Health Resources and Services Administration (HRSA) is the primary federal agency for improving access to healthcare by strengthening the healthcare workforce, building healthy communities, and achieving health equity. 

Integrated care involves a team of primary care, dental, and behavioral health practitioners working together using a systematic, cost-effective approach to patient care.

After the reading the following HRSA Report:

https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/primarycare-dentist/reports/actpcmd-14-report.pdf

1-Discuss what are the 4 main recommendations given on this report and the rationales for each one.

APA style, 600 words, 2 references not older than 2 years. 

Purpose

The purpose of the assignment is to guide students in identifying behaviors and interactions that commonly occur during the health history portion of a well-child exam. In doing so, students can develop strategies to improve anticipatory guidance and health education by using effective, non-biased, and non-judgmental communication.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

Synthesize information in which addresses child health promotion,  developmental surveillance, observation of parent-child interaction,  anticipatory guidance, social determinants of health, and/or cultural competence.

1. As you view the video, observe the parent-child and the parent-provider interactions. Pay particular attention to the parent’s responses to the provider’s questions making note of inappropriate and appropriate responses.
    
2. Choose five (5) topics from the following categories to complete the assignment: 
   • Cognitive Developmental Milestones
   • Physical Developmental Milestones
   • Social-Emotional Developmental Milestones
   • Safety
   • Alcohol/Substance Use
   • Environmental Health Risks
   • Temper Tantrums and Discipline
   • Sleep Routines
   • Car Seat Safety
   • Healthy Teeth
3. You will develop and complete a table for each one of the five (5)  categories using the example below as a guide. (Note: There are at least  10 categories addressed in the video, you must choose five (5) and create a separate table for each one).
4. For each of the tables, complete each section: 
   1. Issue: Category name
   2. Negative interaction/behavior: What did you see or hear that was inappropriate? 
   3. Positive interaction/behavior: What did you see that was appropriate? 
   4. Guidelines/recommendation: What does the research recommend? 
   5. Scholarly reference: Must be in APA format within the table. 
   6. Professional/Ethical Communication: How will provide non-judgmental and non-bias education regarding the issue identified? Needs to be at least 3 sentences. Helpful Hints: Acknowledge how they feel, state the facts, and provide education or re-frame the approach.
5. Scholarly references should be peer-reviewed, preferably a Clinical  Practice Guideline (CPG), intended for providers (MDs, NPs) and no more than 5 years old (unless it is a clinical practice guideline’s most recent update).

Preparing the Paper

1. The table provided below is an example only. It cannot be used to satisfy the requirements for any part of the assignment.
2. You may format your tables according to your preference, but APA format is required for the reference column.

SEE ATTACHMENTS FOR TABLE FORMAT AND SPECIFIC REQUIREMENTS (The attachment says week 3 but is the right rubric)

VIDEO TRANSCRIPT (SECOND ATTACHMENT) MUST READ IN ORDER TO COMPLETE THE ASSIGNMENT

The CDC and Healthy People 2020 continue to educate on the importance, the improved ease of access and insurance coverage for screenings and vaccinations. It is the responsibility of nurses to engage our aging adults in self-advocating for services that benefit the individual and community health. 

A: How can you, as a registered nurse, impact older adults to encourage routine vaccination? 

B: What impact does this have on the community as a whole?

Your initial posting should be at least 400 words

 This is the ongoing project discussion portion of this class. My population is geriatric/elderly. The problem is BP…

I will attach previous discussions because it all needs to tie in together

350 words

at least 3 references cited in the discussion.

must be last 5 years

Overview: Dr. Marcia Stanhope (2020) explained that evidence-based public health practice refers to those decisions made by using the best available evidence, data and information systems and program frameworks; engaging community stakeholders in the decision-making process; evaluating the results; and then disseminating that information to those who can use the information.

Practicum Discussion: This week, your assignment will be to incorporate all of the information you have gathered from the community—including the population itself, health data, interviews/conversations with interested community members, and your community assessment, including your Windshield Survey—as well as what you have gathered from scholarly literature to propose measureable interventions. Measureable interventions mean that the results can be measured through some data that could be collected (Stanhope, 2020). This requires thinking in terms of actions and then measuring results. An evaluation of interventions is important to see whether or not they are effective in solving a health care problem. Remember, you will need to use the data you gathered to determine whether or not a problem exists in your community and to then determine whether your interventions might be effective.

Please discuss the following points in your Practicum Discussion:

• Identify one evidence-based behavior change that would promote health in your selected population.
• Suggest one specific culturally sensitive, evidence-based, measureable intervention to address the health problem for your selected population.
• Think in terms of measuring outcomes. What outcomes would you expect to see once the intervention(s) are in place? Be specific.

By Day 4

Post your response to this Discussion.

Support your response with references from the professional nursing literature.

GOAL of PRACTICUM PROJECT

Overall Purpose for Practicum: Develop a potential project to improve the health of a specific population of interest or a population at risk.

This practicum is designed to help you develop as a scholar practitioner and health leader to promote positive social change in your own community. In this practicum experience you will focus on primary prevention of a health problem in your community (see text for definition.)  You already possess the knowledge and skills to help those who are acutely ill. This experience will help learn how to prevent a health problem in a specific population at risk at the community and system level of care (see text for definition). Consequently, because you are well aware of how to care for individuals you will now develop leadership and advocacy skills to improve the health of the community.  Collaborating with other professionals and community members in your community will be the key to a successful practicum and project. Collaborate with each other in the discussions, with your instructor, with health care professionals (nurses and other disciplines), with local and state departments of health, and most importantly with the population you hope to help. As an advocate, you will promote positive social change through collaboration with families, communities, and professionals in the health care system. You will develop a culturally relevant proposal that could improve health outcomes for a specific population at risk in your community. 

WK 1

I live in a small community located in northwest metropolitan Atlanta, Georgia. The population as of 2019, was 21,760 people. The breakdown of the population is 31% under the age of 18, 14.9% 65 years or older, 51.2% are women. 73% White, 20.8% Black/African American, 12.7% Latino/Hispanic. I am currently practicing at a privately owned hospice company where we provide services to adult patients in their homes and facilities in North Georgia.

Race is a major social determinant of health. African Americans have a higher rate of significant health problems and functional limitations.  Economic resources are also a social determinant of health. As poverty increases, mortality rates increase. Economic resources are also needed to provide basic needs such as housing and food, and is required to obtain health care and medications. Social isolation and loneliness also are social determinants that have profound effects, especially during the COVID 19 pandemic.

As a hospice nurse, the majority of my patients are the geriatric population and the population at risk I am choosing to focus on for this project. The most prevalent health problems include heart disease, respiratory diseases, stroke, cancer, diabetes, and dementia.  Depression is also a problem that occurs, leading to increased suicide rates of the geriatric patient. Injuries or death related to falls is a perpetual problem in the elderly. Malnutrition is widespread and seen in nearly every older patient, which is related to access to food, decreased physical ability to shop, cook, or eat. Malnutrition could also happen due to other comorbid conditions that the senior has such as dementia.

References

U.S. Census Bureau QuickFacts: Cartersville city, Georgia. (n.d.). Www.Census.Gov. Retrieved September 7, 2020, from https://www.census.gov/quickfacts/cartersvillecitygeorgia

Equity and Social Determinants of Health Among Older Adults | American Society on Aging. (n.d.). Www.Asaging.Org. Retrieved September 7, 2020, from https://www.asaging.org/blog/equity-and-social-determinants-health-among-older-adults#:~:text=Race%20long%20has%20been%20known%20to%20be%20a

10 common elderly health issues – Vital Record. (2018, June 25). Vital Record. https://vitalrecord.tamhsc.edu/10-common-elderly-health-issues/

WK2

According to the CDC (FastStats – Hypertension, 2019), 63.1% of adults age 60 and over have high blood pressure, which is three times higher than adults aged 20-44. Georgia ranks #33rd in the nation.  (Explore High Blood Pressure in the United States | 2019 Annual Report, n.d.). High blood pressure is one of the leading risk factors in heart attack and stroke.

As a person ages, the size of the liver decreases, and the blood flow is reduced, which reduces how quickly the liver metabolizes medication. Kidney size is reduced, and blood flow is less, resulting in low renal clearance (Beers Criteria: Some Medications to Avoid in the Elderly, 2012). Because of these physiological changes, controlling blood pressure in geriatric patients can be challenging. Cognitive impairments due to age-related dementia can result in medication noncompliance and not being able to recognize symptoms of hyper/hypotension. Physical limitations result in difficulty going to regular doctor appointments, regular physical activity, and not being able to cook a healthy heart diet, all leading to uncontrolled blood pressure.

The geriatric patient needs to be closely monitored due to drug sensitivity. Because of increased sensitivity to medication, orthostatic hypotension is a significant concern for the elderly population. Orthostatic hypotension can result in falls, syncope, or death. (Arik & Yavuz, 2014)

In looking for information for this discussion, I utilized Google Scholar for my search engine. I found much of my statistics through CDC website.

References

ARIK, G., & YAVUZ, B. B. (2014). Hypertension in Older Adults-Geriatrician Point of View. Journal of Gerontology & Geriatric Research, 03(05). https://doi.org/10.4172/2167-7182.1000182

Beers Criteria: Some Medications to Avoid in the Elderly. (2012). Tmc.Edu. https://www.uth.tmc.edu/HGEC/GemsAndPearls/medications_BeersCriteria.html

Explore High Blood Pressure in the United States | 2019 Annual Report. (n.d.). America’s Health Rankings. Retrieved September 13, 2020, from https://www.americashealthrankings.org/explore/annual/measure/Hypertension

FastStats – Hypertension. (2019). https://www.cdc.gov/nchs/fastats/hypertension.htm

WK3

We all know the top risk factors for getting or becoming more severely ill from Covid-19 include age, heart disease, or diabetes. Surprisingly, there may be a genetic link to being more susceptible or getting more severely sick from Covid-19 according to researchers. (Willingham, 2020).  Researches have recently tied the severity and susceptibility of COVID-19 to two genetic links associated with a person’s immune system. One is a persons blood type, the other is a gene that regulates chemokines (Willingham, 2020). Researchers warn that this genetic knowledge is not 100% and does not factor in the social and economic inequalities that increase risk of susceptibility and severity, rather it reveals information about the disease susceptibility which may help identify therapeutic drugs to target those biological pathways and lead the way to a cure for the entire populations, not just those with specific genes (Willingham, 2020).  Chromosome 3 hold genes that encode chemokines to attract immune cells and proteins that interact with our gatekeeper into cells, angiotensin-converting enzyme 2, also known as ACE2 (Willingham, 2020).  On chromosome 9 lies DNA that determines a person’s blood type.  Compared with other blood types, type A are at a higher risk of getting Covid-19 and have a 1.5 times higher risk of respiratory failure and those with type O had the lowest chance of all blood types for getting Covid-19 or experiencing respiratory failure (Willingham, 2020). 

By 2050 the population of adults 65 and older is expected to be 83.7 million, almost double the population in 2012 (Journal of the American Geriatrics Society). The minority population of older adults is expected to rise from 20.7% in 2012 to 39.1% in 2050 with the largest increase in Asian, Native Hawaiian, and other Pacific Islander populations , and the Hispanic population over 65 will have doubled (Journal of the American Geriatrics Society).  This means that our elderly care will also have to be ethnically diverse, culturally sensitive, and unbiased.

Culturally sensitive interventions that would be top priority would be asking the patient their preferred language and offering interpreter service in that language for any education (Journal of the American Geriatrics Society, 2016).  This is important with any education but can be lifesaving for Covid-19 prevention education. It is equally important to know the patient’s education level, cognition, and hearing to ensure understanding as well as knowing if they have a surrogate or who all will be involved in decision making (Journal of the American Geriatrics Society, 2016).  Customizing care to and individual’s cultural and language preferences will result in a more positive health outcome for this diverse population (Journal of the American Geriatrics Society, 2016).

Achieving High-Quality Multicultural Geriatric Care. (2016). Journal of the American Geriatrics Society, 64(2), 255-260.  https://doi.org/10.1111/jgs.13924

Willingham, E. (2020). Genes May Influence Covid-19 Risk, New Studies Hint.  Scientific America. Retrieved from: https://www.scientificamerican.com/article/genes-may-influence-covid-19-risk-new-studies-hint/#:~:text=Combing%20through%20the%20genome%2C%20researchers,2%20coronavirus%20into%20our%20cells

This week your assignment will be focusing on conducting a community assessment and writing a health policy brief. You will need to have a community health provider to interview. The interview does not have to be in person but needs to be with a community health provider that works in the community being assessed. You will use the Functional Health Patterns document provided in the Study Materials Folder to conduct a “windshield” survey of your community. Note: you will need to do some research to find supportive data for many components of the Functional Health Patterns that cannot be determined through a windshield survey. Ex. Child abuse rates, STI rates, Obesity %, etc. The Functional Health Patterns data is part of your PPTX. Speaker notes should be provided for content slides.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students to engage in learning within the context of their hospital organization, specific care discipline, and local communities.

This assignment consists of both an interview and a PowerPoint (PPT) presentation.

Assessment/Interview

Select a community of interest in your region. Perform a physical assessment of the community.

1. Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”

2. Interview a community health and public health provider regarding that person’s role and experiences within the community.

Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.

Complete the “Provider Interview Acknowledgement Form” prior to conducting the interview. Submit this document separately in its respective dropbox.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation.

PowerPoint Presentation

Create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

1. Description of community and community boundaries: the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges, including any identified social determinates of health.

2. Summary of community assessment: (a) funding sources and (b) partnerships.

3. Summary of interview with community health/public health provider.

4. Identification of an issue that is lacking or an opportunity for health promotion.

5. A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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