Monica Bullock    1 posts   Re: Topic 3 DQ 1  Paz-Pacheco, E., Sandoval, M. A., Ardena, G. J. R., Paterno, E., Juban, N., Lantion-Ang, F. L., … Bongon, J. (2017). Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting. Primary Health Care Research & Development (Cambridge University Press / UK), 18(1), 35–49. https://doi- org.lopes.idm.oclc.org/10.1017/S1463423616000335  This study was done to assess the effectiveness of diabetes self-management in rural agricultural towns. It gives a great out line of how the programs were implemented and great statistics. This fits with the population that I deal with at my practicum sight. The down side is that the study was conducted in the Philippines. Not that the information is not valid it just makes it less relatable. On that not I think I would need more information for evidence based practice changes, something relatable to the US. For my capstone project I think it provides great ideas to solve the problem.  Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos, & Romeu Mendes. (2019). The Impact of a Community-Based Food Education Program on Nutrition- Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial. International Journal of Environmental Research and Public Health, (13), 2403. https://doi-org.lopes.idm.oclc.org/10.3390/ijerph16132403  This study focused on food based interventions. Educating the community on food and how it will affect the body. Randomly people were assigned a workout program and diet program then tested the knowledge of food nutrients through a questionnaire before and after to produce results. I think this is a good study to use because it shows how food is a major role in life style changes and the effects on A1C. The down side is the study data is confusion to read and it does only focus on a specific demographic, but it does apply to the question I want to answer. This would be relatable and with the support of another study would be great for evidence based change.  Prezio, E. A., Pagán, J. A., Shuval, K., & Culica, D. (2014). The Community Diabetes Education (CoDE) Program: Cost-Effectiveness and Health Outcomes. American Journal of Preventive Medicine, 47(6), 771–779. https://doi- org.lopes.idm.oclc.org/10.1016/j.amepre.2014.08.016  The study looks at how effective community based teaching programs are with minority and low income groups. Once education was initiated the participants A1 C was tracked for a year to observe for any improvements. Cost was also evaluated vs benefits. I think this is a good one study to use since in recent years I have seen these type of programs pop up in the community. The study focuses on Mexican American who are uninsured, a large part of my community population. I think this would provide enough for evidence based practice changes since it is relatable to my community.  Bielamowicz, M. K., Pope, P., & Rice, C. A. (2013). Sustaining a Creative Community-Based Diabetes Education Program: Motivating Texans With Type 2 Diabetes to Do Well With Diabetes Control. Diabetes Educator, 39(1), 119–127. https://doi- org.lopes.idm.oclc.org/10.1177/0145721712470605  This is an interesting one that take place in Texas and uses cooking as the way to have patients take action in the their own self-care. Using a free healthy cooking class offered to anyone that signed up participants were interviewed at the beginning to see what they viewed as healthy life style changes and cooking. A1Cwere also measured and glucoses levels. At the end of the classes the same things were measured to show improvement and more interest in self-care. This is a unique way to have patients take responsibility for their care through the food they prepare. The down side is the person has to have an interest in cooking and food. On its own I think this would have a strong argument for evidence based changes, but would be stronger with added support from a different study.  Aguiar, E. J., Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Young, M. D., & Callister, R. (2016). Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT. American Journal of Preventive Medicine, 50(3), 353–364. https://doiorg.lopes.idm.oclc.org/10.1016/j.amepre.2015.08.020  This study looks at the PULSE program which contains education on weight loss through life style modifications. It followed high risk men for one year to see if there was improvements in A1C and glucose with the implementation. The program is gender tailored and individually tailored. Weakens would be it only focusses on men, but still could provide good information on life style changes and the effects.

Develop a concept map of the responses of the assigned system to burn injury. identify aspects important to patient survival during the resuscitation and acute phase of the burn injury , Include lab values that may be impacted one of the following body systems:

 Respiratory

 Cardiovascular

 Neurological

 Gastrointestinal

 Renal

 Psychosocial

Peer 1 

Advanced practice nurses play a major role in transforming the healthcare system enhancing increased healthcare accessibility, provision of value-driven healthcare environment as well as promote the delivery of high quality of care to patients. The advanced practice nurses develop and implement numerous initiatives and health programs aimed at promoting effective disease management thereby enhancing continuous improvement in value, access, and quality of healthcare services (Pickard, 2014). 

          There are various tactics utilized by advanced practice nurses to put them in a better strategic position regarding pay equality. Such tactics include designing and implementing cost-efficient and effective healthcare models to facilitate maximum utilization of advanced practice nurses’ contributions. Furthermore, the diversity associated with a nursing practice including a wide range of roles and numerous varieties of practice settings calls for application of care and cost-effectiveness standards thereby influencing nurses to acquire a better position on pay equality (Pickard, 2014). Another tactic employed to enhance advanced practice nurses attains pay equality is enhancing the appropriate presentation of nursing practice in both the decision-making panels of the government and private organizations. The presentation facilitates the implementation of effective metrics under which payment, pricing, cost, and value are based on. 

          Advanced practice nurses should not view themselves as lower-cost providers given that their knowledge, skills, and capabilities of healthcare practice continue to expand and advance over a given period. This means that their delivery of care services improves with time calling for an increase in payment to enhance maximum utilization of their dynamic evolving skills to impact the positive transformation of the healthcare system (Woo, 2017). As APNs continuously contribute to the establishment of innovative healthcare models to enhance the satisfaction of the patient’s needs, the payment schemes must include appropriate measures of the value contributed by the APN 

Peer 2 

Although advanced practice nurses, commonly referred to as APN, provides somewhat similar services, their pay often tends to match owing to a variety of distinct reasons. A persistent salary gap exists in the nursing profession (Bhagyalekshmi, Sha, & Rajendran, 2019). As a result, this has been perceived, by many, as both discriminatory and harmful. The salary gap often exists on gender basis. Based on a study conducted by Nurse.com, fields where female nursing practitioners are considered to be dominant bear significant disparities in terms of pay (Yi, 2016). In such scenarios, male APNs tend to earn more money in the profession as compared to their female counterparts. As such, the need prevails to come up with relevant strategies that would facilitate relevant means of bridging the said gap. 

One of how pay inequity could be rectified is by ensuring that female nurse representatives can negotiate salaries for female nurses before them accepting the employment opportunity (Yi, 2016). Las such, one should not be willing to accept a job before issuing a counteroffer regardless of how much one requires or is need of the job. By doing so, this should enable employers to create favorable offers for all their employees based on their specified qualifications.  

Another way in which equality may be promoted in the nursing profession is by ensuring that there is proper representation for all nurses (Yi, 2016). Similar to how workers from different profession obtain proper representation such as their involvement in trade unions, nurses should also have a relevant body which is intended to guarantee proper working conditions for them. In addition to this, the employees, in this case, may be able to obtain better pays that are bot no-discriminatory and equal among all nurses. 

APNs’ Position 

Owing to APNs’ contribution to the healthcare system, they must be treated similarly when it comes to matters regarding their pay (Yi, 2016). The main reason for this is because people in the profession often undergo proper training that makes them uniquely skilled for their various position, and hence their services may and cannot be provided by individuals from other career fields.  

Although nurses are involved in the provision of low-cost services to patients, this should not necessitate lower pay in comparison to other occupations (Hakim & Bahri, 2016). The main reason behind this mostly lies behind the fact that they provide services that are crucial and life-saving from a literal point of view. As such, this should necessitate them to push for a pay that is comparable with others. This should be extended to them being issued with similar services as well. By doing so, this would enable the nurses to feel highly motivated hence allowing them to provide better services to their customers (Yi, 2016). As a result, the facility or institution in which they provide may be able to experience increased growth more so since more people would be willing to obtain healthcare services from the hospital in question.  

With the inclusion of equal pay among APNs, this would create room for proper working conditions in the profession. In addition to this, this would ensure that proper legal requirements are instilled concerning the protection of the welfare of employees (Hakim & Bahri, 2016). Similarly, this would allow for the creation of opportunities where nurses experience economic boost hence ensuring that they work in a manner that best guarantees innovation and competitiveness in the profession. 

Response post with a minimum of 150 words each response. Word document, double space. APA (6th) 

Below is the original activity if you needed:

Reflect on the current roles of advanced practice nurses in healthcare as the care providers at the front line of disease management and health promotion in primary care and many other specialty settings. What do you think are some effective tactics for APN strategic positioning regarding pay equality? Should APNs position themselves as lower-cost providers who provide better care or push for comparable worth, same service and same pay?
 

Below is an article that provides great practical information that highlights how provider productivity is calculated in the clinical setting, which is important to know as future nurse practitioners.

Calculating Your Worth: Understanding Productivity and Value- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/

 Discuss two personal strength and  weaknesses you have regarding substance-induced mental disorders. Name two method for improvement for each of these, and discuss why it is important for you to work on these skills if you want to present your findings in a more formal setting