• Home

Y

Comments

Responses such as “I agree”, “thanks for that information – I didn’t know that”, “I experienced that also”, etc. will not receive participation credit. Please do not repeat what is already mentioned in the post. Responses should be a minimum of 150 words and minimum of 2 peer reviewed or scholarly sources with 5 years

Please do not to “cut and paste” answers from your references such as lists, bullet points, etc. This will not receive points for responses that are “cut and paste” even if you provide a citation.


Post 1:

According to Grand Canyon University, “Vulnerable populations are groups of people who require special attention related to well-being and safety, including persons who cannot advocate for their own needs such as children, prisoners, and the cognitively, emotionally, and physically impaired” (2018). Examples of vulnerable population groups are refugee and immigrant populations, individuals who live in poverty, LGBTQ populations, and individuals who are uninsured or underinsured.

The U.S. Census Bureau reported that there were 1,203,000 same-sex couples living together in 2019 (Current Population Survey, Annual Social and Economic Supplement, 2019). Same-sex couples are included within the LGBTQ population and are vulnerable because of the adversity and discrimination that can occur when these individuals seek medical services or because of diseases which may be associated with being more prominent within this population group, such as HIV or AIDS (Grand Canyon University, 2018). One of the biggest challenges facing individuals who belong to the LGBTQ population is discrimination, which has been associated with high rates of mental health disorders including suicide (Office of Disease Prevention and Health Promotion, 2020). Many individuals feel unsafe, unaccepted, and bullied, which is why many individuals do not feel they can advocate for themselves. In addition, there is a lack of laws protecting these individuals from health care discrimination including health insurance access. Nursing advocacy is important for this population because it allows us to eliminate health disparities which can lead to improved reduction in disease transmission, improved mental and physical health, and reduced health care costs (Office of Disease Prevention and Health Promotion, 2020).

References

Current Population Survey, Annual Social and Economic Supplement. (2019). Who Is Living Together? Same-Sex Couples in the United States. In U.S. Census Bureau. https://www.census.gov/library/visualizations/2019/comm/living-together-same-sex.html

Grand Canyon University (Ed). (2018). Community & Public Health: The Future of Health Care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

Office of Disease Prevention and Health Promotion. (2020). Lesbian, Gay, Bisexual, and Transgender Health | Healthy People 2020. HealthyPeople.gov. https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

Post 2:

The United States has many elderly people and according to statistics 16,9% of US population is 65 or older. These are a vulnerable population due to their cognitive disabilities and chronic conditions. They spend most of their time in nursing homes and institutions as they may struggle to perform activities of daily living, and this leads to elderly abuse and exploitation.  There is reduction in social and family support overtime, and they end up living the last days of their lives lonely and abandoned. Despite the many   elderly people representation groups, the abuse still goes on because most of them are not able to speak for themselves when they abused so most of the abuse is not reported. Financial constraints because of prolonged hospital admissions due to many chronic illnesses also leave them in poverty (Fernandes, 2019). The high costs of medicines required to sustain their life leads to the depletion of their funds and since most of them will not be physically fit to work for themselves they end up living in poverty. Many people swindle them out of their riches, and all this put them at risk for stress and mental illness. They also have multiple barriers in adhering to their medications due to dementia, poor eyesight, and failure to understand due to hearing deficits. When working with these groups nurses must give them a chance to make decisions about their health because they need a sense of control and mental preparedness for their health (Okpalauwaekwe, 2022). Nursing advocacy for the elderly is beneficial to improve the quality of their life and their general health. This also gives them a voice for their concerns to be heard and addressed. They also need help in remembering doctor’s appointments and taking medications and having an advocate will improve their overall health outcome.

References

Fernandes Barbosa, K. T., Rodrigues Lopes de Oliveira, F. M., & Melo Fernandes, M. das G. (2019). Vulnerability of the elderly: a conceptual analysis. Revista Brasileira de Enfermagem72, 337–344. 
https://doi-org.lopes.idm.oclc.org/10.1590/0034-7167-2018-0728

Post 3:

In the United States, significant disparities exist in healthcare for vulnerable populations. There are a number of groups that are considered vulnerable populations, including racial and ethnic minorities, the economically disadvantaged, and those with chronic health conditions. Vulnerable groups are people who are at high risk for poor health status and healthcare access, who undergo significant disparities and have limited access to healthcare service. According to WHO, vulnerable population include; the uninsured, pregnant women, pediatric group, malnourished people, children, the homeless, people with HIV/AIDS, racial and ethnic minorities, economically disadvantaged and people with chronic health conditions.

In the United States, older adults are more vulnerable than other populations because they have low immunity and likely to have multiple comorbid physical and/or mental health conditions. A study found that the elderly don’t frequently receive the care recommended for them, such as preventive care and feeds the cycle of being vulnerable. Older adults are increasingly dependent of others for basic needs which automatically makes them vulnerable. The number of older adults who are aged 65 or older. is 14.5% (46.3 million) of the US population. The challenges they face include vary from isolation in their homes, failure to afford healthcare services and difficulties while getting access to healthcare services and general transportation, food access and preparation and mobility.

The elderly are unable to advocate well for themselves, There are ethical issues including; protecting their rights and human dignity, providing care with possible risk to their own health, informed consent, staffing patterns that limits their access to nursing care and more. Nursing advocacy would help our aging population, addressing patients physical, mental, psychosocial and emotional needs. Nursing advocacy involves thinking about the social determinants of health, hygiene, and barriers to access such as transportation, money, as well as each patients available support resources and help in navigating those to aid in minimizing stress levels. Competent nurses place an emphasis on the patient’s health and general well-being and therefore improving their health condition.

Joszt, L. (2018, July 20). Vulnerable populations in healthcare. https://www.ajmc.com/view/5-vulnerable-populations-in-healthcare

Centers for Disease Control and Prevention (CDC) (2003). Trends in aging–United States and worldwide. MMWR. Morbidity and mortality weekly report, 52(6), 101–106.

Okpalauwaekwe, U., Li, C.-Y., & Tzeng, H.-M. (2022). Social Determinants and Self-Care for Making Good Treatment Decisions and Treatment Participation in Older Adults: A Cross-Sectional Survey Study. Nursing Reports12(1), 198–209. https://doi-org.lopes.idm.oclc.org/10.3390/nursrep12010020

Post 4:

A vulnerable population in the united states that has seen a rise lately is homeless veterans. Although flawless counts are impossible to come by the transient nature of homeless populations presents a major difficulty , the Department of Veterans Affairs estimates that 107,000 veterans are homeless on any given night.( Pinestreetinn) These groups particularly need advocacy due to the nature of their careers that they have been through being a veterans. More recently Iraq/Afghanistan veterans that experience homelessness have other underlying issues such as mental health issues, adapting back into civilian life, PTSD and lack of support from their families. For many of these veterans the military is the only thing that they knew and was their main support system. When these veterans are discharged after service the veteran affairs (VA) sometimes does not offer enough support to transition these individual back in to the normal society. This on top of other issues such as substance abuse can cause his group to become homeless and become harder to break out of homelessness. People experiencing homelessness generally need a holistic approach to care, according to Weber. That includes addressing patients’ physical, mental, psychosocial and emotional needs. It involves thinking about the social determinants of health, including employment, hygiene, and barriers to access such as transportation ( Hilton 2022) Nurse advocating for these individuals are beneficial because this group needs expert support to get through this difficult tme in their life.

About the Author: Lisette Hilton Lisette Hilton, Hilton, L., & 16, C. V. F. (2022, February 24). Health Care for the homeless is what these nurses do best. Nurse.com Blog. Retrieved April 18, 2022, from 
https://www.nurse.com/blog/2022/02/03/providing-health-care-for-the-homeless-what-nurses-do-best/
 

Mightyspark. (2022). Facts about homeless veterans. Pine Street Inn. Retrieved April 18, 2022, from https://www.pinestreetinn.org/news_events/facts_about_homeless_veterans 

Y

Post 5:

Nurses encounter implicit bias in their nature of work. Humans aware or unaware hold implicit bias and nurses are not spared, they often hold some type of bias towards some of their patients. It is important for the nurse to know the type of bias they have so that they will be able to correct it. It is important to acknowledge that one has a weakness (Faulkner 2018). Nurses meet people from all distinct cultural backgrounds in their daily practice. The work of a nurse is centered on the patient and their families, to give them the best care which is acceptable to their culture. Problems of culture are often the cause of the patient’s threat to security. Culture can mean communication barrier between the nurse and a patient. Sometimes it is more complex when the beliefs or culture of the patient is not accepted, for example gays or lesbians who are not accepted in most African countries face challenges to access treatment, hence they fear disclosing their status. (Kaihlanen 2019). Nurses should be professionally trained in how to offer culturally competent care, following the nursing code of conduct and ethics which do not allow them to use emotional personal feelings and judgement when rendering care. Cultural dissonance is associated with cultural beliefs of individuals and nurses should take complete history upon first encounter with the patient and avoid dissonance. Knowing the culture of the patient helps to avoid bias or dissonance in case one chooses to be nursed buy different gender, which is usually mistaken for racism. For the nurses to offer a culturally competent health promotion, a thorough assessment needs to be done first, involving the patient, and studying their way of life so that it can be included in the teaching plan.  

 

References: 

 Faulkner, A. (2018). Community & public health: The future of health care. 

https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/chapter/3
 

 

Kaihlanen, A.-M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing18(1), N.PAG. 
https://doi-org.lopes.idm.oclc.org/10.1186/s12912-019-0363-x
 


Post 6:

Healthcare professionals can detect bias and stereotypes in a healthcare setting by asking, listening, and observing how patients and their family members talk or behave during the delivery of healthcare services (Edgoose et al., 2019). Asking and listening technique is applicable in situations where a patient appears depressed or demoralized. In such cases, nurses can ask questions and listen to their patients explain how they feel. Some patients may appear dissatisfied when prescribed a particular medication.

Some patients go to the extent of asking whether it is a must to take that drug. Nurses should allow patients to express their opinions. In that case, the nurse will have a chance to ask questions and detect biases and stereotypes.

The primary goal of the healthcare system is to deliver quality and safe care to every patient regardless of their culture, health beliefs, and religion. Therefore, nurses should identify their patients’ health needs, preferences, and values. This knowledge will promote patients’ satisfaction. It is, therefore, paramount for nurses to learn and comprehend different cultures to facilitate the delivery of culturally competent care (Enriquez, 2020). Communication plays a significant role in the healthcare system (Cook & Brunton, 2018). Nurses should possess communication skills to communicate effectively with patients from different cultural backgrounds.

One of the strategies that can help nurses eliminate cultural dissonance is personal awareness. Nurses should conduct inward reflection that helps to identify ideas that contribute to bias (Cook & Brunton, 2018). Moreover, nurses should carry out cultural competence self-assessment to help them gauge their strengths and weaknesses when treating patients from diverse cultural backgrounds.

References

Cook, C., & Brunton, M. (2018). The importance of moral emotions for effective collaboration in culturally diverse healthcare teams. Nursing inquiry25(2), e12214.

Edgoose, J. Y., Quiogue, M., & Sidhar, K. (2019). How to identify, understand, and unlearn implicit bias in patient care. Family practice management26(4), 29-33. 
https://www.aafp.org/fpm/2019/0700/p29.html

Enriquez, U. (2020). Embracing a New Culture. Fast Facts for Making the Most of Your Career in Nursing, 151.

Y


Post 5:

The Affordable Care Act (ACA) is a healthcare reform with provisions for health insurance coverage for uninsured individuals, lower costs, improve the efficiency of health care, preventative care, extension of dependents to age 26 and also prevent insurance companies from denying or increasing premiums for pre-existing conditions (Green, 2018).

The number of uninsured individuals under age 65 of the population went from 16.6 percent before ACA took effect to only 10 percent in the first quarter and the number keeps decreasing. ACA has increased the number of individuals with health insurance thereby helping in reducing cost in the health system. ACA invests in programs such as Partnership for Patients that is designed to improve quality care by reducing hospital acquired conditions; it is estimated the initiative has help save 125,000 lives and 28.2 billion dollars in health care cost from 2011 to 2015 ACA also supports public health prevention efforts by providing funding for programs and mandates insurance companies to cover preventative care (APHA, 2017).

The role of the nurse in implementing the law:

Nurses as lifelong learners and change agents have to continue expanding their knowledge to transform with today’s healthcare system with the focus on preventive care. Nurses can advocate for the at risk population in the community, reduce health disparities, and improve health and wellbeing. Nurse’s also need to be involved in the community, know the stakeholders in the community who are interested in supporting the community and helping with the change process, and also get involved in politics to voice the needs in their communities (Green, 2018).

References

APHA, (2017). Why do we need the Affordable Care Act? Retrieved from https://www.apha.org › files › pdf › topics › aca › why_need_aca_2017 

Green, S. (2018). The Environment Policy and Health Effectiveness. In GCU’s, Community and  public health: The future of health care. Retrieved from https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/community-and-public-health_the-future-of-health-care_1e.php

Post 6:

The Affordable Care Act represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The ACA was signed into law under the Obama Administration with the goal of adjusting the affordability, quality and availability of health insurance and, by extension, healthcare as a whole. This law is complex, but four important elements of the Affordable Care Act in relation to community and public health are:

-Expansion of access to insurance coverage- the affordable care act aims at covering of more than 30 million people who have not been insured.. This is done through expansion of both private as well as public insurance.

-Increase in consumer insurance protection- this is achieved through : prohibition of lifetime monetary caps in insurance coverage as well as limiting of the annual caps

-Emphasis on prevention and wellness- this element establishes a prevention & public fund for provision of grants to various states to enhance prevention of diseases.

-Improvement in health quality and system performance- this outlines various provisions for the improvement of quality as well as system performance. For instance, research to enable effectiveness of a number of medical treatments as well as demonstration of projects in order to develop mechanisms for payment so as to improve efficiency and results.

-Promotion of health workforce development- the ACA outlines the issues of workforce by use of various provisions for instance, supporting of new primary models of care such as medical homes as well as team management of chronic illnesses.

The ACA places a greater focus on outcomes, with more pressure on nurses to show they can give effective care. This means the demand for advanced practice nurses (APNs) and nurse practitioners (NPs) has also increased. With the current and projected nursing shortages and recent demand during pandemic crisis, I honestly feel like we’re headed for disaster with nurses that are under more stress.

Madeleine J. Kerr, Sebastiana del Rosario Gargantua‐Aguila, Kari Glavin, Michelle L. L. Honey, Nursen O. Nahcivan, Selda Secginli, Karen S. Martin, Karen A. Monsen, Feasibility of describing community strengths relative to Omaha system concepts, Public Health Nursing, 10.1111/phn.12558, 36, 2, (245-253), (2018).

Edmonds, J. K., Campbell, L. A., & Gilder, R. E. (2017). Public Health Nursing Practice in the Affordable Care Act Era: A National Survey. Public health nursing (Boston, Mass.)34(1), 50–58. 
https://doi.org/10.1111/phn.12286

Manchikanti, L., Caraway, D. L., Parr, A. T., Fellows, B., & Hirsch, J. A. (2011). Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain physician14(1), E35–E67.

Y

Question 1:

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.


Question 2:

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

1. “About the Affordable Care Act”

2. “Health Care Transformation: The Affordable Care Act and More”

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

Question 3:

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.

2. Create a problem statement.

3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

4. Discuss the impact on the health care delivery system.

Policy Brief – Rubric

Collapse All Benchmark – Policy Brief – Rubric

Description of Policy Health Issue

24 points

Criteria Description

Description of Policy Health Issue

5. Excellent

24 points

A detailed description of the policy issue is presented. The origin of the policy is described and a strong correlation between the policy and the health issue for the population selected is established. The level at which this occurs is discussed. Strong rationale and evidence are offered for support. Insight into the policy health issue is demonstrated.

Problem Statement

24 points

Criteria Description

Problem Statement

5. Excellent

24 points

A problem statement is thoroughly developed with supporting details.

Suggestions for Addressing the Policy

Health Issue (B)

24 points

Criteria Description

Suggestions for Addressing the Policy Health Issue (C1.4)

5. Excellent

24 points

Suggestions for addressing the issue are thoroughly developed with supporting details. All assignment criteria are met and well-supported. The suggestions are well-supported and offer clear steps for initiating policy change.

Impact on Health Care Delivery System

24 points

Criteria Description

Impact on Health Care Delivery System

5. Excellent

24 points

A discussion on the impact on the health care delivery system is thoroughly developed with supporting details.

Thesis Development and Purpose

6 points

Criteria Description

Thesis Development and Purpose

5. Excellent

6 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction

6 points

Criteria Description

Argument Logic and Construction

5. Excellent

6 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. Good

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

6 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. Excellent

6 points

Writer is clearly in command of standard, written, academic English.

Paper Format (use of appropriate style for the major and assignment)

2.4 points

Criteria Description

Paper Format (use of appropriate style for the major and assignment)

5. Excellent

2.4 points

All format elements are correct.

Documentation of Sources

3.6 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

3.6 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Question 4:

Select a community of interest in your region. Perform a physical assessment of the community:

1. Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”

2. Interview a community health and public health provider regarding that person’s role and experiences within the community.


Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.

Complete the “Provider Interview Acknowledgement Form” prior to conducting the interview. Submit this document separately in its respective drop box.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation.


PowerPoint Presentation

Create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

1. Description of community and community boundaries: the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges, including any identified social determinates of health.

2. Summary of community assessment: (a) funding sources and (b) partnerships.

3. Summary of interview with community health/public health provider.

4. Identification of an issue that is lacking or an opportunity for health promotion.

5. A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.

Community Assessment and Analysis Presentation – Rubric

Collapse All Community Assessment And Analysis Presentation – Rubric

Description of Community and Community Boundaries

25 points

Criteria Description

Description of Community and Community Boundaries: (People, Geographic, Geopolitical, Financial, Educational Level, Ethnic, Phenomenological Features and Types of Interactions, Goals, Interests, Barriers, and Challenges, Including Social Determinates of Health)

5. Excellent

25 points

Description of community is complete. Boundaries are described in great detail, distinguishing environmental boundaries, environmental relationships, and external systems that comprise the open, community system.

Summary of Community Health Assessment

25 points

Criteria Description

Summary of Community Health Assessment

5. Excellent

25 points

Discussion of functional health patterns is clear, complete, and comprehensive, with indications for actual, at-risk, and potential diagnoses as well as recommendations for surveillance and preventive measures.

Identification of Issue That Is Lacking or an Opportunity for Health Promotion

25 points

Criteria Description

Identification of Issue That Is Lacking or an Opportunity for Health Promotion

5. Excellent

25 points

Identification of an issue that is lacking or an opportunity for health promotion is effectively included.

Conclusion With Summary of Findings and Impressions of General Community Health

18.75 points

Criteria Description

Conclusion With Summary of Findings and Impressions of General Community Health

5. Excellent

18.75 points

Conclusion is comprehensive, with a detailed summary of key findings that explains general health of the community and offers rationale for recommendations.

Summary of Interview With Community Health/Public Health Provider

18.75 points

Criteria Description

Summary of Interview With Community Health/Public Health Provider

5. Excellent

18.75 points

Summary table is comprehensive, with a detailed description of findings, as well as actual, at-risk, and potential diagnoses and recommendations for surveillance and preventative measures.

Layout

6.25 points

Criteria Description

Layout

5. Excellent

6.25 points

The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.

Language Use and Audience Awareness (includes sentence construction, word choice, etc.)

6.25 points

Criteria Description

Language Use and Audience Awareness (includes sentence construction, word choice, etc.)

5. Excellent

6.25 points

The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.

Y

Post 1:

During the delivery of healthcare in the United States, half of the funds come from dedicated funding at the federal, state, and local levels in the form of various block grants to state safety-net programs. Medicare and Medicaid usually cover 21 percent of treatment, private insurance covers 14 percent, and 10 percent is paid directly by patients as out-of-pocket costs. The Centers for Medicare and Medicaid Services is the largest governmental source of health coverage funding. The U.S health system does not provide health care to the country’s entire population. Instead, most citizens are covered by a combination of private insurance and various federal and state programs. Some of the techniques that health care services use to promote sustainability include zero-waste policies, water conservation, and telehealth services that reduce carbon-based fuel consumption (Gee, 2021).

Medicaid has increased access to care and health care use as well as improved self-reported health. According to research, one year out from the lottery, the adults who gained Medicaid were 70 percent more likely to have a regular place of care and 55 percent more likely to have a regular doctor than the adults who do not gain coverage. It covers essential services like annual check-ups and dental care for kids from low-income families, in that increasing its access will provide more and more Americans with access to the quality and affordable health care they need and deserve. Health reform may accelerate the trend toward health care becoming a dominant employment sector in the economy (Oberlander, 2019). They may also require greater increases in administrative and health care support personnel rather than in physicians and nurses. It also addresses the benefits people receive and how people obtain health insurance.

References

Gee, R. E., Shulkin, D., & Romm, I. (2021). A blueprint for comprehensive Medicaid reform. JAMA, 325(7), 619-620.

Oberlander, J. (2019). Navigating the shifting terrain of US health care reform—Medicare for all, single-payer, and the public option. The Milbank Quarterly, 97(4), 939.

Post 2:

Health care in America is delivered inpatient, outpatient and ambulatory care. There are other delivery systems like mental health, long-term and home care. Services are often delivered by healthcare providers like physicians, nurses and other medically trained professionals. Payment for these services has changed overtime. Currently paying for one’s medical expenses is a possibility but highly unlikely. Most people use health insurance to help pay their medical expenses. Health insurance can either be obtained by private companies and with the agreement with government. Another way to finance health insurance is through state or federal government agencies whether they be Medicaid or other government health insurance agencies. Funding is provided by federal, state and cities. Management of the health care system is done by numerous agencies, like the Centers for Medicare and Medicaid Services and Center for Consumer Information and Oversight. The sustainably of the ACA depends on support from the public. Lately, there has been an attempt from certain political parties to dismantle the ACA. The ACA also depends on support and cooperation from health care providers in order to help provide the health services (Green, 2018).

There are certain issues that still need better management when it comes to the education of the Affordable Care Act. For example, there is still a lack of education to the general public about the Affordable Care Act. According to the article by Crowley and Bornstein, there needs to be more services available to the public to provide face-to- education and enrollment services to prevent a delay of healthcare. Any delay in healthcare can put the general public in a harmful way (Crowley & Bornstein, 2019). My reform solution would be to provide more education about how to receive coverage, the different types of coverage and how to properly enroll in ACA. This will help prevent confusion and a delay in patient care. The predicted effect will be an increase of enrolled individuals who have more insight and understanding of the care they are going to be receiving and other services they qualify for. This would lessen the burden of health care workers who previously would have to explain the benefits and services available. The effect on stakeholders will be an increase in individuals who will need to be trained and ready to provide the education to the public: city workers, government and state officials.

References

Green, S. (2018). The Environment Policy and Health Effectiveness. In GCU’s, Community and

public health: The future of health care.

https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/community-and-public-health_the-future-of-health-care_1e.php 

Crowley, R., Bornstein, S. (2019). Improving Patient and Affordable Care Act Insurance

Coverage Provision. American College of Physicians. 170(90) pg, 651-653.

https://annals.org/aim/fullarticle/2731120/improving-patient-protection-affordable-care-act-s-insurance-coverage-provisions

Post 3:

Among sophisticated industrialized countries, the United States healthcare system is unparalleled (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). The United States lacks a uniform healthcare system, does not have universal healthcare coverage, and only recently approved legislation requiring practically everyone to have healthcare coverage. The US health care system is best described as a hybrid system, as it does not operate a national health service, a single-payer national health insurance system, or a multi-payer universal health insurance fund. In 2014, private funds accounted for 48 percent of healthcare spending in the United States, with consumers accounting for 28 percent and private enterprises accounting for 20 percent (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). The federal government was responsible for 28% of spending, while state and municipal governments were responsible for 17%. [1] Even if it is sponsored by the government, most of the health care is given privately (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). 

The biggest reason Americans describe having difficulty getting health care is the prohibitively high cost (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). Americans with low means are far more likely than their counterparts in other countries to report not seeing a doctor when they are unwell, not obtaining a recommended test, treatment, or follow-up care, not filling a prescription, and not visiting a dentist. In the United States, 59% of doctors admit that their patients have financial difficulties (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). In 2013, 31% of uninsured individuals said they didn’t seek or delayed medical care because of the expense, compared to 5% of privately insured adults and 27% of those on government insurance, such as Medicaid/CHIP and Medicare (The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO, 2016). 

The Affordable Care Act (ACA), which was put into law several years ago, may be the best proposal for improving health outcomes (The Affordable Care Act Insurance Reforms: Where Are We Now, and What’s Next? – PMC, 2016). 

The Affordable Care Act established preexisting condition protections and removed patient cost-sharing for high-value preventative care. The law also requires employers to provide breastfeeding mothers with breaks at work, expands the availability of calorie counts in restaurants, and establishes the Prevention and Public Health Fund, which aids the Centers for Disease Control and Prevention (CDC) and state agencies in detecting and responding to health threats like COVID-19 (The Affordable Care Act Insurance Reforms: Where Are We Now, and What’s Next? – PMC, 2016). 

References 

The Affordable Care Act Insurance Reforms: Where Are We Now, and What’s Next? – PMC. (2016, January 1). PubMed Central (PMC); www.ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714719/ 

 

The U.S. Health Care System: An International Perspective — Department for Professional Employees, AFL-CIO. (2016, August 15). Department for Professional Employees, AFL-CIO; www.dpeaflcio.org. https://www.dpeaflcio.org/factsheets/the-us-health-care-system-an-international-perspective 


Post 4:

A health care delivery system incorporates four functional components, financing, insurance, delivery, and payment, (the quad-function model). Health care delivery systems differ depending on the arrangement of these components. 

There are three main finance sources for health care in the United States: 

· the government

· private health insurers 

·  individuals. 

Between Medicaid, Medicare and the other health care programs it runs, the federal government covers just about half of all medical spending.

The current US delivery system and financing structures are unsustainable. Inequitable distribution of resources continues, and an increasing number of American families do not have access to adequate care.

 

Effectiveness of delivery;

The U.S. health care delivery system is complex and massive. I honestly feel unqualified to judge the effectiveness accurately, but while my gut instinct wants to say “no” the data supports that it is functioning better than any other system worldwide of its size. The vast array of institutions includes 5,700 hospitals, 15,900 nursing homes, almost 2,900 inpatient mental health facilities, and 11,000 home health agencies and hospices. Despite spending far more on healthcare than other high-income nations, the US scores poorly on many key health measures, including life expectancy, preventable hospital admissions, suicide, and maternal mortality. And for all that expense, satisfaction with the current healthcare system is low.

 

Effects on of health reforms:

By making health coverage more affordable and accessible and thus increasing the number of Americans with coverage, by funding community-based public health and prevention programs, and by supporting research and tracking on key health measures, the ACA can help begin to reduce disparities, improve access to preventive care, improve health outcomes and reduce the nation’s health spending.

American Nurses Association. (2010). Health care reform toolkit. Retrieved from http://www.nursingworld.org/healthcarereformtoolkit(link is external)

Havaei, F., Dahinten, V. S., & MacPhee, M. (2019). Effect of Nursing Care Delivery Models on Registered Nurse Outcomes. SAGE Open Nursing. https://doi.org/10.1177/2377960819869088

 Cleveland, K.A., Motter, T., Smith, Y., (May 31, 2019) “Affordable Care: Harnessing the Power of Nurses” OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 2, Manuscript 2.

 

Y

Question 1:

Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial. 

Question 2:

How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format. 

Question 3:

The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

1. Primary Prevention/Health Promotion

2. Secondary Prevention/Screenings for a Vulnerable Population

3. Bioterrorism/Disaster

4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.

2. Request feedback (strengths and opportunities for improvement) from the provider.

3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal – Rubric

Planning and Topic

30 points

Criteria Description

Planning and Topic

5. Excellent

30 points

The teaching plan is based on an approved topic. The epidemiological rational is well-supported and relevance to the topic is demonstrated.

Effectiveness of Teaching Plan Criteria

40 points

Criteria Description

Effectiveness of Teaching Plan Criteria

5. Excellent

40 points

All assignment criteria are thoroughly completed. Rational and detail is provided throughout.

Therapeutic Communication (B)

10 points

Criteria Description

Therapeutic Communication (C4.2)

5. Excellent

10 points

The teaching plan is communicated with an activity that uses clear active listening techniques to connect with the audience. A clear description of how the attention of the audience was captured and how the presentation was concluded is presented. The teaching plan thoroughly describes nonverbal techniques that were employed, such as eye contact, appropriate dress for the setting, facial expressions, and voice intonation.

Organization of Proposal, Paragraph Development, and Transitions

10 points

Criteria Description

Organization of Proposal, Paragraph Development, and Transitions

5. Excellent

10 points

Proposal is well-organized and logical. Ideas progress and relate to each other. Paragraph and transition construction guide the reader.

Criteria 2Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5 points

Criteria Description

Criteria 2Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. Excellent

5 points

Writer is clearly in command of standard, written, academic English.

Paper Format (use of appropriate style for the major and assignment)

2 points

Criteria Description

Paper Format (use of appropriate style for the major and assignment)

5. Excellent

2 points

All format elements are correct.

Documentation of Sources

3 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

3 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.


Y

Post 5:

Global health is becoming increasingly important in terms of both global security and population security in the United States. It is vital to think about health in a global framework as the globe and its economies become increasingly globalized, including substantial international travel and business. 

In the case of coronavirus disease 2019 (COVID-19), which is caused by a novel coronavirus currently known as SARS-CoV-2, the past is repeated on a far greater scale following Ebola (Nakatani et al., 2020). The WHO Country Office in China was notified on December 31, 2019, that cases of pneumonia of unknown cause had been discovered in Wuhan, Hubei Province, China (Nakatani et al., 2020). 

This is a natural outcome of a globalized world in which commodities and people move at unprecedented scales and speeds. Since the turn of the century, global outbreaks have occurred approximately every five years: the SARS (severe acute respiratory syndrome) outbreak in Asia in 2003, the H1N1 (influenza virus A/H1N1) pandemic in 2009, the Ebola outbreak in West Africa in 2001, and the COVID-19 pandemic in 2020 (Nakatani et al., 2020). 

The worldwide economy has taken a huge hit as a result of the COVID-19 pandemic, with the International Monetary Fund (IMF) forecasting a 3.9 percent reduction in global median GDP from 2019 to 2020, the worst downturn since the Great Depression (Economic Impact of COVID-19 on PEPFAR Countries, 2022). The global economy was predicted to increase last year, in 2021, as countries began to reopen and vaccines became accessible, though still below pre-pandemic estimates, and recovery has been unequal across countries and regions (Economic Impact of COVID-19 on PEPFAR Countries, 2022). 

COVID-19 has revealed ongoing inequities based on income, age, race, gender, and region. Despite recent improvements in global health, individuals around the world continue to face complex, interwoven dangers to their health and well-being rooted in social, economic, political, and environmental factors (The Impact of COVID-19 on Global Health Goals, 2021). 

The pandemic has also exposed major flaws in country’s health-information systems. While high-resource settings have experienced issues such as capacity constraints and fragmentation, weaker health systems risk compromising decades of hard-won health and development benefits (The Impact of COVID-19 on Global Health Goals, 2021). 

The unique character of multidisciplinary collaborations, which have the capacity to reach disproportionally affected populations or those with chronic issues of mistrust in the healthcare system, is a significant strength of our framework for mobilizing health care through community involvement (Epps, 2021). Many of the health inequities exacerbated by the COVID-19 epidemic can be addressed by using key influencers and community partners. People with low literacy (and limited healthcare literacy) require culturally competent, relevant information as well as the capacity to provide feedback to a trusted community adviser who can help support healthcare behavior improvements (Epps, 2021). 

 

References 

Economic Impact of COVID-19 on PEPFAR Countries. (2022, February 7). KFF; www.kff.org. 
https://www.kff.org/global-health-policy/issue-brief/economic-impact-of-covid-19-on-pepfar-countries/#:~:text=Key%20Facts,downturn%20since%20the%20Great%20Depression

 

Epps, F. (2021, April 1). A Framework for Mobilizing Health Care to Respond to the Community Within the COVID-19 Pandemic. A Framework for Mobilizing Health Care to Respond to the Community Within the COVID-19 Pandemic; www.cdc.gov. 
https://www.cdc.gov/pcd/issues/2021/20_0572.htm
 

 

Nakatani, H., Katsuno, K., & Urabe, H. (2020, September 15). Global health landscape challenges triggered by COVID-19 – Inflammation and Regeneration. BioMed Central; inflammregen.biomedcentral.com. 
https://inflammregen.biomedcentral.com/articles/10.1186/s41232-020-00144-5
 

 

The impact of COVID-19 on global health goals. (2021, May 20). The Impact of COVID-19 on Global Health Goals; www.who.int. 
https://www.who.int/news-room/spotlight/the-impact-of-covid-19-on-global-health-goals
 


Post 6:

According to World Health Organization, the Human Immunodeficiency Virus (HIV) is still in the top ten health issues in the globe. Thirty-three million people are infected with HIV; including, one million people in the United States. There are 68% of adults and 53% of children infected with HIV who are receiving antiretroviral therapy (ART) in the globe (WHO, 2020). HIV is a virus that attacks cells in the immune system and can transmit by body fluids. HIV destroys white blood cells called CD4 cells (WHO, 2020). Therefore, the person infected with HIV has a high risk of easily getting any infection due to weakening immunity. Antiretroviral therapy is a choice of treatment for HIV. With HIV being treated, the person can live a healthy and long life with treatment; however, HIV is a life-long condition.

With underprivileged health care systems in developing countries especially in Africa, shortage of essential medical professionals is one of the major health care problems due to various economical and regulatory factors. Hence for HIV treatment, excessive workload and burnout of medical workers further worsen this problem. With a burden for increased cases of diseases; such as tuberculosis (TB), malnutrition, diarrhea, meningitis, and pneumocystis carinii pneumonia (PCP), in the context of opportunistic HIV-related infections suggests that programmed prevention, care, and treatment must be changed in order to react to new scenarios (Tawfik & Kinoti, 2006).

Health care delivery systems work collaboratively by educating people about risk factors, transmissions, screening, preventions, and treatment for HIV. Also, there is the President’s Emergency Plan For AIDS Reliefs (PREFAR) program to support HIV/AIDS prevention and treatment in developing countries (CDC, 2021). Also, funding agencies actively work in the developing countries with lower Gross Domestic Product (GDP) to screening, prevention, and care for HIV.

Reference:

Centers for disease control and prevention. (2021, April 13). PEPFAR – For fifteen years, CDC played a critical role in PEPFAR’s effort. Retrieved from https://www.cdc.gov/globalhivtb/who-we-are/pepfar15/PEPFAR15.html

Tawfik, L., & Kinoti, S. (2006, March). The impact of HIV/AIDS on the health workforce in developing countries. Retrieved from https://www.who.int/hrh/documents/Impact_of_HIV.pdf

World Health Organization. (2020, November 30). HIV/AIDS. Retrieved from https://www.who.int/news-room/fact-sheets/detail/hiv-aids

Y

Question 1:

Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial. – Minimum of 250 words (Please cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.)

Question 2:

How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format. – Minimum of 250 words (Please cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.)


Y


Community Teaching Work Plan Proposal

Planning and Topic

Directions: Develop an educational series proposal for your community using one of the following four topics:

1. Bioterrorism/Disaster

2. Environmental Issues

3. Primary Prevention/Health Promotion

4. Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:

Estimated Time Teaching Will Last:

Location of Teaching:

Supplies, Material, Equipment Needed:

Estimated Cost:

Community and Target Aggregate:

Topic:

Identification of Focus for Community Teaching (Topic Selection):

Epidemiological Rationale for Topic (Statistics Related to Topic):


Teaching Plan Criteria

Your teaching plan will be graded based on its effectiveness and relevance to the population selected. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

Nursing Diagnosis:

Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn.

Learning Theory to Be Utilized: Explain how the theory will be applied.

Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.

How Does This HP2020 Objective Relate to Alma Ata’s Health for All Global Initiatives

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods:

Behavioral Objective
and Domain

Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)

Content
(be specific)

Example – The Food Pyramid has five food groups which are….

Healthy foods from each group are….
Unhealthy foods containing a lot of sugar or fat are….

Strategies/Methods

(label and describe)

Example – Interactive poster presentation of the Food Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.

1.

1.

1.

2.

2.

2.

3.

3.

3.

4.

4.

4.

Creativity: How was creativity applied in the teaching methods/strategies?


Planned Evaluation of Objectives (Outcome Evaluation): Describe what you will measure for each objective and how.

1.

2.

3.

4.

Planned Evaluation of Goal: Describe how and when you could evaluate the overall effectiveness of your teaching plan.

Planned Evaluation of Lesson and Teacher (Process Evaluation):

Barriers: What are potential barriers that may arise during teaching and how will those be handled?

Therapeutic Communication

4.2 Communicate therapeutically with patients.

How will you begin your presentation and capture the interest of your audience? Describe the type of activity will you use with your audience to exhibit active listening? Describe how you applied active listening in tailoring your presentation to your audience? How will you conclude your presentation? What nonverbal communication techniques will you employ?

© 2019. Grand Canyon University. All Rights Reserved.

3

Y

Comments

Responses such as “I agree”, “thanks for that information – I didn’t know that”, “I experienced that also”, etc. will not receive participation credit. Please do not repeat what is already mentioned in the post. Responses should be a minimum of 150 words and minimum of 2 peer reviewed or scholarly sources with 5 years

Please do not to “cut and paste” answers from your references such as lists, bullet points, etc. This will not receive points for responses that are “cut and paste” even if you provide a citation.

Post 1:

Social determinants of health are conditions contributing to or hindering a person’s well-being. These conditions include where people were born, live, play, work and age. These elements are some of the biological, environmental, social and economic variables that affect a person’s ability to have and maintain good health. Several factors related to health outcomes include language and literacy, early childhood development, ability to obtain and maintain a job, social support, living conditions, and having access to health services and the quality of those services.  

The communicable disease chain model is used to describe an infection spread within a population. There are six links to this chain that include: infectious agents, reservoirs, portal of exit, mode of transmission, portal of entry and susceptible hosts.  Infectious agents are bacteria, viruses, fungi or parasites that can spread and lead to disease. A reservoir is where the infectious agent lives and multiplies. This includes humans, animals, arthropods, plants and soil. The portal of exit is when a pathogen exits from a reservoir (humans- blood or respiratory secretions, which would be the mode of transmission). The portal of entry is the way the infectious agent enters a new host (broken skin). The susceptible host is any carrier of an infection or someone at risk of infection.  

Nurses are involved in all levels of prevention. Primary prevention includes promoting education to the public in health promotion measures to prevent the occurrence of disease. Secondary prevention for example is when a nurse conducts screenings for early detection and treatment of health conditions. Tertiary prevention is when nurses continue to use health education and undertake measures to avoid chronic disability and to delay further deterioration from health issues. Nurses can also help to break the link within the communicable disease chain by practicing proper hand hygiene, using proper PPE, being up to date on vaccine and staying home when sick. 

National Foundation for Infectious Diseases. (2016). Help break the chain of 

infection 
https://www.nfid.org/2016/10/18/help-break-the-chain-of-infection/
 

Green, S. (2018). Community & Public Health: The Future of Health Care. Retrieved from 
https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/
 

Post 2:

Several factors influence health. These factors are generally categorized as determinants of health, and they include genetics, environmental and physical influences, behaviors, medical and social factors. Among the five categories, the common one is the social determinants of health. This category encompasses social and economic conditions that significantly influence individual and community health. The social determinants of health are shaped by the socioeconomic position of an individual, which includes power, the amount of money an individual has, and the resources possessed by an individual. The socioeconomic position of an individual can be shaped by several factors, including an individual’s occupation, education, and income level. The social determinants of health thus impact the individual’s health and wellbeing. It is usually important to address social determinants of health because it is the primary approach to realizing health equity.

Social determinants of health contribute to the development of diseases in a number of ways. For instance, as documented by the Center for Disease Control and Prevention, poverty which is one of the social determinants of health, inhibits the ability of an individual to access healthy food and a safe neighborhood. Research indicates that children born to parents with limited educational attainment are more likely to live in an environment that does not promote healthy living, thus contributing to disease development (Marmot & Bell, 2019). Individuals living in poverty are more likely to live in areas with limited access to healthcare services. Their poor economic status makes it hard for them to seek medical care when they fall ill. As Palmer et al. (2019) argue, as income decreases, the likelihood of premature death increases. Factors like unemployment and job insecurity can contribute to mental health problems. Individuals who are jobless often find it hard to earn a living. Their life experience can subject them to depression. Lack of access to affordable healthcare can contribute to the development of disease because it makes individuals resolve to other non-western or traditional medicines that may not offer the desired protection against illnesses. Another social determinant of health that can contribute to the development of disease is food insecurity. Food insecurity is associated with poor nutrition. Poor nutrition is the root course of certain chronic diseases such as obesity, diabetes, and Kwashiorkor, among others. Lack of housing and basic amenities can also contribute to the development of diseases such as Malaria, Cholera, Amoeba, and Typhoid, among others.

The communicable disease chain model is designed to represent the fundamental idea of how disease can spread from one host (person) to another. In particular, the fundamental idea represented in the chain of infection model is that it is possible for the individual to break the chain at any point to help prevent the spread of disease (Gerhardts et al., 2012). Breaking the chain means reducing the risk of the spread of disease. There are steps that nurses can take to break the link within the communicable disease chain. One of the components of the chain of infection is a communicable disease. A communicable disease is a disease caused by infectious agents. Therefore, breaking the link within the communicable disease chain would require initiating some practices that can help prevent the spread of the disease. For instance, constant practicing of hand-washing can help in breaking the link within the communicable disease chain. Hand-washing prevents the spread of infection, thus breaking the chain of infection model. Other steps include the use of disinfectants, pasteurization, and the use of antibiotics, among others.

 

 References

 Gerhardts, A., Hammer, T. R., Balluff, C., Mucha, H., & Hoefer, D. (2012). A model of the transmission of micro‐organisms in a public setting and its correlation to pathogen infection risks. Journal of Applied Microbiology, 112(3), 614-621. https://doi.org/10.1111/j.1365-2672.2012.05234.x

Marmot, M., & Bell, R. (2019). Social determinants and non-communicable diseases: time for integrated action. BMJ, 364. DOI: https://doi.org/10.1136/bmj.l251

Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: future directions for health disparities research. DOI: https://doi.org/10.2105/AJPH.2019.304964

Post 3:

There exists a range of intrinsic and extrinsic factors or determinants of health that can impact and influence an individual and her/his family health and wellbeing. Intesinics determinants of health comprises biology, genetic and behavioral factors. For example, an individual family member’s biology (age or sex) and genetics (rare genetic or familial heredity diseases) are some examples of intrinsic determinants of health that play a critical role in underlying disease progression (Islam, 2019). Moreover, an individual’s behaviors (such as routine physical exercise, balanced and nutritional diet, alcohol or cigarette or illicit drugs use) are some other examples of intrinsic determinants of health that not only impact the health of a particualar individual but these behavioural factors also influence the health of the other family members (Islam, 2019). It is relatively easy to directly associate the impact and influence of intrinsic factors to health, it is less easy to directly associate the impact and influence of extrinsic determinants or factors (such as family socioeconomic status and ease of access and affordability to quality health care services) to individual and family health. Among many extrinsic factors, five domains of social determinants of health (SDOH) significantly impact the health and wellbeing of an individual and her/his family members (social determinants of health, 2018). These five domains of SDOH include 1) economic stability, 2) education access & quality, 3) healthcare access & quality, 4) neighborhood & built quality, and 5) social & community context. Inadequate or a complete lack of some or all of these five domains of SDOH can contribute to the development of disease which would ultimately result in detrimental health effects to both the individual and family.   

According to the traditional epidemiological communicable disease chain model, transmission of infectious diseases results from the interaction of infectious agents (bacteria, viruses, fungi, and parasites) with human and non-human hosts, and environment (Centers for Disease Control and Prevention, 2012). This sequence of events is called the chain of infection through which infectious agents can be spread and lead to disease in the population. There are six links to this chain that include infectious agents, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. For example, transmission of infectious disease occurs when the infectious agent leaves its reservoir or host (such as humans, animals, arthropods, plants, and soil) through a portal of exit (such as blood, respiratory secretions, GI and urinary secretions). Subsequently, the infectious agent gets conveyed by some mode of transmission (such as direct contact, ingestion, or inhalation of infectious agents), and enters through an appropriate portal of entry (broken skin, respiratory tract, mucous membranes, catheters, and lines) to infect a susceptible (new) host. This sequence is sometimes called the chain of infection (Centers for Disease Control and Prevention, 2012). Through proper understanding of the sequence of events during the chain of infection, nurses and other healthcare professionals can help prevent spread of communicable diseases by practicing proper hand hygiene covering coughs and sneezes, wearing PPE, by timely vaccination, and staying home when feeling sick. 

References

Islam M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications. Frontiers in public health7, 11. https://doi.org/10.3389/fpubh.2019.00011

Social determinants of health (SDOH) (2018). Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved February 6, 2022, from  https://health.gov/healthypeople/objectives-and-data/social-determinants-health

Centers for Disease Control and Prevention. (2012). Principles of Epidemiology. Centers for Disease Control and Prevention. Retrieved April 11, 2022, from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section10.html


Post 4:

Health outcomes depend on both medical and non-medical factors. Non-medical factors that affect humans’ health and well-being are called social determinants of health (World Health Organization [WHO], n. d.). Social Determinants of Health can be described as conditions, in which people live, learn, work, and age that have an impact on health. According to the Office of Disease Prevention and Health Outcomes, social determinants of health can be grouped into five domains. These domains involve economic stability, access to education and its quality, access to medical services and their quality, neighborhood and built environment, and social and community conditions. SDH depend on the distribution of money, resources, and power at all levels (global, national, and local) (WHO, n. d.). As a result of inequalities in such distribution, there are significant differences in health outcomes both within and between countries and even between neighborhoods within the same cities because the SDH are contributing factors to health inequities and the development of a range of diseases. That is especially true for vulnerable populations. Poverty often is an issue with poor sanitation, lack of clean / safe drinking water and appropriate nutrition, limited access to healthcare, and lack of education; which ALL increase poor health outcomes. These conditions lead to the development of diseases directly which outcomes depends on SDH. A sad and vicious cycle.

The communicable disease chain model represents the minimum requirements that are needed for the presence and spread of a communicable disease in a population. The main idea is that it is possible to reduce the

occurrence and transmission of diseases by taking specific actions. We all have a very fresh perspective of this in action with our recent panndemic and the handling of this attempt to slow the curve in transmission with government mandates on both National and local scales . According to this model, the presence of an infectious agent (for example, bacteria or viruses), host (humans, animals, or plants), and the environment are three core elements of disease occurrence and spread. The absence of at least one of these elements breaks the communicable disease chain (National Foundation for Infectious Diseases [NFID], 2016). In this way, the communicable disease chain model shows that it is possible to address the presence and spread of such a disease, it is possible to stop the transmission!

Nurses can play a part in breaking the link within the communicable disease chain. Proper diagnosis and treatment, health education and health promotion are important steps that will have a big impact. This often involves the promotion of proper hand hygiene, vaccination, the importance of staying home when sick, and

wise usage of antibiotics (to prevent antibiotic resistance) on levels ranging from influencing and educating friends and family all the way to educating larger numbers of people within the community. I have traveled three separate times to Honduras with WGO on medical mission trips and was humbled and empowered by how much difference can be made in a community simply with education. We often did not take truckloads of supplies, like lice shampoo into the rural villages, but we educated the local women on bagging their bedding and clothing in trash bags and setting them in the sun to allow the bugs and eggs to die, on cleaning the combs between use on each other, on proper grooming and more. Simple education assisted in big changes! Educated health care professionals play an important role in breaking the link within the communicable disease chain.

National Foundation for Infectious Diseases. (2016, October 18). Help break the chain of

infection https://www.nfid.org/2016/10/18/help-break-the-chain-of-infection/

Office of Disease Prevention and Health Outcomes. (n. d.).

Social determinants of health. https://health.gov/healthypeople/objectives-and-data/social-determinants-health

Roberts, S. (2018, January 10). Key factors: Poverty and poor health. Health Poverty Action.

https://www.healthpovertyaction.org/news-events/key-facts-poverty-and-poor-health/

World Health Organization. (n. d.). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1