My name is Marjacha Mbah Christina. Currently, I work as a respiratory nurse, having acquired an associate degree in nursing a while back. I was previously a certified nursing assistant (CNA). I am a hardworking individual who is determined in everything I do. Being quite outgoing, I easily form bonds with those around me. I am a strong believer in teamwork and pursue collaboration and cooperation with my colleagues in all possible areas within the workplace. I will also highlight several professional goals I have and outline measures I intend to pursue to achieve those goals.
My Goals
One of my long-term goals is to balance my personal life and my professional life. Striking a balance between these two aspects of my life is very important as a nursing practitioner. Additionally, achieving this balance in my life ensures that no responsibilities are ignored while also facilitating my growth and development as an all-rounded individual in all aspects of life.
Another long-term goal I hope to achieve is to obtain a higher management position. I want to be in a position of leadership where I can lead my colleagues to achieve set goals and objectives. Being in a management position is also important as it confers the power to make and influence health policies to improve the overall safety and quality of healthcare.
Improving my competency level within my area of specialization is the third objective I hope to achieve. Familiarizing myself with procedures, protocols, and other information within my area of specialization is key. Learning and embracing new trends and protocols is important. Accordingly, all this translates to improved quality of health care and, consequently, improved patient safety and satisfaction.
How I Will Get There
Striking a balance between my professional and personal life entails having and adhering to a strict schedule. This schedule should clearly outline all duties, enabling me to plan adequately. Setting aside time for my family, friends, and other hobbies I enjoy is also important. It means that I do not spend all my time at the workplace and that I am also capable of thriving socially. Having a clearly written down schedule within the next two months is important as it will allow me to plan all my activities and set aside adequate time for my family and friends. The shortage of employees forcing us to work extra hours may hinder this goal as it may disrupt my already planned schedule.
Achieving a management or leadership position can be achieved by furthering my education. Earning a BSN or post-graduate degree while also accumulating several years of experience puts me in a suitable position to be in charge. Widening my social circle also increases the chance of interacting with various people who can assist me in my journey to attaining a leadership position. I aim to enroll back in school so as to further my education and put myself in a better place to be considered for a management position. The high cost and lack of adequate time due to various responsibilities may hinder me from furthering my education. However, this shall not deter me.
Improving my competency level entails practicing any procedures that I may not be comfortable with to the point that I become almost perfect. Attending workshops and other forums also provides an avenue to learn new skills and acquire new knowledge (Di Mario & La Torre, 2021). I plan to start attending seminars and other conferences within six months as it will allow me to improve my knowledge and skill set, consequently improving the quality of care I deliver. Time may prove a hindrance, but I intend to remain focused to achieve my dreams.
References
Di Mario, S., & La Torre, G. (2021). Managerial qualities by the nursing coordinators: an umbrella review. a Clinica terapeutica, 172(6), 564569. https://doi.org/10.7417/CT.2021.2379
ASSIGNMENT: For this touchstone, you will be writing a success narrative consisting of three components. Specifically, you will write about the following:
Success Narrative
1. Who I Am Now: Create a brief biographical statement describing your academic and professional history, as well as any relevant personal characteristics youd like to share.
2. My Goals: Identify three (3) professional and/or academic long-term goals for your future.
3. How I Will Get There: Based on the professional or academic goals you created, identify at least two (2) short-term steps for each of these goals, and set target dates for each of these short-term steps. Make sure that in your plan to achieve these goals, you account for obstacles that may present themselves along the way.
Assignment Guidelines
DIRECTIONS: Refer to the list below throughout the writing process. Do not submit your Touchstone until it meets these guidelines.
1. Who I Am Now
? Have you provided a brief biographical statement explaining your educational and career experiences thus far?
? Have you shared any personal characteristics (e.g., determination, flexibility) that you feel are relevant to your narrative?
2. My Goals
? Have you provided three long-term goals you wish to accomplish?
? Have you connected those goals to either your academic or professional aspirations?
3. How I Will Get There
? Have you identified and explained at least two short-term steps for achieving each of your three goals?
? Have you set target dates for each of these steps?
? Have you addressed any obstacles you might face in pursuit of these goals?
Requirements
The following requirements must be met for your submission to be graded:
Composition must be 2-3 pages (approximately 500-750 words).
Double-space the composition and use one-inch margins.
Use a readable 12-point font.
All writing must be appropriate for an academic context.
Composition must be original and written for this assignment.
Plagiarism of any kind is strictly prohibited.
Submission must include your name, the name of the course, the date, and the title of your composition.
Include all of the assignment components in a single file.
Acceptable file formats include .doc, and .docx.
Patton, Zalon, and Ludwick (2019) argue that nurses are the most significant number of healthcare practitioners; they end up spending a significant amount of time with patients and share a distinctive intimacy with patients; they also provide an essential understanding and probable solutions to several high-profile as well as complex healthcare problems like value, cost, quality, and access. Nurses have a unique qualification to take on significant roles in the policy. Eddie Bernice Johnson was one of the nurse leaders who played an essential role in enhancing policy. He was the first Black American to be elected into public office in Dallas. As a nurse leader, Bernice has advocated for better healthcare access and identifying the value of nurses in the healthcare industry. She supported and sponsored the federal funding directed to nurses education to mitigate nurse shortage problems in healthcare (Nurse, 2021). She also champions the recognition and respect of nurses in public health. During the drafting of the Affordable Care Act, she offered insight into issues of insurance firms and how they impact healthcare.
The success recorded by Bernice can be attributed to her strong interpersonal relations and her zeal for advocacy, which enabled her to push for reforms in healthcare. She also attributes her success to her strong organizational and communication skills and the trust the general public bestowed upon her.
Her major obstacle was her race and gender, which resulted in discrimination in her position. However, she claims to have overcome such challenges by using her voice to air any concerns against minorities and ensuring that she is fully dedicated to her role as a legislator since this would leave little to no room for criticism based on her performance as a black woman.
Discuss an example of how a nurse leader was successful in spearheading change within an organization, institution, or government that impacted healthcare policy. What driving forces led to the nurse leaders success? What obstacles were encountered, and how were they addressed?
Telemedicine can be described as a way a health practitioner can provide health services remotely to a patient in different locations using technology (Snyder & Kerns 2021). Examples of such technology include phone calls, messaging, and email, but in most cases, video conferencing. Telemedicine has revolutionized the healthcare sector because it offers multiple benefits, including reducing a patients travel expenses and saving time. Secondly, considering the recent COVID-19 pandemic, hospitals especially were not a safe place for anyone due to the high potential of contagious patients. Telemedicine is handy in such situations, ensuring the patients are safe at home and not exposed to hazardous conditions (Snyder & Kerns 2021). Thirdly, telemedicine offers privacy and convenience because one can talk to a doctor in the comfort of their home. Fourthly, telemedicine reduces the likelihood of missed appointments or cancellations significantly, boosting the populations health status (Balestra, 2018).
Telemedicine can improve patient outcomes because, as mentioned above, patients will most likely not miss appointments through remote access. This is crucial as a healthcare provider can determine the patients health status, evaluate whether they need new prescriptions and if their treatment is progressing accordingly, and, importantly, provide preventative care (Perisetti & Goyal 2021). Telemedicine completely changed access to medical care by making it easy and convenient. All one needs is a computer or a smartphone to access telemedicine, which is even more crucial in emergencies. For instance, initially, one would call 911 and wait for ambulance services; however, today, through telemedicine, one can also call a doctor, who can offer crucial ways to help the patient since they are familiar with the patients problem.
References
Balestra, M. (2018). Telehealth and legal implications for nurse practitioners. The Journal for Nurse Practitioners, 14(1), 33-39.
Perisetti, A., & Goyal, H. (2021). Successful distancing: telemedicine in gastroenterology and hepatology during the COVID-19 pandemic. Digestive diseases and sciences, 66(4), 945-953.
Snyder, E. F., & Kerns, L. (2021). Telehealth billing for nurse practitioners during COVID-19: policy updates. The Journal for Nurse Practitioners, 17(3), 258-263.
Reflect on your experience with using telemedicine. (If you have not used telemedicine, discuss the benefits and how it can improve patient outcomes.) How did telemedicine change the access of care to the patient being cared for?
https://drive.google.com/file/d/1lRkSkxSCls26hfGyBDIWZiO7NQE8crVx/view
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Thank you for sharing your post. Throughout the 20th century, nurses in the Eastern side of the US started staffing immunization clinics. These led to many lives being saved as people were vaccinated against diseases such as TB and polio. In 1918 many peoples lives were saved from vaccination against the influenza outbreak and in 2009 from the H1N epidemic (Deering, 2021). As the country suffers from the COVID-19 pandemic, it is clear that the largest disease outbreak of contagious diseases occurs before the development of a vaccine. Deering (2021) adds that when the vaccine rates are low, the outbreaks return. An example is the resurgence of measles in 1989-1991 in the US, where only 50% of the children had been vaccinated. 90% of the women failed to be vaccinated, while 123 people died. In 2008, the measles outbreak re-emerged, with 90% of the cases reported were those who had skipped vaccination or whose immunization status was unknown.
Nurse Practitioners, as you have mentioned, play a significant role in the prevention of diseases through education of patients on the need for vaccination and also in administering vaccinations to patients. Balestra (2016) notes that NPs offer patients evidence-based information on the safety of vaccines, the possible side effects, and in some countries, all vaccinations are administered by nurses. It is often a major struggle that nurses face in trying to convince patients and parents to get vaccinated or have their children vaccinated. When people do not see others getting sick from the disease, they believe that they are not in any danger of infection. NPs must advise that remaining unvaccinated can affect the patient and kin. In rural areas, NPs often fill the gap between physicians and patients, and hence it means that the communities seek advice from NPs regarding vaccinations. Additionally, school nurses also play a significant role in giving advice to parents and students on the requirements of vaccines.
References
Balestra, M. (2016). The antivaccine movement: Legal implications for nurse practitioners. The Nurse Practitioner, 41(11), 12-14.
A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Response on Vaccination
Evaluating the issues of people being hesitant to receive vaccines can be viewed from multiple angles, many of which bring the concept of balance between personal liberty choices of wanting to vaccinate or not vaccinate and violating other peoples public health. As society is using electronics to find information about vaccines with pros/cons, parents are also looking for control over their childrens health. Ideally, parents would like to be armed with accurate scientific information so that they can objectively weigh the benefits and risks of vaccination and make informed decisions about immunizing their children (Glanz et al., 2015).
It can also be noted that to achieve high immunization in society and prevent an outbreak of an illness such as Measles, 95% of the population needs to be vaccinated. Therefore, the NP can assist families and patients in general in understanding the importance of vaccinations. And providing them with evidence-based, factual literature that they are able to read. And being educated to provide the families and patients with support is a key to nursing.
Glanz, J. M., Kraus, C. R., & Daley, M. F. (2015). Addressing Parental Vaccine Concerns: Engagement, Balance, and Timing. PLoS biology, 13(8), e1002227. https://doi.org/10.1371/journal.pbio.1002227
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The current healthcare system is facing a significant cultural challenge due to diversity in race, gender, religion, and ethnicity within the population (Nair & Adetayo, 2019). This further creates the need to improve cultural competency among care providers. The Purnell model is one of the models adopted in developing cultural competency and providing culturally sensitive care. This paper discusses the application of culturally sensitive care within healthcare, the theory and organizational framework of the Purnell Model, the models 12 domains and their relevance in transcultural healthcare, and the application of the model to become a culturally competent health provider.
Culturally Sensitive Care and Its Application within Health Care
The cultural diversity in current patient populations requires healthcare providers to possess competencies that enable them to provide culturally sensitive healthcare services that meet the needs of each individual. Cultural sensitivity embraces the different cultural views that exist within patient populations. It supports the development of healthcare interventions sensitive to the cultural domains and processes that affect an individuals health (Tramonti et al., 2021). The provision of culturally sensitive care highly considers the current diversity and embraces the cultural differences due to the diversity (Boyd et al., 2022). Therefore, applying culturally sensitive care within health care enables nurses and other health professionals to provide person- and patient-centered care. Further, culturally sensitive care improves patient satisfaction with the care received and positively impacts the care outcomes.
Theory and Organizational Framework of the Purnell Model
The Purnell Model was developed after recognizing the need to have a tool to improve cultural sensitivity among nurses and physicians in their daily practice. The model is organized in five circles. The circles present the 12 constructs that influence culture and the various aspects of the culture, which include the modern globalized society, the community, the family, and the person (Albougami, 2016).
The outermost circle is the broader aspect of culture in the global society. The next circle is the community aspect. The third circle is the family, while the fourth circle presents the person. The innermost circle of the Purnell Model shows the 12 constructs that influence culture (Purnell, 2002). According to the model, acquiring cultural competence is a process. Nurses and physicians must achieve unconscious and conscious competence to be culturally competent. This includes understanding and appreciating the differences in the various aspects of culture, such as religion, ethnicity, race, family background, and other elements, such as political affiliations and physical appearance.
Relevance of the Purnell Model to Transcultural Health Care
The Purnell Model is very relevant in transcultural health care. The model focuses on the various aspects of culture and how they influence relationships and collaboration in health care. The model provides approaches in which healthcare providers can consider the different cultural views in developing care plans for patients at an individual level. Providing adequate care services in multicultural settings requires an appreciation of cultural differences and how such differences in cultural views influence health and care outcomes. According to Ray (2016), transcultural caring in health care involves applying aspects of self-reflection, which enables nurses and physicians to better understand themselves as cultural beings, allowing them to understand differences in sociocultural experiences better. This understanding significantly influences their ability to provide adequate healthcare services even in cross- and multicultural settings. Therefore, the Purnell Model can help healthcare practitioners develop cultural competence to provide culturally sensitive care in multicultural healthcare systems.
Purnells 12 Domains of Culture and Their Role in the Diversity of Health Care
The Purnell Model has 12 domains of culture. These include heritage, communication, family roles and organization, workforce issues, bicultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing, death rituals, spirituality, healthcare practices, and healthcare practitioner domains. These domains are interrelated and influence each other to impact the definition of diversity in health care. There is visible cultural, gender, and ethnic underrepresentation at all levels of current health care, including training, practice, and leadership (Nair & Adetayo, 2019). Employing each of the domains of culture can help highlight the cultural disparities at all levels of health care and in the delivery of care services within a diverse population. Therefore, the domains of the Purnell Model can help develop various strategies that can help achieve diversity in health care.
Application of Purnells Model to become a More Culturally Competent Health Care Provider
The Purnell Model can help develop cultural competence in providing health care services as a nurse practitioner (NP). Cultural competence means effectively collaborating and interacting with people from different cultural backgrounds(Nair & Adetayo, 2019). Being an NP means working with people and patients from diverse cultural backgrounds. Through its 12 domains and the various levels of understanding of culture, society, the community, the family, and the person, the model can help me understand and appreciate the differences in views of social issues, health, and the care provided. Through these, the NP can develop effective health care plans and interventions that are sensitive to the individual patient and are flexible and responsive to the dynamic nature of culture.
In conclusion, the Purnell model is critical to developing a culturally sensitive healthcare workforce. Cultural competence supports the provision of diverse patient populations. Conclusively, culturally sensitive care impacts the effectiveness of care and patient and provider experiences.
References
Albougami, A. S. (2016). Comparison of Four Cultural Competence Models in Transcultural Nursing: A Discussion Paper. International Archives of Nursing and Health Care, 2(4). https://doi.org/10.23937/2469-5823/1510053
Boyd, J. E., Ouellette, M. J., Puccinelli, C., & McCabe, R. E. (2022). Case Formulation, Behavior Analysis, and Diagnostic Interviews. Comprehensive Clinical Psychology, 115. https://doi.org/10.1016/B978-0-12-818697-8.00197-7
Nair, L., & Adetayo, O. A. (2019). Cultural Competence and Ethnic Diversity in Healthcare. Plastic and Reconstructive Surgery Global Open, 7(5), E2219. https://doi.org/10.1097/GOX.0000000000002219
Purnell, L. (2002). The Purnell Model for Cultural Competence. Journal of Transcultural Nursing?: Official Journal of the Transcultural Nursing Society, 13(3), 193196. https://doi.org/10.1177/10459602013003006
Ray, M. A. (2016). Transcultural Caring Dynamics in Nursing and Health Care (2nd ed.). F.A Davis Company.
Tramonti, F., Giorgi, F., & Fanali, A. (2021). Systems thinking and the biopsychosocial approach: a multilevel framework for patient-centered care. Systems Research and Behavioral Science, 38(2), 215230. https://onlinelibrary.wiley.com/doi/abs/10.1002/sres.2725
Diversity has a significant influence on health care. Studying transcultural health care helps health professionals understand different cultures to provide holistic and individualized health care. Review the Purnell Model for Cultural Competence, including the theory, framework, and 12 domains. Write a 750-1,000-word paper exploring the Purnell Model for Cultural Competence. Include the following:
Purnell Model
Explain culturally sensitive care and its application within health care.
Explain the theory and organizational framework of the Purnell Model and discuss its relevance to transcultural health care.
Describe Purnells 12 domains of culture, and assess how each of these domains plays an active role in the diversity of health care in your specific field.
Discuss how this model can be applied when working with different cultures to become a more culturally competent healthcare provider.
Cite at least three references, including the course textbook.
Prepare this assignment according to the guidelines in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. For assistance, a link to the LopesWrite technical support articles is in Class Resources.
Benchmark Information
This benchmark assignment assesses the following programmatic competency:
BS Health Sciences
1.1 Explain culturally sensitive care and its application within health care.
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Hospital-acquired infections are infections that a patient acquires while being admitted to a hospital for a reason other than that infection. These infections commonly have viral, bacterial, or fungal causation, with the most common hospital-acquired infections being bloodstream infections, urinary tract infections, pneumonia, and surgical site infections (Barrasa-Villar et al., 2017). This paper aims to look at a qualitative research study named Beyond the hospital infection control guidelines: a qualitative study using positive deviance to characterize gray areas and to achieve efficacy and clarity in the prevention of healthcare-associated infections. and expounds further on it.
Qualitative Research Design
The qualitative research design employed in this study was the qualitative constructivist research methodology. This method involved various data-collecting methods, including personal interviews, observations, and video recordings of specific hospital procedures to improve infection control (Gesser-Edelsburg et al., 2018). Eight two personalTwoterviews were conducted with hospital staff. The study was done in two intensive care units at Hadassah Hospital in Hospital in March 2018.
Credibility of Results
Participants for this study were chosen based on a sampling and participant recruitment method. Intensive and heterogeneous sampling was employed in the first stage of patient identification, with snowball sampling being employed in the second sampling stage. Accuracy and completeness of data were achieved through the triangulation of the data obtained from various sources to enhance the validity of the results (Gesser-Edelsburg et al., 2018). Validity was further enhanced by obtaining confirmation from the infection control unit concerning the various positive deviance practices. The study was also conducted on various day shifts for periods of tperiodsures were observed and documented, further improving the credibility. The results are believable based on the protocols followed during data collection and ensuring the data is valid (Melnyk & Fineout-Overholt, 2019).
Implications of the Results
New insights developed by Fruity may significantly increase the sensitivity to other peoples needs. The study recommended encouraging hospital staff to come up with solutions to the various situations that they encountered during their delivery of care. The solutions would then be shared within the unit, facilitating changes from the most junior staff to the senior-most. Understanding this would significantly increase situational competence as staff would use the solutions they have formulated within their unit rather than depending on new or specific documented guidelines to deal with the situations they encounter (Gesser-Edelsburget et al., 2018).
Effect on the Reader
The results obtained from this study are plausible and believable. The results obtained indicate that set guidelines for reducing hospital-acquired infections cannot always cover the various scenarios that arise during the delivery of care. These guidelines have, in some circumstances, led to an increase in the spread of these infections. The study revealed that many came up with solutions to address contentious situations. The study dramatically draws my attention as the reader from the start until the end.
Results
Results indicated the need for staff to develop guidelines and solutions for some gray regions during care delivery (Gesser-Edelsburg et al., 2018). This need arose because the set guidelines did not always address all arising issues and sometimes contributed to increased hospital-acquired infections. The research approach fantastically fits the purpose of this study as it involved observing staff members and procedures done in intensive care units for extended periods to document the issue of hospital-acquired infections.
Study Approach
The study approach in the study is studyntifiable as the pragmatic study approach. The studys objectivity dramatically enables the researcher to identify the study approach. The data collection and analysis techniques are conducted appropriately. Data collection involves several interviews, observations, and video footage, significantly increasing the validity of the results obtained.
Need for the Study
The great need for this study is noted in the literature. The literature highlights the various attempts to formulate and implement various guidelines that are aimed at curbing infections during the delivery of care. These guidelines often lead to situations where staff do not know what to do as specific scenarios are not addressed within the guidelines, resulting in confusion and uncertainty. This necessitated the need for this study. The study aims to characterize the unaddressed areas, referred to as gray areas in this study, and identify practices done by individuals who come up with creative solutions based on the challenges they face to reduce hospital-acquired infections (Gesser-Edelsburg et al., 2018).
Is the Sampling Clear and Guided by Study Needs?
The sampling done is clear and well-guided by study needs. The researcher chose to focus on intensive care units where staff is exposed to various stressful situations, including work stress and the death of patients. These situations greatly hinder the observance of the guidelines recommended for hospital-acquired infections. Therefore, there is a great need to develop viable solutions and share them in these units. The sample size and composition greatly reflect the studys needs. The study involved interviewing more than 90% of staff working in the MICU and GICU, occasionally encountering these stressful situations (Gesser-Edelsburg et al., 2018). The phenomenon, which is human experience, is not well identified.
Data collection procedures
The data collection procedures are clear and well laid out. The staff received a clear explanation of the study and what it hoped to achieve. This was followed by the signing of an informed consent form before interviews were conducted and video footage was collected. The researchers role was collecting data through observations, interviews, and video footage while maintaining objectivity and neutrality, ensuring that focus was maintained on highlighting the positive practices (Gesser-Edelsburg et al., 2018).
Data analysis procedures
Data gathered through the various collection methods was analyzed, and the main challenges and positive deviance practices were noted through content analysis. Further analysis through content analysis was done to identify sub-themes obtained from the areas that confused and to classify further areas of positive deviance that stood out. The results obtained from this study were broken down into various key areas, including the classification of positive deviance practice, gray areas during care delivery, and lack of uniformity in infection control procedures, among others (Gesser-Edelsburg et al., 2018).
Presentation of Specific Findings
The data meanings derived from the data described are in context. The data from the study is well broken down into various headings and sub-headings. The research addresses the issue brought up at the beginning in a manner that is clear and concise. This form of writing makes the study relatively easy to understand.
Relevance of the Study
The results obtained from this study are beneficial and relevant for both staff and patients. The main aim is to reduce the rate of hospital-acquired infection. The study indicated that set guidelines for infection prevention are not always followed, especially in high-pressure situations. It also indicated the existence of several scenarios not addressed by set guidelines. These necessitated the need for hospital staff to apply positive deviance and develop well-suited guidelines within their various units (Gesser-Edelsburg et al., 2018). The application of those guidelines will result in reducing the rate of hospital-acquired infections (Houghton et al., 2020).
Conclusion
The increased rate of hospital-acquired infections facilitated the need for this study. This study indicated some gray regions that confuse implementing set guidelines to reduce hospital-acquired information. It further highlighted the role of positive deviance by hospital staff in an attempt to curb the increasing rate of hospital-acquired infections.
References
Barrasa-Villar, J. I., Aibar-Remón, C., Prieto-Andrés, P., Mareca-Doñate, R., & Moliner-Lahoz, J. (2017). Impact on Morbidity, Mortality, and Length of Stay of Hospital-Acquired Infections by Resistant Microorganisms. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 65(4), 644652. https://doi.org/10.1093/cid/cix411
Gesser-Edelsburg, A., Cohen, R., Halavi, A. M., Zemach, M., van Heerden, P. V., Sviri, S., Benenson, S., Trahtemberg, U., Orenbuch-Harroch, E., Lowenstein, L., Shteinberg, D., Salmon, A., & Moses, A. (2018). Beyond the hospital infection control guidelines: a qualitative study using positive deviance to characterize gray areas and to achieve efficacy and clarity in the prevention of healthcare-associated infections. Antimicrobial resistance and infection control, 7, 124. https://doi.org/10.1186/s13756-018-0418-x
Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., Chan, X. H., Devane, D., & Biesty, L. M. (2020). Barriers and facilitators to healthcare workers adherence with Infection Prevention and Control (IPC) guidelines for respiratory infectious diseases: A rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews, 2020(8). https://doi.org/10.1002/14651858.cd013582
Melnyk, B. M., & Fineout-Overholt, E. (2019). Chapter 5. In Evidence-based practice in Practice& Healthcare: a guide to best practice. essay, Wolters Kluwer.
Write a fully developed and detailed APA essay addressing the following points/questions. There is no required word count; be sure to answer all the questions for each question in detail completely. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page are required. Review the rubric criteria for this assignment.
Qualitative Research
Conduct a literature search to select a qualitative research study on the topic identified in Module 1. Conduct an initial critical appraisal of the study.
Respond to the overview questions for the critical appraisal of qualitative studies, including:
What type of qualitative research design was utilized to conduct the study?
Are the results valid/trustworthy and credible?
How were the participants chosen?
How were the accuracy and completeness of data assured?
How plausible/believable are the results?
Are implications of the research stated?
May new insights increase sensitivity to others needs?
May understandings enhance situational competence?
What is the effect on the reader?
Are the results plausible and believable?
Is the reader imaginatively drawn to the experience?
What are the results of the study?
Does the research approach fit the purpose of the study?
How does the researcher identify the study approach?
Are the data collection and analysis techniques appropriate?
Is the significance/importance of the study explicit?
Does the literature support a need for the study?
What is the studys potential contribution?
Is the sampling precise and guided by study needs?
Does the researcher control the selection of the sample?
Do sample size and composition reflect the study needs?
Is the phenomenon (human experience) identified?
Are data collection procedures clear?
Are sources and means of verifying data explicit?
Are researcher roles and activities explained?
Are data analysis procedures described?
Does analysis guide directions of sampling when it ends?
Are data management processes described?
What are the reported results (descriptive or interpretation)?
How are specific findings presented?
Are the data meanings derived from data described in context?
Does the writing effectively promote understanding?
Will the results help me care for my patients?
Are the results relevant to persons in similar situations?
Are the results relevant to patient values and circumstances?
How may the results be applied to clinical practice?
Please answer the questions thoroughly using complete sentences and APA format. Explain responses to yes/no questions in detail by presenting information found in the study to support your response.
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Great work with your post! Racial disparities have been studied regarding primary care both at the private offices and the community health centers. Historically, the outpatient departments and the ED have been used by African Americans at rates higher than those recorded among Whites. Conversely, African Americans have preferred private physicians at only two-thirds of the rate Whites seek medical help (Arnett et al., 2016). The preferential use of non-primary care sites as the source of care restricts African Americans relative exposure to the primary care experiences potential preventive health benefits. Additionally, the preferential use of non-primary care sites, such as the ED, correlates to poor health outcomes compared to Whites in several different illnesses, thus placing African Americans at a disadvantage.
Several studies have also established racial and medical disparities, with African Americans reporting higher levels and rates of mistrust than Whites. This is why medical doubt has been proposed as a possible explanation for present and point of future exploration into the care disparitys usual source. Medical doubt has also been linked to higher ED utilization rates, lower preventive service utilization rates, and fewer behaviors on health-seeking (Cuevas et al., 2016). Emerging evidence suggests that residential segregation can confound the link between healthcare utilization and medical mistrust.
Segregation disadvantages different African-American communities, which are highly segregated by concentrating on uninsured status and poverty (Cornell et al., 2019). At the individual level, this results in a lack of resources such as educational opportunities, financial capital, and provided insurance, typically enabling and predisposing a person to use primary care. Segregation, independent of individual factors, interacts at the neighborhood level with race. The uninsured status concentration results in fewer primary care physicians in the segregated African-American communities compared to the less segregated White communities.
References
Arnett, M. J., Thorpe, R. J., Jr, Gaskin, D. J., Bowie, J. V., & LaVeist, T. A. (2016). Race, Medical Mistrust, and Segregation in Primary Care as Usual Source of Care: Findings from the Exploring Health Disparities in Integrated Communities Study. Journal of urban health: bulletin of the New York Academy of Medicine, 93(3), 456467. https://doi.org/10.1007/s11524-016-0054-9
Connell, C. L., Wang, S. C., Crook, L., & Yadrick, K. (2019). Barriers to healthcare seeking and provision among African American adults in the rural Mississippi delta region: Community and provider perspectives. Journal of Community Health, 44(4), 636-645.
Cuevas, A. G., OBrien, K., & Saha, S. (2016). African American experiences in healthcare: I always feel like Im getting skipped over. Health Psychology, 35(9), 987.
-I NEED TO RESPOND ON THIS TOPIC
A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last five years
Racial Disparities
Religion is described as a language, righteousness, education, kinship, social relationship, and behavior pattern for African Americans. African spirituality acknowledges that beliefs and practices touch on and tell every aspect of human life. Therefore, they cannot separate religion daily (Chirozazzi, 2019). According to Swihart et al. (2021), the diversity of religions within our worlds population challenges healthcare providers and systems to deliver culturally competent medical care. Cultural competence is the gift of health providers and organizations to provide health care services that satisfy patients cultural, social, and religious requirements and their families. Many research types have reported that African-American populations delay preventive healthcare more often due to medical mistrust and racism (Powell et al., 2019). Improving preventive health screening with African Americans needs to discuss medical suspicion and discrimination in and outside healthcare organizations. Culturally competent care can help grow my future advanced nursing role as a new nurse practitioner to improve patient quality and care issues for the African-American population. Strategies that also help me achieve these goals involve giving quality care, overcoming racial and ethnic health inequalities, and promoting policies and procedures that limit barriers to implementing culturally competent patient care.
References
Chiorazzi, A. (2019, March 22). The spirituality of Africa. Retrieved March 26, 2021, from https://news.harvard.edu/gazette/story/2015/10/the-spirituality-of-africa/
Powell W, Richmond J, Mohottige D, Yen I, Joslyn A, Corbie-Smith G. Medical Mistrust, Racism, and Delays in Preventive Health Screening Among African-American Men.
More states are increasingly making use of telehealth to fill provider shortage gaps and ensure increased access to specialty care. Due to the coronavirus pandemic, many states started advocating for telemedicine to lessen the spread of the disease and ease pressure on healthcare (Volk et al., 2021; Weigel et al., 2020). Higher reimbursement rates for certain services encourage healthcare providers to deliver the service and facilitate increased access to that service, whereas lower reimbursement could have the opposite effect. Expansions on telehealth services could improve general access to health care in Los Angeles, California. Additionally, Medi-Cal beneficiaries, the majority of whom are low-income and with various complex needs, are likely to benefit from the increased convenience brought about by telehealth services. A permanent extension of particular telehealth flexibilities is expected to result in improved access to health care for Medi-Cal beneficiaries. The comfort of getting care for patients and delivering care for the providers can also be enhanced with increased reimbursement.
However, lower reimbursement rates are likely to discourage providers from making telehealth visits available at comparable levels to the service offered in person. Telehealth modalities like live-video telehealth have proven clinically effective for the treatment of various conditions (Legislative Analysts Office, 2021). Providing telehealth services is likely to be more attractive than giving in-person services due to the probable superior convenience and the potentially lower expense of delivery. Suppose providers are going to obtain high reimbursement rates for telehealth services in comparison with service delivery expenses. In that case, providers are likely to choose to provide telehealth services even when in-person care could be more appropriate. This is likely to have a negative effect on the quality of care. Such incentive effects need to be considered in setting reimbursement rates for telehealth services.
References
Legislative Analysts Office. (2021). Analysis of the Governors Medi-Cal Telehealth Proposal. https://lao.ca.gov/Publications/Report/4430
How do U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?
Policy Analysis
LOS ANGELES CA
BOOK: Patton, Zalon, Ludwick Chaps 5 & 6
Expectations
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last five years
GovTrack.us (2019). S.787115th Congress: Telehealth Innovation and Improvement Act of 2017.
National Telehealth Policy Resource Center: https://www.cchpca.org/resources/news
Telemedicine Regulations in California (2019). Chiron Health.
Wicklund, E. (2019). CMS at ATA: Medicare coverage of telehealth will take some time. mHealth Intelligence.
American Telemedicine Association (2019). Policy updates.
American Telemedicine Association (2019) State of the States reports: Coverage and reimbursement.
Political competence is the ability to comprehend what actions to take and when to take these actions, anticipate any possible resistances, and determine people suited to help you achieve the agenda. In the nursing profession, political competence is the skills and values that a nurse requires to be effectively involved in politics surrounding the nursing profession (Melo et al., 2017). A nurse leader can demonstrate political competence by participating in political advocacy and policy formulation. Nurses have the highest number of healthcare professionals who spend most of their time with patients. Hence, they are uniquely positioned to understand and develop potential solutions to healthcare problems such as access to care, healthcare costs, and quality (Patton et al., 2019). Subsequently, they can participate in political advocacy to help in policy formulation.
The primary role of nurse leaders is to supervise their subordinates, make clinical decisions, and direct patient care(Patton et al., 2019). Nurses can, however, be involved in political processes that affect the nursing profession. Nurse leaders can use their skills and experiences to overcome political problems that affect the nursing profession. This consists of the use of political competence. At the local level, nurse leaders can demonstrate political competence in the local level by encouraging their subordinates to vote for good local leaders who can implement policies that ensure quality healthcare services. At the national level, they can demonstrate political competence by participating in political advocacy. A nurse leader can take leadership positions in national organizations such as the American Nurses Association. A nurse leader can thus represent other nurses in policy-making processes. They can participate in the enactment of healthcare acts and give their input. This can help formulate policies that will ensure quality and cost-effective healthcare services are offered to patients.
References
Melo, W. S., Oliveira, P. J., Monteiro, F. P., Santos, F. C., Silva, M. J., Calderon, C. J., Fonseca, L. N., & Simão, A. A. (2017). Guide of attributes of the nurses political competence: A methodological study. Revista Brasileira de Enfermagem, 70(3), 526-534. https://doi.org/10.1590/0034-7167-2016-0483
Patton, R. M., Zalon, M. L., & Ludwick, R. (2019). Nurses making policy: From bedside to boardroom (2nd ed.). Springer Publishing Company.
Define political competence and discuss at least one example of how a nurse leader has or could demonstrate political competence at the local, state, or national level. The example may be from an organizational perspective or a political challenge.
BOOK: Patton, Zalon, Ludwick (2019): Chapters 1, 2
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Political Competence
Given that nurses comprise the largest sector of healthcare providers, spend the most time with patients, and share a unique intimacy with patients related to functional care activities, nurses bring critical understanding and potential solutions to many high-profile, complex healthcare issues such as access, quality, cost, and value. Nurses. practice at the intersection of public policy and personal lives; they are, therefore, ideally situated and morally obligated to include sociopolitical advocacy in their practice (Falk-Rafael, 2005, p. 222). Every day, nurses see how health policy decisions, such as access to care based on pre-existing conditions, impact patients and their families and how organizational staffing policies may harm patients and adversely affect nurses and their work environment. Creating and maintaining health policy is everyones job. Some believe that ones position defines policy involvement. We argue that health policy is everyones responsibility. Nurse managers, educators, and administrators are often viewed as having more obvious roles in the successful articulation of federal and state regulations and implementation of institutional policies. Nurses providing direct care live at the edge of those policies and regulations every day, an advantage that is vital to informing, shaping, monitoring, and evaluating policy. Nurses are uniquely qualified to assume important roles in policy. We agree with Feldman and Lewenson, who state that nursing skills are political skills (2000, p. 58). 4 We make the case, beginning with this chapter and throughout the book, that once policy skills are understood and practiced, nurses can successfully engage in advocacy through policy making. These skills are essential to nurses in the trenches, performing direct care across all settings, and nurses in leadership, education, and research positions. Thus, policy work is the role of every nurse. The following Policy Challenge illustrates how care at the bedside can lead to a policy journey with great impact.
Drug and dosage: PO Verapamil (Isoptin SR) 180 mg once a day.
Indication: Stage one Hypertension.
Instructions: Take verapamil sustained-release 180 mg tablets by mouth for high blood pressure in the morning with food for three months, then follow up with our office for assessment of any need for additional refills.
Dispense 100 tablets
Number of refills 0
Number of refills: 0
Substitution: Yes ? No ?
Signature:
DEA Number (if required): Not applicable.
References
Fansen, M. (2018). A4582 Study on the safety of the washout application of Verapamil Hydrochloride Sustained-release TabletsJournal of Hypertension, 36, e145.
Goh, W. P., Tao, X., Zhang, J., & Yong, J. (2020). Feature-based learning in drug prescription system for medical clinics. Neural processing letters, 52(3), 1703-1721.
Darrin Derenger is a 57-year-old mail carrier who has been diagnosed with stage 1 hypertension. He comes into the clinic for a blood pressure check and to refill his medications. He is currently taking verapamil sustained-release 180mg tablets in the morning with food. You have decided to fill his prescriptions for three months.
DOB: 02/13/1961 Address: 951 Beach St. Morris, IL NKA
