900� British�Journal�of�Nursing,�2013,�Vol�22,�No�15

900� British�Journal�of�Nursing,�2013,�Vol�22,�No�15

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T he� challenges� to� the� NHS� over� the�coming�years�to�maintain�and�enhance�public� health� and� wellbeing� are� vast�and� complex.� Lifestyle� choices� and� the� causes� of� ill� health� are� now� more� fully� understood� by� health� professionals� who� have� strategies� at� their� disposal� to� support� people� better� in� making� decisions� and� choices� that� are� positive� for� their� general� health.� In� June� 2013,� to� help� accelerate� this� process,� Public� Health�England�published�Nursing and Midwifery Contribution to Public Health� (Public� Health� England,�2013).�This�new�guidance�document� is� designed� to� illuminate� the� specific� roles� of� specialist� public� health� nurses,� but� also� to� reinforce� the� pivotal� health-promoting� practitioner� role� that� every� registered� nurse� and� midwife� has� in� making� every� patient/ client�contact�count.

Background A� report� by� The� King’s� Fund� (2012)� has� shown�that�high�levels�of�admission�to�hospital,� especially� of� elderly� patients,� can� often� be� attributed� to� poor� coordination� between� the� different� elements� of� the� healthcare� system,� in�particular�between�primary� and� secondary� care.� Furthermore,� the� King’s� Fund� believe� that� emergency� admissions� among� people� with� long-term� conditions� that� could� have� been�managed�in�primary�care�cost�the�NHS� £1.42� billion� per� year,� a� figure� that� could� be� significantly� reduced� through� investment� in� primary� and� community-based� services.� Key� to� this� aspiration� is� promoting� the� role� of� nursing� and� midwifery� in� protecting� and� improving� public� health� care,� one� of� the� six� key� action� areas� of� the� national� nursing� midwifery� and� care� strategy,� Compassion in Practice�(DH,�2012).

This� strategy� is� designed� to� support� the� delivery� of� the� values� and� behaviours� of� the� ‘6Cs’,� now� the� principal� driver� for� nursing� in� the�wake�of� the�publication�of� the�Francis� Inquiry,�which�revealed�suboptimal�standards�of� care�at�the�Mid�Staffordshire�NHS�Foundation� Trust�(Francis,�2013).

To�help�achieve�this,�Public�Health�England�� (PHE)�has�prioritised�five�key�areas�for�action: ■■ Designing� strategies� to� promote� longevity� and� improved� health� outcomes� by� tackling� preventable� deaths� and� ill� health� associated� with� smoking,� hypertension,� obesity,� poor� nutrition,� suboptimal� mental� health,� insufficient�exercise�and�alcohol�abuse ■■ Decreasing� the� personal� suffering� caused� by� disease� and� disability� by� concentrating� resources�on�preventing�and�recovering�from� the�long-term�conditions�that�have�significant� impact�on�lives,�including�dementia,�anxiety,� depression�and�drug�dependency ■■ Safeguarding�the�population�from�infectious� diseases�and�environmental�hazards,�including� antibiotic-resistant� infections.� PHE� has� reported�that�cases�of�measles�in�England�are� at� their� highest� recorded� levels� since� 1994,� with�1168�confirmed�cases�between�January� and�May�2013 ■■ Helping�families�to�give�children�and�young� people� the� best� chances� in� life� through� working� with� health� visiting� and� school� nursing,� family� nurse� partnerships� and� the� Troubled�Families�programme�(Department� for� Communities� and� Local� Government,� 2013).� Through� this� programme,� the� government� is�committed� to�working�with� local� authorities� and� their� partners� to� help� the� estimated� 120�000� troubled� families� in� England� to� improve� their� life� trajectories� radically� by� 2015.� This� is� because� the� government� is� committed� to� ensuring� that� the� children� in� these� troubled� families� are� afforded� a� better� life� and� simultaneously� reducing�the�burden�on�the�Exchequer ■■ Improving� health� in� the� workplace� by� encouraging� employers� to� support� their� staff,�and�those�moving�into�and�out�of�the� workforce,�to�lead�healthier�lives. To� achieve� these� priorities,� PHE� will�

promote�‘place-based’�public�health�systems.�In� simple�terms,�‘place-based’�approaches�are�one� strategy� to� improve� the�health� and�wellbeing� of� local� communities� where� specific� groups� of� individuals� can� be� targeted� for� health�

interventions.� The� Tasmanian� Government,� Australia� (2012),� has� produced� a� detailed� position� paper� on�‘place-based’� public� health� systems,� in� which� stakeholders� engage� in� a� collaborative� process� to� address� health� issues� within� a� geographic� space,� such� as� a� neighbourhood� or� specific� community.� This� system� recognises� that� there� is� a� complex� relationship�between�people,�place�and�health.� People� who� live� in� disadvantaged� areas� and� who� may� be� affected� by� social� exclusion,� unemployment,� poor� education� and� poor� physical�environments�may�have�a�greater�risk� of� poor� health� and� wellbeing� than� those� in� affluent�areas.�It�is�this�difference�between�the� health� and� wellbeing� outcomes� of� poor� and� wealthy�communities�that�can�be�described�as� ‘place-based� health� inequity’.� Given� the� UK� economic� downturn,� it� is� not� surprising� that� ‘place-based’�public�health�systems�are�seen�as� a�way�of�targeting�precious�health�resources.

Independence, wellbeing and health The� first� action� area� of� ‘Compassion� in� Practice’� concentrates� on� helping� people� to� stay� independent,� maximising� wellbeing� and� improving� health� outcomes.� It� is� this� action� area� that� the� nursing� and� midwifery� contribution�to�public�health�focuses�on.�

Helping all nurses and midwives to maximise their role in public health This�aspect�of�the�new�guidance�document�is� designed� to� illuminate� the� contribution� that� all�registered�nurses�and�midwives,�irrespective� of� their� place� of� work,� can� make� to� helping� people�mange�their�own�health�and�wellbeing� better.�Nearly� 20� years� ago,�Nutbeam� (1996)� was� arguing� for� the� necessity� of� accurately� defining�what� constitutes� evidence�of� success� in� health� promotion;� the� nursing� profession� is� now� helping� to� build� this� evidence� base.� The� government� believes� that� nurses� should� take� opportunities� at� every� patient� contact� to� maximise� wellbeing� and� improve� health� outcomes� and,� where� possible,� reduce� inequalities.� It� needs� to� be� stressed� that� the�

Professor Alan Glasper discusses the latest Department of Health initiative to enhance the public health role of nursing and midwifery in improving health and wellbeing in society

The nursing and midwifery contribution to public health

 

 

British�Journal�of�Nursing,�2013,�Vol�22,�No�15� 901

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government� itself� has� been� accused�of� empty� rhetoric� after� it� was� revealed� in� the� popular� press� that� it� had� shelved� plans� to� make� plain� packaging� of� cigarettes� compulsory� and� abandoned� its� much-vaunted� aspiration� to� introduce�a�minimum�unit�alcohol�price�(Mail� Online,�2013).�Despite�this,�the�new�guidance� document� illuminates� how� nurses� can� make� every� person� contact� count� in� the� vision� for� improved� public� health,� both� locally� and� nationally.�Measures�include,�among�others: ■■ Promoting�compassion�in�practice�in�social- care�settings ■■ Developing� the� nursing� and� midwifery� contribution� to� the� promotion� of� good� mental� health� and� the� reduction� of� health� inequalities� for� people� with� learning� disabilities ■■ Maximising� the� leadership� role� of� public- health�nurses�and�developing�a�new�model�to� promote�the�public-health�role�of�midwives ■■ Enabling�nurses�to�learn�the�skills�of�health� promotion�to�optimise�every�patient�contact ■■ Enhancing� school� nursing� to� improve� the� health�and�wellbeing�of�children�and�young� people ■■ Supporting�nurses� in�better� helping�people� with�dementia� ■■ Promoting� health� visiting� to� showcase� its� pivotal� role� in� helping� children� and� their� families� get� the� best� start� in� life.� It� is� important� to� direct� efforts� towards� the� prevention�of�child�abuse�and�neglect�before� patterns� of� abuse� are� established� within� families�(MacMilllan�et�al,�2005)�� ■■ Ensuring� that� nurses� are� given� access� to� appropriate� technology� and� highlighting� the�contribution�of�the�National�Institute�of� Health�and�Care�Excellence�(NICE)�through� development�of�an�accessible�evidence�base� for�public�health�nursing ■■ Promoting�interagency�working.

What can nurses do to maximise the ‘nursing and midwifery contribution to public health’? There�are�a�number�of�actions�that�nurses�and� midwives� can� take� to� make� this� new� vision� for�public�health�work,�configured�around�the� individual,�the�community�and�the�population: ■■ Public health and the individual:�The� vision�for�public�health�seeks�to�make�every� nursing� contact� count,� with� every� nurse� being� able� to� offer� up-to-date� advice� to� patients� and� their� families,� based� on� best� evidence�pertinent�to�health�and�wellbeing.� Nursing� advice� that�helps� individuals�make� lifestyle� choices� to�prevent�health�problems� should�be�given�at�every�opportunity.�Nurses�

should�be�able�to�signpost�individuals�to�the� appropriate�people�or�agencies�that�can�best� help�them.�Additionally,�the�role�of�the�nurse� is�to�help�patients�identify�and�set�achievable� health� goals,� and� be� able� to� refer� them� to� others� within� the� multiprofessional� team� when�concerns�are�identified ■■ Public health and the community:� Nurses�working�in�the�community�should�be� able� to� assess,�plan�and�provide�community� needs,� especially� within� hard-to-reach� groups,� such� as� traveller� communities,�who� fail� to�access�health� services.�As�part�of� this� new� vision,� community� nurses� need� to� be� enabled� to� engage� with� communities� and� those� who� commission� services,� and� to� plan,� implement� and� subsequently� review� health� ‘place-based’� projects.� To� achieve� this,� community� nurses� need� to� develop� enhanced� communication� strategies� to� be� more�able� to�articulate� the�health�concerns� of� their� areas� of� health� jurisdiction,� and� to� collect� and� use� population-level� data� to� underpin�their�assertions ■■ Public health and the population: Community�nurses� and�midwives� need� to� be� more�able�to�influence�and�configure�both�the� political�and�policy�agendas�directly,�so�that�they� can�better�represent�their�healthcare�constituents.� This�will�result�in�maximised�opportunities�for� improving� population� health� and� addressing� health� inequalities.� Better� engagement� with� strategic�partners�and�the�public�is�necessary�to� identify� health� need,� set� objectives� and� health� priorities,�and�the�methods�to�measure�success� accurately.� In� building� sustained� community� health� capacity,� improvement� of� health� and� wellbeing,�and�reduction�of�health�inequalities,� should� be� achievable.�To� bring� this� vision� to� fruition,�the�nursing�and�midwifery�community� teams� must� be� enabled� to� develop� the� skill� toolkit� they� need� to� deliver� the� envisaged� service�improvements.�

Conclusion The� Public� Health� Outcomes� Framework,� launched�in�May�2013,�is�designed�to�improve� and�protect�the�nation’s�health�and�wellbeing� with� a� rapid� improvement� in� the� health� of� the� poorest� members� of� society.� This� new� guidance� document,� Nursing and Midwifery Contribution to Public Health,� recognises� that� nurses� and� midwives� are� pivotal� in� making� this� vision� for� the� nation’s� health� a� reality.� The� whole� of� the� nursing� workforce,� wherever�and�whenever� they�work,�must�be� enabled� to� contribute� to� improvements� in� public�health� at� every� level—promoting� the� health� of� the� individual,� the� community� in� which� they� work� and,� ultimately,� the� entire� population.��� BJN

Department� for� Communities� and� Local� Government� (2013)� Helping Troubled Families Turn their Lives Around.� https://www.gov.uk/government/policies/helping- troubled-families-turn-their-lives-around� (accessed� 23� July�2013)

Department� of� Health� (DoH)� (2012)� Compassion in Practice.� http://www.england.nhs.uk/wp-content/ uploads/2012/12/compassion-in-practice.pdf� (accessed� 23�July�2013)

DoH�(2013)�Public�Health�Outcomes�Framework�2013�to� 2016� and� technical� updates.� http://tinyurl.com/d45acrg� (accesssed�23�July�2013)

Department� of� Health� and� Human� Services,� Tasmania,� Australia� (2012)� Place-Based Approaches to Health and Wellbeing.� http://www.dhhs.tas.gov.au/_data/…/Place- ased_Issues_Paper_V1.0.pdf�(accessed�23�July�2013)

Francis�R�(2013)�Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry.� http://www.midstaffspublicinquiry.� com/sites/default/files/report/Executive%20summary.� pdf�(accessed�23�July�2013)

King’s� Fund� (2012)� Data Briefing: Emergency Hospital Admissions for Ambulatory Care-sensitive Conditions.�http:// www.kingsfund.org.uk/publications/data-briefing- emergency-hospital-admissions-ambulatory-care- sensitive-conditions�(accessed�23�July�2013)

MacMillan�HL,�et�al�(2005)�Effectiveness�of�home�visitation� by�public-health�nurses�in�prevention�of�the�recurrence�of� child�physical�abuse�and�neglect:�a�randomised�controlled� trial.�Lancet�365(9473):�1786–93

Mail� Online� (2013)� Stubbed Out.� 23� July.� http://tinyurl. com/kxxtqlg�(accessed�23�July�2013)

Nutbeam�D�(1996)�Health�outcomes�and�health�promotion:� defining�success� in�health�promotion.�Offic J Aust Health Promot Professionals�6(2):�58–60

Public� Health� England� (2013)� Nursing and Midwifery Contribution to Public Health.� https://www.gov.uk/ government/publications/nursing-and-midwifery- contribution-to-public-health�(accessed�23�July�2013)

Key PoInTs

n The challenges to the NHS over the forthcoming years to maintain and enhance public health and well-being are vast and complex

n The new guidance document which describes the nursing and midwifery contribution to public health is designed to address the challenges to the health and well-being of people in society.

n Every registered nurse and midwife has a duty to make every patient /client contact count in promoting public health.

n Place-based approaches are one strategy which can be used by community nurses and midwives to improve the health and wellbeing of local communities.

n The government want to maximise the leadership role of public health nurses and midwives.

 

 

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 The world is becoming smaller and smaller and when companies look to expand they often look outside their original footprint

Description

Part I: The world is becoming smaller and smaller and when companies look to expand they often look outside their original footprint. Rasmussen Healthcare Systems is looking to expand their system to another state. To help advise Rasmussen on this decision, you will write 4-5 pages that compare and contrast the healthcare reform policies of the state where you reside and another state of your choice. Please keep in mind the position and facility you selected. Make sure to include the following:

  1. Discuss the purpose of each state’s reform.
  2. Describe a minimum of three specific examples of similarities and differences in healthcare reform policies in the two states.
  3. Discuss in detail some of the ethical issues and moral disputes in each state’s reform.
  4. Discuss your recommendation on whether Rasmussen Healthcare Systems should expand to the second state.
  5. This portion of your assignment will require you to research and examine information from various sources. Use a minimum of five credible sources for your paper, with three being an academic source from the Rasmussen College Online Library (don’t forget to include in-text citations throughout your paper with paraphrasing or quoting).
  6. Make sure to include your APA formatted reference page.

Example of Potential Useful Websites

  • https://mn.gov/dhs/health-care-reform/
  • https://www.kdheks.gov/hcf/ppaca/

Part II: PowerPoint is typically the application of choice when conducting a meeting. There are many philosophies on how to create an effective PowerPoint, so do some research on the dos and don’ts. Then create a professional PowerPoint that you would present to the management team at your location that highlights your research. SkillSurfer in the online tutoring platform offers beginner, intermediate, and advanced tutorials on Microsoft Office products. Make sure to include the following in your PowerPoint:

  1. Length of PowerPoint is up to the student.
  2. Highlight specific policy changes in each state’s reform.
  3. Highlight each similarity and difference.
  4. Highlight your final recommendation on whether Rasmussen Healthcare Systems should expand to the other state.
  5. Use the Notes area on each slide as needed to expand on the key points.
  6. You may use a free screen capture site such as Screencast-O-Matic to record a video of your presentation. Screencast-O-Matic is a site and program that can perform screen desk and audio capture up to 15 minutes for free, and can be utilized on a Windows or Mac computer. (Note: You can use a similar program if you prefer. Screencast-O-Matic is just one suggestion). Make sure that both your voice and the PowerPoint slides are captured on the video. Your presentation should be 10 minutes or less.
  7. If you are utilizing the Screencast-O-Matic option, please watch this short instructional video on how to record, upload, and provide your instructor with the web link to your recorded presentation. If you would like to present your PowerPoint document within a live session, please reach out to your instructor for more details.

Your presentation should include an introduction, a concise discussion of each slide, and a conclusion. Make sure to use audience specific language and tone in your PowerPoint. Remember, you would be presenting this to the management team at your location. The presentation will be assessed on your overall knowledge of the content, clarity of your voice, pronunciation of words, organization of your presentation, proper recording of your presentation, overall aesthetics and professionalism, and general clarity to your presentation.

Your presentation should be 10 minutes or less. Make sure to address the following:

  • Include a link to the location of your live video on the last slide of your PowerPoint presentation.
  • Make sure to use audience specific language and tone in your PowerPoint. Remember, you would be presenting this to the management team at your location.

Save both your paper and PowerPoint presentation to a folder on your computer. Then, zip or compress your folder. Upload the zipped folder (with both the paper and PowerPoint) to the assignment dropbox

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n addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
  2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

BS in Health Sciences 1.2; BS Nursing (RN to BSN ) 5.2

Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

Utilize the case study and the “applying four principles” assignment that I uploaded to answer the above questions. 

Please use this reading material I have provided below as support to answer the above questions.

Read “Doing a Culturally Sensitive Spiritual Assessment: Recognizing Spiritual Themes and Using the HOPE Questions,” by Anandarajah, from AMA Journal of Ethics (2005).

URL:https://journalofethics.ama-assn.org/article/doing-culturally-sensitive-spiritual-assessment-recognizing-spiritual-themes-and-using-hope/2005-05

https://search-credoreference-com.lopes.idm.oclc.org/content/entry/sppbioeth/advance_directives/0?institutionId=5865

https://journalofethics.ama-assn.org/article/end-life-and-sanctity-life-commentary-1/2005-05

https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/5

Please follow all directions given when writing this paper. Thank you.

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The future of healthcare is focused upon improving patient outcomes and patient satisfaction

The future of healthcare is focused upon improving patient outcomes and patient satisfaction. Through the application of research studies and theory, evidence based practice development will lead the profession of nursing into the future whereby knowledge and skills support the practice of providing quality care.

Locate one nursing theory and one non-nursing theory. Describe how two practitioners can bring these separate theories together to provide meaningful patient care.

at least 4 reference and 3 parragraf

Please review the Discussion Board Participation grading rubric under Course Resources. This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion. Please see the Academic Success Center located in the student portal for assistance with writing, APA, and online communication.

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