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Advance Care Planning Education for Older Adults
Get PDFAdvanced care planning guides health care professionals and surrogate decision-makers choices on end of life (EOL) care when individuals are no longer able to speak for themselves. Advanced care plans can benefit patients in their last six months of life by improving their quality of life and by reducing family members anxiety, depression, and stress when dealing with EOL treatment options. Aside from these benefits, poor communication and knowledge deficits often create barriers when medical staff, families or patients try to broach the subject of EOL care. Barriers can be overcome when health care professionals facilitate advanced care planning conversations in the right setting, with staff trusted by patients, and when medical decisions are not urgent. This scholarly project educated individuals older than 55 years of age. They were provided education on advanced directives, medical terminology, and how to initiate conversations about end of life wishes with family or friends. In one education session, two people attended. Of those two individuals, one had an advanced care plan, and the other individual did not have an advanced care plan. This education session encouraged the participants to update their existing advanced care plan routinely with changes and create one if they previously had not. This education session highlights the importance of educating individuals on the options they have towards EOL and what that can do to ensure their wishes are followed when they can no longer speak for themselves
What is the Most Effective Management for Patients with Concomitant Gallstones and Bile Duct Stones?
Get PDFBackground: Gallstone disease is common with a high prevalence in developed nations and is expected to rise as the obesity and metabolic syndrome epidemic worsens. The associated relationship between gallstone and biliary tract disease is complex. The most effective treatment approach for patients with concomitant gallstones and bile duct stones is controversial. Multiple different combinations of one-step and two-step endoscopic and/or surgical techniques exist. Advancements in laparoscopic and endoscopic methods have paved the way for a minimally invasive approach to managing cholecystocholedocholithiasis (CCL).
Methods: A literature review was conducted via systematic search of Google Scholar and PubMed to evaluate articles comparing various interventions and associated complications and outcomes between them.
Discussion: There are advantages and disadvantages amongst of each treatment strategy without a clear consensus as to which procedure is superior. Although a two-stage sequential approach is most often used in real-world clinical practice, the literature reports many favorable outcomes for a single-step procedure in terms of fewer complications, better bile duct clearance, and shorter hospital stay. Preferential treatment for a one-step protocol is also attributed to the economic pressure to limit costs and resources being used.
Conclusion: Evidence from the literature continues to support the use of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) as the mainstay treatment in patients with concurrent gallbladder and bile duct calculi. Currently, gold standard treatment is determined at the specific healthcare practice led by local professional expertise of a multidisciplinary team, endoscopist or surgeon preferences, patient risk, and available resources
What Are the Most Effective Risk Factor Management Strategies for The Prevention and Control of Hypertension?
Get PDFHypertension (HTN) affects millions of people globally. With the rising burden of HTN in primary care and its associated morbidity and mortality, it is necessary to explore effective risk factor management to control and prevent it in people most at risk. This research addressed both modifiable risk factors such as obesity, smoking, alcohol, and diet as well as non- modifiable risk factors such as age, race/ethnicity, and family history. The aim of this paper was to examine the most effective risk factor management strategies to control and prevent hypertension. The studies reviewed indicate that there are various risk factor management strategies that are deemed effective in reducing blood pressure (BP) and improving HTN management. These approaches include increasing physical exercise, diet therapy such as the DASH diet, weight loss, and smoking cessation and limited alcohol intake. While each of these strategies is effective, patient adherence to guidelines is essential to promote desirable outcomes. Lastly, regular health check-ups among at-risk populations are effective in managing the risk factors through early detection. Future studies can examine how the implementation of these strategies can minimize or eliminate the need for medication
How Do Modifiable Risk Factors Impact the Progression of Alzheimer’s Disease?
Get PDFAlzheimer’s disease remains a significant health burden that affects millions in the United States. This research pursued to shed light on the modifiable risk factors and help individuals at high risk for Alzheimer’s disease minimize the chances of cognitive decline. A search of literature was conducted on databases such as PubMed, Google Scholar, and Medline. Randomized control trials, longitudinal studies, systematic reviews, and meta-analyses were identified and included in the paper. The modifiable risk factors that play a role in the onset and progression of Alzheimer’s disease include stress, inadequate physical exercise, lack of sleep hygiene, and lack of social engagement. However, in the studies that focused on modifying these factors, results showed an improved cognitive performance. Other modifiable factors such as alcohol and dietary intake, including omega-3 fatty acids and carotenoid-rich foods, were found to slow cognitive decline. Additionally, the MIND, DASH, and the Mediterranean diet are recommended for high-risk patients. The general implication of these findings is that modifying these risk factors for high-risk patients can lead to better cognitive performance and slow AD progress. Future studies can focus on conducting longitudinal factors such as alcohol intake due to the inconsistent findings documented in this research. The burden of Alzheimer’s disease can be reduced nationwide by effectively addressing these modifiable risk factors
Preventing Rehospitalizations Among Older Adults With Heart Failure
No full textOlder adults admitted to skilled nursing facilities expect that their care will be well- managed during their stay. For many residents, the goal is to return home after a short-term stay. For others, the plan is to stay as a long-term patient with the assumption that medical needs will be met while in the facility. Regardless of the goal of care, hospital readmissions are costly and diminish the quality of life for these patients. Heart failure (HF) has been noted to be a top reason for rehospitalizations. A lack of knowledge of HF among licensed nurses within SNF settings has led to hospital readmissions. This project was created to establish an effective educational competency for licensed nurses after noting that 11 patients were rehospitalized between July and October 2020 at a 56-bed SNF within Southeastern Minnesota. At this SNF, there are no HF protocols established. A 17-slide PowerPoint presentation was developed to present applicable HF information to licensed nurses working in a SNF. In order to develop situational awareness among licensed nurses, a case study simulation was also created. A 20-point pre and post assessment tool was established to determine effectiveness of the competency. This project was guided by Jean Watson’s (2008) Theory of Human Caring with an emphasis placed on her Caritas Processes of transpersonal teaching and helping- learning. Concepts of transformational leadership and their applicability to advancing nursing practice were demonstrated in this project. Implications for future projects were also provided with the goal of inspiring other nurse to prevent hospital readmissions among older adults admitted to SNFs utilizing a variety of interventions
Nursing Education on Sepsis
No full textSepsis diagnosis delay is a prevalent problem affecting millions worldwide. Global efforts to combat the sepsis problem led to the development of the Surviving Sepsis Campaign protocol to promote early sepsis detection. Yet, complying with the protocol remains a challenge. Nurses working at the bedside in the hospital are often the first to observe possible sepsis cases; however, many nurses lack the necessary knowledge to recognize the symptoms and follow the protocol. A nursing audit was conducted in the hospital to assess nurses\u27 knowledge regarding sepsis identification and management tools listed in the sepsis protocol. The audit findings showed a lack of knowledge regarding early clinical signs and symptoms of sepsis and treatment regimens. A quality improvement initiative designed to educate nurses in a Midwest teaching hospital about changes in the signs, symptoms, and laboratory findings for the early identification of sepsis, was created. Using Newman\u27s Health as Expanding Consciousness as a framework, targeted educational interventions were developed to address the nurses’ knowledge deficit that results in sepsis protocol non-compliance. The intervention will also provide the nurses with practical tools essential to recognize early signs and symptoms of sepsis and empowers them to avoid diagnosis delay resulting in patient morbidity, mortality, and potential disability at this Midwest hospital
Painting Support Group: a Gateway to Healing Anxiety and Depression
No full textInitiative-taking disease prevention and health promotion strategies are foundations of public health that nurses have the power to support. Yet, mental illnesses like anxiety and depression have in the past often been a low priority or overlooked, leading to harmful effects on all aspects of a person\u27s health. This thesis dives into the future, describing and explicating a nurse-led pilot project inspired by Jean Watson\u27s Theory of Human Caring to support healing among young women in the Minneapolis community struggling specifically with anxiety and depression. Each session, held at a local college art room, is composed of a combination of art therapy, community support, education, and connection to resources, which merge to advance the project\u27s goals. Data has been collected from archives, interviews, newspapers, and published reports to ensure evidence-based implementation of sensitive, positive healing sessions. Effective interventions are ensured by understanding historical and cultural perspectives that combine with healing and protective methods. To uphold holistic healing, Jean Watson\u27s Caring Theory promotes truly empathetic approaches. To create a safe, welcoming space, the literature examines social, emotional, and physical aspects along with how to allow for vulnerability and protect against shame. It explores how to build positive states of mind like hope, joy, and peace to promote mental wellness. To achieve effective, long-lasting education and harmless resource support, it explores the concept of autonomy, including the role of power, risk, and cultural humility. Finally, it explores how the creative process reaches across cultural, language, and processing boundaries as well as physical, social, and spiritual barriers to uphold the use of art as a gateway to healing. Before the pilot project can be realized, I discuss the need for further partnership establishment, the formation of educational materials, and solidifying connections to resources. Then, as the project takes place, critical appraisal strategies to measure its effectiveness is discussed. This pilot project has the potential to meet challenges and needs faced by women in the Minneapolis community in a unique, creative way that moves beyond traditional public health interventions for anxiety and depression
Latina Adolescent Dating Violence Public Narrative
Get PDFA scholarly project has been conducted to assess use of public narrative between health care providers (HCPs) and Latina adolescents to reduce dating violence (DV) health consequences. Latina adolescents require an innovative, transcultural approach for dating violence care to reduce barriers to care. Healthcare providers must structure dating violence care to Latina adolescents due to different dating violence patterns and health consequences compared to other ethnicities and generations. There is minimal evidence- based research on the use of public narrative and its effects of use in the healthcare setting. The application of public narrative and the citizen professional will be presented to healthcare providers at a community-based clinic that predominantly treats Latino patients. The overall conclusion was that the use of public narrative and the citizen professional could benefit Latina adolescent dating violence care. The healthcare providers see more Latina adults than adolescents that suffer from dating violence but conclude that public narrative and citizen professional would be beneficial for Latina adults as well. Further investigation needs to be done to address Latina adolescent perspectives on public narrative and citizen professional utilization for dating violence in the healthcare setting. Overall, this scholarly project enhances the advanced nursing practice by developing a cost-effective, transcultural approach towards improving healthcare for Latina adolescent dating violence victims
Pivoting during a Pandemic: School Social Work Practice with Families during COVID-19
Get PDFThe COVID-19 global pandemic led to the unprecedented shuttering of nearly all K–12 public education settings across the United States from March through June 2020. This article explores how school social workers’ roles, responsibilities, and work tasks shifted during Spring 2020 distance learning to address the continuing and changing needs of families and the larger school community. Interviews were conductedd with twenty school social workers in K–12 public schools, across three states, to understand the primary needs of children and families during the pandemic and to learn how school social workers can be most effective in responding to these needs.The data were analyzed using a grounded theory approach. Study findings revealed that during Spring 2020, school social workers consistently had increased contact and interaction with students’ parents that centered around two major activities: (1) food assistance and referrals for families and (2) parent check-ins and coaching. The article discusses implications for the field of school social work during crises and beyond. Considerations include increased funding for schools that serve communities disproportionately impacted by the pandemic and the reprioritization of school social workers’ roles and responsibilities to include increased contact with parents are discussed
Mental Healthcare in Costa Rica: A Critical Perspective
Get PDFThe country of Costa Rica often ranks high on happiness metrics and healthcare quality metrics. Mental healthcare in Costa Rica is often not discussed when reviewing those metrics. This paper attempts to explore mental healthcare in Costa Rica through a critical lens. Specifically, what factors affect the mental health of Costa Rican’s, if they experience mental health issues at the same rates as other areas of the world, what access is like, the prevalence of stigma surrounding mental illness, and how the COVID-19 pandemic has affected mental health. Through literature review and conversing with locals, it was found that mental healthcare in Costa Rica needs improvement. Funding research studies, the creation of campaigns to reduce stigma, increasing funding for outpatient mental health services, and providing more training on mental illness for primary care physicians are areas in which the Costa Rican healthcare system can improve