Nursing

Advocacy Paper
Choose a patient-care situation in which the RN should intervene and advocate for the patient. An example of such a situation might be when a patient has not been given complete informed consent.
Include the following in your paper:
Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
Apply the Bioethical Decision Making Model ( attached) to the specific clinical ethical situation that you choose. Address each section of the model in your paper.
Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.
Your paper should be 4-5 pages.
You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.
Review the rubric for further information on how your assignment will be graded.
Rubric
NURS_521_DE – Advocacy Paper Rubric
NURS_521_DE – Advocacy Paper Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Content
50 to >43.5 pts
Meets Expectations
Content is clear, thorough, and organized effectively. Main points are well supported. Meets all of the criteria of the written assignment.
43.5 to >37.5 pts
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Some points are well supported. Meets most of the criteria of the written assignment.
37.5 to >29.5 pts
Below Expectations
Content is generally unclear, not thorough, and organized ineffectively. Main points are not well supported. Meets only a few of the criteria of the written assignment.
29.5 to >0 pts
Does Not Meet Expectations
Content is disconnected, unorganized, and does not meet the criteria of the written assignment.
50 pts
This criterion is linked to a Learning Outcome Clarity and Coherence
50 to >43.5 pts
Meets Expectations
Writing flows smoothly from one idea to another. Writer has taken pains to assist the reader in following the logic of the ideas expressed.
43.5 to >37.5 pts
Approaches Expectations
Sentences are mostly structured to clearly communicate ideas. Transitions between paragraphs make the writer’s points easy to follow.
37.5 to >29.5 pts
Below Expectations
Sentence structure and word choice sometimes interfere with clarity of content and distract the reader.
29.5 to >0 pts
Does Not Meet Expectations
Poor sentence structure, sentences do not make sense; no clarity evident in the paper.
50 pts
This criterion is linked to a Learning Outcome References and Citations Within the Body of the Paper
12.5 to >10.88 pts
Meets Expectations
The required number of scholarly references is used and cited skillfully throughout the paper.
10.88 to >9.38 pts
Approaches Expectations
The required number of scholarly references is used but some may not be cited accurately or skillfully throughout the paper.
9.38 to >7.38 pts
Below Expectations
The required number of scholarly references is not used and most are not cited accurately or skillfully throughout the paper.
7.38 to >0 pts
Does Not Meet Expectations
References or citations are not included in the body of the paper and writing indicates none were used.
12.5 pts
This criterion is linked to a Learning Outcome Mechanics and APA
12.5 to >10.88 pts
Meets Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
10.88 to >9.38 pts
Approaches Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
9.38 to >7.38 pts
Below Expectations
The assignment generally follows current APA format with several mistakes and grammatical, spelling, or punctuation errors. Most sources are cited and referenced incorrectly.
7.38 to >0 pts
Does Not Meet Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Sources are missing.
12.5 pts
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Solution
Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
A Clinical situation in which a registered nurse should intervene and advocate for a patient is a situation in which a patient has not received clear instructions for self-care. For example, in a healthcare facility, a physician can focus on only the diagnosis and administration of medication to a diabetes patient, which might mainly include insulin therapy. As a result of having a heavy workload, a physician can sometimes forget to recommend important self-care strategies that can be adopted to effectively manage their condition. In an instance where a patient receives unclear self-care instructions, the registered nurses can therefore act as an advocate for a patient by either alerting the physician or the medical facility to effectively resolve the issue and ensure that a diabetes patient has received adequate self-care instructions that can effectively support the pharmacological treatments that they receive.
Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model in your paper.
Utilizing the bioethical decision-making model, the first step is defining the dilemma (Forte et al., 2018). In the case study where a diabetes patient does not receive instructions related to their self-care activities, the ethical dilemma will be related to the principle of beneficence and nonmaleficence. By deciding not to provide a diabetes patient with clear self-care instructions, a physician can therefore be placing the health of a patient at significant risk or even place the patient at risk of not fully managing their diabetes condition. By not providing clear self-care instructions, a physician can be directly acting against the interest of the patient, which is against the principle of beneficence. By not providing clear self-care instructions, a physician can also be said not to be following the ethical principle of nonmaleficence which calls on all healthcare practitioners to be actively involved in preventing direct harm to their patients (Forte et al., 2018).
The medical facts that are relevant to an ethical dilemma in which a physician does not provide clear self-care instructions to a diabetes patient include the patient struggling to have proper glycemic control as a result of poor diet and lack of physical activity and even being obese in many instances. As a result of high blood sugar, which is one of the major symptoms of diabetes, it is therefore vital for patients to control their blood sugar through a combination of a healthy diet including fruits and vegetables, physical activity, and insulin therapy. By not providing self-care instructions such as regular physical activity and a healthy diet made up of fruits and vegetables, a physician will therefore be creating ethical issues related to the principle of beneficence and nonmaleficence.
The non-medical facts related to a patient with diabetes who does not receive adequate self-care instructions relate to their culture, religion, social and economic status. For a diabetes patient who comes from a culture that values foods that may contribute to a rise in blood sugar, such as high sugar and oil diet, the lack of self-care instructions can contribute to the worsening of their condition. Diabetes patients from low socioeconomic classes and statuses can also struggle to take the right diet to maintain their blood sugar.
The situation in which a physician does not provide adequate health care instructions to a diabetes patient relates to the second provision of the nurses’ code of ethics, which highlights the primacy of patient interests and also states that the primary commitment of nurses should be to the patient whether they are groups, families, individuals, populations, or communities (Porter, 2013). In a case scenario in which a physician does not provide adequate self-care instructions to a diabetes patient, it is the duty of the registered nurse to be committed to the patient and to ensure the patient receives adequate health care.
Considering the ethical dilemma in which a physician does not provide sufficient health care instructions for diabetes patients, the facts of the case include that definition does not follow the ethical principles of beneficence and nonmaleficence. Self-care instructions, which include requesting a diabetes patient to be involved in physical activities such as walking and taking a healthy diet made up of vegetables and fruits, are also central to the recovery of a patient.
In the ethical dilemma in which a physician does not provide sufficient self-care instructions to a diabetes patient, the items that need clarification to include that the diabetes patient requires to be involved in self-care activities such as taking a healthy diet and physical activities in combination with insulin therapy in order to effectively control their blood sugar.
The decision-makers in the ethical dilemma include the patient who is 65 years old and who is competent in making their own choices. For adult patients who are of the right frame of mind to make their own decisions, healthcare practitioners, including physicians and registered nurses, need to provide adequate advice related to self-care instructions and then allow such patients to make a decision on whether to follow the instructions or not.
In the case study where a diabetes patient does not receive instructions related to their self-care activities, the ethical dilemma will be related to the principle of beneficence and nonmaleficence. By deciding not to provide a diabetes patient with clear self-care instructions, a physician can therefore be placing the health of a patient at significant risk or even place the patient at risk of not fully managing their diabetes condition. By not providing clear self-care instructions, a physician can therefore be directly acting against the interest of the patient, which is against the principle of beneficence. By not providing yourself care instructions, a physician can also be said not to be following the ethical principle of nonmaleficence which calls on all healthcare practitioners to be actively involved in preventing direct harm to their patients(Forte et al., 2018).
In the case where a diabetes patient receives unclear self-care instructions from a physician, there are several steps that a registered nurse can take, including escalating the issue to the unit manager or reminding the physician to provide self-care instructions for the diabetes patient. The main shortcomings of reporting the physician to the unit manager would be undermining teamwork and collaboration in a given health care department. On the other hand, by opting to request the physician to provide more self-care instructions for diabetes patients in a diplomatic way, a nurse can enhance collaboration and teamwork in a healthcare facility while also advocating for the rights of the patient (Nsiah et al., 2019).
The process that can be utilized for the ethical dilemma related to a diabetes patient who does not receive adequate self-care instructions from a physician includes using diplomacy to remind the physician to provide the necessary instructions to the patient.
Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.
Nursing advocacy is important in the clinical setting in that it can help different members of the health care team to uphold the right standards of care. Nursing advocacy can also help to improve the outcomes of patients. Nurses are important patient advocates (Nsiah et al., 2019).
References
Forte, D. N., Kawai, F., & Cohen, C. (2018). A bioethical framework to guide the decision-making process in the care of seriously ill patients. BMC Medical Ethics, 19(1). https://doi.org/10.1186/s12910-018-0317-y
Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307
Porter, R. B. (2013). The American Nurses Association Code of Ethics. Journal of the Dermatology Nurses’ Association, 5(1), 31–34. https://doi.org/10.1097/jdn.0b013e31827d9eaa

The practicum experience was done at NYC Dept and Health: Office of School Health Division. Over the past 2 weeks, time was spent visiting nurses in the medical room, approved Medication Administration Forms, assisting with training, ensuring nurses have needed supplies, and meeting with principals to discuss issues arising in the medical room and OSH policies. The main focus of my practicum is managing students with asthma in the school setting.
Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.
Unlike a personal journal of thoughts and feelings, this leadership journal is a record of your activities, assessments, and learning related to this academic experience.
Journal entries should include a record of the number of hours spent with your nurse leader each week.
Write a journal entry of 750-1,500 words on the subject of serving, including the following:1. Practicum Activities Reflection: Provide observations and thoughts on the activities in your practicum setting during Topics 9-10.
2. Application of Leadership: Identify three to five personal values or characteristics that you believe are critical components of a good leader, such as honesty, compassion, or fairness. How do you express those values in your professional life?
3. Practicum Project Preparation: How have you prepared those who will be affected by your project for its implementation?
4. Leadership Video Reflection: Reflect on at least two things you learned from the “Servant Leadership – Issue of Example” video. https://www.youtube.com/watch?v=jBra6jSTHSE&list=PLqKj_eriTOI9Js2i_C2mitH1P96Zf6Q__&index=6
Use the “Leadership Journal Template” to complete this assignment.
APA format is not required, but solid academic writing is expected.
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Solution
Practicum Activities Reflection:
Discuss some of your activities with your preceptor, what projects you are working on, and what observations about leadership you have made during the past two weeks. This does not need to be a step-by-step diary. Instead, this is a place to reflect on how your observations and activities have compared to what you have learned in your courses thus far.
During my practicum, I had a meeting with my nurse preceptor. We came up with a plan for my practicum. The initial experience was a full day spent with the preceptor since I observed him carry out several leadership activities. By the end of the day, I noted down all my observations about how the preceptor interacted with other healthcare providers at the healthcare facility. Later, we held a debriefing session. In the debriefing session, we discussed what I learned, what I observed, and how I saw the leadership concepts I studied in class be9ng applied in the activities of the preceptor. Later, we came up with data on when I would simulate the managers’ role at the facility.
Application of Leadership:
Each Leadership Journal assignment will include specific questions for you to answer.
Components of a Good Leader
A good leader should have intentionality, commitment, vision, honesty, compassion and humility.
Intentionality- as a leader, being intentional in all your leadership activities creates the ripple effect and change required in your organization. Besides, a leader ought to be intentional in goal setting, communication, modeling values, being service-minded, reflecting, building relationships, and modeling values (Malik et al., 2017).
Commitment- a good leader should be committed to the people by believing in them. Besides, a good leader should be committed to the concept of shared leadership. Also, commitment in leadership involves seeking a win-win solution for everyone.
Vision- Great leaders have a vision for what they are trying to accomplish and how they will get there. Besides, a leader with a clear vision inspires, builds trust, and get results when executed well.
Honesty- a good leader is transparent about all the activities involved in an organization. They open up to all the stakeholders about how the funds on the healthcare facility are used. A transparent leader keeps their team in the loop, share information freely and invite open communication within their companies (Malik et al., 2017). They support their team members to combine their insights, efforts, skills, passion, talents, and enthusiasm to work together for the greater good.
Compassion- a compassionate leader will seek influence, not authority. Besides, they are not demanding but encouraging. Also, they support acknowledge and guide their team members.
Humility- a humble leader needs to understand they are an integral part of the success, but not the sole source (Malik et al., 2017). Besides, humble leaders understand that to be a part of something greater than yourself is one of life’s greatest opportunities.
Practicum Project Preparation:
Each Leadership Journal assignment will include specific questions for you to answer.
How I prepared those who will be affected by my project for its implementation
I collected all the requirements from all the stakeholders- After creating the project charter and identifying the key stakeholders, I gathered all the essential requirements. Besides, I defined the scope of the project and determined what I needed to deliver to my stakeholders. I ensured there was effective communication amongst the stakeholders to ensure all the important details of the project were not missed.
Defined the scope of the project. Together with the stakeholders, we developed a comprehensive description of the project and the deliverables in form of a project scope statement. Also, I ensured there was a clear understanding of the boundaries of the project.
Created a work breakdown structure. I broke down all the project’s scope into small and more manageable deliverables and groups of related tasks. Breaking down the project’s scope allowed me to assign the different resources available to different parts of the project based on the required skills. Therefore, the work breakdown facilitated coordination and planning.
Defined the activities of my project. I listed the work packages into a list of project activities. As a result, I was able to plan the activities to be performed to create the deliverables of the project.
Estimated activity duration, resources, and cost (Susilowati et al., 2021). I did an estimate of the duration, resources, costs, and resources to determine whether the project was viable and the set expectations. Also, estimation made it possible to keep all the costs under control.
Build-in contingencies. A plan without contingency is a bad plan. Projects do not go as planned, hence the need for building backup plans. After looking at the historical data on similar projects in the past, I was able to identify the possible risks.
Created a performance measurement baseline. Lastly, I developed an integrated scope-schedule-cost baseline for the project work. It served as a control tool for the project. The performance measurement baseline of the project helped me to measure performance upon completion of the project.
Leadership Video Reflection:
In the YouTube video Servant Leadership – The Issue of Humility, leaders should lead their teams by example. For instance, when a leader wants their team to meet the target set by the organization, they should be at the forefront formulating the strategies for achieving the desired results (GCU Academics Nursing, 2016). Besides, a good leader should be the first person to execute the set strategies. Furthermore, a leader should inspire his juniors to be conservative through their action. Inspiration calls for transparency, integrity, and dedication to work. Therefore, a leader should always ensure, they mean what they say, and should keep their promises. Also, leaders ought to be influential in the essence of leadership.
References
GCU Academics Nursing (2016, October) Servant Leadership – The Issue Of Humility. Retrieved December 4, 2021
https://www.youtube.com/watch?v=jBra6jSTHSE&list=PLqKj_eriTOI9Js2i_C2mitH1P96Zf6Q__&index=6
Malik, W. U., Javed, M., & Hassan, S. T. (2017). Influence of transformational leadership components on job satisfaction and organizational commitment. Pakistan Journal of Commerce and Social Sciences (PJCSS), 11(1), 147-166.
Susilowati, M., Kurniawan, Y., Prasetiya, H. P., Beatrix, R., Dewa, W. A., & Ahsan, M. (2021, March). How to manage scope, time and cost of project management plan to develop manufacture information system. In IOP Conference Series: Materials Science and Engineering (Vol. 1098, No. 6, p. 062006). IOP Publishing.

This paper is a debate. I am writing the opening statement and 1 argument. My group is the CON group I will attach the instructions and rubric. I am just writing one con argument
Read the following information about the TIGER (Informatics/HC literacy/information technology) Initiative:
Review the Tiger Initiative Report Download Tiger Initiative Report, Executive Summary. The initiative includes all competencies for basic computer skills, information literacy, and information management. If you go to the main Tiger Initiative/HiMSS website (Links to an external site.), under Reports you may find more information for your debate. (Links to an external site.)
The 9 Principles of Good Debating – The International Institute of Debate.HTML download The 9 Principles of Good Debating – The International Institute of Debate.htm
The purpose of this peer-reviewed assignment is to debate the importance of the competencies outlined in the TIGER Report relative to the competencies of your chosen specialty area. Each of you has been randomly assigned to either the “pro-group” or the “con-group.” The “pro-group” argues that TIGER Competencies are equally – and critically – important while the “con-group” argues that special competencies are more important and the TIGER competencies should only be considered for those in nursing informatics.
Click on the People tab on the left to access your group. As a group, you are to work on three items:
opening statement
3 arguments with authoritative sources, and
closing argument
Group assignments are different from last week. Use this group discussion board only to collaborate with your group. You must post your opening statement and 3 arguments to the Week 6 Discussion Board (below) no later than Wednesday at midnight. Carefully consider how to best present your arguments. Will you just post a written statement? Use PowerPoint slides? Record a video? Use your technology skills to the best advantage!
Then, after careful viewing and/or reading of the opposing viewpoints and online discussion with the opposing team, each group will discuss and revise their closing arguments. The closing statement for each group should be posted to the Week 6 Discussion board no later than Saturday at midnight. Again, consider which technology format might best showcase your arguments.
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Solution
TIGER Debate
The TIGER initiative was established to ensure that the quality of service offered by nurses is improved through the competence, safety, and compassion expressed by the patients (Shaw et al., 2017). Through the initiative, the nurses’ preparedness to use technology in their practice is investigated so that their areas of weakness can be addressed and the best outcomes produced in the long run (Shaw et al., 2017). While this initiative has a good intention, some situations require special competencies since some emergencies require skills, experience, and competencies instead of the competencies promoted by the TIGER initiative. This being the case, the TIGER initiative should only be promoted for professionals involved in health informatics, given that special competencies play a bigger role in saving patients’ lives in emergencies.
One of the reasons why special competencies are more important than the skills promoted by the TIGER initiative is because special competencies ensure that different personnel is equipped with the right skills to ensure optimal performance outcomes (Brown 2017). Through special competencies, it will be possible to align the individual performances posted by the personnel with the overall organizational goals (Brown 2017). Special competencies recognize the need for specialization in the workforce, whereby different personnel is equipped with the necessary skills, personalities, attitudes, and knowledge, hence improving the outcomes of the different roles that they play within the organization (Park, 2018). special competencies are therefore more task-specific than the competencies suggested in the TIGER initiative since the TIGER initiative does not consider the possibility of some workers needing fewer skills in telehealth and more skills in other important areas that will improve the experiences of the patients that they handle (Park, 2018). For example, some nurses require bedside manners more than competence in technology since they handle patients, which is less demanding of the competencies suggested by the TIGER initiative and more dependent on special competencies.
References
Brown, C. L. (2017). Linking public health nursing competencies and service?learning in a global setting. Public Health Nursing, 34(5), 485-492.
Park, S. J., & Ji, E. S. (2018). A structural model on the nursing competencies of nursing simulation learners. Journal of Korean Academy of Nursing, 48(5), 588-600.
Shaw, T., Sensmeier, J., & Anderson, C. (2017). The evolution of the TIGER initiative. CIN: Computers, Informatics, Nursing, 35(6), 278-280.

Case Study Analysis of a 42 Year-Old Male with Cellulitis
Scenario: A 42-year-old man comes to the clinic with a chief complaint of pain, redness, and swelling of his right calf. He states that he had been working in his yard using a string trimmer when the trimmer slipped and cut his leg. He cleaned the wound with water from the garden hose and covered the wound with a large Band-Aid. Several days later, he developed a fever to 100.6? F and chills and noticed that his leg was swollen and red. He comes to the emergency department for definitive care.
The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis in which you:
Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.
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Solution
Cellulitis is a serious condition caused by infection of a break in the skin, usually common in the lower limbs. The microorganisms or bacteria that usually cause this infection are those that form the microbiome found in the skin. In other words, they are the normal flora of the skin around the cut or breakage in the skin (Hammer & McPhee, 2018). Any condition that causes a breach in the integrity of the skin or lowered immunity is a predisposing factor to cellulitis. They include obesity, diabetes mellitus, and old age (Cranendonk et al., 2017). The purpose of this paper is to discuss the case of the 42-year-old that suffered an accidental cut on the lower limb and later developed cellulitis.
Why the Patient resented with the Symptoms Described
The patient in the case study presented to the clinic with pain (dolor), redness (rubor), and swelling (tumor). Together with heat or warmth (calor), these are the four major signs of inflammation (Hammer & McPhee, 2018). Hannula-Jouppi et al. (2013) expressly include warmth (calor), fever, leucocytosis, and lymphangitis amongst the presenting symptoms of cellulitis. The most common causes of cellulitis in these circumstances are streptococci and staphylococci. Increasingly, methicillin-resistant Staphylococcus aureus (MRSA) is becoming a common cause of cellulitis and causing serious challenges with antibiotic therapy (Katzung, 2018).
The reason why the patient presented with the symptoms described above and in the case study is that the bacteria that caused the cellulitis infection also caused inflammation in the affected lower limb with the cut (Cranendonk et al., 2017; Hammer & McPhee, 2018). Once they enter the body through the cut, their exotoxins stimulate the release of leucocytes in the local circulatory vasculature of the affected lower limb. These leucocytes then mediate the disruption of endothelial integrity allowing extravasation and infiltration of the affected area by leucocytes. This extravasation of fluid causes the swelling (tumor); with some of the leucocytes acting like phagocytes that engulf the bacteria. The swelling presses on nerve endings causing pain (dolor).
The influx of serous fluid, leucocytes, and other serum components to the affected area of the lower limb makes the skin thinner and appears erythematous or red (rubor). The inflammatory chemokines or chemoattractants cause the blood flow to increase in the area of infection and inflammation. Since blood in the body is generally warm, this causes the warmth (calor) of the swollen site. The fever the patient has is a normal bodily response to infection aimed at altering the normal body homeostasis making it difficult for the bacteria to survive (Hammer & McPhee, 2018).
Genetic Component to Cellulitis
According to Hannula-Jouppi et al. (2013), there is a genetic susceptibility to infection and cellulitis caused by specific host genetic factors. The AGTR1 gene or Angiotensin II receptor type I gene has been strongly linked by scholarly literature to genetic susceptibility to cellulitis and the related condition of erysipelas (Hannula-Jouppi et al., 2013).
The Process of Immunosuppression and Its Effect on Body Systems
Immunosuppression is the repression of the body’s immune system such that it becomes less efficient and effective at protecting the body from disease-causing microorganisms. Immunity is conferred by several lines of defense. The first line of defense is the skin that provides a mechanical barrier to bacterial invasion. In the case of our patient, this skin integrity was breached by the cut. The second line of defense is cellular in status and involves lymphocytes (B cells and T cells), monocytes, and granulocytes (Hammer & McPhee, 2018). Both the first-line and second-line defenses are compromised in immunosuppression. The effect on the body systems is a derangement of functions as the thermoregulatory center raises the body temperature above optimum to try and make it unfavorable for the bacteria.
References
Cranendonk, D.R., Lavrijsen, A.P.M., Prins, J.M., & Wiersinga, W.J. (2017). Cellulitis: Current insights into pathophysiology and clinical management. The Netherlands Journal of Medicine, 75(9), 366-378. https://www.njmonline.nl/getpdf.php?id=1907
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Hannula-Jouppi, K., Massinen, S., Siljander, T., Mäkelä, S., Kivinen, K., Leinonen, R., … Kere, J. (2013). Genetic susceptibility to non-necrotizing erysipelas/ cellulitis. PLoS ONE, 8(2), e56225. https://doi.org/10.1371/journal.pone.0056225
Katzung, B.G. (Ed) (2018). Basic and clinical pharmacology, 14th ed. McGraw-Hill Education.

Assignment 1: Structural Versus Strategic Family Therapies
Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.
Learning Objectives
Students will:
Compare structural family therapy to strategic family therapy
Create structural family maps
Justify recommendations for family therapy
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
Refer to Gerlach (2015) in this week’s Learning Resources for guidance on creating a structural family map.
The Assignment
In a 2- to 3-page paper, address the following:
Summarize the key points of both structural family therapy and strategic family therapy.
Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

Topic 2: Epidemiology And Communicable Diseases
Objectives:
1. Apply the principles of epidemiology to community health nursing.
2. Explain the value of demographic data in community health.
3. Apply the epidemiology triangle to a communicable disease occurring at a global level.
4. Evaluate the communicable disease chain model.
5. Discuss the impact of global health issues on public health systems.
6. Explain how social determinants of health contribute to the development of disease.
Epidemiology Paper (8 PAGES, 10 REFERENCES)
Assessment Description
Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.
Communicable Disease Selection
1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza
Epidemiology Paper Requirements
1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.
Resources
Collapse All ResourcesCollapse All
Social Determinants of Health
Read “Social Determinants of Health,” from the Healthy People 2030 website.
https://health.gov/healthypeople/objectives-and-data/social-determinants-health
________________________________________
Communicable Disease Chain
Refer to the “Communicable Disease Chain” as needed to complete your assignment.
NRS-428VN-RS2-CommunicableDiseaseChain.doc
________________________________________
World Health Organization
Explore the World Health Organization (WHO) website.
http://www.who.int/en/
________________________________________
2017 National Notifiable Conditions (Historical)
Explore the 2017 National Notifiable Conditions (Historical) page of the Centers for Disease Control and Prevention (CDC) website.
https://wwwn.cdc.gov/nndss/conditions/notifiable/2017/
________________________________________
Chain of Infection
Use the media piece “Chain of Infection” to assist you in completing your Topic 2 assignment.
http://lc.gcumedia.com/nsg403c/chain-of-infection/chain-of-infection-v1.1.html
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Community and Public Health: The Future of Health Care
Read Chapter 2 in Community and Public Health: The Future of Health Care.
https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/community-and-public-health_the-future-of-health-care_1e.php
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U.S. Department of Health and Human Services
Explore the U.S. Department of Health and Human Services (HHS) website.
https://www.hhs.gov/
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Centers for Disease Control and Prevention
Explore the Centers for Disease Control and Prevention (CDC) website.
https://www.cdc.gov/
________________________________________
Families USA
Explore the Families USA website.
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Attachments
Epidemiology Paper – Rubric
Collapse All Epidemiology Paper – RubricCollapse All
Comprehensive Description of a Communicable Disease and the Demographic of Interest
12.5 points
Criteria Description
Comprehensive Description of a Communicable Disease and the Demographic of Interest
5. Excellent
12.5 points
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
4. Good
11.5 points
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
3. Satisfactory
11 points
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
2. Less Than Satisfactory
10 points
Limited and/or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
1. Unsatisfactory
0 points
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Determinants of Health and Explanation of How Determinants Contribute to Disease Development
12.5 points
Criteria Description
Determinants of Health and Explanation of How Determinants Contribute to Disease Development
5. Excellent
12.5 points
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
4. Good
11.5 points
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
3. Satisfactory
11 points
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
2. Less Than Satisfactory
10 points
Paper partially describes the determinants of health in relation to disease development.
1. Unsatisfactory
0 points
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors
25 points
Criteria Description
Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors
5. Excellent
25 points
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological triangle. A visual description of the triangle and how the components of the model interact is included.
4. Good
23 points
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
3. Satisfactory
22 points
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
2. Less Than Satisfactory
20 points
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
1. Unsatisfactory
0 points
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
Role of the Community Health Nurse and Importance of Demographic Data
25 points
Criteria Description
Role of the Community Health Nurse and Importance of Demographic Data
5. Excellent
25 points
Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up. A clear explanation of the importance of demographic data to community health is presented.
4. Good
23 points
Discussion of the role of community health nurse is clear, with a comprehensive description of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is presented.
3. Satisfactory
22 points
Discussion of the role of the community health nurses is limited, with a brief overview of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is summarized.
2. Less Than Satisfactory
20 points
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills. An incomplete explanation of why demographic data are necessary to community health is provided.
1. Unsatisfactory
0 points
Discussion of the role of the community health nurse is omitted or unclear. An explanation of why demographic data are necessary to community health is omitted or unclear.
National Agency or Organization That Works to Addresses Communicable Disease
12.5 points
Criteria Description
National Agency or Organization That Works to Addresses Communicable Disease
5. Excellent
12.5 points
An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered.
4. Good
11.5 points
An agency or organization is identified, but discussion regarding efforts to address communicable disease is brief.
3. Satisfactory
11 points
An agency or organization is identified, but discussion regarding efforts to address communicable disease is lacking.
2. Less Than Satisfactory
10 points
An agency or organization is identified, but discussion is vague or inaccurate in relation to the communicable disease chosen.
1. Unsatisfactory
0 points
Agency and description of contribution are omitted.
Global Implication
12.5 points
Criteria Description
Global Implication
5. Excellent
12.5 points
A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.
4. Good
11.5 points
A discussion of the global implication of the disease is clear, with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.
3. Satisfactory
11 points
A discussion of the global implication of the disease is limited, with some integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.
2. Less Than Satisfactory
10 points
A discussion of the global implication of the disease is vague, with no integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is not provided.
1. Unsatisfactory
0 points
Global implication of the disease is omitted or unclear.
Thesis, Position, or Purpose
6.25 points
Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
5. Excellent
6.25 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.
4. Good
5.75 points
The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated.
3. Satisfactory
5.5 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.
2. Less Than Satisfactory
5 points
The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience.
1. Unsatisfactory
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.
Development, Structure, and Conclusion
6.25 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves from development.
5. Excellent
6.25 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.
4. Good
5.75 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.
3. Satisfactory
5.5 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.
2. Less Than Satisfactory
5 points
Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose.
1. Unsatisfactory
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.
Evidence
6.25 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers other perspectives.
5. Excellent
6.25 points
Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.
4. Good
5.75 points
Relevant evidence that includes other perspectives is used.
3. Satisfactory
5.5 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.
2. Less Than Satisfactory
5 points
Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect.
1. Unsatisfactory
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.
Mechanics of Writing
2.5 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.
5. Excellent
2.5 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
4. Good
2.3 points
Few mechanical errors are present. Suitable language choice and sentence structure are used.
3. Satisfactory
2.2 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.
2. Less Than Satisfactory
2 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.
1. Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.
Format/Documentation
3.75 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.
5. Excellent
3.75 points
No errors in formatting or documentation are present.
4. Good
3.45 points
Appropriate format and documentation are used with only minor errors.
3. Satisfactory
3.3 points
Appropriate format and documentation are used, although there are some obvious errors.
2. Less Than Satisfactory
3 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.
1. Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
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Solution
Communicable diseases, including tuberculosis, HIV/AIDS, and influenza, have a considerable effect on the global population. Factors such as globalization significantly impact the spread and severity of communicable diseases. For example, the constant changes in the status of human interactions affect the spread of infectious diseases globally. Nurses and other healthcare providers have the essential role of minimizing the spread and impact of communicable diseases in their populations. They utilize primary, secondary, and tertiary health promotion methods to empower the affected and those at risk to transform their lifestyles and behaviors. They also select best practice interventions that optimize care outcomes, including safety, quality, and efficiency. Therefore, this research paper explores the epidemiology of HIV/AIDS.
Description of the Communicable Disease
HIV/AIDS is the chosen communicable disease. HIV/AIDS is a viral infection attributed to the human immunodeficiency virus. It attacks the immune system of the body. Lack of treatment leads to viral progression to acquired immunodeficiency syndrome (AIDS). People affected by HIV/AIDS experience various symptoms during its symptomatic phase. They include fever, chills, night sweats, rash, muscle aches, swollen lymph nodes, fatigue, sore throat, oral ulcers, and diarrhea that last for a week (Dumais, 2017). Patients also report rapid weight loss, pneumonia, skin blotches, and neurological disorders, including depression and memory loss.
The main transmission mode of HIV/AIDS is through contact with infected fluids, including semen, breast milk, blood, or vaginal secretions. Direct transmission also occurs during the utero life, where the mother transmits the virus to the fetus during pregnancy and delivery. Behaviors such as having multiple sexual partners, injectable drugs, unprotected sex, and a history of sexually transmitted diseases predispose to HIV/AIDS. HIV/AIDS is associated with several complications. They include tuberculosis, cytomegalovirus, toxoplasmosis, cryptococcal meningitis, candidiasis, and pneumocystis pneumonia. Patients are also increasingly predisposed to non-AIDS-related cancers, liver disease, frailty, renal disease, and diabetes (Capriotti, 2018; Dumais, 2017). HIV/AIDS does not have a cure. However, patients are treated with antiretroviral medications that suppress the viral load in the body. Symptomatic treatments for conditions such as oral candidiasis, meningitis, and pneumonia are also used to prevent further immune suppression.
The existing statistics show HIV/AIDS as a national and global health concern. Statistics show that 34800 new HIV/AIDS cases were reportedin 2019. It represented a decline of 8% in the incidence rate. The rate of infections was highest among people aged 45-54 years, followed by those aged 35-44 years. Overall, about 1.2 million people in the USA have HIV/AIDS, with 13% not knowing their status. The minority groups, including bisexual, gay, and other men that have sex with men, lead in the populations affected by HIV/AIDS in the USA (HIV.GOV, 2021). HIV/AIDS is a reportable disease. Healthcare institutions report diagnosed cases of HIV/AIDS to the CDC’s National HIV Surveillance System and the respective departments of health in different states. The cases are reportedafter they are diagnosed.
Social Determinants of Health
Social determinants of health refer to modifiable factors that contribute to health inequalities. Factors evident in places where people are born, live, work, and thrive act as social determinants of their health. HIV/AIDS is associated with several determinants of health. One of them is ethnicity (Hogan et al., 2021). HIV/AIDS is high in ethnic minorities, including African Americans. Socioeconomic status or poverty is also another social determinant of health. Accordingly, the rate of HIV/AIDS is high among individuals from socio-economically deprived families. Factors such as engagement in risky sexual activities predispose them to sexually transmitted infections, including HIV/AIDS.
Employment status is also another social determinant of health in HIV/AIDS. Employment status influences an individual’s socioeconomic status, access, and care affordability. The rate of HIV/AIDS tends to be higher among unemployed individuals than employed due to their increased predisposition to risky behaviors, including drug abuse and prostitution. The level of education is also a critical social determinant of health in HIV/AIDS. High rates of HIV/AIDS have been reported in populations with a low level of education (Friedman et al., 2018). Level of education influences constructs such as level of awareness, employment, and socioeconomic status of the population. Access to care also acts as a source of inequality in individuals affected by HIV/AIDS. Populations with limited access to healthcare due to lack of medical insurance coverage and unaffordability of care are likely to report high cases of HIV/AIDS. Factors such as delays in early diagnosis and initiation of treatment contribute to poor outcomes in HIV/AIDS management. Low access to healthcare services also affects the knowledge of the population about the prevention of the spread of HIV/AIDS (Santos et al., 2018). Therefore, it is important that interventions that address the social determinants of health in HIV/AIDS be implemented to promote the population’s health.
Epidemiological Triangle
An epidemiological triangle is a tool used to develop a deeper understanding of the mechanism of an infectious disease in the population. It provides insights into the relationships between agent, host, and environment in infectious disease. The agent refers to the microorganism causing the disease. Concerning HIV/AIDS, the agent causing the infection is a virus. The commonest type of virus causing HIV/AIDS is HIV-1 (Gopalappa et al., 2017). HIV-2 is less common with low virulence and similar symptoms to HIV-1. Factors related to HIV influence its ability to cause infection to the host. They include virulence or pathogenicity and dose. Virulence is the ability of a disease-causing microorganism to cause disease. HIV has a high level of virulence, as it can invade and multiply itself in the host. The dose refers to the amount or concentration of a disease-causing microorganism (Gopalappa et al., 2017). Often, HIV exists in high doses with an enhanced ability to invade and multiply in the host. HIV spreads through hosts’ direct contact with infected fluids, including semen, vaginal secretions, and blood.
Host in the epidemiological triangle refers to the carrier of the disease. It refers to the individuals affected by HIV/AIDS. Several host factors influence their ability to be affected by HIV and the development of AIDs. One of them is immune status. The risk for HIV infection is high in individuals with lowered immunity. The rate of viral invasion, multiplication, and further suppression is high. The other host-related factor is individual behaviors. Behaviors such as engaging in unprotected sex, having multiple sexual partners, and using injected drugs with sharing needles increase the risk of host exposure to the agent (Mahdavi et al., 2021). Pregnancy is also another host-related factor for HIV/AIDS. Pregnant mothers infected with HIV/AIDS have an increased risk of infecting their unborn babies through mother-to-child transmission or during delivery and breastfeeding. Individuals suffering from existing medical conditions are also increasingly predisposed to HIV/AIDS. Co-existing comorbidities low immune status of the patients, hence, their vulnerability to the agent. Patients on existing treatments for malignancies also have a high risk of HIV infection due to their suppressed immunity (Joas et al., 2018). Patients receiving blood transfusions or involved in road accidents are also at risk due to contact with contaminated fluids.
Environment refers to the external factors that affect the epidemiologic outbreak. Environmental factors affect the spread of the disease,not attributed to the host and agent. The environmental factors in HIV/AIDS include communities with a high rate of sexually transmitted diseases and a low level of reporting (Dumais, 2017). Such conditions contribute to the flourishing of HIV/AIDS. Socioeconomic factors such as poverty also contribute to the spread of HIV/AIDS by limiting access to the needed treatment. Social discrimination or isolation of individuals affected by HIV/AIDS also discourages the populations from utilizing screening and treatment services (Dumais, 2017). Consequently, they contribute to the increased spread of the disease in the population.
Role of the Community Health Nurse
Community health nurses have several roles in the epidemiological management and prevention of HIV/AIDS. One of the roles is case finding. Case finding entails the identification of cases affected by HIV/AIDS and the populations at risk. The community health nurse screens the population to identify the cases. She also determines the vulnerable populations, including sex workers, transgender persons, substance and drug abusers, and individuals with multiple sex partners and engaging in unprotected sex (Mottiar& Lodge, 2018). The nurse educates the vulnerable population about the preventive measures against HIV/AIDs and the importance of screening and early treatment for the identified cases.
The community health nurse also reports identified cases to the respective authorities. Reporting is important to determine HIV/ the prevalence, incidence, and severity of HIV/AIDS in specific populations. The data aids in distributing resources for HIV/AIDS to the population. The nurse also collects data related to HIV/AIDS in the population (Knettel et al., 2021). The data provide insights into the severity, spread, and patterns of the disease in the population. The nurse analyzes the collected data to provide an accurate picture of the population’s disease pattern, spread, and burden. The nurse also disseminates the analyzed data to the population, healthcare providers, and public health officials to stimulate action. Dissemination approaches, including community presentations, journal publications, conference presentations, and new policies based on the outcomes, are effective. The community health nurse also undertakes follow-up of cases. Follow-up aims to ensure adherence to treatment by the infected and determine other needs that may affect the treatment outcomes (Knettel et al., 2021). Therefore, community health nurses play crucial roles in the epidemiological management of HIV/AIDS.
National Agency
UNAIDS is a national agency that addresses HIV/AIDS in the USA and other global states. UNAIDS is a global effort initiated to drive efforts to end HIV/AIDS by 2030 as part of the global Sustainable Development Goals. The agency prides itself in inspiring regional, global, national, and local leadership in addressing HIV/AIDS (UNAIDS,2021). The agency acts as a global problem solver by incorporating the populations affected by HIV/AIDS in decision-making. It also delivers and monitors the response initiatives against HIV/AIDS. The agency collaborates with countries and communities to develop appropriate interventions to ending HIV/AIDS and advocate the adoption of measures to address policy and legal barriers to HIV/AIDS response. UNAIDS benefit patients affected by HIV/AIDS in several ways. First, it advocates for access to treatment and preventive services by the affected populations and those at risk (UNAIDS,2021). An example is seen from expanding the access to antiretroviral drugs for HIV/AIDs patients. UNAIDS also advocates the rights of HIV patients. It ensures the prioritization of their needs in policy planning and implementation. It also supports programs to enhance the quality of life of HIV patients, including education, gender-based, and social protection of their rights.
Global Implication
HIV/AIDS has adverse global implications. Statistics show that HIV/AIDS affects about 38 million people globally. It acts as a source of disease burden since most of the affected globally do not access preventive and treatment services. HIV/AIDS affects the quality of life of the affected patients and their significant others. Patients require frequent hospitalizations for opportunistic infections, which can take a toll on them and their significant others (Navon, 2018). The need for frequent hospital visits and hospitalizations also result in declining productivity among the patients and their families.
HIV/AIDS also has huge financial implications for the global states. For example, the USA spent more than $34.8 billion in 2019 treating and combating HIV/AIDS (KFF, 2021). According to Dieleman et al. (2018), there was an increase in the annualized rate of healthcare spending per capita due to HIV/AIDS from 1995 to 2015. The largest growth was reported in upper-middle-income countries and low-middle-income countries. The increase led to $9.1 trillion spent on healthcare globally in treating and combating HIV/AIDS.
HIV/AIDS also contributes to a high percentage of mortalities globally. For example, the UNAIDS report that 47.8 million have died due to HIV/AIDS-related illnesses since its start as a global epidemic. In addition, 680000 people died due to HIV-related illnesses in 2020(UNAIDS, n.d.-a). UNICEF (2021) reports that about 330 children globally died due to HIV/AIDS-related illnesses daily in 2020. Factors such as inadequate access to HIV treatment and prevention contributed to most children’s mortalities.
Countries have adopted several interventions to address HIV/AIDS. One of the interventions adopted in most countries is increasing access to treatment by ensuring free antiretroviral drugs. Access to treatment prolongs the life of the affected and improves their overall quality of life (Chenneville et al., 2020; Mandsager et al., 2018). Screening services for HIV/AIDS are also free. The population can access free HIV testing and health educational services. The population also receives support in nutritional aid to address nutrition-related deficiencies.
Conclusion
HIV/AIDS is an epidemic with a high disease burden globally. Epidemiological analysis shows the presence of the host, agent, and environmental factors that influence its spread globally. The community health nurse plays several roles in addressing HIV/AIDS. The roles include case finding, data collection, analysis, dissemination, and follow-up of patients. HIV/AIDS has several complications, which increase the need for timely treatment of identified cases. Vulnerable populations should be prioritized in policy decision-making to minimize the spread and impact of the disease in them. Agencies such as UNAIDS play vital roles in addressing HIV/AIDS. Countries should collaborate in implementing interventions that reduce the incidence and prevalence rate of HIV/AIDS to promote the health of the public.
References
Capriotti, T. (2018).HIV/AIDS: An Update for Home Healthcare Clinicians.Home Healthcare Now, 36(6), 348–355. https://doi.org/10.1097/NHH.0000000000000706
Chenneville, T., Gabbidon, K., Hanson, P., & Holyfield, C. (2020).The Impact of COVID-19 on HIV Treatment and Research: A Call to Action.International Journal of Environmental Research and Public Health, 17(12), 4548. https://doi.org/10.3390/ijerph17124548
Dieleman, J. L., Haakenstad, A., Micah, A., Moses, M., Abbafati, C., Acharya, P., Adhikari, T. B., Adou, A. K., Kiadaliri, A. A., Alam, K., Alizadeh-Navaei, R., Alkerwi, A., Ammar, W., Antonio, C. A. T., Aremu, O., Asgedom, S. W., Atey, T. M., Avila-Burgos, L., Awasthi, A., … Murray, C. J. L. (2018). Spending on health and HIV/AIDS: Domestic health spending and development assistance in 188 countries, 1995–2015.The Lancet, 391(10132), 1799–1829. https://doi.org/10.1016/S0140-6736(18)30698-6
Dumais, N. (2017). HIV/AIDS: Contemporary Challenges.BoD – Books on Demand.
Friedman, E. E., Dean, H. D., &Duffus, W. A. (2018). Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Reports, 133(4), 392–412. https://doi.org/10.1177/0033354918774788
Gopalappa, C., Farnham, P. G., Chen, Y.-H., &Sansom, S. L. (2017).Progression and Transmission of HIV/AIDS (PATH 2.0): A New, Agent-Based Model to Estimate HIV Transmissions in the United States.Medical Decision

Discussion board of advanced pathophysiology
(There are two discussions. Please write one page each for each discussion.)
Prompt 1
Select one of the following discussion prompts to address:
Consider the long-term effects of hyperglycemia as seen in poorly controlled diabetes. Consider factors that lead to good or poor compliance in regimens designed to decrease hyperglycemia and improve health outcomes in diabetics. Review this article (Links to an external site.) https://diabetesjournals.org/clinical/article/24/2/71/1610/Improving-Patient-Adherenceand identify the key factors that can interfere with compliance.
Describe the pathophysiology, clinical manifestations, evaluation, and treatment of two diseases of the posterior pituitary–syndrome of inappropriate antidiuretic hormone secretion (SIADH) and diabetes insipidus (DI).
Discuss Grave’s Disease and the systemic manifestations and treatment of hyperthyroidism. Describe the pathophysiology, clinical manifestations, evaluation, and treatment of hypothyroidism.
advanced pathophysiology
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
Prompt 2
Select one of the following discussion prompts to address:
• Describe the pathophysiology, clinical manifestations, evaluation, and treatment of polycystic ovary syndrome (PCOS).
• Discuss common causes of galactorrhea and describe the pathophysiology, clinical manifestations, evaluation, and treatment of galactorrhea.
• Describe benign prostatic hypertrophy (BPH) and discuss the pathogenesis, clinical manifestations, evaluation, and treatment of BPH.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
Textbook:
Pathophysiology: The Biologic Basis for Disease in Adults and Children
• Author: Kathryn L. McCance and Sue E. Huether
• Publisher: Elsevier
• Edition: 7th (2014)
Chapter 21-26
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NURS 6052 – Essentials Of Evidence-Based Practice
To ensure patient care’s safety, high quality, and cost-effectiveness, nurses base their practice on sound and tested evidence. Students will better understand evidence-based practice (EBP) and how it interacts with and is aligned with research and quality improvement in this course. Students will learn how to search for evidence using databases and apply their knowledge of research methodologies to critically appraise literature.
Additionally, they will look for ways to improve their synthesis and integration skills to determine whether a change in practice is necessary based on evidence. Students will examine the complexities of leading and mentoring change within an organization to improve nursing practice by analyzing implementation, evaluation, and dissemination strategies.
Prerequisites
MSN Nurse Practitioner Specializations
NURS 6002N or NURS 6003N
MSN Other Specializations
NURS 6002 or NURS 6003
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NURS 6052 – Essentials of Evidence-Based Practice
Question of interest: “For critically ill patients, does monitoring Stoke Volume yield more accurate or more appropriate diagnostic/ assessment information than Central Venous Pressure during fluid resuscitation?”
To Complete:
Write a 3- to 4-page paper that includes the following information:
A synopsis of your area of interest, identification of the problem you’ve chosen, and explanation of the significance of this problem for nursing practice
The five questions you generated, as well as a description of how you evaluated their feasibility.
Your preliminary PICOT question, as well as a description of each PICOT variable pertinent to your inquiry
At least 10 keywords that could be used to conduct a literature search for your PICOT question, as well as a rationale for your choices
Nurses base practice on sound and tested evidence to ensure the safety, high quality, and cost-effectiveness of patient care. This course provides students the opportunity to gain a better understanding of the development and relationship of nursing theory, research, and practice. Through a variety of online activities and coursework, students explore the role of nursing theory in both research and practice. They examine research literature to differentiate and critique various research designs, including quantitative, qualitative, and mixed-method models; appraise statistical data; and analyze evidence. Acquired knowledge helps students to critically evaluate research to make decisions about use of findings to enhance practice
Week 1 Assignment
Evidence-Based Practice and the Quadruple Aim
Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
To Prepare:
Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
To Complete:
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:
Patient experience
Population health
Costs
Work life of healthcare providers
Week 2 & 3 Assignment
Evidence-Based Project
Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: An Introduction to Clinical Inquiry
Create a 4- to 5-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you used keywords to search on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four peer-reviewed articles you selected.
Part 2: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
The full citation of each peer-reviewed article in APA format.
A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.
Week 5 Assignment
Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews
Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest for the Assignment.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
The Assignment (Evidence-Based Project)
Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four peer-reviewed articles you selected.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Week 7 Assignment
Evidence-Based Project, Part 4: Critical Appraisal of Research
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use appraisal tools to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
Review the Resources and consider the importance of critically appraising research evidence.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tools document provided in the Resources.
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include:
An evaluation table
A levels of evidence table
An outcomes synthesis table
Part 4B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
Week 9 Assignment
Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
Reflect on the four peer-reviewed articles you critically appraised in Module 4.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
The Assignment: (Evidence-Based Project)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the evaluation table (1 slide)
An explanation about what you learned from completing the levels of evidence table (1 slide)
An explanation about what you learned from completing the outcomes synthesis table (1 slide)
Week 11 Assignment
Evidence-Based Capstone Project, Part 6: Disseminating Results
The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.
To Prepare:
Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
Consider the best method of disseminating the results of your presentation to an audience.
To Complete:
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.
Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Assignment: Evidence Based Project Part 1: Identifying Research Methodologies
Assignment: Evidence-Based Project, Part 1: Identifying Research Methodologies
Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
The full citation of each peer-reviewed article in APA format.
A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.
Excellent
Part 1: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

Analysis of a pertinent healthcare issue
Assignment: Analysis of a Pertinent Healthcare Issue
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings.
Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances.
Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
To Prepare:
Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
By Day 7 of Week 2
The healthcare issue I selected was the current nursing shortage.
Excellent
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
· Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
23 (23%) – 25 (25%)
The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization.
The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected.
· Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations. 27 (27%) – 30 (30%)
A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.
The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.
· Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples. 27 (27%) – 30 (30%)
A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.
The response accurately and thoroughly explains in detail how the strategies may impact an organization both positively and negatively, with specific and accurate examples.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
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Solution
Analysis of a Pertinent Healthcare Issue: Current Nursing Shortage
The scarcity of nurses in healthcare facilities across the United States is without a doubt one of the most pressing current national healthcare concerns. Almost every healthcare organization in the country, including mine, is affected by this issue. When there aren’t enough nurses, there’s bound to be burnout among the few remaining employees (Jacobs et al., 2018).
This is a truth that is harmful to the organization, because a nurse who is burned out as a result of an excessive workload is useless and dangerous. Because of physical and psychological exhaustion, this nurse is prone to making major errors of judgment. As an organization, this is a risk that may be avoided but is difficult to manage due to a shortage of skilled nurses.
As a result, the company faces the possibility of being sued for carelessness and malpractice. These could result in a vicarious liability finding and massive financial damages as a result of settled lawsuits. Organizational risk management is thus a reality that many healthcare organizations must deal with in light of nursing workforce shortages (Pittman & Scully-Russ, 2016; Ricketts & Fraher, 2013).
The goal of this paper is to look at the impact of nursing shortage in a hospital context and possible solutions.
How the Shortage of Nurses Impacts the Organization
The current nursing shortage has a huge influence on our organization. The hospital’s one nurse informaticist and three primary health care nurse practitioners have all quit in the last three months. Despite the human resource department’s best efforts, finding the suitable nursing personnel with the right training, experience, and skill mix to replace these four has proven impossible.
As a result, the remaining nurses and nurse practitioners are under a great deal of stress and are becoming demoralized as a result of the increased workload. It has been noted that replacing expert nurses who leave for a variety of reasons is a difficult assignment. Some of the reasons for this quick turnover have been noted, including the loss of professional development budgetary allocations by organizational policy makers, a lack of financial assistance for student nurses, and poor or insufficient remuneration (Palumbo et al., 2017; Wise, 2018)
As a result, healthcare organizations like ours should be very concerned if they lack the essential skill mix or number of nurses to provide high-quality, safe treatment. As an incentive, policymakers should keep in mind that overworked nurses may feel more powerful and motivated if they are compensated fairly and recognized for their efforts (Day-Calder, 2017).
Concise Presentation of Two Articles on the Healthcare Issue of Nurse Shortage
According to Combes et al. (2018), a scarcity of nursing staff may be due to the concerned organization’s uncompetitive compensation (Palumbo et al., 2017). Between 2003 and 2005, they looked into the position of assistant nurses (ANs) and registered nurses (RNs) working in hospitals in England.
They discovered that increasing the pay competitiveness of registered nurses by 10% reduced the shortage of both RNs and ANs by 0.6 percent for RNs and 0.4 percent for ANs.
According to Wise (2018), the treatment of cancer patients at the King George Hospital Cedar Centre in the United Kingdom had to be halted when four oncology nurses departed the hospital and two others went on maternity leave. They were forced to do so because the cancer center’s oncology nurses were in short supply due to the absence of these six. Of course, such a decision will have disastrous consequences.
Not only will the cancer patients treated at the hospital suffer as a result of the shutdown, but the clinic itself will receive unfavorable press and may lose public trust. Regaining that reputation and trust may take a long time after that.
However, this hospital, like ours, should investigate why a group of four oncology nurses had to quit at the same time, hampering its operations. As previously stated, the potential reasons could be salary, current staffing practices, or a lack of transformational leadership on the part of the organization’s nursing managers.
Because nurses constitute the backbone of the healthcare industry, these issues would be prioritized and addressed with urgency in most businesses.
Some of the Effective Strategies to Curb Organizational Nurse Shortage
Giving nurses equitable compensation, engaging in staff development programs, fostering a suitable working atmosphere through transformational nursing leadership, and taking a bottom-up approach to nursing management have all been mentioned as solutions that work to address this healthcare issue (Wise, 2018; Combes et al., 2018; Day-Calder, 2017).
Legislation, on the other hand, is a very successful technique for dealing with this threat. The National Nursing Shortage Reform and Patient Advocacy Act was introduced in 2015 by Democratic senators Sherrod Brown (Ohio), Barbara Boxer (California), and Democratic House Representative Jan Schakowsky (Rubin, 2015). This bill aimed to establish minimum nurse-to-patient ratios in all hospitals, safeguard nurses’ advocacy roles, and enshrine mandated investment in nurse training and retraining in law.
As a result, the bill’s purpose was to improve patient safety and facilitate the delivery of high-quality healthcare. Support was given by amongst others the California Nurses Association (Rubin, 2015).
These techniques may have a good impact on my organization by increasing nurse numbers, as well as the quality of nursing care and the enjoyment of working as a nurse.
They will only have a negative influence on my firm if they consume monies that could have been used to purchase new equipment and other permanent assets. However, because the number of professional nurses is decreasing and demand is outstripping supply, the investment is well worth the effort (Triggle, 2015).
References
Combes, J-B., Elliott, R.F. & Skåtun, D. (2018): Hospital staff shortage: The role of the competitiveness of pay of different groups of nursing staff on staff shortage. Applied Economics. https://doi.org/10.1080/00036846.2018.1490000
Day-Calder, M. (2017). How to cope with staff shortages. Nursing Standard, 31(19). http://dx.doi.org/10.7748/ns.31.19.37.s40
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231-245. https://doi.org/10.1097/NAQ.0000000000000303
Palumbo, M.V., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33, 400-404. http://dx.doi.org/10.1016/j.profnurs.2016.11.005
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1-15. https://doi.org/10.1186/s12960-016-0154-3
Ricketts, T.C., & Fraher, E.P. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874-1880. https://doi.org/10.1377/hlthaff.2013.0531
Rubin, R. (2015). Bill takes aim at nationwide shortage of nurses. JAMA, 313(18), 1787. https://doi.org/10.1001/jama.2015.3747
Triggle, N. (2015). Staff shortages threaten move into community care services. Nursing Management, 22(3). https://doi.org/10.7748/nm.22.3.8.s10
Wise, J. (2018). Hospital suspends chemotherapy because of nurse shortage. BMJ. http://dx.doi.org/10.1136/bmj.k4687