Develop and share your personal nursing mission statement. How will this guide and impact your nursing practice now and in the future? 

The benchmark assesses the following competencies:

1.4 Participate in health care policy development to influence nursing practice and health care.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
2. Create a problem statement.
3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
4. Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

http://www.who.int/hrh/documents/policy_brief/en/

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

                                      Main Post

Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

Patients today are much sicker than they used to be. The advanced practice nurse needs to manage all comorbidities in the plan of care. In this post, I will discuss the patient’s health care needs and a recommended treatment plan, including pharmacotherapeutic choices. Also, I will present an education strategy to assist the patient in managing their disease conditions. The patient has a history of hypertension, myocardial infarction, hyperlipidemia angina, and diabetes type two. Her needs center around the management of these comorbidities. Also, I noticed that her serum creatinine is on the high end of the range if not outside of it. This fact is not surprising considering her diabetes. The case reports that she was doing well until about a month ago. It was tempting to consider adding another medication to the regimen. However, I believe that either the metoprolol is not high enough to manage her current disease state or she has been missing doses, and I am leaning toward the latter. If withdrawn suddenly, the drug can increase the incidence and intensity of anginal attacks. Metoprolol is the first-line drug for stable angina and should be working (Rosenthal & Burchum, 2018).  

A review of her current drug therapy appears appropriate. Aspirin, simvastatin, and metformin are competent choices, and the doses are adequate. My plan would include an assessment of how she takes medication at home and manages them before making any changes. If this were in order, I would increase the metoprolol to 75 mg twice a day and set a follow-up appointment in two weeks. I prefer to increase the dose of metoprolol first before adding any new drug because of polypharmacy considerations, and the drug does not require renal adjustment (Epocrates, 2019). This fact is beneficial to consider because she has diabetes. Assuming that the patient has missed doses over the last month, the priority is to determine why. Costa et al. (2015) recommend explaining how to take medication, discussing reluctance to take drugs, and a conversation about the patient’s beliefs and knowledge about their health and treatment. I believe that this is a great strategy to use with the patient. Medication adherence is troubling and particularly so with the elderly who have multiple medications and conditions. I think it is essential for the patient and provider to be partners in the plan of care. The patient must agree to it and fully understand their conditions and the purpose of each medication. 

                                          References

Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E., Laosa, O., … Marengoni, A. (2015). Interventional tools to improve          medication adherence: review of literature. Patient Preference And Adherence, 9, 1303–1314. doi:10.2147/PPA.S87551Epocrates. (2019). Metoprolol Tartrate Adult Dosing. Retrieved from https://online.epocrates.com/drugs/25501/metoprolol-        tartrate/Adult-DosingRosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO:        Elsevier.

Write a professional essay in 3rd person using APA 6th edition format.

The paper must be written in 3rd person

3-4 pages long

Include a title page and a reference page

Include a minimum of 2 scholarly references 

Rubric

CriteriaRatingsPts 

Title page 5.0 pts
Description of topic selection 5.0 pts
Use of 3rd person in the entire essay 10.0 pts
In-text citations 10.0 pts
Paraphrasing 20.0 pts
Thesis statement 5.0 pts
Introduction paragraph 10.0 pts
subtopic paragraphs 10.0 pts
conclusion 5.0 pts
Reference page 10.0 pts
Grammarly documentation 5.0 pts
APA formatting 5.0 pts

Total Points: 100.0 

  Critically appraise the below article using the criteria listed below:

Articles Websites: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714350/

  PICO question:   In patients with substance use disorder, how does the implementation of a buprenorphine treatment program affect treatment retention compared to a methadone treatment program? 

Research purpose/question/hypothesis

· Quote (add page number) or rephrase the research purpose and/or research question/hypothesis if there is any.

· Identify the major study variables:  can be found in the above statements. Data on these study variables are usually collected using the instruments/tools described in the “measurement” section.

Research design 

· Name of the research design and its level of evidence associated with your PICO question.

· Advantages and disadvantages of this design

Sampling technique, sample size and sample characteristics

· Is sample size adequate or too small?

· Are there any sampling bias? 

· Was the non-response rate high?

Measurement and data collection: 

· The name, reliability and validity of each measurement/tool (except the one for demographics) 

· Data collection methods (who, how and through what channel), e.g. structured vs semi-structured survey, self-report vs. observation or interviewer rated, bio-physiological vs. psycho-social-behavioral, face-to-face vs mailed, telephone, online, computer based, etc. 

· Strategies or lack of description of such strategies to yield high-quality and unbiased data 

Data analysis  

· How were the data analyzed? Were the statistics used appropriate? 

· If there were missing data, did the researchers described how missing data were handled?

·  For longitudinal and repeated measure designs, did attrition or loss to follow-up affect study results? If there were attrition, what statistical methods were used to reach unbiased results?

Other design-specific issues

· Answer the appraisal questions specific to the research design of your article but have not been covered in above sections. 

Major research findings 

· Include the magnitude of effect and strength of association (effect size). 

· Are the findings clinical significant?

Overall validity of the study:

Summarize your answer to the question, “Are the results of the study valid” and state why