Health and Human Services

 How Healthy is Your Community?

The expression “Think Globally, Act Locally” guides your Discussion this week. By accessing information from the U.S. Department of Health and Human Services, you will have the opportunity to learn how healthy your community is. You will identify the key health issues and vulnerable populations in your own county. Understanding the factors that influence the health status of residents in your county will provide you with a local perspective to compare to global health challenges you will examine in weeks to come.

To prepare for this Discussion, first learn a little about the health statistics for your county. If you are not located in the U.S., pick a state and county you might like to visit or know more about to complete this assignment. Go to the Community Health Status Indicators Report, and select your state and county to review your local report.
http://wwwn.cdc.gov/CommunityHealth/homepage.aspx?j=1

Then, go to the Walden Library and find at least one recent (within last 5 years) article in addition to your Learning Resources to document, and support, the concepts you include in your Discussion post. For suggestions to help with your search, visit the Library http://library.waldenu.edu/908.htm

By Day 4, post a comprehensive response to the following:

Using the information available on the Community Health Status Indicators Report, provide a summary of the following information in your county. Use the article(s) you located, as well as your Learning Resources, to support your answers to the following questions in your post:

1. Identify your county and state.
2. How healthy is your county? What evidence did you use to come to your conclusion?
3. What vulnerable populations are identified in your county? Are there groups of individuals who have health disparities? Are there issues related to access to care within your county? If so, what are they?
4. Highlight the risk factors for premature death and environmental health concerns seen in you county.
5. Where does your county excel or fall behind in preventive health? Provide examples.
 

Resources for files below:

https://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/SDOH-workbook.pdf
https://class.waldenu.edu/bbcswebdav/institution/USW1/201830_05/BS_HLST/HLTH_3115_WC/artifacts/USW1_HLTH_3115_Week2-WHO_Social_Determinants_health_exec_summary.pdf

Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2137064/
https://www.cdc.gov/obesity/data/adult.html
https://www.cdc.gov/nchs/
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Case Study: Healing and Autonomy

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

1. In 250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

2. In 450-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and non-maleficence in James’s care?

3. In 250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to include a strong thesis and support your responses with the topic study materials (minimum of 4 citations and references).

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be 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.

5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

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what statistical tests are being used for data analysis?

Description:
Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

  1. In the articles you have reviewed, what statistical tests are being used for data analysis?
  2. Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
  3. Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?
· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017).  The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models.
·  Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008).
· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.
· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups?
· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.
· Do the authors appropriately indicate implications of the data analysis, or do they overstretch? 
· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted.
· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.
References
· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026
· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539
· McCrum-Gardner, E. (2008).  Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41
· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671
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Types of Statistical use
There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018).
Appropriateness of the statistical test 
The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research.  One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.
Conclusion
The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.
References
Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac-                   canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf
McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf
Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles  on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246
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Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

National initiatives driven by the American Nurses Association have determined nursing-quality outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-quality indicators:

•  complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT

•  patient falls

•  surgical patient complications, including infection, pulmonary failure, and metabolic derangement

•  length of patient hospital stay

•  restraint prevalence

•  incidence of failure to rescue, which could potentially result in increased morbidity or mortality

•  patient satisfaction

•  nurse satisfaction and staffing 

Scenario:

Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.

A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.

The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular, chopped meat.” The tray contained the remains of a chopped pork cutlet.

The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.

When the patient’s daughter visited later that night, she was not told of the incident.

The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never killed anyone.”

The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.

The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Analyze the scenario (suggested length of 2–3 pages) by doing the following:

A.  Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care. 

B.  Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital. 

C.  Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario. 

D.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized. 

E.  Demonstrate professional communication in the content and presentation of your submission

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1)     Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community

…5 1)     Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community]]>

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American history homework help

For Part 1 of the Unit 3 Exam, read the four documents attached above. Using the documents and the textbook, write an essay answering the questions listed below. Grades will be based on the content of the answer and must be more than 400 words in length. Direct quotes do not count toward the required word count.

Video Link:

Here is the actual footage of Dwight D. Eisenhower delivering his 1961 “Farewell Address” – https://www.c-span.org/video/?15026-1/president-dwight-eisenhower-farewell-address (Document 4 is a transcript of this speech)

Part 1 Questions:

1. In Document 1, how does Franklin D. Roosevelt characterize World War II and the threat posed by fascism and Nazi Germany? Had he survived, do you think Roosevelt would have characterized the Cold War and the Soviet Union in the same way? Why, or why not?
2. Describe the primary arguments explained in Documents 2 and 3. How does Kennan explain the threat of the Soviet Union and communism? How does he characterize the weaknesses of the Soviet system? How do Kennan and the NSC (Document 3) suggest the United States respond to the perceived threat of the Soviet Union and communism?
3. Using the textbook, provide some specific examples of how the ideas in documents 2 and 3 shaped U.S. foreign policy from 1945-1960.
4. In his farewell speech (video and Document 4), what does Eisenhower say about the Cold War? How does his message reflect the ideas from Documents 2 and 3? What warnings does he give for the future? How does Eisenhower’s speech relate to Roosevelt’s (Document 1)?

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    Document2-LongTelegram.docx
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    Document4-Eisenhower-Farewell.docx
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    Document1-FourFreedoms2.docx
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    Document3-NSC68.docx
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Boeing International

You are training leader for global organization who has noticed that employees do not share knowledge with each other. As leader you must develop a solution to advance in the organization.

 *Give three reasons as to why employees do not share knowledge.

*Give three solutions that your organization can incorporate to encourage knowledge sharing among employees. 

*Outline a plan for professional training and development related to your career and include how you plan to be committed and intentional about knowledge sharing (e.g., job rotation, cross training, mentoring, etc.) 

must contain image and speaker notes (1 paragraph). 1 peer review source. total slides will be (12) including (with) title and reference

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AH Patient Encounter

AH Patient Encounter
Step 1: Complete i-Human Patients® Case for Arielle Hernandez.
Access i-Human Patients® by clicking the Exercise tab.
ORDER A PLAGIARISM-FREE PAPER NOW
Click the Cases tab to complete the i-Human Patients® Case for AH.

  • Interview AH to obtain her complete patient history.
  • Document your findings in i-Human Patients®.
  • Complete a health assessment and focused physical exam based on current evidence.
  • Document your health assessment and focused physical exam findings and develop a problem list for AH.

Note: You must attempt and score a cumulative 70% on the i-Human Patients® assessments in weeks 1, 3, and 5 to successfully complete the required lab component of the course.
Step 2: Interpret the data.
Determine which tests you would expect to see for AH based on the results of the history, exam, and problem list.
Evaluate the test results to determine the actual and/or potential diseases for which AH is at risk.
Create a 350-word summary note explaining how you arrived at AH’s problem list.

  • Provide relevant assessment results (questions and answers).
  • Cite the lab results that correlate with the assessment findings.

Click the Assignment Files tab to submit your summary, evidence-based assessment guidance, and interview results documentation.

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DESCRIBE THE SIMILARITIES AND DIFFERENCES THAT EXIST BETWEEN INPATIENT HEALTHCARE FACILITIES AND OUTPATIENT HEALTHCARE FACILITIES.

1. Describe the similarities and differences that exist between inpatient healthcare facilities and outpatient healthcare facilities. Give three examples of inpatient facilities and three examples of outpatient facilities. Be sure to include information about the services each facility named provides.
Your response must be at least 200 words in length.

2. Discuss the usage of data in health care today. As a healthcare administrator, how would you make the best use of data that you have collected? Be sure to consider national data, state data, and facility data in your answer.
Your response must be at least 200 words in length.

3. Discuss how expanded life spans and the new opportunities people have to obtain preventive health screenings as a result of the Affordable Care Act have affected how often people utilize healthcare services.
Your response must be at least 200 words in length.

4. You are the administrator of a 250-bed hospital in the Midwest. A recent report from your county tells you that the population within a 25-mile radius of your facility is getting younger. The median age has decreased from 35 years of age to 29 years of age, which is related to the opening of a new college campus. How will this transition to a younger patient population affect your facility? Are there services in your facility that may need to be expanded? Are there services in your facility that many need to be reduced or eliminated? How might these changes impact staffing for your facility?
Your response must be at least 200 words in length.

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>Nursing homework help

Make a PPT with Evidence Base Practice. PICOT Question:  Are educated Medical-Surgical nurses (I) more successful in performing COVID-19 nasopharyngeal swabs (P) compared with non-educated Medical-Surgical nurses (C) for accurate COVID-19 test results (O)?
I uploaded a PPT that you can use/edit. Check all the articles in the reference list I put in and search 3 more articles that is related to my PICOT question. You have to base all the articles to my PICOT questions. I need it tomorrow in less than 24 hours, if early I appreciate it. Thank you.
*Hope you know how to grade articles using The Johns Hopkins Nursing Evidence-based Practice Rating Scale.
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    NasopharyngealSwabEducationforCOVID-19.pptx
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    JHNEDPEvidenceRatingScale.pdf
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