Professional Portfolio
Professional Mission Statement
To promote the treatment and health of all patients within my area of care to the best of my abilities, without any form of discrimination, to treat each patient equally and to always ensure that I have a conscience and be considerate to all of my patients and their wellbeing. To always uphold the professional needs of my co-workers and partner to the equal standards.
A. Professional Summary
As a nurse I began my professional career after getting inspiration from being my uncle’s caregiver. During this time I was able to become very proficient with different skills which I developed a good working relationship with some of the nurses that came in to visit my uncle. I was then inspired to attend a nursing school which I enrolled to university in 2015. After going through the intense program and clinical attachment, I was able to receive my ASN which enabled me to become a registered nurse. During my clinical also I have been able to get first-hand experience with the operation room and decided to pursue as a nursing in circulating. I also took my first job which was in the delivery room and began my nursing career in 2016. It was during this time that I was able to gain a lot of experience on the issue of trauma and also got my certification in trauma counselling. After working as a nurse in charge in the delivery area, I decided that I would go on with my education and pursue an associate of operating nurse certification, I was able to the BSN in Nursing, where I also switched different careers and a now a registered nurse and in charge of community hospital in my home area. I have also been able to do several papers of which some represent the passion that I hold as being a nurse.
The tasks I did are part of my evidence based practices which represent me well as a nurse and a learner. As a learner, I was able to conduct studies and evaluated the health needs of my community so as to ensure that there is a proper understanding on how the health systems operated and I was able to also learn the best way in which to apply my knowledge in nursing to improve the different systems. As a healthcare professionals, I was able to apply different theories and my knowledge in coming up with various care plans, implement and evaluate the community hospital and the use of gained information in my papers.
As part of my professional competencies have been expressed in my role as the charge registered nurse. When I began my nursing profession, I always felt excited regarding the operation room and I thought that this is going to be my calling, however, soon I came to realize that I needed to have a solid ground in ensuring the growth of my knowledge as a nurse. In this line I was able to find that in the home and the health nursing, my evidence based practice and other community projects that I did were very instrumental in lifting up my professional strengths. I have come to realize that as a nurse I am community driven, and I am able to thrive in the one on one environments in nursing care, I also feel that I have a lot of opportunities to grow as a nurse and improve the systems that can better be used to support patients under my care.
During the progression of my program I was also faced with a couple of challenge toward the completion of my course. Some of these challenges were community health study related while others were personal. In respect to my personal challenges it included having to move from one state to my current place of residence, the other included a career change from the emergency theatre to the delivery theatre, having go buy a new home and having to relocate my spouse to live with me. Among the challenges that I encountered in my study were those that I faced daily during my practice as I tried to balance social and professional life. The biggest one was time management especially when most of my personal issues can into place. Even thought it was important to attend all classes, at times family would interrupt my class schedules and I had to re-organize myself, in some special cases, I had to accept the needs of my family before the needs of work, however, this was not the case when I am dealing with people in the study, my tutors were very understanding to the extent that they have assisted me in applying for some scholarship which I would use in my final semester thus helping me complete my goals. These challenges were overcome by putting more reliance on my spouse, friend and mentors (Locsin, 2002). I have also made honestly to be my top policy and share challenges and achievements which helped me a lot.
In respect to the nine outcomes the following were met:
- Effective Communication – my communication skills have drastically improved and I now speak to my fellow nurses and patients as a professional. I know how to write grant proposals for research and memos for my fellow nurses.
- Clinical Reasoning – I have been able to gain solid understanding of physiology and anatomy, how to perform different skills and disease processes. However given the knowledge I have in plans of are and new processes are some of the areas that I will need to put more energy.
- Professional accountability – These have been expressed by my community health field project of which I managed a grant for the study area to completion.
- Synthesis of Knowledge - this was achieved through the whole process from the initial part, it was also necessary that I ensure I have engage various forms of sciences to complete projects and gain a proper understanding of the human process.
- Compassion for Patients – as an inspired nurse, I have always expressed by compassion for patients by empathising with patient situations and extending this compassion to their families and friends.
- Becoming a Leader and educator – during my time as a nurse in charge I have been able to express my abilities as a leader, I have often presented different leadership projects and this has also been expressed through various support for my theories as I explain the need for new processes and for stakeholders in my clinic.
- Interpersonal communication – when it comes to healthcare, interpersonal communication is expressed in the way I coordinate different departments to ensure that the needs of the patients are met all the time. I have used these skills during by work on community health during evidence based practice.
- Knowledge of Genetics and Genomics – during my studies I have been able to learn ways that I can integrate genetics and genomics in the care and support for my patients where through the use of genomics I was able to utilize the American museum of natural history.
- Utilization of Information technology – I had a chance of trying telemedicine during community health work, and I have competently used the social media to provide instruction and send memo to nurses under me which has worked well to improving care (Purdy, 2016).
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During my professional practice I have been able to take on many roles. For example in my role as a leader, I was able to learn a lot about what it meant to be a nurse. I was also able to learn that I am in a position to advocate for the needs of my patients while also attending to my fellow nurses to ensure that the promote positive patient experience in the hospital. I do this as I strive to ensure that the cost of health care is reduced so that the patient and the family does not incur a lot of burden.
As a scientist I have used my role to inquire and inform various decisions made in regard to healthcare especially on the issues around admission and adherence to medicine. I do not only follow what has been written in the book, but I also try to research on ways that I can improve nursing care and practice. As a detective I have used my role to investigate the cause of burnout and poor motivation from my fellow nurses, I have also solved various patient complaints by addressing the issues with the nurses involved. I also examine the admission processes and collected evidence as part of advocating for change. As a manager, I have been in the forefront to ensuring that the needs of my nursing staff and that of patients have been met. I also look at the whole picture of nursing care as a process of constant change and we are supposed to work as a team. I have been able to create different roasters for the nurses to ensure that there is a reduction of burnout and assigned roles for nurses in regard to the areas that they felt comfortable to work under. As a charge nurse, I feel so comfortable on my role and I will continue to use these experiences to ensure proper nursing practice.
B. Quality and Safety
From the time that I enrolled in the nursing profession, I have always felt that there is a way that I could be able to improve the profession. During the processes I have been able to learn more skills and attended different seminars that ensured that I practice my nursing profession with quality and safety. This is because quality and safety are among the most important aspects to the nursing practice. To my personal experience, quality and safety is about taking the time to learn way in which one can complete a particular process or procedure through the laid out steps. It is meant to cause no harm to the patient. One example is when you take the time to complete various competencies in the nursing training for drawing blood, for which I learnt ways to take time to effectively complete the task. In the same manner, the values and professional roles also assisted me a lot in reflecting on my role as a registered nurse and way that I would ensure quality and safety in regard to the nurse’s code of ethics. While I was doing my study, I also realized the value of using the Nursing code of ethics when providing the quality and safety for each patient that I met. I was also able to learn a lot with the Institute of health improvement which enabled me to learn how to integrated quality and safety in my daily nursing practice (Ihi, 2019). The institute of health improvement is among the leading innovators, partners, conveners and drivers of results in improvement of healthcare. These course were very important to me as described by the institute as they also assisted me when it comes to gaining the knowledge and the right confidence to ensure safety and quality in nursing practice (Ihi, 2019). I also received a health and safety certificate which is proof that I have complete a safety courses and this can provide me with great leverage to my future employers and fellow workmates.
C. Evidence Based Practice
In respect to evidence based practice but the tasks I did in my course have enabled me to professionally grow in different ways. Evidence based practice task 1 helped be to be a professional researcher, as I searched for the will support my hypothesis and knowledge. I also have a lot respect in regard to the nursing researcher and the amount of contribution they made to the practices. Also during the evidence based practice 2, I was able to learn new skills that qualified by as a research nurse, however I will use the knowledge gained from the course with me. Also in respect to evidence based practice and applied nursing research provided my with the right education on how to take the practice of nursing into science. This is because science is based on evidence and truth, the nursing practice becomes valid only when it has been backed up with scientific research. The practice is also changing on a daily basis will means need for more knowledge. With this in mind, I have come to make a difference between primary and secondary research. When it comes to primary research, the authors that did the study actually performed the whole research themselves. This is usually utilized when there is a new idea that the researcher has established and is in the process of proving a new theory in regard to scientific evidence. According to secondary research, this is based on the studies that were conducted by other authors.
In this regard secondary research would be very important to use especially when one wants to establish a popular practice in the in the modern setting. This course was very important to me as it enabled me to come up with a report as a secondary researcher and ways to evaluate the current articles in the primary research, during the secondary study I was also able to sift out some of the papers with solid foundation. The believability and relevancy of the data are among the main key to finding out the right study. If an article was found not to be relevant in the process, then it was not reliable, meaning that one is not supposed to use it as a source in research work. It is also important to note that even though the issue of quality improvement and research may seem similar, they are usually not the same. This is because quality improvement is about the common procedure, the general nursing practice and medical facilities. The process is quick yet a very effective manner in correcting the action through evaluation and experience. However, after the work is done, the right action taken, it is very important to back up the change including data.
This also shows that research is a very important aspect in nursing and development processes. It will also involve the development of testing, theory and evaluation that will be used to concede the right conclusion. With regard to evidence based practice I have come to embrace my role as an in charge nurses. I have openly used various topics in respect to my everyday practice and make use of this course toe enable be to understand better my nursing role. Also I was able to take information that I learnt from other nurses to understand ways in which a much more efficient admission and practices towards discharge would enable me eliminate the various wasted resources and improve the outcomes of patients. Also I learned that I was not much of a novice nurse which explained ways that I could more efficiently serve patients under my care and reduce the amount loss of resources during practice.
D. Applied Leadership
If there is one thing that I was able to learn from by roles as a professional nurses is applied leadership, this also worked form me during the time I was completing my leadership and learning experience. To my point of view, applied leadership was about taking the right theory or the right idea and applying it all through the leadership through my work place. In my professional role and values course, I was also able to learn a lot regarding ways to develop in my professional mission statement. In most cases, I was a nurse in charge, and mission’s statement was able to run with my specific roles as a nurse.
“To promote the treatment and health of all patients within my area of care to the best of my abilities, without any form of discrimination, to treat each patient equally and to always ensure that I have a conscience and be considerate to all of my patients and their wellbeing. To always uphold the professional needs of my co-workers and partner to the equal standards.” However in respect to my role as a charge nurse, I would then adjust my mission statement which can read something like
To ensure a collaborative effort towards the promotion of good health and treatment for all patients within my area of care to the best of my abilities, without any form of discrimination, to treat each patient equally and to always ensure that I have a conscience and be considerate to all of my patients and their wellbeing. To always uphold the professional needs of my co-workers and partner to the equal standards.
It is important to acknowledge that my professional mission statement is very much in line by explaining on ways in which I shall conduct myself as a registered nurse. I plan to continue making use of my mission statement as a guide through my career as a constant reminder on ways that I am going to treat my patients, also as a reminder on ways that I should always conduct myself to the highest standards. The mission statement also shows that I need to hold my associate to the highest standards.
I think that I wholeheartedly that in the event one is going to fill their mind with positivity, then these thoughts are going to manifest into the real practice. In this regard I am going to make use of my mission statement as part of the outline to my nursing practice, including adding things that will ensure I become a better nurse. In order to ensure that I meet the requirements of my mission statement, I will ensure there is proper collaboration between me and other healthcare providers. Whether it is about communicating with the doctors, patients and fellow nurses and other professionals, I need to collaborate with my team to ensure the effective and efficient way of doing work and providing a positive outcome for patients. As a nurse in charge, I will also be required to collaborate with other stakeholders at my position during the leadership and learning experience. Collaboration is very important as it ensures that all the projects I am involved in succeed, thus I need to communicate with stakeholders so that we are in the same line in terms of project development.
E. Community Health Population
My choice for community health population was in Sentinal city. The
The sentinel is a city that has a population of 663,862 with a total of four neighbourhoods. Among the cities, the best maintained is Acer tech and the Nightingale square in addition to the older industrial heights and industrial Casper park district which has the highest population of 352643 while industrial heights records the lowest population at 38,855. Nightingale follows in the population at 103, 974 while the remaining 168,390 are the population in Acer Tech center (Areavibes, 2019). Also 7.4% of this population make up children under the age of 5 years while 21% are people between ages 5-18 year of age. Also 10.5% of this community is above the age of 65 which the remaining population is made of adults between ages 19-64 years. When it comes to the ethnic demographics, the city is made of different races and ethnic groups (Areavibes, 2019). Most of the population is made up 80.6% whites. The second biggest race population is of black people at 10.4% while Asians come in at third place at 3.7% while Hawaiians and other islanders make up 0.2% and 3.1% of the population. There are also two more races. When it comes to the distribution of income the median household income distribution can be defined in the four major regions where nightingale square $269, 500, while Acer Tech Center $166,300, Casper Park District $80,000 and Industrial Height $24, 672. However, the median household include for the entire city is can be calculated at roughly $49,091 (Areavibes, 2019). Individuals that do not have health insurance are mostly under the age of 65 with the Industrial Height leading at 37.5% while Casper Park comes in second at 22.7% and Acer Tech center at 1.5% lastly the Nightingale Square third at 0.7%. This data indicates that it is evident the median household include can be said to be inversely proportional to the number of people not insured.
In the same line, my main health concerns was on the growing rates of Sexually transmitted Diseases in Sentinal City. As part of my community health assessment I discovered that sexually transmitted infection is one of the main community health concerns in the city. According to statistics from the center for disease control and prevention, more than 2.3 million cases of gonorrhoea, chlamydia and syphilis were reported in the city (Areavibes, 2019). The number has continued to grow to an alarming rate that federal agency call for more resource to be allocation to halt the rising cases of sexually transmitted diseases and continue to steadily climbing in Colorado.
During my work with various community figures, I also came to the conclusion that there were still a lot of community issues which when unrecognized in the city apart from the irresponsible and unprotected sex. It was obvious that since Sentinal city was located in Colorado state.
However my main interest remained in the prevention of the social and cultural causes of STD, however I had to speak to the community before beginning the project so that I do not have change the direction of my studies. I also came to understand that it is the intention of the community to reverse the spread of STDs and calling for the need for more community awareness to stop the social and cultural factors that promote STDs. The center for diseases control was good in providing me with information I needed and enabled me to get a better understanding of social demographics and how they play a role in the spread of STDs as the clinical approach alone cannot have a lasting impact as it is not only about administering medication. This information will thus be helpful for me as it will assist me in conducting further investigations on how this can impact on patient Behavioral change, care and support.
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Community Health And Population-focused Nursing
WGU -C228 Task 1
Demographics Assessment
Sentinel City, with a total population of 663,862 comprises four different neighborhoods - the newer and better maintained Acer Tech and Nightingale Square as well as the older, industrial Casper Park District and Industrial Heights. The demographics assessment of Sentinel City provides more depth to the characteristics of its population. Casper Park district has the highest population (352643), and industrial Heights has the lowest (38855). 103974 people reside in Nightingale Square and the remaining 168390 in Acer Tech Center. 7.4% of the total population comprises children under the age of 5 years, and 21.7% are those between 5-18 years of age.10.5% of the community is above the age of 65 and the remaining are adults between 19-64 years of age.
The city comprises different race and ethnic groups. Most of the population, around 80.6%, is White. African American make up 10.4% of the people, Asians 3.7%, Hawaiians and other Pacific Islander 0.2% and 3.1% of the population are two or more races.
Median household income distributions in the four neighborhoods are as follows: Nightingale Square -$269,550, Acer Tech Center - $166,300, Casper Park District - $80,134, Industrial Heights - $24,672. While the median household income for the entirety of the city comes to roughly $49,091.
People without health insurance, under age 65, is at its highest in Industrial heights (37.5%) followed by Casper Park District (22.7%), Acer Tech Center 1.5% and Nightingale Square 0.7%. Thus, it is very evident from the data that median household income is inversely proportional to the percentage of non-insured people in a neighborhood.
Neighborhood/community safety assessment
The neighborhood/community safety assessment tool helps to identify safety hazards within the city. The neighborhoods of Acer Tech and Nightingale Square gave clean and well-maintained buildings and streets with no pollution. There are more safety concerns and hazards in Casper Park and Industrial Heights. These include old, dirty and unrepaired buildings with graffiti on the walls. There is garbage outside buildings and bins are turned over with trash all around. An abandoned car was seen in Industrial Heights while another was set on fire. Rats and stray dogs are recognized around the city. The statistics also show that there have been 10-20% of strays observed in the last 4 years. 90%of the animals entering shelter were not spayed/neutered. Dog biting needing hospitalization is excessive in Industrial Heights, at 43%.
According to the statistics released by City Hall, the average EMS response time of Sentinel City is 7.46 minutes, which is a little behind comparison city 3 (5.43 minutes). Comparison city 2 has the highest time of 12.14 minutes and town 1 reports 8.32 minutes.
Sentinel City crime rate is reported to be 3,605 per 100,000. The violent crimes reported in the previous year were murder (20 incidents), rape (312), robbery (559) and aggravated assault (1231). Frequent charges included public intoxication (6%), reckless conduct (6%), criminal trespassing (9%), possession of a controlled substance (16%), battery (17%), warrants (23%) among others. As per a statement from officer Cooper, Nightingale Square has the lowest crime rate, while Industrial Heights and Casper Park District have greater crime rates. Gang violence is also present in the city. Last year there were 100 cases of gang-related aggravated assault, 20 cases of murder, 38 cases of rape and 40 robberies linked to gangs. More males than females have been victims of violent crimes, in general.
Scavenger hunt tool
The scavenger hunt tool provides us information about the services offered by community resources available to the residents of Sentinel City. The Department of Parks & Recreation offer informative lessons such as swimming classes, nutrition classes, gardening classes, kids summer programs, city sports leagues, adult fitness programs, and after-school programs. Frequent park complaints revolve around things such as park hygiene and upkeep, the excessive number of home-less individuals, and crime. The park and recreations budget has gone down from 60% in the year 1 to 35% last year.
The Healthcare System provides a variety of services for the elderly population. The portion of the elderly implementing the service in the last 12 months are as follows: elderly transportation - 6.8%, service animals-2.5%, meals on wheels – 1.3%, senior exploitation prevention advocates – 0.9%, community centers - 2.9%, government welfare – 7.6% and medicinal advocates – 8.3%. Living units for the elderly in the city include senior apartments, nursing home units, assisted living units, skilled nursing care beds, swing beds, and senior centers.
The social services provided by the city leadership include adult as well as child protective services like help with adoption, independent living services for young people, stay at home programs and nutrition programs like WIC for women who are pregnant, breastfeeding, postpartum or those with infants and SNAP for low income, disabled or elderly.
Better Health Clinic, formerly known as Community Health Center, provides services similar to Planned Parenthood such as but not limited to birth control, counseling, infertility services, sexually transmitted disease treatments, breast cancer as well as cervical cancer screenings, and other preventive services. They also keep a record of all the sexually transmitted diseases like hepatitis B, HIV, syphilis, HSV2, gonorrhea, Trichomoniasis, and chlamydia last year by age distribution. In addition to that, they provide information about teenage pregnancies, birth, and death rates over the previous 5 years.
There is a soup kitchen operated by the Interfaith Church of Sentinel city that caters to mostly homeless adults (64%). Other people that benefit from the kitchen are elderly, veterans, disabled people, homeless children, and some healthy adults and children too. Their sources for supplemental nutrition are emergency, food assistance, and USDA commodity programs. Father Eudaro Martinez is a priest and manages the church, where homeless residents like Dwyane Thomas gets 2 meals every day.
The Affordable Housing Project operates out of Casper Park district. They compile statistics regarding crime reported on property, neighborhoods, and citywide, vacant/occupied property units, average income by unit types and common tenant complaints. Frequent tenant complaints include factory smoke, dogs barking, noise, police activity, high rent and loitering among others. Of all the 2-bedroom units in the city, 44%are occupied. Among the 1-bedroom units 26%, and 44% of studios are currently filled.
Windshield survey
Driving through Sentinel city allows us to conduct a windshield survey of the community. Most buildings are made of bricks and concrete and mostly connected to each other. The buildings in Acer Tech and Nightingale Square seem to be newer and well maintained as well as similar in height and structure. There is also more sense of pride in these neighborhoods with big billboards advertising the community. There is also grass and well-maintained trees and benches along the streets. The buildings in Casper Park and Industrial Heights are much older and worn out and dissimilar with broken doors/windows, boarded up windows, graffiti and disrepair in general.
The city is more urbanized and has very few open spaces. The common areas in Acer Tech and Nightingale Square are well-kept. There are tennis courts in Nightingale Square. There is also a small children’s park in Industrial Heights and green open space in Casper Park. According to the mayor, they have the intention to create more open areas to incentivize more outdoor physical activity as he feels there are many benefits some of which would be environmental, in the building of eco-friendly urban settings.
There are no hard and fast boundaries between the four distinct neighborhoods. The Industrial Heights and Casper Park looks more streamlined and economical, whereas the other two are better maintained.
The majority of people uses buses for their daily commute, followed by bicycles and cars. The city roads are well maintained and are safe for bicyclists, cars, and pedestrians. The city itself does not have any big highways. One gas station was spotted in Nightingale Square. There are also some rail tracks that pass-through Casper Park District as well as Acer tech center; however, I didn't locate any train station. The mayor believes that there should be convenient public transit. There ought to be adjustments for various groups such as bicyclists, pedestrians, and differently abled individuals. The mayor intends to start hosting car-share and bike-share programs for Sentinel City.
The city has a variety of service centers. There is a recreation center with tennis courts in nightingale square, and people are seen actively playing on the courts. There are parks and playgrounds. There is a small playground in industrial heights where children are seen dancing. There are medical and dental offices as well with patients seen entering and leaving the buildings.
There are many stores in sentinel city for residents to shop. Bodega supermarket and deli is located in industrial heights where they have information about tobacco sales and nutrition. Joe’s Grocery is another store which found in Nightingale square where customers are seen walking in and out of it. Another outdoor market is seen in the Acer tech center.
Traveling through sentinel city during the day gives a glimpse of the vibrant community, and most of the people are out and about. I spotted people walking their dogs on leashes, groups engaging in different parts of the city, joggers, people playing tennis, children in the parks, protesters outside city hall. I also spotted people in prisoners on the ground in Casper park district. This is where I stopped to speak to Fabio Kamaka who was on a prison work release. Other people are also dressed as expected. There are officers on duty in uniforms as well as children going to school in school uniform. Pet dogs on leash, stray dogs, and cats are seen. The older neighborhoods also seem to be infected with rats. There is plenty of activity on the streets during the day which shows the vibrancy of the community of Sentinel city.
White/Caucasian make up most of the population. Other races like African American, American Indians, and Asians are also spotted in the city. I spotted a sushi place in Casper Park and a Mexican restaurant in Nightingale square. There are also different ethnicities in the town.
Better health clinics are in Industrial heights, and a car is seen on fire outside the clinic. The clinic provides information about sexually transmitted diseases. There seems to be a problem of alcohol addiction in the city as evident from billboards everywhere. There is a big billboard outside Joe’s grocery that talks about fighting addiction. Some of the billboards advertising about "don’t text and drive," e-cigarette promotion in industrial heights and one in Acer tech that says "save your lungs."
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A political protest for tax reforms is seen outside the city hall. There are posters around that ask you to vote, but I didn’t observe anything linked to a particular political party. Radio seems to be the most important source of media for the community. Radio buzz 96.5FM is in Acer Tech Center. There are no signs of television use in the city. There is also print media like magazines that are sold in stores like Bodega. English seems to be the primary language of media communication.
Analysis of Collected Data
It is evident that there are several issues in the city. Cleanliness is a big concern. There is trash everywhere around the town, along with stray dogs and cats, rats running around and pollution. The citizens also have endorsed that cleanliness is a problem.
People have raised a lot of concern about rising crime in the city. According to statistics, Industrial Heights is leading to criminal activity. The mayor has also mentioned that he is trying to identify solutions that will help decrease crime in the neighborhoods.
There is a lack of adequate spaces in the city to have a physical activity. The only place with space to play is in the parks of the city. I didn't find any front or backyard around the houses of Sentinel city, where kids or even adults can play with their kids. The residents also expressed concerns about the growing population of homeless.
C1. Top Three Health Problems based on Healthy People goals:
This assessment has clearly conveyed that Sentinel City has wellbeing differences that arise from social, monetary or natural burdens. These influence the population in Sentinel city with more impediments to wellbeing dependent on their socio-economic situation, age, sex, personal, physical handicaps, and/or mental wellness.
The following are the top three problems identified in the city:
Pollution & environmental issues: A milestone of the Healthy People is to develop social and physical environments that promote health and equally. Healthy People 2020 highlights the importance of addressing the social determinants to “Create social and physical environments that promote good health for all” as one of the four overarching goals for the decade. Physical determinants include natural environments, such as green space as well as the built environment, such as buildings, sidewalks, bike lanes, and roads, schools, and recreational settings. Sentinel city has several environmental safety concerns that affect the wellbeing of the residents. These include old, dirty and unrepaired buildings with graffiti on the walls, garbage outside, fewer green spaces and air pollution.
Access to healthcare and STD prevalence: The community evaluation of Sentinel City shows that sexually transmitted diseases are common in the city among students. Gonorrhea and Chlamydia are the most common ones among ages 15-24. Another objective of Healthy People 2020 is to advocate for safe sexual behaviors and enlarge access to exceptional services to lower rates of sexually transmitted diseases (STDs) as well as combating their complications.
Teen pregnancy: Teenage pregnancy rates in Sentinel City have gone up in the last year compared to the 3 previous years. One of the goals of Healthy People 2020 is to improve the healthy development, health, safety, and well-being of adolescents and young. The leading causes of the issues among adolescents and young adults are mostly preventable. Adolescents who have excellent communication and are bonded with a caring adult are less likely to engage in risky behaviors. Parents who supervise and are involved with their adolescents’ activities are promoting a safe environment for them to explore opportunities. The children of families living in poverty are more likely to have health conditions and poorer health status, as well as lower access to and use of health care services.
C2. Community resources available to address one of the problems identified in part C1.
There are a few resources available in Sentinel City to deal with healthcare issues. Better Health Clinic provides services and information to deal with sexually transmitted diseases among other health issues. Information and statistics about different diseases and vaccinations can be obtained from the Public Health Department in Nightingale Square. Acer Tech has some information about Sentinel City’s health care services such as orthodontic and medicinal programs for the senior citizens.
C3. Identify a primary prevention topic based on the problem you selected in part C2.
I believe that Sentinel City should focus on improving the quality of life for the teens and provide more education on STDs as well as on protective sex. In addition to that, they need to advertise about the disease itself, and the consequences of it can have on one's health if not get treated. They need to have this conversation started in middle and high schools and how and where to find the help if needed. The city needs to provide the public health department with more resources and the public with more education so that STDs can be prevented.
- Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community.
Walking through the simulation has been extremely useful in giving me an idea of how to conduct an actual community assessment. It gives me a sense of the spots to get essential data while surveying my locale. I know where to go to get information on health services that a community has access to, resources for homeless, statistics about issues like crime and diseases, food safety issues, resources for recreation and computer and English classes among others. The simulation exercise also helped me appreciate the importance of talking to city residents to get their perspective of the services provided by the city and with local business owners to understand the market issues. Speaking to the mayor gives an idea about plans for the city’s development. Overall, this simulation has been a very valued tool to get some practical experiences of how to go about a community assessment in a real-world care setting.
Read PDF : Community Health And Population-focused Nursing
CAUTI Paper
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Author
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McCoy, C., Paredes, M., Allen, S., Blackey, J., Nielsen, C., Paluzzi, A., Radovich, P. (2017). |
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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The aim of the paper is to come up with preventions strategies towards Catheter Associated Urinary Tract Infection within the inpatient oncology population by implementing part of the evidence based nurse driven protocol used in the discontinuation of the indwelling urinary catheters.
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Conceptual Framework (if any) |
The conceptual framework is based on the findings from the literature review which has openly demonstrated that ensuring staff education is very fundamental to the CAUTI prevention and also ensures a reduction of the IUC duration. |
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Study Design & Method |
● The study conducted a literature review that analyzed 45 articles on the said topic. ● From the selection, eighteen articles were not used on the ground that there was poor research done and the quality or relevance of the article was also low in respect to the clinical question. ● All the articles used during the literature review were based on the development of the protocol in levels I and III which as ranged from good to high quality.
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Population/ Sample/ sample size Setting |
Since the study methodology was based on a literature review of previous done studies there was not population sample. |
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Major Variables and their definitions
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CAUTI rates: being able to come up with a particular number of infections in regard to the number of urinary catheter line days, multiplied by 1000, it is important to mention that the CAUTI rates are often mentioned per the catheter days.
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Measurements/ Instruments/ Tools |
Knowledge of Inpatient Oncology team: the study made use of a survey to check level of knowledge they had on CAUTI. Understanding institutional policies: it was also important for the study to investigate the role that institutional policies play in the current application in the management of CAUTI.
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Data Analysis
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The study analyzed the implementation of compliance strategies which showed the need collaboration between different professional in regard to lack of reduction in the IUC days. |
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Findings
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● There was a significant presence of nurse knowledge on the compliance with guidelines towards the CAUTI procedures. ● There was however lack of understanding on the IUC related complications among other healthcare providers with affected the outcome. Study limitations:
● Data was not reliable since it was a literature review and no primary data was collected. ● ● |
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Mori, C. (2014). A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol;. Medsurg Nursing, 23(1), 15-28.
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Quantitative study |
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Aim of Article/Paper
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The main aim of the paper was to provide an evaluation of the effectiveness of the nurse-driven indwelling Urinary catheter removal protocol in an acute care setting.
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Conceptual Framework (if any) |
The conceptual framework was on Donabedian rational of assessing the organizational procedure and policy structure. This was also used to implement a workable urinary catheter policy regarding removal within the particular structure. In the end it is expected that this will produce a positive outcome in relation to prompting the catheter removal and the catheter needs assessment.
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Study Design & Method |
● The study made a retrospective chart review for measuring the prevalence of the catheter usage dwelt time. ● It also measured CAUTIs before and after implementation. ● Tabulation was done for indwelling catheter. ● The sum were divided by patient days X 100 to get the percentage and total tabulation was done. ● The number was CAUTI was then multiplied by 100 to get the percentage of the CAUTI.
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Population/ Sample/ sample size Setting |
The sample was collected from 150 bet community hospitals from mother united states.
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Major Variables and their definitions
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CAUTI rates: this was measured by the percentage.
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Measurements/ Instruments/ Tools |
Prevalence of catheter usage- done by the new measuring the percentage. Use of retrospective chart review and computer database: this was important in reviewing the patient demographic information. |
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Data Analysis
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This was done through reviewing the computer database and calculating the prevalence catheter usage. |
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Findings
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● There is relevance in using the nurse driven protocol as a way of reducing the incidents of urinary cauterization to reduce incidents of CAUTI Study limitations:
● Lack of a nurse driven protocol saw a reduction of duration on use of indwelling catheters
● |
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing, 38(6), 273. doi:10.7257/1053-816x.2018.38.6.273
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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This paper aimed at implementing an interactive CAUTI prevention educational program through two main units in regard to an acute nurse knowledge by looking at the appropriateness if the indwelling urinary catheter care. The paper also looked to find ways of reducing the incidences of CAUTI experience in respect to patients.
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Conceptual Framework (if any) |
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Study Design & Method |
● The study made use of a Pre/past study design in assessing the knowledge of nurses on indwelling urinary catheter care and the incidences of CAUTI in each unit. ● The study made use of two units within a 393 bed acute care hospitals which were also selected on the basis of high rates of the CAUTI. ●
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Population/ Sample/ sample size Setting |
The sample size consisted of unit nurses in a one hour interactive, multifaceted CAUTI prevention. The sample consisted of 53 nurses.
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Major Variables and their definitions
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Knowledge assesment, acquisition of skills and the demonstration of competency.
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Measurements/ Instruments/ Tools |
Knowledge of the prevention Methods: In this study, the issue of education was important and began with the presentation of the research team and the development protocol at the staff meeting. The study also included various case studies that engaged the bedside oncology nurses in viewing this through the evidence based IUC indication in addition to the nurses driven removal protocol. Also education is addressed in the IUC care component including the new charting requirement.
Also Read : Nursing Writing Services
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Data Analysis
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Data was analyzed through a paired t test which significantly informed the knowledge of nurses through a summary score across the three knowledge subscale scores. The CAUTI rates were observed declining to zero from 7.49 and 1.56 from 4.12. |
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Findings
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The study was very consisted with the evidence base literature as it demonstrated an interactive, multifaceted CAUTI prevention education program which can help in increasing the knowledge of nurses in the most appropriate and indwelling urinary catheter care and incidence decrease of CAUTI in regard to hospitalized patients.
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter-Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29. doi:10.7257/1053-816x.2012.32.1.29
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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. The aim of the study article was to make an evaluation of the current literature to investigate on the best’s strategies in reducing the length of time for the placement of catheter, the effects of strategies in regard to the duration and removal of catheters. It also looked at the incidences regarding the CAUTI
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Conceptual Framework (if any) |
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Study Design & Method |
The study methodology was based on a review of electronic articles where a search was made using selected key words from 53 abstracts which were then appraised. From the study, only 9 of the searches were found to be focusing on the reduction of the duration of the use of catheter and the incidences of CAUTI.
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Population/ Sample/ sample size Setting |
Non since the paper was based on literature review of electronic articles |
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Major Variables and their definitions
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CAUTI incidences: the paper investigated the evidence in regard to the reduction of the use of catheter. |
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Measurements/ Instruments/ Tools |
Literature review |
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Data Analysis
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● This was done through a review of each literature then a discussion was made on the different literature supporting the project aim. ● Data ways also analyzed by looking at the nursing led interventions and the informatics led interventions. ● Discussion and conclusions were then made in regard to the different studies. |
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Findings
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The study supported the informatics and the nurse led interventions in ensuring a reduction of the length of incidences of CAUTI and catheterization of the CAUTI.
Limitations There was not specific interventions which clearly superior that the other. Since this was a literature review based study, it is possible that the data was not reliable.
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Andrade, V. L., & Fernandes, F. A. (2016). Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines. Revista Latino-Americana de Enfermagem, 24(0). doi:10.1590/1518-8345.0963.2678
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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This research is meant to come up with different research strategies that healthcare professionals can use in regard to the implementation of the Center for Disearch control and prevention guidelines when it comes to the prevention of catheterism related urinary tract infection.
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Conceptual Framework (if any) |
The conceptual framework was based on the review of literature which informed the researchers that there was a high level of evidence regarding the matter being investigated. The evidence was also divided to three important levels which was able to show continued validity regarding the problem resolution.
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Study Design & Method |
● The study was conducting through a systematic literature review in respect to the data from CINAHL. Other data came from Cochrane plus collection, Nursing and allied health collection, Mediclatina, Academic search complete, MEDLINE(r), Science direct, Nursing reference centre, willey only library. There was an also as sample of 13 articles that were selected. ● As part of the research strategy, the research made use of different health descriptors that include infection, urinary tract, and catheter and nurse. These descriptors were used in finding answers to the research aim, it was also important to find out how the nurses operationalized the center for disease and control recommendations in the intervention and praxis on CAUTI prevention.
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Population/ Sample/ sample size Setting |
The study was based on a literature review meaning there was not sample that was collected apart from the literature review used. |
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Major Variables and their definitions
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CAUTI rates: This looked at the evidence of the major cause of increase rates of urinary tract infections and the prevention measures, looking at the ways that this has reduced the infections. The literature enabled the researcher to learn more about the best practices regarding the rates of infections.
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Measurements/ Instruments/ Tools |
The prevention mechanism: the study looked at the different prevention mechanism applied in different situations and ways that this reduced the rate of infection.
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Data Analysis
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The analysis was based on finding the different strategies that nurse’s use on responding to catheter related urinary tract infection. Literature from different studies was selected and analyzed based on the issue of prevention and control and ensuring that there is the improvement of safety for the individual that is looking for better health services using this technique.
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Findings
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● The studies have actually shown that there is a reduction of the urinary tract infection in regard to catheterism using the reminder systems in decreasing in terms to individuals that submitted to urinary catherism, also this audits on bundles of expansion and nursing professional practice. Study limitations:
● The major limitation was that data was no primary meaning that some of the information could be unreliable. ● ● |
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Meddings, J., Saint, S., Krein, S. L., Gaies, E., Reichert, H., Hickner, A., Mody, L. (2017). Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. Journal of Hospital Medicine, 12(5), 356-368. doi:10.12788/jhm.2724
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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The aim of this study is to provide a review of strategies that are used in the reduction of Urinary tract infections within the nursing home residents.
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Conceptual Framework (if any) |
The conceptual framework comes from the analysis of 20 records that discuss 19 interventions. This included 10 pre-post non-randomized interventions, 8 randomized controlled trials, and 1 non-randomized intervention that has concurrent controls. The outcome definition also greatly varied. There were also thirteen strategies that were employed in the reduction of catheter use and the improvement in regard to the care of catheter. There were also nine studies employed in regard to the general infection and strategies for prevention.
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Study Design & Method |
● The study methodology is based on a systematic review of literature from various medical source databases including Cochrane Library, Ovid MEDLINE, CINAHL and web of science.
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Population/ Sample/ sample size Setting |
Since this study is based on a literature review on various source based on the study aim. |
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Major Variables and their definitions
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CAUTI INCIDENCE: The study conducted a review of various incidence of urinary tract infection caused by the catheter. It also looked at the different measure that health institutions take in prevention of the incidences.
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Measurements/ Instruments/ Tools |
The management of catheter related urinary tract infection: the study looked at the different forms of managing catheter infections in hospitals which is applied in different rates of infection. |
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Data Analysis
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The data analysis was done from the reviewed literature. Where the presence of CAUTI reduction was recognized and there were also nine studies which indicated reduction of UTI and reduction of bacteriuria.
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Findings
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Study limitations: ● The study actually indicates that various medical practice an actually see the reduction of UTI or CAUTI among the nursing home residents like reduction and the improvement of catheter use, improvement of hygiene, enhanced barriers to precautions among other factors. ● The main limitation in the study was lack of collection of primary data as a way of verifying existing studies. ● |
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Appraisal:
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Level of Evidence |
Quality |
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Author
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Henry, M. (2018). Evaluation of evidence-based practice of catheter associated urinary tract infections prevention in a critical care setting: An integrative review. Journal of Nursing Education and Practice, 8(7), 22. doi:10.5430/jnep.v8n7p22
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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This article is based on the estimate 449,300 catheter associated tract urinary infection (CAUTI) incidents that affect patients in the united states and 13,000 CAUTI related deaths each year in the united states. The main aim of this article thus was to provide an appraisal and integration regarding evidence based practice in the prevention of CAUTI intervention strategies to advice on the safety and quality related initiative in ensuring the improvement of patient care.
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Conceptual Framework (if any) |
The framework is based on conducting literature searches which the author conducted using the cumulative index in relation to Nursing an Allied Literature (CINAHL), PubMed database, Embase where the researcher explored various interventions in the prevention of CAUTI in regard to nursing practice as a way of ensuring the integration of best evidence based practices on the strategies used in the prevention of CAUT and improvement on the type of care given to the patient.
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Study Design & Method |
● In the study the researcher used a total of 20 articles which were compiled on the basis of inclusion an exclusion criteria. The articles were also taken under study and the chosen articles were was done in regard to two areas: nurse education, improvement of knowledge and the CAUTI prevention.
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Population/ Sample/ sample size Setting |
The study was based on the systematic review of literature. |
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Major Variables and their definitions
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Nurse education: the study investigated whether nurses with more knowledge and experience in CAUTI prevention were more likely to produce more results in terms of prevention than nurses without. CAUTI prevention: the paper looked at the issue of intervention and prevention practices. |
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Measurements/ Instruments/ Tools |
CAUTI Prevention strategies: the study looks at different mechanisms used by medical practitioners as part of best practices towards prevention of UTI and CAUTI. |
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Data Analysis
>
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The study articles selected were reviewed by the research and encompassed a review on the articles that provide the most relevant information in regard to catheter associated UTI and nurse competency.
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Findings
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The study indicated that there was potential lack of nurse’s compliance in regard to the prevention of CAUTI infection and control which is a problem in the nursing practice. Thus to reduce CAUTI rates prevention is better than management.
Study limitations:
● The paper is a systematic literature review which provide evidence based practice so there was no limitation. ● ● |
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Appraisal:
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Level of Evidence |
Quality |
Applicability to my facility:
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Were the study patients similar to my patients of interest? |
Yes No NA |
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Were all patient-important outcomes considered? |
Yes No NA |
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Were patient safety variable considered? |
Yes No NA |
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Were the outcomes objective and unbiased? |
Yes No NA |
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Are the likely benefits worth the cost & potential risk? |
Yes No NA |
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How do the results fit with previous research in this area? |
Yes No NA |
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Can the study be replicated at my facility? |
Yes No NA |
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Are the results applicable to my patient population? |
Yes No NA |
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Can I use the results in managing my patients? |
Yes No NA |
Read PDF : Community Health And Population-focused Nursing
AHRQ Cauti Prevention
CAUTI Paper
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Author
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McCoy, C., Paredes, M., Allen, S., Blackey, J., Nielsen, C., Paluzzi, A., … Radovich, P. (2017). |
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Type of Article/Paper (EB guideline, systematic review, RTC, case study, etc.) |
Qualitative study |
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Aim of Article/Paper
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The aim of the paper is to come up with preventions strategies towards Catheter Associated Urinary Tract Infection within the inpatient oncology population by implementing part of the evidence based nurse driven protocol used in the discontinuation of the indwelling urinary catheters.
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Conceptual Framework (if any) |
The conceptual framework is based on the findings from the literature review which has openly demonstrated that ensuring staff education is very fundamental to the CAUTI prevention and also ensures a reduction of the IUC duration. The educational interventions are also going to be important to ensure that there is application of some of the best practices for the IUC care in addition to evidence based indications for the continuation of the IUC removal. Also when it comes to empowering nurses regarding the inpatient oncology units is important as this also advocate for the patient’s with inappropriate IUC and can play a very important role in respect to the prevention protocols.
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Study Design & Method |
● Due to lack of evidence IUC practices the methodology entailed a team of seven acute care nurses from two of the medical surgical oncology units that were required to ensure the development of an evidence based CAUTI prevention protocol. ● There was then a clinical question to be followed with was that in adults, how would the implementation of the nurse driven IUC algorithm, compared to the current practices in urinary catheter affect the number of CAUTI as per quarter? ● The study conducted a literature review that analyzed 45 articles on the said topic. ● From the selection, eighteen articles were not used on the ground that there was poor research done and the quality or relevance of the article was also low in respect to the clinical question. ● After this, the inpatient oncology unit evidence based practice team made use of the Johns Hopkins process of review to ensure the level and quality of evidence in respect to the remaining articles. ● After this, each of the article was then reviewed independently three times to ensure the validation on the level of quality of evidence. ● The study also came up with a summary of the table of articles to used, which was important in allowing for the ease in identification of the CAUTI prevention best practices. ● In any case all the articles used during the literature review were based on the development of the protocol in levels I and III which as ranged from good to high quality.
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Population/ Sample/ sample size Setting |
Since the study methodology was based on a literature review of previous done studies there was not population sample. |
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Major Variables and their definitions
|
CAUTI rates: being able to come up with a particular number of infections in regard to the number of urinary catheter line days, multiplied by 1000, it is important to mention that the CAUTI rates are often mentioned per the catheter days.
|
|
|
Measurements/ Instruments/ Tools |
Knowledge of Inpatient Oncology team: the study made use of a survey to check whether the knowledge of the impatient oncology team was enough to manage the urinary catheter care in regard to the level of knowledge they had on CAUTI. Understanding institutional policies: it was also important for the study to investigate the role that institutional policies play in the current application in the management of CAUTI. Knowledge of the prevention Methods: In this study, the issue of education was important and began with the presentation of the research team and the development protocol at the staff meeting. The study also included various case studies that engaged the bedside oncology nurses in viewing this through the evidence based IUC indication in addition to the nurses driven removal protocol. Also education is addressed in the IUC care component including the new charting requirement. In this regard an education audit tool is also very important to ensure the oncology team adheres to compliance and nurses understand the key steps in prevention of CAUTI
|
|
|
Data Analysis
|
The study analyzed the implementation of compliance strategies which showed the need collaboration between different professional in regard to lack of reduction in the IUC days. |
|
|
Findings
|
● There was a significant presence of nurse knowledge on the compliance with guidelines towards the CAUTI procedures. ● There was however lack of understanding on the IUC related complications among other healthcare providers with affected the outcome. Study limitations:
● Data was not reliable since it was a literature review and no primary data was collected. ● ● |
|
|
Appraisal:
|
Level of Evidence |
Quality |
Applicability to my facility:
|
Were the study patients similar to my patients of interest? |
Yes No NA |
|
Were all patient-important outcomes considered? |
Yes No NA |
|
Were patient safety variable considered? |
Yes No NA |
|
Were the outcomes objective and unbiased? |
Yes No NA |
|
Are the likely benefits worth the cost & potential risk? |
Yes No NA |
|
How do the results fit with previous research in this area? |
Yes No NA |
|
Can the study be replicated at my facility? |
Yes No NA |
|
Are the results applicable to my patient population? |
Yes No NA |
|
Can I use the results in managing my patients? |
Yes No NA |
Read PDF : AHRQ Cauti Prevention
Discussion Response
Discussion Response
Post #1
Nursing professionals and doctors focus on providing quality healthcare. Despite exhibiting diverse viewpoints towards health, these professionals make use of social construction theories. Importantly, both nurses and doctors must be responsive to their relationships with patients. Studies have indicated that gestures and words used during interactions could symbolize larger issues including how doctors can maintain their authority (Thomas et al., 2014). Similarly, patients can also use their spoken signals and expressions to influence the doctors and nurses in understanding patient’s social and health backgrounds. Based on these signals nursing professionals can interpret the signals; hence adapting to their language and behavior. The social construct theory reveals how nurses or medical practitioners can construct and reconstruct their patients (Riel, 2016). Personal identity and social construct seem to overlap for doctors and patients. Therefore, nurses can use such values and beliefs derived from personal identity and social context to influence the response of patients when promoting a healthier lifestyle and controlling chronic pain. The social construction theory makes it possible for nurses to respond to the needs and complex personal different to achieve quality patient care.
Read PDF : Nursing Writing Services
Post #2
The behavior of an individual can easily be transformed based on the reinforcement of operant conditioning. Behavioral modification presumes that measurable and observable conducts are critical for change. Without a doubt, the behavior is determined by a set of rules. In most cases, studies have proved that behavioral modification techniques can never disappoint, but can be applied inconsistently of inefficiently leading to undesired change (Barley & Lawson, 2016). For example, children have functioned effectively under the right consequences. Punishments and reinforcers are consequences which weaken and reinforce behaviors respectively. Student’s behaviors depend on the consequences of their classroom behaviors. Similarly, it has proved critical to motivating people to change their unhealthy behaviors. According to Hardcastle et al. (2015), health behavior change depends on the level of motivation. The social psychological theorists have focused on promoting actions by transforming motivation into action through self-motivation, goal-setting, implementation intentions, and action planning. Therefore, positive reinforcement or operant conditioning can help to reinforce desired behavior.