DNP 840 Topic 2 DQ 2 Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system?

Identify a significant problem with one of the three payment structures used in the health care industry across the care continuum (from DQ 1) and propose a solution from one of the other two payment structures.

Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system?

For diabetic patients in a primary care clinic, does implementation of American Diabetes Association Professional Practice Committee American Diabetes Associations Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2022 guidelines: Medical Nutrition Therapy Interventions impact HbA1C compared to current practice over 12 weeks?

My patient population is mostly lower socioeconomic individuals with little or no health insurance coverage (Edupuganti et al., 2019). A large majority are immigrants with questionable citizenship status. For example, I have Sudanese patients with limited English, and caring for them is sometimes challenging due to communication barriers. I and others use translation applications, but paid translation services are outside our budget. This clinic is a free service funded by donations, grants, and Medicaid or Medicare (Centers for Disease Control and Prevention, 2022). I have volunteered here for a few years and am still waiting to see a private insurance carrier. Many patients live in multigenerational homes whose income falls well below the poverty guidelines. Their food choices are limited as the clinic is in a desert. Hence, healthy, nutrient-dense foods are scarce. In addition, health literacy, educational levels, and access to transportation are limited. Therefore, if we reflect on Maslow’s needs theory, we realize that this population struggles with basic needs; and try as I may, those that can vote focus on essentials such as food and utilities. Unfortunately, their lack of participation in voting may reduce their probability of political change. Hence their circumstances are social determinants affect increasing their risk for adverse outcomes.

Sadly, this North Texas clinic resembles many faith-based outreach programs nationwide. Its multiracial

and ethnically diverse community falls within the marginalized groups discussed in previous courses (Centers for Disease Control and Prevention, 2022). The health disparities result in more significant rates of diabetes, obesity, heart disease, and hypertension. Therefore the life expectancy for patients in the clinic is much lower. These factors will ultimately affect diabetic outcomes. What is clear is that we must tailor care to reflect the individual. The MNT process has several components, many encouraging a culturally specific diet. The MNT program also suggests including a dietician, education, and support. Incorporating these factors may assist with compliance and increase positive patient outcomes.

DNP 840 Topic 2 DQ 2 Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system? References

Centers for Disease Control and Prevention. (2022, July 1). What is health equity? Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html

Edupuganti, S., Bushman, J., Maditz, R., Kaminoulu, P., & Halalau, A. (2019). A quality improvement project to increase compliance with diabetes measures in an academic outpatient setting. Clinical Diabetes and Endocrinology, 5(1). https://doi.org/10.1186/s40842-019-0084-9

MY PICOT Question

For cardiopulmonary patients admitted in a long-term care facility, will the translation of Macchio et al.’s research on follow-up with a cardiologist or primary caregiver, compared to current practice at the site, decrease the rates of readmission by 25% within 30 Days?

Selected Patient Population 

The selected patient population for the PICOT research comprises of male and female geriatric patients with an average age of 65 years and with cardiopulmonary disease.

Socioeconomic/Sociopolitical Factors

Cardiopulmonary disease patients face several socioeconomic and sociopolitical factors that influence their health. For instance, studies show that people with low income have a higher risk of developing cardiopulmonary disease and a higher risk of death than those with high income (Schultz et al., 2018). Also, low-income patients from poor neighborhoods are less likely to receive quality care, undergo necessary interventions, and receive recommended medications or follow-up medical check-ups. Educational attainment is another socioeconomic factor that influences the health of Cardiopulmonary patients. Studies show that patients with low educational attainment have an increased risk of cardiopulmonary disease and mortality. This is because they have more comorbidities and receive fewer interventions compared to those with high educational attainment. However, individuals with higher education levels are associated with increased alcohol consumption, smoking, and diabetes (Schultz et al., 2018). This puts them at an increased risk of cardiopulmonary disease. However, they are more likely to receive quality interventions and tertiary prevention programs.

Healthcare organizations are also affected by these factors that influence cardiopulmonary patients’ health. Treating cardiovascular diseases is significantly costly for healthcare organizations as it consists of frequent hospitalizations, long lengths of stay, numerous medications, and costly specialists. This, however, aligns with the norms of the U.S. healthcare system, which is plagued with a high cost and demand for healthcare.

DNP 840 Topic 2 DQ 2 Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system? Reference

Schultz, W. M., Kelli, H. M., Lisko, J. C., Varghese, T., Shen, J., Sandesara, P., Quyyumi, A. A., Taylor, H. A., Gulati, M., Harold, J. G., Mieres, J. H., Ferdinand, K. C., Mensah, G. A., & Sperling, L. S. (2018). Socioeconomic Status and Cardiovascular Outcomes.  Circulation, 137(20), 2166–2178. https://doi.org/10.1161/circulationaha.117.029652

For ED patients being admitted, will the implementation of an interdisciplinary approach from the Agency for Healthcare Research and Quality TeamSTEPPS Handoff, versus current practice, improve throughput in 12 weeks?

Patient overcrowding in emergency departments (ED) negatively impacts the quality of patient care, patient safety, and caregiver engagement. Solutions to reduce overcrowding should be centered around developing a process that promotes efficiency, quality, and empowers the caregiver to provide an excellent patient experience. The purpose of this project is to implement a nursing-driven throughput process. Areas of focus include a rapid triage model that focuses on patient intake and a team-based care model focused on efficient disposition. These processes were designed to reduce overall length patient length of stay in the ED. The benefits of this project are centered around improving patient outcomes in the ED that are associated with reduced length of stay. Other benefits include increased communication and collaboration with the nursing staff to improve caregiver engagement. As the landscape of healthcare evolves, strategies to reduce ED overcrowding must also evolve to reflect how the community uses the ED. Overcrowding directly affects patient care quality, decreases caregiver satisfaction, and places the ED at risk for more significant systemic problems. By implementing a nurse-driven triage model and team-based care approach, caregivers are empowered to impact ED wait times, patient throughput, and reduce the overall length of stay. The PIT model and team-based care approach allow caregivers to collaborate to improve communication and workplace efficiency. As a result, they can improve team morale, increase communication efficiency, and create an environment that focuses on delivering the best patient care experience.

Ahsan et al. (2019), explains that Adequate health care is a basic need for every citizen of a country, and emergency department is a critical part of the hospitals. Therefore, a separate ED is usually designed in most of the hospitals to provide the necessary emergency care to the patients in need. As the population increases, the demand of emergency care also increases in almost every country of the world. Sometimes, many non-emergency patients turn up into the EDs mainly due to the lack of primary healthcare services and lack of proper awareness of the purpose of emergency services. As a result, the EDs are getting busier day by day. On the other hand, these EDs are on constant pressure due to the budget constraints and additional regulations from governments. Healthcare sector in every country is very sensitive, and it plays an important role in national politics. So, any deviation from the desired healthcare service may create additional pressure on the healthcare professionals.

Ahsan, K.B., Alam, M.R., Morel, D.G. et al. Emergency department resource optimisation for improved performance: a review. J Ind Eng Int 15 (Suppl 1), 253–266 (2019). https://doi.org/10.1007/s40092-019-00335-x

Austin, E.E., Blakely, B., Tufanaru, C. et al. Strategies to measure and improve emergency department performance: a scoping review. Scand J Trauma Resusc Emerg Med 28, 55 (2020). https://doi.org/10.1186/s13049-020-0074

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: DNP 840 Topic 2 DQ 2 Identify a significant problem with one of the three payment structures 

For diabetic patients in a primary care clinic, does implementation of American Diabetes Association Professional Practice Committee American Diabetes Associations Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2022 guidelines: Medical Nutrition Therapy Interventions impact HbA1C compared to current practice over 12 weeks?

My patient population is mostly lower socioeconomic individuals with little or no health insurance coverage (Edupuganti et al., 2019). A large majority are immigrants with questionable citizenship status. For example, I have Sudanese patients with limited English, and caring for them is sometimes challenging due to communication barriers. I and others use translation applications, but paid translation services are outside our budget. This clinic is a free service funded by donations, grants, and Medicaid or Medicare (Centers for Disease Control and Prevention, 2022). I have volunteered here for a few years and am still waiting to see a private insurance carrier. Many patients live in multigenerational homes whose income falls well below the poverty guidelines. Their food choices are limited as the clinic is in a desert. Hence, healthy, nutrient-dense foods are scarce. In addition, health literacy, educational levels, and access to transportation are limited. Therefore, if we reflect on Maslow’s needs theory, we realize that this population struggles with basic needs; and try as I may, those that can vote focus on essentials such as food and utilities. Unfortunately, their lack of participation in voting may reduce their probability of political change. Hence their circumstances are social determinants affect increasing their risk for adverse outcomes.

Sadly, this North Texas clinic resembles many faith-based outreach programs nationwide. Its multiracial and ethnically diverse community falls within the marginalized groups discussed in previous courses (Centers for Disease Control and Prevention, 2022). The health disparities result in more significant rates of diabetes, obesity, heart disease, and hypertension. Therefore the life expectancy for patients in the clinic is much lower. These factors will ultimately affect diabetic outcomes. What is clear is that we must tailor care to reflect the individual. The MNT process has several components, many encouraging a culturally specific diet. The MNT program also suggests including a dietician, education, and support. Incorporating these factors may assist with compliance and increase positive patient outcomes.

DNP 840 Topic 2 DQ 2 Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system? References

Centers for Disease Control and Prevention. (2022, July 1). What is health equity? Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html

Edupuganti, S., Bushman, J., Maditz, R., Kaminoulu, P., & Halalau, A. (2019). A quality improvement project to increase compliance with diabetes measures in an academic outpatient setting. Clinical Diabetes and Endocrinology, 5(1). https://doi.org/10.1186/s40842-019-0084-9

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed

• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource

DNP 840 Topic 2 DQ 2 Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system?  Discussion Rubric

		Excellent 90–100	Good 80–89	Fair 70–79	Poor 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing		6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation		9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date.	7 (7%) – 7 (7%) Posts main Discussion by due date.	0 (0%) – 6 (6%) Similar Posts health and medical Discussion: Medical Examination of Immigrants Discussion: Medical Examination of Immigrants Discussion: Medical Examination of Immigrants Discussion: Medical Examination of Immigrants ORDER NOW FOR AN ORIGINAL PAPER… health and medical Rising healthcare costs impact Rising healthcare costs impact Rising healthcare costs impact: An understanding of health care cost, access to care, and quality of care… health and medical Annotated Bibliography from nursing Lit Search Annotated Bibliography from nursing Lit Search Annotated Bibliography from Lit Search Nursing 4pages or 1200words 15 sources Annotated bibliography of a… health and medical Patient Outcomes Assignment Patient Outcomes Assignment Patient Outcomes Assignment Patient Outcomes Assignment ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Patient Outcomes Assignment Review the… health and medical Capella University Continuous Auditing and Risk Based Audit Planning Discussion Capella University Continuous Auditing and Risk Based Audit Planning Discussion Capella University Continuous Auditing and Risk Based Audit Planning Discussion Capella… health and medical HCA 497 Week 2 DQ 2 Quality Management Techniques HCA 497 Week 2 DQ 2 Quality Management Techniques HCA 497 Week 2 DQ 2 Quality Management Techniques Evaluate the effectiveness…