A journal article review is an important course assignment. See guidelines and detailed instructions below. Articles should be from peer-reviewed or scholarly journals and relate to the field of study. To successfully accomplish the main objectives of this assignment, students will perform a critical, constructive analysis of recent published studies (journal articles) in the healthcare or public health fields through summary, classification, analysis and comparison. A review and critique of the methodological approach and discussion of the applications in the field are expected. Establishing the Research Context Once you are reasonably familiar with the article, it is important to gain an understanding of the research context. Article to be reviewed/critiqued: Instructions: Read critically the articles. Many journal articles can be quite complex and use complicated wording and statistics. You may need to read the article a few times before you get a full grasp of it. 

Students should address the following questions/topics: 

1. Explore and retrieve a journal article related to a topic of your interest.

 2. The article should be based on a quantitative research design. 

3. Identify/construct the main research question(s) of the study. (20 points)

 4. Review and discuss the Methods section of each article follow the sub-sections below: 

a. Identify the study design. (10 points)

 b. Report the sample size, power and sampling methods used. (10 points) 

c. Report the variables (indicators) explored/analyzed in the study. 

i. Independent/Predictor/Explanatory. Quantitative/Qualitative. (20 points) 

ii. Dependent/Response/Outcome. Quantitative/Qualitative. (20 points) 

5. Write a summary paper 1 to 2 pages in length in MS Word format. 

a. Include the purpose for the article and the most relevant findings. (10 points) 6. Add a citation for the journal article at the top of the review using the American Psychological Association’s (APA) format. (10 points) 

 Locate a news article or story related to a current event in healthcare policy. Some examples may be, but are not limited to healthcare reform, the Affordable Care Act, prescription drugs, healthcare costs, insurance coverage, healthcare fraud, transparency, or underinsured populations. 

• Provide a brief overview of the article, and include the URL link.
• As a healthcare professional, has this raised any ethical questions or concerns for you?
• How can a community health nurse (CHN) be involved as a change agent for related healthcare policies?

Question 1

Routine Health Periodicity for the Gynecologic and Clinical Breast Exam (CBE)

In order to maintain good reproductive and sexual health, females should visit a gynecologist for an exam about once per year, even if a Pap test isn’t performed. A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks (ACOG, 2017).

The periodic well-woman care visit should include screening, evaluation and counseling, and immunizations based on age and risk factors. Sexually active adolescents shouldn’t wait until age 21 to see a gynecologist for the first time. Recent recommendations state that girls should have their first gynecologic visit between the ages of 13 years and 15 years (ACOG, 2017).

According to the U.S. Preventive Services Task Force (2018) the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic women for the early detection and treatment of a range of gynecologic conditions. The interval for specific individual services may differ for individual patients, and the scope of services provided may vary in different ambulatory care settings (USPSTF, 2018).

The Centers for Disease Control and Prevention (2018), states that the best way to find breast cancer is with a mammogram; having a CBE or a BSE has not been found to decrease the risk of dying from breast cancer. Even if the patient chooses to have annual CBEs and to perform regularly BSEs, it is essential to also get mammograms regularly. The USPSTF recommended that women begin mammograms at age 50, not 40, and decrease the frequency thereafter. The USPSTF stated that current evidence is insufficient on the additional benefits versus harms of CBE beyond screening mammogram in women older than 40 years (USPSTF, 2018).

Health Factors Utilized to Determine the Need for a Pap Test

The need for a PAP test depends on factors such as a woman’s age, health history, recent Pap test results, and whether or not she has had HPV. The American Cancer Society (ACS) and the USPSTF both recommend that women get their first Pap test at age 21. Co-testing with Pap and HPV begins at age 30 years. Current interim guidance for stand-alone HPV primary screening begins at age 25 years. Most women between age 21 and age 30 should have a Pap test every three years, assuming their previous Pap test results were normal (Carcio and Secor, 2015).

Women who are Pap/negative and HPV/positive should perform Pap and HPV in 12 months. HIV-infected women should have biannual Pap tests in the first year of diagnosis and then may reduce frequency to annual Pap tests based on the results. A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group (Carcio and Secor, 2015).

When is the Pap test no longer necessary?

The PAP test is no longer necessary in women who have had a total hysterectomy, but if the hysterectomy was done because of cervical cancer or precancerous cell changes, she may still need Pap tests. Also, after age 65, most women may no longer need Pap tests if their last three Pap tests were normal, they are not at high risk for cervical cancer, and they have gone 10 years without an abnormal test (HHS.gov, 2019).

                                                          References

Carcio, H. & Secor, M.C. (2015). Advanced health assessment of women: Clinical skills and procedure. 3rd ed. New York: Springer.

Center for Disease Control and Prevention (2018). What are benefits and riskd of screening. Retrieved from https://www.cdc.gov/cancer/breast/basic_info/benefits-risks.htm

The American College of Obstetricians and Gynecologists (2017). First Gynocologic exam. Retrieved from https://www.acog.org/Patients/FAQs/Your-First-Gynecologic-Visit-Especially-for-Teens

U.S. Preventive Services Task Force (2018). Final recommendation Statement. Ginecological conditions. Retrieved from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/gynecological-conditions-screening-with-the-pelvic-examination

US Department of Health and Human Services (2019). Cervical Cancer Screening (Pap Test). Retrieved from https://www.hhs.gov/opa/reproductive-health/fact-sheets/pap-test/index.html

The following requirements correspond to the criteria in the assignment scoring guide, so be sure to address each point:

1. Analyze organizational or system strengths, weaknesses, opportunities, and threats (SWOT) in relation to the selected project aim.      
   • Support the SWOT analysis with contextual information specific to the organization or health care system.
   • Identify and rate major known risks (low, medium, high risk) that could be barriers to the project.
   • Explain major assumptions for the project, including a description of logistical constraints that may affect the fidelity of the project.
2. Summarize pertinent ethical considerations that may be encountered during the project.      
   • Address protected health information, HIPAA, human subject considerations, equitable care, and appropriate use of data.
3. Describe the communication strategies that will be used during the project.      
   • Specify how the project manager will communicate to the executive sponsor, project team members, and stakeholders, including frequency of status updates, project team meetings, and so on.
   • Include descriptions of any visual tools or processes that will be used in communication such as Gemba walks, Gantt charts, dashboards, or safety cross.
4. List proposed outcomes and corresponding metrics to measure the outcomes.      
   • Operationally define outcome measures.
   • Operationally define process measures.
5. Describe the purpose and use of the data collection plan.             
   • Include a description of primary or secondary data, source, data integrity, and data security plan.
   • Attach a data collection tool in Excel appropriate for the data source and time frame for the project; include this as an appendix.  

John is a doctor in Hope Geral hospital. The doctor has been working for five years. He started working in this hospital when he acquired his degree though this is the hospital in which he did his internship. Doctor John is the doctor in judge in Hope General Hospital. The doctor’s leadership style is transformational leadership. The doctor is focused on bringing change to the organization. Dr. John leads his team, and also he is a mentor to most nurses who are doing their intern in the organization, Dr. John takes at least three hours to monitor what the nurses in practice are doing and also he uses this time to guide them. The Dr is also friendly to the patient, and most patients have hi number, and they can call the doctor any time within the working hours for assistance. For emergency cases, the doctor has another number that patients use to call for help. The doctor works both within the organization and outside when the need arises.

Dr. John is a transformational leader; he communicates a lot with his team (Gray et al., 2017). He conducts a lot of open meetings; this is to allow his team members to express their views regarding the change the doctor he what to make. Since Dr. John was assigned as the doctor in judge, he has made a lot of changes within the organization. At first, the rate of readmission was 40%, but in the past five years, the rate has dropped by half.

The doctor has a vital role he is playing within the organization; the Dr ensures that every department is running effectively, and also he has a communication chain that helps him to gather information which can help the organization become more productive. Dr. John encourages a lot of teamwork. An example, in every ward, Dr. John ensures that there are three professionals from different departments who are delivering care to the patients.

I chose Doctor John as my preceptor because some time ago, I accompanied my father to the hospital, and his case required this particular doctor to attend to him. As the doctor as examining him, he sounded friendly and ready to explain to us every procedure my father will require, and also, he made us understand the health issue that was affecting my father. From this incident, I saw the doctor be the best mentor to me. Most people from my community also trust the doctor due to his good work. The doctor is in charge of the organization he has ensured that professions are comfortable within the organization and will the recruitment team members to focus on other things instead of recruiting professionals regularly. Due to the change today, patients are safe in HGH, and the patient outcome has improved significantly.

Different health care leaders have different strategies that can help an organization, but also patients can be of great help in giving views that will govern the organization (Nelson et al., 2015). The purpose of a health care organization is to achieve the patient outcome; therefore, to get to know what the patients can be of great help. When conducting health care, this can be the best time to understand what the patients need. Different patients have different needs, but the primary need is quality services; thus, from the many options the patient will give, the leader should choose the best views.

The leader can protect health issues; this is because the primary role of a health care leader is to ensure the organization can deliver quality services that help to achieve the patient outcome (Hannum et al., 2017). An example, falling has been an issue in most health care organizations. Looking at the problem, some organizations have overcome the issue while others have not. The difference is causes be the difference in governance. In HGH, the leader aims to make a change; thus, this leader has made proper strategies that will help him achieve this change, and results have been observed even though not to its maximum. Dr. John has been able to protect his team, which is to ensure that their jobs are secured. 

Ethics can be an issue if a leader does not take a good look at the problem. Today HGH has all the principles of ethics; this has helped the organization to receive the patient had lost to the competitors. Dr. John, together with his team, when an issue arises, they discuss, and Dr. John makes the final decision. For many years the organization had problems with high recruitment, which affected a lot the organization’s productivity, but since Dr. John was chosen as a leader, this has reduced significantly.

The issue Dr. John has encountered regarding organization data is the lack of useful data. Dr. John, when he reported first at the office, a lot of data, especially the finance files, were missing at that time the organization was falling due to lack of funds. Dr. John is not sure what he was to do to help the organization because even the drugs were not available at the organization. Dr. John made strategies and got some money, which enabled him to manage the organization until it was stable. The finance issue affected the organization for about two years. Today the organization is trusted with the community, and also they receive a patient from other communities this shows that the organization is now stable 

1. Write coherently to support a central idea, using correct grammar, mechanics, and APA formatting.

The authors of the assigned article, “A Patient-Driven Adaptive Prediction Technique to Improve Personalized Risk Estimation for Clinical Decision Support (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392846/) have found that using patient-driven, adaptive technologies to guide clinical decision making are influencing the quality of patient care. How might these technologies minimize risk, promote health, and encourage patient engagement in their own care? one page. APA. NEED IT BY 8 AM FLORIDA TIME.