According to Russell et al (2017), diabetes is the seventh leading cause of death in the United States (US) and affects more than 29.1 million Americans.  Its prevalence is reported to have doubled in the last 30 years with disease management costing $245 billion each year (Russell et al., 2017). Not only does diabetes require life-long therapy, but it increases hospitalizations with an increased risk of strokes, heart attacks, kidney disease, and even amputations (Russell et al., 2017). This information is more national but has been added to show the comparison to the local area of Los Angeles, California. According to the Los Angeles County Department of Public Health, the population is 10,192,376. Of this number, 1 in 10 people have diabetes and 46% have prediabetes (Los Angeles County Department of Public Health [LADPH], 2017). Diabetes is also ranked the 7th leading cause of death in Los Angeles and in 2016 the cost of care was over $6 billion (LADPH, 2016 & 2017). Other health risks that increase with the diagnosis of diabetes as mentioned above and the cost of care for diabetes in Los Angeles puts a tremendous strain on the healthcare system. With statistics as such, the county of Los Angeles has to target the areas impacted and develop programs to assist with prevention and management.  The LAPDH seeks to identify barriers such as access to healthcare, disparities among groups, track health trends, and even compare LA County with national data with aims to decrease the prevalence of diabetes (LADPH, 2017). When providing care, consideration has to be given to early diagnosis and comorbidities. Nurses are having to take care of more patients with diabetes and other comorbidities associated with diabetes. The emergency room nurses see an increased amount of patients due to hyper/hypoglycemic episodes and more patients are being seen with dialysis initiation (Burner et al. 2019). These nurses are also educated/trained to approach patients of the Latino population as many refuse to get consistent care due to lack of documentation (Burner et al. 2019). This again affects the quality of care given to the patients because the emergency room is no place to try and manage this often chronic problem.

The LADPH is a major stakeholder in the diabetes practice problem. Along with the tasks identified above, the LADPH also partners with other organizations such as the Latino Diabetes Association (LDA). The LDA is important to LA county as the Latino population is one of the largest affected by diabetes (LADPH, 2017). I found it amazing that the LDA is partnering with Cal State L.A. Electrical and Computer Engineering and Computer Science Departments for a mobile app for Type 2 Diabetes (Latino Diabetes Association, 2018). I loved it because I had already read the article from Russell et al (2017) that produces great results from text-messaging to reduce A1c levels and improved patient outcomes. Another organization leading the way in L.A. County is UCLA. UCLA has the Gonda Diabetes Center which was founded in 2000. The goal of this organization is to educate patients, the public, and healthcare members about diabetes, provide diabetes care, and conduct diabetes research (UCLA Health, 2019).  Staffing there is a combination of physicians, dieticians, certified diabetic educators, and they partner with the Gonda Vascular Center (UCLA Health, 2019). There is also a large collaboration with cardiologists and nephrologists.

Diabetes is a major health concern in my setting. This Federally Qualified Health Center(FQHC) is in an underserved area with mostly Latinos and African Americans. These individuals make up the largest portion of the diabetes population in LA County (LADPH, 2017). If I had to take a guess, I would say over 60% of the patients have diabetes. The current practice is to give patients paper glucose logs for 1-2 weeks and have them complete self-monitoring and return to the appointment with the log completed. This is problematic because many do not return for appointments and when they do the logs are rarely ever completed. Although the forms are given in their language, many report not understanding the instructions. Of the few that attempt the paper log, it is rarely ever complete. There are often times or complete days missing. This makes it extremely difficult to manage the patient. As a provider, you do not want the patient going without medication but proper management is essential; even more when insulin is involved in treatment. I am looking forward to implementing lost cost interventions and knowledge that will improve patient outcomes in this setting.

Reference

Burner E, Terp S, Lam CN, Neill E, Menchine M, Arora S. (2019). Access to care, nativity, and disease management among Latinos with diabetes in a safety-net healthcare setting. AIMS Public Health. 6(4) 488-501. doi:10.3934/publichealth.2019.4.488. PMID: 31909069; PMCID: PMC6940585.

Latino Diabetes Association. (2018). Our programs. https://lda.org/

Los Angeles County Department of Public Health. (2016). Diabetes Continues to Increase in Los Angeles County. http://publichealth.lacounty.gov/diabetes/docs/Press_Release_Diabetes_Continues_to_Increase_in_LA_County_November2016.pdf

LA County Department of Public Health. (2017). Key Indicators of Health by Service Planning Area. http://publichealth.lacounty.gov/ha/docs/2015LACHS/KeyIndicator/PH-KIH_2017-sec%20UPDATED.pdf

Russell, N.M., Vess, J., Durham, C., & Johnson, E. (2017). Text-messaging to support diabetes self-management in a rural health clinic: A Quality Improvement project. Online Journal of Nursing Informatics, 21(2).

UCLA Health (2019). Gonda (Goldschmied) Diabetes Center. https://www.uclahealth.org/endocrinology/gonda-diabetes-center?utm_source=google&utm_medium=Yext

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO-THREE  SOURCES NO LATER THAN FIVE YEARS

Library Assignment #1 – AACN Essentials Paper Due Saturday

The purpose of this assignment is to provide a concise description and appraisal of the American Association of Colleges of Nursing (AACN) Essentials of master’s Education in Nursing. Following APA guideline, provide a brief explanation on each of the essentials reflecting on each essential affects the clinical practice and the author’s interpretation of each essential. Make sure to include a (Title page, abstract, introduction, body, conclusion, and reference page). 

Please find that AACN Masters Degree Essentials attached as a reference.

Upon completion. submit your assignment via Turn-it-in.com. Your plagiarism score must be below 20%. The utilization of paraphrasing or quotations with proper in-text citations will help lower your score. Refer to APA 7th ed.  guidelines. 

Title Page: Title of article, journal information, and your name and date. (1 point)

Abstract: Summary of an article (1-2 paragraphs). (1 point)

The Problem: (2 or 3 paragraphs). (1 point)

Is the problem clearly stated?
Is the problem practically important? What is the purpose of the study? What is the hypothesis?
Are the key terms defined?

Review of Literature: (1 -2 paragraphs). (2 points)

Are the cited sources pertinent to the study? Is the review too broad or too narrow?
Are the references recent?
Is there any evidence of bias?

Design and Procedures: (3-4 paragraphs). (2 points)

What research methodology was used? Was it a replica study or an original study? What measurement tools were used?
How were the procedures structures?
Was a pilot study conducted?
What are the variables?
How was sampling performed?

Data analysis and Presentation: (1 – 2 paragraphs) (2 points)

How was the data analyzed?
Did findings support the hypothesis and purpose? Were the weaknesses and problems discussed?

Conclusions and Implications: (2-3 paragraphs). (1 point)

Are the conclusions of the study related to the original purpose? Were the implications discussed?
Whom the results and conclusions will affect?
What recommendations were made at the conclusion?

What is your overall assessment of the study and the article?

Total 10 points (100%)

Im asking for 7 pages to develop the assignment. Due date: Wednesday 20th @8:00am. Please make sure it is Plagarism free (less than 20%). Use APA 7th ed. 

 

Instructions

Analyze: Discourse Communities

Evaluation Title: Discourse Communities 

Before starting a research project it is imperative to recognize your discourse community. This will lead you to suitable places to conduct your research and will assist you in communicating with your audience in a language that they recognize and relate to.

To complete this assessment, consider the discourse communities or groups of people with whom you share common interests. Consider the individuals that discuss topics important to the group.

• List all learning and social discourse communities that you are a member of.

Respond to the questions below in an essay that provides an analysis of your discourse communities.

• What topics of discussion, issues, problems, or concerns keep these communities together? What constitutes new knowledge for your group? Is it created experimentally, through discussion, or through a combination of these two and other methods?
• How would you characterize the kinds of language which each of these communities uses? Is it formal, informal, complex, simple, and so on? How are the community’s reasons for existence you listed in the first question reflected in their language?
• When you entered into the community, did you have to change your discourse, both oral and written, in any way, to be accepted and to participate in the discussions of the community?
• Does your community or group produce any written documents? These may include books, professional journals, newsletters, and other documents. What is the purpose of those documents, their intended audience, and the language that they use? How different are these documents from one community to the next?
• How often does a community you belong to come into contact with other intellectual and discourse groups? What kinds of conversations take place? How are conflicts and disagreements negotiated and resolved? How does each group adjust its discourse to hear the other side and be heard by it?

Validate your statements and opinions with supporting evidence (citations and references) in APA form.

PLEASE FOLLOW THE  INSTRUCTION BELOW

ZERO PLAGIARISM

5 REFERENCES

 

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

• Evaluate clients for treatment of mental health disorders
• Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

• Decision #1: Differential Diagnosis
  • 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?
• Decision #2: Treatment Plan for Psychotherapy
  • 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?
• Decision #3: Treatment Plan for Psychopharmacology
  • 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 and their families.

 

Critical thinking activities

1. Your community is at risk for a specific type of natural disaster (e.g., tornado, flood, hurricane, earthquake). Use Nightingale’s principles and observations to develop an emergency plan for one of these events. Outline the items you would include in the plan.

2. Using Nightingale’s concepts of ventilation, light, noise, and cleanliness, analyze the setting in which you are practicing nursing as an employee or student.

3. You are participating in a quality improvement project in your work setting. Share how you would develop ideas to present to the group based on a Nightingale approach