200 words for each response.

1) 

Social Determinants and Disease Development

       Social determinants of health are conditions in which a person is born in to – social, economic and physical conditions to include resources and daily needs, biases, crime and violence statistics, community support, availability of sending and receiving communication, education quality and community, etc., each impacts an individuals daily activities, health, wellness and evidence of disease.  Individual behaviors will also support or not, the chain of events that lead to health or illness.  Although many circumstances may prevent wellness, it is up to the individual how these circumstances will impact their life.

Chain of Infection

       The chain of infection is comprised of six units; the infectious agent or the germ; the reservoir or where the pathogen lives; portal of exit, why and how the infectious agent exits it reservoir; mode of transmission, how it is passed on; portal of entry, how the infectious agent enters its new host; and the susceptible host which can be any person or animal.

How the Community Health Nurse Can Break the Chain of Infection

       Community nurses and education are at the center of breaking communicable disease processes from spreading, surveillance of and prevention.  In order to stop the infectious agent from spreading it is imperative to break the link of transmission.  Hand hygiene, vaccination, prevention of spreading an organism could include education on the importance of covering your cough or sneeze, isolate the person or persons infected, use of personal protective equipment when indicated, especially in healthcare settings, utilizing antibiotics wisely.  At home and beyond, maintain and clean your home especially the high use areas such as countertops, faucets, light switches, bathroom surfaces, keyboards or cell phones, doorknobs or the steering wheel of your car.  In grocery stores, utilize the antiseptic wipes to wipe down cart handles, etc.  If you find yourself or a loved one as a patient in a hospital or clinic setting, speak up, call out anyone who enters your room to utilize hand sanitizers prior to engaging in your care.  All are ways to break the link and to prevent spread of infectious agents.

       Improve community knowledge and information of possible outbreaks and the steps needed to contain the infectious agent.  Through collaboration with local healthcare professionals, social media or television, provide hyperlinks to public health forums or available telephone numbers for social support services.  Community health nurses need to be well informed and educated in surveillance statistics of their local area in order to break the chain of infection.

References

Clark, M. J. (2015). Population and community health nursing (6th ed.).  Boston, MA: Pearson

     Chapter 3

Infection Prevention and You.  Break the Chain of Infection.  Retrieved from (professional.site.

     apic.org)

Prevention by Breaking the Chain of Infection.  Retrieved from (cdn.ps.emap.com)

Social Determinants of Health.  Retrieved from (healthypeople.org)

2) 

Social determinants of health can be connected with a person’s culture. The way that a person’s culture views healthy habits can impact their health. Social determinants of health can be defined as conditions that people are born and function in (Healthy People 2020, n.d.). Some examples of social determinants are the availability to meet daily needs (Healthy People 2020, n.d.). This means that a person access to healthy food, health care, safe housing, social support, etc. (Healthy People 2020, n.d.). I believe that social determinants of health can have a major development to disease. When someone has access to clean water, air, and food it can make a difference in the spread of disease. Florence Nightingale believed in this theory as well and made sure that soldiers had access to clean water, air, and food. Nightingale found that 10 times more soldiers died of “filth disease” than died of bullets (Markel, 2017). Nightingale believed that the reason so many soldiers died was because of the filthy conditions that they were living in. These soldiers did not have access to clean conditions during the war, if these soldiers were born in these conditions, I am sure that they would find that many of them would be sick throughout their life.

            The chain of infection is how infection is spread from person to person. The reservoir is where the infection normally lives and grows (Centers for Disease Control, n.d.). These reservoirs can be environmental, human, or animal. Next in the chain is the portal of exit. This is how the infection leaves a host. A mode of transmission is how a pathogen is spread from host to host (CDC, n.d.). A portal of entry is how the infectious agent enters a host (CDC, n.d.).  The final link is to have a susceptible host (CDC, n.d.). The Center for Disease Control (n.d.) suggests that preventing the spread of infection can be done by protecting the portal of entry, increasing a host’s defenses, and finally by eliminating at transmission. A community health nurse can help break this chain by studying the different parts of the chain of infection and how to adequately stop the spread of infection. If a nurse wants to break a link in the transmission, they can protect the way that the infection is spread. For instance, when at the hospital and a patient has an infection with a disease that can be spread by direct contact, we make sure to dress in gloves and a gown to make sure that we are protecting ourselves from the spread of disease. If someone in the community has an airborne disease like tuberculosis, the community health nurse can prevent the spread of infection by making sure the infected person does not leave their house.

Reference:

Centers for disease Control. (n.d.). Principles of epidemiology | Lesson 1 – Section 10. Retrieved

from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section10.html.

Healthy People 2020. (n.d.). Social determinants of health. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.

 

  

Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. 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 stop to complete the following: 

o Decision #1 

§ Which decision did you select?

§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.

§ What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

§ Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

o Decision #2 

§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.

§ What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. 

§ Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

o Decision #3 

§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.

§ What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

§ Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

· Also include how ethical considerations might impact your treatment plan and communication with clients.

Monica Bullock    1 posts   Re: Topic 3 DQ 1  Paz-Pacheco, E., Sandoval, M. A., Ardena, G. J. R., Paterno, E., Juban, N., Lantion-Ang, F. L., … Bongon, J. (2017). Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting. Primary Health Care Research & Development (Cambridge University Press / UK), 18(1), 35–49. https://doi- org.lopes.idm.oclc.org/10.1017/S1463423616000335  This study was done to assess the effectiveness of diabetes self-management in rural agricultural towns. It gives a great out line of how the programs were implemented and great statistics. This fits with the population that I deal with at my practicum sight. The down side is that the study was conducted in the Philippines. Not that the information is not valid it just makes it less relatable. On that not I think I would need more information for evidence based practice changes, something relatable to the US. For my capstone project I think it provides great ideas to solve the problem.  Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos, & Romeu Mendes. (2019). The Impact of a Community-Based Food Education Program on Nutrition- Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial. International Journal of Environmental Research and Public Health, (13), 2403. https://doi-org.lopes.idm.oclc.org/10.3390/ijerph16132403  This study focused on food based interventions. Educating the community on food and how it will affect the body. Randomly people were assigned a workout program and diet program then tested the knowledge of food nutrients through a questionnaire before and after to produce results. I think this is a good study to use because it shows how food is a major role in life style changes and the effects on A1C. The down side is the study data is confusion to read and it does only focus on a specific demographic, but it does apply to the question I want to answer. This would be relatable and with the support of another study would be great for evidence based change.  Prezio, E. A., Pagán, J. A., Shuval, K., & Culica, D. (2014). The Community Diabetes Education (CoDE) Program: Cost-Effectiveness and Health Outcomes. American Journal of Preventive Medicine, 47(6), 771–779. https://doi- org.lopes.idm.oclc.org/10.1016/j.amepre.2014.08.016  The study looks at how effective community based teaching programs are with minority and low income groups. Once education was initiated the participants A1 C was tracked for a year to observe for any improvements. Cost was also evaluated vs benefits. I think this is a good one study to use since in recent years I have seen these type of programs pop up in the community. The study focuses on Mexican American who are uninsured, a large part of my community population. I think this would provide enough for evidence based practice changes since it is relatable to my community.  Bielamowicz, M. K., Pope, P., & Rice, C. A. (2013). Sustaining a Creative Community-Based Diabetes Education Program: Motivating Texans With Type 2 Diabetes to Do Well With Diabetes Control. Diabetes Educator, 39(1), 119–127. https://doi- org.lopes.idm.oclc.org/10.1177/0145721712470605  This is an interesting one that take place in Texas and uses cooking as the way to have patients take action in the their own self-care. Using a free healthy cooking class offered to anyone that signed up participants were interviewed at the beginning to see what they viewed as healthy life style changes and cooking. A1Cwere also measured and glucoses levels. At the end of the classes the same things were measured to show improvement and more interest in self-care. This is a unique way to have patients take responsibility for their care through the food they prepare. The down side is the person has to have an interest in cooking and food. On its own I think this would have a strong argument for evidence based changes, but would be stronger with added support from a different study.  Aguiar, E. J., Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Young, M. D., & Callister, R. (2016). Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT. American Journal of Preventive Medicine, 50(3), 353–364. https://doiorg.lopes.idm.oclc.org/10.1016/j.amepre.2015.08.020  This study looks at the PULSE program which contains education on weight loss through life style modifications. It followed high risk men for one year to see if there was improvements in A1C and glucose with the implementation. The program is gender tailored and individually tailored. Weakens would be it only focusses on men, but still could provide good information on life style changes and the effects.

  

1-This is a tough topic.  Here you are, a working family, you are going to school to better yourself even further and you millions of others are still faced with these decisions about health care.  When you say you pray I know you mean that literally because our daughter is in the same boat.  My husband keeps talking about wanting to retire early but he just does not understand the cost of having good health care.  I will probably be working until I am 90 because I will be afraid of Medicare and not being able to afford good care.  Wish we had better answers but we are not getting anywhere fast…that’s for sure. 

  

2-The most important elements of the Affordable Care Act were to get more people insured, to keep costs down and to improve overall care and outcomes.  New laws were to make affordable health insurance available to more people.  The law would provide consumers with premium tax credits that will lower costs for households that qualify.  To qualify households must have incomes between 100% and 400% of the federal poverty level. Another component was to expand the Medicaid program.  This would now cover all adults with income below 138% of the federal poverty level.  In addition, the goal was to support medical care delivery methods designed to lower costs of health care overall.

As nurses, we need to continue to be innovators and continue our work in research.  We need to focus on continuing to improve on patient safety and improving quality of care.  Nurses need to continue to be lifelong learners and meet demands of a changing society.  We must also continue to raise the bar for education with advanced degrees.  We must continue to push for more diversity in our profession to keep up with our diverse society to make patients more comfortable.  We also need to continue to bring our ideas to the table and be leaders within our organizations.  As we foster interprofessional collaboration the patients will benefit from teams working more closely together to improve patient care. 

  

3-The key elements of the Affordable Care Act are the following: providing national access to healthcare coverage for the entire population from birth through retirement, this will provide coverage for about 94 percent of the American people, to improve quality, affordability and fairness of health insurance coverage, to enhance healthcare efficiency, quality, diversity and values, to reduce wasteful spending, and to improve public health by expanding clinical preventive care and community investments.

The Act focuses on improving public health by investing in primary health care, especially in medically underserved communities. It also increased insurance coverage for clinical preventive services and procedures. For instance, physical examination, annual wellness visits, well child visits, immunizations, screening exams, like colonoscopy, mammograms and cervical cancer, are all covered by insurance with no cost sharing. In addition, the development of a national preventive plan and the establishment of a Prevention and Public Health Trust Fund, to fund investments in communities that will improve public health. Further investments are being made to in school-based health programs, preventive oral health care, tobacco cessation and adding prevention planning to Medicare.

Nurses are play a vital role and a an extremely important driving force in the implementation of this law. By developing innovative care models like transition of care, home care, care management, and nurse managed clinics, nurses will improve quality of care and lower health care cost.  Also, participating in research to aid in scientific evidence-based practices which improves quality, safety and patient outcome. Advanced practices nurses help increase the availability of primary care providers and provide cost effective care. Lastly, nursing leadership will be needed to implement better workflows to reduce medication errors, improve quality and care coordination, and increasing access to medical care. For these reasons and many others, nurses are of upmost importance in the implementation process of this Act.

 

The benchmark assesses the following competencies:

3.3 Provide individualized education to diverse patient populations in a variety of health care settings.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Based on the feedback offered by the provider, identify the best approach for teaching. Prepare a presentation based on the Teaching Work Plan and present the information to your community.

Options for Delivery

Select one of the following options for delivery and prepare the applicable presentation:

1. PowerPoint presentation – no more than 30 minutes
2. Pamphlet presentation – 1 to 2 pages
3. Poster presentation

Selection of Community Setting

These are considered appropriate community settings. Choose one of the following:

1. Public health clinic
2. Community health center
3. Long-term care facility
4. Transitional care facility
5. Home health center
6. University/School health center
7. Church community
8. Adult/Child care center

Community Teaching Experience Approval Form

Before presenting information to the community, seek approval from an agency administrator or representative using the “Community Teaching Experience Approval Form.” Submit this form as directed in the Community Teaching Experience Approval assignment drop box.

General Requirements

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.