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Health promotion for homeless people essay
What is evidence based practice in nursing quiz
What is evidence based practice in nursing quiz
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The purpose of the scholarly paper part two is to demonstrate the completion of the evidence-based homeless health promotion project; it is specific to the population living in Miami, Florida. Part two of the project presents evidence-based interventions to address measurable and unfavorable health outcomes associated with risk factors that were identified in part one of the project. Also, health promotion project evaluation will be provided. The discussion in part two exclusively focuses on the evidence-based practice (EBP) interventions associated with high risk factors affecting the population. According to Health Care for the Homeless (n.d.) explains that homelessness is critically linked to mental illness. This implication alerts nursing …show more content…
to provide evidence-based interventions for the prevention of homelessness and health promotion. Positive outcomes can be achieved by providing early diagnosis, treatment, referrals, and psychiatric outpatient services therefore improving the health and wellness for individuals and their population. Evidence-Based Interventions The Doctor in Nursing Practice (DNP) is in the position to advocate, influence in decision making, discuss ethical dilemmas, and healthcare policy change for developing health promotion projects (Zaccagnini, 2014). These professional practices can improve health outcomes for the homeless individuals, communities, and populations with mental disability. Through advocacy, The DNP leader can motivate and educate community leaders to take action in preventing homelessness. Advocating and reaching out to those vulnerable individuals and their population is the key to assuring that they receive compassionate care and allocation of services (Zaccagnini, 2014). Utilizing Rationale for Interventions The intent of implementing evidence-based interventions is to provide supportive health services and facilitate health behaviors change to improve the health and well-being of individuals and their communities (Leddy, 2006).
In order to build an effective health promotion project for the population, individual interventions, challenges, and limitations should be addressed first. The uniqueness of the population is based on the core and fundamental aspects of mental disorders. Substance Abuse and Mental Health Services Administration (SAMHSA) (2009) states that mental illness is incapacitated with multiple factors affecting thought process, association, affect, and ambivalence. These implications, limitations, and challenges must be assessed individually in order to incorporate individuals for participating in health promotion programs. Nursing interventions and recommendations must be tailored to teaching patients how to cope with stress, disease, adherence to medication regimen, and build support …show more content…
system. The health system provides management and wellness programs for those individuals who are not cognitively impaired. Dealing with the homeless that are mentally incapacitated, nursing intervention priority should be to assist them with developing coping skills, education for adherence to medication regimen, and promoting health behaviors. As individuals’ struggles with persistent mental symptoms, interventions should target minimizing the mental illness symptoms; Hallucinations, psychosis, depression, and suicidal tendencies. This can be achieved by providing interventions to support adherence to medication treatment and outpatient psychiatric therapy services. When individuals are properly medicated and meet criteria for recovery, nursing interventions focus in coordinating outreach programs in communities and health promotion projects therefore improving the health of vulnerable individuals, communities, and populations that are at risk (SAMHSA, 2009). Identification of Outcome Measurements Homeless patients with mental disability are frequently brought to emergency rooms for medical and psychiatric care.
Discharge planning for these patients into the community does not consider living in shelters and assisted living facilities. The revolving door situation creates negative outcomes for patients and organizations. These organizational alternative housing services do not provide medication supervision, therefore adherence to medication regimen and treatment is not provided to them. Consequently, they return to hospitals seeking follow-up treatment. Unfortunately exacerbation of mental illness symptoms is inevitable reflected from premature discharge and inadequate follow-up care. It is imperative that all patients receive proper treatment and discharge plan. Providing discharge instructions to patients for transitioning to independent living and self-care is not sufficient. Proactive health interventions and planning organizational strategies are needed to improve health outcomes for patients who are living in health care institutions (National Health Care for the Homeless council,
2008).
Lee et al. (2010) state living on the streets can increase social instability and drug abuse. These two interferences may ignite or resurface a person’s mental health problem. Roche (2004) says there is a significant relationship between homelessness, mental health, and physical health. A person with a mental health issue may possible neglect their physical health. McMahon (2009) outlines treatment a client who had poor physical, mental health and homelessness. Mental health issues do not predetermine poor physical health, but may be a related factor. Strine et al.(2012) outline studies on Adverse Childhood Experiences (ACE) making connections to mental health issues and substance use while Montgomery, Cutuli, Evan-Chase, Treglia and Culhane (2013) makes a connection between ACE, h...
With nearly 3.18 million people in the United States, there are 610.042 individuals who are homeless which calculates to about nearly one in five individuals (U.S. Census Bureau, 2014 and HUD/US, 2013). At any time situations can change that can render an individual’s homeless. There are no qualities that exempt individuals from the chances of becoming homeless. However, there are certain predispositions and characteristics that can predict the likelihood of becoming homeless. Homelessness can be contributed to a number of situations such as occupational stress, financial stress, mental health issues, substance use, gender, age, race, disabilities, incarceration, chronic illness, and family stress.
While it is true that housing is correlated with positive outcomes in the homeless population, it does not account for supportive services that this population may also need. Housing is one plan of action for preventing homelessness, but it does not solve the problem. Persisting health problems may prevent an individual from ever reaching housing stability for them a permanent house would not be beneficial if the problem is their health. Housing without supportive services cannot end homelessness.3,4 Providing housing for the homeless is a measure taken after people have experienced the trauma of losing their home. Intervention efforts should be concentrated on preventing the loss of homes, and safety that can ultimately influence a person 's health
Rather than preparing graduates in education or consulting as previous graduate nursing programs had done, this program educated psychiatric-mental health nurses as therapists with the ability to assess and diagnose mental health issues as well as psychiatric disorders and treat them via individual, group, and family therapy (ANA, 2014). Thus, the Psychiatric Mental Health Clinical Nurse Specialist (PMH-CNS), one of the initial advanced practice nursing roles (Schmidt, 2013), was born. After Community Mental Health Centers Act of 1963 led to deinstitutionalization of individuals with mental illness, PMH-CNSs played a crucial role in reintegrating formerly institutionalized individuals back into community life (ANA, 2014). PMH-CNSs have been providing care in a wide range of setting and obtaining third-party reimbursement since the late 1960’s. In 1974 a national certification for PMH-CNSs was created (APNA, 2010). Subsequently, PMH-CNSs began to be granted prescriptive privileges in the Pacific Northwest in the late 1970s, that practice has now spread to 37 states and the District of Columbia (APNA,
individuals with serious mental illness residing in supported housing environments, Community Mental Health Journal, 47(4), doi: 10.007/s105
...em to come to the same general conclusion: public health programs for the homeless are not as effective as they could be. Whether it is not providing full attention in the type of service that is provided or a lack of outreach by the programs, a majority of people are not receiving the care they need. Instead of criticizing homeless people for crowding the emergency rooms consider the fact that they typically do not have an easily accessible alternative for medical care. “Systems like the Boston Health Care for the Homeless Program have spent the past decades building a public health program that now has helped find insurance for 76% of patients who come through” (Oppenheimer et al., 2010, p.1401). It is important that cities all across the country begin programs that will improve and eventually completely eliminate the health care inaccessibility for the homeless.
Recently at Shadow Health General Hospital, this nurse came across a patient, we will call TJ, who had an infected, slow healing wound on her foot. TJ is 28 year old African American woman, 170 cm tall, 90 kg and body mass index (BMI) of 31, who was diagnosed with type 2 diabetes four years ago. It was evident from the onset of meeting TJ that she wasn’t a very compliant patient, in terms of self-assessing her blood sugar or taking her medication. Due to her lack of compliancy, she displayed very poor glycemic control, there was plenty of both subjective and objective data supporting this.
Zlotnick, C., Zerger, S., & Wolfe, P. B. (2013). Health care for the homeless: What we have learned in the past 30 years and what's next. American Journal of Public Health, 103(2), 199-205.
All studies seem to come to the same general conclusion: public health programs for the homeless are not as effective as they could be. Whether it is inadequacy in the type of service that is provided or a lack of outreach by the programs, a majority of people are not receiving the care they need. Instead of criticizing homeless people for crowding the emergency rooms consider the fact that they typically do not have an easily accessible alternative for medical care. Systems like the Boston Health Care for the Homeless Program have spent the past decades building a public health program that now has helped find insurance for 76% of patients who come through (Oppenheimer et al., 2010, p.1401). It is important that cities all across the United States begin programs that will improve and eventually eliminate health care inaccessibility for the homeless.
According to an article by Craig, "In the last decade there has been growing concern about the numbers of mentally ill homeless people on the streets in Britain. It is widely believed that this is a direct consequence of the closure of hospital asylums," (Craig 1). Due to lack of care and insufficient policies, mental illnesses have put a vast amount of individuals on the streets thus, adding to the homeless population.
By the conclusion of this project, based on the learning material supplied and hygiene items provided, the homeless population will be empowered to take responsibility for the actions they can control when dealing with their own health. Implementation is each person’s own task. As health care workers we can’t make anyone take care of their health, that obligation is within them.
Funding for disease prevention and health promotion nationally is highly dependent on government funding through Medicare (Australian Government, 2014). This is largely out of our control. We, as nurses, can still do our part to promote public health in every ward, department or other setting we work in. Chronic diseases are associated with economic, social and health burdens. They cause premature deaths due to diseases which have risk factors that are highly preventable. They are affected by social determinants of health (Australian Institute of Health and Welfare (AIWH), 2014), factors that Medicare need to take in to consideration when allocating funding in the annual budget (Fry, 2010). Chronic diseases are mostly managed through a community-based
In our effort to address the barriers to healthcare access, our mission is to improve our clients well-being and health outcomes by providing medical, mental, and preventive services for individuals with a history of chronic homelessness. With a collaborative effort aided by the case management and outreach currently offered by the Watts Labor Community Action Committee (WLCAC), the mobile clinic will provide additional supporting services that will focus on bringing mental health services, healthcare and social services directly to our clients. As we strive to integrate our services by collocating a mobile clinic, we will focus on disease prevention and healthcare promotion through primary care, while employing a biopsychosocial approached with the goal of optimizing wellness within the population we serve. The objectives outline for the medical outreach program will focus on improved quality of care by using every advantage that is presented with a collocated model and the cross discipline solving techniques that will be available with coordinated care. This holistic approach will include a care team that will bring additional resources and will also focus on being the link to additional comprehensive services while monitoring treatment and outcomes. The integration of services can also prove to be cost effective by the flexibility it offers and by consolidating the resources currently available at WLCAC. The program will also be sustainable by using the working relationships it will have with other community health providers and by using the educational services provided by the University of Southern California. Providing medical services that touch upon primary care practice guidelines,...
Health promotion as described by the Ottawa Charter is the process of enabling individuals to gain control over and to improve one’s condition of health and their wellbeing (Khasnabis, Heinicke Motsch, Achu, et al., 2010). Moreover, the Ottawa Charter also highlights the significance of building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services in order to strengthen people’s potential (WHO, The Ottawa Charter for Health Promotion, 1986).
Many believe that a common thread among the homeless is a lack of permanent and stable housing. But beyond that, the factors leading to homelessness and the services that are needed are unique according to the individual. To put them into one general category ? the homeless- suggests that people are homeless for similar reasons and therefore a single solution is the answer. Every homeless person shares the basic needs of affordable housing, adequate incomes and attainable healthcare. But a wide range of other unmet needs cause some people to become or remain homeless which include drug treatment, employment training, transportation, childcare and mental health services (Center 8.)