Comprehensive Application of Epidemiology Essay

Comprehensive Application of Epidemiology Essay

Comprehensive Application of Epidemiology Essay

Comprehensive Application of Epidemiology Sample Essay

Cardiovascular problems comprise a crucial health concern in the modern world because of their increasing prevalence and impact on the population. Conditions such as heart disease act as a source of considerable disease burden to patients and their significant others. The Healthy People 2030 has considered heart disease a priority and developed objectives that guide the evaluation of the effectiveness of population-centered interventions to address it. A DNP-prepared nurse is responsible for implementing innovative, patient-centered interventions that prevent heart disease and its associated complications among the affected populations. Therefore, the purpose of this paper is to explore the issue of heart disease, propose an innovative primary prevention intervention, and examine the roles of a DNP nurse.

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Problem Identification

The selected health problem from the Healthy People 2030 is heart disease. Heart disease is currently considered the leading cause of deaths in America (health.gov, n.d.). Heart disease encompass a range of cardiovascular conditions that affect blood vessels such as coronary artery disease, heart valves, heart muscles, and causing irregular heartbeats as seen in arrythmias (Benjamin et al., 2019). The population’s impacts of heart disease increase the need for prioritized interventions to address it in communities.

Significance

Heart disease was chosen in this paper for several reasons. First, heart disease is currently the leading cause of deaths in America. According to the Centers for Disease Control and Prevention (CDC), a person dies from heart disease in America in every 34 seconds. The statistics by the CDC also show that heart disease accounted for 697000 deaths in 2020. This rate translated into 1 in every 5 deaths being caused by heart disease. Heart disease is highly expensive for patients, families, communities, and the country. Patients and families suffer from the high costs of care incurred from frequent hospital visits and hospitalizations. The community suffers from a decline in productivity from the disease. America incurs huge costs related to heart disease. For example, the spending in heart disease from 2017 to 2018 was $229 billion (CDC, 2022). This cost includes that for health care services, lost productivity, and medicines that patients need.

Heart disease also lowers patients’ quality of life. The decline in quality of life arises from the lost productivity and engagement in social and occupational roles by the patients. Frequent and prolonged hospitalization also reduces the productivity levels of the patients and their families. Heart disease also predisposes patients to mental health problems. The risk of them developing mental health problems such as depression and anxiety is high (Coffey et al., 2021; Ng et al., 2021). The complex disease’ demands also affects the socioeconomic status and development of patients and their families, increasing the need for innovative interventions to prevent and promote optimum outcomes.

Background

As noted initially, heart disease is a term for conditions that affect the heart’s pumping activity. It encompasses conditions such as coronary artery disease, cardiac dysthymias, congenital heart diseases, and those affecting the valves. Heart disease symptoms depend largely on the type. For example, patients suffering from coronary artery disease may experience symptoms such as shortness of breath, chest pain, pressure, and tightness. Patients may also report chest pain that radiates to the jaw, neck or shoulders. They may also have weakness, numbness, and pain in the extremities. Patients with cardiac dysthymias may report dizziness, chest pain, fainting, lightheadedness, tachycardia, and bradycardia. Valvular heart disease may present with symptoms such as fatigue, irregular heartbeat, shortness of breath, and syncope (Tsao et al., 2022). Therefore, accurate diagnosis is crucial to facilitate effective, safe, and efficient treatments for patients and their families.

Heart disease is attributed to several factors. One of the leading causes is the deposition of fats and plaques on the walls of the arteries to cause arteriosclerosis. The deposits narrow the blood vessel lumen and impede the normal blood flow to the heart and other body tissues. The other cause is hypertension. Uncontrolled or poorly managed hypertension impairs cardiac function by causing cardiomyopathy, which is associated with heart disease. Heart disease also has several risk factors (Severino et al., 2020). They include high levels of low-density lipoproteins, cholesterols, obesity, diabetes, and tobacco smoking.

Evidence-based interventions have been explored to prevent and manage heart disease. They include the provision of health education, counseling, early treatment, adoption of nurse-led interventions on heart disease self-management, and use of medications. These interventions have been effective. For example, health education on heart disease self-management promotes healthy lifestyle and behavioral change. Pharmacological interventions such as the use of antihypertensives are effective in symptom control. Counseling services help patients cope with the demands of the disease, thereby minimizing the risk of mental health problems such as depression and anxiety (Otto et al., 2021). The information on these interventions helps in identifying gaps in practice that can be addressed through innovative care.

Innovative Intervention and Its Implications

A proposed innovative primary prevention intervention is visiting communities to screen the community members for risk of heart disease. Screening is an effective intervention for early diagnosis, prevention, and treatment of heart disease. Most of the current interventions in healthcare are not community-centered. In this case, patients are largely diagnosed with heart disease upon entry to healthcare system for heart disease-related conditions or causes (Otto et al., 2021). An innovative solution would be taking screening services to communities rather than waiting for disease progression at the healthcare settings.

The provision of screening services at the community level has considerable implications to health care. First, it will facilitate early diagnosis and treatment of heart disease and its associated risk factors. Early identification will result in the adoption of interventions that prevent heart disease progression and development of complications. Those found at a risk will be counselled on the potential interventions they should adopt to prevent heart disease. For example, interventions such as health education and guidance on healthy lifestyles and behaviors reverses the risk of complications associated with obesity and overweight. The other implication associated with the intervention is the increased awareness among the community members on heart disease and other cardiovascular conditions. The incorporation of strategies such as health education will empower community members to be proactively involved in promoting their health (Gupta & Wood, 2019). The other implication of the intervention is the increased utilization of healthcare services. Increased community awareness about their health risks and issues will heighten their utilization of healthcare services to prevent and manage other health problems. Therefore, the intervention will indirectly promote the health of the entire community by focusing on screening them for heart disease. The intervention will also raise the need for community-centered policies to ensure population health (Tsao et al., 2022). The success of the intervention will require organizational, staff, and community support for its success.

Roles of a DNP Nurse

The DNP prepared nurse plays several roles in the implementation of the intervention. One of the roles is care provider. The nurse utilizes her knowledge and skills in nursing to assess, plan, implement, and evaluate care interventions. The nurse also screens the community members for heart disease and its associated risks. Through it, the nurse promotes the use of scientific approaches to ensuring the reduction of heart disease burden in the population (aacn.org, 2006).The other role by the DNP nurse is health education. The nurse educates the community, those at risk and affected about strategies to promote healthy living. The education empowers them to embrace healthy lifestyles and behaviors (Healthcare, 2023). For example, the nurse educates them about the importance of engaging in active physical activity to minimize the risk of cardiovascular problems.

The DNP nurse also coordinates activities involved in the implementation of the intervention. The coordination roles include resource allocation, personnel management, and ensuring the implementation is per the developed plan. The coordination role by the nurses ensures efficiency in the realization of the project outcomes. The other DNP nurse’s role is advocate. The nurse advocates for adequate resource allocation for the intervention and the protection of rights of the community members. Successful implementation of the intervention requires the use of human, financial, and material resources. The DNP nurse lobbies for adequate resource support from the organization and communities (John & Keleher, 2021). The advocacy role also extends to ensuring the adoption of healthcare policies that minimize the rates and impact of heart disease on the population. The nurse also ensures the utilization of approaches that align with the values, beliefs, and practices of the communities alongside the promotion of quality and safety (aacn.org, 2006).

Conclusion

In conclusion, the selected health problem from the Healthy People 2030 objectives is heart disease. Heart disease was selected because of its impact on patients, families, communities and the country. The proposed intervention entails offering heart disease screening services in the communities. The DNP nurse plays crucial roles in ensuring the success of the intervention.

References

aacn.org. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice.

Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., Delling, F. N., Djousse, L., Elkind, M. S. V., Ferguson, J. F., Fornage, M., Jordan, L. C., Khan, S. S., Kissela, B. M., Knutson, K. L., … On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2019). Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation, 139(10). https://doi.org/10.1161/CIR.0000000000000659

CDC. (2022, October 14). Heart Disease Facts | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/facts.htm

Coffey, S., Roberts-Thomson, R., Brown, A., Carapetis, J., Chen, M., Enriquez-Sarano, M., Zühlke, L., & Prendergast, B. D. (2021). Global epidemiology of valvular heart disease. Nature Reviews Cardiology, 18(12), Article 12. https://doi.org/10.1038/s41569-021-00570-z

Gupta, R., & Wood, D. A. (2019). Primary prevention of ischaemic heart disease: Populations, individuals, and health professionals. The Lancet, 394(10199), 685–696. https://doi.org/10.1016/S0140-6736(19)31893-8

Healthcare, S. (2023). Community Health Officers, Fundamental of Nursing—2023. Svastham 24/7.

health.gov. (n.d.). Objectives and Data—Healthy People 2030 | health.gov. Retrieved April 3, 2023, from https://health.gov/healthypeople/objectives-and-data

John, W. S., & Keleher, H. (2021). Community Nursing Practice: Theory, Skills and Issues. Taylor & Francis Group.

Ng, A. C. T., Delgado, V., Borlaug, B. A., & Bax, J. J. (2021). Diabesity: The combined burden of obesity and diabetes on heart disease and the role of imaging. Nature Reviews Cardiology, 18(4), Article 4. https://doi.org/10.1038/s41569-020-00465-5

Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F., Jneid, H., Krieger, E. V., Mack, M., McLeod, C., O, ’Gara Patrick T., Rigolin, V. H., Sundt, T. M., Thompson, A., & Toly, C. (2021). 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary. Journal of the American College of Cardiology, 77(4), 450–500. https://doi.org/10.1016/j.jacc.2020.11.035

Severino, P., D’Amato, A., Pucci, M., Infusino, F., Adamo, F., Birtolo, L. I., Netti, L., Montefusco, G., Chimenti, C., Lavalle, C., Maestrini, V., Mancone, M., Chilian, W. M., & Fedele, F. (2020). Ischemic Heart Disease Pathophysiology Paradigms Overview: From Plaque Activation to Microvascular Dysfunction. International Journal of Molecular Sciences, 21(21), Article 21. https://doi.org/10.3390/ijms21218118

Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Ferguson, J. F., Generoso, G., Ho, J. E., Kalani, R., Khan, S. S., Kissela, B. M., … null,  null. (2022). Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation, 145(8), e153–e639. https://doi.org/10.1161/CIR.0000000000001052

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Module XI: Genetics and Genomics in the Clinical Practice of Epidemiology

Introduction

Genetic and genomic science is impacting nursing care. Advances in science have uncovered that mostly all diseases and conditions have genetic or genomic roots. Application of these principles is critical in all aspects of clinical practice and academic preparation for the DNP and will be reviewed in this module.

Also included in this module is a discussion on infection control and its relationship to clinical epidemiology. Infection control as a specialty for nurses began in the 1960s. In 1970, only 10% of hospitals had Infection Control Practitioner (ICP) and only 10% had policies on intravenous line and ventilator circuit changes. It wasn’t until the 1980s that hospitals began actively employing ICPs. Components of infection control programs at that time included surveillance and analysis of nosocomial infections and development and implementation of prevention and control measures; these remain in place today.

Although pioneers, including Semmelweis, Nightingale, and Farr, identified the need for such programs in healthcare, hospital epidemiology programs did not appear until the mid-1900s. Epidemics of staphylococcal infections in a variety of patients were the major reason for the development of hospital epidemiology as a discipline. Over the years, the Joint Commission (JC) has implemented infection control standards and the Occupational Health and Safety Administration (OHSA) has published documents on blood-borne pathogen protection.

Infection control has advanced and developed as a specialty. The Association for Professionals in Infection Control (APIC) is the professional organization that provides a certification examination for ICPs. The American Journal of Infection Control is its official publication.

Objectives

Upon completion of this module the student will be able to:

• Differentiate genetics and genomics.
• Discuss the application of genetic science with disease management.
• Complete a family health history.

Definitions

Since 2003 with the completion of the Human Genome Project, scientists have been able to isolate human DNA and identify specific genes that cause disease and impact health promotion, prevention and treatment. Before continuing on the theory for genetics and genomics it is important to clarify a few associated definitions:

• Genetics: study of heredity and transmission of inherited variations
• Genomes: genetic component of an organism
• Genomics: study of the structure of genomes/genes and how they interact with each other, as influenced by environmental, cultural and psychosocial variables.
  • See this fact sheet about the difference between genetics and genomics  Genetics vs. Genomics Fact Sheet (genome.gov)
• Pedigree: a graph of a family health history using standard symbols

Genetics, Genomics and the Family History

Family health histories are important to gather to determine the degree of risk to 3 generations of family members. Sharing the same genes and environments can expose patients to chronic diseases. Health promotion and prevention activities are developed based upon the risk factors. It is difficult for patients to have knowledge of all family members and their health. The following websites provide some tools that can be utilized by family members in planning processes for detecting family health histories:

• http://www.cdc.gov/genomics/
• https://www.hhs.gov/programs/prevention-and-wellness/family-health-history/index.html

Welcome to week 11

Readings

• Merrill Chapter 11 (pg. 239)
• Manolio, T., Rowley, R., Williams, M., Roden, D., Ginsburg, G., Bult, C., Chisholm, R., Deverka, P., McLeod, H., Mensah, G., Relling, M., Rodriquez, L., Tamburro, C., and Green, E. (2019). Opportunities, resources, and techniques for implementing genomics in clinical care. The Lancet(394)10197, 511-520.   Implementing genomics into clinical care article
• Genetic Epidemiology (genome.gov)
• Genomics and precision health

Discussions

Module XI
Discussion 1	Please complete the case study on Maria at the following link: https://www.genomicscases.net/en  
 Discuss new information that you learned about genetics and its application to clinical practice from the case study. How will this new information assist you in your future role after completing your DNP degree? Module XI: Discussion 1
Assignment	Module XI: Comprehensive Application of Epidemiology
	Post your initial response by Wednesday at 11:59 PM EST. Respond to two students by Saturday at 11:59 PM EST. The initial discussion post and discussion responses occur on three different calendar days of each electronic week. All responses should be a minimum of 300 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and referenced.  A minimum of 2 references are required (other than the course textbook). These are not the complete guidelines for participating in discussions. Please refer to the Grading Rubric for Online Discussion found in the Course Resources module. Special Guidance on APA formatting in Discussion Posts APA formatting is required in discussion posts with the following two exceptions (due to limitations with the text editor in LIVE):  double line space and indent 1/2 inch from the left margin. Discussion posts will NOT be evaluated on those two formatting requirements. All other APA formatting guidelines should be followed. For example, in-text citations must be formatted with the appropriate information and in the correct sequence (Author, year), reference list entries must include all appropriate information following guidelines for capitalization, italics, and be in the correct sequence. Refer to the APA Publication Manual 7th ed. for each source type’s specific requirements. Please let your instructor know if you have any questions.

Wilkes University