Physical geography

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You must write a research essay on the comparative
geography of two municipalities within British Columbia of your choice. Your essay
should answer which is the better of the two municipalities to settle in and raise a new
family in the next 10 years. One of the municipalities must be from Metro
Vancouver, while the other must be from another region of British Columbia. Your
research essay should cover at least two elements from the following list to secure
maximum marks:
 Physical geography
 Population characteristics
 Social and cultural patterns
 Urban and settlement patterns
 Main economic sectors

 

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The impact of drug legalization on the economy

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Question Description

  • Students must prepare a three to four page typewritten double-spaced paper on a current macroeconomic topic that is pertinent to class material. This can be chosen from the textbook, newspapers, magazines, or current economics periodicals.
  • Students will be expected to analyze and evaluate the issue or topic and provide recommendations. Here are some sample topics:

– The impact of drug legalization on the economy

– Using economics, how would you fix the homeless problem in California?

– Is the bullet train viable in California?

– How do interest rates affect consumers and their purchasing patterns

– How could the “Great Recession” have been prevented?

– Countries that do not believe in comparative advantage

– How could the Federal Government reduce the national debt?

– If you were the President of the U.S. what would you do to improve the economy?

– Which presidential candidate will have the most profound impact on the economy?

  • Length – 3 to 4 pages in length, double-spaced, with 1 inch margins. Any paper that deviates from these requirements will be penalized (this does not include the title page and the table of contents).Arial or New Times Roman (12 pt) will be the only acceptable fonts. Use headings within the report when appropriate. A table of contents page is necessary. Plan the paper carefully so as to develop an organized and non-redundant report. It should be organized and assembled as a continuous report and should not appear to be several independent segments bound together. You must have a minimum of five sources. Please cite your sources using MLA or APA Format (the Writing Center can offer assistance if you do not know how to do this). Some other helpful sites include – http://owl.english.purdue.edu/owl/resource/560/01/ (Links to an external site.)Links to an external site., http://owl.english.purdue.edu/owl/resource/557/01/ (Links to an external site.)Links to an external site., http://www.cuyamaca.edu/tpagaard/EnglDept/Resource…
  • Table of Contents, five references (reference page), and three-four pages in the body of the paper
 

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Complete the leadership style self-assessment under learning activities.

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Question Description

Overview

  • Complete the leadership style self-assessment under learning activities.
  • Use information from your assigned readings and the literature related to leadership styles, and leadership and management theories to complete the paper.
  • Discuss your style of leadership based on the completed self-assessment.
  • Describe what leadership and management theories align with your leadership style.
  • Based on your leadership style, discuss the type of work environment, and three key actions or behaviors that you must demonstrate to be a successful leader.

Objectives

  • Students will compare and contrast leadership and management principles.Identify one’s own leadership style.
  • Students will identify one’s own leadership style.

Points: 40

Due Date: Sun, May 19 by 11:59 p.m. Eastern Standard Time (EST) of the US.

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 6th edition formatting, citations and references. Click here to download the Microsoft Word APA 6th edition template. Make sure you cross-reference the APA 6th edition book as well before submitting the assignment.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

 

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Information Technology

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Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment

References:

  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Response posts: Minimum 100 words excluding references.

10 to 10 Points

Responses to colleagues demonstrated insight and critical review of the colleagues’ posts and stimulate further discussion

Responded to a minimum of two (2) peers and included a minimum of one (1) peer-reviewed* or course materials reference per response.

Responses are a minimum of 100 words and are posted on different days of the discussion period by the due date

Discussion1

It is pertinent that medical personnel have access to a patient’s lab results, imaging, assessment flowsheets and medication records, in order to appropriately care for their physical needs. Health information technology allows for nurses and other medical staff, to obtain the information needed to accurately treat and sometimes cure our patient’s illnesses. The EHR, or electronic health record, was created and mandated throughout health care facilities across America, to provide healthcare professionals the tools needed to help heal their patients. (Wallace et al, 2013) But as with any new technology, there are complications that arise that can have negative consequences.

There are two types of IT (Information Technology) related incidents that can have severe negative outcomes. The first of these IT issues is to have human-computer problems. When a human-computer incident occurs, it means that there was an interface issue between the human user and the health information system that caused the human user to use the system incorrectly. (Wallace et al, 2013) The second type of IT incident is a computer related issue, such as a glitch, that causes problems in how the equipment and software function. (Wallace et al, 2013)

Wallace et al (2013), gives an example in a case study of how a hospital switched from using paper MARs, to eMARs (electronic medication administration records) and a computer related incident occurred causing a patient to be overdosed on morphine and to go into respiratory arrest. When the situation was debriefed, the cause of the overdosing was found to be that the eMAR was not displaying the entire medication order; therefore the nurses were not able to see the administration instructions in their entirety, causing the nurse to administer to high of a dose. The patient had to be intubated and resuscitated during the overdose, but was able to be saved. Because this type of IT incident was computer related, the IT developer from that hospital was able to easily fix the problem within the eMAR. The potential consequences that this patient faced due to this computer related incident and overdosing could have been as severe as death. The patient could have developed brain death from the hypoxia, or could have had an ischemic stroke or MI. (Rull, 2017)

Nursing leaders today, can establish a culture of safety related to health IT by, reinforcing the practice of the five rights of medication administration that every nurse learns in nursing school, and by enforcing that order clarifications be performed before medication is administered at all times. (Wallace, 2013) If the nurse in the case study was not sure of which morphine dose to give, or would have even questioned the orders, it might have prevented the patient from suffering these harsh consequences. When a nurse practices her five rights of medication administration, he or she has to pay close attention to the medication order itself as well as the medication packaging in hand. He or she would have in this case had to get an order clarify performed due to the parameters not being clearly seen on the medication orders. The nurse manager is responsible for making sure that the nurses practice using these five rights in order to prevent medication errors. He or she may sometimes have to enact written discipline on those nurses who wish to not obey nursing protocol.

Health information technology has helped bring the world of medicine a long way in recent years. It is not without its flaws, but if medical staff is trained to use it appropriately and wisely, it can help make the health care experience for our patients much better.

Reference

Rull, G. (2017). Respiratory Failure-Complications. Retrieved December 06, 2017, from https://patient.info/health/respiratory-failure-le…

Wallace, C., Zimmer, K., Possanza, L., Giannini, R., Solomon, R. (2013). How to Identify and Address Unsafe Conditions Associated with Health IT. Westat. (pgs. 7-13)

Discussion 2

In the rapidly changing world of technological advances, and the application of these new technologies into the world of healthcare, questions regarding the safety of the application of these technologies become an issue. The use of electronic medical records, and their ability to access information quickly and communicate to care team members almost simultaneously (Burkhardt & Nathaniel, 2014), have been in use for my entire ten-year career in healthcare. Legal and ethical obligations to the protection of the safety of these records requires safeguards to be implemented (Burkhardt & Nathaniel, 2014). What if the safeguards fail or are not correctly implemented? The purpose of this post is to examine and identify the potential issues related to health information technology and discuss nursing leader’s role in establishing a culture of safety related to health information technology.

The two main issues in health information technology arise from either computer-related issues or human-computer issues (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013). In computer-related issues, an issue with (1) system interface, (2) system/software configuration, or (3) software function cause a disruption in the transmission of data and inhibits system/software functionalization (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013). In human-computer issues, human error, in areas such as data entry, patient identification, medication selection errors, or failure to operate or understand the system properly, creates the issues in the health information technology (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013).

Wallace, Zimmer, Possanza, Gianinni, & Solomon (2013) present a case study in which a computer-related issue with the electronic medical record, as well as a possible human error, result in an adverse event of a respiratory arrest for a patient that required intubation and resuscitation. The patient was ordered extended-release morphine every twelve hours and immediate-release morphine as needed, but the electronic medication administration record displayed both orders as morphine with the dosing information cut off and not visible (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013). The patient received both doses at the same time, resulting in the respiratory arrest and the resultant follow up included the health information technology developer to include the drug formulation for morphine as well as to allow the electronic medication administration record to display and prevent the cut off of dosing information (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013). The computer-related error is obvious by the inability for the electronic medication administration record to display all pertinent information related to the morphine orders, but I feel an error in judgement is displayed by the nurse in giving both the extended-release and immediate-release morphine at the same time. The case study presented by Wallace, Zimmer, Possanza, Gianinni, & Solomon (2013) does not fully allow for complete mental visualization of the electronic medication administration record, but does indicate the nurse mistakenly gave both drug formulations. I personally would not feel comfortable with giving both the extended-release and immediate-release morphine at the same time, nor would I be comfortable with the presentation of the orders on the electronic medication administration record and would look to seek clarity from the ordering physician. The resultant consequences for the patient of the respiratory arrest with intubation and resuscitation (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013) are just one of the potential consequences, as death, subsequent cardiac arrest, coma, hypoxemia, or at the very least increased somnolence could have occurred.

Finally, nurse leaders can establish a culture of safety towards health information technology by guiding, instituting, and practicing strategies that provide monitoring, measurement, and improvement to concerns of patient safety in regards to health information technology (Singh & Sittig, 2016). Encouraging the reporting of issues with health information technology (Wallace, Zimmer, Possanza, Gianinni, & Solomon, 2013) and by complying with institutional precautions and safeguards, nurses can foster a culture of safety in health information technology.

References

Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & Issues In Contemporary Nursing Fourth Edition. Stamford: Cengage Learning.

Singh, H., & Sittig, D. F. (2016). Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Quality & Safety, 25(4), 226-232. doi:10.1136/bmjqs-2015-004486

Wallace, C., Zimmer, K. P., Possanza, L., Giannini, R., & Solomon, R. (2013, November 15). How to Identify and Address Unsafe Conditions Associated with Health IT. Retrieved December 4, 2017, from blackboard.ohio.edu: https://ohio.box.com/s/1fde8j0m666d3084umbl8xu262m…

 

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Having knowledge about a new evidence-based practice

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DQ2 1–It will be interesting to see how many more theories are developed in the next twenty years. I think the behavioral change theories are interesting as well. Another change theory is Prochaska and DiClemente’s (1983) transtheoretical model of behavioral change. This theory looks at the client’s enthusiasm and eagerness to make healthier lifestyle changes (Heiss, 2013). Because patients have to make a conscious decision to quit drinking or to quit using drugs, it requires a behavioral change. “Lifestyle modification programs encourage self-responsibility for health and represent the action phase of health behavior” (Heiss, 2013, p. 479). The patient will need to make frequent appointments with a substance abuse counselor for support, so the patient can make behavioral changes. There are five stages of change, for example, precontemplation (no desire for change), contemplation (thinking about change), preparation (plan for change), action (beginning to change), and maintenance (change in lifestyle has been made for over 6 months (Heiss, 2013). This theory could be used for this nurse’s project because screening, brief intervention, and referral to treatment (SBIRT) depends on the patient’s willingness to make lifestyle changes. This nurse’s mentor uses this theory when she works with her prenatal patients who use drugs during pregnancy. She educates her patients and those who are willing to make lifestyle changes do abstain. Those who are not ready to make a change will keep getting education until the prenatal patient decides to change. Sometimes they do not. There have been many prenatal patients that have stopped using marijuana until after they deliver their baby, so this has been successful.

DQ2 2———- In order to implement an evidence-based practice project, the nurse needs to decide which change theory to use. Using a theory helps organize and structure the way change is implemented. According to Mitchell (2013), “…managers, or change agents, identify an appropriate change theory or model to provide a framework for implementing, managing and evaluating change” (p. 32; Pearson et al., 2005). One theory is Kurt Lewin’s (1951) change theory that can be described as unfreezing, moving, and refreezing. In this theory, if the nurse needed to change a workflow, it would require unfreezing so that the change could be made. While the new workflow is being used and tested, this would be called moving. Once the new workflow is being used routinely, then refreezing would happen. The manager or nurse could then monitor the change to make sure staff do not go back to the old ways of doing things.

A second theory is Rogers’ (2003) innovation theory. There are five stages of this theory which include: (1) having knowledge about a new evidence-based practice, (2) forming thoughts about the new evidence-based practice, (3) deciding whether to use or not use the new evidence-based practice, (4) using the new evidence-based practice, and (5) adopting the new practice or stop using the new practice (Garon, 2014).

The nurse can provide education about the importance of the new EBP. Individuals will adopt the change at different times during implementation, and managers can work with individuals who are having a difficult time making the needed change. Some staff may be excited to try the new change and help implement it. Once the problems are worked out, then the staff will evaluate the change to see if it improves practice. If it does, they will use the new EBP, and if it does not, the staff could go back to the old way of doing things or make changes to the new EBP until it improves the practice.

This nurse’s mentor has used Roger’s (2003) innovation theory with her OB patients. She has used this theory to develop her OB workflow for patients who have positive drug screens. She knows it is important for her OB patients to get counseled on the effects of drugs on the unborn baby (knowledge about EBP). For patients who have positive urine drug screens, she tries to have the patient see the behavioral health counselor during their prenatal appointment. The behavioral health counselor has limited time to see patients, which can be frustrating for this nurse’s mentor (forming thoughts). It is hard to run the OB clinic and communicate with the counselor on who needs to be seen (deciding whether to use EBP). Sometimes the counselor has to leave to go to a meeting, so the OB nurse recently changed her workflow to include a huddle sheet for the counselor, so that he or she knows which patients need to be seen (using the EBP). She has yet to adopt this practice because she is monitoring the outcome. Janie would probably use Roger’s implementation theory because she would have to work with the behavioral health team and nurses to implement any changes for SBIRT. It would require feedback from the staff involved, and the staff would need to do a pilot project to work out any problems before any changes would be adopted.

DQ2 3 —-Both theories are used when implementing planned changes in nursing practice.They help in realization of established goals. In both change, agents are the driving forces and are very necessary in realization of the change. Both theories have steps used when implementing them.

Both theories has resistant forces which must be come over to realize the change.

DIFFERENCES.

Lewin’s change theory has three steps of implementation which include unfreezing- moving – freezing, while Roger’s theory have five steps which include; awareness, interest, evaluation, implementation and adoption. Unfreezing is the process which involves finding a method change stage, which is also called “moving to a new level” or “movement,” involves a process of change in thoughts, feeling, behavior, or all three, that is in some way more liberating or more productive of making it possible for people to let go of an old pattern that was somehow counterproductive. The refreezing stage is establishing the change as the new habit, so that it now becomes the “standard operating procedure.” Without this final stage, it can be easy for the patient to go back to old habits (Nursing Theory, 2016).

Roger’s theory is applied for long-term changes while Lewin’s can be applied for short term change projects. Roger’s theory success is fully realized when the earlier resistant agents adopt the change and support it while Lewin’s theory success is only realized if the driving forces dominate the resistant force. Roger’s change theory promotes awareness and the participant interest before implementing the change.

Roger’s theory makes most sense of implementing my EBP project. This is because the theory promotes awareness of the change, promotes interest of implementation of EBP among the involved parties and evaluate the success of trial studies before the actual implementation.

The theory will also promote implementation of my project among the opposing direction after the success of the project becomes evident.

I think Roger’s theory is more relevant to my project. Martha Rogers’s theory is a useful model for addressing the growing issue of nursing burnout, which is known to cause increased rates of morbidity and mortality in the clinical setting (Alligood, 2014).

DQ1 4——– According to Mitchell (2013), “…planned change, which is a purposeful, calculated, and collaborative effort to bring about improvements…” is the most frequent way change is performed in many facilities (p. 32). Change causes stress for many staff members. It is important for the nurse, who is implementing the change, to have support from administration and staff, and to have the resources to make the needed change. If the budget does not support the change, it may not be a good time to implement it. In order for the nurse to plan and implement an evidence-based project, he or she needs to assess for obstacles that would prevent implementation, and make sure staff know why changes need to take place. According to McLaughlin and Sanchez (2017), the nurse needs to “… identify the knowledge, beliefs, and behaviors that are common in the existing system and to raise the awareness of a need for shifting decision making about clinical care toward a consideration of current best evidence” (p. 96).

Identifying key employees that can serve on a committee for the evidence-based project can help move the change forward. Sharing ideas and solutions regarding a problem can provide support for the change. The nurse can bring forth his or her information on the evidence-based practices to share with her committee, so that research can be shared. If staff are excited about the change, the change can be seen as a positive by other staff. If the department is busy, it will be important for staff to be involved in training and have frequent updates as to when any evidence-based changes will take place. Communication is the key to alleviating stress. In some instances, a pilot project may be a great way to implement a new evidence-based practice. During implementation, the new evidence-based practice can be used in one group, and any problems can be worked out until the process runs smoothly. Then, the new evidence-based practice can be rolled out to the rest of the department.

My mentor knows that change creates stress. She was frustrated with the last change that took place in the department because the nurses were not involved in the planning or implementation of the change. Nurses triage and perform nurse visits. In the past the nurses could double book patients and fit patients into the providers’ schedules. Now nurses must request an appointment time from the front desk, and after the nurse spends the time triaging and asking the doctor to see the patient, the front desk can deny the appointment request. This is very frustrating to a nurse who has spent 20 minutes with a patient. The nurses were trained on the new change in less than five minutes, and were expected to implement it within two days. The nursing staff did not understand the reason for the change, and the change caused chaos in the department.

When implementing Janie’s evidence-based practice, it would be better to bring the ideas for the change to the people it will impact (nursing and behavioral health staff), let them participate in the plan and implementation for the change, and then run a pilot project to see if the change can work. It would be a good idea to discuss solutions to possible problems before implementing the pilot project, so that the implementation can run more smoothly.

Minimum of 60 words for each response with proper in text citation and references

 

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Nursing Intervention

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Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution

  • Nursing Intervention
  • Patient Care
  • Health Care Agency
  • Nursing Practice

Please see attachment of the NSR 433 material completed previously completed

 

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Allen County Health Department

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Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.
  • Words Limit
  • Response posts: Minimum 100 words excluding references.

Discussion 1

Even though I live in a small community, the health department for my county is not far from my community. The Allen County Health Department is located at 219 East Market Street in Lima, Ohio. For questions you cannot find on the website you can call them at 419-228-4457.

The mission for the Allen County Health Department is to help promote health and protect the health of those that they serve in Allen County (Allen County Public Health, 2017). The Allen County Health Department values collaboration, integrity, respect, equality, empowerment and communication (Allen County Public Health, 2017). The health commissioner is Kathy Luhn. The Health Department has been around for 100 years serving the community with their health needs.

The Allen County Health Department offers a wide variety of services to the Allen County community. They offer family planning, women’s preventative health care, breast cancer and cervical cancer programs, HIV/AIDS program, STD clinic, disease management programs, and immunizations (Allen County Public Health, 2017). The role of the community health nurses is that they protect the community from health threats, educate on health issues, provide health solutions, and advance the health throughout the community (Allen County Public Health, 2017).

The components of the emergency planning consists of medical reserves and corp, disease surveillance and outbreak response and some fact sheets to help when an emergency arises (Allen County Public Health, 2017). The main goal of the emergency planning is that it will strengthen the capacity to repose to a natural or manmade disaster focusing on public health (Allen County Public Health, 2017).

As stated in Community/Public Health nursing, public health is referred to as the efforts organized by the community to protect, promote and restore the health of those that it serves (Nies & Mcewen, 2014). One program that our health department does not offer is something for mental illness. Mental illness has become a big part of our community and it needs to have the resources for those that need it. We currently only have one place for those to go and it is hard for most of them to get to. Having another place for those in crisis to go will not only help those who need it but also give them a sense of security that there are people out there who want to help them.

As you can see, the Allen County Health Department has a great amount of resources to offer the community. There is only one thing that I would like to add to help those in the community. Otherwise, the health department has helped the community out in so many ways and will continue to do so. 

References

Allen County Public Health. (2017). Retrieved February 05, 2018, from https://www.allencountypublichealth.org/

Nies, M. A., & McEwen, M. (2014). Community/public health nursing: promoting the health of populations. St. Louis, MO: Elsevier.

Discussion 2

It is important to know where to get information regarding community programs and to learn important issues going on within the community. The purpose of this discussion is to introduce the Allegheny County Health Department and familiarize the public of its importance to the community.

The Allegheny County Health Department is located in Pittsburgh, PA at 542 Fourth Avenue 15219. The phone number to contact the health department is 412-687-2243. The mission of the health department is to protect, promote and preserve the health and well-being of the Allegheny County residents (Hacker). The Allegheny County Health Department was founded in 1957. According to the health commissioner, Karen Hacker, the health department aims to promote wellness of the individuals and the community as a whole. Preventing illness, injury, and premature death or disability and protecting the community from harmful substances from chemicals, biological and physical hazards within the environment are goals of the health department.

The health commissioner is Karen Hacker, MD, MPH. She has been the commissioner since 2013. Her educational background is impressive, receiving her undergraduate degree from Yale University, MD from Northwestern University, and her MPH from Boston University.

The health department has provided services to children from ages 1-20years old for dentistry, there are services for homeless and shelter outreach; for women expecting their first child, a visiting nurse makes home visits to assess and educate the new mother up to a certain age, also there are services to help families with special needs children; there are clinical services to test for sexually transmitted diseases/infections, there are also services provided to check car seats and boosters, and driving programs that are free to the Allegheny County residents, just to name a few. The information that is listed on the website is very valuable for residents if they are in need of a service or need to refer services to someone they know.

The role of the public nurse is to promote wellness and educate to prevent illness, and injury. The public nurse focuses on disease prevention and health promotion (McEwen & Nies, 2015, p.11). By using the six standards of nursing, the public nurse can educate residents of the community and hopefully motivate the residents to become proactive in their health.

Allegheny County Health Department (ACHD) has an emergency preparedness and response program. This emergency response is important and focuses on educating the residents of the community on how to prepare for emergencies. It works with organizations within the community to help prepare, alleviate the emergency, and bounce back from any devastation. The emergency preparedness and response program are supported by the Pennsylvania Department of Health and the CDC. As a home health nurse, the department of health has recently mandated the agency to implement an emergency plan for patients who are admitted with our home care. We have a paper that lists items to keep in mind and on hand, in case the patient has to leave the home, that they can easily pick up and leave the home safely and have a few days’ worth of clothes, food/snacks, water, and medications. The paper has more information listed and it’s to help prepare individuals in case a natural disaster happens. Our area has not had too many tornadoes, or been affected by tsunami’s, or hurricanes, but it is important to know these things in case something does happen.

I think a service that would be helpful to the public is a weight loss program. There are many programs out there to lose weight but cost a fortune. Since obesity seems to be a major issue of many communities and states, it only makes sense to provide a service that is free to community residents. Education is key but having a program that one can obtain free information on how to safely lose weight and have the support of a public nurse or other medical personnel would be ideal. There could be weekly weigh ins or support via phone if someone called in or if the nurse called the individual. Providing community activities such as, community walks or having a weight race could engage individuals to get healthier and be more active.

References:

Hacker, K. (2015). Retrieved from www.achd.net/admin/director-hacker.html

McEwen, M. & Nies, M. A. (2015). Community/public health nursing. (6th ed.) (p.11).

St. Louis, Missouri: Elsevier Inc.

 

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The Allen County Health Department

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Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.
  • Words Limit
  • Response posts: Minimum 100 words excluding references.

Discussion 1

Even though I live in a small community, the health department for my county is not far from my community. The Allen County Health Department is located at 219 East Market Street in Lima, Ohio. For questions you cannot find on the website you can call them at 419-228-4457.

The mission for the Allen County Health Department is to help promote health and protect the health of those that they serve in Allen County (Allen County Public Health, 2017). The Allen County Health Department values collaboration, integrity, respect, equality, empowerment and communication (Allen County Public Health, 2017). The health commissioner is Kathy Luhn. The Health Department has been around for 100 years serving the community with their health needs.

The Allen County Health Department offers a wide variety of services to the Allen County community. They offer family planning, women’s preventative health care, breast cancer and cervical cancer programs, HIV/AIDS program, STD clinic, disease management programs, and immunizations (Allen County Public Health, 2017). The role of the community health nurses is that they protect the community from health threats, educate on health issues, provide health solutions, and advance the health throughout the community (Allen County Public Health, 2017).

The components of the emergency planning consists of medical reserves and corp, disease surveillance and outbreak response and some fact sheets to help when an emergency arises (Allen County Public Health, 2017). The main goal of the emergency planning is that it will strengthen the capacity to repose to a natural or manmade disaster focusing on public health (Allen County Public Health, 2017).

As stated in Community/Public Health nursing, public health is referred to as the efforts organized by the community to protect, promote and restore the health of those that it serves (Nies & Mcewen, 2014). One program that our health department does not offer is something for mental illness. Mental illness has become a big part of our community and it needs to have the resources for those that need it. We currently only have one place for those to go and it is hard for most of them to get to. Having another place for those in crisis to go will not only help those who need it but also give them a sense of security that there are people out there who want to help them.

As you can see, the Allen County Health Department has a great amount of resources to offer the community. There is only one thing that I would like to add to help those in the community. Otherwise, the health department has helped the community out in so many ways and will continue to do so. 

References

Allen County Public Health. (2017). Retrieved February 05, 2018, from https://www.allencountypublichealth.org/

Nies, M. A., & McEwen, M. (2014). Community/public health nursing: promoting the health of populations. St. Louis, MO: Elsevier.

Discussion 2

It is important to know where to get information regarding community programs and to learn important issues going on within the community. The purpose of this discussion is to introduce the Allegheny County Health Department and familiarize the public of its importance to the community.

The Allegheny County Health Department is located in Pittsburgh, PA at 542 Fourth Avenue 15219. The phone number to contact the health department is 412-687-2243. The mission of the health department is to protect, promote and preserve the health and well-being of the Allegheny County residents (Hacker). The Allegheny County Health Department was founded in 1957. According to the health commissioner, Karen Hacker, the health department aims to promote wellness of the individuals and the community as a whole. Preventing illness, injury, and premature death or disability and protecting the community from harmful substances from chemicals, biological and physical hazards within the environment are goals of the health department.

The health commissioner is Karen Hacker, MD, MPH. She has been the commissioner since 2013. Her educational background is impressive, receiving her undergraduate degree from Yale University, MD from Northwestern University, and her MPH from Boston University.

The health department has provided services to children from ages 1-20years old for dentistry, there are services for homeless and shelter outreach; for women expecting their first child, a visiting nurse makes home visits to assess and educate the new mother up to a certain age, also there are services to help families with special needs children; there are clinical services to test for sexually transmitted diseases/infections, there are also services provided to check car seats and boosters, and driving programs that are free to the Allegheny County residents, just to name a few. The information that is listed on the website is very valuable for residents if they are in need of a service or need to refer services to someone they know.

The role of the public nurse is to promote wellness and educate to prevent illness, and injury. The public nurse focuses on disease prevention and health promotion (McEwen & Nies, 2015, p.11). By using the six standards of nursing, the public nurse can educate residents of the community and hopefully motivate the residents to become proactive in their health.

Allegheny County Health Department (ACHD) has an emergency preparedness and response program. This emergency response is important and focuses on educating the residents of the community on how to prepare for emergencies. It works with organizations within the community to help prepare, alleviate the emergency, and bounce back from any devastation. The emergency preparedness and response program are supported by the Pennsylvania Department of Health and the CDC. As a home health nurse, the department of health has recently mandated the agency to implement an emergency plan for patients who are admitted with our home care. We have a paper that lists items to keep in mind and on hand, in case the patient has to leave the home, that they can easily pick up and leave the home safely and have a few days’ worth of clothes, food/snacks, water, and medications. The paper has more information listed and it’s to help prepare individuals in case a natural disaster happens. Our area has not had too many tornadoes, or been affected by tsunami’s, or hurricanes, but it is important to know these things in case something does happen.

I think a service that would be helpful to the public is a weight loss program. There are many programs out there to lose weight but cost a fortune. Since obesity seems to be a major issue of many communities and states, it only makes sense to provide a service that is free to community residents. Education is key but having a program that one can obtain free information on how to safely lose weight and have the support of a public nurse or other medical personnel would be ideal. There could be weekly weigh ins or support via phone if someone called in or if the nurse called the individual. Providing community activities such as, community walks or having a weight race could engage individuals to get healthier and be more active.

References:

Hacker, K. (2015). Retrieved from www.achd.net/admin/director-hacker.html

McEwen, M. & Nies, M. A. (2015). Community/public health nursing. (6th ed.) (p.11).

St. Louis, Missouri: Elsevier Inc.

 

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Skin-to-skin contact

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1———Skin-to-skin contact has a multitude of researched benefits for an infant including, thermoregulation, cardiac regulation, neurostimulation, stabilization of blood glucose levels and encouraging the initiation on breastfeeding. Breastfeeding also has been proven to have extensive benefits such as a decreased risk of cancer, diabetes, childhood obesity, development of allergies and an increase in overall intelligence just to name a few. For my EBP I am suggesting that all maternity units should implement immediate skin-to-skin contact (SSC) between mother and infant (or father and infant if mother not stable to do so) as standard newborn care in order to promote breastfeeding along with the additional health benefits.

One obstacle of initiating SSC is lack of infant stabilization, especially in neonates. Many neonates are very unstable from minute to minute, hour to hour and day to day and due to this instability, it is hard to implement skin-to-skin contact at any point in their recovery because of the need to continuously monitor their vitals. Currently, “sensors that measure a premature newborn’s heart rate, breathing rate and other vital signs in the neonatal intensive care unit require electrodes whose glue can hurt and scar a preemie’s delicate skin, and wires that can prevent cuddles and other skin-to-skin contact babies need” (McCartney, N. & Pawlowski A., 2019).

Researchers at Northwestern University have recently “unveiled wireless soft, ultra-thin, flexible skin-like sensors” in hopes that this will be a suitable alternative for monitoring neonates’ vital signs. Wireless sensors are placed both on the baby’s chest and foot and then data is transmitted using near-field communication. Near-field communication is a technology that resembles that used to make a wireless payment from a smartphone. This technology could allow for infants to be placed skin-to-skin with their mothers, receiving the above-mentioned benefits of SSC and hopefully encouraging the process of breastfeeding or even mothers milk to come in (McCartney, N. & Pawlowski A., 2019).

While the article discusses the use of this technology within the NICU, there is no reason why it couldn’t be useful for full-term, healthy newborns within a maternity unit as well. When SSC is initiated for any newborn the nurse still needs to assess the infant’s vitals regularly to assure that their vitals remain stable. In order to complete this assessment, the RN needs to disrupt the independent SSC between mother and infant. While SSC isn’t discontinued, the manipulation required by the nurse in order to accurately assess the infant’s vitals does cause slight discontinuation of infant contentment on his/her mothers’ chest. There are also many instances when a nurse needs to disrupt an infant breastfeeding in order to get their assessment. This can all be avoided if there were an easier way to monitor the infant’s vitals independently from physical touch and intervention. Overall, I believe this would only enhance the mother/infant bonding and skin-to-skin experience and benefits!

2———–Healthcare technology includes bedside physiologic monitors, pulse oximetry devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic medical records (EMRs) as well as electronic health records (EHRs). It is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. Healthcare technology also plays an important role in projects’ implementation. In my capstone project, I am using cloud based/web based EMR that can improve the implementation process and the outcomes of the EBP.

Cloud-based software technology was introduced to replace the paper. The EMR technology “gives health care providers information in formats that were not possible with paper charts” (Manca, 2015). For instance, the EMR technology enables viewing and printing graphs of values such as weight, cholesterol levels, and blood pressure, tracking changes over time; improves attainment of chronic disease management, prevention, and screening targets (Manca, 2015). Also, EMRs can provide treatment goals or alerts to remind providers when certain prevention and screening maneuvers are due or out of date. For instance, as in case of CAUTIs prevention, which is the topic of my project, EMR system with physician order entry and nursing documentation builds charting modules that reinforce the appropriateness of catheter use, reducing CAUTIs incidences and hence improving patient outcomes. A physician order for a catheter requires criteria for catheter insertion “mapped to the nursing checklist, which triggers a “foley maintenance protocol” (Pharmacy OneSource Blog, 2014). A device-specific charting module provides for nursing documentation of patient voiding method and serves as a physician reminder of the catheter’s presence (Pharmacy OneSource Blog, 2014). Thus, the EMR technology assists in driving evidence-based care and improves its outcomes.

3——Use of information and communication technology (ICT) can improve the implementation process and the outcomes of EBP project. This is because through ICT, systematic research can be carried out that can provide adequate evidence about the EBP project. ICT allows for internet search for relevant information that can enhance Evidence Based Practice. I therefore plan to use this technology especially in research so as to obtain enough evidence from systematic research. Additionally, through ICT I can be able to obtain a lot of relevant information through internet search on all the aspects of the EBP project.

A survey conducted in 2017 reports that of nurses surveyed, 63 percent report that their work has caused them to feel burned out. One of the most significant contributors to nurse satisfaction is their perceived control over their work environment — particularly their schedule and patient assignments ( Marcus, M 2018).

In my project, I believe that technology is being used to help me in finding more easy way to complete my task, but it is not considering much on solving the issues or helps in replacing nurses in count. Technologies are making it easier for nurses to remotely monitor patients while performing other duties, such as electronic health records, have cut down on paperwork, and telehealth services with remote nursing are keeping patients out of the hospital, reducing the time-consuming duties of full time care.

The most common barrier which we find usually in most of the technologies would be failing in addressing the real problem, but helping in some other ways for eradicating the problems. Our hospital use lots of learning modules where we need to enroll for it and complete each module with the post test and certification, which really helps me in adding up my knowledge and to carry out the work in an efficiency manner.

MINIMUM OF 60 WORDS FOR EACH ANSWER WITH PROPER CITATION AND REFERENCES

 

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