Read the section titled “Reflective Practice: Pants on Fire” from chapter “Health Policy, Politics, and Professional Ethics” and address the questions below:

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Read the section titled “Reflective Practice: Pants on Fire” from chapter “Health Policy, Politics, and Professional Ethics” and address the questions below:

  • How do you judge Palin’s quote? [“And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.] Effective strategy to oppose Democrats’ plans for health care reform or unethical scaremongering?
  • Reflect on what informs your judgment: commitment to advance care planning, analysis of facts, and/or political party loyalties?
  • Is it right for nurses to endorse health reform legislation even if the legislation is not perfect? Does this apply to the recently failed American Health Care Act?

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Working in a cancer unit, I have learned that no matter what treatments, or surgeries doctors choose, unfortunately a lot of the time the cancer wins.

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Cristina Garcia Martinez 

1 posts

Re:Topic 10 DQ 2

Working in a cancer unit, I have learned that no matter what treatments, or surgeries doctors choose, unfortunately a lot of the time the cancer wins. However, as a nurse I have learned that even though I am unable to make a difference in their overall diagnosis outcome, I can make a difference in their care and well being by using evidence based practice. For example, I found that our unit has the highest CLABSI rate compared to the rest of the entire hospital. So clearly we are doing something wrong, and we need to find that problem and fix it. Our patients are already going through enough and it’s up to us as BSN prepared nurses to implement EBP in the clinical setting to protect our patients from these unnecessary and preventable infections. Making changes over time based on evidence is necessary in order to keep up with our continuously changing health care. BSN prepared nurses understanding of EBP across patient care gives them the unique ability to act as partners with other health professionals and to lead the improvement and redesign of the health care system (IOM, 2010). The first way I will continue to integrate evidence is by staying up to date with the changing health care system. It’s important to be aware of the changes going on outside of our work environment because the can make all the difference in your practice. I feel that nurses tend to get “comfortable” in the way they practice nursing. However, nursing and the health care system will continue to change and we must keep up with those changes. Second, I will make sure that I advocate for the nurses in our workplace by always asking questions, and requesting that our unit receives continuous training in changes occurring out in the nursing world.

 Reference:

Institute of Medicine (2010). The Future of Nursing: Leading Change and Advancing Health. Retrieved from https://campaignforaction.org/resource/future-nursing-iom-report/

 

Josphina Chavara 

1 posts

Re:Topic 10 DQ 2

When an EBP is utilized by a nurse, he or she knows that the EBP stems from the result of trials, experiments, tests, routine examinations, and best practices that took a closer examination on the results and the intended results. The BSN-prepare nurse is confident that the EBP utilized is not something that comes from random ideas put together; it is the result of tried and true procedure that improves upon and evolves the nurse’s understanding of what treatment/medication/action works best for the patient currently. Furthermore, the EBP goes through several rigorous sets of eyes to see its role in improving healthcare. According to the Online Journal of Issues in Nursing (2013), for EBP to be successfully adopted and sustained, it needs to be supported and adopted by “individual care providers, microsystem and system leaders, as well as policy makers.” In doing so, the EBP must also be regulated and approved on a federal, state and local level.  The EBP is a testament of stability, reliability, and effectiveness, so BSN-prepared RNs are able to provide a level of care that comes with a form of elevated awareness on best practices and procedure for the patient. This author plans on using the best possible system of care for her patients, and in doing so will provide EBP-supported actions from the moment of patient admittance. I already have a reputation with my patients for having a relatable and comfortable presence, and my work colleagues are aware that I am a strong supporter of using the latest known treatments for my patients.The other plan I have it to ask my fellow nurses to embrace EBP and challenge them to bring their own EBP that they feel passionate about and bring it in to the workplace as considerations for work. The biggest obstacle for something like this would be nurses who would feel like EBP is a waste of time unless they’ve been explicitly directed by the nurse manager or a doctor. In a way, I can understand their hesitance; the safest thing to do in an industry that is rife with mistreatment and clinical error is to simply only act when directed. The other main obstacle is time, as in the time needed to train nurses to be familiar with the EBP. However, EBP’s strength comes from its proven roots and authenticity, and therefore it would only make sense to convince nurses of how it improves their impact as a nurse and changes the lives of patients for the better. Reference: The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. (2013, May). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html

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Tobacco Control Program

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Running head: [TITLE] 1

 

Running Head: Tobacco Control Program 2

 

 

Group #2 – Tobacco Control Program

COH 380 – Health Promotion Program, Planning and Evaluation

Professor Hoolihan

May 20, 2018

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

Tobacco use is a risk factor for a wide variety of health problems. In the United States alone, tobacco use kills more than 480,000 individuals each year, wherein more than 41,000 of these deaths are due to secondhand smoke exposure (Centers for Disease Control and Prevention, 2018). Surprisingly, cigarette smoking is higher among individuals currently serving in the military, particularly those personnel who have been deployed (Centers for Disease Control and Prevention, 2018). For instance, tobacco use prevalence, including both smokeless and smoking, is lowest among Air Force (40%) personnel and highest among Marines (61%) (Smith, Poston, Haddock, & Malone, 2016). In this case, health promotion through tobacco control program provides an excellent opportunity to encourage military personnel smokers and nonsmokers to improve health status by preventing tobacco use.

Health Problem

Almost every organ in the body is at risk due to tobacco use. Cigarette smoking accounts for at least 30% of all cancer deaths, with most of the case caused by tobacco use is lung cancer (National Institute of Health, 2018). Also, tobacco use can cause lung diseases such as chronic bronchitis, emphysema, asthma, and chronic obstructive pulmonary disease (COPD) (National Institute of Health, 2018). Additionally, smoking cigarette can also increase the risk for developing cardiovascular diseases including stroke, heart attack, vascular disease, and aneurysm (National Institute of Health, 2018).

Program Planning Model

In this tobacco control program, PRECEDE-PROCEED planning model is utilized. PRECEDE stands for Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation; and PROCEED spells out Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (as cited in McKenzie, Neiger, & Thackeray, 2017). This planning model has eight phases: (1) social assessment, (2) epidemiological assessment, (3) educational and ecological assessment, (4) administrative & policy assessment and intervention alignment, (5) implementation, (6) process evaluation, (7) impact evaluation, (8) outcome evaluation (McKenzie, Neiger, & Thackeray, 2017).

Phase 1: Social assessment and situational analysis

The data used in this study was collected from the service-level health promotion leaders in the military such in the different branches of the Naval Hospitals, Army Medical Centers, and Air Force bases. These data include the medical history of the military personnel who experienced smoking cigarette in the past and those who are currently smoking.

Phase 2: Epidemiological assessment

It is important to consider the impact of tobacco use on the different military branches such as in the Army, Navy, Air Force, and Marine Corps divisions. The level of stress in the military is a behavioral risk factor for tobacco use. Smoking cigarette is perceived as a method for countering stress. Furthermore, the military population is ethnically diverse. It is essential to examine the ethnic background that drives the behavioral aspect of tobacco use.

Phase 3: Educational and ecological assessment

Every military personnel have different missions and level of stress provided by the workforce. And each personnel have different beliefs, traditions, and way of coping with tension and stress before and after duties.

Phase 4: Administrative & policy assessment and intervention alignment

It is significant to define the framework of tobacco use by assessing the work policy, health intervention, and personal behavior in the military groups.

Needs Assessment

Primary Data Collection

According to a recent interview conducted, there are different issues for a different segment of the population, for example, Mental Health Smokers, Substance Abuse Smokers, Coping Smokers, Social Smokers, Regular Smokers and Parolee Smokers all have different needs. The most smokers are not willing to implement a change with smoking habits until they are ready to do so. The strategies have been active with clients who are eager to be educated, supported and connected to resources to plan for a quit attempt. These groups need support groups and Local Smoking Cessation Programs.

Secondary Data Collection

Proof based prescribed procedures for tobacco control have been generally advanced and have prevailing with regards to diminishing tobacco use in the United States. The advisory group perceives, notwithstanding, that recognizing the accepted procedures for particular and assorted populaces can be testing (Eriksen, 2000). Decreasing tobacco utilize faces uncommon difficulties since tobacco items are lawful and simple to get, exceptionally addictive, and vigorously advanced by a tobacco industry that burns through billions of dollars a year to advance tobacco as a component of the American culture (Rogers, 2010). Making a sans tobacco culture will rely upon building up a situation that empowers forbearance and makes numerous kinds of successful help and consolation open to differing populaces.

A wellbeing needs evaluation is a deliberate technique to survey the present and conceivable medical problems confronting a populace. From this confirmation needs and asset assignment that will enhance wellbeing and decrease disparities can be agreed. Needs appraisals can be more extensive than wellbeing and can incorporate measurements, for example, financial, similar to the case with this evaluation. Needs assessments are frequently structured as follows:

Definition of the issue

Epidemiological necessities appraisal

Comparative needs evaluation

Current administration arrangement

Corporate necessities evaluation (partner sees)

Identification of neglected needs

Recommendations for change

This structure freely takes after the Stevens and beam system and draws on the NICE direction for Health Needs Assessment yet is separated to center around the partner sees and new advancements on the Tobacco Control plan.

Conclusion

This paper will focus on health promotion for the military personnel who are at risk for developing smoking-related diseases such as lung cancer and diseases and cardiovascular diseases due to tobacco use.

 

References

Centers for Disease Control and Prevention. (2018). Burden of tobacco use in the U.S. Retrieved from https://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html

McKenzie, J., Neiger, B., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs (7th edition). United States of America: Pearson Education, Inc. Retrieved from www.chegg.com

National Institute of Health. (2018). Tobacco, nicotine, and e-cigarettes. Retrieved from https://www.drugabuse.gov/publications/tobacco-nicotine-e-cigarettes/what-are-physical-health-consequences-tobacco-use

Eriksen, M. (2000). Best practices for comprehensive tobacco control programs: opportunities for managed care organisations. Tobacco Control, 9(90001), 11-14.

Ranjan, R., & Jain, S. (2018). Strengthening National Tobacco Control Program (NTCP) to advance tobacco control (TC) policy in Uttar Pradesh (UP). Tobacco Induced Diseases, 16(1).

Rogers, T. (2010). The California Tobacco Control Program: introduction to the 20-year retrospective. Tobacco Control, 19(Supplement 1), 1-2.

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A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition.

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A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. How would you address your patient’s concerns?  What medication would you add and why?

Constipation is among the commonest reason that makes people self medicate (Teri Moser Woo 2016 pp535). It is very common and can be caused by variety of factors ranging from lack of exercise, immobility, neuronal abnormality, iatrogenic causes as well. Appropriate management requires an evaluation for secondary etiologies, such as systemic disorders and drugs. Once secondary causes have been eliminated, idiopathic constipation may be associated with normal or slow colonic transit, defecatory dysfunction (pelvic floor dysfunction), or both. Laboratory work up specifically electrolytes and radiological investigation would be considered for the above mentioned patient. This is after a thorough History and physical exam.

Since the patient above exercises and eats well, I would start with a stimulant Laxative in this case. Stimulant laxatives — Stimulant laxatives such as bisacodyl (e.g., some forms of Dulcolax), Senna (e.g., Senokot), and sodium picosulfate (e.g., Dulcolax drops). According to (Johnson DA, Barkun AN, Cohen LB, et al 2014) A randomized four-week trial of sodium picosulfate (10 mg daily) in 45 patients with chronic constipation demonstrated improved bowel function for those receiving medication compared with placebo

 

                                                                        Senna

Category: Senna is a stimulant laxative, primarily exert their effects via alteration of electrolyte transport by the intestinal mucosa. They also increase intestinal motor activity

Use: Senna is use for constipation, generally causes bowel movement in 6 to 12 hours

Warning and Education: Senna should be used appropriately. Failure to have a bowel movement or occurrence of rectal bleeding after use should be reported to health care provider. It is not recommended for use in patients experiencing stomach pain, nausea, vomiting, or a sudden change in bowel movements which lasts >2 weeks. If constipation did not improve after being on Senna for one week, return to the clinic. Do not use for more than 1 week.

Adverse reaction: Some adverse reaction that can result from Senna use include: abdominal cramps, diarrhea, nausea, vomiting

 

References

Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. [PubMed 27060684]

Johnson DA, Barkun AN, Cohen LB, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Am J Gastroenterol, 2014;109(10):1528-1545. [PubMed 25223578]

Woo, T. M. & Robinson, M. V. (2016): Pharmacotherapeutics for Advanced Practice Nurse

Prescribers. (4TH ed.). Philadelphia: F. A. Davis Co

Liu Z, Yan S, Wu J, et al. Acupuncture for Chronic Severe Functional Constipation: A Randomized Trial. Ann Intern Med 2016; 165:761.

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