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Chapter 19: Environmental Health

Assisting communities to adapt to climate change is a challenge we face. 

1. Pick a community near you and determine what climate change impacts they may face.

2. What vulnerabilities they may have. 

Remember to consider especially vulnerable populations within those communities and identify their specific challenges. (Websites such as CDC’s Climate and Health or EPA’s Climate Change Adaption Resource Center might be helpful.)   NO MORE THAN 21% OF PLAGIARISM 

Worldview Analysis and Personal Inventory 

Based on the required topic study materials, write a reflection about worldview and respond to following:

1. In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.
2. In 250-300 words, explain what scientism is and describe two of the main arguments against it.
3. In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview:
   1. What is ultimate reality?
   2. What is the nature of the universe?
   3. What is a human being?
   4. What is knowledge?
   5. What is your basis of ethics?
   6. What is the purpose of your existence?

Remember to support your reflection with the topic study materials.

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines”
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.

Please see attached file for instructions

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

1. The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
2. The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
3. A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
4. Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
5. Significance of the topic and its implications for nursing practice.
6. A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Write a five- paragraph argumentative essay:

 Take your stance and defend whether Facebook, WhatsApp, and Twitter be banned permanently?  

 Follow APA style 7th edition guidelines . Plagiarism is academic misconduct. While citing sources, rephrase the sentences and then cite them per APA format. You all must have at least 3 references. 

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

1. Describe the health care organization or network.
2. Describe the organization’s overall readiness based on your findings.
3. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
4. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
5. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

Develop a PICOT question that defines a gap in practice and write a 2–3 page executive summary presenting the key elements that decision makers will need to make decisions.

Note: Complete the assessments in this course in the order in which they are presented.

It is important to define your ideas clearly and precisely to help develop and sustain stakeholder buy-in with any project being created to improve outcomes. Using a PICOT gives the reader a clear idea of your improvement project in one succinct sentence. Another important communication tool is written for the administrative stakeholders in the form of an executive summary. The executive summary provides a brief and precise narrative of what you want to expedite for your improvement project. Executive summaries are commonly associated with business plans, marketing plans, evaluation studies, and other materials that are created to guide decision making and action. As an actionable document, the executive summary is meant to set out the key elements that a decision maker will need in order to make decisions and, as important, to justify those decisions to those to whom the decision maker is responsible.

Assignment Summary

Develop a PICOT question that defines a gap in practice related to a specific population at the organizational, regional, or national level for care coordination. Write a 2–3 page executive summary (not including the title and reference pages). Include 4–6 scholarly sources on the reference page.

You are encouraged to formulate a PICOT question based on a clinical question from your field of expertise or reflective of a specialization or strong area of career interest.

Grading Criteria

The numbered assignment instructions outlined below correspond to the grading criteria in the Defining a Gap in Practice: Executive Summary Scoring Guide, so be sure to address each point. You may also want to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Analyze clinical priorities for a specific population to effectively influence health outcomes with a care coordination process.
2. Apply a PICOT question to a gap in practice at the organizational, regional, or national level for care coordination.    
   • What is the PICOT question?
   • Provide and explanation of the selected gap.
3. Evaluate the potential services and resources for care coordination that are currently available for use with the selected population.
4. Assess the type of care coordination intervention that would best fit to enhance evidence-based practice.
5. Summarize the selected nursing diagnosis to support the strategy for collaborative care to present to the interprofessional team to develop stakeholder understanding. 
   • Present an assessment of the issue to start the process.
6. Explain the planning of the intervention and expected outcomes you want to achieve for the care coordination process using the scope and standards of practice for care coordination. 
   • What are the planning steps for the intervention?
   • What expected outcomes you want to achieve?
7. Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.

The audience for this presentation is an interprofessional team (including people in the care coordination process and leadership who are approving the process). Your objective is to develop stakeholder understanding and acceptance.​​​​

Additional Requirements

• Written communication: Write clearly, accurately, and professionally, incorporating sources appropriately.
• APA guidelines: Resources and citations are formatted according to current APA Style and Format. When appropriate, use APA-formatted headings.
• Font and font size: Times Roman, 12 point.

Minimum of 300 words with at least two peer review reference in 7th edition apa style.

Reflect upon the selected practice problem DIABETES and consider the following.

• What are the common barriers to evidence translation in addressing this problem?
• What strategies might you adopt to be aware of new evidence?
• How will you determine which evidence to implement?
• How will you ensure continuation or sustainability of the change?