Community health

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Use the internet and other resources (including health department and agency annual reports) to complete the table below. Compare the demographic and health data from the target community to city, state and national data.

Data Table 1:

Community Indicators

Target Community

[Name]

City/County

[Name]

State

[Name]

United States

[or other country or regions]

Demographics

Age

Race

Gender

Education level
(may need to divide this into two or more categories)

Income level (
again, may need categories)

Percent living at or below FPL
(federal poverty line)

Unemployment rate

Data Table 2:

Health Status Indicators

Target Community
[Name]

City/County

[Name]

State

[Name]

United States

[or other country or regions]

Life expectancy

Infant mortality;

Maternal/ child health outcomes

Morbidity and mortality data

(i.e., prevalence of diseases, causes of death; include several categories)

Data Table 3:

Physical/Social Environment

(Tailor to your target problem, include at least 5 indicators)

Target Community
[Name]

City/County

[Name]

State

[Name]

United States

[or other country or regions]

Liquor store density

School readiness/reading proficiency

School absenteeism

Homicide rate

Youth homicide rate

Vacant lot density

Food desert
(percentage assigned)

The Target Community is “Annapolis Family support center”. Please google it to see what they do and fill out the above table as you search for the information on the internet.

Advanced Nursing Inquiry and Evidence Based Practice

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Mixed methods research designs combine quantitative and qualitative research methods to answer research questions requiring both perspectives. Describe the pros and cons of a mixed method research design. Please include 400 words in your initial post with two scholarly references by Wednesday midnight. Please answer two peers by Saturday midnight with 200 words. 

NUR 435 – Week 3 Discussion: Managing Change

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tep 1 Consider a change in practice that took place at your workplace.

Step 2 Answer the Prompts:

·         What was the involvement of team members in the change process? Did “rank and file” members of the team participate on the team planning for change?

·         What steps were taken to prepare for change?

·         How were the goals and outcomes communicated to team members? Was the communication clear or could it have been improved?

·         What was the outcome of the change?

·         In your opinion, what elements are required in order to have a culture that is open to change?

Nursing Theory Week 5

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Using the criteria presented in week 2, critique the theory of Self-Efficacy using the internal and external criticism evaluation process, use three references

questions

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Original Work, No Plagiarism, Cite and Reference

Mary admires the NIH-funded work of her postdoctoral advisor, Henryk, who pioneers research on alternative treatments for fever due to infectious diseases. Mary is one of many co-workers who has assisted Henryk in compiling the most comprehensive database ever assembled, tracking many different infectious agents, species of animals, and different interventions and their outcomes. Henryk’s interpretation of this rich dataset suggests that some “alternative medicines” are highly effective in certain species, but have no therapeutic value in others. He is completing his analysis and interpretation, and is preparing a manuscript for submission. Mary will be a co-author because of her part in collecting data for the study.

Mary is preparing to seek an Assistant Professor position and wants to build on her postdoctoral work.  She asks Henryk for permission to use the dataset to develop her own project. However, she plans to use a different methodology for analysis and interpretation of the dataset to address a different aspect of the outcomes of treatment. At that point, she will develop a career development proposal to submit to the NIH.

Henryk is unwilling to share the entire dataset prior to publishing his interpretation of these data. However, Mary has access to the database as part of her current project, and therefore she decides that it is ethical for her to look more closely at the data. Mary spends quite a lot of time looking at the data and Henryk’s analysis, and realizes that he has excluded specific datapoints that impact his interpretation. Henryk’s draft manuscript carefully justifies the exclusion of these data in the methods section so that there is no issue with data falsification.

Mary realizes that if she includes these datapoints, an entirely new understanding of therapies to treat fever could emerge. Mary is excited about her impending grant proposal, but is concerned about how to broach the discussion of her use of the data with Henryk.

Discussion Questions

1. Must Henryk share his database with Mary before publication? After publication? Must he share it with others, outside his lab, and if so, when?

2. Who owns the database at this point: Henryk? The institution? NIH? The public?

3. Why is sharing a dataset beneficial to the person who collected it? How is it potentially risky?

4. Is Henryk obligated to document how datapoints were included or excluded in the methods section of his paper?

Global Healthcare comparison.

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Resources to Use

To Prepare:

  • Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this assignment.
  • Select at least one additional country to compare to the U.S. for this assignment.
  • Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
  • Review and download the Global Health Comparison Matrix provided in the Resources.

 

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

  • Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
  • Explain the strengths and weaknesses of each policy.
  • Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
  • Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
  • Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
  • Explain how the health policy you selected might impact the role of the nurse in each country.
  • Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

  • Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples

Social Determinants

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Give a one page description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of healthLinks to an external site., and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

(Please Note: The underlined “social determinants of health” in the above content is meant to hotlink to the following Walden webpage and content:

Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden Links to an external site.University)

Nursing

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Diabetes Mellitus Medications 

Insulin  

Type                     Name                    Onset          Peak Action      Duration      

Rapid Acting             

Insulin              

 

Short Acting               

Insulin                

                

Intermediate    

Acting Insulin

 

 


Long Acting                        

Insulin                                                                                                 

          

          

 

Ultra Long          

Acting Insulin           


Option Bank:

30-90 min 36+hrs 3-5 hrs        15-30 min 5-7 hrs Peakless 1-2 hrs

2-3 hrs No Peak 6 hrs 24 hrs 30-60 mins 1 hr 4-6 hrs

14-24 hrs

Glargine (Lantus)/Detemir (Levemir Glargine u-300(Toujeo)

Insulin Isophane/Humulin N/ Novolin N Regular Insulin/Humulin R/Novolin R

Human insulin/ lispro (Humalog)/Novolog 

THE APPLICATION OF DATA TO PROBLEM-SOLVING

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THE APPLICATION OF DATA TO PROBLEM-SOLVING

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

· Reflect on the concepts of informatics and knowledge work as presented in the Resources.

· Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

aswpos3

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Respond to what he wrote, be argumentative with the answers, and polite. References, and at least 2 paragraphs.

· Suggest a way to advocate for the profession.

· Share resources with those who are in your state.

Licensure and Certification in Georgia

            In Georgia, Advanced Practice Nurse Practitioners (APRNs) are governed and receive their practice authorization from the Georgia Board of Nursing. The Georgia Board of Nursing recognizes the use of the term “APRN” to cover a range of titles, which include Certified Nurse Midwives (CNM), Certified Nurse Practitioners (NP), Certified Registered Nurse Anesthetists (CRNA), Clinical Nurse Specialists/Psych-Mental Health (CNS-PMH) or Clinical Nurse Specialist (CNS). Also, in Georgia, an applicant must possess a valid registered nurse license before applying for an APRN license. According to Georgia Board of Nursing (2021), the applicant must meet the initial requirements for an APRN application, which include a completed Board application with required fee official transcript which verifies graduation with a master's or higher degree in nursing for the respective nurse practitioner specialty or a graduate level post-masters certificate in an advanced practice registered nurse practitioner specialty and evidence of advanced pharmacology within the curriculum or as a separate course, advanced physical assessment, and pathophysiology and certification of current national certification from the respective Board-recognized certifying organization. In addition, the applicant must show documentation that shows four years immediately preceding the date of current application that shows five hundred hours of practice as an APRN or graduation from a nursing education program or graduate level post-master certificate in an advanced practice registered nurse practitioner specialty or completion of Georgia Board-approved advanced practice registered nurse reentry/refresher program (Georgia Board of Nursing, 2021).

            In the state of Georgia, APRNs practice under a restricted regulatory structure. American Association of Nurse Practitioners (2022) noted that Georgia restricts patient access to nurse practitioner care and requires physician delegation/supervision for practice. Also, unlike other states, Georgia has two types of nurse protocol agreements. If the APRN is practicing under O.C.G.A. § 43-34-23, the APRN would evaluate the patient, formulate a diagnosis, determine the course of treatment, and they would call in the prescription to the pharmacy under their collaborating physician's name, just like a nurse or medical assistant would. This type of nurse protocol does not require approval from the medical board (American Association of Nurse Practitioners, 2022).  However, if the APRN practices under O.C.G.A. § 43-34-25, the APRN signs her prescriptions. This type of agreement must be submitted to the Board of Medical Examiners within 30 days of being signed (along with a fee of $150). APRNs must note that if they are to prescribe controlled substances, they must possess their own DEA number, and they are unable to prescribe Schedule II drugs in the state of Georgia. APRNs in Georgia are only allowed to prescribe Schedule III-V drugs. Regardless of which nurse protocol the APRN is practicing under, both protocols must include the following information: shall be in writing and signed by the advanced practice nurse and the delegating physician; shall be dated, available upon request, and specify parameters under which medical acts delegated by the physician may be performed; shall include provisions for periodic review of patient records by the delegating physician; shall be reviewed, revised or updated annually; shall include a provision for immediate consultation with the delegating physician or a physician designated in the absence of the delegating physician; hall contain written provisions regarding the procedure for dispensing dangerous drugs which comply with O.C.G.A. §§ 43-34-23(a)(3), (3.1), (4), and (5), if the dispensing of dangerous drugs is included as a delegated medical act in the nurse protocol agreement; and Shall contain written provisions regarding the procedure for ordering controlled substances which comply with paragraph (b)(1) of O.C.G.A. § 43-34-23, if the ordering of controlled substances is included as a delegated medical act in the nurse protocol agreement (Georgia Board of Nursing, 2021).

            Any medical provider that prescribes controlled substances must be registered with the federal Drug Enforcement Administration (DEA). This process can be done via the Drug Enforcement Administration's website. The online application consists of the following six components, personal information, email address validation, activity, state license (supervisory agreements, with specific authority for controlled substances), background information, application fee ($888) and confirmation (Drug Enforcement Administration, n.d.). This must be renewed every three years.

            The state of Georgia has a prescription drug monitoring program that is known as the Georgia Prescription Drug Monitoring Program (PDMP) is an online database that monitors and tracks the prescribing and dispensing of controlled substances in the state of Georgia (Georgia Department of Public Health, 2023). This information can be used to monitor a patient's-controlled substance history. All prescribers with an active Georgia professional license and active DEA number are required to register in the GA PDMP (Georgia Department of Public Health, 2023).

            According to Georgia Board of Nursing (2021), Georgia defines the scope of practice for a nurse practitioner as

“A nurse practitioner provides advanced practice nursing care and medical services specific to the nurse practitioner respective specialty to individuals, families and groups, emphasizing health promotion and disease prevention as well as the diagnosis and management of acute and chronic diseases. The nurse practitioner collaborates as necessary with a variety of individuals to diagnose and manage clients' health care problems (Georgia Board of Nursing, 2021).”

According to Hudspeth and Klein (2019), for safe practice and to optimize access to care, APRN's should have a clear and concise understanding of their board of nursing's standards of practice (SOP).

            When reviewing the licensure and certification for APRN for the state of Georgia I was surprised to learn about that Georgia has two different types of nurse-provider agreements. I also was surprised that the APRN must pay a fee to the medical board for the review of their supervision agreement. It seems that the medical board want to restrict the authority of APRNs in the state. Its very disheartening to be so restricted in Georgia, but I can move to a state like New York or New Mexico and have full authority. Overall, I feel that no matter the state, all APRNs should have the same authority. However, this is unlikely because medical boards and providers make money from the APRNs.  

 

                                                                 References

American Association of Nurse Practitioners. (2022, October). 
Georgia state policy fact sheet. Www.aanp.org. 

https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/georgia-state-policy-fact-sheetLinks to an external site.

Drug Enforcement Administration . (n.d.). 
Application for Registration Under Controlled Substances Act of 1970. Drug Enforcement Administration . 

https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1Links to an external site.

Georgia Board of Nursing. (2021). 
Chapter 410-11:Regulation of Advanced Practice  Registered Nurses . Rules and Regulations of the State of Georgia. 

https://rules.sos.ga.gov/GAC/410-11Links to an external site.

Georgia Department of Public Health. (2023). 
Prescription drug monitoring program. Georgia Department of Public Health. 

https://dph.georgia.gov/pdmp#:~:text=The%20Georgia%20Prescription%20Drug%20Monitoring%20Program%20(PDMP)%20is%20an%20electronicLinks to an external site.

Hudspeth, R. S., & Klein, T. A. (2019). Understanding Nurse Practitioner Scope of Practice. 
Journal of the American Association of Nurse Practitioners, 
31(8), 468–473. 

https://doi.org/10.1097/jxx.0000000000000268Links to an external site.


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