The role of nurses in the COVID-19 vaccination mandate, telemedicine, and prescription drug pricing is pivotal in advocating for and ensuring a more efficient and patient-centered healthcare system. First and foremost, nurses have played an indispensable role in the global fight against the COVID-19 pandemic. Their contribution to the vaccination efforts has been monumental. Nurses have not only administered vaccines but also served as the face of hope and comfort to countless individuals receiving the vaccine. Their compassionate and humanistic approach has helped alleviate vaccine hesitancy and fear, ensuring that a larger segment of the population gets vaccinated. Beyond the actual vaccination process, nurses have been at the forefront of patient education, conducting interviews to gather crucial health information, and explaining the importance of immunization. Their meticulous monitoring of patients for adverse reactions has been essential in maintaining the safety of the vaccination process. In essence, nurses have been the linchpin of prevention during this pandemic, working tirelessly to protect public health (Pérez, 2021).

Telemedicine, another significant development in healthcare, has been further accelerated by the pandemic. Nurses have been instrumental in the adoption and effective implementation of telemedicine services. Through telehealth platforms, nurses have been able to provide care remotely, ensuring that patients continue to receive vital medical attention while minimizing the risk of virus transmission. This has been especially crucial for individuals with chronic conditions who require regular check-ups and monitoring. Nurses have not only conducted virtual consultations but have also played a vital role in educating patients on how to use telemedicine effectively. They have bridged the gap between technology and healthcare, making it more accessible and user-friendly for patients, ultimately saving them time, money, and, most importantly, lives.

On the front of prescription drug pricing, nurses have also been advocates for patients. The pandemic disrupted global supply chains, leading to fluctuations in the prices of essential medications, particularly for individuals with non-communicable diseases (NCDs). Nurses, as patient advocates, have been vocal in highlighting the challenges patients face due to rising drug costs. They have played a crucial role in bringing attention to this issue at both the individual patient level and within healthcare organizations. Nurses have been at the forefront of working with healthcare providers to explore cost-effective alternatives and to ensure that patients continue to have access to the medications they need. Their advocacy extends to policy discussions, pushing for reforms in drug pricing that would prioritize patient affordability and well-being (OPS, 2023).

In conclusion, nurses have demonstrated their indispensable role as advocates in the healthcare system during the COVID-19 pandemic. They have tirelessly worked to administer vaccines, provide compassionate care, and promote prevention. Nurses have embraced telemedicine as a means to deliver care remotely, making it accessible and convenient for patients. Additionally, they have been vocal advocates for patients grappling with rising prescription drug prices, working to ensure that healthcare remains patient-centered. The pandemic has highlighted the resilience, dedication, and advocacy of nurses, reinforcing their crucial position in shaping the future of healthcare.

 Week Four APA Assignment: Evaluating the socioeconomic impact of healthcare across our diverse communities: Educating our clients regarding accessibility and affordability.

• Sections of the assignment must include:
  Introduction
  Focus points covered in the discussion posts
  Any arguments and rationales for your stance
  Conclusion or Summary
• The components of your APA Assignment includes the following:
  The assignment must be completed on a word document.
  Your APA  Assignment must include a title page (Refer to Purdue OWL).
  All in-text citations must be used when paraphrasing or quoting a previous author.
  All references must reflect the in-text citations used.
  All reference sources must be within the past 5 years unless it is the works of a nurse theorist or a significant reference material.
  The length of the assignment must be 750-1000 words. Please pay attention to spelling and grammar. Points are deducted for repeat offenders.
  Upon completion of the assignment, you must submit it via Turnitin.com and please note that your plagiarism score should be no more than 20%. If you score higher, please make adjustments

Original Work, No Plagiarism, Cite and Reference

Joanna, a psychiatrist, has a busy clinical practice. She is widely recognized as a leader in reducing the number of psychotic episodes that patients with schizophrenia experience. Her treatment modalities are largely informed by her research. She has performed numerous clinical trial studies combining various antipsychotic and other medications to achieve longer intervals without episodes. She has cultivated a trusting relationship with her patients as many have seen her for more than five years as she has provide hope and relief to a great number of them.

Joanna is enrolling participants into a randomized placebo-controlled study with a promising new drug to treat schizophrenia. Although two other psychiatrists in her practice are referring patients to the study, she also decides to offer the protocol to patients in her practice that meet the inclusion criteria.

As part of the consent process, she explains to patients that there is a 50-50 chance whether they are placed in the group receiving the investigational drug or in the group that receives the placebo (sugar pill). She tells them that those who are given placebos will not be offered standard-of-care medicine so that important drug-placebo differences can be identified. Joanna also tells them that rational decision-making does not seem to be affected during short periods of medication-free intervals, according to the most recent research. She does acknowledge that studies have had mixed results about the increased risk of suicidality, however.

One of Joanna’s patients, a potential participant named Duncan, asks how long the study is supposed to last. Joanna knows that Duncan has failed other attempts of reducing the length and severity of his schizophrenic episodes. She also believes that he may be a good candidate for the study—as long as he’s not in the placebo group.  There’s no guarantee that he’ll receive the treatment, or do well on it. If he doesn’t enroll, then his clinical care will go on uninterrupted. If he does enroll, this new experimental drug may be his best shot at receiving an effective treatment so that he can lead a more normal life.

Joanna asks if Duncan is interested. Duncan responds, “Whatever you think is best. You’re the doc.”

Questions:

1. How many different kinds of conflicts of interest does Joanna have?

2. How concerned should she be that her patient(s) might not grasp the risks of participating in a drug trial?

3. In your own words, what is a therapeutic misconception?

4. What do you think motivates patients like Duncan to respond “Whatever you think is best”?

5. Should clinical researchers be allowed to enroll their own patients in a study?

EVIDENCE BASE IN DESIGN

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

· Milstead, J. A., & Short, N. M. (2019). 
Health policy and politics: A nurse's guide (6th ed.). Jones & Bartlett Learning.

· Chapter 5, “Public Policy Design” (pp. 87–95 only)

· Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)

· Chapter 9, “Interprofessional Practice” (pp. 152–160 only)

· Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)

· American Nurses Association (ANA). (n.d.). 


Advocacy

Links to an external site.
. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/

· Centers for Disease Control and Prevention (CDC). (n.d.). 


Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation

Links to an external site.
. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf

·

Congress.govLinks to an external site.
. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

· Klein, K. J., & Sorra, J. S. (1996). 

The challenge of innovation implementationLinks to an external site.
. 
Academy of Management Review, 21(4), 1055–1080.

· Sacristán, J., & Dilla, T. D. (2015). 

No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.
. 
Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.

· Tummers, L., & Bekkers, V. (2014). 

Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.
. 
Public Management Review, 16(4), 527–547.

To Prepare:

· Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

· Review the health policy you identified and reflect on the background and development of this health policy.

BY DAY 3 OF WEEK 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

BY DAY 6 OF WEEK 7

Respond to at least 
two of your colleagues
* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

PEER REVIEW

#1 Briana – WEEK 7 DISCUSSION MAIN POST

H.R. 1712 – Rural Health Innovation Act of 2023

     Emergency medical services in the rural community setting can be challenging. Along with the area being large and sparsely populated in some places, there may also be difficult terrain, and the providers may need to travel further to transport the patient to the hospital (Rural Health Information Hub, 2022). This bill would provide two grant programs to help increase access to emergency care in these rural areas (CRH, 2023). The first grant funds federally qualified healthcare centers in these areas, including urgent care, triage, and other services (CRH, 2023). The second grant would also increase funding for rural emergency services, but this grant provides funding to health departments (CRH, 2023). There has been a long-standing history of the need to increase emergency services to rural areas, and slowly, we are working to provide these services. Telehealth has also impacted this in that it allows easier access to services in these rural areas; however, emergency care still needs to be improved.

     Social determinants of healthcare should always be considered whenever a new law or policy is being developed. The social determinant of healthcare that is the most addressed by this bill would be access to affordable, quality healthcare (World Health Organization, 2023). Some rural areas are undereducated, and residents may live in poverty, causing them not to seek out regular healthcare services. It is commonly seen that those with lower socioeconomic statuses are more at risk for poor health (World Health Organization, 2023). Expanding emergency services would allow these residents to at least be cared for in urgent need. Increased funding would improve the accessibility of healthcare and its support services. Increasing services in these areas would improve the population health of these areas now and in the future.

References

CRS. (2023). H.R.1712 – Rural Health Innovation Act of 2023. Congress.gov; Library of Congress. 
https://www.congress.gov/bill/118th-congress/house-bill/1712?q=%7B%22search%22%3A%22health+policy%22%7D&s=1&r=31
Links to an external site.

Rural Health Information Hub. (2022). Rural Emergency Medical Services (EMS) and Trauma Introduction – Rural Health Information Hub. Ruralhealthinfo.org; U.S. Department of Health and Human Services. 
https://www.ruralhealthinfo.org/topics/emergency-medical-services
Links to an external site.

World Health Organization. (2023). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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#2 ANDERSON /Discussion- Week 7

H.Res.434

The H. Res.434-Declaring a mental health crisis among youth in the United States, and expressing the pressing need for historic investments in mental health care for students was authored by Democrat Seth Moulton, District 6 114th-118th, Massachusetts. It was introduced on the house on 5/22/23; the bill focus on the mental health crisis affecting youth in the United States; it acknowledges that the Covid-19 pandemic has exacerbated depression with an increase of 30% in emergency room admissions from adolescents, the World Health Association cites suicide as the fourth leading cause of death between ages 15-19, The National Institutes of Health states that low-income population, and those living in rural areas are by far the most affected, state mental health resources are scarce or its funds are mismanaged (Congress.gov, 2023).

To alleviate the ongoing crisis, the bill proposes to: increase mental health training of school educators, invest robust funding toward on-campus mental health resources, preserve the continuity of mental health treatment to lower-income students despite of their legal status in the country, recognize that physical health and mental health are intertwined, educate the public on mental health disorders to reduce its stigma, develop a highly efficient method to contact high-risk and isolated population to support children/adolescent suffering from mental health disorders, curb prejudice and discrimination in schools towards students diagnosed with mental health disorders, and to regularly screen incarcerated juveniles whose mental health issues are often times overlooked (Congress.gov, 2023).

Social Determinants  

There are two main social determinants linked to the mental health crisis among children; the covid-19 pandemic and the “digital depression”.  The pandemic altered the lives of children all over the world. In the United States, it has forced school shut-downs as classroom attendance became remotely driven leading children to feel more isolated due to loss of physical/emotional contact with their schoolmates. Lower-income children/adolescents were the most affected by the pandemic because some of their parents have lost their jobs and struggled to make ends meet. The isolation caused decrease in physical activity and an overwhelming increase in social media screen time. When in-person classes resumed, school districts were made aware that the pandemic had increased depression among their students; however schools firmly believed that discussing mental health issues with students equated to putting “ideas” into their heads (Ayer & Colpe, 2022) also, school districts were already overwhelmed with other issues such as food insecurities, student housing instability, and teachers burnout. Studies show that 72% of children/adolescents did not receive mental health treatment and that schools did not initiate depression screenings as a way to curb teen suicide. School teachers spend long hours with their students, they are likely to best recognize signs of depression and other mental health disorders affecting their students with the assist of a school nurse. The federal government added $122 billion in school programs which part of that fund had been allocated to suicide prevention (Ayer & Colpe, 2022) therefore 72% of children not having had received mental health screening/care raise alarming questions whether or not schools are well-equipped and safe to mentally afflicted  students; another obstacle is that 77% of parents did not report suicide ideation or other ongoing mental health ailments to the school possibly fearing that their children would be treated poorly, “downgraded ” to special ED, or be bullied by their classmates. In addition to parental overlook, there is limited mental health training in the school system particularly to provide support to gay and nonbinary/trans students who are more victimized and harassed by their classmates.

The second social determinant it is digitalization. The average time adolescents spend on social media averages nine hours daily. The pandemic inevitably led children to spend more time using smart phone and computers in lieu of physical activity and healthier socialization with other children. It is likely that during the pandemic, their parents began to dedicate more time to social media by simply working from home; parenting style has also “softened” as younger parents are less restrictive to their children screen time. Although social media was not created to harm children (Ghaemi, 2020) it does impact their mental health negatively because children/adolescents often go to sleep with their phones on causing day-time anxiety/mood disorders secondary to sleep deprivation; adolescents have partially developed brain maturation, particularly on the frontal lobe; therefore they are at higher risk to engage in dangerous sexual behavior/encounters, participate in peer-pressured bullying towards their schoolmates, pick up unsafe habits such as e-smoking, and take part in substance abuse. Cyber bullying has grown with its hate speech nuances causing targeted teenagers to become depressed, anxious and/or die of suicide.

Evidence-based support

Prevention is the key to manage depression and suicide among children and adolescents. Depression is still underreported  and under diagnosed in children (Patra & Kumar, 2022), suicide deaths have surpassed automobile accident deaths, and one in ten adolescents in high school have verbalized suicide ideation. Pediatricians are still reluctant to screen/treat children who present symptoms of mental health disorders fearing that they might over diagnose their clients based on false-positive screening scores; however there is more benefit in identifying and initiating treatment rather than ignoring the issue. There are multiple assessment tools available nowadays that use questionaries, parent interviews or child-self-report tools; providers who may not feel confident about treating these children should make a referral to a qualified mental health provider because early identification is key to prevent teen suicide.

Also, healthcare providers should not focus on making the ” right” diagnosis because in depression the mood is always ” negative” followed by visible signs and symptoms such as feelings of sadness, isolation, decrease in physical activity, poor eyes contact, lack of energy, and poor academic performance. Some providers also believe that discussing mental health issues with children could lead them to embrace these ideas which is a misconception because there are more benefits than risks to obtaining early detection and treatment. The main downfall is parental denial of children's poor mental health due to strict religious views on pharmacological treatments ( scientologists for example do not believe in prescription drugs) or the fear that their children will be perceived differently and be mistreated. The National Suicide Prevention warns that depression and suicide ideation should be taken seriously (Patra & Kumar, 2022) as there are multiple resources available today to prevent this ill fate among youth; healthcare providers who feel uncomfortable treating these disorders should make swift referrals, and school bodies should immediately utilize the money allocated to them to kick off school-based screening programs. 

When digitalization issues are concerned, it is vital that parents become more vigilant and monitor their children online activities closer. Given the availability of smart phones facilitated through texting and chatting, teenagers have gained easier access to sex, drugs, and pornography (Ghaemi, 2020). The goal is not to ban social media from children and adolescents; the recommendations are straightforward to follow: delay screen time to younger children, remove smart phones from the bedroom to promote sleep hygiene, limit screen time to one hour daily to mildly depressive children, and restrict social media altogether to severely depressive children presenting suicide thoughts (Ghaemi, 2020).

Current treatment options to depression are SSRI antidepressants, counseling and psychotherapy accompanied by diet and exercise. The most important content of H.Res.434 is educating parents, school bodies, and healthcare providers about recognizing  mental health disorders among children particularly to those living in rural areas where resources are oftentimes scarce. Also, it is important to work with low-income families who may not see mental health as a priority over housing and food. 

    

References

Ayer, L., & Colpe, L. J. (2022). The Key Role of Schools in Youth Suicide Prevention. 
Journal of the American Academy of Child & Adolescent Psychiatry, 
62(1). 
https://doi.org/10.1016/j.jaac.2022.06.022
Links to an external site.

Congress.gov. (2023). 
Congress.gov | Library of Congress. Congress.gov. 
https://www.congress.gov/
Links to an external site.

Ghaemi, S. N. (2020). Digital depression: a new disease of the millennium? 
Acta Psychiatrica Scandinavica, 
141(4), 356–361. 
https://doi.org/10.1111/acps.13151
Links to an external site.

Patra, K. P., & Kumar, R. (2022). 
Screening For Depression and Suicide in Children. PubMed; StatPearls Publishing. 
https://www.ncbi.nlm.nih.gov/books/NBK576416/
Links to an external site.

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Reflecting on Your Nursing Destiny

Discussion post reply

Hello class!

As I approach the culmination of my nursing career, I am excited about the various ways in which I can contribute to service both within my organization and community, while also considering the global impact of my nursing areas of interest and professional development. One area from the Recommendations list in the lesson that I find particularly significant is the emphasis on “Health Promotion and Disease Prevention.”

1. Contribution to Service:

Within my organization:
-Mentorship and Education: I would take on the role of a mentor for new nurses, sharing my experience and knowledge to help them navigate the challenges of healthcare delivery. This would involve providing guidance on patient care, critical thinking, and professional development.
– Process Improvement: Drawing from my years of experience, I could actively participate in quality improvement initiatives. By identifying inefficiencies and suggesting evidence-based changes, I can contribute to enhancing patient outcomes and the overall healthcare delivery process.

Within my community:
– Health Workshops: Collaborating with local community centers and schools, I could conduct workshops on health promotion and disease prevention. Empowering individuals with knowledge about healthy lifestyles, nutrition, and preventive measures can lead to healthier communities.
– Screening Camps: Organizing health screening camps in underserved areas could aid in the early detection of health issues. This proactive approach aligns with the principle of prevention, potentially reducing the burden on healthcare facilities in the long run.

2. Global Impact of Nursing Areas:

Given my interest in telemedicine and healthcare technology:
– Telemedicine Outreach: I envision participating in global telemedicine initiatives, connecting with remote and underserved populations to provide healthcare consultation and guidance. This could bridge the gap in access to medical expertise and improve health outcomes in areas with limited resources.
– Health Tech Advocacy: As technology continues to shape healthcare, I would advocate for the responsible integration of health tech solutions globally. This includes ensuring data privacy, promoting digital literacy among healthcare providers, and making sure technological advancements are accessible and equitable.

3. Expanding Roles of Nurses:

The area from the Recommendation list that resonates with me is “Policy Advocacy and Leadership.” Nurses are uniquely positioned to influence healthcare policy due to their frontline experience and holistic perspective on patient care. As a nurse leader, I would actively engage in advocating for policy changes that improve healthcare delivery, increase patient access to services, and enhance nursing practice. This might involve collaborating with healthcare policymakers, participating in discussions on healthcare reform, and being a voice for the nursing community.

In conclusion, I am committed to contributing to service within my organization, community, and the global healthcare landscape. By focusing on health promotion and disease prevention, embracing telemedicine and healthcare technology, and advocating for policy changes, I aim to make a positive impact on patient outcomes, healthcare accessibility, and nursing practice at large.

( Saundra)