Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community.

Select one of the following as the focus for the teaching plan:

1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues

Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the “Community Teaching Experience” form.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

-I picked Primary Prevention/Health Promotion  in Miami Florida

You will be working on this project for Modules 7 and 8. You must go out into your community to complete the windshield survey! This project cannot be completed by doing online research. For the paper, make sure interviews are cited as personal communication.  

Defining the Community

Your community can be a pediatric, adolescence, young adults, adult, elderly or a combination.

Clearly delineate the following dimensions before starting the process of community assessment:

• Describe the population that is being assessed?
• What is/are the race(s) of this population within the community?
• Are there boundaries of this group? If so, what are they?
• Does this community exist within a certain city or county?
• Are there general characteristics that separate this group from others?
• Education levels, birth/death rates, age of deaths, insured/uninsured?
• Where is this group located geographically…? Urban/rural?
• Why is a community assessment being performed? What purpose will it serve?
• How will information for the community assessment be collected?

Assessment

After the community has been defined, the next phase is assessment. The following items describe several resources and methods that can be used to gather and generate data. These items serve as a starting point for data collection. This is not an all-inclusive list of resources and methods that may be used when a community assessment is conducted.

The time frame for completion of the assessment may influence which methods are used. Nonetheless, these items should be reviewed to determine what information will be useful to collect about the community that is being assessed. It is not necessary to use all of these resources and methods; however, use of a variety of methods is helpful when one is exploring the needs of a community.

Data Gathering (collecting information that already exists)

Demographics of the Community

• When demographic data are collected, it is useful to collect data from a variety of levels so comparisons can be made.
• If the population that is being assessed is located within a specific setting, it may be best to contact that agency to retrieve specific information about that population.
• The following resources provide a broad overview of the demographics of a city, county, or state:
• American Fact Finder—Find population, housing, and economic and geographic data for your city based on U.S. Census data
• State and County Quick Facts—Easy access to facts about people, business, and geography, based on U.S. Census data
• Obtain information about a specific city or county on these useful websites www.epodunk.com and www.city-data.com

Information from Government Agencies

• Healthy People 2020—this resource is published by the U.S. Department of Health and Human Services. It identifies health improvement goals and objectives for the country to be reached by the year 2020
• National Center for Health Statistics—this agency is part of the Centers for Disease Control and Prevention; this website provides statistical information about the health of Americans
• Centers for Disease Control and Prevention (CDC)—The CDC website contains a large amount of information related to the health of the American population. The search engine within this website can be used to find relevant information
• Federal agencies with statistical programs
• Every state in the United States has its own specific health improvement plan and goals that are based on the Healthy People 2020 document. This information may be available on the state health department website.
• State and local health departments provide information related to vital statistics for the community.

Other Data Sources

• America’s Health Rankings—this website provides information about various health indicators for each state: https://www.americashealthrankings.org/
• Other relevant data sources may be found by conducting an Internet search related to the topic that is being examined through the community assessment.

After data are collected from various sources, it is important to review the information and to identify assets and areas for improvement in the community by comparing local data (if available) versus state and national data. This will facilitate organization of the information that has already been obtained and will provide direction for the next step of the process.

Data Generation (data are developed that do not already exist):

Windshield Surveys

With the use of public transportation or by driving a vehicle around the community, one can observe common characteristics of the community.

Examples of key observations to make when one is assessing the community through a windshield survey include the following:

• Age of the homes in the community
• Location of parks and other recreational areas
• Amount of space between homes and businesses
• Neighborhood hangouts
• Transportation in the community
• Quality and safety of streets and sidewalks
• Stores and other businesses
• People out in the community
• Cleanliness of the community
• Billboards or other media displays
• Places of worship
• Healthcare facilities

Participant Observation

Spend time observing the population that is being assessed. Through observation of interactions among group members, much can be learned about the community, including the following:

• Developmental level of the population
• Effectiveness of peer-to-peer interactions
• Respect for peers and others
• Safety in the environment
• Economic status

Informant Interviews

Informants could be people who are familiar with and interact with the population on a regular basis.

Examples of questions that may be asked of key informants include the following:

• Strengths/assets of the community
• Areas of improvement for the community
• Concerns of community members
• Access to health care
• Emergency plans for natural or man-made disasters

Focus Groups

Focus groups (usually small groups of 6-12 people) can be helpful when one is gathering information about specific areas of concern within the population. Use of a focus group involves open dialogue about the population, whereas an interview or survey yields only individual responses.

• Focus groups may be effective for assessing the following:
• Satisfaction with services provided
• Community resources used
• Transportation issues within the community
• Safety within the community
• General concerns of members of the population

Surveys

Surveys may be used to collect data from the community. Selecting a sample of the target population may prove helpful in the collection of data that are easier to analyze. It is important to ensure that the sample is representative of the target population.

A survey should be developed that takes into consideration the developmental level of the group that is being assessed. Questions should be written at the appropriate developmental level, so they are answered in a way that makes the data useful. Surveys might include closed-ended (yes/no), multiple choice (several responses to choose from), Likert scale (Strongly Agree/Agree/Neutral/Disagree/Strongly Disagree), or open-ended (“why”/“how”) questions.

Topics that may be addressed in a survey include the following:

• Demographic information
• Status of employment
• Safety within community
• Safety in environment
• Personal safety (seatbelts, helmets, etc.)
• Stressors/stress management patterns
• Risky behaviors
• Support systems
• Volunteer/community activities
• Rest patterns
• Nutrition
• Dental hygiene
• Health promotion activities

Level 1 headings are centered and bold. Level 2 headings are bold and at the left margin. Your submission should be a minimum of 2000 words (maximum 2500 words) in length and should completely answer the proposed questions as listed under “Define the community.” You should have a minimum of three (3) references.

APA formatting required and all responses should be combined into a single document for submission. Use the rubric as a guide for the evaluation method of the project.

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

• Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
• Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

The main discussion will need at least 3 references and also in APA 7 format

The two discussions below will need at least three references all in APA 7 format each

Thomas discussion

Competing needs in the world of healthcare exist on a number of levels including the national level and also at the most local levels.  I normally work on a COVID free orthopedic unit that focuses mostly on diabetic amputations, elective joint replacements and surgeries following orthopedic trauma.  Initially during the pandemic, we halted our elective surgeries which was consistent with national guidelines (Diaz et al., 2020).  As numbers stabilized, we began elective surgeries again, but recently we have seen numbers of COVID cases increase locally.  In the past few weeks, we have started taking on more medical/surgical patients in order to make room for COVID patients on other medical surgical floors.  The competing needs in this situation include the needs of the hospital in terms of freeing up beds for COVID patients, staffing needs on my unit as we are taking on more patients, and also resources that we need in order to care for this new group of patients.  The competing needs of the hospital in this case with regard to caring for COVID patients and also caring for other medical surgical patients resulted in a policy change on my unit.  The policy change in this case was our switch from a unit that cared for orthopedic patients only to one that was more inclusive of other medical/surgical patients.

The stressor that I selected for the previous discussion was care of the elderly.  One area of conflict that I constantly see is the desire of family members to provide care for patients in the home when they are unable to fully meet the needs of the patient.  Some patients require 24 hour care and unfortunately many families are not able to fully provide that care.  Caring for the frail elderly in the home is often preferred.  However, informal care providers are often presented with the challenges of self-care, educating themselves about how to provide care, finding additional support, and a lack of societal recognition for the role that they play in healthcare (Plöthner et al., 2019).  Despite the best efforts of family members and assistance from home care services, the level of care is still lacking, which places the patient at risk for declining health status.  The competing need in this instance is the medical needs of the patient, competing with the ability of the family to provide those services or at least set up home care.  A review by Hirschman and Hodgson (2018) identified several evidence-based approaches that may help to delay transition of care to skilled nursing facilities among patients with dementia.  Programs such as the New York University Care Giver Intervention, Goals of Care intervention, MIND at home and Partners in Dementia Care help families to obtain the skills and resources required to provide adequate care to the dementia population in the home setting.  The overarching theme is that while competing needs do exist in this area, education can help to reduce the burden on families and possibly help them to achieve the goal of home care for their loved ones.

Fortunately, policies are in place that prevent elderly patients from living at home when they are unable to receive adequate care.  Recently I worked with at patient that suffered from severe dementia and his wife and children were working very hard to get approval to have him stay at home as opposed to being discharged to a skilled nursing facility.  The patient is still on our unit, but it is questionable how the scenario will play out.  At this point, a hearing is pending to determine if the patient requires a conservator.  In the state of Connecticut, a conservator of the person is assigned to individuals determined to be unable to competently care for themselves.  The conservator of the person is responsible for all matters including those related to finances and healthcare (“Conservatorships,” n.d.).  Policy in this case will overrule the desires of the family to keep the patient at home and ultimately, the patient will be placed in the appropriate care environment.

Conservatorships.  (n.d.).  Retrieved from https://www.ctprobate.gov/Pages/Conservatorships.aspx.

Diaz, A., Sarac, B. A., Schoenbrunner, A. R., Janis, J. E., & Pawlik, T. M. (2020). Elective surgery in the time of COVID-19. The American Journal of  Surgery, 220(2), 300-302.  Retrieved from https://www.americanjournalofsurgery.com/article/S0002-9610(20)30218-X/pdf.

Hirschman, K. B., & Hodgson, N. A. (2018). Evidence-based interventions for transitions in care for individuals living with dementia. The Gerontologist, 58(suppl_1), S129-S140.  https://doi.org/10.1093/geront/gnx152.

Plöthner, M., Schmidt, K., De Jong, L., Zeidler, J., & Damm, K. (2019). Needs and preferences of informal caregivers regarding outpatient care for the elderly: A systematic literature review.  BMC geriatrics, 19(1), 82.  https://doi.org/10.1186/s12877-019-1068-4.

Bill’s discussion

Organizational Policies and Practices to Support Healthcare Issues

Competing Needs

Competing needs can have a significant impact on the development of policy. This is mainly because the policy’s primary objective is to align with the needs (Tinetti et al. 2019). Therefore, in cases where there are competing needs, such as the needs of the patients, workforce, and resources, policy development can be challenging. For example, a policy to ensure the efficiency of service needs to consider the issue of nurses’ workload, stress, and burnout. Therefore, the policy would be required to address burnout, anxiety, and workload before proposing efficient health care strategies.

Specific Competing Need

Quality is a specific competing need in health care that affects nurse burnout. In health care organizations, nurses are expected to provide high-quality service that ensures the client’s safety and satisfaction (Saban et al. 2019). However, the issue of nurse burnouts in different health organizations affects this need. Thus, despite being expected to deliver high-quality services, the nurses could be limited to various problems such as stress and lack of motivation due to burnout.

The significant impacts of the competing needs include medical errors, nurse turnover, depletion of organization resources, and patient dissatisfaction. A high nurse turnover would require the organization to invest in new hires, which often require comprehensive training before adapting to the organization’s culture. Due to the stress and exhaustion associated with burnouts, the nurses will deliver lo quality services, which can result in increased errors and patient dissatisfaction.

How Policy Address the Issue

A policy can address these issues by ensuring that the nurses and the patient’s needs are addressed. In most cases, the nurses’ needs are a prerequisite to meeting patients’ needs. Nurses satisfied with their work will often be motivated, thus delivering high-quality work as observed by De Simone et al. (2018). In this case, the policy should address the nurse’s issues, such as reduced workload and shift hours to reduce burnout cases. This will, in turn, reduce the turnover rates as well as improve patient satisfaction rates.

References

De Simone, S., Planta, A., & Cicotto, G. (2018). The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses’ turnover intention and patient satisfaction. Applied Nursing Research, 39, 130-140.

Saban, M., Dagan, E., & Drach-Zahavy, A. (2019). The relationship between mindfulness, triage accuracy, and patient satisfaction in the emergency department: A moderation-mediation model. Journal of Emergency Nursing, 45(6), 644-660.

Tinetti, M. E., Naik, A. D., Dindo, L., Costello, D. M., Esterson, J., Geda, M., … & Kang, G. (2019). Association of patient priorities–aligned decision-making with patient outcomes and ambulatory health care burden among older adults with multiple chronic conditions: a nonrandomized clinical trial. JAMA Internal Medicine, 179(12), 1688-1697.

Assignment: Practicum: Cover Letter, Resume, and Portfolio

Your cover letter should be:

• -Presented and formatted in a professional business manner
• -Addressed properly
• -Clear and concise and include:
  • Content Introduction
  • Content Body
  • Content Conclusion
• -Personal philosophy statement
• -Self-assessment
• -Personal goals (short term and long term)
• -Achievements
• -2 letter of recomendation

SEE ATTACHED ASSIGNMENT TO FOLLOW BUT IT HAS TO BE DIFFERENT. THANK YOU.