Month: June 2020

What is vulnerability? Merriam- Webster defines vulnerable as “capable of being physically or emotionally wounded.” In my opinion, we are all vulnerable by that definition.

What is vulnerability? Merriam- Webster defines vulnerable as “capable of being physically or emotionally wounded.” In my opinion, we are all vulnerable by that definition. In healthcare, vulnerable populations are considered those who cannot advocate for their needs or well-being. For example, children, members of the LGBTQ community, prisoners, ethnic minorities, impoverished, and physically or mentally impaired would all be considered vulnerable. (Falkner, 2018). Children, in my opinion, are the most vulnerable because they lack decision making skills and autonomy to advocate for their needs or health care decisions. Children must count on the adults around them to make these decisions for them and unfortunately, some adults take advantage of this vulnerability. As healthcare providers, it is our responsibility to advocate for our patients even and especially when their caregivers are making decisions that will cause them harm. This is a slippery slope as choices such as refusal of vaccinations or life- saving blood products (because of religion) is a protected right. Ethics committees and judicial members are often tasked to intervene in life-saving decisions when the child’s best interest is at risk. So, I beg the very controversial question, how much longer will we continue to watch children die from vaccine- preventable illnesses until the government intervenes?

 

Reference

Falkner, A. (2018). Community as Client. In Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

“Vulnerable.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/vulnerable.

There are many different groups of people who are categorized as vulnerable population such as racial and ethnic minorities, the economically disadvantaged, those with chronic health conditions, those who live in rural areas and the elderly (AMJC, 2018). These vulnerable populations health and healthcare problems are often worsened by social factors. They may experience greater risk factors, worse access to care, and increased morbidity and mortality with the general population.

The economically disadvantaged is one group of the vulnerable population as they are at risk for poor health status and access to healthcare. They experience significant disparities in life expectancy, access and utilization of healthcare, morbidity and mortality. In general, low-income individuals are more likely to have chronic illnesses, and the impact of these illnesses can be more severe, individuals with low incomes are also disproportionately racial and ethnic minorities. These low income people may be less like to have health insurance coverage or may be underinsured and as a result they have less interaction with the healthcare system as stated by Pamella Riley, MD, vice president of delivery system reform at The Commonwealth Fund (AJMC, 2018). These individuals are more likely to behavioral health issues such as depression, substance abuse problem and chronic medical conditions like obesity or diabetes.

Numerous efforts are been made to reduce the disparities in healthcare. Persons who are poorer often are stigmatized and not given the chance to express themselves and they are often unaware of the community healthcare resources available to them. The community health nurse comes in contact with these persons and he/she will assess these individuals and identify their needs, make necessary referrals, raise awareness, provide education and put guideline in place with the help of other health professionals and stakeholders (Waisel, 2013). Patients can be educated on how to prevent diseases and maintain the best possible health even if they are poor. The nurse should remain non-judgmental, be culturally aware, show respect to all patients when giving care regardless of race or social status.

Reference

Joszt, L. (2018). 5 Vulnerable populations in healthcare. American Journal of Management Care. Retrieved from https://www.ajmc.com/newsroom/5-vulnerable-populations-in-healthcare

Waisel, D. B. (2013). Vulnerable populations in healthcare. Current opinion in anesthesiology 26(2) p186-192.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23385323/

Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:

Week 4 Journal Entry

Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client.
  • Using citation in APA Format with at least three references no more than five years old, include introduction and conclusion.

Write an explanation of your observations of the client William in Thompson Family Case Study, including behaviors that align to the PTSD criteria in DSM-5.

 Write an explanation of your observations of the client William in Thompson Family Case Study, including behaviors that align to the PTSD criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature. Using proper citation in APA Format, at least three references no more than five years old

Using Part I, write and revise the original learner objectives submitted. Use the A-B-C-D method of writing objectives. The objectives should incorporate Bloom’s taxonomy, be written at the appropriate level for the audience, and include at least two learning domains (cognitive, psychomotor, and affective).

Class Design Project: Part 2

 Details: Using the Personal Class Design Project – Part 1 assignment you began in NUR-647E, you will complete the course design to include learner objectives, outline, teaching strategies, and associated evaluation, and method.

Using Part I, write and revise the original learner objectives submitted. Use the A-B-C-D method of writing objectives. The objectives should incorporate Bloom’s taxonomy, be written at the appropriate level for the audience, and include at least two learning domains (cognitive, psychomotor, and affective).

(See Attachments)

Refer to “NUR-649E – Nursing Education Seminar II: A-B-C-D Approach to Objective Writing” and

“NUR-649E – Nursing Education Seminar II: Learning Domains.” Map out a class time frame, outlining when to cover each of the content areas.

Refer to “NUR-649E – Nursing Education Seminar II: Lesson Plan Template.

In addition to the content area, include the class time frame:

1. Time frame for covering each topic area

2. Teaching strategy for each objective

3. How the learning will be evaluated

4. Include rationale for each selected instruction and the evaluation method used.

Support your rationale by citing at least three scholarly, peer-reviewed resources (less than 5 years old) in addition to the course materials.  There is no predetermined length for this assignment.

It is intended that each student will develop a class that can be utilized in the student’s selected area of education.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Health researchers not only systematically plan and implement health studies but also apply research findings to advance the health professions’ knowledge base and professional practice.

Discussion: Selecting Research Methods

Health researchers not only systematically plan and implement health studies but also apply research findings to advance the health professions’ knowledge base and professional practice. The types of questions the researchers ask are what determine whether a quantitative, qualitative, or mixed-methods approach is most suitable for a particular research study.

Research questions that ask “what” explore relationships between variables. Such questions require a quantitative approach. For example: “What” is the rate of influenza in my community? “What” is the relationship between selected demographic characteristics and a diagnosis of influenza?

Questions that ask “why” or “how” require a qualitative approach. For example: “Why” might Latina women in a particular neighborhood be wary of accessing reproductive health services?

Studies that seek an answer to “what,” “why,” and “how” questions employ a mixed-method approach of both quantitative and qualitative methods.

Post an explanation of the research method you would choose to conduct the public health study proposed in the scenario. Explain why you would choose this research method over others. Include in your explanation the benefits and limitations of the research method you selected. Be sure to indicate the sources used in your response, either course readings or other outside sources, using correct APA 6th edition form and style.

SCENARIO: Discussion Scenario Imagine that you are the director of a community health clinic that specializes in diabetes mellitus type 2 (DB2) diagnosis and management. According to research conducted by clinic employees, a significant percentage of the individuals who attend the clinic for this disease are not adhering to the diabetes management plans that the clinic provides. As the director, you wonder if there is some way to identify, at the point of diagnosis, those patients who are most likely to avoid adhering to their medications and post-diagnosis management plan. Doing so would enable the clinic to target potential nonadherers for more intensive education about DB2 management. You have hired a professional health researcher to design a study to answer the following questions:

1. Are there demographic and other characteristics associated with people who are likely to be nonadherers to the DB2 post-diagnosis management plan? If so, what are the determinants?

2. Can one predict who is likely to be a nonadherer?

3. What type of research study design is required to answer these research questions, and why?

1. In your own words and using the proper evidence-based references define communicable and infectious disease. Discuss if there is any similarity and how they related each other. Give some example of communicable disease and infectious disease and why they are classified like that.

Communicable Disease and Infectious Disease.  Sexually Transmitted Disease and HIV and AIDS.

Review the attached PowerPoint presentations.  Once done answer the following questions:

1.  In your own words and using the proper evidence-based references define communicable and infectious disease.  Discuss if there is any similarity and how they related each other.  Give some example of communicable disease and infectious disease and why they are classified like that.

2.  Discuss the vaccination requirement in our state (Florida), and tell me if they are given to prevent communicable of infectious disease.  Give examples.

3.  Discuss why is no a “typical” STI patient.  Why does the presence of STI greatly increased the risk of HIV transmission?

4.  Present an overview of the medication Prep (Truvada) and discuss the pros and cons of the use of this medication in the prevention of communicable and infectious disease.

– APA format word document, Arial 12 font, attached to the forum tab in the discussion board titled “Week 4 discussion questions”.

– A minimum of 3 evidence-based references no older than 5 years are required.

– A minimum of 600 words is required (excluding first and last page).

Select three of the pillars discussed in the article and present how these pillars are vital to TIH’s consumers, support services, business operations, and administration.

For your Assignment # 3, read the following article:

Rodak, S. (2012). 10 Pillars of Success for Top Healthcare Workplaces. Retrieved from http://www.beckershospitalreview.com/hospital-management-administration/10-pillars-of-success-for-top-healthcare-workplaces.html

Remember, you have been named the Administrative Director at Trident International Hospital (TIH) and will be presenting your PPT to the Board of Directors at TIH for approval. TIH is restructuring to meet the current needs of their consumers. The article discusses 10 pillars of success for top health care workplaces. In 5-6 additional slides, you are to:

  1. Select three of the pillars discussed in the article and present how these pillars are vital to TIH’s consumers, support services, business operations, and administration.
  2. Research and select a health care model (i.e., Value Based, Volume Based, Fee-For-Service, Cost-Based, etc.) for TIH.
    1. Provide rationale how the selected model addresses the 3 pillars of success and will meet the current needs of TIH’s consumers.

Your PPT should be professional and provide substantial information.

At this point (with the continuation of slides from Assignments 1 & 2), your total presentation should be at least 15-18 slides (not including the title and reference slide). Speaker notes are required.

  1. Limit your PPT to a maximum of 18 slides.
  2. Support your powerpoint with peer-reviewed articles, with at least 3-4 references. Use the following source for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php

1. In your own words and using the proper evidence-based references define communicable and infectious disease. Discuss if there is any similarity and how they related each other

Communicable Disease and Infectious Disease.

Sexually Transmitted Disease and HIV and AIDS.

1.  In your own words and using the proper evidence-based references define communicable and infectious disease.  Discuss if there is any similarity and how they related each other.  Give some example of communicable disease and infectious disease and why they are classified like that.

2.  Discuss the vaccination requirement in our state and tell me if they are given to prevent communicable of infectious disease.  Give examples.

3.  Discuss why is no a “typical” STI patient.  Why does the presence of STI greatly increased the risk of HIV transmission?

4.  Present an overview of the medication Prep (Truvada) and discuss the pros and cons of the use of this medication in the prevention of communicable and infectious disease.

As stated in the course syllabus this assignment must be presented based on the instructions given;  in an APA format word document, Arial 12 font, attached to the forum tab in the discussion board titled “Week 4 discussion questions”.

A minimum of 3 evidence-based references no older than 5 years  (excluding the class textbook) is required. You must post at least two replies to any of your peers sustained with the proper references.  A minimum of 600 words is required (excluding first and last page).

According to Grove, Gray, & Burns (2015), extraneous variables are present in all studies and can affect the study and the relationships among the variables

Comment1

According to Grove, Gray, & Burns (2015), extraneous variables are present in all studies and can affect the study and the relationships among the variables.  Researchers
must continually look for extraneous variables throughout the research to prevent a biased impact.  They can be confounding, which means they are not recognized until the study is in progress, or environmental, which includes the climate, family, etc. Extraneous variables are more of a concern in quantitative research because they can prevent the researcher from obtaining a clear understanding and they are not recognized until the study is in progress but profoundly affect the outcome of the study (Gray, et al, 2015).  While in most qualitative studies, extraneous variables are usually controlled because subjects are studied in their natural environments.  By selecting a sampling of
participants who are characteristic of the population being studied, extraneous variables can be controlled by the researcher.   Grove, et al (2015) provides the example of research on the effect of relaxation therapy and the patient’s perception of incisional pain.  In order to control extraneous variables, the researcher needed a sampling of patients who are in a hospital environment and receiving one type of intravenous pain medication.   This type of sampling would reduce the extraneous variables such as surgical incision and time, amount and type of pain medication administered postoperatively and their perception of incisional pain (Grove, et al, 2015).

Comment 2

There are 4 types of extraneous variables:

*Situational variables- which are aspects of the environment that might affect the participant’s behavior. For example; noise, temperature, lighting conditions. Situational variables should be controlled so they are the same for all participants.

*Participant/person variables- This refers to the ways in which each participant varies from the other, and how this could affect the results. For example; mood, intelligence, anxiety, nerves, concentration.

*Experimenter/ investigator effects- The experimenter unconsciously conveys to participants how they should behave – this is called experimenter bias.

*Demand characteristics- these are all the clues in an experiment which convey to the participant the purpose of the research. Experimenters should attempt to minimize these factors by keeping the environment as natural as possible, carefully following standardized procedures.

Through control, the researcher can reduce the influence of extraneous variables.

Through control, the researcher can reduce the influence of extraneous variables. variables exist in all studies and can interfere with obtaining a clear understanding of the relationships among the study variables. For example, if a study focused on the effect of relaxation therapy on the perception of incisional pain, the researchers would have to control the extraneous variables, such as type of surgical incision and time, amount, and type of pain medication administered after surgery, to prevent their influence on the patient’s perception of pain. Selecting only patients with abdominal incisions who are hospitalized and receiving only one type of pain medication intravenously after surgery would control some of these extraneous variables. Controlling extraneous variables enables researchers to determine the effects of an intervention or treatment on study outcomes more accurately.

Comment 2

The levels of evidence  from strongest to weakest  are as follows :

•  Systemic review of experimental studies (well-designed randomized controlled trials [RCTs])•  Meta-analyses of experimental (RCT) & quasi-experimental studies•  Integrative reviews of experimental (RTC) & quasi-experimental studies•  Single experimental study (RCT)•  Single quasi-experimental study•  Meta-analysis of correlational studies•  Integrative reviews of correlational & descriptive studies•  Qualitative research meta- synthesis & meta-summaries•  Single correlational study•  Single qualitative or descriptive study•  Opinions of respected authorities based upon clinical evidence, reports of expert committees  (Grove, Gray, & Burns, 2015, p.  24 )

Systemic review is reviewed by experts in the field of research  who meticulously  evaluate the content. Meta-analysis uses quantitative approaches to review the research from multiple studies. Integrate review is a compiling of research that has been revised and abridged. Single experimental study is a true experimental study where researchers are typically unaware as to which participants are receiving the intervention. Meta-analysis compiles qualitative data while searching for common themes among comparable  research studies  (Peterson et al., 2014, p.  62-63)