As an advanced practice nurse in South Florida, my area of practice will be geriatrics. The future of my practice will lead me to participate in a program such as the Community Care for the Elderly (CCE) program that is run by the Department of Elder Affairs, State of Florida (State of Florida, 2011). I feel strongly enough about helping elderly patients that if I cannot make this a paying job, I will volunteer for such a program.

Many elderly patients find themselves in a nursing home due to financial restrictions and loss of specific functions. However, these patients are still very alive and deserve to have access to care with as little difficulty as possible – this means not having to travel and seeing them with less wait time than any other facility would be able to, since I will be coming directly to them. Being able to have these services where they currently live will help to create a safe space for them as they navigate the huge change from independent living to a community care living situation and to their new functional limitations.

Some of the specific interventions that I will do are weekly individual nursing appointments to address everyday concerns that may be separate from the reason they are in the nursing home and simply needs an active team member to connect the resources to the problem. I will also locate a psychological/psychiatric practitioner to come and have mental health wellness sessions with the residents to allow them to establish and feel comfortable with a new reality. Additionally, services would also be offered to family members caring with their elderly loved one. Caregiver stress will be addressed and mitigation to this issue would be a focus of my practice as well.  

State of Florida. (2011). Community care for the elderly (CCE) program. Retrieved from http://elderaffairs.state.fl.us/doea/cce.php

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Please answer to this discussion post w/ a minimum of 200 words. No plagiarism, APA Style and cited. Thanks!

                                              Reflective Journal

Learners are required to maintain a reflective journal integrating leadership and inquiry into current practice.

In your journal, reflect on the personal knowledge and skills gained in this course (Data Analysis) and address a variable combination of the following: new practice approaches, intraprofessional collaboration, health care delivery and clinical systems, ethical considerations in health care, population health concerns, the role of technology in improving health care outcomes, health policy, leadership and economic models, or health disparities. Outline what you have discovered about your professional practice and the personal strengths and weaknesses that have surfaced. What additional resources and abilities could be introduced to a given situation to influence optimal outcomes? Finally, how did you meet the competencies aligned to this course?

  In your own words and quoting the appropriate evidence-based references define what is family and the different types of family.  Please tell us what type of family do you belong?

2.   How do you feel that the value system differs from that of your parents? And from your grandparents? Why have these changes come about? As practicing nurses, why is it important to consider these generational differences in values and beliefs?

3.  Discuss traditional health beliefs & practices that have been passed down by families. Are these cultural or regional beliefs? Do you continue to practice any of the same things? Why or why not?

4.  How do you believe that family members and their upbringing have affected your own health or could affect a patient/individual’s health? Discuss positive & negative effects as well as physical, emotional & spiritual health. Give some examples.

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used and 2 replies to any of your peers sustained with the appropriate references must be posted.  Only the assignment must be attached in a word document in the forum, replies do not.  References must be no older than 5 years.  A minimum of 700 words is required

 Strategic Thinking Map: Recommendations

The next component of your Project is evaluating alternatives and strategic choice as part of the Recommendations section for your analysis. Using the Project Case Study provided conduct an evaluation of alternatives and strategic choice pertaining to your recommendations for this project. Your recommendations should be based directly on what you outlined in your assessment and include the following:

• Strategies for intervening in potential weaknesses and threats discovered in your market and SWOT analyses
• Strategies for attracting healthcare professionals and staff
• Feasibility for development satellite clinic
• Value-adding strategies, support, and resources (e.g., equipment, technology, etc.)
• Development of strategic initiatives

Consider the use of corporate-level, divisional-level, organizational-level, and unit-level strategies in your recommendations section and include a summary of key points.

For this assignment, develop a written report of your recommendations section and use the example strategic thinking maps from previous modules as a tool to assist with the different facets of the strategic planning process.

The map is to be used only as a supplement for your written recommendations.

Your well-written recommendations should meet the following requirements:

• Be 3-4 pages in length, not including the cover, abstract (optional), or reference pages.
• Utilize headings to organize the content in your work.
• Include the strategic thinking map in addition to/or as a part of the 3-4 pages of content.
• Include a minimum of four references with associated in-text citations. 
• Be formatted according to the APA writing requirements.

CASE STUDY

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CHIEF COMPLAINT: “I have been having dark stool and stomach pain for 3 days.”

HISTORY OF PRESENT ILLNESS: Mr. Marsh is a 32 year old who has been recently promoted to junior partner at a prestigious law firm. He is proud of his accomplishments at such a young age, and after being with the firm for a short time. He admits to feeling pressure and stress due to this new stage. He’s been having stomach pain for about a month, but it has worsened over the past few days. He reports that his stool has a dark, black appearance as well. Because of his hectic schedule, he does not really eat much, but when he does eat, he has a burning pain after meals. He takes medications for pain relief.

Prior to this visit, Mr. Marsh is healthy. His past medical history was for a tonsillectomy & adenoidectomy at age 10. Denies smoking, drinking or recreational drug use. He has annual check-ups as scheduled.

PHYSICAL EXAMINATION: AAOx 3. Well groomed, well nourished white male. Vital signs: BP 110/80 mmHg, HR 100/bpm right arm sitting, RR-18/bpm, T 98.6

HEENT/SKIN: Head is normocephalic. PERRLA. Tympanic membrane pearly gray. Patent nares. No bulging turbinates. Neck supple, trachea midline. Pallor of face. Mucous membranes moist, intact.

CARDIOVASCULAR: Lungs are clear to auscultation and percussion. S1, S2. No murmurs, bruit or thrills. Peripheral pulses are present but are rapid and weak.

ABDOMEN/RECTUM: To be completed by the nurse.

Rectal examination revealed black, tarry stool.

LABORATORY TESTS: Hemoglobin 9gm/dL, Hematocrit 27%, MCV 90. WBC 13,000/mm. PT/PTT – normal. BUN 12 mg/dL, Creatinine 0. 8 mg/dL. EKG-normal sinus rhythm, Chest x-ray -normal. X-ray of abdomen (kidney, ureter, bladder-KUB) is unremarkable.

1. What are signs and symptoms of anemia?
2. What is rebound tenderness? Guarding?
3. What do the vital signs reveal?
4. What would your abdominal assessment reveal? (Think IAPP)

a.Inspection-

b. Auscultation-

c. Percussion-

d. Palpation-

5.What medication could have contributed to his symptoms?

6. What is the diagnosis?

7. What medication regimen would be ordered for treatment?

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DISCUSSION

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Please write 1 paragraph for each of the following (total 3 paragraphs) and each paragraph shall be no more than 6 sentences.

*** Minus 1 point for extra long paragraphs or over 9 sentences.

(Make sure to post in the assignment & discussion tabs)

1. What is the difference between osteoporosis, osteopenia & osteomalacia?

2. Name 3 treatments for osteoporosis.

3. For what reason would a wrench need to be readily accesible for a patient on an orthopedic unit?

4. What is the proper order/sequence to assess the GI system?

5. Name one medication that affects the oral cavity (i.e. gums).