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Evidenced-based data gathered from international national state

This week we will be using evidenced-based data, gathered from international, national, state and local government and agency websites to assess the health of a community (defined as a county in our course).

evidenced-based data gathered from international national state

This week we will be using evidenced-based data, gathered from international, national, state and local government and agency websites to assess the health of a community (defined as a county in our course).

Objective: Integrate assessment data from national, state and local sources into community planning.

In order to meet this objective you must:

Firstly, Read Chapters 10, 12, and 20 in your text.

Secondly, Review County Health Statistics – population characteristics. and indicators of health.

Thirdly, Go to this website and work through the (Module 1) determinants of health section: http://www.aptrweb.org/pophealthmodules

Fourthly, Using these and other websites please answer the Application Exercise questions below and post to ASULearn.

Further, Youth Risk Behavior Survey http://www.cdc.gov/HealthyYouth/yrbs/index.htm

Moreover, Healthy People 2030 www.healthypeople.gov

Further, Healthy Carolinians www.healthycarolinians.org

Also, NC Center for Health Statistics https://schs.dph.ncdhhs.gov/

Additionally, County Health Rankings http://www.countyhealthrankings.org/#app/north-carolina/2012

NC Oral Health https://www2.ncdhhs.gov/dph/oralhealth/stats/MeasuringOralHealth.htm

 

Substance Abuse Statistics

 

Some of you may find numbers for your county (like Mecklenburg) but in rural counties statistics may not be available. You can report this answer using NC data if that is the most specific information you can find. If anyone stumbles across any additional helpful links please share them!

http://www.rwjf.org/en/library/articles-and-news/2013/09/interactive–prescription-drug-abuse.html

Additional Dental Health Links- if you can’t find county specific information you can report NC data for this question too.

https://www2.ncdhhs.gov/dph/oralhealth/stats/

https://www2.ncdhhs.gov/dph/oralhealth/

http://www.ncfahp.org/nc-oral-health-collaborative.aspx

Application Exercise:

Please find data from local, state and national websites/databases and /or interview local health care professionals to answer the following questions about your county.

1. Demographic data (age, race, gender, education levels, employment/unemployment rates and household income) about the people in your county.

2 The 3 leading causes of death in your county.

3 The 3 leading causes of admissions to the local EDs (You may have to call the hospital to obtain this information).

4 The teen pregnancy rate in your county. (Please note this is reported as a rate not a percentage)

5 The childhood immunization rates for your state or county.

6 Percentage of people in your county using mental health services.

7 Percentage of people in your county with substance abuse problems.

8 The percentages by age of people in your county who are obese.

9 Data about the dental health of people in your county. (you may need to be creative in how you measure)

10 What programs are currently offered in your county health department?

Angela is a 54-year-old married woman with three adult children

Angela is a 54-year-old married woman with three adult children. She has been the office manager of a small law firm for 20 years and has enjoyed her work until this past year. She has rheumatoid arthritis with minimal impairment

Angela is a 54-year-old married woman with three adult children

Guidelines: Support your responses with scholarly academic references using APA style format.

In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response;

is factually correct with relevant scholarly citations, references, and examples;

demonstrates a clear connection to the readings

In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.

Case:
Angela is a 54-year-old married woman with three adult children. She has been the office manager of a small law firm for 20 years and has enjoyed her work until this past year. She has rheumatoid arthritis with minimal impairment that has been managed well with NSAIDs. Has been taking conjugate estrogens for 8 years and decide to stop taking them because of her concern of their risks without sufficient medical benefit. Also, she has tolerated the discontinuation without difficulty.

Assessment:

At her annual medical checkup appointment, she told her primary care provider that she seem to be tire all the time. Also, she was gaining weight because she had no interest in her usual exercise activities and had been overeating, not from appetite but out of boredom. She denies that she and her husband have had marital difficulties beyond the ordinary and she was please with the achievements of her children.

She noticed that she has difficulty falling asleep at night and awakens around 4 a.m. most mornings without her alarm. Cannot go back to sleep even though she still feels tired. Finds little joy in her life but cannot pinpoint any particular concern.

Although she denies suicidal feelings, she does not feel that there is meaning to her life:

“My husband and kids would go on fine if I died and probably wouldn’t miss me that much.”

The primary care provider asks Angela to fill out a Beck’s Depression Scale, which indicated she has moderate depression.

1. What medication would you first prescribe to this patient?

2. She comes back in 2 weeks and states she has not noticed and change in her mood since starting on the medication. Moreover, what would be your response?

3. Further, what are the possible problems with the medication you prescribe?

4. Finally, how long should you continue the treatment regimen?

SOAP NOTE on a patient with Hypothyroidism

This is an assignment that focuses on creation of SOAP NOTE on a patient with Hypothyroidism. The paper will also focus on the social history and also medical history.

Creation of SOAP NOTE on a patient with Hypothyroidism

Topic
Firstly, create a 2 page SOAP NOTE on a patient who has Hypothyroidism. You would will also need to create ALL of the INFORMATION that goes in the SOAP Note that would be associated with a person who has Hypothyroidism. Please write your plan as Nurse Practitioner who works in primary care. I have uploaded an EXAMPLE of the Typhon Documentation that out instructor requires for us to upload every week for clinicals, so it can assist you with writing this SOAP Note.
INSTRUCTIONS:

Subjective (S):
CC: chief complaint – What are they being seen for? This is the reason that the patient sought care, stated in their own words/words of their caregiver, or paraphrased.
HPI: history of present illness – use the “OLDCART” approach for collecting data and documenting findings.  [O=onset, L=location, D=duration, C=characteristics, A=associated/aggravating factors, R=relieving factors, T=treatment, S=summary]
The HPI would flow better if you use oldcart information in paragraph form using complete sentences

PMH: past medical history – This should also include past illness/diagnosis, conditions, traumas, hospitalizations, and surgical history. Include dates if possible.
Allergies: State the offending medication/food and the reactions.
Medications: Names, dosages, and routes of administration.

Creation of SOAP NOTE on a patient with Hypothyroidism

Social history: Related to the problem, educational level/literacy, smoking, alcohol, drugs, HIV risk, sexually active, caffeine, work and other stressors. Cultural and spiritual beliefs that impact health and illness. Financial resources.
Family history: Additionally, use terms like maternal, paternal and the diseases and the ages they were deceased or diagnosed if known.
Health Maintenance/Promotion – Required for all SOAP notes: Immunizations, exercise, diet, etc. However, remember to use the United States Clinical Preventative Services Task Force (USPSTF) guidelines for age appropriate indicators. This should reflect what the patient is presently doing regarding the guidelines.

ROS: review of systems – [Refer to your course modules and also the Bickley Etext (Bates Guide) as a guide when conducting your ROS to make sure you have not missed any important symptoms, particularly in areas that you have not already thoroughly explored while discussing the history of present illness.]
Additionally, ROS would be easier to read if you don’t run all systems together. Start each system on a new line.

You would also want to include any pertinent negatives or positives that would help with your differential diagnosis. For acute episodic (focused) visits (i.e. sprained ankle, sore throat, etc.) you may be omitting certain areas such as GYN, Rectal, GI/Abd, etc.
General: May include if patient has had a fever, chills, fatigue, malaise, etc.

Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital

You are the Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital in a major city. As a result of a restructuring of the hospital networks in the local Area Health Service you have been asked to combine the 32 general surgical ward with a new 12 bed, short stay surgical ward which has been built adjacent to your ward.

Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital

You are the Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital in a major city. As a result of a restructuring of the hospital networks in the local Area Health Service you have been asked to combine the 32 general surgical ward with a new 12 bed, short stay surgical ward which has been built adjacent to your ward.

Please answer the questions that follow in relation to this case analysis.

Firstly,  Develop a business plan (approx. 1000 words)

Secondly,  Identify the steps required in developing a nursing service business plan and explain why they are important.

Thirdly, Name the documents and data would you need to collect and analyse to develop a service profile.

Fourthly, Examine the service demand for the new service level.

Further, Explain the type of workload methodology that might be useful for determining the supply of nurses to staff the new service level.

Briefly discuss any skill-mix or staff education issues which might need to be taken into account for the new combined service.

Developing a cost centre budget (approx. 1000 words)

Also, Discuss the benefits of having the Nurse Manager develop a cost centre budget for a specific area of responsibility. Flexible, zero-based and output-based budgeting are three alternative budgeting methods that could be adopted by the Nurse Manager to develop a budget plan for this new combined service.

Which method would you consider most appropriate and why?

Remember, your answer should compare and contrast the different methodologies and include discussion of the merits, weaknesses and applications of each model.

In the context of developing a cost centre expenditure budget: Provide an outline the three main areas of expenditure (line items). They will be consider  for the expenditure budget. Also, give examples of the issues to be consider for each area of expenditure prior to starting calculations.

Identify and discuss the cost centre reports generated within your organisation. They will provide a baseline for the budget calculations.

Develop a sample Salaries and Wages budget (approx. 300 words)

Develop a sample Salaries and Wages budget for this profile. Make notes on all your calculations to demonstrate your thinking. Explain the assumptions that you make to underpin your decisions

Literature search of Nursing PICOT question

This is an assignment that focuses on a literature search of a suitable PICOT question. This should be identified from module 1. Additionally, the references used shall be rated using the provided links in the assessment.

Literature search of a suitable PICOT question.

INSTRUCTIONS

Complete the assignment, using this Word file as a worksheet. Type your answers directly on this sheet. Use APA style and include citations to support your work.
Include your PICOT question from Module 1. Identify in parenthesis each part of the question (the (P) (I) (C) (O) and (T), if a time element is included).
QUESTIONS

Firstly, perform a literature search for the PICOT question identified from your assignment that you completed for Module 1. Use Chapter 3 and the PubMed Search Example document as a guide to conduct your search. Then, write 1-2 paragraphs discussing your approach and steps taken to perform the literature search. Also, include the names of the databases you used to perform your literature search.
Provide a list of 10 references related to your chosen PICOT question.

Secondly, for each of the 10 references, rate the level of evidence. Use a specific evidence rating scale. See the following examples:
·       https://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford
·       http://www.abiebr.com/set/1-introduction-and-methodology/determining-levels-evidence
The resources in Appendix B may be helpful.  Additionally, provide a rationale for the rating you chose.
Lastly, complete an Evaluation Table Template for the ten references as presented in Appendix C.

Thirdly, discuss in 1-2 paragraphs any difficulties you experienced in performing the literature search and rating the evidence. Subsequently, synthesize and critique the quality of the research evidence on your topic. Lastly, comment on your level of comfort in performing a literature search.
References

Make sure to conduct a research as indicated. All resources to be in a clear citation and referencing style and format. In this case, use APA style.