Total Knee Replacement and Imaging

 Introduction

Total knee replacement and imaging are done to ensure proper functioning of the knee joints. The prosthesis is used to correct abnormalities or imbalances in the bone and bon tissues. Radiography imaging is done to locate the extent of the disease.

Body

Total knee replacement is performed on a common practice with over 1.5 million procedures being done yearly around the world.  The reasons for performing the procedure is to relieve pain or regain the right functioning of a seriously damaged knee through a replacement of all the 3 components of knee joints.  The main aim is to correct imbalances of the soft tissues or bone abnormalities. Radiography imaging is done to assess the extent of the patient’s knees diseases and helps to align the limb and accurately place the implants (Scott 2015).  It is necessary in determining whether a patent qualifies for a TKR surgery, where surgeons check for bony abnormalities , the narrowing of joint space , alignment of the a patient’s knees and whether the prosthesis fit on the intended bone.  The radiograph imaging is also important for follow up and for postoperative examination.  The quality of image greatly determines the effectiveness of patient care due to accurate positioning and reduced errors (Scott 2015).

 The image view can be in form of Anteroposterior Weight-bearing projection, Weight-bearing Lateral Projection, Tangential Patellofemoral Projections and Weight-bearing Posteroanterior Projection, Full-leg Length (Hip-Knee-Ankle) AP Projection, Posteroanterior Oblique Condylar Projection. The various types of imaging include Computer Tomography, Magnetic Resonance Imaging, Fluoroscopy and Nuclear imaging.  The use of Computer Tomography is appropriate if there is pain, in case of inclusive or negative cultures for joint aspirations and effective joint aspiration for purpose of infection (Scott 2015).

A prosthesis is used the problematic bones’ surfaces. The available prosthesis comes in different sizes, materials for component and fixation methods so as to ensure matching of patent’s body in the best way possible for restoration of joint functioning.  The components of the prosthesis used should match the patient’s body as strongly as possible.   Narcotic pain drugs are administered to manage pain after the procedure.  Complications have been reported during the follow-up with 14 – 44 percent patents reporting persistent pain (Scott 2015).

Conclusion

The Total Knee Replacement procedure is carried out in many patients across the world, where prosthesis is used to replace or correct the problematic surfaces if the knee. The imaging of the knee to locate the issue is done in different ways with different equipments.

References

Scott A. Total knee replacement and imaging. Radiologic Technology [serial online]. 2015;(1):65. Available from: Academic OneFile, Ipswich, MA.

CANTEL MEDICAL

1. Ratios from the most current and available 3 years

Ratios illustrate the capability of a given company to cater for its existing debts and accountabilities from its resources and sustainable revenue generation (Russ, 2010). CANTEL Medical has acquired positive financial ratios for the last three consecutive years contrary to the competitors. The market has changed thus requiring the corporation of all the players some pressures that most of its peers have not been able to meet. Despite the acquired revenue, CANTEL has remained rather committed based on its capability to make an additional investment into innovative products that have in turn grown its share. As at the end of 2017 the company has experienced a three consecutive year’s financial growth with an approximation of 16%. The market has compensated the company since it has acquired and steady growth and revenue sustainability.

Apart from the revenue aspect, the company’s stock price is essential in measuring the growth and stability of debts settlement.  To begin with, Asset is a fundamental resource which is owned by the company and holds financial importance. CMD’s assets increased with close to 90 million dollars from 2016 up to 2017 (Traders, 2017). Liabilities are comprised the existing obligations such as short-run loans, suppliers payments and other pending payments taken to fund projects. The actual liability for CANTEL is 260.44 Million dollars. Shareholders equity is also a liability since it represents the debt owed to the shareholders of the company’s stock. During the three year period, the stock increased rather unexpectedly. Within the medical innovative industry, CANTEL is actually valued as it commands a market worth that is more than 4 times its actual tangible equity. However for the company’s Price to earnings (PE) ration on the stock as at the end of 2016 was 7.0 a state that is below the average earning in the industry. This, therefore, illustrates a wider opportunity for expansion (Traders, 2017). The constant revenue increase as the company seeks to strategically acquire is something that is admired by its investors.

2. Alternative Strategies

There are some strategic alternatives that CANTEL can utilize to guard its sustainability and financial stability in the highly competitive market. This might include cost reduction, differentiation, business modification and diversification. Cost leadership is a niche approach that means that the company will be competing on the basis of cost (Russ, 2010). The company can lower its pricing to gain a large market share that does not equate with that of the competitor. Since the consumers in the market are different, this implies that low-cost approach will be effective in attracting new customers while retaining the existing ones. Differentiation is applicable in a competitive market. The company can add more innovative features to the existing products to create more value to the consumers. While diversification means to create newer products or expand to new markets. This approach is essential since CANTEL is innovative and it can no rely on differentiation to gain a competitive edge. This approach has assisted the company in exploring a wider market with new products thus making it hard for the rivals to match its strategies. On the other hand business adjacent is another strategic alternative. This involves getting into a market space where the business utilizes its comprehensive potential to generate adequate finances (Russ, 2010). The business is mainly focused on the existing market demands as its opportunities for expansion. A successful adjacent must consider the needs of the market while developing new products.

Figure 1: Cantel Medical Ratio Chart

ReferencesTop of FormBottom of Form

Russ, M. (2010). Knowledge management strategies for business development. Hershey, Pa: IGI Global.

Traders. (2017). CANTEL MEDICAL: Management's Discussion and Analysis of Financial Condition and Results of Operations. (form 10-K). Retrieved from http://www.4-traders.com/CANTEL-MEDICAL-CORP-12112/news/CANTEL-MEDICAL-Management-s-Discussion-and-Analysis-of-Financial-Condition-and-Results-of-Operatio-25195046/

Journal summary 13

Medical Ethics and Law in Radiologic Technology

  Introduction

Radiologic technologists are guided by medical ethics that are outlined in ethical standards established by professional body. The basis of such ethics is derived from various theories of ethics discussed below.

 Body

Medical ethics are basically guided by a person’s professional view of what is right or wrong.  As a medical practitioner, a radiologic technologist professional identity is founded in his or her ability to make right decisions relating to the health care offered to patients.  The individual uses personal values as the basis of determining what is right or wrong, evaluate their ideas , actions and relationships.  Ethics are defined externally but personally applied through behaviors that are consistent with values and beliefs outlined by the professional association.  There 8 theories that have greatly been applied to health care (Matthews & Matthews 2015). Aristotle’s Phronesis theory is based on the notion that a person should have more strength than their impulses and apply reasoning while making decisions.  Radiologic technologist should base their decision on what a reasonable person with similar training would do. The natural law theory by Thomas Aquinas focuses on natural law as an aspect of divine providence and human role as emerging from natural law.  It is based on the idea of practical rationality arising from basic good principle, which emphasis on respecting the dignity of others and assists them to live in their community (Matthews & Matthews 2015).  

The deontological ethics by Immanuel Kant is based on the idea that the greatest virtue comes from doing what should do since they have to or they agree to.  John Stuart Mill’s theory of utilitarianism focuses on the notion that morally sound or ethical decision or action is one that leads to greatest benefits to majority of people in the community.  Martin Buber theory was based on the idea that the greatest ethical relationship that a person can get into is I-THOU (Matthews & Matthews 2015). People in such a relationship can recognize the existing differences in people and embrace them as being valuable. Viktor Frankl is based on the notion that an individual who is conscious has moral integrity and tries to do thaty which is considered to be right. John Rawls theory is based on maximin principle and liberty principle. Liberty principle means that every person should enjoy same basic rights and maximin principle refers to actions that a person may take to tackle inequality in a society (Matthews & Matthews 2015).

 Lawrence Kohlberg theories hold that people have varying capacities of ethical reasoning and that health care administrators are bestowed with much authority and trust by the society. The last theory relates more to health care professionals including radiologic technologists who are guided by a standard of ethics that spell out principles of conduct. Health care professionals face litigation arising from violating such ethics and should understand the impacts of these lawsuits (Matthews & Matthews 2015).

Conclusion

Medical ethics guiding the radiologic technologists are majorly derived from Lawrence Kohlberg theories that emphasis on ethical reasoning, authority and trust. The professionals must be aware of such ethics to avoid litigations

References

Matthews E, Matthews T. Medical Ethics and Law of Radiologic Technology. Radiologic technology. 2015:163

 Preventing Overweight and Obesity through Physical Activity and Healthy Nutrition

1. B) Problem description

The St. Lucie district or county is situated on the eastern coastline of Florida. The county comprises, Port St. Lucie, St. Lucie Village towns, and Fort Pierce. Being the most advancing county in the USA, the district covers a region of about 572 square miles. In respect to the county’s rapid development, the district has more than 291,000 inhabitants. The geographical location of the county along the coastline or shore of Florida permits the district to experience subtropical climate. The composition of the county comprised low income, minority group, and medically underserved populace. The varied population of the county comprises African American, Whites, Hispanics, Asians, and American Indians. Despite efforts of various health organizations in combating effects of chronic illnesses, overweight and obesity have resulted in the loss of lives in numerous parts of the USA. Both child and adult obesity contribute to 16.1% and 30% health concern in the St. Lucie County respectively. Selling of fast foodstuffs and restaurants are the mostly conducted business activity in the county. Various business operations are centrally conducted in the Port St. Lucie as opposed to other regions such as Fort Pierce. Even though most business activities are performed in the Port St. Lucie, numerous homesteads are situated next to the region. Some of the surrounding homesteads are singled families located on a small piece of land, while other homes are situated on a large tract of land. Though the homesteads are located on different size of land in Port St. Lucie, some homesteads have well-maintained yards, however, the Fort Pierce has non-distinguished neighborhoods.

1. C) The connection between overweight and obesity to health disparity within the population of St. Lucie County.

1) Kotelchuck index on health disparity in the county

Even though the challenges of obesity and overweight affect both children and elderly persons, the exacerbation of the problem can be attributed to health disparity among the population that constitutes the St. Lucie County. The health inequality among the population can be linked to income discrepancies among the Blacks, Whites, Hispanics, Asians, and American Indians in the county. The inhabitants of the Fort Pierce are majorly blacks. They form the large portion of the low-income population in the county as opposed to the White population that receives higher incomes. The Fort Pierce has limited number of playgrounds and stores dealing in retail food as compared to the Port St. Lucie. Generally, low-income families have minimal access to healthy foodstuffs and opportunities to participate in physical activities. In addition, the higher life expectancy of the White population in relation to the Blacks depicts the existing health disparity in various parts of the county. According to Meyer, Johnston, Crocker, and Heil (2015), the Kotelchuck index shows that approximately 22.9% of children born in the county received intermediate or inadequate parental care. Additionally, 44.7% of the children delivered in the year 2015, were born of obese or overweight mothers.

2) Major prevention and community resources utilized in addressing obesity and overweight challenges in the county.

Firstly, the St. Lucie County has a well-designed gym program aimed at assisting the adults who have attained the age of 65 years and above to address chronic challenges, especially those that are associated with obesity and overweight. The silver sneak program is offered through the partnership with the LA fitness club, YMCA, and the Civic Center of Port St. Lucie. Despite the intention of the program to assist the elderly persons in the county, several county members including the youths have accepted the program. The accessibility of the program has been facilitated through the insurance qualifications of young adults, particularly, those who are considered physical challenged or has chronic disorders. Though the program assists in reducing instances of overweight and obesity in the target population, several attendees receive a better forum for socializing.

Secondly, the St. Lucie County has different resources used in addressing overweight and obesity in the elderly and young population. School forms a major factor in addressing challenges of obesity and overweight among the young population. In ascertaining instances of overweight and obesity in the youth, performing Body Mass Index (BMI) plays a significant role. According to Ogden, Carroll, Kit, and Flegal (2012), children who are obese have a BMI which is larger than or equivalent to specific sex and age highlighted in the 95th percentile growth chart of the center of disease control (CDC) in 2000.The higher the Body Mass Index, the higher the danger of suffering from chronic disorders like diabetes, high blood pressure, coronary health illnesses, sleep apnea, some types of cancer, and gallbladder illnesses. Approximately, 17% of children between the ages of 2 to 19 years in the USA are categorized as obese (Ogden et al., 2012).

In addition, 31% of children who are below 18 years in the county have higher chances of becoming obese and gaining excess body mass. According to Ogden, Carroll, Kit, and Flegal (2012), about 6% to 50% of children who are suffering from obesity and overweight are likely to experience the challenge even during their adulthood. The St. Lucie County school has discouraged consumption juice and snacks while promoting the drinking of water. Besides, the school promotes regular participation in physical education. The cafeteria of Floresta Elementary school situated in Port St. Lucie offers a variety of health foodstuffs to the students. The cafeteria provides vegetable patties, wide types of fruits, baked chicken, water, and 1% milk products. Both teachers of the elementary school and parents are working jointly to address challenges of obesity and overweight among the students. Teachers are responsible for encouraging students to consume vegetables and fruits. Parents of the students have restriction responsibility for the consumption of unhealthy snacks through the administration of the elementary school. Healthy nutrition entails consuming vegetables and fruits daily. Consequently, obesity and overweight among the youths can be addressed through promoting proper nutrition and active involvement in sporting activities.

Apart from the schools, the county has various nutrition options necessary for encouraging healthy consumption habits among the youths and the elderly persons. The St. Lucie County has many farmers’ markets. These markets avail vegetables and fruits to the county’s populace at affordable prices in comparison to the available grocery stores. The district has about 36 food banks which offer fresh vegetables and fruits to the buyers daily (Lewis, Jones, Horner, & Sugai, 2010). The availability of cheap fruits and vegetables permits members of the district to have access to a variety of healthy nutrition options. Besides farmers’ markets, the county has several food pantries offering fresh vegetables, beans, grains, and fruits cheaply to the consumers. Therefore, the challenges of obesity and overweight among the youths can be addressed through promotion of healthy nutrition and regular participation in physical exercises or activities.

Lastly, the administration of the county has joined the struggle to address effects of obesity and overweight among the residents. The regime has established women infant and children nutrition program to enhanced well-being of pregnant, postpartum, and lactating women. The program aimed at advancing the health of infants, children between the age of zero to five years through the promotion of nutritious food and nutritious counseling. The program has contributed to the significant enhancement of children’s well-being through improved diet (Ogden et al., 2012). The program has encouraged women to purchase fruits, grains, canned fish, vegetables, cheese, milk, baby meat, and beans.   

3) Underlying causes of obesity and overweight among the youths

It is evident that obesity is a major issue in the contemporary society whose causes are widely known. Environment plays a significant role in the inhibition of obesity and excess body mass in children. In that, the contemporariness today is a major drive to the issue not only because the living standards have changed but also because most people ignore the need for healthy living.  Ensuring healthy consumption requires an environment which promotes healthy habits among the inhabitants (Lewis, Jones, Horner, & Sugai, 2010). Overweight and obesity among the youths and adults in the county or district can be associated with poor healthy food selections and lack of participation in physical activities. Places like schools, child maintenance or care centers, and communities affects children’s diet and activities. The foodstuffs and drinks which these institutions offer to children influence their well-being. Besides drinks and foodstuffs, the opportunities offered to children to participate in physical activities assist in addressing challenges connected to obesity and overweight. Subsequently, vigorous involvement in sporting activities and proper recommended nutrition is useful in obesity and overweight prevention among the children in the county.

Furthermore, social assistance, peers, affordability of nutritious foodstuffs, policies, promotion, and marketing determines the St. Lucie County arrangement, thereby affects physical activities and diet of the inhabitants. Based on series of interviews with cafeteria operators, teachers, students, and family practitioners in the county, overweight and obesity are caused by unhealthy eating behavior or habits among the students. Behaviors that result in an excess mass gain in both children and adults entail consumption of products rich in high-calorie, low-nutrient beverages, and food. Excess mass gain can be through lack of physical exercise and active participation in sedentary or inactive activities like watching television (Ogden et al., 2012). Several youths suffering from obesity and overweight are engaged in the consumption of unhealthy snacks. They irregularly participate in physical activities or exercises, especially during their leisure time.

By contrast, the challenges of obesity and overweight in the youths can be resolved through consumption of healthy diet and actively participating in physical activities in school. Maintaining equilibrium state of calories or energy obtained from foodstuffs and beverages requires active participation in physical activities. Calories or energy balance prevents excess mass gain in both children and adults. Additionally, consumption of healthy food and active physical participation has health benefits such as prevention of cancer, heart illnesses, and diabetes.

1. D) Evidence-based activities linked to obesity and overweight prevention in the St. Lucie County

Effective results of evidence-based practices in the communal health require capacity building and proper training of nurses. This plays a significant role in ensuring effective application of evidence-based practices in their daily operations to deliver better health outcomes in the St. Lucie County. Prevention of obesity and overweight in children and adults requires an effective application of Positive Behavior Intervention Support (PBIS). The PBIS is based on examination strategy designed to improve the ability of learning institutions to train learners effectively (Lewis, Jones, Horner, & Sugai, 2010). The strategy aimed at preventing unpleasant behaviors among students. Integration of the PBIS in health practices in the community has a vital role in enhancing social behaviors and academic performance of all students. Some behaviors are connected to chronic disorders such as diseases that result from obesity and overweight. The strategy provides baseline data necessary for combating impacts of obesity and overweight among the youth population of the St. Lucie County (Abdul-Rasoul, 2012). Besides the provision of baseline data, the strategy assists in redirecting the behavior of youths positively. The Positive Behavior Intervention Support (PBIS) is not only effective in preventing the rise of obesity but also seeks to create awareness and familiarity of the issue among the public. It is evidently argued that most individuals fall to unhealthy eating alternatives for the lack of knowledge which is particularly true. However, the program is aimed at eliminating the lack of knowledge while rampantly reducing obesity among both children and adults.

1. E) Community health nursing social media campaign approach in conveying and addressing obesity and overweight

“Active Sporting and Fresh Food Consumption.” The campaign strategy considers lack of active participation in physical activities and unhealthy food consumption as the causes of obesity and overweight among the adults and youths. The approach assists in creating awareness of the effects of obesity and overweight among the adults and the youths. Apart from creating awareness, the social media campaign strategy aims at promoting behavioral change among the students through active participation in physical activities and consumption of healthy food.

• Objective of the social media campaign approach

The objectives of the “Active Sporting and Healthy Food Consumption” social media campaign in relation to adolescents or youths and children from the county are:

• To create awareness and familiarity of the obesity issue, its effects, causes and prevention measures.
• To minimize the percentage of youths and children with age range of two to nine years old who are obese and overweight to a portion less than 16.1% within the next five years.
• Promote universal accessibility to retail shops selling a variety of healthy foodstuffs within the St. Lucie County in the USA. The accessibility plays a crucial role in encouraging healthy diet among the inhabitants.
• Promote the contribution of vegetables, grains, and fruits to children and youths’ diet in the St. Lucie County.
• Increase the number of learning institutions that provide healthy foodstuffs and beverages to the students.
• Minimize the consumption of sodium and saturated fats among the children and youths in the St. Lucie County.
• Improve the students’ involvement in physical education or activities both at the learning institution or at home.
• To promote healthy eating habits and practices to deter overweight cases among the youths and children in the county and the entire USA.
• Population-Focused Social Marketing Intervention To Advance The Health Message

Population-focused social marketing campaigns are significant in organizing meaningful involvements to improve communal awareness concerning certain health-related problems. The communal awareness promotes better comprehension, modifies transformational agenda, and influences attitudes resulting in voluntary behavioral change, hence encouraging positive food consumption habits among members of a given community: communal welfare improvement. Social marketing conveys various information to the target groups. For instance, the theme of obesity and overweight can encompass sub-campaigns aiming complete physical activities, total energy, and fat consumption in sequence information. Fit-4-life and Physical activity, nutrition, and obesity (PANO) are some of the Social Marketing Interventions that may play significant function in enhancing the conveyance of obesity and overweight prevention among the youths and children in the St. Lucie County. This interventions will be effective in ensuring that the states social networking campaigns goals are achieved without fail thus leading to healthy living and reduced obesity cases in the county and national wide.

Physical Activity, Nutrition, and Obesity (PANO)

Lack of participation in physical activities and unhealthy consumption of foodstuffs results in substantial mortality and morbidity across all ages. Inactive participation in physical activities and unhealthy nutrition contributes to obesity, overweight, and energy imbalance in the human body. Regarding health challenges in the St. Lucie County, PANO has a mission to offer strategies and goals for communities, governments, media, health care providers, worksites, and learning institutions to minimize obesity and overweight among the youths and children (CDC, 2013). The intervention assists in preventing obesity and overweight through acknowledgment of various economic, behavior, social, and environment aspects that influence human health. The health marketing intervention utilizes population-focused strategy in addressing the function of nutrition and physical exercise in enhancing and preventing obesity and overweight among the youths and children in the county. PANO plays a vital role in addressing overweight and obesity through promoting system alterations, programs execution, policies, and approaches in enhancing healthy consumption habits, active participation in physical activities among the youths and children in the county.

Fit-4-life

According to Gombosi, Olasin, and Bittle (2007), the fit for life is a social marketing intervention functions as a comprehensive initiative aimed at primary prevention of obesity and overweight through utilization of school-based health lessons. The initiative uses computer-generated wellness club and communal well-being affairs to encourage active participation in physical activities and healthy nutrition.

• Appropriate social media platform for obesity and overweight prevention

Social networks play a significant role in addressing obesity and overweight among children and youths through connecting them with their peers. Approximately all youths and children in the USA have access to Internet-enabled cell phones. The accelerating utilization of social networking in tweeting and texting (Facebook), the platforms has an important function in combating overweight and obesity among the youths. The utilization of tweeter and Facebook offer appropriate platforms for internet-based campaigns to encourage active participation in physical activities, loss of weight, and healthy consumption of foodstuffs among the youths (Lakerveld, Brug, Bot, Teixeira, Rutter, Woodward, and Robertson, 2012). The effective effort to address obesity and overweight among the youths and children through social networking in the county requires the active involvement of parents, peers, school administration.

1. Advantages of Facebook in preventing obesity and overweight among the children and youths in the county

Facebook acts as an appropriate social media platform in the effort to address obesity and overweight among the youths. The platform is free, user-friendly in preventing overweight and obesity among the youths. Depending on its large coverage, Facebook connects a great number of peers, therefore, can positively assist in preventing overweight and obesity (Huhman, Potter, Nolin, Piesse, Judkins, Banspach, and Wong, 2010). Like other social media platforms, Facebook can display various sub-campaigns topics aimed at discouraging unhealthy consumption and promoting active involvement in physical exercise among children and youths in the county. Subsequently, Facebook continues to play significant function in aiding current and future nurses’ practices through providing education forum (health recommendations) for both youths and adult: significance in preventing excess body mass via physical and healthy consumption. Facebook is advantageous given that it enables the spreading of information within the shortest period thus reaching the widest population. This platform is effective in creating awareness and facilitating debates among youths regarding the most effective healthy measures that will in turn support the objective of reduced obesity rate among children and adults in America.

Benefits of tweeter in preventing obesity and overweight among the children and youths in the county

Tweeter plays a significant role in addressing obesity and overweight among the youths and children. Tweeter connects a great number of parents, teachers, health practitioners, and peers. Health practitioners may post best health practices aimed at preventing excessive body mass gain and obesity across all age (Huhman et al., 2010). Parents, teachers, and youths may decide to implement the practices, thereby discouraging unhealthy consumption, and promoting active involvement in physical exercise among children and youths in the county, therefore, preventing overweight and obesity.

1. F) Significance of preventing obesity and overweight among the youths and children through physical activities and healthy consumption

Involvement in active physical exercises and healthy consumption of foodstuff assist children to grow and maintain healthy body mass throughout their childhood. Active participation in physical activities helps in ensuring a proper balance of calories or body energy obtained from beverages and food. Burning off calories through active play helps youths and children to maintain healthy body weight (Mohanan, Tapp, McWilliams, and Dulin, 2014). In addition, active participation in physical activities and healthy food consumption results in health advantages such as prevention of chronic disorders like hypertension, high cholesterol which causes cardiovascular disorders, cancers, sleep apnea and asthma (breathing challenges), depression and anxiety (psychological illness), low individual-esteem, diabetes, and stigma in children and youths. Furthermore, physical exercises and healthy diet prevent future obesity in obese children.

1. H) Social media campaign execution arrangement

Effective participation of the appropriate stakeholders in the implementation of social media campaign promotes overweight and obesity prevention among the youths. Numerous actors such as local and national regime, sports organizations, teachers-parents’ association, and media are important in obesity and overweight prevention (McPherson, Mirkin, Heatherley, and Homer, 2012). The stakeholders can ensure effective message conveyance through financial contribution used in compensating the paid media in discouraging inactive participation in physical exercises and unhealthy consumption of foodstuffs among the youths and children in the St. Lucie County.

Implementation timeline of the project

Though health messages through social media are conveyed quickly, however, the platform requires a perfectly draft ed message to result in effective health outcomes among the youths. “Active sporting and healthy consumption,” strategy may require approximately 3 months and above to affect the present and future generation on the importance of healthy food consumption and engagement in active physical sporting in school and at home.

Topic: causes, effects, and prevention of obesity in the St. Lucie County

Since the campaign is based on social networking, evaluation of its effectiveness requires numerical consideration of the viewers and comments (Huhman et al., 2010). The greater the number of viewers, the greater the message coverage and consequently the massive positive health impact it might cause among the youths, children, and adults in the county. Depending on the period required for the campaign to result in positive health outcomes among the target group, the initial stage will require about $50 million dollars with a reduced subsequent donation from the local regime, national administration, parents, corporates, and school administrations.

1. Importance of obesity and overweight prevention through physical activities and healthy consumption to the community and future nursing practices.

Generally, the intervention will ensure implementation of practices and policies aimed at promoting consumption of healthy beverages and foods in child welfare facilities, recreation centers, schools, and to limit the accessibility to high-calorie products, unhealthy food nutrients in the community.

Influence of PANO on future nursing practices

Furthermore, the initiative will promote nurses’ empowerment and capacity building to comprehend application of evidence-based approaches in addressing obesity and overweight among the community members. This plays a significant function in guaranteeing effective utilization of evidence-based practices in nurses’ daily operations aimed at delivering better healthcare services to the St. Lucie County. Consequently, PANO will assist nurses’ future practices targeting in establishment of a healthy community and individuals across various initiatives through capacity building to execute evidence-based strategies, infrastructural and environmental transformation.

References

Abdul-Rasoul, M. M. (2012). Obesity in children and adolescents in Gulf countries: facts and solutions. Avances en diabetologia, 28(3), 64-69.

Centers for Disease Control. (2013). Make a difference at your school.

Gombosi, R. L., Olasin, R. M., & Bittle, J. L. (2007). Tioga County Fit for Life: a primary obesity prevention project. Clinical pediatrics, 46(7), 592-600.

Huhman, M., L. Potter, M. Nolin, A. Piesse, D. Judkins, S. Banspach, and F. Wong., (2010). The influence of the VERB campaign on children’s physical activity in 2002 to 2006. American Journal of Public Health 100(4):638-645.

Lakerveld, J., Brug, J., Bot, S., Teixeira, P. J., Rutter, H., Woodward, E. ... & Robertson, A. (2012). Sustainable prevention of obesity through integrated strategies: The SPOTLIGHT project’s conceptual framework and design. BMC public health, 12(1), 793.

Lewis, T. J., Jones, S. E., Horner, R. H., & Sugai, G. (2010). School-wide positive behavior support and students with emotional/behavioral disorders: Implications for prevention, identification, and intervention. Exceptionality, 18(2), 82-93.

McPherson, M. E., Mirkin, R., Heatherley, P. N., & Homer, C. J. (2012). Educating health care professionals in advocacy for childhood obesity prevention in their communities: integrating public health and primary care in the Be Our Voice project. American journal of public health, 102(8), e37-e43.

Meyer, M. C., Johnston, A. M., Crocker, A. M., & Heil, S. H. (2015). Methadone and buprenorphine for opioid dependence during pregnancy: a retrospective cohort study. Journal of addiction medicine, 9(2), 81.
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity in the United States, 2009-2012. CDC: NCHS Data Brief, No. 82, January 2012. Retrieved from9/23/2012 from: www.cdc.gov/nchs/data.databriefs/db82.pdf

Mohanan, S., Tapp, H., McWilliams, A., & Dulin, M. (2014). Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care. Experimental Biology and Medicine, 239(11), 1531-1540.

MYLAN

 Mylan is an international healthcare firm with a focus on producing medicines that are of high quality and to everybody that needs them. The firm has a long history and heritage of offering generic pharmaceuticals and championing improved healthcare globally. The mission of the firm is, therefore, a commitment to setting healthcare standards and combining efforts globally to offer the entire population medicine that are of high quality (Mylan, 2017). This involves innovation to cater for unmet health needs, embracing a habit of service excellence and reliability, doing the right thing and influencing future health outcome through global leadership.  The mission of the firm involves unlocking extra value first for patients, then shareholders and employees and being a global leader on the same.  The values of the company are ingrained in the company’s code of ethics which comprises of innovation, integrity, reliability, teamwork and service (Mylan, 2017).

 In line with its values, the firm has involved in various activities aimed at improving community health. For instance the firm has a program where patient safety measures are complemented by providing support and in formation in different languages. All the partners that undertake to storing and distribution of the products of the firm have to comply with the acceptable distribution practices. In the efforts to provide quality medicine and health care the firm’s role extend beyond offering affordable medicine (Mylan, 2017). For instance, the firm works in collaboration with civil society and non-profit organizations in implementation of HIV-treatment programs and stems its effects.  However, the firm under the leadership of Heather Bresch has been involved in a controversy of overcharging Medicaid for EpiPen, an allergy medicine. This goes against its mission of offering affordable care to all people (Weintraub, 2016).

Culture refers to a firm’s shared beliefs, but climate refers to shared attitudes or perception especially in relation to employee engagement.  The culture for Mylan is a commitment among every member to offer high quality medicine, through teamwork and collaboration. The climate relates to embracing and challenging every employee in the team to take charge of implementing change and moving away from status quo (Mylan, 2017). These aspects are important to a leader since providing quality care requires the involved of all members of the organization who are driven by a common purpose.

References

Mylan , (2017).Corporate Governance. Retrieved from: http://www.mylan.com/en/company/corporate-policy

Learning in practice (nursing)

This is a time of great transformation in health services. Hence there is the need for a clear view on the best way to deliver services within dermatology department. Educational programs in nursing are quite vital to the improvement of competencies by the employees; however, these programs must be relevant to a multi-professional dermatologist at the most appropriate level of their specialty rather than their profession. This competence strategy will describe the remit of the educational programs and will offer a variety of skills that may be regarded as important in their role hence allowing the development of job specialization. However, the current state of education and clinical preparation for nurses is at a critical position. This is because of the fact that most of the dermatologists acquire their specialized skills and know-how through the on-job training with other dermatologists, educational training and with restricted clinical residency experiences. This has therefore made it so hard for the definition of the core body of knowledge and the standard for education preparation required in offering a base for competent dermatology nurse practitioners. There is the need for the realization of the importance of the establishment of minimum knowledge and standard of nurse’s competencies.

According to Dermatology Workforce Group, (2007), the decisions in regards to patient care by dermatologists are often made by a team rather than an individual. Therefore, nurses within this dermatologists department must, rely on the role of the leaders so as to empower the team to attain the organization’s goal. As a result of this, a well maintained open communication, as well as better coordination within the organization, will be realized. Nurse leaders should, therefore, encourage and support the subordinate dermatologists placing on a clear vision and building on trust and their capacity to influence subordinates to realize their vision, greatly influences the employees' satisfaction. Good health care requires a good team conduct, hence, it is recommended that nurses should establish good relationships with the care teams and should work on improving these relationships. In so doing, employees’ satisfaction will be developed.

Transformational leadership in nursing is one of the most effective leadership following its emphasis on the improvement of supportive relationship building. These relationships are attributed to enabling employees to find meaning in their work, allowing them to communicate their proposals and collaborative participation in teamwork towards effecting positive change. Nursing practitioners cite recognition and empowerment as major reasons behind satisfaction and acceptance of the profession hence resulting in nurses’ engagement in learning (Walker, Cooke,  Henderson, & Creedy, 2011).

In today’s nurse leader, an appreciation for workplace culture is quite important. Nurse practitioner’s attitude towards culture enhances them to better understand staff conducts and relationships. Continuous learning culture in dermatology organizations is quite important. This learning environment allows nurse practitioners to propose new schemes. Nurses are therefore challenged to become inquisitive and more research-oriented (Tsai, 2011). This, therefore, fosters a culture of continuous competence improvement. In most cases, nurses working within dermatology department practitioners may collide with each other but it is important for them to realize the power that is vested in apology and transparency. Organizations that embrace this culture often improve their relationships and thus are able to help one another in the different cases regarding the patients and also the treatment options hence becoming productive. The health organization ought to develop a just and fair culture is quite important in having a productive workforce. In a fair and just organization, interpersonal learning is balanced with an individual’s discipline and responsibility. Anytime that the organization is at a position of discussing mistakes with transparency with a motive of learning from them and when the organization uses resources needed to get to understand the root cause of the mistake, then the organization seizes to being a blame game but rather it becomes an environment that fosters respect and open learning of new ways of doing things in a better way.

Presence of a healthy organizational culture allows practitioners to experience precious learning in the organization. Learning in the workplace is quite essential as it allows the provision of an evidence-based and progressive improvement in safe patient care which is core in attaining good patient results. Therefore, there is the need for nurses to learn within an organization that promotes the implementation of evidence-based, expert practice and allows for the best patient results. In addition, organizations’ learning informs the extent and progression of nursing practice and is also linked to the regulatory needs that are connected to dermatology practice. Organization culture has important economic as well as organizational imperatives. A healthy organization fosters good human relationships and hence promoting job satisfaction. As a result of the increased job satisfaction, there are high chances of employees’ retention and ultimately low nurses turnover rates. Therefore, by addressing the issue of nurses’ retention, organizations are in a better position to economically save so many finances due to the already cut cost of employing new employees (Tsai, 2011).

Following the high need for education in nursing, it is important for the organization to offer educational and career empowerment through offering the nurses financial support and also allocating them with enough time for educational development and research. The organization should also empower them to carry out special projects and publications. This will expound on their knowledge of dermatology health knowledge hence will reduce their need to quit and thus less turnover and competence. The organization should incorporate a culture of mentorship through arranging for educational seminars and conferences for the nurses working dermatological wards as this will allow them to all benefit from the organization’s effort in creating awareness about a given subject related to skin disorders (Davis, White, & Stephenson, 2016).

The most common diseases experienced by health professionals are the skin disorders. There is a high prevalence of a wide range of people suffering from eczema while others suffer from psoriasis and a small number suffer from rare genetic skin disorders. These skin disorders, however, have proved to affect people of all ages and the increasing need for children, teenagers and in old patients needs to be realized and a solution needs to be established. Some of the common skin disorders are frequently increasing in numbers and this has resulted in an epidemic of skin cancer. As a result of this, there has been a rapid increase in demand for dermatological services as an outcome of this change and due to the changing attitude of people towards skin disorders. There has also been an increase in the number of referral cases to dermatologists by general practitioners more than all the other medical specialties. However, the majority of these patients are faced with mild skin problems that are often self-managed and they become effective once an earlier diagnosis is offered to them. The referral systems are quite positive hindrances to optimal care for patients suffering from long-term skin disorders. This is because of the long waiting period that the patients go through. The patient’s skin problem may end up deteriorating during the intervening period, in spite of the fact that the dermatologist is already aware of the patient’s diagnosis and the treatment needs required by the patient. However, in relation to these facts, it is so disappointing that the education curriculum in nursing for all professions and to all levels is very restricted, with the exception of the education skills offered for hospital physicians training in this area (Dermatology Workforce Group, 2007).  The standard medical undergraduate curriculum for dermatologists involves only six days of training while the general practitioners are usually exposed to skin problems during their daily practice. It is so unfortunate that in six GP’s only one of them has the formal training in dermatology. There is no prearranged post-qualifying education program for nurses in dermatology department. On the other hand, dermatology content among the pre-registered nursing programs differs largely and is at present not standardized. Therefore, there are limited educational opportunities in dermatological pharmacy with no structure formulated. Though there are accredited open learning courses for pharmacists interested, there are no standards set as to whether it is mandatory for nurse pharmacists to take this course and there are no incentives allocated for the same. In regards to these arguments, there is a pressing need to consider how nursing services should be configured so as to ensure that the already existing expertise is at maximum use and to delineate the educational aspects that are of importance in generating competent nursing practitioners at all levels (Dermatology Workforce Group, 2007).

According to Bobonich, & Cooper, 2012), for a nurse to specialize in dermatology, they are required to first complete their master program focusing on a specialty in one of the well-defined populations. In the past, acquiring an additional nursing skills was just a subspecialty know-how and having the clinical skills was just subjective, inconstant and unclearly defined. However, in the modern health care systems, there is the need for advanced dermatology science which is essential in the development of competencies. The current nursing education programs should, therefore, consider integrating the basic science and advanced science in nursing. These educational elements in the core curricular of nursing will enable learners to improve on their clinical competencies. It is therefore paramount that the nursing institutions should define and create a standard for the nursing studies. In doing so, the practitioners will be able to understand the expected minimum level of expert performance in their area of work hence they will be able to increase their productivity.

According to Lyons & Ousley, (2015), insufficient nursing education is not limited to nurse practitioners. A considerable amount of United States medical school graduates pursue primary medical care courses while another large number devotes their studies to dermatology diseases. According to a survey carried out, it is quite evident that nursing is among the most inadequately taught course in medical schools as compared to other educational curriculums. Medical schools thus fail to adequately prepare nurse students specializing in dermatology in regard to diagnosis and treatment of the common skin disorders. Most of the medical schools offered dermatology students less than 18 hours of dermatology training. This is the major reason as to why the primary caregivers and nurse practitioners have a difficult time diagnosing the skin problems. Nurse practitioners within the primary care department, they ought to have accurate, useful and proficient tools so as to direct them in diagnosing a skin problem (Bobonich, & Cooper, 2012). Nursing education, therefore, requires clinical experience and exposure, an interaction between instructor and feedback from them, quality and focused know-how attainment. However, there are limited commitments in regards to nursing education with reverence to clinical requirements of advanced practice programs.

The need for nursing education has been determined by the high rates of skin disorders mostly among the elderly. In reality, frequently, the primary care physicians are the ones who are initially held responsible for treating skin patients. They are thus expected and challenged to train themselves while on the job so as to have an effective response to some of the common nursing problems amongst these patients. Their inexperience is attributed to the lack of training of nurses as only a few numbers of practitioners have received formal training at a nursing medical school. Although this educational need has been acknowledged by practitioners and medical schools, it is so unfortunate that the need has been unmet (Bobonich, & Cooper, 2012). It is thus quite clear that this knowledge deficit is translating to insufficient diagnosis and unsuitable treatments that are out of place in treating skin disorders. This, therefore, promotes a need for more efficient training strategies in nursing health area. There is limited research in nursing area and this has created a gap in pediatric nursing treatments. The lack of research has therefore caused an increase in the number of nursing problems amongst patients of this age group. Due to lack of knowledge on how to diagnose and treat these skin disorders in children has resulted in increased referrals to the few nurses in the field. As these nurses enquire and read about the alternative treatment options they end up taking a lot of time to treat these patients hence aggravating the numbers of sick children. Most practitioners or even nurses have insufficient or no specific education skills in pediatrics (Bobonich, & Cooper, 2012).

According to In Brooker, & In Waugh, (2013), leadership is all about setting pace and opening up f new opportunities in order to assist people in achieving their goals and in delivering quality standards. Registered practitioners, therefore, has a leadership potential which goes beyond knowing everything but rather it is all about being able to reflect the knowledge in practice, connecting energy from the clinical team and to progressively make improvements in the day to day activities. Therefore, for dermatologists to lead in delivering their quality services to their patients a national standard on their program of study ought to be delivered to all universities and it should be inclusive of work-related learning. The core role of health practice and service improvement, research and evaluation include an establishment of a research culture that would be embedded in providing evidence in practice. Nurse practitioners are required to make a considerable contribution to the strategic governance of clinical administration. Clinical nurses should work towards ensuring effective mechanisms in health care are put in place and to ensure that the patients’ safety is adhered to. This will foster a culture of patient-centered practice, teamwork development and meeting of health services delivery. Education, training and staff development are some of the elements that aim at developing a culture for learning in practice and to maintain the connection with the specialists hence resulting in improved competencies. It is through this expert practice, education, research, and development that the nurse health department will improve its service delivery, diagnosis, treatment and therapies across all age groups including the pediatrics (In Brooker, & In Waugh, 2013).

To sum it up, nurse leaders should establish a standardized educational curriculum and preparation of nurse practitioners. This curriculum development, therefore, ought to be planned carefully, with well-thought implementation process and evaluation. It is thus recommended that a thorough health education in this line of profession ought to be considered with a high emphasis on the interdisciplinary education. The standardized program of study should be founded on the basis of consensus of judgment as this will direct the formal as well as the informal nursing education and practice. All this will help in promoting dialogue and ensuring that there is quality nursing health care.

References

Tsai, Y. (2011). The relationship between organizational culture, leadership behavior, and job satisfaction. BMC health services research, 11(1), 98.

Davis, K., White, S., & Stephenson, M. (2016). The influence of workplace culture on nurses’ learning experiences: A systematic review of qualitative evidence. JBI database of systematic reviews and implementation reports, 14(6), 274-346.

Walker, R., Cooke, M., Henderson, A., & Creedy, D. K. (2011). Characteristics of leadership that influence clinical learning: A narrative review. Nurse Education Today, 31(8), 743-756.

Lyons, F., & Ousley, L. E. (2015). Dermatology for the advanced practice nurse.

In Brooker, C., & In Waugh, A. (2013). Foundations of nursing practice: Fundamentals of holistic care.

Bobonich, M., & Cooper, K. D. (2012). A core curriculum for dermatology nurse practitioners: Using Delphi technique. Journal of the Dermatology Nurses' Association, 4(2), 108.

Dermatology Workforce Group. (2007). Models of Integrated Service Delivery in Dermatology.

Discussion # 4

 There are three issues that may results from prescriptive authority of controlled substances in relation to Heather Alfonso case. These includes prescription of controlled substances for reasons other than related to ones professional practice, the promotion of controlled substances and prescription of substances that are controlled and in Schedule II listing without following the practitioners requirements in Pharmacy Practice Act. The nurse was alleged to have received kickbacks from the manufacturer of a controlled substance for speaking engagements which was violated the provision of not prescribing such substance for the purpose of promoting it (Chedekel, 2015). In addition, the nurse administered Schedule II drugs like Opioids without following the laid down procedures or requirements for such a prescription. She, therefore, prescribed the drugs for the reasons other than those related to her professional practice. The violation of the Pharmacy Practice Act by the nurse led to authorities’ withdrawal of federal and state licenses (Chedekel, 2015).

The APRN are not required to have physicians to co-sign orders and even their prescription for drugs or substances that have been controlled, and this seems to have led to the issues of violation of regulations that have been laid down on the same. However, prescribing authority is essential in caring for patients in different places including offices , homes and hospitals. The solution for such a case is to have an extent of prescription authority to be limited to physicians, since this primarily is the responsibility of the physicians (In Blair & In Mirr, 2015). In other cases, the leadership of under which the APRN operates should be offered more responsibility over the practices of the nurses to avoid such cases.

References

Chedekel , L., (2015).High-Prescribing Nurse Surrenders Drug Licenses. Retrieved from: http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/

In Blair, K. A., & In Mirr, J. M. P. (2015). Advanced practice nursing: Core concepts for professional role development.197-199

Health of the Latino immigrants

As Latino immigrants arrive in America, they are among the healthiest people in the United States. They are not affected by major killing diseases such as psychiatric diseases or even the hearts diseases. This is quite different with the native Latino’s and the Native Americans who live in the United States as they exhibit higher rates of these major diseases (Latinos Latino paradox, n.d).

The Latino paradox exists in the Cleveland Latino community. The Cleveland Latino community usually has health results that are paradoxically comparable to or rather better health outcomes than those of the US non-Latino or the Native Americans. It is a paradox since in most cases across the world; low socioeconomic status is often connected to poor population health and higher mortality rates. However, this is not the case with the immigrant (Latinos Latino paradox, n.d).

Though the immigrant Latinos are often tired and poor, their health status is incredible and has a low mortality rate (Arriving Healthy, n.d). However, this may be associated with their place of birth or social forces. These social forces within America influence the American way of doing things and this has greatly contributed to their high rates of mortality and diseases as compared to the Latino immigrants whose place of birth has a more different social force.

Upon arrival, the relationship between wealth and health are loosely tied but as the year's progress, the Latino’s relationship between health and wealth starts becoming closely tied. This is due to the fact that the discrimination rates increases over the years, the low wages, poor working conditions and so many other stressors contribute towards their ill health. Therefore after five years since their arrival, they tend to be among the people with the highest number of diabetes and high cases of high blood pressure among other diseases (Wealth Equals Health, n.d).  

References

Arriving Healthy (n.d). Video Excerpt, Unnatural Causes-Episode 3. Retrieved from: https://unnaturalcauses.org/video_clips_detail.php?res_id=493

Wealth Equals Health (n.d). Video Excerpt, Unnatural Causes - Episode 3. Retrieved from: https://unnaturalcauses.org/video_clips_detail.php?res_id=492

Latino paradox (n.d). Video Excerpt, Unnatural Causes-Episode 3. Retrieved from: https://unnaturalcauses.org/video_clips_detail.php?res_id=215

Evidence Based Integration Paper

Case Overview

The patient has an asthma condition. Asthma can best be described as the health condition in which the airways contracts and becomes swollen with the production of extra mucus than the required amount (Subbarao, Mandhane & Sears, 2009). This usually led to difficulty in breathing thus activating cough and wheeziness (Kaplan et al, 2009). For my patient, Asthma is a major nuisance as it interferes with his daily life which might lead to severe asthma attacks which are deadly. The patient acquired the illnesses as a form of inheritance given that his family has a long history of the illness. However, given that he is obese and had been an active smoker for decades this also intensified the condition. The treatment that I have been trying on the patient includes oral medications and the use of inhalers when an attack arises. However, the patient is not satisfied with the treatment on the ground that it is insufficiently effective in addition to the fact that the medicines have severe side effects that hinders him from being active.

The current treatment that the patient has been trying is considered standard and effective because Asthma is a chronic illness cannot be cured but the symptoms can be controlled (Subbarao, Mandhane & Sears, 2009). The patient has been experiencing breath shortness, coughing and wheezing and this is the reason that oral medicines were recommended to lower the development and to ensure that the patient is able to fully take part in their daily activities as a normal person. However, these medications are strong and therefore causes severe side effects such as a headache, dizziness and low coordination during the first phase of consumption but later becomes stable as the body becomes used to them. Some of the commonly used treatment are oral drugs, inhalers, and drugs that are in most cases administered through nebulizer and breathing gadgets.

The patient is however interested in dance therapy as the alternative treatment option.  This therapeutic treatment is aimed at developing an individual’s physical, social as well as psychological stabilities (Ukena, Fishman & Niebling, 2008). This is an effective approach given that it leads to the loss of weight and lowers depression, nervousness and seclusion feelings in general. In addition, the therapy leads to the enhancement of the immune structure by active physical engagement and psychological development which deters the illness from growing further. However, this method cannot be categorized as fully effective for an individual suffering from chronic asthma because medical treatment is also a necessity in controlling the symptoms which might threaten an individual’s life (Ukena, Fishman & Niebling, 2008).

It is widely acknowledged that dancing therapy is associated with the utmost health benefits in general (Kaplan et al, 2009). This is because while improving mobility it leads to psychological stability and the loss of weight which helps in preventing chronic illnesses. However, based on the acquired evidence, it is worth noting that, Asthma requires clinical treatment in addition to physical therapy to ensure that the illness is fully controlled (Kaplan et al, 2009). If the illness is left untreated citing the source as the engagement of physical therapy then the condition might intensify leading to the increased reliance on an inhaler for the patient. It is therefore recommended that the therapy can be incorporated with medicines that are to be taken orally in order to stabilize the condition while improving the general status of the body. This means that the drugs will work to prevent the development and the combination is an effective one that is associated with fewer effects.

References

Kaplan, A. G., Balter, M. S., Bell, A. D., Kim, H., & McIvor, R. A. (2009). Diagnosis of asthma in adults. CMAJ : Canadian Medical Association Journal, 181(10), E210–E220. http://doi.org/10.1503/cmaj.080006

Subbarao, P., Mandhane, P. J., & Sears, M. R. (2009). Asthma: epidemiology, etiology and risk factors. CMAJ : Canadian Medical Association Journal, 181(9), E181–E190. http://doi.org/10.1503/cmaj.080612

Ukena, D., Fishman, L., & Niebling, W.-B. (2008). Bronchial Asthma: Diagnosis and Long-Term Treatment in Adults. Deutsches Ärzteblatt International, 105(21), 385–394. http://doi.org/10.3238/arztebl.2008.0385

Problem Analysis

Interoperability in healthcare refers to the ability of various systems and applications to exchange data through communication and use such information to enhance healthcare delivery to individuals. The various layers of interoperability are seen the moment the 22-year old patient visit the health care facility in search of health care services.  The human layer interoperability sets in motion some other layers including process interoperability and clinical interoperability.   The achievement of process interoperability occurs once human beings come to a common understanding in the entire network, the coordination of interoperation of business systems and work processes (Benson, & Grieve 2016).  The human layer interoperability in this case occurs when the tasks are performed such as physical examination and diagnosing asthma in the patient.  These tasks are, therefore, coordinated in a way that the processes can take advantage of various systems in the organization and provide the required health care services.

  Clinical interoperability in the above case is seen in the coordination of the clinicians in undertaking various tasks to ensure the care services provided to the patient is seamless.  The tasks undertaken by clinicians in form of physical examination and diagnosis of the disease indicates the clinical interoperability under then human layer that ensures that the 22-year old patient is offered the appropriate healthcare services.  It is achieved when the data is collected and used for treating the disease that the patient is suffering from.  The technology interoperability makes it possible for human layer interoperability to be seen in the case (Benson, & Grieve 2016).  This is largely observed in the technical interoperability, where data collected from the consultation by the patient, physical examination and the clinical diagnosis, where the information collected was updated in the organization’s electronic records and even the generation of the ordered work list item needed for radiology System.

 Technical interoperability involves moving information from one system to another so that distance does not become an issue. Given that the technical interoperability is considered as domain independent, it has no regard for the meaning of the information being exchanged (Benson, & Grieve 2016).  The exchange of the aforementioned information regarding the condition of the 22-year old patient was done through the systems that did not care to understand or alter the data they are conveying to other systems. The data layer interoperability is seen in semantic interoperability once the exchange of collected information (Benson, & Grieve 2016). The passage of information to EHR in absence of any prior negotiation and which works to provide support in decision making, data inquiries and is a good indication of semantic interoperability. The clinical information has to be understood by those collecting it at the lab and the end users who include both the clinicians and the 22-year old patient.  The organization layer interoperability is seen in the information governance or control while dealing with the patient (Benson, & Grieve 2016). The control of the information across the entire process ensures that the required data in terms of work list is obtained.

Reference

Benson, T., & Grieve, G. (2016). Principles of Health Interoperability: SNOMED CT, HL7 and FHIR. Cham: Springer International Publishing.19-23

Table of Contents

1. List of organization types. 2
2. Shadow experience report. 2
3. a) Brief description of the organization. 2
4. b) Shadow experience description. 3
5. c) Interview questions and responses. 4
6. d) Personal reflection. 5
7. Thank you note. 6

References. 7

HEALTH COMMUNICATION ENGAGED LEARNING PROJECT

1. List of organization types

• Hospitals
• Medical clinics
• Nursing homes
• Addiction counseling centers
• Healthcare administration

2. Shadow experience report
3. Brief description of the organization

Hospitals are health facilities that are well designed for organized medical practitioners and inpatient facilities that offer services to sick people 24/7. They offer varying and wide range of services to their patients hence ensuring that they receive the medical attention that they require.

Medical clinics refer to a medical group that is well known for their progressive multi-specialty services that are geared towards healing and excellence. They are the most effective in the healthcare industry as they empower their patients through honest communications with them hence allowing them to gain loyalty from their clients (Elrod & Fortenberry, 2017).

Nursing homes refer to institutions that offer health care within a residential setting. The institutions major in offering a supportive environment to patients who cannot be able to carry out some of the tasks on their own following their illnesses or due to aging.

Addiction counseling centers these are institutions those are organized and are run by counselors who more than often support systems addiction patients. They thus build a relationship with their patient which is solely based on trust and thus enables them to counsel the patients offering them with support, resources and the right guidance as they go through the recovery process. These centers are therefore important in addiction management (Elrod & Fortenberry, 2017).

Healthcare administration is a system that relates to the public health leadership, management and administrative. It is all about making both the short term and long term decisions that affect the healthcare system’s strategies. It, therefore, works hard to improve the health facility’s business through endeavoring to convey sound policy and high-quality health care (Elrod & Fortenberry, 2017).

1. Shadow experience description

It was such a great experience having to shadow a nurse who worked in the emergency department. She was serving a patient who had tried committing suicide and her signs were ranging from vomiting to a head injury. The nurse was quite seamless as she attended to the patient and she took quality time with her patient as she also tried to keep her at ease.  Her patient became solemn as well as calm but after a while, she started sobbing and at that particular time she communicated to the nurse why she had tried committing suicide. The nurse listened to her and this was a clear indication that she cared for her patient and this build trust between the nurse and the patient.

In a hospital organization, I managed to shadow a physician. It was quite observable that physicians have a hard time having to deliver bad news to their patients. However, this physician whom I followed was a team player and a leader also. He was able to effectively communicate with his colleagues in a good way hence allowing them to all work towards a common goal of attaining their goal of ensuring patients health. Being physicians is not an easy task, I witnessed a physician who was on his off day is called in to respond to an emergency. Minutes later he was already in the hospital doing work just like the other physicians who were on shift that day.

I was also able to shadow a doctor in a nursing home. Most of the patients in this center are quite uncooperative as some feel that they should not be there. One thing that I observed was that empathy with patients is very crucial. One woman was not responding to any of the therapies given. However, after the doctor explained to the woman patient that he understood how she might be feeling for being in the institution and that all her frustrations for being there were all genuine, the patient opened up. This allowed the doctor to build trust and hence he was able to treat her pain due to the doctor’s empathy.

Shadowing a non-clinical financial analyst in the department of health administration, I was able to observe that remembering a patient is quite important and thus the analysts always strive to remember the patient's name once they come to make payments. They focus on the finances of the health institutions ensuring that all operations run smoothly.

1. Interview questions and responses

What do you like most and least in this line of profession?

According to the medical practitioners, they all gave related answers where they asserted that what they liked most was the fact that they were able to save the lives of peoples by given them an immediate assistance once they were brought in the health facilities. However, they all disliked the working hours in their professions as sometimes the shifts get extended following an emergency or are even called in while they are away from the hospital.

Is communication important in this profession and why?

Communication is important in health care. The nurse, the physician and the doctor agreed that for them to be effective they had to communicate with other nurses and the doctors as well as with the non-clinical officers such as the financial analyst so as to get the right resources. The doctor also said that in some cases they have been forced to make communications with other doctors from other hospitals so as to seek their assistance in offering a given treatment. Do you have a specific strategy that you use on patients?

How have you been able to get to where you are today?

All the medical practitioners talked about determination, patience and more research. They all agreed that this field requires them to be tolerant and kind as they are dealing with fragile people who need their moral, emotional and physical support. Researching enabled them to be up to date with the current treatments.

What do you expect to be the future of healthcare?

Health care system is rapidly going through some changes and the employers in this industry wants workers who are creative and innovative and who can administer the best treatment services.

1. Personal reflection

All through my shadowing exercise, one of the most lessons that I have learned is that patients feel at ease and comfortable with their health care whenever they feel that their feelings are recognized. I also realized that doctors, counselors, and nurses share a bond that involves trust building, guidance, and empathy. Having such a bond is as important for patients as it is all that they stand for. It is also quite evident that medical professionals have adopted the advanced technology which is readily available in the health institutions. Medical practitioners that I got to shadow were all in agreement that the use of this great technology has enabled them to look at the patient’s records and their lab and physicians reports in regards to the patient’s history. It is through this that they have been able to effectively communicate with their medical team members and with the non-medical members who work together in coming up with the best treatment plan for the patients.

3. Thank you note

Copied to; the physician, nurse, doctor, financial analyst and the counselor.

Thank you so much for taking the time and patience to teach me so much about what medical career is all about and allowing me to shadow you during this time. I am truly thankful for the great gesture and for this opportunity to shadow such a brilliant professional in an admirable profession. Thank you for your time; it was such a great learning experience.

Sincerely,

Learning in practice (nursing)

This is a time of great transformation in health services. Hence there is the need for a clear view on the best way to deliver services within dermatology department. Educational programs in dermatology are quite vital to the improvement of competencies by the employees; however, these programs must be relevant to a multi-professional dermatologist at the most appropriate level of their specialty rather than their profession. This competence strategy will describe the remit of the educational programs and will offer a variety of skills that may be regarded as important in their role hence allowing the development of job specialization. However, the current state of education and clinical preparation for dermatologists is at a critical position. This is because of the fact that most of the dermatologists acquire their specialized skills and know-how through the on-job training with other dermatologists, educational training and with restricted clinical residency experiences. This has therefore made it so hard for the definition of the core body of knowledge and the standard for education preparation required in offering a base for competent dermatology nurse practitioners. There is the need for the realization of the importance of the establishment of minimum knowledge and standard of dermatologist’s competencies.

According to Dermatology Workforce Group, (2007), the decisions in regards to patient care by dermatologists are often made by a team rather than an individual. Therefore, dermatologists must, therefore, rely on the role of the leaders so as to empower the team to attain the organization’s goal. As a result of this, a well maintained open communication, as well as better coordination within the organization, will be realized. Dermatologist leaders should, therefore, encourage and support the subordinate dermatologists placing on a clear vision and building on trust and their capacity to influence subordinates to realize their vision, greatly influences the employees' satisfaction. Good health care requires a good team conduct, hence, it is recommended that dermatologists should establish good relationships with the care teams and should work on improving these relationships. In so doing, employees’ satisfaction will be developed.

Transformational leadership in dermatology is one of the most effective leadership following its emphasis on the improvement of supportive relationship building. These relationships are attributed to enabling employees to find meaning in their work, allowing them to communicate their proposals and collaborative participation in teamwork towards effecting positive change. Dermatologist practitioners cite recognition and empowerment as major reasons behind satisfaction and acceptance of the profession hence resulting in nurses’ engagement in learning (Walker, Cooke,  Henderson, & Creedy, 2011).

In today’s nurse leader, an appreciation for workplace culture is quite important. Nurse practitioner’s attitude towards culture enhances them to better understand staff conducts and relationships. Continuous learning culture in dermatology organizations is quite important. This learning environment allows nurse practitioners to propose new schemes. Nurses are therefore challenged to become inquisitive and more research-oriented (Tsai, 2011). This, therefore, fosters a culture of continuous competence improvement. In most cases, dermatology nurse practitioners may collide with each other but it is important for them to realize the power that is vested in apology and transparency. Organizations that embrace this culture often improve their relationships and thus are able to help one another in the different cases regarding the patients and also the treatment options hence becoming productive. The dermatology organization ought to develop a just and fair culture is quite important in having a productive workforce. In a fair and just organization, interpersonal learning is balanced with an individual’s discipline and responsibility. Anytime that the organization is at a position of discussing mistakes with transparency with a motive of learning from them and when the organization uses resources needed to get to understand the root cause of the mistake, then the organization seizes to being a blame game but rather it becomes an environment that fosters respect and open learning of new ways of doing things in a better way.

Presence of a healthy organizational culture allows practitioners to experience precious learning in the organization. Learning in the workplace is quite essential as it allows the provision of an evidence-based and progressive improvement in safe patient care which is core in attaining good patient results. Therefore, there is the need for dermatologists to learn within an organization that promotes the implementation of evidence-based, expert practice and allows for the best patient results. In addition, organizations’ learning informs the extent and progression of nursing practice and is also linked to the regulatory needs that are connected to dermatology practice. Organization culture has important economic as well as organizational imperatives. A healthy organization fosters good human relationships and hence promoting job satisfaction. As a result of the increased job satisfaction, there are high chances of employees’ retention and ultimately low dermatologists’ turnover rates. Therefore, by addressing the issue of nurses’ retention, organizations are in a better position to economically save so many finances due to the already cut cost of employing new employees (Tsai, 2011).

Following the high need for education in dermatology, it is important for the organization to offer educational and career empowerment through offering the nurses financial support and also allocating them with enough time for educational development and research. The organization should also empower them to carry out special projects and publications. This will expound on their knowledge of dermatology health knowledge hence will reduce their need to quit and thus less turnover and competence. The organization should incorporate a culture of mentorship through arranging for educational seminars and conferences for the dermatologists as this will allow them to all benefit from the organization’s effort in creating awareness about a given subject related to skin disorders (Davis, White, & Stephenson, 2016).

The most common diseases experienced by health professionals are the skin disorders. There is a high prevalence of a wide range of people suffering from eczema while others suffer from psoriasis and a small number suffer from rare genetic skin disorders. These skin disorders, however, have proved to affect people of all ages and the increasing need for children, teenagers and in old patients needs to be realized and a solution needs to be established. Some of the common skin disorders are frequently increasing in numbers and this has resulted in an epidemic of skin cancer. As a result of this, there has been a rapid increase in demand for dermatological services as an outcome of this change and due to the changing attitude of people towards skin disorders. There has also been an increase in the number of referral cases to dermatologists by general practitioners more than all the other medical specialties. However, the majority of these patients are faced with mild skin problems that are often self-managed and they become effective once an earlier diagnosis is offered to them. The referral systems are quite positive hindrances to optimal care for patients suffering from long-term skin disorders. This is because of the long waiting period that the patients go through. The patient’s skin problem may end up deteriorating during the intervening period, in spite of the fact that the dermatologist is already aware of the patient’s diagnosis and the treatment needs required by the patient. However, in relation to these facts, it is so disappointing that the education curriculum in dermatology for all professions and to all levels is very restricted, with the exception of the education skills offered for hospital physicians training in this area (Dermatology Workforce Group, 2007).  The standard medical undergraduate curriculum for dermatologists involves only six days of training while the general practitioners are usually exposed to skin problems during their daily practice. It is so unfortunate that in six GP’s only one of them has the formal training in dermatology. There is no prearranged post-qualifying education program for nurses in dermatology. On the other hand, dermatology content among the pre-registered nursing programs differs largely and is at present not standardized. Therefore, there are limited educational opportunities in dermatological pharmacy with no structure formulated. Though there are accredited open learning courses for pharmacists interested, there are no standards set as to whether it is mandatory for dermatologists’ pharmacists to take this course and there are no incentives allocated for the same. In regards to these arguments, there is a pressing need to consider how dermatological services should be configured so as to ensure that the already existing expertise is at maximum use and to delineate the educational aspects that are of importance in generating competent dermatologist practitioners at all levels (Dermatology Workforce Group, 2007).

According to Bobonich, & Cooper, 2012), for a nurse to specialize in dermatology, they are required to first complete their master program focusing on a specialty in one of the well-defined populations. In the past, acquiring an additional dermatology was just a subspecialty know-how and having the clinical skills was just subjective, inconstant and unclearly defined. However, in the modern health care systems, there is the need for advanced dermatology science which is essential in the development of competencies. The current dermatology education programs should, therefore, consider integrating the basic science and advanced science in dermatology. These educational elements in the core curricular of dermatology will enable learners to improve on their clinical competencies. It is therefore paramount that the dermatology institutions should define and create a standard for the dermatology studies. In doing so, the practitioners will be able to understand the expected minimum level of expert performance in their area of work hence they will be able to increase their productivity.

According to Lyons & Ousley, (2015), insufficient dermatological education is not limited to nurse practitioners. A considerable amount of United States medical school graduates pursue primary medical care courses while another large number devotes their studies to dermatology diseases. According to a survey carried out, it is quite evident that dermatology is among the most inadequately taught course in medical schools as compared to other educational curriculums. Medical schools thus fail to adequately prepare dermatology students in regards to diagnosis and treatment of the common skin disorders. Most of the medical schools offered dermatology students less than 18 hours of dermatology training. This is the major reason as to why the primary caregivers and nurse practitioners have a difficult time diagnosing the skin problems. Nurse practitioners as well as dermatologists within the primary care department, they ought to have accurate, useful and proficient tools so as to direct them in diagnosing a skin problem (Bobonich, & Cooper, 2012). Dermatology education, therefore, requires clinical experience and exposure, an interaction between instructor and feedback from them, quality and focused know-how attainment. However, there are limited commitments in regards to dermatology education with reverence to clinical requirements of advanced practice programs.

The need for dermatological education has been determined by the high rates of skin disorders mostly among the elderly. In reality, frequently, the primary care physicians are the ones who are initially held responsible for treating skin patients. They are thus expected and challenged to train themselves while on the job so as to have an effective response to some of the common dermatologic problems amongst these patients. Their inexperience is attributed to the lack of training on dermatology as only a few numbers of practitioners have received formal training at a dermatology medical school. Although this educational need has been acknowledged by practitioners and medical schools, it is so unfortunate that the need has been unmet (Bobonich, & Cooper, 2012). It is thus quite clear that this knowledge deficit is translating to insufficient diagnosis and unsuitable treatments that are out of place in treating skin disorders. This, therefore, promotes a need for more efficient training strategies in dermatology health area. There is limited research in dermatology area and this has created a gap in pediatric dermatological treatments. The lack of research has therefore caused an increase in the number of dermatological problems amongst patients of this age group. Due to lack of knowledge on how to diagnose and treat these skin disorders in children has resulted in increased referrals to the few dermatologists in the field. As these dermatologists enquire and read about the alternative treatment options they end up taking a lot of time to treat these patients hence aggravating the numbers of sick children. Most practitioners or even dermatological nurses have insufficient or no specific education skills in pediatrics (Bobonich, & Cooper, 2012).

According to In Brooker, & In Waugh, (2013), leadership is all about setting pace and opening up f new opportunities in order to assist people in achieving their goals and in delivering quality standards. Registered practitioners, therefore, has a leadership potential which goes beyond knowing everything but rather it is all about being able to reflect the knowledge in practice, connecting energy from the clinical team and to progressively make improvements in the day to day activities. Therefore, for dermatologists to lead in delivering their quality services to their patients a national standard on their program of study ought to be delivered to all universities and it should be inclusive of work-related learning. The core role of health practice and service improvement, research and evaluation include an establishment of a research culture that would be embedded in providing evidence in practice. Dermatologists among other nurse practitioners are required to make a considerable contribution to the strategic governance of clinical administration. Clinical dermatologists should work towards ensuring effective mechanisms in health care are put in place and to ensure that the patients’ safety is adhered to. This will foster a culture of patient-centered practice, teamwork development and meeting of health services delivery. Education, training and staff development are some of the elements that aim at developing a culture for learning in practice and to maintain the connection with the specialists hence resulting in improved competencies. It is through this expert practice, education, research, and development that the dermatologic health department will improve its service delivery, diagnosis, treatment and therapies across all age groups including the pediatrics (In Brooker, & In Waugh, 2013).

To sum it up, dermatology leaders should establish a standardized educational curriculum and preparation of dermatology nurse practitioners. This curriculum development, therefore, ought to be planned carefully, with well-thought implementation process and evaluation. It is thus recommended that a thorough health education in this line of profession ought to be considered with a high emphasis on the interdisciplinary education. The standardized program of study should be founded on the basis of consensus of judgment as this will direct the formal as well as the informal dermatology education and practice. All this will help in promoting dialogue and ensuring that there is quality dermatological health care.

References

Tsai, Y. (2011). The relationship between organizational culture, leadership behavior, and job satisfaction. BMC health services research, 11(1), 98.

Davis, K., White, S., & Stephenson, M. (2016). The influence of workplace culture on nurses’ learning experiences: A systematic review of qualitative evidence. JBI database of systematic reviews and implementation reports, 14(6), 274-346.

Walker, R., Cooke, M., Henderson, A., & Creedy, D. K. (2011). Characteristics of leadership that influence clinical learning: A narrative review. Nurse Education Today, 31(8), 743-756.

Lyons, F., & Ousley, L. E. (2015). Dermatology for the advanced practice nurse.

In Brooker, C., & In Waugh, A. (2013). Foundations of nursing practice: Fundamentals of holistic care.

Bobonich, M., & Cooper, K. D. (2012). A core curriculum for dermatology nurse practitioners: Using Delphi technique. Journal of the Dermatology Nurses' Association, 4(2), 108.

Dermatology Workforce Group. (2007). Models of Integrated Service Delivery in Dermatology.