Discussion: Access to and usage of health care.

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Discussion: Access to and usage of health care.

Discussion: Access to and usage of health care.

There are several factors that can influence the access to and usage of health care.


Write

a 350- 500 -word paper that discusses the factors and their effect on health care usage.


Address

the following in your paper:

  • Identify one or two health factors that influence the usage of health care.
  • Explain the impact the factor or factors have on health care access.
  • Explain how a lack of or delayed access to health care has an impact on an individual’s health status.


Cite

at least 1 peer-reviewed or scholarly reference and your textbook to support your information.


Format

your paper according to APA guidelines. Your paper must include an introduction, conclusion, and a reference page.


Resources:

Undergraduate APA Sample Paper, Center for Writing Excellence




ORDER NOW FOR CUSTOM-WRITTEN, PLAGIARISM-FREE PAPERS




You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.


Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.


Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.


The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.



ADDITIONAL INSTRUCTIONS FOR THE CLASS


Discussion Questions (DQ)


Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.


Weekly Participation


Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.


APA Format and Writing Quality


Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.


Use of Direct Quotes


I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.


LopesWrite Policy


For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.


Late Policy


The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.


Communication


Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.



Discussion: Access to and usage of health care.


Quality Improvement Project for Patient Prescription Record

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The aim of this quality improvement project is to ensure that nurses record in the designated box on patients Prescription and administration record (to be referred to as: Kardex) if High Dose Antipsychotics Monitoring is Applicable YES or NO (to be referred as: applicable Y/N) and subsequently if yes, that the High Dose Antipsychotic Therapy monitoring form (to be referred to as: Monitoring form and the Early Warning Signs (EWS) Form have been activated for completion. The purpose of this is to secure patient safety from the side effects of the medication.

There is widespread evidence which clearly links antipsychotic medication contributing to physical health problems such as cardiovascular problems, weight gain, endocrine problems, metabolic syndrome and sudden death (Gumber et al, 2010; Churchword et al, 2009; Tyson et al, 1999). Many premature deaths of people with serious mental illness are due to poor medical care that fails to monitor risk factors which may be due to side effects of medication (Cohen & Hove, 2001). A council report by the Royal College of Psychiatrists (2006) revealed that past audits of high dose antipsychotic prescribing for in- patients showed poor adherence to monitoring recommendations. All patients on high dose antipsychotic treatment must be monitored. These guidelines attempt to clarify the identification of patients on high dose antipsychotics, factors to be taken into account before such prescribing and the documentation required when antipsychotics are prescribed in high dose; furthermore it is a policy requirement of Forth Valley that this documentation is completed for these patients (Forth Valley, 2011).

The charge nurse highlighted a concern when evaluating the patients Kardex audit, it showed 100% non-compliance for the completion of the Yes/No response for high dose antipsychotics monitoring. Subsequently when the patients are receiving high dose antipsychotics, there was inconsistency of the completion of the Therapy monitoring form and EWS form. A recent audit of patient Kardexes confirmed the charges nurse finding (see Pareto chart, Appendix B).

To begin the process of the quality improvement project, a general ward meeting was held and attended by all staff in the ward that was on shift. During the meeting the charge nurse highlighted the recent findings of the Kardex audit. Concerns were raised that many areas on the Kardex were not being completed, and reminded staff nurses that this is not acceptable and needs to be improved. As a nurse it is extremely important to keep accurate documentation, good record keeping is an fundamental part of nursing practice, and is necessary to the delivery of safe and effective care (Nursing and Midwifery Council, (NMC) 2010).

As an attempt to focus the quality improvement project more specifically the results of the audit were presented using a Pareto chart (Appendix B). The data confirmed the areas on the Kardex which were not being completed however, high dose antipsychotic monitoring Yes/No was the highest at 100% non-completion, therefore it was agreed that a new strategy would be implemented to improve this. McLaughlin and Kaluzny (2006) state that the defect focused on does not necessarily need to be the greatest frequency to be improved first, but attention should be given to that defect that may have a devastating result, such as an adverse event or even death. However the defect in this instance was the highest and potentially could cause an adverse event.

Following the meeting a questionnaire (Appendix C) was devised and completed anonymously by the pharmacists, consultants and staff nurses to identify the root causes of why this area on the Kardex was not completed. A fishbone diagram was used to illustrate the findings (Appendix D). When populating the fishbone diagram with the data, it was clear to see that there were many reasons that each member of the multidisciplinary team had not completed the applicable area on the Kardex. Role confusion was a common theme from each member of the team. Hill-Smith et al (2012) claims that this is not unusual within multi-disciplinary teams and that respectful communication and clear instructions is of high importance in the delivery of high quality clinical care. Therefore based on these findings PDSA one was developed (Appendix G1). This tested whether the nurse attending the MDT meeting completes the Applicable Y/N on the patients’ Kardex following an email reminder and a verbal prompt from charge nurse before attending the meeting. The test confirmed there was a breakdown in communication, the nurse did not receive the email or a verbal reminder from the charge nurse prior to attending the MDT meeting therefore they were not aware of the procedure that had been discussed and as a consequence the applicable area on the form was not completed, this was confirmed by an audit of the Kardex (Appendix H). This informed the decision for PDSA two (Appendix G2). The nurse coordinating the shift should use the visual prompt situated on the shift coordinating sheet to remind the nurse attending the MDT meeting, to update applicable Y/N on the patients Kardex. The small change of a visual reminder on the shift coordinating sheet proved to be success. It reminded the coordinating nurse to verbally prompt the nurse attending the MDT meeting to complete the patient’s Kardex in the applicable area, which was shown by the Kardex audit after the shift; all patients’ Kardexes were completed and as a consequently the Therapy form and EWS from were also initiated for completion. These findings are consistent with Simpson (2007) research, where teams have clear operating procedures in place, care coordinating is enhanced.

The assumption was that the email and verbally prompt from the charge nurse would result in nurses completing the Applicable Y/N on all patients Kardexes, following the MDT meeting by 23rd February 2014 by 100%. Furthermore, if yes the Therapy form and the EWS form activated for completion.

Audits were carried out on the dates shown to give a snapshot of the completion of Applicable Y/N on all patients Kardexes in the IPCU ward at that time. Initial findings of the first audit by the charge nurse on 01/02/2014 revealed that Applicable Y/N was completed 0%. The second audit carried out to confirm the previous results on 08/02/2014 which confirmed the charge nurses findings of 0% compliance of Applicable Y/N. PDSA one was carried out on 10/2/2014 the change revealed 0% improvement in the completion of Applicable Y/N. PDSA two was implemented on 21/2/2014 the change was successful, the results of the audit revealed that Applicable Y/N was completed on all patients Kardexes by 100% this in turn activated the completion of the Therapy form and EWS Form.

Comparison of questions, predictions, and analysis of data:

Engaging with the quality improvement (QI) project has required me to learn and apply new skills in practice.

The process of plan, do, study, act (PDSA) cycles were a new technical skill which I had to not only learn myself, but teach fellow staff nurses on the ward, as this was also, a new process to them. I learnt that PDSA cycles provisionally test an idea by testing a change and assessing its impact. After implementing the first cycle, I learnt that it does not always get the results expected when making changes to your process; it taught me that it was better, and more effective to trial a small change to see if it made a difference, before implementing the change permanently. This also gave staff the opportunity to be involved and offer suggestions and see if the proposed changes would work.

I also learnt that communication is an essential and fundamental process during the course of the QI. According to Adams (1999), to persuade others to make an improvement or change, the negotiator must be influential. The Charge nurse in this instance was the influential position to lead change. Unfortunately they were not able to fulfil their obligation in PDSA one, but they carried out the ward meeting and used this as a platform to discuss the Kardex audits with the staff which informed them of the need to make an improvement in practice. Once the need for the new process was established and its principles by the email from the charge nurse, informing the reasoning for a change in practice, this was used as a base for PDSA two. I learnt that it is just as important to define the risk of not making a change (Plummer, 2000) and in this circumstance, changing practice would not only enhance quality of care to patients, but it would promote the involvement between staff nurses and the MDT, building trust and confidence to make the change, whereas the risk of not making the change, could potentially cause an adverse event

A final learning point I would like to include was how staff nurses initially were resistant to change. In my opinion from observing, the nurses were quite defensive as though they were being blamed for not doing their job correctly. The questionnaire used was an effective communication tool and successful resource for managing this resistance. It give staff the opportunity to anonymously feedback their reasons for not completing the applicable area on the Kardex, it also let them express their opinion without being condemned. Also, I feel that during this time, they were able to adjust and prepare for the change which minimised resistance (Bernhard and Walsh, 1995). I felt it was essential to take note of all their views as individuals and as team members, which provided further explanation of their reasoning for non-completion. Accountability was a consistent reason used by nurses for their reason for non-completion, as they felt it was a doctor or the pharmacist role and they did not want to be accountable for making the decision. When it was clarified that it was a team decision, by email from the charge nurse, the nursing staff felt supported. Mitchell (2001) states that accountability in nursing is a complex issue and acknowledged the importance of team support in the identification of roles and responsibilities. Frequent ideas and conversations with staff were held over the ten days, in advance of the change in PDSA two which I feel made the improvement successful and run smoother as nursing staff were aware of the new change.

I have learnt that within nursing it is important to continually improve the way we work. Working at every level developing the knowledge, technical skills, including leadership, are vital for long-term improvement. Continually learning may be important not only to ensure that we have the skills needed to improve the quality of healthcare, but also to enhance the motivation to do so.

Discuss the project’s significance on the local system and any findings that may be generalizable to other systems:

Relocation to a new site change what been good practice and now a gap had appeared in the process of monitoring patient.

The outcome of this project was a success. It was predicted that by 23rd February 2014 applicable Y/N would be completed by 100%. By establishing the success of the visual prompt in PDSA two on the co-ordinating sheet, was a very small but effective change.

As a consequence, at the following staff meeting it was decided that the visual prompt would be a permanent fixture on the coordinating sheet, as it was a sustainable reminder to future shift coordinators, thus improving the initiation of therapy monitoring and EWS forms, and overall patient safety outcomes.

Discuss the factors that promoted the success of the project and that were barriers to success. What did you learn from doing this project? What are your reflections on the role of the team?

The factors which promoted success in the project were support and leadership from the charge nurse at the beginning of my placement. They helped identify areas in the ward which they felt needed improvement. Furthermore, as a student who had never been in a mental health ward, I felt overwhelmed with the task and this support and guidance helped me through the project.

The use of the tools were a great way to involve staff on the ward to feel part of the project and broke down the barriers of pointing blame and focussed their attention in a systematic way, and explored the potential causes of the non-completions.

I was amazed as how such a small change help facilitate and test change in a manageable way. I now understand that Quality improvement as a way of approaching change in healthcare that focuses on self-reflection, assessing needs and gaps, and considering how to improve in a multifaceted manner. I feel I have gained an enormous understanding in about quality improvement in that it aims to create an ethos of continuous reflection and a commitment to ongoing improvement. It provides nurses to gain an the skills and knowledge needed to assess the performance of healthcare and individual and population needs, to understand the gaps between current activities and best practice and to have the tools and confidence to develop activities to reduce these gaps

Thus, the scan did not focus only on narrowly defined quality improvement models such as ‘plan, do, study, act’ (PDSA) cycles.

Nurs 6221 | NURS 6221 – Managing Human Resources | Walden University

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Part 1: Job Description Analysis

To Prepare:

Review the Learning Resources on human resource management and recruitment, job analysis, and job design.

Identify a job description from your current healthcare organization or where you have previously worked. Choose a job description that will enable you to determine the type of employees you are looking for as well as the selection criteria.

Based on the job description, develop a recruitment and selection plan. For Part 1, you will focus on developing and refining the job description. Consider:

What are the responsibilities of this job?

What are the competencies and KSAOs (knowledge, skills, abilities, other attributes) required for this job?

How would you evaluate a candidate to determine fit for this position, both in terms of technical competencies for the job and fit with the culture and values of the organization?

How could the job description be improved to ensure a successful hiring process?

Consider how you could use social media, such as LinkedIn or online employment recruitment sites, to maximize the field of qualified recruits.

If you are on LinkedIn, explore how the site functions as a recruitment source. If you are not on LinkedIn, create a profile for this Assignment, and then begin your research.

Identify and explore recruitment websites (e.g., Indeed, ZipRecruiter, CareerBuilder) that have been used to recruit for this type of position. Depending on the job, also explore discipline-specific websites where jobs are advertised (e.g., Nurse.org, ANA’s Career Center). Pay particular attention to how jobs are presented to interested job seekers.

Part 1 Assignment: Job Description Analysis

In 2–3 pages, include the following:

Explain the role of the nurse executive in developing job descriptions and why it represents an essential human resource management function.

Analyze the job description you have selected as the focus of your Assignment. Include the source of the job description and critique the job description for clarity and accuracy.

Explain how well the job description defines the required employee attributes for the job and how it could be improved. If information is available, describe how the tasks and competencies associated with this job may have changed since the job description was conceived.

Write a new or revised job description that reflects your analysis and which you would use for advertising the position and recruiting candidates for the job.

Explain how you would use social media and online job search technology to maximize presentation of the job description and reach a broader share of potential recruits.

Describe two examples of how jobs similar to your chosen position are presented to interested job seekers from the social media and online job sites you visit.

Part 2 Assignment: Interview and Selection Plan

Based on the job description you created or revised in Part 1, design an interview and selection process for that job. In 3–4 pages, include the following:

Describe the ideal candidate for this job, and explain the sources of information you would use in evaluating applicants.

Explain an overview of your process to identify, and select that candidate.

Focusing on the interview, explain:

Who within the healthcare organization would be involved in the interview process, and why

Pre-interview guidance and preparation for interviewers and recruits

How interview outcomes would be compiled

How differences in interview ratings would be resolved

List five essential questions you would ask in an interview to evaluate key employee characteristics for this job. For each question, explain what you would look and listen for in the candidate’s response.

Explain how you would measure a candidate and assess the recruit’s fitness for the position.

Analyze your interview and selection process for potential challenges, and explain how you would address those challenges to improve the process and outcomes, including retaining good employees.

Paragraph Development and Transitions:There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

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Paragraph Development and Transitions:There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

RUBRIC:
1-Comprehensive Description of a Communicable Disease and the Demographic of Interest: Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.

2-Determinants of Health and Explanation of How Determinants Contribute to Disease Development:Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
3-Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors):The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
4-Role of the Community Health Nurse:Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow up.
5-National Agency or Organization That Works to Addresses Communicable Disease:An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered.
6-Thesis Development and Purpose:Thesis is comprehensive, contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
7-Paragraph Development and Transitions:There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
8-Mechanics of Writing (includes spelling, punctuation, grammar, language use):Writer is clearly in command of standard, written, academic English.
9-Global Implication:A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.
10-Paper Format:All format elements are correct.
11-Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment):In-text citations and a reference page are complete. The documentation of cited sources is free of error.

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance completing this assignment.
Communicable Disease Selection
Choose one communicable disease from the following list:
1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza
Epidemiology Paper Requirements
Address the following:
1. Describe the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. (The textbook describes each element of the epidemiologic triangle). Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up).
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organization(s) contributes to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Environmental Factors and Health Promotion Pamphlet

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Environmental Factors and Health Promotion Pamphlet: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants

1.Develop a pamphlet to inform parents and caregivers about environmental factors that can affect the health of infants.
2.Use the “Pamphlet Template” document to help you create your pamphlet. Include the following:
3.Select an environmental factor that poses a threat to the health or safety of infants.
4.Explain how the environmental factor you selected can potentially affect the health or safety of infants.
5.Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
6.Offer examples, interventions, and suggestions from evidence-based research. A minimum of three scholarly resources are required.
7.Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.
8.In developing your pamphlet, take into consideration the healthcare literacy level of your target audience.

Part II: Pamphlet Sharing Experience
1.Share the pamphlet you have developed with a parent of an infant child. The parent may be a person from your neighborhood, a parent of an infant from a child-care center in your community, or a parent from another organization, such as a church group with which you have an affiliation.
2.Provide a written summary of the teaching / learning interaction. Include in your summary:
3.Demographical information of the parent and child (age, gender, ethnicity, educational level).
4.Description of parent response to teaching.
5.Assessment of parent understanding.
6.Your impressions of the experience; what went well, what can be improved.

Specify common law quality initiatives that are still found in 21st-century healthcare organizations. analyze three (3) quality initiatives for your organization.

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Specify common law quality initiatives that are still found in 21st-century healthcare organizations.
analyze three (3) quality initiatives for your organization.

Determine the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing the quality of care for the patients.

Differentiate between quality in a free market healthcare system and in single-payer government system with three (3) examples for each.

Specify three (3) common law quality initiatives that are still found in 21st-century healthcare organizations.

A 65 year-old female patient who was diagnosed with an intracapsular hip fracture and has undergone a hip replacement surgery.

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A 65 year-old female patient who was diagnosed with an intracapsular hip fracture and has undergone a hip replacement surgery. The patient

stated that her injury occurred when she slipped on the floor of her bathroom. She was previously diagnosed with type 2 diabetes mellitus and is

on oral anti-diabetic medications.
–This is only a suggestion! You can select any scenario that will be best presented.

Note: There is a sample essay I will attach to help with the format I seek. That one is for someone who worked in the children’s unit but got a

good grade upon submission. I believe we can do better 

The Question:

Students will complete a case study which discusses the provision and coordination of person-centred care linked to a real person they have

cared for whilst on clinical placement.

Case study instructions;

• Utilise the Clinical Reasoning Cycle (Levett-Jones, 2013) (a clinical decision making framework) to plan and evaluate person-centred care
• Considering the person’s situation, collect, process and present related health information
• Identify and prioritise at least three (3) nursing problems/issues based on the health assessment data that you have identified for the person

at the centre of care.
• Establish goals for priority of nursing care as related to the nursing problem/issues identified.
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided.
• Reflect on the person’s outcomes.

Research Proposal Form Example: Health Research

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Josefina B. dela Cuesta


Purpose

  1. “What are the stress management techniques of Health Care Assistant of St John’s Hospital?”
  2. The Purpose of the study is to determine the stress management technique of health care assistant of St John’s Hospital and through this it will benefit them by identifying the different coping mechanism that will help them to overcome stress. Moreover, through this study it will help the organization to discover useful stress management technique that would fit to the health care providers that will help them to give the best quality of care to their patients.
  3. Stress is defined as “state of psychological and physical l imbalance causing from the inequality between situational demand and the person’s ability and motivation to meet those needs (Akrani, 2011). According to Akrani (2011) stress can be open as positive or negative, in a positive stress when the condition deals an opportunity to a person to attain something and act as a motivator for a vital performance. Furthermore for a negative stress if an individual experienced social mental and emotional problem (Akrani, 2011).

According to study being exposed to stress to work for a long a period of time, it may decrease the efficiency of an individual to work hard and give consequences on one’s health as well as the family as well. Moreover workplace stress can caused several factors which include decision making skills. Furthermore, Healthcare professionals are among the first six most stressful ones but not all have the same level of stress. For all professionals, the workload and adequate manning are the main cause of stress (Kionis,Giannou Drantaki, 2015)

Moreover, stress is very complicated phenomenon that can never be confident and decisive so on the other side, each individual should take into account to perceive the different stressful factors. Continually, work – related stress combine with psychological quest, ethical problems and patient’s demand can be a burden on the emotional state of an individual. Having stress-related work especially on health care workers could lead to poor quality of care which can decrease their professional satisfaction thus their quality of life as well. Unceasing interaction with families, patients can rise anger, embarrassment, fear, and desperation thus leading health professionals to a more frustrating condition. Stress sources act progressively on a person leading to physical, emotional and behavioral reactions, or even to psychosomatic disease (Kionis,et.al 2015)

So, through this study the researcher will determine the different stress management technique of the health care assistants of St John Hospital to cope with their stress and identify their sources of stress.

Qualitative research is purposely to discover a proposed interest group’s scope of conduct and the acknowledgments that drive it with reference to particular points or issues. It uses an in-depth study of small group of persons to guide and support the development of theories. The outcomes of qualitative research are descriptive rather than predictive (Qualitative Research Consultants Association, 2016).

Moreover qualitative method includes in depth interviews with individuals, group discussions for example for two to ten contributor or respondents, and also through diary and journal exercises and in context observations. Furthermore, meetings may be conducted in person, through telephone interview, video conferencing and via internet (Qualitative Research Consultants Association, 2016)

Qualitative research is appropriate on this study because it will determine what are the stress management techniques utilized by the health care assistants of St. John Hospital and they overcome their stress and also to identify what are the different stressor that is causing them stress. On this study, the researcher will be focusing on the experiences instead of numerical interpretation of the study. Furthermore, qualitative research will expound the simple description that will be provided by the respondents of the study.

  1. The researcher will provide questionnaires to the respondents and to NZCDI
  2. The researcher will provide hard copy to the stakeholders and soft copy when needed.
  3. The research study will be conducted in St John’s Hospital
  4. The participants will take10- 15 minutes to answer the given questionnaire for them.
  5. The researcher itself will analyse the results of the research and will make the conclusion.
  6. The Data gathered by the researcher will be analyze statistically through their experiences give using descriptive
  7. The researcher, students and health care assistants of St John Hospital will be benefited on this research. Through this research the health care assistants will help them how to manage their stress well and identify what are stress management technique that is applicable for them.
  1. Intellectual Property
  • Not Applicable
  1. Personal Qualification
  • Josefina B. dela Cuesta
  • I Josefina dela Cuesta, finished by bachelor of nursing In the Philippines and had done one research paper, and before this research I was working as an emergency nurse in Kingdom of Saudi Arabia, and currently taking up Diploma Health Management level which allows me to conduct different research and studies in relation the health care field 7 in Cornell Institute of Business and Technology.
  1. Budget
  • Travel ( Gas Charge)- 20$
  • Gifts/Koha (tokens)- 30$
  • Photocopy- 10$


Ethics Proposal Form

  1. Participants
  • Health Care Assistants in St John’s Hospital
  1. Recruitment

    N/A

b. The researcher will make the initial contact to the main participants which are the health care assistant in St John Hospital in particular

c. The Health Care Assistant f St John’s Hospital is the main participants on this study.

III.

Consent

  1. Refer to Appendix-3
  2. The researcher will be responsible in obtaining the consent from the health care assistant at St John Hospital
  3. If participants cannot signed for consent for the given questionnaires he/she can use the thumb mark as a sign that he/she agreed to participate in the study.
  4. All the Health Care participants on this study are at the right age so need to provide a copy of parental and minor consent on this study
  5. In the research study there were no participants that are institutionalized or appointed guardian because all of the participants are at legal age and are at the good state of mind in making decision
  6. Before giving the questionnaires participants will be given an informed consent to complete before answering the questionnaires.
  1. Compensation
  • Not Applicable
  1. Materials
  • Questionnaires
  • i-vii(Not Applicable)
  1. Risk
  • Privacy and Confidentiality
  • The given questionnaires will remain confidential because their names will not be recorded because it will not contain any personal data on their identification like their names and address.
  1. Conflict/Resolution
  • If the participant wishes to withdraw during the implementation of the study he/she will not be forced and will not be included in the data that will be collected
  1. Controversial or Culturally Contentious Research
  • Not Applicable
  • Not Applicable


Participant’s Information Sheet


WHAT IS THE PURPOSE OF THE STUDY?

The Purpose of the study is to determine the stress management technique of health care assistant of St John’s Hospital and through this it will benefit them by identifying the different coping mechanism that will help them to overcome stress. Moreover, through this study it will help the organization to discover useful stress management technique that would fit to the health care providers that will help them to give the best quality of care to their patients.


WHAT WILL MY PARTICIPATION IN THE STUDY INVOLVE?

The researcher chooses St John’s Hospital as the institution for the study and the health care assistant are the foremost participant on this study. The participants will be given set of questionnaires, approximately 25 questions that will be analyze by the researcher. In addition, the researcher will also give 15 (fifteen minutes) to answer the given questions and there is no health information included by the participants.


WHAT ARE THE POSSIBLE BENEFITS AND RISKS OF THIS STUDY?

The benefits of this research is to identify the different stress management technique that would help the health care assistant of St John’s Hospital in order for them to cope up with stress, to have better quality care to their patients. In addition, having effective stress management technique it will develop the sense of independency of the health care assistants and to avoid any errors in the workplace.


WHO PAYS FOR THE STUDY?

The researcher will be responsible in providing the necessary needs of the study and the participants will not spend any amount or money in the study.


WHAT IF SOMETHING GOES WRONG?

If you were injured in this study, which is unlikely, you would be eligible to apply for compensation from ACC just as you would be if you were injured in an accident at work or at home. This does not mean that your claim will automatically be accepted. You will have to lodge a claim with ACC, which may take some time to assess. If your claim is accepted, you will receive funding to assist in your recovery.


WHAT ARE MY RIGHTS?

The participants on this study he/she can withdraw anytime with the research conducted since it is a voluntary act and not a force for them. The respondents have the right to access of the data collected by the researcher and if the respondent wishes to ho have a copy the researcher must give a copy of the study. Moreover, the researcher is the sole responsible of keeping the privacy and confidentiality of the research conducted.


WHAT HAPPENS AFTER THE STUDY OR IF I CHANGE MY MIND?

This study is a requirement for the researcher’s studies and the study will be saved for future use. The results of the study will be presented through a power point presentation and the researcher will give a hard copy to St John’s Hospital. Through this research study it will help the health care assistant in dealing their work-related stress and identify the different stress management technique that will help them in managing their stress that will promote better quality of care.


References

Akrani, G. (2011, March 27). What is Stress? Meaning, Definition and Causes of Stress. Retrieved December 2016, from Kalyan City Life: http://kalyan-city.blogspot.co.nz/2011/03/what-is-stress-meaning-definition-and.html

Koinis,, A., Giannou, V., & Drantaki, V. (2015, April). The Impact of Healthcare Workers Job Environment on Their Mental-emotional Health. Coping Strategies: The Case of a Local General Hospital. Retrieved from US National Library of Medicine :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768542/

Qualitative Research Consultants Association. (2016). What is Qualitative Research? Retrieved December 2016, from Qualitative Research Consultants Association: http://www.qrca.org/?page=whatisqualresearch

Varvogli, L. (2017). Stress management techniques: evidence-based procedures that reduce stress and promote health. Retrieved February 2017, from Health Science Journal: http://www.hsj.gr/medicine/stress-management-techniques-evidencebased-procedures-that-reduce-stress-and-promote-health.php?aid=3429

Health Promotion Activity for HIV

/in /by

  • GRACE GAISEY


HEALTH PROMOTION


Health promotion about raising awareness of Human Immunodeficiency Syndrome (HIV). Group members

– Grace Gaisey, Ethel Onyewuotu, Isabelle Bialan, John Daramewa, Nana Sarpong- Mensah and Peace Uzoma.


Introduction

This essay highlights assessing, planning, implementing and the evaluation of a health promotion activity on HIV.

The World Health Organisation (WHO), 2013) defines HIV as a virus which infects the cells in the immune system by destroying its function to a stage that infections may begin to occur as a result of weakening the immune system.


Assessment of Health Need

Health needs assessment is an efficient method in reviewing health issues involving a population which leads to approved priorities and allocation of resources that assist in the improvement of health and reduce inequalities (National Institute for Health and Care Excellence (NICE), 2009).

This is beneficial as it contributes to the description patterns of disease in a local population and the differences from other location, such as districts, regional or national disease patterns such as HIV as it is a pandemic disease (National Aids Trust (NAT), 2014), and creates the opportunity in learning more about the needs and priorities of the local population to provide the objectives needed to work towards meeting those needs (Wright, Wilkinson and Williams, 2009).


Epidemiology and demographic statistics

Naidoo and Wills (2009) defined epidemiology as the study of occurrence and spread of disease in a population. Demography on the other hand is the size, composition and the distribution of human populations and their changes resulting from fertility and mortality (Dudley, Poston & Bouvier, 2010).

HIV is a transmitted disease with almost 75 million people infected with the virus worldwide, with data trends indicating it has increased as 36 million people were living with HIV by the end of 2012 (WHO, 2014). It has also been estimated that the 75 million infected with HIV caught the virus by means of transmission, such as sexual intercourse and mother to child transmission (WHO, 2013).

For instance, it has been estimated that 5.1 million of children worldwide have been infected with HIV through mother to child transmission (NAT, 2013). Thus, early infant diagnosis is being scaled up in many countries, but in 2011 only 35% of the infants born to mothers living with HIV received HIV test and has been increased by 46% between 2010 and 2012 from 2.4 million to 3.5million (WHO, 2013).

The demographic statistics from data trends indicates that, about 36 million people have died of HIV globally since 2012 compared to 30.3 million people in 2001 which shows an increase of 17% (WHO, 2014). Although the mortality among the population are infants aged 1-5 years and has increased with 3.34 million (NAT, 2013). HIV causes mortality among adults, however, according to estimates by WHO (2013), infants who has HIV are more likely to die between the ages of 1 and 5 years, respectively, with 2.3 million dying as a result while adults have the likelihood of dying between 15 and 60 years.


Target group

The target group for this HP activity is 15-24 years as statistics shown by the Public Health England (PHE) (2013) indicate young people under 25 are more at risk of contracting HIV with a peak age of women between 15-20 years and 20-24 for men. This has been indicated as a public health issue in many countries as 40% of new HIV infections are seen among 15 to 24 year olds (PHE, 2013).

WHO (2013) further corresponded stating, half of the 75 million people infected with HIV in the world are young women aged 15 to 20 years, accounting for all new infections, and there is a growing recognition that these women and girls with HIV infection is shaped by gender inequalities and violence against them.


Behavioral aspects that might affect this health issue.

According to the National Institute of Allergy and Infectious Disease (2014), behavioral aspects that can affect the risk of HIV includes individual sexuality and self-esteem. For instance, research indicates that most ongoing risk behaviour for HIV transmission has been described for men who have sex with men (MSM) (NAT, 2014). It has also been estimated that, 10 million people of MSM are living with HIV globally and in 41,100 in the UK in 2012 which has been increasing in the recent years, making public health experts have concerns about the rising rate among MSM (NAT, 2014).


Policies

In 2013, World Health Organisation published a global policy in which they provided recommendations on HIV testing and counselling. They estimated that about 20 million adolescents aged 10-24 years are living with HIV worldwide with half of them unaware of their infection. This policy aims at giving a high priority to enhance access to HIV testing and counselling globally, which is beneficial as it involve the improvement of health and is appropriate for the HP activity as advising people on HIV testing and offering counselling gives the opportunity to care, treatment and support for people and permit them to know their status (British HIV Association, 2014).

In addition, the policy also outlined the need for giving sufficient information on HIV awareness and an early diagnosis and treatment as it can reduce the progression and the prevention of HIV transmission. Thus, the WHO (2013) corresponded by recommending that HIV testing and counselling should be offered in global hospitals as this will assist the diagnosis and management of the infection.

In the UK, the NAT (2012) provides a policy based on HIV prevention and its aim is to promote health of the UK population with a prevention of an HIV test action plan to reduce late diagnosis of HIV in the UK. This is a relevant policy as HIV has become a generalised epidemic in the UK that affects the health and well being of enormous people from all social classes (NAT, 2014). HIV is not only a health issue, but also a developmental issue that affects the social, cultural, political and the economics of the country (British HIV Association, 2014) as it is associated with serious morbidity that includes a high cost of treatment and care (PHE, 2013).

The initiative of this policy is to facilitate an increase in HIV testing in all healthcare settings in order to reduce the proportion of individuals who are unaware of their HIV infection with the motive of benefitting the individual and the public health. This is vital as maintaining focus on increasing regular HIV testing is a key component of the prevention and care of the people in raising the awareness of HIV of the people in the UK. As a result, the UK national guidelines for HIV testing from the British HIV Association, (2008) recommends that an HIV test should be offered to all newly registering patients in general practice and general hospital admissions and promote the awareness of HIV which will assist in reducing late diagnosis of HIV.


Type of needs

According to NICE (2008), an understanding of the assessment of health needs requires a definition of need which indicates the capacity of a benefit from an intervention. Bradshaw (1972) suggests there are four dimensions of need; however, the Bradshaw need chosen was the normative need as it is based on professional judgement (Coles & Porter, 2008). It creates the need for professionals to identify standard requirements (Gruen & Black, 2006). For instance, the WHO (2013) recommended that HIV testing should be offered in global hospitals. This indicates a health need as data indicates that most people are unaware of their infection (NAT, 2013).


Approach

Ewles and Simnett (2003) model comprises of five approaches to health promotion which consists of medical approach, behavioural change approach, educational approach, societal change approach and client-centred approach. Thus, the educational approach was chosen as having an educational approach in health promotion offers individual information to ascertain health benefits for themselves (Ewles and Simnett, 2003). The health belief model is seen to be the most common theory used in health promotion, providing the benefits of educational approach (Glanz, Rimer & Viswanath, 2008). The model is essential for addressing problem behaviours that raises health concerns (Black, Hawk & Keene, 2006). For example, high risk of sexual behaviour and the possibility of contracting HIV, this is an identification of individual behaviours. Willz (2007) further suggested that health professionals need to be mindful of this model so as to enable them in educating and promoting health in individuals from various cultural and ethnic groups.

The strength of the educational approach is based on the fact that it permits people to make an informed decision about their health by providing knowledge and information to different cultural and ethnic groups which the health belief model corresponds to. However, Naidoo and Wills (2009) further explain that the educational approach differs from the other approaches as it does not use reinforcement to achieve its aim which is a limitation. The Royal College of Nursing (2011) corresponded with this view advocating that the role of the nurse is to inform and not persuade.


Aims and Objectives

The group had aims and objectives to ensure everyone recognizes what needs to be achieved. For that reason, the group identified the aim as raising awareness for HIV and with the objectives that comprises participants will be able to identify the main differences between HIV and AIDS, identify the symptoms of HIV and the safest option to fight off the menace, able to understand three risk factors of transmitting HIV and identify three places to access information on HIV.


Evaluation

Stufflebeam and Shinkfield (2007) explained health promotion evaluation as a process that is concerned with assessing health related activity against the goals in a way that results and contributes to future decision making. In addition, Black, Hawks & Keene (2006) further stated that evaluation is made so as to determine if aims and objectives have been met and determine the efficiency of the methods used. This is vital as without evaluation, the idea of if objectives are met would not be known and also problems and weakness encountered would not be seen to rectify.

Thorogood and Coombes (2010) states there are three stages of evaluation in health promotion; this includes process, impact and outcome.

In the process of the health promotion activity, the group utilised a method of approach so as to achieve the aims and objectives. Thus, the educational approach was chosen as the group used educational materials such as penis model as an illustration on safe use of condom, posters which were clear and easy to read, distributed leaflets to assist in expanding the knowledge of the participants on HIV awareness as Linsley, Kane and Owen (2011) states, good quality health information leaflets assist individuals to make informed choices about their health.

In addition, Health belief model (1974) suggests that, people need to have some kind of knowledge, such as information given to them through leaflets and posters to take actions in changing their behaviour or make a health related decision.

The interactions that took place during the health promotion(HP) activity was done through raising awareness of HIV to our target group by explaining and discussing the health issue with the participants and after giving a questionnaire for them to answer to enable the group gather information on as to whether the objectives has been met.

The impact evaluation involves in assessing the activity in regards of the aims and objectives set by the group. Naidoo and Wills (2008) state that the impact evaluation is the immediate effect the health promotion have on people. Essentially, this refers to the measurement of what has been achieved by the group.

The questionnaire given to the participants were analysed by the group which indicated that 87% in 27 people tick the right answer and 3 people in 13% had the wrong answer. From the evaluation carried out, 13% of the participants answered the questionnaire wrongly because it was distributed to them before explaining what the health issue was about. Out of the 30 questions set, only 3 participants had it wrong, which means the group was able to expand the knowledge of the participants and their understanding on HIV.

Green and Kreuter (2008) explained outcome evaluation measures as the long term effects of HP activity and whether it has achieved its goals. The outcome effect of the HP activity will be difficult for the group to identify as it there will be a follow up which will be difficult to contact participants again.

There are some improvements that could have been made to improve the HP activity. Hence, demonstration of the penis model should be kept in a discreet position and not visible to the audience so as to not be seen as offensive to others. In addition, the standing poster should be clear and group members must ensure it is not blocked from the audience whiles interacting with them.

Royal College of nursing (2007) states health promoters are in the contribution to improving the health of the public. Thus, their role as a health promoter is to plan and develop ways that assist people improve and manage their health. Linsley, Kane and Owen (2011) further corresponded saying health promoters must have an evidence-based understanding of the important effects that can be made through health promotion interventions and communicating with people to develop their awareness of activities leading to better health and become knowledgeable about their own health status which will improve the overall health population.

The HP activity on raising awareness on HIV could be carried out in Gum clinics within the target group of 15- 24 years. According to French (2009), people can go to gum clinics no matter their age. As stated by the RCN (2012), nurses are health promoters and in an ideal position to influence the people they interact with in order to empower positive health outcomes. Thus, the role of the nurse as a health promoter is to provide advice and support through one to one interventions with clients to improve their sexual health (French, 2009). The nurse can also implement guidance on prevention and risk reduction support of HIV to clients by providing relevant information, leaflets and condoms so as to raise their awareness on HIV.


Conclusion

This essay has outlined a health promotion activity based on raising awareness of HIV, with a health need assessments and target population identified. The essay has also outlined epidemiology and the demographic trends associated with health policies that govern it. The writer also identified the approaches and the aims and objectives with an evaluation of the effectiveness of the health promotion activity and the role of the health promoter.


References

Bradshaw ref.

Black, M., Hawks H.,& Keene, M. (2006).

Evaluation in health promotion

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British HIV Association.(2014).

UK National Guideline for HIV Testing

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Coles, L. & Porter, E. (2008).

Public health skills. A practical guide for nurses and publich health practitioners

. Oxford: Blackwell.

Croyle, R. T. (2005).

Theory at a Glance: Application to Health Promotion and Health Behaviour

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(ed). Department of Health and Human Services, National Institutes of Health. Available at

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Dudley. L., Poston, J. & Bouvier, F. (2010).

Population and society. An introduction to demography

. New York: Cambridge University Press.

Ewles,L. & Simnett, I. (2003).

Promoting Health -A Practical Guide

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(ed). Edinburgh: Bailliere Tindall.

French, K. (2009).

Sexual Health

. Chichester: Blackwell Publication.

Glanz, K., Rimer. B., & Viswanath, K. (2008).

Health behaviour and health education

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(ed). San Francisco: J. Wiley.

Green, L.W. & Kreuter, M.W. (2008).

Health promotion planning: an educational and environmental approach

. Mountain View, CA: Mayfield.

Gruen, R. & Black, N. (2006).

Understanding health services

. Berkshire: Open university press.

Linsley, P., Kane. R., and Owen, S. (2011

). Nursing for public health promotion, principles and practice

. Oxford: Oxford university press.

National Aids Trust.(2012).

HIV testing, action plan

. London: NAT.

National Aids Trust.(2014).

Men who have sex with men (MSM

). London: NAT.

Naidoo,J. and Wills, J. (2009).

Foundations for Health Promotion

. Edinburgh: Bailliere Tindall Elsevier.

Naidoo, J. & Wills, J. (2008).

Health Promotion Foundations for Practice

. London: BailliereTindall.

Public Health England. (2013).

HIV in the United Kingdom: 2013 report

. London: PHE.

Public Health England. (2013).

HIV in the UK: 2013 Report

. London: PHE.

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: prevents, promote and protect. London: RCN.

Royal College of Nursing. (2007).

Nurses as partners in delivering public health

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Thorogood, M. & Coombes, Y. (2010).

Evaluating Health Promotion

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Wills, J. (2007).

Promoting Health

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World Health Organisation. (2013).

Global update on HIV treatment: Result, impacts and opportunities

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World Health Organisation. (2013). HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV. Geneva: WHO.

Wright. J., Wilkinson, R. J., Williams. R. (2009). Development and importance of health needs assessment.

British medical journal

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United Kingdom: National Institute for Health and Care Excellence. (2008).

Health needs assessment at a glance

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Explain why this is an ethical issue in nursing and health care.

/in /by

Explain why this is an ethical issue in nursing and health care.

1. Clearly describe the ethical issue including definition(s), brief history and all subtypes/ sub-issues on the issue. Gives 4 or more examples.

2. Explain why this is an ethical issue in nursing and health care. Gives at least 3 potential impacts in nursing

3. Describe the viewpoints (3 pro and 3 con) this ethical issue Include the position(s) of 3 or more professional nursing organization(s) regarding this issue.

4. Choose one of the pros or cons previously discussed; explain your PERSONAL position. Include, in your discussion, FOUR professional values as expressed in THE ANA CODES OF ETHICS AND OTHER NURSING PROFESSIONAL DOCUMENTS . Be certain to include documentation

5. CLEARY DISCUSS 5 OR MORE STRATEGIES that nurses collectively, could further enhance ethical nursing practice on a daily basis. (Take this opportunity to be creative and identify what you might do to facilitate ethical nursing practice )