NR553 Week 8 Discussion, Reflection of Global Health Concepts

Week 8: Reflection of Global Health Concepts The course Global Health has been enlightening on many issues including the various burden of disease, particularly, in the developing countries, emerging threats to global health such as mental health, and health inequities which are prevalent globally, even in the developed countries particularly due to poverty. It also highlighted the importance of nurses partnering with agencies such as non-governmental organizations. Besides, I enjoyed the discussions which were significantly insightful on various global health concerns. One of the concepts that stood out for me is the significance of primary care in the global health. According to the World Health Organization (2018), primary health care is about caring for people rather than the treatment for specific diseases. Further, it facilitates comprehensive, accessible, community-based care that meets the health need of individuals throughout their lives. It is comprised of a broad spectrum of services from prevention to the management of chronic health conditions and palliative care. Markle, Fisher, and Smego, (2007) state that primary health care is distinct from tertiary and secondary as it is mainly provided in the community rather than in the hospital setting. According to Markle, Fisher, and Smego, (2007 in the developed nations primary healthcare professionals include nurses, family, doctors, and pharmacists among other healthcare workers. However, in the developing countries is mainly provided by health workers who have received substantially short courses of training due to lack of adequate health systems. Primary health care enhances healthcare outcomes and thus is one of the major reasons for significant health disparities in such areas as maternal health. I consequently believe the strengthening of primary health systems would significantly promote health, and it is therefore vital that nurses play a leading role in the formulation and implementation of policies that facilitate primary health care. I will, therefore, be actively involved in the promotions primary health care through such ways as supporting agencies geared towards enhancement of primary health care. References Markle, W. H., Fisher, M. A., & Smego, R. A. (2007). Understanding global health. New York, NY: McGraw Hill World Health Organization. What Is Primary Health Care? retrieved from, PEER REPSONSE TO POST: Hi Carole, Dr. Fildes and Class: I agree that primary health care is vital. Januszewska et al. (2018) studied participants who did not have type 2 diabetes but had risk factors that increased their risk for type 2 diabetes. The researchers found that those who received medical advice and were educated of their increased risk of diabetes had a greater incidence of weight loss than those in the control group who did not receive education from their primary health care provider. They also discovered that "medical triggers" like a participant finding out that they had high "sugar in their blood" or "high cholesterol" by their primary health care professionals increased their chance of changing their lifestyle towards healthier options (increased physical activities, low fat, weight loss) than those who did not receive this information. References Januszewska, A., Solska, B., Lindstrom, J., Wojtowicz, E., Tuomilehto, J., Schwartz, P., Skarbek, K., Sqybinski, Z., Windak, A., & Dydejczyk, A. (2018). Determinants of weight outcomes in type 2 diabetes prevention intervention in primary health care setting. BioMed Central, 18(97), 1-9, doi:10.1186/s12889-017-4977-1 Leslie PROFESOR RESPONSE TO PEER: Thank you Leslie, Nurses are great assets in primary care! Do they hire RNs in primary care? Dr. Fildes PROFESSOR RESPONSE TO POST: Hi Carole, You are spot on, check this out: Health Affairs (Links to an external site.)Links to an external site.Vol. 37, No. 6 (Links to an external site.)Links to an external site.: Hospitals, Primary Care & More Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners (Links to an external site.)Links to an external site. • Abstract The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008–16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery. Thank you, Carole. Like you, I believe that if all can be in a medical home with a primary care provider, our health outcomes will be better. Dr. Fildes RESPONSE TO PROFESSOR AND PEER: Dr. Fildes, Leslie, and classmates, According to the Institute of Medicine, nurses have key responsibilities for the essential components of primary care that include integrating care, increasing accessibility to care, addressing a large majority of personal health care needs, building sustained partnerships with patients, and practicing in the context of family and community (Institute of Medicine [IOM], 1996). Nurses are assuming more accountability for primary care needs. Across settings and specialties, nurses at all levels are responsible for providing a diverse range of primary care services in coordination with the inter-professional team. They assess health needs, develop health plans, provide care, educate patients, coordinate transitions between providers and care settings, and manage chronic diseases. With the current primary care provider shortage in the United States, the field of primary care is unable to deliver all the acute, chronic, preventative, care services that the community needs. According to the California Healthcare Foundation, "nurses are a large and dynamic workforce that can be tapped to promote patient engagement and help patients attain the skills and knowledge needed to improve their health" (2015). Primary care practice leaders must redesign their practices to use RNs in thoughtful ways in response to patient needs in primary care. Redesigns need to have the support of payers and policymakers, including regulators. For example, there are health centers that have implemented co-visits, also known as flip visits, during which the RN collects vital signs, takes the patients history, performs a physical exam, orders a diagnostic test, implements pertinent standing orders, and creates a nurse note (Funk & Davis, 2015). The nurse presents the history to the provider in front of the patient, allowing the provider to clarify details. The nurse also implements a care plan, including appropriate patient education during the visit. These co-visits can be billed as providers visits as long as the documentation complies with the payer's regulations or in accordance with the Center for Medicaid and Medicare Services (Funk & Davis, 2015). RNs can be empowered to add dynamic capabilities to meet the nation's growing demand for primary care by leading the initiative for transformational changes in primary care practice. Reference California Healthcare Foundation. (2015). RN role reimagined. How empowering registered nurses can improve primary care. Retrieved from Funk, K. A., & Davis, M. (2015). Enhancing the Role of the Nurse in Primary Care: The RN “Co-Visit” Model. Journal of General Internal Medicine, 30(12), 1871–1873. Institute of Medicine. (1996). Primary care: America's health in a new era. Washington, DC: The National Academies Press