Framingham Heart Study: The First 20 Years, Coursework Example

Assignment 5: The circumstances surrounding CAUTIS involves an examination of the population which is most likely to experience this condition, such as hospitalized patients who require catheterization due to compromised health. Most importantly, it is important to address the possible environmental factors which contribute to this condition, as it has become increasingly prevalent in many hospitals, as indwelling urinary catheters may account for as many as 80 percent of all urinary tract infections in this setting (Blodgett, 2009). For each additional day that a patient requires catheterization, there is a 3-10 percent risk of developing a CAUTI and subsequent complications, and there is an additional approximate cost of $589 per individual case that is identified (Blodgett, 2009). Due to the potential preventative nature of these infections, the Centers for Medicare and Medicaid Services will not cover the treatment of these events, thereby placing the risk back on hospitals to minimize these infections as often as possible (Blodgett, 2009).

The prevention of CAUTIS may be supported by diagnostic factors that include urine cultures, leukocyte esterase and nitrite cultures, and microscopy/Gram’s stain testing, all of which may contribute to the prevention of these infections in some patients (Blodgett, 2009). It is imperative that patients who have catheters are evaluated on a routine basis and that catheters are removed in a timely manner as appropriate (Blodgett, 2009). The risk of disparity for patients with catheters is higher in the sense that hospitalized patients who require catheters may not receive the appropriate amount of attention and focus; therefore, their catheters may be forgotten or unknown by some medical staff, thereby increasing the risk of infection (Blodgett, 2009). In this capacity, healthcare providers must be prepared to work in collaboration to prevent the risk of CAUTIS in patients, using reminder methods and other tools to ensure that patients receive the proper attention and focus to minimize infection risk (Blodgett, 2009).

Assignment 6: Psychosocial factors have a significant impact on health and wellbeing for many people and represent a need to be reflective of the challenges related to disease and other health concerns. It is imperative that there must be a greater emphasis on the continued development of programs and methods that will support individuals as they struggle with psychosocial factors throughout their lives. Physical health is contingent upon a variety of psychosocial factors, such a stress, and this requires an understanding of how stress is related to health concerns for many patients (Wang & Chen, 2009). Factors such as socioeconomic status may also bring upon additional stress for patients and create new challenges for patients, in spite of the difficulties of daily living (Matthews, Gallo, & Taylor, 2010). From this perspective, it is inevitable that patients will experience issues that contribute to chronic disease and limit the ability to experience health-related improvements (Matthews et.al, 2010).

From a strategic perspective, programs and support systems must be available for patients who suffer from different types of chronic disease related to psychosocial factors and must learn how to improve their coping skills over time. This will ensure that they are prepared to manage a variety of events and support an environment in which health is made a priority. In this context, patients must be able to understand the larger picture and be cognizant of the issues that ultimately impact their health in order to be successful in advancing their own wellbeing to a higher level. It is expected that nurses will play a role in this process and create opportunities for patients to recognize their own psychosocial risk factors to improve their health and wellbeing in different ways. Nurses possess the knowledge and expertise that is required to improve health and utilize these tools in a manner that is consistent with the objectives of achieving optimal health and wellbeing for patients across many risk groups, including those who experience chronic disease.

Assignment 7: The study by Elliott et.al (1999) addressed the significance of chronic pain within the community setting, adopting a random sampling method which evaluated a sample of 5,036 patients within a specific area of Scotland, with questions regarding the nature of pain and questionnaires regarding the level of expressed needs and chronic pain. The questionnaire method was appropriate and accounted for several sociodemographic factors that provided insight regarding the study participants. The survey was effective in generating responses regarding the nature of chronic pain; however, it does not answer all questions regarding chronic pain and demonstrates that older populations are likely to experience different perspectives than younger persons.

In the study by Oppenheimer (2010), the history of the Framingham Heart Study is examined over a 20-year period, using a retrospective approach to ask important questions regarding the role of epidemiological analysis in heart disease and their ability to have an impact on the practice environment. This study reflects the importance of the epidemiologic nature of heart disease and what is required to promote these investigations to clinicians as valid and effective in the treatment of the disease (Oppenheimer, 2010). This study is effective in addressing the perspectives of the Framingham Heart Study and in determining how to address the parameters of heart disease by using prior epidemiological data in the process. This reflects a need to further examine the utilization of epidemiologic principles and their application to heart disease and other conditions, as they are likely to be useful in supporting a framework whereby there are significant opportunities available to better understand these issues. Trends in treatment are largely contingent upon epidemiological data as a means of supporting new treatment methods and other factors that will have a lasting impact on outcomes for patients with heart disease and other related conditions.

Assignment 8: The risk or likelihood of a specific health problem requires an examination of the different risk factors which may contribute to the prevalence of disease. Specific characteristics may play a critical role in how disease states are identified, and this supports the adoption of measures of effect to influence nursing-related outcomes. Nursing-based interventions require the development of new perspectives to support change and to recognize the value of integrating epidemiological principles in order to better understand the risk of disease. It is important for nurses to recognize their responsibility to work with patients and to optimize conditions in such a way that it has an impact on healthcare practice.

Measures of effect provide nurses with the tools that are required to improve outcomes for patients and to determine how disease states are identified and how nurse-sensitive outcomes will translate into the practice environment (Ingersoll, McIntosh, & Williams, 2000). Measures of effect must be utilized because they demonstrate the importance of interventions and whether or not they will have a positive impact on outcomes for patients, along with the expectations set forth with prevention and treatment that will minimize the symptoms and prevalence of disease (Sheldon, 2000). For example, the identification of disease requires nurses to examine risk factors and other critical measures that influence these states, thereby requiring nurses to understand the role of nurses in examining prior measures of effect to influence how treatment decisions are made. This process is ongoing and requires nurses to recognize their responsibility to utilize measures of effect to make decisions that will positively impact patient outcomes. If these measures are not used, there is a significant risk of increasing disease risk for many patients across different populations. This process enables nurses to utilize the tools at their disposal to promote positive prevention and treatment decisions to improve quality of life for many people.

References

Blodgett, T. J. (2009). Reminder systems to reduce the duration of indwelling urinary catheters: a narrative review. Urologic nursing, 29(5), 369.

Elliott, A.M., Smith, B.H., Penny, K.I., Smith, W. Cairns, & Chambers, W. Alistair (1999). The epidemiology of chronic pain in the community. The Lancet, 354, 1248-1252.

Ingersoll, G. L., McIntosh, E., & Williams, M. (2000). Nurse?sensitive outcomes of advanced practice. Journal of Advanced Nursing, 32(5), 1272-1281.

Matthews, K. A., Gallo, L. C., & Taylor, S. E. (2010). Are psychosocial factors mediators of socioeconomic status and health connections?. Annals of the New York Academy of Sciences, 1186(1), 146-173.

Oppenheimer, G. M. (2010). Framingham heart study: the first 20 years.Progress in cardiovascular diseases, 53(1), 55-61.

Sheldon, T. (2000). Statistics for evidence-based nursing. Evidence Based Nursing, 3, 4-6.

Wang, Y., & Chen, X. (2011). How much of racial/ethnic disparities in dietary intakes, exercise, and weight status can be explained by nutrition-and health-related psychosocial factors and socioeconomic status among US adults?.Journal of the American Dietetic Association, 111(12), 1904-1911.