The fight against Tuberculosis in Homelessness.

Project 2: Fight against Tuberculosis in the Homeless

This paper aims at discussing the fight againsttuberculosis in the homeless. Specifically, this project aims to lower the cases of tuberculosis among homeless individuals, which is a significant public health issue(Holland et al., 2019). Its name is “The Management of Tuberculosis among HomelessIndividuals in the Staten Island borough of New York City.”This paper will include a goal statement, objectives of the project, methodology, resources,formative evaluation, summative evaluation, and timeline.The fight against Tuberculosis in Homelessness.

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Goal Statement and Objectives

This project focuses on reducing cases of tuberculosis among homeless individuals. According to Gupta et al. (2015), the high rate of tuberculosis is among the significant public health issues facing homeless individuals. Theproject will utilize nursing resources to solve tuberculosis among homeless persons in the Staten Island borough of New York City. Individuals diagnosed with tuberculosis will be treated in the community clinic. The nurses who will be involved in the project will be equipped with knowledge about tuberculosis. Particularly, they will be educated about the strategies that can be implemented to reduce tuberculosis among homeless persons in the Staten Island borough of New York City.The fight against Tuberculosis in Homelessness. The trainer will emphasize on the significance of maintaining a healthy environment to control this contagious disease. According to Riccardo et al. (2018), environmental health, including consuming clean water, having adequate sanitation, and safe shelter plays a crucial role in regulating infectious diseases, including tuberculosis. Additionally, healthcare workers will be trained on how to diagnose the disease at an early stage and treat it. Early diagnosis and effective treatment prevent the disease from spreading further (Jo, 2017).The fight against Tuberculosis in Homelessness.

The adopted strategy will enhance the achievement of critical objectives. First, it will enable healthcare providers to apply the acquired knowledge to lower tuberculosis cases among the targeted population. This objective will be measured by comparing cases of tuberculosis before and after the project. Secondly, the strategy will enable providers to understand tuberculosis, including its spread, diagnosis, and treatment. This objective will be measured by comparing the number of tuberculosis patients treated at the community clinic before and after the implementation of this project.The fight against Tuberculosis in Homelessness.

Methodology

The project will utilize a mixed methodology in which quantitative and qualitative elements will be utilized to gather the required data. Consequently, both qualitative (open-ended) and quantitative (closed-ended) data will be collected. Fifty homeless individuals from the Staten Island borough of New York City will participate in the study. This methodology will support the achievement of the set objectives. First, it will enable healthcare providers to apply the acquired knowledge to lower tuberculosis cases among the targeted population. The knowledge will be applied among homeless persons in the Staten Island borough of New York Citywho has been diagnosed with tuberculosis. The method will be applied after the completion of the project. It will be applied by adopting measures that prevent further spread of pathogens, causing this disease. Secondly, this methodology will enable providers to understand tuberculosis. The care providers will give questionnaires with both closed and open-ended questions to the sample population. The participants will fill these questionnaires providing details about the tuberculosis tool kit and return them. The provided responses will, in turn, help the nurses to prevent and treat tuberculosis amongst the homeless population.The fight against Tuberculosis in Homelessness.

Resources

The completion of this project will require various resources, including human, physical, and technical resources. First, trainers will be required to equip the nurses with knowledge about preventing, diagnosing, and treating tuberculosis among homeless persons in the Staten Island borough of New York City. Additionally, participants (homeless individuals residing in the Staten Island borough of New York City) will be involved to provide details about the spread and impact of tuberculosis in the city. Physical resources, including treatment-monitoring tools, will be required to facilitate the diagnosis of tuberculosis among homeless individuals in the targeted region(Lee et al., 2020). Finally, technical resources, including a network of TB facilities, will be required to facilitate this condition’s diagnosis. According to Getahunet al. (2012), technical resources prevent the spread of tuberculosis.The fight against Tuberculosis in Homelessness.

Formative Evaluation

A formative evaluation of this project will be conducted to assess whether it is proceeding as planned. This evaluation is conducted before the implementation and at various stages of the project(Frunza,2014). First, the members of the project team will conduct a formative evaluation before the actual implementation. This action will enable them to assess whether they have met the requirements for implementing the proposed project. Any required adjustment will be made before the implementation, thus increasing the project’s likelihood of success.The fight against Tuberculosis in Homelessness.

Additionally, this evaluation will be done during the implementation process, starting at the initiation stage. This phase will involve understanding the goals, objectives, requirements, priorities, and deadlines of the proposed project. The implementation team will assess whether the results of this step meet the expectations. The second evaluation will be conducted at the end of the planning phase. This stage of the implementation process outlines all the activities, the required resources such as treatment-monitoring tools, and the specific time that each one of them will be conducted. Evaluating this stage will enable the implementation team to correct any error before proceeding to the execution phase. Formative evaluation is conducted throughout the execution phase since it is the most critical stage of project implementation. It is conducted to ensure that everything is executed as planned. Continuous evaluation of this stage increases the possibility of achieving the desired results. Therefore, formative evaluation is recommendable for this project. Evaluating the project at every step will enable the implementation team to make the required correction before proceeding to the next stage. In other words, the team will be able to improve the project’s design and overall performance.The fight against Tuberculosis in Homelessness.

The results of this evaluation will be used to determine if the project is proceeding as planned. The project will be on the right track if these results meet the expectations. On the contrary, the project will not be proceeding as planned if the results differ with the expectations significantly. A slight difference between the two will be addressed by making some adjustments at various implementation stages. Nonetheless, the project will be abandoned if a substantial difference is reported between the actual results and expectations.The fight against Tuberculosis in Homelessness.

Summative Evaluation

This evaluation will be conducted at the end of this project to assess the overall outcomes. The evaluation will be conducted by comparing the final results with the targets set at the beginning of the project. The project will be considered successful in the cases of homeless individuals with tuberculosis reducing following this project’s implementation. However, a slight difference in the cases of tuberculosis might be reported. Under such circumstances, the project is considered as successful. On the contrary, the project will be considered to have failed if no difference in tuberculosis cases will be reported. Therefore, the results of the summative evaluation will be used to determine the success of the project.The fight against Tuberculosis in Homelessness.

Timeline

The proposed project will be conducted in various stages, including initiation, planning, execution, and closure. All four stages will be complemented in 8 weeks. The implementation team will spend the first week to initiate the project. The team members will understand the goals, objectives, requirements, priorities, and deadlines of the proposed projectthis week. Planning for the proposed project will be done in weeks two and three. The team members will gather all the resources and set the deadline required to fight tuberculosis among the targeted population. The execution of the project will be conducted from week four to week seven. The nurse will be educated about reducing the spread of tuberculosis among homeless persons in the Staten Island borough of New York City. Finally, the project will be closed in week 8. During this period, the implementation team will summarize the project results and determine the next action to be taken. The fight against Tuberculosis in Homelessness.

The above discussion indicates that tuberculosis management among homeless persons in the Staten Island borough of New York City will be done in for significant stages. The first stage initiation will involve understanding the goals, objectives, requirements, priorities, and deadlines of the proposed project. The second stage planning will involve gathering the required materials and setting the timeframe for completing the project. The third stage, which is execution, will involve utilizing the acquired knowledge to reduce tuberculosis cases among the targeted population. The final stage of the project, closure, will focus on comparing the results to assess whether the actual outcomes match the expectations.

The fight against Tuberculosis in homelessness

Introduction

Homelessness is a significant public health concern. There are many facets of homelessness that not only can harm the homeless but also the public. Due to the lack of medical treatment and environmental exposure, homeless people can develop an infectious disease that can ultimately cause an outbreak andcreate a public health threat. This is a sobering fact for the health care personnel, with evidence suggesting that appropriate interventions could help prevent and control the spread of diseases (Luchenski, 2018).The fight against Tuberculosis in Homelessness. A review of demographic data for New York City reveals that in April of 2020, there were about 60,422 homeless persons in the city who include 20,494 children and 13,861 families (Coalition for the Homeless, 2020). The prevalence of physical ailments to contain infectious diseases among this population is approximately 44%. The USA’s average life expectancy is 78 years, while the average life expectancy of homeless persons is 44 years. All homeless persons are spiritually, psychologically, socially, and physically vulnerable, and they experience higher rates of suicide, homicide, and violence than persons who are housed. Older adults, women, and children are the most vulnerable in this population (Lee & Donaldson, 2018). The homeless population presents a concern with poor adherence to discharge instructions.The fight against Tuberculosis in Homelessness. This contributes to burnout among nurses as well as increased levels of frustration and powerlessness. Some nurses understand that this population has unique needs, and they leverage their position to improve their health care. However, their efforts are limited due to lack of knowledge by individual nurses who do not understand the personal beliefs and values of the homeless persons, so they end up prescribing medication and offering professional advice without comprehending their lifestyle (Rae & Rees, 2015). The present paper proposes a project that makes use of street outreach strategy among nurses serving homeless persons in the Staten Island borough of New York City to improve health care outcomes among the population. The project’s objective is to leverage nursing resources to ensure the efficient delivery of health care among homeless persons in New York City.The fight against Tuberculosis in Homelessness.

Goal statement

The project will leverage nursing resources to target homeless persons in the Staten Island borough of New York City. The nurses engaged in the project will be educated onthe communicable disease tuberculosis prevention and treatment towards a specific community. This will facilitate knowledge and compliance towards this infectious disease.The homeless and nurses can be considered cultural strangers who avoid each other on regular occasions because of mutual fears. Creating the program will allow a personalized care plan that each patient can easily subscribe to for the best care outcomes (Lee & Donaldson, 2018).The fight against Tuberculosis in Homelessness.

Project objectives

The project will educate nurses to identify homeless individuals. The nurses will then use their educational tools and assessments to understand the conditions particular to each patient. This strategy will enable the nurses to take time and exercise understanding oftheir needs, culture, and situation without prejudice and communicates with dignity, and respect to the patients.The fight against Tuberculosis in Homelessness.

1. The selected nurse personnel will pilot and evaluate the educational tool kit targeted at homeless persons within the defined geographical area resulting in a 50% increase in adherence to knowledge and compliance.
2. Improve health care outcomes among the targeted homeless persons resulting in a 70% increase visit to medical clinics.

Homeless persons are classified as residing in places not intended for habitation and usually unsafe areas. They have the most mediocre health outcomes in society, and their numbers are increasing. They are socially excluded, and their circumstances make it difficult for them to adhere and comply (Kearns et al., 2015). They are 10 times more likely to be re-hospitalized than the general population. They typically rely on emergency rooms and facilities that serve the poor to obtain the needed healthcare services. They are more susceptible to certain medical conditions, have greater difficulty accessing health care when needed, and are harder to treat than other populations, all because they do not have a home (Health Quality Ontario, 2016). The fight against Tuberculosis in Homelessness.There are significant barriers that hinder their access to health care, to include inflexible appointment and registration rules, competing priorities even as they struggle to survive on the streets, and negative attitudes of medical personnel. This results in about 33% of treatable conditions among the population worsening to result in either disability or death (Dorney-Smith et al., 2018). Nurses’ can help address this concern by bringing educational in aneasy, simple, and appropriate leveldirectly to homeless patients, thereby ensuring that this underserved population receives medical care (Lamb & Joels, 2014). This is expected to personalize nursing care delivery so that patients are more receptive to health care and attend regular visits (Ungparkon & Rae, 2019).The fight against Tuberculosis in Homelessness.

Methodology

The project intends to apply a mixed methodology philosophy in which quantitative and qualitative elements will be included. The methodology will consist of participatory action principles within a community health nurse model identified by Goeman, Howard, and Ogrin (2019). The participatory action principles focus on involving the community to understand their world and ensure that the nursing services are appropriate for their needs.The fight against Tuberculosis in Homelessness. In this instance, the community health model will be co-located with a facility providing medical services in the Staten Island borough area of New York City. The program will recruit three nurses who will provide nursing services to homeless patients through the tuberculosis educational tool kit. The hired nurses will serve homeless patients who reside within the local community of the outreach center. The program expects homeless people living within the area covered by the program as high users of the nursing services. The recruited nurses will focus on meeting the specific healthcare needs of homeless persons who do not access mainstream nursing services. In this project, the community health model will fill a gap by offering a flexible nursing care response to homeless persons. The program’s specific nursing services will include emotional support and primary care, such as patient education and treatment (Goeman, Howard & Ogrin, 2019).The fight against Tuberculosis in Homelessness.

Resources

The program will require evidence-based peer-review articles, government, and educational websites in creating the education program. Program director to approve education program, provide workspace including computers, office supplies, and printing. Volunteer nurses will be educated on the tuberculosis tool kit offering personalized nursing care services to homeless patients. In addition to identifying some of the universal health care problems affecting this population, the challenges they face, and monitoring the changes in their health status. Besides that, the program will use a standard patient needs assessment tool to understand the specific nursing care needs of this population.The fight against Tuberculosis in Homelessness.

Formative evaluation

Formative evaluation will be conducted during the project’s implementation to improve the performance and design of the project. Two formative evaluation approaches will be applied. Firstly, the interactive evaluation will be conducted during the project implementation to improve its design even as it is rolled out. This is a continuous improvement approach that uses a project diary, focus group, and semi-structured interviews with participants to identify the project aspects that can be improved. Secondly, monitoring evaluation will be conducted during the project implementation to ensure that the activities undertaken in the project are effectively and efficiently delivered. This evaluation uses observation, dartboard, questionnaire, and time tracking (Moran, Burson & Conrad, 2014).The fight against Tuberculosis in Homelessness.

Summative evaluation

A summative evaluation will be conducted to determine the impact of the project on homeless persons who are the target group. This will determine what the project has achieved in terms of its objectives. At the end of the project, it will be undertaken to assess whether the project met its goals and objectives if there were unintended consequences and benefits, what was learned, and how to improve in future projects. The summative evaluation will collect two data types. The first data type is qualitative data that is collected through health care outcomes and focus group discussions. The second data type is quantitative data collected through questionnaires and counts (Moran, Burson & Conrad, 2014).The fight against Tuberculosis in Homelessness.

Timeline

Eight activities have been identified as critical for the successful implementation and conclusion of the project. The first activity is to finalize the project implementation details. This will be completed in the first week. The second activity is to determine the project’s geographical boundaries in terms of the area in which the homeless patients can be located. This will be conducted in the first week. The third activity is to recruit nurses who will participate in the project. This will be held in the second week. The fourth activity is to acquire the resources for the project to include evidence base materials, and the standard patient needs assessment tool. The fifth activity is to roll out the project. This will be conducted over seven weeks, beginning in the third week and ending in the ninth week. The sixth activity is to conduct formative evaluations and make adjustments to the project design. This will be done weekly over five weeks, beginning in the fourth week and ending in the eighth week. The seventh activity is summative evaluation. This will be conducted over two weeks, starting in the tenth week and ending in the eleventh week. The last action is to submit findings and recommendations that will be held in the eleventh week (see Table 1).The fight against Tuberculosis in Homelessness.

Project #2

Fight against Tuberculosis in the Homeless (POWER POINT ATTACHED)

YOU ARE NOW IN A LEADERSHIP ROLE, HOW WILL YOU CREATE THE PROGRAM FROM Project 1. AND HOW WILL YOU SUSTAIN IT?

*NEEDS TO BE ON A PERSONAL LEVEL, DETAILS NOT GENERALIZED

Title:

The title should include the name of your project and should follow the UniformGuidelines format.

Introduction:

The introduction includes the purpose of the paper, the goal of the project, and the

name of the project. It also outlines the structure of the paper.

Goal statement:

A goal statement identifies what you expect to accomplish, the focus area, and the

population. It introduces the project and conveys, in broad terms, how you plan to solvea particular problem or issue.

Project objectives:

Project objectives delineate your strategy for reaching the goal and the steps you willfollow to complete the project. You must includeTWO measurable objectives thatuse Application-level or higher verbs from Bloom’s Taxonomy.The fight against Tuberculosis in Homelessness.

Evidence-based review of the literature for project justification:

This review provides evidence-based support for your identified problem, projectmethods, and evaluation The literature should be directedtoward justifying the project, not focus on potential solutions. You must include a reviewof your specialization’s professional-practice standards and guidelines related to yourproject

Methodology:

This section addresses in detail how you will accomplish the project objectives. Include,as relevant, the who, when, where, and how of each objective.The fight against Tuberculosis in Homelessness.

Resources:

Identify and justify the human, physical, and/or technical resources you will need tocomplete this project. Note that for this assignment, you do not have to address thefinancial aspects of your plan.

Formative evaluation:

Describe how and when you will conduct formative evaluation of your project. Explainhow you will use the evaluation results and how you will determine if the project isproceeding as planned.The fight against Tuberculosis in Homelessness.

Summative evaluation:

Describe how and when you will conduct summative evaluation of your project. Explainhow you will use the evaluation results.

Timeline:

Create a graphic timeline representing significant stages of your project. Provide a

narrative to help your Instructor understand the timeline. Include the timeline in an

Appendix to your Practicum Project Plan.

PublicHealthNursing:ScopeandStandardsofPractice,2ndEdition

Standards of ProfessionalPublic Healthnursing Practice

Standard 12. Leadership

The public health nurse demonstrates leadership in the professional practice setting and theprofession. Competencies Thepublichealthnurse:

■Overseesthe nursing caregivenbyotherswhileretaining accountability forthequalityofpublichealthnursingcareprovided.

■Abidesbythevision,theassociatedgoals,andtheplantoimplementandmeasureprogressofanindividual,family,community,orpopulation.

■Actsinaccordancewithorganizationalgoals,includingparticipationinemergencypreparednessandresponseactivities.

■Facilitatesdevelopmentoforganizationalplanstoimplementprogramsandpolicies.

■Participatesinteamstoassurecompliancewithorganizationalpolicies.

■Mentorscolleaguesintheacquisitionofclinicalknowledge,skills,abilities,andjudgment.

■Treatscolleagueswithrespect,trust,anddignity.■Demonstratesacommitmenttolifelonglearning.

■Demonstratesconflictresolutionskills.

■Contributestopromotinga culturallyresponsiveworkenvironment.

■Participatesinprofessionalorganizations.

■Seekswaystoadvancenursingautonomyandaccountability.■Articulatesnursingandpublichealthknowledgeandskillstotheinterdisciplinaryteam,administrators,educators,policymakers,andappropriateintersectoralpartners.The fight against Tuberculosis in Homelessness.

■Participatesineffortstoinfluencehealthcarepolicytoincreaseaccesstocare,improvequalityofcareprovided,andensureethicalandequitableprovisionofcare.

PublicHealthNursing Standards of Professional Public Health nursing

PracticePublicHealthNursing:ScopeandStandardsofPractice,Competencies Forthe Advanced Public Health Nurse

Theadvancedpublichealthnurse:

■Influencesdecision-makingbodiestoimprovetheprofessionalpracticeenvironmentandhealthoutcomes.

■Providesdirectiontoenhancetheeffectivenessoftheinterprofessionalteam.

■Promotesadvancedpublichealthnursingandroledevelopmentbyinterpretingitsroleforpopulations,partners,andothers.

■Modelsexpertpracticetointersectoralteammembers,interprofessionalcolleagues,andothers.

■Mentorscolleaguesfortheadvancementofnursingpractice,theprofession,andqualitypublichealthservices

.

American Nurses Association. (2013). Public Health Nursing : Scope and Standards of Practice: Vol. 2nd ed. American Nurses Association.The fight against Tuberculosis in Homelessness.