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There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges

“More than 80% of homeless people have at least one chronic health condition & more than 50% have a mental health disease” (Chronic Disease Management in the Homeless, 2014). Of the populations there are about 40-60% that suffer from substance abuse.

Some of the risk factors of those that are homeless are tobacco abuse, alcohol abuse, malnutrition, exposure to the environment, IV drug use, trauma, stress and suppressed immunity.

Some of the barriers to treatment are no access to medications, medication storage, no transportation, no financial resources, no housing, and poor nutritional access.

Treatment approaches for the homeless that have chronic disease are to discuss in detail the patient’s limitations to follow the treatment plan. You should also try to empower the patient by helping them set goals and set priorities that they will be able to obtain. There are also homeless assistance programs that would benefit those that were willing to receive it like HUD and the National Coalition for the Homeless.

What are social determinants of health? How do social determinants of health contribute to the development of illness? What is a communicable disease chain? Are there steps that a nurse can take to break a link within the communicable disease chain? Give a specific example. 

Readings within your text covering international/global health and the following websites will assist you in answering these questions:

1. U.S. Centers for Disease Control and Prevention (CDC) Global Health website: http://www.cdc.gov/cogh/index.htm
2. U.S. Department of Health & Human Services (HHS) Global Health website: http://www.globalhealth.gov/index.html
3. Families USA – Why Global Health Matters—Here and Abroad website: http://www.familiesusa.org/
4. World Health Organization (WHO) website: http://www.who.int

1-A T-test and a Z-test are almost similar in theory, but have a different application mechanism. The major difference with these two is the size of the sample applied in each case. The t-test is appropriate for smaller samples. Any sample less that 30 units are best analysed using the t-test, while beyond 30 units require a z-test. A z-test is also better if the standard deviation is not known.  

 T tests are used to compare a given mean to the mean of the given population; it can be applied to either individual values or ones that are paired. The T test can be helpful when you do not know the standard deviation and is best utilized when your sample size is smaller (n<30 sample size) (Lango, 2015). For example, in a Z test you must know the standard 

2-Z-test- implies a hypothesis test which ascertains if the means of two datasets are different from each other when variance is given. It is based on normal distribution with a known population variance and a large sample size >30 units

 T-test- refers to a type of parametric test that is applied to identify how the means of two sets of data differ from one another when variance is not given.  It is based on student T distribution when the population is unknown and the sample size is smaller, <30 units.  

Reference

Difference Between t-test and z-test (with Comparison Chart) – Key Differences. (2018, March 10). Retrieved from https://keydifferences.com/difference-between-t-test-and-z-test.html

3-Yes, in theory these two test are common with differences only setting in when applying them. Both used in hypothesis setting, the z-test is better applicable when the standard deviation is known, and when dealing with a larger sample size. A z-test is better to use when dealing with a larger sample size than of over 30. A t-test is better when the sample size is less than 30, and when dealing with an unknown standard deviation

Write a 2 Paragraph response (with 2-3 sources) to this post offering additional/alternative ideas regarding opportunities and risks related to the observations shared.

Healthcare system presently is faced with challenges to improving quality of care and controlling costs and according to the Institute of Medicine, electronic health records (EHR) serve as a solution to these challenges (2001). The Health Information Technology for Economic and Clinical Health Act (HITECH) passed by President Barack Obama promotes the adaptation of EHR system by providing health organizations and providers with incentives through Medicare and Medicaid for meaningful utilization of EHR systems (McGonigle&Mastrian, 2017). Technology in nursing has evolved and transformed the way nurses work and continues to grow, along with the role’s nurses play in today’s health care environment (Melissa Wirkus, 2016).For many years the paper chat served as the patient’s primary medical records such as medical histories, medical diagnosis, medications, and other pertinent patient information. In the future, an expected healthcare technology trend in nursing practice will be a significant increase in the use of the Electronic health record (EHR) instead of the traditional paper charting As technology continues to grow so does additional information technology that helps caregivers, engage patients and improve efficiencies and better patient outcomes (Laureate Education, 2018). For example, patients can now have access to their medical health records at their own convenient through online portals and can effectively communicate with their health care provider. In addition, patients are also using social media platforms like Facebook and twitter to get/communicate with others with the same health-related diagnosis.

According to McGonigle & Mastrain “Public health information systems represent a partnership of federal, state, and local public health professionals” (2017). In the present-day majority of health care organizations are embracing the implementation of electronic health records. In the hospital I work, we are making use of the Meditech operating system. Patient medical histories, diagnosis, home medications, and current medications are updated and readily available. During patient’s hospital stay, all health care providers can log in with their personal access codes to document as well as view patients’ labs, patient notes, care plans and so on. More so, one intriguing benefit for the patients is during the patient’s hospital stay and at discharge, patients are educated about our patient portal where they can easily log in to look up their personal medical records.

Potential Risk/ Challenge Associated with data Safety.

A potential risk associated with data and or technology safety is the lack of patient confidentiality. For example, when a nurse who is from a different unit assesses patient medical records they took care of three days before, that is considered a break in patients ‘confidentiality because that nurse has no reason viewing records of a patient who is not assigned to them. At my facility, they monitor nurses who try to access a patient’s chart without proper authorization. This can lead to disciplinary action or termination of employment. The administration has zero tolerance for this behavior. With advancement in information technology patient’s vital information such as test results, labs, and assessments are automatically synched from the operating machine to the appropriate patient’s EMR. This prevents possible errors that can arise with paper documentation. At my current organization, the Meditech EMR system is utilized to its full extent. The EMR system allows a congruent flow inpatient care from providers and clinicians and prevents possible human errors. Informatics has assisted in the incorporation of information technology in healthcare delivery, by providing a haven for patients’ data and making valuable patient data readily available for treatment.

Finally, an inherent risk associated with a legislature that limits telehealth services pertains to reimbursement. State laws and rules regarding reimbursement rates for telehealth services differ, even within the same jurisdiction, for telemedicine profitability are driven primarily by payers, including Medicare, Medicaid, and private insurance companies (Fanburg & Walzman, 2018). Such inconsistency in reimbursement rules for telehealth services can create weak incentives among providers to expand telehealth care. Thus, each provider must be aware of legal policies governing telehealth practice within respective jurisdictions to promote telehealth services successfully.

As stated above, a current and future trend that has evolved and still evolving is the introduction of social media and telehealth. Currently, telehealth is trending I have seen many health-related groups on Facebook where patients with the same diagnoses communicate, ask questions, and even get healthcare provider recommendations. Telehealth, on the other hand, is the use of electronic information and telecommunications technologies to assist and promote long-distance clinical health care systems (McGonigle&Mastrian, 2017). For example, individuals who are looking for quick answers to their health problems, and maybe have no means of transportation, telehealth is beneficial for them in the comfort of their homes. Services like this offer patient immediate healthcare consult/answers and refrains patient from going to the emergency room and sitting there for several hours before being attended to. This impacts nursing practice positively. Telehealth nursing can be done anywhere. Nurses can make use of technology to conduct telehealth sessions in their homes, at doctor’s offices, in prisons, and in clinics and hospitals. Basically, any place where the proper technology is available is a suitable place for telehealth nursing. For example, in emergencies, nurses from around the world can participate in telephone triage set-ups. Wherever nursing is done in a telehealth setting, nurses can monitor a patient’s oxygen levels, heart rate, respiration, blood glucose and more. In addition, patients contact their nurses through the telehealth system to get help. In non-emergency situations, they can get the nurse to take their blood pressure readings or glucose readings, for instance. Nurses can instruct patients as to how to dress a wound or treat a minor burn. The patients usually find their telehealth nurses through their managed health care organization. Nurses must be overseen there to regulate patient access to the system. Most of the time, the goal is to reduce the number of trips patients make to the ER.

These are the sources you used for my post. You can use these or any others you want. I trust your judgement

Baniasadi, T., Kalhori, S.R., Ayyoubzadeh, S.M., Zakerabasali, S., & Pourmohamadkhan, M. (2018). Study of challenges to utilize mobile-based health care monitoring systems: A descriptive literature review. Journal of Telemedicine and Telecare, 24(10), 661–668. DOI: 10.1177/1357633X18804747

Naseribooriabadi, T., & Sheikhtaheri, A. (2015). Social media and health care: Necessity of facing their challenges. Iranian Journal of Public Health, 44(4), 596–597. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441977/

University of Saint Mary. (n.d.). Five exciting technologies that are changing nursing practice. Retrieved from https://online.stmary.edu/msn/resources/five-technologies-changing-nursing-practice

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32. doi:10.3390/informatics4030032

 For the middle-aged adult, exercise can reduce the risk of various health problems. Choose three health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist clients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the client. Support your response with evidence-based literature.