VIII. Clinical Prevention and Population Health for Improving Health (AACN, 2011)
"Nursing leadership within health systems is required to design and ensure the delivery of clinical prevention interventions and population-based care that promotes health, reduces the risk of chronic illness, and prevents disease" (AACN, 2011, p. 24). I was able to meet this essential by evaluating a WHO initiative on how globally vital breastfeeding is to newborns. Secondly, after reading the book Dopesick I was able to see how the opioid epidemic has affected my hometown of Southwest, Virginia. During my women's and families clinicals, I was able to work at a rural obgyn clinic to promote health maintenance and screening to prevent chronic disease. Lastly, through the use of Shadowhealth I was able to complete a soap note on an interactive patient with chronic health issues.
First, I was able to meet this initiative through my research on how vital breastfeeding is globally to newborns. I learned that breastfeeding promotion initiatives are initiated at the local, state, national, and international government levels. The role of the APRN should be to promote breastfeeding to new mothers and providers should educate mothers on the benefits of breastfeeding. In my role as a future APRN, I will take every opportunity during nursery and newborn checks to educate families on the benefits of breastfeeding. If the mother is struggling with breastfeeding, the APRN should find resources such as lactation to consult.
WHO Global Initiative
Second, I was able to meet this initiative after reading the book Dopesick. The opioid epidemic is something that has always been a part of my life. I have had close friends and family members struggle with opioid addiction. In our area of Southwest, Virginia and Northeast, Tennessee opioid addiction has been on the rise for the last 10 years. This book highlighted the fact that opioid addiction just doesn't destroy a person from the inside, but rather from the outside out. Addiction rips families apart and causes irreversible damage like a tornado does to everything that comes in its path. As the APRN, clinical judgement must be used when prescribing opioids. In the book most cases of addiction were due to poor management from the provider. The provider failed to acknowledge that the patient was addicted to the medication and yet continued to refill the patient's prescription. Working in the nicu, I have seen the consequences of opioid use during pregnancy. I have held the withdrawing infant that is inconsolable that only has relief from morphine for the pain. Addiction is a real problem, and I will do everything in my power as an APRN to make sure to prescribe and manage the prescribing of opioids to prevent long term consequences of addiction.
Opioid Addiction
Next, I was able to meet this essential during my women's and families clinicals at a rural obgyn clinic in Southwest, Virginia. I did one of my journal entries on a premenopausal woman with chronic health problems such as diabetes and anemia. The patient had been non-compliant with taking her metformin and watching her diet. She was also suffering from chronic anemia due to heavy menstrual cycles. I learned during this clinical rotation that the nurse practitioner sometimes served the role as the patient's primary care provider. She put patients on iron supplementation, anxiety/depression medications, and advocated for her patients by referring them for mammograms and other specialties. The APRN must assume this responsibility to ensure effective patient care across the health continuum.
Soap Note Chronic GYN Problem
Lastly, I was able to meet this essential by completing a soap note using Shadowhealth to discuss pertinent health maintenance issues on chronic disease. The patient from the module had uncontrolled type II diabetes along with asthma and menstrual irregularities. Through interactive software such as Shadowhealth, APRNs can stay up to date on current Healthy People 2020 recommendations. Even in the scope of our practice as PNP students, children under the age of 10 are developing chronic issues such as hypertension, obesity, and hyperlipidemia. These issues can be prevented through the APRN providing health maintenance and education to families at each well child visit.
Shadowhealth Assignment
Strengths
&
Weaknesses
My strengths include being able to provide health maintenance, primary, and secondary prevention education to my patients. I have always had a passion for educating my patients. I love seeing the look on a patient's face when they finally come to terms with their disease and the implications that they may face if the disease isn't properly controlled. My education during this program has prepared me to share my wealth of information on pediatric nursing to the not just my patients but to my community setting.
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My weaknesses include understanding all the forms of diabetes medications in the adult population. Since my program is PNP, the pharmacology for adult diabetes medications is very extensive. I find UptoDate and Epocrates as usual tools when trying to decipher which medication is the right chose for the adolescent or adult patient.