Fluent Essays

1) Minimum 5 full pages (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page Parts 2, and 4 have the same questions, however, you must answer with different references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.            Part 1: minimum 1 page            Part 2: minimum 1 page            Part 3: minimum 1 page            Part 4: minimum 1 page            Part 5: minimum 1 page    Submit 1 document per part 2)¨******APA norms          All paragraphs must be narrative and cited in the text- each paragraph          Bulleted responses are not accepted          Don't write in the first person           Don't copy and paste the questions.          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph Submit 1 document per part 3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)  ********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks) 4) Minimum 3 references per part not older than 5 years  (Journals, books) (No websites)  All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed. 5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next Example: Q 1. Nursing is XXXXX Q 2. Health is XXXX 6) You must name the files according to the part you are answering:  Example: Part 1.doc  Part 2.doc __________________________________________________________________________________ Parts 2, 4, and 5 have the same questions, however, you must answer with different references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted. Part 1: Nursing Research  Based on your course reading assignments and your pending research problem (Check file 1) 1. What type of study do you believe you are conducting (Quantitative type, a cross-sectional descriptive multicenter design) 2. Explain your type of study 3. Why this type of study is the most convenient for your research.   Part 2: Health Care Polic ( 1 paragraph per question) Go to the following website by clicking on the provided link,  http://www.countyhealthrankings.org/  Select a county and a state  (Florida- Tallahassee) in which you plan to work as an APRN.  After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions: 1. Briefly list the general statistics pertaining to a specific health concern that is on the rise in selected the city/county (Florida- Tallahassee) 2. How can the creation of a community health center program help to address this public health problem? 3. What can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem? Part 3: Nursing Research  Based on your course reading assignments and your pending research problem (Check file 3) 1. What type of study do you believe you are conducting (Descriptive, cross-sectional, quantitative study) 2. Explain your type of study 3. Why this type of study is the most convenient for your research. Part 4: Health Care Polic ( 1 paragraph per question) Go to the following website by clicking on the provided link,  http://www.countyhealthrankings.org/  Select a county and a state  (Florida- Miami) in which you plan to work as an APRN.  After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions: 1. Briefly list the general statistics pertaining to a specific health concern that is on the rise in selected the city/county (Florida- Miami) 2. How can the creation of a community health center program help to address this public health problem? 3. What can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem? Part 5: Nursing Research  Based on your course reading assignments and your pending research problem (Check file 5) 1. What type of study do you believe you are conducting (Quali-quantitative desing) 2. Explain your type of study 3. Why this type of study is the most convenient for your research. 2 2 Quality Of Care of Nurses in the Coronary Unit to Patients with Myocardial Infarction. Introduction to the Problem The World Health Organization (WHO, 2020) points out that cardiovascular diseases (CVD) are a group of disorders of the heart and blood vessels being the leading cause of death worldwide, affecting to a much greater extent low and middle-income countries, more than 80% of deaths from this cause occur in those countries, according to an estimate, more than 17.5 million people died in 2019 and affected both sexes equally, however, 80% are preventable with a healthy diet, physical activity regulates, as well as verify and control risk factors such as hypertension, high cholesterol, and sugar levels or diabetes. Acute myocardial infarction is characterized by the lack of oxygen in the myocardium due to insufficient coronary flow; its pathogenesis is related to an intraluminal thrombus that develops on an atherosclerotic plaque or atheroma plaque, which triggers the occlusion of the involved artery, the clinical picture is characteristic. It is accompanied by typical electrocardiographic and enzymatic alterations; the treatment has evolved in recent decades, from simple rest and the use of heparin to thrombolytic therapy and primary angioplasty, considered the treatment of choice in hospitals with adequate resources (Carrabba, 2019). In the United States, the World Health Organization in 2018 recorded a mortality rate from cardiovascular disease and diabetes of 237 per 100,000 inhabitants, followed by Spain with 68 per 100,000 inhabitants and Mexico with 21 per 100,000 inhabitants. Thus, the annual number of deaths due to cardiovascular diseases is expected to increase from 17 million in 2018 to 25 million in 2030 (WHO, 2019). In the United States, studies have indicated that the mean age ranges from 36 to 96 years and that 13, 3% did not have conventional cardiovascular risk factors and that 75% of cases presented typical pain (retrosternal pain, oppressive, severe, with or without radiation), a total of 117 patients were admitted to Columbia University Division Of Cardiology in 2019; therefore, cardiology nurses had to assist patients with myocardial infarction, in such a way that cardiovascular diseases constitute one of the most important causes of morbidity and mortality. Clearly Identify the Problem Cardiology Nursing is currently at a threshold of social relevance since cardiovascular diseases have become the leading causes of death and disability in the world; they present as an acute coronary ischemic syndrome, triggering unstable angina or acute infarction of myocardium (AIM) that is pathologically translated by the existence of necrosis in an area of ​​the heart muscle and associated with some risk factors such as hypercholesterolemia, arterial hypertension, smoking and diabetes Mellitus among others (Hariprasath, 2018). The main objective of the treatment of infarction is to avoid the death of the patient, the necrosis of the ischemic myocardium at risk, and its extension, thus avoiding the appearance of complications, making highly specialized nursing care necessary for patients with myocardial infarction in about clinical manifestations, assessment, care planning, and evaluation, as well as in teaching the patient and his environment (Boerma, 2019). In this regard, the Coronary Unit constitutes a section of hospitals endowed with material resources, technicians, and highly specialized nurses who must provide comprehensive care with an ethical attitude to critical patients, whose pathological condition puts their lives at severe risk and who present reversible conditions that make the application of monitoring, surveillance, management, and advanced life support necessary (Mohammed et.al, 2020). Thus, nursing care is of the highest level and is provided 24 hours a day with the provision of specialized care based on standards of efficiency and hospital quality, nursing actions are largely implicit in the care of patients with AMI from arrival at the coronary care unit, by identifying absolute and relative signs and symptoms and contraindications to thrombolytic treatment, performing an electrocardiogram for diagnosis, monitoring the patient, channeling a peripheral line, taking vital signs, pain relief, and the preparation and administration of the fibrinolytic, the speed in its administration is the key for it to have greater effectiveness that in many cases are decisive to achieve satisfaction in the services (Nonogi, 2019). Significance of the problem to Nursing Currently, the quality of nursing care is a crucial factor to participate in the disciplinary exploration of quality and risk-free health care practices, thus providing the interaction of nursing care with the patient, ensuring that the care is optimal and holistic. In this regard, Nursing care in Coronary Units to patients with myocardial infarction is based on the clinical assessment of nursing by human response patterns for which they require their scientific foundations, crystallized in the nursing process, which guides in a planned way, systematized and organized of its actions identifies the actual and potential health problems that allow decision-making based on the knowledge and existing evidence about nursing care to be applied in a systematic and organized way of Clinical Nursing Practice, to provide nursing care in a timely and effective manner, which allows reducing hospital readmissions and optimizing institutional resources (Nonogi¸2019). The physical assessment carried out by the nursing professional, in their own and derived functions, begins with the pain assistance, which should assess the type of pain, location, duration and cause that triggers it, the meaning of the pain for the patient, and the result of the emotional response are essential factors for the nurse to assist him, the fear and anxiety produced by the pain can increase work and heart rate by sympathetic stimulation (Mohammed et.al, 2020).. In this regard, the perspective of the search for the quality of nursing care in the coronary unit is becoming increasingly important given that said personnel are the ones who receive these patients; therefore, they must have the knowledge and high-level preparation to guide properly timely all their efforts, not only to provide specific treatment to the person with a heart attack but also towards the prevention and early detection of complications. Purpose of the Research Considering the focus of the study, the purpose of the research is to publicize the attention and quality of care that the nurses of the coronary unit provide to patients with myocardial infarction in our reality, to design strategies and develop programs strengthening highly specialized care and humanistic practice calling for the nursing professional to reflect to carry out work that provides patient satisfaction as an indicator of quality. Research Questions Is there a relationship between nursing care and the quality of care provided to patients with myocardial infarction in the coronary unit? What is the relationship between nursing care and the quality of care for patients with myocardial infarction? Master's Essentials that aligned with the topic Essential III determines the participatory need of nurses to improve the quality of the services they offer as health professionals (AACN, 2011). Nurses with this approach are expected to have adequate knowledge, tools, and skills to meet healthcare standards and quality and safety. Thus, the safety of patients is a fundamental objective of nursing actions, and quality is the value that guides their actions for the benefit of patients and their integrity. 2 2 Prevalence of Overweight and Obesity in Nursing Students at Florida National University Introduction to the Problem Overweight and obesity are together the new pandemic of the 21st century, primarily responsible for the development of Chronic Noncommunicable Diseases (NCDs), which represent the leading cause of morbidity and mortality in the world, especially in developed countries such as the United States, representing a significant burden on the American health system. Among the risk factors associated with overweight, obesity, and NCDs, they are modifiable if the development of Healthy Lifestyles (HLS) is appropriately encouraged (WHO, 2019). Regardless, it is difficult for a person to develop these habits; it is even more so when the healthcare staff receives change advice, which they do not apply. And it is that the prevalence of harmful habits such as smoking and sedentary lifestyle among nurses remain relatively high. For this reason, it seeks to identify from the first years of the training career the situation of the students in terms of the knowledge and application of HLS (WHO, 2019). To also be able to modify patterns that in the long term impact the prevalence of overweight, obesity, and NCD in patients. Since the existence of HLS in nurses is related to a more excellent disposition for preventive counseling and acquisition of healthy habits by patients. That is why higher education institutions, as trainers of integral subjects, play an essential role in the establishment of knowledge, behaviors, and attitudes during study and training in these institutions, so it is necessary to know the characteristics of lifestyles to promote strategies aimed at contributing to the acquisition of behaviors and conducts that favor the development of a healthy lifestyle for students (Kurnat, 2020). Clearly Identify the Problem Obesity is a chronic disease with multiple causes expressed from the interaction of social, behavioral, psychological, metabolic, cellular, and molecular factors, defined as excess adipose tissue about weight. The problem is that in the United States, the latest information released at the Second National Obesity Meeting confirmed that 51% of the American adult population is overweight and obese, leaving the fact that each of every two Americans suffers and lives with these diseases (World Obesity and Weight Management Congress, 2021). According to the latest data published by the CDC (2020), overweight in the population between 18 and 64 years of age increased compared to the reported results, showing that 51.2% of the population suffers from weight gain and that this is higher pathology in women (55.2%) than in men (45.6%). Smoking is considered a 21st-century pandemic, for which no effective health programs have been created to counteract it; in the United States, the prevalence of cigarette smoking in American adult population between 18 and 69 years of age is 12.8%, being higher in men than in women, for which it has been determined that many of the smokers suffer higher levels of depression and anxiety than their non-smoking peers, within the consequences of long-term consumption is lung cancer, coronary heart disease, other cancers, and chronic lung disease, being also a significant risk factor for atherosclerosis (CDC, 2020). Alcohol is the most consumed psychoactive substance in the world and is easily and legally accessible for sale and access for the elderly; in the country, 35% of the population between 12 and 65 years of age are alcohol consumers, and the highest consumption is in young people from 18 to 24 years old, corresponding to 46%, within the problems related to alcohol consumption, there are effects on perception, motor execution, and muscular coordination, as well as on memory and mental functions such as comprehension and learning; its excessive consumption causes damage to organs such as liver, heart, and brain (CDC, 2020). Similarly, interpersonal relationships are affected, and there is a greater risk of family problems, fights, fights with friends, acts of violence, and traffic accidents. Therefore, it is essential to consider that these high percentages of overweight and obesity are related to behaviors that are far from healthy habits, such as physical inactivity, inadequate diet, and the consumption of tobacco and alcohol, which together constitute the leading cause of chronic non-communicable diseases such as cardiovascular diseases (such as heart attacks and strokes), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. These diseases in the United States impose a burden of morbidity and mortality of about 80%, seriously affecting the economic stability of these countries and citizens (CDC, 2020). Significance of the problem to Nursing The importance of evaluating the prevalence of overweight and obesity in nursing students at Florida National University arises from their roles as health promoters, since they are the first link in the prevention of the development of overweight and obesity, so that the Citizens expect health professionals to be the example and reflection of healthy habits, since patients trust their knowledge, hoping that they are the reflection of a good state of health (Mkiller, 2018). Thus, students must understand the comprehensive approach regarding their duties and obligations as health promoters. In addition, it is nursing, a career in which students should be encouraged to seek optimization of their habits and food and physical resources because, within the academic program, they have first-line knowledge about the consequences of obesity and on weight, as well as the possibility of developing sports practices and healthy eating routines, unlike other professions (Romero-Blanco et.la, 2021). So, this makes the autonomy of each nursing student essential for the development of these competencies. Purpose of the research According to those mentioned above, it is proposed to identify the prevalence of overweight and obesity in nursing students at Florida National University. Since it is necessary to identify these factors from the beginning but to know which ones prevail throughout medical training or if, on the contrary, they undergo some modification that favors the appearance of chronic non-communicable diseases. Thus, this study is a reliable source willing to explore the option of serving as a basis for future studies on obesity and the weight of nursing students. In this way, it is possible to affirm that future researchers have a basis for identifying the status of students at Florida National University. Research Questions What is the prevalence of Overweight and Obesity in nursing students at Florida National University? Is the proportion of one in two overweight Americans applicable to Florida National University nursing students? What are the eating habits, physical activity and presentation of sedentary lifestyle in the study population? Master's Essentials Essential Two: Organizational and Systems Leadership Considering that citizens expect to find in health professionals the reflection of good eating habits, physical activity, and mental health. This Essential focuses on promoting the leadership of health institutions and their members so that each health professional should be an example of their knowledge. References AACN. (2011). AACN—The essentials of master’s education in nursing. Essential Knowledge for CNL® and APRN Nurse Leaders, 4-5. https://doi.org/10.1891/9780826183712.ap01 CDC. (2020, February 27). Products - DATA Briefs - Number 360 - February 2020. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db360.htm Kurnat, K. (2020). Nurses' health promoting lifestyle behaviors in a community hospital. Retrieved September 25, 2021, from https://pubmed.ncbi.nlm.nih.gov/28532732/ Miller, T. (2018). Overweight and obesity in nurses, advanced practice nurses, and nurse educators. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18460166/ Romero-Blanco, C., Hernández-Martínez, A., Parra-Fernández, M., Onieva-Zafra, M., Prado-Laguna, M., & Rodríguez-Almagro, J. (2021, April 18). Food addiction and lifestyle habits among university Nursing students. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073513/ WHO. (2019). Non communicable diseases. Retrieved September 25, 2021, from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases World Obesity and Weight Management Congress. (2021). Obesity conferences 2021: Obesity Events: WORLD Obesity Congress: OBESITY 2021. Retrieved from https://obesityworldconference.com/ 2 2 Quality of Care and Application of Pressure Ulcer Prevention Measures Introduction to the Problem Pressure ulcers constitute one of the most frequent problems in daily nursing practice, being a great challenge and a great responsibility in both prevention and treatment due to autonomy of action. Pressure ulcers have been a serious problem that has mainly affected people who must remain bedridden for long periods due to trauma or illness (Hampton, 2020). There is evidence that this complication was known from very ancient times. Currently, worldwide, there are records on pressure ulcers; in terms of prevention, WHO (2020) establishes that 3 to 11% of hospitalized people develop pressure ulcers. The incidence of people with ulcers per pressure is 8.5%. In medical centers for veterans, it is 7.4%, and in nursing homes, 23.9%. The prevalence of pressure ulcers in the hospital environment can reach up to 45% in chronically ill patients and over 9% of all hospitalized people, constituting a health problem in chronic conditions and people in acute states. According to the CDC (2019) in the United States, pressure ulcers were reported in 5% to 32% of patients admitted to a district general hospital (the exact rate depends on the combination of cases) and in 4% to 7% of patients in the community settings. On the other hand, according to the National Commission for the Prevention and Treatment of Pressure Ulcers (2019) there are no records of incidence and prevalence of pressure ulcers at an international level; however, the costs involved in management are high considering the costs of America and Europe. On the other hand, Menzel (2018) indicates that in recent years, a demographic transition has been underway in Western societies, with a vertiginous increase in the number of people over 65 years of age and, in particular, those over 80 years of age. This type of ulcer causes suffering and considerably increases the morbidity and mortality of the affected persons. That is why prevention is an important aspect; This seeks to avoid prolonged pressure and conduct a routine inspection of susceptible areas. WHO (2020) states that although a person of any age develops pressure ulcers if they do not change position frequently, this risk is increased in older adults due to age-related skin changes, including loss of moisture, subcutaneous fat, and increased blood pressure. Pressure ulcers constitute a significant public health problem due to their repercussions in different areas, such as the health level of those who suffer from them, users' quality of life and their environments, the consumption of resources for the health system, in situations that are often avoidable. Most pressure ulcers can be 95% preventable. Clearly Identify the Problem The appearance of pressure ulcers is a process that is closely related to the nursing care provided to the patient in internal medicine units in hospitals in the United States. There is no doubt that the higher the quality and extent of such care, the lower the incidence of pressure ulcers. In this context, caring for a patient with pressure ulcers entails an increase in the time required in health care and a consequent increase in the workload (Lyder, 2018). On the other hand, it should be noted that when a patient develops a pressure ulcer, their predisposition to suffer from various disorders derived from it increases, such as pain, infections, and physical deterioration. All this, in turn, affects a series of factors of a diverse nature (personal, family, health, etc.). Bedsores or pressure ulcers are lesions that occur in the skin and deep tissues, produced by the prolonged support of the skin against bone areas. They occur preferably in the points of support of the body or more significant pressure such as the buttocks, region close to the coccyx, heels, shoulders, knees (Lyder, 2018). Pressure ulcers affect people who are immobile in bed for a long time, lying on their back, or having fecal and urinary incontinence. They can also occur in the elderly, people with diabetes, arteriosclerosis, terminal diseases, malnutrition, obesity, among others. Pressure ulcers are caused by a lack of blood supply to an area, causing laceration of the skin due to prolonged pressure on bony or cartilaginous prominences (Hampton, 2020) Significance of the problem to Nursing The nursing professional has a primary role in health promotion, which is the strategy that allows you to seek an optimal health status for a specific population, where health education plays a fundamental role. Health promotion provides citizen-patients with the necessary means to improve their health and exercise greater control over it (nursing professional¸2018). If ulcers are not treated in time, they can cause necrosis (destruction of tissues, gangrene), purulent secretions, lousy odor, bone lesions, and general discomfort in patients. Bedsores have severe epidemiological consequences; they are associated with severe infection and necrosis. The economic cost of treating bedsores is very high and time-consuming. The most frequent location about the pressure areas is - 65% in the pelvic area - 30% in the lower and upper extremities - 5% in other areas such as the occipital (posterior region of the head), scapulae (back), nose (when carrying a nasogastric tube) (WHO, 2020). The first warning sign is erythema or redness of the area. Pressure ulcers can and should be avoided with good nursing care within a general plan that includes the multidisciplinary work of the doctor, nurse, patient, and family. It is necessary to find the ideal treatment for each type of ulcer and, in many cases, use different treatments, depending on the evolution. The important thing is to make the individual consultations in health units promptly. This research is vital for nursing because it aims to show that from the nursing intervention, the excellent evolution and resolution of pressure ulcers depend, in addition to being a clear indicator of the quality of care both at the intra-hospital and extra-hospital level because they seriously aggravate the general condition patient due to increased risk of infection and metabolic complications. Purpose of the research Failure to resolve the nursing intervention in patients with pressure ulcers associated with risk factors in hospitalized patients will increase the risk of developing pressure ulcers, and inmates who are already scared run the risk of gangrene and aggravate their condition not because of the pathology for which he was admitted, but because of complications in pressure ulcers (Hampton, 2020). There is low immunity; therefore, patients are exposed to remain immunosuppressed, a situation that deteriorates their health, taking them to extremes that compromise their life and speedy recovery, with the concern of family members and the home health that would further raise hospital costs. In such a way that the purpose of this study is to identify the impact of nursing actions in the prevention, intervention, and care of pressure ulcers in immobilized patients or with mobility limitations to demonstrate the importance of pacification and education for the prevention of skin injuries from nursing, and thus, reduce hospital costs and minimize the suffering of patients. Research Questions How is the nursing intervention in patients with pressure ulcers associated with the risk factors of hospitalized patients? Are patients at risk of developing pressure ulcers assessed? Are there enough supplies to provide nursing care according to the needs of the patient? What are the risk factors for pressure ulcers?