How can community health nurses apply the strategies of cultural   competence to their practice? Provide at least one example from each   of the following four strategies: cultural preservation, cultural   accommodation, cultural repatterning, and cultural brokering. What is   a possible barrier to applying the strategy/example chosen? Use an   example that is different than the postings of other students. This   example should include an evidence-based article that addresses a   cultural issue. Response should include an APA reference.

Three top healthcare issues with room for improvement in Rockford, Illinois, are opioid abuse, high blood pressure, and obesity (NYU Langone Health, 2021). Obesity is a significant contributor to multiple chronic diseases and metabolic disorders (Jakobsen et al., 2018). Chronic diseases accounted for most US healthcare costs and decreased productivity (Chapel et al., 2017). Global Burden of Disease researchers (Institute for Health Metrics and Evaluation, 2021) acknowledge that these diseases increase societal costs, morbidity, and mortality by limiting healthy days lived.

     Several national initiatives are underway that have a local impact on this burden of disease. The Substance Abuse and Mental Health Services Administration (SAMHSA) endorses using Medication-Assisted Therapy (MAT) to mitigate opioid abuse and the societal effects of chronic substance abuse (SAMHSA, 2020). The American Heart Association provides a comprehensive public health education program on steps to control high blood pressure to reduce heart disease and strokes (American Heart Association, 2021). The Centers for Disease Control and Prevention (2021) offers multiple interventions to reduce obesity in the Healthy People 2030 goals outlined by the Division of Nutrition, Physical Activity, and Obesity.

     Concerned voters could influence local policymakers to transfer these national initiatives to Rockford with an informed advocate, such as the DNP scholar. The advocate starts by building a grassroots coalition of the voting public to endorse specific improvements to existing health policy. Next, prepare a health policy brief, then research and contact the policymakers to open discussion. The brief should specify the problem and current policy while providing a rationale for change that includes the impact of the health problem on the constituency. Harnessing the power of multiple voters increases the likelihood that those in power will actively consider a policy change. Social media, like Twitter, can be used to build this coalition. My suggested tweet is #HealthyPeople 2030, #Healthy Rockford! Improve our community step by step! Healthy People 2030 | Data & Statistics | DNPAO | CDC (Links to an external site.)

     Dr. Riley presented her case to Congressman Aiken just as recommended. The DNP scholar was prepared and researched the issue and her audience’s stance on healthcare access. Dr. Riley met with stakeholders to inform discussion with the congressman on the impacts and relevance of improving access to transportation in her community. Dr. Riley introduced herself as a concerned health professional and advocate, presented the pros and cons of the proposed clinic bill, and stated appreciation for partial gains while remaining open to future improvements. She was thankful and expressed her willingness to offer professional support on future projects.  Dr. Riley’s approach left Congressman Aiken with a positive memory of Dr. Riley, specifically, and the profession of nursing and nurse practitioners as collaborative partners in health policy. She could have provided a business card, including email in parting. A follow-up email thanking the congressman would support this memorable encounter.

References

American Heart Association. (2021). Five steps to control your blood pressure. Five Simple Steps to Control Your Blood Pressure | American Heart Association (Links to an external site.)

Centers for Disease Control and Health Prevention. (2021). Healthy People 2030: Indicators and objectives align with DNPAO’s work. Healthy People 2030 | Data & Statistics | DNPAO | CDC (Links to an external site.)

Chapel, J.M., Ritchey, M.D., Zhang, D., & Wang, G. (2017). Prevalence and medical costs of chronic diseases among adult Medicaid beneficiaries. American Journal of Preventative Medicine, 53(6, S2), S143-S154. https://doi.org/10.1016/j.amepre.2017.07.019 (Links to an external site.)

Institute for Health Metrics and Evaluation. (2021). GBD Compare. GBD Compare | IHME Viz Hub (healthdata.org) (Links to an external site.)

Jakobsen, G.S., Smastuen, M.C., Sandbu, R., Nordstrand, N., Hofso, D, Lindberg, M., Hertel, J.K., & Hjelmesaeth, J. (2018). Association of bariatric surgery vs. medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA 319(3), 291-301. https://doi.org/10.1001/jama.2017.21055 (Links to an external site.)

NYU Langone Health. (2021). City Health Dashboard: Rockford, Illinois. Rockford, IL – City Highlights | City Health Dashboard (Links to an external site.)

Substance Abuse and Mental Health Services Administration. (2020). Naltrexone. Naltrexone | SAMHSA

I NEED A COMMENT FOR THIS DICUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE 3 SOURCES NO LATER THAN 5 YEARS

Literature Evaluation Table 

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. Being able to articulate the information and successfully summarize relevant peer-reviewed articles in a scholarly fashion helps to support the student’s ability and confidence to further develop and synthesize the progressively more complex assignments that constitute the components of the course change proposal capstone project.

For this assignment, the student will provide a synopsis of eight peer-reviewed articles from nursing journals using an evaluation table that determines the level and strength of evidence for each of the eight articles. The articles should be current within the last 5 years and closely relate to the PICOT statement developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. Use the “Literature Evaluation Table” resource to complete this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation 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.

You are not required to submit this assignment to LopesWrite.

AttachmentsNRS-490-RS-LiteratureEvaluationTable.docx

Sickle cell anemia 

I need 3 slides power point 

Include the following in the presentation:

a) A clinical description and definition of the disease or illness.

b) Pathophysiology and history of the disease or illness.

c) An explanation of the impact of this disease/condition on adults to the health care system and nursing practice. 

d) A description of the impact of this disease or illness during childhood. 

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

3) Mr. B is a 70 year old man who developed sub sternal chest pains radiating down his left arm while at home. he was taken to the ER via ambulance. His breathing was labored, pulses rapid and weak and his skin was cold and clammy. an ECG was done which revealed significant “Q” waves in most leads. Troponin level was elevated. Arterial blood was draw with the following results.

Ph 7.22

PCO2 30 MM

HG PO2 70 MM

HG O2 SAT 88%

HCO3 22 MEQ/LITER

1. Aside from the obvious diagnosis of MI, what is Mr. B’s acid base status and what caused this disturbance?

post your initial response by Tuesday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references  are required (other than text). Refer to grading rubric for online discussion.