Identify disparities in health among populations for a Healthy People 2020 health issue. For this assignment:

1. Describe the chosen Healthy People 2020 topic area and specific health issue.
2. Contrast causes of disparities related to this health issue within populations.
3. Propose a public health communication strategy to reduce disparity and promote health.
4. Outline a plan for the communication.
5. Describe an evaluation plan for the communication.
6. Create targeted communication for each population.
7. Reflect on learning through this project.

Submission Instructions:

• The paper is to be formatted per current APA, be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
• The paper is to be 5 – 7 pages in length, excluding the title, abstract and references page.
• Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
• Journal articles and books should be referenced according to current APA style.

Turn it in report needs to be less than 10%.

 

https://www.medpagetoday.com/blogs/themethodsman/69237 (link)

Chapter 5 tackles the subject of physician employment.  The employment of hospitalists is a growing trend.  For this assignment, you will read this article, (Links to an external site.) then answer the following questions regarding the use of hospitalists versus primary care physicians as care providers for admitted patients.  Before reading the article, make sure to read the section in Chapter 5 “Employment and Earnings of Physicians”.  After reading the article and the text, answer the following questions in 300 words or more in paragraph format (5 or more sentences, correct spelling a grammar, one or more paragraphs).  Do NOT respond in questions and answer format.  Thoughtfully respond to one or more classmates after you submit your original post.  Remember to use your own words.  There are comments at the end of the article; don’t make the mistake of plagiarizing their words.  I want your opinion, not someone else’s.

• What is a hospitalist?
• What is the difference between a hospitalist and a primary care physician?  
• Why is the number of hospitalists growing?
• What did the results of the study indicate?
• Although the study has not been replicated for reliability, what did you learn from the study?  How did the results make you feel?  
• If the study is repeated and the results turn out to be reliable, what changes would you recommend?  If you do not recommend changes, explain why.

Capstone project paper:  The paper has to focus on infection control topic utilizing evidence based research  

The paper has to be written in APA format, have a minimum of five academic scholarly journal articles used to support proposal. The final paper should be at least 3 pages long with maximum of 5 pages. This is a continuation of Assignment # 1

 

0130: Admission nurses note (RN): Client arrived via EMS from long-term-care for evaluation of “low blood sugar.” Pt. arrived confused (alert and oriented X 1) and is a known diabetic. Finger stick was 45. Orange juice and crackers, given repeat finger stick 104. Pt now alert and oriented X 4. Report from the charge nurse at the long-term-care facility indicates that the client has been having frequent bouts of hypoglycemia.

0530: (RN) Foley catheter inserted for incontinence–pt. “too weak” to get up to the bathroom and is experiencing bouts of incontinence.

600 mL clear yellow urine noted. The nurse indicates that the ER is “very busy” and “short-staffed.” 0545 (Admitting Physician) See history and physical. Pt. admitted to the medical-surgical service for evaluation of recurrent hypoglycemia.

View the ER chart before the pt. is transferred to the floor:

0730: (RN) Report is given to RN on 3 North.

Emergency Department Chart

Client: Mabel Simpson

DOB: 4/23/1941

Admission Date 8/16/2019

Medical Diagnosis: recurrent hypoglycemia

Allergies: None

Vitals/ Data Collection: Temp.- 97.3 PO

History: Diabetes (insulin dependent)  

Medications: Insulin R titrated to finger sticks

Allergies: None

Vitals/ Data Collection: Pulse- 68

History: Hypertension

Medications: Furosemide 20 MG twice per day

Allergies: None

Vitals/ Data Collection: Respirations- 18

History: Atrial Fibrillation

Medications: Warfarin 5 Mg Mon, Wed, Fri 2 Mg Tues, Thurs

Allergies: None

Vitals/ Data Collection: Blood Pressure- 122/86

History: Rheumatoid Arthritis   

Medications: Enalapril 5 Mg once per day

Allergies: None

Vitals/ Data Collection: No C/O pain

History: Mild Heart Failure (class 1)

Medications: Proventil inhaler as needed for wheezing

Allergies: None

Vitals/ Data Collection: Alert and oriented X 4

History: Former Smoker- smoked 1 pack per day X 40 years- last smoked 10 years ago

Medications: Methotrexate 2.5 Mg per day

Allergies: None

Vitals/ Data Collection: Lungs: No adventitious sounds

History: Appendectomy as a child

Medications: Tylenol 650 Mg as needed for pain or fever

Allergies: None

Vitals/ Data Collection: + Bowel sounds

History: Mobility (baseline): able to ambulate slowly with minimal assist

Clear yellow urine draining from Foley catheter in adequate amts.

Medications: 

Allergies: None

Vitals/ Data Collection: Clear yellow urine draining from Foley catheter in adequate amts.

History: 

Medications: 

Allergies: None

8/16/2019

10:00: (RN) Pt received on 3 North. Alert and oriented X 4. Fingerstick 81. Eating breakfast. Offering no complaints.

8/17/2019 (Medical Assistant)

0130: Sleeping Soundly

0700: (LPN) alert and oriented Finger stick 124. Offering no complaints. Medications given as ordered. Foley catheter draining cloudy yellow urine- RN notified.

1100: (Case Manager note): Pt. alert and oriented. Blood sugar stable. Will speak to the physician about discharge tomorrow morning.

1300: (Physical Therapy): Ambulated to the hallway 200 feet. Ambulates slowly- baseline as per long-term-care facility charge nurse. Recommend physical therapy after discharge, however, ambulated well enough for discharge.

1600: (LPN) Pt found to be confused (alert and oriented X 1). RN notified. Fingerstick 130. Vitals 97.5 (axillary), 110, 24, 98/64

1800: (Medical assistant) 400 cc’s emptied from catheter bag.

0100: (RN) Pt confused and combative. Attempting to pull out her IV and repeatedly removing her gown. Pt’s physician was paged- ordered Lorazepam 1 MG IM. Medicated as ordered and slept the remainder of the night with no incident.

0700: (RN) Pt awake and alert but combative. Finger stick-124. Vitals: 98.9 (axillary), 116, 28, 90/55

1730: (LPN) Unable to administer medication. Pt appears extremely confused. RN notified.

1200: (LPN) Pt’s daughter at bedside. Daughter indicates that her mother is not normally confused and is concerned that she may have had a stroke and notes that her mom feels “very warm.” RN notified. Foley catheter draining cloudy urine.

1230: (Medical Assistant) Vital signs: T 103.6 (rectal), P=130, BP=84/43, resp rate=28

1300: (RN) Rapid response called (because of the change in condition) and client transferred to the ICU.

Update: The client spent 3 days in the ICU but unfortunately did not recover.

Please answer the following questions:

1. Why did this client become confused and combative? (5-10 sentences)
2. What pivotal decision made in the ER directly caused this client’s worsening condition? (1-2 sentences)
3. What type of incontinence did this client have? Explain your answer. (5-10 sentences)
4. What factors in the client’s medical history contributed to the client’s change in condition? (5-10 sentences)
5. How did communication (or lack thereof) contribute to the poor outcome for this client? (5-10 sentences)