Compare and Contrast Britain's and the United States health history and current structure

  

In a 5-6 page Microsoft Word document, compare and contrast Britain’s and the United States health history and current structure, including: Different philosophical approaches to the provision of care Organization Financing Delivery of health services and public health systems Utilize your textbook and other scholarly sources for this assignment help to assist with your research. You may also find the following websites helpful: The Future of Public Health: A History of the Public Health System Overview of Healthcare in the UK

MAP-IT framework is a tool for organizing and gauging societal public health endeavors. Experienced and inexperienced public health workers may use MAP-IT processes to build ans develop a community that is healthy (McKnight, Kretzmann 1996). The MAP-IT approach takes time, effort, and a series of stages to ‘map out’ the journey towards a community’s desired change. Remember that there is no one solution that fit all when it comes to this, therefore, some procedures are needed repetitively. A coalition can use MAP-IT to develop a chronological, organized plan aimed towards a given community’s requirements.

Mobilize

Nursing intervention is developed to establish and enforce park exercise activities in zip code 33127. After looking at the data collected from the community at zip code 33127, it was rather evident that residents, especially on the north side of the zip code, are not even trying to participate in the community’s public parks.

Following the underlying investigation, the nurse intervention determines that a different strategy is required, and it brings together important stakeholders in the postal district 33127 to help nurture an agreement. The Nursing Intervention Task Force will comprise representatives from environmental health, education, and the community public health practitioners. The task force’s mission is to develop and maintain a healthy community in the postal district.

Assess

The task force holds a strategic planning meeting; furthermore, the task force holds data mining on healthy living from exercise. During the assessment, the task force discovered that the rate of chronic diseases reported in the postal district 33127 is alarming, especially among young people in the community. It has been discovered that the lack of physical exercise majorly triggers chronic disease.

Currently, the staffing, skills and information on the importance of healthy living are at our disposal, but where do we go from there? From further deliberation, it is concluded that we would need funding to conduct public awareness campaigns, initiate the building fitness park, and install outdoor exercise equipment.

Plan

During the afternoon of the strategic planning meeting, the task force agreed that installing at least four outdoor fitness equipment in the postal district 33127 should be the priority in addressing the rising chronic illness rate.

Our head decided to contact a community-based organization (CBO) with a long history of dealing with public workout equipment installation and ask them to assist in developing a project plan. If money is approved, the CBO signs a letter of understanding to participate in the project. In addition, the director collaborates with other members of the postal district’s health department and government to draft a plan.

We suggest a pilot program in which exercise equipment is installed in public parks. Some unemployed locals would be trained to assist in the procedures as part of the pilot program. We also decided to keep an eye on the rate of chronic illnesses to determine if it is decreasing. The federal government funds the project due to supporting data being the primary cause.

Implement

The CBO is enthusiastic about the project and is in charge of communicating with locals about the installations and reacting to emerging issues. In addition, the CBO is responsible for overseeing and performing the project’s training and employment aspects.

Our project manager manages the whole project and collaborates with contractors to ensure proper completion. In the parks, equipment such as sit-up benches, dip and leg raise stations, vertical ladders, and rope climbs is erected. In addition, two parks dedicated to workouts are being built. All of this takes place over the course of one and a half years.

Track

The task force keeps track of the project’s development and gathers official and informal data to assess its impact. Since the parks have been improved, the number of cases of chronic illnesses has decreased. Residents say they feel healthier now than they did before the adoption, and there are fewer incidents of heart attacks. Consequently, the inhabitants are pleased with the workout equipment in the parks. The task group understands that they must remain focused and engaged for the program to continue.

Conclusion at https://onlyassignmenthelp.com/custom-writing-service/write-my-assignment-for-me/get-information-technology-assignment-help-from-expert-writers/ 

In the execution of a solution, evaluation and tracking are critical activities. These tasks, which are carried out in phases, offer practitioners various information (McEwan & Bigelow, 1997). For example, the preliminary evaluation aids in the identification of barriers and risks. It is feasible to take early strategies that focus on this knowledge to optimize the advantages of the solution while avoiding the danger of failure (StudyCorgi, 2021). The post-evaluation of results aids in determining the plan’s overall efficiency. The information may be utilized to improve the existing educational program and help design new, more complex ones.

REFERENCES

StudyCorgi. (2021) MAP-IT Model: Evaluation of Plan Effectiveness. Retrieved 21 June 2022, from https://studycorgi.com/map-it-model-evaluation-of-plan-effectiveness/

McEwan, K., & Bigelow, A. (1997). Using a logic model to focus health services on population health goals. Canadian Journal of Program Evaluation 12(1): 167-174.

McKnight, J. L., & Kretzmann, J. P. (1996) Mapping Community Capacity. Onlyassignmenthelp.com The Asset-Based Community Development Institute, Institute for Policy Research, Northwestern University.

Improving test taken strategies

please see the attached files for details information and rubrics.

Unit 7 Discussion Case Study —2 Peer Response 600w. Due 10-20-23

Unit 7 Discussion Case Study —2 Peer Response 600w. Due 10-20-23

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

Unit 7: Initial Discussion-Case Study RM

· A 70-year-old woman has scheduled an initial evaluation with you. Her medical diagnoses include hypertension, hyperglycemia, mild obesity, and hyperlipidemia. Her psychiatric diagnoses include anxiety and depression. Her current medications are atorvastatin 20 mg daily for seven years, Ozempic 1 mg injection weekly for three years, lisinopril 10 mg daily for 10 years, and Abilify 5 mg daily for six years. 

· Labs: Fasting Blood Glucose – 115, HbgA1C – 6.9, Total Cholesterol – 200, LDL – 100, HDL – 37. Her height is 5’2” and her weight is 176 pounds. Her blood pressure was 146/83 upon arrival at the office.  

· During your interview, she explains she became depressed following the death of her husband seven years ago. She became anxious about performing everyday tasks without him present.  After starting Abilify, she gained 25 pounds and required an increased dose of atorvastatin and Ozempic. She has been unable to lose the weight she gained and tries to closely monitor her dietary intake due to her persistently elevated glucose but reports still craving carbohydrates.  Her depression has improved slightly but she is still anxious to go out alone, so she no longer goes for daily walks to exercise. 

Subjective: 

CC: initial evaluation 

HPI: A 70-year-old female presents to the clinic for initial evaluation. She is a new patient in the practice. She reports a current history of hypertension, hyperglycemia, mild obesity, and hyperlipidemia. She also reports currently being diagnosed with anxiety and depression. She reports taking atorvastatin 20 mg daily for 7 years for hyperlipidemia, Ozempic 1 mg injection weekly for three years for hyperglycemia, lisinopril 10 mg daily for 10 years for hypertension, and ability 5 mg daily for 6 years for depression. 

PMH: Hypertension, hyperlipidemia, hyperglycemia, mild obesity, anxiety, and depression.  

Allergies: none reported 

Medications: atorvastatin 20 mg daily for 7 years for hyperlipidemia, Ozempic 1 mg injection weekly for three years for hyperglycemia, lisinopril 10 mg daily for 10 years for hypertension, and Abilify 5 mg daily for 6 years for depression. 

SH: Patient lost her husband seven years ago and became depressed. The patient reports her anxiety increased to perform everyday tasks without her husband. The patient states, that after starting Abilify she gained 25 pounds and required an increased dose of atorvastatin and Ozempic.  She has been unable to lose the weight she gained and tries to closely monitor her dietary intake due to her persistently elevated glucose but reports still craving carbohydrates.  Her depression has improved slightly but she is still anxious to go out alone, so she no longer goes for daily walks to exercise. 

FH: N/A 

Health promotion and maintenance: N/A 

ROS:  

Constitutional 

reports weight gain of 25 lbs. 

Head 

N/A 

Eyes 

N/A 

Ears, Nose, Mouth, Throat 

N/A 

Neck 

N/A 

Cardiovascular/Peripheral Vascular 

N/A 

Respiratory 

N/A 

Breast 

N/A 

 

 

Gastrointestinal 

Reports increased cravings for carbohydrates. 

Genitourinary 

N/A 

Musculoskeletal 

N/A 

Integumentary 

N/A 

Neurological 

Alert and oriented x 3.  

Psychiatric (screening tools: Ex: PHQ-9, MMSE, GAD-7) 

Reports anxiety to go out of her house alone and depression slightly improved 

Endocrine 

Reports persistent elevated glucose and carbohydrate cravings. 

Hematologic/Lymphatic 

N/A 

Allergic/Immunologic 

N/A 

Other 

  

Objective:   

Her height is 5’2” and her weight is 176 pounds. Her blood pressure was 146/83 upon arrival at the office.  Labs: Fasting Blood Glucose – 115, HbgA1C – 6.9, Total Cholesterol – 200, LDL – 100, HDL – 37. 

·
What advice or modifications to his treatment regimen would you recommend for your new patient? (Discuss a minimum of two). Please support your answer with research-based evidence.  

This 70-year-old female patient presents with diabetes as evidenced by a FBS of 115 

and a HgbA1C of 6.9. A HgbA1C level equal to 6.5% or greater indicates a diagnosis of diabetes mellitus 

(Centers for Disease Control and Prevention, 2023). The patient is currently at considerable risk for cardiovascular disease due to her borderline total cholesterol level of 200, LDL of 100, and HDL 37. The patient’s height is 5’2″ and weight is 176 lbs, BMI is 32.2 as per CDC (Centers for Disease Control) guidelines patient is obese which also contributes to cardiovascular disease (Centers for Disease Control and Prevention, 2022). The normal weight for the height of this patient is between 101lbs-136lbs (Centers for Disease Control and Prevention, 2022). According to Healthline, total cholesterol levels should be less than 200, LDL less than 100, HDL greater than 60, and triglycerides less than 149 for adult patients (2021). The patient has also been experiencing high blood pressure, BP 146/83 upon arrival. The patient has currently been taking lisinopril 10 mg daily for hypertension, atorvastatin 20 mg daily for 7 years for hyperlipidemia and Ozempic 1 mg injection weekly for three years for hyperglycemia. 

The patient has also been taking Abilify 5 mg daily for 6 years for depression. During this time, the patient gained twenty-five pounds and required an increased dose of Ozempic and atorvastatin. The patient has been unable to lose the weight she gained and reports closely monitoring dietary intake due to persistently increased glucose levels and carbohydrate cravings. The patient’s states depression slightly improved, however, anxiety has not improved and now the patient is having trouble leaving the house alone.  

According to the patient’s assessment, my treatment plan would be to continue Ozempic 1 mg injections weekly for diabetes management and add metformin IR 500mg PO BID with meals (Corcoran & Jacobs, 2023). Patient to check finger stick blood glucose levels 1-2 times daily on an empty stomach. Recommend the patient to a diabetes education program. To manage her cholesterol levels, I would titrate her atorvastatin from 20 mg to 40 mg PO daily. Re-check patient's lipid levels in 2-4 weeks (Drugs, 2023). To manage her high blood pressure, I would increase her lisinopril to 10 mg PO BID as a study shows that prescribing lisinopril twice daily vs once daily shows more improvements in SBP. Mean adjusted SBP reduction was 10.2 mm Hg greater in the twice‐daily cohort compared with the once‐daily cohort (Tsai et al., 2017). The patient will be coming back for follow-up in 2-4 weeks for further treatment outcome and if necessary, treatment plan adjustment.  

The patient has chronic depression that has improved slightly; however, she does voice increased anxiety and new symptoms of fear of going out alone since her husband died seven years ago. The patient is now restricting herself from going out for walks and exercise. She is starting to exhibit symptoms of agoraphobia. The patient is currently taking Abilify 5 mg PO daily for 6 years. Typically, second-generation antipsychotics are not the first line of treatment for depression, they are used once they have tried many antidepressants with no effect. I suggest treatment augmentation with an antidepressant. Zoloft is an SSRI that does not counteract Abilify, start Zoloft at 25 mg PO daily and increase the dose weekly as needed. Zoloft is used for depression and social anxiety disorder (Psych Central, 2021). The patient will also benefit from psychopharmacology, psychotherapy, cognitive behavioral therapy. 

Lastly, lifestyle change recommendations include diet and exercise modification. Work your way up to 150 minutes of moderate-intensity aerobic activity each week. This could be brisk walking 30 minutes a day, 5 days a week. Or you could do 75 minutes of vigorous-intensity aerobic activity each week, such as swimming laps. Regular physical activity provides immediate and long-term 

health benefits.Links to an external site.
 Physical activity and weight loss will Improve sleep quality, reduce high blood pressure, and reduce risk for type 2 diabetes, heart attack, stroke, and 

several forms of cancerLinks to an external site.
. It can help reduce arthritis pain and associated disability, reduce the risk for osteoporosis and falls, and reduce symptoms of depression and anxiety (Centers for Disease Control and Prevention, 2023). 

·
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?  

 Yes, as a practicing PMHNP for the state of Pennsylvania, prescribe drugs, devices, and Schedule II-V controlled substances if there is a written collaboration agreement with a physician (Pennsylvania Coalition of Nurse Practitioners, n.d.).  

References: 

Balaram, K., & Marwaha, R. (2023). Agoraphobia.
 NIH


https://www.ncbi.nlm.nih.gov/books/NBK554387/Links to an external site.
 

Centers for Disease Control and Prevention. (2022). Adult BMI calculator. CDC. 


https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.htmlLinks to an external site.
 

Centers for Disease Control and Prevention. (2023). Diabetes tests. 
CDC

  

https://www.cdc.gov/diabetes/basics/getting-tested.htmlLinks to an external site.
 

Centers for Disease Control and Prevention. (2023). Physical activity for a healthy weight. 
CDC. 


https://www.cdc.gov/healthyweight/physical_activity/index.htmlLinks to an external site.
 

Corcoran, C., & Jacobs, T.F. (2023). Metformin. 
NIH

https://www.ncbi.nlm.nih.gov/books/NBK518983/Links to an external site.
 

Drugs. (2023). Atorvastatin dosage. 


https://www.drugs.com/dosage/atorvastatin.html#Usual_Adult_Dose_for_HypertriglyceridemiaLinks to an external site.
 

Pennsylvania Coalition of Nurse Practitioners. (n.d.). Scope of Practice. PACNP. 


https://www.pacnp.org/page/ScopeofPractice#:~:text=In%20Pennsylvania%2C%20an%20NP%20may,collaboration%20agreement%20with%20a%20physicianLinks to an external site.

Psych Central. (2021). Zoloft: What you want to know? 

https://psychcentral.com/drugs/zoloft#basicsLinks to an external site.
 

Tsai, T., Kroehl, M. E., Smith, S. M., Thompson, A. M., Dai, I. Y., & Trinkley, K. E. (2017). Efficacy and 

safety of twice- vs once-daily dosing of lisinopril for hypertension. 
Journal of clinical hypertension (Greenwich, Conn.)
19(9), 868–873. https://doi.org/10.1111/jch.13011 

Unit 7 Discussion Case Study MV

What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Support your answer with research-based evidence.

In managing this patient's weight concern, a comprehensive approach that addresses both behavioral and pharmacological aspects would be necessary. First and foremost it's crucial to evaluate if the patient is prepared to make changes and how motivated she is to lose weight. We can use motivational interviewing techniques to delve into her reasons, for wanting to shed pounds and uncover any obstacles or difficulties she might encounter (Bischof et al., 2021). To address her worries, about how her weight might affect her ability to care for her child it could be advantageous to involve a team of professionals that includes a registered dietitian, an exercise specialist and a psychologist or therapist. The dietitian can work with the patient to develop a personalized meal plan that takes into consideration her busy schedule and frequent eating out habits. Emphasizing portion control, incorporating healthier food choices, and encouraging mindful eating practices have been shown to be effective in managing obesity (Foster et al., 2018). In terms of physical activity, an exercise specialist can help the patient create an individualized exercise routine that is feasible given her current responsibilities as a stay-at-home mother. Promoting regular physical activity has been found to aid in weight loss so finding activities that she enjoys and can incorporate into her daily routine will enhance adherence maintenance (Posadzki et al., 2020).

What would be our approach to the sexual side effects she is experiencing?

Regarding the sexual side effects experienced by the patient, it is crucial to address these concerns openly and compassionately. It's important to determine whether the issues are primarily caused by medication use or if they're influenced by factors, like stress or relationship dynamics. It might be beneficial to educate the patient about how fluoxetine and olanzapine can affect sexual functioning. If it is determined that the medication is causing these problems switching from fluoxetine to another antidepressant that has a less impact on sexual function could be considered. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine have been linked to sexual dysfunction (Yuan et al., 2021). Bupropion, which is an atypical antidepressant, with a lower likelihood of causing sexual side effects could be an alternative option worth exploring (Montejo et al., 2019).

If you suggest additional medication, look up your state’s prescribing laws. Are PMHNPs able to prescribe the medication you recommend?

Before suggesting any additional medication options such as Bupropion, it is essential to review prescribing laws specific to Illinois. As a PMHNP prescribing additional medication for the above concerns would depend on state laws. According to the Illinois Nurse Practice Act (2017), advanced practice registered nurses (APRNs) including PMHNPs have prescriptive authority. However, there are specific conditions and restrictions outlined in the Act (AANP, 2022). Therefore, it is necessary to review the current regulations and guidelines set forth by the Illinois Department of Financial and Professional Regulation (IDFPR) to ensure compliance with prescribing laws when considering Bupropion as a treatment option for this patient (Kleinpell et al., 2023). Psychiatric Mental Health Nurse Practitioners (PMHNPs) in Illinois have prescriptive authority to reduce practice. Illinois state law requires a career-long regulated collaborative agreement with a psychiatrist in order for the NP to prescribe medication. The nurse practitioner-psychiatrist collaborative practice agreement outlines their working relationship. It describes the categories of care, treatment, and procedures the nurse practitioner expects to perform (AANP, 2022). In Illinois, psychiatrists are not required to be physically present with the PMHNP. The psychiatrist must be available for consultation whether in person or by phone. A collaborating psychiatrist and PMHNP are required to meet at least once a month (AANP, 2022).

Include the subjective and objective information in this post.

Subjective information:

The patient reports concerns about her weight and its impact on her ability to care for her disabled child after her husband's death. She has tried numerous 'fad diets' without long-term success, losing only 15 pounds at most and maintaining it for three months. The patient expresses feelings of shame related to sexual dysfunction, specifically difficulty achieving orgasm during intimate moments with her husband.

Objective information:

The patient's objective data include being morbidly obese at 340 pounds with a height of 5'5″. She also has type II diabetes, hypertension, and hyperlipidemia. Additionally, she eats out frequently due to her children's busy schedules and leads a sedentary lifestyle with no regular physical activity.

References

American Association of Nurse Practitioners (2022). State practice by type. Retrieved from https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment/66-legislation-regulation/state-practice-environment/1380-state-practice-by-typeLinks to an external site.

Bischof, G., Bischof, A., & Rumpf, H.-J. (2021). Motivational interviewing: An evidence-based approach for use in medical practice. Deutsches Ärzteblatt international. https://doi.org/10.3238/arztebl.m2021.0014Links to an external site.

Foster, D., Sanchez-Collins, S., & Cheskin, L. J. (2018). Multidisciplinary team–based obesity treatment in patients with diabetes: Current practices and the state of the science. Diabetes Spectrum, 30(4), 244–249. https://doi.org/10.2337/ds17-0045Links to an external site.

Kleinpell, R., Myers, C. R., & Schorn, M. N. (2023). Addressing barriers to aprn practice: Policy and regulatory implications during covid-19. Journal of Nursing Regulation, 14(1), 13–20. https://doi.org/10.1016/s2155-8256(23)00064-9Links to an external site.

Montejo, A., Prieto, N., de Alarcón, R., Casado-Espada, N., de la Iglesia, J., & Montejo, L. (2019). Management strategies for antidepressant-related sexual dysfunction: A clinical approach. Journal of Clinical Medicine, 8(10), 1640. https://doi.org/10.3390/jcm8101640Links to an external site.

Posadzki, P., Pieper, D., Bajpai, R., Makaruk, H., Könsgen, N., Neuhaus, A., & Semwal, M. (2020). Exercise/physical activity and health outcomes: An overview of cochrane systematic reviews. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09855-3Links to an external site.

Yuan, S., & Deban, C. E. (2021). Ssri-induced hypersexuality. American Journal of Psychiatry Residents' Journal, 16(3), 9–12. https://doi.org/10.1176/appi.ajp-rj.2021.160305Links to an external site.

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

 You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire. 

Week 6 – Discussion

HUM 1050 – Introduction to Literature

Week 6 – Discussion

Instructions:

This week, we shift our discussion to poetry, focusing on the work of Martin Espada. You will upload a PowerPoint in the discussion and in the Dropbox for grading that includes a visual that interprets one of his poems. Choose a poem from the link below:

https://www.poetryfoundation.org/poets/martin-espada

Your presentation should be a minimum of six slides and may have more depending on the length of the poem. Here is a suggested layout:

· Slide 1: Include the title of the presentation and your name, college name, course name, instructor name, date

· Slide 2: Include a brief bio of the poet.

· Slide 3: Introduce the poem with a link to the poem.

· Slides 4-5: Present the visual you have selected. Give the background on the visual and explain its relevance to the poem.

· Slide 6: Reference list in APA format. 

 

Criteria

Ratings

The Poem

This criterion is linked to a Learning Outcome

Focus on poem

CSLO 3

threshold: 15.0 pts

15 pts

Mastery

15 pts The poem presented clearly on the slide(s)

The VIsual

This criterion is linked to a Learning Outcome

Visual presented

CSLO 3

threshold: 15.0 pts

15 pts

Mastery

15 pts A vivid image that interprets the poem clearly presented

Theme of poem

This criterion is linked to a Learning Outcome

Theme of poem

CSLO 4

threshold: 20.0 pts

20 pts

Mastery

20 pts The theme of the poem clearly presented

Author's Biography

This criterion is linked to a Learning Outcome

Author’s biography

CSLO 4

threshold: 20.0 pts

10 pts

Mastery

10 pts Poet’s biography clearly presented

Formatting and Readability

This criterion is linked to a Learning Outcome

Formatting and readability

CSLO 6

threshold: 10.0 pts

20 pts

Mastery

20 pts Text and layout are clear and easy to

APA Formatting

This criterion is linked to a Learning Outcome

APA formatting

CSLO 5

threshold: 10.0 pts

10 pts

Mastery

10 pts Citations and References are properly presented

Language

This criterion is linked to a Learning Outcome

Language is appropriate

CSLO 6

threshold: 10.0 pts

10 pts

Mastery

10 pts Fewer than 3 grammatical, punctuation, or mechanical errors

Capstone

What areas related to test-taking do you feel need improvement? What strategies could you utilize to improve your own test-taking skills? List a minimum of five strategies you have identified that will assist in your successful outcome.

Your initial response to the post should be 400 words in length and include proper APA formatting when referencing your resources.

R1.2 see attachment

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .



Theresa Dinard

     Here, in the state of Florida, one of the main barriers was the clause that nurse practitioners must work on the sponsorship of a physician or within close proximity of a physician. That has been relaxed by legislation that says only nurse can work in most sectors of healthcare, without oversight of a physician, this allows APRNs autonomy in a medspa, primary care clinics and/or even telemedicine when working independently and as an entrepreneur.

    Since June of 2020, Florida operates under “Full practice”policy, which allows nurses that have proof of at least 3000 clinical hours of experience and graduate level pharmacology and differential diagnosis courses, the privilege to operate autonomously in primary care, med spas and even telemedicine under this regulation. This is considered to be the gold standard as APRNs are now able to register as an Autonomous Advanced Practice Registered Nurse and practice to the full extent of their role (Fla. BON, 2023) 

     With just just three short years ago, APRNs had to work under the supervision or sponsorship of a physician that was either either working in the practice or had a vested interest in a clinic where the APRN is practicing. Some states may also hold a prescriptive regulation or the APRN whereas they can only order certain schedules and medications. In some instances there may be pushback from physicians who do not co-sign the concept of nurse practitioners and or having the privileges that they are allowed believing that they are not trained like physicians. In some communities nurse practitioners may not be a choice of patients to be examined by and may just prefer their doctor instead.

     For midwives in Florida, some of the barriers include the need to have a supervisory agreement with a Florida licensed physician for post graduate supervisory hours A lack of recognition as primary care providers on Medicaid and Medicare and private insurance company provider panels and other restrictions. (Hastings, et al, 2018)

     CRNAs have barriers such a lack of fair reimbursement by third-party, payers,  stating that they are not trained on the same skill level as physicians and failure of some of the other surgical groups or colleagues to recognize CRNAs as board certified to administer anesthesia. (Toney, 2023)

     Rep. Cary Pigman (R-Sebring) and Sen. Jeff Brandes (R-St. Petersburg) joined members of the interest groups for APRNs the Florida Association of Nurse Anesthetists (https://www.fana.org/)and the Florida Nurse Practitioner Network (https://fnpn.enpnetwork.com/) in making new legislation that forwards, the causes nurse practitioners and pushes for more independence for them as well.

References 

Toney-Butler TJ, Martin RL. Florida Nurse Practice Act Laws and Rules. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 

Hastings-Tolsma M, Foster SW, Brucker MC, Nodine P, Burpo R, Camune B, Griggs J, Callahan TJ. Nature and scope of certified nurse-midwifery practice: A workforce study. J Clin Nurs. 2018 Nov;27(21-22):4000-4017. doi: 10.1111/jocn.14489. Epub 2018 Jun 20. PMID: 29679403; PMCID: PMC7992184.

another

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

1. Access the 

Ethical Case Studies
 media piece to review the case studies you will be using for this assessment.

· Select the case most closely related to your area of interest and use it to complete the assessment.

·
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.

· Include the selected case study in your reference list, using proper APA style and format. Refer to the 

Evidence and APA
 section of the Writing Center for guidance.

2. Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

· Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

· Identify who is involved or affected by the ethical problem or issue.

· Access the 

Ethical Decision-Making Model
 media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

· Apply the three components outlined in the Ethical Decision-Making Model media.

· Analyze the factors that contributed to the ethical problem or issue identified in the case study.

· Describe the factors that contributed to the problem or issue and explain how they contributed.

3. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

· In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The 

NHS-FPX4000: Developing a Health Care Perspective Library Guide
 will help you locate appropriate references.

· Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

· Review the 

Think Critically About Source Quality
 resource.

· Assess the credibility of the information source.

· Assess the relevance of the information source.

4. Discuss the effectiveness of the communication approaches present in a case study.

· Describe how the health care professional in the case study communicated with others.

· Assess instances where the professional communicated effectively or ineffectively.

· Explain which communication approaches should be used and which ones should be avoided.

· Describe the consequences of using effective and non-effective communication approaches.

5. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

· Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

· Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

· Discuss the key lessons this case provides for health care professionals.

6. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

· Describe the proposed solution.

· Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

· Discuss how likely it is the proposed solution will foster professional collaboration.

7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

· Apply the principles of effective composition.

· Determine the proper application of the rules of grammar and mechanics.

8. Write using APA style for in-text citations, quotes, and references.

· Determine the proper application of APA formatting requirements and scholarly writing standards.

· Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

·

Assessment 3 Example [PDF]


 Download Assessment 3 Example [PDF]
.

Additional Requirements

Your assessment should also meet the following requirements:

·
Length: 3–5 typed, double-spaced pages, not including the title page and reference page.

·
Font and font size: Times New Roman, 12 point.

·
APA tutorial: Use the 

APA Style Paper Tutorial [DOCX]
 for guidance.

·
Written communication: Use correct spelling, grammar, and punctuation.

·
References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.

·
APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

discussion 4 diversity

 

After studying Module 4: Lecture Materials & Resources, discuss the following:

The St. Fleur family is well respected in the Haitian community because they are religious with great moral values. They moved to the United States because of political issues in Haiti. Ronald, the youngest son of this family, is 27 years old and lives at home with his mother and father. Recently, he began having fevers and subsequently developed pneumonia. He was admitted to the hospital, where laboratory tests were HIV positive. Ronald was in shock when the doctor informed him that he was HIV positive. He confessed to the doctor that he was gay, but he could not tell his family. He said that he did not want to bring shame to the family. Because he couldn’t be in a formal relationship disowning to his family and the Haitian community’s view of homosexuality, he has been very promiscuous over the years.

  1. What are Haitians’ views of homosexuality?
  2. If Ronald’s parents were to learn of his positive HIV status, how might they react if they are religious and traditional?
  3. Identify three major culturally congruent strategies a healthcare provider can implement to address HIV prevention practices in the Haitian community?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.