EPIDEMIOLOGY AND POPULATION HEALTH REFLECT ON YOUR NURSING PRACTICE FOR A MOM

Epidemiology and Population Health
Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?
The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.
The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.
For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

Review      the Learning Resources, focusing on the smallpox epidemic of the 1960s and      1970s and how health organizations applied principles of epidemiology to      eradicate this disease. (See attached file)
In      light of this example, consider the cost effectiveness of addressing      smallpox at the population level.
Using      the Learning Resources, research a current population health problem      (local or global). Select one on which to focus for this Discussion.
Think      about how principles of epidemiology are being applied—or could be      applied—to address the problem.
What      lessons from the use of epidemiology in the eradication of smallpox might      be applicable to this selected problem? What are the financial benefits of      addressing this issue at the population level as opposed to the individual      level?

By tomorrow Wednesday 02/28/18 by 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:
Post a cohesive response that addresses the following:

1) Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.

2) Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?

3) Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
Chapter 1, “History and Scope of Epidemiology”
Chapter 2, “Practical Applications of Epidemiology” (pages 49–80 only)
Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field. The assigned section of Chapter 2 addresses several uses of epidemiology.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
Building Cultures of Health and Wellness (xxvii)
In the “Population Health Mandate” section of the course text, the authors provide an introduction to population health, noting that it has three core components: health outcomes, health 
determinants, and policies.
Chapter 2, “The Spectrum of Care”
In Chapter 2, the authors examine the purposes of the population health approach. Two key themes are introduced in this chapter: 1) population health as it relates to the challenges of quality and cost in health care, and 2) population health as an approach to not only reducing the burden of chronic illness but also to promoting wellness and increasing prevention.
Chapter 8, “Behavioral Economics”
In Chapter 8, the authors examine effect of social and cognitive function on an individual’s economic decisions. Reinforced by legislation, behavioral economics can be applied in population health to influence and change health outcomes. Compelling examples of incremental improvements (e.g., corporate wellness programs) are provided throughout the chapter.

Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28–32. 
This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.

Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf
This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/
The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, “timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.” It is one of the most important sources of timely public health data published anywhere.

World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/
The World Health Organization provides a succinct overview of the eradication of small pox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:

American Public Health Association. (2011). Retrieved from http://www.apha.org/
Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/

Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm

U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/

Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16

U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
In this week’s program, “Introduction to Epidemiology and Population Health,” Dr. Hull and Dr. Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.

Laureate Education (Producer). (2012). Epidemiology and population health: Epidemiology in nursing practice [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 4 minutes.
In “Epidemiology in Nursing Practice,” Dr. Rebecca Lee, Dr. Donna Shambley-Ebron, and Dr. Missie Willmarth discuss how epidemiology is utilized in nursing practice and, in particular, why it is salient for DNP-prepared nurses.

Optional Resources

Long, D. A., & Sheehan, P. (2010). A case study of population health improvement at a Midwest regional hospital employer. Population Health Management, 13(3), 163–173.

Oudin, Åström D., Bertfil, F., & Joacim R. (2011). Heat wave impact on morbidity and mortality in the elderly population: A review of recent studies. Occupational and Environmental Medicine, 69(2), 99–105.

Excite. (2004). An introduction to epidemiology. Retrieved from http://www.cdc.gov/excite/classroom/intro_epi.htm

DRIVING CHANGE.

ITS IMPORTANT TO MEET THE COMPETENCES !!!

Develop a 4–6-page proposal for executive leadership that addresses changes you would like to see within your organization that would advance the field of nursing.    

Nursing is in the midst of many changes. In this assessment you will consider how you can be a driving force to bring about needed change within the field of nursing.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Explain strategies for effective interprofessional teamwork and collaboration in health care delivery.            
    • (IMPORTANT) -Analyze barriers and resistance to change, and describe strategies to overcome these barriers and resistance to change from an organization, patients, or colleagues.
    • (IMPORTANT) -Identify other health care professionals to enlist as members of an interprofessional team to drive change in an organization.
  • Competency 2: Analyze the implications of working with interprofessional teams in multifaceted health care settings.            
    • (IMPORTANT) -Analyze how a problem impacts an organization, patients, or the nursing profession. 
  • Competency 3: Develop evidence-based nursing interventions to address specific problems and enable systemic change.            
    • (IMPORTANT) -Describe evidence-based solutions to a problem and develop a plan to implement these solutions. 
  • Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations of a nursing professional.           
    • (IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, and mechanics. Use correct APA format.

Assessment Instructions 

Preparation

To prepare for this assessment, you will need to think about changes you feel are needed to address a problem either within nursing as a professional field or within the organization where you work. Narrow down your options by considering which change would best be undertaken by an interprofessional team. Some examples for you to consider might include:

  • The use of mobile and portable technology to support patients.
  • Using evidence-based practice (EBP) to improve patient care.
  • Increasing patient safety and quality of care.
  • The use of medical technology such as genes and stem cells, or robots in the OR.
  • Addressing the nursing shortage now and into the future.
  • Improving the work environment (providing calm, supportive spaces for nurses; improved dialog between health care professionals).
  • Better safety for nurses at work (violence, spreading diseases, physical injury).
  • Substance abuse by health care professionals.

Or you can narrow the scope to an issue within your own organization:

  • Developing a mobility program for an inpatient unit.
  • Implementing “smart” technology to assist in patient monitoring.
  • Creating a mentoring program to attract and retain nurses.
  • Implementing protocols for infection control and/or treatment of an epidemic.
  • Developing a plan to eliminate physical violence and verbal abuse in the workplace.
  • Other.

Once you have selected an issue to address, look for scholarly and professional articles that focus on the problem, the needed change, and how interprofessional teams can work together to drive change.

Requirements

Lately you have noticed the need for changes within your organization that would advance the field of nursing. You have decided to develop a proposal and submit it to executive leadership. Format this assessment as a professional proposal. You may want to look at how proposals are drafted within your organization and follow that format. You will still need a references page; follow APA guidelines for in-text citations and references.

Address the following in your proposal:

  • Briefly describe the problem and how it impacts the organization, patients, and/or the nursing profession.
  • Describe possible evidence-based interventions for the problem.
  • Analyze potential barriers and resistance to change that might come from the organization, patients, and/or colleagues.
  • Describe strategies to overcome barriers and resistance to change.
  • Develop a plan to implement evidence-based interventions. What steps would you take? What resources might you need?
  • Identify other health care professionals to enlist as team members to help drive change in the organization.

Your completed assessment should be 4–6 pages in length, not including title page and references page. Support your statements and intervention plan with references to and citations for at least four scholarly or professional resources.

Additional Requirements

  • Include a title page and references page.
  • Reference at least four current scholarly or professional resources.
  • Use APA format for citations and references.
  • Use Times New Roman font, 12 point.
  • Double space.

Explain how you would promote stakeholder involvement for your proposed change, and encourage them to become change champions.

NURS 6241: STRATEGIC PLANNING IN HEALTH CARE ORGANIZATIONS – Discussion 10 (Grading Rubic and Media Attached)

Discussion: Team Building and Addressing Barriers to Planned Change

Planning and implementing change can be quite challenging, especially in a complex health care environment. No matter what kind of change is undertaken, there are likely to be some obstacles. Yet, wise leader-managers, and those with whom they work, recognize that change is necessary and revitalizing; they see that planned change can not only contribute to organizational sustainability but also promote high-quality care and positively impact patient outcomes. These leader-managers harness a larger vision and engage in forethought and analysis to minimize and address barriers to planned change.

Based on what you have learned about the change process and strategic planning, what barriers do you think may arise related to the change you are proposing through your Course Project? How would you cultivate stakeholder involvement and promote team building for your planned change?

As you think about these questions, consider the following statement: “The system will evolve based on changes in the behavior of the people in the system” (Nesse, Kutcher, Wood, & Rummans, 2010, p. 27).

Do you agree? Why or why not? How does this relate to the specifics of your strategic plan?

To prepare:

Review the information presented in the Learning Resources, including Dr. Carol Huston’s comments on addressing barriers to implementing a strategic plan change. Consider insights related to change theory, common barriers to change, and strategies for addressing these barriers that relate to the implementation of your proposed change.

Identify specific barriers you are likely to encounter with your proposed change, including resistance to change. Evaluate strategies that may be used to minimize or address these barriers.

Think about the value of stakeholder involvement in planned change, as well as the specifics of stakeholder participation in your strategic plan to champion the change. Who should be involved in strategic planning and at what point? How could they serve as change champions?

Post an explanation of strategies you would use to minimize or address barriers, including resistance to change, related to your strategic plan. Explain how you would promote stakeholder involvement for your proposed change, and encourage them to become change champions.

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Provide feedback on their strategies for addressing barriers to change.

Suggest additional strategies for addressing barriers or resistance.

Offer additional insights for identifying appropriate stakeholders.

Suggest additional stakeholders or change champions to be involved.

Required Readings

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Chapter 8, “Planned Change” (pp. 162–180)

(Note: You may have read this in a previous course.)

Sare, M. V., & Ogilvie, L. (2010). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.

Review Chapter 7, “The Three Key Elements of the Strategic Planning Process: A Vision That Guides Nursing’s Future Action”

“The Architect, Change Agent, and Communicator: Three Crucial Roles in Strategic Planning” section (pp. 135–136)

Chapter 9, “Understanding Change Theory: Strategic Planning Change Agents” (pp. 171–194)

Chapter 10, “Communicating the Strategic Plan” (pp. 195–212)

Chapter 11, “Eight Cautionary Tales of Strategic Planning” (pp. 215–226)

Chapter 9 examines change theories and how these theories can be applied in strategic planning. Chapter 10 explores the importance of communication throughout the strategic planning process and how strong communication and reduce barriers to change. Chapter 11 provides examples from the field of strategic planning efforts.

Gerrish, K., McDonnell, A., Nolan, M., Guillaume, L., Kirshbaum, M., & Tod, A. (2011). The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses. Journal of Advanced Nursing, 67(9), 2004–2014.

Retrieved from the Walden Library databases.

This article describes some of the barriers to change (in this case, implementing evidence-based practices) that nurses encounter and examines knowledge brokering to facilitate change.

McMurray, A., Chaboyer W., Wallis, M., & Fetherston, C. (2010). Implementing bedside handover: Strategies for change management. Journal of Clinical Nursing, 19(17/18), 2580–2589.

Retrieved from the Walden Library databases.

This article examines a change in nursing handover practices to analyze change management with attention to individuals’ attitudes, motivations, and concerns. See Figure 2 for example of unfreezing, moving, and freezing.

Nesse, R. E., Kutcher, G., Wood, D., & Rummans, T. (2010). Framing change for high-value healthcare systems. Journal for Healthcare Quality, 32(1), 23–28.

Retrieved from the Walden Library databases.

The authors address factors that impede change and discuss change management principles, including the value of team investment for facilitating change.

Required Media

Laureate Education (Producer). (2013c). Challenges of implementation [Video file]. Retrieved from https://class.waldenu.edu

Note:  The approximate length of this media piece is 3 minutes.

Dr. Carol Huston discusses some of the challenges faced when implementing a strategic plan and strategies for addressing those challenges.

Respond on to two different days who selected different immune disorders and/or factors than you, in the following ways:Share insights on how the factor you selected impacts the pathophysiology of

Respond on to  two different days who selected different immune disorders and/or factors than you, in the following ways:Share insights on how the factor you selected impacts the pathophysiology of

Respond on to  two different days who selected different immune disorders and/or factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

                                                       Main Post

Maladaptive Responses to Immune Disorders

      For this week’s discussion post, we will discuss the maladaptive and physiological responses of HIV and Lupus.  We will first discuss the pathophysiology of each and then further break the disorders down.  We will review how the gender factor might impact the pathophysiology of the disease.

Pathophysiology of HIV

     Human Immunodeficiency Virus (HIV) is the viral infection that leads to Acquired Immune Deficiency Syndrome (AIDS).    HIV is a blood-borne pathogen.  Modes of transmission for HIV are IV drug abuse, blood product transfusion or transmission, maternal-child transmission, and both homosexual and heterosexual populations can be affected.  HIV seeks and destroys the CD-4+ Th cells.  CD-4+ cells are essential or the cytotoxic T cell and plasma cell development.  Because of the CD-4+ destruction, there is a suppressed immune response which leads to AIDS (Huether & McCance, 2017). 

Maladaptive Response and the Female Factor

     Maladaptive responses to HIV are anxiety, disturbed thought processes, imbalanced nutrition, infective coping, social isolation, this is just a few.  Women make up more than half the cases worldwide.  Approximately 50,000 new cases of HIV present each year in the United States, 25% of these new cases are from heterosexual relationships with two-thirds of that percentage being women, highest among black women (Huether & McCance, 2017).

Pathophysiology of Lupus

     Autoantibodies target specific self-antigens known as the initiation phase.  Environmental factors, such as sunlight, may be the cause for these triggers or viral infections like Epstein-Barr. SLE has long been thought to have an active genetic link.  In an average individual, apoptotic cells self destruct but for individuals with systemic lupus erythema (SLE) effectively immunize themselves with bad cells from their tissue.  The body fights itself instead of excreting the bad cells.  Propagation is the second phase of SLE; this phase involves the inflammatory response and tissue damage and can affect the heart, kidneys, brain, skin, and joints.  Thirdly is the flare stage and includes a quicker and more vigorous immune response; this stage may provoke disease flares (Hammer & McPhee, 2019).

Maladaptive Response and the Female Factor

     Maladaptive responses to SLE might be altered image issues, fatigue related to chronic inflammation, and impaired skin integrity related to skin rash.  Women are ten times more likely to develop SLE than men.  African Americans have the highest risk, followed by Hispanics, Asian Americans, and Native Americans.  The primary age to develop SLE is between 20-40 years old (the childbearing years) with the most prevalent age being around 30 (Lewis, Bucher, Heitkemper, & Harding, 2017).

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th  ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis, MO: Mosby.

Lewis, S.L., Bucher, L., Heitkemper, M.M., & Harding, M.M.  (2017) Medical-surgical nuring assessment and management of clinical problems (10th ed.).  St. Louis, MO:  Elsevier