NUR415/NUR425 Discussion posts and peer responses

Discussion Questions Requirements: Main discussion post should be at least 2-3 paragraphs. Two peer responses should be at least 50 words minimum. NUR415 Discussion post: Step 1: The patient-centered medical home (PCMH) model also known as a health home is a health care delivery model designed to improve access to care increase quality and reduce costs. Familiarize yourself with the PCMH model. Use these websites or research them on your own. Step 2: For this discussion select one of the health care delivery settings discussed in the assigned reading (e.g. home health/hospice long term care the VA system retail/nursing clinics community health centers) and consider ways in which the setting could incorporate aspects of the PCMH model. Specifically address access quality and cost. Finally discuss the nurse’s role in advocating for these changes. If possible share your own experiences and example of this model (or related principles). Step 3: Read other students posts and respond to at least two of them. Cite any sources in 7th. ed APA format. Response Posts: In your responses to your classmates contribute to the discussion with your own original opinions or interpretation of the course materials. NUR415 Student Posts: Student#1: A PCMH is a model of care that strengthens the clinical-patient relationship by replacing episodic care with coordinated whole person and long-term care (Patient-centered medical home 2011: Health care that revolves around you 2011). The primary care clinician leads a team of clinical and community health providers who take collective responsibility for patient care. They coordinate care for the patient’s health needs and arrange for appropriate care with other qualified health services. For my discussion I am selecting home health I am currently working in this area of nursing and have been for 4 years now. Home health has been on the rise due to shorter hospitalization time. Access: Access to home health is easily obtained when discharge you will be appointed a home health agency if home health is needed or you can use your specified agency of choice. If not recently hospitalized then the signing provider would send over a referral and other needed documents for start of care (SOC). When admitted to home health services they usually extended on call hours for patient’s convenience if anything comes up. Quality: The quality of care received in home health is great considering all services will be provided to the patient in the home due to taxing effort to leave home. Services can include but not limited to RN/LPN PT/PTA’s OT/COTA’s ST and MSW. From my experience home health has been a great asset in the rehabilitation process for patient’s recovery and management of chronic conditions. Cost: The company I am currently working for excepts all major insurances. The cost billed is per visit rate or per episode. The cost is reasonable considering the cost of hospitalization/SNF cost. In home health nurses are the case manager coordinating all aspects of care. I feel like we do a great job with access and cost of care. I do always feel like there is room to improve the quality of services to always ensure we are striving for excellences when it comes to enhancing patient centered outcomes. Student#2:Hospice care services provide clinical social emotional and spiritual care and support for a patient and their immediate family members near the end of life. As part of hospice the care team provides palliative care—designed to keep the patient as comfortable as possible with a variety of interventions to reduce and manage pain and other symptoms (BAYADA 2019). Hospice patients benefit from home health because they can live out their remaining days in the comfort of their home. Being at home surrounded by family and friends can at times improve the quality of life. To access hospice care your loved one must be diagnosed by a physician with a terminal illness with less than six months to live if the illness follows its typical path. If your loved one lives beyond this six-month timeframe they can continue to receive hospice care if a physician recertifies their eligibility (When Is It Time for Hospice? When to Call Hospice Care n.d.). When a patient beings hospice they receive care from a team who will support their physical emotional and spiritual needs. All medication and medical supplies and equipment related to the diagnosis are provided at no additional cost to the patient or family. Nurses should always advocate for whatever will provide their patient with the best quality of life and even more in the ending stages of life! NUR425 Discussion Post To create your initial post to this discussion forum complete the following steps. Step 1: Find an article.Identify one peer-reviewed article from a nursing journal focused on the health needs of one of the following populations in the United States: Step 2: Read the article.Critically read the article. While you read note the audience targeted by the article the purpose of the article how evidence is incorporated into the nursing implications the major ideas of the article whether the article makes sense whether the conclusions are logical and so on. Step 3: Summarize the article and propose a population-based interventionSummarize the article including the audience and purpose of the article as well as the implications for population-based nursing. Based on the information in the article propose one population-focused intervention. Make sure that you use APA format to properly cite the article. Step 4: Post to the discussion forum.Post the summary of your article to the discussion forum. In addition to your original post be sure to provide a meaningful response to at least two of your peers’ posts. Read other students article summaries and respond to at least two other students postings that focused on the health needs of two populations that were different from the one you chose. (Step 1 lists the three populations.) What else do you want to know about the health need? Comment and/or expand on the implications for population-based nursing posed for the other two populations. Give suggestions for enhancing the proposed interventions. Expand on aspects of population-based and community-based nursing as defined by others that are different from or complementary to your own ideas. Your initial post should be 2-3 paragraphs long and follow the requirements outlined in the discussion rubric. Please add to the discussion in your peer responses with informative responses instead of posts similar to “great idea! I really agree with you.” The initial post and the peer responses have different deadlines. Make sure that your discussion adheres to these deadlines. APA guidelines and plagiarism prevention matter in discussion posts just like with other scholarly assignments. Cite all references appropriately using APA format. NUR425 Student Posts: Student#1: I read an article from the American Journal of Nursing that addresses the use of alcohol in women who are pregnant. Alcohol consumption during pregnancy can influence fetal development causing lifelong behavioral intellectual and physical impairments known as fetal alcohol spectrum dis s. (FASDs) No amount or type of alcohol is considered safe to consume during pregnancy. High and sustained levels of alcohol use during pregnancy increase the likelihood of FASDs in children exposed prenatally. Because of alcohols potential teratogenic effects abstinence from alcohol is recommended for pregnant women. (Mitchell A. 2020). However despite the warnings on harming an unborn baby alcohol use in pregnancy is still common. A recent analysis of 2015-2017 Behavioral Risk Factor Surveillance System (BRFSS) data found that an estimated 11.5% of pregnant women 1 in 9 reported alcohol use and 3.9% reported binge drinking in the past 30 days. 10.2% of pregnant women reporting current drinking and 3.1% reporting binge drinking. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use as a population-wide clinical preventive service that includes doing the screening on pregnant women. This tool provides moms engaged in drinking with brief behavioral counseling interventions. (Mitchell A. 2020). Based on the information in the article a community health nurse would focus on prenatal education and maintaining the health of the mother and child during pregnancy. Advocating for maternal health and wellness in ways such as teaching about healthy foods prenatal vitamins staying active safely and abstaining from hazardous teratogenic substances that may harm their unborn child. Addressing all issues that bring danger to the child they are holding safe in utero would be a priority. Engaging in discussion groups encouraging peer counseling providing resources that help mothers not only sustain from alcohol but any substance such as nicotine or narcotic medications that are toxic to the fetus. Student #2:I read an article about the effects of screentime on the health and well-being of children and adolescents. The purpose of this article was to show evidence that screen time for children and adolescents can have multiple health issues. The audience of this article is children and adolescents. There are many side effects of having too much screen time for our children. It was found to have moderately strong evidence for associations between screentime and more significant obesity and higher depressive symptoms; moderate evidence for an association between screentime and higher energy intake less healthy diet quality and more inferior quality of life (Stiglic & Viner 2019). There was weak evidence for associations of screentime with behavior problems anxiety hyperactivity and inattention poorer self-esteem poorer well-being and poorer psychosocial health metabolic syndrome poorer cardiorespiratory fitness poorer cognitive development and lower educational attainments and poor sleep outcomes (Stiglic & Viner 2019). There was no or insufficient evidence for an association of screentime with eating dis s or suicidal ideation individual cardiovascular risk factors asthma prevalence or pain (Stiglic & Viner 2019). I think a proposed intervention would be to get our children engaged in more physical activities. Sometimes parents are left to blame as well; we use screen time as a babysitter. We as parents need to be involved in our childrens lives and spend time with them by throwing a ball swimming riding bikes anything to help promote physical activity. We are supposed to lead by example and when our children see us on the phones all the time then that is what our children want to do as well. Requirements: Main discussion post should be at least 2-3 paragraphs. Two peer responses should be at least 50 words minimum. | .doc file The Medical Home Model of Care (Links to an external site.) How the Affordable Care Act Will Strengthen the Nations Primary Care Foundation (Links to an external site.) Health Policy Gateway (Links to an external site.) Women Children and adolescents Families