Examining and interpreting trends in epidemiological measures

In this activity, you will examine and interpret lung cancer 

incidence
 rates in the United States over a 40 year period and compare trends over time between males and females. 

Step 1: 
Access the 

SEER*Explorer
 (Surveillance, Epidemiology, and End Results Program) data from the U.S National Cancer Institute. Spend at least 10 minutes exploring the data and the functionality of this interactive data-generating tool.

Step 2: 
Generate a graph that illustrates the incidence rates for lung cancer from 1975 to 2017. Ensure that your data set contains information on both sexes.

Use the Seer*Explorer to generate the graph. Make the following selections in the dropdown menus: ‘Lung & Bronchus’ for Choose Cancer Site, ‘SEER Incidence’ for Data Source, 'Race/Ethnicity' for Characteristics to Compare, ‘Both Sexes’ for Sex, ‘All Races (includes Hispanics)’ for Race/Ethnicity Legend, and ‘All Ages’ for Age. Once you have generated the graph, be sure to read the information regarding the 'Data Source' found below the graph to ensure you understand how the data were generated. Click on 'Download and Share' to access the option to save the image.  

Step 3: 
Answer each of the following questions about the data on cancer incidence in 100 words or less.

1.     What types of incidence rates are being presented here?

2.     What do the crude incidence rates tell us?

3.     What do age-adjusted rates tell us?

4.     Why is it important to age-adjust the rate?

Describe the change in U.S. lung cancer incidence from 1975 to 2017 in both men and women combined. Discuss the factors that may account for the observed trends during this time period. Be sure to include a copy of your graph in your completed assignment.  Your answer should contain a maximum of 250 words. Be sure to include a copy of your graph in your completed assignment.  

Step 4: 
Generate a new graph that illustrates the incidence rates for lung cancer in males from 1975 to 2017. Next, include the incidence rates for lung cancer in females during the same time period. Save the graphs.

Step 5: 
Compare and contrast lung cancer incidence rates in males and in females from 1975 to 2017. Discuss the factors that may account for any observed differences. Be sure to justify your answer. Be sure to include a copy of your graphs in your completed assignment. Your answer should contain about 150 words.

Step 6: 
Discuss why it is important for public health practitioners to examine trends in incidence rates over time. Your answer should contain about 150 words.

Please be sure to adhere to the following when posting your weekly discussions:

1. Students are to write their name and the appropriate

discussion number/discussion title in the title bar for each discussion. For

example 
Discussion 1: Micheal Cabrera or Discussion 3: Sheila Smith. This is important in identifying that students are submitting original posts as well as response posts as required.

2. Students are to submit their discussions 
directly onto Blackboard Discussion Board.Attachments submitted as discussion board posts will not be graded.

3.  As a reminder, 

all discussion posts must be minimum 500-550 words, references 

mustbe cited in 
APA format 7th Edition, and must include minimum of 
3 scholarly resources published within the past 5-7 
years (not part of the classroom coursework).  

DISCUSSION POSTS WILL BE DUE NO LATER THAN SUNDAY, by 11:59 pm

[removed]

  What study type is considered at the highest rung of the evidence-based pyramid? 

  The highest rung on the evidence-based pyramid is the meta-analysis tier. Meta-analysis is a group of systematic reviews of multiple studies to find and compare the absolute best evidence available for a specific condition, population, or intervention. There is a precise, systematic methodology to research, choose, review, and evaluate the studies to include them in the meta-analysis (Tracy, et al., 2023). It gains the top tier of the evidence-based pyramid because meta-analysis yields the strongest level of evidence after all these systematic reviews (Melnyk & Fineoout-Overholt, 2019). These specific meta-analysis studies then present a summary of the current best evidence available for the area of interest. The meta-analyses can then guide clinicians to make evidence-based decisions for the treatment of their patients.

References: 

Melnyk, B. M., Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing and Healthcare (4th ed.). Wolters Kluwer

Tracy, M. F., O’Grady, E. T., & Phillips, S. J. (2023). Hamric & Hanson’s Advanced Practice Nursing: An Integrative Approach (7th ed.). Amsterdam: Elsevier.   

Preparing the Discussion

You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient's chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you. 

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety. 

Case Study Responses: 

1. Analyze the case study for potential issues for members of the healthcare team from office conflict. Contrast the potential effects for each member of the healthcare team based on the required readings from the week. Discuss the potential ethical and legal implications for each of the following practice members: 

· Medical assistant

· Nurse Practitioner

· Medical Director

· Practice

2. What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes? 

3. What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.

4. A scholarly resource must be used for EACH discussion question each week.

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .

Jacqueline Kenney

Good Evening Professor,

 

              I work in one of the largest hospital systems in Atlanta. The facility I work for has the bed capacity for 686 patients. The hospital specializes in cardiovascular procedures (the implantation of the LVAD) and transplantation of liver, and kidneys. The hospital attracts people from across the country. People coming from literally every state, and sometimes from out of the country.

            The area where I see the EHR impeding patient care, and again this might be in part, due to end-user negligence, are providers not utilizing the information and data contained within the patient's EHR frequently enough.  We run off a system called EPIC (EHR). I have come to realize most hospitals in the state of Georgia, and other states use EPIC as well.  Embedded within the EPIC system is a hyperlink called Care Everywhere. The Care Everywhere tab allows all providers on the EPIC system to see notes, documentation, tests results, frequency of visits, and more. This data covers every hospital, clinical, urgent care, and office visit the patient has encountered so as long as the facility is on the EPIC system. I believe the shear amount of medical information becomes overwhelming and time consuming to comb through, especially for medical providers who are already seeing numerous patients at the bedside and in specialty offices. 

          Despite medical documentation being readily available to providers across the healthcare spectrum, there seems to be little time for a busy Cardiologist to review necessary documentation from the patient's Pulmonary doctor, or the notes placed from Endocrinology. Often a patient comes for a visit due to CAD, but the patient is also a diabetic with uncontrolled elevated blood glucose. We know one disease process feeds the other, but in spite of the EHR containing valuable patient data, providers are still missing imperative clinical information required to treat the patients holistically. 

          The one department which I see consistently using chart review to coordinate care with patients, providers, and families are RN Case Managers within the hospital setting.  RN Case Managers, and Care Coordinators are responsible for knowing what is missing in the patient continuum of care. The RNCM interfaces with the providers, and assists in providing education to both medical MDs and patients regarding critical clinical information which will advance the clinical process and bring better patient outcomes. McBride & Tietze (2018) discussed unintended harm, or consequences suffered by patients with the implementation of the EHR. One such consequence has to do with physicians required to research, and review copious amounts of previous documentation, as well as being required to spend greater amounts of time entering documentation.  Such time consuming tasks often create information, and important patient data not being read, or documented in an effort to save time, and so providers can physically see more patients. 

 

Resources

                FAAN, S.M.P.R. C., & FAAN, M.T.P.R. F. (2018). 
Nursing Informatics for the Advanced Practice Nurse (2nd ed.). Springer Publishing LLC. 

https://ambassadored.vitalsource.com/books/9780826140555Links to an external site.

           Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. 
BMC health services research, 
19(1), 92. https://doi.org/10.1186/s12913-019-3916

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