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In your professional life you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment.

Being adept at research will help you find the information you need. For this assessment, you will select and research a current health care problem or issue faced by a health care organization.

NHS-FPX4000 Assessment 2 Capella Demonstration of Proficiency

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

1. View the Assessment Topic Areas| Transcript media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

• 1. • Describe the health care problem or issue.
     • Describe your interest in the topic.
     • Describe any professional experience you have with this topic.

2. Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used.

• 1. • You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search.
     • Use keywords related to the health care problem or issue you are researching to select relevant articles.

3. Assess the credibility of the information sources you find.

• 1. • Determine if the source is from an academic peer-reviewed journal.
     • Determine if the publication is current.
     • Determine if information in the academic peer-reviewed journal article is still relevant.

4. Select four current scholarly or academic peer-reviewed journal articles published during the past three to five years that relate to your topic.
5. Explain the relevance of the information sources.

• 1. • Describe how the health care problem or issue is addressed in each source.
     • Discuss what kind of contribution each source provides on your selected topic.

6. Analyze the scholarly literature or academic peer-reviewed journal articles using the annotated bibliography organizational format.

• 1. • The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic.
     • List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
     • Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
     • Follow the reference with the annotation.

7. In your annotation:

• 1. • Identify the purpose of the article.
     • Summarize the source:

• 1. 1. • What are the main arguments?
        • What topics are covered?
     2. Include the conclusions and findings of the article.
     3. Write your annotation in a paragraph form. The annotation should be approximately 150 words (1 to 3 paragraphs) in length.

8. In a separate paragraph or two at the end of the paper, summarize what you learned from your research.

• 1. 1. List the main points you learned from your research.
     2. Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• • Assessment 2 Example [PDF].

NHS-FPX4000 Assessment 2 Capella Additional Requirements

• 1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
  2. Font and font size: Times New Roman, 12 point.
  3. APA Template: Use the APA template linked in the resources. Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOCX] for guidance.
  4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  5. Content: Provide a title page and reference page following APA style.
  6. References: Use at least four scholarly or academic peer-reviewed journal articles.
  7. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
  8. NHS-FPX4000 Assessment 2 Capella

Note: Review the Applying Research Skills Scoring Guide for the grading criteria applied to this assessment.

NHS-FPX4000 Assessment 2 Topic Areas

Selecting a topic for your written assessments can be challenging, but it’s important to make a thoughtful choice.

Choose a topic area of interest to you from the topic suggestions in this media piece. You will use this topic to complete Assessments 2 and 3. Be sure to select a topic that will be manageable for a written assessment.

To explore the chosen topic, you should use the Socratic Problem-Solving Approach, focusing on the sections specifically called out in the assessment guidelines.

NHS-FPX4000 Topic 1: Limited Access to Healthcare

Short Description:

Consumers face barriers to healthcare access for assorted reasons. For example: due to geographic location, provider availability, transportation issues and mobility.

Potential Intervention Approaches:

• Healthcare information online
• Telemedicine
• In–home healthcare services

Keywords for Articles:

online health information seeking, health care access, health information systems, consumer health information, chronic disease, health information search, health seeking behavior, rural nursing

references:

Bhandari, N. (2014). Seeking health information online: does limited healthcare access matter? Journal of the American Medical Informatics Association: JAMIA (1067-5027), 21 (6), p. 1113. https://www-ncbi-nlm-nih-gov.library.capella.edu/pmc/articles/PMC4215038/

Lee, K., Hoti, K., Hughes, J. D., & Emmerton, L. (2014). Dr Google and the Consumer: A Qualitative Study Exploring the Navigational Needs and Online Health Information-Seeking Behaviors of Consumers with Chronic Health Conditions. Journal of Medical Internet Research, 16(12), e262. http://doi.org.library.capella.edu/10.2196/jmir.3706

Ware, P., Bartlett, S. J., Paré, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., … Ahmed, S. (2017). Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interactive Journal of Medical Research, 6(1), e3. http://doi.org.library.capella.edu/10.2196/ijmr.4447

Pratt, D. (2015). Telehealth and telemedicine. Albany Law Journal of Science & Technology. (1059-4280), 25 (3), p. 495. http://www.lexisnexis.com.library.capella.edu/hottopics/lnacademic/?shr=t&csi=148364&sr=TITLE(%22Telehealth+telemedicine+in+2015%22)+and+date+is+2015

Topic 2: Healthcare Disparities

Short Description:

In 2010, the Federal Department of Human and Health Service (DHHS) launched the Healthy People 2020 goals to include a goal to eliminate health inequality/disparity.

Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity;

geographic location; or other characteristics historically linked to discrimination or exclusion” (Office of Disease Prevention and Health Promotion, 2017, p.1).

Potential Intervention Approaches:

• Federal goals
• Community health improvement plans
• Patient advocacy efforts
• “Triple Aim” for populations

Keywords for Articles:

health disparities, community health assessment, community health improvement plan, strategic planning, local health departments, health inequities

References:

Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/disparities

Shah G.H., & Sheahan J.P. (2016). Local health departments’ activities to address health disparities and inequities: Are we moving in the right direction? International Journal of Environmental Research and Public Health. 2016; 13(1):44. http://www.mdpi.com/1660-4601/13/1/44

Institute for Healthcare Improvement. (2017). Triple Aim for Populations. http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx

NHS-FPX4000 Assessment 2 Topic 3: Medication Errors

Short Description:

A medication error is a preventable adverse effect of a patient taking the wrong medication or dosage, whether or not it is evident or harmful to the patient. Medication errors can be a source of serious patient harm, including death.

Potential Intervention Approaches:

• Medical staff education
• Packaging improvements
• Patient medication safety training

Keywords for Articles:

medication administration, medication errors, medication safety

References:

Cohen, M. (2016). Medication errors (miscellaneous). Nursing. 46(2):72, February 2016. DOI: 10.1097/01.NURSE.0000476239.09094.06

Institute for Healthcare Improvement. (2017). Improve Core Processes for Administering Medications. http://www.ihi.org/resources/Pages/Changes/ImproveCoreProcessesforAdministeringMedications.aspx

Agency for Healthcare Research and Quality. (2012). Table 6: Categories of Medication Error Classification. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/match/matchtab6.html

Schmidt, K., Taylor, A., & Pearson, A. (2017). Reduction of medication errors: A unique approach. Journal of Nursing Care Quality. 32(2), April/June 2017, 150–156.

NHS-FPX4000 Assessment 2 Topic 4: Healthcare System Errors

Short Description: 

The health care system in the United States has been the subject of much debate as experts try to determine the best way to deliver high-quality care.

In Crossing the Quality Chasm, the Institute of Medicine (2001) called for the redesign of health care delivery systems and their external environments to promote care that is safe, effective, patient-centered, timely, efficient, and equitable.

Potential Intervention Approaches:

• Systemwide transformation
• Process redesign
• Electronic health records

Keywords for Articles:

multi-stakeholder collaboration, healthcare system redesign

References:

Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US).Agency for Healthcare Research and Quality.

(2017). Hospitals and Health Systems. http://www.ahrq.gov/professionals/systems/index.html

Roberts, B. (2017). Relationship-based care: The institute of medicine’s core competencies in action. Creative Nursing, 05/2016, 22(2).

Credits

1. Subject Matter Expert: Joan Vermillion
2. Interactive Design: Lori Olson
3. Media Instructional Design: Felicity Pearson
4. Instructional Design: Celina Byers
5. Project Manager: Alan Campbell

Resources: Research and Annotated Bibliographies

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Content

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• How do you approach a problem or issue within your organization? How often do you need credible information to solve a personal or professional problem? Credible information is information that is trustworthy.
• One of the best sources for credible information is the professional literature of the field you are studying; in your case, health care.
• Professional literature is research that has been written and reviewed by other people in your field.

The following resources can help you as you complete your research and seek out professional literature on a health care topic.

• • Gennaro, S. (2016). Why write? Journal of Nursing Scholarship, 48(2), 117.
  • National Institutes of Health, U.S. National Library of Medicine. (2017). Evidence-based practice and health technology assessment. Retrieved from https://www.nlm.nih.gov/hsrinfo/evidence_based_practice.html
  • Rollins, J. A. (2017). Healthcare: It’s “so complicated.” Pediatric Nursing, 43(2), 58, 102.

Each of the following Research Guides is written with a specific program in mind. The one for your program can provide insights about researching topics related to your field.

• • Nursing (BSN) Library Research Guide.
  • Public Health Undergraduate Library Research Guide.
  • Health Care Administration Undergraduate Library Research Guide.

The following resources provide specific information about annotated bibliographies.

• • What Not To Do: Source Material for the Annotated Bibliography | Transcript.
  • Sample Annotated Bibliography [PDF].

NHS-FPX4000 Assessment 2, Healthcare Disparities Sample Approach

Health Disparities

Brief Problem Description

The World Health Organization defines health disparities as “systematic differences in the health status of different population groups” (WHO, 2018). Often, populations portray different factors regarding healthcare services accessibility, where fundamental considerations such as socio-cultural and economic considerations play a significant role in determining how they access quality healthcare.

The World Health Organization (WHO) recognizes social factors like education, employment status, gender, ethnicity, and income levels as essential determinants of how people access healthcare services. In this sense, socioeconomic disparities contribute to the unfairness and exclusion of the population in mainstream healthcare services.

Personal Experience and Interest in the Topic

My interest in the topic relies massively on my working experience with communities facing various socio-economic constraints. I have worked with community-based health organizations targeting to empower rural communities and promote health awareness. I have had opportunities to interact with people struggling with poverty, geographical isolation, low income, and low-level education. Undoubtedly, these disparities affect how people access quality care services. Therefore, I became interested in researching the topic to obtain insights into scientifically proven interventions to reduce inequalities. 

Potential Interventions Include:

• Health promotion/advocacy programs
• Quadruple Aims for health equality
• Community improvement strategies
• Multi-disciplinary strategies

Identifying Peer-reviewed Journals

In this section, I leveraged my research knowledge to identify peer-reviewed scholarly publications that I believe should help me develop and support my proposed intervention plan. In addition to using resources that were accessible through the University library portal, I also conducted a search on external databases relevant to nursing, among them Google Scholar, Medline, and CINAHL.

For better search results, I implemented information outlined in the BSN Library Research Guide and learned vital information on how to aggregate and segregate the different internet resources. Once I was conversant with how to navigate through the library and database materials, I managed to refine and filter my search results to obtain only the appropriate scholarly resources.

Further, I used the University Library to access such credible databases as ProQuest and Ebscohost, which also provided some credible resources. By narrowing my search area nursing and health sciences, I was able to obtain only resources relevant to my nursing program.

Assessing Credibility and Relevance of Information Sources

While the University’s portal has specific features that make it easy to access quality scholarly materials on any topic, one must refine the search to obtain the most relevant, recent materials. One can obtain credible resources by simply inputting critical topic words in the University library portal. During my search, some of the keywords I used included health disparities, healthcare access, community health improvement plan, social determinants of health, among others. The search engines have functionalities that enables one to filter the keywords and to tick checkboxes for peer-reviewed and scholarly sources for more refined search results.

To further refine my search outcomes, I sorted the articles based on publication date, from the most recent to the oldest. Additionally, the search engines have a publication date tab that allows one to customize the search range by year of publication, thus making it easier to obtain recent articles. Given the dynamic health environment, only recent peer-reviewed articles with relevant, contemporary nursing and healthcare information must be used in developing an intervention plan. For this reason, I limited my search range to studies published within the last five years.

Peer Reviewed Academic Journals Annotated Bibliography

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

This scholarly article by Garzon-Orjuela et al. (2020) identified and synthesized strategies that facilitate the reduction of health inequalities. The researchers defined healthcare inequalities as differences in health among people or society (Carzon-Orjuela et al., 2020). The background of the study involved reflections on the governments’ interventions or incentives that focus on equity to enhance progress or eliminate health disparities.

One of the strengths of this scholarly journal is that the researchers delved into an in-depth systematic search strategy to select scholarly articles from reputable databases. The researchers indicated many interventions from scientific journals, including multi-disciplinary and team performance, telemedicine, communication between providers, and educational outreach interventions as potential approaches to addressing healthcare inequalities.

Arguably, this research is relevant, up-to-date, and reliable in presenting the various interventions for addressing health inequalities. Firstly, this article is a peer-reviewed scholarly journal and consolidates information from many scholarly articles. Undoubtedly, the study’s findings apply when addressing concerns of inadequate measures to address health inequalities. For instance, the researchers earmarked multi-disciplinary cooperation, multi-sectoral cooperation, technological advancements, and teamwork as scientifically proven approaches to reduce health disparities. As a result, it is possible to apply these interventions in various healthcare contexts.

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, And Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840 

The scholarly article narrowed down health disparities to racial factors that affect how populations access healthcare services. In this sense, the researchers sought to establish the causes of racial inequalities in the US by utilizing quantitative and qualitative data collection and analysis strategies. The study was part of a  sequential mixed-methods study conducted in the US’s Veterans Health Administration (VHA) care system.

The study’s participants were 53 healthcare providers working at three sites in the VHA. The recruitment strategy for the respondents relied on email communication between the researchers and healthcare professionals (potential participants). Essentially, the study identified several patients, providers, healthcare system, and social structural factors that facilitate racial disparities in access to healthcare services. The researchers concluded that understanding racial healthcare disparities is fundamental in informing interventions to addressing health inequalities.

This study is credible because it is peer-reviewed, current, and relies on insights from reputable researchers. Apart from these considerations for determining a reliable scholarly source, the study’s findings apply to inspiring measures to address racial disparities in healthcare. For instance, the investigators suggested openness among healthcare providers as the most profound strategy for reducing racial disparities.

Transparency among healthcare professionals entails various aspects, including effective communication, meaningful relationships, unbiased operations, and positive workplace perceptions. Arguably, these suggestions are vital in addressing workplace stress emanating from racial stereotypes.

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8 

This scholarly journal provides insights into the impact of multi-component community-based health promotion interventions in reducing health discrepancies by focusing on socio-economic status (SES). Therefore, the researchers conducted a comprehensive review to consolidate information about closing the gaps within populations to alleviate healthcare inequalities. The systematic review strategy relied on thorough screening of reputable scholarly article databases such as PubMed and PsycINFO.

 Undoubtedly, this research is credible and reliable because it has satisfied peer-review considerations. The systematic review earmarked community-based interventions as vital tools for socio-economic equality in health behavior and status outcomes. The researchers argued that the subsequent community-based interventions for addressing health inequalities should reduce price barriers, promote physical and mental health, and create a healthier environment necessary to support health changes (Nick & von dem Knesebeck, 2020). Arguably, the study’s findings present ideal approaches to address health disparities in different social contexts.

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y 

This scholarly article provides insights into the Quadruple Aim to address the rising economic and social pressures facilitating health inequalities. In this sense, the Quadruple Aim approach includes interventions like improving patient experience, reducing cost, advancing population health, and improving provider’s experiences. For purposeful research, the investigators conducted 10 case studies in three Canadian provinces of Nova Scotia, Ontario, and British Columbia to investigate experiences of primary care and public health collaboration.

The ability to focus articulate current scholarly findings and peer-review criteria render this study credible and reliable. The research identifies provider capacity building, community-based health promotion programs, outreach interventions, and regional immunization management as fundamental approaches for addressing health inequalities in the three Canadian provinces.

Also, researchers identified inadequate collaboration, resource constraints, geographical challenges, and varying organizational goals as barriers to effective strategies for addressing health inequalities. The study concluded that the Quadruple Aims are profound strategies to promote health quality by addressing socio-economic challenges within Canadian populations. The measures presented in the study apply to other nations because they are scientifically proven and tested.

Lessons from the Annotated Bibliography

After preparing an annotated bibliography, I learned that health inequalities pose challenges to countries and communities because they affect how population sections access healthcare services. I realized that the World Health Organization recognizes health disparities as a critical issue in the global health sector.

Some of the causes of health inequalities, as stipulated by the World Health Organization (2018), include economic status, education level, race, ethnicity, gender, and income level. Therefore, governments target alleviating poverty, racial inequalities, illiteracy, and geographical constraints that limit access to health services.

Fortunately, scholarly studies identify community-based strategies, multi-disciplinary cooperation, health advocacy programs, health promotion, capacity building, and fiscal interventions as possible means of realizing health equality. According to Valaitis et al. (2020), these approaches form the basis of the Quadruple Aims for improving patient experience and reducing health costs. Although nations may develop area-specific policies to reduce health disparities, it is crucial to rely on scientific study findings when conceptualizing ideal measures to address causal factors to health inequalities.

References

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840 

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8 

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y

World Health Organization, WHO. (2018). Health inequities and their causes. Retrieved 25 July 2021, from https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes.