Case Study on genetic Disorders : Part 3 Assignment

DNP 810 Topic 5 Case Study on genetic Disorders : Part 3 Assignment

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You will be creating a case study in stages over four course topics. This Case Study on genetic Disorders : Part 3 Assignment will add to your previous work in Topic 3. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy, Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating.

General Requirements:

Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Directions:

For this assignment (Part 3 of the “Case Study”), write a paper (1,000-1,250 words) incorporating genetics information learned from assigned readings in Topics 1-5.

Include the following:

1. Examine how genetics can influence policy issues.
2. Discuss any nutritional influences for the cause of this disease.
3. Discuss the process of nutritional assessment and counseling as it relates to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness.
4. Discuss the prevalence rates, testing, treatment, and prognosis as they relate to human nutrition.

It may be possible to earn portfolio practice immersion hours for this assignment. Enter the following after the references section of your paper:

Practice Immersion Hours Completion Statement DNP-810

I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Typhon Student Tracking System for verification purposes and will be sure all approvals are in place from my faculty and practice mentor.Case Study on genetic Disorders : Part 3 Assignment

DNP 810 Topic 6 Health Issues for the Aging Example Paper

Aging cause major socio-economic effect for the community, including the healthcare organizations. As people ages, their health generally declines requiring more medical attention. They are also at higher risk for chronic disease such as: Alzheimer’s disease, diabetes, arthritis, heart disease and particularly falls which can impact their health and quality of life (Awang, Mansor, Nai Peng & Nik Osman, 2018). Falls are the major reason of injury in adults aged 65 years or older. Falls often generate moderate to severe harms like head trauma, fractures and death leading to longer hospital stays, unnecessary admissions/readmissions and increase the healthcare expenditures (Jin, 2018).  Given the aging population growth and the damaging effect of falls, this paper will analyze how to incorporate quality improvement solutions into public policy in order to reduce the occurrence of falls and fall-related damage in the aging population.

Evaluation of Literature, Suggestions, Resolution to Issue

Fall is a major public health issue that can bring about serious injuries and even death in the elderly. In 2014, approximately 27,000 elderly died from unintentional fall injuries and the emergency departments treated 2.8 million elderly of which 742,000 required hospitalization. Elderly fall cost approximately $35 billion in 2012 and is expected to increase to $100 billion in 2030, without the cost for therapy and grievances. Falls created over 20 million dollars annually and increased hospital stay to an extra 6.9 days costing the patient an extra $13,806 (Phelan, Mahoney, Voit & Stevens, 2015). Since falls can be prevented, the Centers for Medicare and Medicaid Services since 2008 have stopped reimbursing hospitals for detrimental fall-related injuries. As a result, fall prevention have become for the healthcare systems both a financial and patient safety importance. Healthcare organizations have put into effect various programs to prevent falls among patients. Preventing falls is important to preserve patient safety and decrease the financial weight on the healthcare system (Staggs, Mion & Shorr, 2015). Decreasing and preventing falls among the elderly has been a focus of study for years due to the rising number of individuals living into older age. Many interventions such as exercise, home safety assessment, modification and multifactorial have been established through randomized controlled trials (RCTs) and subsequently condensed in systematic reviews and meta-analyses and have been showed to be effective in preventing falls among the elderly (Stubbs, Brefka & Denkinger, 2015). Solutions and development of approaches to decrease the incidence of falls have been a noticeable emphasis in the literature for years. There is now convincing indication that falls can be averted with a variety of resolutions. Studies have shown that exercise programs and home/environment evaluations by an occupational therapist can reduce the number of falls (Pighills, Ballinger, Pickering, & Chari, 2016)

Incorporating Solution into Public Policy

The United States (US) population is aging, quickly, the number of older adults is anticipated to increase from 50 million to 75 million as the last group of baby boomers turns 65. By 2034, older adults are predicted to be more than their children in the nation’s history (Naylor, Hirschman, Hanlon, Bowles, Bradway, McCauley, & Pauly, 2014). The urgency to incorporate falls prevention among older adults into public policy should be considered. Policy, research and practice are unified elements needed for a successful and workable program of falls prevention for the elderly.  The development and complicated nature of fall risk among a fast-growing aging populace requires a practical and organized approach to prevention.  The function of policy is to grant the infrastructure and funding necessary for the incorporation of falls prevention into practice.  Research is essential to provide facts to support the successful application of fall prevention interventions.  Practice is where evidence is employed based on the guidelines and rules set by policy (Houry, Florence, Baldwin, Stevens & McClure, 2016).

Medicaid and Medicare which is the second and third major health insurance providers in the US has several policies that can be used to tackle falls prevention, however, they have not all been used to their full benefits. As the guarantor of more than 48 million Americans elderly, the Medicare program can demand, authorize, and incentivize provider actions associated to falls prevention.  Additionally, numerous Medicare Advantage (MA) plans have contracted with community-based establishments to offer falls prevention services to the elderly consisting of free fitness programs and Silver-Sneakers programs (Horton, Dwyer & Seiler, 2018).

Determining Barriers to Implementation of Solution

Implementation of falls prevention can be guided by several reasons including environmental and circumstantial problems; staff understanding, views and mindsets; organizational values and climate; staff assignments; and access to correct equipment and funds. Barriers can include viewpoints that falls cannot be avoided, inadequate understanding on falls prevention in patients with multifaceted care needs like cognitive impairment, lack of funds and involvement in falls prevention efforts (Ayton, Barker, Morello, Brand, Talevski, Landgren, Melhem, Bian, Brauer, Hill, Livingston & Botti, 2017).

Managing falls in the elderly can be difficult due to their multi-factorial make-up. Contributing factors include environmental/home hazards, poor health and functional debilities. Despite various successful interventions to prevent falls among the elderly, such as multi-component exercises, home hazard adjustments, medication evaluations, healthcare providers may not be prepared to manage falls due to numerous challenges. Both elderly and clinicians need to adjust their traditional ways of living and working in order to adopt new approaches and actions that can decrease falls (Loganathan, Ng, Tan & Low, 2015). Other barriers in implementing fall prevention solutions is a lack of organization between diverse local, state and federal organizations. Even though various agencies have their own falls prevention plans, there is no main agency that organizes programs/actions being managed by all of them. In addition, funds offered to the states often must undergo diverse regulations and restrictions. At the state level, fall/injury prevention programs particularly tend have a low importance, and normally there is only one person organizing state-wide efforts (Healthy housing solutions, 2017).

Options for Public and/or Private Funding

Many states have allocated funds to create and uphold statewide fall prevention plans. For instance, the Massachusetts government have launched a fall prevention plan, which propose prevention stratagems in a yearly report. Washington also have an established fall prevention program and funding for services provided by the program. In 2008, Congress approved the Safety of Seniors Act, which orders the secretary of health and human services to give funding and to support states that have various elderly fall prevention programs. The states of Minnesota, Kentucky, New Hampshire and California have utilized the ‘Core Injury Prevention” Grants funding from the Center for Disease Control and Prevention (CDC)’s “National Center for Injury Prevention and Control” to form local teams that support evidence-based plans for fall prevention (Scotti, 2016). The Administration on Aging, a program within Administration for Community Living (ACL), has given over $4.8 million grants for the development and implementation evidence-based falls prevention services and tactics nationwide. ACL awarded ten grants to public and private not-for-profit units, as well as state organizations and community, and four grants to ethnic organizations (ACL, 2019). Policymakers need to allocate adequate funding for the development of effective falls prevention plans. The CDC through the “Center for Injury Prevention”, participates in a variety of surveillance, study, and activities implementation to decrease elderly falls. The CDC appraises data to find and broadcast valuable falls prevention programs, develops teaching tools for providers and sustains state attempts to decrease elderly falls through the “Core State Violence and Injury Prevention Program” funding. The government’s FY2018 budget have planned to remove funding for falls prevention programs at the CDC, however, the Senate has instead advised to continue financing the CDC’s fall programs at around $2 million a vital ongoing savings that would increase in future years considering the fifty billion in yearly medical expenses to manage falls (Horton, Dwyer & Seiler, 2018).

Recommended Solution

When taking measures to apply recommended solution for falls, the reasons that generate fall must be considered for instance intrinsic and extrinsic risk. Intrinsic risk can be attributed to normal aging process and acute or chronic medical issues. Extrinsic factors are associated to the physical environment for example unsuitable floor conditions, lack of grab bars, defective or inappropriate use of equipment (Frieson, Tan, Ory & Smith, 2018). The CDC has founded a process termed “STEADI” (Stopping Elderly Accidents, Deaths, and Injuries) that provides guided interventions to help clinicians integrate falls assessment and prevention into their establishment. Also implementing the American Geriatrics Society’s  guideline will help providers to decrease elderly falls. Another way to reduce fall is through continuing education trainings for providers to better assess the elderly at risk of falls through appropriate management and referral to fall prevention programs. Clinicians also need to provide home adjustments help support to keep the elderly safe in their homes to reduce and prevent falls. Lastly, incorporating medication review is important in assessing elderly at fall-risk. Several groups of medications, principally psychoactive, antidepressants and sedatives medication put the elderly at greater risk, they are provable predictors of falls as they alter the sensorium and destabilize gait and balance (Casey, Parker, Winkler, Liu, Lambert, & Eckstrom, 2017).

To conclude, the inevitable growth in elderly people produce several age-related chronic diseases and severe problems on quality of life. It is important for DNP-prepared nurses to quickly detect those at risk for fall and increase the community awareness of falls prevention. Given the injurious effects falls have on patients and the high cost on the patient and the healthcare system, there is need for clinicians to promote preventive care and make sure to perform methodical assessment as well as a thorough physical examination, fall assessment, medication review, functional and environmental assessment (Khadka & Darai, 2018). With each preventing falls, the patients/families, providers and the healthcare organizations all profit. DNP-prepared nurses have an integral responsibility in decreasing fall among the elderly. Understanding older adults’ standpoint on falls prevention and how to get them involve in fall prevention activities is important to keep the elderly safe in their homes and communities rather than going to nursing home care (Phelan, Mahoney, Voit & Stevens, 2015).

References

Administration for Community Living (ACL). (2019). ACL Funds Evidence-Based Falls

Prevention Grants. Retrieved from https://acl.gov/news-and-events/announcements-latest-news/acl-funds-evidence-based-falls-prevention-grants.

Awang, H., Mansor, N., Nai Peng, T., & Nik Osman, N. A. (2018). Understanding ageing: fear of

chronic diseases later in life. The Journal of international medical research, 46(1), 175–184. https://doi.org/10.1177/0300060517710857.

Ayton, D. R., Barker, A. L., Morello, R. T., Brand, C. A., Talevski, J., Landgren, F. S., Melhem,

171932. M., Bian, E., Brauer, S. G., Hill, K. D., Livingston, P. M., & Botti, M. (2017). Barriers and enablers to the implementation of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomised controlled trial. PloS one, 12(2), e0171932. https://doi.org/10.1371/journal.pone.0171932.

Casey, C. M., Parker, E. M., Winkler, G., Liu, X., Lambert, G. H., & Eckstrom, E. (2017).

Lessons Learned From Implementing CDC’s STEADI Falls Prevention Algorithm in Primary Care. The Gerontologist, 57(4), 787–796. doi:10.1093/geront/gnw074.

Frieson, C. W., Tan, M. P., Ory, M. G., & Smith, M. L. (2018). Editorial: Evidence-Based

Practices to Reduce Falls and Fall-Related Injuries Among Older Adults. Frontiers in public health, 6, 222. https://doi.org/10.3389/fpubh.2018.00222.

Horton, K., Dwyer, G., & Seiler, N. (2018). Older Adult Falls—Costly But Not Inevitable.

Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20180402.25780/full/.

Houry, D., Florence, C.,  Baldwin, G., Stevens, J., & McClure, R. (2016). The CDC Injury Centers

Response to the Growing Public Health Problem of Falls Among Older Adults.  American Journal of Lifestyle Medicine, 10, 74-77.

Jin, J. (2018). Prevention of Falls in Older Adults. JAMA, 319(16),1734.

doi:10.1001/jama.2018.4396.Case Study on genetic Disorders : Part 3 Assignment

Khadka, A., & Darai, A. (2018). Common Health Problems and their contributing factors among

elderly residing in Changu VDC. Journal of Institute of Medicine, 40(1), 103–107.

Loganathan, A., Ng, C. J., Tan, M. P., & Low, W. Y. (2015). Barriers faced by healthcare

professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study. BMJ, 5, e008460. doi: 10.1136/bmjopen-2015-008460.Case Study on genetic Disorders : Part 3 Assignment

Naylor, M. D., Hirschman, K. B.,. Hanlon, A. L ., Bowles, K. H., Bradway, C.,  McCauley, M., &

Pauly, M. V. (2014). Comparison of evidence-based interventions on outcomes of hospitalized, cognitively impaired older adults. Journal of Comparative Effectiveness Research, 3(3), 245-257.

Phelan, E. A., Mahoney, J. E., Voit, J. C., & Stevens, J. A. (2015). Assessment and management of

fall risk in primary care settings. The Medical clinics of North America, 99(2), 281–293. https://doi.org/10.1016/j.mcna.2014.11.004.Case Study on genetic Disorders : Part 3 Assignment

Pighills, A., Ballinger, C., Pickering, R., & Chari, S. (2016). A critical review of the effectiveness

of environmental assessment and modification in the prevention of falls amongst community dwelling older people. British Journal of Occupational Therapy, 79(3), 133-143. doi:10.1177/0308022615600181

Scotti, S. (2016). Preventing Elderly Falls. National Conference of State Legislatures (NCSL), 24,

17.Case Study on genetic Disorders : Part 3 Assignment

Staggs, V. S., Mion, L. C., & Shorr, R. I. (2015). Consistent differences in medical unit fall rates:

Implications for research and practice. Journal of American Geriatric Society, 63(5), 983987. doi:10.111/jgs.13387.Case Study on genetic Disorders : Part 3 Assignment

Stubbs, B., Brefka, S., & Denkinger, M.D. (2015). What works to prevent falls in community-

dwelling older adults? Umbrella review of meta-analyses of randomized controlled trials. Phys. Ther, 95, 1095–1110. doi: 10.2522/ptj.20140461.Casey, C. M., Parker, E. M., Winkler, G., Liu, X., Lambert, G. H., & Eckstrom, E. (2017).

Lessons Learned From Implementing CDC’s STEADI Falls Prevention Algorithm in Primary Care. The Gerontologist, 57(4), 787–796. doi:10.1093/geront/gnw074.Case Study on genetic Disorders : Part 3 Assignment