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Ventilator Associated Pneumonia (VAPs) in children

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Follow all the given guidelines. See the attached files.

SAMPLE ANSWER

Reflection #1: Ventilator Associated Pneumonia (VAPs) in children

VAPs are hospital acquired pneumonia that occurs in patients who have undergone mechanical ventilation for more than 48 hours; and previously had no symptoms of respiratory infection before the treatment. VAP occurs when bacteria colonize the lower respiratory tract in patient undergoing mechanical ventilation treatment. Microorganisms can be introduced to the lower respiratory system through micro-aspiration of bacteria from upper respiratory system or gastrointestinal tract or via biofilm production from the endotracheal tube (ETT) The diagnosis for ventilator associated pneumonia in children (VAP) is challenge. VAP is ranked as high health risk for hospitalized children. It accounts for 18% to 26% of Hospital Acquired Infections (HAIs). Currently, pneumonia is ranked as the 6^th leading cause of death in US (Swedick et al, 2012).

VAP prevalence rate ranges from 10 to 30% and mortality rate ranging from 33% to 50%. It is associated with lengthened hospital stays; increased health costs, high rates of multi-drug resistant infections and delayed recoveries. It is estimated that 300000 VAP incidences are reported every year; and costs health care over $12billion annually. VAP is also associated with prolonged hospital stays to up to 22 days, costing $40000 per patient. The hospitalization cost for pediatric VAP cases is $308534 as compared to $252652 for patients free VAP. Evidently, there needs an effective strategy to target control for VAP from vantage points including medical team training universal hygiene and establishing effective protocol for microbiological infection surveillance. Integration of VAP strategic preventive interventions into clinical practices has been ineffective. In fact; studies indicate that only 22.3% of nurses and care givers practice the published infection prevention recommendations. The implementation of VAP-prevention guideline from previous studies is inconclusive (Cooper &Haut, 2013).

References

Cooper, VB., &Haut, C. (2O13) Preventing ventilator associated pneumonia in children: An evidence based protocol. Critical Nurse Care 33; 3, 21-33. Retrieved on January 21^st, 2015 from

[http://eds.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=ace834bd-2fcf-4f62-8716-b48d2268013c%40sessionmgr113&vid=0&hid=108]

Swedick, MB. Et al. (2012) Using evidence based practice to prevent ventilator associated pneumonia. Critical Nurse Care 32; 4, 41-54. Retrieved on January 21^st, 2015 from [http://eds.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=4e4b66cd-23f9-45e8-a2f5-1006c82cf90b%40sessionmgr115&vid=0&hid=108]

Reflection #2: Ventilator Associated Pneumonia (VAPs) in children – PICO (T)

Research question: Which is the most effective preventive strategy to reduce the VAP prevalence in intubated children: VAP bundle or standard oral hygiene?

Endotracheal tube insertion criteria and duration, high level of microscopic aspiration, Biofilms from colonization
VAP is associated with microbial infection consistent with presence of endotracheal tube and mechanical ventilation for more than 48 hrs. In children, it is often associated with oral and mechanical hygiene because there is association between oropharynx microbials and VAPs incidences.
Maintenance of good oral hygiene such as tooth brushing and use of oral antiseptic reagents such as chlorhexidine, airways clearance and use of bedside protocols preventive strategies
The incidence of VAPs in children could be effectively reduced in children through implementing VAPs prevention guidelines and use of ventilator care bundles
Treatment is matched to the causative agent for 7 to 14days

The article on “proposed pediatric specific bundle offers new strategies for preventing ventilator associated pneumonia in children” by Viejo C. evaluates the evidence for mechanical hygiene and ventilator care bundles in prevention of VAP incidences in children. The paper acknowledges the limited research in VAP prevalence and prevention strategies in children. Further, the article recommends the integration of VAP strategic preventive interventions into clinical practices to effectively reduce VAP incidences in children. In fact; studies indicate that only few of nurses and care givers practice the published infection prevention recommendations. The implementation of VAP-prevention guideline will facilitate effective reduction of VAP in children.

References

Viejo, A. (2013) ‘Pediatric specific bundle offer new strategies for preventing associated pneumonia in children.’ Retrieved on January 21^st, 2015 from [http://www.prnewswire.com/news-releases/pediatric-specific-bundle-offers-new-strategies-for-preventing-ventilator-association

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Monitoring Public Health in Developing Countries

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Monitoring Public Health in Developing Countries

The challenges associated with monitoring public health increase in developing countries. Due to a lack of a robust infrastructure in many developing nations, a considerable number of diseases and conditions go unmonitored. In today’s climate of global interconnectivity, the failure to detect an emerging threat in a developing country could very well result in a pandemic spreading around the world. This is one of several possible implications of inadequate disease surveillance. The Discussion this week is concerned with how inadequate surveillance might influence ethical decision making in developing countries.

Analyze the ethical considerations associated with insufficient surveillance. Consider your own position on who should be held responsible for public health in developing countries.

post an analysis of the ethical implications of not investigating diseases/conditions in developing countries. Formulate a position on who should be held responsible for establishing, maintaining, and monitoring public health surveillance systems in developing countries.

SAMPLE ANSWER

Monitoring Public Health in Developing Countries

Adequate surveillance of diseases is one of the ways that countries manage various diseases. Ensuring that surveillance systems are in place has played a key role in the management of various diseases in most of the developed countries. However, developing countries continue to experience rampant cases of diseases because of poor surveillance systems in place. This paper therefore, analyses the ethical implications of failing to investigate disease/conditions in developing countries as well as those responsible for establishing, maintaining and monitoring public health surveillance systems in these countries.

Failing to investigate diseases in developing world has various ethical implications to the people as well as to the governments. One of the ethical implications is respect. It is through surveillance that various diseases affecting people such as communicable diseases can be identified and preventive strategies adopted (Carrel & Rennie, 2008). Human life is precious and requires to be respected by the government. Failing to prevent and manage these diseases through surveillance causes unnecessary preventable deaths. This is unethical as there is no protection and safeguarding of people lives.

Lack of surveillance hampers the right of individuals to access quality healthcare. It is a right for all the people to have access to quality healthcare (Carrel & Rennie, 2008). This right is not provided to many people in developing countries because of lack of investigation and surveillance of diseases that affect the people. In developing countries, the time taken for a health condition to be reported to the authorities is long and this contributes to increased levels of infections and deaths. This is therefore unethical because, those responsible to ensure that all people receive quality healthcare are not up to their tasks.

Inadequate surveillance as well has ethical implications as it lead to inequality and unfairness in accessibility to healthcare. Many of the people that have low income levels and those living in dilapidated conditions face challenges in accessing healthcare because of lack of surveillance in comparison with those that have medium or higher levels of income. This is an unethical practice that has contributed to increase in mortality rates among such individuals especially children and women that are more vulnerable (Carrel & Rennie, 2008).

Another ethical implication of lack of investigation is increased level of injustice in the society. This therefore, makes some people to feel abandoned and not cared for. This increases resentment and bitterness among the population hence the likelihood of resistance and as well loss of hope (Parrella et al., 2013). For instance, failing to report cases of outbreaks to the relevant authorities can be caused by lack of modalities for the people to voice their concerns. This therefore, causes increased spread of diseases and outbreaks that lead to higher levels of deaths.

Another ethical implication of failing to investigate diseases is increased incidences of corruption and lack of planning (Carrel & Rennie, 2008). Many people will be forced to pay bribes as they seek for medication and this increases the level of corruption. Failing to investigate diseases and conditions means that the authorities have poor planning policies on prevention and management of diseases in the developing countries.

The body responsible for establishing, maintaining, and monitoring public health surveillance systems in developing countries is the government. Governments of these countries have the responsibility to ensure that appropriate policies are implemented to ensure that enough measures are in place to investigate diseases and other conditions (Carrel & Rennie, 2008). The government is required to work closely with the public health institutions, private sector and other nongovernmental organizations to ensure that there is enough surveillance systems in the country to enhance provision of quality healthcare to all the people. Government is expected to provide funding for such programs as one of the mechanisms or strategies of managing and preventing various diseases.

In conclusion, it is important that countries adopt preventive measures as a strategy to manage diseases. One of the ways is through surveillance of disease for early management. Developing countries lag behind because of lack of failing to put surveillance measures in place. The government is responsible in ensuring that appropriate policies are in place to investigate diseases. Governments as well provide financial support, advice as well as partnering with other stakeholders to ensure disease surveillance in their countries.

References

Carrel, M., & Rennie, S. (2008). Demographic and health surveillance: longitudinal ethical

Considerations. Retrieved from: https://www.who.int/bulletin/volumes/86/8/08-051037.pdf

Parrella, A., et al., (2013). Healthcare providers’ knowledge, experience and challenges of reporting adverse events following immunisation: a qualitative study. BMC Health Services Research, 13(1)1-12.

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Canadian Surveillance Systems and EHRs

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Canadian Surveillance Systems and EHRs

In today’s technology-driven world, communication often occurs through the use of electronic devices. From cell phones to computers, society relies on these electronic devices on a regular basis. In response to this trend, many agencies and governments are promoting the use of electronic communication tools such as electronic health records (EHRs). For instance, the Canadian government has funded billions of dollars toward the use of EHRs (Health Canada, 2009; Office of the Auditor General of Canada, 2010.
Select two Canadian disease surveillance systems of interest to you. Then, consider the implications of EHRs for each of the systems.

post a brief description of each of the Canadian surveillance systems you selected. Describe how EHRs are used in the two systems, noting similarities and differences between the two you selected. Analyze the potential challenges and opportunities of using EHRs in a similar manner in your own country. Provide recommendations for how those challenges might be addressed. Respond to a colleague who provided different recommendations and/or who addressed different systems than you.

Use APA formatting for your discussion and to cite your resources.

SAMPLE ANSWER

Canadian Surveillance Systems and EHRs

There are many forms of Canadian Surveillance Systems that are currently in use. Among them include the Canadian Chronic Disease Surveillance System (Diabetes) and the Canadian Communicable Disease Surveillance System. The Chronic Disease Surveillance System (Diabetes) became established in 1997. The system was to use of administrative health data to collect information about diabetes and manage it effectively. Electronic Health Records have an implication on the surveillance system. For example, with the data, the surveillance systems for diabetes can identify the trends in diabetes (Robitaille et al., 2012). Hence, it becomes easier to know if the disease-causing mechanisms are evolving. On the other hand, the Canadian Communicable Disease Surveillance System is a disease monitoring and evaluation procedure that takes care of changes in the health of a population ((James et al., 2012). As a result, it takes into consideration their care, prevention and control programs (James et al., 2012).

With the use of EHRs in health facilities, there are some similarities and differences that the two Canadian surveillance systems incur. For example, EHR data has not yet become fully centralized (Terry et al., 2008). As a result, it happens that the two forms of surveillance have different EHR units that they have their data input for future use in surveillance. The analysis of data from various surveillance systems also does qualify in uniformity (Terry et al., 2008). Hence, there are differences between communicable and chronic diseases surveillance in relation to EHR programs. However, there are also similarities. HER policies are uniform across the platform, and when it comes to disease surveillance systems, they apply in equal measures.

Using EHR has challenges, and they depend on the country that they are being applied, in my country; the use of EHR systems will undergo major setbacks due to inconsistency in data collection and reporting. Quality reporting requirements provide another challenge that comes with the usage of electronic reporting in my country. There are situations where the information fed into the systems will not represent the reality. In the process, the information will mislead causing the reporting systems to make a wrong perception and conclusion. There are several issues that come with the use of EHR systems. Among them include feasibility of the data and its viability (Terry et al., 2008). Additionally, other challenges include the challenge of taking up a well-tested measure to see if they apply in the right frames.

Despite some of these challenges very general, they apply to my native country and are very rampant. To deal with them, it becomes important to consider their source and come up with a strategy. Governments should come out and engage in engage in health research to see how to improve the surveillance systems. With the possibility of succeeding, most of the issues that come with the condition will reduce in their sharpness or become eradicated altogether.

One of my colleagues chose to address the blood transfusion surveillance system used in Canada. For this type of surveillance system, there is a high likelihood that it has success chances. For example, in the collection of information from the blood transfusions and donations taking place, the data collected becomes huge. Hence, it is used to check diseases in the blood, and how it reacts in different individuals. In the end, all the information and surveillance will have a greater positive effect. Most the systems however work in a similar ways with the only difference coming from their application and use of EHR systems.

References

James, R. C., Blanchard, J. F., Campbell, D., Clottey, C., Osei, W., Svenson, L. W., &

Noseworthy, T. W. (2003). A model for non-communicable disease surveillance in Canada: the prairie pilot diabetes surveillance system. Chronic diseases in Canada, 25(1), 7-12.

Robitaille, C., Dai, S., Waters, C., Loukine, L., Bancej, C., Quach, S., … & Quan, H. (2012).

Diagnosed hypertension in Canada: incidence, prevalence and associated mortality. Canadian Medical Association Journal, 184(1), E49-E56.

Terry, A. L., Thorpe, C. F., Giles, G., Brown, J. B., Harris, S. B., Reid, G. J., … & Stewart, M.

(2008). Implementing electronic health records Key factors in primary care. Canadian Family Physician, 54(5), 730-736.

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Journal Entry on Abdominal Pain Assignment

Practicum Experience:Journal Entry on Abdominal Pain

Order Instructions:

Practicum Experience: Journal Entry
After completing this week’s Practicum Experience:
1).Reflect on a patient who presented with abdominal pain, (Write a description of a patient with abdominal pain including signs and symptom).
2) Describe the patient’s personal and medical history
3) What are the patient’s drug therapy and treatments?
4) What are the patient’s follow-up care?
NOTE: If you did not evaluate a patient with this background during the last 6 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.
Required Resources, you may choose from another textbook or articles
Readings
• Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.
o Part 12, “Evaluation and Management of Gastrointestinal Disorders” (pp. 612–722)

This part examines the pathophysiology and clinical presentation of several GI disorders. It also describes diagnostic criteria, differential diagnosis, and management methods for GI disorders.
o Part 20, “Evaluation and Management of Infectious Disease”
? Chapter 234, “Infectious Diarrhea” (pp. 1263–1271)

This chapter describes characteristics of three types of infectious diarrhea and identifies the pathophysiology, clinical presentation, treatment options, and possible causes of the disorder.

SAMPLE ANSWER

Practicum Experience: Journal Entry on Abdominal Pain

Abdominal patient care involves the reflection of a past activity, reflection and evaluation that leads development of knowledge and understanding of concepts broadly. This involves a sequence of activities including description of what things that have taken place, feelings that are developed by the individuals involved, evaluation of the right and wrong things in the experience, analysis of the situation, conclusion and a decision on what to do in order to handle the matter.

Bed bathing, as one of the requirement of taking care of a patient suffering from abdominal pains, is a vital part of a patient’s hygiene as it stimulates circulation and relaxes the body. A proper bed bath involves gathering of the necessary equipment like disposable gloves, waste bag, wash cloth, bedpan, towels and soap. A patient is given a bedpan or urinal before bathing, bed bathing is a private procedure, which may make the patient feel embarrassed, and it is important to respect privacy by covering them with clean sheets and putting curtains around their bed (Barker, 2013). Washing of patients begins from the furthest extremity to prevent dripping water across the already cleaned parts. Placing the hand and legs of patients in water is a procedure which helps them to feel fresh and it softens their nails.

During bed bathing, the nurse communicates with the patient and performs checking of the body to get clear information on the client’s progress. The process of communication is one which helps in evaluation of services’ quality hence improving the relationship between patients and health assistants (Buttaro, Trybulski, Polgar & Sandberg-Cook, 2013). Patients get their bed bath under the supervision of a registered bank nurse, after washing the patient the nurse helped to apply cavillion cream on the patient’s bottom, the patient had a moisture lesion on the skin.

During bed bathing, the nurse needs to make a decision on the kind of cream, spray or oil to use depending on the type of skin the patient has. Creams are advisable for moisturized intact skins while sprays are important for dry and broken skin due to their ability to moisturize the skin (Peate & Peate, 2012).

Nurses need to get updated information on how to treat bedridden patients to avoid conflicts with the patients and their assistant practitioners. According to researches carried out in the nursing field, the nurses and medical practitioners require continuous trainings and facilities that expose them to the updated information to avoid making mistakes with their patients (Timby, 2009). From research, it is clear that there are many nurses who make mistakes out of ignorance. Clear and relevant information exist in books and articles on handling of the patient’s skin depending on the moisture level to avoid infections and creating

In conclusion, from the information provided in the paper that discussing professional issues within an environment where clients are available is not okay. Looking at the healthcare sector as explained in the paper, it was not appropriate for the nurse and the other employee to argue on the patient’s caretaking procedure while the patient overheard. Patients in the first place are individuals who are weak and ought to be taken good care of because they need to recover from their illness and regain their health and strength (Melnyk & Fineout-Overholt, 2011). They are individuals who should be given full care making sure that their environment is conducive for them.

References

Barker, J. H. (2013). Evidence-based practice for nurses. London: SAGE.

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & health care: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. http://file.zums.ac.ir/ebook/208-Evidence-Based%20Practice%20in%20Nursing%20&%20Healthcare%20-%20A%20Guide%20to%20Best%20Practice,%20Second%20Edition-Be.pdf

Peate, I., & Peate, I. (2012). The student’s guide to becoming a nurse. Chichester, U.K: Wiley-Blackwell.

Timby, B. K. (2009). Fundamental nursing skills and concepts. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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Improving the U.S. Healthcare Needs

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Submit Draft of Abbreviated Quantitative Research Plan on (Health disparities are a growing concern in the U.S. There are also a significant proportion of people with limited or no health insurance which may prevent them from receiving adequate health care, medication, and the use preventative measures such as exercise and diet. How would you address this issue?)

You will apply quantitative research methods when you develop an abbreviated quantitative research plan that seeks to answer your research problem and research questions/hypotheses.

To prepare for this Application, first focus on the following instructions:

Review Chapter 8 in the course text, Research Design, the “Threats to Internal Validity” handout, and the “Quantitative Methods: Examples” med
Based on your discipline’s research problem scenario, create a problem statement.
Draft an introduction for your abbreviated research plan.

Next, ask yourself the following questions:

What are your research questions? To what extent can you test them? How would you justify the viability of your questions?
What are your hypotheses? How would you test them?
Why would this design be the most appropriate for answering the research questions? Conversely, why would qualitative and mixed methods designs not be appropriate?
What quantitative approach would you select for this study? Why is that approach the most appropriate one for answering the research questions?
What theoretical framework or perspective would you use?
What is your target population? How would you identify and recruit participants? What factors would contribute to determining appropriate sample size? You will not need to calculate sample size for this assignment.
What are the independent and dependent variables?
If appropriate for your plan, what instruments might you need?
What data collection procedures might you use? Why would those be the most appropriate methods to use?
How would that data help to answer your research question(s)/hypotheses?
What are threats to validity? How might you mitigate them?
How might you analyze the data?
What are the ethical considerations related to the plan?

The assignment:

Craft a 2- to 3-page paper in which you do the following:

Provide an introduction.
Provide a purpose statement.
Provide viable research questions and hypotheses.
Generate a written research plan that addresses the above questions.

SAMPLE ANSWER

Improving the U.S. Healthcare Needs

Introduction

The present health disparities being witnessed in the U.S. is worrisome. This is coupled with the fact that majority of U.S. nationals do not adequately enjoy health covers, meant to be provided by established health insurance companies. Contrary to what it is expected, the usage of preventive measures including diet and exercise has been limited, thus putting the progress of health among people to question. It calls for the government and key agencies to safeguard the health of their dear citizens by ensuring that there is comprehensive medical cover being provided by insurance companies; that everyone exercises proper diet, and that every citizen accesses quality health care by virtue of being informed of everything concerning their health.

Research Question

This proposal seeks to determine the appropriate medical interventions required for ensuring comprehensive health care, medical covers, and role being played by health insurance companies to safeguard the health of Americans. The proposal shall seek to answer the below question:

What are the appropriate medical care and insurance cover that should be enjoyed by all U.S citizens to protect and foster their health?

Research Methodology

The research methodology used affects the results of any research. Research methodology affects data collection methods (Reswell 2003, p31). Quantitative data requires the measuring of variables and testing of existing hypothesis. Quantitative research methodology involves verification of numerical data. Qualitative research methodology involves theoretical data. It involves evaluation of existing theories, beliefs, and hypothesis in order to either approve or disapprove them. Research methodology and research in general involves finding a solution to a problem. This research uses qualitative research methods to gather information from relevant bodies and people who will inform of the methods that should be used for safeguarding the health of U.S. citizens, by providing the with the required medical care and ensuring their health vitality and enjoyment. The aim of the research is to trigger necessary verifiable actions to be taken with immediate effect to salvage the problem. This proposal uses only quantitative data in its analysis. It also employs various data collection methods such as surveys, interviews, as well as observation in order to answer the research question.

Research Design

According to Kumar (2010, p93), research design entails both the research methodology as well as the procedures used. This proposal applies descriptive research design that involves case studies, surveys, and observation methods. The research design allows the collection of data at the least possible cost, time, and effort. The research design enables the answering of the research problem by outlining the below objective of the study:

To establish the appropriate healthcare practices that can be adopted by the U.S. Government, together with relevant agencies and health insurance bodies to safeguard the health of the citizens.

The project will use both primary and secondary data sources on sourcing information about health insurance covers. The method of data collection used includes conducting of surveys, interviews, as well as collection of data from secondary sources. This research will collect information from relevant bodies and health insurance companies as well. The research will use random sampling in choosing relevant bodies and health insurance companies to obtain information. This research will also conduct interviews of citizens who have been denied proper medical care by seeking to find out their fears, the needs, and the suffering they undergo for failing to access proper health care. The research tools used prevents this research from digressing away from the research objectives. This is by ensuring accurate collection of data. The research tools determine the methods of data collection used.

Rational for using quantitative approach

This research uses quantitative approach as opposed to qualitative approach. This is because data on the research is mostly quantitative. This data exists only in terms of words and not numerically. The type of data collected determines the kind of research therefore; this research uses quantitative approach due to the use of quantitative data.

Research sampling methods

This research uses small size samples in order to achieve accurate results. This research uses probability sampling in choosing the samples interviewed. This is where every health care agencies, health care insurance companies, and citizens have equal chance of selection. The research uses cluster sampling where the researcher organizes the samples into groups to have equal chances of selection.

Data collection

This research uses interview method to collect information from health care agencies on the best approach to use in providing for adequate health care to citizens. This research adheres to ethical issues in data collection such as privacy of information. The research does not reveal the names of the citizens interviewed as a way of maintaining confidentiality. This research also sought the consent of the interviewees before using their information in data analysis (Willkes, 2012). Apart from conducting interviews, the research collected information through conducting surveys on the best healthcare practices on all citizens. The research also applies observation method to collect data. Observing the citizens reactions to what is lacking in health care platforms enabled in developing conclusions of the research.

Application of results to improve healthcare

The research recommends that key health care agencies and insurance companies should embark on transforming the situation presently in the U.S. The research proposes that everyone should be insured against health risks, and that any losses of lives as well as injuries.

Conclusion

It is therefore necessary that nurses and other hospital workers adopt safety mechanism of alleviating this situation. This research proposes the adopting of proper health measures that if well implemented, can significantly reduce the recent health care trends in America.

References

Gordon .C & Schmelzer, M(2012) Care of the Patient in Excited Delirium. Journal of Emergency Nursing, Vol 39, 2, pp 190-196.

Kumar .R (2010). Research Methodology: A step-by-Step Guide for Beginners. London, UK SAGE

Reswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: Sage Publ.

Willkes, G. M. (2012). 2013 oncology nursing drug handbook. Sudbury, Jones & Bartlett learning.

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Workforce Issues on Patient Safety

Order Instructions:

Workforce Issues on Patient Safety

In this assignment, you will consider how workforce issues impact on patient safety.

Discussion Question 1

Using the an Online Library, research workforce issues and patient safety.

Based on your research, complete the following tasks:
•Identify and describe the research problems, purpose, objectives, and hypothesis of the research.
•Evaluate the credibility and validity of the study.

Discussion Question 2

Read the following titles of research studies from an Online Library. Identify the type of research used in each study (qualitative or quantitative). Provide a rationale for your selection.
•A study of the effects of cardiac rehabilitation exercise program on the morale and motivation of persons recovering from recent heart attacks.
•An exploratory ethno-botanical study of medicinal plants used by the Turks in the treatment of eye disorders.
•A study of the impact of different dietary patterns on breast cancer patients.
•The effectiveness of the acquired immunodeficiency syndrome (AIDS) Drug Assistance Program (ADAP).
•A study of the effects of different types of music on sleeping patterns of elderly insomnia patients.
•A study of the impact of political and social trends on the direction of nursing research.

Suggested References:

Shisana, O., Rice, K., Zungu, N., & Zuma, K. (2010). Gender and poverty in South Africa in the era of HIV/AIDS: A quantitative study. Journal of Women’s
Health (15409996), 19(1), 39–46.

Ko, E., Nelson-Becker, H., Park, Y., & Shin, M. (2013). End-of-Life decision making in older Korean adults: Concerns, preferences, and expectations. Educational
Gerontology, 39(2), 71–81.

Witzke, J., Rhone, R., Backhaus, D., & Shaver, N. (2008). How sweet the sound: Research evidence for the use of music in Alzheimer’s dementia. Journal of Gerontological Nursing, 34(10), 45–52.

Sandvik, A., Melender, H., Jonsén, E., Jönsson, G., Salmu, M., & Hilli, Y. (2012).
Nursing students’ experiences of the first clinical education: A nordic quantitative study. Nordic Journal of Nursing Research & Clinical Studies /Vård I Norden, 32(3), 20–25.

Cooper, C., Taft, L., & Thelen, M. (2004). Examining the role of technology in learning: An evaluation of online clinical conferencing. Journal of Professional Nursing, 20(3), 160–166.

Roulston, A., Bickerstaff, D., Haynes, T., Rutherford, L., & Jones, L. (2012). A pilot study to evaluate an outpatient service for people with advanced lung cancer. International Journal of Palliative Nursing, 18(5), 225–233.

SAMPLE ANSWER

Workforce Issues on Patient Safety

Discussion question 1

Patient safety in many health institutions faced challenges that relates to workforce issues. Various studies demonstrate that in deed measures are required to make some improvements in the workforce to enhance the level of patient safety. In the study, “The effects of workforce issues on patient safety” by Gelinas and David (2004) it is clear that there are number of issues that relates to the workforce that affects the safety of patients in the health centers.

The research problem in this study is lack of focus to relevant workforce issues hence leading to injuries and poor patient safety. The purpose of the study was to provide an insight on the failures in the health facilities such as staff retention, competency development and orientation and training issues that compromise on the patient safety. The objectives of the study were to provide amicable solutions to the problems that face workforce in health care. Other objective is to ensure that there is good leadership in the hospitals to provide motivation to the workforce. Cultural aspects as well require a redress to enhance transformation in health facilities to enhance patient safety. The study hypothesis is inferred and is to promote positive values among workforce and motivate them to reduce patient injury.

Validity and credibility of a study matters a lot credibility of the study compels people to adopt the study as they have confidence in it. The study is credible as it incorporates credible sources of reference. It is well supported with statistic from other studies that makes it credible. Professionals as well carried out the study. The study as well incorporated evidences from various public reports, which makes it credible (Gelinas & David, 2004). The study validity is as well evident with the use of authoritative information and models. Information is well researched and proved. The fact the study was approved to be included in the database, is a clear indication that it meet the threshold of validity and credibility.

Discussion Question 2

Researchers decide to adopt to different research designs either qualitative and quantitative or mixed depending on the nature of the study. Some of the topics of study can be well understood through any of these study designs (Rofail, Maguire, Kissner, Colligs & Abetz-Webb, 2014). The topics of these studies as well can provide some insights to the research study adopted. Studies in relation to effects of cardiac rehabilitation exercise program on the morale and motivation of persons recovering from recent heart attacks uses qualitative research designs. The reason for adoption of this design is that it generates information through interviews that can be explained and described to enhance understanding (Mayberry & Kent, 1983). Researcher can observe the patients as well as interrogate them to determine whether they are motivated or their morale has increased after exposure to rehabilitative exercise. Other studies that adopt qualitative design include, A study of the effects of different types of music on sleeping patterns of elderly insomnia patients and A study of the impact of political and social trends on the direction of nursing research. These studies do not require reliance of statistics or to present the findings using statistics.

On the other hand, some studies require adoption of quantitative study designs for the findings to be of great value and assistance. Examples of these studies may includes an exploratory ethno-botanical study of medicinal plants used by the Turks in the treatment of eye disorders, a study of the impact of different dietary patterns on breast cancer patients and The effectiveness of the acquired immunodeficiency syndrome (AIDS) Drug Assistance Program (ADAP). These studies require presentation of data using numerical statistics to enhance their understanding.

References

Gelinas, L., & David, Y. (2004). The Effect of Workforce Issues on Patient Safety. Nursing Economic, 22(5):266-279

Mayberry, J., & Kent, J. (1983). Recent progress in cardiac nursing and rehabilitation programmes. Journal of Advanced Nursing, 8(4): 329-333

Rofail, D., Maguire, L., Kissner, M., Colligs, A., & Abetz-Webb, L. (2014).Review: Health- related quality of life is compromised in individuals with spina bifida: results from qualitative and quantitative studies. In European Journal of Obstetrics and Gynecology, 181:214-222

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Digital Dashboard for Tuberculosis

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Digital Dashboard for tuberculosis.
This portion of your Scholar-Practitioner Project (Digital dash board for tuberculosis) requires that you put to use the informatics display techniques.create a mock-up screen of a “digital dashboard” for tuberculosis disease surveillance system. Include a framework for the display of data based on the algorithm using appropriate graphics, symbols, and words., and words. You may use PowerPoint, Word, Prezi, or a program of your choosing to create the screen. Additionally, you may choose to annotate the mock-up as appropriate.

Please save the mock-up in one of the following formats:

PowerPoint file: Use “.ppt” extension
Word file: Use “.doc” extension
Prezi file: Use “.pez” extension
PDF file: Use “.pdf” extension
Image file: Use “.jpg” or “.gif” extension
Rich text file: Use “.rtf” extension
Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure your in-text citations and reference list are correct.

SAMPLE ANSWER

Digital Dashboard for Tuberculosis

Week 5 information: Tuberculosis disease surveillance system

TB disease surveillance system is essential in ensuring closer monitoring and management of the disease. The system must function appropriately to have tangible benefits to the users. Quality assurance is very critical part of any surveillance system that operates successful. Quality assurance ensures that the system is continuously monitored evaluated and data is improved.

In US, national tuberculosis Surveillance System (NTSS) is located at the division of tuberculosis Elimination (DTBE) and functions as the national repository of TB disease surveillance data. Center for Diseases control and prevention receive information/data from the various jurisdictions reports through a standardized data collection from known as RVCT) Report of Verified of Case OF Tuberculosis (Center for Disease Control and Prevention (CDC), 2014).

The RVCT is usually revised on period basis to take into consideration the new changes in the disease epidemiology. The latest implementation was done in the year 2009 and it incorporated more recent development such as web-based systems. There is still a lot that have been done to ensure that data is collected and reported well to ensure that adequate information is available. Various teams form partnerships with public health officials and other local professionals to develop and in launching of national training programs on the new RVCT (WHO, 2014). These initiatives are undertake to foster or enhance quality of data collected. In management of TB, it is critical to have enough data or information about the prevalence of the diseases. This information on the areas the disease is prevalence as well helps to come up with appropriate strategies to manage the disease.

Five factors require consideration to ensure quality assurance of the tuberculosis surveillance systems. These components includes, case detection, data accuracy, data completeness, data timeliness and data security and confidentiality (Center for Disease Control and Prevention (CDC), 2014). Case detection is the first aspect. Once an instance of specific diseases or even exposure such as TB is done, a health care worker reports it. This information as well is collected from laboratory work or from a medical or a vetenary care. The observation or such incidence should be diagnosed and verified.

Data accuracy is another important component of quality assurance. The submitted data need to match with the patient record at the location or point of care (Arkansas Department of Health, 2014). The data recorded in the surveillance system need to remain consistent with the activities that happened in the clinical encounter if they were not clinically appropriate or if they were clinically appropriate.

The third component is data completeness. This measure helps to ascertain whether information submitted has complete set of data items or not (Center for Disease Control and Prevention (CDC), 2014). This is very important as it ensures that any information stored in the system is complete and therefore can be relied in the future. This requires verification of such information to ensure that it is complete and meets the threshold set for data completeness.

Data is also required to factor in the aspect of timeliness. It is important that prompt reporting of surveillance data is done to the health authorities. Once the information is accessed, it is very important that this information is reported immediately to provide an appropriate mechanisms responding to the same and instituting to preventive mechanism.

The last component is data security and confidentiality. Security of data entails measures in place geared at protecting data of public health and information systems from accessibility by unauthorized release (Center for Disease Control and Prevention (CDC), 2014). It also involves measures concerning information identification, loss of information and damage of the systems. Data confidentiality aims to protect personal information gathered by public health organizations. Personal information should not be released to third parties without the consent of the owner of the information or the patients.

Quality Assurance components of TB surveillance system

References

Arkansas Department of Health. (2014). National Electronic Disease Surveillance System (NEDSS) . Retrieved from: http://www.healthy.arkansas.gov/programsServices/epidemiology/Surveillance/Pages/Nedss.aspx

Center for Disease Control and Prevention. (CDC). (2014). Hot Off the Press! Quality Assurance for Tuberculosis Surveillance Data: A Guide and Toolkit – 2013. Retrieved from:http://www.cdc.gov/tb/publications/newsletters/notes/TBN_3_13/dataguide_toolkit.htm

Center for Disease Control and Prevention. (CDC). (2014). Tuberculosis Information Management System (TIMS) Replacements. Retrieved from: http://www.cdc.gov/tb/programs/tims/NEDSS.

WHO. (2014). Standards and benchmarks for tuberculosis surveillance and vital registration systems: Checklist and user guide. Retrieved from: http://www.who.int/tb/publications/standardsandbenchmarks/en/

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Bow & Tie analysis for Medication Safety

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Topic- Medication Safety

In Week 7, the class examined the Joint Commission’s framework for root cause analysis of sentinel Incidents in health care organizations. For purposes of this project, a critical incident is a key occurrence, but it is not a sentinel event. A bow-tie analysis places the critical incident at the center of the framework and identifies in graphic format the root cause leading up to the incident on the left side of the critical incident. On the right side of the incident, key preventive measures are graphically represented. In one image, you will capture the incident (at the center), the causes for failure in quality, and (on the right) preventive measures a manager can put in place to stop this failure from happening in the future. The final graphic will appear as a bow-tie. The instructor will provide an example. Each student will select a critical incident for approval by the instructor.

This project must include a cover page, a one-page explanation, a one-page graphic image (bow-tie analysis), and references.

SAMPLE ANSWER

Bow & Tie analysis for Medication Safety

Medical practitioners use various prescriptions to treat different infectious illnesses, deal with the symptoms of continual ailments, and relieving pain. Generally, medicines are safe is used as indicated by the medical practitioner or as described in the labeling. Nonetheless, there are certain risks associated with different prescriptions. Recent statistics indicate that adverse medication events have resulted in more than 700,000 visitations to the emergency departments of different sanatoriums within the United States (Current awareness: Pharmaco epidemiology and drug safety, 2010). This entails the injuries acquired from the use of prescriptions. Most analysts indicate that such adverse medication events are avoidable. Medical personnel and ailing individuals can aid in reducing the risk of injuries from prescriptions by comprehending the key concepts of medication safety. Such educational programs ought to be conducted in different forums by focusing on various population groups in terms of age brackets, gender, and health conditions.

In order to enhance medication safety, it is important to systematically evaluate the noteworthy prescription errors in addition to determining the feasible causes of such unpleasant events. The Bow-Tie model is an effective risk analysis mechanism that can be used in the healthcare subsector with the main aim of effectively analyzing the risks, possible causes, and impacts of various adverse prescription events. In the hospital setting, some of the risk factors associated with medication safety include administration faults of injectable medicines (Phipps, Noyce, Walshe, Parker & Ashcroft, 2011). This may be prevented by using an electronic system to crosscheck the prescriptions. This prevention measure may also aid in avoiding adverse prescription events caused by the placement of medication stickers attached to the prescription account of the wrong individual. Another risk factor that is bound to cause adverse prescription events as indicated through the Bow-Tie analysis is the confusion that occurs when transferring prescription information between different sanatoriums or wards (Workman, LaCharity & Kruchko, 2011). However, such a situation may be dealt with by using an electronic information exchange program.

CONSEQUENCES

RECOVERY MEASURES

Bow-Tie Diagram

UNDERLYING CAUSES

Little consideration made on structural aspects aimed at enhancing awareness among nursing personnel regarding prescription errors and the reported adverse medication events

Effects of medication errors vary in severity from one patient to another (delayed management of morbidities)

Complains from the ailing individuals

The ailing individual is aware of risks associate with prescriptions and cautions the nurse

Nurses recommend preliminary medication orders (unpermitted)

Medical doctors do not recommend medication to an ailing individual who is newly admitted into the sanatorium

Nurses make sure if the suitable medications have been stipulated (warning function)

PREVENTIVE BARRIER

INITIAL ERROR

Surgeons giving priority to ailing individuals over the timely prescription of medications

An extremely busy schedule for resident surgeons

A large percentage of surgeons are often not available in hospital wards

References

Current awareness: Pharmacoepidemiology and drug safety. (April 01, 2010). Pharmacoepidemiology and Drug Safety, 19, 4.)

Phipps, D., Noyce, P., Walshe, K., Parker, D., & Ashcroft, D. (January 01, 2011). Risk-based regulation of healthcare professionals: What are the implications for pharmacists?. Health, Risk & Society, 13, 3, 277-292.

Workman, M. L., LaCharity, L. A., & Kruchko, S. C. (2011). Understanding pharmacology: Essentials for medication safety. St. Louis, Mo: Elsevier/Saunders. https://www.elsevier.com/books/understanding-pharmacology/workman/978-1-4557-3976-9

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Surveillance System Comparison Essay

Surveillance System Comparison

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Surveillance System Comparison
This section of your Scholar-Practitioner Project prompts you to explore modern surveillance systems applied at different levels of government related to the disease you selected. In addition, you describe the government’s responsibility to monitor and report at the four political levels. By understanding the reporting requirements of government, you are able to design your surveillance system to meet those requirements.

To complete this portion of your Scholar-Practitioner Project, write a 2- to 3-page paper that addresses the following:

Identify modern surveillance systems implemented at the local, state, regional, and national levels related to the disease you selected.
Evaluate the effectiveness of the modern systems in monitoring the disease you selected.
Analyze the government’s responsibilities for monitoring the disease/condition you selected at the different political levels (local, state, regional, and national). Include an explanation of how the reporting requirements differ at each level.
Suggest how you would apply any lessons learned in this exercise to the system you are constructing.

SAMPLE ANSWER

Surveillance System Comparison

Modern surveillance systems implemented at the local, state, regional, and national levels

Early warning surveillance systems are designed to create an early alert of a disease threat through the detection of mere presence of potentially infectious micro-organisms. Early warning surveillance systems are mostly monitored at the federal level. Syndromic surveillance deals with symptoms indicative of Ebola virus. This surveillance system providing real time monitoring for non-specific, prediagnostic indicators of disease outbreaks has been broadly adopted by cities, states and the national government. States use The Real Time Outbreak and Disease Surveillance System (RODS) in gathering data on symptoms of emergency room patients (Institute of Medicine (US) Forum on Microbial Threats, 2007).

Situational awareness surveillance systems are used in monitoring the progress and outcome of an intervention for purposes of mitigating or stopping the progression of a communicable disease. Cities, states and the national government have shown a wide and multifaceted use of surveillance for describing and informing response throughout the entire period of an outbreak. Animal surveillance systems help in detecting transmission of the Ebola virus among animal and human populations over space and time, in addition to predicting future transmission patterns.
The effectiveness of the modern systems in monitoring Ebola virus

The modern surveillance systems assist local and state health departments in enhancing, designing, and developing means for rapid detection of Ebola outbreaks as well as other public health threats and emergencies. These surveillance systems enable the health departments to investigate and mitigate such outbreaks of part of a National Electronic Disease Surveillance System. For instance, syndromic surveillance systems help in providing timelier identification of disease outbreaks than could be achieved through traditional surveillance systems. Nevertheless, sysndromic surveillance has been criticized for the few outbreaks that it has managed to detect and most people are doubtful as to its potential to perform better than alternative systems to alert the public health community to a problem.

The government’s responsibilities for monitoring Ebola virus at the different political levels (local, state, regional, and national)

In America, public health surveillance for infectious diseases occurs through a variety of local, state, regional and federal programs. Healthcare providers and others often report cases of ‘notifiable’ infectious disease as defined under local and state health codes to health departments. Accordingly, health department officials conduct a verification of the disease reports, monitor disease incidence, identify possible, and send the findings to the Centers for Disease Control and Prevention. The Centers for Disease Control and Prevention and other federal agencies carry out an independent gathering and analysis of information for disease surveillance. Furthermore, the federal agencies fund national and international networks for disease surveillance laboratories which establish diagnostic tests and develop disease diagnostic research. Despite the CDC having set out guidelines for surveillance systems funded by the national government, there is a general lack of evaluation. In addition, so far there is barely any evidence to support the cost-effectiveness of massive national public health surveillance investments.

In conclusion, it is very important to note that effective surveillance requires a clear appreciation of the capabilities sought. When designing a surveillance system, I need to establish the phenomena that need detection, the populations in which detection is needed, and the data that would be most effective for that purpose. An effective surveillance system should be follow legally and professionally acceptable processes, be cost-effective, and have the ability to identify in an ongoing predictive, sensitive, simple, timely, standardized, and flexible manner the emergence of meaningful epidemiological phenomena as well as their particular associations.

Reference

Institute of Medicine (US) Forum on Microbial Threats. (2007). Global infectious disease surveillance and detection: Assessing the challenges – finding solutions, workshop summary. Washington DC: National Academies Press.

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History of Disease Surveillance Assignment

History of Disease Surveillance

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History of Disease Surveillance

The historical record of any movement is composed of significant turning points or events. The same can be found in the historical development of disease surveillance. This week, you analyze the influence of key events in guiding the evolution of disease surveillance and predict the future trajectory of disease surveillance and its impact.

To complete this Application Assignment, write a 2- to 3-page paper analyzing the influence that specific historical events have had in the evolution of disease surveillance systems. Then, forecast the next phase(s) in disease surveillance and explain how the changes that you predict will impact public health policy and practice.

SAMPLE ANSWER

Influence that Specific Historical Events have had in the Evolution of Disease Surveillance Systems

Public health actions are vital to the wellbeing of communities and the society in general. As a result, among the methods that are used to enhance the effectiveness of community wellbeing is disease surveillance systems. Disease surveillance systems are the strategies that are used to collect, analyze, manage, analyze and interpret that is used to stimulate public health actions (Tsui et al., 2003). However, the transition of the disease surveillance system has been impacted by a number of factors among them historical events. However, the surveillance systems have been specifically focusing on infectious diseases as compared to other kinds of diseases (Tsui et al., 2003). As a result, the main role of surveillance systems is to detect outbreaks, provide guidance for national allocation, coordinate outbreak responses, monitor control programs and describe the epidemiology of diseases.

Te first law that impacted disease surveillance systems came about in 1893 when the law got enacted. In the specifications of the law, it was required that all municipal authorities should present health information on a weekly basis (Tsui et al., 2003). In the same year, Michigan came out as the first state to use the reporting of infectious diseases (Tsui et al., 2003). The events acted as a hallmark for infectious disease surveillance and the resultant diseases surveillance systems. In 1916, poliomyelitis became severe all over the country, and the surveillance of the disease was not a question of contention (Tsui et al., 2003). As a result, all states in the United States began to present morbidity reports that acted in the part of disease surveillance systems. In addition, the influenza pandemic that hit the United States in 1919 also led to mandatory surveillance by 1925 (Tsui et al., 2003).

In 1935, America established its first ever national health survey system that took effect immediately and all over the United States (Tsui et al., 2003). The survey system worked well with all infectious diseases, and the United States began to have a more relaxed picture of infectious diseases and how to deal with them. However, disease surveillance systems became official in 1963 when the Center for Disease Control (CDC) chief epidemiologist gave a speech about disease surveillance systems (Tsui et al., 2003). In the speech, he identified disease surveillance systems will work well for populations as compared to individuals. Alexander Langmuir became the father of disease surveillance systems, and this key event played a great role in the evolution of the surveillance systems.

Before Langmuir’s speech in 1963, there was a key event in 1955 that changed the face of disease surveillance systems. A polio vaccination sprang into motion in 1955 (Tsui et al., 2003). However, soon after setting the program into motion, some of the polio cases were identified to originate from the program (Tsui et al., 2003). As a result, the program was shut up, and CDC set up a team to investigate the issue. Daily surveillance reports became a necessity from each state in the United States, and the information was sent to the polio vaccination program head (Tsui et al., 2003). With officers in the field, the problem was identified in certain manufacturer of the vaccines and corrected. Thereafter, other events followed that further cause the evolution of disease surveillance systems. Among the events included the 1986 CDC report that contained information and recommendations and the increased popularity of the systems in the 1990s (Tsui et al., 2003).

In my prediction, disease surveillance systems are about to evolve to the point that they will play a role in defining likely outbreaks before they occur. The aspect will become possible through the use of information to predict trends. As a result, the society will become more protected in terms of infections. In the process, public health policy and practice will enhance its significance in fighting with diseases.

Reference

Tsui, F. C., Espino, J. U., Dato, V. M., Gesteland, P. H., Hutman, J., & Wagner, M. M. (2003).

Technical description of RODS: a real-time public health surveillance system. Journal of the American Medical Informatics Association, 10(5), 399-408.

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