Unit 3 Discussion 1 – COVID-19 Testing Mandate
Instructions:
·
Did your classmate appropriately identify the gaps in the
policy?
·
Did your classmate adequately summarize scientific evidence to
support or discredit the structure of this policy?
·
Provide feedback on your classmate’s recommended approach to
ensuring compliance.
Please be sure to
validate your opinions and ideas with citations and references in APA format.
1st person post
India
Pellerin
As a nursing home administrator in Oklahoma during the
COVID-19 epidemic, I am responsible for enforcing Governor Kevin Stitt’s
regulation, which requires every staff member entering a nursing facility to
have a negative COVID-19 test result. While this policy seeks to safeguard
vulnerable people, various gaps and factors must be addressed to guarantee its
efficacy and consistency with scientific knowledge.
Elders
in nursing homes are at increased risk of catching the virus. It is critical
that individuals who care for them do not expose them to the virus. A variety
of elements influence the approach’s efficacy. These include regular testing
and preventive actions. Employees might be tested often, either weekly or
biweekly. This would identify and segregate people who may be impacted. Aside
from testing, initiatives such as mask use, appropriate hand cleanliness, and
immunization can help to decrease the virus’s transmission.
There
are loopholes in this policy that the nursing home may encounter, such as
requiring a staff to test just once, which does not guarantee that they will
remain virus-free. They may test negative one week and then contract the
infection the next week. Even people who test negative can spread the
infection. These folks are known as asymptomatic carriers. These gaps indicate
that more measures may be required to guarantee the safety of personnel and
patients.
Additional
procedures will be required to guarantee compliance with the state regulation
while retaining the integrity of evidence-based practice. This includes regular
testing schedules, immunizations, viral education, preventative measures
including mask wearing and hand cleanliness, and test results that are
delivered on time.
By
addressing policy gaps and integrating evidence-based practices, we may
improve the safety and well-being of nursing home patients and staff during the
COVID-19 pandemic.
2nd person post
Tyler Hodge
Initial Response
Firstly,
the policy does not specify the frequency of testing. Given the rapid
transmission rate of COVID-19, a one-time negative test result does not
guarantee that a staffer remains virus-free, especially considering the
potential for exposure between tests. Research suggests that regular, frequent
testing is necessary to effectively monitor and control the spread of the virus
in high-risk environments like nursing homes (D’Adamo, Yoshikawa, &
Ouslander, 2020).
Secondly,
the policy lacks guidance on what type of test should be used. Different
COVID-19 tests vary in sensitivity and turnaround time. Rapid antigen tests
provide quick results but are less sensitive compared to RT-PCR tests, which
are more accurate but take longer to process (Mina, Parker, & Larremore,
2020). The absence of a standardized testing protocol could lead to
inconsistencies in screening efficacy.
Scientific
evidence supports the approach of regular testing and stringent infection
control measures in nursing homes. Studies have shown that frequent testing,
combined with other preventive strategies like PPE usage, social distancing,
and vaccination, significantly reduces the incidence of COVID-19 in these
settings (White et al., 2021).
To
ensure compliance while maintaining the integrity of evidence-based practice, I
would implement a comprehensive testing schedule, requiring bi-weekly RT-PCR
tests for all staff members. Additionally, I would establish a protocol for
immediate isolation and contact tracing in case of a positive result. Providing
continuous education on proper PPE usage and hygiene practices will also be
essential. By adopting these measures, our facility can better protect
residents and staff, aligning with both state mandates and scientific
recommendations.
Unit 3 Discussion 2 – Advancing Community Health
Instructions
·
Explain why you agree or disagree with the level of government
involvement described by your classmate.
·
Are the proposed solutions feasible? Why or why not?
Please be sure to
validate your opinions and ideas with citations and references in APA format.
3rd person post
Lia Barrow
Hello Class,
Three
issues impacting the health of my community are obesity, mental health
disorders, and substance abuse.
1.
Obesity:
o Government involvement:
Governments at all levels (local, state, and federal) are involved in
addressing obesity through various initiatives such as nutrition education
programs, regulations on food labeling and advertising, subsidies for healthy
foods, and community wellness initiatives.
o Improved with more
government involvement: More government involvement could include implementing
stricter regulations on unhealthy food advertising, increasing funding for
community fitness programs, and providing incentives for businesses to offer
healthier food options.
o Solution: Implementing
comprehensive school-based wellness programs that include nutrition education,
physical activity promotion, and access to healthy meals. (Finkelstein et al.,
2005)
2.
Mental Health Disorders:
o Government involvement:
Governments play a significant role in mental health through funding for mental
health services, implementation of mental health policies, and regulation of
mental health facilities.
o Improved with more
government involvement: Increased government involvement could involve
expanding access to mental health services, increasing funding for mental
health research, and implementing anti-stigma campaigns to promote awareness
and acceptance.
o Solution: Establishing
integrated care models that provide both physical and mental health services in
primary care settings to improve access to mental health care. (Unutzer et al.,
2006)
3.
Substance Abuse:
o Government involvement:
Governments are heavily involved in substance abuse prevention and treatment
through initiatives such as drug education programs, regulation of alcohol and
tobacco sales, funding for addiction treatment centers, and enforcement of drug
laws.
o Improved with more
government involvement: More government involvement could include increasing
funding for addiction treatment programs, implementing harm reduction
strategies such as needle exchange programs, and enhancing regulation of
pharmaceutical opioids.
o Solution: Implementing
evidence-based prevention programs in schools and communities targeting risk
factors associated with substance abuse, such as peer pressure and lack of
parental supervision. (Botvin et al., 2000)
4th person post
Darren Vizer
Unit 3/2 Discussion
Professor and class,
Policies aim to enhance
quality of life and civic engagement, but their efficacy varies. In Eau Claire,
Wisconsin, the community faces significant health challenges, including
diabetes, mental health issues like depression, and teen pregnancy. Examining the
government’s involvement at various levels and proposing solutions can offer
insights into improving these health issues.
Health Issues in Eau
Claire, Wisconsin
1. Diabetes
o Government
Involvement: Diabetes management in Eau Claire involves multiple government
levels. Federally, programs like the National Diabetes Prevention Program
(NDPP) provide resources and funding for diabetes prevention and education
(Centers for Disease Control and Prevention [CDC], 2020). At the state level,
Wisconsin’s Department of Health Services (DHS) supports local initiatives and
offers grants to community health organizations (Wisconsin DHS, 2023). Locally,
the Eau Claire City County Health Department organizes awareness campaigns and
screening events.
o Improvement
with Government Involvement: More government involvement could enhance
diabetes prevention and management. Increased funding for local programs and
broader implementation of NDPP could lead to better outcomes. Enhanced
collaboration between federal, state, and local agencies can ensure cohesive
efforts and resource allocation.
o Proposed
Solutions: Implement community-based health education programs focusing
on lifestyle changes, increase access to affordable healthcare and nutrition,
and establish partnerships with local businesses to promote healthier food
options and physical activity.
2. Depression
o Government
Involvement: Mental health support in Eau Claire involves federal, state,
and local governments. The federal government provides funding through programs
like the Substance Abuse and Mental Health Services Administration (SAMHSA)
(SAMHSA, 2021). State-level initiatives include mental health grants and
support for local mental health agencies (Wisconsin DHS, 2022). Locally, the
Eau Claire City County Health Department offers counseling services and mental
health awareness programs.
o Improvement
with Government Involvement: Increasing government involvement can
significantly improve mental health services. Enhanced funding for mental
health facilities and training for mental health professionals can address
service shortages. State and federal support for local mental health
initiatives can improve access and quality of care.
o Proposed
Solutions: Expand mental health services in schools and workplaces,
increase funding for mental health awareness and prevention programs, and
provide training for primary care providers to identify and manage mental
health issues.
3. Teen
Pregnancy
o Government
Involvement: Teen pregnancy prevention involves various government levels.
Federally, the Office of Adolescent Health (OAH) funds teen pregnancy
prevention programs (Office of Population Affairs, 2020). At the state level,
Wisconsin’s DHS supports educational initiatives and provides grants for local
organizations addressing teen pregnancy (Wisconsin DHS, 2021). Locally, the Eau
Claire City County Health Department offers sex education and resources for
teens and parents.
o Improvement
with Government Involvement: More government involvement could further
reduce teen pregnancy rates. Increased funding for comprehensive sex education
and access to contraception can be effective. Coordinated efforts between
federal, state, and local governments can ensure consistent messaging and
resources.
o Proposed
Solutions: Implement comprehensive sex education programs in schools,
increase access to contraception and reproductive health services, and engage
community leaders and parents in prevention efforts.
Conclusion Addressing
the health issues of diabetes, depression, and teen pregnancy in Eau Claire,
Wisconsin requires a multi-faceted approach involving all levels of government.
Increased government involvement through funding, education, and resources can
significantly improve these issues. Implementing community-based solutions and
fostering partnerships will enhance the effectiveness of these initiatives and
improve overall community health.
Instructions: Cough
Please
respond to at least 2 of your peer’s posts. To ensure that your responses
are substantive, use at least three of these prompts:
·
Do you agree with your peers’ treatment plan approach?
·
Take an opposing view to a peer and present a logical argument
supporting an alternate approach.
·
Share your thoughts on how you support their treatment plan and
explain why.
·
Present new references that support your opinions.
Responses
need to address all components of the question, demonstrate critical thinking
and analysis, and include peer reviewed journal evidence to support the
student’s position.
Please
be sure to validate your opinions and ideas with in-text citations and
corresponding references in APA format.
Please
review the rubric to ensure that your response meets the criteria.
5th person post
Alyson Quartly
What questions would have been asked as part of
the medical history?
I
would ask about any history of smoking, what previous/current employments he
has had for chemical exposure, I would ask about any history of substance use.
I would ask if he had a respiratory infection of any kind prior to the cough. I
would ask if he recalls swallowing something “down the wrong pipe”. I would ask
if there has ever been production to the cough and if he has found any relief
with positioning (Dunphy et al., 2022). I would ask if he at any point
experienced other new symptoms, such as swelling to lower extremities, any
chest involvement, or dizziness (Dunphy et al., 2022). I would also ask if he
had to take any short-term medications between then and now, as some
antibiotics can cause a cough and fibrosis (Dunphy et al., 2022).
What would you assess
for/what body systems would you assess as part of the physical exam?
I
would assess the cardiovascular, respiratory, ENT, and lymphatic systems. I
would listen to the heart and lungs for any clues, I would check the nose for
any discharge or edema, I would check the throat for cobble stoning as this can
be indicative of smoking or postnasal drip (Dunphy et al., 2022). I would
palpate the neck to see if any lymph nodes are flared (Dunphy et al., 2022). I
would check his ears as this can provide clues about allergies or if there is
wax on the ear hairs which can also lead to coughing (Dunphy et al., 2022). I
would also have the patient force air out to listen for any wheezing (Dunphy et
al., 2022).
Are there any tests that
should be completed before producing a diagnosis? Why or why not?
To
be safe, I would order a CBC to rule in/out a potential infection (Dunphy et
al., 2022).
Based on the medical
history and physical exam, what is the likely diagnosis? Include
your differentials.
The
likely diagnosis is that the patient is experiencing side effects of his
lisinopril. A dry, hacking, non-productive cough, is a side effect patients
experience and normally starts within the first few months of treatment (Lopez
et al., 2023).
Differential
diagnosis: URI, allergic rhinitis, asthma, aspiration
What is the treatment for
this patient, including education? Any medications should include full
prescribing information
We
will discontinue the ACE and switch to an ARB at this time. This will be:
Losartan
25mg PO qdaily #30, 1 refills – follow up in one month.
Education
will consist of lifestyle modifications (if not in place already) such as
decreasing sodium intake, having a healthy die3t and exercising about 150
minutes a week (Arcangelo et al., 2021)
He
will also be educated on not waiting so long to be seen. I would let him know
that if about after a week or two and no improvement on something such as a
cough, there is likely something underlying causing it (Dunphy et al., 2022). I
would let him know that his cough is likely to go away after the switch of
medications within a few weeks (Lopez et al., 2023).
6th person post
Lindsay Landers
What questions would have been asked as part of the medical
history?
Some
of the questions that should be asked are:
Have
you discovered any cough triggers? Have you had a fever, sweats at night, or
lost any weight? Have you experienced any shortness of breath or cough? Have
you experienced any difficulty in swallowing?
What
would you assess for/what body systems would you assess as part of the physical
exam?
The
provider should listen to the patient’s lungs for any abnormal lung sounds. We
should assess the patient’s throat and nose for postnasal drip or infection.
The provider should listen to the patient’s heart to assess for abnormal sounds
such as an abnormal heart rhythm or murmur. Lastly, the patient’s skin should
be assessed for any rashes or signs of infection.
Are
there any tests that should be completed before producing a diagnosis? Why or
why not?
A
test that should be run is a chest x-ray to rule out lung disease or infection.
Another test that should be run is blood work such as CBC to rule out infection
or a BNP to make sure this isn’t heart failure related or a d-dimer to rule out
blood clot. Lastly, the patient could have a pulmonary function test to assess
the patient’s lung function.
Based
on the medical history and physical exam, what is the likely diagnosis? Include
your differentials.
One
of the most frequent side effects of angiotensin-converting enzyme inhibitors
(ACEIs) is coughing (Pinto et al., 2020). The ACE inhibitor (lisinopril) he
started taking six months ago is most likely the reason for his cough,
according to his medical history and physical examination. Some patients using
ACE inhibitors have been documented to develop a chronic dry cough. Some other
possible diagnoses would be allergic rhinitis, lung cancer, GERD, or COPD.
What
is the treatment for this patient, including education? Any medications should
include full prescribing information.
losartan
(Cozaar), 50mg, 1 tablet, PO, once a day, for 30 days (Mayo Clinic., 2023). The
patient should make a follow-up appointment for 2 weeks.
Switching
to losartan could help to lower the patients’ risk of stroke and help decrease
neuropathy from diabetes which the patient has.
The
treatment for this patient would be to discontinue her lisinopril and switch to
a different medication. The patient should continue to take their metformin,
aspirin, and loratadine as prescribed. The patient should monitor their blood
pressure at home as well as their blood sugar levels at home.
Education
for this patient should include the significance of routine follow-up visits to
keep an eye on his condition. The patient should also have education on the
potential side effects of their medications. Lastly, the patient should be
educated on how crucial it is to keep up a healthy lifestyle, which includes
exercise and diet, to control his hypertension and diabetes.
