strategies to choose from numerous interventions available. The Department of Health and Human Services was given the responsibilities to come up with as many as possible educational remedies to the plague of teenage pregnancy irrespective of opinions of the two groups earlier discussed. The culmination of using this approach led to the isolation of teenage pregnancy as a separate issue from adult women which led to the creation of Teen Pregnancy Prevention Initiative (TPPI) by this administration.

The Trump Administration favored the abstinence-only education method to reduce teenage pregnancy. This led to the significant cut of funding for the Teen Pregnancy Prevention Initiative of the Obama Administration. An amendment was approved in 2015 that allowed insurers to opt out of covering preventive services for women such as birth control in favor of abstinence. The funding cut was a $216 million savings for the government. On the other hand, it has been estimated that in 2010, expense from the government towards teen pregnancy and childbirth cost U.S. tax payers $9.4 billion (Teen Pregnancy Prevention, 2017). This however by no means is meant to undermine the stand of this administration, but to analyze the cost and effects of different approaches on this health concern.

References

Ballaro, B., & Ginsburg, J. (2019). Abstinence education. Salem Press Encyclopedia.

Pam Belluck. (2018). Trump Administration Pushes Abstinence in Teen Pregnancy Programs.

Solomon-Fears, C. (2015). Federal Strategies to Reduce Teen Pregnancy. Congressional Research Service: Report, 7–20.

Teen Pregnancy Prevention. (2017). Congressional Digest, 96(7), 30.

 

NURS_6050_Module01_Week01_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. Presidential Healthcare Agendas.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

NURS 5315 Advanced Pathophysiology Case Study

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NURS 5315 Advanced Pathophysiology Case Study

NURS 5315 Advanced Pathophysiology
Case Study #2 – Fall 2018

Mr. James is a 62 year old male in a primary care practice being seen for a health maintenance visit (last visit was over 10 years ago). His only complaint of note is fatigue but generally feels well. He denies any limitations in “doing the things I like to do”, including yard work and fishing. He works full time as a supervisor for a commercial construction company. He is married and has 2 daughters. His oldest daughter is expecting their first grandchild. NURS 5315 Advanced Pathophysiology Case Study.

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He has a history of “recreational” IV drug use when he was in his early 20s while he was in the military. Denies any drug use since that time. He indicates “minimal” alcohol use – generally no more than 2-3 beers or glasses of wine a week. He has no chronic illnesses and does not take any medicines on a regular basis. NURS 5315 Advanced Pathophysiology Case Study.

Physical exam:
Vitals: 38.1-97-18-183/139
Normocephalic. Alert & Oriented x3.
Eyes: PERL. No nystagmus, no icterus.
Neck: Supple, no cervical lymphadenopathy
Cardiovascular: Normal Rate and rhythm. No murmur, gallops. 2+/4+ radial, brachial, dorsalis pedis pulses bilaterally. No jugular venous distension. No edema.
Pulmonary: Lungs are clear. No dyspnea or orthopnea.
Abdomen: Soft and nontender, active bowel sounds. No liver enlargement; abdomen flat. No striae.
Skin: Warm and dry; no rashes. Multiple tattoos on both arms.
Rectal exam: Stool is brown, no rectal masses.

NURS 5315 Advanced Pathophysiology Case Study

Lab results:

CBC: WBC 9,000; RBC 5.10; Hemoglobin 15.3 g/dL Hematocrit 46%; 90; Platelets 152,000.
Electrolyte Panel: Sodium 136 mEq/L; Potassium 3.7 mEq/L; Creatinine 1.1 mg/dL; BUN 12 mg/dL; Glucose 115mg/dL
Alanine aminotransferase (ALT) 36
Aspartate aminotransferase (AST) 50
Bilirubin (total) 0.9 mg/dL
Hepatitis A IgM negative; IgG positive
Hepatitis B surface antigen negative; surface antibody positive; core antibody negative
Hepatitis C (HCV) antibody reactive (positive), Hepatitis C RNA positive with an undetectable viral load.

Respond to the following questions regarding the Case Study

1. The clinical scenario is most consistent with which type of hepatitis? You may list your answer below using a bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.

2. What specific data in the clinical scenario supports your diagnosis? You may list your answers below using bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts)

3. What is the most likely cause of this patient’s diagnosis you noted in Question 1? You may list your answer below using a bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.

4. Describe key pathophysiologic concepts that relate to the diagnosis in question 1. To answer this question completely, you must answer all of the sub-questions below using complete sentences. Each sub-question may be answered in 1-6 sentences. ***Citations are required for each answer to each question using APA format. You MAY NOT use direct quotes.

a. How does Hepatitis lead to an increased risk of hepatocellular carcinoma? Describe how the virus affects the hepatocytes and may lead to cancer. ( 10 pts)

b. How does Hepatitis lead to cirrhosis of the liver? Describe the pathologic steps of how cirrhosis develops and how cellular changes can lead to liver failure. ( 10 pts). NURS 5315 Advanced Pathophysiology Case Study.

c. One of the negative sequela of liver failure is increased bleeding. Why do individuals with liver failure experience potentially life threatening bleeding? Describe how liver failure leads to coagulopathy. ( 10 pts)

d. Portal hypertension is also a negative sequela of liver failure. Describe how liver failure leads to portal hypertension AND how portal hypertension manifests. (10 pts)

5. Mr. James is concerned that he will transmit the virus to his new granddaughter after she is born.
What is the likelihood of transmitting the virus to his granddaughter? Provide a single sentence that includes your rationale. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.

APA Format

Information is presented in a scholarly manner (clear, grammatically correct) and reflects synthesis of information from sources. APA format is correctly used for citations and references. Submission follows assignment guidelines; does not exceed page limit. (15 pts). NURS 5315 Advanced Pathophysiology Case Study.

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Week 1- The Issue of Mental Healthcare Access

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Week 1- The Issue of Mental Healthcare Access
COLLAPSE

Main Question Post-Across America, people are suffering in silence and afraid to seek treatment or sometimes even afraid to tell anyone of their ailment. Mental illness is the ailment that- due to stigma, lack of access and other factors- many Americans are not being treated for. Past presidential administrations have addressed some of the concerns regarding mental health treatment but more progress needs to be made, especially in regards to access to mental health services.

Mental health access has been a significant health concern in the United States that continues to need addressing. According to a report from Mental Health America, “17% (over 7.5 million) of adults with a mental illness remain uninsured” and of those who did have insurance, 56.5% received no treatment in the past year (Mental Health America, 2020). The issue of mental healthcare access has many facets, including but not limited to provider shortage, high cost, insurance coverage disparity, social stigma and geographical barriers to offered care, such as living in a rural area (Cohen Veteran’s Network, 2018). Several presidential administrations have tried to address some of these concerns that lead to inadequate mental health access.

Under President George W. Bush, the New Freedom Commission on Mental Health was created in 2002, which outlined suggestions for improving services for those dealing with mental illnesses (Hart, 2016). This was an attempt for mental health experts to speak out and offer their opinions on how the government could best impact the wellness of those affected by mental illness and it also identified several barriers to access that could be addressed by the government (President’s New Freedom Commission on Mental Health, 2003). While the commission was useful in identifying areas of need and barriers, it fell short of leading to any immediate policy change. The Paul Wellstone and Pete Domenici Mental Health Parity and Addictions Equity Act was signed in 2008 by President Bush, which addressed access to care by stating that the coverage in health insurance for mental health had to be equal to the coverage for other medical conditions (Hart, 2016) Week 1- The Issue of Mental Healthcare Access. Once again this was a step in the right direction but had no effect on the millions of Americans who were uninsured, living far from providers, unable to afford care nor did it address the stigma surrounding mental illness or its treatment.

President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law in 2010 which allowed Medicaid plans to include mental health, in addition to other health plans eligible in the ACA (Hart, 2016). While the affordable care act did provide some with insurance, the Census Bureau showed that In 2018 27.5 million people remained uninsured, a number which had increased since 2017 when the number was 25.6 million uninsured (Berchick, Barnett & Upton, 2019). In 2015, President Obama signed the Cures Act, which included a multifaceted approach to improving mental health care access. It helped increase mental health workers and providers, ensured health plans were held accountable to pay for mental health services under the parity law and increased resources for mental health services (Carlock, 2016).

More recently, in 2019 President Donald J. Trump increased health care, including mental health benefits, to veterans who otherwise would not have qualified for health insurance (Cronk, 2018). While this did not affect Americans as a whole, it was a much-needed lifeline to our veterans and transitioning service members. Since the Corona virus outbreak, President Trump has taken initiative to ensure those with mental illness can get care by expanding access to telemedicine for Medicare patients, ensuring those who are self-isolating, those in rural, hard to reach areas and those at highest risk can get the medical health services they need and the President urged insurance companies to also reevaluate their telemedicine benefits, as well (U.S. Centers for Medicare & Medicaid Services., 2020). Time will tell if these changes are permanent and what the new administration or second term of this current administration will enact for mental health access in the coming years.

While all three Presidents addressed mental health in their own way, the specific issue of access has yet to be resolved. I would have made a few changes, more along the lines of President Obama’s Cures Act. Anything that will address mental health care access will have to be a multipronged approach that does not only address the insurance portion of the problem. Just as important as coverage is the need for more mental healthcare providers, the regulation of care cost and, perhaps the most important, the stigma around mental illness and its treatment needs to be proactively addressed. I believe education and awareness will be the best tool for combating stigma and once that is done, the need for reforms and policy will naturally come about as the population at large becomes aware of the intense need.

Resources

Berchick, E.R., Barnett, J.C., and Upton, R.D. (2019, November 9). Health Insurance Coverage in the United States: 2018. Report number P60-267 (RV).  https://www.census.gov/library/publications/2019/demo/p60-267.html

Carlock, H. (2016, December 16). Signed, Sealed, Delivered: Mental Health Reform is a Law. National Alliance on Mental Illness (NAMI). https://www.nami.org/Blogs/NAMI-Blog/December-2016/Signed-Sealed-Delivered-Mental-Health-Reform-is

Cohen Veteran’s Network. (2018). America’s Mental Health 2018: Attitudes and Access to Care [Infographic]. https://www.cohenveteransnetwork.org/wp-content/uploads/2018/10/CVN_Infographic_10.8.18_1045am.pdf

Cronk, T.M. (2018, January 10). President Trump signs order to improve mental health care for transitioning veterans. US Army. https://www.army.mil/article/198936/president_trump_signs_order_to_improve_mental_health_care_for_transitioning_veterans

Hart, J.W. (2016, February 15). How Presidents Have Shaped Mental Health Care. National Alliance on Mental Illness (NAMI). https://www.nami.org/Blogs/NAMI-Blog/February-2016/How-Presidents-Have-Shaped-Mental-Health-Care. Week 1- The Issue of Mental Healthcare Access.

Final Report for the President’s New Freedom Commission on Mental Health, SMA 03-3832, (May 2003).  https://govinfo.library.unt.edu/mentalhealthcommission/index.html

Mental Health America. (2020). The 2020 State of Mental Health Report. Mental Health America. https://www.mhanational.org/issues/state-mental-health-america

U.S. Centers for Medicare & Medicaid Services. (2020, March 17). President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak [Press Release]. https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak

Response

I appreciate you initiating a discussion on mental illness. When we think of someone being “healthy,” we think of the physical being of that individual. We associate obesity, hypertension, diabetes, etc. as being unhealthy. However, maintaining mental health is just as important as physical health. I often think people assume that mental health conditions, such as anxiety and depression, are self-made and, therefore, should be self-controlled.  I wholeheartedly agree that the stigma of mental health begins with a lack of knowledge of how powerful the brain is. It’s a harsh reality that people with mental health issues don’t receive the same support as someone with cancer or any other chronic or acute illness. In fact, “many people with a mental illness report the associated stigma being as bad, if not worse, than the illness itself” (Shann, C. et al., 2019). While I agree that mental health services’ accessibility needs to be expanded, I believe the fight starts with attacking the stigma of mental health illness through education.

References

Shann, C., Martin, A., Chester, A., & Ruddock, S. (2019). Effectiveness and application of an online leadership intervention to promote mental health and reduce depression-related stigma in organizations.

Journal of Occupational Health Psychology, 24(1), 20–35. https://doi-org.ezp.waldenulibrary.org/10.1037/ocp0000110

 

Discussion: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

Review the Resources and reflect on the importance of agenda setting.
Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

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NURS_6050_Module01_Week01_Discussion_Rubric

Grid View
List View

Excellent Good Fair Poor
Main Posting

45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

 

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

 

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

 

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness

10 (10%) – 10 (10%)
Posts main post by day 3.

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)
Does not post by day 3.

First Response

17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English. Week 1- The Issue of Mental Healthcare Access.

 

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

 

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

 

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response

16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

 

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

 

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

 

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation

5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

Mental Health Accessibility and Knowledgeable Treatment

 

My topic for discussion is the need for adequate mental health accessibility and the proper treatment to all those in need. The mental health care crisis continues to be a topic that effects the community. The Center of Disease Control (2018) states that individuals with mental health disorders face an increase risk of physical health issues such as heart disease, diabetes and HIV. Those individuals have a decrease in life expectancy by 25 years largely due to treatable illnesses.

The Bush agenda was to understand the need for mental health care within the United States. An executive order was signed in 2002 to further investigate the need for mental health care. The interim order was for a six-month period of research for the delegated official to present the barriers to the unmet needs, yet to come with evidence-based strategies that were successful.   According to National Institute of Medicine (2005), in 2004 Bush set an agenda for individuals living with mental illness to be viewed as more acceptable.

During the Obama administration his agenda was to look at mental health not only for veterans, and adults, but for the undiagnosed youth as well.  The Mental Health and Substance Abuse Parity Act was signed in 2008.  This offered individuals with mental health disorders to have their care treated and paid for through insurance equally as it would have been for other healthcare services. During a health conference (2013) former President Barak Obama stated that less than 40% of individuals with mental health issues seek treatment.  He went on to make a very thought-provoking statement that if one had a broken limb, they would seek medical attention what is so different? If something needs repair, we seek help.

Trumps current agenda is to tackle mental health among veterans. The agenda is to encourage outright mental health for veterans, through organizations looking into those with mental health disorders instead of leaving the responsibility on the veteran themselves.  A fact sheet from Whitehouse.gov (2019), stated that veterans often sustain physical or emotional traumatic experiences that cause them to experience mental health issues.  The article goes on to state that there are 20 veterans on average in 2016 that commit suicide daily.

Each administration sought out to focus on one or more parts of the mental health puzzle.  Most did not key in on the educational aspect for those who need it most teachers, nurses, law enforcement, doctors, and community organizations emphasizing the need for the children and families of those living with individuals undiagnosed or diagnosed with mental or behavioral illness that actively effect the ability to be successful in society. Currently I am with a nonbiological child that I have found it to be difficult to have resources that are knowledgeable in providing help to combat her illness Week 1- The Issue of Mental Healthcare Access. This has become more of an issue for myself and family ultimately effecting my income and mental health as well.  This should be a focus the health of a family unit dealing with individuals with mental/behavioral health disorders.

Center of Disease Control. (2018). Learn about Mental Health. Retrieved from: https://www.cdc.gov/mentalhealth/learn/

Fact Sheets. President Donald J. Trump Issues a National Call to Action to Empower Veterans and End the National Tragedy of Veteran Suicide. (2019). Retrieved May 31, 2020 from: https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-issues-national-call-action-empower-veterans-end-national-tragedy-veteran-suicide/

Lenzer J. (2005). Bush unveils mental health action plan. BMJ: British Medical Journal, 331(7517), 592.

Obama B. (2013, June 5). Remarks by the President at National Conference on Mental Health. President Obama Speaks at the National Conference on Mental Health, East Room. https://obamawhitehouse.archives.gov/photos-and-video/video/2013/06/03/president-obama-speaks-national-conference-mental-health#transcript. Week 1- The Issue of Mental Healthcare Access.

Structural Versus Strategic Family Therapies

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Structural Versus Strategic Family Therapies

Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Structural Versus Strategic Family Therapies Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

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                                        Learning Objectives

Students will:

· Compare structural family therapy to strategic family therapy

· Create structural family maps (Refer to Gerlach (2015) in this week’s Learning  

   Resources for guidance on creating a structural family map.) or LOOK AT THE 

   ATTACHED ONE.

· Justify recommendations for family therapy

                                                     The Assignment

In a 2- to 3-page Structural Versus Strategic Family Therapies paper, address the following:

· Summarize the key points of both structural family therapy and strategic family

therapy.

· Compare structural family therapy to strategic family therapy, noting the

strengths and weaknesses of each.

· Provide an example of a family in your practicum using a structural family map.

Note: Be sure to maintain HIPAA regulations (Refer to Gerlach (2015) in this 

  week’s Learning Resources for guidance on creating a structural family map.) or 

  LOOK AT THE ATTACHED ONE.

· Recommend a specific therapy for the family, and justify your choice using the

Learning Resources

Required Readings

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

  • Chapter 5, “Bowen Family Systems Therapy” (pp.      69–88)
  • Chapter 6, “Strategic Family Therapy” (pp.      89–109)
  • Chapter 7, “Structural Family Therapy” (pp. 110–128)

Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110. Structural Versus Strategic Family Therapies.

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167–174. doi:10.1080/01926187.2013.794046

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. doi:10.1080/01926187.2012.727673. Structural Versus Strategic Family Therapies.

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113

Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. doi:10.1080/10503307.2013.856044

                                                     Required Media

Psychotherapy.net (Producer). (2010). Bowenian family therapy [Video file]. Mill Valley, CA: Author.

Triangle Productions (Producer). (2001). Brief strategic therapy with couples[Video file]. La Jolla, CA: Author. Structural Versus Strategic Family Therapies.

Performance Appraisal – ideal nursing unit essay

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Performance Appraisal – ideal nursing unit essay

Subjective and Objective Aspects

Discuss the subjective and objective aspects of performance appraisal evaluations and how nurse managers can make these experiences most useful to clinical nurses.

Evaluators

Examine and discuss who should evaluate clinical nurses. Should it be an evaluation by peers, oneself, nurse manager, shift supervisor, physician, nurse extender, and so on? Students should identify who should participate in the performance evaluation process and what their role should be, with a rationale for why they should contribute their feedback.

Analyze the common evaluator errors as defined in the assigned readings and describe each in your own words. Discuss how an evaluator can avoid these nasty pitfalls. Performance Appraisal – ideal nursing unit essay.

Performance Appraisal

In nursing clinical practice, performance appraisals are an integral part of improving performance and not a tool to find weaknesses in practice and punish nurse practitioners. Through collaboration with nurse managers and supervisors, nurses are provided with the opportunity to discuss their clinical performance and to highlight areas that are performed well and those that require support or training. This helps an individual to obtain adequate skills and knowledge to become an exemplary team player (Melnyk et al., 2014). In this paper, I will discuss the objective and subjective aspects that should be included in performance appraisals. A brief discussion of clinical nurse evaluators, the role played by each and the clinical tools that can be used to elicit feedback will also be provided. Performance Appraisal – ideal nursing unit essay.

Subjective and Objective Aspects of Performance Appraisal Evaluations

            When conducting a performance appraisal evaluation, it is necessary to ensure that the likelihood of nurse employees to believe that the entire process is subjective rather than objective is important. Subjective aspects evaluate the performance of a nurse in general while objective aspects evaluate the performance of a nurse against specific established standards (Fan et al., 2015). Subjective features include intangible aspects that a nurse possesses such as personality, communication skills, conflict resolution skills, work quality, teamwork, strengths and weaknesses of nurse practitioners.

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Nurse Managers can make good use of subjective aspects in clinical practice by using the information provided to control how nurses are rewarded and incentivized. Incentives motivate nurses with good performance to become the best and those who perform averagely or minimally to put more effort into their clinical practice (Fan et al., 2015).  Similarly, subjective aspects can be used to identify opportunities for training among nurses. In this context, training can be particular to obtain skills and knowledge in problem-solving, communication or to acquire knowledge about the specific topic area in the nursing field. Nurses can then apply this knowledge and skills in clinical practice to improve treatment outcomes. Performance Appraisal – ideal nursing unit essay.

In the evaluation process, objectivity based on tangible and measurable evidence and this has a less likelihood of biases. Therefore, objective aspects may include, specific ratings on the quantity of work done by a nurse, time to report and leave work, a completion rate of duties assigned among others (Fan et al., 2015).  Objective experiences can be made more useful when making decisions about the allocation of work/duties and promotions. This is because objectives aspects provide more tangible data that can be used to gauge a person’s capability to handle specific tasks.

Evaluators

Clinical nurses should be evaluated by nurse managers. Nurse managers have two roles in clinical practice: to serve as administrative leaders and to provide clinical care. Since they act as in charges, they plan, coordinate and evaluate nursing activities in healthcare settings. According to Fan et al., (2015), nurse managers are experts in their areas of practice and possess exemplary instructional, communication and interpersonal skills to be role models for new graduates, students, and other advancing nurses. Performance Appraisal – ideal nursing unit essay.

In the performance evaluation process, the role of nurse managers should be specific to orientation, training, appraisal and providing feedback. In orientation, nursing students should be provided with a description of the roles and responsibilities they will be performing. They should also engage then in continuous training to develop their skills and capabilities further (Spano-Szekely et al., 2016).  Preferably, they can also identify those with high potential and reward them to progressively inspire good performance. It is mandatory that when evaluating the students, nurse managers provide regular feedback to help the students determine whether additional skills and training are needed for acceptable performance, or whether they exceed expectations. Feedback also helps to minimize instances of poor practice. Possible tools that can be used to provide feedback include the feedback sandwich that starts with positive feedback, negative feedback then closing with specific that build a student’s trust and courage (Helminen et al., 2016).  The situation-behavior-impact is another tool which provides learners with the opportunity to reflect on their actions and what they are required to change. Performance Appraisal – ideal nursing unit essay.

 References

Fan, J. Y., Wang, Y. H., Chao, L. F., Jane, S. W., & Hsu, L. L. (2015). Performance evaluation of nursing students following competency-based education. Nurse education today, 35(1), 97-103.

Helminen, K., Coco, K., Johnson, M., Turunen, H., & Tossavainen, K. (2016). Summative assessment of the clinical practice of student nurses: A review of the literature. International Journal of Nursing Studies, 53, 308-319.

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.

Spano-Szekely, L., Griffin, M. T. Q., Clavelle, J., & Fitzpatrick, J. J. (2016). Emotional intelligence and transformational leadership in nurse managers. Journal of Nursing Administration, 46(2), 101-108. Performance Appraisal – ideal nursing unit essay.

NURS 6050 week 1 Discussion: Presidential Agendas

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Initial Post

The health care topic that I’ve chosen to explore that has reached the Presidential level is the  Opioid epidemic.  Health care disparities seem to arise daily. Opioid abuse /addiction occurs from the use of prescription drugs, none prescription drugs as well as illegal drugs. Drug abuse has been an ongoing challenge in years past and present.  According to (Murray 2019) “Millions of Americans are impacted by the opioid crises”. People are dying at alarming rates due to opioid over doses. Drug abuse has crippled our neighborhoods and communities for decades and continues to be on the rise.” The misuse of and addiction to opioids including prescription opioids, heroin, and synthetic opiods such as Fentanyl, is a serious problem that affects not only the health of many Americans but social and economic welfare of our country” (National Institute on Drug Abuse [NIDA,2018]). In this forum I will explore the stance of President Bush, Obama, and Trump and their strategic efforts to address this epidemic which continues to be an ongoing concern to date NURS 6050 week 1 Discussion: Presidential Agendas.

Presidential Agendas

According to (Ending America’s Opioid Crises, The White House) “President Trump’s Initiative to Stop Opioid Abuse, unveiled in 2018,  confronting the driving forces behind the opioid crises”. The first part of his plan was to educate American’s on the the dangerousness of abusing opioids. Secondly, he wanted to get better control on how drugs were being imported into the United States. To date the President plans to build a wall on the Mexican boarder, who tends to be a heavy supplier. He also, plans to rid the state of illegal immigrant drug traffickers. His final efforts are to aid those who struggle with addiction with more treatment options. President Trump has allocated billions of funds to address the ongoing concerns of the opioid crises. I agree with his on going efforts to limit access to these drugs both legally and illegally. My only opposition is that I would place more treatment centers in those areas that are largely affected, giving equal access to all that has fallen victim.

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President Obama signed a Bipartisan Bill to Combat Opioid Epidemic. According to (Reilly, 2016) “On July 22, President Barrack Obama signed into law the Comprehensive Addiction and Recovery Act, legislation that is the first of its kind to offer a multifaceted federal response to the prescription opioid and heroin epidemic ravaging communities across the United States”. The purpose of this bill will be to combat the misuse of opioids and ensure that people have access to effective treatment. This plan includes proper surveillance by Medicare prescription drug plans to oversee safe prescribing. According to (Reily,2016) “In 2011, more than 1.7 million Medicare beneficiaries received an opioid dose that put them at increased risk of overdose; nearly a quarter million of them received these high doses for 90 or more consecutive days”. Expanding treatment options is also at the forefront of this plan as well. Commonly compared to President Trump’s plan the Comprehensive Addiction and Recovery Act also addresses the intricate concern of ensuring proper treatment.

In 2002 President Bush announced his drug control strategy. President Busch stated ” We’re determined to limit drug supply, to reduce demand and to provide addicts with effective and compassionate drug treatment” (Bush, 2002). Bush also vowed to fight drug use and substantially those who dealt in drugs. Another effort was to target drug supply, by  calling on the coast guards to increase security at the boarders to limit drugs from coming in overseas. The president also sought help from our Homeland Security Director to examine ways to improve our national boarder management system. President Bush urged Americans to do their part as well and to not misuse and abuse drugs in any way. He also urged parents to do their jobs by educating their children on the importance of staying clear of drugs. I also agree with Presidents Bush’s efforts as well, and although the drug crises has continued to arise I believe with every effort put into place we become a step closer in bridging this problem. My only draw back is that president Bush did not implement in his plan how he would combat the control of prescription opioids which continues to be on the rise.

While opioid addiction continues to be a common place among American’s, as a health care professional I am grateful that this is not only viewed as an addiction but also an illness that requires proper treatment. I believe that it is also important to educate our patients after major surgeries the potential risk of becoming addicted to prescription pain medications. As health care providers we really need to encourage patients to choose the least addictive form of medications possible. I also believe that its important to place treatment centers in the most affected areas and in places were patients can easily access them. I commend all three presidents for their conscious efforts to combat this epidemic. Although American’s continue to struggle with this issue, I believe with the strategies that have been put into place Americans have a greater chance at being liberated from this deadly addiction.

References

Murray, K., (2019).Racial Disparities in Opioid Addiction Treatment in Black and White Populations. Retrieved June,1,2020 from https.//www.addictioncenter.com/news/2019/10/racial-disparities-opioid-addiction-treatment/

Ending America’s Opioid Crises|The White House,(2020). The White House. Retrieved June, 1, 2020, from https://www.whitehouse.gov/opioids/

Reilly, K., (2016). President Obama Signes Bipartisan Bill to Combat Opioid Epidemic . Retrieved on June, 1, 2020, from https://www.pewtrusts.org/en/research-and-analysis/articles/2016/07/22/president-obama-signs-bipartisan-bill-to-combat-opioid-epedimic NURS 6050 week 1 Discussion: Presidential Agendas.

President Bush Announces Drug Control Strategy (2002). Retrieved June, 2, 2020, from https://2001-2009.state.gov/p/inl/rls/rm/8451.htm.

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

  • Review the Resources and reflect on the importance of agenda setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

 

Discussion – Week 1
COLLAPSE

After reading the discussion question, I had a lot of topics that came to mind. I work in the Emergency Department and we receive a lot of patients who has narcotic addiction and are mentally disabled. So instantly, I wanted to choose between the two but I think that health insurance is a bigger topic and so I decided on that. I have been in this country for 20 plus years and I can say that I have been lucky and blessed that I never had to worry about having insurance. The hospital I currently work at is located in a underserved community where a high percentage of our patients are homeless. Our hospital was built to provide care to these communities and we are able to do so with the help of the government. Yes, we are funded by the government. Due to the pandemic, our hospital is facing a budget cut and we are not really sure whats going to happen to these communities who have leaned on us for support. We have never turned anybody away. We don’t ask if you have money to pay or if you are legal in this country NURS 6050 week 1 Discussion: Presidential Agendas. We serve everyone equally. In my opinion, this is how it should be. We should be a country where we can take care of our people, not based on what insurance they have or if they have papers. With that thought, I will discuss what President Bush, Obama and Trump have done regarding this topic.

President Bush was believed to have strengthened  America’s health care system (The white house, n.d.). The president enacted policies that helped more than 40 million Americans get better access to prescription drugs (The white house, n.d.). He also ensured healthcare was affordable, transparent, portable and efficient by empowering Americans to take charge of their health care decision making, helped provide treatment to nearly 17 million people, increased funding at the National Institutes of health and expanded the trade adjustment assistance program add a tax credit to help lower the price (The white house, n.d.). He also made sure the veterans were included in his policies. He increased funding for their medical care, created a program for seriously-injured members, provided money to support traumatic brain injury patients, and he created the defense center for psychological health (The white house, n.d.).

During the Obama administration, he created Affordable Care Act, also known as Obamacare, which ensures all Americans has health insurance (Health for California, n.d.) During this time, everyone had to have health insurance or you might be subjected to a penalty (Health for California, n.d.) With Obamacare, businesses who has more than 50 employees have to provide health care insurance (Health for California, n.d.) Health insurance also cannot deny a person based on their pre-existing conditions (Health for California, n.d.). More advantages include covering adults over 65 years of age, young adults are added to their parents until age of 26 and the premium is based on your income to ensure they are affordable.

During Trump’s campaign, he already mentioned asking Congress to immediately repeal Obamacare (Atkinson, 2017). On the official white house website (n.d.), it stated:

“Obamacare is hurting American families, farmers, and small business with skyrocketing health insurance cost. Moreover, soaring deductibles and copays have made already unaffordable plans unusable. Close to half of U.S. counties are projected to have only one health insurer on their exchanges in 2018. Replacing Obamacare will force insurance companies for their customers with lower costs and higher-quality service. In the meantime, the President is using his executive authority to reduce barriers to more affordable options for Americans and U.S. businesses.”

What do you think Trump has done?

References

Atkinson, J. (2017). The health care policies of President Trump. Retreived from  https://journal.practicelink.com/reform-recap/the-health-care-policies-of-president-trump/

Health for California (n.d.) Obama Care California. Retreived from  https://www.healthforcalifornia.com/obamacare#:~:text=Obama%20Care%20California,Affordable%20Care%20Act%20(PPACA).&text=Obamacare%20ensures%20all%20Americans%20in,of%20money%20in%20the%20process.

The White House: President George W. Bush. (n.d.) The Bush Record. Retreived from  https://georgewbush-whitehouse.archives.gov/infocus/bushrecord/factsheets/healthcare.html

White house (n.d.). Healthcare. Retreived from  https://www.whitehouse.gov/issues/healthcare/

 

NURS_6050_Module01_Week01_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

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Discussion – Week 1
COLLAPSE

The topic I chose for this initial discussion is improving healthcare access in the American Indian population. According to the Indian Health Service (IHS), “The American Indian people have long experienced lower health status when compared with other Americans” (ihs.gov). 28.6% of American Indians under the age of 65 are without health insurance coverage (CDC.gov). Due to economic adversity, inadequate education, poverty, discrimination of health services, cultural differences and poor social conditions, lower life expectancy (approximately 5.5 years less) and disease burden is seen among the American Indian people when compared with other Americans (IHS.gov). The leading causes of death in American Indians include diseases of the heart, malignant neoplasm, unintentional injuries, and diabetes (IHS.gov). Regardless of political affiliation, the past three presidents of the United States, George W. Bush, Barack Obama and Donald Trump, incorporated methods in their administrative agendas regarding access to healthcare in an attempt to improve quality of life for the American Indian people.

President George Bush’s administration pushed to cut funding to healthcare for American Indians, indicating that “urban Indians can find care at community centers” (Indianz, 2007). Democrats and Republicans alike worked to reverse the cut in the 2007 and 2008 budgets. According to the same article, “Urban Indian organizations provide health services such as dental, pharmaceutical, vision, alcohol or mental health treatment, suicide prevention and family wellness” (Indianz, 2007) NURS 6050 week 1 Discussion: Presidential Agendas. By cutting funds to this important organization, American Indians would be without access to healthcare and health services.

President Barack Obama and his administration focused on strengthening the government-to-government relationship with Indian Tribes by implementing Executive Order 13175, “Consultation and Coordination with Tribal Governments” (Obama, 2011). Further, President Obama “signed into law the Affordable Care Act (ACA), which is improving the quality of health care and making it more accessible and affordable for all Americans, including Native Americans” (Obama, 2011). The Obama administration continued to provide resources for the American Indian people by ensuring the ACA implemented new and expanded services available through IHS (Obama, 2011). Additionally, First Lady Michelle Obama launched Let’s Move in Indian Country to ensure healthy and affordable choices of food for children and families and improving opportunities for physical activity (Obama, 2011).

President Donald Trump, considering the recent COVID-19 pandemic, provided multiple resources for American Indians regarding access to healthcare. According to President Trump, in early May 2020, “the CARES Act [was signed] into law, providing $8 billion to address coronavirus preparedness, response, and recover for American Indians” (Trump, 2020). An additional $1 billion was allocated through the IHS to support tribes and tribal organizations in their coronavirus response efforts (Trump, 2020). Continuing with President Obama’s efforts in improving government relationships, President Trump worked to enhance coordination between the Federal Government and tribal leaders. Finally, “President Trump re-activated the White House Council on Native American Affairs to promote economic development and rural prosperity in Indian Country” (Trump, 2020).

As healthcare workers, we are drawn to helping those who are in need, and ensuring our patients have access to the highest level of care. As a registered nurse in a rural area, I often encounter the American Indian population. By keeping myself educated on the government’s agenda regarding access to healthcare for the American Indian people, I can implement change and ensure my community continues to receive the access and resources needed to receive this highest level of care.

 

 

References

Disparities: Fact Sheets. (2019, October). Retrieved June 2, 2020, from https://www.ihs.gov/newsroom/factsheets/disparities/

FastStats – Health of American Indian or Alaska Native Population. (2017, May 3). Retrieved June 2, 2020, from https://www.cdc.gov/nchs/fastats/american-indian-health.htm

Indianz. (2007, March 12). Bush administration takes limited view of Indian health. Retrieved June 2, 2020, from https://www.indianz.com/News/2007/001803.asp

Obama, B. (2011, December 2). Obama Administration Record for American Indians and Alaska Natives. Retrieved June 2, 2020, from https://obamawhitehouse.archives.gov/sites/default/files/docs/american_indians_and_alaska_natives_community_record_0.pdf

Trump, D. J. (2020, May 5). President Donald J. Trump is Protecting the Native American Community as We Combat the Coronavirus. Retrieved June 2, 2020, from https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-protecting-native-american-community-combat-coronavirus/ NURS 6050 week 1 Discussion: Presidential Agendas.

Organizational Analysis essay assignment paper example

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Organizational Analysis essay assignment paper example

Required Deliverables
Parts 1–3 of this five part assessment will guide the recommendations you make in Part 4, and help determine what form of leadership is needed in Part 5.

Part 1: SWOT (Strengths, Weaknesses, Opportunities, Threats) or PEST (Political, Economic, Socio-cultural, Technological) Analysis Table.
Part 2: Brief Organizational Assessment Narrative and Organizational Scorecard Table.
Part 3: Brief Gap Analysis Narrative and Gap Analysis Table.
Part 4: Executive Briefing Report.
Part 5: Brief Leadership Implications Narrative.

Preparation
Before you create and submit your Deliverables, select a familiar health care organization to use in each assessment in this course. Choose the organization where you currently work, an organization where you have previously worked, or an organization where you might like to work in the future. Organizational Analysis essay assignment paper example.

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Directions
Conduct an organizational analysis for your selected organization. Incorporate each of the following parts and be sure you carefully read the requirements for each. Organizational Analysis essay assignment paper example.

Part 1: Environmental Assessment
Conduct a brief environmental analysis using a tool such as SWOT or PEST and summarize your findings in table format. You may choose to do both a SWOT and a PEST (or other) analysis, but you are only required to do one. Include impact from the Affordable Care Act in your analysis.

Part 2: Organizational Assessment
Create a table based on your internal analysis of the organization\’s mission, vision, values, culture, and strategic direction. Then, write a brief narrative in which you explain the organization\’s mission, vision, values, and culture, as well as the current strategic direction. Organizational Analysis essay assignment paper example.

Apply a framework such as the organizational, or balanced, scorecard to measure performance relative to the strategy. Indicate if the strategy fits the external environment.
You may use any table format you wish, but be sure you include 1–2 priority performance indicators, internal benchmarks or targets (be sure you include financial and quality targets), and the four categories.
Note: Part 2 is comprised of your brief narrative and the organizational scorecard in table format.

Part 3: Gap Identification
Select 1–2 priority performance indicators within each of the four major categories: business operations, finance, customer satisfaction, and organizational learning and growth. Organizational Analysis essay assignment paper example.

Identify the performance measurements and internal benchmarks or targets for each of the priority performance indicators. Be sure you include financial and quality targets. Use a table similar to the organizational scorecard to identify the gaps between desired and actual performance. Be sure you integrate the strategic direction and scorecard into your gap identification.
Conduct a gap analysis of actual to benchmark or target outcomes. Refer to and integrate the organizational strategic direction and scorecard. Briefly explain any additional gaps you identified between stated organizational values and actual culture. Organizational Analysis essay assignment paper example.
Note: Part 3 is comprised of your gap identification table and a brief narrative.

Part 4: Leadership Recommendation
Write an executive briefing report in which you clearly and concisely outline evidence-based recommendations to close the identified gaps and better align with organizational strategy and targets. Organizational Analysis essay assignment paper example.

Include within your recommendations the resources that will be needed, such as human, financial, technical, and so on. Be sure that you reference your resources to support your recommendations. Keep in mind that this is an executive briefing report; you want to be thorough while still being concise.
Reference a minimum of five resources in this assessment. Look for professional, scholarly research articles on improving performance in health care organizations, how the Affordable Care Act is affecting health care organizations, and other related topics to use in guiding the recommendations you will make to close the gaps you have identified. Organizational Analysis essay assignment paper example.
Part 5: Leadership Implications
Write a brief narrative in which you explain the role of the organization\’s leader with regard to shaping strategic direction, aligning organizational values and culture, and managing change. What are the critical success competencies needed to achieve desired organizational outcomes? Cite your resources to support your statements.

Additional Requirements
Structure: Include a title page, table of contents, and reference page.
Length: There is no required number of pages. Your length will vary depending on the organization you use. Begin each part of the briefing report on a new page. Your goal—and your challenge—is to provide as much detail and information as possible in a direct and concise way. Organizational Analysis essay assignment paper example.
References: Cite at least five current scholarly or professional resources.
Format: Use APA style for citations and references only. Otherwise, follow the formatting and style conventions of an executive briefing report. Use headings and subheadings as appropriate for a professional document.
Font: Times New Roman font, 12 point. Organizational Analysis essay assignment paper example.

 

PROFICIENT DISTINGUISHED
Analyzes the environmental factors, including the Affordable Care Act, that affect the success of a health care organization. Analyzes the environmental factors, including the Affordable Care Act, that affect the success of a health care organization and grounds the analysis on an in-depth examination of the literature.
Analyzes outcomes relative to the organizational directional strategy. Organizational Analysis essay assignment paper example. Analyzes outcomes relative to the organizational directional strategy and assesses fit with the environment.
Identifies gaps in desired versus actual organizational performance. Identifies gaps in desired versus actual organizational performance and demonstrates in-depth understanding of the relationship between environmental factors and organizational success.
Proposes evidence-based recommendations to close gaps identified in the organizational assessment. Organizational Analysis essay assignment paper example. Proposes evidence-based recommendations to close gaps identified in the organizational assessment and considers the benefits and limitations of each recommendation.
Describes the critical success leadership competencies needed to achieve organizational outcomes. Describes and analyzes the critical success leadership competencies needed to achieve organizational outcomes. Organizational Analysis essay assignment paper example.
Writes coherently, concisely, logically, and with strong support from relevant professional resources, in an appropriate format, with correct grammar, usage, and mechanics as expected of a health care administration professiona Writes coherently, substantively, concisely, logically, and with strong support from relevant professional resources, in a consistently appropriate format, with correct grammar, usage, and mechanics as expected of a health care administration professional.
Organizational Analysis essay assignment paper example

NURS 6512 Week 3 Quiz

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NURS 6512 Week 3 Quiz

  1. Which of the following is a major function of dietary protein?
  2. Which medication is frequently associated with weight gain?
  3. Which of the following is not a characteristic of the plan portion of the problem-oriented medical record?
  4. When recording assessments during the construction of the problem-oriented medical record, the examiner should:
  5. Subjective and symptomatic data are:

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  6. Which of the following is the most accurate reflection of an individual s food intake?
  7. Adult recommended dietary fat intake is _____ % of daily caloric intake. NURS 6512 Week 3 Quiz.
  8. You are using the rule of thumb for advising a 150-pound person regarding the appropriate number of calories to promote weight loss. Your advice is for the person to consume no more than _____ calories.
  9. When recording physical findings, which data are recorded first for all systems?
  10. Deficiency of which of the following is a concern in the vegetarian diet?
  11. The position on a clock, topographic notations, and anatomic landmarks:
  12. Which part of the information contained in the patient s record may be used in court?
  13. A 17-year-old girl presents to the clinic for a sport s physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she:
  14. Under normal circumstances, how much water is lost daily by the body? NURS 6512 Week 3 Quiz.
  15. The recommended minimum daily protein requirement for the normal adult is:
  16. During adolescence, the head size normally increases as a result of:
  17. Mrs. Layton is a 33-year-old patient who has obesity. The majority of adult obesity begins:
  18. Infants born to the same parents are normally within which range of weight of each other?
  19. How much of the weight gained during a normal pregnancy is accounted for by the fetus?
  20. In clinical practice, the Ballard Assessment Tool is used to assess a newborn’s: NURS 6512 Week 3 Quiz.

Nurs 6512 Wk 1 Discussion – Building a Health History

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Nurs 6512 Wk 1 Discussion – Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks. Nurs 6512 Wk 1 Discussion – Building a Health History.For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

·        76-year-old Black/African-American male with disabilities living in an urban setting

·        Adolescent Hispanic/Latino boy living in a middle-class suburb

·        55-year-old Asian female living in a high-density poverty housing complex

·        Pre-school aged white female living in a rural community. Nurs 6512 Wk 1 Discussion – Building a Health History.

·        16-year-old white pregnant teenager living in an inner-city neighborhood

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To prepare:

With the information presented in Chapter 1 in mind, consider the following:

·        How would your communication and interview techniques for building a health history differ with each patient?

·        How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

·        What risk assessment instruments would be appropriate to use with each patient?

·        What questions would you ask each patient to assess his or her health risks?

·        Select one patient from the list above on which to focus for this Discussion. Nurs 6512 Wk 1 Discussion – Building a Health History.

·        Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

·        Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.

·        Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history. Nurs 6512 Wk 1 Discussion – Building a Health History.

Post a 1 page paper APA format  1. a description of the interview and communication techniques you would use with your selected patient.

2. Explain why you would use these techniques.

3 Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient.

4 Provide at least five targeted questions you would ask the patient. Nurs 6512 Wk 1 Discussion – Building a Health History.

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “The History and Interviewing Process” (pp. 1–21)

This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability. Nurs 6512 Wk 1 Discussion – Building a Health History.

o   Chapter 26, “Recording Information” (pp. 616–631)

This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

·        Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 1, “Medicolegal Principles of Documentation” (pp. 1–12 and abbreviations, pp. 18)

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

·        Deeks, A., Lombard, C., Michelmore, J., & Teede, H. (2009). The effects of gender and age on health related behaviors. BMC Public Health, 9, 213–220.
Retrieved from the Walden Library databases.

This article describes a study that sought to determine the effects of gender and age on health-related behaviors. In the study, the authors also investigated the effects of screening practices, health beliefs, and perceived future health needs. Nurs 6512 Wk 1 Discussion – Building a Health History.

·        Delpierre, C., Lauwers-Cances, V., Datta, G. D., Berkman, L., & Lang, T. (2009). Impact of social position on the effect of cardiovascular risk factors on self-rated health. American Journal of Public Health, 99(7), 1278–1284.
Retrieved from the Walden Library databases.

This study assessed the influence of education level on the association between self-rated health and cardiovascular risk factors. The authors explain their methods and results, and they provide recommendations for similar studies in different countries and cultures.

·        Lee, D. W., Neumann, P. J., & Rizzo, J. A. (2010). Understanding the medical and nonmedical value of diagnostic testing. Value in Health, 13(2), 310–314.
Retrieved from the Walden Library databases.

The authors of this article detail their attempts to develop a framework for defining the potential value of diagnostic testing. The authors also discuss the implications of their framework for health care delivery systems. Nurs 6512 Wk 1 Discussion – Building a Health History.

·        University of Michigan Medical School. (2003). Geriatric functional assessment.
Retrieved from http://www.med.umich.edu/lrc/coursepages/m1/HGD/GeriatricFunctionalAssess.pdf

This article provides an exercise that emphasizes accurate functional status assessments and effective communication with older patients. The authors recommend tools and techniques to be used when caring for older patients.

Note about Uploading Media:
Please refer to the Kaltura Media Uploader page located in the course navigation menu.. The documents on this page provide guidance on how to upload media for your Health Assessment Videos assignments for this course.

Optional Resources

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 2, “History Taking and the Medical Record” (pp. 15–33). Nurs 6512 Wk 1 Discussion – Building a Health History.