NUR 443 Public Health Nursing

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NUR 443 Public Health Nursing

Precede-Proceed Model

Curley (2020) Chapter 7 p. 176-178

exercise 7.2 You are interested in developing a program to reduce the rate of readmission’s for (Diabetes) heart failure at an urban (Primary Care Physician office) academic medical center. There have been many prior initiatives to address this issue. Explain the process you will undertake to develop an effective program including consideration of established best practices and the outcomes of past initiatives.NUR 443 Public Health Nursing

How might you use the PRECEDE–PROCEED Model to plan, implement, and evaluate the program?

PRECEDE (This is the planning stage. Work with a committee comprised of people who are stakeholders and who have a working understanding of the target population and the issues/problems related to readmission’s.

  1. Determine population needs. (Reduce readmission rates.)
  2. Identify health determinants of these needs. (What are the characteristics of the population of patients who are readmitted? What are the most common reasons for readmission’s?)
  3. Analyze behaviors and environmental determinants of health needs. (What are the educational needs/resource requirements of this population?)
  4. Outline factors that predispose, reinforce, or enable behaviors. (Identify factors that contribute to readmission’s.)
  5. Ascertain interventions best suited to change behaviors. (Based on the information that you have garnered, write your objectives and design specific interventions to achieve your objectives.)

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PROCEED

  1. Evaluate interventions.
  2. Evaluate the impact of the interventions on factors that supported the behavior as well as the behavior itself. (Survey patients and stakeholders.)NUR 443 Public Health Nursing
  3. Evaluate outcomes.

Applying the Evidence – Literature review

Curley (2020) Ch 5

Intervention table 5.5 is on p. 124-126 in Curley (2020) – use for template for literature review

Describe in your own words a clinical problem you would like to examine. Explain why you think it is important to address this problem, Carry out a literature review for the clinical question you wrote, and describe how you would apply the PRECEDE: PROCEED model to address your clinical question

TABLE 5.5 p. 124-126 Example

TITLE/AUTHOR  DESCRIPTION OF THE IN TERVENTION     PURPOSE AND POPULATIONS     OUTCOMES ACHIEVED

Ko, E., Lee, J., & Hong, Y. (2016). Willingness to complete advance directives among low-income older adults living in the USA. Health & Social Care in the Community, 24(6), 708–716.

This study was conducted as part of a larger study that explored advance care planning in low-income adults. A cross- sectional design was used. Face-to-face interviews were conducted with the participants. Questionnaires used were: EOL preference questionnaire, attitude towards advance decision-making questionnaire, and the Luben Support Network Scale. Willingness to complete an advance directive and availability of healthcare proxy were yes/no questions.           To explore low-income older adults’ willingness to complete advance directives, and the role of social support and other predictors that impact their willingness. It included 204 older adults living in two supportive housing facilities or members of a senior center. Participants were selected through random sampling methods. Inclusion criteria included age over 60 and mentally competent

The majority of participants (72.1%) reported a willingness to complete advance directives. Self-rated health, attitudes toward advance decision-making and social support were some of the factors affecting their decisions.

Population at Risk of Diabetes in my Community

Diabetes is a metabolic disease causing high blood sugar where sugar is moved from the blood by insulin. Patients suffering from diabetes are greatly affected the socio-biologic cycle of diabetes that encompass some factors including access to healthy food, housing, level of income as well as the level of education (CFDCA, 2016). Diabetes is also affected by an individual’s lifestyle factors like access to primary healthcare, dietary choices and the level of the individuals’ physical activities. There are several social determinants affecting the healthcare outcome of a community including personal health practice and coping skills, healthy child development, literacy, social support network as well as the level of income.NUR 443 Public Health Nursing

According to Centers for Disease Control and Prevention (2016), the vulnerability of diabetes differs from one population to the other where minority populations are at a greater risk of being affected by diabetes. For instance Latino Americans, Native Hawaiians and American Indians are at a great risk of developing diabetes. In addition, adults aged 45 years and above are at a higher risk of diabetes development. Religious beliefs are known to help the patients suffering from diabetes to come with the shortcomings associated with diabetes by encouraging positive habits.

Families with previous diabetes history are at a higher chances of developing diabetes. Therefore, it is advisable for individuals coming from families where they previously had a person with diabetes to frequently get a blood test for early diagnosis (Tseng et al, 2017). Patients suffering from pancreas disease are also prone to getting diabetes since the ability to make insulin is slowed down. Overweight and obese is also a precipitating factor to high exposure of diabetes development. The rise in obesity in the community has greatly contributed to an increase in the cases of children and teenagers developing diabetes.

References

Centers for Disease Control and Prevention. (2016). National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services, 2016.

CFDCA, P. (2016). National Diabetes Statistics Report: Estimates of Diabetes and Its Nurden in the United States, 2016. Atlanta, GA: US Department of Health and Human Services.

Tseng, E., Greer, R. C., O’Rourke, P., Yeh, H. C., McGuire, M. M., Clark, J. M., & Maruthur, N.            M. (2017). Survey of primary care providers’ knowledge of screening for, diagnosing and      managing prediabetes. Journal of general internal medicine, 32(11), 1172-1178.

NUR 443 Public Health Nursing