NURS 419 Population-Focused Nursing

Point Value: 100 points

Purpose and Relationship to Course Objectives

The purpose of this assignment is to comprehensively study a disease or health concern across its lifespan, using the interventions model we are studying in class. As we have frequently discussed over the last several weeks, healthcare focuses primarily on responding to acute care issues, with much less emphasis focused on the prevention of the disease/health concern. Additionally, fragmented care, inadequate care coordination and discharge planning, short hospital stays and length of time spent with one’s primary care provider (PCP) have resulted in poor management outcomes and unnecessary re-admissions. This is made worse by not effectively addressing the social determinants of health and the resultant disparities experienced by the poor and vulnerable in our society.

Instructions & Guidelines:

1. Choose a disease or healthcare concern. It does not have to be a priority noted in your CHNA. You are free to choose any topic. Clear the topic with this instructor. I highly recommend you choose a topic identified in HP 2020 as it will be easiest to identify the gold standard(s) of care for the topic you have chosen.

2. Search and review all the available information regarding this disease/health concern.

3. Prepare a paper summarizing the following topics listed below (#4)

4. Content must include:

a. Introduction and identification of the healthcare concern (Also, why you chose this topic.)

b. Normal anatomy and physiology of the affected organ(s)

c. Pathophysiology/etiology of the disease

d. Incidence and prevalence rates (i.e. how many people have the disease)

e. Mortality rates – include age-adjusted data if available (i.e. how many people are dying from the disease)

f. Risk factors for the disease

g. Gold standard(s) for managing this disease across its lifespan (LHIs, or other goals – ex: A1c <7); HP2020 (or other credible sources)

h. Primary Interventions (Health Promotion/Disease Prevention)

i. Health Promotion

ii. Disease prevention (as applicable)

iii. Create a sample health education program – be specific – provide a content outline with goals, objectives and measurable outcomes (use template provided)

i. Secondary Interventions (Early diagnosis and prompt treatment to limit disability of the disease)

i. Risk Assessment & Screening (discuss known risk factors and who should be screened and when as a result), risk assessment, screening and invasive testing. Note: be specific…include values and implications – use evidenced based practice.

ii. Diagnosis (i.e. what criteria are used to diagnose this disease?)

iii. Treatment – be specific – how is disease/concern treated? Include diagnostic testing, pharmacotherapeutics, labwork, management protocols, etc.

j. Tertiary Interventions (Chronic disease management or “wrap-around care” program)

i. Discharge planning, follow-up, subspecialty referrals, meds, labs…..

ii. Patient education – Detail specifically what the educational needs are…

k. Conclusions – including what are the implications if we do not respond to this disease….both for the individual and the healthcare system

5. I highly recommend that you make an appointment with the NIU Writing Center for assistance in preparing this paper. I expect the paper to be in APA format and should be between 20-30 pages in length. Reasonably sized tables and diagrams may be used – but must be cited. Appointments can be scheduled by contacting the Writing Center at https://niu.mywonline.com

Overall Evaluation Rubric:

Total possible: 100 points (See sample outline for additional breakdown)

Points may be subtracted for grammar, syntax, neatness, format and professionalism. All assignments must be typed and APA format. Any tables and graphs must be cited.

NURS 419 Chronic Disease Synthesis Paper

Sample Outline, Format, and Grading Rubric

Title

Identify the name of the disease you have chosen to study. Ex: Diabetes

Introduction (5 points)

Provide a brief introduction of your topic and include a discussion of why you chose it. You may use first person in this section.

Anatomy and Physiology of the Affected Organ(s) (5)

Discuss the normal structure and function of the organ(s) related to the disease you have chosen. For example, discuss the normal structure and function of the pancreas. You can include reasonably-sized detail, diagrams, etc.

Pathophysiology / Etiology of the Disease (5)

Discuss what “malfunctions” during the normal function of the organ (pathophysiology). Then discuss what happens as a result of the organ malfunction and explain how this causes the disease (etiology).

Incidence and Prevalence of the Disease (5)

Discuss overall how many cases of the disease are there in the US today (Prevalence). Also discuss how many new cases are occurring annually (Incidence). Based on the I&P, reflect on the magnitude/severity of the problem and its economic burden on society and the health of our nation.

Mortality Rates (5)

This section is somewhat similar to the above section, but I want you to reflect on how many people are dying/will die of this disease annually. Include a discussion – if appropriate – related to the comorbidities of this disease. (For example, people don’t usually die of diabetes – they may die of heart disease that has occurred as a result of being a poorly controlled diabetic. Provide any age-adjusted death rate data if available.

Risk Factors (5)

Identify and discuss the risk factors for this disease. Who is at risk? What are the risk factors? Which risk factors are modifiable vs. non-modifiable? How does one change or modify the “modifiable” risk factors?

Gold Standard(s) of Care for the Disease (5)

Discuss the standard of care for each facet of the disease. For example, in diabetes, visit the HP2020 website and research under the “Objectives” tab. You will find 16+ gold standards of care. In addition, for each gold standard, HP2020 includes baseline data r/t where we are with managing the standard today (baseline) and where we would like to see clinical improvement within the next 10 years (Target). If you have selected a topic not included in HP2020 and need assistance, please feel free to contact me. Remember, there are gold standards for prevention, treatment and follow-up of any given disease.

Gold Standards for Primary Intervention

Include standards of care for health promotion and disease prevention of your chosen topic. Include baseline data and targets as discussed above. Note: you will identify the standards in this section, but discuss them in detail under the Primary Intervention Section below.

Gold Standards for Secondary Intervention

Include standards of care for risk assessment/screening, diagnosis, treatment and pharmacologic management of your chosen topic. Include baseline data and targets as discussed above. Note: you will identify the standards in this section, but discuss them in detail under the Secondary Intervention Section below.

Gold Standards for Tertiary Intervention

Include standards of care for chronic disease management of your chosen topic. Include baseline data and targets as discussed above. Note: you will identify the standards in this section, but discuss them in detail under the Tertiary Intervention Section below.

Primary Intervention

Health Promotion (5)

Provide a discussion related to the topics that would need to be considered when educating a client on how to stay healthy, avoid developing risk factors, how to recognize when to seek care. Don’t forget to educate clients regarding the normal function of the affected organ and what happens when it malfunctions.

Disease Prevention (5)

Discuss strategies for the prevention of this disease. Identify what factors can be changed or modified to present individuals from developing the disease.

Sample Health Education Program (10)

Create a 1-hour education session using the format from CTE #7. Include any risk factors, health promotion, disease prevention activities, treatment and/or long term management topics that are pertinent. Present the outline below:

Program Title: (2)

Keep it simple and short.

Brief Description of the Program: (2)

No more than 1-2 sentences.

Goal: (2)

No more than 1-2 sentences.

Objectives: (2)

Develop 3-4 objectives. Don’t forget to include the “how” and “what” information in each

objective. Hint: refer to the lecture on primary intervention if you are unsure.

Measurable Outcomes: (2)

Develop 1 measurable outcome for each of the above objectives.

Discuss the Role of the Nurse in the Provision of Primary Intervention (5)

Discuss the role of the nurse as provider, designer/manager/coordinator of care in the primary preventive care of individuals, families and communities. Address any legal, ethical or professional issues that the nurse might encounter when rendering preventive care.

Secondary Intervention

Risk Assessment & Screening (5)

Discuss how are individuals screened for the disease – including those with and without risk factors. Provide an example of a paper or electronic screening/survey. Discuss its reliability and what is typically done with the results/findings. Then discuss any invasive screening/testing that is done. What are the lab values that indicate positive findings? Be sure your examples are evidence-based.

Diagnosis (5)

Discuss in detail what criteria are used to confirm diagnosis of the disease? Lab values – include both normal and abnormal values? Testing? Findings on physical examination…

Treatment (5)

Discuss at length treatment/management of the disease. What criteria are used to indicate that the disease has been stabilized? Discuss and describe in detail diagnostic testing/or labs are monitored as evidence of stabilization – include normal/abnormal values. What other treatment modalities are incorporated – nutrition, physical therapy, social services.

Pharmacologic Management (5)

Discuss pharmacotherapeutic management. Identify at least 3 medications used to treat the disease. Identify name; discuss typical dosage, frequency, expected action, potential side effects (mild and severe) and how to manage severe side effects. Identify any known contraindications to the medication.

Discuss the Role of the Nurse in the Provision of Secondary Intervention (5)

Discuss the role of the nurse as provider, designer/manager/coordinator of care in the secondary preventive care of individuals, families and communities. Address any legal, ethical or professional issues that the nurse might encounter when rendering secondary care.

Tertiary Intervention

Long Term Chronic Disease Management (5)

Discuss discharge planning and long term management/care of the patient with this disease. What types of referrals, follow-ups are needed. Discuss education that needs to be completed/reinforced to support the client’s ability to function independently or with assistance. Identify routine labwork that will need to be done. Discuss typical medications at discharge – what needs to be taught to the client regarding the self-administration of these meds?

The Role of the Nurse in Chronic Disease Management (5)

Discuss the roles of the nurse – as they relate to tertiary intervention – in supporting treatment/management of the disease in the outpatient and home setting. How does the nurse support/facilitate a return to an optimum state of wellness? Discuss any necessary home care, referrals, follow-up or changes that need to be made in the client’s living arrangement to ensure safety. Note: you do not need to include a patient education – content outline.

Be sure to discuss the role of the nurse as provider, designer/manager/coordinator of care in the tertiary care of individuals, families and communities. Address any legal, ethical or professional issues that the nurse might encounter when rendering tertiary care.

Conclusion (5)

Discuss what you learned from preparing this paper. As a health care system – what things are we doing well to manage this disease? As a health care system – what things are we not doing well and how does it negatively impact the care and well-being of clients with this disease. Are we cost-effectively managing this disease? What are the opportunities for improvement? What will be the consequences if we do not capture the opportunities for improvement? You may use first person in this section.

Revised 8/24/2021