Nursing Capstone. Week 13 Final Project

Author:

April 6th, 2022

Table of Contents

Nursing Capstone

13

Preface 1

Health Promotion Project 2

Practicum Site Affiliation Agreement 2

Sponsor/Preceptor Selection 3

Project Proposal. 3

Reflective Practicum Journal 3

Clinical Hours Log 3

Student Evaluation of the Practicum Experience 3

Review of Students 3

Practice Setting Requirement 3

Students Health Requirements 4

Health Insurance 4

Valid Nursing License 4

Students Liability Insurance 5

Cardiopulmonary Resuscitation 5

Comprehensive Background Check 5

Drug Testing 6

HIPAA / OSHA Policy 6

Sponsor/Preceptor Responsibilities 7

Students Responsibilities 8

Course Faculty Responsibilities 9

Students Checklist for Planning Practicum Experience 9

APPENDICES

Appendix A RN-BSN Practicum Proposal 11

Appendix B Direct Activities Log 12

Appendix C Indirect Activities Log 13

Appendix D Review of Students by Sponsor/Preceptor 14

Appendix E Students Evaluation of Practicum Experience 15

Appendix F Students Health Assessment Form 16

Appendix G CastleBranch Clinical Requirements 18

See suprograms.info for program duration, tuition, fees, and other costs, median debt, salary data, alumni success, and other important info.

PREFACE

The purpose of this information packet is to serve as a reference for College of Nursing policies and information about the practicum course, NSG4076, RN to BSN Capstone Synthesis. Students are required to read this information packet and the South University RN-BSN Students Handbook to promote effective communication and positive student outcomes. The College of Nursing revises information and policies contained in this information packet periodically and will keep students informed of any such changes.

The clinically focused capstone course in the RN-BSN program reflects the requirements of our accrediting body, the American Association of Colleges of Nursing (AACN). AACN released a position statement in 2012, requiring practice experiences for all baccalaureate students, including RN-BSN students. This clinical experience should lead to the development of higher-level psychomotor skills and critical thinking for the RN-BSN students.

Practice experiences for the RN-BSN include direct and indirect care.

The following definitions of direct and indirect care (listed below) can be found in the AACN white paper Expectations for Practice Experiences in the RN to Baccalaureate Curriculum (AACN 2012, p. 3):

· Direct care refers to nursing care activities provided at the point of care to patients or working with other healthcare providers that are intended to achieve specific health goals or achieve selected health outcomes. Direct care may be provided in a wide range of settings, including long term care, home health, community-based settings, and education settings (Suby, 2009; Upenieks, Akhavan, Kolterman, et al., 2007).

· Indirect care refers to nursing decisions, actions, or interventions that are provided through or on behalf of patients. These decisions or interventions create the conditions under which nursing care or self-care may occur. Nurses might use administrative decisions, population or aggregate health planning, or policy development to affect health outcomes in this way (Suby, 2009; Upenieks, Akhavan, Kotlerman, et al., 2007).

NSG4076 course description:

In this clinical course, the student integrates and synthesizes the curricular components of assessment, health promotion/clinical prevention, research, professionalism, teaching, leadership, information management and technology, as well as healthcare policies to create and implement a clinical project relating to the healthcare needs of an aggregate within the community. Creation and implementation of the project will include direct and indirect care of clients in the selected aggregate.

This is the last course in the students’ program of study. The focus of this practicum is community health. The following information provides guidance in the implementation of a community health and population-focused health promotion activity. A final note: Throughout this course, the student will draw on previous learning. Students may also find that previously completed course assignments, projects, and textbooks are useful for completing the assignments in this course.

Additional information about the clinical practicum is located in the practicum preparation classroom modules (for online students).

HEALTH PROMOTION PROJECT

Students will use a community assessment model (e.g. Community as Partner) to do an abbreviated assessment of their selected aggregate/community. The students will create or obtain materials from the agency for the project. The assessment must include data collection and a windshield survey. The students will perform a data analysis to determine trends showing strengths and weaknesses that may identify community health problems for a particular aggregate at-need or at-risk. The students will then collaborate with a community agency to develop a nursing care plan and implement a health promotion project to address the problems and needs of the aggregate. The students in collaboration with the community agency will implement the health promotion project.

An evaluation of the entire project must be included. The entire process requires study and interpretation of content from NSG4074 Health Promotion and Clinical Prevention.

Students will identify a community health concern of a specific aggregate population to plan and implement a health promotion project to address this issue.

The students will select an aggregate population. (Note: the students will not be able to select a client population from their place of employment.) This is a community project; in-patient groups are not appropriate for this project. The students will need to select a population that they may physically access. The students may choose their community, county, city, or another group or organization. Some examples include:

1. Senior citizen’s center

1. School or a particular grade level in a school

1. Faith based group

1. Support group

1. Non-profit organization (e.g., AHA, ADA, Alzheimer’s)

1. Day care

1. Local public health department.

Students will be required to meet with their selected patient aggregation. The purpose of these meetings will be to conduct an environmental assessment; assess the aggregate, family, and the community where the aggregate resides; and then implement a health plan with a group from the aggregate.

Students will be working with a student identified organization and sponsor /preceptor in this clinical course. Students are required to complete 150 clinical hours – indirect care accounts for 110 hours and direct care accounts for 40 hours. Indirect hours include – time students spend with preceptors discussing the community assessment, identifying a project for the community, and completing research for the project. The direct care time includes the time students are actually completing the community assessment, and presenting health promotion projects to community members. Students should plan to allocate at least 15 hours per week for the practicum experience (150 hours/practicum).

PRACTICUM SITE AFFILIATION AGREEMENT

Approval of the practicum site must be complete 1 month prior to the start of class. A clinical affiliation agreement is required for students’ practicum site. This process can take weeks to several months to obtain approval. Begin to plan this community experience early.

SPONSOR/PRECEPTOR SELECTION

The sponsor/preceptor must hold a decision making position at the facility. This person could be an employee or volunteer if a non-profit organization. The sponsor/preceptor must be able to provide access to the aggregate and assist the students in planning, implementing and evaluating the students’ project. A CV or resume’ of the preceptor/sponsor is required.

PROJECT PROPOSAL

The project proposal is due 1 month prior to the start of class. The students must submit the Project Proposal form to the Assistant Clinical Coordinator (online students) for approval by the Program Director or the campus Program Director. The students will also submit the proposal to the course faculty at the start of the course. (Form is included in packet).

REFLECTIVE PRACTICUM JOURNAL

A reflective journal will be submitted focusing on students’ health promotion project and practicum goals.

CLINICAL HOURS LOG

Please note that students are required to keep a log of clinical hours using the Verification of Clinical Hours form. Students will record direct and indirect hours in their clinical hour’s log. The clinical sponsor/preceptor must sign the clinical log and submit to course faculty as directed. (Form is included in packet).

STUDENTS’S EVALUATION OF THE PRACTICUM EXPERIENCE

Students must complete an evaluation of the practicum experience. (Form is included in packet).

REVIEW OF STUDENTS

The sponsor/preceptor will complete a final review of the student and submit the completed review to the course faculty as directed.

PRACTICE SETTING REQUIREMENTS

· A practice setting is defined as any time students have contact involving patients, patient care settings, students or student learning settings, or community organizations for a University project or course requirement.

· Students are responsible for having an approved letter of agreement (Affiliation Agreement) in place when practicing.

· Students are responsible for ensuring that the letter of agreement (Affiliation Agreement), sponsor/preceptor information and all other necessary documents are received at least 30 days prior to the start of the session.

· Practicum locations must meet the course objectives for the enrolled course. Program Directors approve all practicum locations. Students may not enter a practice setting until official notification from the Program Director or faculty has been received. Hours spent at a clinical site that has not received final approval will not count.

· Practicum rotations at the students’ place of employment is prohibited.

· Students may only be involved in obtainment of practicum hours with students South University approved sponsor/preceptor. Students may NOT utilize other individuals at the facility without prior approval of the course faculty.

· Students must wear nametags (Photo ID) identifying them as a South University students and a professional lab coat with South University emblem (if a lab coat is required by the facility).

· Attire must be professional and appropriate to the setting.

· Communication for students occurs through students’ university email addresses. If students do not have a South University email address or do not know how to access it, check with the Academic counselor (online students) or Program Director (campus students).

STUDENTS HEALTH REQUIREMENTS

Students are required to obtain a health assessment at least four (4) weeks prior to the start of their clinical experience and each year while in the program. Hepatitis B, Mumps, Measles, Rubella, Rubeola, and Varicella Titers and/or vaccinations are required. An annual assessment for TB is required. A PPD or QuantiFERON test is required. If a positive tuberculosis screen is reported, students must submit one negative Chest X-Ray report with the original Health Assessment and obtain an annual physical examination to rule out active chest disease. TDAP is required within 10 years.

Students will submit completed health assessment forms to CastleBranch. (Online students, the form is included in packet and available in the modules).

Students who are on a medical leave will need to obtain a medical clearance prior to returning to the practicum setting.

HEALTH INSURANCE

South University requires nursing students to carry Health Insurance or comparable coverage for emergency medical care. Some of the clinical facilities and agencies require proof of health insurance coverage prior to students’ participation at clinical sites. Students are responsible for any expenses related to any illness or accidents that may occur while participating in the South University nursing program. Submit a copy of students’ insurance card and signed attestation to CastleBranch.

VALID NURSING LICENSE

A valid unencumbered* license as a Registered Nursing in all U.S. state or territory which the student is licensed, including the state in which the student completes all assignments for the program. (Note that military, federal and foreign educated nurses must meet this state requirement for nursing licensure.) An unencumbered license(s) must be maintained throughout the program. It is the student’s responsibility to inform the Program Director and/or Academic Clinical Coordinator if the student’s license(s) becomes encumbered. Failure of such notification of encumbered status can lead to failure to progress in the program. If relocating, please ensure that the RN-BSN program is approved for clinical placement within that state. Contact the Program Director (campus students) or Academic Counselor (online students) for this information.

*Unencumbered License – A license that is not revoked, suspended, or made probationary or conditional by the State licensing or registering authority as the result of disciplinary action. A copy of student’s current license must be on record with CastleBranch.

STUDENTS’ LIABILITY INSURANCE

South University provides professional liability insurance to all students attending practicum courses. This policy is limited to students participating in their clinical practicum courses taken at South University.

CARDIOPULMONARY RESUSCITATION

Students must provide proof of completion of the American Heart Association Health Care Provider level CPR course prior to participation in any practicum course. Students agrees to maintain current CPR Provider status throughout their attendance at South University. Students cannot attend any practicum experience without a valid CPR card. A copy of a valid CPR card must be on record with CastleBranch.

COMPREHENSIVE BACKGROUND CHECKS

Nurses are entrusted with the health, safety and welfare of patients. The nursing curriculum contains a didactic and clinical component. Clinical facilities where student nurses practice are required by accreditation agencies to obtain background checks for security purposes on individuals that render patient care.

All students applying for the South University nursing program are required to obtain a criminal background investigation (Level 2) prior to starting the first day of class. Any students who fails to provide a background check prior to the first day of the term when their enrollment begins will be unregistered from class and will not be allowed to attend class until the background check is provided. A student’s failure to provide a criminal background check prior to their start date will result in the following:

• Removal from class

• Cancellation of enrollment

• No final course grades

• No transcript

Students are responsible for the cost of the criminal background investigation. Certification of a clear criminal/background history is required to place students in clinical environments. A student whose investigation shows a felony conviction or findings/misdemeanors that constitute a significant breach of moral or ethical conduct cannot be cleared for clinical and thus will be withdrawn from consideration or if accepted must withdraw or cancel from the nursing program. During the nursing program, an enrolled student must notify the program director or clinical coordinator of a criminal conviction and/or of behaviors that constitute a significant breach of moral or ethical standards. Annual updates will be required during the program of study. A felony conviction and/or behaviors/misdemeanor conviction that constitute a significant breach of moral or ethical standards will result in immediate dismissal from the nursing program.

Acceptance into a South University educational program, or its completion, does not imply or guarantee that a student will be able to obtain such licensure or certification.

The Nursing Program Director may be required to submit written documentation regarding student status to boards of nursing and clinical agencies as early as upon receipt of the student’s CON application. Students may be required to obtain additional background checks as requested by clinical agencies or boards of nursing.

Comprehensive Background Directions:

Overview: Castlebranch.com is a service that allows students to order their own background check online. All drug testing information is obtained through Castlebranch.com. Information collected through Castlebranch.com is secure, tamper-proof, and kept confidential. The services performed by Castle Branch are based on guidelines provided by students’ organization, so students get the information students need, all from one source. The results are posted on the Castlebranch.com website where the students, as well as the school, can view them.

Ordering Instructions:

1. Go to www.Castlebranch.com and click on “Place order.”

2. In the Package Code box, enter the package code provided by the Campus Program Director or Assistant Clinical Coordinator.

3. Enter payment information – Visa, MasterCard, or Money Order. Follow the online instructions to complete students’ order.

Retrieval Instructions

Once an order is submitted, students will receive a confirmation email containing the password needed to view the results of students’ background check. To view student results, visit www.Castlebranch.com , and enter password in the area provided on the lower right side of the homepage, then enter the last four digits of students Social Security Number. Results are typically available in approximately three days, though some searches take longer so please allow adequate time when ordering. The Program Director will be able to view student results in CertifiedBackground.com once complete. For A Summary of Students Rights Under the Fair Credit Reporting Act visit www.ftc.gov .

DRUG TESTING

Many health care facilities require that all persons caring for patients submit to drug screening. Students will submit to urine drug screening during the RN-BSN program and as required by practice facilities. Students who refuse to obtain a urine drug screen or have a positive urine drug screens may NOT attend clinical practice courses, which could result in dismissal from the nursing program. A student with a positive urine drug screen will be required to obtain medical clearance to assess “fitness for duty”. Students are responsible for the financial costs of required drug tests. Students without medical justification for positive drug screen will be removed from the program.

HIPAA/OSHA POLICY

All students are required to submit a current (within the last 12 months) certificate of completion for HIPAA and OSHA training . South University will accept a certificate of completion from student’s employer, as most nurses complete this training as part of an annual competency.

Documentation of HIPAA/OSHA training is required prior to entering the practicum site. Students may send a certificate of completion from students’ employer (completed in last 12 months), or find an online site that provides training (suggestions are noted below). In addition to HIPAA, required OSHA training must consist of blood borne pathogens and hazard communication training. Students are responsible for submitting the certificate of completion to the CastleBranch site.

There are many HIPAA/OSHA training sites on Internet. The sites listed below are not endorsed by South University, but appear to meet all of the requirements for HIPAA/OSHA training. Students may also find students own online sites for HIPAA/OSHA training.

*HIPAA and OSHA training is at the expense of the students since it is required by clinical facilities prior to practicum placement.

HIPAA

· HIPAA Training.com: https://www.hipaatraining.com/hipaa-training-for-healthcare-providers

· HIPAA General Awareness Training Course My HIPAA Training: http://myhipaatraining.com/

Basic HIPAA Training Course

OSHA (blood borne pathogens and hazard communication needed)

OSHAcademy Occupational Safety & Health Training: http://www.oshatrain.org/courses/index.html

· Hazard Communication Program (Course number 705)

· Blood borne pathogens (course number 755)

Although the courses are free there is a cost to download the certificate needed.

All clinical requirements, including but not limited to physical, background check, drug screen, vaccines, and trainings are to be updated annually. There are no exceptions to this rule.

SPONSOR/PRECEPTOR RESPONSIBILITIES

The following responsibilities are identified and will be used as a guide for the clinical practicum experiences:

The practicum sponsor/preceptor will:

· Orient students to the setting including identification of facility policies and procedures.

· Become familiar with course objectives.

· Provide documentation of student’s hours at mid-term and at completion of the course.

· Maintain open communication with Faculty and Students and provide current phone numbers, address and email.

· Supervise the students in the facility setting.

· Provide suggestions that will assist students in developing and implementing the proposed project.

· Contact course faculty member concerning any issues that may arise.

· Complete a final review of the students.

STUDENTS RESPONSIBILITIES

The students will:

· Comply with all academic, clinical or community facility policies and procedures.

· Comply with all South University College of Nursing policies and procedures identified in the University Catalog and/or RN-BSN Students Handbook. Failure to exhibit integrity, ethical conduct, or professional standards may warrant dismissal from South University.

· Establish with sponsor/preceptor, the Project Proposal and successfully complete the terms established within it.

· Adhere to all practicum facility policies.

· Be present at the approved practicum site with the approved sponsor/preceptors for the specified course.

· Ensure sponsor/preceptor has a copy of the current course syllabus.

· Identify project goals for the practicum experience with course faculty and practicum sponsor/preceptor. Review learning goals before starting the practicum with course faculty and practicum preceptor.

· Comply with health and other professional requirements of the clinical facility prior to the start of the practicum experience.

· Be prepared to work in the practicum setting in a safe manner that demonstrates professional standards and arrive at the agreed time.

· Attend all established practicum days, or notify sponsor/preceptor and faculty of absence and establish clinical make-up experience.

· Dress in a professional manner consistent with clinical facility guidelines and be clearly identified as being a South Universitystudent. ID Badges and lab coat must be worn at all times in the community/practicum settings identifying the students as a South University student.

For online students, contact SUOIDrequest@southuniversity.edu to obtain an ID badge.

For online students, in order to provide students with an ID card, please provide the following information:

· Full Name

· Students ID Number

· Mailing Address

· Name of the Program

· Headshot Photo:

· jpeg format (less than 100kb)

· Front face (no profiles)

· No sunglasses or hats/headgear

· Copy of Driver’s License

ID Badges should be ordered 5 weeks in advance of enrolling in the first practicum course.

Lab coat

· Students are to order their lab coat through MEDWEAR. Note that ALL EMBROIDERED ITEMS ARE A FINAL SALE. Please allow up to 5 weeks for delivery.

http://medwearuniforms.com/group-sales/southuniversity/onlinestudentstore.php

COURSE FACULTY RESPONSIBILITIES

The course faculty member will:

· Establish communication between sponsor/preceptor and the faculty member.

· Be available to sponsor/preceptor to discuss any issues that may arise with the students.

· Counsel with sponsor/preceptor and students during the course.

· Identify students at risk and notify the program director by midterm.

· Initiate and follow up on remediation plans as needed.

· Maintain active communication with the students regarding classroom and clinical performance.

· Maintain responsibility for the final grade determination based on the grading rubric and the clinical performance evaluation.

STUDENT CHECKLIST FOR PLANNING PRACTICUM EXPERIENCE

· The student is responsible for researching, identifying and contacting a facility or organization and arranging for the Practicum experience.

· The student must obtain agreement from an individual in a position to act as the sponsor/preceptor.

· The Clinical Coordinator and/or Program Director must review and approve the arrangement prior to start of the practicum courses.

· The student MUST provide the sponsor/preceptor with a copy of the Practicum Information Packet.

· The student MUST direct the sponsor/preceptor to complete and sign the Practicum Proposal form. All information must be provided on the agreement including the sponsor’s/preceptor’s position title, licensure information, if applicable, and contact information (telephone number, CV/resumé, and email address).

· The Affiliation Agreement must be executed between South University and the clinical setting institution. PLEASE NOTE: the Affiliation Agreement is usually reviewed by legal counsel of the clinical site facility. This may take some time to complete. Students are advised to start the process as soon as possible prior to the start of the academic session in which the Practicum will be started.

· Submit the signed Affiliation Agreement and Practicum Proposal to the South University Clinical Coordinator and/or Program Director prior to the start of the practicum.

· In general, two copies of the signed affiliation agreement are forwarded to the Clinical Coordinator and then one copy of the signed and fully executed affiliation agreement is returned to the practicum institution.

· Prior to starting the Practicum Course, all documents must be completed and the arrangements for the practicum approved by the Clinical Coordinator. The agreement MUST be in place one-month PRIOR to the students engaging in any practicum experiences at the designated practicum institution.

· Students will maintain contact with their professor in the Practicum Course. There will be contact between the student’s South University Professor and his/her Practicum Sponsor/Preceptor during the practicum experience via telephone and or email.

· The student will complete a log of his/her practicum experiences.

APPENDICES

SOUTH UNIVERSITY

College of Nursing AND PUBLIC HEALTH

RN-BSN DEGREE Program

RN-BSN Practicum Proposal

Please complete this document outlining student’s proposed site and planned project. This form must be returned to student’s Clinical Coordinator for approval by the Program Director. The proposal must be submitted 4 weeks prior to the start of class. Review the course syllabus for objectives.

Student Name: Date Submitted: Course Start Date:

Contact Method:

Phone:

Email:

Practicum Information

Agency/Organization:

Address (street/city/state/zip):

Phone Number: Fax Number:

Sponsor/preceptor Person’s Name:

Position at agency:

Sponsor/preceptor Signature:

APPENDIX B

SOUTH UNIVERSITY

COLLEGE OF NURSING AND PUBLIC HEALTH

RN-BSN DEGREE PROGRAM

DIRECT ACTIVITIES LOG

This log is to start on the first day that the students is physically present at the Practicum site and begins working with his/her contact person. It continues until the Practicum is completed. This signed form must be submitted by student’s sponsor/preceptor via email to the course instructor at week five and week nine.

The total number of clinical hours required is 150, direct care hours’ minimum is forty (40).

Student Name: Practicum: Organization:

First date at Practicum site: Course Start Date:

Date	Hours completedDirect	Brief Description of Activity










Total Hours

Total Number of Hours Completed:

Sponsor/Preceptor Signature: Date:

Student Signature: Date:

Total Number of Hours Completed:

Sponsor/Preceptor Signature: Date:

Student Signature: Date:

APPENDIX C

SOUTH UNIVERSITY

College of Nursing AND PUBLIC HEALTH

RN-BSN DEGREE Program

INDirect Activities log

This log is to help students track student’s indirect care hours. The total number of clinical hours required is 150, indirect care hours’ minimum is one hundred ten (110). This form must be submitted every other week with student’s journal to allow student’s course facilitator to be sure students are staying on track with student’s hours. The sponsor/preceptor will email the signed log to the classroom faculty in weeks 5 and 9.

Students Name: Practicum: Organization: Course Start Date:

Date	Hours completedIndirect	Calculate the number of indirect hours each every other week when submitted	Brief Description of Activity










Total Hours

Total Number of Hours Completed:

Sponsor/Preceptor Signature*: Date:

Student Signature: Date:

Total Number of Hours Completed:

Sponsor/Preceptor Signature*: Date:

Student Signature: Date:

*My signature confirms only those indirect student hours at the facility

APPENDIX D

SOUTH UNIVERSITY

COLLEGE OF NURSING AND PUBLIC HEALTH

RN-BSN DEGREE PROGRAM

REVIEW OF STUDENT BY SPONSOR/PRECEPTOR

Student Name:

Site/Sponsor/Preceptor:

Date: Course

Please review the student by responding to the items below. Student comments are valuable. If student has any questions or concerns, please contact the course instructor.

Use the following scale to complete the student review:

SA Strongly Agree

A Agree

U Uncertain

D Disagree

SD Strongly Disagree

The student:

1. Consistently demonstrates caring behavior to members

of aggregate and facility. SA A U D SD

2. Was punctual and present in the facility as arranged. SA A U D SD

3. Wore professional attire and identification. SA A U D SD

4. Came to the facility prepared to participate and learn. SA A U D SD

5. Project presented accurate information that met the needs

of the aggregate. SA A U D SD

Additional Comments:

Sponsor/Preceptor Signature: Date:

APPENDIX E

SOUTH UNIVERSITY

College of Nursing AND PUBLIC HEALTH

RN-BSN DEGREE Program

STUDENT EVALUATION OF PRACTICUM EXPERIENCE

Complete this evaluation form and submit to the course instructor via the Dropbox in Week 10 of the Practicum course. Answer all questions please. The Practicum is not considered complete until this form has been submitted.

Student Name: Preceptor Name: Agency/Organization Name:

Practicum Start Date: End Date Form Completed/Submitted:

Describe the initial goals and objectives of the project. Were the goals and objectives met?Why or why not?
Describe the major (3‐5) activitiesrelated to student’s Practicum and how much time (%) was spent on each.
Do students think those activitiescontributed to student’s learning experience? If so, which activities did students find most helpful and least helpful?
What do students this were the most important skills that students gained through this experience?
List the core competencies addressed through student Practicum.
Would students recommend this agency/organization to others for a Practicum? Why or why not?
Describe student working relationship with the Preceptor.
How could this experience be improved?

Student signature: _________________________________________Date: _________________

APPENDIX F

SOUTH UNIVERSITY

College of Nursing AND PUBLIC HEALTH

RN-BSN DEGREE Program

STUDENTS HEALTH ASSESSMENT FORM

Name Date / /

Address

Date of Birth / / Male Female Phone

Please note: This health assessment must be completed by an MD, DO, PA or ARNP. Assessment by other health care providers will NOT be accepted.

PHYSICAL ASSESSMENT

Height Weight Vital Signs: BP __________P _________R _________ Temperature___________

Visual Acuity (R) (L) Uses Eyeglasses YES NO Uses contact lens YES NO

Hearing Acuity (R) (L) Uses hearing aid YES NO

Immunization Record (must include dates)

MMR 1. Date / / Hepatitis Series 1. Date / / 2. Date / / 2. Date / /

Varicella 1. Date / / 3. Date / /

2. Date / /

Seasonal flu Date / / Tetanus Diphtheria acellular pertussis (Tdap) Date /

MEDICAL HISTORY:

PHYSICAL ASSESSMENT (CONTINUED)

	Normal	Abnormal	Comments if Abnormal
Skin
HEENT
Heart
Lungs
Abdomen
Musculoskeletal
Neurological

THE FOLLOWING DIAGNOSTIC TESTS MAY BE REQUIRED:

Please attach a copy of all lab results including titer levels

TITERS:	DATE	IMMUNE	NON-IMMUNE
Rubeola (if no proof of vaccines)
Rubella (if no proof of vaccines)
Mumps (if no proof of vaccines)
Varicella (if no proof of vaccines)
Hepatitis B (required if immunized)

Urinalysis	DATE	NORMAL FINDINGS	ABNORMAL FINDINGS

Hemoglobin/Hematocrit	DATE	NORMAL FINDINGS	ABNORMAL FINDINGS

*PPD1 Step (Quantiferon, Mantoux, or T-Spot)	DATE	POSITIVE	NEGATIVE

*If PPD is positive the students must provide documentation of a negative chest x-ray within the past 5 years and annual negative symptom analysis signed by the provider. If any of these titers do not show immunity, the appropriate vaccine(s) or boosters are to be administered unless medically contraindicated as listed by the CDC.

Does this individual have any physical or mental conditions, disabilities or medical limitations that would prohibit the individual from functioning in the capacity of an Advanced Practice Registered Nurse?

YES NO (if yes, state reason)

Healthcare Provider Name and Title (PRINT)

Healthcare Provider Signature Date

Healthcare Provider Address City State Zip

Healthcare Provider Telephone Number ( )

APPENDIX G

SOUTH UNIVERSITY

College of Nursing AND PUBLIC HEALTH

RN-BSN DEGREE Program

CASTLEBRANCH CLINICAL REQUIREMENTS

Students Health Insurance	Must submit proof of insurance ANNUALLY (copy of insurance card with student’s name on it or document from employer or insurance company which identifies students by name and verifies coverage)Must sign Attestation document once
Measles/Mumps & Rubella (MMR)	Evidence of immunity includes any of the following:Written documentation of vaccination with 2 doses of MMR vaccine (minimum of 4 weeks apart)Positive antibody for all three componentsIf negative or equivocal (and no evidence of 2 doses of vaccine) – will need 1 booster and a repeat titer 1 month following boosterExemptions must be in accordance with state guidelines for vaccine exemption and submission of 1) attestation signed by religious leader or medical provider and 2) Acknowledgement of Unvaccinated Status Form signed by site that they acknowledge and accept the student’s lack of immunity.
Varicella (Chicken Pox)	1. Evidence of immunity includes any of the following:written documentation of vaccination with 2 doses of varicella vaccine (minimum of 4 weeks apart) Positive antibody.If negative or equivocal (and no evidence of 2 doses of vaccine) – will be prompted to repeat the 2 vaccine seriesExemptions must be in accordance with state guidelines for vaccine exemption and submission of 1) attestation signed by religious leader or medical provider and 2) Acknowledgement of Unvaccinated Status Form signed by site that they acknowledge and accept the student’s lack of immunity.
Hepatitis B	1. Evidence of immunity includes ALL of the following:Signed Hepatitis B Vaccine Statement (available for download)Written documentation of completed 3 vaccination seriesPositive surface antibody (HBsAb) titerIf titer is negative, will be prompted to repeat the 3 vaccine series followed by a titer. If the titer is still negative after a second vaccine series, testing for HBsAg and total anti-HBc is needed to determine infection status. OR Documentation of a Signed declination waiver
TB Testing	1. Annual negative test result on any of the following:1 step TB skin test (TST/Mantoux)QuantiFERON TB Gold (QFT-GIT) testT-SPOT TB test (T-Spot). If positive; need an initial Chest X-Ray (current within 5 years) AND annually submit a Symptom Assessment for TB Form signed by a medical providerIf assessment reveals symptoms, a chest X-ray would be required to determine presence of active infection.
Tetanus, Diphtheria, & Pertussis (Tdap)	1. Evidence of a Tdap vaccine within 10 years.After evidence of initial Tdap vaccine within 10 years, a booster every 10 years with standard Td vaccine is acceptable.Exemptions must be in accordance with state guidelines for vaccine exemption and submission of 1) attestation signed by religious leader or medical provider and 2) Acknowledgement of Unvaccinated Status Form signed by site that they acknowledge and accept the student’s lack of immunity.
CPR Certification	Must be American Heart Association Healthcare Provider or a certification issued in accordance with AHA HCP curriculum. Provide proof of either:AHA eCardAHA printed card. Must submit front and back of the card and must be signed (will accept pending status if written evidence of successful course completion and card is delayed)The renewal date will be set according to the expiration date of the CPR certification.ACLS is not acceptable in place of Healthcare Provider
Influenza Vaccine	1. Documentation of flu vaccine within the most recent or current influenza seasonExemptions must be in accordance with state guidelines for vaccine exemption and submission of 1) attestation signed by religious leader or medical provider and 2) Acknowledgement of Unvaccinated Status Form signed by site that they acknowledge and accept the student’s lack of immunity.
Physical Examination	1. Must submit Students Health Assessment form ANNUALLY. It must be completed and signed by a medical professional.
RN License	1. Submit a copy of current unencumbered RN License or verification of licensure through the state website. The renewal date will be set according to the expiration date of the license.
HIPAA Education	1. Submit HIPAA training documentation to this requirement– must show date. Renewal date will be one year from date of documentation.If completed at place of employment, submit certificate of completion and content outline.May access at: My HIPAA Training: http://myhipaatraining.com/ Basic HIPAA Training Course
OSHA-Blood Borne Pathogens	1. Submit OSHA-Blood-Borne pathogens training documentation to this requirement-must show date. Renewal date will be one year from date of documentation. If completed at place of employment, submit certificate of completion and content outline. May access at: OSHAcademy Occupational Safety & Health Training: http://www.oshatrain.org/courses/index.html Bloodborne Pathogens Program Management (course number 755)
OSHA-Hazardous Materials	1. Submit OSHA-Hazardous Materials training documentation to this requirement- must show date. Renewal date will be one year from date of documentation. If completed at place of employment, submit certificate of completion and content outline.May access at: OSHAcademy Occupational Safety & Health Training: http://www.oshatrain.org/courses/index.html Hazard Communication Program (course number 705)
Certified Background Screening	1. Annually7-Year County Criminal Search7-Year Employment Verification (initial only)Nationwide Sex Offender SearchNationwide Healthcare Fraud & Abuse SearchMedicare & Medicaid Sanctioned, Excluded individualsOffice of Research Integrity (ORI)Office of Regulatory Affairs (ORA)FDA Debarment CheckState Exclusion ListOffice of Inspector General (OIG) List of Excluded Individuals/EntitiesOffice of Foreign Assets Control (OFAC)US Department of TreasurySpecially Designed Nationals (SDN)General Services Administration (GSA)Excluded Parties ListPatriot ActSocial Security AlertResidency HistoryVerification of Professional LicenseNationwide Fingerprinting
Certified 10-Panel Urine Drug Screen	1. Annually
Adult and Child Mandatory Reporter Training (Iowa only)	1. Submit Adult and Child Mandatory Reporter Training documentation to this requirement. Renewal date will be 5 years from date of documentation. If completed at place of employment, submit certificate of completion and content outline. May access further information at: http://idph.iowa.gov/abuse-ed-review

Capstone Community Aggregate Paper

[Your Name]

NSG 4075 Holistic Professional Nursing

Your Instructor’s Name and credentials go here

South University

Capstone Community Aggregate

The purpose of this paper is to discuss the creation and implementation of a health promotion project by synthesizing all information collected throughout the RN to BSN completion program. [Put the text of your paper here and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Introduction & Problem Statement

[Put the text of your paper here providing an introduction to the problem and a clear statement of what you intended to accomplish with your project. INCLUDE the relevancy of the topic you chose, concerns regarding the issue, how this issue impacts nursing and healthcare. INCLUDE literature review references and/or current event articles to support your perspective. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Trends and Statistics

[Put the text of your paper here, presenting relevant trends, etiology of the problem, prevalence & incidence statistics (referencing as appropriate) – USE relates statistics form the CDC or other relevant data information and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Related Sources

[Put the text of your paper here discussing relevant information to the problem and your project, referencing as appropriate. You must provide at least ONE Peer-Reviewed nursing articles and at least TWO current event articles/internet sites or other forms of media to demonstrate appropriate research. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

The Client: Objective & Subjective Assessment

[Put the text of your paper here introducing your aggregate and the representative of your aggregate. In the sections below, you will clearly and concisely describe your client using BOTH subjective and objective information. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Case Study

[Put the text of your paper here and summarize your findings related to the issues presented by your client and discuss how and intent to improve your client’s health/life. Include both Objective and Subjective information. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Aggregates’ Demographics

[Put the text of your paper here present the demographics of the aggregate here (remember an aggregate is a GROUP of people, not just one individual) and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Gordon’s 11 Functional Health Patterns

See Appendix B of this paper. You may include your entire Gordon’s information as an appendix, but here you want to SUMARIZE the information and only present items that are relative to the issue you are addressing. Describe the content of the relevant portions of the Gordon’s here. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Health Perception and Health Management.[Put the text of your paper here discussing the health perception(s) of the individual that represents your aggregate and his/her current management strategy. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Nutrition and Metabolism.[Put the text of your paper here discussing the nutrition and metabolism of the individual that represents you aggregate, if relevant. If NOT relevant, leave this sub-topic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Elimination. Put the text of your paper here discussing the elimination of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Activity and Exercise. [Put the text of your paper here discussing the activity and exercise of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Cognition and Perception. [Put the text of your paper here discussing the cognition and perception of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Sleep and Rest. [Put the text of your paper here discussing the sleep and rest of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Self-Perception and Self-Concept. [Put the text of your paper here discussing the Self-perception and self-concept of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Roles and Relationships. [Put the text of your paper here discussing the roles and relationships of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Sexuality and Reproduction. [Put the text of your paper here discussing the sexuality and reproduction of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Coping and Stress Tolerance. [Put the text of your paper here discussing the coping and Stress Tolerance of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Values and Belief. [Put the text of your paper here discussing the values and beliefs of the individual that represents you aggregate if relevant. If NOT relevant, leave this subtopic out. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Windshield Survey

[Put the text of your paper here and describing the relevant finding of your Windshield survey in paragraph form . You may include your entire windshield survey as an APPENDIX, but in this section, you should present your findings in paragraph format.

Concept Map

[Put the text of your paper here describing your concept map. THIS is an EXAMPLE of a CONCEPT map – yours may be different. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Genogram: One Individual in Aggregate

[Put the text of your paper here and describing the genogram of the individual representing your aggregate, if appropriate. CLEARLY identify your individual in your genograms. Include children of your aggregate exemplar, if appropriate. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Paternal Side:

Maternal Side:

Plan of the Project

Community Stakeholder’s Identified

[Put the text of your paper here describing the community stakeholders you have identified related to both your aggregate and the individual with whom you are working who represents your aggregate. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

[Put the text of your paper here and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Financial and Political Implications

[Put the text of your paper here discussing the financial and political implications of your health promotion plan as it relates to both the entire aggregate and the individual that represents your aggregate. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Feasibility of the Project

Provision of Alternate Plan and Interventions

[Put the text of your paper here discussing an alternative plan if your initial plan does not work. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Role of Change Agent

[Put the text of your paper here discuss the role of a change agent and your specific role as the change agent for your aggregate and for the individual that is representing your aggregate. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Implementation and Evaluation of the Project

Implementation of the Project

[Describe in detail what you did and how you did it (your health promotion plan) and the progress made. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Evaluation of the Project

Evaluation: Did the project intervention address the original identified problem? [Put the text of your paper here describing and critiquing your health promotion plan – i.e. – DID IT WORK? WHY or why not???? and Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Implications to Nursing Practice in the Local Community

[Put the text of your paper here discussing how your plan can affect (or be used by) nurses practicing in the local community. Provide at least three nursing implications that would affect nursing practice in the local community. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Implications to Nursing Practice and Global Health

[Put the text of your paper here discussing how your plan might impact nurses around the world and global health. Provide at least three nursing implications that would affect nursing practice in terms of global health. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Summary, Recommendations and Conclusion

[Put the text of your paper here presenting your recommendations related to your project as well as a summary of the project and your conclusions Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

[Summarize your paper here, about two to three paragraphs].

References

PLEASE NOTE: These are SAMPLE References. You need to remove these and insert your own references here

Harwood, L., Ridley, J., Wilson, B., & Laschinger, H. (2010). Workplace empowerment and

burnout in Canadian nephrology nurses. CANNT Journal, 20(2), 12-17. Retrieved from CINAHL with Full Text database.

McCaffrey, R., Hayes, R., Stuart, W., Cassell, A., Farrell, C., Miller-Reyes, C., et al. (2010). A

program to improve communication and collaboration between nurses and medical residents. Journal of Continuing Education in Nursing, 41(4), 172-178. doi:10.3928/00220124-20100326-04.

Uyehara, J., Magnussen, L., Itano, J., & Zhang, S. (2007). Facilitating program and NCLEX-RN

success in a generic BSN program. Nursing Forum, 42(1), 31-38. Retrieved from CINAHL with Full Text database.

https://ecampus.phoenix.edu/secure/aapd/cwe/citation_generator/gen.asp

Running head: CAPSTONE COMMUNITY AGGREGATE PAPER 12

Running head: CAPSTONE COMMUNITY AGGREGATE PAPER 18

N:\3. RN-BSN Completion Program\RN to BSN Curriculum\RN to BSN WPB\NSG4075\2015_4 – Fall\Items to Upload to eCompanion\4-TEMPLATE.Capstone Project Paper.docx

Appendices

Appendix A

Housing	What is the age and condition of housing in the neighborhoods you’re surveying? Are houses and apartment buildings kept up, or are they run-down and in need of repair? Are yards neat or overgrown?Other buildings. Are the buildings mostly or fully occupied? Do public and commercial buildings seem accessible to people with disabilities – ramped, street level entries, etc.?
Public Spaces	Are there public spaces where people can gather? Are they well kept up? Do they have seating areas, trees and plants, attractive design, cafes or food vendors, or other features meant to encourage people to use the space? Who uses these spaces? Is there diversity?
Parks	Are parks used by a variety of people?? Are they well kept up? Are there sports facilities – basketball courts, soccer pitches, baseball fields, cricket pitches, etc.? Are they used at night?
Culture and Entertainment	Are there museums, libraries, theaters, restaurants, clubs, sports stadiums, historic sites, etc.? Are they accessible to all parts of the community (centrally located, reachable by public transportation)? Do they reflect the cultures of community members?•Streetscape. The streetscape is the environment created by streets and the sidewalks, buildings, trees, etc. that line them. Are there trees and/or plants? Are there sidewalks? Are building facades and storefronts attractive and welcoming? Are the streets and sidewalks relatively clean? Are there trash cans? Is there outdoor seating?
Street Use	Are there people on the streets at most times of day? In the evening? How late? Do they interact with one another? Are streets and sidewalks well lit at night?
Commercial Activity	What kinds of businesses are there? Are there boarded-up or vacant storefronts? Is there a mix of large and small businesses? Are there grocery stores and supermarkets, pharmacies, and other stores that provide necessities in all parts of the community?
Signs	What languages are business signs in? Are traffic signs informative? Are there signs directing people to various parts of the community (downtown, museums, highways, etc.)?
Industry	What kinds of industry exist in the community? Does it seem to be causing pollution?
Land Use	How much open space is there? How are residential, commercial, and industrial areas distributed? Do major roads or railroad tracks divide neighborhoods, or are they on the edges of the community?
Infrastructure	What is the condition of roads, bridges, sidewalks, etc.? Are there differences in these conditions from one area of the community to another? Do all parts of the community seem to be equally served by electricity, water, phone, fiber optic, wastewater treatment, waste disposal, and other infrastructure services?
Public Transportation	Is there a functioning public transportation system? Is it well used? By whom? Does it allow relatively easy access to all parts of the community? How easy is it to navigate and use? How much does it cost? Are its vehicles energy-efficient?
Traffic	How heavy is traffic in the community? Is it mostly commercial and industrial – vans, trucks, etc. – or mostly private cars? Is there ever gridlock? Is there much bicycle traffic? Are there bike lanes? Are there bike racks in many places?
Environmental Quality	How much usable green space is there, and is it scattered throughout the community? Is there smog or haze? Does the air smell of smoke, garbage, car exhaust, chemicals, industrial waste, etc.? Does the water in streams, ponds, lakes, etc. seem reasonably clear?
Race/Ethnicity.	Who lives in the community? Are there identifiable racial and ethnic groups? Do particular groups seem to live in particular areas?
Faith Communities	What kinds of religious institutions are there? Do the institutions of one particular religion or sect dominate? Are there separate houses of worship for people of different ethnicities or races, even if they share the same faith?
Health Services	How many hospitals and clinics are there in the community? Where are they located? How big are they? How easy are they to get to?
Community And Public Services	Are there identifiable community service providers and organizations in the community – mental health centers, food banks, homeless shelters, welfare offices, etc.? Are they concentrated in a particular area? Are they easy to reach by public transportation?
Community Safety	Where are police and fire stations located? Are they in good repair? Is the community well-lit at night?
Public Schools	Are schools in different neighborhoods in noticeably different states of repair? Are schools well maintained? Or in some developing countries, are there schools in the community at all?
Higher Education	Are there two- and four-year colleges and/or universities in the community? Where are they located? Do they seem open to the community, or do they seem self-contained and isolated?
Political Activity	Are there signs or other indications of political activity? Is it clear that political activity is allowed and/or encouraged? Are there protests or demonstrations?
Community Organizations	What evidence is there of organizations in the community? Are there service clubs – Lions, Elks, Masons, etc.? Are there other organizations – centered around community issues, the environment, sports or leisure pursuits, socialization, etc.?
Media	Are there local media outlets – radio and TV stations, newspapers, Internet sites devoted to local issues? Are they independent, or are they sponsored or run by government or corporations? Where are their facilities?
Differences Among Neighborhoods Or Areas Of The Community	What are the differences among different parts of the community? Are schools, stores, public and other buildings, streets, etc. in different areas in different condition? Do some areas seem neglected, while others are clearly maintained?
Over-All Impression of the Community	The “feel” of the community. What is your overall impression of the community?

Appendix B

Gordon’s Functional Health Patterns

Marjorie Gordon (1987) proposed functional health patterns as a guide for establishing a comprehensive nursing data base. These 11 categories make possible a systematic and standardized approach to data collection, and enable the nurse to determine the following aspects of health and human function:

Health Perception and Health Management. Data collection is focused on the person’s perceived level of health and well-being, and on practices for maintaining health. Habits that may be detrimental to health are also evaluated, including smoking and alcohol or drug use. Actual or potential problems related to safety and health management may be identified as well as needs for modifications in the home or needs for continued care in the home.

Nutrition and Metabolism Assessment is focused on the pattern of food and fluid consumption relative to metabolic need. The adequacy of local nutrient supplies is evaluated. Actual or potential problems related to fluid balance, tissue integrity, and host defenses may be identified as well as problems with the gastrointestinal system.

Elimination. Data collection is focused on excretory patterns (bowel, bladder, skin). Excretory problems such as incontinence, constipation, diarrhea, and urinary retention may be identified.

Activity and Exercise. Assessment is focused on the activities of daily living requiring energy expenditure, including self-care activities, exercise, and leisure activities. The status of major body systems involved with activity and exercise is evaluated, including the respiratory, cardiovascular, and musculoskeletal systems.

Cognition and Perception. Assessment is focused on the ability to comprehend and use information and on the sensory functions. Data pertaining to neurologic functions are collected to aid this process. Sensory experiences such as pain and altered sensory input may be identified and further evaluated.

Sleep and Rest. Assessment is focused on the person’s sleep, rest, and relaxation practices. Dysfunctional sleep patterns, fatigue, and responses to sleep deprivation may be identified.

Self-Perception and Self-Concept. Assessment is focused on the person’s attitudes toward self, including identity, body image, and sense of self-worth. The person’s level of self-esteem and response to threats to his or her self-concept may be identified.

Roles and Relationships. Assessment is focused on the person’s roles in the world and relationships with others. Satisfaction with roles, role strain, or dysfunctional relationships may be further evaluated.

Sexuality and Reproduction. Assessment is focused on the person’s satisfaction or dissatisfaction with sexuality patterns and reproductive functions. Concerns with sexuality may he identified.

Coping and Stress Tolerance. Assessment is focused on the person’s perception of stress and on his or her coping strategies Support systems are evaluated, and symptoms of stress are noted. The effectiveness of a person’s coping strategies in terms of stress tolerance may be further evaluated.

Values and Belief. Assessment is focused on the person’s values and beliefs (including spiritual beliefs), or on the goals that guide his or her choices or decisions.

Reference:

Koshar, J. (n.d.). Retrieved on September 29, 2014 from http://www.sonoma.edu/users/k/koshar/n340/N345_Gordon_FHP.html

Appendix C

NSG 4075 Scholarly Capstone Paper Rubric

Week Due	TOPIC to be ADDRESSED and COVERED	PotentialPoints	EARNEDPoints
Week 210/12/15	Introduction & Problem Statement
DATE DUE	 Rationale of relevancy regarding chosen issue/topic	3
4/17/16	 Concerns clearly stated regarding chosen issue/topic	3
	 Description of how this particular topic impacts Nursing and Healthcare	3
	 Includes literature review references and/or current events articles to support your perspective	3
Week 3	Trends & Statistics
DATE DUE	 Identify trends	3
4/24/16	 Etiology	3
	 Prevalence & incidence	3
	 Related statistics from CDC (www.cdc.gov) website (or other relevant –related data base	3
	Related Sources
DATE DUE	 Provide at least one peer‐reviewed nursing article	2
4/24/16	 Provide at least two current events articles/internet/use of media	2
Week 4	The Client: Objective & Subjective Assessment
DATE DUE	 Case Study	3
5/1/16	 Aggregates’ demographics	3
	 Assessment Data: Case Study	3
Week 5	Additional Assessment Data
DATE DUE	 Windshield Survey	6
5/816	 Concept Map	6
Week 6	Genogram: One Individual in Aggregate
DATE DUE	· Include both sides of family	5
5/15/16	· Include children as applicable
Week 7	Plan of Project
DATE DUE	 Stakeholder’s identified	3
5/22/16	 Financial and political implications	3
	Feasibility of the project
DATE DUE	 Provision of alternate plan and interventions	3
5/22/16	 Role of change agent	3
Week 8	Implementation of Project
DATE DUE5/29/16	· Written report of how you have (and perhaps are still) implementing your project and you progress so far	25
Week 9	Summation
DATE DUE6/5/16	 EvaluationDid the project intervention address the original identified problem?	2
	 Implications to Nursing Practice LocallyProvides at least three nursing implications that would affect nursing in the localcommunity of practice	2
	 Implications to Nursing Practice Global HealthProvides at least three nursing implications that would affect nursing practice interms of global health	2
	 Summary, Recommendations and ConclusionSynthesize all information and clearly present in APA style	3
Week 10	Completed Scholarly Capstone Project (30 % of course grade)	100 points
DATE DUE	REMEMBER – 10% per day will be deducted from each week’s total points earned
6/12/16	FINAL GRADE

Appendix D

Writing the your Research Project and Scholarly Paper from Start to Finish

Capstone Community Aggregate Paper

Name

NSG 4075 Holistic Professional Nursing

Professor

university

Capstone Community Aggregate

The purpose of this paper is to discuss the creation and implementation of a health promotion project by synthesizing all information collected throughout the RN to BSN completion program. Complex issues are involved with implementing effective health programs. These issues arise from the unique barriers that exist in culturally-stricken communities as well as from the inherent complexity of the health care field.

Introduction & Problem Statement

In order to catalyze behavioral changes at a societal scale, health education programs must address the cultural and social dimensions of health care. This means that healthcare necessities will not be used unless accompanied by effective and culturally appropriate education. When working in a different cultural and social context, it is necessary to engage with a community “from within” in order to build an environment of trust. Culturally appropriate education efforts are tailored and framed from the perspective of the target community. Thus, to develop a culturally relevant education program, one must engage strategically with local culture to look at the way in which culture influences lifestyle and behavior.

Trends and Statistics

Hillsborough County has a diverse population in terms of race and ethnicity, age, and

income. Chronic diseases continue to be a concern in terms of their incidence, prevalence, and

the impact they have on the quality of life of individuals, families, and communities. Various

health conditions continue to disproportionately impact minority populations. According to

current data from the Florida Community Health Assessment Resource Tool Set (CHARTS), of

residents who reported being of one race, about 78% were White and about 17% were Black or

African American. Collectively, Asian, Native American Indian, Native Alaskan, Native

Hawaiian, and Pacific Islander accounted for 3.7% of the population. About 23.4% of the

population also reported being of Hispanic or Latino origin. Approximately 14.5% of people

residing in Hillsborough County in 2015-2016 were foreign born; 85.5% were native, including

39.0% who were born in Florida. Among those, 24.2% spoke a language other than English in

the home.

Related Sources

Implementing a healthcare education initiative without an adequate understanding of the local culture can be counter-productive, giving rise to more problems than solutions. For example, when working in a new cultural environment, health workers cannot assume that other cultures readily share, or are ready to submit to, their philosophies and belief systems. Diversity: is a word that means something different to each and every person. The changing demographics and economics of our growing multicultural world and the long-standing disparities in the health status of people from culturally diverse backgrounds have challenged health care providers and organizations to consider cultural diversity as a priority. Peer reviewed and research articles have demonstrated that there is a direct relationship between culture and health practices. In fact, of the many factors that are known to determine health beliefs and behaviors, culture is the most influential (Hardwood, 1981).

The Client: Objective & Subjective Assessment

Mr. J.P is a 75 years old, male client, diagnosed with Dementia, Diabetes Mellitus and

Obesity. J.P resides in a small ALF in Town and Country area. Client’s general health: Patient

diagnosed with HTN.DMII and Dementia. Cigarette smoker for 15 years and does not like to

exercise or been in a diet, complaining of feeling tired, fatigued and mild headache. Blood

pressure: 160/90.

Case Study

The following Functional Health Pattern assessment is based on a 75 year old Spanish man who lives in an ALF at Town and Country Community. Some of the issues found during this assessment were the lack of knowledge, cultural barriers and the resistant to change his behaviors. For subjective and objective data please see above. The purpose of this case study is to present a model that will be helpful in providing culturally competent care.

Aggregates’ Demographics

The physical boundaries include Memorial Hwy and clear boundaries that indicates where the community ends and begins. The economic boundaries in this community are very distinct. The rural areas contain a mix of both high-low income housing. The age of the housing range from 1965-1990. The urban area has several new retail centers that keep themselves busy and well maintained. Very few people have been seen walking around or on the street. The majority of the community is Hispanics and a small American influence is noted too. Most of the religious establishments are Catholics but the community shows homogeneity in religious preferences. The primary method of transportation is the car, with a very few sidewalks so walking is not a viable mean. Few political campaign posters were posted on houses or in store windows. Party affiliations were not readily apparent.

Gordon’s 11 Functional Health Pattern

J.P is aware of the need to maintain his health and undertakes preventative measures in order to have a fair health record. The diagnosed hypertension he experiences is appropriately monitored, but he is not compliant with his medication, diet and activity as reflected by his assessment.

Health Perception and Health Management

J.P perceives his health to be reasonably fair, not 100%, but fairly well for his age. Although J.P takes medication for the management of Hypertension (High Blood Pressure), he complaints of blurred vision and headaches frequently. When not controlled, Hypertension puts strain on the heart, damages blood vessels in the kidneys and damages the retina, resulting in a loss of vision (Herlihy 2007, p.331).

Nutrition and Metabolism

During a 24 hour period J.P usually consumes three main meals and rarely has snacks during the day. He believes his culture influences his eating pattern. He has no food allergies but does not modify his diet regularly based on his body image and weight fluctuations. Research suggests people who potentially suffer from a binge-eating disorder have a history of weight fluctuations and obesity (Edlin et al. 1997).

Activity and Exercise

He does not like to exercise. The risks of developing cardiovascular disease are greatly decreased by regular exercises such as walking and aerobic activity in addition to increasing the benefits of physiological and psychological wellbeing (Crisp and Taylor 2005, p.920).

Cognition and Perception

The average brain shrinks approximately 5-10% in weight between the ages of 20 and 90 resulting in a decrease in working memory, however, the brain can adapt and grow new cells, but this is dependent on physical activity, stimulation and learning (Santrock 2006). J.P is AOX2, disoriented to time and becoming more forgetful.

Self-Perception and Self-Concept

Of the most interest and focus, and highlighted throughout this assessment, was J.P’s image of himself. Although he states he is reasonably satisfied with his current status in life and what he has achieved for himself and his family, his perception of how he looks demonstrates issues around physical dissatisfaction, possible low self esteem and a lack of confidence in social situations. Erikson (1965) theories maintaining a positive self image and feelings of self worth is essential in order to achieve a successful transition to old age despite changing abilities and limitations.

Values and Belief

An individual’s sense of spirituality can be influenced by culture, life experiences and religious beliefs (Brush 2000). J.P is a practicing Catholic and spiritual person. His family and faith have always been the most important part of his life.

Windshield Survey

The leading cause of death for Hillsborough County residents is heart disease. While

the heart disease death rate has shown some improvement, it has remained the leading

cause of death for years, mimicking national data. The two major forms of cardiovascular

disease that make the greatest contribution to mortality are stroke and coronary heart

disease. In 2017, 2,756 average annual deaths from cardiovascular disease occurred in

Hillsborough County, with 1,517 people who died of coronary heart disease, and 421 who

died from stroke.

Concept Map

Genogram: One Individual in Aggregate

Plan of the Project

Taking this into account, nurses must initiate case finding activities and then provide appropriate patient education. For instance, once and older adult is identified as being at risk for heart disease, the nurse can teach the patient or caregiver to reduce the chance by exercising regularly, reviewing medications with their doctors and following a proper diet. The primary care practitioners in Town and Country include physicians, physicians’ assistants, and nurse practitioners.

Community Stakeholder’s Identified

PHYSICAL HEALTH: Free or sliding-scale medical facilities and other similar programs provide a clear benefit for low-income people and can improve community health.

SAFETY AND SECURITY: Neighborhood watch or patrol programs, better policing in high-crime neighborhoods, work safety initiatives – all of these and many other efforts can improve safety for specific populations or for the community as a whole.

MENTAL HEALTH: Community mental health centers and adult day care can be extremely important not only to people with mental health issues, but also to their families and to the community as a whole

Financial and Political Implications

Recently, much policy attention has been focused on the use of personal financial incentives to effect changes in health related behavior. Examples include schemes aimed at helping smokers to quit, people to eat healthily, and to adhere to their medication. On the other hand, incentive schemes all place individual choice and responsibility for personal behavior at the center of policy, and it is arguable that they are more respectful of autonomy than alternative, more frankly coercive or structure‐ rather than agency‐focused approaches to population health.

Feasibility of the Project

Hypertension is a highly prevalent risk factor for cardiovascular disease, and its early identification and management results in reductions in morbidity and mortality. My objectives were to: (1) determine the extent to which the emergency department (ED) has been used to screen patients for undiagnosed hypertension; (2) estimate the incidence of undiagnosed hypertension in the Town and Country population; (3) identify and describe the programs for hypertension screening; and (4) determine the feasibility of hypertension screening programs and the requirements for further study. An online search of databases (i.e., OVID Search, CINAHL, Scopus, Web of Science), unpublished sources (i.e., ProQuest Dissertation & Theses and Papers First), and a manual search of the reference lists of relevant studies was also completed. Hypertension screening in the ED is feasible. Individuals with elevated blood pressure (BP) in the ED should be referred for follow‐up. Further study is needed to develop a screening tool that is predictive of persistently elevated BP in undiagnosed individuals.

Provision of Alternate Plan and Interventions

Create coalitions and pursue health promotion education with community leaders to create health initiatives that teach chronic disease prevention strategies. The following elements should be included: Create education programs and materials for older adults to make necessary changes in diet. Teach patient to ask about medications that have been prescribed for him or her.

Refer patient and family to community resources that may offer assistance to the patient when

needed.

Role of Change Agent

Communication is at the center of all advocacies, getting the message out there, gaining the support of stakeholders and the public and putting pressure on decision makers will make the difference.

Implementation

Encourage patient to maintain a diary of food intake, including when and where eating takes place and the circumstances and feelings around which the food was eaten. Refer to dietitian as indicated.Instruct and assist in appropriate food selections, such as a diet rich in fruits, vegetables, and low-fat dairy foods referred to as the DASH Dietary Approaches to Stop Hypertension) diet and avoiding foods high in saturated fat (butter, cheese, eggs, ice cream, meat) and cholesterol (fatty meat, egg yolks, whole dairy products, shrimp, organ meats).

Evaluation of the Project

Health resource utilization was collected by self-report as the number of hospitalizations, emergency room (ER) visits, and physician office visits during the study period. Pharmacist recommendations were collected, categorized, and evaluated for physician acceptance. From the patient perspective, nurses provided tailored educational services and home BP monitoring equipment to engage them in their hypertension care. From the physician perspective, nurses provided information regarding medication use and home BP measurements and collaborative patient care occurred. Importantly, physicians were willing to work with nurses to improve patient care. Clearly, this strategy would not be effective if either the physician or nurse was not willing to collaborate.

Implications to Nursing Practice in the Local Community

A community health nurse can reach out to the president, council members, and

community leaders of Town and Country in an effort to reach out to the community via meetings, seminars, and school presentation, which will facilitate community education and bring about awareness about major community issues. The need for more accessible health insurance and screening clinics, as well as increased health education needs to be

implemented. Similarly, the importance of regular doctor’s visits and health screenings should

be emphasized through community health initiatives. The elderly may be in need of services

like home health aides, assisted living, or tele-health technology. Utilizing community

resources and health initiatives would enable the neighborhood to be educated as well as be

involved in disease management which will bring about positive changes.

Implications to Nursing Practice and Global Health

Global health work is complicated by a variety of factors. First, the local environment of each target community varies widely, each presenting unique challenges to the delivery of health care. This means that education efforts must be locally conceived, tailored, and implemented. Secondly, barriers to accessing care are widespread and require innovative strategies to overcome them. Third, the healthcare field is complex in nature, requiring trained professionals and follow-up care to ensure adherence to drug regimens. In order for global health programs to be effective, these complexities must be recognized, understood and addressed.

Summary, Recommendations and Conclusion

Continued improvement and increased participation in health initiatives, improved cleanliness, increased income, community safety, and continued access to healthcare are all long term elements that should continue to be addressed.

References

Campinha-Bacote, J., (January 31, 2003). “Many Faces: Addressing Diversity in Health Care”.

Online Journal of Issues in Nursing. Vol. 8 No. 1, Manuscript 2. Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContent

Volume82003/No1Jan2003/AddressingDiversityinHealthCare.aspx

The Provider’s Guide to Quality and Culture http://erc.msh.org/quality&culture

National Center for Cultural Competence (NCCC) www.georgetown.edu/research/gucdc/nccc/

Transcultural and Multicultural Health Links http://web.nmsu.edu/~ebosman/trannurs/index.shtml

Thomas, Stephen B., Michael J. Fine, and Said A. Ibrahim. “Health Disparities: The Importance of Culture and Health Communication.” Am J Public Health Dec 2004 Web.23 Jun 2009.

Edward O’Neil Jr., A Practical Guide to Global Health Service (American Medical Association, 2006), 24.

Running head: CAPSTONE COMMUNITY AGGREGATE PAPER 16

Running head: CAPSTONE COMMUNITY AGGREGATE PAPER 21

N:\3. RN-BSN Completion Program\RN to BSN Curriculum\RN to BSN WPB\NSG4075\2015_4 – Fall\Items to Upload to eCompanion\4-TEMPLATE.Capstone Project Paper.docx

Appendices

Appendix A

Housing	The age of the housing range from 1965-1990. The urban area has several new retail centers that keep themselves busy and well maintained. Very few people have been seen walking around or on the street. The majority of the community is Hispanics and a small American influence is noted too.
Public Spaces	Pollo Tropical. KFC. Taco Bell. Joe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary schooJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venuesJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venuesJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venuesJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venuesJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venuesJoe¶s Sports Bar and Grill appeared crowed. Itwas located in Afton Park and is a place for sports fans to come together on the weekend or after work. It was advertising the NCAA basketball tournament. There were severalshopping plazas, with Concord Mills being themost popular. Many people (especiallyteenagers) walk around the mall as a way tosocialize. Children were observed playing onthe playground at the elementary school.The common areas, particularly located near Lowe¶s Motor Speedway and Concord MillsMall, appeared welcoming and open to the public. It was inferred that this is related to thedraw of people from all over the region, stateand country to these venues
Parks	Trail
Culture and Entertainment	AMC theater. Town and Country library
Street Use	Very few people walking on the street.
Commercial Activity	A mix of large and small businesses: grocery stores and supermarkets, pharmacies, and other stores that provide necessities in all parts of the community
Signs	There are signs directing people to various parts of the community (downtown, museums, highways, etc.) in English and Spanish.
Industry	Water plant.
Land Use	Major roads or railroad tracks divide neighborhoods, but spaces are well distributed.
Infrastructure	The community seems to be equally served by electricity, water, phone, fiber optic, wastewater treatment, waste disposal, and other infrastructure services.
Public Transportation	The primary method of transportation is the car, with a very few sidewalks so walking is not a viable mean.
Traffic	Private cars mostly
Environmental Quality	The air does not smell of smoke, garbage, car exhaust, chemicals, industrial waste, etc… and the water in streams, ponds and lakes seem reasonably clear.
Race/Ethnicity.	The majority of the community is Hispanics and a small American influence is noted too.
Faith Communities	Most of the religious establishments are Catholics but the community shows homogeneity in religious preferences.
Health Services	There are two main hospitals and several clinics in the community with easy accessibility.
Community And Public Services	There are identifiable community service providers and organizations such as mental health centers, food banks, homeless shelters, welfare offices, etc…easily to reach by public transportation.
Community Safety	Police and fire stations are located within the community, in good repair and the community in general is well-lit at night.
Public Schools	Schools are in different neighborhoods in noticeably different states of repair.
Higher Education	There are two- and four-year colleges and/or universities in the community located near to Dale Mabry. They seem open to the community.
Political Activity	Few political campaign posters were posted on houses or in store windows.
Community Organizations	Evidence is there of organizations in the community such as Masons.
Media	No local media outlets found.
Differences Among Neighborhoods Or Areas Of The Community	There are some differences among different parts of the community: stores, public and other buildings, streets, etc…in which the areas seem neglected, while others are clearly maintained.
Over-All Impression of the Community	My overall impression of the community is good and safe.

Appendix B

Gordon’s Functional Health Patterns

Client’s general health: Patient diagnosed with HTN.DMII and Dementia.

Any colds in the past year? Pneumonia

Most important things you do to keep healthy? None

Use of cigarettes, alcohol, drugs? Cigarette smoker for 15 years

Perform self-exams, i.e. testicular self-examination? No

Accidents at home, work, school, driving? None

In past, has it been easy to find ways to carry out doctor’s or nurse’s suggestions? (If

appropriate) – No

What do you think caused current illness? I do not like to exercise or been in a diet.

What actions have you taken since symptoms started? None

What things are most important to your health? No answer

Typical daily food intake? Rice, beans, pork, pasta, bread, buttermilk, juice

Typical daily fluid intake? 4 glasses (8oz) of water.

Appetite? Good

Food or eating: Discomfort, swallowing difficulties, diet restrictions, able to follow? Low

Sodium

Healing problems – None

Examination (examples of objective data):

Weight loss/gain? Weight gain (20lbs)

Height loss/gain? 5’6’’

Skin problems: Dryness

Dental problems? Dentures

Temp. 97.9F

Abdominal assessment.

Soft and non-tender. LBM 04/18/18. Protuberant. Problems with constipation.

Urine: yellow, clear. Denies any urgency, frequency or retention.

This pattern centers on activity level, exercise program, and leisure activities.

History (subjective data):

Sufficient energy for desired and/or required activities? I do not have energy to do anything

Exercise pattern? Type? regularity? None

Spare time (leisure) activities? I like to sleep most of the day

Perceived ability for feeding, grooming, bathing, general mobility, toileting, and home

maintenance, bed mobility, dressing and shopping? Minimal Assistance needed

Examination (examples of objective data):

Gait: Unsteady

Posture: Normal

Range of motion (ROM) joints: Good

Hand grip – Strong and equal

Respiration: 20

Blood pressure: 160/90

General appearance: Well groomed

Cardiac assessment: No murmurs. Regular heartbeat.

Respiratory assessment: LCTA

Assesses sleep and rest patterns.

History (subjective data):

Generally rested and ready for activity after sleep? Somnolence

Sleep onset problems? None

Sleep routine? 7 hours

Sleep apnea symptoms? None

Assesses the ability of the individual to understand and follow directions, retain

information, make decisions, and solve problems. Also assesses the five senses.

History (subjective data):

Hearing difficulty? Impaired

Hearing aid? None

Vision? Normal

Wears glasses? Yes

Last checked? I do not remember

Any change in memory? Disoriented to time. Confused. Forgetful.

Concentration? Easily distracted

Important decisions easy/difficult to make? Difficult to make

Easiest way for you to learn things? Visual

Pain? Arthritis

Examination (examples of objective data):

Language spoken: Spanish

Vocabulary level: 12 Grade

Attention span: Fair. Long term

How do you describe yourself? Most of the time, I feel good

Anxious? : Sometimes

Depressed? No

Eye contact: Yes

Voice and speech pattern: Calm and fluently

Body posture: Relaxed

Genogram

Mr. J.P resides in small ALF with 5 other residents. He is widowed, no children and family

history of cardiac problems.

Community Health Promotion Plan to prevent Heart Disease

Name

Problem & Significance

Community & Participant

Assessment of the Community & of the Participant

The Health Promotion Plan

Implementation of the Plan

Results

Evaluation

Implications for Nursing Practice

WHY?

Significance

The leading cause of death for Hillsborough County residents is heart disease. While the heart disease death rate has shown some improvement, it has remained the leading cause of death for years, mimicking national data. The two major forms of cardiovascular disease that make the greatest contribution to mortality are stroke and coronary heart disease. In 2017, 2,756 average annual deaths from cardiovascular disease occurred in Hillsborough County, with 1,517 people who died of coronary heart disease, and 421 who died from stroke.

The Problem

High incidence of Cardiac Diseases

Concept Map

Contribute to

Education

Lack of access to healthcare

Contribute to

Obesity

Frequent emergency hospitalizations

Forced absenteeism

Cultural lifestyle

CAD, stroke, CKD,

Result in DEATH

Elevated BP

Diabetes Mellitus

High Cholesterol

Physical inactivity

Stress

Financial problems

Windshield Survey of the community

Characteristics of the Community that are relevant to the problem

Health disparities are differences in the prevalence, incidence, mortality, burden of disease, and other adverse health conditions that exist among specific population groups. These differences exist due to underlying causes which include:

Health Disparities

• Socio-economic factors, such as income, education, poverty

• Occupational conditions, such as underemployment

• Individual health behaviors, such as high-risk behavior

• Living conditions, such as inadequate transportation and housing

• Discriminatory treatment based on gender, sexual orientation, race, disability, etc.

• Differential use of health services based on patient preferences, health insurance status,

provider bias, or the limited availability of providers

In 2017, an estimated 15.2% of the population in the county reported income in the past 12 months below the poverty level (Office of Economic and Demographic Research).

The prevalence of several acute and/or chronic health conditions in the county can also give a picture of the health status of the population. The findings from the 2017 BRFSS survey indicate that 71% of resident adults had no regular vigorous activity, 74% consumed less than 5 servings of fruits and vegetables each day, 39% were overweight, and 25% were obese.

Despite the number of health care resources in the county, 28% of adults surveyed in 2017 had no personal health care provider, which is higher than the state (23%). Hispanic women (22%) were the most likely to report the inability to access medical care when compared to White and Black women (15% and 19%).

The Participant

Demographics of the Primer Case

Hillsborough County is located midway along the west coast of Florida in the Tampa – St. Petersburg metropolitan area. One of 67 counties in Florida, with its 1,050.9 square miles in land area and a population density of 1,047.9 per square mile, Hillsborough County is the fourth largest county in the state. The population in Hillsborough County is projected to reach 1,537,290 by the year 2025.

Genogram

Characteristics of the Participant that are relevant to the problem

Subjective Assessment

Headache

Blurred vision

Tired

Objective Assessment

Vitals taken as follows:

-Temperature: 37.2°C

-Pulse rate: 83beats/minutes

-Respiration rate: 18breaths/minutes

-Blood pressure: 180/100mmHg

Gordon’s Health Patterns Assessment

Pattern	Assessment of Participant
Health Perception-Health Mgmt	He perceives his health to be reasonably fair, not 100%, but fairly good for his age. Although he takes medication for the management of Hypertension (High Blood Pressure), diagnosed in 2009, he feels that it is well controlled and does not impact on his ability to perform his ADL’s.
Nutritional-Metabolic	During a 24 hour period he usually consumes three main meals and rarely has snacks. He has no food allergies but does modify his diet regularly based on his body image and weight fluctuations.
Elimination	His voiding pattern is approximately once per day dependent on his daily schedule and his fluid intake.
Activity-Exercise	He does not exercise.
Sleep-Rest	He enjoys sleeping and will generally achieve 8-9 hours per night.
Cognitive-Perceptual	He likes to read which he feels supports his cognitive functions. The most significant change has been his vision as he has aged.
Self-Perception –Self-Concept	He clearly states he doesn’t feel old at 65 years however he believes his weight issues affect his ability to feel confident. He does not perceive himself as being old but tired.
Roles-Relationships	He is a father and grandfather. He views his primary roles at this stage of his life as being a grandfather. He does not belong to any social groups.
Sexuality-Reproductive	His sexual desires fluctuate over the years with highs and lows.
Coping-Stress Tolerance	His wife and daughters were his primary means of support during this time although he did consider accessing professional counseling. He drinks alcohol to relieve stress .
Values-Beliefs	His family and faith have always been the most important part of his life.

The Plan

Concrete steps	Who will be involved	Criteria for success
Assess risk or presence of conditions associated with obesity	PATIENT AND DAUGHTERS	Obesity is an added risk with high blood pressure because of the disproportion between fixed aortic capacity and increased cardiac output associated with increased body mass.

Assess patient and daughters understanding of direct relationship between hypertension and obesity.		Reduction in weight may obviate the need for drug therapy or decrease the amount of medication needed for control of BP. Faulty eating habits contribute to atherosclerosis and obesity, which predispose to hypertension and subsequent complications (stroke, kidney disease, heart failure).

Discuss necessity for decreased caloric intake and limited intake of fats, salt, and sugar as indicated		Excessive salt intake expands the intravascular fluid volume and may damage kidneys, which can further aggravate hypertension.

Establish a realistic weight reduction plan with the patient such as 1lb weight loss per wk.		Reducing caloric intake by 500 calories daily theoretically yields a weight loss of 1 lb per wk. Slow reduction in weight is therefore indicative of fat loss with muscle sparing and generally reflects a change in eating habits.

The Implementation

Encourage patient to maintain a diary of food intake, including when and where eating takes place and the circumstances and feelings around which the food was eaten.

Refer to dietitian as indicated.

Instruct and assist in appropriate food selections, such as a diet rich in fruits, vegetables, and low-fat dairy foods referred to as the DASH Dietary Approaches to Stop Hypertension) diet and avoiding foods high in saturated fat (butter, cheese, eggs, ice cream, meat) and cholesterol (fatty meat, egg yolks, whole dairy products, shrimp, organ meats).

Evaluating the Results

After 3 hours the patient and daughters will be able to verbalize understanding of the instructions given.

After 1 week of interventions, the client’s blood pressure will be within normal limits.

After 1 month of interventions, the client will loose 3lbs to start maintaining a healthy weight.

Evaluating the Results

Cost/Benefit & Sustainability Analysis

The Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries with two or more chronic conditions accounted for 93 percent of Medicare spending in 2017, or about $276 billion.

Among hypertensive and people with elevated cholesterol, the uninsured more often had uncontrolled conditions.

Financial Implications

Direct health care spending to treat hypertension totaled $42.9 billion in 2017, with almost half ($20.4 billion) in the form of prescription drugs.

The mean expenditure per person for the treatment of hypertension was higher for Hispanics and non-Hispanic blacks ($981 and $887, respectively), than for non-Hispanic whites ($679) and non-Hispanic others ($661).

Implications for Nursing Caring

Community Nursing

Goal: Reduce prevalence of obesity in Hillsborough County

Objective: Create and implement a social marketing campaign that increases self awareness of negative consequences of being overweight/obese among a selected population of Hillsborough County residents by December 2018.

Global Nursing

References

Edward O’Neil Jr., A Practical Guide to Global Health Service (American Medical Association, 2006), 24.

Florida Vital Statistics: http :// www.flpublichealth.com/VSBOOK/VSBOOK.aspx

Hillsborough.floridahealth.gov | Website Review for hillsborough.floridahealth.gov. (n.d.). Retrieved from https:// www.woorank.com/en/www/hillsborough.floridahealth.gov

Running head: IMPLEMENTATION & EVALUATION OF HEALTH 1

IMPLEMENTATION & EVALUATION OF HEALTH PROMOTION PAPER 5

Implementation & Evaluation of Health Promotion Plan

[Your Name]

NSG4075 Holistic Professional Nursing

Instructor’s name and credentials here

South University

Implementation & Evaluation of Health Promotion Plan

The purpose of this paper is to [Put the text of your paper here telling what you are going to write about in this paper and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Health Promotion Plan Background

Summarize the background of your health promotion plan here…. [Put the text of your paper here – Clearly describe why you chose this particular project, giving important background information and statistics related to the problem you have chosen to address and include REFERNECES AS APPROPRIATE. The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Evaluation of the Initial Plan

[Put the text of your paper here; Clearly describe how you planned to implement your plan – the steps you went through during your planning phase and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Action Plan Implemented

[Put the text of your paper here – Clearly describe what you did as your health promotion plan and the last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Evaluation of the Health Promotion Plan

Project’s Cost-Effectiveness

[Put the text of your paper here discussing the project’s cost-effectiveness (i.e., how much your project cost and was the money spent worthwhile – could you have accomplished the same effect for less money?) The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Project’s Practical Use and Sustainability

[Put the text of your paper here discussing why your plan is practical (or not) and how it could be sustained. The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Project’s Financial Implications

[Put the text of your paper here comparing the cost of continuing the project compared to the cost to the public of not having such a program available REFERNECE AS APPROPRIATE. The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Over-All Summary and Expectations

[Put the text of your paper here and present an overall summary of your project and your expectations regarding the future of your representative of the aggregate related to his/her overall health and response to this project (i.e., will the individual continue to successfully follow the plan you have initiated, and what will be the results, etc.). The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

Conclusion

[Put the text of your paper here Summarizing your entire project in two or three paragraphs – the good parts, the bad parts, etc., and it’s potential impact if it is continued. The last page of your paper is reserved for the references. Please see the South APA Guidelines and South APA Basics documents to ensure that your references are properly constructed].

References

Harwood, L., Ridley, J., Wilson, B., & Laschinger, H. (2010). Workplace empowerment and

burnout in Canadian nephrology nurses. CANNT Journal, 20(2), 12-17. Retrieved from CINAHL with Full Text database.

McCaffrey, R., Hayes, R., Stuart, W., Cassell, A., Farrell, C., Miller-Reyes, C., et al. (2010). A

program to improve communication and collaboration between nurses and medical residents. Journal of Continuing Education in Nursing, 41(4), 172-178. doi:10.3928/00220124-20100326-04.

Uyehara, J., Magnussen, L., Itano, J., & Zhang, S. (2007). Facilitating program and NCLEX-RN

success in a generic BSN program. Nursing Forum, 42(1), 31-38. Retrieved from CINAHL with Full Text database.

https://ecampus.phoenix.edu/secure/aapd/cwe/citation_generator/gen.asp

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Nursing Capstone. Week 13 Final Project

Nursing Capstone

13

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