DNP 825 Topic 6 DQ 2

DNP 825 Topic 6 DQ 2

How can large, aggregated databases be used to improve population health

Discuss a health-related need present in your community. What health improvement program or methodology would you use to solve this problem and what would be a reasonable timeline for implementation? Provide examples of measures that APNs might use when collaborating with direct care nurses to implement evidence-based changes based on community health improvement programs. Provide any relevant literature to support your response.

Discuss a health-related need present in your community.

The health related need present in my community is Covid-19 vaccination to help end Covid-19 pandemic as a preventable health concern. Vaccination is the most impactful and cost-effective public health intervention available for averting the pandemic. It offers protection against Covid-19 as a preventable disease while laying the foundation for primary health care, providing an avenue for delivering other basic health services, and bringing the community into contact with health systems (Henry et al., 2021). In addition, the investment in Covid-19 vaccination would bring about broad economic and social benefits. Getting fully vaccinated against Covid-19 is important for preventing serious illness, acts as a safe and reliable way for building protection against first infection, and offers added protection for those previously infection (Bartsch et al., 2021). Since Covid-19 first emerged in 2019, there has been tremendous gains in developing and providing public access to vaccines. Despite these achievements, the vaccination coverage rates have stagnated. Approximately 80.9% of the USA population has received at least one dose of the vaccine while only 69.1% of the population is fully vaccinated. There is a need to increase Covid-19 vaccination rates (Our World in Data, 2023).

What health improvement program or methodology would you use to solve this problem and what would be a reasonable timeline for implementation? Provide examples of measures that APNs might use when collaborating with direct care nurses to implement evidence-based changes based on community health improvement programs.

An appropriate program for improving vaccination rate is nurse-led public education that would be implemented in two months. The education program would focus on rethinking how nurses talk about vaccines and changing the views of those who are highly skeptical about vaccine effectiveness and safety. This involves creating education material that amplifies accurate and positive information about the vaccines, while building public resilience to misinformation. In addition, presenting vaccination as a social norm; showing that it is a common and widely accepted health activity. This aspect leverages the trusted and powerful voice of nurses as it gets individuals to share the positive impacts of vaccination on their lives (Stanhope & Lancaster, 2020).

References

Bartsch, S. M., O’Shea, K. J., Wedlock, P. T., Strych, U., Ferguson, M. C., Bottazzi, M. E., Randall, S. L., Siegmund, S. S., Cox, S. N., Hotez, P. J., & Lee, B. Y. (2021). The Benefits of Vaccinating With the First Available COVID-19 Coronavirus Vaccine. American journal of preventive medicine, 60(5), 605–613. https://doi.org/10.1016/j.amepre.2021.01.001

Henry, D. A., Jones, M. A., Stehlik, P., & Glasziou, P. P. (2021). Effectiveness of COVID-19 vaccines: findings from real world studies. The Medical journal of Australia, 215(4), 149–151.e1. https://doi.org/10.5694/mja2.51182

Our World in Data (2023, January 10). Coronavirus (COVID-19) Vaccinations. https://ourworldindata.org/covid-vaccinations?country=USA

Stanhope, M., & Lancaster, J. (2020). Public Health Nursing: Population-Centered Health Care in the Co

REPLY

it is true that vaccination is the most impactful and cost-effective public health intervention available for averting COVID-19 pandemic. Before the vaccine was discovered there were high mortality and transmission rates. Therefore, vaccination came as a sigh of relief to many people who were vulnerable to the respiratory complications. However, high demand of vaccine has crippled efforts from other health stakeholders to avert the pandemic (Biswas et al., 2021). Unfortunately, some people struggled to access vaccines since there was high demand. Getting fully vaccinated against Covid-19 is important for preventing serious illness, acts as a safe and reliable way for building protection against first infection. The introduction of the boaster shot was important in improving body resilience to the virus. The cost of having adequate vaccine at the peak of the pandemic scared many health stakeholders (Ndwandwe & Wiysonge, 2021). Still, high mortality and transmission rates compelled governments to spend a significant part of their budget to acquire vaccines. Global and regional donors also played a crucial role of ensuring that vaccines are accessible regardless of the geographical locations.

References

Biswas, N., Mustapha, T., Khubchandani, J., & Price, J. H. (2021). The nature and extent of COVID-19 vaccination hesitancy in healthcare workers. Journal of community health, 46(6), 1244-1251.

Ndwandwe, D., & Wiysonge, C. S. (2021). COVID-19 vaccines. Current opinion in immunology, 71, 111-116. https://doi.org/10.1016/j.coi.2021.07.003

Many nurses and health care workers have lost their lives due to hospital facilities un-preparedness when it comes to dealings with pandemics such as COVID-19 by ensuring that enough health protection equipment’s were readily available to provide for healthcare workers and nurses who sacrifice a lot to ensure that there is provision of quality health leading to recovery (Shrader, Assadzandi, Pilkerton, & Ashcraft, 2020).

During the pandemic, nurses felt more stressed, had fewer flow experiences, and were less satisfied with their work, life, work-performance, and well-being than before the pandemic. In addition, nurses felt more appreciation from society but less from their patients. Sense of humor and the perceived appreciation of society and patients were confirmed as buffers of negative pandemic-related effects. Nurses have been at the forefront of the fight against health-threatening epidemics worldwide and will continue to fight on the front lines in the future. In this struggle, it is important for nurses to provide holistic patient care, continuity in nursing care, shortening of hospital stay due to the pandemic, reducing mortality, reducing infection and increasing the quality of life. For the nurses to provide the desired/expected care, they must have good working conditions, adequate nutrition and rest, and the PPE they use should not cause any harm (Rosner E, 2020).

Among the methodology that will be used to solve these challenges is by writing a bill that will be introduced in the congress thus ensuring that the issue is legislated and given the much concentration it requires. To be included in the bills provision is calling and

proposing for an increased emergency fund that will be used to purchase protective equipment’s for working nurses. All healthcare organizations should be inspected regularly to assess their compliance on ensuring that they provide safety equipment’s to protect nurses. Lastly, any organizations that fails to put in place effective measures to provide effective should be punished accordingly to ensure that they comply (Mello, Greene, J. A., & Sharfstein, 2020).

Among measures that APNs might use when collaborating with direct care nurses to implement evidence-based changes based on community health improvement programs will include formation of a joint committee that will carry out effective research on the issue before they may report to respective authorities. The joint meeting should be able to combine their expertise in documenting and indicating the number of nurses who lost their lives due to lack of protective equipment’s. After formation of the document, it will be easy to forward the complaints and bills to respective parties in healthcare system for implementation. The other strategy is organizing

effective campaigns that will ensure that the plights of nurses when it comes to lack of access to effective protective equipment’s is heard. They may achieve the same by mobilizing all individuals at their levels to down their tools if they are ignored thus putting pressure for effective action.

References

Mello, M. M., Greene, J. A., & Sharfstein,J. M. (2020). Attacks on public health officials during COVID-19. Jama, 324(8), 741-742.

Rosner E . Adverse effects of prolonged mask use among healthcare professionals during COVID-19. J Infect Dis Epidemiol. 2020;6(3):130.

Shrader, C. D., Assadzandi, S., Pilkerton, C. S., & Ashcraft, A. M. (2020). Responding to a COVID-19 Outbreak at a Long-Term Care Facility. Journal of Applied Gerontology, 0733464820959163.

RESPOND HERE

ELSIE I concur with you that some pandemics such as COVID-19 have led to deaths of many nurses and health care workers. Unfortunately, COVID-19 has limited warning time. As a result, hospital facilities and workers were caught unaware. Limited understanding to the pandemic and unprepared intervention mechanisms exposed healthcare workers to dangerous work environment (Galanis et al., 2021). The public and other players expected health workers to contain the pandemic at all costs. As a result, some contacted the virus but recovered as others died due to respiratory complications associated with the same virus. Limited personal protective equipment (PPEs) at the beginning of the pandemic increased chances of health care workers contacting the virus (Al Thobaity & Alshammari, 2020). Besides, nurses and health care workers were received many patients with COVID-19 symptoms. During the pandemic, nurses felt more stressed, had fewer flow experiences, and were less satisfied with their work, life, work-performance, and well-being than before the pandemic. Limited resting time frustrated many nurses during the peak of this pandemic.

References

Al Thobaity, A., & Alshammari, F. (2020). Nurses on the frontline against the COVID-19 pandemic: an integrative review. Dubai Medical Journal, 3(3), 87-92. https://doi.org/10.1159/000509361

Galanis, P., Vraka, I., Fragkou, D., Bilali, A., & Kaitelidou, D. (2021). Nurses’ burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis. Journal of advanced nursing, 77(8), 3286-3302. https://doi.org/10.1111/jan.14839

Topic 6 DQ 2

There are a great many health concerns in Baltimore City including the opioid overuse and abuse, smoking, obesity but also low birth weight, and although HIV rates in the city have declined over the past decade, Baltimore consistently ranks in the top five cities worldwide for infections. About 13,400 residents are estimated to be living with HIV; and while African Americans constitute 62% of the population, they account for more than 85% of those living with HIV (Baltimore City Health Department, 2016). However, the health concern I would like to discuss on this post is how 30% of children in Baltimore have Adverse Childhood Experience (ACE) scores of 2 or more, meaning that they have experienced more than two incidences of events such as domestic violence, living with someone with an alcohol/drug problem, the death of a parent, or being a victim/witness of neighborhood violence.

A health improvement program to address children with elevated ACE scores, which can lead to mental health issues among other concerns, includes community programs for youth and teens, church groups, big brother and big sister programs, and STD clinics. Tsuyuki et al. (2019) discovered each additional ACE reported was associated with greater risk of very early sexual initiation. Per the authors, ACEs have gained recent attention due to emerging evidence of their complex and long-lasting impacts on health. Children exposed to four or more ACEs have up to 12 times the odds of having negative health outcomes in adulthood than children without such exposures. There is no clear timeline as studies vary depending on target area (decreasing domestic violence versus grief therapy) because this sis a wide rage of categories within the ACE scores.

Advanced Practice Nurses (APN’s) are in a unique position to assist with programs as leaders in the healthcare community. APN’s can facilitate care, place individuals in connection with resources, coordinate care and evaluate effectiveness of programs. Alvanzo et al. (2020) suggest ACEs are associated with a variety of physical and mental health problems, including increased risk for problematic drinking and development of alcohol and other substance use disorders. APN’s can initiate health promotion through alcohol reduction programs, outreach groups, and work directly with community members in schools, faith-based organizations, health fairs, and other events. “Several strategies that aim to prevent prescription drug misuse including the CDC prescribing guidelines, prescription drug monitoring program (PDMP), and community-based prevention efforts. A focus on prescriber education is a next logical step. Without streamlined educational practices that support identification of patient need and risk, as well as alternative pain management strategies, there is a risk for biased prescribing (undertreatment of high-risk and marginalized patient groups), inconsistent pain management, unnecessary patient burden, and even possibly death” (Ojeda et al., 2022).

References

Alvanzo, A. A. H., Storr, C. L., Reboussin, B., Green, K. M., Mojtabai, R., La Flair, L. N., Cullen, B. A., Susukida, R., Seamans, M., & Crum, R. M. (2020). Adverse childhood experiences (ACEs) and transitions in stages of alcohol involvement among US adults: Progression and regression. Child Abuse & Neglect, 107. https://doi-org.lopes.idm.oclc.org/10.1016/j.chiabu.2020.104624

Baltimore City Health Department (2016) https://www.health.baltimorecity.gov

Ojeda, M. S., Chen, A. M. H., Miracle, T., Delaney, E., Freiermuth, C. E., & Sprague, J. E. (2022). HealthCare educational differences in pain management, adverse childhood experiences and their relationship to substance use disorder education. Substance Abuse Treatment, Prevention & Policy, 17(1), 1–8. https://doi-org.lopes.idm.oclc.org/10.1186/s13011-022-00436-8

Tsuyuki, K., Noor A Al-Alusi, Jacquelyn C Campbell, DeMarjion Murry, Andrea N Cimino, Argentina E Servin, & Jamila K Stockman. (2019). Adverse childhood experiences (ACEs) are associated with forced and very early sexual initiation among Black women accessing publicly funded STD clinics in Baltimore, MD. PLoS ONE, 14(5), e0216279. https://doi-org.lopes.idm.oclc.org/10.1371/journal.pone.0216279

RESPOND HERE

it is true that Baltimore city has many health concerns ranging from opioid overuse and abuse, smoking, obesity but also low birth weight, and HIV/AIDS infection. The health status of this region calls for elaborate intervention. Different stakeholders may be involved in handling health concerns in Baltimore City. Collective approach can help in sorting these health issues bedeviling the city (Tsuyuki et al., 2019). Unfortunately, children are not exempted in some of these health concerns. Therefore, timely and reliable intervention is necessary in Baltimore. A health improvement program to address children with elevated ACE scores, which can lead to mental health issues among other concerns. Children should be prioritized in the recovery process (Gentner & Leppert, 2019). Other people with special needs in the city should also be identified in time to avoid escalation of their conditions. ACEs have gained recent attention due to emerging evidence of their complex and long-lasting impacts on health. Competent people should be in charge of ACEs to guarantee its success.

References

Gentner, M. B., & Leppert, M. L. O. C. (2019). Environmental influences on health and development: nutrition, substance exposure, and adverse childhood experiences. Developmental Medicine & Child Neurology, 61(9), 1008-1014. https://doi.org/10.1111/dmcn.14149

Tsuyuki, K., Al-Alusi, N. A., Campbell, J. C., Murry, D., Cimino, A. N., Servin, A. E., & Stockman, J. K. (2019). Adverse childhood experiences (ACEs) are associated with forced and very early sexual initiation among Black women accessing publicly funded STD clinics in Baltimore, MD. PLoS One, 14(5), e0216279. https://doi.org/10.1371/journal.pone.0216279