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In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

PLEASE RESPOND TO THE TWO PEOPLE DISCUSSIONS (KENYA AND Goldie) 

NOTHING LESS THAN A PARAGRAPH. 

Kenya Mcclendon 

Based on this 35 y.o. female with symptoms of a “very painful” vesicular rash along the left lateral rib, under the breast and has fatigue. Additionally, the woman has a 6-month-old infant who is breastfeeding and three other children over 3 years of age, all of whom were not vaccinated. Vesicular rashes can appear on almost any region of the skin and vesicular rash that appear on the trunk area are filled with red blisters. (Mayo Clinic, 2018).  Based on the information provided, chickenpox or shingles, herpes are possible diagnoses, however, chickenpox appears to be the probable diagnosis.

Chickenpox is an infection caused by the varicella-zoster virus. It causes an itchy rash with small, fluid-filled blisters, which is non-painful. Chickenpox is highly contagious to people who haven’t had the disease or been vaccinated against it. The chickenpox vaccine protects children and the initial dose if given between 12-15 months of age. Due to the woman declining the vaccine for her children, there is a high risk and the likelihood that her children may have also been exposed to the virus. I would ask if the children had an itchy rash, fever, poor appetite, or had gone to a daycare. Based the woman’s rash being painful, chickenpox is ruled out. The most probable diagnosis is shingles.

Shingles is an infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. (Mayo Clinic, 2018).  Even after the chickenpox infection is over, the virus may live in your nervous system for years before reactivating as shingles. This type of viral infection is characterized by a red skin rash that can cause pain and burning. Shingles usually appears as a stripe of blisters on one side of the body, typically on the torso, neck, or face. (Mayo Clinic, 2018). The woman is experiencing symptoms of fatigue  due to recent stress related to providing 24-hour care in her home to her mother, who is seriously ill.

 I would gather more information by asking the woman if her mom currently has a rash, did her mom have a history of chickenpox and was she vaccinated. Shingles could spread through direct contact with fluid from the rash blisters. (CDC, 2019). Treatment includes antiviral medications such as Acyclovir (Zovirax),: 800 mg PO q4hr while awake (5 times daily) for 7-10 days, Valacyclovir (Valtrex)  1000 milligrams (mg) three times a day for seven days and Famciclovir 500 milligrams (mg) every eight hours for seven days. (CDC, 2019). These medications are the most effective to treat shingles, shorten the length and severity of the illness and should be taken as soon as possible after the rash appears. (CDC, 2019). Pain medicine, would include Acetaminophen 325-650 mg every four hours as needed. The woman requires a two week follow-up care with medical provider.

Reference

Centers of Disease Control and Prevention (2019). Shingles. Retrieved from https://www.cdc.gov/shingles/about/index.html

Mayo Clinic Staff. (2018). Shingles.
mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

2 Goldie Nwachuku 

1. Which conditions should be considered as possible diagnoses?

Ans: It is possible the 35 year old woman has Shingles or herpes zoster, which is a viral infection caused by chicken pus virus known as varicellar-zoster virus

1. What additional information should be gathered to make the diagnosis?

Ans:Taking medical history, looking at the rash and scraping the tissue from the rash or swab some fluid from the blisters and send to lab for testing

1. Which condition is the woman likely experiencing?

Ans:The woman is experiencing herpes zoster or shingles virus due to the symptoms of severe pain and rash on the left lateral rib area.

1. What other information should you obtain from the patient?

Ans: Taking Medical history including history of chicken pox and chicken pox vaccine (Hollier, 2016).

1. What treatment plan should you prescribe?

Ans: Research study shows that shingle vaccine is a preventative therapy and not a treatment for those who already have shingles.

No treatment for shingles

Antiviral medications taken 3 days after rash appears to help reduce severity of shingle attack

Cool wash cloth, pain reliever, calamine lotion, oatmeal bath to help relieve itching.

1. What follow-up care should you recommend?

Ans:According to Centers for Disease control and prevention (CDC), it is recommended that the patient with shingles stay away from anyone who has not had chicken pox or the chicken pox vaccine or any one with weak immune system.

After recovering, to get RZV, shingrix a preferred shingles vaccine given in 2 doses separated by 2 to 6 months apart.

1. Based on the likely diagnosis, what are your concerns about the other members of the family?

Ans: Shingles are not contagious but one can catch chicken pox from someone with shingles if one never have chicken pox or vaccine as in the case of the three children over 3 years whom parents have chosen not to vaccinate against common childhood illnesses. Stress can increase risk of shingles. Immune system may be weaker when one have infection.

The new born baby of mother with shingle may be given Zoster immune globulin due to baby immature of immune system to fight off the attack.

The main objective of medical research on shingles are to develop drugs to fight the disease and prevent or treat its complications and also to study and understand the disease well to prevent it especially in people at high risk (National Center for Immunization and Respiratory Disease).

Resources:

• Stevens District Hospital Strategic Planning Scenario
• Strategic Planning Process Grading Criteria

Stevens District Hospital is a 162-bed acute care hospital that is qualified as a not-for-profit facility. The hospital is located in Jefferson City, which has a population of 50,000 with 80,000 in the regional market. The hospital provides a general range of acute care services, including medical/surgical, rehab, and emergency care.

Your role in this planning process will be as the director of the radiology department, where you perform a wide variety of X-ray procedures, nuclear medicine, ultrasound, and MRI testing. In this planning process, you will evaluate the strengths, weaknesses, opportunities, and threats to the hospital, and the role your department can play in increasing business for the hospital. 

Create a 10- to 12-slide Microsoft® PowerPoint® presentation as an educational tool that showcases your knowledge of the strategic planning process and its role in the hospital. Your presentation should:

• Describe the purpose of a strategic plan.
• Consider how a strategic plan should align to the mission and vision statements.
• Explain why multiple stakeholders are important to the strategic planning process.
• Describe all stakeholders that are involved in the strategic planning process.
• Consider their position and level of decision-making.
• Explain the purpose of a communication plan in the strategic planning process.

Cite 3 peer-reviewed, scholarly, or similar references to support your presentation.

Format your assignment according to APA guidelines. Include a title page, detailed speaker notes, and a references page.

I NEED A RESPONSE TO THIS ASSIGNMENT

ZERO PLAGIARISM

3 REFERENCES

Cognitive Behavioral Therapy (CBT) helps in changing thinking patterns and unhealthy habits. This therapy sessions can be helpful both in group and family sessions. CBT helps patients reframe and retrain their thought processes both in group and family sessions. During a group session medication and cognitive behavior therapy ,are combined to help control the core symptoms of distraction, short attention span and impulsiveness.It is more effective at increasing the habits and skills needed for executive self-management and may also serve to improve emotional and interpersonal self-regulation. During psychotherapy sessions and after, the therapist is expected to complete therapy notes about patient’s behavior and responses. An example is during sessions whereby the therapist lists a couple of hypotheses and examine questions to be asked that can prompt responses from the patient. During the sessions for patients struggling with Post Traumatic Stress Disorder, multiple treatment modalities were used. According to Norman, Hemblen, Schnurr, and Eftekhari (2018), the Clinical Practice Guideline (CPG) for Post traumatic Stress Disorder in 2017 suggested evidence-based recommendations for the treatment of PTSD that are most effective therapies for the disorder these are; individual trauma-focused psychotherapies, primarily Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement.

Cognitive Behavioral Therapy is used in Family therapy. It is recommended in the treatment of ADHD and other mental health related diseases. During family sessions, it was noted that Parents are often exasperated by children with ADHD, and when an adult has the illness, spouses and children are affected. In family therapy, the family can learn ways to help and support each other.CBT is typically a short-term intervention, with changes often apparent after only a few sessions.

During family Cognitive therapy sessions examples of discussions were anxiety, analysis of family relationships, and a variety of other topics. This helped to alleviate some of the symptoms of ADHD, especially in those who are experiencing other issues, such as anxiety and depression, along with ADHD. Talk therapy  helped alleviate some of these concerns, bringing one’s ADHD back into focus.

Skill based therapy is particularly effective with young children. Therapists specializing in the treatment of attention problems can focus on helping children develop specific skills and time management strategies. CBT is helpful in changing unhealthy habits.During these sessions the child can be helped to talk about upsetting thoughts and feelings, explore self-defeating patterns of behavior, learn alternative ways to handle emotions, feel better about him or herself despite the disorder, identify and build on their strengths, answer unhealthy or irrational thoughts, cope with daily problems, and control their attention and aggression. Medication helps to control the core symptoms of distraction, short attention span and impulsive behaviors. CBT is more effective at increasing the habits and skills needed for executive self-management and may also serve to improve emotional and interpersonal self-regulation (Martin n.d).

            Family therapy is recommended in the treatment of ADHD because ADHD does not just affect those who have the condition. Parents are often exasperated by children with ADHD, and when an adult has the illness, spouses and children may be affected. In family therapy, the family can learn ways to help and support each other. (Psychcentral.org). Example was during a family and CBT group session where the patient continued to be suicidal and verbalizes thoughts of hurting herself through cutting or strangulation. She is currently on the 1:1 care and have staff with her 24/7 until discontinued by the psychiatrist.

During Individual therapy she verbalized purging after eating because she does not want to get fat and loosing self-esteem. The therapist continues to use psychotherapy in groups and individual to help patient focus. She denies visual and auditory hallucinations.

During the family sessions, the patient is nervous and anxious, twisting her fingers and verbalized that the father emotionally abused her. She expressed anger.

Explain at least two challenges counselors might encounter when using CBT in the group setting.

Being misinterpreted during the session by other patients and family members during sessions.

Having family sessions with parents who are divorced and fighting over child custody.

References

Martins (n.d). Additional Treatments for ADHD. Retrieved October 18, 2020 from https://psychcentral.com/lib/additional-treatments-for-adhd/

Norman, S., Hemblen, J., Schnurr, P., & Eftekhari, A., (2018). Overview of Psychotherapy for PTSD. PTSD: National Center for PTSD. Retrieved October 18,,2020 from https://www.ptsd.va.gov/professional/treatment/overview/overview-treatment-research.asp

Parekh, R. (2017). What is Posttraumatic Stress Disorder? American Psychiatric Association. Retrieved October 18,2020 from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

 The Evolving Healthcare Technology Environment

The focus of this week’s discussion is health technology. It offers the opportunity to share your thinking about three questions:

Start with an operational definition of “healthcare technology” to offer the reader context for your post. It may not mean the same thing to all.

1. What are the most important trends in health care technology?

2. What factors are driving and/or limiting the further growth of health care technologies?

3. Based on the above trends and factors, identify five (5) ways health technology will likely change the role of health care managers by 2030

4. Which laws are in place to integrate information technology into healthcare?H

Assignment Content

1. In response to federal policy and service requirements, health insurance plans are increasingly developing high-deductible insurance policies and narrow networks. These types of policies require the consumer to pay more out-of-pocket. To portray this in a positive light, this trend has been labeled as “consumer-based” to suggest that the consumer must pay more from their own funds and, thus, encourage consumers to make better health care choices. However, this could be labeled as a burden on the consumer.

   Write a 350- to 525-word article that identifies and evaluates the impact that federal or state health care policies are having on consumer costs. Explore both positive and negative effects.

   Include a citation of your article in your assignment.

   Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

    

Part I

A condition/medication template will be provided. Conditions will be given for each system. You will identify one drug/medication to treat each condition and give full details for that medication on the template provided here.

Conditions:

• Psoriasis
• Thrush
• Dystonia
• Gout

Part II

Answer the following questions.

1. Describe the risk factors for hypocalcemia.

2. Describe osteoporosis.

3. Describe the treatment for abnormal calcium levels.

4. Describe osteoarthritis and rheumatoid arthritis.

5. Describe the treatment for arthritis.

6. Describe gout, including its risk factors and treatment.

7. Describe the use of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, disease-modifying antirheumatic drugs, and corticosteroids for bone and joint inflammation.

8. Describe phantom limb pain and its treatmen

Part III

When I attended elementary school back in the late 80’s, it was not uncommon for the school nurse to visit classrooms and check children’s hair for head lice. If the nurse did detect head lice on an individual they would be sent home until successfully treated in order to not spread head lice to other children. It seems that in this day in age checks and restrictions for children with headlice have became much more relaxed. Please follow the link and read the article.

https://www.cbsnews.com/news/should-kids-with-head-lice-be-allowed-at-school/  

Now answer the question: Should kids with head lice be allowed at school?

(40 points) you will choose, and review ONE case study provided. You will be responsible for reviewing the case and assigning multi-axial diagnoses. You will also be responsible for providing a rationale for the diagnoses, as well as a discussion of rule outs, differential diagnoses, and prognosis. This assignment should be 2-3 pages in length (typed, double-spaced, one-inch margins in APA format)

Case Summary #1

Robin Henderson is a 30-year-old married Caucasian woman with no children who lives in a middle-class urban area with her husband. Robin was referred to a clinical psychologist by her psychiatrist. The psychiatrist has been treating Robin for more than 18 months with primarily anti-depressant medication. During this time, Robin has been hospitalized at least 10 times (one hospitalization lasted 6 months) for treatment of suicidal ideation (and one near lethal attempt) and numerous instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns. Robin was accompanied by her husband to the first meeting with the clinical psychologist. Her husband stated that both he and the patient’s family considered Robin “too dangerous” to be outside a hospital setting. Consequently, he and her family were seriously discussing the possibility of long-term inpatient care. However, Robin expressed a strong preference for outpatient treatment, although no therapist had agreed to accept Robin as an outpatient client. The clinical psychologist agreed to accept Robin into therapy, if she was committed to working toward behavioral change and stay in treatment for at least 1 year. This agreement also included Robin contracting for safety- agreeing she would not attempt suicide.

Clinical History Robin was raised as an only child. Both her father (who worked as a salesman) and her mother had a history of alcohol abuse and depression. Robin disclosed in therapy that she had experienced severe physical abuse by her mother throughout childhood. When Robin was 5, her father began sexually abusing her. Although the sexual abuse had been non-violent for the first several years, her father’s sexual advances became physically abusive when Robin was about 12 years old. This abuse continued through Robin’s first years of high school. Beginning at age 14, Robin began having difficulties with alcohol abuse and bulimia nervosa. In fact, Robin met her husband at an A.A (Alcoholics Anonymous) meeting while she was attending college. Robin continued to display binge-drinking behavior at an intermittent frequency and often engaged in restricted food intake with consequent eating binges. Despite these behaviors, Robin was able to function well in work and school settings, until the age of 27.

She had earned her college degree and completed 2 years of medical school. However, during her second year of medical school, a classmate that Robin barely knew committed suicide. Robin reported that when she heard of the suicide, she decided to kill herself as well. Robin displayed very little insight as to why the situation had provoked her inclination to kill herself. Within weeks, Robin dropped out of medical school and became severely depressed and actively suicidal. A certain chain of events seemed to precede Robin’s suicidal behavior. This chain began with an interpersonal encounter, usually with her husband, which caused Robin to feel threatened, criticized or unloved (usually with no clear or objective basis for this perception. These feelings were followed by urges to either self-mutilate or kill herself. Robin’s decision to self-mutilate or attempt suicide were often done out of spite- accompanied by the thought, “I’ll show you.” Robin’s self-injurious behaviors appeared to be attention-seeking. Once Robin burned her leg very deeply and filled the area with dirt to convince the doctor that she needed medical attention- she required reconstructive surgery. Although she had been able to function competently in school and at work, Robin’s interpersonal behavior was erratic and unstable; she would quickly and without reason, fluctuate from one extreme to the other. Robin’s behavior was very inconsistent- she would behave appropriately at times, well-mannered and reasonable and at other times she seemed irrational and enraged, often verbally berating her friends. Afterwards she would become worried that she had permanently alienated them. Robin would frantically do something kind for her friends to bring them emotionally closer to her. When friends or family tried to distance themselves from her, Robin would threaten suicide to keep them from leaving her. During treatment, Robin’s husband reported that he could not take her suicidal and erratic behavior any longer. Robin’s husband filed for divorce shortly after her treatment began. Robin began binge drinking and taking illegal pain medication. Robin reported suicidal ideation and feeling of worthlessness. Robin displayed signs of improvement during therapy, but this ended in her 14 months of treatment when she committed suicide by consuming an overdose of prescription medication and alcohol.

Case Summary #2

 At the time of his admission to the psychiatric hospital, Carl Landau was a 19-year-old single African American male. Carl was a college freshman majoring in philosophy who had withdrawn from school because of his incapacitating symptoms and behaviors. He had an 8-year history of emotional and behavioral problems that had become increasingly severe, including excessive washing and showering; ceremonial rituals for dressing and studying; compulsive placement of any objects he handled; grotesque hissing, coughing, and head tossing while eating; and shuffling and wiping his feet while walking.

These behaviors interfered with every aspect of his daily functioning. Carl had steadily deteriorated over the past 2 years. He had isolated himself from his friends and family, refused meals, and neglected his personal appearance. His hair was very long, as he had refused to have it cut in 5 years. He had never shaved or trimmed his beard. When Carl walked, he shuffled and took small steps on his toes while continually looking back, checking and rechecking. On occasion, he would run in place. Carl had withdrawn his left arm completely from his shirt sleeve, as if it was injured and his shirt was a sling.

Seven weeks prior to his admission to the hospital, Carl’s behaviors had become so time-consuming and debilitating that he refused to engage in any personal hygiene for fear that grooming, and cleaning would interfere with his studying. Although Carl had previously showered almost continuously, at this time he did not shower at all. He stopped washing his hair, brushing his teeth and changing his clothes. He left his bedroom infrequently, and he had begun defecating on paper towels and urinating in paper cups while in his bedroom, he would store the waste in the corner of his closet. His eating habits degenerated from eating with the family, to eating in the adjacent room, to eating in his room. In the 2 months prior to his admission, Carl had lost 20 pounds and would only eat late at night, when others were asleep. He felt eating was “barbaric” and his eating rituals consisted of hissing noises, coughs and hacks, and severe head tossing. His food intake had been narrowed to peanut butter, or a combination of ice cream, sugar, cocoa and mayonnaise. Carl did not eat several foods (e.g., cola, beef, and butter) because he felt they contained diseases and germs that were poisonous. In addition, he was preoccupied with the placement of objects. Excessive time was spent ensuring that wastebaskets and curtains were in the proper places. These preoccupations had progressed to tilting of wastebaskets and twisting of curtains, which Carl periodically checked throughout the day. These behaviors were associated with distressing thoughts that he could not get out of his mind, unless he engaged in these actions. Carl reported that some of his rituals while eating was attempts to reduce the probability of being contaminated or poisoned. For example, the loud hissing sounds and coughing before he out the food in his mouth were part of his attempts to exhale all of the air from his system, thereby allowing the food that he swallowed to enter an air-free and sterile environment (his stomach) Carl realized that this was not rational, but was strongly driven by the idea of reducing any chance of contamination. This belief also motivated Carl to stop showering and using the bathroom. Carl feared that he may nick himself while shaving, which would allow contaminants (that might kill him) to enter his body. The placements of objects in a certain way (waste basket, curtains, shirt sleeve) were all methods to protect him and his family from some future catastrophe such as contracting AIDS. The more Carl tried to dismiss these thoughts or resist engaging in a problem behavior, the more distressing his thoughts became.

 Clinical History

 Carl was raised in a very caring family consisting of himself, a younger brother, his mother, and his father who was a minister at a local church. Carl was quiet and withdrawn and only had a few friends. Nevertheless, he did very well in school and was functioning reasonably well until the seventh grade, when he became the object of jokes and ridicule by a group of students in his class. Under their constant harassment, Carl began experiencing emotional distress, and many of his problem behaviors emerged. Although he performed very well academically throughout high school, Carl began to deteriorate to the point that he often missed school and went from having few friends to no friends. Increasingly, Carl started withdrawing to his bedroom to engage in problem behaviors described previously. This marked deterioration in Carl’s behavior prompted his parents to bring him into treatment.

Case Summary #3

Mr. Ben Simpson is a single, unemployed, 44-year-old Caucasian man brought to the emergency room by the police for striking an elderly woman in his apartment building. His chief complaint is, “That damn bitch. She and the rest of them deserved more than that for what they put me through.” The patient has been continuously ill since age 22. During his first year of law school, he gradually became more and more convinced that his classmates were making fun of him. He noticed that they would snort and sneeze whenever he entered the classroom. When a girl he was dating broke off the relationship with him, he believed that she had been “replaced” by a look-alike. He called the police and asked for their help to solve the “kidnapping.” His academic performance in school declined dramatically, and he was asked to leave and seek psychiatric care.

Mr. Simpson got a job as an investment counselor at a bank, which he held for 7 months. However, he was receiving an increasing number of distracting “signals” from co-workers, and he became more and more suspicious and withdrawn. It was at this time that he first reported hearing voices. He was eventually fired and soon thereafter was hospitalized for the first time, at age 24. He has not worked since

Mr. Simpson has been hospitalized 12 times, the longest stay being 8 months. However, in the last 5 years he has been hospitalized only once, for 3 weeks. During the hospitalizations he has received various antipsychotic drugs. Although outpatient medication has been prescribed, he usually stops taking it shortly after leaving the hospital. Aside from twice-yearly lunch meetings with his uncle and his contacts with mental health workers, he is totally isolated socially. He lives on his own and manages his own financial affairs, including a modest inheritance. He reads the Wall Street Journal daily. He cooks and cleans for himself.

Mr. Simpson maintains that his apartment is the center of a large communication system that involves all the major television networks, his neighbors, and apparently hundreds of “actors” in his neighborhood. There are secret cameras in his apartment that carefully monitor all his activities. When he is watching television, many of his minor actions (e.g., going to the bathroom) are soon directly commented on by the announcer. Whenever he goes outside, the “actors” have all been warned to keep him under surveillance. Everyone on the street watches him. His neighbors operate two different “machines”; one is responsible for all his voices, except the “joker.” He is not certain who controls this voice, which “visits” him only occasionally and is very funny. The other voices, which he hears many times each day, are generated by this machine, which he sometimes thinks is directly run by the neighbor whom he attacked. For example, when he is going over his investments, these “harassing” voices constantly tell him which stocks to buy. The other machine he calls “the dream machine.” This machine puts erotic dreams into his head, usually of “black women.”

Mr. Simpson described other unusual experiences. For example, he recently went to a shoe

store 30 miles from his house in the hope of buying some shoes that wouldn’t be “altered.”

However, he soon found out that, like the rest of the shoes he buys, special nails had been

put into the bottom of the shoes to annoy him. He was amazed that his decision concerning

which shoe store to go to must have been known to his “harassers” before he himself knew

it, so that they had time to get the altered shoes made up especially for him. He realizes that

great effort and “millions of dollars” are involved in keeping him under surveillance. He

sometimes thinks this is all part of a large experiment to discover the secret of his “superior

intelligence.”

At the interview, Mr. Simpson is well groomed, and his speech is coherent, and goal directed. His affect is, at most, only mildly blunted. He was initially very angry at being brought in by the police. After several weeks of treatment with an antipsychotic drug that failed to control his psychotic symptoms, he was transferred to a long-term care facility with a plan to arrange a structured living situation for him.

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Describe sampling theory and provide examples to illustrate your definition. Discuss generalizability as it applies to nursing research

Title Begin this paragraph with your introduction. The introduction should briefly talk about the purpose for a Community Health Assessments. Introduce your selected Sentinel City community. Assessment Using your eight social determinants of health (subsystems), discuss the living condition within your community. Present your overall findings relative to the assignment’s social determinants of health in weeks 1-4. Analysis From the information you discussed above, analysis the information as the overall health of the community. What are the strengths and the challenges of the community? Describe the data you found that directly relates to the health concern you believe exist for your chosen community or a vulnerable population in the community. This data can be obtained from your templates in weeks 1-4. Make the connection between your community’s major health concerns and the Healthy People 2020/2030 objectives. Nursing Diagnosis You may have to brush up writing nursing diagnoses. Once you identified the leading challenge for the community/population, write a nursing diagnosis. Here is a link to help you figure some out – https://nursekey.com/community-diagnosis-planning-andintervention/ Be thorough and specific related to the problem, interventions, and expected outcomes.  3 Plan In this section, you will detail your plan for improvement for you community. This is the section for your interventions. Interventions must be achievable, measurable, and time limited. Include the information gained from Social Determinate worksheet to build the plan. Include the people from the city and the community you will work with, for example, the mayor, the police, the local church leaders, etc. Plans should be detailed, realistic (funding and supplies type of stuff), time limited, and measurable. Evaluation Because this is a simulation, you will not have an actual implementation for evaluation, but you will have an evaluation plan. How would you measure the success or needed adjustments to the plan? Did the intervention help correct the issue? How would you know? Explain how these interventions will increase the quality of life for the people that live in your chosen SC community. Conclusion Briefly summarize your paper and draw your conclusions. Make observations about the community and its place within Sentinel City. What future do you see for this community?