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The ways stigma can influence health care delivery

The ways stigma can influence health care delivery for marginalised people and groups in Australian society

Order Instructions:

Discuss the ways stigma can influence health care delivery for marginalised people and groups in Australian society? People from the following groups may be stigmatized.

Explore this question from one of the following marginalised groups: refugees, Indigenous Australians, mentally ill or homeless people, older adults or the disabled.

Students will learn to reflect on sociological topics related to society, culture and health and apply the Sociological Imagination Template to their chosen topic. Using the Reflective Learning and Writing Proforma on LEO respond to one of the two topics provided below for the reflective assessment task. Use the proforma steps as headings and write in paragraphs below the headings. Ensure that you use all the factors from the SI template in completing this reflective writing task. It is not necessary to use all four factors in every Step of the proforma. All sources should be referenced using APA style.

SAMPLE ANSWER

The ways stigma can influence health care delivery

Step 1:

Carefully choose one question from the Reflective Learning and Writing Assessment section of the unit outline to guide your reflection. Write the question here:

How does stigma prevent the delivery of healthcare to mentally ill patients in Australia?

Step 2:

Reflect upon and analyse your experiences and observations in relation to your chosen question from Step 1, using the four factors from Willis’ (2004, as cited in Germov, 2014, p. 7-8) sociological imagination template (SI template):

Whereas the treatment of mental illness in Australia is embedded on technological advances and medical research that is informed by not only scientific inquiry but also evidence based results, stigma tends to impact the quality of care patients receive. While dealing with mentally ill patients at my former place of work, I would notice stigma as the most terrifying barrier to quality mental healthcare. One of my patients, who traced her roots in South Asia, recounted just cultural issues impede members of this community from seeking mental healthcare owing to negative thoughts and ethos that encourage the community to pinpoint persons with mental illness. Moreover, an aboriginal patient with a poor self-mage indicated that members of his community tend to repress symptoms to an extent that they fear seeking medical attention after internalizing the community mindset. By and large, this is evident of cultural stigma, which is anything but a cultural mindset unconsciously perpetuated by members of the community Willis’ (2010, as cited in Germov, 2014). Additionally, stigma hinders their access to services and contributes to low self-worth and greater seclusion and despair. A shocking revelation of how stigma impacts on the delivery of healthcare was evident when mentally ill patient indicated how medical practitioners would treat them as non-entities. As a team leader, I made a follow to determine if the allegations were founded or malicious. Going through the patient’s medical record I was able to identify the care giver that had attended to the patient. After a close examination I noticed that both the caregiver and the patient shared the same cultural background. With this revelation I was quick to learn that caregivers with a certain cultural orientation irrespective of their medical background tend to hold with high esteem issues of stigma and the society’s mindset. This is demonstrated by the highest level of discrimination against persons with mental illness when it comes to the delivery of quality healthcare Willis’ (2010, as cited in Germov, 2014).

With this backdrop from a clinical setting, I learnt that a genuine interaction from the community through to medical facilities in the absence of a pre-determined mindset can help curtail stigma. Essentially, these experiences demonstrate that minority groups have similar views concerning the stigma that persons with mental illness are subjected to wherever they go (Bradby, 2012). An elder brother to one of my patients’ told me just how stigma had crushed the self-esteem of not only the patient but also the entire family on allegations that that could imply a family spell that sweeps across blood of generations. It becomes common sense that stigmatization is literally what hinders the minority group from seeking medical attention (Hampton and Toombs, 2013).

Step 3:

Next, identify and cite one of the readings, articles or videos from eModule 1 or 2 and discuss how this resource helps you to expand and deepen your original reflections on this topic. Remember to relate the information from this resource back to the factors from the sociological imagination template. (400 words; use two academic sources – one from your textbook Second Opinion by Germov (2014))

The article’s commitment in highlighting stigma as a deterrent to quality mental health care helped me to understand the need for advocacy to de-stigmatize the people. In addition, I learnt new discoveries, techniques and knowledge synthesis. Past studies have main concentrated on descriptive, for instance number of individual that stigmatize depression. The articles adequately evaluate theoretical approaches of stigma. Furthermore, I learnt how stigma operates from a social perspective because the author would conceptualize stigma as a series of mind set and stereotypes about groups. For instance, the mental ill have been considered by the society to be dangerous which is not the case (Germov, 2014). Besides, I learnt that sociologists consider stigma as a structural aspect. This is based on the political as well as economic reasons, particular institutions have been set in the society which promote stigma or lead to discrimination of people with mental illness. For example, for mental illness one of the structural forms is the law which undermines their ability to vote, have a family among others. The article also exposed the fact that people with psychiatric problems do not get the medical attention compared to other people. This implies that medical facilities discriminate against people with mental illness. Another thing would emerge from the article is the labeling theory. The term stigma would suggest that mental ill persons are socially unkempt. So the article helped me to understand that just because someone has to check with psychiatrist does not mean that they are mentally ill (Germov, 2014). The article demonstrates that stigmatization many interfere with treatment. These are some people with mental illness that decide not to seek for medical attention. So the article enabled me to understand that persons with mental illness want to avoid the labels by refusing to seek psychiatrist attention.

According to the article, I learnt that there different ways of combating stigma including public awareness, protest and contact. Protest is like shame on you type of statement and an appeal to the public to change their negative mindset towards people with mental illness. On the other hand, public awareness is all about transposing the myths of mental illness using facts. Much as public awareness is widely used, its impact seems to wash out in short period of time. Contact approach is involved with introducing persons with psychiatric illness to rest which decreases stigma. Much as the article exposes that structural stigma can be combated in accordance with social justice, I learnt that it has some associated implications. For instance, its injustice to leave mental issues to people with this problem, rather this is a society’s challenge which requires looking at changes in the community to provide these people with an equal chance.

Step 4:

Now, building upon your reflections using the sociological imagination template, answer the original question you identified in Step 1, using at least four academic sources (e.g. journal articles, research reports) to support your answer. Locate these academic sources through your own information search.

Stigma and discrimination continue manifesting as a part of the fabric and tradition of Australia society (Burbank, 2011). It has significantly affected minority populations, the general healthcare system, and the nursing profession. Usually, stigma is based on the differences that arise due to age, ethnicity, religion, sexual orientation, gender, race, age or any other characteristic by which people vary (Massaro, 2012). The Australian Nursing Association is determined to work towards the eradication of stigma and discrimination in the profession of nursing, in the education of nurses, in organizations where nurses work as well as well as in the practice of nursing (Barry & Yuill, 2012).

The organization is also committed to promoting egalitarianism and promoting justice in the access and delivery of quality health care to all people regardless of their differences. Stigma associated with mental illness has been attributed to unfairness when it comes to unequal treatment of persons suffering from the condition (Willis, Reynolds & Keleher, 2012). Stigma leads to individual prejudice in terms of disallowed resources, and systemic inequity such as socio-economic, legal and institution discrimination. Moreover, stigma often thwart mentally impaired persons from seeking medical attention, sticking to treatment procedures, getting employment and living harmoniously in the society.

Mindsets towards mental infirmity differ among persons, households, traditions, cultures and nations. Cultural as well as religious teachings impact beliefs concerning the origins and nature of mental sickness (Willis, Reynolds & Keleher, 2012). Besides influencing whether persons with mental illness face social embarrassment, perceptions about mental sickness can impact patients’ eagerness and motivation to look for medical treatment and stick by the guidelines. Deeply ingrained stigmatization has had a wide range of implications in Australia. Structures of discrimination continue putting a severe toll on the minorities contributing majorly to the fact that the minorities are still dying at a younger age compared to other people in the general population (Keleher & MacDougall, 2011). Here are some of the ways through which stigmatization affects health care delivery.

As such, comprehending both cultural and individual mindset about mental sickness is elementary for the execution of proficient strategies to mental health care. Studies indicate that individual experience with mental sickness is distinct. An assessment of ethno cultural value system and mental sickness conducted by Willis & Elmer, (2011) underscores a broad range of cultural beliefs concerning mental health. For example, whereas American Indian communities do not confound mental sickness, others castigate only some mental sickness, while others castigate all mental sickness.

Stigmatization puts the marginalized groups at great risk for long-term health problems. For instance, previous research has found out that refugees who are exposed to stigmatization especially during adolescence have high chances of developing stress-related health issues (Massaro, 2012). This puts them at the risk of acquiring chronic diseases later in their life. Researchers found out specifically that this group of individuals is more likely to have higher levels of hypertension, higher levels of stress related hormones once they turn 20 and a higher body mass index (Barry & Yuill, 2012). Stigmatization also exposes minority groups to high psychological toll which has been linked closely to hypertension. Just the fear of discrimination triggers stress-related responses among refugees which translate to the constant biological stressors that these individuals experience.

Nonetheless, the castigation of mental sickness can be controlled by other variables including perceived cause of the sickness. A study conducted in 2003 on Chinese Americans and European Americans were executed with a vignette in which persons with schizophrenia were diagnosed (LaNave & Navarro, 2013). Respondents were informed of the fact that individual’s sickness was somewhat hereditary in origin, as such respondents were queried to contemplate a scenario in which their children would date, marry or replicate with the subject of the vignette.

In Australia, majority of nurses harbor unconscious racial biases especially towards marginalized groups especially the Indigenous Australians. A study conducted in 2012 indicated that about two-thirds of primary care nurses discriminate against the Indigenous Australians. The research suggested that clinicians spend less time with the Natives and do not involve them in medical decisions. However, majority of the health officials are not aware that they are treating this group of people any differently (Bessant, & Watts, 2012).

Genetic ascription of mental sickness importantly abridged the reluctance to get married and procreate among Chinese Americans, while enhancing the same among the European Americans, a factor that underpinned previous findings of cultural differences. Genetic attribution of mental illness significantly reduced unwillingness to marry and reproduce among Chinese Americans, but it increased the same measures among European Americans, supporting previous findings of cultural variations in patterns of mental illness stigmatization (Bessant & Watts, 2012). This form of stigma creates an environment in which the Natives do not feel welcome in the medical system that some have started to avoid seeking medical attention. This has led to the deterioration of their health and increased number of deaths among this group. Furthermore, Indigenous Australians are more likely to lack access to health insurance and less likely to have a regular doctor for checkups. This has resulted in circumstance whereby the Natives die from preventable diseases at higher rates compared to other people in the society due to delayed treatment (Couzos & Murray, 2010).

Several studies have demonstrated other considerable attitude variations towards mental sickness among various cultures in North America. For instance a comprehensive observation ethnographic research of chronic mental ailing people, the European respondents regularly seek treatment from health care providers and seem to convey beliefs regarding mental conditions related to biomedical views on the sickness (Macionis & Plummer, 2012). On the other hand, African Americans as well as Latino respondents mostly put emphasis on non-biomedical understanding of the symptoms of mental sickness. Even though participants alleged that they face stigma as a result of their mental condition, stigma was the main aspect of African Americans’ views however it was not greatly accentuated by European of American decent (Couzos & Murray, 2010).

Step 5:

Finally, choose one of the Graduate Attributes (at the front of the Unit Outline) that is most relevant and explain how answering this eModule question has helped you to develop this Graduate Attribute.

Research and Inquiry:

The answering of this eModule has helped me to enhance my research and inquiry skills. In bid to understanding how stigma impedes healthcare especially on person with mental health, I conducted an extensive study that highlights the popular belief on persons that need mental healthcare. The review of literature from various sources gave me not only an informed position from which to argue my case, but also augmented my knowledge base in nursing. The discrimination perpetuated by healthcare facilities against persons with mental illness shaped not only my critical thinking skills in try to formulate new comprehension but also when it comes to appraising the existing body of literature on nursing and to acknowledge the drawbacks of that knowledge. Having noted that most studies had been devoted in exploring the public view of mental illness, I would therefore recommend research on community based mitigation plans or approaches through proper legislation as the best way to controlling the segregation that persons with mental illness grapple with. In the end, I have come to realize the importance of research and management care.

References

Barry, A-M., & Yuill, C. (2012). Understanding the sociology of health: An introduction (3^rd ed.). London: Sage.

Bessant, J., & Watts, R. (2012). Sociology Australia (3^rd ed.). Crow’s Nest, NSW: Allen Unwin.

Bradby, H. (2012). Medicine, health and society: A critical sociology. Thousand Oaks, CA:Sage.

Burbank, V. K. (2011). An ethnography of stress: The social determinants of health in Aboriginal

Couzos, S., & Murray, R. (2010). Aboriginal primary health care: An evidence-based approach (3^rd ed.). South Melbourne, VIC: Oxford University Press.

Germov, J. (2014). Second Opinion: An Introduction to Health Sociology. Fifth Edition. Oxford University Press.

Hampton and Toombs (2013) Indigenous Australians and health: The wombat in the room. South Melbourne, VIC: Oxford University Press.

Keleher, H., & MacDougall, C. (Eds.). (2011). Understanding health: A determinants approach. (3^rd ed.). South Melbourne, VIC.: Oxford University Press.

LaNave, K., & Navarro, C.S. (2008). Teaching manual for living justice and peace: Catholic social teaching in practice. Winona, MN: Saint Mary’s Press.

Macionis, J.J., & Plummer, K. (2012). Sociology: A global introduction (5^th ed.). Harlow, UK: Pearson/Prentice Hall

Massaro, T. (2012). Living justice: Catholic social teaching in action (2^nd Classroom ed.). Lanham, MD: Rowman & Littlefield.

Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2012). Understanding the Australian health care system (2 nd ed.) Chatswood, NSW: Elsevier.

Willis, K., & Elmer, S. (2011). Society, culture and health: An introduction to sociology for nurses. (2^nd ed.). South Melbourne, VIC.: Oxford University Press.

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Comprehensive nursing Case Study Paper

Comprehensive nursing

Order Instructions:

This is the case study of the subject comprehensive nursing, which is due on 18th of march

Scenario is Mrs Alright is a 77 years old lady who has been brought in by ambulance after being found on the floor by her carer this morning.
She had a fall last night while mobilizing to the toilet
and mechanism of falls looks like she tripped on the corner of a mat in the hallway. found in the hallway on the floorboards.
Pre medical history (from carer)
Type 1 diabetic on insulin Hypertension Hyperlipidaemia Osteoporosis
Recent UTI on ABS ( EColi) AMI 2007
CABGs 2008
CCF
O/E
Obvious facial lacerations above R) eyebrow and across bridge of nose
Left wrist deformity from FOOSH
LHS hip pain, leg shortened and internally rotated? # NOF Bruising to LHS of leg and face
Patient confused and complaining of nausea
Small bedside patient
Pain assessment _ not able to ascertain but vocalizes on movement Diaphoretic
Fruity odour to breathe noted
BASELINE OBSERVATIONS Temperature 35.2 C
Bp 100/55
RR 25 bpm deep and rapid breathing BSL 15 mm
HR 130 bpm
Capillary refill 4 secs/ sluggish
Questions to answer for the case study are
1. list two most likely nursing diagnosis for Mrs Alright and list one reason from the clinical information that leads you to believe this?
2. Due to Mrs Aright’s PMH, identify two potential complications of her fall
3. List two clinical interventions that you would prioritize for Mrs Alright and list one physiological reason each intervention?
4. List two chronic conditions of Mrs Alright that may have caused her fall and list one pathophysiological reason that leads you to believe this?
5. List two reasons why a 77 year old lady is more risk of sustaining a fracture after a fall?
Scenario
MRS Alright is now stable enough for surgery and goes to theatre at 0700 for an ORIF of her right hip. She RTW at 1100 after being stabilized in recovery. You are the nurse looking after her for the rest of your shift. Mrs Alright is complaining of sever pain in RHS
6. List two questions you would ask when assessing this patient’s pain levels?
7. List two ways in which a cognitively impaired patient who is unable to communicate, express that they were in pain?
Scenario
Post operatively the patient has a PCA for pain management
with morphine. This is set at an infusion rate of 2 ml/hr. the infusion has been made up with 100 mg of morphine in 50 ml. Ms Alright is complaining of severe pain in her RHS and the anesthetist has ordered a 5 mg bolus to be given.
8. list two benefits and two risk factors for Mrs Alright caused by the pharmacological actions of morphine?
9. Identify two degenerative changes that occur in the elderly and explain how those changes may cause a pathophysiological response to morphine?
10. state two clinical interventions as your priority for Mrs Alright while on her PCA?
THE FIRST ASSIGNMENT, WHICH IS CASE SCENARIO IS
1 TO 5 QUESTIONS ARE FOR 200 WORDS
6 TO 10 QUESTIONS ARE 200 WORDS
APA style
THE LINK TO THE WEBSITE F0R MORE INFORMATION IS federation university library only for referencing
THREE REFERENCES REQUIRED
ONE OF THEM SHOULD BE FROM BOOK medical surgical nursing (LEMONE AND BURKE )

SAMPLE ANSWER

The two possible diagnoses for Alright may be acute pain and fluid volume deficit. The patient is suffering from osteoporosis since she fell, she may be experiencing pain (Buffum et al., 2007, p. 325). Additionally the patient may be experiencing fluid volume deficit since she has low blood pressure, rapid and deep breathing, and she is also nauseated (Whitney and Rolfes, 2011, p. 45).
From her past medical history, she was found to have suffered from osteoporosis. Patients suffering from osteoporosis normally have problems with their skeleton due to weakening of bones. This condition is characterized by low bone mass, and bone tissue is known to undergo microarchitectural deterioration. The fragility of the bone increases and the bones fail to bear weight. As such, the victim may fall with a small trip since the legs cannot support the weight (Buffum et al., 2007, p. 325). Mrs. Alright may also have fallen due to lack of energy. The level of hydration may be low and thus prevent generation of enough energy (Whitney and Rolfes, 2011, p. 65).
I would prioritize oral rehydration for the patient using oral rehydration salts (Whitney and Rolfes, 2011, p. 67). Due to the pain that Mrs. Alright may be experiencing, I would consider the administration of naproxen. This drug is a pain reliever and will be effecting in easing the pain experienced by the patient (Burke and LeMOne, 2013, p. 65).
One of the chronic conditions is type 1 diabetes under which the patient is on treatment using The patient may risk suffering from insulin shock. The level of blood glucose may drop causing a consequent reduction in energy produced in the cells. Muscle cells weaken and thus fail to support the body to regain its upright position in the event of tripping (Whitney and Rolfes, 2011, p. 49). Osteoporosis is also another chronic condition that may be attributed to the patients` fall. This condition is associated with thinning and weakening of bones. Bone fractures may also occur with initial falling. The patient may have fallen because the thin and weak bones failed to support her weight during tripping (Buffum et al., 2007, p. 325).
Women aged 77 years may sustain fractures after a fall because the weakening of their bones, which is associated with increased Additionally, at this age, such women do not exercise a lot to strengthen their bones. Therefore, their bones become fragile and thus can fracture easily (Dagenais and Haldeman, 2012, p. 234).
The two questions are:
Where is your pain?
What makes your pain worse?
The common pain behavior for cognitively impaired include:
Facial expressions like frowning
Verbal expressions like sighing (Buffum et al., 2007, p. 316).
The use of morphine may be associated with benefits like:
The patient may experience a faster relief of pain
The chances of being dependent on morphine are reduced

The risks may include:

Heightened feeling of nausea
She may also experience increased sweating
The process of degeneration of the inter-vertebral disc is common among the elderly. Degeneration of the inter-vertebral disc is associated with problems in the spine resulting in the development of back pain, which is known to spread to the buttocks, as well as the thigh region. Morphine is generally used as medication for easing this pain. Pain is experienced daily as degeneration of discs occurs due to repeated daily stresses. The regular use of morphine to ease pain results in morphine dependence. Osteoporosis is also another example of degeneration of bones among the elderly. Continued use of morphine containing drugs may lead to morphine dependence (Dagenais and Haldeman, 2012, p. 234).
While Alright is on PCA for management of postoperative pain, I would prioritize administration of morphine at 5 mL/hr infusion rate. The infusion will contain 50 mg of morphine in 25 ml of fluid. I will also consider administration of paracetamol currently with infusion of morphine via PCA (Burke and LeMOne, 2013, p. 78).

References

Buffum, M. D., Hutt, E., Chang, V. T., Craine, M. H., & Snow, A. L. (2007). Cognitive impairment and pain management: review of issues and challenges. Journal of Rehabilitation Research and Development, 44, 2, 315-330.

Burke, L., & LeMOne, P. (2013). Medical-Surgical Nursing. New York: Pearson Higher Education AU.

Dagenais, S., & Haldeman, S. (2012). Evidence-based management of low back pain. St Louis, Missouri: Elsevier Mosby.

Whitney, E. N., & Rolfes, S. R. (2011). Understanding nutrition. Australia: Wadsworth, Cengage Learning.

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HIV and Pregnancy among African teens

Order Instructions:

Identify your selected empirical research problem (HIV and Pregnancy among African teen) and the units of analysis. Include support for these units as being reasonable for comparison and how you would avoid the ecological and individualistic fallacies.

Determine two researchable hypotheses based on your research problem (HIV and Pregnancy among African teen). For each hypothesis, identify the independent, dependent, and control variables. Moreover, estimate expected changes in the magnitude and relations between the dependent and independent variables.

SAMPLE ANSWER

HIV and Pregnancy among African teens

Problem Statement

HIV and Pregnancy among African teen rates are constantly increasing as per the international comparison. The problem leads to school dropout, causes future unemployment among the youth, preterm birth and mental disturbances which results into poor mental health.

Objectives

The objectives of this study are to determine and understand the attitudes and perception of teenagers in Africa concerning early pregnancies in teenagers. The other objective is to determine the understanding of the teenagers concerning sexuality and use of contraceptives to prevent infection of sexually transmitted diseases. This study will contribute to the knowledge concerning HIV and teenage pregnancy in Africa. In addition, the study will pursue the deeper understanding of how the youth perceive early pregnancy and to identify factors in their own view that can prevent this problem.

Researchable hypothesis

The teenagers in Africa do not understand sexuality and use of contraceptives to prevent infection of sexually transmitted diseases.
The teenagers in Africa do not understand the effects of early pregnancies in their own life.

The study will involve qualitative data. The independent variables for the study will include the need to prove fertility, Poor sexual negotiation skills and Poverty. The dependent variables will include Peer pressure from boyfriends or the social networks, the need to prove one’s fertility and Socio economic factors. The control variables on the other hand will include: Pregnant teenagers, Teenage girls who are aged 16-19 years who have never had who had never been pregnant and Teenagers who had a baby while they were teenagers (Bastien, Leshabari & Klepp , 2009.12).

Expected results

The teenagers being ignorant about the consequences of early pregnancy and of having unprotected sex
The teenagers engage in early sex due to poverty

References

Bastien S, Leshabari MT, Klepp KI, (2009) Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania. African Journal of AIDS Research, 2009; 8(2):213–22. https://www.ncbi.nlm.nih.gov/pubmed/25875572

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Telehealth technology in CHF’s care

Order Instructions:

Instruction are contained in the attached files.

SAMPLE ANSWER

Telehealth technology in CHF’s care

According to evidence based practice, hospitals are under pressure from public insurance to provide quality care to minimize re admissions especially for patients suffering from Congestive Heart Failure (CHF). This calls for proper utilization of telehealth technology to improve patient’s outcome. CHF, a cardiovascular complication arises when the heart is unable to pump enough blood as demanded by the body. This results to irregular heartbeat, fluid retention and shortness of breath. The conditions are usually fatal especially among the elderly. With the new trend of telehealth systems, CHF patient will become empowered to manage their symptoms better and improve the quality of life. This is one of the strategies which are aimed at improving smooth transitional processes of hospital care to home care. The move is aimed at reducing the rate of re admissions and emergency department visits by the CHF patients (American Nurses Association, 2010).

Despite the innumerable advantages, there is reduced acceptance of the new technology, which has become the road block for successful implementation of the programs. There are concerns that integration of telehealth systems will interfere with the nurse-patient relationship. This indicates the need to implement a strategy/ action plan which is tailored made for this particular health care facility to ensure that collaborative involvement is achieved. The change model that will be utilized to implement the nursing changes is the John Hopkins Nursing Evidence based practice (JHNEBP).

Change Model Overview

The Johns Hopkins Nursing evidence based practice model was chosen due to its ability to effectively guide the translation of healthcare evidences into practice. The model is characterized by three cornerstones of nursing including practice, education and research. The model also integrates the internal and external factors during transition.

Source: http://www.medscape.com/viewarticle/773058_4

JHNEBP model has three phases commonly referred to as the PET processes; (a) identification of the problem question; b) systematic review of the problem question and research evidence and c) Translation process which includes implementation processes, pilot study, outcomes evaluation and monitoring of the findings. The model provides examples of EBP projects which have been successful, and guides step by step the process for planning and implementing the program.

Source: http://www.medscape.com/viewarticle/773058_

Practice Question

Step 1: EBP question identification

Telehealth are the best intervention to manage and improve CHF quality of life. However, the use of Telehealth has not developed at the anticipated scale and pace. There are increased organizational, resources/financial, technological barriers and mixed perceptions and evidence of the telehealth have hindered implementation of the system. The research question is “why nursing care interventions coupled with telehealth technology is is increasingly being resisted, even with the increased evidence that it improves CHF patient’s quality of life?”

The Problem in this case is the resistance to care management change by nurses who provide care for CHF patients. The intervention being considered is to establish a tailor made implementation action to reverse the resistance into acceptance of telehealth technology. This is because the technology will empower the patient and simultaneously provide workload relief to the nurses. The intervention will be compared with the conventional standard care. The desired outcome includes reduction of re-hospitalization, ER visits and considerable reduction of CHF care costs. The overall outcome expected is improved CHF patient quality of life and reduction of nurses care workload; thereby increasing quality service delivery.

Step 2: Scope of practice question

Among the non-communicable diseases, CHF is reported to be the leading cause for mortality and morbidity in the industrialized countries. Additionally, it is the leading cause for hospitalization and emergency department visits. Despite the advances in pharmacology and medical care trends, nurses who provide care for CHF are faced with increased workloads (62%) due to the increased rates of re-hospitalization. With no exception, the CHF trend (prevalence and increased medical resource consumption) is projected to increase by five folds if no intervention is put in place (Dearholt &Dang, 2012).

According to literature, effective disease management requires the patient to be actively involved in disease management and decision making processes. Unfortunately, patient empowerment has been lagging in CHF disease management system for a long period of time; thus the increased re-hospitalization incidences. The introduction of telehealth technology is important because it facilitates frequent communication between the patient and the care provider; the ability to monitor health at home increases patient’s health outcome (American Nurses Association, 2010).

Steps 3, 4, and 5: Team

For a study to have an impact on the health policy, communication with the relevant stake holders (who are directly affected by the transition) is very important. In this context, the stake holder’s participants include; Advanced community nurse, Nurse CHF service managers semi-clinical staff (includes telehealth installers), General practitioner, and Organizational commissioning managers.

The varying stakeholders were chosen because each group has values which seem important. For example, the physician is concerned with patient safety and quality care delivery; whereas organizational commissioning managers are concerned with system efficiencies at a low cost of operational cost. By involving the stakeholders, the negative perceptions and doubts about telehealth technology will be addressed; and could result to changes of ideas position from negative grounds to a neutral one.

Evidence

Steps 6 and 7: Internal and external search for evidence

Four patterns of nursing research evidence influenced the internal search for evidence. This includes empirical evidence which is based on scientific research; ethical evidence based on nurse’s perception, cultural competency and preferences; personal evidence and aesthetic evidence. Empirical evidence indicates that two thirds of the healthcare providers are not willing to integrate telehealth care due to uncertainty on assessing patient’s suitability, and the difficulty in prediction of the patient’s response to the technology (concerns of depression and anxiety). Again, there is limited data which is relevant to telehealth patient outcomes coupled with the mixed published evidence reduced the acceptance of the new trend. Ethical evidence is discerned through limited referral, implying that only the patients of certain economic status can enjoy the privileges. There are also concerns on impact of the technology on nurse’s roles especially with the sharing of care delivery with the patient. These evidences highlight the absence of shared visions and telehealth rationale, thus the heightened resistance among the CHF care providers (American Nurses Association, 2010).

The external evidence search includes the legislation and standards. For instance, the public health insurance policies are emphasizing hospital to minimize the rates or re-admission and re-hospitalization. Again, World Health Organization has outlined standards for telemedicine. The importance of telemedicine in ensuring that patient’s safety and quality of care is delivered.

Steps 8 and 9: Summarize the evidence

Analysis of data generated from Veterans Health Administration (VHA) on Home Telehealth program indicated a 25% reduction in length of hospitalization days and 19% less re-admissions. Data generated from the Center for Connected Health (CCH) program which has been offering cardiovascular patients care intervention indicates 84.7% success in CHF management while undertaking the program. Another remote monitoring program I Ontario Telemedicine Network which had 800 patients with CHF indicated 65% reduction in hospital admission and 72% reduction on emergency visits (American Psychological Association, 2010).

Lawton (2010) acknowledges the importance of telehealth technology. However, the prevailing barriers impede successful integration of new trend in the healthcare sector. Paul and colleagues (2010) evaluations produces comparable results. This includes 27.1% readmission reduction and reduction of ER visits by 38.3%. The study concludes by pinpointing cost effectiveness as the key challenge for the program implementation in most healthcare settings.

Baker and Colleagues (2010) evaluations on the role of telehealth in managing CHF disease indicated a 15% mortality rate reduction, and 18% ER visits reduction. Brewster and colleagues found out that increased staff resistance as the main barrier for integration of telehealth system. The paper recommends future research on cost effectiveness and nurse workload reduction.

Step 10: Recommendations for change

The largest challenge in the implementation of telehealth is staff resistance to change. The results indicated that staff acceptance is critical for telehealth to be integrated; and is a research area which has been largely neglected. Until the innovation is viewed as better than or superior than conventional care, challenges on implementation will persist. In this case, it is not a question of replacing the technology face to face with the conventional approach, but rather according the staff support demand which ensure that their skills are improved, which will further change judgment and knowledge.

Further translational research to ascertain the benefits of the innovation would be effective in overcoming the barriers. Where most of them focus on training; the training scope should be expanded to include ways to retain and to refine strong staff-patient interaction and training on equipment use. These processes will empower staff; that in turn will empower the patients. The computer based hybrid models should entail staff training, lessons on home monitoring, and access to specialist and in person patient care which will change nurse’s perception on telehealth.

Translation

Steps 11, 12, and 13: Action plan

A computer based training module will be implemented. This module will contain all the hospital policies and protocols regarding evidence based practice. The exact model is the Continuous Quality model; FOCUS-PDSA. The action steps include (Dearholt &Dang, 2012):

Step 1: Find the underlying root for telehealth resistance by the staff

Step 2: Organizing committee and relevant stake holders to preside over the identified barriers

Step 3: Analysis and clarification of the underlying concepts

Step 4: Understanding the barriers and analyzing the discrepancies

Step 5: Recommendation of solution: Computerized training model

Step 6: Implementation of the solution recommended

Step 7: Evaluation of the outcome.

Steps 14 and 15: Evaluating outcomes

The outcomes evaluation will be conducted after 12 months. Evaluation will not be limited to this stipulated period. This is because interventions outcomes may not be immediately realized within the short term duration (Dearholt &Dang, 2012). Evaluation will include measuring the percentage or re-hospitalization, emergency department visits rates, and the mortality rates in two groups, the intervention group and control group. Additionally, evaluation tools such as 4 Likert scale will be used to evaluate nurses and patients responses.

Steps 16, 17, and 18: Implementation

Implementation of the action plan entails integration of online computer based practice. The first part of the module will have the prevalence rates of telehealth resistance and its clinical implications. The second part will highlight the procedures for telehealth, including the risky behaviors associated with poor telehealth practices. The implementation of this strategy is necessary because it will ensure that the novice’s nurses and new employees learn about safe telehealth process. If the strategy is found to be successful, it will be integrated in other departments. This model is chosen due to its efficacy, it is time conscious, easily accessible and can be retrieved on demand and at any location (Dearholt &Dang, 2012).

Conclusion

As indicated from the study, growing number of systematic reviews indicates a range of improved outcomes of normal care. The practice question was on how to address the increased resistance of integrating telehealth technology in management of CHF patients. The research evidence indicates reduced re-hospitalization rates, reduced mortality, reduced ER visits, which results to reduced quality of care. The study translation includes the implementation of nurse led computerized coaching on the approaches to manage the telehealth procedures. This strategy is aimed at improving nurse’s clinical judgments, reducing nurse workloads; and to simultaneously, improve CHF patient quality of life.

References

American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring.

American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC:

Baker, LC. Macaulay, D S., Sort, A., Diner, M., Johnson, G., Birnbaum, G. (2012). Effects of Care Management and Telehealth: A Longitudinal Analysis Using Medicare Data. Journal of the American Geriatrics Society 1: 1560–1567

Brewster, L., Gail M., Wessels, B., Kelly, C., & Hawley, M.(2013) Factors affecting frontline staff acceptance of telehealth technologies: a mixed-method systematic review. Journal of Advanced Nursing 1: 660–667

Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International Lawton, G. (2010). Telehealth Delivers many benefits, but concerns linger. PTin motion journal.

Paul, YT. , Gregory, Pecina, J., Stroebel, R., Chaudhry, R., Shah, N.D., & Naessens, JM. (2010). A randomized controlled trial of telemonitoring in older adults with multiple chronic conditions: the Tele-ERA study. BMC Health Services Research 10: 255

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Perceptions of health, disability, illness and behavior

Understanding perceptions of health, disability, illness and behavior

Order Instructions:

LO1. Understanding perceptions of health, disability, illness and behavior:

1.1 Analyse concepts of disability, illness and behaviour in relation to
Health and social care service users.
1.2 Assess how perceptions of specific needs have changed over time.

1.3 Analyse the impact of legislation, social policy, society and
culture on the ways that services are made available for
individuals with specific needs.

LO2. Understand how health and social care services and systems support individuals with specific needs
2.1 Analyse the care needs of individuals with specific needs.
2.2 Explain current systems for supporting individuals with specific
needs.
2.3 Analyse the impact of legislation, social policy, society and
culture on the ways that services are made available for
individuals with specific needs.

LO3. Understand approaches and intervention strategies that support individuals with
specific needs
3.1 Explain the approaches and interventions available to support
individuals with specific needs.
3.2 Evaluate the effectiveness of intervention strategies for an
individual with specific need(s)
3.3 Discuss the potential impact of emerging developments on
support for individuals with specific needs.

LO4. Understand strategies for coping with challenging behaviours
associated with specific needs.

4.1 Explain different concepts of challenging behaviour.
4.2 Describe the potential impact of challenging behavior on health
and social care organizations.
4.3 Analyse strategies for working with challenging behaviours.

Case Study 1
Baby Peter ‘was failed by all agencies’
Peter Connelly (also known as “Baby P”) was a 17-month-old English boy who died in London after suffering more than fifty injuries over an eight-month period, during which he was repeatedly seen by Haringey Children’s services and NHS health professionals.
Peter Connelly was born to Tracey Connelly on 1 March 2006. In November, Connelly’s new boyfriend, Steven Barker, moved in with her. In December, a GP noticed bruises on Peter’s face and chest. His mother was arrested and Peter was put into the care of a family friend, but returned home to his mother’s care in January 2007. Over the next few months, Peter was admitted to hospital on two occasions suffering from injuries including bruising, scratches and swelling on the side of the head. Connelly was arrested again in May 2007.

In June 2007, a social worker observed marks on Peter and informed the police. A medical examination concluded that the bruising was due to abuse. On 4 June, the baby was placed with a friend for safeguarding. Over a month later, on 25 July, Haringey Council’s Children & Young People’s Service obtained legal advice which indicated that the “threshold for initiating Care Proceedings…was not met.
On 1 August 2007, Baby Peter was seen at St. Ann’s Hospital in North London by locum paediatrician Dr. Sabah Al-Zayyat. Serious injuries, including a broken back and broken ribs, very likely went undetected.
The next day, an ambulance was called and Peter was found in his cot, blue and clad only in a nappy. After attempts at resuscitation, he was taken to North Middlesex hospital with his mother but was pronounced dead at 12:20 pm. A post-mortem revealed he had swallowed a tooth after being punched. Other injuries included a broken back, broken ribs, mutilated fingertips and fingernails missing.
The police immediately began a murder investigation and Baby P’s mother was arrested. So too were Barker, his brother Jason Owen and his 15-year old girlfriend, who had fled to and were hiding in a campsite in Epping Forest.
Baby P’s real first name was revealed as “Peter” on the conclusion of a subsequent trial of Peter’s mother’s boyfriend on a charge of raping a two-year-old.
The case caused shock and concern among the public and in Parliament, partly because of the magnitude of Peter’s injuries, and partly because Peter had lived in the London Borough of Haringey, North London, under the same child care authorities that had already failed ten years earlier.
Peter’s mother Tracey Connelly, her boyfriend Steven Barker, and Jason Owen (later revealed to be the brother of Barker) were all convicted of causing or allowing the death of a child, the mother having pleaded guilty to the charge.
The child protection services of Haringey and other agencies were widely criticised. Following the conviction, three inquiries and a nationwide review of social service care were launched, and the Head of Children’s Services at Haringey was removed by direction of the government minister.
A report by Graham Badman suggested that Baby Peter’s “horrifying death” was down to the incompetence of almost every member of staff who came into contact with him.
The report stated that “the practice of the majority, both individually and collectively was incompetent.”
“Their approach was completely inadequate and did not meet the challenge of the case,” it argued.
Source: http://www.bbc.co.uk/news/education

Case study Two:
The Bournewood Case
Rights for vulnerable people in the care system
Mr. and Mrs. E live in a picturesque cottage in a quiet Surrey Village. Inside, the house is buzzing with activity: three Old English sheepdogs, rescued from a home for abandoned animals, roam about the kitchen and patio. Photos of family outings cover the walls. Footsteps on the stairs signal the entrance of HL, the autistic man for whom Mr. and Mrs. E are carers. He pauses for a silent greeting before making his way swiftly to the fridge. “He knows exactly where we keep his favourite juice,” laughs Mrs. E.
Mr. and Mrs. E, are remarkable people, whose struggle for HL’s human rights has changed the way vulnerable people are treated under British law.

HL came to live with Mr. and Mrs. E in 1994, under a resettlement scheme from Bournewood hospital where he had lived for 32 years. With their children grown up, the couple had decided to open their home to someone who needed it. Looking after HL was no easy task: he cannot talk, and needs help with basic tasks like washing and dressing himself. Mrs. E says: “It’s fair to say that it was a challenge – but it was rewarding to see how much HL benefited from living in a family setting. At first he was very institutionalised, but he gradually became more confident and progressed beyond all expectations.”
A requirement of his placement was that HL would attend a day centre once a week, to which he travelled by the centre’s transport. On July 22nd 1997, three years after he had come to live with Mr. and Mrs. E, it was not the usual driver who collected from their home. Rather than taking him straight to the day centre as normal, the driver took a different route, collecting others on the way. HL became increasingly agitated.
The next thing Mr. and Mrs. E knew was that HL had been taken back into Bournewood hospital and detained there. He had been admitted informally, using a clause in the Mental Health Act 1983 under which the hospital simply had to argue that it was in his “best interests” – and as HL cannot speak, he was unable to object. Mr. and Mrs. E were not allowed to visit him, apparently in case he wanted to leave with them. “They sent us a letter thanking us for agreeing not to visit,” says Mrs. E. “We hadn’t agreed anything – they had decided, without any consultation.”
When Mr. and Mrs. E realised that HL was not going to be allowed home, they engaged a solicitor on his behalf and took a case for unlawful detention to the High Court, which ruled against him. The Appeal Court overturned the decision in October 1997, and the hospital chose to section HL, although he did not meet the criteria, and in December that year he was finally discharged by the hospital managers. “When he got home he was in a terrible state,” says Mrs. E. The couple has a video showing the abuses to which HL had been subjected in the hospital: he looks half-starved, with blackened toenails and scabs on his face. “When he came home he just ate and slept for three weeks.”
Meanwhile, the hospital trust, supported by the Department of Health, appealed to the House of Lords over the ruling. The Mental Health Act Commission suggested that 22,000 people being detained informally would have to be detained formally under the Mental Health Act if the ruling were upheld. In 1998, the House of Lords overturned the ruling that HL’s detention had been illegal. Mr. and Mrs. E decided to take the case to the European Court of Human Rights, which in October 2004 ruled in HL’s favour. As a result the government introduced the new Deprivation of Liberty Safeguards, which came into force in April 2009.

Source:http://www.equalityhumanrights.com/human-rights/our-human-rights-work/human-rights-inquiries/our-human-rights-inquiry/case-studies/the-bournewood-case/

Description of problem to be solved
As a Health and Social Care Practitioner, your responsibilities include, among others, assessing specific needs of people with disabilities, analyzing their care needs and also, evaluating strategies for giving support to people with challenging behaviours. You are therefore required in this assignment to demonstrate your understanding of Specific needs in Health and Social Care

Learning Outcome 1
The first part of your essay requires you to analyse concepts of disability, illness and behaviour in relation to Health and Social Care service users and give your assessment of how perceptions of specific needs have changed over time.
You are to examine the impact of legislation, social policy, society and culture on the ways that services are made available for individuals with specific needs.

Learning Outcome 2
Use the Bournewood case below to support this part of your essay, refer to stponline for further reading materials and learning resources.
This section of your essay requires you to describe the specific need of the individual, informing your audience about his condition and how it affects well-being and capacity. Discuss the systems available to support such individuals and link this to the case study. Build your arguments for and against and include your final decision in relation to the assessment criteria.

Learning Outcome 3
Explain the approaches and interventions available to support individuals with specific needs. Use both case studies as benchmarks and evaluate the effectiveness of the interventions strategies use. Discuss the potential impact of emerging developments on support for people with specific needs.

Learning Outcome 4

The last part of the assignment concerns your understanding of the strategies for coping with challenging behaviours associated with specific needs. Students are expected to explain the approaches and interventions available to support individuals with specific needs

Furthermore, students must describe the potential impact of challenging behaviour on health and social care organizations and analyse strategies for working with challenging behaviours.

*Please see the Merit and Distinction criteria below

SAMPLE ANSWER

People who require social and health care services have the right to treatment with respect, dignity, and compassion by practitioners with expertise and time to attend to their needs. This is a requirement that is guided by law. These individuals require a type of care that is patient-centered and takes into account the needs, and wishes and of the individuals` without any reservation. Many social barriers should be removed or reduced for the victims. Teams of caregivers are required to emphasize on effective models. For instance, adherence and self-management are crucial to migrant populations, who may receive care in different locations, while community linkages are relevant for homeless individuals in order to ensure a fully supported care. A good health for these persons is vital for their engagement with the community, learning, as well as working (Pratt, 2010).

Individual suffering from autism while have lifelong encounters related to the developmental disability. The exact cause of autism has not yet been uncovered, but studies reveal the involvement of genetic factors. The spectrum of conditions associated with autism cover wide range. The spectrum varies from intense severity in some patients t subtle difficulties in understanding in those of average or above average intelligence. Autism is also associated with difficulties in learning. The disability of autistic people is characterized by a triad of impairments. These include absence or impaired two-way social interaction, absence or impaired comprehension, use of language and non-verbal communication. With reference to the Bournewood case, Mr. HL`s greetings involved staring at people in silence, then went his way. Autistic individuals may encounter episodes of high or low sensitivity that leads to unexpected reactions to the environment. When Mr. HL was introduced to a new drive and a new route, he became highly agitated, and this caused him to be detained back in the hospital. Day care center services have been established for autistic individuals. Patients in resettlement schemes may also benefit from the services offered at the day centers. As exemplified by the Bournewood case, resettlement schemes, where patients are assigned to homes of caregivers yield best results, especially when the patients adapt to the respective settings. Mr. HL had lived well for three years before his environment was changed, something he did not like (The Bournewood Case (n.d); Edwards, 2008).

Taking care of individuals with particular needs can be quite challenging. Various interventions are available, which have proved to yield better results in terms of caring for individuals with particular needs. The interventions include adoption of a person-centered approach, where the needs and aspirations of the patient are considered. Individual and comprehensive patient-oriented support plans can also be into account. Provision of a setting that is appropriate for the individuals in also vital. For Mr. HL, a home, where he could live with his caregivers was the correct option for him. He could have his plans of coming home, and take his drink among other stuff. Mr. HL enjoyed the home setting, where he could interact with his caregivers often. Changing his environment, a little-caused problems that caused him trouble. Regarding baby Peter`s case, it is clearly shown that general practitioners must learn to be advocates for their patients. Peter`s condition was noticed while he was still living with the guardians, but no action was taken. This negligence resulted in the death of Peter (Sellgren, 2010).

Establishment of detailed and concrete approaches in order to achieve a healthy social interaction, communication, and development of independent skills is the best strategy of helping individuals with particular needs. Patient activities should be structured effectively to make sure that the patient is comfortable. The surrounding environment must also be considered since the patient must be comfortable. A change in this environment must be considered with extreme care. Additionally, caregivers must be carefully monitored by individuals, health organizations, and human rights organizations to make sure the progress of the victims is satisfactory. This strategy can minimize the development of unexpected outcomes.

Reference

The Bournewood Case. (n.d) Case Study Two: Rights for Vulnerable People in the Care System. Retrieved from http://www.equalityhumanrights.com/about-us/our-work/human-rights/human-rights-inquiries/our-human-rights-inquiry/case-studies/the-bournewood-case on 15/2/2015.

Edwards, D. (2008). Providing practical support for people with autism spectrum disorder: supported living in the community. London: Jessica Kingsley

Pratt, J. R. (2010). Long-term care: Managing across the continuum. Sudbury, Mass: Jones and Bartlett Publishers.

Sellgren, K. (2010, October 26). Baby Peter ‘was failed by all agencies. BBC: News Education and Family. Retrieved from http://www.bbc.com/news/education-11621391 on 15/2/2015.

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Setting Metrics for Progress and Success Childhood Obesity

Order Instructions:

HLTH 8136 Week 10 Group Activity

Just as there is a growing trend for public health interventions to be evaluated for their effectiveness, so public health organizations are increasingly expected to show their own “return on investment.”
The concept of return on investment, or ROI, is just one of the business principles that public health leaders are incorporating in their organizations to bring about more effective ways of conducting public health. Revenue generation, entrepreneurialism, and cost shifting are among the other principles that leaders should be conversant with. Business skills are vital because they allow an organization to make the greatest impact on the health of communities using the limited resources they have.
This week you will learn about a wide range of business principles and practices that can improve the effectiveness of public health organizations and can even allow them to generate revenues to help keep their programs afloat. You will also focus this week on a matter that pertains to many professionals as they attempt to move ahead in their career: the problem of leadership derailment, in which for one reason or another a leader’s career stalls. In the video program this week you will hear more about how you can recognize whether your career is derailing and what you can do to keep it on track.

ANSWER THESE QUESTIONS:

Setting Metrics for Progress and Success Childhood Obesity

1. What is the relationship between ROI and evaluation?

2. How would you measure ROI for your group’s particular program or endeavor? What are the metrics you would set by which to measure progress and success? Justify your choices.

3. What other business skills would be important for a leader to demonstrate in leading this proposed change? Explain your views.

USE THE FOLLOWING ARTICLES ONLY (DO NOT DEVIATE FROM ARTICLES)

Orton, S., & Menkens, A. (2006). Business planning for public health from the North Carolina institute for public health. Journal of Public Health Management & Practice, 12(5), 489-492.

Roper, W. L. (2006). The Management Academy for Public Health: Together we can make a difference. Journal of Public Health Management & Practice, 12(5), 407-408.

PLEASE APPLY THE APPLICATION ASSIGNMENT RUBRIC WHEN WRITING PAPER.

I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.

II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.

III. Paper should be well organized, uses scholarly tone, follows APA style, uses
original writing and proper paraphrasing, contains very few or no writing and/or
spelling errors, and is fully consistent with doctoral level writing style.

IV. Paper should be mostly consistent with doctoral level writing style.

SAMPLE ANSWER

Introduction

The major challenges facing the health sector especially in public health management is the need for more accountability and effective business management skills. The demand for accountability and prudent resource management strategies in public expenditure in provision of health care services is greatly hampered by the need to offer quality services and also the need to increase accessibility to all areas of public health.

Evaluation refers to the assessment of the performance of the of the Return on Investment (ROI) strategies that have been implemented at the health facility. Public Health practitioners are trained to offer services that provide the opportunity for the common public to lead a standard healthy life. To measure the ROI of a successful health facility, the practitioner collects data on the number of attendees seeking services at particular health facility that needs to be evaluated. For example, the number of children brought to the center for immunization against the threat of rabies, bioterrorism or for checkup on obesity related complications and who are mostly underinsured or poor. The success rate can be compared to the percentage rate of the number of immunized children against the estimated number of children in that region (Roper, 2006). An average rate of about 50% is fair while less than 50% will be considered below average. The other ROI measures can be implemented on the number of projects that are being undertake in a particular district for example on such programs like the prevention of lead poisoning and the support for preterm children. However, the success rates for such projects can be evaluated through pilot projects to assess their success or failure rates. The data collected in the field can be analyzed and used to make cross-disciplinary collaboration in order to improve and protect public health services.

Finally, the application of Management Academy business models from the University of North Carolina that combines business models and public health management while utilizing the state-of-the-art modern business methods to manage the facilities can greatly provide good returns on investment made (Orton & Menkens, 2006). The entrepreneurial approach of managing public health aims at maintaining the sustainability of the programs being undertaken by practitioners who are experienced in business planning skills.

References

Orton, S. & Menkens, A. (2006). Business planning for public health from the North Carolina institute for public health. Journal of Public Health Management & Practice, 12(5), 489-492.

Roper, W. L. (2006). The Management Academy for Public Health: Together we can make a difference. Journal of Public Health Management & Practice, 12(5), 407-408.

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Sanitary napkin making machine Paper

Sanitary napkin making machine transforming women’s lives in India

Order Instructions:

This assignment is for my P. AD – Social Change class. Below is the assignment.

I’m fine if the writer chose the innovation that he/she wants to write about.

Based on the ideas of innovation & invention, research an innovation that you feel has had a major impact on either American culture, the culture of another country, or the global culture as a whole.
BE CREATIVE! It is not fun to read 30 papers about the cell phone, Facebook, or iTunes. Think outside the box!
1. Give a brief history about how the innovation came about- who discovered it, how did they discover it, what does it do …… pretend no matter what you innovation is that I have never heard of it.
2. Describe the impact this innovation has had on the culture you chose. Has it made society better or worse? Were there unintended consequences that could not have been foreseen at the time of discovery?
3-4 pages+ bibliography: IF YOU DO NOT HAVE IN TEXT CITATIONS OR A BIBLIOGRAPHY IN MLA/APA FORMAT YOU WILL GET A “0”

SAMPLE ANSWER

Sanitary napkin making machine transforming women’s lives in India

Introduction

When Arunachalam Muruganantham decided to dedicate his life to solving womens’ menstrual problems, members of his community despised him for undertaking a ‘dirty’ endeavor and his wife almost left him. His determination however saw Muruganantham recognized as one of the 100 most influential personalities in the world by TIME magazine in 2014 for the invention of an affordable sanitary napkins manufacturing machine; which has transformed the lives of numerous women in India.

History

The journey to this invention began when Muruganantham realized that his wife often had to sacrifice her need for sanitary towels in order to save enough for the family’s food (Bachai, 2014). Upon further research, Muruganantham discovered that sanitary towels were indeed expensive, yet the cost was equal to 40 times the cost of raw materials produced (Bachai, 2014). It is following this discovery that he decided to build a machine that would help women in India access affordable sanitary napkins.

Muruganantham tested the absorbency of his first napkins which were made of cotton on himself by placing a goat’s blood in a football bladder in his pants. This earned him alienation from family and friends who thought he was either a pervert or bewitched and his wife, even though they later re-united, filed for a divorce. The napkins did not work and he had to do further research and with the help of a professor contacted manufacturing companies who gave him a sample material consisting of cellulose from tree bark (Bazelon, 2014).

Muruganantham then proceeded to invent the low-cost machine; a process that took him four and a half years. This machine, which is capable of producing 120 units per hour, is a grinder-type in which cellulose fluid is broken down into a soft material resembling cotton; which is then converted to rectangular compact pieces with the aid of another machine (Bachai, 2014). A non-woven cloth is then used to wrap the pieces to make the sanitary napkins, which are then disinfected using ultraviolet treatment.

Impact of innovation

This innovation has had a significant in the culture of women in India and has definitely made the society a better place. It has transformed the life of women by normalizing menstrual days as opposed to when they would be grounded because of lack of proper sanitary wear. In addition, the machine has provided employment opportunities for women, thus increasing the number of women in India’s workforce.

Women in India including school going children would have to stay at home because of the unreliable methods of protection used including the use of sand, ash and rags which were also unhygienic. A 2011 study by BBC had established that only 12% of women in India used sanitary pads due to costs and this innovation is therefore very welcome in the region (Bazelon, 2014). Many girls according to Muruganantham would drop out of school once they reached puberty due to lack of reliable sanitary solutions. The introduction of the machine has made menstrual days easier for women and created consistency in school attendance among girls. This can be said to have improved gender equity in schools and the community by preventing women from being disrupted from their normal lives during their menstrual days; and thus becoming more useful members of the society. To a great extent, women are now more empowered in the Indian society as girls will get an opportunity to learn, get employed and thus empower themselves (Bachai, 2014).

The machines have provided financial empowerment to women in the Indian society, elevating them to independence in a culturally male dominated region. Muruganantham has given over 12,500 women a means of employment, having made over 1300 machines, distributed in 23 out of 29 states in India (Bazelon, 2014; Bachai, 2014). Muruganantham’s intention is to ensure all women in India have access to hygienic sanitary napkins and that employment opportunities for over one million women are created (The Times of India, 2014). These machines are a breakthrough for women in India who have had to endure an inferior role in the society where women were not accorded the desired respect.

According to Neilsen and Waldrop (2014), women in India still face discrimination and their place in the society still remains that of subversive beings. As a result, women have to endure poverty as their male counterparts are favored with the little that is available; leaving them destitute and helpless. With the invention of the machine however, women can now earn a living, invest and overcome poverty. It also means that they are able to provide better livelihoods for their families; including being in a position to pay school fees for their children (Bachai, 2014). This has empowered women and accorded them the respect they deserve in the community. This invention is thereby helping India in overcoming the discriminatory culture and making women’s lives so much better.

At the moment, the impact of the innovation can be considered positive and unintended consequences are negligible if any. This innovation has made the society better and replication of the same in other developing countries is highly recommended.

References

Bachai, S. (2014). Man Who Got His Period Develops Low-Cost Sanitary Napkins, Voted A TIME Influential Person. Retrieved on January 28, 2015 from http://www.medicaldaily.com/man-who-got-his-period-develops-low-cost-sanitary-napkins-voted-time-influential-person-287804

Bazelon, E. (2014). The Man Who Made the Period Safe for the Women of India. Retrieved on January 28, 2015 from http://www.slate.com/blogs/xx_factor/2014/03/05/arunachalam_muruganantham_the_man_who_created_his_own_sanitary_pad_and_made.html

Neilsen, K. B. & Waldrop, A. (2014). Women, Gender and Everyday Social Transformation in India. London, UK: Anthem Press

The Times of India. (2014). First man to wear sanitary napkin: An ‘unlikely’ hero for Indian women. Retrieved on January 28, 2015 from http://timesofindia.indiatimes.com/india/First-man-to-wear-sanitary-napkin-An-unlikely-hero-for-Indian-women/articleshow/40783382.cms

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Healthcare Organizations Assignment Paper

Healthcare Organizations

Many nongovernmental organizations (NGOs) and government organizations often work side by side on the same problem.
To prepare for this Application Assignment, explore the web pages of the organizations provided in your Learning Resources, this week, to learn about the
work they are doing. Look for one health issue that you can see in both the NGO and government organizations for this assignment.
To complete this Application Assignment, write a 2- to 3-page paper that summarizes and compares the roles and function of one governmental and one
nongovernmental organization (NGO) public or global health organization for a specific health issue. Be sure that your summary includes information about the following:
1. Where are the organizations’ headquarters located?
2. What is the mission or purpose of these organizations?
3. What populations do they serve? And what do they do?
4. How are the organizations funded? Are they part of a larger public health infrastructure?
5. Do these organizations mention collaboration with any other agencies or organizations?
6. Are there any major public health issues these organizations are currently focusing on?
7. What might be some ethical issues that are related to the mission of these organizations? (If the organizations have a code of conduct or ethics
statement, provide a brief summary in your description.)
8. Summarize what you learned in researching these organizations: What were the most interesting things you learned in this application? How are the
organizations you selected similar or different?
Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources, as required.

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Exploring Actual and Potential Health Problems Essay

In this assignment, you will be exploring actual and potential health problems in the childhood years using a functional health assessment and Erickson’s
Stages of Child Development. To complete this assignment, do the following:
1. This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to
beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
2. Using the textbook, complete the "Children’s Functional Health Pattern Assessment." Follow the instructions in the resource for completing the
assignment.
3. Cite and reference any outside sources used in your answers. Include in your assessment a thorough discussion of Erickson’s Stages of Child Development as it pertains to the development age of the child.

TEXTBOOK
Physical Examination & Health Assessment BY CAROLYN JARVIS.
Read chapters 3-4, and read age-specific information in chapters 8-27 in the textbook.
http://evolve.elsevier.com
BE SURE TO USE AT 3 SOURCES
ACADEMIC LEVEL IS BACHELORS.

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Health Workforce Issues (Paramedic)

Health workforce issues e.g. rural General Practitioner training; expanded scope of practice for paramedics in rural locations; working hours for junior doctors; nurse practitioners in emergency departments; inter-professional practice.

The purpose of this assignment is to develop your written and database searching skills.

You are to search for three (3) published journal articles* by three (3) different authors from three (3) different journals on one (1) of the listed topics.
You will write a short summary of each of the articles.
*This does NOT include: newspaper articles, news reports or editorials or web pages.
Structure : 50- 75
Introduction: 50 -75
Provide a brief overview of the topic and what you intend to discuss with the reader in the following 3 articles.

Article 1
200 words Full reference here (Harvard or APA) as a heading.

Description
Tell the reader the main concepts, purpose and outcomes of the article. What was the author intending to demonstrate with this article.
Identify methods
Briefly tell the reader what methods were used to collect the data (information) used in the article ? did these include descriptive (interview, focus
group), or statistical (survey, questionnaire), how many people were involved, who were the participants (male, female, children, ages)?
Relationships with other health professionals
From the information found identify any (actual or potential) relationships with other health professionals.
Future practice reflection
Reflect on your future health professional practice.
What ideas and thoughts does the information provided in the article stimulate in relation to how you might practice as a health professional?
Be specific here about you and your future practice.

Article 2 200 words Reference

Description of the article
Identify methods
Relationship with other health professionals Future practice reflection.

Article 3 200 words

Reference
Description
Identify methods
Relationship with other health professionals Future practice reflection.
Conclusion 50-75 words
Make a brief statement that connects the 3 articles to the intention provided in your introduction
Self Assessment 50 words
Reflect on how you felt in completing this task, what were the challenges, what do you need to improve before the next task and identify what support you
need.

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