Question 14 1 pts
Why is oral vancomycin not used for systemic infections?
Group of answer choices
It is rapidly inactivated by gastric acid.
It is not absorbed from the gastrointestinal tract.
It has a high risk of causing systemic allergic reactions.
It is too potent for systemic use and can lead to toxicity.
It is rapidly metabolized by liver enzymes, reducing its efficacy.
NURS-6521 Walden University Final exam – Which statement is most accurate regarding the comparison between alteplase and streptokinase?
Question 7 1 pts
Which statement is most accurate regarding the comparison between alteplase and streptokinase?
Group of answer choices
Alteplase is contraindicated in myocardial infarction, while streptokinase is not.
Alteplase has a lower risk of intracerebral hemorrhage
Alteplase shows an affinity for fibrin-bound plasminogen, while streptokinase does not.
Alteplase is more widely used worldwide.
Alteplase has a lower cost.
Question 6 1 pts
What is more likely a side effect of meperidine than other opiates?
Group of answer choices
Miosis
Respiratory depression
Less dopamine stimulation
Seizures
Sedation
NURS-6521 Walden University Final exam – Which patient population is at the highest risk of experiencing seizures when prescribed a tricyclic antidepressant?
Question 4 1 pts
Which patient population is at the highest risk of experiencing seizures when prescribed a tricyclic antidepressant?
Group of answer choices
Individuals with hypothyroidism
Patients with a history of migraine headaches
Individuals with chronic alcohol use disorder
Individuals diagnosed with essential hypertension
Patients with type 2 diabetes mellitus
NURS-6521 Walden University Final exam – What is most accurate regarding fentanyl?
Question 3 1 pts
What is most accurate regarding fentanyl?
Group of answer choices
It has a long duration of action.
It is not used as a recreational drug.
It is about 80 times more potent than morphine.
Fentanyl is not appropriate for sedation in the ICU.
Fentanyl should not be coadministered with midazolam.
Presidential agendas Walden University
Presidential Agendas: Mental Health
Consider a topic (mental health) that rises to the presidential level.
Mental health is a population health topic that rises to the presidential level. It is a public health concern that affects the ability of individuals to live a fulfilling life that includes the ability to undertake professional and social responsibilities, such as work, family, and school tasks. A poor mental health outcome is associated with physical and social problems. The issue rises to the presidential level because it is a population health concern requiring government intervention at the federal and state levels to ensure that population health needs are met and a healthy lifestyle is promoted while detecting, preventing, and responding to mental health issues (Singh et al., 2022).
How did the current and previous presidents handle the problem?
President Donald Trump handled the mental health issue in 2020 by signing Executive Order 13954, dubbed “Saving Lives through Increased Support for Mental- and Behavioral-Health Needs”. This executive order sought to address mental health issues at the federal by allocating resources to minimize suicide ideation and drug-related deaths following the Covid-19 pandemic. It established a working group tasked with improving the coordination of mental health services between stakeholders while funding state agencies and organizations to support mental health treatment efforts (Government Information, 2020) Presidential agendas Walden University.
President Joe Biden handled the mental health issue through the Unity Agenda, a national mental health strategy implemented at the federal level to strengthen system capacity while linking more people to care and creating a continuum of support. The president’s focus was on transforming health and social services and infrastructure to equitably and holistically address mental health issues by strengthening capacity through greater investment, research, certification, and training. In addition, the Unity Agenda focused on connecting Americans to mental healthcare services by increasing resources, support for public health institutions, improving care access, expanding and strengthening parity, integrating mental healthcare into primary care, and embedding mental healthcare into community-based settings. Besides that, the Unity Agenda creates a healthy environment by banning activities that may impact mental health outcomes, such as targeted advertisement, strengthened privacy, halted discriminatory decision-making algorithms that limit opportunities, improved online protection, expanded intervention and support services, trained mental health professionals, and invested in research (The White House, 2022).
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What would you do differently?
While the two presidents made significant efforts in addressing mental health concerns, there is a notable focus on tertiary prevention and intervention efforts that involve interventions for persons with established mental health issues to prevent relapse and associated outcomes, such as premature mortality, physical illness, and health risk behavior. There is a need to invest government resources towards primary promotion efforts that involve promoting protective factors for mental well-being across the population, including meaningful activity, employment, education, adequate housing, and physical activity. Additionally, more resources should be invested in secondary promotion activities that involve early prevention to promote protective factors for mental well-being (Moller et al., 2020).
Furthermore, there is a need to recognize that some population groups are at higher risk of mental health issues and poor well-being, thereby creating a need to invest proportional more government resources in the primary, secondary and tertiary promotion activities targeting them. For instance, adult high risk groups may include minority ethnic groups, persons with learning disabilities, prisoners, and homeless persons. This would help to prevent the widening inequalities between populations. Even as the high risk groups benefit from the prevention strategies, the low risk groups would also benefit (Moller et al., 2020) Presidential agendas Walden university.
References
Singh, V., Kumar, A., & Gupta, S. (2022). Mental Health Prevention and Promotion-A Narrative Review.
Frontiers in psychiatry, 13
, 898009.
https://doi.org/10.3389/fpsyt.2022.898009
Moller, N., Vossler, A., Jones, D., & Kaposi, D. (Eds.) (2020).
Understanding Mental Health and Counselling
. SAGE Publications.
Government Information (2020, October 3).
Executive Order 13954—Saving Lives Through Increased Support for Mental- and Behavioral-Health Needs
.
https://www.govinfo.gov/content/pkg/DCPD-202000758/pdf/DCPD-202000758.pdf
The White House (2022, March 1).
FACT SHEET: President Biden to Announce Strategy to Address Our National Mental Health Crisis, As Part of Unity Agenda in his First State of the Union
.
https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such
high-profile components of presidential agendas
. It is also little wonder why they become such hotly debated agenda items. Presidential agendas Walden university
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
Reference:
New York State Department of Health. (n.d.). Making New York the healthiest state: Achieving the triple aim. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf Presidential agendas Walden university
Ergonomic and human factors evaluation of workplace
The purpose of this Ergonomic and human factors evaluation of workplace assignment is to evaluate the physical environment of information technology in your work area, hospital, clinical setting, office, or classroom.
View the video on ergonomics and human factors:
In a 2–3-page Ergonomic and human factors evaluation of workplace paper:
Describe the physical, cognitive, and organizational ergonomic conditions present or absent in the assessment of your work area.
Identify how human factors presented in the video apply to your work area physical and functional characteristics.
Suggest ways in which the ergonomic design of the work area can be improved to mitigate human factors and to better facilitate human-computer interaction, reduce risk factors, and promote safety
Ergonomic and human factors evaluation of workplace
Ergonomic and Human Factors Evaluation of an IT Workspace
When assessing both the ergonomic and human factors in my workplace, which is the information technology office environment, it is necessary to consider both the physical, cognitive, and organizational aspects of the ergonomic situation. These factors play a very important role in determining the effect of the workspace on productivity, safety, and comfort (Hamed et al., 2023). Based on the knowledge given in the video on ergonomics and human factors, this assessment takes into account the current state of affairs and what can be done further.
Physical Ergonomic Conditions
In a physical setting, the workspace is also fairly ergonomic, though not consistent in its design. Office chairs are adjustable and also have support in the lumbar area, which fits the guidelines of ergonomics in reducing stress in the body. Nonetheless, there are also non-adjustable tables with a height that causes employees to time at musculoskeletal discomfort. The height of the computer monitors is not maintained at the eye level, which is a contravention of the ergonomics procedure that recommends the use of screens that are positioned to minimize neck aches. Then there is lighting- fluorescent lights are bright and cause glare on the screens, leading to eye strain. Noises can be controlled, though it would be even more appropriate with the use of acoustic panels or noise-absorbing partitions, especially in open offices Ergonomic and human factors evaluation of workplace.
Cognitive and Organizational Ergonomics
The surroundings are also disorganized and mismatched in terms of cognition, which influences judgments and mental exhaustion. According to the video presentation, interfaces and workstations that lack intuition and are too complicated may overload the working memory and reduce the effectiveness of the tasks. The computer systems being used have disarrayed dashboards, and it has to be clicked many times to do basic tasks. This contravenes the stimulus-response compatibility that implies that the actions of users should be intuitive in relation to the responses of the system. At the organizational level, there is no standard way of taking breaks and rotating tasks in the workplace, which translates to long hours of sitting and cognitive burnout, particularly in a job that requires a lot of screen time and concentration.
Human Factors Applied to Workplace Characteristics
The affording, user stereotype, and perceptual abilities are clear human factors that are applicable in the present workspace. As an example, ambiguous forms of user interfaces in internal software platforms lead to wrong entries. This situation shows an imbalance between the expectations of a user and the system’s behavior. The video says that affordances are meant to dictate user action naturally. Still, our internal systems tend to give us false or cloaked affordances that are misleading to the user, like buttons that can be clicked, but nothing happens. Moreover, we can observe the absence of a user-centered design in tools employed in scheduling or documentation, failing to prioritize the codes of relevant information, therefore, causing cognitive overload.
Recommendations for Ergonomic Improvement
In order to improve human-computer interaction and contribute to safety, a number of ergonomic enhancements are suggested. On a physical level, the substitution of fixed desks with adjustable sit-stand desks would give them the option of alternating sitting positions and reducing physical strain. They ought to install monitors that can be mounted or adjusted at eye level. The application of less harsh, task-oriented light would reduce eye strain. Mentally, software interfaces are to be redesigned using the human factor engineering principles. The minimization of the required number of clicks and the consolidation of similar activities can simplify the performance of tasks and the pressure of making decisions.
On an organizational level, increased mental alertness can be achieved by introducing frequent micro-breaks and encouraging task variety (Albulescu et al., 2022). Ensuring a safer and more efficient workplace would involve training their staff on the basic ergonomic principles and also doing periodic ergonomic audits. It is the inclusion of the simulation-based system used for training that is addressed in the video, which would enhance the familiarity level and minimize errors.
Finally, a proper ergonomics and human factors assessment demonstrates that physical and cognitive ergonomics are the part and parcel of the workplace safety, efficiency, and satisfaction of the user. As Park et al. (2022) opine, it is possible to improve performance and minimize the risk of workplaces by redesigning the work environment based on the principles of user-centered design, which involves making systems, tasks, and tools adaptable to the capabilities and expectations of people Ergonomic and human factors evaluation of workplace.
References
Albulescu, P., Macsinga, I., Rusu, A., Sulea, C., Bodnaru, A., & Tulbure, B. T. (2022). ” Give me a break!” A systematic review and meta-analysis on the efficacy of micro-breaks for increasing well-being and performance.
PloS one
,
17
(8), e0272460.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272460&utm_medium=organic&utm_source=blog&utm_campaign=beat-burnout
Hamed, S. A., Hussain, M. R. M., Jani, H. H. M., Sabri, S. S. S., & Rusli, N. (2023). The impacts of physical workplace environment (PWE) on employees productivity.
International Journal of Business and Technology Management
,
5
(4), 369-376.
https://www.researchgate.net/profile/Sapiah-Abdul-Hamed/publication/391220256_The_Impacts_of_Physical_Workplace_Environment_PWE_on_Employees_Productivity/links/680ef568bfbe974b23bc76cc/The-Impacts-of-Physical-Workplace-Environment-PWE-on-Employees-Productivity.pdf
Let’s Teach Science. (2020, November 17).
Human factors engineering (ergonomics)
[Video]. YouTube.
Park, D. Y., Choi, J., Ryu, S., & Kim, M. J. (2022). A user-centered approach to the application of BIM in smart working environments.
Sensors
,
22
(8), 2871.
https://www.mdpi.com/1424-8220/22/8/2871
Ergonomic and human factors evaluation of workplace
Presidential Agendas
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
Reference:
New York State Department of Health. (n.d.). Making New York the healthiest state: Achieving the triple aim. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf
To Prepare:
Review the Resources and reflect on the importance of agenda setting.
Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
Presidential Agendas – Diabetes Policy Approaches
Diabetes has been a chronic public health problem in the United States for several years. Currently, it affects more than 37 million people and costs the American economy over 300 billion US dollars every year. This problem indicates that facilities of prevention, cost control in treatment, and access to a range of care are all intricately connected (Hill-Briggs et al., 2020). Donald Trump and Joe Biden, together with their predecessors, responded to this disease with different approaches, as the latter differ in their priorities and worldviews (Tuomilehto et al., 2023). A more detailed analysis of their accomplishments and failures is presented, as well as better ways to reach the target population.
The Trump Administration’s Approach
The Trump administration (2017–2021) placed a great deal of focus on the low pricing of drugs, and that’d be a delight to diabetic patients who need expensive drugs like insulin. The Part D Senior Savings Model, launched by the administration in the year 2020, lets Medicare Part D plans limit monthly insulin prices to $35 for seniors (Shao et al., 2020). This was a great stride towards changing the status quo as far as insulin was concerned, given that its costs put a lot of pressure on the elderly, especially those with fixed incomes (Shao et al., 2020). Trump’s policy of addressing affordability tried to target a specific group of the population, more specifically, Medicare beneficiaries. Nevertheless, this success was fungible due to other health policies that were implemented during Trump’s presidency. Actions to dismantle and replace the ACA generated unknown risks for preexisting condition consumers, including diabetics (Marino et al., 2020). While the administration did not prevail in fully repealing the ACA, the halting of the mandate’s penalties lowered coverage rates that might deter many Americans with diabetes from receiving adequate care. They said such steps eroded systemic work towards achieving health equity, especially in the prevention and control of chronic illnesses. Nevertheless, the administration sustained the funding for diabetes research through other related departments, such as the NIH (Hill-Briggs et al., 2020). However, its wider concentration on the issue of deregulation and market approaches was not very successful in addressing some systemic issues when it came to diabetes prevention as well as management listening to some communities behind.
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The Biden Administration’s Policies
The current Biden presidency from 2021 has continued on some of Trump’s policies but offers a much broader concept for healthcare evolution. Clearly, one of Biden’s major accomplishments is the Inflation Reduction Act (IRA) of 2022, which has proposed an affordable insulin price of $35 monthly for patients who are the beneficiary of Medicare. This policy was similar to Trump’s earlier Medicare effort, but this one expanded on it by pledging to make insulin cheaper for everyone. However, doing this universally would require more legislative action. The Biden administration has also focused on improving the Affordable Care Act, which provides citizens with the healthcare services they need (Marino et al., 2020).
Biden signed into law additional subsidies and pushed the expansion of Medicaid, making it possible for millions of Americans to receive such preventive services as diabetes testing and counselling (Tuomilehto et al., 2023). Of these, disparities are most affected by these measures because a large proportion of diabetic patients are from low-income or minority groups that may not have adequate insurance coverage. Furthermore, increasing affordability and access are also important in Biden’s administration approach; besides that, there are social factors, such as household income, education, and neighbourhoods, that influence diabetes incidence rates (Tuomilehto et al., 2023). Although, to date, there are still no large-scale programs addressing these determinants specifically, the administration’s focus on health equity for diabetes is a move that addresses the social determinants of this disease.
Efforts from Previous Administrations
The Obama administration (2009–2017) is significant in that it established much of the modern environment for diabetes-related reforms with the ACA (Tuomilehto et al., 2023). The exclusion for preexisting conditions and the increase in the role of Medicaid were two of the pillars in which the law helped increase the number of opportunities for those with diabetes. Further, the ACA-driven requirement for coverage of preventive services without cost-sharing made it possible for more American citizens to undergo diabetes screening and early detection. These changes can be briefly discussed as follows: These changes could be considered a new direction in the development of the national diabetes plan, which touched not only the treatment but also prevention facets. Earlier than Obama, the Bush government of 2001–2009 also stated that extending Medicare Part D meant possessing significant drug coverage on behalf of seniors. While this happened before the 15-year framework of work, it laid the groundwork for subsequent attempts at affordable diabetes medications, a goal which has remained unfulfilled (Hill-Briggs et al., 2020) Presidential Agendas.
Persistent Challenges and Policy Gaps
Although Diabetes has seen progress made across administrations, there are several persistent challenges that have prevented us from winning the war on Diabetes. Those without Medicare or comprehensive insurance coverage continue to be high on the list of those who pay high insulin prices. The Biden administration is seeking to widen access to insulin at affordable prices, but legislation establishing universal price caps there has been stalled in Congress for millions (Tuomilehto et al., 2023). Secondly, diabetes prevention is underfunded in comparison to diabetes treatments. To reduce the long-term prevalence of diabetes, preventive initiatives such as community-based programs to promote healthier lifestyles are needed. Meanwhile, diabetes outcomes continue to be exacerbated by health disparities esp, especially in underserved communities. For instance, limited access to healthy food, safe places to exercise, and good healthcare leave an unfair mark on minority and low-income populations, repeating poor health outcome cycles for millions (Tuomilehto et al., 2023).
Different Approaches
To fill these gaps, a more comprehensive and vigorous strategy is required. First, it becomes necessary to keep insulin affordable to all patients. Making the $35 price cap applicable to all citizens, independent of insurance coverage, would thus help millions (Tuomilehto et al., 2023). Thus, this could be done either by working together with Congress to pass legislation or through partnerships with drug manufacturing firms. Second, prevention can no longer be an afterthought, let alone ignored completely. Development of funding for ranks like the National Diabetes Prevention Program (NDPP) would assist Group C with more initiatives to reach high-risk populations likely to change their lifestyle to avert type 2 diabetes (Shao et al., 2020). These interventions could be delivered through schools, workplaces and various community-based organizations and initiatives teaching people the need to take healthy foods and practising exercise.
Third, improving health potential is necessary; fourth, it is correct to focus on health needs; fifth, the social determinants of health must be considered. Measures that enhance the population’s capability to purchase healthy foods, including cheaper fresh foods or gardening in city areas, decreased diabetes risk considerably. At the same time, enhancing enrollment facilities that encourage active living, such as parks and trails, would be beneficial to an individual’s health. It is a necessity that everyone, regardless of their own status in life, should have primary health care. Thus, the affirmation of extending the program Medicaid in all states and striving for a
common healthcare coverage platform would entail that no one is left with no opportunity
to either treat or prevent diabetes itself (Tuomilehto et al., 2023). This would also reduce inequalities that worse-off groups experienced, such as the less privileged in society Presidential Agendas.
Conclusion
The past fifteen years saw actual advancements in the management of diabetes by the US Administration, primarily in insufficiency of insulin and healthcare coverage. Recent encouraging steps taken by the Biden administration to build upon such progress underscore affordability, equity and preventive care. However, the sustained high costs, the inequalities in access to health services, and insufficient resources to support the prevention programs demand better solutions. There are three key strategies that would, collectively, prevent tens of millions of Americans from developing diabetes and enable those with the disease to live long, healthy lives: universal access to care, prevention, and systems reform.
References
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., … & Haire-Joshu, D. (2020). Social determinants of health and diabetes: a scientific review.
Diabetes care
,
44
(1), 258.
https://doi.org/10.2337/dci20-0053
Marino, M., Angier, H., Springer, R., Valenzuela, S., Hoopes, M., O’malley, J., … & Huguet, N. (2020). The Affordable Care Act: effects of insurance on diabetes biomarkers.
Diabetes Care
,
43
(9), 2074-2081.
https://doi.org/10.2337/dc19-1571
Shao, H., Guan, D., Guo, J., Jiao, T., Zhang, Y., Luo, J., … & Brown, J. D. (2022). Projected impact of the Medicare Part D senior savings model on diabetes-related health and economic outcomes among insulin users covered by Medicare.
Diabetes Care
,
45
(8), 1814-1821.
https://doi.org/10.2337/dc21-2601
Tuomilehto, J., Uusitupa, M., Gregg, E. W., & Lindström, J. (2023). Type 2 diabetes prevention programs—from proof-of-concept trials to national intervention and beyond.
Journal of clinical medicine
,
12
(5), 1876.
https://doi.org/10.3390/jcm12051876
Presidential Agendas
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of
presidential agendas
. It is also little wonder why they become such hotly debated agenda items.
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
PRESIDENTIAL AGENDAS
Identify the Population Health concern you selected.
Opioid Epidemic
Describe the Population Health concern you selected and the factors that contribute to it.
Opioid epidemic and substance abuse and misuse deaths due to overdose are on the increase in the United States. This crisis is affecting more men and women in the country and from across every community (Short, 2022). The extensive pandemic on opioids became critical starting in the 1990s and has ravaged the United’s States for many years. Billions of dollars have been spent in managing the opioid users’ health issues and prevention and treating patients with overdose complications. Presidents have been critical in addressing this issue across their terms and still it is relevant and affecting millions of people. For instance, the Obama, Biden and president Trump’s administrations have been critical of the opioids use and abuse across in the country. They came up with policies, approaches and budgets to address the issue which even though this is reducing still a lot of work remains to be done by Trump’s second term in office (Gross, 2019).
Administration (President Name)
(Donald J. Trump)
(Joe Biden)
(Barack Obama)
Describe the administrative agenda focus related to this issue for the current and two previous presidents.
When President Trump came into power in 2017 the opioid crisis was in critical state across the American communities. For instance, in 2016 about 64,000 people across America died as a result of drugs overdose (Humphreys et al., 2022). Among these, the opioid deaths due to overdose were 42000 in the same year. In October of 2017 Trump declared the issue of opioid crisis as a public health crisis. This led to president’s commitment in subsequent line of actions in addressing this crisis. The Trump’s initiative was to ‘Stop Opioid Abuse’ (Wen, 2020).
Since coming to power in 2021 Joe Biden made his intentions clear regarding fighting against opioid overdose issue. At the time he took oath office there were an estimated 31% year-on-year increasing overdose. As at 2024 as the term of Biden was coming to an end the reduction in overdose deaths was at 7.5 percent.
The major policies
made by Biden were to remove the existing barriers on treating patients suffering from overdose and expanding the lifesaving overdose reversals drugs (Humphreys et al., 2022).
In his tenure in office president Obama was critical on making policies that directly addressed decades of setbacks on opioids use. Initial thing Obama did was to expand on the Tricare system of treating patients including intensive outpatients programs. He also addressed the issue of supply of fentanyl from China and increased the number of practitioners allowed to prescribe buprenorphine in managing opioids. Additionally, Obama brought about the support to telemedicine and distance learning programs in expanding access to healthcare across rural communities Presidential Agendas.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue
As of 2018 president trump had acquired an estimated $6 billion for a two year period in fighting Opioid crisis. In 2019 there were additional $1.8 billion towards addressing opioid crisis and saving lives.
Biden administration has been critical about reducing the deaths associated with opioids overdose. In response to this, the administration set aside some of the biggest finding of $167.2 billion for the four years. This was 20.6% more compared to the Trumps first term in addressing opioid crisis (Jaffe, 2020).
In his last year in office, Obama proposed a huge funding of $1.1 billion towards fighting opioid use and heroine abuse. This includes $950 million for supporting cooperative activities, $50 million for National Health Service Corps and $30 million for evaluating the effectiveness of these programs (Humphreys et al., 2022).
Explain how each of the presidential administrations approached the issue
The trump administration in his first term and hopefully in this second term will progress in using prevention, treatment, recovery, and research strategy. This includes the efforts by Trump to help in improving the functions of HHS through increased Naloxone prescribing in managing opioids abuse (Wen, 2020) Presidential Agendas.
Biden came to power while facing the pandemic ion Covid-19 and another pandemic on opioid use. To effectively address this issue the president expanded the use of Affordable Care Act to individuals battling opioids addiction. This also included reforms to the criminal justice system, additional funding, reduced overprescribing and halting illicit drugs coming to the united states (Jaffe, 2020).
The Obama’s administration major strategy in addressing opioid crisis was ensuring the medications are available to the most vulnerable rural communities. This also included the education to nurses and doctors in ensuring they create awareness and treatment of substance abuse and help reduce stigma across communities. Obama was determined to ensure everyone has easy access to treatment and was concerned about the minorities who had been discriminated for decades regarding access to care.
References
Gross, J., & Gordon, D. B. (2019). The Strengths and Weaknesses of Current US Policy to Address Pain.
American journal of public health
,
109
(1), 66–72.
https://doi.org/10.2105/AJPH.2018.304746
Humphreys, K., Shover, C. L., Andrews, C. M., Bohnert, A. S. B., Brandeau, M. L., Caulkins, J. P., Chen, J. H., Cuéllar, M. F., Hurd, Y. L., Juurlink, D. N., Koh, H. K., Krebs, E. E., Lembke, A., Mackey, S. C., Larrimore Ouellette, L., Suffoletto, B., & Timko, C. (2022). Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission.
Lancet (London, England)
,
399
(10324), 555–604.
https://doi.org/10.1016/S0140-6736(21)02252-2
Jaffe S. (2020). US election 2020: public health.
Lancet (London, England)
,
396
(10256), 946–947. https://doi.org/10.1016/S0140-6736(20)32036-5
Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning
Wen, L. S., & Sadeghi, N. B. (2020). The opioid crisis and the 2020 US election: crossroads for a national epidemic.
Lancet (London, England)
,
396
(10259), 1316–1318.
https://doi.org/10.1016/S0140-6736(20)32113-9
PICOT Question Development: Stroke-Related Patient Falls
Your Name
Institutional Affiliation
Course Code and Title
Instructor Name
Month, Year
PICOT Question Development: Stroke-Related Patient Falls
Hospitalized stroke patients are at risk for falls, which are challenging in healthcare settings and result in increased morbidity, length of hospital stay, and healthcare costs (Djurovic et al., 2021). This paper investigates the role of bed alarms and fall prevention protocols in reducing fall-from-bed incidence in stroke patients as compared to standard care without alarms. The aim is to evaluate evidence-based fall prevention strategies in this population and determine whether bed alarms and active fall prevention are associated with improved patient outcomes in the first 30 days following admission.
Problem Statement
Stroke patients often experience various physical and cognitive impairments, making them highly susceptible to falls. Falls are one of the most common adverse events in hospitalized patients, as reported by the Agency for Healthcare Research and Quality (AHRQ) (2021), and are of most significant concern in stroke survivors due to muscle weakness, impaired balance, and altered mental status (Dykes et al., 2024). Falls could lead to serious complications such as fractures, head trauma, and further neurological degeneration, resulting in patient morbidity and increasing use of hospital resources.
While hospitals have implemented general fall prevention protocols, stroke patients continue to experience falls. Routine safety care includes bed rails, nonslip flooring, and staff education, but such interventions only rarely protect the stroke patient, who sometimes tries to mobilize without support (Hill, 2023). A potential solution is provided by real-time alerts to healthcare providers to allow timely intervention and reduction of fall-related injuries by bed alarms and structured protocols for fall prevention. Targeted interventions aimed at populations at high risk of any or several adverse outcomes, including stroke patients, may help improve safety outcomes. Given this importance, the need for a more comprehensive fall prevention strategy, including technological and evidence-based interventions, is even greater.
Improved PICOT Question
In hospitalized stroke patients (P), how does the use of bed alarms and fall prevention protocols (I) compared to standard care without alarms (C) affect the incidence of falls from bed (O) within the first 30 days of admission (T)?
Population of Interest
This
study focuses
on hospitalized stroke patients at high risk for falls that are associated with physical and cognitive impairments in the population. Commonly, stroke patients present with hemiparesis, gait disturbances, visual deficits, and proprioception, which then causes an increased risk of falling (Djurovic et al., 2021). Falls also tend to be associated with cognitive changes such as poststroke delirium, confusion, or other changes in the brain. In particular, Li et al. (2024) claim that stroke impairments are very complex, so specialized fall prevention strategies for stroke patients are important in promoting patient safety and reducing adverse outcomes.
Intervention of Interest
The intervention of interest is using bed alarms and comprehensive fall prevention protocols. A bed alarm is an early warning system that would notify the healthcare provider when the patient tries to disembark from the bed without the healthcare provider’s supervision (Takase, 2022). These alarms are beneficial for stroke patients with insight or cognitive issues that preclude them from reaching out to help themselves. Fall prevention protocols include intervention strategies for routine risk assessment, patient and family education, scheduled toileting, and mobility assistance. These interventions aim to proactively reduce patient and environmental fall risks.
Evidence Supporting the Intervention
In several studies, bed alarm systems and fall prevention protocols have been studied for effectiveness in reducing fall rates in hospitalized patients. A systematic review by Cortés et al. (2021) notes that bed alarms decrease fall incidence among at-risk patients, including those with neurological disorders, using a structured fall prevention program. In a follow-up study, Turner et al. (2022) explain that early mobility assessments and bedside technology can enhance patient safety outcomes. In addition, Weber et al. (2024) confirmed that fall rates in hospitals where fall prevention strategies had been introduced were reduced by nearly 30% by targeting high-risk patients using bed alarms. Therefore, stroke care units may benefit from combining bed alarms with structured clinical practices to prevent falls PICOT Question Development: Stroke-Related Patient Falls .
Comparison of Interest
The comparison group consists of stroke patients who receive standard care without bed alarms. Standard prevention procedures comprise routine risk assessment, education to patients and families, scheduled toileting, and mobility assistance. These measures offer a means to prevent falls in stroke patients with severe impairment of mobility or mental function but are not adequate to prevent falls in such patients. The difference in fall rates between the intervention and comparison groups will be used to evaluate enhanced fall prevention strategies.
Outcome of Interest
The primary outcome of interest includes the incidence of falls from bed in hospitalized stroke patients. This outcome will be measured by recording a patient’s fall in the first 30 days of admission from incident reports and electronic health records. Fall incidence has been established as a valid and reliable clinical outcome measure in patient safety research (Heikkilä et al., 2023). Apart from fall rates, secondary outcomes like injuries related to falls, hospital length of stay, and patient satisfaction with safety measures can also be evaluated to assess the intervention’s effectiveness fully.
Timeframe
This study spans 30 days for the implementation phase, roughly the acute hospitalization period for most stroke patients. The timeframe allows for adequate assessment of the impact of bed alarms and fall prevention protocols on fall rates in assessments for variability in patient’s length of stay. Pre-intervention and post-intervention fall incidence rates will be collected to determine the effectiveness of the intervention.
Conclusion
Despite intensive efforts at fall prevention, hospitalized stroke patients still suffer a very high rate of falls, resulting in severe complications and additional burdens on healthcare. Because of the high risk of falls among stroke patients, the evidence of such interventions as bed alarms and comprehensive fall prevention programs can help to decrease falls, increase patient safety, and improve outcomes. Such
interventions
have been successful from a scholarly perspective, and targeted fall prevention measures in high-risk populations are shown to be a necessity. Future research should further develop new strategies for maximizing fall prevention in stroke care units to benefit patients and reduce rates of such preventable injuries.
References
Agency for Healthcare Research and Quality. (2021, February).
Fall tips: A patient-centered fall prevention toolkit
. Agency for Healthcare Research and Quality.
https://www.ahrq.gov/patient-safety/settings/hospital/fall-tips/index.html
Cortés, O. L., Piñeros, H., Aya, P. A., Sarmiento, J., & Arévalo, I. (2021). Systematic review and meta-analysis of clinical trials.
Medicine
,
100
(41), e27467.
https://doi.org/10.1097/md.0000000000027467
Djurovic, O., Mihaljevic, O., Radovanovic, S., Kostic, S., Vukicevic, M., Brkic, B. G., Stankovic, S., Radulovic, D., Vukomanovic, I. S., & Radevic, S. R. (2021). Risk factors related to falling in patients after stroke.
Iranian Journal of Public Health
,
50
(9).
https://doi.org/10.18502/ijph.v50i9.7056
Dykes, P. C., Sousane, Z., & Mossburg, S. E. (2024, December 18).
The ongoing journey to prevent patient falls
. The Ongoing Journey to Prevent Patient Falls.
https://psnet.ahrq.gov/perspective/ongoing-journey-prevent-patient-falls
Heikkilä, A., Lehtonen, L., & Junttila, K. (2023). Consequences of inpatient falls in acute care—A retrospective register study.
Journal of Patient Safety
,
20
(5), 10.1097/PTS.0000000000001230.
https://doi.org/10.1097/PTS.0000000000001230
Hill, K. (2023). Preventing falls through service innovations: Institutional and hospital settings.
Oxford Research Encyclopedia of Global Public Health
.
https://doi.org/10.1093/acrefore/9780190632366.013.471
Li, X., He, Y., Wang, D., & Rezaei, M. J. (2024). Stroke rehabilitation: From diagnosis to therapy.
Frontiers in Neurology
,
15
(15).
https://doi.org/10.3389/fneur.2024.1402729
Takase, M. (2022). Falls as the result of the interplay between nurses, patient, and the environment: Using text-mining to uncover how and why falls happen.
International Journal of Nursing Sciences
,
10
(1), 30–37.
https://doi.org/10.1016/j.ijnss.2022.12.003
Turner, K., Staggs, V. S., Potter, C., Cramer, E., Shorr, R. I., & Mion, L. C. (2022). Fall prevention practices and implementation strategies.
Journal of Patient Safety
,
18
(1).
https://doi.org/10.1097/pts.0000000000000758
Weber, K., Lauener, S. K., Deschodt, M., Grossmann, F., & Schwendimann, R. (2024). Patient involvement in fall prevention in an acute care hospital: A pilot study.
International Journal of Nursing Sciences
.
https://doi.org/10.1016/j.ijnss.2024.08.012
PICOT Question Development: Stroke-Related Patient Falls
Picot Assignment Example
Written Assignment: Develop a PICOT
In a document of between 700 and 1100 words (3 to 4 pages),
identify an evidence-based problem from a clinical setting (such as
long-term care, home care, or community agency). Develop a well-
written clinical question using the PICOT, PICO, or PIO method (P
= Population, I = Implementation, C= Comparison, O = Outcome, T
= Time).
In your assignment, be sure to include the following:
An introduction to the problem, including your
personal connection to this problem and a brief
summary of relevant background information
Information about the population who will be affected
by the resulting project
A well-written PICOT/PICO/PIO question, including
your rationale for why this is an EBP or QI question
and not a research question
An assessment of the feasibility of, and potential
barriers to, the change you’re proposing
Identification of the stakeholders involved in the
practice change or quality improvement (for example,
the agency from whom you would need permission to
complete the project)
A note about the question: Learners sometimes have problems
writing an EBP/QI question but write a research question instead. An
EBP/QI question should never use the words how or why. Those
terms belong in a research question. Your question should
acknowledge that evidence already exists. Below are some
examples.
Instead of asking:
How does the use of kangaroo care help increase infant
weight gain? (a research question)
You will ask:
Will nurses (P) who attend a class on the practice
change of using kangaroo care (I) score higher on a
post-class test than on a pretest given before the class
(O)?
Instead of asking:
What is the effectiveness of a pressure injury
prevention bundle for adult intensive care unit (ICU)
patients? (a research question)
You will ask:
In adult intensive care unit (ICU) patients (P), will the
implementation of a pressure injury prevention bundle
(I) compared to receiving standard pressure injury
prevention (C) reduce the incidence of pressure injuries
(O) after two months (T)?
Instead of asking:
What is the relationship between self-reported job
satisfaction among nurses and turnover intentions? (a
research question)
You will ask:
Among nursing staff in a large urban hospital (P), will a decrease in the patient-to-nurse ratio (I) reduce RN turnover (O) after eight
months (T)?
Picot Assignment Example
Pressure injuries, also referred to as pressure ulcers, continue to be a concern in most long-term care facilities, particularly among elderly patients who are confined to their wheelchairs or beds. Such injuries are known to cause complications that may include infections, lengthy hospitalization, loss of valuable time, and an overall poor standard of living for patients (Mondragon & Zito, 2022). Pressure ulcers remain a persistent problem in my clinical setting despite aggressive prevention measures. Their increasingly frequent occurrences highlight the importance of developing additional evidence-based strategies to curb the issue. Solving this problem is closely affecting my course personally because I have witnessed the suffering of patients and medical professionals. In my facility, increased pressure ulcer injuries lead to increased workload on nursing staff, burnout, and lower job satisfaction rates. According to Singh et al. (2023), an integrated pressure injury prevention bundle will help in reducing the incidences in identified high-risk patients Picot Assignment Example. This evidence-based proposal, therefore, seeks to identify evidence-based strategies to address the increasing incidences of pressure ulcers, prevent complications, and promote patient well-being.
ORDER A PLAGIARISM-FREE PAPER HERE
Affected Population
The targeted population most at risk of being impacted by the project will be the geriatric patients admitted to long-term care facilities who are most prone to developing pressure ulcers. These people mostly suffer from restricted mobility because of diseases like dementia, stroke, or physical disability, and thus, may be at risk of pressure ulcers or skin breakdown. Most of these patients are confined to their beds or spend extensive periods of their time in wheelchairs, which also makes them prone to developing pressure injuries (Elli et al., 2022). They are also more likely to have other ailments like diabetes, poor nutrition, or immune suppression, factors that also predispose them to skin breakdown. The nursing staff and caregivers who will be attending to these patients will also be affected by the project since they will be expected to embrace and generate compliance with the pressure injury prevention initiatives. The project focuses on the patients by minimizing pressure injuries while also aiming at the quality of care offered by the health personnel in the facility.
PICOT Question and Rationale
In elderly residents of long-term care at risk of developing pressure injuries (P), will the incorporation of a structured pressure injury prevention bundle that consists of regular repositioning, use of pressure-relieving mattresses and cushions, daily assessment of the skin condition, adequate nutrition and hydration, and proper moisture control (I), compared to standard practices (C) lead to the prevention of pressure injuries (O) in six months (T)?
The justification for this PICOT statement is based on past research evidence, including studies by Zhetmekova et al. (2024) suggesting that residents in long-term care facility settings are at a high risk of presenting pressure injuries because of their age, the presence of chronic systematic diseases, and their confinement to wheelchairs or beds for long periods. A structured pressure injury prevention bundle is an evidence-based approach to organizing and implementing several interventions that have been shown to reduce these risks, including repositioning, using pressure-relieving devices, and evaluating the skin at least once per day (Gillespie et al., 2020). This bundle helps in dealing with factors that are considered to be leading to pressure injuries, such as skin integrity, moisture, and nutrition. The PICOT statement is guided by the proposition of individual interventions that have been proven effective in prior research. It seeks to consolidate these individual interventions and implement them collectively as a care bundle to reduce the incidence of pressure ulcers.
Feasibility Analysis
The long-term feasibility of adopting a structured pressure injury prevention is fairly high as most of the measures, including turning of patients, use of pressure-relieving devices, and daily skin checks, are well within the routine care duties that nursing professionals perform and do not in any way require extra resources. Such practices conform to existing care practices and, therefore, promote the ease of dissemination. However, potential barriers may involve staff resistance to changing existing practices, especially in areas of heavy utilization with time constraints. In such cases, frequent repositioning schedules may not always be feasible unless the facility purchases automatic turn beds to reposition patients as needed frequently (Asiri, 2023) Picot Assignment Example. In addition, financial constraints may present a challenge as to whether pressure-relieving devices are wholly unaffordable or whether recurrent staff training is needed to enforce the change of the protocols. Gaining management support and commitment, as well as the support and cooperation of other stakeholders, including caregivers and patients, is essential to addressing these barriers and maintaining the change. Resolution of these problems would, therefore, require the education of the project staff and the provision of adequate resources.
Key Stakeholders Involved in the Program
The key stakeholder groups involved in this practice change will include direct care nursing staff, who will deliver the pressure injury prevention bundle, and their managers, who will monitor compliance with the new guidelines. The facility management and administration will be key stakeholders since they will be involved in supervising and implementing the project and provide funds, sanctions, and permission to buy pressure relieving devices, as well as support staff training, which is an essential starting point for the ongoing implementation of the project (Yan et al., 2021). Other staff members could include wound care specialists or consultants who may help clinicians offer care to patients to recommend the most appropriate care practices for wounds and skin injuries. In addition, patients and their families will be significant stakeholders since they will be the ones who will feel the positive effects of the intervention due to changes in their care. Permission to practice change will require endorsement from the administration of the long-term care facility and, usually, the governing health board to ensure that the practice change aligns with regulatory and institutional policies. Significant cooperation with all these stakeholders is vital to achieve effective implementation and sustainability of these strategies.
Conclusion
Pressure injury prevention bundle is an evidence-based strategy for long-term care facilities in the management of pressure injuries in high-risk elderly residents. The
PICOT question
focuses on the use of evidence-based interventions: repositioning at least four times daily, using pressure-relieving devices together with skin checks daily, and nutrition and moisture management to enhance patient outcomes in six months. This change is possible as the new care protocols are developed on the basis of the existing ones. However, constraints like staff resistance and time and resource constraints have to be considered and responded to by adequate training and management. With this change project, several stakeholders, including nursing staff, facility executive management, wound specialists, and the patients and their families, can be considered crucial to the success of the initiative. Through collaboration and achieving requisite permissions, the proposed quality improvement project promises reduced pressure injuries, thereby improving the quality of life for elderly patients admitted to long-term care facilities. Picot Assignment Example
References
Asiri, S. (2023). Turning and repositioning frequency to prevent hospital-acquired pressure injuries among adult patients: Systematic review.
Inquiry: A Journal of Medical Care Organization, Provision and Financing
,
60
(1), 00469580231215209.
https://doi.org/10.1177/00469580231215209
Elli, C., Novella, A., Nobili, A., Ianes, A., & Pasina, L. (2022). Factors associated with a high-risk profile for developing pressure injuries in long-term residents of nursing homes.
Medical Principles and Practice
,
31
(5).
https://doi.org/10.1159/000527063
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults.
Cochrane Database of Systematic Reviews
,
6
(6), 1–65.
https://doi.org/10.1002/14651858.cd009958.pub3
Mondragon, N., & Zito, P. M. (2022).
Pressure injury
. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK557868/
Singh, C., Shoqirat, N., Thorpe, L., & Villaneuva, S. (2023). Sustainable pressure injury prevention.
BMJ Open Quality
,
12
(2), e002248–e002248.
https://doi.org/10.1136/bmjoq-2022-002248
Yan, B., Dandan, H., & Xiangli, M. (2021). Effect of training programs on nurses’ ability to care for subjects with pressure injuries: A meta‐analysis.
International Wound Journal
,
19
(2).
https://doi.org/10.1111/iwj.13627
Zhetmekova, Z., Kassym, L., Kussainova, A., Akhmetova, A., Everink, I., Orazalina, A., Zhanaspayeva, G., Botabayeva, A., Kozhakhmetova, D., Olzhayeva, R., & Semenova, Y. (2024). The prevalence and risk factors of pressure ulcers among residents of long-term care institutions: a case study of Kazakhstan.
Scientific Reports (Nature Publishing Group)
,
14
(1).
https://doi.org/10.1038/s41598-024-57721-8
Picot Assignment Example