Instructions:

For this discussion, you are to use the following website: https://www.census.gov/acs/www/data/data-tables-and-tools/data-profiles/2017/ (Links to an external site.)

• On the landing page, type in the name of your state and then the name of your city or place.
• Click on “Get Data Profile.”
• On the new page, you will see links to 4 sets of information on your area: 
  • Social
  • Education
  • Housing
  • Demographic
• Choose any two variables you think might be related and find them using the links to the related set.  In the tables, locate the variables you chose to work with. For example, you could use the number of rooms (in a house) under Housing and household incomes and benefits under Economy.
• Find the values for each of your two variables for several years. For example, you might use the number of rooms and household income for 2012- 2017.
• Use Excel to make a scatterplot and to find the correlation coefficient. You should then have 6 points on the scatterplot, one for each year.

Share your scatterplot and correlation coefficient in your post and use them to address the following in your discussion post:

• Why did you think a relationship exists between the two variables you chose? 
• Based on the Excel scatterplot and output
  • State what type of relationship exists:  Negative, positive, or none. 
  • Describe the relationship in words, including what happens to one as the other changes. For example, as the number of rooms in a house increases, does the family income increase?
• Does the statistical information you obtained support or refute your alternative hypothesis that a relationship exists?
  • How?
  • If you did not find a relationship, why do you think that is?
• What is the value of knowing there is a correlation between the variables? For example, what businesses might flourish in a wealthy area?   
• Would another variable better explain the relationship?  
• How might the city use such information to make improvements?  For example, if you found a relationship between crime and poverty, would it make sense to address poverty as a priority?
• Can you conclude that one variable is causing the other? Why or why not?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Estimated time to complete: 2 hours

Poverty Reflection Assignment 3

What role does your facility play in keeping people healthy? Would the Health Leads program work in your facility? Why or why not?

 While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. A conclusion section, incorporating recommendations for further research

 For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.

Potential topics may include:

•      Using prenatal and infancy home visits to prevent child abuse and neglect

•      Preventing falls in the elderly

•      Reducing population salt intake

•      Reducing tobacco use among adults

•      Preventing risky sexual behavior among youth and young adults

•      Reducing drug experimentation among young adults

Include the following in your paper:

• Introduction:
  • Provide an overview of the community health issue as described in Part A with identified causes and influences, including knowledge gaps. 
  • Detail the prevalence of the issue inside and outside the United States.
  • Describe potential monetary costs associated with the issue in the United States.
  • You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).
• Describe advance practice roles and management strategies that affect change at the community level.
• Identify key community and social resources that negatively and positivelyaffect the selected issue.
• Identify changes or enhancements in community-related services for your selected topic.
• Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.
• Conclusion:
  • A summary of the goals and challenges
  • An assessment of the outlook for action/progress
• Appendix A: Include your community assessment from Week 3 as Appendix A.

Your paper should be 3–5 pages in length (not including the cover or reference pages). Use APA throughout.

Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.

Case 3

• 16-year-old white pregnant teenager living in an inner-city neighborhood.

What are the barriers to interpersonal communication?

            As a clinician, interpersonal communication barriers when dealing with a 16-year-old white pregnant teenager are many. They include fatigue, anxiety and embarrassment, age difference between clinician and patient, and the patient’s values and beliefs (Bosworth, 2010). For one, pregnant adolescent patients might have a problem concentrating due to fatigue. Thus, gathering information from such a patient might be a difficult task for any clinician. When patients are not entirely concentrated on giving the correct information, accurately diagnosing and treating them will be a huge ask. Adolescent patients tend to be anxious or embarrassed about their condition, especially if it is an unplanned pregnancy. No one would feel comfortable getting undressed in front of a stranger, much less a teenage mom-to-be. Thus, anticipating embarrassment and finding a way to minimize it can help ease an uncomfortable situation.

            Also, everyone has their assumptions based on their culture or beliefs. A 16-year-old white pregnant teenager can genuinely believe that only a female nurse can attend to her and that men would not do a thorough job. The clinician should consider such assumptions before attending to the patient. This goes hand in hand with those adolescent patients who believe that junior staff can properly treat them. The age difference between the clinician and the patient can sometimes be an issue, especially if the patient feels she will not communicate comfortably with an older attendant. Lastly, a 16-year-old white pregnant teenager is most likely to be anxious or embarrassed about her condition. Teenagers may be hesitant to openly discuss their condition in the present of a parent, and my also feel guilty and worried about what their peers might think of them. Thus, the privacy and confidentiality of this interaction will be of utmost importance. 

What are the procedures and examination techniques that will be used during the physical exam of your patient?

            The 16-year-old white pregnant teenager will be taken through a geriatric assessment. However, since teenagers may hesitate to talk freely in the presence of their parent, the clinician should ask for permission on the patient’s behalf for the parents to be absent while the interview is being conducted. Also, the clinician should avoid any painful or intrusive procedures and do as much as possible with the patient still dressed and seated. The patient should also be asked if they prefer certain things done and whether there are specific movements they feel uncomfortable doing. For this patient, the first step will be to arrange for privacy, quiet, and any special needs since the physical examination will be affected by the environment’s quality. It will also be essential to make sure the patient is calm, relaxed, and adequately draped or gowned. The next step will be to conduct a general inspection and check for vital signs, and an eye and ear examination will follow this. An ophthalmo-otoscopy will then be undertaken before connecting the otoscope to the nasal speculum and examining the nares. A mouth examination will then follow before evaluating the face to examine symmetry and other details concerning motor divisions of the V and VI cranial nerves. For a young mother, a complete examination may be easier if it is divided into multiple sessions rather than taking the patient through hours of exhaustive tasks. The procedure will yield a more relevant and complete list of psychosocial issues, functional problems, or medical problems. Results will be thoughtfully integrated with the patient’s pathophysiology and history (Ball et al., 2015). 

Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.

           The Subjective, Objective, Assessment, and Plan (SOAP) is an acronym used in nursing to document patient’s data in a structured way. It provides clinicians with a framework for evaluating patients’ information. Also, it offers a cognitive outline that aids in clinical reasoning. Using the framework, nurses are able to assess, diagnose, and treat patients in an informed and reasoned manner. This paper aims to discuss S.O.A.P. approach in documenting patients’ data. 

           The subjective (S) stands for the patent’s experiences, personal views, and feelings. The component included here is chief complaint (CC), history of present illness (H.P.I.), and review of systems (R.O.S.). The patient chief complaint is a short statement of the patient purpose to visit the hospital. History of present illness describes the patient current situation or condition since the time that the symptoms for the disease started showing. It describes the condition in a narrative form. The review of systems compiles the pertinent and negative symptoms (Jenkins &David, 2019). 

           The Objective assessment (O) entails the documentation of information that the clinician observes from the current patients’ condition. This documentation covers vital signs, physical evaluation findings, imaging results, laboratory information, and other diagnostics data. Simultaneously, the assessment section entails the synthesis of evidence documented in the ‘subjective’ and ‘objective’ sections. This section records the assessment of the patient’s situation, how the problem behaves, and any changes in the condition. It is at this stage that the decision-making process is discussed in more in-depth details (Jenkins & David, 2019). Lastly, the plan (P) section documents what is supposed to address the patient’s concerns. This includes things like doing ordering referrals, additional testing, and consultations with other health care providers. Also, it documents the goals therapy, drugs, and procedures performed on the patient (Jenkins & David, 2019).  

Reference

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination . St. Louis, MO.

Bosworth, H. (Ed.). (2010). Improving patient treatment adherence: A clinician’s guide. Springer Science & Business Media.

Jenkins, M. L., & Davis, A. (2019). Transforming Nursing Documentation. Studies in health technology and informatics, 264, 625-628.

Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue?

What are the common barriers to evidence translation in addressing this problem?

     Diabetes is a significant burden in the United States and affects over 34 million people (CDC, 2020). As we continue to learn about this chronic and progressive illness, we have identified the lack of improvement in the management of the disease and the opportunities to close the knowledge gap in nursing practice. Studies have found many reasons contributing to the ability to translate evidence into successful solutions to this problem.  Two key limiters in evidence translation are the patient’s ability for self-management and nursing, and clinician, lack of diabetes knowledge (Alotaibi et al., 2017). Nurses require knowledge to teach diabetic patients and their families about their treatment plan and the risks of poor glucose management. However, many nurses are only skilled at the simple tasks of monitoring glucose levels and point of care treatments. They are often lacking knowledge regarding the underpinning of diabetes in relation to physiology and complication risks (Alotaibi et al., 2017).  Reasons for this include lack of instruction, inconsistent academic preparation, lack of resources in their work environment, and inadequate involvement in providing care to diabetic patients.

What strategies might you adopt to be aware of new evidence?

     In order to address diabetes education and knowledge in the organization, we would evaluate the accuracy of the problem (Tucker, 2017). First, there is the need to understand if there is a gap in our nursing practice of diabetics. This may include evaluating the theoretical understanding of diabetes and the pathophysiology, as well as managing blood glucose levels and reducing complication risks for patients. Various surveys of nurses could be performed to assess the perceived and actual knowledge in these areas. There would also be the need to perform rigorous literature reviews to access new evidence related to diabetes prevalence and treatment options.

     There would also be the need to gain insight as to the education currently provided to diabetic patients in our organization and what changes are necessary for improvement. We would need to include our nurses in this assessment as they bring experience, opinions, and clinical judgement that can contribute to our adoption of new evidence (Tucker, 2017).  

     An evaluation of the organizational culture would be necessary to ensure buy-in by other clinicians if changes are to be implemented. Utilizing interprofessional collaboration to set the foundation for new evidence-based practice can help to motivate the teams to improve patient outcomes while also influencing nurses to be more engaged in their new knowledge in caring for diabetic patients (Tacia et al., 2015).  Ensuring leadership engagement, sharing of values for EBP, and support and resources for frontline nurses will improve adoption of EBP into our practice (Dang & Dearholt, 2018; Tucker, 2016).

How will you determine which evidence to implement?

     Using a framework, such as the PARIHS, will allow us to evaluate the barriers to translating new evidence into our practice by evaluating which evidence is best as well as evaluating the organizational capacity and quality for implementation and change (White et al., 2016).  Evaluating my organizations readiness for change will help to develop the framework for the project and to determine not only if we can successfully change a practice but then to sustain such changes.  

     Next, we will work with key stakeholders and diabetic experts to determine what evidence is necessary to implement. We will use a methodical approach to researching, evaluating, and determining which evidence will improve our nurses’ knowledge of diabetes and which evidence will improve our organizations’ care of diabetic patients. We have learned about clinical practice guidelines (CPGs) as a source of EBP in the care of diabetics (White et al., 2016). 

     We will derive the plan through a systematic approach and allow for input into each step and process.  This will include a questionnaire early in the planning steps to evaluate knowledge and define our practice question.  The next steps will include the review of evidence and determination what is the best evidence to support diabetes education to frontline nurses. There will also be evaluation of the diabetes CPGs. Implementation of learning will be inclusive of online instruction, unit huddles, and diabetes conferences.  After implementation of the education, we will focus on how the nurses translate their new knowledge into practice. We will ensure that technology with our EHR assists the staff in achieving this work without increasing workload and stress.

How will you ensure continuation or sustainability of the change?

     Organizations that support QI, EBP, and research must ensure that they are inclusive of their nurses in such practices. There is the need for leaders, clinicians, and staff to understand the reason for these practices and to live the vision of EBP in their practice (Dang & Dearholt, 2018). In our organization, we have supported nurses while also setting the expectations for EBP by implementing into our strategic imperatives, our Nursing specific goals, and by including frontline nurses in all decisions for change. Our commitment to patient outcomes will ensure that this practice change is well-aligned with our organizational goals.

     Specific communication plans regarding the improvement plan for diabetic education will be provided to all nurses. It will provide the goals for the change, explain the vision for improvement, and explain target audiences that will be included in the project (Dang & Dearholt, 2018).  Staff involvement will be requested, and focus groups will help to share learned information. The education timeline will be clearly defined, and all roles and responsibilities will be shared. The team will have access to resources and there will be interprofessional support with physician partners in this change (Tacia et al., 2015).  We will utilize mentors and informal leaders to help support the teams through positivity and advocacy for their fellow team members (Dang & Dearholt, 2018). Lastly, we will develop a tool for evaluation of our improvement and establish metrics for improvement.  

Please make a comment for this discussion board with at least 2 paragraphs and 2 sources no later than 5 years 

Write a 175- to 265-word response to the following question (minimum length is 4-5 substantive sentences – a standard paragraph). Include a minimum of one peer-reviewed reference to support your post (must be cited per APA guidelines):

• What type of leader are you and how will that style fit with the health care industry? Explain your answer.

Module 2 – SLP

MOBILIZING SUPPORT FOR HEALTH EDUCATION PROGRAMS

Now that you have identified your health problem and your potential mini-grant funding source, beginning the process of developing your project concept. One of the best ways for doing so is to develop a concept paper. 

Read How to Write a Concept Paper for information on writing a one-page concept paper. After doing so, write your own one-page concept paper for the (hypothetical) project for which you will apply for a mini-grant.

NOTE: Keep in mind that the project you propose in your concept paper should have a basis in health behavior theory, so you will need to provide reference citations for scholarly material consulted in developing the document.

Length: Please submit your one-page concept paper at the conclusion of this module 

SLP Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric that is linked within the course. Review it before you begin working on the assignment.

Your submission should meet the guidelines on file format, in-text citations and references, scholarly sources, scholarly writing, and use of direct quotes noted under Module 1 Assignment Expectations.