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Diverse Population Memo/Issue Brief
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Leadership Role in Healthcare Policy: Diverse Population
The purpose of this assignment is to provide your audience with healthcare information necessary to provide person-centered-care for the vulnerable/diverse population you selected
Because of the disproportionate risk, cost, quality, overlapping issues (intersectionality), you will need at least two or three-pages (SINGLE SPACED) for an Issue Brief. APA for references and in-text citations (The link below takes you to an excellent example of an issue brief).
Be sure to speak to your audience when writing. You can keep the audience you used previously or select another audience.
You may use any or all of the information you submitted for the Diverse Population Assignment in Lesson 5
Kaiser Family Foundation has an Issue Brief that should be very helpful
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Issue Brief Part II Instructions
Use the following as a guide for your issue brief (formally named issue memo). I know it will be impossible to cover all of the information below, cover key issues/components.
1) Identify the vulnerable/diverse population you selected
Briefly explain to your audience why the diverse groups are vulnerable to disparities and why the disparities matter.
2) What is the status of the diverse group currently
Is the vulnerable/diverse population you selected, at disproportionate risk of being uninsured, lack access to care, and unable to pay for care, likely experience worse/adverse health outcomes.
Is the vulnerable/diverse population you face overlapping systems (intersectionality) with various social stratification, such as class, race, sexual orientation, age, income, disability, and gender, etc
Diverse Population Memo/Issue Brief
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4) What are some vital healthcare reform initiatives to address the vulnerable/diverse population selected?
5) What are some of the significant risks for the diverse group if there are no healthcare system changes to the population you selected?
6) As a professional nurse, at what point(s) in the Public Policy Process (Lesson 2) would you recommend advocating for the population you selected?
7) Are there risks for a professional nurse regarding professional nursing standards and the Nursing Practice Act when providing care for the selected population? (Example: During the Pandemic, nurses were allowed to work in other states, strong feelings about a population can cause nurses to do more than within their scope of practice, etc.) Cite the nursing standards or practice act you are aligning with in your brief.
8) References
Diverse Population Memo/Issue Brief
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Effective communication in Consumer Health Education
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Effective communication in Consumer Health Education
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Effective communication in Consumer Health Education
Purpose
The purpose of this assignment is to engage learners in evaluating factors that contribute to effective communication and health literacy in consumer health education materials.
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Effective communication in Consumer Health Education
STEP 2: EVALUATE
Publication Information
Identify the publication title, author(s), year/date of publication, and source location (URL).
Purpose and Intended Audience
In one paragraph, summarize the purpose of the material and the intended audience. Describe the target audience that the authors want to address (e.g., persons who have diabetes, are sexually active, are caregivers to persons with dementia, the general public, etc.).
Effective communication in Consumer Health Education
Category Analysis
Evaluate the material using the 7 categories of the CDC Clear Communication Index: 1) Main Message and Call to Action; 2) Language; 3) Information Design; 4) State of the Science; 5) Behavioral Recommendations; 6) Numbers; and 7) Risk.
This section can be formatted as a list, bullet points, or in paragraph format. Include examples of how clearly the main message is communicated and prominently located within the material, how main ideas and supporting ideas are organized, use of visual cues and headings, language considerations, how graphics, colors reinforce the main message; how or whether scientific evidence or authoritative sources inform the main message or recommendations; how or whether actionable behavioral recommendations are provided; whether and how numbers are used to communicate recommendations or risk, and how the risk associated with the health condition or behavior applies to the target audience or health outcomes.
Strengths and Recommendations for Improvement
In one-to-two paragraphs describe three strengths of the material and at least one recommendation for improvement based on your evaluation.
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Effective communication in Consumer Health Education
STEP 3: SUBMIT
Prepare your evaluation using a word processor such as MS Word. Upload the file to the assignment link as either a Word document or PDF.
Review your work for content quality and depth, organization, and grammar. Use the grading rubric to guide your preparation.
Be sure to include the reference for the resource in APA Style format.
If the material is not available electronically, please scan and upload the document with your analysis.
Effective communication in Consumer Health Education
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Community Teaching Work Plan Proposal
PowerPoint slides and information from the World Health Organisation (WHO) portal were employed in this presentation. The nursing diagnosis is a willingness to learn. Learning includes the cognitive, affective and psychomotor domains (Nies & McEwen, 2011). It is, however, paramount to evaluate the enthusiasm to learn about the target audience. Apart from the disposition to learn, it is critical to assess the age group of audience, academic level, intervention structure, reading and writing capability, mental level and developmental level.
Any physical restrictions such as audibility, graphical and coordination should equally be considered. Variables that include readiness to learn are culture, emotional attributes, support structures and so forth. Family structure, monetary and social status are other variables. Nonetheless, it is critical to evaluate language barrier before drafting the teaching plan. When it comes to the learning model, bandura’s social learning theory was employed.
Learning can transpire through direct observation or instruction presented in a social backdrop. The presentation’s target audiences were policy makers and security personnel. The simple language was used for easier comprehension of the audience.
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Community Teaching Work Plan
Summary of Teaching Plan
While the aspect of teaching the community on potential attacks is a serious issue in our nation, demonstrating to them the importance of security interventions, was a significant cause. The probability that a nation can experience bioterrorism/disaster is somewhat factual. In the recent past, for instance, Americans experienced the effects of September 11, wars and animosity (Harkness & DeMarco, 2012).
These are indicators that present people the fundamental basis to learn safety strategies. The presentation was the toughest of issues I had to conduct. Public speaking is not my strong point; nevertheless, I considered it my responsibility as a nurse to educate the community on tactics that could help them solve emerging problems. In most cases, PowerPoint presentations are useful tools when it comes to disseminating knowledge to individuals that do not understand complex issues. So, during the presentation, the audience would appear instinctive and interested.
The same applies to me. When a presentation touches not just on my safety but others as well, I would be more than keen to pay attention. The presentation took approximately 20 minutes, which involved explaining and discussion. In general, I was confident regarding teaching and giving detailed examples on this particular issue. This group also was keen and considered this information relevant.
Community Teaching Work Plan
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Epidemiological Rational
Epidemiology is the study of the occurrence of diseases in different individuals. In addition, epidemiology involves the importance of having the plan to prevent such diseases. It is not exceptional for ordinary individuals to be unaware of epidemiology. Nevertheless, it is our duty to study not only the causes but also the impacts of detrimental as well as the sickening field of health.
Some fields of the study are not natural, and as such, easier to learn and prevent. While it is significantly incredible to control dangerous pathogens, what becomes apparent is that the cure for some physical illness has not been discovered. As such, the ability to take out a whole community has considerable impacts. This is not a thought; rather it is an endemic and probabilities are certain. Besides the 9/11 terrorist attacks, one month later there was anthrax outbreak (Markowitz & Rosner, 2004).
Also, there are also cases of smallpox, among other contagious diseases. For that reason, it is of great importance for the community to be educated about these diseases and ways of preventing them. Much as one may wonder the way of teaching or fathom the results, the solution revolves around trying. For me, nursing is not just a profession but a way of life. In short, teaching the community about epidemiology was rewarding because I executed my duties and saved lives of others.
Community Teaching Work Plan
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Evaluation of Teaching Experience
By and large, the teaching experience was a rewarding and positive experience. Throughout my nursing career, I have never been compassionate teaching the community, and the skills acquired from this experience helped me throughout my career. While the subject was challenging regarding teaching, understanding information was considerably tough. In reality, it was hard to believe that this was not imaginary; this scenario can occur later on in life.
Personally, I detest and greed people have against others is inconceivable. When I completed the task, I was compelled to share what I learned with others to assist them in preventing these attacks. The majority of people who participated in my presentation were ignorant regarding the occurrence of these events or were even aware that they have already occurred. My response was simple.
I was not aware that this was a genuine issue or took place in the past. Before beginning this project, teaching the community was not my interest as such I cannot believe that some other people would like this subject and consider as a component of their lives unless they have no other choice. The reaction I obtained from this group was a mixture of various positive and inquisitive. Nonetheless, there some reactions that contributed to other useful information.
Community Teaching Work Plan
Community Response to Teaching
In the beginning, individuals who attended my presentation on bioterrorism awareness appeared reluctant. But when I began my assessment about the issue they were at ease and ready to get along. It was intricate to get these people to recognize the relevance of the issue. The community had been threatened with destructive attacks, however; it was certainly possible. As I wrapped up the presentations, various issues were raised including the time, the manner and the reason such attacks can happen.
For sure, I tried my best to respond to these questions, although I could not explain that area in the discussion. I merely intended to explain to the community the knowledge regarding these deadly communicable illnesses rather than the reasons they occur or the time they could happen. This demonstrates that teaching this group stimulated them to think out of the box (Harkness & DeMarco, 2012).
A few people, who offered insights on this issue, covered some of the disputed issues since they were former and currently they retired veterans. The queries addressed by these individuals just stated that human beings do not understand and cannot know until an event takes place. In the case of an occurrence, the country has to be prepared, not just for the deadly disease but also terrorist attacks. The group that attended learning was rather compelled following the views of the retired veterans who shared some of the things he did during the war.
Maybe this group will carry on with daily lives, I do not find it strange, but some gained understanding regarding bioterrorism as well as a different perspective. A remarkable lifestyle change is necessary because it help the group to be ready for any possible event. Of course, this was not my objective; rather my intention was informing the public to protect themselves and others.
Community Teaching Work Plan
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Areas of Strength and Improvement
This was more than just another task that I wanted to accomplish but rather a challenge. I will always attempt to do my very best in any condition; this was an issue I never imagined I would have to deal with. I must admit that any PowerPoint presentation would be to realize this assignment with positive results and benefit to those around. Owing to the number of persons that were in attendance, I believe I was able to realize most of those objectives. While my group speaking capabilities were not that perfect, I had the confidence to put my point across in a coherent manner.
My PowerPoint was simple to comprehend with just the right data to justify every aspect in the presentation. Again, my competence to present before strangers on a subject that I was not conversant with previously caught me surprised. Certainly, I had some doubts about my capability, and the real battle to overcome was in the mind. At the outset, for instance, I was never audible enough, implicitly people seated in the back could not hear me.
Community Teaching Work Plan
This is to say, I would have started the presentation with vigor to be heard by almost everyone in attendance. I would understand being told to speak up loud. I guess the tension stemmed from self-consciousness or the usual timid disposition that presented. Nonetheless, as the presentation went on, I gained the self-confidence and was even willing to do better.
The answers section is another area that I needed to have done thorough preparation. Some questions took a tall order for me, and I, therefore, relied on other individuals. Towards the end, I recognized that meticulous preparation would have equipped me entirely. Honestly speaking the experience was one of a lifetime and it was obvious for a few probing minds to question my competence. Generally speaking, I have the confidence the whole presentation was a hit. While I set out wobbling and terrified, I gained the confidence in the long-run. As I wrapped up, I recognized that preparation should become a way of life.
Community Teaching Work Plan
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STIs Practicum Journal Entry
This practicum is one of the most fascinating experiences in my clinical practice. Dealing with patients diagnosed with sexually transmitted infections (STIs) is challenging as most of the patient are hesitant to talk openly to a nurse or doctor about their experiences, which makes it challenging during clinical decision making processes (American Congress of Obstetricians and Gynaecologists, 2011).
Mrs. Kate (pseudo name) a 21 year old college student presented to the clinic with complaints of itchiness around her genitalia, sharp burning sensation during sexual intercourse and had noted whitish discharge that had foul smell. From the clinical manifestation, I gathered that the patient is suffering from an infection, which could be either sexually transmitted infections (STIs) or urinary tract infections (UTIs). There is a thin line that separated the two, which indicated the need for further laboratory test.
According to Centre for disease control and prevention (CDC), UTIs and STIs clinical manifestations are non-specific and are a common to problem for females. This highlights the likelihood of misdiagnosis. The common clinical manifestation for the urogenital diseases includes a burning sensation during urination, vaginal discharges and pelvic pain. However, in UTIs infection, vaginal discharge with awful smell is normally absent. The patient with urinary tract infection tends to have fever. A pelvic exam, urine culture and vaginal culture results indicate that the patient had yeast vaginal infection (CDC, 2013).
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One of the challenges experienced during this practicum was during sexual history assessment. Initially, the patient was hesitant to disclose the information because it is a taboo and also she believed that disclosing this information would victimize her. After reinforcing the issue of confidentiality, the patient became relaxed and disclosed the sensitive information.
The sexual history assessment was done using the general guide of the ‘5 Ps.’ This included the number of sex partners, the type of sexual activity, the rates of use of protection, and use of contraceptives. This helped me understand the patient literacy and perspectives about UTI (Schuiling and Likis, 2013).
The patients seemed somewhat distressed when I gave her the diagnosis results. However, she was cooperative all through the care plan. The patient was advised to have regular check up with the gynaecologists. This is because sexually transmitted infections (STIs) have short and long term impacts that can be life threatening. The short term impacts include emotional disturbances due to physical changes.
The long term effects include genital sores, inflammation, infertility issues and pelvic inflammatory reactions. Fortunately, genital yeast infections like other sexually transmitted infections (STIs) is manageable if diagnosed early and proper medication regimen is provided (CDC, 2013).
The patient had tried to manage the itchiness and pain using Tylenol (OTC) and vaginal cream, which yielded little success. The patient was given fluconazole 150 mg and Terconazole 80 mg both orally administered one suppository/day for at least 3 days. The medication ensured that the patient did not get recurrent infection. The patient was encouraged to observe hygiene and practice abstinence during the medication regimen. Other hygiene measures such as mutual monogamy, abstinence and avoid of douching practices.
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This practicum was very enlightening, especially on ways to practice cultural competency. I noticed that sexually transmitted infections (STIs) education focuses in specific information on signs and symptoms which seems to be the worst case scenarios and a taboo to most of the community.
The only down to earth guidance is abstinence and use of condom. If not handled with care, the interaction with the patient could affect patient psychosocial status. I have learnt a lot from this practicum and will use the knowledge to help other patients to identify risk factors and practice preventive measures (Schuiling and Likis, 2013).
References
American Congress of Obstetricians and Gynecologists. (2011). Guideline for adolescent health care (2nd ed.). Retrieved from http://www.acog.org
Centers for Disease Control and Prevention (CDC). (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from http://stacks.cdc.gov/view/cdc/13174
Schuiling, K. D., & Likis, F. E. (2013). Women’s gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.
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Lack of Proper Education on Patient with Type 2 Diabetes
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Lack of proper education on patient with type 2 diabetes
Locating the Best Evidence
Often, type 2 diabetes patients lack proper education mainly because of the different barriers that they face as well as the receiving education that lacks a proper algorithm. Therefore, there is a great need for these measures to be acted upon so that the patients can realize more positive outcomes. Mshunqane, Stewart and Rothberg (2012) indicated that diabetes type 2 is associated with numerous complications, many of which can cause death if not managed appropriately.
In addition to this, at the worldwide level, the disease is acknowledge as a main challenge that nags the policymakers each day. There is presently some staggering statistics of the increasing prevalence as well as the linked economic and health impact.
Further, the World Economic Forum, World Health Organization, as well as the United Nations recognize the challenge. All these bodies suggest for collective dedication to improve the life quality of the patients as well as prevent the disease. They are clear that the challenge is universal, urgent, and critical. There is also the acknowledgment that the disease is serious for two main reasons (Stults-Kolehmainen & Sinha, 2014).
First is the health impacts linked to it which are more critical including increased likelihood for lower limb amputations, blindness, heart attacks, kidney failure, as well as stroke. Second, there are indirect and direct costs which are a major drain on the healthcare budgets as well as productivity.
The issue is very urgent considering that its prevalence is rising. Moreover, managing the complications associated with the disease is very costly, same as incorporating appropriate measures to ensure that the patients lead a high quality and independent life. The mentioned bodies also agree that proper education is one of the strategies through which the disease can be prevented and managed efficiently.
However, there are a number of barriers that prevent this and the education algorithm normally used is inappropriate. Therefore, this systematic review will aim at finding information suggesting the appropriate algorithm as well as the common barriers as well as how they can be addressed.
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Methods
Search strategy
Peer-reviewed academic journals will be sought from different databases, and these will be used to conduct the systematic review (Lee et al., 2013). The intention will be creating a proper algorithm on diabetes type 2 education, as well as identify some of the barriers to proper education and how they can be addressed. The databases to be used for the systematic review are CENTRAL, Social Science Citation Index, Science Citation Index, PSYCLinfo, Medline, ERIC, and CINAHL.
The references to the articles that were selected were also evaluated for leads. Reading the reviews was necessary as it helped identify if the article was appropriate. In relation to the inclusion criteria, there was selection of articles that were not older than five years. Particularly, there was selection of those discussing the barriers to proper diabetes type 2 education and their solutions, and those discussing proper education standards (Kapoor & Kleinbart, 2012).
Critically Analyzing the Evidence and Synthesis
Proper education algorithm
Type 2 diabetes education preventive measures will be informed to all the people through local barazas. This would ensure that all people engage in appropriate lifestyles to prevent the disease. Cultural competent educators, and those with proper listening and communication skills will be used to offer the education so that no one can be left behind (Garber, Gross & Slonim, 2010).
It will be necessary to educate the patients on all aspects of the disease including the causes, risk factors, predisposing factors, preventive strategies, available treatments, and management. In addition, awareness on how a patient can ensure self-care should be offered, same as the complications and the direct and indirect costs that a family can suffer because of the disease.
Moreover, the educator should go into details when elaborating on the preventive measures including the diet and physical activity. The more the patients and all people know about the disease and how it is connected to other chronic conditions, the more efficiently they can engage in self-care (Green, 2014).
Barriers and addressing them for patients to be able to receive the recommended type 2 diabetes education, they should really be concerned about their healthcare and ready to access or seek quality medical education. However, because of the ignorance some patient have, they prefer using over-the-counter medications or seeking traditional medicine men. They never seek the quality healthcare services because of their ignorance and low socioeconomic backgrounds.
Therefore, even the use of preventive services among these patients is very minimal. To address this, the local authorities will be given a chance to mobilize people from their living areas, so that education can start at the grassroots level before even being offered at the healthcare institution (Zoepke & Green, 2012).
In addition, there are many elderly people suffering from type 2 diabetes and with hearing, memory, and vision challenges. These will be offered the education in the presence of caregivers who can assist them around (Chijioke, Adamu &Makusidi, 2010).
Feasibility, Benefits, and Risks
Feasibility
The project of delivering proper education to the type 2 diabetes, patients is feasible, especially if the most appropriate education is being delivered, with a consideration of the personal factors, and if the barriers that might hinder the education have been considered and measures to address these put in place. Healthcare providers would only need to offer patients attending the institution for medical care services the pamphlets containing all the necessary information.
However, when dealing with type 2 diabetes patients, it would be necessary to find out first what they already know and later creating awareness while dispelling the misconceptions. This would be relatively cheap. It would also be necessary to explore other factors that affect individual patients so that advice can be offered (Rosenstock & Owens, 2008).
Barriers
After proper education is offered and the barriers to it addressed, some patients might still lack the funds to purchase even the affordable local foods. Considering that some patients might be elderly, there might be issues such as improper vision, hearing loss, and memory loss, which might influence practice of the education.
Benefits
Ensuring that the patients are receiving proper education and implementing it is essential in that it can go a long way in reducing the high prevalence of the disease, preventing complications, reducing the high costs needed to treat and manage the condition, as well as the losses related to loss of productivity and need for a higher quality of life (Ruffin, 2016).
Risks
Some of the anticipated risks include limited resources to ensure that adequate and proper education on type 2 diabetes is being delivered to the patients (Valencia &Florez, 2014). In addition, there might be absence of cultural competence professionals to deal with patients from different backgrounds. In addition, tracking the patients at their homes to ensure that they are implementing the proper education appropriately can be difficult and costly.
Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Green, B. (June 06, 2014). Diabetes and diabetic foot ulcers : an often hidden problem : review. Sa Pharmacist’s Assistant, 14, 3, 23-26.
Kapoor, B., & Kleinbart, M. (2012). Building an Integrated Patient Information System for a Healthcare Network. Journal of Cases on Information Technology (jcit), 14, 2, 27-41.
Mshunqane, N., Stewart, A. V., & Rothberg, A. D. (January 01, 2012). Type 2 diabetes management : patient knowledge and health care team perceptions, South Africa : original research. African Primary Health Care and Family Medicine, 4, 1, 1-7.
Rosenstock, J., & Owens, D. (January 01, 2008). Treatment of Type 2 Using Insulin: When to Introduce?.
Ruffin, T. R. (January 01, 2016). Health Information Technology and Change.
Stults-Kolehmainen, M. A., & Sinha, R. (January 01, 2014). The Effects of Stress on Physical Activity and Exercise. Sports Medicine, 44, 1, 81-121.
Valencia, W. M., &Florez, H. (January 01, 2014). Pharmacological treatment of diabetes in older people. Diabetes, Obesity & Metabolism, 16, 12, 1192-203.
Zoepke, A., & Green, B. (January 01, 2012). Diabetes and diabetic foot ulcers : an often hidden problem : general review. Wound Healing Southern Africa, 5, 1, 19-22.
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Influenza results after infection by the influenza virus. There are several factors which predispose an individual to develop the disease. To start with, infants and children less than five years of age are prone to the virus since their immune system is not entirely developed. The complications tend to be more than order children especially if they have chronic conditions such as diabetes or asthma (Harper & Bridges, 2009).
Adults older than 65years of age are also at increased risk of influenza since the immune system weakens with age. Individuals working or living in high densely populated areas such as army barracks, college dormitories, hospitals and refugee camps are also at risk due to a close interpersonal contact. In case an individual has influenza, there is an increased possibility of the spread of the influenza virus (Fukuda & Singleton, 2012).
Additionally, people with a weakened immune system such as those with diabetes, asthma tend to develop the disease because their body is unable to fight off the flu virus. Pregnant women are prone to illnesses since their bodies undergo various changes during the pregnancy period which affects their ability to fight infection (Harper & Bridges, 2009). The use of certain medications, which impairs the immune system, such as steroids by individuals who have undergone organ transplant is also associated with the influenza virus.
Goals and Objectives
Prevention and containment of influenza can be managed through various ways. Vaccination is known to be the best method of prevention. The Center for Disease Control in 2014 recommended that children under the age of six months and those individuals who are at risk such as health care workers, caregivers, and patients above 64 years be immunized annually. There should also be routine vaccination of people working in hospitals and facilities which offer long term care. Chemoprophylaxis using antivirals such as amantadine can help contain an outbreak. This should be done in case an outbreak is suspected; chemoprophylaxis should be administered to risk groups (Harper & Bridges, 2009).
Also, implementation of hand hygiene, cough etiquette, screening and isolation of infected individuals, adherence to set standard precautions for all patients and implementation of environmental infection prevention measures are some of the ideas that can be put in place to help in prevention of influenza. Measuring vaccination coverage will help in evaluation of existing prevention programs (Fukuda & Singleton, 2012). The use of protective gears, for example, for any contact with a potentially infectious material and the change of gloves, when handling different patients. Wear a gown when handling infected patient to avoid coming into contact with body fluids such as respiratory secretions (Harper & Bridges 2009).
Limiting access and movement of patients within the facility to avoid environmental infection control programs should be put in places such as disinfection and cleaning of frequently touched surfaces and objects in the health care setting. Waste products should be discarded according to layer down policies (Harper & Bridges, 2009). Also, proper planning by the health cares facilities during an outbreak is important.
Health facilities should come up with policies regarding infection control in care settings, health care and social settings, case-finding, treatment and management protocols regarding influenza (Fukuda & Singleton, 2012). Proper implementation of routine laboratory biosafety, proper specimen handling and hospital infection control policies. There should be a clear definition of an outbreak and protocol for management of the influenza virus in preparedness of an outbreak.
This can be managed through initiating a surveillance strategy to help identify infected persons or potential outbreaks through disease testing (Fukuda & Singleton, 2012). Also, it can be done through educational programs to help review laid down protocols for transmission, manifestation, and treatment of the disease. Healthcare facilities should ensure proper disease surveillance. These facilities should also ensure adequate availability of all materials and pharmaceuticals that may be required in the management of influenza outbreaks.
Educational Interventions
All healthcare providers should receive training concerning influenza disease, including symptoms, transmission, and prevention during orientation to a health care setting. There should be provision of updates to these healthcare providers through seminars and ongoing training programs (Harper& Bridges, 2009). Health care providers should be educated on prevention aspects which include proper use of gloves and gowning.
Health care providers should be given current protocols during seminars and conferences. Furthermore, media campaigns on vaccination of influenza should be done to ensure information reach targeted individuals. The society should be informed about the disease and the benefits of vaccinations to ensure that even the risk groups can take the necessary measures particularly the children and the aged (Fukuda & Singleton, 2012).
Health Promotion Behavior Theory
Health belief model would be the fittest for curbing and treating influenza affected individuals. This is because they will tend to seek medical attention in case of flu symptoms in case they understand the severity or seriousness of the disease basing on the knowledge they have acquired through training (Rosenstock, 2012).
Also by understanding that they are at risk of influenza, they will tend to seek medical attention when certain symptoms are experienced. When these individuals understand the benefits of immunization, they will tend to go for it.
References
Fukuda, K. & Singleton, J. A. (2012). Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports/Centers for Disease Control, 51(RR-3), 1-31.
An individual experiencing sensory impairment may face quite a number of challenges in life. With respect to higher level needs that are defined in Maslow’s hierarchy of needs. A visually challenged individual may find it harder to actualize these higher level needs. The higher level needs that include self-actualization, self-esteem and love and belonging needs, are among the particular needs that this paper will try to elaborate on how challenging they are to a visually challenged individual to meet them.
Love and belonging is nature to most if not all human beings. These needs depict the nature of the interpersonal relationships that are adopted by most humans. However, for a Sensory Impairment person. It may be quite difficult for them to find a sense of belonging in an environment that does not favor him or her. Creating interpersonal relationships with people without actually seeing their physical appearance will be the main issue to be dealt with.
Consequently, self-esteem needs are quite important in Maslow’s hierarchy. But for a Sensory Impairment person, attaining this needs may be a challenge. They may find it extremely hard to gain confidence. It might be quite difficult for this particular individual to be able to satisfy his or her desire to be valued by other people when he or she is visually challenged.
Lastly, self-actualization needs is on the pinnacle of Maslow’s hierarchy. Self-actualization entails five key things that are key to human beings. However, for visually challenged individuals, to fully satisfy their self-actualization need may prove to be hard if the person has not yet accepted the impairment condition that faces him or her.
The nursing intervention that would be applied by a registered nurse may include the following practices. First of all when meeting the patient, the nurse will have to make a good first impression. Reason being first impression go a long way into helping visually impaired patients feel cared for.
This also helps in creating a healthy relationship between the two parties (Treas & Wilkinson, 2013). Second of all, the nurse would help the patient meet their self-esteem and self-actualization goals by helping then get to know the environment they are staying in. This would help them feel confident by not requiring aid all the time to perform the basic life activities from time to time.
Therefore, for a visually impaired individual, the attainment of the love and belonging, self-esteem and self-actualization goals may be a cumbersome task. However, with the application of the right nursing intervention by a registered nurse. The attainment of these needs in the long run may be an overcome able situation.
Part 1: Code Blue educational video from the Regina Qu’Appelle Health Region.
Time sequence
Issue noted
code
comments
0-22 seconds
Breach of Australian Resuscitation Council Guidelines:
BARCG- Guideline 2 priorities in an emergency
Finds Mr. Smith unresponsive. Fails to follow the Guide 2 BLS algorithm because she failed to assess danger, but she assessed the airway, as she is seen checking for the escape of air from the patients mouth or nose as recommended by guide 5. Implications: Delay in resuscitation processes increases the risk of reduced cardiac output to the brain due to poor compressions.
Time 3.26
Poor technical skills
PTS – BARCG Guide 6 & 8
Chest compressions inadequate as recommended by Guide 6. The recommended chest compressions are 30 chest compressions followed by two breaths. The chest compressions are slow than required by Guide 8. “A good CPR should deliver chest compressions over the lower half of the sternum at a depth of 5 cm” (ARC guide 8). Long pauses in CPR before shock delivery. Guide 6 discourages long pauses and distractions during a CPR Implications: Long pauses, distractions, slow and inadequate chest compressions lower the chance of patient’s survival
Poor Non-Technical skillsPNTS
Time 0.30
Situation awareness
PNTS- SA
The nurse did not press the emergency push button system to call for help immediately and instead used the overturn Implications: Delayed response by the code blue team
Time 0.30 secsTime 2.26 minutes
Decision making
PNTS- DM
Delay in full code response. The team arrived 2 minutes later after the call alert Implications: This led to delay important activities such as defibrillation. However, the rest of the decisions such as medication, hyperventilation and defibrillation activities went on well once the code blue captain arrived.
Time 3.36
Task management
PNTS-TM
Compressors for more than five cycles. One compressor was working for almost 5 minutes which is too long for a compressor. According to Guide 5, “the compressor roles approximately after 2 minutes or after five cycles of compressions and ventilations at a ratio of 30:2 so as to maintain the quality of compressions” (ARC guide 5). However, other task management processes such as airway positioning, nasopharyngeal airway placement, bag-valve mask ventilation were correctly performed.
Time 5.28Time 12.55
Communication
PNTS- comm
Occasionally fails to use the closed up communication which leads to miscommunications. For instance, at minute 12.55, the recorder had missed recording the endotracheal tube particulars due to poor communication strategy. The team used the SBAR technique to report the patient’s medical history to the code blue team leader. All the information was recorded including all the medication administered and other CPR outcomes such as cardiac rhythm before a shock was delivered. This is vital for future references.
Teamwork
PNTS-Team
No introduction was done by the team members, but they delegated the resuscitation duties appropriately. The team consisted of a coordinator, compressor nurse, airway manager, nurse in charge of defibrillator, captain/leader and crash cart manager.
Leadership
PNTS- Leadership
The leader failed to evaluate the BLS on arrival. However, Mr. Sellinger (the code captain) performed his tasks effectively including identification of cardiac rhythm, initiation of ACLS protocol, and evaluation of the protocol reviewed the code blue documentation form and signed the code blue form after completing the code blue.
PART 2: Analysis of the issues covered
Code blue should be contacted immediately for all unresponsive patients. Calling for help and initiation for help should be done simultaneously. One of the issues identified in this case study is delayed in the response of code blue code due to poor call out systems. The code team member should call out loudly for help through the facility-wide response system. In this technology, the nurse should have pressed the Blue code push button to ensure that the code blue team were notified accordingly (Bayramoglu et al., 2013).
As the nurse in charge waits for code blue team, he or she should initiate CPR (Clarke, Apesoa-Varano, & Barton, 2016). The code team are expected to introduce themselves as they arrive as well as and their roles statements such as “Am Mr. J. and will take document” or “I’ll take the airway” which helps in ensuring there is clear role differentiation. The service user physician should be contacted immediately.
According to Price, Applegarth & Price (2012), the healthcare provider should first assess the patient dangers and risks before they start the air management. This was not done in the case study and violated the ARC guide four which states that the patient’s mouth should be opened and head slightly turned downwards to remove the airways (Australian Resuscitation Council, 2008).
An ineffective cough indicates a severe obstruction. In this case, if the patient is responsive, the healthcare provider should give about five back blows, and if still, it is ineffective, they should give at least five chest thrusts (McInnes et al., 2012). This article states that for all unresponsive patients, the healthcare should send for help and start CPR immediately. Similarly, guideline 5 recommends that all patients who are breathing abnormally or are unresponsive require being resuscitated.
The first thing when assessing breathing, the rescuers should check for movement around the chest (lower part) and abdomen (upper part). They should check for the exhalation through the patient’s oral cavity or nose, and feel the movement of air in the patient’s mouth or nose. The guide recommends a ratio of compressions to rescue breaths as 30:2 (Australian Resuscitation Council, 2008).
According to this article, the first nurse to respond should start saving the patient’s life by performing chest compressions immediately (100 compressions per minute). Although important, the nurse should not wait for backboard , they should start chest compressions as it can be put in place later when the code team arrives. The switching the compressor roles in the case study is present but it took quite a long time than that recommended by ARC guide 6 which is approximately after 2 minutes.
To maintain the quality, the ventilations ratio should be maintained at 30:2 (Castelao et al., 2013). This is supported by Guide 6 which recommends that interruptions to chest compressions should be minimized. The best location to perform the compressions is the sternum- the lower half part of it. The healthcare provider’s heel is placed at the central part of the chest and put the other hand on top it. The recommended rates of compressions are 100 to 120 compressions per minute which are about two compressions per second.
The guide also outlines on the quality of compressions ( which is identified as poor in the case study) where it suggests that depth of compressions should be “at least 2 inches (5cm) with complete chest recoil after every compression” this helps the heart to re-fill completely by the next round of compressions. The number of interruptions should be minimized to ensure maintain the quantity and quality of compressions (Eroglu et al., 2014).
According to the article, the patient should be given 2 ventilations for every 30 seconds of oxygen-bag-mask device assisted ventilation. The oxygen level should be set to the flow meter 15 L/min, and where applicable, the reservoir should be fully open ensure that the patient gets 100% oxygen for each breath. One strength observed in the study is the fact that bag-mask device is best done by two blue code team members where one open the airway to fasten the mask on whereas the second one squeezes the oxygen bag.
Also, the article states that defibrillation is very critical and that the use of placement hands-free defibrillation pads is a safer option than hands held defibrillation paddles (Girotra et al., 2012; Prince et al., 2014). The article states that the deployment of automated external defibrillators (AED) should be used as soon as possible as it reduces mortality and morbidity associated with cardiac arrest caused by either ventricular fibrillation or ventricular tachycardia (Australian Resuscitation Council, 2008).
The compressions should resume immediately after delivering shock even with a normal heart rhythm as it will not provide enough cardiac output that will ensure adequate perfusion. It is recommended that 2 minutes the cardiac rhythm should be assessed after 5 cycles of a CPR (Merchant et al., 2014). The use of vasopressors in cardiac arrest is recommended only when there are no high-quality CPR. It is important to be extra cautious when administering a drug. This is because miscommunication is a common issue which often leads in the administration of incorrect drug doses or medications.
This can be prevented by using “closed loop” method of communication (Segon et al., 2014; William et al., 2016). For instance, when a nurse receives an order to inject some medicine, they should repeat the information of drug prescribed out loud, inject it and then announce it again after administration (Price et al., 2012). This method was used in some instances, but in the instance that it was absent, the recorder was prone to miss out some key aspects; for example, in this code blue simulation, the recorder had missed recording the endotracheal tube measurements.
The article suggests that an effective code blue team should have leader who controls the all the procedures and efforts of resuscitation. They communicate with the staff involved and evaluate the cardiac rhythm of a patient. Mr. Sellinger is the team captain of the case study and was standing in a position such that he could effectively see all of the resuscitation procedures and efforts. If the organization allows, the family member can be allowed into the room. It is also important to ensure that the information is well recorded.
In the case study, the recorder is shown documenting all the resuscitation process. However, it is important to understand that documentation process is done according the healthcare facility’s policy (McEvoy et al., 2014; Sahin et al., 2016). The recorder should remind the code team when time for a specific task has elapsed and must record all the activities taking place including the medicines prescribed. The article also suggests that all clinical areas should grant quick access to equipment such as blood glucose, blood pressure, and equipment of pulse oximetry and other equipment so as to effectively manage a deteriorating patient (Clarke, Carolina Apesoa-Varano, & Barton, 2016).
Through this case study, it is evident code training programs using simulation is beneficial and has been recommended by various healthcare institution organizations since 1999. This training will help the learners to improve cardiac resuscitation outcomes as it offers an opportunity for regular hands-on practice within the hospitals. This also helps the team to understand the various roles and responsibilities expected during a full code. Along with continuing education and mock codes, the team members become confident in their responsibilities (Gutwirth, Williams, Boyle, & Allen, 2012).
Bayramoglu, A., Cakir, Z. G., Akoz, A., Ozogul, B., Aslan, S., & Saritemur, M. (2013). Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. The Eurasian Journal of Medicine, 45(3), 163–166. http://doi.org/10.5152/eajm.2013.34
Castelao, E. F., Russo, S. G., Riethmüller, M., & Boos, M. (2013). Effects of team coordination during cardiopulmonary resuscitation: A systematic review of the literature. Journal of critical care, 28(4), 504-521.
Clarke, S., Apesoa-Varano, E. C., & Barton, J. (2016). Code Blue: Methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259.
Girotra, S., Nallamothu, B. K., Spertus, J. A., Li, Y., Krumholz, H. M., & Chan, P. S. (2012). Trends in Survival after In-Hospital Cardiac Arrest. The New England Journal of Medicine, 367(20), 1912–1920. http://doi.org/10.1056/NEJMoa1109148
Gutwirth, H., Williams, B., Boyle, M., & Allen, T. (2012). CPR compression depth and rate about physical exertion in paramedic students. Journal of Paramedic Practice, 4(2).
McEvoy, M. D., Field, L. C., Moore, H. E., Smalley, J. C., Nietert, P. J., & Scarbrough, S. (2014). The Effect of Adherence to ACLS Protocols on Survival of Event in the Setting of In-Hospital Cardiac Arrest. Resuscitation, 85(1), 10.1016/j.resuscitation.2013.09.019. http://doi.org/10.1016/j.resuscitation.2013.09.019
Merchant, R. M., Berg, R. A., Yang, L., Becker, L. B., Groeneveld, P. W., & Chan, P. S. (2014). Hospital Variation in Survival After In‐hospital Cardiac Arrest. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 3(1), e000400. http://doi.org/10.1161/JAHA.113.000400
McInnes, A. D., Sutton, R. M., Nishisaki, A., Niles, D., Leffelman, J., Boyle, L., … Nadkarni, V. M. (2012). The ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents. Resuscitation, 83(12), 1462–1466. http://doi.org/10.1016/j.resuscitation.2012.05.010
Price, J. W., Applegarth, O., Vu, M., & Price, J. R. (2012). Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Canadian Medical Education Journal, 3(1), e4–e20.
Prince, C. R., Hines, E. J., Chyou, P.-H., & Heegeman, D. J. (2014). Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes. Clinical Medicine & Research, 12(1-2), 47–57. http://doi.org/10.3121/cmr.2014.1201
Segon, A., Ahmad, S., Segon, Y., Kumar, V., Friedman, H., & Ali, M. (2014). Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital. Journal of Graduate Medical Education, 6(1), 61–64. http://doi.org/10.4300/JGME-D-13-00165.1
Sahin, K. E., Ozdinc, O. Z., Yoldas, S., Goktay, A., & Dorak, S. (2016). Code Blue evaluation in children’s hospital. World Journal of Emergency Medicine, 7(3), 208–212. http://doi.org/10.5847/wjem.j.1920-8642.2016.03.008
Williams, K.-L., Rideout, J., Pritchett-Kelly, S., McDonald, M., Mullins-Richards, P., & Dubrowski, A. (2016). Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses. Cureus, 8(12), e938. http://doi.org/10.7759/cureus.938
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Gonorrhea is a sexually transmitted infection (STI) ,caused by Neisseria gonorrhoeae a bacteria which infects the mucous membranes. The bacteria is often transmitted from one individual to another during sexual contact, including anal, oral or vaginal intercourse. However, babies can also be infected with this condition during childbirth if the mother is infected. In babies, the disease affects their eyes. Hethcote &Yorke (2014) report that some of the factors that may increase the risk of one getting the infection include age, new sex partner, history of gonorrhea infection, multiple sex partners, and co-infection with other sexually transmitted diseases.
The bacteria cannot survive outside human body for long therefore it cannot be transmitted by sharing baths and towel, cups, toilets and seats, kissing or hugging.
Once infected, one presents with urethral discharge while urinating. The infection is treatable therefore one should seek medical attention early after noticing the symptoms.
Presentation of Gonorrhea
Usually, the infection causes no symptoms. However, when they appear it affects multiple body parts, but it appears commonly in the genital tract. Men who have been diagnosed with gonorrhea pus-like discharge from the tip of the penis, painful urination, and swelling and pain in one testicle. In women, the infection causes increased vaginal discharge, dysuria, dyspanuria, pelvic or abdominal pain, and vaginal bleeding between periods such as after vaginal intercourse.
The infection can also infect other body parts such as the rectum where it causes anal itching, discharge of the pus-like substance from the rectum, strains during bowel movements, and bleeding. When it infects the eyes, it may cause light sensitivity, eye pain, and pus-like discharge from one or both eyes. Patients may also develop a sore throat or swollen lymph nodes in the neck if the infection spreads to the throat. It can also disseminate to the various joints causing septic arthritis whereby the affected joints become red, warm, swollen, and extremely painful during movements.
Treatment of Gonorrhea
Adults who have been diagnosed with gonorrhea are prescribed with antibiotics. The Centers for Disease Control and Prevention (CDC) has recommended that patients with uncomplicated gonorrhea should be given a ceftriaxone injection in combination two oral antibiotics, that is, either doxycycline or azithromycin. This is advisable because the drugs provide a wide range of activity which is required due to the emergence of strains of drug-resistant Neisseria gonorrhoeae(Kerani et al. 2015).
Babies who are infected during childbirth are given two eye drops of erythromycin to prevent the spread of the infection. To avoid reinfection with gonorrhea, the patients are advised to abstain from unprotected sex for seven days after he/she has completed the treatment regimen and the symptoms have resolved.
The infection can cause some complications if it is untreated. For instance, it can cause infertility in women by spreading to the oviduct and the uterus cause Pelvic Inflammatory Disease (PID) which causes scarring of the fallopian tubes, increase in pregnancy complications as well as infertility. Infertility can also occur in men if the infection affects the epididymis. Most importantly, the gonorrhea infection predisposes a person to the risk of being infected with STIs such as the Human Immunodeficiency Virus (HIV).
The following steps should be taken to reduce the risk of gonorrhea infection. First, sexually active women should be encouraged to visit health centers annually for gonorrhea screening (Jackson, McNair & Coleman, 2015). Condoms should also be used if a person is having sex with a new sex partner. For those who have been diagnosed with the disease, they should encourage their partners to also go to a hospital for testing.
Prognosis
Gonorrhea has a good prognosis especially if antibiotic therapy is administered early enough. Usually, the infection clears within 2 to 4 weeks if the Neisseria gonorrhoeaeis susceptible to the antibiotics that have been administered. For individuals who have are immune-compromised such as patients with HIV, the infection may last for months and become more severe.
References
Hethcote, H. W., & Yorke, J. (2014). Gonorrhea transmission dynamics and control (Vol. 56). Springer.
Kerani, R. P., Stenger, M. R., Weinstock, H., Bernstein, K. T., Reed, M., Schumacher, C., … & Golden, M. (2015). Gonorrhea treatment practices in the STD Surveillance Network, 2010–2012. Sexually transmitted diseases, 42(1), 6-12.
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