Nursing

Assignment- PUB 655- TOPIC 4- Social Determinants of Global Health and Health Equity Infographic
This paper has a Part 1 and Part 2
(1) -Part 1- create a visual ( Infographic) to represent a health issue in a lower- to middle-income country
-Part 2 is essay with a 250-300 word count
Choose a health issue of your choice in a lower- to middle-income country of your choice.
Please ensure that each of the components listed on the question page is answered.
Please utilize headers to ensure all parts of the questions are answered.
-Details of the question and the rubric are also uploaded
-Please include the introduction, Thesis statement, and conclusion in the paper.
– Include section headings for each section component where needed
– Sources must be published within the last 5 years. It must be from 2016 and after
– Sources must be appropriate for the assignment criteria and public health content.
– Please do not use blogs as references
-References should be in APA 7th ed.
-Add references to reference page
-Add the hyperlink for each reference in APA 7th edition format
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Solution
Part 2: Diabetes in Pakistan
In contemporary times diabetes is one of the most prevalent diseases in low and middle-income countries. Diabetes is a chronic health condition that affects how an individual’s body converts food into energy. After consuming food, it’s usually broken down into glucose and released into the bloodstream. A rise in blood sugar in the bloodstream signals the pancreas to release insulin (Aamir et al., 2019). Insulin acts as a catalyst allowing blood sugar into the body cells to be utilized as energy. Individuals with diabetes do not make enough insulin or have insulin resistance which makes it difficult for their body to use insulin as it should. The causes of diabetes include an inactive lifestyle and obesity (Aamir et al., 2019).
In Pakistan, which is a low-income country, the prevalence of diabetes is estimated to be at least 17.1%, with over 19 million adults living with diabetes. The significant proportion of adults with diabetes in Pakistan places them at risk of life-threatening complications, including premature deaths as a result of cardiovascular diseases, high blood pressure, damage to major organs such as eyes and kidneys and stroke, among others. In Pakistan, the main contributors to the rising prevalence of diabetes include dietary habits, lack of exercise and rising obesity (Adnan & Aasim, 2020).
The high prevalence of diabetes in low-income countries such as Pakistan should be addressed because of the significant adverse effects that high prevalence of such a health condition has on the general population including, economic loss due to low productivity in the affected population, premature deaths, higher healthcare costs (Akhtar et al., 2019).
Social and economic income inequalities have a significant effect on how diabetes is addressed in that diabetes is a lifestyle condition mainly caused by dietary habits and lack of exercise. Low-income communities might not be able to afford a more healthy diet made up of fruits and vegetables and might not perform physical exercises so as to prevent themselves from diabetes or improve their quality of life if already affected by diabetes(Aamir et al., 2019).
References
Aamir, A. H., Ul-Haq, Z., Mahar, S. A., Qureshi, F. M., Ahmad, I., Jawa, A., Sheikh, A., Raza, A., Fazid, S., Jadoon, Z., Ishtiaq, O., Safdar, N., Afridi, H., & Heald, A. H. (2019). Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan. BMJ Open, 9(2), e025300. https://doi.org/10.1136/bmjopen-2018-025300
Adnan, M., & Aasim, M. (2020). Prevalence of Type 2 Diabetes Mellitus in Adult Population of Pakistan: A Meta-Analysis of Prospective Cross-Sectional Surveys. Annals of Global Health, 86(1). https://doi.org/10.5334/aogh.2679
Akhtar, S., Nasir, J. A., Abbas, T., & Sarwar, A. (2019). Diabetes in Pakistan: A systematic review and meta-analysis. Pakistan Journal of Medical Sciences, 35(4). https://doi.org/10.12669/pjms.35.4.194

Case Study: Mrs. J.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
Subjective Data
Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is ”running away.”
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data
Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications administered through drug therapy control her symptoms:
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
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Solution
Case Study: Mrs. J.
The case study provided for this discussion presents a 63-year-old married female patient with a history of chronic obstructive pulmonary disease (COPD), chronic heart failure, and hypertension. The patient has been using 2L of oxygen/nasal cannula for respiratory aid during activity and still smokes about 2 packs of cigarettes every day for the past 40 years. However, her present flu-like symptoms such as malaise, nausea, productive cough, and fever started about 3 days ago. During this time, the patient reports defaulting from her antihypertensives. She reports difficulties in performing routine daily activities and even requires assistance to move around the house. Her current admission to the hospital ICU is a result of acute exacerbation of COPD and acute decompensated heart failure. This discussion evaluates the case of this patient from clinical manifestations, nursing interventions, and care plans to appropriate preventive measures.
Clinical Manifestations of Mrs. J.
Mrs. J reports that she started having flu-like symptoms such as malaise, nausea, productive cough, and fever about 3 days ago. She also needs assistance to move around the house, with difficulties in carrying out routine daily activities. The subjective portion of information reveals symptoms such as anxiety, lack of air, fatigue, shortness of breath, palpitations. Upon conducting a physical examination, it is noted that the patient is obese with increased heart rate, irregular heartbeats, bradycardia, presence of S3 sound with diminished S1 and S2, and atrial fibrillations. The patient also displays the presence of respiratory crackles, productive cough, bloody sputum, diminished right lower lobe breathing sound, and hepatomegaly.
Evaluation of Nursing Interventions at Admissions
The patient was admitted to the ICU with an acute exacerbation of COPD and acute decompensated heart failure. The recommended nursing interventions are thus aimed at improving the patient’s heart pump function and maintaining normal blood pressure in addition to relieving respiratory symptoms such as shortness of breath (Doenges et al., 2019). It was necessary to administer furosemide given that the patient was admitted as a result of acute decompensated heart failure which is associated with leg or foot swelling that is managed by diuretics. Enalapril was administered to help manage and prevent atrial fibrillation, which is demonstrated by the patient’s irregular and elevated heart rate of 118.
Metoprolol is effective in maintaining sinus rhythm and preventing atrial fibrillation but was not necessary at the point of admission given the patient’s low blood pressure (Doenges et al., 2019). Morphine was also not necessary given that the patient was not in any kind of pain.Inhaled short-acting bronchodilator (ProAir HFA) on the other hand was necessary for quick relief of the patient’s shortness of breath and prevent COPD complications. Lastly Inhaled corticosteroid (Flovent HFA) was not appropriate, given that this drug can only be considered in long-term therapy for patients with asthma, especially when a short-acting bronchodilator has already been used.
Cardiovascular Conditions Leading to Heart Failure and Interventions
Conditions such as hypertension, myocardial infarction, coronary artery disease, and abnormal heart valves. Hypertension is the main risk factor for heart failure as a result of overworking the heart to promote normal blood circulation. In such a condition, the recommended nursing intervention is to regularly monitor the patient’s blood pressure and ensure great compliance with antihypertensives. Coronary artery disease is associated with cholesterol and fatty deposits in the heart arteries (Inciardi et al., 2020). Monitoring the patient’s cholesterol level and lipid profile in addition to the use of dietary control is necessary to prevent the development of heart failure. For patients who have had a history of heart attack the nursing care plan will involve monitoring the patient’s vitals regularly and administration of antianginals to prevent heart attack (Mahmud et al., 2020). Lastly, abnormal heart valves can also lead to overworking of the heart which can eventually lead to heart failure. This can be prevented by the use of blood thinners and lifestyle modifications.
Nursing Interventions for Older Patients to Prevent Problems Caused by Multiple Drug Interactions
Given that most elderly patients present with comorbidities, there isa high possibility of polypharmacy. To prevent problems associated with multiple drug interactions, it is necessary to eliminate duplicate medication during care transition to avoid toxic doses which promote adverse drug reaction (Unlu et al., 2020). Assessment of the treatment plan is crucial to prevent drug-drug interaction and avoid the associated adverse effects. Nurses should conduct medical reconciliation to avoid instances of prescription errors (Unlu et al., 2020). Lastly drug dosage review should be conducted to ensure that administered drugs are safe, with reduced incidences of adverse events.
Health Promotion and Restoration Teaching Plan
The patient must be educated on the pathophysiology of his health condition and the importance of taking the prescribed medication (Inciardi et al., 2020). She should also adopt a healthy diet low on sodium, fats, and calories, and frequent physical exercise to promote her health (Mahmud et al., 2020). The patient should also be advised to stop smoking through the adoption of appropriate smoking cessation programs, to prevent the effects of tobacco smoke in worsening COPD symptoms. Consequently, she needs to frequently monitor her vitals to evaluate the treatment outcome. It is also necessary for the patient to sign up for cardiac rehabilitation which is crucial in improving the quality of life and even prolonging the patient’s life expectancy (Mahmud et al., 2020). Additional resources which will help the patient identify life modification strategies to promote health and independent living include ‘American Heart Association’, ‘Centers for Disease Control and Prevention’ and ‘National Heart, Lung, and Blood Institute’ among others.
Method for Providing Education to Prevent Hospital Readmissions
To promote the patient’s recovery and prevent possibilities of readmission, it is necessary to advise the patients on the importance of complying with the medications prescribed at the indicated dose, frequency, and duration (Unlu et al., 2020). The patient must also be educated about the side effects to avoid unexpected symptoms which would otherwise make the patient stop using the drug.
COPD Triggers and Options for Smoking Cessation
Cigarette smoking is the leading cause of COPD, whereas tobacco smoke is also associated with increased increase exacerbation frequency. To help the patient stop smoking, and promote their quality of life it is necessary to consider referral to a smoking cessation counselor (Inciardi et al., 2020). The counselor will be able to evaluate the patients extend of addiction and develop the most effective cessation program to help the patient quit smoking.
Conclusion
The provided case study illustrates a patient with cardiorespiratory problems, which can lead to heart failure. The patient however received adequate care in the ICU, upon admission. It is however necessary to educate the patient on appropriate life modifications such as exercise and a healthy diet to promote well-being and prevent complications associated with these disorders.
References
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing care plans: Guidelines for individualizing client care across the life span. FA Davis.
Inciardi, R. M., Lupi, L., Zaccone, G., Italia, L., Raffo, M., Tomasoni, D., … & Metra, M. (2020). Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA cardiology, 5(7), 819-824. https://doi.org/10.1001/jamacardio.2020.1096.
Mahmud, E., Dauerman, H. L., Welt, F. G., Messenger, J. C., Rao, S. V., Grines, C., … & Henry, T. D. (2020). Management of acute myocardial infarction during the COVID-19 pandemic: a position statement from the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP). Journal of the American College of Cardiology, 76(11), 1375-1384. https://doi.org/10.1016/j.jacc.2020.04.039.
Unlu, O., Levitan, E. B., Reshetnyak, E., Kneifati-Hayek, J., Diaz, I., Archambault, A., … & Goyal, P. (2020). Polypharmacy in older adults hospitalized for heart failure. Circulation: Heart Failure, 13(11), e006977. https://doi.org/10.1161/CIRCHEARTFAILURE.120.006977

Discussion Post
According to your worldview, what value does a human person have?
How does your position affect your stance on controversial bioethical issues, such as abortion, designer babies, and stem cell research?
Reference
https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/2
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Solution
According to your worldview, what value does a human person have?
According to my worldview, a human person has immeasurable value. In the story of creation, humans are given a special role and awarded an elevated position over other creations. In fact, after creating Adam and Eve, God declared that humans shall rule over all other creations. In addition, humans are created in the image of God. This implies that humans have some divine features thus making human life inviolable and sacrosanct. This extends to all life, whether good or evil (White, n.d.). Besides that, all creations were placed at the disposal of humans who were given the freedom and independence to make individual decisions. With this freedom and independence, humans have a responsibility for their actions and would be answerable to God on the day of judgment. In essence, the value of a human person is immutable (Anderson, Clark & Naugle, 2017).
How does your position affect your stance on controversial bioethical issues, such as abortion, designer babies, and stem cell research?
My position that the value of human life is immeasurable has an influence on my stance on controversial bioethical issues. Firstly, other creations can be sacrificed, when necessary, to save human life. That is because humans were created and awarded an elevated position over other creations with dominion over them. Secondly, humans are created in the image of God and have some divine features, thus making human life sacred. This implies that taking a human life is akin to threatening the life of God. Thirdly, humans have the freedom and independence to make individual decisions but are ultimately answerable to God. This means that for every decision made and action is taken, God will demand an account. Given these three points, I would only support the controversial bioethical issues if there is no threat to human life, and whatever sacrifices are made help to preserve human life. For instance, if a pregnancy threatens the life of a mother, then I would consider abortion to save the mother’s life since both the mother and child would be lost if the pregnancy continues to term.
References
Anderson, T. J., Clark, W. M., & Naugle, D. K. (2017). An Introduction to Christian Worldview: Pursuing God’s Perspective in a Pluralistic World. InterVarsity Press (IVP).
White, N. H. (n.d.). God, Humanity, and Human Dignity. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/2

Enhancing Quality and Safety
For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.
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Solution
Medication Errors
One of the most common quality issues pertaining to medication administration in the healthcare setting is medication error. Despite the increasing prevalence of medication errors, it’s preventable through quality improvement interventions. Medication error is any preventable event resulting from inappropriate use of medication, which may or may not results in patient harm while under the care of a health care professional. Medication error results from a failure in one or more of the five rights of medication. The five rights include medication, time, route, right patient, and dosage (Hammoudi et al., 2018). Modern healthcare delivery systems have continued to evolve, and emphasis has been placed on system design complementing the medication administration process. Unfortunately, system design has contributed to medical administration errors through inadequate training of healthcare providers, convoluted processes, distractors, and system misconfiguration.
Despite the invention of various technologies aimed at promoting better healthcare delivery, medication errors remain prevalent in the US (Tsegaye et al., 2020). A significant portion of the medication errors occurs to hospitalized children due to the difficulty of weight-based pediatric dosing, where dosage depends on calculations of weight and height. The variability in weight calculations increases the risk of wrong dosage administration. The most common medication errors are missing doses, wrong dosage, and wrong medication. The most significant causes of these errors include poor health provider and patient communication, lack of health literacy among patients, shortage of healthcare providers, and poorly developed medication safety protocol. To resolve this quality issue, evidence-based interventions should focus on mitigating the cayuses.
The potential evidence-based solution to Medication Errors
Increased studies on medication errors have led to various recommendations with the potential to address medication errors. Medication error is a complex quality issue that requires the collaboration of various healthcare stakeholders for better results. Healthcare leaders, nurses, and patients have a critical role in addressing this quality issue. One of the identified leading causes of medication error is poor health literacy among patients. This can be addressed through a collaboration of patients and nurses. The patient’s role includes being informed and vigilant about the prescribed medication’s purpose, dosage, and side effects. The knowledge will help patients take an active role in their care administration. The role of a nurse, in this case, is educating the patient on correct medication administration. Their role also includes giving clear instructions on medication administration and notifying the patient when the medication rules change (Kim et al., 2018).
Another significant cause of medication errors is the regular distraction of healthcare providers, contributing to errors and omissions in drug administration. Healthcare leaders and nurses can play a critical role in addressing this healthcare deficiency. Healthcare leaders can implement and enforce organizational policies aimed at optimizing workflow. The policies aim at preventing distractions during medication administration by ensuring that nurses are not interrupted to focus on other roles before they finish attending to a particular patient. In institutions where interruptions are unavoidable, strategies should be implemented to ensure that the nurses comply with the safety procedures by introducing monitoring ad surveillance programs.
Healthcare organizations can also use the rapidly advancing technology to mitigate medication errors. Examples of High-tech solutions to mitigate medical administration errors include barcode scanning of medication, patient armbands, and smart infusion bands. Barcode medication administration uses barcodes to link the patient with the right medication. This significantly reduces medical errors as the correct prediction and medication are given to the right patient. The use of barcodes in a study showed that medical errors were reduced by 41% and adverse drug events reduced by 51% (Rudzewicz, 2021). This affirms the effectiveness of barcodes as a solution to medication administration errors. In addition, many hospitals have adopted smart infusion pumps in the United States. About 88% of hospitals currently use smart infusion pumps with dose error reduction software. However, smart infusion pumps interfaces and programming requirements are prone to errors. Inaccurate programming negates the advantages of smart infusion pumps. Therefore, it is essential to use a drug library to ensure accurate programming.
Although technology can help mitigate medication errors, it has been found to play a part in facilitating medication errors. This is through poor knowledge of operating the most advanced technology medical tools and systems (Dyb & Warth, 2019). Besides, the lack of clear guidelines and policies governing medical technology in organizations contributes to medication errors. Healthcare leaders and healthcare providers have a role in mitigating this issue. Healthcare providers have a role to keep updated on the rapidly developing therapeutic products regarding safe administration and side effects. On the other hand, healthcare leaders have a role in implementing policies to govern the integration of new therapeutic products in healthcare settings to promote patient safety.
Therefore, despite medication error being a prevalent issue in many healthcare settings, it’s preventable through evidence-based strategies, such as patent education, provider education, and implementation of drug safety protocols in organizations. However, since this is a complex problem, a collaboration of various healthcare providers is required to implement the proposed evidence-based solutions.
References
Dyb, K., & Warth, L. L. (2019, July). Implementing eHealth Technologies: The Need for Changed Work Practices to Reduce Medication Errors. In ICIMTH (pp. 83-86). https://books.google.co.ke/books?hl=en&lr=&id=1mawDwAAQBAJ&oi=fnd&pg=PA83&dq=addressing+medication+errors&ots=dJ30RwEcPr&sig=F9JV0kl1yaUI9DTxu2W48QTS0JA&redir_esc=y#v=onepage&q=addressing%20medication%20errors&f=false
Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046. https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12546
Kim, P. C., Shen, J. J., Angosta, A. D., Frakes, K., & Li, C. (2018). Errors associated with the rights of medication administration at hospital settings. Journal of Hospital and Healthcare Administration. https://pdfs.semanticscholar.org/4fa4/ae1574b8c12944f96be772c3b55b59f18b4d.pdf
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2021). Medical error reduction and prevention. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, 13, 1621. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764714/

Addressing Ethical Issues
Helping professionals often face difficult decisions in their work that may have ethical ramifications. Ethical dilemmas span all areas of your professional practice from confidentiality and privacy to cultural considerations. For this Assignment, you concentrate on cultural considerations that may pose challenges to ethical practice. (Culture is broadly defined here as the behaviors, traditions, and/or beliefs of any subgroup.) Select one of the two case studies below to use for this assignment. After analyzing the case study, consider how you might address the issues present using your professional practice code of ethics.
Review the case studies below before the write-up
Case Study #1
Nitin and Priya are first-generation Indian-American immigrants, while their 16-year-old son was born and raised in the United States. They were reluctant to engage in treatment, but are doing so at the request of their son, Sujay. In Sujay’s view, his parents are being overly controlling regarding his upcoming choice of college, which is causing increasingly frequent clashes between him and his parents. Sujay wants to attend art school, while his parents want him to attend engineering school. They state that a career in science, religion, law, or medicine is the appropriate path for a person of his caste. Sujay claims that while he wants to please his parents, he feels they are stifling his passion and imposing cultural norms that, to him, are a part of their “world” and not his. You have little knowledge of Indian culture or the caste system and are unsure whether the issue at hand is a matter of controlling parents dealing with a life transition issue or a serious conflict involving social and cultural influences.
Case Study #2
Nicole and Julia explain to you that their relationship has felt strained lately and that they fear they are heading for a breakup. The couple explain to you that they have been in a long-term, non-monogamous relationship, but that lately, Nicole has expressed desire to change this practice. Julia feels that Nicole is “changing the rules halfway through the game” and that her sexual relationships with others are of no consequence to how she feels about Nicole. Their current relationship practice conflicts with your own personal opinion about the role of monogamy in relationships, and thus you feel conflicted about how to handle the situation.
• Identify the case study you chose and describe the ethical issue(s) present in it.
• Explain how you would address each of these issues.
• Justify your response using the appropriate professional Code of Ethics.
Support your Assignment with specific references to all resources used in its preparation. You are asked to provide a reference list for all resources.

Students will:
Analyze psychological issues that may arise in children faced with special circumstances
Evaluate assessment measures used with children faced with special circumstances
Evaluate treatment options used with children faced with special circumstances
Analyze cultural influences on treatments (D)
To Prepare for the Discussion:
Review the Learning Resources.
Select one of the following topics for the Discussion:
Adoption
Foster care
Gender dysphoria
Forensic issues
Impact of terrorism on children
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post:
Write your selected disorder in the subject line of your Discussion post.
Explain the psychological issues that may result from your topic.
Describe the most effective assessment measure that could be used, and explain why you selected this.
Explain the treatment options available for children and adolescents involved with your selected disorder.
Explain how culture may influence treatment.
By Day 6
Respond to at least two of your colleagues who selected a topic other than the topic you selected. Provide at least two additional treatment strategies that could be used with this client and at least one additional cultural influence that you think should be considered. Explain your responses.

NURS 5051 Module04 Week08 Assignment Rubric
Week 5 Assignment:Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
To Prepare:
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies
The Assignment: (4-5 pages not including the title and reference page)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
Use the Safe Assign Drafts to check your match percentage before submitting your work.
By Day 7 of Week 8
Submit your completed Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK8Assgn+last name+first initial
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
· Properly identify 4 peer-reviewed research articles you reviewed.
· Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Points Range: 77 (77%) – 85 (85%)
The responses accurately and clearly identify 4 peer-reviewed research articles for the Assignment.
The responses accurately and thoroughly summarize in detail each study reviewed, explaining in detail the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described.
Specific, accurate, and detailed examples are provided which fully support the responses.
Feedback:
Points Range: 68 (68%) – 76 (76%)
The responses identify 4 peer-reviewed research articles for the Assignment.
The responses summarize each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described.
Accurate examples are provided which support the responses provided.
Feedback:
Points Range: 60 (60%) – 67 (67%)
The responses vaguely or inaccurately identify 4 or less peer-reviewed articles for the Assignment.
The responses summarize each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described that is vague or inaccurate.
Examples provided to support the responses are vague or inaccurate.
Feedback:
Points Range: 0 – 59
The responses vaguely and inaccurately identify less than 4 peer-reviewed articles for the Assignment, or are missing.
The responses vaguely and inaccurately summarize each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described, or are missing.
Examples provided to support the responses are vague and inaccurate, or are missing.
Feedback:
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.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Feedback:
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Feedback:
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
Feedback:
Points Range: 0 – 3 (3%)
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Feedback: Points Range: 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. Feedback: Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors. Feedback: Points Range: 0 – 3 (3%) Contains many (? 5) APA format errors. Feedback: Total Points: 100 Name: NURS_5051_Module04_Week08_Assignment_Rubric PLACE ORDER NOW SOLUTION The Use of Clinical Systems to Improve Outcomes and Efficiencies: A Review of Literature Healthcare informatics ushered in a new era of artificial intelligence and novel technology, making healthcare delivery much easier, better, and sophisticated. The breakthrough report To Err Is Human, published and issued by the Institute of Medicine (IOM) in 1999, was essential in driving this shift away from traditional manpower-based methods to healthcare service delivery (Palatnik, 2016). According to this estimate, around 98,000 individuals died each year in the United States as a result of preventable medical errors at the time. The goal of this research is to look at four cases that show how clinical systems can help improve outcomes and efficiency. Background As a result, one of the IOM report’s multiple suggestions was that technology be used to reduce the incidence of human mistake. This indicates that it was recognized that technology will play a key role in facilitating the efficacy of healthcare interventions and increasing patient outcomes. Following the publication of that report, many healthcare organizations began to recognize the value of having electronic patient records and medical information. Legislation has also begun to target healthcare organizations’ implementation of health information systems (HIS). Healthcare providers and institutions purchased and installed electronic health records (EHR) systems from available vendors to demonstrate acceptance and compliance (McGonigle & Mastrian, 2017). Four Current Scholarly Studies The four studies that were obtained from databases published in the recent five years are listed below. They are peer-reviewed research articles that highlight the significance of clinical systems in improving patient outcomes and facilitating the efficiency of healthcare practitioners and the interventions they deploy. It’s worth mentioning that all of the clinical systems investigated in these studies are technologically based. They are: Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631 Fedele, D.A., Cushing, C.C., Fritz, A., Amaro, C.M., & Ortega, A. (2017). Mobile health interventions for improving health outcomes in youth. JAMA Pediatrics, 171(5), 461. https://doi.org/10.1001/jamapediatrics.2017.0042 Islam, M.M., Poly, T.N., & Li, Y.-C. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of Medical Informatics, 27(01), 083–090.https://doi.org/10.1055/s-0038-1667075 Rao-Gupta, S., Kruger, D., Leak, L.D., Tieman, L.A., & Manworren, R.C.B. (2018). Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing, 19(3), 212–221. https://doi.org/10.1016/j.pmn.2017.11.002 Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631 The goal of Alotaibi and Federico (2017)’s research was to find evidence that clinical systems based on technology are important in improving outcomes and facilitating efficacy. They discovered overwhelming evidence in support of at least 14 clinical systems that are often utilized by various providers to improve performance and the quality of care they offer to patients. Their strong counsel, on the other hand, is that the provider must carefully consider which clinical system to employ and from which vendor to obtain it. This is because their research demonstrated that not all vendors’ ostensibly new clinical systems are evidence-based. Patient data management systems (PDMS), computerized provider order entry (CPOE) systems, electronic medication administration record (eMAR), electronic medical record (EMR), patient care portals, bar code medication administration (BCMA), and clinical decision support (CDS) systems are some of the clinical systems for which they found evidence of a role in improving outcomes and increasing efficacy (Alotaibi & Federico, 2017). Proper patient information management (by PDMS), effective and error-free drug prescription and medication administration (by COPE and BCMA), and other improvements to outcomes and efficiency were demonstrated in this study. The most essential lesson learned is that, when properly handled, technology can be a huge help in providing high-quality patient care. Fedele, D.A., Cushing, C.C., Fritz, A., Amaro, C.M., & Ortega, A. (2017). Mobile health interventions for improving health outcomes in youth. JAMA Pediatrics, 171(5), 461. https://doi.org/10.1001/jamapediatrics.2017.0042 Fedele et al. (2017) is the other study to look at. Its goal was to determine the efficacy of clinical systems based on mobile phone technology for delivering interventions such as health education and prevention. This was a robust meta-analysis that found that mobile phone-based clinical systems have a vital role in improving outcomes and enhancing service delivery efficiency (Fedele et al., 2017). The noticeable changes in the habits of the young (behavioral and lifestyle modification) as a result of the mobile phone interventions used demonstrated an improvement in outcomes and efficiency. The most essential takeaway is that, as smartphones become virtually an unavoidable need in today’s world, their reach can be leveraged to have clinical systems that are effective, efficient, patient-centered, timely, equitable, and safe. Islam, M.M., Poly, T.N., & Li, Y.-C. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of Medical Informatics, 27(01), 083–090. https://doi.org/10.1055/s-0038-1667075 Islam et al. (2018) is the third one to look at. Its goal was to determine the importance of clinical information systems (CIS) in promoting better patient outcomes and healthcare worker efficiency. The outcomes were unmistakable. Clinical information systems have been demonstrated to be effective in decreasing clinical and medication errors that would otherwise be made by healthcare personnel such as doctors and nurses (Islam et al., 2017). The reduction in occurrences of medical errors, which was the focus of the IOM report stated in the introduction – To Err Is Human – demonstrated the improvement in results and efficiency. The takeaway is that technology, in the form of novel healthcare systems, can help to reduce avoidable mortality. Rao-Gupta, S., Kruger, D., Leak, L.D., Tieman, L.A., & Manworren, R.C.B. (2018). Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing, 19(3), 212–221. https://doi.org/10.1016/j.pmn.2017.11.002 Rao-Gupta et al. (2018) conducted the fourth and final study on interactive patient care clinical systems. Rao-Gupta et al. (2018) claim that interactive patient care clinical systems are beneficial in increasing treatment outcomes. They were able to demonstrate that this method might greatly enhance medication order administration. Better outcomes and efficiency were demonstrated as a result of the automation and integration of the medication systems (Rao-Gupta et al., 2018). As in the other research papers listed above, well-designed clinical systems promote health satisfaction and clinician efficacy. Conclusion In the delivery of medicine, clinical information systems are becoming increasingly vital. This is because they are becoming increasingly important in creating efficiency and providing high-quality treatment. As a result, modern healthcare technology is and will continue to be an important aspect of healthcare delivery. Well-designed clinical systems have been shown to improve patient outcomes and practitioner performance in peer-reviewed research. References Agency for Healthcare Research and Quality [AHRQ] (2018). Six domains of health care quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631 Fedele, D.A., Cushing, C.C., Fritz, A., Amaro, C.M., & Ortega, A. (2017). Mobile health interventions for improving health outcomes in youth. JAMA Pediatrics, 171(5), 461. https://doi.org/10.1001/jamapediatrics.2017.0042 Islam, M.M., Poly, T.N., & Li, Y.-C. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of Medical Informatics, 27(01), 083–090. https://doi.org/10.1055/s-0038-1667075 McGonigle, D., & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge, 4th ed. Jones & Bartlett Learning. Palatnik, A. (2016). To err is human. Nursing Critical Care, 11(5), 4. https://doi.org/10.1097/01.CCN.0000490961.44977.8d Rao-Gupta, S., Kruger, D., Leak, L.D., Tieman, L.A., & Manworren, R.C.B. (2018). Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing, 19(3), 212–221. https://doi.org/10.1016/j.pmn.2017.11.002 Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. https://doi.org/10.1016/j.techfore.2015.12.019

The IOM published report, “Future of Nursing: Leading Change, Advancing Health,” makes recommendations for lifelong learning and achieving higher levels of education.
In 1,000-1,250 words, examine the importance of nursing education and discuss your overall educational goals.
Include the following:
Discuss your options in the job market based on your educational level. (I have a BSN)
Review the IOM Future of Nursing Recommendations for achieving higher levels of education. Describe what professional certification and advanced degrees (MSN, DNP, etc.) you want to pursue and explain your reasons for wanting to attain the education. Discuss your timeline for accomplishing these goals. (MSN-Acute Care Practitioner & Educator 4years. want more bedside experience and want to take a break from school.)
Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.
Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics.
Discuss whether continuing nursing education should be mandatory. Provide support for your response.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Assignment-PUB 655- TOPIC 5- Participatory Learning and Action Tools
VERY IMPORTANT-Details
1. -Please select and practice one of the participatory learning and action tools from the question. You can select either- Appreciative inquiry interview OR Holistic worldview analysis. I want to leave that to the writer’s choice.
2. I work as a Public Health Nurse in case you want to use the job- for the group identified in the question.
-Please read the question page in details.
-Details of the question and the rubric are also uploaded
-Please read the Rubric before you start
-Please include the Introduction, Thesis statement, and conclusion in the paper.
– Include section headings for each section component where needed
– Sources must be published within the last 5 years. It must be from 2017 and after
– Sources must be appropriate for the assignment criteria and public health content.
– Please do not use blogs as references
-References should be in APA 7th ed.
-Add references to reference page
-Add the hyperlink for each reference in APA 7th edition format.
Thank you
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Solution
Participatory Learning and Action Tool
PLA is an action approach used in research to draw essential ideas and perspectives of stakeholders’ involvement. The action tool encourages stakeholders’ engagement towards achieving the stipulated objectives. Therefore, it is a practical research technique with different stakeholders having world view perspectives and may involve the existence of power and require balancing (de Brún et al., 2017). Its main principle validates the reversal of the stakeholders’ involvement to research as beneficiaries to direct collaborators and partners. This study reviews the Appreciative Inquiry Interview PLA tool, participants involved, cultural insights learnt from the chosen participants, challenges encountered in facilitating the tool, participants’ response, and effects of the community engagement approach in the health policies.
Appreciative Inquiry Interview
An appreciative inquiry interview is a systematic approach for organizational and social engagement. It comprises questions and dialogue systems that enable participants to recognize their strengths, advantages, and opportunities within their communities. It is an asset or strength-based technique that focuses on positive idea generation over negative problem identification. Hence, helping communities based in public health activities to create social change by recognizing their existing strengths and opportunities and working towards improvement. The questions and dialogue application in this tool enables individuals to collectively work towards bettering their lives with the available resources in their communities.
I decided to select this tool because it focuses on creating positive social change over the problem-identification approach. As a public health nurse, this tool is essential in my career to enhance quality health outcomes among the participants that I work with because, through the tool, they can narrate specific challenges that arise from the health issues affecting them. The tool identifies a collective goal among the participants through four stages to enhance the positive change. It uses four core cycle stages to improve its effectiveness in creating positive change among participants. The stages are as follows, discovery, which involves crafting questions, conducting concrete interviews focusing on the goal of the topic, sharing best practices during the interview to insight participants’ engagement and responding effectively.
The dream stage allows the participants to reflect on their visions their experiences, think of ways to put the dreams into reality and improve themselves (Sandars & Murdoch-Eaton, 2017). The design stage enables selecting appropriate and relevant design elements to help create positive change and realize the available opportunities and strengths within the community settings. The destiny stage enables individuals to review their accomplishments and uphold their achievements (Sandars & Murdoch-Eaton, 2017). This also allows them to work collectively to improve those weak barriers that could still impact the sustainability of the positive change.
Participants
This study focuses on developing a weight program for obese adolescents. Obesity remains a major health issue among the young and adults, with young people suffering from severe health complications, especially in low-income countries. Obese is more prevalent among young people, especially children, because it begins from childhood. In countries like New Zealand, adolescents are the most affected group in obesity (Teevale & Kaholokula, 2018). The application of the appreciative inquiry interview tool is essential in the successful implementation of public health strategies that can help manage the issue of obesity, especially among young people. I learnt that most young people suffering from obesity are influenced by eating behaviors and physical activities. Most of these young people coming from poor households cannot access the health services needed for their condition hence increasing the obesity rates and other health complications such as heart attack and stroke among them.
Challenges in Facilitating the Tool
The appreciative inquiry tool can be tiring for the participants due to its wide range of information. Therefore, some participants can easily ignore the critical information by skipping some processes to get to the final stage of the approach. Therefore, this affects the validity of the tool in conducting the study.
The tool can also make the participants feel like their problems are not being considered. This is because the tool focuses on improving the communities through strengthening them and not necessarily a problem-solving approach. Therefore, it aims at creating positive social change. Due to its systematic structure of alternative approach, it is so hard for participants to realize that the tool touches on the problems through the factors influencing the development of these problems. For instance, in this case, the focus was on finding healthier alternatives to develop weight programs. The validation of the interview questions focused on both the obese and non-obese families, comparing their eating and physical behaviors to find effective strategies that can be implemented to solve this health condition.
Effectiveness of AI Tool on the Participants
The participants gave diverse ideas both from healthy and obese households. Those households with healthy members had strict adherence to nutrition schedules for their families compared to the others. Their ideas were essential in validating effective strategies for implementing nutritional interventions on weight programs to help educate obese young people and change their eating and physical behaviors to improve their health and wellbeing.
The main diversity between the two groups is the socio-economic status. Those families earning low incomes could not afford some nutritious foods thus were forced to live on the available foods they had to sustain for the day. Those households with healthy family members volunteered to create positive change by ensuring all the children’s health and wellbeing were under control. This was going to be possible through volunteering to provide free training for physical exercise and contribute to the provision of healthy meals, constituting fruits and low sugar calories in various schools these children attended.
Health in all Policies
Health in all policies mandates quality care through a critical investigation of social determinants of health such as healthy foods, sustainable environment, effective health costs and services (Walsh et al., 2018). An appreciative inquiry tool can assess the social determinants of health, such as costs in health to manage the mortality rates, especially in chronic illnesses. For instance, different hospitals can be interviewed on their cost-effectiveness and the health services they provide to determine an affordable cost to ensure the community members can access health services on chronic illnesses and mental disorders.
Effectiveness in Reducing Health Disparities
The appreciative inquiry interview tool is essential in managing public health in various ways. The four-cycle stages are the guidelines in facilitating fundamental actions to provide positive change and outcomes. By identifying strengths and bringing community members together, the tool encourages active participation in the long run. The community members can collectively voluntarily bring together the available resources, both human and labor. In responding to the interview questions, they get motivated, especially in identifying their dreams, goals, objectives, and aim to reach the destiny stage and live the life they have all been admiring. The appreciative inquiry process enables people to find alternatives for their problems and work on them. For example, the tool can help the community reduce the prevalence of infectious diseases using the available resources, knowledge and skills. The tool helps change negative perspectives to positive, reflect on past experiences and find alternatives to progress positively, thus an alternative approach (Armstrong et al., 2020).
References
Armstrong, A. J., Holmes, C. M., & Henning, D. (2020). A changing world, again. How Appreciative Inquiry can guide our growth. Social Sciences & Humanities Open, 2(1), 100038. https://www.sciencedirect.com/science/article/pii/S2590291120300279
de Brún, T., O’Reilly-de Brún, M., Weel-Baumgarten, V., Burns, N., Dowrick, C., Lionis, C., … & MacFarlane, A. (2017). Using Participatory Learning & Action (PLA) research techniques for inter-stakeholder dialogue in primary healthcare: an analysis of stakeholders’ experiences. Research involvement and engagement, 3(1), 1-25. https://researchinvolvement.biomedcentral.com/articles/10.1186/s40900-017-0077-8
Sandars, J., & Murdoch-Eaton, D. (2017). Appreciative inquiry in medical education. Medical Teacher, 39(2), 123-127. https://eprints.whiterose.ac.uk/109397/3/Appreciative%20Inquiry_ARTICLE_280216%20%281%29.pdf
Teevale, T., & Kaholokula, J. K. (2018). Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand. Australian and New Zealand Journal of public health, 42(1), 7-11. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1753-6405.12719
Walsh, M., John, D., Peritore, N., Morris, A., Bird, C., Ceraso, M., … & Riportella, R. (2018). Health in all policies: Working across sectors in Cooperative Extension to promote health for all. Journal of Human Sciences and Extension, 6(2). https://www.jhseonline.com/article/view/718

identifying a problem you have or are currently experiencing in the workplace or your personal life.
identify a problem you have or are currently experiencing in the workplace or your personal life.
Provide a comprehensive introduction to the situation, including the background and scope of the problem, all individuals involved in the situation, any solutions that were attempted, as well as the outcome of those solutions. Make sure you have clearly identified who owns the problem and why. (Remember that you cannot always control the actions of others, so it should be a problem you own and thus have control over the alternatives for action.)
Then apply a formal problem-solving or decision-making model and apply each step of the model to reach a decision about the best way to address the problem. Make sure you identify whether a maximizing or satisfying solution was needed and why. Also make sure you have specific evaluation criteria that include both process (how you will measure the quality of your decision making itself) and outcome measures (actual outcomes).
Authenticity is important in this paper. Be realistic in your problem solving in terms of the time, energy, and power you must implement the chosen alternative. In addition, it is important to demonstrate self-awareness in your analysis by discussing what personal values or beliefs might have influenced your choices.
double-spaced, in length, not counting title page and references. APA format required (title page, citations in body of paper, and reference list). An introduction and conclusion are required. The steps of the problem-solving or decision-making model chosen are recommended as additional subheadings for the paper.
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Solution
Workplace experience
There is an increased requirement to advance in expertise and skills in the fast-growing healthcare world. With this advancement and growth, there is an increase in issues and problems that require prompt problem-solving skills by nurses and healthcare providers (Annizar et al., 2020). Covid-19 is one of the current issues affecting the healthcare sector globally. The pandemic has swept over the continent rapidly, giving little time for research on testing, its incidence and prevalence, vaccine, and prevention. This has demanded prompt action and problem-solving skills from healthcare workers to prevent its spread and reduce the deaths resulting from it. As a student nurse in a Covid-19 testing and vaccination area, I have had scenarios that require problem-solving. Problem-solving involves the process of finding solutions to complex or challenging issues. Moreover, problem-solving requires professionals and individuals to break down an experience and reflect on their experiences while they are taking place to apply them in the future (Annizar et al., 2020). Thus, this article describes a problem I experienced as a student nurse, how I applied the IDEAL problem-solving model to handle this issue.
Description
I was working in the Covid testing and vaccination area while rushing to fasten the waiting line for people waiting to be tested. That day, other days, the testing area was more packed compared to the vaccination area. Nurses and medical staff were held up testing people to ensure prompt and accurate results. We were all wearing our protective equipment to avoid contacting Covid-19. As is the procedure, all individuals that turned covid-19 negative were advised to take the vaccine to help protect themselves against the disease. The hospital staff was also coming for testing and others to get vaccinated. While attending to hospital staff and individuals on this particular day, a nurse tested negative and refused to take the vaccine, claiming the vaccine research was done too quickly. She feared it would affect her fertility in the long run. This didn’t come as a shock to the medical staff and me in the department, as we had heard this controversy from other medical staff for a while.
Moreover, other medical staff had even went to the extent of claiming they had developed antibodies from working in the front lines of this pandemic and from already contacting the virus thus did not need the vaccine. As a student nurse, I thought it wise to find a solution to this controversy and encourage more staff to get the vaccine to avoid risking their health and well-being. Before I was assigned to assist in the testing and vaccination area in the healthcare facility, I had very little knowledge about COVID-19 and had many misconceptions about the vaccine. However, the head nurse educated me on the testing process, the vaccine, its development process, safety, and research to ensure its safety. Moreover, I researched more on the pandemic and vaccine, which enlightened me on the importance of getting vaccinated, especially frontline nurses and medical staff.
This pattern of nurses refusing vaccines due to various misconceptions was clearly a sign of misinformation. Misinformation contributes significantly to vaccine controversies and refusal among nurses, mainly because they are not educated on the facts and intricacies of vaccine research (Alotiby & Al-Harbi, 2021). This scenario prompted me to speak to my preceptor, the head nurse, to develop a solution that would help stop this misinformation and vaccine controversy from spreading more. After all, how can patients accept vaccines if the frontline staff themselves are not keen on being vaccinated? With a go-ahead from him, I employed the IDEAL problem-solving model to develop the best solution for this scenario. The IDEAL problem-solving model helps individuals and organizations determine the cause of a problem up to implementing an effective solution (Annizar et al., 2020). IDEAL stands for; Identifying the problem, Defining the outcome, Exploring possible strategies, Acting on ideas, and Looking for effects (Annizar et al., 2020).
Identifying the problem
After the WHO declared COVID-19 a global pandemic in March 2020, misinformation regarding its cures, causes and treatments appeared in numerous media outlets. This misinformation has since continued growing despite WHO creating web pages on Covid-19 misconceptions to curb the spread. As mentioned above, nurses and medical staff are also not immune to misinformation (Alotiby & Al-Harbi, 2021). Moreover, 27% of U.S health workers and medical staff have not been vaccinated against this disease as of July 2021. The attitudes of health workers towards the vaccine as portrayed in the scenario above mirror the rest of the country as individuals can become more vaccine-resistant. Therefore, I decided to analyze the possible measures to curb and prevent this problem of misinformation and ultimately found the most promising and effective one.
Defining an outcome
Problem-solving enables an individual to develop the best strategies to ultimately receive the best goal or objective (Annizar et al., 2020). As stated in the scenario described above, the number of individuals willing to receive the COVID-19 vaccine was much lower than those being tested. Patients and healthcare staff are skeptical about taking the vaccine due to fear and misinformation on its effects (Alotiby & Al-Harbi, 2021). Therefore, through employing the best strategy to reduce and curb this misinformation, I aimed to create awareness on the importance of the vaccine and ensure I relay correct research information about the vaccine to medical staff and patients. This would be a challenging task for me as I had to strategize on how to communicate with the crowds and nurses who had a positive attitude towards the vaccine from the beginning. It is difficult to change an individual’s beliefs about a situation or opinion. Being a student nurse planning to speak to frontline nurses and medical staff added to my anxiety as I feared rejection being inferior to them in terms of expertise and knowledge. However, I was determined to spread awareness on the importance of the vaccine and achieve my goal regardless. This would also enhance my problem-solving skills in future scenarios.
Exploring possible strategies
The possible strategies I brainstormed and decided to explore more on after pinpointing my objective and outcome for this task were encouraging nurses to scrutinize their news sources and educating them on vaccine importance and the accurate information regarding it. Scrutinizing news resources entails consuming information from social media critically. Approximately two-thirds of Americans consume news on social media, meaning that at some point, they scroll through news stories too. Therefore, encouraging nurses and medical staff to critically analyze and search for key indicators of whether the news is accurate and timely would help stop the consumption of fake and inaccurate news, which is the key source of misinformation (Chaghari et al., 2019). The second strategy entails creating an education and training program to teach nurses more on covid-19 vaccines and their effects on human health and immunity. Education and training of nurses greatly help in creating more awareness for them and ultimately their patients, families, and the community. If nurses are aware of the details of a condition, disease, or situation, they are more likely to train the public on its importance and effects, thus promoting better health and patient outcomes (Chaghari et al., 2019).
Acting on Ideas
After thoroughly exploring my strategy options and my key objective for this task, I decided to implement the education and training program in Covid-19 vaccine for nurses. I chose this strategy because I could also include the scrutinizing of news sources into the program rather than adopt it as a single strategy. Moreover, with the demand for medical attention by patients in hospitals, nurses rarely have time to listen and scroll through social media due to long working hours. A training and education program, however, can be planned to suit their schedules. This program would include role modeling and promotion of self-learning. Role modeling entails leading by example and indirectly letting the learner follow your action (Chaghari et al., 2019). For instance, if the nurse leader and I took the vaccine in front of the other nurses and allowed them to see how it affects our daily activities, it would encourage them to take it after they observe little to no effects on health and disregard the misinformation. Promoting self-learning includes emphasizing the program’s goals and objectives to the medical staff and letting them follow their principles to assess whether the vaccine is essential both to them and their patients (Chaghari et al., 2019).
Learning and looking for effects
After implementing the education program, more nurses began taking the vaccine, with some of them attributing it to self-assessment and our emphasis on the importance of the vaccine. The program will continue being taught by other student nurses and head nurses in hospitals to ensure more nurses take vaccination more seriously as it protects their health and the general population. Moreover, the nurses started encouraging patients and individuals to be vaccinated and educating them on research and its safety. I was elated to observe a slight increase in individuals taking the vaccine after the program began.
Conclusion
Healthcare organizations face numerous problems daily, and having measures and objectives to solve these issues is crucial to ensuring they improve health and patient outcomes. This scenario helped me develop better problem-solving skills while thoroughly reflecting on my strengths, values, and weaknesses in dealing with such situations. I am now confident in dealing with future scenarios that require my prompt problem-solving skills. Moreover, I am confident I can train and educate even my superiors in some issues as knowledge is continuous, and sharing it promotes better health and patient outcomes. In addition, this scenario helped me realize that healthcare institutions should set up training and education programs to deal with sharing research information on medical conditions and pandemics such as COVID-19. Inadequate research and education lead to misinformation on crucial things such as medicine, vaccines, and treatment options in healthcare facilities. Finally, discussing this scenario has enhanced my confidence in handling similar incidences in my future practice in the healthcare sector.
References
Alotiby, A. A., & Al-Harbi, L. N. (2021). Attitudes towards COVID-19-Related Medical Misinformation among Healthcare Workers and Non-Healthcare Workers in Saudi Arabia during the Pandemic: An Online Cross-Sectional Survey. International Journal of Environmental Research and Public Health, 18(11), 6123. https://dx.doi.org/10.3390%2Fijerph18116123
Annizar, A. M., Jakaria, M. H. D., Mukhlis, M., & Apriyono, F. (2020, February). Problem solving analysis of rational inequality based on IDEAL model. In Journal of Physics: Conference Series (Vol. 1465, No. 1, p. 012033). IOP Publishing. http://dx.doi.org/10.1088/1742-6596/1465/1/012033
Chaghari, M., Saffari, M., Ebadi, A., & Ameryoun, A. (2017). Empowering education: A new model for in-service training of nursing staff. Journal of advances in medical education & professionalism, 5(1), 26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5238493/