Nur495journal W1

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Each week you will be expected to provide the following information to your community practice instructor through your journal entries:

  1. What are your upcoming week’s specific learning goals and objectives?
  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.

 
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Theoretical Frameworks

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By Friday (note this is a day later than uual) , post your initial response to the assigned discussion questions in the below Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University Online Library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

No later than by the end of the week, review and comment on the discussion question responses posted by at least two of your peers. Be objective, clear, and concise. Always use constructive language. All comments should be posted to the appropriate topic in this Discussion Area.

Discussion Question

Visit South’s online library and review these two articles.

  • Connelly, L. M. (2014). Use of theoretical frameworks in research. MEDSURG Nursing, 23(3), 187-188.
  • Green, H. E. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38.

Next, review the evidence you are collecting for your proposed study. Which theories have others cited? Are you seeing a common theme? Next construct a conceptual map p.  You can use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.  I am really interested in you identifying theories used in work about your topic .

Provide constructive, supportive feedback to your classmates’ posts

 
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Nur495reply

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prompt1

An issue or area of public health concern in my community is the incidence of childhood asthma and childhood asthma attacks. In Los Angeles County, 9% of children have been diagnosed with asthma (County of Los Angeles Public Health, n.d.). Asthma incidence affects disproportionately minorities with higher cases in Latino and Black children. Rates have increased over the last ten years in both Latino and Black children. Hispanic children are affected at a rate of about 8% where as Black children are much higher at a rate of 25% (County of Los Angeles Public Health, n.d.).  The issue is attributed to environmental factors such as second-hand smoking and pollution. To make an impact on this issue, community health nurses need to partner with different key players. Through collaboration and partnership, alliances can be formed with other entities to problem solve such as law enforcement, government officials, non-profit organizations and community members.  (Choi & Choi, 2012). Collaborations need to be formed with parents, school nurses, family planning, law makers, and medical providers. Efforts need to be focused on prevention through education to discuss triggers and dangers of risk factors.

prIssues of concern to the public’s health in my city are the high poverty rate and the uninsured population. The poverty rate and uninsured rate of my city are higher than the national rate. According to Data USA (2017), 15.1% of the population for whom poverty status is determined in Alhambra, CA live below the poverty line, a number that is higher than the national average of 13.1%. In 2017, the uninsured rate in my city was 10.1% and 8.8% was the national level. (Data USA, 2017) I believe the poverty rate and uninsured rate are connected because most uninsured people are in low-income (Tolbert et al, 2019)

Even after the affordable care act, some people in my city are still having trouble to get health care. Therefore,  the public health nurses should partner with the city, Medi-Cal, faith-based organizations, and some affordable care clinics to provide people more affordable health care insurances, free or low cost health care services, education about healthy lifestyle, job training, etc. I found out that there are 8 free health care clinics in my city, and they have been providing health care services to low income or uninsured people. ompt2

 
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Nur340reply

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prompt1

Climate change is a constant problem that the Los Angeles community has been and is currently experiencing. It has caused much damage to people and the environment, by temperatures rising and natural disasters. Climate change is a severe threat to everyone living on earth. The earth’s temperatures have been increasing over the years. According to Chartteriee, “ over the last 8000 years, Earth’s surface temperature raised by 1 degree Celsius only and the present rate of global temperature would rise by 2.5 degrees Celsius by 2050” (2019).

Another environmental condition that follows climate change is vector-borne diseases. Hotter temperatures can cause Vectors like mosquitoes and are an increasing concern in the Los Angeles Region. The Asian tiger mosquito, for example, is responsible for outbreaks of Dengue fever in Florida, Hawaii, Texas, and has identified recently in the San Gabriel Valley (publichealth.gov). This and other species of mosquitoes feed more frequently and breed more rapidly in warmer weather. Changes in the environmental patterns introduce human diseases that could not have been a problem before. For example, malaria is one of the vector-borne illnesses which is sensitive to long term climate change.

prompt2

Two environmental conditions that are most impacting the area where I currently live, Northern California, are climate change and wildfires. Climate change has been impacting California’s fresh water supply for many years now. Most of our fresh water comes from the Sierra Nevada snowpack which is now at only 14 percent of normal (Howard, 2014). The climate continues to get hotter and drier forcing farmers and cities to turn to reservoirs and groundwater which can only last so long (Howard, 2014). The lack of water and hotter, drier climates has resulted in larger and more frequently occurring wildfires (Howard, 2014). Wildfires have been plaguing not only Northern California but the entire state of California more so in recent years than they ever did in the past. This is largely in part due to climate change and the drier land we are surrounded by (Howard, 2014).

Good resources to obtain data regarding climate change and wildfires are the CA.gov website and the Cal Fire website. Both of these sites contain useful information regarding the impact of climate change on California, indicators of climate change, daily wildfire reports, and what you can do to help your community.

 
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Nur561reply1

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Collapse

While first-line treatments for mental health crises are typically medication and psychological therapies, lifestyle modifications can also be recommended when the patient has been stabilized enough to receive and retain information. Many of my adolescent patients suffer from anxiety and depression and have erratic sleep schedules as well as addictions to their cell phones and social media. These types of patients grew in numbers in the midst of the coronavirus pandemic where children were kept indoors and attended school online.  Adolescents started going to sleep later and waking up later, feeling less and less motivated to do well in their studies. I’ve had to encourage numerous patients to modify their sleep habits, one being to reduce exposure to light prior to sleeping, especially blue light from their smartphones (Sarris & Firth, 2018).

Two strategies used in the simulation that I use are encouraging the patient to ask questions and using the teach-back method to ensure that the patient understood what was taught. There were times where a patient misunderstood and repeated the information I presented incorrectly. I was then able to clarify and correct any misunderstandings by re-wording what I said in simpler terms and had them teach back until they had a good grasp of what was taught.

One of the biggest challenges I face when trying to improve health literacy in adolescent patients is their lack of insight into their current situation. Many of my patients tend to blame their parents for their situation, and while that may be the case for a good number of them, they create an emotional barrier to learning any lifestyle modifications.

reply2

I personally Always involve the patients and their families in healthcare decisions. I work with hospice patients and their families; their pain management is a priority. Because I deal with dying patients, we use opioids to manage pain. Over the years, I have had patient families telling me that they will not give the morphine. It is my job to educate them that just because the patient is on hospice, they don’t start taking the morphine right away; if their pain is managed with Tylenol, then they stay on that until they may need something stronger . Strategies I use that were mentioned in the simulation are active listening, medication reconciliation, and teach back.

 
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Nur561reply2

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reply1

In the African American society, they have more struggles then most, they are taught not stay quiet and not express things that “whites” would not like. “Individuals and families who are below the poverty level or lack adequate resources have limited access to health care services such as prenatal and maternal care, childhood immunizations, dental checkups, well-child care, and a wide range of other health promoting and preventive services” (Mandel,2013,page.32). These societies have been turned away and forgot for years, and the need help and assistance that can help improve their health.

Many of the health problems of Native Americans can be linked directly to the social and economic conditions described (Mandel,2013, page.33). Both African Americans and Native Americans suffer from the same stigma, the culture does not have enough to ensure safety and quality among all members. Native Americans have been turned away and forgot for years, and need help establishing their needs.

reply2

Asian Americans are individuals with origins in far East, Southeast Asia and Indian Subcontinent (U.S. Department of Health and Human Services Office of Minority Health, 2019). Asian Americans are most at risk for heart disease, stroke, cancer, and diabetes (U.S. Department of Health and Human Services Office of Minority Health, 2019). The CDC (2020) reports 11.7% obesity rate and 8.3% with poor health.

Latino/Hispanic Americans are individuals from Cuba, Mexico, South or Central America, Spanish Culture, Puerto Rico. Latino Americans have a much higher rate of obesity when compared to Asian Americans. The CDC (2020) reports over 48.4% Latino Americans are diagnosed with obesity. 20.1% are not insured, when compared to Asian Americans 7.4% do not have coverage. Latino Americans also have a leading cause of death of cancer, heart disease and unintentional injuries (CDC, 2020).

Both populations have similar health issues, but Latino Americans have a greater obesity rate than Asian Americans. Furthermore, Latino Americans have a greater percentage of individuals uninsured.

 
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Discussion.

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Ms. Martin is a 55-year-old woman who has been on HRT for 4 years. HRT was prescribed because Ms. Martin was experiencing vasomotor symptoms associated with menopause. Her last mammogram was 2 years ago and last pap was 5 years ago. Ms. Martin made an appointment with her nurse practitioner to discuss discontinuing HRT after hearing and reading news reports about the dangers associated with the medication. Except for the HRT, Ms. Martin is taking no medication other than a daily vitamin. She had a tubal ligation after the birth of her third child but has had no other surgeries or history of any medical conditions. Her father had cardiovascular disease and died of a myocardial infarction at 77 years of age. Her mother was diagnosed with breast cancer at 81 years of age. Ms. Martin does not smoke and rarely drinks alcohol. She likes to work in her garden but is not involved in a formal exercise program. She has gained about 10 pounds since menopause.

  • What evidence-based information will you provide to Ms. Martin regarding her concerns of HRT? Discuss the advantages and risks associated with HRT.
  • What are your recommendations for Ms. Martin? Will you recommend continuing or discontinuing HRT and why?
  • What alternative treatments for menopausal symptoms will you discuss with Ms. Martin?
  • Discuss the recommended screening tests, using the latest evidence based guidelines that Ms. Martin should have.
  • What health promotion, maintenance, and prevention education would be important to provide to Ms. Martin?

Do 2 pages

Provide references

 
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Clinical Global Impression Scale (CGI) I

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I need a response to this assignmen

2 references

Main Discussion Post

The Clinical Global Impression Scale (CGI) is one of the most widely used brief rating scales in mental health and pharmaceutical trials. The CGI is a standardized assessment tool that allows the clinician to rate the severity of illness, change over time, and efficacy of medication; while taking into account the client’s clinical condition and the severity of side effects. The CGI Scale is widely used in clinical psychopharmacology trials as an outcome measure. The CGI consists of three domains; Global Severity, Global Improvement, and Therapeutic Index. The Global Severity domain of the CGI is a single overall rating of severity of illness, which is rated on a seven-point scale rated from no mental illness to severely ill clients and change over time.  The CGI-Improvement is rated 1-7 from very much improved to very much worse (Jones et al., 2019).   This rating is based upon observed and reported symptoms, behavior, and function in the past seven days.  Symptoms and behaviors can fluctuate over a week; the score should reflect the average severity level during the seven days. The clinicians have many parameters to judge the severity of mental illness for clients in different settings.   However, the CGI is known for its ease of use and ability to track progress through time and is as effective as other more lengthy and tedious instruments (Jones et al., 2019).

The CGI was developed as a simplified global measure to reflect the clinician’s view of the client’s condition before and after initiating medication.  The CGI tool is used to measure mental illness (medical history, psychosocial circumstances, symptoms, behaviors, and impact on functioning) to diagnose clients and measure the client’s response to treatment. For example, the CGI correlates well to scales such as the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale to name a few (Jones et al., 2019).

The CGI is well established and may be used for all psychiatric disorders in all FDA-regulated and most CNS trials; and the non-researcher clinician can easily use it in practice. The CGI is appropriate for use in depression, schizophrenia, anxiety, other mental disorders, regardless of the population, drug, or study measures. The CGI tool may also be used for other disorders such as sleep apnea (Dieltjens et al., 2019). The CGI is a brief and easy tool that may be administered by the practicing clinician to study the progression of treatment while using professional clinical judgment regarding the illness severity over the clinical experience.

In conclusion, the Clinical Global Impression (CGI) is one of the most useful clinical tools available for monitoring outcomes across multiple clinically relevant domains, over time.  The CGI is valid, reliable, and easy to use. The CGI can be effectively and efficiently used across cultures, for clients of all ages and across socio-economic locations, and mental disorders.  The CGI scale allows the APPN to provide a more comprehensive treatment plan by creating a quantifiable measurement of symptoms and treatment efficacy. The clinician can monitor symptoms and improvement or lack of, to determine if the client is getting better or not throughout treatment.  Therefore, allowing the client and provider to make an informed decision providing patient-centered treatment utilizing evidence-based practice.

 
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Assessment 1 Instructions: Health Promotion Plan

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Assessment 1 Instructions: Health Promotion Plan

  • Develop a hypothetical health promotion plan, 2–3 pages in length, addressing a specific health concern for an individual or a group living in the community that you identified from the topic list provided. A hypothetical nonprofit group is highly recommended.
    • Bullying.
    • Home safety.
    • Fall prevention.
    • Immunizations.
    • Tobacco use (vaping, e-cigarettes, hookah, chewing tobacco, or smoking) cessation.
    • All assignments in the course are based upon hypothetical individuals or groups.
      For this assignment, you will plan for and enlist the participation of a hypothetical individual or group in a clinical learning activity based on a health promotion plan, addressing a particular health concern affecting these members of your community.
      Professional Context
      The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a clinical learning experience focused on health promotion associated with a specific community health concern. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation.
      Demonstration of Proficiency
      By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
    • Competency 1: Analyze health risks and health care needs among distinct populations.
      • Analyze a community health concern that is the focus of a health promotion plan.
    • Competency 2: Propose health promotion strategies to improve the health of populations.
      • Explain why a health concern is important for health promotion within a specific population.
      • Establish agreed-upon health goals in collaboration with participants.
    • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
      • Write clearly and concisely in a logically coherent and appropriate form and style.
    • Note: Assessment 1 must be completed first before you are able to submit Assessment 4.
      Preparation
      The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with a specific community health concern. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation.
      You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assignment (Assessment 4).
      To prepare for the assessment, consider various health concerns that you would like to be the focus of your plan from the topic list provided, the populations potentially affected by that concern, and hypothetical individuals or groups living in the community. Then, investigate your chosen concern and best practices for health improvement, based on supporting evidence.
      As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal Communications activity. The information gained from completing this activity will help you succeed with the assessment. Completing activities is also a way to demonstrate engagement.
      Please choose one of the topics below:
    • Bullying.
    • Home safety.
    • Fall prevention.
    • Immunizations.
    • Tobacco use (vaping, e-cigarettes, hookah, chewing tobacco, or smoking) cessation.
    • In addition, you are encouraged to:
    • Complete the Vila Health: Effective Interpersonal Communications simulation.
    • Review the health promotion plan assessment and scoring guide to ensure that you understand the work you will be asked to complete.
    • Review the MacLeod article, “Making SMART Goals Smarter.”
    • Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
      Instructions
      Health Promotion Plan
    • Choose a one of these specific health concern as the focus of your health promotion plan.
      • Bullying.
      • Home safety.
      • Fall prevention.
      • Immunizations.
      • Tobacco use (vaping, e-cigarettes, hookah, chewing tobacco, or smoking) cessation.
    • Then, investigate your chosen concern and best practices for health improvement, based on supporting evidence.
    • Identify populations potentially affected by this health concern. Determine what their related concerns may be and explain why addressing this health concern is important for health promotion.
    • Identify a hypothetical individual or community group among the affected population who would benefit from an educational session about your chosen health concern and associated health improvement strategies.
    • Identify expectations for an educational session, determining goals, and suggestions on how the individual or group needs can be met. The hypothetical audience needs to be described and the educational plan should be outlined. Health goals need to be clear, measurable, and appropriate for this activity.
    • Then, research and document their potential learning needs and health promotion goals.
    • Document Format and Length
      Your health promotion plan should be 2–3 pages in length.
      Supporting Evidence
      Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2020 resources. Cite at least three credible sources published within the past five years, using APA format.
      Graded Requirements
      The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
    • Analyze the health concern that is the focus of your health promotion plan.
      • Consider underlying assumptions and points of uncertainty in your analysis.
    • Explain why a health concern is important for health promotion within a specific population.
      • Examine current population health data.
      • Consider the factors that contribute to health, health disparities, and access to services.
    • Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.
    • Write clearly and concisely in a logically coherent and appropriate form and style.
      • Write with a specific purpose and audience in mind.
      • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
    • Before submitting your assessment for grading, proofread it to minimize errors that could distract readers and make it difficult for them to focus on the substance of your plan.
      Portfolio Prompt: Remember to save the assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
 
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Assessment 2 Instructions: Community Resources

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Assessment 2 Instructions: Community Resources

  • Research a selected local, national, or global nonprofit organization or government agency to determine how it contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.
    As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.
    Professional Context
    Many organizations work to better local and global communities’ quality of life and promote health and safety in times of crisis. As public health and safety advocates, nurses must be cognizant of how such organizations help certain populations. As change agents, nurses must be aware of factors that impact the organization and the services that it offers. Familiarity with these organizations enables the nurse to offer assistance as a volunteer and source of referral.
    This assessment provides an opportunity for you gain insight into the mission, vision, and operations of a community services organization of interest.
    Demonstration of Proficiency
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

    • Competency 1: Analyze health risks and health care needs among distinct populations.
      • Explain how an organization’s work impacts the health and/or safety needs of a local community.
    • Competency 2: Propose health promotion strategies to improve the health of populations.
      • Explain how an organization’s mission and vision enable it to contribute to public health and safety improvements.
    • Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
      • Assess the impact of funding sources, policy, and legislation on an organization’s provision of services.
    • Competency 4: Integrate principles of social justice in community health interventions.
      • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life within a community.
    • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
      • Write clearly and concisely in a logically coherent and appropriate form and style.
    • Note: Complete the assessments in this course in the order in which they are presented.
      Preparation
      Assume you are interested in expanding your role as a nurse and are considering working in an area where you can help to promote equal opportunity and improve the quality of life within the local or global community. You are aware of the work of several nonprofit organizations and government agencies whose work contributes to this effort in some way. You have particular interest in one of these organizations but would like to know more about how it contributes to public health and safety improvements. In addition, you would like to report the results of your research in a scholarly paper that you could submit for publication.
      As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.
      Then, choose the organization or agency you are most interested in researching:
    • American Heart Association.
    • World Heart Federation.
    • Peace Corps.
    • American Red Cross.
    • Habitat for Humanity.
    • United Way.
    • Doctors Without Borders.
    • The Salvation Army.
    • United Nations Children’s Fund (UNICEF).
    • Federal Emergency Management Agency (FEMA).
    • Centers for Disease Control and Prevention (CDC).
    • Department of Homeland Security (DHS).
    • Note: Remember that you can submit all, or a portion of, your draft research paper to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
      Instructions
      Research your chosen organization and submit a report of your findings.
      Document Format and Length
      Format your paper using APA style.
    • Use the APA Style Paper Template. An APA Style Paper Tutorial is also provided to help you in writing and formatting your paper. Be sure to include:
      • A title page and references page. An abstract is not required.
      • A running head on all pages.
      • Appropriate section headings.
    • Your paper should comprise 3–5 pages of content plus title and references pages.
    • Supporting Evidence
      Cite at least three credible sources from peer-reviewed journals or professional industry publications published within the past 5 years that support your research findings.
      Graded Requirements
      The research requirements, outlined below, correspond to the grading criteria in the assessment scoring guide, so be sure to address each point.
    • Explain how the organization’s mission and vision enable it to contribute to public health and safety improvements.
      • Include examples of ways a local and/or global initiative supports organizational mission and vision and promotes public health and safety.
    • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in the community.
      • Consider the effects of social, cultural, economic, and physical barriers.
    • Assess the impact of funding sources, policy, and legislation on the organization’s provision of services.
      • Consider the potential implications of funding decisions, policy, and legislation for individuals, families, and aggregates within the community.
    • Explain how an organization’s work impacts the health and/or safety needs of a local community.
      • Consider how nurses might become involved with the organization.
    • Write clearly and concisely in a logically coherent and appropriate form and style.
      • Write with a specific purpose and audience in mind.
      • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
    • Additional Requirements
      Before submitting your paper, proofread it to minimize errors that could distract readers and make it difficult for them to focus on your research findings.
      Portfolio Prompt: Remember to save the assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
 
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