Fall 2023 I&C for proffesional practice - Copy
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Oklahoma City Community College *
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2535
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Medicine
Date
Feb 20, 2024
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docx
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Week 2
M2 Discussion Rural older adults have a higher prevalence of several chronic diseases compared to urban older adults, including coronary heart disease and diabetes. Diabetes, one of the leading causes of death in the U.S., has been reported to be as much as 17% higher in rural areas than in urban areas. Compared to urban areas, reductions in diabetes mortality are lagging in rural areas. Diabetes was ranked as the third most important rural priority in Rural Healthy People 2020. Rural older adults are also more likely to be obese,
the prevalence of which ranges from 24% in urban counties to 29% in rural counties (Coughlin et al., 2019). I am from the small town of Dibble. There is a population of around 800 and most of my family still lives in the area. I want better for them. The location of people and resources is the biggest contributor to this disparity. Race is not an issue, but culture does play a role. Many people in the rural community do not place a high priority on health and that is passed from one generation to the next. If this disparity is not fixed community members will continue to suffer the negative health effects. When someone finally goes to the hospital it is usually too late or minor issues have compounded into large costly diseases. Covid has affected the small number of rural hospitals due to the distrust in medicine since the pandemic. To address these financial challenges, the Cares Act authorizes $100 billion of financial relief to hospitals and other healthcare providers, including a special allocation of $10 billion for rural providers (Bai & Anderson, 2020).
(Cross et al., 2021) stats
Bai, G., & Anderson, G. F. (2020, July 1). Covid-19 and the financial viability of US Rural Hospitals
. healthaffairs.org. https://www.healthaffairs.org/content/forefront/covid-19-and-financial-
viability-us-rural-hospitals
Cross, S. H., Califf, R. M., & Warraich, H. J. (2021, June 8). Rural-Urban Disparity in Mortality in the US From 1999 to 2019
. Jama Network. https://jamanetwork.com/journals/jama/article-abstract/2780628
Coughlin, S. S., Clary, C., Johnson, J. A., Berman, A., Heboyan, V., Benevides, T., Moore, J., & George, V. (2019, December 16). Continuing challenges in rural health in the United States
. Journal of environment and health sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043306/
Week 3
M3 Goals for my project include increasing the percentage of the rural population that has reliable transportation to the doctor. I would like the number of people who visit the doctor annually for
checkups to increase by 20 percent in the rural areas. Providing access to transportation with the local church is the solution. Getting the number of community members who utilize telehealth options up is another goal. I would like to see half of the community using these services. Getting the community center connected and involved will give the most information to the most people. Money will be a large barrier. Getting the community center reliable internet that can support video calls with Doctors will be a challenge. Compared to urban areas, rural communities face higher poverty rates, lower educational attainment, lack of transportation, a higher proportion of elderly individuals, and lack of access to health
services. Owing to these factors, rural communities face elevated rates of morbidity and mortality and greater percentages of excess deaths from the five leading causes of death including cancer and cardiovascular disease (Coughlin et al., 2019). Reducing the factors that contribute to the disparity should create an environment for the disparity to be corrected. I would measure to see if the community was educated by doing a survey after 3 months. Asking the community if they were aware of
the new opportunities to access medical care. I would want 90% of the community to be aware of the changes being made. After a year a survey evaluating if the community members had seen a doctor in the last year would be completed. After 5 years an evaluation of reduction of disease could be completed. Trust in the medical field after COVID-19 will be a tough thing to overcome but having the option to stay local and use a video conference may encourage more people to see the doctor if they are not exposed to the hospital. Coughlin, S. S., Clary, C., Johnson, J. A., Berman, A., Heboyan, V., Benevides, T., Moore, J., & George, V. (2019, December 16). Continuing challenges in rural health in the United States
. Journal of environment and health sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043306/
Week 4 No post Week 5 M5
When implementing rural healthcare disparities solutions, I am going to rely heavily on the community to help. The community center would need to be approved to host a virtual doctor visit consult office with a trained member to help the citizens. The internet would need to be paid for by donation or worked into the town budget. Educating the community center and town council on the benefits of the changes is going to be extremely important. An important point to remember is that community organization is fundamentally a grassroots process. It's not about an outside "expert" telling a community what it should work on. Instead, it's about community members getting excited about something, and using that energy to create change. In short, community organization is all about empowering people to improve their lives, however, that might be best done (Nagy, n.d.). The community agreeing and understanding the need for change will be important. I would hold meetings at
the community center to educate the general population about the changes. PowerPoints for visual but very simple information. I would publish the information about the meetings in the local newspaper and
send information packets home with the school students to give to the adults in their lives. Times would need to vary to accommodate all. I would also involve the churches with transportation once again. The
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older population may not be open to change and the use of technology centers but with help from a confident helpful associate I would hope they would give it a shot. (
Improving health care infrastructure to rural populations key to reducing health disparities,
2019) photo
Improving health care infrastructure to rural populations key to reducing health disparities
. Business Wire. (2019, September 24). https://www.businesswire.com/news/home/20190924006005/en/Improving-Health-Care-
Infrastructure-to-Rural-Populations-Key-to-Reducing-Health-Disparities
Nagy, J. (n.d.). Section 1. Strategies for Community Change and improvement: An overview
. Chapter 5. Choosing Strategies to Promote Community Health and Development | Section 1. Strategies for Community Change and Improvement: An Overview | Main Section | Community Tool Box. https://ctb.ku.edu/en/table-of-contents/assessment/promotion-strategies/overview/main
Week 6
M6
Using a survey to evaluate the knowledge of the community's recent programs will give me an idea of whether the flyers and newspaper articles were successful in spreading the news. Doing a before and after one-year analysis of the percentage of the community who saw a doctor in the last year will let me know if the community was receiving more regular care from a physician. The next census in 2030 will allow me to analyze the health of the overall community. Regular checks with the community center and
churches will allow me to re-educate or alter the community involvement based off of participation. A much more expensive solution that has been proposed is to build more hospitals in rural areas. I wish this solution was more economically feasible. Access to health care depends on the three pillars of affordability, availability, and willingness to seek care. USDA, Economic Research Service (ERS) researchers compared the availability of health care based on a county’s degree of urbanization. They found that during 2017–19 residents of the most rural counties may have had more difficulty finding and
using health care services than residents living in metropolitan areas or more rural counties with population hubs. Most rural counties had fewer healthcare facilities and were more likely to have health
professional shortage areas, the research showed (Dobis & Todd, 2021). Allowing the building of facilities would solve the problem it is not feasible for a small community to fund. My plan does account for the financial burden of transportation but paying for the treatment still needs to be addressed. Involving a social worker to help enroll the population in healthcare should be evaluated.
Dobis, E. A., & Todd, J. E. (2021, August 1). The most rural counties have the fewest health care services available
. USDA ERS - The Most Rural Counties Have the Fewest Health Care Services Available. https://www.ers.usda.gov/amber-waves/2022/august/the-most-rural-counties-have-the-fewest-
health-care-services-available/
Week 7
Survey complete
M7 Improve access to healthcare by utilizing local community resources like churches. Inform community members of the health risks and the need to see a doctor. Create a community virtual doctor visit space for the community to utilize. Improving access to telehealth. The rural population makes up 15 percent of Americans. Rural Americans are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than their urban counterparts. Unintentional injury deaths are approximately 50 percent higher in rural areas than in urban areas, partly due to a greater risk of death from motor vehicle crashes and opioid overdoses. In general, residents of rural areas in the United States tend to be older and sicker than their urban counterparts (CDC, 2023). Educating the community and involving them in the change is necessary to make improvements. Information on how to fix the mistrust after COVID needs to be studied. Many people do not want to be in the hospital due to fear of acquiring a new illness or general mistrust. Staffing options for rural hospitals need to be addressed and finding a solution to keep them financially positive without making it too expensive for patients. I did not address every group of disparities. The rural community I am focusing on does not have a diverse enough population to study the effects of all the categories. Location, age, culture, and financial status are the main focal points for my proposed change. Centers for Disease Control and Prevention. (2023, May 9). About rural health
. Centers for Disease Control and Prevention. https://www.cdc.gov/ruralhealth/about.html
Week 8 M8 I do not work as a nurse. I have never worked as a nurse ever. I am a medic in the National Guard we stay very up to date on the changing policy. The Guard is good at making the newest soldiers share what
they learned in school with the rest of us. The Tactical Combat Casualty Care (TCCC) collection has been created by the Committee on Tactical Combat Casualty Care (CoTCCC), providing military personnel with the resources to facilitate implementing best medical practices in battlefield trauma care. Through supporting the training of deploying and deployed U.S. military personnel, the material can be used by individuals to engage in self-directed learning, and by instructors as training aids to supplement formal courseware (
Tactical Combat Casualty Care, n.d.
). The deployed Medicine app is also updated frequently, and every soldier is encouraged to stay up to date on current practices. Having the app makes staying current much easier. Since I have been out of medic school for 9 years, I did not learn the most current stuff. Each time we get a new soldier we make sure to include them in our continuing education. I am a Sergeant and do have some input, but I am number one on the promotion list and will have a lot more responsibility in education and other things when I pick up staff sergeant. I plan to start the nursing administration master’s program in January. I do not plan to work until my kiddo starts
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school. So continuing education is my 5 year goal. My vision has not changed and I always knew I wanted to be a stay at home mom. Defense Health Agency. (n.d.). Tactical Combat Casualty Care
. Deployed Medicine. https://www.deployedmedicine.com/market/11