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DNP 810 Course Papers
Aging cause major socio-economic effect for the community, including the healthcare organizations. As people ages, their health generally declines requiring more medical attention. They are also at higher risk for chronic disease such as: Alzheimer’s disease, diabetes, arthritis, heart disease and particularly falls which can impact their health and quality of life (Awang, Mansor, Nai Peng & Nik Osman, 2018). Falls are the major reason of injury in adults aged 65 years or older.
Falls often generate moderate to severe harms like head trauma, fractures and death leading to longer hospital stays, unnecessary admissions/readmissions and increase the healthcare expenditures (Jin, 2018) DNP 810 Course Papers. Given the aging population growth and the damaging effect of falls, this paper will analyze how to incorporate quality improvement solutions into public policy in order to reduce the occurrence of falls and fall-related damage in the aging population.
Fall is a major public health issue that can bring about serious injuries and even death in the elderly. In 2014, approximately 27,000 elderly died from unintentional fall injuries and the emergency departments treated 2.8 million elderly of which 742,000 required hospitalization. Elderly fall cost approximately $35 billion in 2012 and is expected to increase to $100 billion in 2030, without the cost for therapy and grievances.
Falls created over 20 million dollars annually and increased hospital stay to an extra 6.9 days costing the patient an extra $13,806 (Phelan, Mahoney, Voit & Stevens, 2015). Since falls can be prevented, the Centers for Medicare and Medicaid Services since 2008 have stopped reimbursing hospitals for detrimental fall-related injuries DNP 810 Course Papers. As a result, fall prevention have become for the healthcare systems both a financial and patient safety importance.
Healthcare organizations have put into effect various programs to prevent falls among patients. Preventing falls is important to preserve patient safety and decrease the financial weight on the healthcare system (Staggs, Mion & Shorr, 2015). Decreasing and preventing falls among the elderly has been a focus of study for years due to the rising number of individuals living into older age.
Many interventions such as exercise, home safety assessment, modification and multifactorial have been established through randomized controlled trials (RCTs) and subsequently condensed in systematic reviews and meta-analyses and have been showed to be effective in preventing falls among the elderly (Stubbs, Brefka & Denkinger, 2015) DNP 810 Course Papers.
Solutions and development of approaches to decrease the incidence of falls have been a noticeable emphasis in the literature for years DNP 810 Course Papers. There is now convincing indication that falls can be averted with a variety of resolutions. Studies have shown that exercise programs and home/environment evaluations by an occupational therapist can reduce the number of falls (Pighills, Ballinger, Pickering, & Chari, 2016)
The United States (US) population is aging, quickly, the number of older adults is anticipated to increase from 50 million to 75 million as the last group of baby boomers turns 65. By 2034, older adults are predicted to be more than their children in the nation’s history (Naylor, Hirschman, Hanlon, Bowles, Bradway, McCauley, & Pauly, 2014).
The urgency to incorporate falls prevention among older adults into public policy should be considered. Policy, research and practice are unified elements needed for a successful and workable program of falls prevention for the elderly DNP 810 Course Papers. The development and complicated nature of fall risk among a fast-growing aging populace requires a practical and organized approach to prevention.
The function of policy is to grant the infrastructure and funding necessary for the incorporation of falls prevention into practice. Research is essential to provide facts to support the successful application of fall prevention interventions DNP 810 Course Papers. Practice is where evidence is employed based on the guidelines and rules set by policy (Houry, Florence, Baldwin, Stevens & McClure, 2016).
Medicaid and Medicare which is the second and third major health insurance providers in the US has several policies that can be used to tackle falls prevention, however, they have not all been used to their full benefits. As the guarantor of more than 48 million Americans elderly, the Medicare program can demand, authorize, and incentivize provider actions associated to falls prevention.
Additionally, numerous Medicare Advantage (MA) plans have contracted with community-based establishments to offer falls prevention services to the elderly consisting of free fitness programs and Silver-Sneakers programs (Horton, Dwyer & Seiler, 2018) DNP 810 Course Papers.
Implementation of falls prevention can be guided by several reasons including environmental and circumstantial problems; staff understanding, views and mindsets; organizational values and climate; staff assignments; and access to correct equipment and funds DNP 810 Course Papers.
Barriers can include viewpoints that falls cannot be avoided, inadequate understanding on falls prevention in patients with multifaceted care needs like cognitive impairment, lack of funds and involvement in falls prevention efforts (Ayton, Barker, Morello, Brand, Talevski, Landgren, Melhem, Bian, Brauer, Hill, Livingston & Botti, 2017).
Managing falls in the elderly can be difficult due to their multi-factorial make-up. Contributing factors include environmental/home hazards, poor health and functional debilities. Despite various successful interventions to prevent falls among the elderly, such as multi-component exercises, home hazard adjustments, medication evaluations, healthcare providers may not be prepared to manage falls due to numerous challenges.
Both elderly and clinicians need to adjust their traditional ways of living and working in order to adopt new approaches and actions that can decrease falls (Loganathan, Ng, Tan & Low, 2015). Other barriers in implementing fall prevention solutions is a lack of organization between diverse local, state and federal organizations DNP 810 Course Papers.
Even though various agencies have their own falls prevention plans, there is no main agency that organizes programs/actions being managed by all of them. In addition, funds offered to the states often must undergo diverse regulations and restrictions DNP 810 Course Papers. At the state level, fall/injury prevention programs particularly tend have a low importance, and normally there is only one person organizing state-wide efforts (Healthy housing solutions, 2017).
Many states have allocated funds to create and uphold statewide fall prevention plans. For instance, the Massachusetts government have launched a fall prevention plan, which propose prevention stratagems in a yearly report DNP 810 Course Papers. Washington also have an established fall prevention program and funding for services provided by the program.
In 2008, Congress approved the Safety of Seniors Act, which orders the secretary of health and human services to give funding and to support states that have various elderly fall prevention programs. The states of Minnesota, Kentucky, New Hampshire and California have utilized the ‘Core Injury Prevention” Grants funding from the Center for Disease Control and Prevention (CDC)’s “National Center for Injury Prevention and Control” to form local teams that support evidence-based plans for fall prevention (Scotti, 2016).
The Administration on Aging, a program within Administration for Community Living (ACL), has given over $4.8 million grants for the development and implementation evidence-based falls prevention services and tactics nationwide DNP 810 Course Papers. ACL awarded ten grants to public and private not-for-profit units, as well as state organizations and community, and four grants to ethnic organizations (ACL, 2019). Policymakers need to allocate adequate funding for the development of effective falls prevention plans.
The CDC through the “Center for Injury Prevention”, participates in a variety of surveillance, study, and activities implementation to decrease elderly falls DNP 810 Course Papers. The CDC appraises data to find and broadcast valuable falls prevention programs, develops teaching tools for providers and sustains state attempts to decrease elderly falls through the “Core State Violence and Injury Prevention Program” funding.
The government’s FY2018 budget have planned to remove funding for falls prevention programs at the CDC, however, the Senate has instead advised to continue financing the CDC’s fall programs at around $2 million a vital ongoing savings that would increase in future years considering the fifty billion in yearly medical expenses to manage falls (Horton, Dwyer & Seiler, 2018).
When taking measures to apply recommended solution for falls, the reasons that generate fall must be considered for instance intrinsic and extrinsic risk. Intrinsic risk can be attributed to normal aging process and acute or chronic medical issues. Extrinsic factors are associated to the physical environment for example unsuitable floor conditions, lack of grab bars, defective or inappropriate use of equipment (Frieson, Tan, Ory & Smith, 2018).
The CDC has founded a process termed “STEADI” (Stopping Elderly Accidents, Deaths, and Injuries) that provides guided interventions to help clinicians integrate falls assessment and prevention into their establishment DNP 810 Course Papers. Also implementing the American Geriatrics Society’s guideline will help providers to decrease elderly falls. Another way to reduce fall is through continuing education trainings for providers to better assess the elderly at risk of falls through appropriate management and referral to fall prevention programs.
Clinicians also need to provide home adjustments help support to keep the elderly safe in their homes to reduce and prevent falls. Lastly, incorporating medication review is important in assessing elderly at fall-risk DNP 810 Course Papers. Several groups of medications, principally psychoactive, antidepressants and sedatives medication put the elderly at greater risk, they are provable predictors of falls as they alter the sensorium and destabilize gait and balance (Casey, Parker, Winkler, Liu, Lambert, & Eckstrom, 2017).
To conclude, the inevitable growth in elderly people produce several age-related chronic diseases and severe problems on quality of life. It is important for DNP-prepared nurses to quickly detect those at risk for fall and increase the community awareness of falls prevention. Given the injurious effects falls have on patients and the high cost on the patient and the healthcare system, there is need for clinicians to promote preventive care and make sure to perform methodical assessment as well as a thorough physical examination, fall assessment, medication review, functional and environmental assessment (Khadka & Darai, 2018).
With each preventing falls, the patients/families, providers and the healthcare organizations all profit. DNP-prepared nurses have an integral responsibility in decreasing fall among the elderly DNP 810 Course Papers. Understanding older adults’ standpoint on falls prevention and how to get them involve in fall prevention activities is important to keep the elderly safe in their homes and communities rather than going to nursing home care (Phelan, Mahoney, Voit & Stevens, 2015).
Lessons Learned From Implementing CDC’s STEADI Falls Prevention Algorithm in Primary Care. The Gerontologist, 57(4), 787–796.
Choose a news story, within last two years, about genetic or genomic technology. What is the issue presented? From the perspective of an RN or APRN, what are the ethical, cultural, religious, legal, fiscal, and societal implications of the issue? Explain. Support your rationale with a minimum of two scholarly sources.
Identify a specific disease encountered in your clinical practice or personal life. Can your patient’s understanding of DNA/RNA replication, transcription, and translation affect the management of the disease? Explain. Support your rationale with a minimum of two scholarly sources.
Identify a complex inheritance health issue you encountered in your clinical practice or personal life. How would you approach working with a patient of a complex inheritance health issue? Explain. Support your rationale with a minimum of two scholarly sources.
Refer to the complex inheritance health issue identified in DQ 1. Given available genetic tests, which would you use to screen and diagnose this issue? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
A multi-generational family health history can facilitate your management of a patient’s disease. What model would you use to create a multi-generational family health history for a patient? Explain. Support your rationale with a minimum of two scholarly sources.
Why is it important to have a comprehensive health and physical assessment that includes information on environment and genomic influences? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
In the past decade there have been many advances in genetics and genomics and their application to health screening, diagnosis, treatment, and prognosis. What recent advancement do you believe is the most significant for your clinical practice? Explain. Support your rationale with a minimum of two scholarly sources.
Genetic/genomic factors are known to contribute to variability of pharmacologic responses in some patients. How does the variability of responses result in tailoring pharmacologic agents to the care of these patients? Explain. Support your rationale with a minimum of two scholarly sources.
Health issues in a clinical setting can be influenced by nutrition. Identify a health issue that has been positively influenced by nutrition in your clinic. How does nutrition improve health? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
Choose one disorder of malnutrition that is found in your clinical setting or community. What are the genetic and environmental influences on this disorder, including prevalence rates, testing, treatment, and prognosis? How can the doctoral-prepared nurse apply this information into practice? Explain. Support your rationale with a minimum of two scholarly sources.
What is the impact of the aging population on both increased health care expenditures and wasted resources? Do genetics play a role? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
Identify a method that uses evidence-based data to support new or innovative ways to care for the aging population. What are the anticipated outcomes of employing this method and methods like it? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
What is the impact of chronic disease on both increased health care expenditures and wasted resources? Do genetics play a role? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
Identify a method that uses evidence-based data to support new or innovative ways to care for patients with chronic disease. What are the anticipated outcomes of employing this method and methods like it? How can the doctoral-prepared nurse apply this information in practice? Explain. Support your rationale with a minimum of two scholarly sources.
Choose a news story, within last two years, about genetic or genomic technology. What is the issue presented? From the perspective of an RN or APRN, what are the ethical, cultural, religious, legal, fiscal, and societal implications of the issue? Explain. Support your rationale with a minimum of two scholarly sources.
There are several issues that undermine client rights to make genetic and genomic-related decisions and act. Identify two issues you have seen undermine these rights in your clinical setting. What are potential solutions for each? What is your role as the patient advocate with each issue? Explain. Support your rationale with a minimum of two scholarly sources.
The Individual Success Plan (ISP) assignment in this course requires your collaboration with the course faculty early on to establish a plan for successful completion of mutually identified and agreed upon specific deliverables for your programmatic requirements. Programmatic requirements are: (1) completion of required practice immersion hours, (2) completion of work associated with program competencies, (3) work associated toward completion of your Direct Practice Improvement Project.
Use the following information to ensure successful completion of the assignment as it pertains to deliverables due in this course:
Within the ISP, ensure you identify specific deliverables which can include the following: Individualized DNP practice immersion contracts; comprehensive clinical log of hours applied to doctoral level learning outcomes; learner evaluations; mentor evaluations; current and updated CV; scholarly activities; GCU DNP competency self-assessment; reflective journal; course goals and plan for how competencies and practice immersion hours will be met; faculty and mentor approvals of course goals and documented practice immersion hours; and DPI project milestones.
Complete the Contact Information table at the beginning of the ISP document and type in your signature and the date on which you completed the table.
Read the information in the ISP document including the following:
Follow the instructions and complete the ISP.
Taking a family history is an important step in determining current and future health needs and education. There are many tools available to complete a comprehensive health history. The Surgeon General’s Family Health History tool is part of the larger Family Health History Initiative that encourages people to talk about and write down health issues that seem to run in the family, bringing a larger focus on this important issue. This assignment allows the learner to use the tool and become familiar with this initiative.
General Guidelines:
Use the following information to ensure successful completion of the assignment:
Directions:
Use the “My Family Health Portrait” to document your own family history.
Designate a proband for the pedigree with a disease or condition of interest.
Write a summary (750-1,000 words) of your findings. Include the following information:
It may be possible to earn portfolio practice immersion hours for this assignment. Enter the following after the references section of your paper:
Practice Hours Completion Statement DNP-810
I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Typhon Student Tracking System for verification purposes and will be sure all approvals are in place from my faculty and practice mentor.
You will be creating a case study in stages over four course topics. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization in which you practice may specialize in treating.
General Requirements:
Use the following information to ensure successful completion of the assignment:
Directions:
For this assignment (Part 1 of the “Case Study”), write a paper (1,000-1,250 words) incorporating genetics information learned from assigned readings in Topics 1 and 2. Include the following:
It may be possible to earn portfolio practice immersion hours for this assignment. Enter the following after the references section of your paper:
Practice Hours Completion Statement DNP-810
I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Typhon Student Tracking System for verification purposes and will be sure all approvals are in place from my faculty and practice mentor.
You will be creating a case study in stages over four course topics. This assignment will add to your previous work in Topic 2. Use an example from your own personal practice, experience, or your own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating.
General Requirements:
Use the following information to ensure successful completion of the assignment:
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