Increasing access to health care providers through medical home model

Responses to Discussion

It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University Online Library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources. review and comment on the discussion question responses posted by at least two of your peers. Always use constructive language. All comments should be posted to the appropriate topic in this Discussion Area.

QUESTION #1

Role Specialization – Research Problem & Why

My role specialization is Family Nurse Practitioner. The problem I am interested in is to research the implications of leveraging Mobile Health Clinics in addressing the health, racial and age disparities associated with access to primary care. This is of utmost interest to me because, in my current practice as an Emergency Room (ER) and Intensive Care Unit (ICU) RN taking care of patients at the bedside and as a concurrent licensed Medical Insurance professional conducting community outreach, I personally observe a wide chasm in primary care access impacted by race, age and insurance access. As a Home Health RN early in my nursing career, I have witnessed economically-challenged and predominantly minority clients needing better access to health care. My personal observation of this gap on primary health care access was further reinforced as I take care of ER and ICU patients, communicate with their families and conduct outreach programs as a professional licensed Health Insurance agent to educate and serve clients in rural setting in partnership with local Chambers of Commerce and key community influencers. My ultimate goal is to apply the tools and concepts of this course (NSG6101 Nursing Research Methods) in evaluating the feasibility of a chain of Mobile Health Clinics to address this perceived problem on primary care access, especially for seniors, minorities and the underinsured.

Library Search Strategies – Brief Literature Summaries

My search strategy included the use of our South University’s Online Library, and the corresponding database search using the Advanced Search features of the Online Library, key words (such as medical, care, access, disparity, mobile, health, clinics, etc.), and Boolean operators (AND, OR, and NOT). I narrowed down my database search to peer-reviewed scholarly publications limited to the last 5 years. Then, I use the database feature (the magnifying lens icon) that gives me the ability to glance at the article’s Abstract quickly and determine the article’s relevance to my research problem. Also, I found it very handy and convenient that I have the capability to chat online with South University’s librarians days and early nights, every day except Sunday. Consequently, I found the following 3 articles (with their brief summaries) that fit closely to the problem I have identified:

1. Racial disparity in access to cardiac intensive care over 20 years (Shippee, Ferraro, & Thorpe, 2011) : This article suggests that racial inequality exist in Cardiac ICU (CCU) and outlines 3 key findings: (1) Less admission and fewer days admitted for Black adults than White adults; (2) CCU mortality was higher for Black than for White, with the racial disparity accounted for by differences in disease severity; (3) Black/White disparity shrinks after even one CCU admission.

1. Increasing access to health care providers through medical home model may abolish racial disparity in diabetes care: evidence from a cross-sectional study (Lee, Palacio, Alexandraki, Stewart, & Mooradian, 2011) : This article concludes that the Diabetes Rapid Access Program (DRAP) medical home model offers an opportunity to lower care disparities, improve diabetes care and help abolish racial disparity in diabetes care.

1. The scope and impact of mobile health clinics in the United States: a literature review (Yu, Hill, Ricks, Bennet, & Oriol, 2017) : This article concludes that Mobile Health Clinics (MHC) can be a successful, cost effective health care delivery solution for the underserved US population.

How these 3 Articles Support my Research Problem

The 3 aforementioned peer-reviewed, scholarly articles support my chosen research problem based on the following:

1. The first 2 articles validate and enumerate evidences to my personal observation and intuition regarding racial and age inequality and disparity in medical care access, particularly in 2 common health conditions : cardiac and diabetes care;
2. The third article validates and gives evidence to my field observations (during the various community outreach programs that my company sponsored in cooperation with various Chambers of Commerce, Community Health and Senior Centers, private insurance companies and healthcare providers) : that MHC can be a viable solution to closing the primary care access gap especially for minorities, seniors and the underinsured;
3. Most importantly, this whole library-database-search exercise, demonstrates that, if I can easily search for scholarly articles such as these 3 that I quickly found within matters of hours : therefore I can likewise search for other more-focused articles to gather evidences and literatures in support of my research goal. This is powerful for me since this shows that using South University’s online library gives me the ability to further my research work and help me achieve my research goal.

A Chain of MHCs : Potential Innovation to Healthcare

A potential solution for the current health, racial and age disparity on access to primary healthcare lie in exploring the feasibility of a chain of MHCs working in concert together and in conjunction with anchor hospitals near the target communities. Combined with home care delivery concepts (such as DRAP), I need to research deeper into the cost and operational aspects of this proposed solution.

This is exciting particularly for me since I get to “hit two birds with one stone” – complete this major course (NSG6101 Nursing Research Methods) necessary to acquire my MSN-FNP and lay the foundation towards possibly a more detailed DNP-level research on this same topic; ultimately leading to my personal aspirations of owning a chain of MHCs and positively impacting quality primary healthcare delivery especially for the seniors, minorities and the underserved.

In the final analysis, this Week 1 discussion exercise helped me realize how broad my research topic can be. I respectfully submit that I need the Professor’s help to narrow my research topic down so it is appropriate for this course given the allotted time. I sincerely thank the Professor in advance for her guidance.

References

Lee, K., Palacio, C., Alexandraki, I., Stewart, E., & Mooradian, A. D. (2011). Increasing access to health care providers through medical home model may abolish racial disparity in diabetes care: evidence from a cross-sectional study. Journal of the National Medical Association, 103(3), 250–256.

Shippee, T. P., Ferraro, K. F., & Thorpe, R. J. (2011). Racial disparity in access to cardiac intensive care over 20 years. Ethnicity & Health, 16(2), 145–165. https://doi-org.su.idm.oclc.org/10.1080/13557858.2010.544292

Sutter Health. (2019, December 4). Mobile clinic provides healthcare to San Francisco homeless [Video]. YouTube. https://www.youtube.com/watch?v=7lEgklnIMJQ

Yu, S. W. Y., Hill, C., Ricks, M. L., Bennet, J., & Oriol, N. E. (2017). The scope and impact of mobile health clinics in the United States: a literature review. International Journal for Equity in Health, 16, 1–12. https://doi-org.su.idm.oclc.org/10.1186/s12939-017-0671-2

QUESTION #2

Maria Marin Tobon posted Sep 24, 2020 11:06 PM

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Reproductive and Systemic Developmental problem

My role specialization is family nursing. Additionally, I work in a pediatric health center; thus, I have developed a great interest in managing pediatric or children’s health problems. Research in this area of health is critical. In general, as provided for in the American Association of College of Nursing, nursing research is geared towards optimizing patients’ well-being and health. It has become paramount to research on modern-day health problems affecting children. One of them is the reproductive and systematic developmental health problem.

Through the South University’s Online Library and Online peer-reviewed sites, I came through the following articles addressing reproductive and systematic development in children.

1. A systematic review of sexual and reproductive health interventions for young people in humanitarian and lower-and-middle-income country settings – by Desrosiers et al. (2020)
2. Effects of armed conflict on child health and development: A systematic review – by Kadir et al. (2019)
3. Community-based bundled interventions for reproductive and child health in informal settlements: evidence, efficiency, and equity – by Padmadas (2017).

Desrossiers et al. (2020) addressed the need for sexual and reproductive health interventions, especially for lower and middle-income countries. The authors wrote that some strategies to improve reproductive and developmental health amongst children are fidelity monitoring and double-blind designs. In the two methods, the authors argue that one of the outcomes is sexual or reproductive self-efficacy.

Kadir et al. (2019) wrote about the effects of armed conflict on development and child health. The authors noted that armed conflicts affect 10% of children in the world. The authors call for the urgent need for research on the means and mechanisms of addressing conflict issues and children’s exposure to such.

The focus in Padmadas (2017) research is using community-based bundled interventions for the development and reproductive health of children living in informal settlements. The incorporation of issues, such as cultures and societal practices, can be critical in managing children’s developmental health issues, especially those oriented to reproduction.

One of the components of reproductive health in children that I perceive to be critical is a lack of knowledge on sexual matters. Failure to understand reproductive health is one reason for the rampant indulgence of children in sexuality at the early stages of life, especially in low and middle-income countries. To counter the problem, it is critical that nurses, especially in home health, teach children about body parts. This way, the children will, at the early stages, know about private or sensitive body parts. Through graphics and videos, children will learn about their reproductive health system and how to avoid problems associated with sexuality.

References

Desrosiers, A., Betancourt, T., Kergoat, Y., Servilli, C., Say, L., & Kobeissi, L. (2020). A systematic review of sexual and reproductive health interventions for young people in humanitarian and lower-and-middle-income country settings. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08818-y

Kadir, A., Shenoda, S., & Goldhagen, J. (2019). Effects of armed conflict on child health and development: A systematic review. PLOS ONE, 14(1), e0210071. https://doi.org/10.1371/journal.pone.0210071

Padmadas, S. S. (2017). Community-based bundled interventions for reproductive and child health in informal settlements: Evidence, efficiency, and equity. The Lancet Global Health, 5(3), e240-e241. https://doi.org/10.1016/s2214-109x(17)30049-9

Subject:  Masters Nursing

Answer preview…………………

apa 624 words