Module 1: Assignment

Learning Materials

Selekman, J., & Shannon, R. A. (2019). School nursing: A comprehensive text (3rd ed.). F.A. Davis Company. Read Chapters 2,3,6.

National Association of School Nurses. https://www.nasn.org/home

Assignment: Each assignment must contain an INTRODUCTION and CONCLUSION page. Make sure you follow the Grading Rubrics to write the homework.

Assignment:

The Professional Development Assignment should be between 1500 and 2000 words with minimum of two sources from the literature outside of your textbook for this course.

You are a population health nurse working with congestive heart failure clients (greater than the age of 65) who receive services from your hospital. From a population health management perspective, identify services and interventions that address the health needs of this particular population. Your exploration with this particular population should include cost-effective interventions that address health promotion and illness prevention, risk management, care coordination, and disease management.

Assignment Expectations

Length: 1500 – 2000 words; answers must thoroughly address the questions in a clear, concise manner.

Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources to support your claims.

Format: Save your assignment as a Microsoft Word document (.doc or .docx).

File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)

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Population Health Management

Student Name

Institution Affiliation

Course

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Date

Population Health Management

The strength of communities, nations, and the world most significantly depends on society members’ overall health. Unlike clinical practice, public health gives access to a large patient base. The community is the patient. From a population-based healthcare perspective, the focus on an entire population’s health and well-being is vital to medical care and research advancement (Selekman, Shannon & Yonkaitis, 2019). Besides, public health management improves clinical practices for particular groups by predicting illness risks and lowering healthcare costs. For instance, due to enhanced public health management approaches and assimilated medical advancements, congestive heart failure (CHF) cases among the elderly have significantly declined. In general, heart failure is a costly and devastating disease causing severe burdens to the patient and accruing stress to the healthcare providers Khera et al., (2017). However, this essay seeks to identify services and intervention approaches that effectively address CHF patients’ health needs older than 65. Markedly, cost-effective methods to address health promotion, care coordination, and risk and disease management are diligently discussed.

Prevalence

As old age sets in for every human, the susceptibility to illness and ultimate death escalates significantly due to progressive degeneration of cells and tissues. Consequently, more senior people experience decreased physical and mental capacity. According to Butrous & Hummel (2016), the CHF’s ubiquitous nature among older adults is depicted to increase with age advancement. Middle-aged and older adults’ record 1-2% prevalence, patients older than 65-years-old 2-3%, while those beyond the 75-years-old 5-10%. Alternatively, heart failure is approximated at 3-20 cases per 1000 population, and a marked increase of 100 cases per 1000 population for individuals aged 65 years and above (Jaarsma et al., 2018). In terms of gender, cardiovascular disease incidences are typical with the male gender than the female. Due to sex hormones’ protective effects, women’s tendency to develop congestive heart failure is far less than men’s. However, after age 65, the possibility equals for both genders, especially when exposed to risk factors such as high cholesterol levels, high BP, or smoking.

Risk Factors

A single risk factor is sufficient to cause heart failure. Any behavior or trait such as smoking makes the user more susceptible to developing serious illnesses. Hsieh, Paull & Hawkshaw (2020) argue that recognizing CHF’s prevalence and risk factors is a fundamental step in overcoming barriers to accessing quality healthcare services for heart failure patients. On average, men are at a higher risk of developing congestive heart failure than their female counterparts, translating to 10.9% for men and 9.8% women. Therefore, this explains the escalated prevalence among men older than age 65. However, the risk difference narrows as women approach age 65 and beyond. Hypertension, typically high blood pressure, increases the risk of cardiovascular diseases depending on age or ethnicity discrimination. Additionally, high cholesterol levels in the blood form plaque around the artery walls to cause arteriosclerosis; this according to Clarke et al. (2017). Other significant risk factors include smoking, diabetes, physical inactivity, obesity, and overweight. Not to mention stress, alcohol intake, birth control pills, and the effect of sex hormones.

Health Promotion and Illness Prevention

Health promotion and illness prevention are vital concepts dealing with chronic diseases. The two principles require the provider to gain knowledge of a particular condition, in return, educate the patient on behavior modification and lifestyle changes. Based on findings by Fawcett & Ellenbecker (2015), the proposed conceptual model of nursing and population health emphasizes the significance of intersecting nursing practices and population health knowledge and involvement. Concepts such as healthcare system factors, upstream factors, and population health outcomes are inevitably connected. Further, the study concludes that nursing models’ strength should be geared towards the attainment of the highest possible quality of life for a given population (Fawcett & Ellenbecker, 2015). Most significantly, health promotion activities aim to ease access to medication and other interventions that stem diseases in advance. Notably, these programs engage and empower individuals and societies to increase control over their health.

Medical Intervention

Every diagnosis and treatment intervention, particularly chronic diseases, is preceded by careful medical history, symptoms review, and performing the necessary physical examinations. Khera et al. (2017) suggest that specific tests like an electrocardiogram, stress test, blood test, and chest X-rays can be conducted after performing physical examinations. Beta-blockers, the likes of metoprolol and bisoprolol, are ranked among the cheapest, most available, and effective medications for congestive heart failure. The drugs function to lower the heart rate and blood pressure significantly. Patients should start on low doses, about 40mg twice daily, and escalate to a maintenance dose of between 120mg/day-240mg/day until the highest dose is attained (Selekman, Shannon & Yonkaitis, 2019). ACE inhibitors, the likes of captopril, are frequently recommended. Dosage; tablets can be taken from 12.5mg-100mg/daily, or depending on the doctor’s prescription. With diuretics and digitalls, the initial dosage ranges between 6.25-12.5mg PO q48hr, conjoined with glycoside and diuretic. Target therapy is 50mg q8hr to a maximum of 450mg/day maximum. Notably, many other medical interventions can be prescribed by the healthcare provider. 

Surgical Operations

Surgical operations as services and intervention methods for congestive heart failure are not typical. Nonetheless, the doctor can recommend surgery when a correctable condition is identified. Clarke et al. (2017) believe that the uptake of innovative approaches, such as advanced technological equipment used to perform surgeries, is crucial. Markedly, most surgical procedures are proven to be safe and efficient treatments, granted that the operative mortality 0.5%, five-year survival >92%. A more typical surgery intervention for CHF is coronary artery bypass grafting. Similarly, other procedures like a heart transplant, valve replacement, and implantable cardioverter-defibrillator can be performed depending on the doctor’s assessments. Be that as it may, surgical operations can have certain complications on elderly patients. Due to weakened cells and tissues, patients aged more than 65 years can experience pain, extended hospitalization, increased pulmonary complications, and decreased postoperative functional status.

Deploying More Health Workers

As more and more healthcare workers are available to care for elderly patients with congestive heart failure, the chances for readmission decrease significantly. Subsequently, elderly patients can move to their homes or care facilities, where trained health workers can offer palliative care. Consequently, this reduces the chances of more extended hospitalization, mortality and improves the overall quality of life (Jaarsma et al., 2018). Moreover, Butrous & Hummel (2016) emphasize that community health workers connect individuals and families in society to healthcare available services and resources. Interestingly, public health workers are members of a specific population. Therefore, they are more familiar with a community’s needs. In the long run, this boosts community connections by developing confidential and one-one relationships with patients. Deploying more health workers, particularly in areas where needed, can improve a more extensive population’s overall health, including the elderly aged 65 years and above. With the patients’ collaboration, they can manage public health programs, educate the community on healthy lifestyles, and provide direct healthcare to individuals in need.

Establishing Health Care Centers

Deploying more workers necessitates the establishment of health care centers. Like the former, the latter’s advocacy and initiation have proven a positive influence on improving the overall health outcomes for population-based patients. Conferring to Hsieh, Paull & Hawkshaw (2020), more established community health centers enhance access to quality care and betters the healthcare worker-patient relationship. Consequently, this eliminates the numerous barriers encountered by both the provider and the patient. Correspondingly, most community health centers have learning facilities attached to train the youth as a future counter-measure for meeting the increasing demand; this is according to Selekman, Shannon & Yonkaitis (2019). Equally, these facilities aid in risk management by providing a conducive environment for recovery. Care coordination is enhanced through counseling services, support and advocacy, readily available clinical services, and the possibility of in-home services. 

Technological Interventions

Presently, the widespread use of technology has proven an indispensable aspect in community development. In most cases, technological advancements create a better and lively future for users, besides giving power and voice to people within a larger ecosystem. According to Clarke et al. (2017), although there are gaps that continue to hamper the health care system in general, coordinated care and disease management through the adoption of monitoring devices is proven a potential solution. Technological intervention refers to the utilization of advanced devices to aid in diagnosis, treatment, and recovery. In this case, to achieve care coordination and effective disease management, Fawcett & Ellenbecker (2015) suggest that reliable population identification processes targeting single or multiple costly chronic patients can be adopted to promote population health. For instance, telemonitoring devices remotely record and share vital signs with the provider, reducing chances of hospitalization or even mortality.

Diet

Despite the drastic improvements in congestive heart failure treatment, most people with mild cardiovascular conditions have about 50% average life expectancy. The prognosis for individuals with congestive heart failure, says Jaarsma et al. (2018), is still bleak since more than 80% of patients die within one year. Be that as it may, heart-healthy eating conjoined with regular exercise or physical activity is proven to mitigate the risk of cardiovascular diseases. The aim of eating a healthy diet, as Khera et al. (2017) explain, is to relieve symptoms and stop triggering exacerbations. A human being becomes what they eat. A nutrient-rich diet inevitably promotes good overall health. Specifically, incorporating diet into treatment aids in risk and disease management. Eating plenty of vegetables, whole grains, and fruits reduces extra fluid, keeping the heart healthy and functional. Protein sources such as legumes, seafood, and fish can be assimilated into the diet plan.

End-of-Life Care and Palliative Care

Families are the fundamental units of society. It is considered the only place in the universe where life begins and love never ends. The most exciting aspect of end-of-life care is its endeavor to improve patients’ quality of life and the family. Based on Butrous & Hummel’s (2016) arguments through the doctor’s evaluation, CHF patients can recognize their terminal end-stage. At this stage, primary care health workers can offer end-of-life services to relieve chronic pain and other symptoms. The aim is to provide the patient as much comfort as possible. Elderly recovering patients from surgical operations require palliative, support, and hospice care. End-of-life care principles require the provider to offer emotional, physical, social, and spiritual support to patients, carers, and their families.

Conclusion                                                                                    

On balance, recognizing services and intervention programs aimed at addressing CHF patient’s health needs is crucial to overcoming the disease’s general burdens in terms of cost and adverse effects. Health promotion, care coordination, alongside risk and disease management, should be isolated as target goals in offering primary care to older adults 65 years and above with heart failure conditions. Identifying statistical prevalence and risk factors allows healthcare providers to pinpoint the best and most effective health promotion and illness prevention methods. Medical interventions are the first and frequently recommended methods of stemming congestive heart failure abnormalities. Surgical operations, despite their after-effects, are effective on correctable conditions. The uptake of more community health care workers ultimately results in the establishment of more health care centers. Amenably, more patients can be served, reducing illnesses at the community level significantly. A technological, healthy diet and end-of-life care interventions create a cost-effective and beneficial promotional system.

References

Butrous, H., & Hummel, S. L. (2016). Heart failure in older adults. Canadian Journal of Cardiology32(9), 1140-1147.

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population health management20(1), 23-30.

Fawcett, J., & Ellenbecker, C. H. (2015). A proposed conceptual model of nursing and population health. Nursing outlook63(3), 288-298.

Hsieh, V., Paull, G., & Hawkshaw, B. (2020). Heart Failure Integrated Care Project: overcoming barriers encountered by primary health care providers in heart failure management. Australian Health Review44(3), 451-458.

Jaarsma, T., van der Wal, M., Hjelmfors, L., & Strömberg, A. (2018). Talking about palliative care in heart failure. Eur J Heart Fail20(9), 1348-1349.

Khera, R., Pandey, A., Ayers, C. R., Agusala, V., Pruitt, S. L., Halm, E. A., & Berry, J. D. (2017). Contemporary epidemiology of heart failure in fee-for-service Medicare beneficiaries across healthcare settings. Circulation: Heart Failure10(11), e004402.

Selekman, J., Shannon, R. A., & Yonkaitis, C. F. (2019). School nursing: A comprehensive text. FA Davis.