Comment 1

The role of health care reform in shifting the focus from a disease-orientated health care system toward one of wellness and prevention is to avert disease in the public. One of the ideal choices is to promote and encourage good health within groups of people across ages, gender, ethnicity, race, and social economic status. Health care reform, in this context, can strive to help people change the social behavior. Help care reform can enhance people’s ability to care for their health. They can lessen health disparities within the population. In the meantime, help care reform targets non-help care policy that impact people good health. That is, decisions related to social, economic, housing, nutrition, and environment might have a direct effect on wellness and prevention.

 In terms of prevention, health care reform can converge health care practitioners’ attentions and the public’s focus on screenings, immunizations, counseling, and disease management to avert complications. This will encourage health care professional to always encourage patients and their loved ones to take preventive measures and steps to avert unhealthy circumstances in their lives.

                       The profession of nursing has the obligation to educate nursing students and current nursing practitioners to understand the benefits of wellness and prevention in the practice of nursing. Nurse spend most of their working times with patients than any other health care professional. They are the first who witness patients’ calamities. This makes them more apt to embrace this shift because integrating prevention in their practices can avert acute and chronic diseases, and other non-desirable health conditions. Nurse can participate in consumer education or awareness campaigns for the good of society.

Comment 2

n 2010, the Affordable Care Act became law, and the law aims to improve the health care system of the U.S. by widening the health coverage to more Americans and by protecting existing health insurance policyholders (Nordqvist, 2016). Cherry & Jacob (2016) state that the ACA is expected to provide insurance coverage for 32 million previously uninsured Americans. America faces the increased medical expenditures which can be the burden of the American economy.  Moreover, the shortage of health care providers and facilities, as well as the rise in health awareness also alter the care from the treatment of disease to health promotion and disease prevention. As a result, health care reform plays an important role to lead the way in determining the type of providers needed to care for patients (Cherry & Jacob, 2016).

The shift from disease-oriented healthcare towards wellness and prevention provides a health resource to assist in creating a balance to promote health and cure disease. “Health care is a human right and that all persons are entitled to ready access affordable, high-quality health care service” (ANA, 2008). Restructuring the health care system will reinforce and ensure universal access to health care. The primary focus points are affordability, availability, acceptability, and quality of care. Access to care alone is not enough if the quality of care and safety is not satisfactory. A restructured health care system must provide dependable, high-quality care across the country.

There are six specific aims described to raise the quality of care that includes: Safe health care, Effective health care, Patient-Centered Health Care, Timely Health Care, Efficient Health Care, and Equitable Health Care. These aims of health care are essential to the nursing staff because many outcomes are associated with the care provided by the nursing staff. It is our job as nurses to positively embrace the change in health care reform and implement the changes with the highest standards. The agenda for the shift in health care reform can be considered a new step in health care and requires all associated with health care to participate.

Comment 3

Two-thirds of American adults are overweight or obese. Americans get less exercise, spending work and leisure time in from of screens. Diabetes and other chronic diseases are on the rise, a leading driver of escalating medical care costs. More and better medical care will not fix this countries declining health status or slow the rising costs of health care. History and science show that a multifaceted public health effort, including delivery of clinical preventative services, to protect the nations health. America must invest in the policies, programs, community environments and preventative care that are known to protect and restore health. By doing so, this can lower the disease and disability resulting in a decrease in the cost of expensive medical treatment in the future.

Three major reforms re required to make prevention and wellness the cornerstone of national policy.

1. Provide consistent policy leadership that advocates for and funds mutifaceted approaches to prevention and wellness.

2. Strengthen the ability of the public health system to facilitate and provide community-based prevention, health promotion, and early detection of disease.

3. Assure that all Americans have access to recommended clinical preventitive serices.

Nurses are on the frontline for providing valuable education to patients, the public and communities relating to nutrition, exercise and disease prevention. Health promotion should be done everywhere, at every level of our health care system. Nurses are innovative and know how to expand car and improve quality at a lower cost. Emphasizing the use of master-prepared nurses to oversee care from the hospital to within the home reduces hospitalizations.

Answer Sheet:

Variables

1. List the major study variables, and categorize them as research variables or independent and dependent variables.
2. Discuss how well the variables reflect the concepts from the theory framework.
3. List the demographic variables measured in the study, and any extraneous variables identified by the authors. Evaluate whether or not there are missing demographic variables, in your opinion. 

Research Design

1. Identify the specific study design. Explain whether the design was appropriate to answer the study’s research questions/ hypotheses. 
2. Briefly describe the study procedures, including recruitment, screening for eligibility, consent, timing & method of measurement of demographic & key study variables, and intervention, if applicable.
3. Discuss the clarity of description of study procedures. In other words, could another researcher replicate the study using the procedures described in the article? 
4. If more than one group was included in the study, explain how participants were assigned to groups.
5. Describe any threats to design validity mentioned by the authors.  If they did not describe that, then say so.
6. Describe the limits of generalizability (external validity). 

Population, Sample, & Setting

1. What was the population for the study?
2. Identify the specific sampling method used for the study. Discuss the adequacy of the sampling method for producing a sample representative of the population. 
3. Discuss potential biases with the sampling method used.
4. Identify and evaluate the inclusion and exclusion criteria used in the study.
5. Discuss how the planned sample size was determined (including power analysis & consideration of potential attrition if included).
6. Discuss actual sample size attained for the study, including acceptance rate, refusal rate, and attrition rate.
7. Describe study setting and its appropriateness for the study.

Reference List

 

Note: You are required to complete this discussion before submitting the unit assignment.

For this discussion, complete the following:

1. Describe the background of your study.

2. Demonstrate how answering your research question will advance scientific knowledge base.

3. Discuss the implications and contributions of your study to your specialization.

4. Be sure to include in-text citations from the academic literature on your chosen topic.

Once you have received feedback from other learners, complete the unit assignment based on your revised discussion post. 

Readings

Use your Qualitative Inquiry and Research Design text to complete the following:

Review Chapter 3, “Designing a Qualitative Study.” Focus on the subsection, “The Design Structures of a Plan or Proposal.”

Read Chapter 6, “Introducing and Focusing the Study,” pages 127–146. 

      a.  Focus on the following subsections:  

              1. “Introducing and Focusing the Study.”

              2. “The Research Problem Statement.”

Review Percy, Kostere, and Kostere’s 2015 article, “Generic Qualitative Research in Psychology,” from The Qualitative Report, volume 20, issue 2, pages 76–85.

Library Search

Use the library to conduct a brief literature review related to your chosen topic, in preparation for describing the background and addressing how the research  question will advance the scientific knowledge base. You will use this literature review in the unit discussion.

Read the Transcript –  Qualitative Research Proposal 

This illustration help to guide you as you develop the various components of your course project. Boxcars are added to the train as you progress through the course. Each boxcar provides information regarding the development of

individual components of a research proposal.

INTRODUCTION – Advancing Scientific Knowledge, Implications, and Contributions

When choosing a topic for the development of a qualitative study, it is essential that the topic meet the criteria of advancing scientific knowledge within the academic discipline. The issues that need to be addressed are the following:

Will the study advance the scientific knowledge base?

Is the study grounded in the discipline?

Does the study address something that is not known, something that is new or different from prior research, something that extends prior research, or something that fills a gap in the existing literature?

What are the theoretical and practical implications of the study?

How does the study contribute to the discipline?

OBJECTIVES

To successfully complete this learning unit, you will be expected to:

1. Identify components of scientific merit (advances the knowledge base, contributes to theories, and meets the hallmarks of good research).

2. Critically evaluate the individual components of scientific merit of research studies.

3. Demonstrate how answering a specific research question will advance scientific knowledge base.

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Patient safety and infection control (Chapter 27 and 29)

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Question 1Points: 4.00

1. How does safety help contain costs as well as reduce illness and injury?
2. Which environmental hazards can pose risks to a person’s safety.
3. Which preventive actions are in place for motor vehicle accidents, poisoning, falls, fire, and disasters(Remember immunizations, hand washing etc…..)
4. How does the patient’s developmental stage create threats to safety?

Question 2Points: 4.00

1. Review what to assess to ensure the safe use of restraints.
2. What are the four categories of safety risks in a health care agency? 
3. Basing your answers on the four categories, what ways can, you as a new RN, can prevent accidents in your agency?
4. What are the blocks to safety in a health care setting?

Question 3Points: 4.00

1. What is the relationship between chain and transmission of infection
2. What factors place a patient in a health care setting at risk for infections?
3. What are the most common ports of entry and exit, What does an organism require to exist within a reservoir?
4. How does the human body defend against infection?

Question 4Points: 4.00

1. Discuss age, nutritional status, stress, and the current disease process as risk factors for infection.
2. What is the difference between a systemic and localized infection?
3. How do chronic diseases such as diabetes and multiple sclerosis affect the risk of infection?
4. Define and contrast surgical asepsis with medical asepsis.

Question 5Points: 4.00

1. Explain standard  precautions and give two examples of diseases transmitted via blood 
2. What is the difference between hand washing and hand hygiene?
3. Discuss laboratory tests that screen for infection
4. Describe the needed steps and precautions for applying a surgical mask, sterile gown, and sterile gloves.

Question 6Points: 4.00

1. Discuss isolation, isolation precautions, and associated procedures.
2. Review contact, droplet, and airborne precautions and protective environment.
3. For each type of isolation, what precautions should you take?
4. What are the psychological implications for isolation?

Question 7Points: 1.00

1. Describe occupational exposure and the situations and actions that put health care workers at risk.
2. What measures can you as a new RN take to avoid occupational exposure
3. Once a healthcare worker is exposed, describe the post exposure process 

1. What are your upcoming week’s specific learning goals and objectives as a Case Manager?
2. What is your upcoming week’s detailed schedule at your community practice experience placement?
3. Were there any placement items/issues that occurred this week that you feel your instructor should be aware of that are private in nature and are more appropriately shared here than in the discussion board with your classmates?
4. Give a brief description of an objective you worked on this week. Make sure to cite at least one reference showing how your objective relates to the public health knowledge you’ve studied during this course or the public health course. You may choose to reference your e-text, journal articles, or videos you’ve studied during these courses or you may find an outside reference on your own to further enhance your public health knowledge and practices.

Remember, your journal entries are an important aspect of clinical learning as they serve to help you reflect upon and get the most out of your community practice experience. Therefore, your journal entry should include the who, what, where, and when of your community practice experience. Remember, this should simulate a dialogue that would normally take place face-to-face with your community practice experience instructor.