Nursing Grand Rounds presentation 2

Please read carefully the instructions of this week 5 assignment 

RESPONSE TO DISCUSSION BOARD 5

Use the attached document to provide responses to the discussion board. please provide 2 scientific references in APA format.

End of Life Care

Mr. Rivera is a 72-year-old patient with end stage COPD who is in the care of Hospice. He has a history of smoking, hypertension, obesity, and type 2 Diabetes. He is on Oxygen 2L per nasal cannula around the clock. His wife and 2 adult children help with his care. Develop a concept map for Mr. Rivera. Consider the patients Ethnic background (he and his family are from Mexico) and family dynamics. Please use the concept map form provided. 

WEEK 8 INFO SYST. IN HEALTHCARE POST REPLY

Reflection on AACN Essentials Informatics Self-Assessment

Discussion reply

Hello Dr. G. and Classmates,

                I feel I have learned a lot throughout this course! Thank you, Dr. G and to all of my classmates for a great 8 weeks! I feel I am taking a lot of information with me as I prepare to complete my BSN journey in the next 8 weeks! Best of luck to you all, and my wish for you is to be successful and always diligent in your journey, and most importantly use your knowledge to provide the best care possible to all of the patient’s lives you will touch!  Now, to discuss how far we have all come!

                My assessment score improved by 5 points! A couple of areas I have noticed improvement in are understanding the importance of having the redesign of workflow and care processes in place before starting care technology. I also realize how important it is not only for the patient, but for us nurses as well, as we are set to a higher standard of care that we must provide for our patients, and understanding what makes that happen is imperative. So, understanding the data from all sources that include technology is necessary to the care we give our patients. I also now realize how important it is for us to be involved in policy and procedure development. We are the eyes and ears of our patients, what we see or hear them say helps us to improve and develop policies and procedures that will assist with providing them optimal care!

                I will be able to apply this information to improve patient care by being able to stay up to date on the most recent information and technology, as well as monitor the systems and programs that are already in place and be able to be a part of necessary changes that not only benefit the patient, but us as nurses as well. Ultimately, we will always be looking for ways to improve the care we provide for our patients, but it is necessary to understand how and why. As technology continues to grow and improve continuously, I feel that we must stay on board with the most up to date information and know how to implement it into the care we provide! Thank you all for a great 8 weeks! Best of luck in your future endeavors!

( Robin)

Nursing Cultural APA Assignment 3

 Discussion Post Topic #3: Conduct an evaluation of your current neighborhood or place of work. Are there any population shifts? If so, what are the cultural demographics, and has healthcare made transitions to address these transitions.

Sections of the assignment must include:

  • Introduction
  • Focus points covered in the discussion posts
  • Any arguments and rationales for your stance
  • Conclusion or Summary

The components of your APA Assignment includes the following:

  • The assignment must be completed on a word document.
  • Your APA  Assignment must include a title page (Refer to Purdue OWL).
  • All in-text citations must be used when paraphrasing or quoting a previous author.
  • All references must reflect the in-text citations used.
  • All reference sources must be within the past 5 years unless it is the works of a nurse theorist or a significant reference material.
  • The length of the assignment must be 750-1000 words. Please pay attention to spelling and grammar. Points are deducted for repeat offenders.
  • Upon completion of the assignment, you must submit the assignment via Turnitin.com, and please note that your plagiarism score should be no more than 20%. If you score higher, please make adjustments.
  • (Please refer to the APA Grading rubric for additional assistance in completing your assignment).
  • You may reach out to the College Writing Center for further assistance.
  • Please refer to the course grading rubric on your syllabus for assignment specifics.

AGENDA COMPARISON GRID AND FACT SHEET

1

Presidential Agendas

Name

Institution

Course

Instructor

Date

Presidential Agendas

When the presidents come into office several health issues are a priority to them. Likewise, when deciding on the topic of discussion many issues were considered. However, the selected topic is on mental health which has been an issue of concern and has been regarded as a priority health issue among presidents. Mental health is a concern that is attributed to many other factors, which include health factors like the coronavirus pandemic, and economic, social, and contextual factors. There have been significant milestones in mental health treatment among different administrations.

One of the significant progress made in mental health was made during the reign of President Obama. During his reign, Obama expanded mental health care by introducing health coverage under the Affordable Care Act. The ACA was responsible for eliminating the discrimination that existed when offering care to patients with mental health and substance abuse problems. Additionally, the president embarked on building health and behavioral care centers by investing millions of dollars from ACA (National Archives n.d). The services emphasized the importance of promoting mental health access among the police and other personnel involved in the protection of the citizens and their families.

President Trump was not left behind in making positive changes in the provision of mental health care among the citizens. However, Trump's strategy was marred with controversy regarding the eradication of ACA and Medicaid, which reduced the insurance coverage among those who used that program to access mental health services (Courtemanche et al., 2020). This means such strategies hurt low-income earners by denying them to access crucial mental health services. However, the president further implemented an executive order that saw increased access to mental health services among those with the condition, especially during the pandemic. Such services were aimed at prevention of related suicide, reduction of substance use, and improvement of overall mental health. However, the adoption of COVID-19 management measures such as lockdowns, unemployment, and isolation of people from others increased stress and mental health instances among the people.

These two presidents had excellent strategies for addressing the mental health menace that affected the American population. These strategies have been needed for a long time though they have not been put into practice until recently. However, I would focus on improving mental health training among caregivers as a strategy for ensuring everyone has access to mental health services including healthcare providers. It is prudent to ensure even healthcare providers have access to care because they equally share the experiences of dealing with hopeless patients that could potentially affect their emotional and psychological well-being. Availing such services could help caregivers deal with related trauma whenever it occurs.

References

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2020). The impact of the Affordable Care Act on healthcare access and self‐assessed health in the Trump Era (2017‐2018).
Health services research,
55, 841-850.

National Archives.
Addressing Mental Health: Progress in Research, Prevention, Coverage, Recovery and Quality.
https://obamawhitehouse.archives.gov/sites/default/files/docs/mental_health_report_final.pdf

Unit 11 Medications for Pain Management. Peer Response Due 11-14-23. 800w. 4 references

1


Unit 11 – Discussion Medications for Pain Management.

Name

Institution

Course Number and Title

Professor

Date


Concerns about the use of opioids for pain management

Many parties are concerned about the use of opioids for pain management because that which makes them effective also makes them dangerous. Opioids work by binding to opioid receptors in the central nervous system and incite a pleasurable sensation while dulling pain when they bind to receptors in the brain. However, opioids have a pleasurable, tempting effect for some, and their continuous use has a high risk of leading to misuse, abuse, and eventual addiction. At higher doses, opioids can cause fatal heart rate and respiration slowdowns, whereas, at lower dosages, they may only make patients drowsy. Increased attention has been brought about by the increasing incidence of opioid use disorder and the related health effects. Opioids are useful for numbing pain, but they have a double-edged impact since they may also cause tolerance, physical dependency, and addiction.

Furthermore, opioid overdose has elevated to a serious public health emergency, grabbing the attention of governments and medical professionals everywhere. Because of the rising death rates associated with opioid overdoses, with over 75% of overdose cases related to opioids in 2021 (CDC, 2021), the U.S. government, in particular, has taken the lead in fighting the opioid crisis. The illegal usage of synthetic opioids like fentanyl has contributed significantly to the rise in opioid overdose mortality observed in recent years. The American government has responded by enacting several laws, tightening prescription regulations, boosting access to alternative medication, and expanding the availability of addiction treatment programs. These efforts indicate a thorough effort to address the many problems related to the use of opioids in pain treatment.

Article “America’s opioid crisis: the need for an integrated public health approach”

The article presents a timely and comprehensive understanding of the opioid crisis in the U.S. and the need for a comprehensive approach to address the crisis. I agree with the article’s overall premise of the vital necessity of implementing an integrated public health strategy to successfully address this issue, particularly in light of the ongoing rise in overdose fatalities and the fall in life expectancy. Notably, I also think it is necessary to use a collaborative approach across different disciplines, such as neuroscience, pharmacology, epidemiology, treatment services, and prevention, and to integrate interventions across diverse settings for a holistic response.

The article highlights four interrelated themes that encompass the essential elements of a successful public health strategy: bridging the gap between implementation science and practice, person-centered approaches for prevention and treatment, social determinants of health and disease, and using data to build learning systems of care. These topics highlight how important it is to address the intricate relationships between biological and social elements and how development affects brain function and sensitivity to outside stimuli. However, one aspect I would add to the article is to emphasize the role that the pharmaceutical industry, companies, and the drive for profit played in the development and severity of the crisis. It is well-documented that companies such as Purdue Pharma marketed opioids aggressively and had sale agents and sponsored doctors who pushed for more prescriptions; this started the cycle of addiction (Arteaga et al., 2021). Therefore, any comprehensive approach to address the opioid crisis requires new legislation that prevents companies from pushing prescriptions for profit.

Disorders commonly associated with patients who also need pain relief

The demand for pain relief and mental health concerns frequently coexist, complicating healthcare situations. Depression and chronic pain are commonly associated and co-occur with anxiety in people with chronic pain problems (Murez, 2021). Psychological and physical distress co-occurrence can intensify pain perception and impede efficient treatment. Because of the complex relationship that exists between depression and chronic pain, treating both conditions at the same time requires an integrated strategy. The co-occurrence of anxiety disorders and chronic pain issues is another significant correlation. Anxiety can cause increased pain sensitivity and intensify one’s subjective perception of pain (Harvard Health Publishing, 2021). Additionally, it may exacerbate avoidance habits, preventing patients from participating in physical therapy or other non-pharmacological pain relief techniques.

MME

The Morphine Milligram Equivalent (MME) is a standardized metric used in the healthcare industry to quantify the strength and equivalence of different opioid drugs and facilitate simpler comparisons of their effects. When opioid doses must be translated to a standard measure for safety, effectiveness, and regulatory considerations, the MME is very helpful in clinical practice and research. An opioid’s potency in relation to a standard, usually morphine, is represented by a conversion factor, which is applied to determine the MME for a particular opioid. A uniform metric helps assess and compare the various amounts of opioids patients are given, facilitating safer and more effective pain management.

Since MME gives medical providers a common standard to discuss and track opioid doses, it is crucial to reduce the dangers associated with opioid medication. Because it enables a more thorough assessment of a patient’s opioid regimen, this method also helps lower the risk of an opioid overdose. In addition to being beneficial for healthcare professionals, MME is also a crucial instrument for legislators, allowing them to create policies and rules that promote safer prescription practices.

References

Arteaga, C., Barone, V., Lleras-Muney, A., Reber, S., Maclean, C., Aslan, M., Kroft, K., Zarate, R., Weisburst, E., Van Effenterre, C., & Price, D. (2021).
The Opioid Epidemic: Causes and Consequences.
http://www.carolinaarteaga.com/s/Opioids_ArteagaBarone_Nov12.pdf

Blanco, C., Wiley, T. R. A., Lloyd, J. J., Lopez, M. F., & Volkow, N. D. (2020). America’s opioid crisis: the need for an integrated public health approach.
Translational Psychiatry,
10(1).
https://doi.org/10.1038/s41398-020-0847-1

Centers for Disease Control. (2021).
Understanding the epidemic | CDC’s response to the opioid overdose epidemic |.
https://www.cdc.gov/opioids/basics/epidemic.html

Murez, C. R. (2021).
Chronic Pain and Mental Health: The Empowered Patient’s Guide.
https://www.healthcentral.com/pain-management/chronic-pain-and-mental-health

Publishing, H. H. (2021).
Pain, anxiety, and depression. Harvard Health.
https://www.health.harvard.edu/mind-and-mood/pain-anxiety-and-depression

Stahl, S. M. (2021).
Stahl’s Essential Psychopharmacology.
https://doi.org/10.1017/9781108975292

pharmacology

See attached questions and discussion guide

PN1

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week5 Proposed Intervention

 

What are the decisions you made in designing your proposed intervention? Include any ethical considerations or issues you felt were relevant, the setting in which the intervention will occur, the interventions that were selected and why, and how you plan to implement the intervention.

Cite any sources in APA format.

 

Step 5: Develop a Plan for Evaluating the Effectiveness of Your Intervention
Objective: To develop a method to determine if your Intervention achieved your goals.
For each goal, create an evaluation plan including:
 Change Team member responsible for data collection, analysis, and presentation
 A measure and target ranges for the measure.
 Study design (usually pre- and post-intervention study)
 Sample (study group) or data source with comparison group
 Methods for data collection, analysis, interpretation, and presentation.
 Timelines for baseline and for post-intervention data collection and analysis
 Resources required
Step 6: Develop an Implementation Plan
Objective: Part A: To develop a plan for training or educating your staff/patients to successfully
implement your intervention.
Part B: To develop a plan for putting your intervention into place.
Part A: Develop a Plan for Staff and/or Patient Training
 Identify your Instructors, trainee audience(s) and their specific training requirements.
Determine who needs to be trained on what knowledge/skills and by when in order to achieve
your aims.
Part B: Develop an Implementation Plan for the Intervention
 Ensure you have collected all baseline data before implementing the intervention.
 Identify the person(s) responsible for implementation.
 Determine how you will implement your intervention in order to achieve your aims.
 Identify who will use what team strategies and tools, when and where.
 Create an implementation timeline.