Need ONE Response Per Each Discussion Total 6 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
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Discussion4.docxDiscussion 4: Manuel M Cabrera
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Discussion 4
The overall quality of healthcare services in Miami-Dade County, Florida may be viewed as satisfactory. Nevertheless, some of the areas require improvement. For instance, the fact that nearly 19% of individuals in the county are uninsured is problematic because the lack of insurance is linked to a set of adverse outcomes (County Health Rankings & Roadmaps, 2019a). It is noted that at least 7,136 hospital stays in the county are preventable. At least 21% of adults described their health status as poor or fair. In contrast, insurance rate in St. Johns County, Florida is 90% (County Health Rankings & Roadmaps, 2019b). Expanded health coverage in the county leads to significant improvements in health outcomes Available research indicates that health insurance improves the number of outpatient visits while improving outpatient utilization (Sommers, Gawande, & Baicker, 2017). Differently put, health insurance helps to minimize healthcare spending due to the focus on preventive care.
Introduction of a community health center program in Miami-Dade County, Florida should be viewed as beneficial because it would help to address some of the biggest problems linked to the county’s low health insurance rate. The central objective of the program should be to provide vulnerable populations with necessary health services. It is expected that increased access to care would help to reduce the number of preventable stays. The percentage of adults that report poor or fair health status is also expected to decrease (Sommers et al., 2017). Professional nurses should participate in the political process to ensure that the authorities introduce evidence-based policies. It is also important to educate the patients to ensure that they are informed and recognize the importance of health insurance rates. Overall, the county’s current health insurance rate may be viewed as the biggest problem that needs to be addressed, and establishment of a community health center program would help to expand access to care.
References
County Health Rankings & Roadmaps. (2019a). Miami-Dade (DA). Retrieved from https://www.countyhealthrankings.org/app/florida/2019/rankings/miami-dade/county/outcomes/overall/snapshot
County Health Rankings & Roadmaps. (2019b). St. Johns (SJ). Retrieved from https://www.countyhealthrankings.org/app/florida/2019/rankings/st-johns/county/outcomes/overall/snapshot
Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health - What the recent evidence tells us. New England Journal of Medicine, 377(6), 586–593. doi:10.1056/nejmsb1706645
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Gretell Alfonso
Discussion 4: Gretell Alfonso
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Studying the health rankings website health outcomes statistics from united states overall was shocking. The state and county I chose to investigate a little more is Miami Dade, Florida. There are a lot of statistics that caught my attention such as low weight births and infant death rates which I noticed are high among the black population. However, the main statistics that shocked me was the number of HIV cases Miami- Dade has alone. In Miami-Dade as per 2015, the number of HIV cases is the 25,955 per 100,000 (health rankings website). This accounts for about ¼ of the population per 100,000. Compared to other counties in Florida Miami-Dade is significantly high with HIV rates which is very alarming to me and it should be to all of us in the community. As a future family nurse practitioner, I would like to implement a few ideas in order to improve this issue. One of them is to develop educational classes about HIV and AIDS among with other topics at an easy access to everyone. Health care insurances have many limitations and not everyone can afford it, therefore I would also like to create more awareness to legislators on this issue and how it can improve our statistics and healthcare outcomes by providing the same health care quality to every patient. Making insurance companies more aware of their limitation on health care services effects on the population while providing ideas on how HIV/AIDS testing should be included in their policies without the patient having to pay an extra amount of money. I also think that everyone that goes to the doctor's office should be tested for HIV/AIDS along with labs and other routine exams.
The Affordable Care Act was able to make it possible for more than thousands of people to access HIV testing (Wagner, Z., Wu, Y., & Sood, N. 2014). I would like to do the same in the future by making it a routine exam and an exam to be covered by the insurance policies no matter if its ACA or not. By implementing this into our health care system, more people will be tested which will make sure those who have HIV/AIDS are treated with their partners as well. Making this possible will make sure that the population that doesn’t know if they have HIV or AIDS be confronted with the situation and are led to resources that they could benefit from. For example, there is a program that has been around for 15 years servicing the Miami-Dade, Broward and Monroe population for those who benefit from Medicare and have HIV/AIDS called AIDS health care foundation which operates the Positive Healthcare Disease Management Program (AHF MCO secures AHCA managed medical assistance contract to serve broward, Miami-Dade & Monroe county HIV/AIDS patients. 2014). This program provides these patients with their treatment which helps with safety and providing care for these patients. HIV/AIDS is a serious disease that can be spread easily, however just because we have the medications that manage this disease and in return providing longer life spans for these patients, does not make it okay for us to not improve in this issue and decrease the statistics from our community or the world.
References
AHF MCO secures AHCA managed medical assistance contract to serve broward, miami-dade & monroe county HIV/AIDS patients. (2014). Professional Services Close - Up, Retrieved from https://search.proquest.com/docview/1498253177?accountid=158399
Wagner, Z., Wu, Y., & Sood, N. (2014). The affordable care act may increase the number of people getting tested for HIV by nearly 500,000 by 2017. Health Affairs, 33(3), 378-85. Retrieved from https://search.proquest.com/docview/1510370916?accountid=158399
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Mercedes Yumar
Health Care Policy
Policies are formed to make the best outcome for the people of the community, whether it be related to schools, hospitals, or other things that may need a policy in effect. When forming policies, an issue or an important matter will arise that some may feel strongly about. Policy issues related to drug abuse are always on the ballot. These policies must be approved at the level it will affect, which include the four spheres of political action: government, workplace, associations, and/or community levels. Some policies can involve all of these spheres of political action. Avolio (2014) mentions that nurses require the skill of constructing strong arguments that communicate patient perspectives and clinical realities to political debate. Nurses must speak up on issues they see, as people on the outside have no idea of some things that could be changed in medical settings. Avolio (2014) also mentions that issues affecting jobs and patient care would be under the workplace sphere. The government sphere address laws, rules and regulations that govern the nursing practice. Organizations address issues that actually shape the nursing practice and the community sphere addresses issues that affect community health.
An example I have been able to witness in my practice involves drug abuse of pregnant women. Many local hospitals have been having issues with drug abuse and many infants are being born at these hospitals to drug addicted mothers. If a mother is not drug tested throughout the pregnancy or on admit, it is possible that these infants are being sent home without being treated for withdrawals. Some drugs or medications that these mothers are on stay in their infants system until after discharge, keeping the infants withdrawal symptoms at bay until they are at home. These symptoms can be fatal if not correctly treated. In order to get a policy in effect to decrease this incidence, members of the healthcare team must come up with a plan together. They must carefully decide on what to include in the policy they would like in effect and the correct person to represent this policy to (Mason, Gardner, Outlaw & O'Grady, 2016). Drug testing on admit should be mandatory for all patients, as it is in some states already. This idea will be presented to hospital administration, who will then present this potential policy at the state level. Once approved, the solution will be tested and proven to decrease the risk of sending infants home that may suffer withdrawal symptoms after discharge. This policy would involve 3 of the 4 spheres including the government, workplace and community.
References
Avolio, C. (2014). Political Advocacy: Beliefs and practices of registered nurses. University of Windsor. Retrieved from: http://scholar.uwindsor.ca
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O'Grady, E. T. (2016). Policy & politics in nursing and healthcare (7th ed.).
Muller Sanon
Health Care Policy
Nine million children are uninsured in America, or 1 out of every 9 children overall. The disparities are great: 1 in 5 Latino children, 1 in 5 American Indian children, 1 in 8 Black children, 1 in 9 Asian/Pacific Islander children, and 1 in 13 White children is uninsured (Kuo, Etzel, Chilton, Watson, & Gorski, 2012). Based on these numbers, Latino and American Indian children lack access to health care services. People who had an education of high-school level or below are sometimes unaware of how to access healthcare and the programs that are available for people of low income. Many low income families are using the emergency room as a primary care for pediatrics because there is no out-of pocket expense to the parents. They are choosing to use the ER as a clinic instead of for emergencies, this is a clear indication of the lack of sufficient healthcare for pediatrics in our country.
The largest barrier to children accessing healthcare is the lack of providers seeing children and the providers that are willing to see children who are uninsured. There are roughly nine million children in this country who are uninsured, causing an overflow to clinics who provide care to those without insurance. Many pediatricians volunteer at community based health clinics, but also work full-time in a practice where they treat only insured patients. It is important that children understand how important health is and that they are properly treat at a young age. Lack of insurance should not prevent children for healthcare, but sadly in this country it does.
References
Arias, E., Anderson, R., Hsiang-Ching, K., Murphy, S., & Kochanek, K. (2013). National vital statistics reports. National Center for Health Statistics.
Kuo, A. A., Etzel, R. A., Chilton, L. A., Watson, C., & Gorski, P. A. (2012). Primary care pediatrics and public health: meeting the needs of today’s children. American journal of public health, 102(12), e17-e23.
Manuel Cifuentes
Health Care Policy
Upon reviewing the literature, numerous issues arise in Miami-Dade County and in the state of Florida. One of the biggest issues is the percentage of obese individuals that due to lack of exercise, lack of healthy eating, and other environmental factors, continue to gain weight present-day. For instance, this year in Miami-Dade County, 21% of the adult population are struggling with obesity (County Health Rankings and Roadmaps, 2018). In the State of Florida, adults struggling with obesity reach a total of 26% of the entire population (County Health Rankings and Roadmaps, 2018); a trend that appears to be constant throughout the years. With this in mind, many individuals believe that obesity can’t be changed due to its genetic component. However, it has been demonstrated that lifestyle changes can be utilized to treat and prevent obesity (Cui, Gao, Qu, & Liu, 2014).
The problem is that many individuals are not educated on healthy food choices and the importance of being active (Cui et al., 2014). Nonetheless, hope is not lost since creation of community health programs can be utilized to address the issue. For instance, exercise programs along with healthy food eating seminars or webinars can be utilized to gain the attention of those struggling with their lifestyle changes (Sanderson, Diefenbach, Streicher, Jabs, Smirnoff, Horowitz, Zinberg, Clesca, & Richardson, 2013).
As a Nurse Practitioner, one may work with the media to advertise those programs and to bring about change in the lives of his or her clients. It may begin simply by speaking to the patients about different food choices such as eating vegetables and lean meats that will benefit them in the long run (Sanderson et al., 2013). Afterwards, one may refer his or her patient to the appropriate community program in their area so that a healthy lifestyle may be promoted. The creation of the community health center program may help to address the incidence of obesity by educating the public about healthy eating and staying active. The nurse practitioner may aid in advocating policies that address exercise modalities, such as adding sidewalks and parks and recreation for the community.
References
County Health Rankings and Roadmaps. (2018, October 2). Florida. Retrieved from http://www.countyhealthrankings.org/app/florida/2018/rankings/miami-dade/county/factors/overall/snapshot
Cui, R., Gao, M., Qu, S., & Liu, D. (2014). Overexpression of superoxide dismutase 3 gene blocks high-fat diet-induced obesity, fatty liver and insulin resistance. Gene Therapy, 21(9), 840-8. doi: http://dx.doi.org/10.1038/gt.2014.64
Sanderson, S. C., Diefenbach, M. A., Streicher, S. A., Jabs, E. W., Smirnoff, M., Horowitz, C. R., Zinberg, R., Clesca, C., & Richardson, L. D. (2013). Genetic and lifestyle causal beliefs about obesity and associated diseases among ethnically diverse patients: A structured interview study. Public Health Genomics, 16(3), 83-93. doi: http://dx.doi.org/10.1159/000343793
Discussion 4
Yindra Isaac Amador
Health Care Policy
The country of Atlantic in the state of New Jersey ranks 17th on health outcomes in the state. One health outcome in need of improvement in the county is low birthweight, which refers to the percentage of live births with infants weighing less than 2500 grams (County Health Rankings, 2018). The health outcome has various characteristics which warrant the intervention of community health programs and the need for nurse leads to influence policy innovation.
Low birth weight is characterized by developmental and growth problems that lead to premature mortality (County Health Rankings, 2018). The infants are also at high risk of cardiovascular diseases later in life. They also register a higher rate of respiratory and cognitive conditions as compared to infants born with a healthy weight (County Health Rankings, 2018).
The creation of community health center programs provides community health workers who help to address low birth weight. The workers identify women at risk of low birth weight infants and after that connect them to health and social services (Redding et al., 2015). The workers also track the progress of the women concerning the health risk until favorable outcomes are witnessed (Redding et al., 2015). These programs reduce the rate of low birth weights among women at high risk.
A nurse leader has to influence policy innovation to resolve the problem of low birth weights by improving nurse staffing (Lake, Rogowski & Weiner, 2016). Nurse staffing reduces the complications from LBW by facilitating education on post-discharge care interventions (Lake, Rogowski & Weiner, 2016). Adequate staffing also increases lactation assistance provided to mothers of LBW infants.
In conclusion, LBW is a terrible health outcome in Atlantic and is characterized by various effects. Community health programs provide community workers that help mothers at risk of LBW infants. Nurse leaders influence nurse staffing to improve policies on the management of LBW, hence resolving this problem.
References
County Health Rankings. (2018). Low Birth Weight. Retrieved from http://www.countyhealthrankings.org/app/new-jersey/2018/measure/outcomes/37/description
Lake, E., Rogowski, J., & Weiner, J. (2016). Improving the Lives of Fragile Newborns: What Does Nursing Have to Offer? Retrieved from https://ldi.upenn.edu/brief/improving-lives-fragile-newborns-what-does-nursing-have-offer
Redding, S., Conrey, E., Porter, K., Paulson, J., Hughes, K., & Redding, M. (2015). Pathways Community Care Coordination in Low Birth Weight Prevention. Maternal and Child Health Journal, 19(3), 643–650. doi: http://doi.org/10.1007/s10995-014-1554-4
