NURS 6050 Discussion 1: Evidence Base in Design

Sample Answer for NURS 6050 Discussion 1: Evidence Base in Design Included After Question

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.

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.

A Sample Answer For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

The United States is an outlier in maternal medicine. We are one of the wealthiest countries and yet we have one of the worst maternal mortality rates, and it keeps rising. One of the reasons for this high statistic is the lack in maternal medicine equality in the U.S. “Differences in health insurance coverage and access to care play a role in driving worse maternal and infant health outcomes for people of color” (Hill et al., 2022). We as a nation do not provide adequate maternal care to all citizens. Impoverished and minority groups often have the worst maternal outcomes. “Pregnancy-related mortality rates among Black and ASIAN women are over three and two times higher, respectively, compared to the rate for White women” (Hill et al., 2022). This comes back to the lack of health insurance and access to care. Minorities in AMerica tend to seek less pregnancy care and when sought it is usually toward the end of a pregnancy. Fetal Maternal medicine is a topic that is talked about often, but the disparities are often left behind.

Many states look to change this by instituting review committees however their review process for causes is not consistent as seen in the fact that “49 states have formal maternal mortality review committees (MMRC) to investigate pregnancy-associated deaths, only nine states, Washington, D.C., and New York City consider racial disparities and equity in their assessments” (Tu, 2023). This is an issue as majority of maternal deaths are in the minority communities. Also, there are no regulations on these committees having to report their finding as noted that, “reviews are not consistently delivered by all committees. For instance, MMRCs in only 36 states reported their findings to the CDC between 2017 and 2019” (Tu, 2023). The means that 13 committees chose to not report their findings. This is a concern of great magnitude. How can we seek to fix the issue if we cannot see the disparities or the reviews of cases from committees who look into them across the United States.

This is where H.R. 4605 Healthy Moms and Babies Act proposal comes in. This act seeks to narrow the gap in healthcare disparities and provide new ways of access and guidance in the maternal health arena. They seek to establish programs and require maternal health services to those on Medicaid and enrolled in the CHIP program. They seek to expand access to telehealth services for prenatal and postpartum women on Medicaid. The act will establish an advisement group on the birthing process for healthcare professionals, requiring study on Medicaid coverage of doula services as well. In addition, one of the biggest things they are seeking through this Act is to require the Conters for Medicare and Medicaid services to develop guidance on ways to address social determinants of health for pregnancy and postpartum women to reduce maternal mortality for Medicaid and CHIP beneficiaries.

The Healthy Moms and Babies Act seeks to address one of the biggest reasons for the high rate of maternal fetal deaths in this Country. Medicaid deals with some of the most impoverished communities and if we can, through legislation, guarantee that we are providing access to care and narrowing the gap of inequality in healthcare then we as a nation must work to do so. It is a travesty that we as a country can be one of the wealthiest in the world, but we cannot protect our mothers and babies because we have not made the cause of mortality rate a priority.

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

*Note: Throughout this program, your fellow students are referred to as colleagues.

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A Sample Answer 2 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

The health policy I chose to write about pertains to the continuation of telehealth treatment of patients with the limitations established during the COVID19 pandemic. With this legislation, patients that relied on telehealth during the pandemic could continue to receive telehealth care in future years. These patients that telehealth most benefitted were those that were limited in their ability to attain in-person healthcare due to health status or transportation limitations.

Social determinants that affect this include health care access and economic stability. Health care access can be very limiting for some patients, especially those who are in rural areas. For those people, they may have to drive a significant distance to access healthcare, especially if they need to see a specialist. Specialists can be few and far between in healthcare, especially for those who treat rare and unique diseases. Telehealth helps connect people to specialists, who would normally be a great distance away. The financial burden of traveling a great distance, could be enough to deter a patient from seeking the treatment they need. Economic stability ties into the financial burden of travel. If a patient needs to travel a long way to see a specialist, they may not be able to. Additionally, the cost of gas or not having access to a vehicle, can hold patients back from getting treatment.

Arnaert et al. described a study in which Chronic Obstructive Pulmonary Disease (COPD) patients were given a pulse oximeter to measure their oxygenation status and access to a telehealth RN during the COVID19 pandemic. The study found that these patients felt less anxiety during the study due to the daily availability of a healthcare provider to assess their status (2022). COPD patients were some of the most at-risk people during the pandemic, with already compromised respiratory function, leading to increased anxiety during the time of isolation. This improvement of care is not limited to the pandemic. COPD patients can face daily trials due to their conditions, the ease of access to healthcare cannot be understated in this case. Also, these patients are often elderly patients who cannot easily access healthcare, due to restrictions financially or due to access to transportation.

In a study, Lindberg et al. describes the increased use of telehealth for contraceptive care during the COVID19 pandemic. The study showed an increase of usage in rural and urban areas with a greater increase in urban areas (2022). This could be due to increased rates of COVID19 in urban areas. While the increase in rural areas could be due to the distance, they would have to travel to receive quality care. This study showed the efficacy of telehealth by bringing more patients in to the office to receive quality care, where they may not have had before telehealth care was available. Overall, the benefits that this policy would keep cannot be overlooked. With the policies that came into effect during the pandemic, more people had more convenient access to quality healthcare that they did not have before. With this policy continuing measure put into place during the pandemic, quality healthcare would reach more people.

NURS 6050 Discussion 1 Evidence Base in Design
NURS 6050 Discussion 1 Evidence Base in Design

References

Arnaert, A., Ahmad, H., Mohamed, S., Hudson, E., Craciunas, S., Girard, A., Debe, Z., Dantica,  J. L., Denoncourt, C., & Côté-Leblanc, G. (2022).             Experiences of patients with chronic obstructive pulmonary disease receiving integrated telehealth nursing services during COVID-19                       lockdown. BMC Nursing, 21(1), 1–13. https://doi.org/10.1186/s12912-022-00967-2

Lindberg, L. D., Mueller, J., Haas, M., & Jones, R. K. (2022). Telehealth for Contraceptive Care During the COVID-19 Pandemic: Results of a                     2021 National Survey. American Journal of Public Health, 112(Sup5), S545–S554. https://doi.org/10.2105/ajph.2022.306886

Test – H.R.341 – 117th Congress (2021-2022): Ensuring Telehealth Expansion Act of 2021. (2021, February 2). http://www.congress.gov/

A Sample Answer 3 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

Hello Joseph, great post I definitely benefitted from telehealth during the pandemic also. Yes some people may not have access to certain health benefits due to transportation like you mentioned and that could definitely lead to lower health outcomes in underserved communities. You mentioned patients with COPD during the pandemic and I thought this was a great example. Yes these patients have an increased risk of severe pneumonia and poor outcomes when they develop COVID-19. (Leung et al., 2020). While there are a lot of benefits to Telehealth, we cannot overlook the downsides because not every visit can be done remotely. You still have to go into the office for things like imaging tests and blood work, as well as for diagnoses that require a more hands-on approach. (Watson, 2020).

References

Leung, J. M., Niikura, M., Yang, C. W. T., & Sin, D. D. (2020, August 13). Covid-19 and COPD. The European respiratory journal. Retrieved October 10, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424116/

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard Health. Retrieved October 10, 2022, from https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages

A Sample Answer 4 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

I enjoyed reading your post and analyzing your work. Telehealth significantly improves the health outcomes for patients with chronic diseases and those with difficulty accessing care due to challenges of geographical location (Dinesen & Nonnecke, 2019). When you are ill, you can use telemedicine to avoid driving to the doctor’s office or clinic or waiting in a waiting room. Additionally, virtual visits can often be easily accommodated into a busy schedule, eliminating using gas that some may not have. Some patients live far from hospitals or doctor’s offices, which can be a significant challenge for some.

While Telehealth has many benefits, it also has challenges. Some patients have less access to care since half of the senior citizens in the US lack internet connectivity and the knowledge to access and use telemedicine. Older adults are not the only ones affected; low-income families may also not have access to the internet. It also poses limitations, as a doctor cannot do a physical exam, leading to the wrong diagnosis. Additionally, while insurance companies are increasingly covering the cost of telehealth visits, some services might not be covered, leading to out-of-pocket costs (Watson,2020). I do think there is a good evidence base to support this policy. Telehealth has brought more accessible access to healthcare for many people. As you said, more people have convenient access to quality healthcare that they did not have before, and I think that is the focus we need. Although some have connectivity issues and technological disadvantages, I think the benefits outweighs the alternative, and doctor offices will still be available for patients. If legislation wants results, moderating factors that limit robustness across settings, populations, and interventions need to be addressed to see these results (Glasgow et al.,2003).

Dinesen, B., & Nonnecke, B. (2019). Personalized telehealth in the future: A global

research agenda. Journal of Medical Internet Research. Retrieved October 9, 2022, from

https://www.jmir.org/2016/3/e53/

 

Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why Don’t We See More

Translation of Health Promotion Research to Practice? Rethinking the Efficacy-

To-Effectiveness Transition. American Journal of Public Health, 93(8), 1261–

  1. https://doi.org/10.2105/AJPH.93.8.1261

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard Health.

Retrieved October 11, 2022, from https://www.health.harvard.edu/staying- healthy/telehealth-the-advantages-and-disadvantages

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A Sample Answer 5 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

The prevalence of burnout and stress among are healthcare professionals date way before the COVID-19 pandemic. The reality of the US health care environment before the arrival of COVID-19 was already concerning due to shortages of nurses, doctors, respiratory therapists, and other healthcare workers (Ross, 2020). Most healthcare providers are working very long hours with less staffing. The media focus at the beginning of the pandemic was mainly on the number of ventilators and hospital beds, and completely lacking in those discussions was the question of available qualified, healthy healthcare professionals to care for the rest of the population (Ross, 2020). According to Shah et al. (2021), the covid 19 pandemic worsened burnout by worsening the already existing healthcare worker shortages in facilities and hospitals. The lack of nurses and other healthcare providers put so much pressure on the remaining few professionals to shoulder all the responsibility of providing care. The Covid 19 pandemic exacerbated the burnout rates in the healthcare workforce to the extent of suicide for some (Kaine, 2021). This discussion will review a policy that can affect all of us directly or indirectly as healthcare providers, the Dr. Lorna Breen Health Care Provider Protection Act. The Dr. Lorna Breen Health Care Provider Protection Act addresses behavioral health and well-being among health care professionals (congrsss.gov, 2021). Healthcare professionals’ stress and burnout have been studied throughout the nation, especially with the pandemic exacerbating the problem. (Kaine 2021).

Description of the health policy

The Dr. Lorna Breen Health Care Provider Protection Act was introduced in 2020 by Senator Kaine, who has been leading the talks on the mental health impact of the pandemic on health care workers (congesss.gov, 2021). This policy aims to provide the resources for healthcare providers to get the needed care now during the pandemic and in the future (Kaine 2021). The policy calls for the Department of Health and Human Services (HHS) to award grants to hospitals, medical professional associations, and other healthcare facilities for programs to promote mental health and resiliency among health care professionals (congesss.gov, 2021). It is also calling for the Centers for Disease Control and Prevention (CDC) to launch a campaign encouraging health care workers to seek support and treatment for mental and behavioral health concerns without consequence (Congress. Gov, 2021).

As Kaine (2021) stated, the trauma that most healthcare workers are subjected to through the pandemic will leave lifelong emotional and physical damage. Thus, the need for setting this resource for the healthcare workers who risked their lives daily to save others. The grants from HHS are to provide relevant mental and behavioral health training of health care students, residents, or professionals with evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders (Kaine, 2021). In summary, the policy will focus on removing barriers to accessing care and treatment and identifying strategies to promote resiliency, thereby improving mental and behavioral health amongst healthcare providers (Congress.gov, 2021).

Evidence bases to support the proposed policy

The U.S. Senate Passage of the Dr. Lorna Breen Health Care Provider Protection Act has been praised by many organizations, including the American Medical Association (AMA), American College of Emergency Physicians (ACEP), Association of American Medical Colleges (AAMC), the American Foundation for Suicide Prevention (AFSP), the American Hospital Association (AHA), the American Psychiatric Association (APA), American Nurses Association (ANA), and The Physicians Foundation (THE LEGISLATION, n.d.). American Nurses Association (ANA) (2021) applauded the timely and unanimous passage of the Dr. Lorna Breen Health Care Provider Protection Act by the United States Senate on August 6th, 2021. ANA (2021) states that this critical legislation will help reduce and prevent mental and behavioral health conditions, suicide, and burnout among health care professionals who continue to be overwhelmed by the COVID-19 response and recovery efforts. The bipartisan sponsorship of this policy is evidence base to support its proposal. Given the information above, this bill is a national plea for all healthcare workers to get the resources needed to manage mental health and burnout.

References 

ANA Enterprise. (2021, August 11). ANA Applauds U.S. Senate Passage of the Dr. Lorna Breen

Health Care Provider Protection Act. https://www.nursingworld.org/news/news-releases/2021/ana-applauds-u.s.-senate-passage-of-the-dr.-lorna-breen-health-care-provider-protection-act/

Dr. Lorna Breen Health Care Provider Protection Act, S.610, 117th Cong. (2021-2022)

https://www.congress.gov/bill/117th-congress/senate-bill/610

Kaine, T. (2021, March 4). Kaine Leads Colleagues in Bipartisan, Bicameral Legislation to

Support Health Care Workers’ Mental Health amid COVID-19. United States Senator from Virginiahttps://www.kaine.senate.gov/press-releases/kaine-leads-colleagues-in-bipartisan-bicameral-legislation-to-support-health-care-workers-mental-health-amid-covid-19

Ross, J. (2020). The Exacerbation of Burnout During COVID-19: A Major Concern for

Nurse Safety. Journal of Peri Anesthesia Nursing.

https://www.jopan.org/article/S1089-9472(20)30111-8/pdf

Shah, M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M. & Ali, M.K. (2021, February 4).

Prevalence of and Factors Associated with Nurse Burnout in the US. JAMA.

doi:10.1001/jamanetworkopen.2020.36469.

THE LEGISLATION. (n.d.). The Dr. Lorna Breen Health Care Provider Protection Act.

A Sample Answer 6 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design

Title: NURS 6050 Discussion 1: Evidence Base in Design

Thank you for your excellent post. I want to add that suicide is a tough something across the world. I think the media can assist ease the problem. Telling people that there are options and resources utilizing media, such as commercials, billboards, and pamphlets, can get many people. A study on a public understanding campaign in Nagoya, Japan, demonstrated a reduction in suicide rates. The study focused on the connection between suicide rates and a campaign to raise public understanding of depression and inspire people to aim for help (Szlyk et al., 2021). It took place over two years, and in 2010, Nagoya had a suicide pace of 20.3 per 100,000 people (Szlyk et al., 2021). The results showed that wards of the city with more periodic issuances of the promotional pamphlet regarding mental health and depression symptoms helped decrease the number of suicides in the subsequent months (Szlyk et al., 2021). Suicide rates among men, in particular, declined following the public understanding campaign (Szlyk et al., 2021). According to World Health Organization, suicide is a significant public health issue with economic, emotional, and far-reaching social effects.

There are about one million suicides every year worldwide, and it is noted that about six people are impacted by one death (Kapur & Goldney, 2019). There are numerous misunderstandings regarding suicide, and the media can play an essential role in dispelling different myths (Kapur & Goldney, 2019). Visual, verbal, or written media is a form of telling people. Advertising concerning suicide, the signs and symptoms, and how to aim for help is an action in the correct direction. Many people do not aim for help because they feel death is the only solution and it will resolve their issues. Family members may recognize the signs and symptoms they listened to through media and connect it to individuals they know are undergoing symptoms. If it occurs, they can look for help and maybe prevent suicide from occurring.

Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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