1.  Discuss the historical trends and current conceptions of the cause and treatment of substance abuse.

2.  Describe the ethical and legal implications of substance abuse.

3.  Identify factors that influence violence.

4.  Identify at-risk populations for violence and the role of public health in dealing with the epidemic of violence.

As stated in the syllabus present your assignment in an APA format, word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 6 discussion questions”.  A minimum of 2 evidence-based references is required.  A minimum of 600 words is required!

Comment 1

Working in a hospital, or any type of medical facility, is not limited to one type of nurse or nursing education. Nurses with both ADNs and BSNs are typically employed at any number of facilities. Under the proper instruction and motivation, nurses can adequately perform the functions of their positions with ease. However, there have been studies which link patient safety outcomes and nursing education. Research from Weinberg et. al (2012) “links higher proportions of nurses with baccalaureate of science in nursing (BSN) degrees to lower patient mortality rates” (Weinberg et. al, 2012, p. 4). It is likely that nurses who have pursued a higher degree than the ADN simply receive more knowledge about specific interventions and procedures. From my own real-life experiences, I do not really agree with this research. Nurses who are compassionate, caring, meticulous and focus on the needs of the patients will generate positive outcomes for their patients. The contribution of the work environment and the use of interdisciplinary teams are essential to providing adequate patient safety. These factors must also be considered when making assertions regarding patient safety outcomes and nursing education. It is difficult to solely pin the claim that patient safety is lessened by the effects of lower education, separating it from all the other components which can contribute. 

Comment 2

Multiple studies were found that link patient safety outcomes to ADN and BSN nurses.  It is believed that one’s level education have a lot to say on how much he or she knows and how well he or she practices. In a study by Aiken, Clarke, Cheung, Sloane, & Silber (2003), it was concluded that changing the educational background of hospital nurses by increasing the percentage of those having a BSN or higher, would decrease substantially the mortality rate for patients that have surgery in general and for those developing complications.  A growing body of research suggests that hospital having a higher proportion of Nurses with a BSN on staff is linked to better patient outcomes, and other studies supported an association between BSN staffing and outcomes such as lower incidence of pressure ulcers, hospital acquired pneumonia, postoperative deep vein thrombosis and post surgical mortality rate (Robert Wood Johnson Foundation, 2013).

Although most nurses call to the profession are from a caring, compassionate nurse heart and the love for this profession, nurses also need to be prepared and have the knowledge to be able to fulfill this passion to the highest level of expectation. Researches that link patient’s safety and outcomes to ADN and BSN or higher level are based on real life experiences.  Nurses with higher education such as a BSN or higher, communicate better, they are better critical thinkers, problem solvers and are able to better assess and evaluate patients’ situations.  Although I am not done with my BSN, I had put into my current practice so much I have learned from my previous BSN classes. With a BSN level, nurses learn to give better care to patients with chronic illness and most importantly we learn to promote wellness and work toward disease prevention to prevent chronic illness; we learn to apply appropriate method to help our patients understand our teaching; we learn leadership and management skills and many more. BSN level helps nurses deliver care to a higher level while considering actions that impact health care costs and patients’ outcomes. BSN or higher help nurses deliver quality care to the patients to prevent complications and increase outcomes.   

Comment 3

“Nursing is unique among the health care professions in the United States in that it has multiple educational pathways leading to an entry-level license to practice” (Institute of Medicine ,2010). Associate nursing degree (ADN) is designed to be completed within two years. The main focuses are provision of patient care in a safe manner professional and ethical behavior, effective collaboration and application of nursing knowledge. Baccalaureate nursing program (BSN) is designed to be completed within four years. This program is designed to educate nurses with core and upper level courses. Nurses in this program are expected to function in basic leadership capacity after completion (American Association of Colleges of Nursing, 2017)

 Both BSN nurses and ADN nurses are trained to perform certain basic skills like medication administration and wound care for example. In any given situation that involved patient care both nurses are expected to critically think to improve the patient’s outcome. Whether having a BSN degree or ADN degree, saving lives are what all nurses are entrusted to do. Nurses have one of the most well respected professions. We are trained to critically think and administer care in the most severe situations. And almost all the time we rise to the occasion and beyond. As nurses we are always edifying ourselves because technology and medicine are always evolving; this only gives us the opportunity to prepared and produce the best nursing care possible for our patients in treating their illnesse

 

C. T. a 48-year-old male patient presents for a checkup.  He admits it has been 4 years since he has been seen by a medical professional and at that time was diagnosed with an upper respiratory illness. He did have his blood pressure takin a year ago at his employer’s health fair and was told it was a “little high”.

He has had no major illness or chronic diseases. He has no known allergies and does not take any regular medication.

His family history shows that is father died of a heart attack at age 68, his mother is alive and well at age 72, he has a 50-year-old brother with depression and alcoholism, and one son who is healthy at age 24. He did have a maternal uncle with prostate cancer.

On review of systems, he has occasional headaches, experiences shortness of breath when he walks upstairs, and gets up once a night to urinate.

• What should the major objectives of this health maintenance visit be?
• What conditions, risk factors, and health related behaviors should be screened for during this visit?
• What are the common causes of morbidity and mortality for 48-year-old men in the United States?

Read and respond to two of your peers posts. Compare and contrast your responses with theirs and discuss different perspectives.

Use correct APA formatting and in text citations to support your responses.

Please answer to this discussion post with a minimum of 200 words, APA Style, and no plagiarism. 

_______________________________________________________

Access to healthcare is a primal right of each citizen. The government has adopted various strategies to help make healthcare more affordable to citizens across all walks of life. Medicare and Medicaid are those strategies which the state has used in order to make sure that healthcare is accessible to all.

Medicare is a health program funded by the United States government which is available for its citizens, legal residents who have lived in the US for at least 5 years or persons that are above the age of 65 (Klosko, 2017). Medicare has been in existence for more than 50 years and has acted as a bedrock of health security to most Americans by providing essential health benefits that a majority of the patients need but cannot afford. Before it was launched, very few Americans could afford insurance in order to help pay their health bills. Insurance was not as accessible as it is today as it involved very high premiums (Biles, Guterman, and Casillas, 2016). In some cases, individuals were denied insurance due to age or a preexisting health condition.

One of the major reasons why Medicare is preferred to Medicaid is because it is structured to help the low income households who may be in dire need of health services but cannot afford. Medicare is categorized into two, that is Medicare A and Medicare B. Medicare is hospital insurance which covers inpatient services which is basically healthcare received in a health institution or nursing facility. Medicare Part B is medical insurance which covers outpatient services, laboratory visits and preventive care. Medicare is structured this way so that the beneficiaries can select their most convenient option (Klosko, 2017).

Other benefits of Medicare include low monthly premiums which are quite affordable. Another advantage is that it is broadly accepted in hospitals. In addition, it is also flexible when choosing a preferred healthcare provider (Biles, Guterman, and Casillas, 2016). As a result, I feel that Medicare has had a great impact to the people of Florida.

References

Biles, B. B., Guterman, S. G., & Casillas, G. C. (2016). Are Medicare Advantage Plans Lower-Cost Than Traditional Medicare? doi:10.15868/socialsector.25061

Klosko, G. (2017). Medicare and Medicaid. Oxford Scholarship Online. doi:10.1093/acprof:oso/9780199973415.003.0008

comment1

Prior to the passing of the Patient Protection and Affordable Care Act (PPACA) of 2010, the health care system was fragmented.  There was no one single entity responsible for the overall coordination and quality of a patient’s care.  The PPACA provides many provisions that seek to connect the quality of care with the cost of care.  It creates incentives for integrated care delivery models and pays for coordination and quality of care. One innovative care delivery model addressed in the PPACA is the accountable care organization (American Nurses Association [ANA], 2010).

                An Accountable Care Organization (ACO) is a collaboration of primary care providers, a hospital, specialists, and other health care professionals that accept joint responsibility for the quality and cost of patient care.  While ACOs are not new, the PPACA brought them to the forefront of new delivery models and provides the ACO with more leeway regarding who can lead them.  This permits greater nursing leadership and participation.  In fact, a key term in the PPACA is “ACO professional.” The law defines the ACO professional as a physician “and” a nurse practitioner, clinical nurse specialist, or a physician assistant (ANA, 2010).

  

comment2

In the PCMH, the team would know and care for the patient in their home. This would require a consistent and timely team work between team members. The use of electronic medical records increase the teams timely response and care. Also included with electronic care systems is the ability to request a consult from another team member. The progress, charting, labs and other pertinent information would be made available to each team member at all times. It is also imperative that nurses and physicians be able to contact a specialty physician. Getting to know who is on your team and being able to contact the specialty is important. Relationships need to be built or reinforced in order to provide quality care. In the PCMH, the care is focused on medical care given in the home (Haas, S., 2010). Patient-Centered Primary Care Collaborative (PCPCC) published an Annual Review of Evidence 2014-2015, in which it examined the cost measures and utilization of services. It was reported that PCMH care costs were lower and the health care quality had improved (Gross, A., 2016). The report continued to state that “The evidence continues to build that a high performing, patient-centered medical home – especially when supported by multiple, committed and aligned payers – is the foundation for a better performing health care system”. “…it [PCMH] can control costs and promote the right care” (Gross, A., 2016). The report continued to show evidence of improved health care, improved health for the client, decreased hospital admissions and emergency room visits. Overall, the quality of care was increased and costs decreased (Gross, A., 2016). Using  a telehealth with the RN as the point of contact increases the clients confidence at being heard. Some places call this form as a telehealth buddy, where the RN can triage, educate and counsel the patient (Haas, S., 2010). Telehealth systems are in place to compliment the home visits by the RN and helps the client to feel as though the health care team is always available to them without the traveling or long waits for doctor’s appointments.