Write a three (3) to four (4) page double spaced paper in APA format discussing the findings on your specific topic in your own words. Note – paper length does not include cover page or References page.

iv. Structure your paper as follows:

a. Cover page

b. Overview describing the importance of the research topic in your own words

c. Purpose of Research of the article in your own words

d. Review of the Literature summarized in your own words

Comment1

According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace?

Sepsis is a major cause of hospitalization and death throughout the world, the hospital I work out has a screening process that we as nurse must assess the patients every 4 hours for signs of sepsis. The symptoms can be easily overlooked, and death rates continues to increase for septic shock. The point of the screening is to recognize early signs of septic shock and initial treatment right away. Patients, BP, heart rate, respirations, temperature and wbc indicates to the nurse if patient has a positive screen for sepsis, once the test is positive the nurse must obtain a lactated acid, blood cultures, and informed the doctor.

According to Birriel, 2013, Early treatment of sepsis, severe sepsis, or septic shock with quantitative fluid resuscitation has been shown to improve patient outcomes in multiple studies,(4,5) as has early treatment with antibiotics(5-8); however, to attain the greatest benefit from these therapies, sepsis must be identified as early as possible in its course.

Comment2

Few years ago, the facility that I work wanted all nurses to do hands off communication at bedside.  A lot of nurses were very reluctant to this change.  At some point the facility became very serious about it and wanted all the nurses to implement it. Now not only we have to give report at bedside, we have to wake patients and families up, so they can participate.  I found it very interesting and proficient.  It takes less time to give report, good for patient safety, patients and families are less anxious and ask less questions afterward because they know the plan of care for that specific day, and help nurses not to forget to pass on any relevant information to the patients’ cases.  This is what two authors have to say about bedside report:  “In traditional shift to shift reporting, nurses spend the end of their shift (and often into overtime) transcribing or taping a report for the oncoming nurse, who then spends the first portion of his or her shift reading the notes or listening to the tape.  Bedside shift reporting saves time and allows the incoming nurse to ask questions. It also improves patient safety by involving the patient and ensuring patient and caregivers are on the same page.” (Hendren, 2010).  “Conducting nurse-to-nurse shift report at the bedside, in the presence of the patient puts the patient central to all care activity information (Anderson & Mangino, 2006).  It allows the introduction of the incoming nurse by the outgoing nurse to the patient and the family.  Being in the room, helps incoming nurse to ask questions, visually see all medicines that the patient is having.  Bedside reports also provide the opportunity to reassess the patient’s goals from the prior period and update the goals as needed. Anderson and Mangino (2006) observed increased patient, staff, and physician satisfaction as well as financial savings after implementing bedside shift report.” (Manning, 20036).

To Prepare:

• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

 Incorporate challenges you would anticipate for the proposals in the write up below, as well as arguments to overcome those challenges. Should be 200 to 400 words:

 There are many Americans who are unable to afford quality healthcare in the U.S. health system. This is due for many reasons. There are about two million Americans who fall into the insurance coverage gap. These individuals make slightly above the annual income requirement for Medicaid but are still living in poverty and are not covered by the ACA (Garfield, Orgera and Damico, 2020). The original intent of the ACA was to expand Medicaid and the Children’s Health Insurance Program to provide coverage to millions of uninsured, low-income Americans (Understanding the ACA, 2019). However, a supreme court ruling in 2012 allowed states to opt out of the expansion of Medicaid. 18 states, primarily southern states did not adopt Medicaid expansion, leaving many Americans remaining uninsured.
Medicaid expansion or adjustments of Medicaid qualifications is a public policy that needs to be changed to improve quality of healthcare. Uninsured rates rose in the 18 states who did not expand Medicaid and individuals of low-income uninsured rate rose from 21-25% (Mills, 2018). Hospitals have a choice whether to treat uninsured individuals. Many times they do treat them but the hospitals do not always get reimbursed for those healthcare costs (Mills, 2018). Most individuals who lack insurance get most of their healthcare in emergency rooms. That not only increases healthcare costs, but also increases waiting times, resulting in compromised quality of care for everyone. With the expansion of Medicaid in those states who opted out of it, this would not only reduce healthcare costs, but would reduce waiting times in the emergency room as people would have the option to see their primary care rather than take up a bed in the emergency room.
Another public policy that could be used to reduce healthcare costs and improve quality is a single-payer or Medicare for all healthcare system. A single-payer system would grant everyone access to healthcare. Cai et al. (2020) conducted an analysis that shows savings from a single-payer system would outweigh the costs. This would grant all U.S. citizens the right to obtain healthcare. Individuals would be able to receive the preventative care, annual physicals and screenings and treatments without taking an emergency room bed from someone who really needs it. Granting the uninsured access to these services could also improve public health, resulting in less hospitalizations and healthcare costs annually.
The ACA had intended to improve quality of healthcare for everyone without significantly increasing expenses. Unfortunately, that could not happen nationwide due to a supreme court ruling that granted the states the opportunity to opt out of Medicaid expansion. If that court ruling had not happened, it is likely that millions of Americans would have been granted insurance or access to quality healthcare. If the republicans chose to replace the ACA without a similar or better healthcare plan, this could also result in more uninsured individuals receiving either no healthcare or poor-quality healthcare. There needs to be a public policy change for the U.S. healthcare system. Individuals should have a right to receive healthcare. Without insurance or any type of coverage, individuals cannot afford to be sick.