student peer response C .R and. B.J. M.F J.N

C. R posted Oct 20, 2021 7:24 AM

While many things can deter healthy living, a sedentary lifestyle is key in preventing an ideal healthy living situation. Different social determinants of health exist, and not living a healthy active lifestyle can help to determine an unhealthy life. Healthy People 2020 relates that social determinants of health are the conditions that a person is born into; this can include where they reside, obtain an education, work, play, who/what they worship, and their age (Healthy people 2020, n.d., para. 5). These can all affect how a person lives their life, their health, and risk factors for poor health and diseases. All of those determinants play a factor in determining the lifestyle someone leads, as well as what health issues can be prevented or pop up as a result of that lifestyle. For example, a child who grows up staying inside all of the time playing video games or watching the television all day rather than playing outside and living an active lifestyle will be more likely to develop health issues such as obesity, diabetes, and high blood pressure. A person who lives in a not as developed neighborhood may not have as many resources as those in “richer” neighborhoods, and as a result, they could also have greater rates of infection or diseases. 

The chain of infection involves a few different elements. Those are as follows: an infectious agent, a source for growth, a portal of exit, a mode of transmission, the portal of entry, and a host (Potter et al., 2016, p. 443).  This all starts with an infectious agent, which grows in a reservoir and then is transmitted to someone or through something-the source of growth. The portal of exit is how it is transmitted from the source of growth. Examples include blood, saliva, stool, etc. which then sets up for how it is transmitted, which determines our level of isolation (Potter et al., 2016, p. 443-445). The community health nurse can be responsible for aiding to break this chain of infection, and the best possible way to do that is for them to provide education. By providing education on different diseases, how they transmit, and the best way to prevent them the public can take this information and be better prepared to stop the transmission. Another way the community health nurse can help to stop the break the chain of infection is to raise funds or utilize what is provided by the organization to set up sanitizing stations at restaurants, restrooms, and other public places. All in all, it is the responsibility of everyone to help stop the chain of infection and to help create a healthier lifestyle; everyone should do their part and aid in the cause.

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Social Determinants and the Public Health Nurse

B. J posted Oct 19, 2021 7:00 PM

     Overall health is thought to be linked to multiple factors in one’s lifetime, both intrinsic and extrinsic, their endogeneity persistent across human existence.  Social determinants of health include social factors, access to healthcare services, environmental factors, policymaking, genetics, and behavior (Office of Disease Prevention and Health Promotion [ODPHP], 2021).  Social determinants of health within these categories may include peer pressure, lack of internet access, genetic predisposition, educational background, and living situation among others.  All of these factors have the potential to shape a person’s health status, from decisions that affect health to increased risk of disease dealt in your genetic deck of cards.  The research and professional acceptance that looks at health as a composite of factors and not just a clear-cut chain of events, is supported by multiple models used to categorize these determinants, such as The Lalonde Report and the Evans and Stoddart models (Clark, 2015).  

     To understand how these social determinants affect health, imagine you do not have access to transportation to get to your doctor’s appointment, this can cause a host of issues, either lack of proactive care, missed diagnoses or leaving diseases untreated without necessary prescriptions.  Another example could be growing up near a factory that is later found to have been emitting carcinogenic toxins into the water supply for the past two decades.  This likely exposure to carcinogens could lead to cancer in the future.  Social determinants could further affect patients’ care during cancer treatment, such as distrust of the medical system and treatments or a late-stage diagnosis due to delay in seeking care (Karam, 2020).  

     Public health nurses are in a unique position to consider these social determinants when planning, implementing, and evaluating care to community members.  The recent COVID-19 pandemic has brought to the forefront of global health the fallout from disparities directly resulting from social determinants.  Direct causation is still being determined, but African Americans are 2.7 times more likely to be hospitalized due to COVID-19 than non-Hispanics white patients (Karam, 2020).  Public health nurses often staff local clinics, potentially increasing access to care in both rural and urban settings.  Nurses can provide education to patients on how to access their medical information online, increasing the incidence of treatment compliance and follow-up care (Bryant, 2021).

     The chain of infection involves looking at a disease process, from its inception, how it behaves within the environment and the role of the public health nurse in mitigating its effects.  The host is the carrier of the condition, with multiple factors at play including biological, psychological, and immunological factors (Clark, 2015).  Agents are considered the cause of the disease process and vary in their toxigenicity, resistance, and virulence among others (Clark, 2015).  An infection takes a path that begins with a portal of entry to the host, and a portal of exit when it leaves the host.  These paths are directly related to the mode of transmission, which details an agent’s infectivity.  Pathogenicity is an agent’s ability to cause disease, a measure of the proportion of persons infected who suffer the disease (Centers for Disease Control and Prevention, 2014).  Virulence is closely tied to pathogenicity, referring to the severity of the illness.  Resistance refers to an agent’s ability to survive under certain conditions, such as when it is exposed to antibiotics (Clark, 2015).

     Public health nurses are an integral part of interrupting, minimizing, and preventing infectious exposure and spread in communities.  Through education, public health nurses can have a tremendous impact.  Education and administration of vaccinations, from efficacy, safety, and keeping up to date, public health nurses are at the forefront of protecting communities in this regard.  Public health nurses, such as those that work within school settings, serve as educators regarding disease prevention, from proper hand hygiene to properly covering our mouth when we cough.  Public health nurses are often the first line of defense contact for patients experiencing symptoms of disease, thus early recognition and treatment supported by nurses can help to interrupt infection virulence in communities.

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                                     Another course. Informatics. 

E-Learning

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M. F posted Oct 19, 2021 9:08 AM

E-Learning

On my topic of E-Learning, multiple teams would be essential to implementing it.  Not only would our technology team be utilized, but also our education department.  It would take collaboration to get the program designed to what needed to be formulated to make the e-learning program work.  Not only would these two teams be utilized, but our Nurse managers and Nurse Clinical Coordinators to make the transition into e-learning. 

The technology team would be utilized to create the technological program to do the learning.  They would incorporate all the factors that can be taught online or through an interactive program or videos to educate patients.  They would make it user accessible from remote locations and at the nurse’s convenience.  This outcome of their program creation is to help nurses gain access to further education in the work field as well as for patient education teachings.  The nursing education department comes up with the curriculum needed to educate nurses and patients.  The Nurse Managers and Nurse Clinical Coordinators will help to coordinate the program getting placed into action.  The plan is to help nurses with any continuing education, re-visiting skills, or medication information management.  It will also provide teaching videos for patient education that can be utilized upon admission and/or before any test or procedure. 

The goal is to keep nurses caught up on their required continuing education credits necessary to renew their nursing license, will help with annual nurse education, allowing nurses to re-visit skills videos for a procedure that needs a refresher course, allows nurses access to evidence-based practices, and aids in teaching patients’ information regarding their care.  E-learning has become an integral part of health professional education, and its multiple benefits have been identified, including increased access to education, cost-effectiveness, and accommodation of multiple learning styles. According to a study done in Lebanon on attitudes of nursing faculty members toward technology and E-Learning, “there are multiple purposes behind the use of ICT information, communication, and technologies) in nursing education. Whether faculty members like it or not, and whether it is available for them or not, ICT use has become a part of the educational system and a lifestyle for some. In nursing education, ICT use has created better facilities for teaching and learning. More precisely, it has become easier to transfer theoretical knowledge into more practical and hands-on information (Nsouli, 2021).” 

There will be faculty who are for and against E-Learning and it will come with many learning curves, but as technology continues to advance, so will the different measures of technology in the medical field.  As nurses, we are taught to adapt and continue moving forward.  Using E-learning, nurses can utilize their own time to continue education, learn more about specific tests or procedures and help to learn more about educating their patients.  A well-educated patient is typically a calmer and more cooperative patient in my experience.  We owe it to ourselves to utilize the new technology for not only the benefits to ourselves but the benefits to our patients. 

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Collaboration in Healthcare Informatics Planning

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J. N posted Oct 20, 2021 8:36 AM

In order to get my company to agree to adding a suicide risk screening tool for children to our charting system we would likely need to present research to a quality improvement board. Using research based articles would seem to be the best way to argue for adding this procedure; doing something like performing a quality improvement survey on the unit to measure a possible need be okay to do but would not necessarily be peer reviewed. If nursing quality approved of the research, there would likely be an ethics consult and/or communication with the legal/risk department. If legal decided that this was okay to do then the company that my employer uses for the electronic chart would have to approve as well. Finally, likely nursing educators would perform an in-service or officially communicate the change to staff. Nursing management would help be the facilitator of communication with all of these departments likely. 

According to Falco et al. (2020), narcissism has been shown to be linked in part to ethical leadership and perceptions of being overly qualified. Alas, Falco et al. (2020) also report that those with narcissistic tendencies may be likely to be more devoted to workload and quality of work produced. This is worth mentioning as something as simple as not having a suicide screener for children admitted for suicidal ideation may seem to go against common sense. Before jumping to any conclusions, I can rest easy in the fact that it may be true that all of the red tape it takes to get something like this changed may involve some narcissism; it also may be true that all of that red tape may be a safeguard against lowly nurses such as myself assuming that I know what’s best for my patient without consulting others and collaborating with experts. 

I will be interested to see if my company has a good reason for not requiring these assessments. I think it’s important for me to remember that know matter what the research says or what my company decides, I have the ethical right to ask any if they are having any unsafe thoughts and if there is anything that staff can do to help them feel safe. Sometimes I myself rely too much on charting the bare essentials and covering my [self] for patient care. I think that nurses have an ethical obligation to not let policy or legal risk drive their practice but rather to push the boundaries of what is expected and attempt to see whether or not the patient’s best interests are in fact the primary reason for a decision. 

At the end of the day, I am grateful for the fact that I have a supportive management team that is able to contact legal or ethics to help support me in processing my actions as a nurse. When I was first hired as a nurse I was provided Spanish interpretation for a parent to be able to sign a pet therapy consent for the next day for their child. I was not certified to do this at the time and a staff member notified management that I did this. My manager helped me communicate with legal and provided me a very fair education warning on this incident. I am glad that we have an accountability system in healthcare in which different specialties can communicate and rely on each other for their respective expertise. 

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