EPIDEMIOLOGY ASSIGNMENT

INSTRUCTIONS:

1. Go to http://www.healthypeople.gov/2020/default.aspx and review the Healthy People 2020 initiative. Pay close attention to the objectives, goals, and indicators.

2. Using your city (MIAMI, FL) or county public health department or the CDC, choose 3 population or community based problems such as disease, disaster, crimes, accidents, falls etc… from the topics outlined in the website and prepare an analysis discussing how these 3 conditions, affect your community and how they were identified and a plan of action to contained them base on healthy people 2020.

3. You can also use the following CDC link https://www.cdc.gov/outbreaks/index.html and identify 3 community infectious outbreaks such as measles and develop the assignment.

The presentation must be in APA format with a minimum of 1500 words (excluding first and references page) with a minimum of 4 evidence-based references using the required Arial 12 font. Must include the zip code of the city or county chosen. Follow the APA example paper that was sent to you at the beginning of the course for guidance. Make sure references are used according to APA guidelines and electronic references must be from reliable sources such as CDC.

The assignment will be post it in the discussion tab of the blackboard for grading and in the SafeAssign exercise in the assignment to verify originality. FNU only accept 35% of plagiarism. I will not accept any assignment that exceeds the percentage of plagiarism establish by the university. 

                                  I need this project completed in 4-5 hours

Description: 

Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

1. In the articles you have reviewed, what statistical tests are being used for data analysis?
2. Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
3. Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?

· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017).  The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models. 

·  Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008). 

· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?

· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.

· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups? 

· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.

· Do the authors appropriately indicate implications of the data analysis, or do they overstretch? 

· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted. 

· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.

                                                                          References

· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026

· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539

· McCrum-Gardner, E. (2008).  Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41 

· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671

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Types of Statistical use

           There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018). 

Appropriateness of the statistical test 

The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research.  One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.

Conclusion

           The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.  

References

Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac-                   canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf

McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf        

Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles  on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246

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Culturally safe care and communication is imperative to person’s having effective person-centred care. Nurses are required to consider how they engage and will approach situations in which individuals have experienced previous harm. This harm may be related to healthcare, previous life trauma or generational behaviours. The use of person-centred therapeutic skills in integral to providing safe care that aligns to the registered nurse standards for practice. The use of the case study below allows students to consider how they will approach situations where individuals are reluctant to seek care.  

Learning Outcomes

• Identify verbal and non-verbal communication strategies and standards that enable therapeutic communication and interprofessional relationships
• Explain how cultural sensitivity and cultural safety aid in the establishment of effective communication with Aboriginal and Torres Strait Islander people and other multicultural communities
• Demonstrate a high level of written and spoken English according to academic conventions and professional nursing standards
• Identify, access and effectively utilise relevant and credible evidence-based research for person-centred practice
• Demonstrate effective communication through clinical handover and the legal documentation of essential information in healthcare records to ensure patient safety

Task Instructions

Read the following case study.

Leo is a 50-year-old man living in your local community. Leo has a past history of Type 2 Diabetes, Coronary Artery Disease and Hypertension. Leo is aboriginal and lives with his wife and three children (aged 12 – 20). Leo disengaged from healthcare due to a previous bad experience where he felt judged due to his cultural background. He has heard you are a new nurse working in his area and has been convinced by his wife and children to attend for a health check-up and care plan. 

1. Discuss how you will utilise communication, cultural sensitivity and safety to develop a therapeutic relationship with Leo, using your knowledge of communication and culture learnt from this unit. The discussion should also include key information and requirements for documentation of your nursing interaction with Leo.
2. Discuss the therapeutic communication tools that you will utilise to develop a connection with Leo.
3. Discuss how will you develop a culturally safe and sensitive interaction with Leo? The written work should also include what strategies/ approach you will take to record your interaction with Leo providing clinical reasoning (explaining why).
4. Read the following instructions for writing an essay:

• Introduction: gives background to the topic and states precisely what the essay intends to cover
• Body Text: shows evidence of critical thinking and analysis; and uses current evidence-based research to support the argument
• Conclusion draws evidence together, does not over-generalise or introduce new material.
• Well structured, logically sequenced essay in appropriate English
• Correct referencing technique

Word counts- 1,500 / References – APA7th standard not more than 10years old and has to be at least 17 journal articles

• Create a power point with the intended audience to be a community health department.
• Focus on a real or fictional disaster that has or could affect your area. For example, if you live on the Florida coast you might choose potential hurricane.  
• Discuss the role of the Community Health Nurse in each stage of disaster. You should include a few slides on each stage of disaster: preparedness, response, recovery with specific activities and resources that the public health nurse would use in each stage.
• Identify other agencies that might be involved. 

The assignment should be submitted in Power Point format, with at least 10 content slides (in addition to a title slide and reference slide) and include at least two scholarly sources other than provided materials.  (State: Texas)