Evidence-Based Population Health Improvement Plan

 

For this assessment, you will create a 5-7 slide PowerPoint presentation about a population health improvement plan. You will then record a video of no more than five minutes presenting your PowerPoint.

Introduction

Master’s-level nurses need to be able to think critically about the evidence, outcomes data, and other relevant information they encounter throughout their daily practice. Often the evidence or information that a nurse encounters, researches, or studies is not presented in the exact context of that nurse’s practice. A key skill of the master’s-level nurse is to transfer evidence from the context in which it was presented and apply it to a different context in order to maximize the benefit to patients in that new context.

Professional Context

Master’s-level nurses need to be able to think beyond the bedside. It is important to be able to research, synthesize, and apply evidence that will result in improved health outcomes for the communities and populations that are part of your care setting. Improving outcomes at a community or population level, even incrementally, can create noticeably significant, aggregate health improvements for patients across all of a care setting.

Scenario

Your organization has created an initiative to improve one of the pervasive and chronic health concerns in the community. Some examples of possibilities for health improvement initiatives include type 2 diabetes, HIV, obesity, and communicable diseases. You will need to do your own research to gather and evaluate the relevant data for your chosen issue.

Once you have created a presentation for the initiative, you have been asked to present to a group of community stakeholders. The purpose of your presentation is to inform and enlist support for the initiative from your audience.

Instructions

The optional Evidence-Based Population Health Improvement Plan Presentation Template [PPTX] is provided to help you prepare your slides. If you choose to work without the template, consider referring to Creating a Presentation: A Guide to Writing and Speaking and Guidelines for Effective PowerPoint Presentations.

The suggested headings for your presentation are:

  • Community Data Evaluation.
  • Meeting Community Needs.
  • Measuring Outcomes.
  • Communication Plan.
  • Evidence.

In your presentation, you will:

  • Evaluate the environmental and epidemiological data about your community to determine a population-focused priority for care.
    • Identify the relevant data. This can be communicated in a table or chart. 
    • Describe the major population health issue suggested by the data within your community.
    • Explain how environmental factors affect the health of community residents.
    • Identify the level of evidence, validity, and reliability for each source.
    • Explain what evidence in the current literature (within the last 5 years) supports your evaluation of the data and the population focused priority of care you have selected.
  • Develop an ethical health improvement plan with outcome criteria that addresses the population health priority that you identified in your evaluation.
    • Consider the environmental realities and challenges existing in the community.
    • Include interventions that will meet community needs.
    • Address potential barriers or misunderstandings related to various cultures prevalent in the community.
    • Propose criteria that can be used to evaluate the achievement of the plan’s outcomes for your population health improvement.
      • Explain why your proposed criteria are appropriate and useful measures of success.
  • Explain a plan to collaborate with a specific community organization to support the implementation of the population health improvement in an ethical, culturally sensitive, and inclusive way.
    • Identify the community stakeholders that are relevant to your Population Health Improvement Plan.
    • Develop a clear communication strategy that is mindful of the cultural and ethical expectations of colleagues and community members regarding data privacy.
    • Ensure that your strategy enables you to make complex medical terms and concepts understandable to members of the community regardless of disabilities, language, or level of education.
  • Explain the value and relevance of the evidence and technology resources used as the basis of a population health improvement plan.
    • Explain why the evidence is valuable and relevant to the community health concern you are addressing.
    • Explain why each piece of evidence is appropriate and informs the goal of improving the health of the community.
  • Communicate the Evidence-Based Population Health Improvement Plan in a professional, effective manner that engages the community organization stakeholders and the community-at-large to implement and sustain change.
    • What specific actions can the community stakeholders take themselves to build a feeling of community ownership in your plan?
  • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Submission Requirements

  • Length of submission: 5–7 slides. Balance text with visuals. Avoid text-heavy slides. Use speaker’s notes for additional content.
  • Length of Video Presentation: No more than five minutes.
  • Font and font size: Appropriate size and weight for a presentation, generally 24–28 points for headings; no smaller than 18 points for bullet-point text. Use a suitable professional typeface, such as Times or Arial, throughout the presentation.
  • Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source material is defined as no older than five years unless it is a seminal work.
  • APA formatting: Resources and citations are formatted according to current APA style.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Apply evidence-based practice to plan patient-centered care.
    • Explain a plan to collaborate with a specific community organization to support the implementation of the population health improvement in an ethical, culturally sensitive, and inclusive way.
  • Competency 2: Apply evidence-based practice to design interventions to improve population health.
    • Develop an ethical health improvement plan with outcome criteria that addresses the population health priority for care identified in the evaluation.
  • Competency 3: Evaluate the value, relevance, and ethics of available evidence upon which clinical decisions are made.
    • Evaluate the environmental and epidemiological data about your community to determine a population-focused priority for care.
    • Explain the value and relevance of the evidence and technology resources used as the basis of a population health improvement plan
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
    • Communicates the Evidence-Based Population Health Improvement Plan in a professional, effective manner that engages the community organization stakeholders and the community-at-large to implement and sustain change.
    • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

case study

THE ASSIGNMENT: 5 PAGES

Examine 
Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

BACKGROUND

Mrs. Maria Perez is a 53 year old Puerto Rican female who presents today due to a rather “embarrassing problem.”

SUBJECTIVE

Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past 2 years, she has been having more and more difficulty maintaining her sobriety since the opening of the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during its grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past 2 years and she is concerned about the negative effects of the cigarette smoking on her health.

She states that she attempts to abstain from drinking but she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much,” but she enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much. She currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.

Mrs. Perez is quite concerned today because she borrowed over $50,000 from her retirement account to pay off her gambling debts, and her husband does not know.

MENTAL STATUS EXAM

The client is a 53 year old Puerto Rican female who is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. When you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation and self-reported mood. She denies visual or auditory hallucinations, and no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact; however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Diagnosis: Gambling disorder, alcohol use disorder

Decision Point One

Vivitrol (naltrexone) injection, 380 mg intramuscularly in the gluteal region every 4 weeks

RESULTS OF DECISION POINT ONE

·
 Client returns to clinic in four weeks

·
 Mrs. Perez says she feels “wonderful” as she has not “touched a drop” of alcohol since receiving the injection

·
 Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling)

·
 Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also has her concerned

Decision Point Two

Add on Valium (diazepam) 5 mg orally TID/PRN/anxiety

RESULTS OF DECISION POINT TWO

·
 Client returns to clinic in four weeks

·
 Mrs. Perez reports that when she first received the Valium, it helped her tremendously. She states “I was like a new person. This is a miracle drug!” However, she reports that she has trouble “waiting” between drug administration times and sometimes takes her Valium early

·
 She is asking today for an increase the Valium dose or frequency

Decision Point Three

Continue current dose of Vivitrol, increase Valium to 10 mg orally TID/PRN/anxiety. Refer to counseling for her ongoing gambling issue

Guidance to Student

Anxiety is a common side effect of Vivitrol. Mrs. Perez reports that she is doing well with this medication, and like other side effects, the anxiety associated with this medication may be transient. The psychiatric mental health nurse practitioner should never initiate benzodiazepines in a client who already has issues with alcohol, or other substance dependencies. Additionally, benzodiazepines are not to be used long-term. Problems associated with long-term benzodiazepine use include the need to increase the dose in order to achieve the same therapeutic effect. This is what we are seeing in Mrs. Perez’s case.

The most appropriate course of action in this case would be to continue the current dose of Vivitrol, while decreasing the Valium with the goal of discontinuation of the drug within the next two weeks. At that point, you would need to evaluate whether or not the side effect of anxiety associated with Vivitrol persists.

Increasing the dose of Valium would not be appropriate, neither would maintaining her on the current dose of Valium. Additionally, the client should be referred for counseling to help with her gambling addiction, as there are no FDA approved medications gambling disorder.

Medication should never be added treat side effect of another medication, unless that side effect is known to be transient (for instance, benzodiazepines are sometimes prescribed to overcome the initial problem of “activation” associated with initiation of SSRI, or SNRI therapy). However, in a client with multiple addictive disorders, benzodiazepines should never be used (unless they are only being used for a limited duration of therapy such as acute alcohol detoxification to prevent seizures).

Additionally, it should be noted that Mrs. Perez continues to engage in problematic gambling, at considerable personal financial cost. Mrs. Perez needs to be referred to a counselor who specializes in the treatment of gambling disorder, and should also be encouraged to establish herself with a local chapter of gamblers anonymous.

You need to discuss smoking cessation options with Mrs. Perez in order to address the totality of addictions, and to enhance her overall health.

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FOCUSED SOAP NOTE AND PATIENT CASE PRESENTATION, 21

  

Respond at least 2 times each . The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.

Discussion

 “Stem cells are undifferentiated, primitive cells with the ability both to multiply and to differentiate into specific kinds of cells. Stem cells hold the promise of allowing researchers to grow specialized cells or tissue, which could be used to treat injuries or disease (e.g., spinal cord injuries, Parkinson’s disease, Alzheimer’s disease, diabetes, strokes, burns).” (Slevin, 2010) 

 Choose ONE of the following issues and post to its thread with supporting evidence. 

1) Discuss what you feel are the potential benefits of stem cell research for Alzheimer’s patients and their families.

2) Share your perspective on the stem cell debate regarding the donation of surplus embryos to couples for “embryo adoption.”

3) Why is the task of disposing of unused frozen human embryos different from disposing of other medical tissue?

4) Discuss why you think embryonic stem cell research “crosses a moral boundary.”

5) Please cite the textbook and any other source used in APA format.

Research Question

Topic: Atherosclerosis

-etiology, clinical manifestations, evaluation, and treatment.

-potential for heart disease and stroke.

at least two sources and masters level terminology

two pages. 

WEEK 7 MSN 5550

 

Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specific

illnesses such as cancer, diabetes, and hypertension.  Share your opinions about holistic and allopathic care.

Would have any conflicts or concerns supporting a patient who chooses holistic or allopathic medicine?

 Word limit 500 words. 

 

Please make sure to provide citations and references (in APA, 7th ed. format) 

w5 yi

Taking into account internal and external criticism that is used to evaluate mid-range theories or their use in research. critique Self-Efficacy theory using the internal and external critique evaluation process.

Nutritional Principles in Nursing

Module 04 Content

1.

Top of Form

Create an outline of your project (1 page). The outline should only contain topic headings and a brief description of what it will cover. See the link below for an APA formatted outline. Remember that your outline will be a guide as you write your paper to keep you on topic and organized.

Required paragraph topics include but are not limited to: the role nutrition plays in the prevention of the disease, etiology, progression, treatment, recommended diets, nursing assessment, nursing interventions, client education, and adherence. Please use library resources to find out more about Nursing Assessment, Interventions, and Client Education.


Nursing Discussion assignment

Please see attachment.

pn 2 m7 written

 Fill out the Table below comparing the Acute Complications of Diabetes.