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NR 443
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NR 443 Week 1 Graded Discussion Topic: Determinants of Health
NR 443 Week 1 Graded Discussion Topic: Determinants of Health Purpose This week’s graded topics relate to the following Course Outcome (CO). CO 1: A... [Show More] pply principles of nursing theory to the public health system by analyzing determinants of health and the public health intervention wheel. (PO 1) The Assignment What are some factors that make some people healthy and others ill? Healthy People 2020 identifies five determinants of health that influence the health of individuals and populations. Healthy People 2020 describes them as “a range of personal, social, economic, and environmental factors that influence health status” (U.S. Department of Health and Human Services, 2018, About Determinants of Health, para. 1). Determinants fall into five categories, including (a) policy making, (b) social factors, (c) health services, (d) individual behavior, and (e) biology and genetics. Go to the Determinants of Health link at https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Determinants-of-Health (Links to an external site.), and click on each determinant to read about it. Choose one of the five determinants other than individual behavior (as we are all aware of how individual behavior impacts health). In your post, describe this determinant and its importance. Discuss how this determinant relates to one intervention from the public health intervention Wheel (Nies & McEwen, 2015, pp 14-15) U.S. Department of health and Human Services. (2014) Healthy People 2020 About Determinants of Health. ANSWER Professor and Class, Choose one of the five determinants and discuss its importance. This was a difficult decision as each of the five determinants of health are so closely interrelated, however I have discovered that policy making has the most widely influence on both individual and population health. In fact, policy making significantly impacts how successful and unsuccessful the additional four determinants can have on the vast majority of health outcomes. For example, it has been estimated that individual behaviors are responsible for approximately 50% of all premature deaths in the United States (McEwen & Nies, 2015). According to Healthy People 2020, tobacco use is classified under the determinant, individual behavior. Policy makers at the state level have been historically known to increase taxes on tobacco sales in efforts to reduce the number of smokers thus improving the overall population health (Healthy People 2020). Secondly, health services is by no means a stranger to the political realm as it continues to be among the top contenders of controversial debates. Fortunately, several literature have supported the correlation of access to health services and disease/illness prevention and health promotion. It was policy making efforts that enacted and signed into law The Patient Protection and Affordable Care Act on March 23, 2010. This law was created to improve access to affordable, quality health insurance for all Americans (Healthcare.gov). Still not convinced? Public safety, transportation options, and quality schools all fall under the umbrella of social determinants of health (Healthy People 2020). Unfortunately the longevity of these functions rely on funding received from the federal, state, and local levels. It was most recently in April 2018 that many marched to our Kentucky capital, Frankfort, to protest against further budget cuts towards public education during the state budget process of 2018-2020. This made national headlines ( Beam & Schreiner, 2018)! Discuss how a community nurse could use one of the 17 intervention categories from the Public Health Intervention Wheel to address this determinant. I have chosen advocacy for one important reason, it takes those to advocate for change to be heard at the government level! We, as professional nurses, should advocate for the general population, community, and/or individuals at the government level for an increase or preservation of current funding towards the prevention and promotion of health. This may include factors such as continued support of public education, cleaner water sanitation, continued affordable healthcare, and academic research. In conclusion, the change starts with someone, somewhere! References Beam, A. & Schreiner, B. (2018). Teacher Victory: Kentucky Lawmakers Override Budget Veto. U.S. News. Retrieved from https://www.usnews.com (Links to an external site.)Links to an external site.. HealthCare.gov. (2018). Affordable Care Act (ACA). USA.gov. Retrieved from https://www.healthcare.gov/glossary/affordable-care-act/ (Links to an external site.)Links to an external site.. Nies, M. A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2018). Healthy People 2020: About Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health [Show Less]
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NR 443 Week 7 Graded Discussion Topic: Healthcare Policy
NR 443 Week 7 Graded Discussion Topic: Healthcare Policy Locate a news article or story related to a current event in healthcare policy. Some examples may... [Show More] be, but are not limited to healthcare reform, the Affordable Care Act, prescription drugs, healthcare costs, insurance coverage, healthcare fraud, transparency, or underinsured populations. • Provide a brief overview of the article, and include the URL link. • As a healthcare professional, has this raised any ethical questions or concerns for you? • How can a community health nurse (CHN) be involved as a change agent for related healthcare policies? ANSWER While millions of people have gained coverage through the expansion of Medicaid under the Affordable Care Act (ACA), state decisions not to implement the expansion leave many without an affordable coverage option. Under the ACA, Medicaid eligibility is extended to nearly all low-income individuals with incomes at or below 138 percent of poverty ($28,676 for a family of three in 20181). The characteristics of the population that falls into the coverage gap largely mirror those of poor uninsured adults. For example, because racial/ethnic minorities are more likely than White non-Hispanics to lack insurance coverage and are more likely to live in families with low incomes, they are disproportionately represented among poor uninsured adults and among people in the coverage gap. Nationally, more than two million poor uninsured adults fall into the “coverage gap” that results from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits. These individuals would be eligible for Medicaid had their state chosen to expand coverage. As a nurse, I think adults in the coverage gap are likely to face barriers in health services or if they do require medical care, potentially serious financial consequences. Many people who are in fair or poor health or are in the age range when health problems start to arise but lack of coverage may lead them to postpone needed care due to the cost. While the safety net of clinics and hospitals that have traditionally served the uninsured population will continue to be an important source of care for the remaining uninsured under the ACA, and this system has been stretched in recent years due to increasing demand and limited resources. One way Community Nurses can help close the insurance gap is to participate in local health events that target the uninsured. Nurses need to be savvy about knowing which programs their own facility can and cannot provide to uninsured patients and to become familiar with their own processes for helping patients move between providers. Nurses are professionals whose understanding, skills and caring concern are used to endorse both individuals and community’s welfare, (Nies, M.A., McEwen, 2019). References: Rachel Garfield. (2019). The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid. Retrieved from https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/ Luhby, T. (February 2019). Closing the Health Insurance Gap. Retrieved from https://minoritynurse.com/closing-the-health-insurance-gap/ Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier. [Show Less]
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NR 443 Week 6 Graded Discussion Topic: Environmental Health
NR 443 Week 6 Graded Discussion Topic: Environmental Health Visit the U.S. Environmental Protection Agency's MyEnvironment site at http://www.epa.gov/my... [Show More] environment (Links to an external site.), and enter your city and state, ZIP code, or location into the location box. Choose one of the topic areas. • My Health • My Climate • My Air • My Water Then, click on the boxes under the Map Contents menu to add data into the map on specific topics. Explore the site to learn more about your environment and things that might be impacting the health of its citizens. • Identify something new you learned about your environment and how it could be affecting health by completing this statement, "I didn't know _____." • How could you, in the role of a community health nurse, address these concerns? I choose the topic area of air for my location. I didn’t know that Essex County residents were exposed to unhealthy levels of ozone for 3 Days in 2014. Ozone Is found in the ozone layer in the earth’s atmosphere which helps protect us from the sun's harmful rays. But ground-level ozone can be bad for your health and the environment. Ground-level ozone is one of the biggest parts of smog. When ozone levels are above the national standard, everyone should try to limit their contact with it by reducing the amount of time spent outside. Air pollution is a leading environmental threat to human health. Particles in the air like dust, dirt, soot, and smoke are one kind of air pollution called particulate matter. Fine particulate matter, or PM2.5, is so small that it cannot be seen in the air. Breathing in PM2.5 may • lead to breathing problems, • make asthma symptoms or some heart conditions worse, and • lead to low birth weight. The national standard for annual PM2.5 levels is 12.0µg/m3. When PM2.5 levels are above 12, this means that air quality is more likely to affect your health. In 2014, the annual level of PM2.5 in Essex County was 9.9µg/m3. Elevated ozone concentrations are also damaging to crops and other plant life. It interferes with the ability of plants to produce and store food, making them more susceptible to disease, insects, other pollutants and harsh weather. Ground-level ozone damages the foliage of trees and other plants, ruining the landscape of cities, parks, forests, and recreation areas. Today, all nurses are challenged to address environmental problems by participating in the assessment and control of environmental factors (CCN, 2016). It is our duty to educate patients and civilians on all safety matters. While assessing methods are handled by federal and state agencies, the role of the nurse in assessment is understanding and interpreting statistical data and assessing objective data for example in a windshield survey. As nurses working in the health care profession, we have a responsibility to the people of our communities to raise awareness of the health implications of environmental changes. References: U.S. Environmental Protection Agency. (2016). MyEnvironment. Retrieved from http://www.epa.gov/myenvironment (Links to an external site.)Links to an external site., Chamberlain College of Nursing. (2016). Week 6 lesson: Factors influencing the health of the community. [Online Lesson]. Downers Grove, IL: DeVry Education Group [Show Less]
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NR 443 Week 6 Assignment: SBIRT Screening, Brief Intervention, and Referral to Treatment Present
NR 443 Week 6 Assignment: SBIRT Screening, Brief Intervention, and Referral to Treatment Presentation Background information SBIRT consists of three majo... [Show More] r components. 1. Screening—A healthcare professional assesses a patient for concerning behaviors using standardized screening tools. Screening can occur in any healthcare setting. 2. Brief Intervention—A healthcare professional engages a patient in a short conversation, providing feedback and advice regarding concerning behaviors. 3. Referral to Treatment—A healthcare professional provides a referral to resources and/or treatment options and additional services available (Substance Abuse and Mental Health Services Administration [SAMHSA], n.d.) Directions 1. Prior to starting the presentation, you are to read the assigned training. SBIRT Education. (n.d.). Overview of screening, assessment and brief intervention: A nursing response to the full spectrum of substance abuse retrieved from https://hospitalsbirt.webs.com/nursingsbirt.htm. Here is the direct link: Intervention and Nursing Response article (Links to an external site.) o Choose "Watch On-Demand Recording" o Start at minute 9:08/slide 12 and end at 1 hr 27 sec (slide 80) Or you may go directly to the YouTube video: SBIRT Education. (2015, May 10). Overview of SBIRT: A nursing response to the full spectrum of substance use [Video File]. Retrieved from https://www.youtube.com/watch?v=TZvCQUmN8c. Here is the direct link: YouTube Video for Intervention and Nursing Response (Links to an external site.) Use this BNI checklist for the role play at the end: BNI Checklist (Links to an external site.) SBIRT Education. (n.d.). Brief negotiated interview checklist [PDF Document]. Retrieved from https://hospitalsbirt.webs.com/nursingsbirt.htm You are encouraged to review the assignment tutorial found at the end of the Academic Integrity Reminder. 2. Next, choose one addiction or problem to focus on for this assignment from the options below. o Nicotine (all tobacco and electronic nicotine delivery systems) o Alcohol o Drug use (addictive prescription or illicit) You must be specific to which drug you are choosing 3. You are required to use one of the problems listed above. Assignments that do not follow the current guidelines or use the required forms or templates will be evaluated for evidence of an academic integrity violation. After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area. 4. After you have chosen the addiction/problem, you are to research SBIRT training specific to that addiction/problem. Before starting to work on the presentation, it is vital you understand how SBIRT is used with that particular addiction/problem. You must find at least two scholarly resources (other than readings assigned in the course) and one video resource. Search YouTube for one SBIRT training video from a reputable source that shows a provider using SBIRT with a patient. Watch this video so that you understand the steps of SBIRT. 5. You may choose to complete this assignment as a PowerPoint poster or PowerPoint multiple slide presentation. Download the SBIRT PowerPoint poster (Links to an external site.) or slide presentation template (Links to an external site.). 6. Submit the completed PowerPoint poster or slide presentation by Sunday, 11:59 p.m. MT at the end of Week 6. 7. Length: The poster should be one page with all boxes on template complete. The slide presentation should be no more than twelve slides, not including the title and references slides. Guidelines Below are the requirements needed for successful completion of the SBIRT: Screening, Brief Intervention, and Referral to Treatment presentation 1. Introduction to the problem and/or addiction: Clearly identify the problem, and discuss specific statistics from your community related to this problem. You may use city or county data. For example, if you choose tobacco use, you should find the tobacco use rate in your city or county. **Please note, this is only an example, you must choose from one of the topic options provided in the guidelines above.** 2. Problem description: Utilize one scholarly reference (not assigned in this course) to describe this problem/addiction. Discuss reasons why this may be a problem in your community. Cite all sources. 3. SBIRT description: Utilize at least one scholarly reference different from the one selected for the problem description above, and not assigned in this course, to describe how SBIRT is used with this specific addiction/problem. Identify specific steps and questions that are used. 4. Video: Locate and describe at least one video that demonstrates SBIRT related to the addiction you chose. 5. Citation: Cite all sources. 6. Community resources: Describe at least two available community resources to which you may refer people who have this problem or an increased potential for acquiring this problem. You are to provide the names of these resources and brief descriptions. You may use online resources if community resources are not available. 7. Conclusion/future implications for nursing: Provide a summary of your findings. Discuss the use of SBIRT in nursing practice. 8. References: Provide all references for all sources utilized. Use APA format; however, a hanging indent is not necessary. 1. necessary. Best Practices in Preparing PowerPoint The following are best practices in preparing this presentation. • Review directions thoroughly. • We recommend that you use one of the linked templates. Replace the placeholder text with your own content. Use a black or colored font that is easy to read. • Be creative. You may choose a design (from Design tab) to enhance visual appeal. • Incorporate graphics, clip art, or photographs to increase interest. • Use short bullet points and large font for easier reading. For PowerPoint slides, use no more than eight lines per slide and no more than eight words per line. • Do not use the notes section in the PowerPoint format (they are not visible in Canvas-Speedgrader) • Cite all sources within the slides or poster with (author, year) as well as on the Reference slide or section. • Proofread prior to final submission. • Spell check for spelling and grammatical errors prior to final submission. Reference Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). SBIRT: Screening, Brief Intervention, and Referral to Treatment. Reminder Before preparing your assignment, please review this "Crediting Sources Made Simple (Links to an external site.)" resource. This tool is intended to help you understand scholarly writing, APA, referencing, and crediting. Please reach out to your instructor with any questions as you prepare your assignment. Rubric NR443 SBIRT Presentation NR443 SBIRT Presentation Criteria Ratings Pts This criterion is linked to a Learning OutcomeIntroduction to problem 25.0 pts Problem is adequately identified and statistical data about the problem in student’s community is clearly presented. 22.0 pts Problem is adequately identified and statistical data presented, but data is not from the student’s community. 20.0 pts Problem is identified and statistical data is presented but data is not relevant to this problem 10.0 pts Problem is not clear or statistical data is not presented. 0.0 pts Problem is not identified and statistical data is not presented. 25.0 pts This criterion is linked to a Learning OutcomeProblem support with scholarly literature and problem rationale. 45.0 pts Thoroughly presents at least one scholarly reference (not assigned in this course) to describe this problem and discusses relevant reasons why this is a problem in student’s community. 40.0 pts Adequately presents at least one scholarly reference (not assigned in this course) to describe this problem and discusses reasons why this is a problem in student’s community. 36.0 pts Presents a scholarly source that is not clearly relevant to problem and reasons for problem are described. 17.0 pts Scholarly source is not presented or reasons for problem are not described. 0.0 pts Scholarly source is not presented and reasons for problem are not described. 45.0 pts This criterion is linked to a Learning OutcomeSBIRT 55.0 pts Thoroughly addresses all of the following elements: • Utilizes at least one scholarly reference (not assigned in this course) to describe how SBIRT is used with this problem. • Identifies specific steps and questions that are used. • Describes at least one video that demonstrates SBIRT related to the problem discussed. 48.0 pts Adequately addresses all of the elements listed in the first column. 44.0 pts Missing one element listed in the first column. 21.0 pts Missing two elements listed in first column. 0.0 pts Does not address any of the elements listed in first column OR is not on one of the assigned addiction/problems. 55.0 pts This criterion is linked to a Learning OutcomeCommunity Resources 40.0 pts Thoroughly addresses all of the following elements: • two relevant community resources that could be used as a referral identified • provides the names of these resources • includes brief description of each referral resource 35.0 pts Adequately addresses all of the elements listed in the first column. 32.0 pts Missing one element listed in the first column. 15.0 pts Missing two elements listed in the first column. 0.0 pts Community resources not addressed. 40.0 pts This criterion is linked to a Learning OutcomeConclusion and Future Implications 25.0 pts Thoroughly summarizes findings. Discusses the implications for the use of SBIRT in nursing practice. 22.0 pts Adequately summarizes findings and use of SBIRT in nursing practice 20.0 pts Summarizes findings but does not discuss use of SBIRT in nursing practice. 10.0 pts Discusses use of SBIRT in nursing practice but does not summarize findings. 0.0 pts Summary and use of SBIRT in nursing practice not present. 25.0 pts This criterion is linked to a Learning OutcomeMechanics and organization 20.0 pts Excellent mechanics and organization with minimal errors of the following: • well organized and logical, • appealing to eye, • includes creativity, • font is easy to read (short bullet points rather than sentences or paragraphs), • correct grammar, punctuation, and spelling, • professional wording is used. 18.0 pts Good mechanics and organization considering the elements listed in the first column. A few errors noted. 16.0 pts Fair mechanics and organization considering the elements listed in the first column. Some errors noted. 8.0 pts Poor mechanics and organization considering the elements listed in the first column. Many errors noted. 0.0 pts Very poor mechanics and organization considering the elements listed in the first column such that it is difficult to follow or understand. 20.0 pts This criterion is linked to a Learning OutcomeAPA 15.0 pts Excellent APA formatting with minimal errors of the following: • all sources cited on the slide or poster • all references listed in place provided in APA format • no more than one short quotation, and • length is no more than 12 slides for PowerPoint, excluding title and reference slides. For poster one page 13.0 pts Good APA formatting considering the elements listed in the first column. A few APA errors noted. 12.0 pts Fair APA formatting considering the elements listed in the first column. Some APA errors noted. 6.0 pts Poor APA formatting considering the elements listed in the first column. Many APA errors noted. 0.0 pts Very poor APA formatting such that paper is difficult to read. Numerous APA errors noted. 15.0 pts This criterion is linked to a Learning OutcomeLate Deduction 0.0 pts 0 points deducted Submitted on time 0.0 pts Not submitted on time - Points deducted 1 day late= 11.25 deduction; 2 days late=22.25 deduction; 3 days late=33.75 deduction; 4 days late =45 deduction; 5 days late=56.25 deduction; 6 days late=67.5 deduction; 7 days late= 78.75 deduction. Score of 0 if more than 7 days late 0.0 pts Total Points: 225.0 [Show Less]
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NR 443 Week 5 Graded Discussion Topic: Disaster Preparedness
NR 443 Week 5 Graded Discussion Topic: Disaster Preparedness Preparing for disasters, terrorist threats, or communicable disease outbreaks is an important... [Show More] part of public health nursing. • Share an overview of a natural or human-made disaster that has occurred in your area in the last 20 years. o Include a URL and reference to the event. This may be a news article. • Describe how your community was impacted. • Describe lessons learned and changes made to preparedness. ANSWER Hurricane Irene impacted thousands of New Jersey residents, confining them to their homes while leaving them without electricity, broken power lines, heavy floods, and dangerously strong winds. However, despite the fury of Hurricane Irene's arrival, Bloomfield's diligent officials worked endlessly throughout the night to ensure the safety of the community. It was the busiest day in Bloomfield Fire Department's history, according to fire officials. They responded to 550 calls for assistance related to the hurricane over a span of 2-3 days. "Their performance was outstanding, and I am extremely proud of them," said Chief Inspector Samuel Infante, "Their tireless work showed how well trained they are. Although the fire department was understaffed at the time, and still is, I don't think we could ask for a better response."(Sophia, 2012) The officials said an event such as Hurricane Irene was rare, the Bloomfield Fire Department purchased water rescue equipment. "We realized we didn't have the equipment at the time for, what we call, swift water rescues," said Fire Chief Joseph McCarthy, "We bought two bags, which would minimize the danger to our personnel. Extra pumps for removing water from basements were also purchased and the Office of Emergency Management now has regular meetings to discuss and plan for such emergencies. The experience of dealing with a disaster makes everyone better prepared to handle it in the future" (Sophia, 2012). Town officials aren't the only ones who need to be prepared for emergencies, residents should also be ready. A hurricane, a major blizzard - they don't catch you by surprise. There's plenty of time to prepare. "Every storm and event bring new problems that we may not have seen before. But with the experience these men and women have and their ability to problem solve quickly we will continue to bring the people of Bloomfield the protection and safety they need in times like these," said Mayor McCarthy as residents of Bloomfield, NJ should learn how to board up and tape their windows, have a sump (Sophia, 2012). Pump installed that runs with or without electricity, purchase a portable generator to provide electricity for basic living needs such as lights, heat, microwaves, and have a licensed electrician wire their portable generator with an interlock directly into your main electrical panel. References: Sophia, Rodriguez (August 28, 2012).Retrieved February 6, 2019, from https://patch.com/new-jersey/bloomfield/hurricane-irene-one-year-ago-today [Show Less]
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NR 443 Week 4 Graded Discussion Topic: Community Settings
NR 443 Week 4 Graded Discussion Topic: Community Settings Community health nurses practice in a variety of settings. Choose one of the following CH settin... [Show More] gs, and describe what you have learned about the setting and the role(s) of the nurse in that setting (see Nies & McEwen, 2019, Chapters 30-34). Please do not choose home health nursing for this discussion because your paper is on home health nursing. • School nursing • Faith-based or parish nursing • Occupational health nursing • Forensic Nursing • Hospice nursing • Correctional nursing Next study levels of prevention in this week's lesson (primary, secondary, and tertiary). Note that the term primary is used differently than in normal conversation. • Describe one of the levels of prevention, and discuss how a community health nurse (CHN) in the setting you discussed can implement this level of prevention. ANSWER “A key role for community health nurses in many settings is involved in health education. Although there are numerous ways community health planners define health education, nurses recognize the important ways they have participated in various nursing roles as teachers in health promotion and prevention,” (CCN, 2019). I choose is Correctional Nursing setting. Recently, I was hired by Correctional Health Services as charge Staff Nurse. I never thought this was going to be the initial of my career. I have realized that correctional nursing is not for everyone, but so far I find that it can be a fulfilling and rewarding career. I believe it is safe because there is added protection of security for all the healthcare staff. I have realized that most patients are appreciative of the care given by the team and myself. Nurses are patient-focused, and there is no doubt that the residents (inmates) at my facility feel the difference and appreciate the healthcare team. “Disease prevention activities protect people from disease and the subsequent effects of disease” (Nies & McEwen, 2019). A level of prevention a community nurse uses at a healthcare setting is primary prevention such as Immunization. I believe Immunization is crucial for everyone. Immunization helps to protect from diseases caused by many bacteria and/or viruses. According to Medscape, “the goal of public health is to prevent disease. It's much easier and more cost-effective to prevent a disease than to treat it. That's exactly what immunizations aim to do”. Vaccines such as Pneumococcal and Influenza are the two vaccines used most at the facility. These vaccines help prevent the spread of diseases. References: Chamberlain College of Nursing (2019). NR443 Community Health Nursing: Week4 lesson # 1. Downers Grove, IL: Online Publication. Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier. https://www.webmd.com/children/vaccines/immunizations-vaccines-power-of-preparation#1 [Show Less]
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NR 443 Week 3 Graded Discussion Topic: Caring for Vulnerable Populations
NR 443 Week 3 Graded Discussion Topic: Caring for Vulnerable Populations Week 3 Case Study for Discussion This case study provides you with an opport... [Show More] unity to immerse yourself in the role of a community health nurse and explore the resources in your community. As you work through the case, reflect on what you have learned about community health nursing in this course, and how you can apply it to this case. Your role: You are working as a community health nurse in your local health department. One of your roles with the health department is to case manage pregnant women who receive Medicaid. You work with an interdisciplinary team both within and outside the agency. Team members: • Anne is a fellow nurse with the health department. She is going on medical leave, so has asked you to assume this case. • Christina is a social worker with the health department. • Tracey is a case worker from Child Protection Services. • Mark is a dietician with the local Women, Infants, and Children (WIC) office. Your client: Mary is a 23-year-old Hispanic female. She is in her first trimester of pregnancy and is developmentally delayed. She also has been diagnosed with bipolar disorder. She is currently unemployed but receives Social Security disability checks monthly. She lives with a roommate in a project apartment complex in a run-down part of town. Anne has visited Mary once and provided the following information as she hands the case to you. Mary had a baby removed from her care when she was 19 years old. Mary cannot explain why this baby was removed other than her house was dirty. She met the father of her current baby on the Internet and states that she has not heard from him recently. During Anne’s visit, Mary stated that she wanted to keep the baby. She asked many questions about healthy eating and having a healthy pregnancy. Mary stated that she has visited the WIC office, received WIC vouchers, and met with Mark who talked to her about what to eat. She asked for help to find a nice apartment and to make other improvements so that she can keep this baby. When Anne started to explore options and difficulties she might encounter in raising this child, she stated that Mary became agitated and did not comprehend why her baby might be removed from her other than “They are against me!” Christina, Mary’s social worker, was able to find the past court records indicating that her first baby was removed due to neglect and living in an unsuitable environment. At that time, Mary was living with her parents in another county. The records indicated that Mary did not show up to her court appointment to appeal the decision, so the baby was permanently removed and has since been adopted. According to Mary’s chart, Tracey from Child Protection Services has stated that CPS is planning on placing Mary’s baby into foster care when it is born due to her cognitive impairment and past history. Your charge: As your first assignment, you are to identify resources in your community that could assist Mary during her pregnancy and help to optimize the health of her infant. Assurance is one of the three core functions of public health. Read this week’s online lesson for more information on assurance. Find a resource in your community (other than WIC) that could assist Mary during her pregnancy. Start by searching the Internet for your local health department’s website. What services (other than your visits and the social worker) do they provide for pregnant women? What about your local welfare office? Are there prenatal or mental health services available? Are there any service organizations, crisis pregnancy centers, or churches providing help for pregnant women? Are there any organizations that serve the Hispanic community? Briefly describe the types of services that you found and then choose one agency and assess this agency in terms of the 4 A’s. Is it accessible, acceptable, affordable, or available for Mary or other pregnant women that you case-manage? This case study focuses on a vulnerable young woman who is facing many risk factors. • Risk factors that may influence health outcomes for vulnerable populations: o Mary is mentally disabled and very vulnerable. She is in jeopardy of losing her second child to the system if resources are not in place to allow for a stable upbringing for this child. Risk factors: Home: Where will she live this time? She was living at home with her parents the last time she gave birth and this still was not enough to be stable. Income: What is her source of income? Is she able to work? Mental Disability: Individuals with Mental Disabilities are often not stable enough to care for themselves let alone others. What is her level of disability? Single parent: Who is her support system? Who is her daycare if employed? Newborn: Having a newborn can be hard. Is she capable of taking care of a newborn? Food: This goes back to income. If there is lack of income, is she enrolled in other food assistant programs to fill in the gaps in the kitchen? Is she capable of cooking safely? • Services: o SNAP (formerly Food Stamps) provides low-income households and the disabled with benefits to purchase food in order to maintain good health. o The Medicaid Program in Erie County provides access to a variety of public health insurance programs including Medicaid, Family Planning Benefits Program and the Medicare Savings Program. o Financial eligibility is determined based on the income and resource standards governing the Public Health Insurance Programs. o Persons eligible for Medicaid may be required to enroll in a Managed Care plan. Location: Erie County Work Center 158 Pearl Street Buffalo, New York 14202 Hours of Operation: 8:00 A.M. - 4:00 P.M. Residents are directed to call 858-7239 o Medicaid: Erie County Work Center 158 Pearl Street Buffalo, New York 14202 Hours of Operation: 8:00 A.M. - 4:00 P.M. o WNY Women's Foundation, Inc.• 742 Delaware Avenue• Buffalo, NY 14209• 716-887-2621 or call WNY 2-1-1: call 211 • Mental Health, Emergency Shelter, Sexual Assault: o Crisis Services 24 Hour Hotline: 716-834-3131 • Career Support Services: o Dress for Success Buffalo: 716-842-0602 (drop-off hours: Wednesdays 10:30 a.m. to 2:30 p.m.) • Child Care Resource Network: 716-877-6666 Health Services: • NYS Health Care Marketplace: 1-855-355- 5777 • Planned Parenthood of Central & Western NY: 1-866 Health Services: • NYS Health Care Marketplace: 1-855-355- 5777 • Leadership & Empowerment: o Community Food System Program o Hispanic Women's League, Inc. o United Way of Buffalo & Erie County o YWCA of WNY • For Women: o Church Women United o Crisis Services o Equality Now o Free Adult Literacy Services o Homeless and Hurting of Western New York o Housing and Support Services o National Partnership for Women and Families o Schlorship Guide for Women o WNY Women‘s Fund o WNY Women's Foundation o Violence Against Women • Health & Wellness: o Buffalo Prenatal-Perinatal Network o Catholic Charities o Developmental Disabilities Services for Children and Adults o New York State Department of Health o Planned Parenthood of Buffalo & Erie County o Resource for Researching Women‘s Health o The Health Care Association of New York o I have chosen: WNY Women's Foundation, Inc Accessible 716-887-2621 or call WNY 2-1-1: call 211 Web: https://wnywomensfoundation.org Address: 742 Delaware Avenue• Buffalo, NY 14209• Acceptable: Too all women Affordable Free Available Always available - The Foundation’s largest investment is in this research-based program designed to enable single mothers to gain family-sustaining jobs. • Are there adequate resources for other vulnerable populations in your community? o I think there are plenty of resource in the community if you know where to look. I think that due to Mary’s disabilities it may be complicated and will require assistance. However, if she were to get in touch with this organization she could be well on her way to freedom and the ability to raise her child. Assurance means: Enforce laws and regulations that protect environmental health and ensure safety - In this case making sure that Mary and her child are save and cared for with the proper resources to sustain this living situation. Link people to needed environmental health services and assure the provision of environmental health services when otherwise unavailable - This agency could held link Mary with the resources she needs. These resources could help keep her sustainable. Assure a competent environmental health workforce - The agency as the means to help her find employment and/or schooling depending on her level of disability. WNY Women's Foundation, Inc. (2018, January) https://wnywomensfoundation.org/ Erie County. (2018, January). http://www2.erie.gov/ Nies, M.A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier. [Show Less]
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NR 443 Week 4 Assignment: Community Settings and Community Health Nursing Roles.
NR 443 Week 4 Assignment: Community Settings and Community Health Nursing Roles.
Purpose
The purpose of this paper is to describe the community health nu... [Show More] rsing role of the home health nursing in the community setting of your choice. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.
Course Outcomes
This assignment enables the student to meet the following Course Outcomes.
CO5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1)
CO6: Utilize a systems-based and collaborative approach to address factors that influence the health of a community and population health problems. (PO 2)
Directions
Watch the tutorial on tips for completing the NR 443 Community Settings and Community Health Nursing
Roles Assignment.
This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper. Please use the recommended APA Template linked below, which incorporates the following categories as the first level headings on your paper. APA formatting helps you to organize your paper in a professional manner and provides consistent methods for citing your sources and completing your reference page. See the documents in the APA category in Course Resources for assistance with APA formatting. The Student Success Strategies resource has great sections on writing scholarly papers and APA formatting.
The role for this paper must be on Home Health Nursing (not including hospice).
Click to view and download the NR 443 Community Settings APA Template (Links to an external site.)Links to an external site. to complete your paper. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder.
Read the chapter of your textbook on the role and take notes based on the outline below.
Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Go to the Chamberlain library at http:/library.chamberlain.edu (Links to an external site.)Links to an external site.. Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best).
Thoroughly address the following categories using the APA Template that is provided.
Introduction (one paragraph):
The introduction should be interesting and capture the reader’s attention.
Introduce the assigned community health nurse role and a community setting where this nurse may work.
Introduce your community and where/how this CHN role is utilized in your community
Identify population(s) served by this role in your community
Include a purpose statement
Community Setting (two to three paragraphs)
Describe a practice setting for the assigned CHN role.
Describe the population(s) served in this setting.
Discuss three health services provided by the assigned CHN role in this setting.
You may use your textbook or an outside scholarly source to address these sub-points.
Health Promotion Nursing Intervention (two to three paragraphs)
Describe in detail health promotion intervention(s) of the assigned CHN role specific to the community setting identified.
Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions.
Include one peer-reviewed journal article discussed that clearly relates to nursing health promotion intervention.
Professional Nursing Organization (two paragraphs)
Provide a detailed description of a professional nursing organization that supports nurses in this role in your own words. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role. Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page.
Discuss one professional issue that this organization is addressing related to this CHN role.
Summary (one paragraph)
The summary reiterates key points about:
The CHN role and community setting
Health promotion intervention
Professional organization
Includes a concluding statement.
Reference Page:The reference page should start on a new page (insert a page break). All references should be cited within the body of the paper as (author or organization, year), and the full reference should be included in APA format on the reference page. A URL link alone is not an adequate reference. See the Chamberlain Guidelines for Professional Writing in the APA Folder in Course Resources for examples of properly formatted references.
Guidelines
The setting for this paper must … on Home Health Nursing (Not including hospice).
Application: Use Microsoft Word 2010 or later to create this assignment on the template provided.
We highly recommend that you used the specific APA paper template for this assignment linked above as the headings are already included.
Scholarly Writing: APA format is required. Review APA documents Course Resources, and use the free resources of tutor.com for writing tutors. Length: This paper is expected to be no more than 4 pages in length (not including the title page and reference list). Quotations should be minimal—please paraphrase your sources. A maximum of one quotation should … used for this paper.
Save your paper with your last name in the document title (e.g., Smith Community Settings).
Submission: Submit your paper by 11:59 p.m. MT Sunday of Week 4.
Late Submission: See the course policy on late submissions.
Best Practices in Preparing the Paper
The following are best practices in preparing this project.
Follow the guidelines above carefully.
Use only the assigned CHN role
Complete you own work.
Use the provided APA assignment specific template.
Ask you instructor if you have any questions.
Visit the SSPRNBSN Student Success resource for help with writing a scholarly paper, APA formatting, and library navigation. This should be one of your course tiles.
Use the 1st column of the grading rubric to make sure all elements of the paper are …
Cite all sources within the paper as well as on the reference page.
Proofread prior to final submission.
Check for spelling and grammar errors prior to final submission with Grammarly.com or the free tutor available through the Tutoring link in the course.
ANSWER
For this week’s topic of discussion, I chose to talk about the setting and role of the Community Health Nurse in the school health setting, as well as an objective from Healthy People 2020 regarding that of bullying among adolescents. At-risk health behaviors typical for teens among the school-aged group tend toward things like violence, irresponsible sexual activity, poor dietary intake, suicide, inadequate physical activity, reckless driving, and the use/abuse of drugs, alcohol, and tobacco (Nies & McEwan, 2019). Community Health Nurses who specifically care for this aggregate population see students for everything from simple medical complaints to immunizations, mental health, health education, to learning disability screening (Nies & McEwan, 2019). Nurses, in this setting, function as a bridge between home and their health care provider (Nies & McEwan, 2019). School Nurses can also administer daily medications, perform vision tests and hearing tests, provide first aid, and provide parents with resources within their community (Nies & McEwan, 2019). NASN (2011) defines the role of the school nurse as “a specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement and health of students.” School Nurses also “facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning” (Nies & McEwan, 2019).
One of the most common issues related to a school-aged adolescent is stress. Stress can lead to more serious symptoms such as eating disorders, substance abuse, anger issues, class absenteeism, problems sleeping, physical exacerbations, sexual promiscuity, depression, and even suicidal ideations (Nies & McEwan, 2019). Depressive disorders usually begin in school-age years and have a direct correlation with the risk of suicidal behaviors (Nies & McEwan, 2019). As a School Nurse, it is especially imperative to be fully aware of typical warning signs and students in need of a mental health referral to a professional (Nies & McEwan, 2019). One such cause of depression can be related to violence, which is a significant risk factor affecting a student’s physical and psychological health (Nies & McEwan, 2019). Warning signs of Violence come in many forms indicating neglect or abuse (e.g. physical, emotional, or sexual) and can ultimately lead to criminal behaviors in some (Nies & McEwan, 2019). In the past decade, many of us have seen the effects of violence among adolescents in the form of school shootings.
A specific issue of interest that I keep hearing about in recent years, but has always been a problem, is bullying and its more recent partner-in-crime trend, cyber-bullying. The healthy objective topic I chose to address this issue, as a community health nurse relates to Violence Prevention – IVP-35 Reduce bullying among adolescents (USDHH, 2016). According to this data, nearly 20% of all high-school aged adolescents report they were bullied at school in 2009 (USDHH, 2016). While some studies suggest that bullying may stem from abuse during an adolescent’s past childhood, one study collected data to find the correlation between bullying behavior and abuse from current adult family members (Fujikawa et al., 2016). According to this study, more students identified themselves as victims of abuse from current adult family members than students who were not exposed to abuse from current adult family members (Fujiwaka et al., 2016). Additionally, the study also revealed there was an increase of suicidal ideations among adolescents dealing with abuse at home (Fujiwaka et al., 2016).
There are many methods and resources that we as community health nurses can use to identify, assess, advocate, and intervene for students whom we suspect are victims of bullying. We can start by noticing common clues that indicate certain health risks, such as depression, that can lead to bullying (Loftus, 2013). It is also important to be aware of common victims, which can be LGBT teens, ethnic minorities, teens with learning disabilities, and teens with physical limitations (Loftus, 2013). Antidiscrimination and anti-harassment policies can be put in place that include LGBT and ethnic diversities to help establish a societal norm, which in turn can change a student’s perceptions (Loftus, 2013). We as community health school nurses must also make sure we utilize specific interventional strategies to identify the root of the issues (Loftus, 2013). Additionally, these policies must be consistently implemented to foster a supportive and protected environment (Loftus, 2013). It is a good idea to raise awareness and gather input from teachers as well as other classmates who are more likely to witness such behavior. As school nurses, we are in a unique position to gain trust with adolescents. Students know we will not be handing out a grade and remain neutral. While bullying has and will always be a natural course of nature for some, there are still ways to end this cycle. Some online resources include www.stopbullying.gov, www.pacer.org, www.stompoutbullyingorg, and www.anitbullyingnetwork.net.
References:
Fujikawa, S., Ando, S., Shimodera, S., Koike, S., Usami, S., Toriyama, R., & ... Nishida, A. (2016). The Association of Current Violence from Adult Family Members with Adolescent Bullying Involvement and Suicidal Feelings. Plos One, 11(10), e0163707. doi:10.1371/journal.pone.0163707
Loftus, T. (2013). You can help stop the cycle of teen bullying. American Nurse Today, 8(3). Retrieved from https://www.americannursetoday.com/you-can-help-stop-the-cycle-of-teen-bullying/
National Association of School Nurses: Role of the school nurse. 2011, Available from
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NR 443 Week 2 Graded Discussion Topic: Demographic and Epidemiologic Assessment
NR 443 Week 2 Graded Discussion Topic: Demographic and Epidemiologic Assessment For this post, you will collect assessment data about your city or county.... [Show More] This post will include information about demographics (general characteristics) and epidemiological data (disease or health behavior rates) of your community. This data collection will help with two sections of your Week 4 Milestone 2 assignment. 1. Demographic data: Go online to the U.S. Census Bureau at http://quickfacts.census.gov/. Obtain information about the demographic characteristics of the population for your city or county of residence. You may have to look at county data if your city is not listed. Collect a range of demographic data about age, ethnicity, poverty levels, housing, and education. 2. Epidemiological data: Go to your city or county health department website (search the Internet) or County Health Rankings (http://www.countyhealthrankings.org/) to discuss epidemiological data about your area. Identify several priority health concerns for your area. Here is a helpful tip sheet about the U.S. Census website that will assist you in using this website as a resource. BEGIN: Demographic and Epidemiological Assessment of Streetsboro, OH, Portage County ANSWER Professor and classmates, Florence Nightingale was a true pioneer in studying the relationship among environment, disease, and patients. Today, these studies continue to drive programs aimed at health promotion and disease prevention. Nurses working in the community are aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes agent, host, an environment (Neis & McEwen, 2015, p. 70). By familiarizing oneself with statistical data developed through census and public health records, identification of corrective action plans can emerge. Different epidemiologic models were developed to study the many factors involved in the development of the health conditions plaguing communities –the web of causation model guides epidemiologists in researching factors associated with chronic illnesses (Neis & McEwen, 2015, p. 73). Investigative efforts often lead to identification of effective prevention measures –providing prevention for the community before has developed is a key initiative. As the Lesson (2015) discusses the value of studying epidemiological data to designing primary prevention efforts is paramount. Demographics Streetsboro, OH (Portage County) per U.S. Census Bureau, population in July 2010 was 16,028. According to U.S Census Bureau, as of 2010 Streetsboro, Portage County had 6,562 households, 31.4% of households had children of 18 years and below, 50.3% are married couples living in the same household, 11.1% of households have a female householder as the head with no other adult partner present, 34.2% are non-families, 26.5% are households with single individuals, and 6.8% of households has someone ages 65 years and above living alone. The average household size was 2.43 and the average family size was 2.97. The city’s population is spread out such that 22.3% were under the age of 18 years, 8.3% ranged from 18-24, 30.5 % from 25-44, 27% from 45-64, and 11.7% aged 65 years and above. The median age was 37.9 years. The gender makeup of the city was 48.5% male and 51.5% female. The median income for an average household in the city is $59,631, and that of a family $71,734. Males have a median income of $43,429 versus $24,854 for females. The city’s per capita income is $28,058. Approximately 5.83% of families and 8.5% of the total population lives below the poverty line. Epidemiology According to the 2016 Portage County health rankings, the priority health concerns for Portage County include- • Smoking - 20% of populace are adult smokers • Obesity - approximately 29% of adults report a BMI of 30 or greater. Although this ranking has remained the same it is above the national average. • Excessive drinking - 19% of adults report heavy drinking • Sexually transmitted infections - This measure is worsening at 221.1 newly reported cases of chlamydia per 100,000 population. • Primary Care Physicians - The ratio of population to physician is 2,410:1 • Mammography screening - 58% of female ages 67-69 enrolled in Medicare receive mammography screening. This ranking is worsening for the county and falls below the national and state average. • Severe Housing problems – 17% of households have at least 1 of 4 housing issues: overcrowding, high housing cost, or lack of kitchen or plumbing facilities. The Portage County Health Status Assessment data for 2015 was released on March 10, 2016. The data was obtained by independent researchers from the Toledo-based Hospital Council of Northwest Ohio (Portage County Community Health Assessment Partnership, 2016). Surveys taken consisted of customized questions and a set of core questions taken from the Center for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, Youth Risk Behavior Surveillance System, and National Survey for Children’s Health (PCCHAP). The survey was a cross-sectional, randomized sample of Portage County residents as follows: adults aged 19 years and older, youth aged 12 to 18 years, and parents of children aged 0 to 11 years. The Health Assessment data identified that 10% of Portage County adults were without health care coverage, the least likely to be uninsured were adults under age 30 (PCCHAP). In Portage County, 18.1% of residents live below the poverty level (PCCHAP). 22% of adults reported they were unable to access a physician within the past year due to cost. This percentage increased to 45% for those under the age of 30 and 33% of those with incomes less than $25,000 (PCCHAP). According to the Portage County Health Status Assessment, adults are affected by the four known risk factors for heart disease, 38% adults had been diagnosed with high blood cholesterol, 29% had high blood pressure, 13% were smokers, and 28% were obese (2016). In 2015, 22% of adults admitted to consuming who drank had five or more drinks (for males) and 4 or more drinks (for females) on one occasion (binge drinking) in the past month (PCCHAP). The Health Assessment identified that according to the BMI by age that 15% of Portage County youth were obese and 15% were considered overweight in 2015 (PCCHAP). Only 13% of Portage County youth admitted to eating 5 or more servings of fruits and vegetables per day, 80% ate 1 to 4 servings of fruits and vegetables per day. About 11% youth reported they went to bed hungry at least one night per week because their family could not afford enough food. 12% of youth did not participate in at least 60 minutes of physical activity on any day in the past week. The CDC recommends that children and adolescents participate in at least 60 minutes of physical activity per day. The 2016 Health Assessment indicated that 26% of Portage County youth had tried cigarette smoking, 21% of current youth smokers smoked cigarettes daily, and 17% of youth used e-cigarettes. The Health Assessment results indicated that 47% of Portage County youth in grades 6-12 had drank at least one drink of alcohol, increasing to 71% of youth seventeen and older. The Health assessment identified that 11% of youth grades 6th-12th had used marijuana at least once in the past 30 days, increasing to 17% of those ages 17 and older, 7% of youth used medications that were not prescribed for them, increasing to 11% of those over the age of 17. (27%) of Portage County youth have had sexual intercourse, increasing to 55% of those ages 17 and over, 55% had multiple sexual partners, and 26% of youth participated in sexting. The Health Assessment results showed that youths exhibit behaviors that endangered their own personal safety or safety of others. 18% of Portage County 6th-12th grade youth had seriously considered attempting suicide in the past year, 27% of youth drivers texted while driving, 23% of youth had been involved in a physical fight in the past year, 43% of youth had been bullied in the past year, and 33% had been bullied on school property. Reference Chamberlain College of Nursing/CCN. (2016). Week 2 lesson: Community assessment and health planning [Online Lesson]. Downers Grove, IL: DeVry Education Group. University of Wisconsin Population Health Institute. (2016). County health rankings & roadmaps. Retrieved from http://www.countyhealthrankings.org/ Nies, M. A., & McEwen, M. (2015). Epidemiology. Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier. Portage County Community Health Assessment Partnership. (2016). Portage County community health needs assessment. Retrieved from http://www.co.portage.oh.us/pchd/ U.S. Census Bureau. (n.d.) Quickfacts: Streetsboro city, OH. Retrieved from http://quickfacts.census.gov/ RESPOND: Machaela, Your community sounds quaint per size and based on the demographics appears to be a middle-class society in which education is a valued element. Also, is evident through many counties researched by the class that the key concerns across America are obesity, smoking, and nutrition. I too am astounded at the rate of deaths before at 18 at such a high percentage. In Pinellas County 2010-2012, the primary culprits of mortality are cancer and heart disease and outweigh total Florida death rates by these as well as unintentional injury and diabetes. Another statistic I found interesting but expected in reading these posts is that there are more women than men in total populations. Homelessness is a major health factor in Pinellas County with 20-30% suffering from mental health disorders. This exercise has truly opened my eyes to see more of my community than I had previously known and has invited fresh insight to my role as a nurse. Reading these posts confirms the need for nurses to utilize their knowledge and efforts to reach the community before illness develops. Thank you for your research, Sherri [Show Less]
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