Leading Health Promotion for Populations

DNP scholars play a significant role in advocating for improved health outcomes for the community. One evidence-based strategy that enhances the attainment of optimal health outcomes is health education aiming to create awareness and impart knowledge on risk factors to promote a healthy population (Paterick et al., 2017). Health education targets to educate community members on healthy living to embrace a healthy lifestyle that makes them less vulnerable to diseases. While it may not be possible to prevent diseases totally, education lessens the severity of diseases by making individuals empowered to manage the diseases and health conditions.

DNP scholars should also foster a respectful and healthy working environment to enhance healthcare reforms. The evidence-based strategy focuses on the need to create an environment that promotes productivity among healthcare providers. Experts reveal gaps in the relationship between hospital management and healthcare providers, leading to a lack of job satisfaction among healthcare providers (Bokhour et al., 2018). Creating a good working environment calls for competitive salaries and benefits, organizational learning, job stability, moral satisfaction, and ethical organizational cultures. When the working environment is good for healthcare workers, they will be productive, resulting in positive patient outcomes.

Several programs are designed to improve populations’ health at local, state, and national levels. Holmes County Chronic Disease Program focuses on providing assistance and education to encourage healthy living within Holmes county in Florida. The program addresses several aspects such as physical activity, nutrition, and disease management (Smith et al., 2018). The program emphasizes the need for clean eating for a healthy lifestyle. The program has helped the community in formulating a healthy meal plan to prevent lifestyle diseases. It also facilitates the drafting of fitness plans which has been resourceful to promote the quality of life in the county.

References

Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N., … & Lukas, C. V. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC health services research, 18(1), 1-11.

Paterick, T. E., Patel, N., Tajik, A. J., & Chandrasekaran, K. (2017). Improving health outcomes through patient education and partnerships with patients. Proceedings (Baylor University. Medical Center), 30(1), 112.

Smith, S. M., McAuliffe, K., Hall, J. M., McDonough, C. W., Gurka, M. J., Robinson, T. O.,… & Cooper-DeHoff, R. M. (2018). Peer-reviewed: Hypertension in Florida: Data from the one Florida clinical data research network. Preventing chronic disease, 15.

Reply to Comment

• Any potential barriers you would anticipate encountering during implementation? Any negative effects on the population at large?

Instructions:

Use an APA 7 style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. 

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

The goal of this assignment is to further understand the perspectives of a service provider for aging adults regarding social, economic, and/or political forces and issues in the current U.S. healthcare system influencing health care delivery in relation to access, cost, and quality. The interview will then be translated into the paper to summarize your findings.

The paper should include a title page and a reference page using APA format and 12-point Times New Roman font. The paper should be six to eight pages in length (NOT including the title page or reference page).

Introduction 

• What is this person’s job title, function, and role within their organization?
• How long have they worked in their current profession, and what credentials do they have that support their work?

Overview or Summary

1. Overview/Summary of Interview
   • What type of work does this person perform?
   • How does their job and organization impact aging adults?
   • Where in the “healthcare system” does their organization fit (acute care, community-based care, senior living, community center, etc.)?
   • How do social factors impact their work (chronic illness patients, lack of services offered, lack of accessibility, social stigmas, lack of community organizations, etc.)?
   • How does the organization initiate interdisciplinary and multidisciplinary change that impacts the quality of health care for diverse communities and populations, families, and individuals? 
   • How do political factors impact their work (Affordable Care Act, Medicare/Medicaid funding and reimbursement, state and federal laws and regulations governing the organization that make it hard to care for people, qualification requirements and standards, etc.)?
   • How do economic factors impact their work (funding sources, costs of care and labor, resource allocation, aging adult financial resources, etc.)?
   • How does this leader approach problem solving and decision making within the organization? Provide an example that reflects this approach. 
   • In what ways are health informatics and health technology used in the aging service organization, and what are challenges or successes that result from these uses?
   • In regard to human capital, how does the organization view diverse workforces? Are there challenges around the development of a qualified workforce? 
   • What social issues or challenges impact this person’s work?
   • What are ethical and legal challenges the service organization for aging adults encounters in their work? How are these challenges managed and solved? Provide examples that highlight these; for example, determining a person’s capacity to make decisions, sexual relationship among residents with dementia, etc. 
2. What are the biggest challenges this person faces in their work with the aging population?
   • Analysis
   • How do service organizations for aging adults address social, political, and economic factors and forces in working with the aging population? What are gaps in current management practices, and what are possible solutions needed to address these?
   • What are future implications to providers in their mission?
   • What is lacking in a social policy issue that would help support this organization? Who should be responsible to address these gaps in policy? What are the micro and macro challenges to implementing change?
   • Are there future concerns that need addressed, such as Medicare funding, transportation needs, technology integration, etc.?
   • Consider principles of strategic leadership and management skills, and analyze how these principles would benefit a ervice provider of aging adults. 
   • How does the current political environment help or hinder the shaping of policies affecting health care organizations and the communities they serve?
3. Personal Reflection
   • How did this experience enhance your understanding of the unique needs of service providers of aging adults?
   • What did you learn that was most surprising to you?
   • How might this experience influence the way you approach your career and profession?
4. Research and Grammar
   • Outside research for this assignment is not required other than an interview with a service provider of aging adults. However, if outside sources are used, these should be cited appropriately.
   • This paper should be written in Times New Roman 12-point font, double spaced.
   • Proper grammar and punctuation are expected, with correct APA formatting.
   • Page requirement is six to eight pages (not including title page or reference page).

It should be an interview of the director of a nursing home .

Use the two attached textbook to respond to the questions below each you can simply copy and past the information from the textbook as long as citation and reference is provided. 

1. 200 words- Describe how a patient      might present (signs and symptoms) with a new onset of atrial fibrillation.      What are the characteristic of the EKG in a atrial fibrillation patient? 
2. 200 words What medications might a      patient with atrial fibrillation be prescribed? Provide at least 5 specific      medication and treatment options.  Why would these medication be given, mechanism      of action?
3. 100 words- Why would a rhythm be      considered a lethal arrhythmia? 
4. 200 words- What labs, diagnostics,      or therapeutic interventions might be appropriate for a client admitted      with an acute coronary syndrome (ACS)? Which are most important to      determine plan of care?
5. 300 words- List one main purpose for      each of the following medication classes and describe how a nurse would      evaluate if they were effective:
   1. nitrates,
   2. beta blockers,
   3. calcium channel blockers,
   4. statins
6. 200 words- What is the difference      between a STEMI and an NSTEMI? How are each managed upon presentation with      chest pain?

200 words- Give an example of a patient that may experience an MI. What questions would you ask them and why would you ask these questions? 

n your reply posts, discuss challenges in knowing when to evaluate a person’s capacity in decision making. Are there instances, such as refusing to care for a chronic illness or choosing to drink alcohol while on complex medications, that may trigger action, and if so, what challenges might you encounter? posts should be 100 to 150 words, with a minimum of one supporting reference included.

Response 1

 Evaluating capacity for older adults poses a challenge as there is a high prevalence of cognitive impairment, such as dementia, as well as medical and neurological comorbidities for this patient population. According to Moye and Marson (2007), these cognitive and physical changes are linked with declines in everyday functioning that includes loss of decision-making skills. This raises legal and ethical concerns in healthcare as some older adult patients may lack the capacity to make decisions regarding their own care. When a patient is deemed incapable of making decisions for themselves, decision making falls to the patient’s guardian or health care proxy (Moye et al., 2005).

From the assigned readings, I was pleasantly surprised to understand the legal implications in place for protection when an individual is deemed incapable of making decisions for themselves. As capacity evaluations strive to protect the dignity and autonomy of all persons (Moye et al., 2005), the legal healthcare proxy or guardian is also in place to represent the individuals’ perceived intentions and desires. It is also reassuring that evaluation of capacity is thorough as to not to inaccurately deem an individual incapable of making their own decisions. Moye et al. (2005) explains that capacity assessment involves causal, functional, interactive, and judgmental abilities.

As a healthcare provider working with elderly patients, it is necessary to utilize all resources when determining an individual’s legal capacity. Moye et al. (2005) states that psychologists working in rehabilitation settings are called on to use their expertise in psychological assessment to help address complex presentations and related capacity questions. Utilizing the expertise of clinical psychologists assists in making the more efficient and concise decisions regarding an elderly individuals’ capacity. Challenges of capacity arise inpatient as well, with the concern if elderly individuals have the capacity to consent for various acute procedures. From my experience, when the nurse practitioners I work with have concerns regarding their patient’s legal capacity, they will consult psych and sometimes social work for guidance. It is important to have a capacity assessment guide in place when working with an older patient population. Tools such as the virtual reality functional capacity assessment tool assist healthcare providers in assessing a patient’s ability to complete instrumental activities such as searching a pantry at home, making a shopping list, or paying for groceries (Atkins et al., 2015). Additionally, providers must develop a framework for assessing cognitive ability and decision-making skills in order to accurately evaluate capacity. 

Response 2

The definition of capacity varies from state to state. In the state of California, the Health Care Decisions Law of 2000. In the legislation the definition of capacity is defined as “a patient’s ability to understand the nature and consequences of proposed health care, including its significant benefits, risks, and alternatives, and to make and communicate a decision” (California’s Health Care Decisions Law Fact Sheet, 2005). As healthcare providers, it is important to provide competent care. It is a patient right to have self-determination over his body or her body and property. However, when the individual is a minor or deemed incompetent, they have the right to have someone to protect their interest and basic rights. According to California Hospitals Association, a patient has capacity to make their own decisions when they are able to response knowingly and intelligently to queries about medical treatment, participate in the plan of care, and understand the information necessary to give or refuse informed consent. A physician needs to assume the role of determining capacity or incapacity and this should be documented in the patients record.

Something I found interesting is a health care agent can make most principal health care decisions regarding an individual care, but there are exceptions. A health care agent can not authorize commitment into an mental institution, electroconvulsive therapy, psychosurgery, sterilization, abortion, or limitation that are specified in the patient advance directive. Another issue is when there is no one in the patients life who can make medical decision in case they become incapable to making medical decisions, there are certain steps an institution needs to follow. The option in place for this situation is to contact the Public Guardian’s Office and seek a conservatorship. The other is to get a court order per Probate Code 3200. However, this is time consuming and costly method. Sadly, patient being unrepresented occurs often. According to a 2006 3study, 16 percent of ICU patients were unrepresented. This group is compromised predominately for patient who are mentally ill, homeless, lives alone, or the elderly who have out lived family and friends (Van Hall & Garret, n.d.).