NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population

Walden University NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population                           

Whether one passes or fails an academic assignment such as the Walden University NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population                         

The introduction for the Walden University NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population                         

After the introduction, move into the main part of the NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population                         

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population                           

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population

Epidemiological approaches are key in analyzing population health problems. Population health problems have been one of the factors that increase disparities in healthcare provision in the U.S. across all ages. Such problems adversely affect various people, leading to the need to develop more effective and robust interventions that can duly address them (Hossain et al., 2020). A notable success has been found in this regard through the use of research evidence. Therefore, the aim of this assignment is to develop a write-up detailing a selected problem, including the environment and a summary of the selected population health problem in terms of person, place, and time. Besides, this paper will further explore the research methods that can be used in assessing and addressing the population health problem, the intervention that can be implemented, the impact of the health outcome, and the evaluation plan based on the health outcome.

The Chosen Problem

The chosen population health problem of public concern is prescription drug overdose, specifically the opioid crisis. The drug overdose epidemic has claimed over 750,000 lives since 1999. The U.S. DHHS (2021) asserts that two out of three drug overdose death involve the use of an opioid. The problem began in the 1990s when pharmaceutical firms reassured the country that individuals would not be addicted to opioid pain killers leading to healthcare providers beginning to prescribe these drugs at higher rates (Nam et al., 2018). The rise in opioid prescription led to widespread misuse of the drugs and non-prescription ones. Studies would later reveal that opioids could be highly addictive (Nam et al., 2018). The Health and Human Services Department declared the issue a public health emergency. Recent figures show that over 70,000 people died from a drug overdose in 2019.

In the year 2019, over 70,000 deaths occurred due to drug overdose, with the rates increasing by over 4% from the previous year. As earlier indicated, opioid overdose leads to most deaths among mortalities caused by drug overdose, with up to 73% of opioid overdose deaths caused by synthetic opioids. Again up to 70% of the drug overdose deaths were attributed to opioid overdose. As of the year 2019, the mortality rates due to opioids were majorly among the White, non-Hispanic (72%) while Black non-Hispanic was 15%. It is also worth noting that opioid overdose and mortality rates due to opioid overdose have sharply risen in the U.S. in recent years (Monico et al., 2020)

The problem affects individuals who use pain killers as non-prescription drugs as a source of drug addiction. Experts opine that since the start of the COVID-19 pandemic, there has been a rise in substance abuse and drug overdose. The restrictive measures to contain the spread of COVID-19 led to increased boredom, which in turn increased the risk of substance abuse, including the use of opioids. The National Institute on Drug Abuse (2021) asserts that misuse of and addiction to opioids, heroin, and synthetic drugs like fentanyl is a critical national issue that impacts public health and social as well as economic welfare of the affected individuals. The Centers for Disease Control and Prevention (CDC) projects that the opioid crisis costs the country over $78 billion each year. These include the cost of healthcare, productivity losses, treatment for addiction, and involvement of individuals with the criminal justice system.

According to the American Medical Association (AMA) (2021), the drug-associated overdose and death epidemic is worsening despite efforts to address the prescription drug overdose problem. According to Healthy People 2020 (2021), substance abuse that entails the use of drugs, alcohol, or both leads to a host of destructive social aspects that increase health disparities. These include disruptions in families, financial difficulties, and lost productivity. The problem is significant because it causes failure in school, a surge in crime, domestic violence as well as child abuse.

The opioid crisis implies that more individuals become addicts leading to mental health challenges and the need for treatment interventions. These individuals also become more susceptible to sexually transmitted infections, including HIV, and a rise in suicide and homicide cases (Liang &Shi, 2019). Efforts by the CDC (2021) through programs like “Prevention for States” focus on providing sufficient resources and support to states to advance interventions aimed at preventing overdose of prescription drugs. Overdose of these drugs causes deaths increases susceptibility to harm and injuries from a host of areas, including road safety issues.

Preliminary Research Hypothesis/Question

The preliminary research question based on the selected issue is “what is the efficacy of a psychosocial counseling program in reducing the prevalence of opioid overdose among youths and young adults?”

The Research Methods

One of the major focuses of healthcare professionals over the years is population health which refers to the health outcomes distribution within a particular population, determinants of health that impact the distribution, and the interventions and policies that affect the determinants (Bor et al., 2017). Therefore, population health study is important since it ensures that there is better healthcare delivery and patient health. Among the strategies that can be applied in studying and critically analyzing a population, the health problem is the epidemiological approach that includes exploration of various aspects such as the role of environment and culture in health issues and how personality impacts health outcomes.

The Epidemiologic Study Design to Be Used

Epidemiologic study designs form an integral part of epidemiologic studies of selected healthcare problems. However, the choice of study design to be applied in epidemiology heavily hinges on various factors. Some of the factors include the hypotheses and research question, the available time and resources, ethics, the type of exposure of interest, and the type of outcome of interest. Therefore, the epidemiologic study design chosen for this potential study is a cross-sectional study. Such a study design is known to be good for the generation of hypotheses, and depending on the question, the strategy is relatively inexpensive, quick, and easy (LoBiondo-Wood& Haber, 2021). In addition, by using the method, a researcher can examine multiple outcomes or exposures and estimate the prevalence of exposures and diseases.

Assessment Strategies

The use of cross-sectional study design to help answer the research questions requires that two groups of participants are used; the control group and the intervention group. The cross-sectional study will take the form of a Pre-test/post-test. From the research question, an intervention suggested is the use of psychosocial counseling. Since the individuals engaged in opioid overdose will be divided into two groups, a suitable sampling will be done before randomization (Nieswiadomy& Bailey, 2018). Non-probability sampling strategy especially snowballing will be used as a sampling strategy.

This method is appropriate as it allows access to the potential participants through other people who can access such individuals. This method is also convenient for the researcher. Randomization will be key in addressing various limitations or problems connected to sampling. The process of randomization can be difficult if a researcher does not understand the statistical aspects of randomization. Therefore, even though it can be convenient to use in such a study, it may be necessary to consult a professional statistician who can help in the whole process. The study is intended to go for a period of one and a half months.

A Summary of Data Collection Activities

Data collection is an integral part of the research process. It gives an investigator the necessary data that can be used in answering the research questions upon an appropriate analysis. During data collection, various activities or strategies can be used to accomplish the targeted end. One of the activities that can be used to obtain the raw data is a survey; surveys can either be conducted online or done using hardcopy means. As such, the targeted survey will be used to determine the rate of opioid overdose among participants. However, it is important for the researcher to be careful with data obtained from the survey as some people can lie, leading to biased data and information (Boswell& Cannon, 2018). In making such data more valid, the researcher can back it up with the data obtained from a patient’s electronic health record. Due to the covid-19 pandemic, conducting online surveys can be the best route to follow so as to obey the health directive efforts on various issues such as social distancing.

Surveys enable the researcher to apply a wide range of questions designed to get the most responses from the respondents. Another data collection strategy that can be applied is the use of electronic health records containing patient data. Electronic health records are a reliable data source as they contain every aspect of a patient’s treatment and hospitalization data (Boswell& Cannon, 2018). A specially trained nurse informaticist will be responsible for obtaining data from the electronic health records to ensure that complete data is retrieved. Therefore, the data obtained from these records can be key in determining how effective the proposed intervention has been in lowering the incidences of opioid overdose among the selected population.

Questionnaires will also be key during the implementation of the intervention. This group of patients will be approached and vital information retrieved from them. It is important to assure the participants that the information they will be giving remains confidential and protected. The questionnaire will contain various questions focusing on information such as the participant’s social and family history, history of opioid use and overdose, some of the factors that make it difficult for them to stop opioid overdose, among other questions. Therefore, questionnaires will form a central part of the tools to be used in the project.

The Intervention

Interventions are key in addressing various clinical and public health problems. The opioid use disorder (OUD) or the opioid use epidemic is a serious public health issue that continues to increase costs on the healthcare system, lead to morbidity and mortality, and exert pressure on limited healthcare resources, especially personnel. While initially aimed at helping patients with chronic and terminal illnesses relieve pain, these drugs have become a public health concern because of their addictive nature, leading to their abuse by nonelderly and those without terminal conditions. Effective interventions are essential to helping the health care system deal with this problem. Such interventions must be supported by research evidence based on the kind of studies conducted from existing literature (Fischer et al., 2021).

The National Institute on Drug Abuse (2021) asserts that the opioid overdose crisis claimed over 50,000 individuals in the U.S. in 2019. The institute observes that this crisis impacts public health and the social and economic welfare of the individuals, families, communities, and the nation because of the increased cost burden estimated to be over $78 billion each year. Every day, at least 90 Americans die prematurely from an overdose that involves an opioid, leaving families and friends bereft. The implication is that using a proven intervention program will help avail resources to state and local governments to develop strategies aimed at easing access to medication and other measures to reduce addiction and associated problems.

The proposed intervention is the use of psychosocial counseling. The plan is to offer psychosocial counseling eight hours per week for the whole study duration; this implies that the sessions will run for two hours for four days per week. A special counseling staff with expertise in drug use, drug overuse, and addiction will conduct the counseling sessions. Outcomes in opioid overuse depend on various factors that need to be addressed to enhance better outcomes. Therefore, during the counseling sessions, the counselors will cover a range of issues such as health promotion, prevention of HIV, medication education, prevention of relapse, and substance abuse education. The counseling team will also delve into some of the useful strategies for lowering opioid overdose.

The intervention is critical as it can be instrumental for healthcare facilities and other stakeholders involved in the fight against opioid overdose to improve their potential of management. Effective management of health problems impacting a population requires scientific and proven ways (Strain et al., 2018). This is evident through using policies and protocols that align every effort to achieve a common goal and offer long-term impact for the affected population. Population health management requires the development of policy interventions that mandate wide acceptance and reforms to enhance access to critical resources by affected individuals and families.

The intervention is supported by various research efforts present in the literature. For example, Coffin et al. (2017) conducted a randomized controlled trial study to determine the efficacy of using a behavioral intervention to lower the rates of opioid overdose among individuals who depend on opioids. The researchers used counseling as the major tool and found out that those who attended counseling sessions were far less likely to experience an opioid overdose.

Recently, Buono et al. (2021) conducted a study to determine the impact of opioid-specific counseling on post-discharge opioid use among patients recovering from reconstructive pelvic surgery. The researchers used a multicenter randomized-controlled trial with one group randomized into opioid-specific counseling or standard generalized counseling. The opioid-specific counseling was conducted at the preoperative and fourteen days postoperative visits. During the counseling, the patients were provided with educational handouts regarding the opioid risks and other opioid-related issues, such as the recommended strategies of disposal and storage.

Upon the analysis of the data, the analysis showed no significant difference in the reduction of opioid use after discharge (Buono et al., 2021). Even though opioid-specific counseling did have a better impact on the consumption of opioids, both counseling methods led to a substantial reduction of opioid misuse and overdose. The implication of this research is that the use of counseling can be key in reducing the rates of opioid overdose.

Section 4: The Impact

An epidemiological approach to the prevalence of opioid use disorder would offer substantial positive effects for the healthy population and systems at both federal and state levels of government (Friis & Sellers, 2021). The use of “Prevention of States” challenges all states to develop a raft of programs to address the opioid crisis as a public health emergency despite the effects of the Coronavirus disease of 2019 (COVID-19) pandemic on the healthcare system. In their study, Lee et al. (2021) evaluate the effects of state policy interventions focused on the Opioid crisis for over 10 years, from 2007 to 2018. The study’s findings indicate that existing state policies have reduced the known indicators of prescription opioid misuse.

These policies have also been effective in reducing opioid overdose-associated mortalities. The authors are also categorical these policies have enhanced the diagnosis of OUD, overdose, and drug overdose mortality from illicit substances. The implication is that states can leverage the CDC’s program as a systems approach to tackling the opioid crisis within their jurisdictions (Strain et al., 2018). The intervention will use a systems approach that entails having different strategies and partners who collaborate at institutional and organizational levels to address the opioid use disorder (OUD).

The Health Resources and Services Administration (HRSA) (2021) asserts that a wide approach that entails using many interventions through one program is essential as it ensures that the affected individuals with different resultant conditions and effects can benefit from available resources. The HRSA asserts that access to resources, technical assistance, and training ensure that providers can integrate behavioral health care services into their practice settings to enhance interventions to address the effects of prescription drug overdose and misuse among the different health populations, especially those targeted (Haley & Saitz, 2020). The “Prevention for States” through its funding component demonstrates the role that inter-agency and inter-governmental collaboration and partnerships play in addressing opioid use disorder by increasing interventions like screening and data collection to inform new and effective policies.

The use of innovative prevention approaches and response to new and emerging crises and opportunities is a component of the intervention by CDC and states. Through this approach, states and their partnering organizations can leverage innovative technology like telehealth to enhance access to substance use disorder treatment in rural, frontier, and underserved urban communities. Using virtual sessions, providers can interact with individuals at risk of relapsing from treatment and explore different approaches to enhance adherence to treatment protocols (HRSA et al., 2021). The essence is that state-level interventional programs can reach more patients and health communities compared to federal strategies and policy frameworks. These interventions will help tackle the crisis by collecting sufficient and appropriate data for stakeholders to make better decisions and choices regarding the OUD.

Stakeholders need opioid-related resources and access to best practices to help tackle the problem. Provision of resources on emerging public health issues like opioids is essential for providers and stakeholders to train, disseminate and inform patients, their families, and communities about the crisis and how to navigate it for a better quality of life (Fischer et al., 2021). Rural populations are at an increased risk of suffering from the opioid crisis because they may have limited access to essential resources, especially information. Therefore, the intervention to empower states ensures that they will have sufficient resources to distribute to different areas and communities within their jurisdictions to encounter the opioid crisis.

The Evaluation Plan

The opioid use disorder (OUD) is a national public health issue that needs effective mitigation and efforts to tackle it from various sectors and stakeholders. The opioid epidemic has led to increased cost of health services and burden on the system, leads to mortality and morbidity, and exerts strain on limited healthcare resources (HRSA, 2021). Evaluation of such interventions and their effects is critical as it offers an opportunity to assess their effectiveness to the target population, particularly those affected by the opioid crisis. Evaluation approaches like outcome evaluation assess the effectiveness of health promotion programs in producing the positive change to reduce the severity of the opioid crisis (Haley & Saitz, 2020). Therefore, this section proposes an evaluation plan for the proposed intervention.

Evaluation offers valuable information concerning the effectiveness of the intervention in achieving its goals. In addition, evaluation can also assess the effectiveness of the methods that were used during the intervention to achieve the set objectives (Linsely et al., 2019). The central focus of the intervention is to reduce the incidences of opioid overdose among youths and young adults who are dependent on opioid use. Therefore, as indicated earlier, the study will take a pre-test post-test cross-sectional design format. As such, data will be collected before the intervention and after the interventions. Such data will be vital in the evaluation process.

Questionnaires are one of the tools that will be used in collecting data for evaluation. These questionnaires will be self-administered to help in determining the rate of opioid use and dependence among the selected population. Questionnaires are more attractive for research as they are easy to administer, and they lead to accurate data collection and ease in the analysis of the collected data (Linsely et al., 2019). Questionnaires have also been shown to have enhanced reliability levels and can effectively measure consistency

As earlier indicated, this project has been planned to go for one and half months. Therefore, the evaluation will take place right at the end of the project. So the outcome to be evaluated is the reduced levels of opioid overdose among the selected population. Various professionals will be involved in the evaluation phase. The leading nurse investigator will be responsible for collecting the evaluation data. The implication is that data will be collected at baseline and after the implementation of the intervention (Linsely et al., 2019).

A statistician will be hired to help in data analysis to reveal trends and the difference between the rates of an opioid overdose before and after the intervention. An independent investigator will also be brought in to help in confirming the accuracy of the collected data and eliminate any inconsistency and data errors that can lead to bias in data analysis and result interpretation. The evaluation will focus on the assessment of behavioral change among users and abusers, initiation of legal frameworks to control prescription of different schedules of drugs, and ethical conduct among providers at different professional levels.

Conclusion

Population health is a major focus of the healthcare sector, and therefore, healthcare experts employ various strategies to identify various health problems that can negatively impact population health and implement research methods to come up with a remedy. The opioid crisis emanating from prescription drug overdose is a national public health issue that requires effective interventions. Stakeholders like nurses need to conduct more research to provide evidence-based solutions to the problem.

Opioid use disorder (OUD) is a public health issue with significant negative effects on individuals, families, and communities. Interventional efforts and activities should focus on enhancing capacity at different levels, from federal to state and local and organizational levels, to deal with the issue and reduce its effects. State programs are essential for stakeholders to encounter the issue because they embrace a systems approach. Existing studies and evidence suggests that these interventions are a critical part of enhancing access to information and treatment while also helping organizations to collect data to make better decisions. Therefore, this write-up has explored the use of psychosocial counseling as an intervention to reduce opioid overdose or opioid use disorder.

References

Bor, J., Cohen, G. H., & Galea, S. (2017). Population health in an era of rising income inequality: USA, 1980–2015. The Lancet, 389(10077), 1475-1490. https://doi.org/10.1016/S0140-6736(17)30571-8.

Boswell, C., & Cannon, S. (2018). Introduction to nursing research. Jones & Bartlett Learning.

Buono, K., Whitcomb, E., Guaderrama, N., Lee, E., Ihara, J., Sudol, N., … & Brueseke, T. (2021). A randomized controlled trial assessing the impact of opioid-specific patient counseling on opioid consumption and disposal after reconstructive pelvic surgery. Female Pelvic Medicine & Reconstructive Surgery, 27(3), 151-158. 10.1097/SPV.0000000000001009

Coffin, P. O., Santos, G. M., Matheson, T., Behar, E., Rowe, C., Rubin, T., … & Vittinghoff, E. (2017). Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial. PloS one, 12(10), e0183354. https://doi.org/10.1371/journal.pone.0183354.

Fischer, B., Pang, M., & Jones, W. (2020). The opioid mortality epidemic in North America: do we understand the supply side dynamics of this unprecedented crisis? Substance abuse treatment, prevention, and policy, 15(1), 1-8. DOI: https://doi.org/10.1186/s13011-020-0256-8

Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones &Bartlett. Chapter 8, “Experimental Study Designs”.

Health Resources and Services Administration (HRSA) (2021). Opioid Crisis.

https://www.hrsa.gov/opioids

Hossain, M. M., Tasnim, S., Sultana, A., Faizah, F., Mazumder, H., Zou, L., … & Ma, P. (2020). Epidemiology of mental health problems in COVID-19: a review. F1000Research, 9. https://dx.doi.org/10.12688%2Ff1000research.24457.1.

Lee, B., Zhao, W., Yang, K. C., Ahn, Y. Y., & Perry, B. L. (2021). Systematic evaluation of state policy interventions targeting the U.S. opioid epidemic, 2007-2018. JAMA network open, 4(2), e2036687-e2036687. https://doi.org/10.1001/jamanetworkopen.2020.36687

Liang, D., & Shi, Y. (2019). Prescription drug monitoring programs and drug overdose deaths involving benzodiazepines and prescription opioids. Drug and alcohol review, 38(5), 494-502.https://doi.org/10.1111/dar.12959

LoBiondo-Wood, G., & Haber, J. (2021). Nursing Research E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Monico, L. B., Ludwig, A., Lertch, E., Dionne, R., Fishman, M., Schwartz, R. P., & Mitchell, S. G. (2021). Opioid overdose experiences in a sample of us adolescents and young adults: a thematic analysis. Addiction, 116(4), 865-873. https://doi.org/10.1111/add.15216

Nam, Y. H., Shea, D. G., Shi, Y., & Moran, J. R. (2017). State prescription drug monitoring

programs and fatal drug overdoses. American Journal of Management Care, 23(5), 297-303.https://pubmed.ncbi.nlm.nih.gov/28738683/

National Institute on Drug Abuse (2021). Opioid Overdose Crisis.

https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

Nieswiadomy, R. M., & Bailey, C. (2018). Foundations of nursing research.

Strain, E., Saxon, A. J., & Hermann, R. (2018). Opioid use disorder: Epidemiology,

pharmacology, clinical manifestations, course, screening, assessment, and diagnosis. Up-to-date, Post, T.W., editor. Up-to-date. Waltham, MA.

U.S. Department of Health and Human Services. (2021). What is the U.S. Opioid Epidemic?

https://www.hhs.gov/opioids/about-the-epidemic/index.html

Sample Answer 2 for NURS 8310 Week 11 Practical Application of Epidemiological Interventions in Settings and Population

Hypertension is a crucial public health concern with increasing prevalence in the modern world. Patients suffering from hypertension experience low-quality life due to the increased need for frequent emergency department visits, hospitalizations, and medications purchase. The risk for complications due to hypertension is also high in cases of poor disease management. Populations, including healthcare providers, are highly predisposed to hypertension due to the stressful nature of their workplaces. Interventions that reduce the risk and rate of hypertension among healthcare providers should be adopted. Healthcare organizations should lead the implementation of evidence-based interventions to address their employees’ needs. Therefore, this epidemiology project explores the issue of hypertension among healthcare providers and proposes an intervention that can be adopted to address it.

Description of the Problem

Selected Environment

The selected environment for this project is the workplace for healthcare providers. The existing literature shows that the workplace environment for healthcare providers is among the leading sources of occupational stress (Thomas et al., 2020). Accordingly, it exposes healthcare providers to stressors that include high workload, working overtime, time-intensive pressures, monotony, inadequate rest periods, and poor physical conditions. The workplace of the healthcare providers is also characterized by hardships that include insomnia, dietary irregularities, and prolonged standing period that predisposes them to health risks. Therefore, hospitals with many occupational risks have been considered very dangerous workplaces for healthcare providers, patients, and their significant others (Khorsandi et al., 2017). Combined, workplace factors that act as sources of stressors predispose healthcare providers to metabolic problems that can also result in blood pressure elevation. Workplace factors such as reduced sleep duration for night shift employees increase the risk of coronary artery calcification, hence, heart diseases, stroke, and even death among them (Kurtul et al., 2020). Consequently, workplace factors play a crucial effect in hypertension development among healthcare providers.

Selected Population Health Problem

The selected population health problem is hypertension among healthcare providers. Hypertension is a health problem characterized by systolic pressure of 130 mm Hg and diastolic blood pressure of 80 mm Hg and above (Iqbal & Jamal, 2021). Individuals affected by hypertension are increasingly predisposed to complications that include stroke, myocardial infarction, heart failure, and renal disease. The patients’ quality of life also declines due to loss of productivity, frequent visits to the emergency department, hospitalizations, and high cost of care (Lee et al., 2018). The causes of hypertension may be idiopathic or attributed to modifiable and non-modifiable factors (Iqbal & Jamal, 2021). The modifiable risk factors associated with hypertension include physical inactivity, diabetes, unhealthy dietary habits, overweight and obesity, and abuse of substances that include alcohol and smoking. Some of the non-modifiable risk factors associated with the condition include genetics, ethnicity, and age (Iqbal & Jamal, 2021).

The global rate of hypertension is high, as seen from the statistics that its prevalence rate is 26% (Iqbal &Jamal, 2021). About one-third of the adults in the United States of America suffer from hypertension. Hypertension prevalence rises with the advancing age of the adult population. The existing evidence demonstrates that between 65 and 75% of the adults in the USA develop hypertension when they reach ages 65-75 years (Iqbal & Jamal, 2021). The rate of men affected by hypertension is high compared to women before they reach the age of 65 years. According to the CDC, almost half of the deaths reported in the USA in 2019 had hypertension as the contributing or causative factor. The CDC further reports that almost half of the adults in the USA have hypertension with 1 in every 4 of them having controlled hypertension. The state incurs significant costs in treating hypertension. For example, the USA spends about $131 billion annually to treat hypertension. Ethnic disparities in hypertension exist, with a high prevalence noted among non-Hispanic black adults compared to American whites (CDC, 2021). The global mortality rate is estimated to be 7.6 million every year (Iqbal & Jamal, 2021).

Healthcare providers are highly predisposed to hypertension due to work-related factors. Accordingly, high-stress levels cause changes in processes including metabolism, increasing their risk of hypertension. High levels of stress have been linked to morbidity and mortality due to hypertension among nurses. Work demands such as night shifts have been shown to increase the risk of healthcare providers developing cardiovascular disease (Kurtul et al., 2020; Sheppard et al., 2020). For example, night shift employees sleep an average of six or fewer hours, which increases the risk of coronary artery disease, hypertension, and stroke among them.

Studies have demonstrated that healthcare providers are exposed to multiple stressors in their workplace. They include working overtime, time-intensive pressures, high workload, complex tasks, inadequate breaks, and poor physical conditions. They are also exposed to hardships that include insomnia, prolonged standing, and dietary irregularities. The cumulative effect of these stressors includes increased risk and prevalence of hypertension among healthcare providers. For example, statistics show that the prevalence of hypertension among hospital employees is 21.3% (Bryant et al., 2020; Kurtul et al., 2020; Sheppard et al., 2020). Therefore, interventions that reduce the rate and risk of hypertension among healthcare providers should be adopted.

Research Question

The project questions that will guide the investigation are as follows:

1. Among healthcare workers of the medical unit aged 20 to 50 years, does psychological stress in the healthcare facility contribute towards the development of hypertension over 6 months?
2. Among Healthcare Personnel On a Medical Unit Aged 20 To 50 Years Having Psychological Stress, Does Blood Pressure Self-Monitoring with A Comprehensive Education in The Healthcare Facility as Compared to No Intervention Contribute to The Deterrence of Development of Hypertension Over 6 Months?

Research Methods

The project will adopt a prospective cohort study. A prospective cohort study is a quantitative study design, which is longitudinal. The study entails following the participants over a given period to determine the relationship between exposure and outcomes. The participants are similar but differ based on factors under focus in the investigation. The prospective cohort study design is appropriate for the project since it seeks to determine the cause of a health problem. The investigation begins at the baseline where data about the exposure and outcomes are collected at the start of the project from both groups. The participants are then followed over time to determine if, and when they developed hypertension or worsening of symptoms following their exposure to workplace stressors.  The advantage of adopting this design for the project is that it will help determine the risk factors of healthcare providers developing hypertension following their exposure to occupational stressors. The design also provides highly reliable and valid data since the collection of data at regular intervals eliminates recall bias (George, 2021).

The participants for the study will be obtained from the medical unit. The approach to selecting them will be done based on convenience sampling. The sampled population will then be randomly assigned to cohorts for follow-up. The inclusion criteria will include individuals aged between 20 and 50 years and willing to participate in the project. Similarly, the participants in the cohorts will be assessed to determine if they have the risk factors attributed to hypertension It will include the examination of risk factors such as unhealthy dietary habits, physical inactivity, diabetes, genetic predisposition, and smoking among others. The focus on the risk factors will aim at ensuring that the participants are only predisposed to psychological stress, which increases their risk of hypertension. Baseline data on socio-demographic characteristics, work-related factors, lifestyle or behavioral factors, body mass index, medical and family history, and perceived stress level will be obtained. The groups will differ based on their levels of psychological stress, which will act as the exposure in the investigation. Comparability should be maintained in prospective cohort studies to enable the determination of the relationship between exposure and outcomes or a disease (Crosswell & Lockwood, 2020). The developed criteria for diagnosing the participants with hypertension will be blood pressure of 130/80 mm Hg or higher. The project interventions will include taking blood pressure measurements on specific developed dates on both extremities with the participants relaxed.

A perceived stress scale will be used in determining the level of stress exposure to the participants. The stress scale will be developed in a form of a questionnaire. The participants will be provided with the questionnaire for them to provide information that relates to their diverse health needs and experiences. The participants will be assigned to either intervention or control groups based on a developed stress threshold score. Those who score higher than the developed threshold will be assigned to the intervention group while those who score below the threshold score will be assigned to the control group. The participants in the intervention and control groups will be the same. The developed stress scale will focus on the stress-related factors in a healthcare practice setting. The stress scale should be developed to focus on the specific stress-related factors in a setting to facilitate the determination of the relationship between exposure and outcomes (Crosswell & Lockwood, 2020).

A digital blood pressure machine (sphygmomanometer) will be used in obtaining blood pressure among the participants. The blood pressure monitoring will be done every two months for the entire duration of the project. The blood pressure measurements will be taken from both arms with patients relaxed. The data for the project will be collected using a digital sphygmomanometer. The measurements will be done in the morning and evening during the period of data collection. The accuracy of the obtained data will be achieved by ensuring that the participants are evaluated to rule out any other risk factors associated with hypertension. The data will be entered into the participants’ records for analysis and comparison between the cohorts. Any participant that is found to have any risk factor associated with hypertension will be discontinued from the project.

The Intervention

The proposed intervention for healthcare personnel experiencing psychological distress in the medical unit entails blood pressure self-monitoring with a comprehensive education. Optimum blood pressure management is an effective way of preventing complications of hypertension such as stroke and cardiovascular disease. Self-monitoring and self-management of blood pressure are effective in reducing blood pressure in hypertensive patients. The effectiveness increases in patients that do not have multi-morbidity (Crosswell & Lockwood, 2020). Significant reductions in blood pressure are reported in cases where intensive co-interventions are used with self-monitoring and self-management of blood pressure.

Therefore, the participants in the project will be educated about the importance of self-monitoring and management of blood pressure. They will be encouraged to monitor their blood pressure daily and adopt interventions, including medication use, lifestyle, and behavioral modifications to promote the optimum reduction in blood pressure. They will also be educated on the importance of self-management of hypertension. The education will focus on aspects of hypertension management that include symptoms of complications associated with hypertension, the importance of medication adherence, lifestyle, and behavioral modifications (Iqbal & Jamal, 2021). Blood pressure will be taken after every two months for the six months from the participants for analysis and determination of intervention effectiveness.

Studies conducted in the past have shown the effectiveness of blood pressure self-monitoring and health education on hypertension outcomes. One of the studies is a randomized controlled study conducted by Persell et al. (2020). The study explored the effect of coaching application use to improve blood pressure monitoring among patients suffering from hypertension.  The analysis of data by the researchers demonstrated that the intervention led to statistically significant systolic blood pressure improvement among the participants in the intervention group compared to those in the control group. There was also an improvement in the self-confidence among the participants in the intervention group to engage in self-monitoring of blood pressure compared to those in the control group (Persell et al., 2020). Therefore, the results support blood pressure monitoring in improving outcomes in hypertension.

The other study that examined the effectiveness of the proposed intervention is the research by Khorsandi et al., (2017). The researchers examined the effectiveness of health education that incorporated the concepts of the health belief model in elderly patients suffering from hypertension. They adopted a quasi-experimental study that involved 100 participants. Data analysis demonstrated that considerable differences existed between the intervention and control groups. Accordingly, there was a significant reduction in the systolic blood pressure among the participants in the intervention group compared to those in the control group. There was also the increased utilization of lifestyle and behavioral interventions for managing hypertension among those in the intervention group compared to those in the control group (Khorsandi et al., 2017). Therefore, the findings support the use of interventions that enhance self-management of hypertension and modification of factors contributing to its development.

The findings in the study by Gamage et al. (2020) also demonstrate the effectiveness of the proposed intervention. The researchers determined the effect of utilizing community health-worked led health education and monitoring in blood pressure control in patients affected by hypertension. The participants were identified using community surveys and enrolled in the study, which was a randomized controlled trial. The project intervention entailed the delivery of group-based education at two weeks intervals for three months. Health education focused on aspects that included lifestyle and behavioral modifications and blood pressure monitoring.  Data analysis demonstrated significant improvements in the blood pressure measurements among the participants in the intervention group compared to those in the control group. The participants in the intervention group had the highest improvements in systolic and diastolic blood pressure compared to the control group (Gamage et al., 2020). Consequently, the findings support the intervention use in hypertension management.

A recent study conducted by Khanal et al. (2021) also demonstrates the effectiveness of the proposed intervention. The researchers examined the effectiveness of health education and support programs on hypertension. The study was a randomized controlled study where the participants received health education for six months with those in the control group receiving the usual care. The results from data analysis demonstrated that the participants in the intervention group had improved controlled blood pressure compared to those in the control group. There was also improvement in the knowledge levels among the participants in the intervention group compared to those in the control group (Khanal et al., 2021). Therefore, the results from this study demonstrate the importance of health education in improving outcomes in patients suffering from hypertension.

Another study by Mini et al. (2022) also supports the use of the proposed intervention in patients with hypertension. The researchers examined the effectiveness of nurse-led educational interventions targeting patients suffering from hypertension. The study was a clustered randomized controlled trial involving 402 teachers with hypertension. The analysis of data obtained from the participants showed that the participants in the intervention group achieved hypertension control after three months compared to those in the control group. There was also a significant improvement in treatment adherence among the participants in the intervention group compared to the control group. Lastly, the participants in the intervention group reported improvements in systolic blood pressure compared to those in the control group.

The study by Yatim et al. (2018) also supports the use of the intervention in patients suffering from hypertension. The researchers examined the effectiveness of a group-based educational intervention on clinical and psychosocial outcomes in patients with hypertension. The study involved 45 participants where the educational interventions were offered for two months. The analysis of the obtained data by the end of the study period showed that the intervention improved hypertension-related aspects such as high-density lipoprotein, physical activity, and cholesterol among the participants. There was also increased adoption of positive self-care behaviors among the study participants. Consequently, the results support the utilization of health education interventions to enhance self-management and outcomes in patients with hypertension.

The Impact

As earlier indicated, hypertension is a condition with negative effects on the patients’ health, wellbeing, and quality of life. Hypertension contributes to adverse health outcomes that include heart disease, stroke, and mortality among the affected populations (Lee et al., 2018). It also increases the healthcare costs incurred by patients and the state in its management. Issues such as the increased need for funding hypertension programs and frequent hospitalizations of patients contribute to high costs incurred in treating hypertension. Therefore, addressing the issue using the proposed intervention is expected to result in some outcomes. One of the outcomes is improved self-monitoring and management of hypertension among the participants. The use of educational interventions to enhance the understanding of the participants about self-monitoring of blood pressure and lifestyle and behavioral modification will facilitate this outcome (Albus et al., 2019). The intervention is also expected to improve the perceived stress levels among the participants. The use of interventions such as health education is expected to increase the level of awareness among the participants on effective self-management and coping strategies needed for effective management of hypertension Gamage et al., 2020).

The intervention is also expected to enhance the level of awareness among the participants about the relationship between hypertension and psychological stress. The knowledge will facilitate the adoption of the desired lifestyle and behavioral modifications by the participants. It will also strengthen their adherence to the developed treatment plans. An improvement in the knowledge of the participants will enhance the sustainability of the adopted interventions for optimum treatment outcomes. Therefore, the educational sessions should impart them with adequate knowledge and skills needed for hypertension self-management. The last potential impact of the project is the reduction in the costs incurred by the participants in managing hypertension. The effective use of the project interventions is expected to promote optimum blood pressure control among the participants. As a result, costs incurred in emergency care visits, hospitalizations, and the purchase of medications are expected to reduce (Khanal et al., 2021). Overall, the intervention is expected to contribute to positive social development. The participants are expected to have a positive quality of life and productivity, hence, social development.

Evaluation

Evaluation is an important process in project implementation, as it provides insights into project effectiveness in achieving its objectives. The evaluation approach to the proposed project will incorporate outcome and process measures. Outcome measures will determine the effectiveness of the intervention in improving hypertension symptoms and preventing its development among nurses experiencing psychological stress. The outcome measures of focus in the project will include changes in the blood pressure, perceived quality of life, emergency department visits, costs incurred in the care process, and hospitalization rate. It will also include the satisfaction level of the participants with the project and consistency in the use of self-monitoring interventions for blood pressure (Albus et al., 2019). The outcome measures will also encompass the constancy of the use of the project interventions by the participants.

Process measures will also be used in evaluating the project. Process measures will examine the effectiveness of the interventions utilized in the implementation process. One of the process measures that would be used in project evaluation is the nature of stakeholder involvement. Active involvement of the stakeholders will be important for the realization of the desired outcomes. The participants and project implementation team will be surveyed to obtain information about their perceived level of participation in the project (Aiken et al., 2021). The other process measure will be resource utilization. Efficiency in resource utilization for optimum project outcomes will be considered a success in this project.

Conclusion

Hypertension is one of the crucial health problems that health workers experience in their lives. Work environmental factors play a critical role in predisposing them to the condition. The work environment for the healthcare providers is highly stressful, which predisposes them to health problems that include hypertension. Besides work conditions, other factors that include obesity, dietary behaviors, smoking, and alcohol consumption among others contribute to hypertension. Hypertension increases the risk of other health problems that include stroke, renal issues, and cardiovascular disease, which lower the patients’ quality of life. Hypertension also increases the costs incurred in seeking the needed care by the affected populations. Evidence-based interventions should be adopted to address hypertension. An example of such is the proposed intervention in this project that aims at encouraging self-monitoring of blood pressure and provision of health education to healthcare providers at risk of developing hypertension due to psychological stress. A prospective cohort study design will be used to investigate the relationship between exposure and outcomes. The proposed duration of the project is six months. The potential impacts of the project include the improvement in quality, safety, and efficiency of care that patients with hypertension receive. Outcome and process measures will be adopted for use in the evaluation of the project.

References

Aiken, L. H., Sloane, D. M., Ball, J., Bruyneel, L., Rafferty, A. M., & Griffiths, P. (2021). Patient satisfaction with hospital care and nurses in England: an observational study. BMJ open, 8(1), e019189. http://dx.doi.org/10.1136/bmjopen-2017-019189

Albus, C., Waller, C., Fritzsche, K., Gunold, H., Haass, M., Hamann, B., Kindermann, I., Köllner, V., Leithäuser, B., Marx, N., Meesmann, M., Michal, M., Ronel, J., Scherer, M., Schrader, V., Schwaab, B., Weber, C. S., & Herrmann-Lingen, C. (2019). Significance of psychosocial factors in cardiology: update 2018: Position paper of the German Cardiac Society: Position paper of the German Cardiac Society. Clinical Research in Cardiology: Official Journal of the German Cardiac Society, 108(11), 1175–1196. https://doi.org/10.1007/s00392-019-01488-w

Bryant, K. B., Sheppard, J. P., Ruiz‐Negrón, N., Kronish, I. M., Fontil, V., King, J. B., Pletcher, M. J., Bibbins‐Domingo, K., Moran, A. E., McManus, R. J., & Bellows, B. K. (2020). Impact of Self‐Monitoring of Blood Pressure on Processes of Hypertension Care and Long‐Term Blood Pressure Control. Journal of the American Heart Association, 9(15), e016174. https://doi.org/10.1161/JAHA.120.016174

CDC. (2021, September 27). Facts About Hypertension | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/facts.htm

Gamage, D. G., Riddell, M. A., Joshi, R., Thankappan, K. R., Chow, C. K., Oldenburg, B., … & Thrift, A. G. (2020). Effectiveness of a scalable group-based education and monitoring program, delivered by health workers, to improve control of hypertension in rural India: A cluster randomized controlled trial. PLoS medicine, 17(1), e1002997. https://doi.org/10.1371/journal.pmed.1002997

George, T., Simon. (2021). Epidemiological Research Applications for Public Health Measurement and Intervention. IGI Global.

Iqbal, A. M., & Jamal, S. F. (2021). Essential Hypertension. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539859/

Khanal, M. K., Bhandari, P., Dhungana, R. R., Bhandari, P., Rawal, L. B., Gurung, Y., … & Courten, B. D. (2021). Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial. PloS one, 16(10), e0258406. https://doi.org/10.1371/journal.pone.0258406

Khorsandi, M., Fekrizadeh, Z., & Roozbahani, N. (2017). Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clinical interventions in aging, 12, 233. https://dx.doi.org/10.2147%2FCIA.S117142.

Kurtul, S., Ak, F. K., & Türk, M. (2020). The prevalence of hypertension and influencing factors among the employees of a university hospital. African Health Sciences, 20(4), 1725–1733.

Lee, M. R., Lim, Y. H., & Hong, Y. C. (2018). Causal association of body mass index with hypertension using a Mendelian randomization design. Medicine, 97(30). https://dx.doi.org/10.1097%2FMD.0000000000011252

Mini, G. K., Sathish, T., Sarma, P. S., & Thankappan, K. R. (2022). Effectiveness of a School‐Based Educational Intervention to Improve Hypertension Control Among Schoolteachers: A Cluster‐Randomized Controlled Trial. Journal of the American Heart Association, e023145. https://doi.org/10.1161/JAHA.121.023145

Persell, S. D., Peprah, Y. A., Lipiszko, D., Lee, J. Y., Li, J. J., Ciolino, J. D., … & Sato, H. (2020). Effect of home blood pressure monitoring via a smartphone hypertension coaching application or tracking application on adults with uncontrolled hypertension: a randomized clinical trial. JAMA network open, 3(3), e200255-e200255. Doi: 10.1001/jamanetworkopen.2020.0255.

Sheppard, J. P., Tucker, K. L., Davison, W. J., Stevens, R., Aekplakorn, W., Bosworth, H. B., Bove, A., Earle, K., Godwin, M., Green, B. B., Hebert, P., Heneghan, C., Hill, N., Hobbs, F. D. R., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., … McManus, R. J. (2020). Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis. American Journal of Hypertension, 33(3), 243–251. https://doi.org/10.1093/ajh/hpz182Crosswell, A. D., & Lockwood, K. G. (2020). Best practices for stress measurement: How to measure psychological stress in health research. Health Psychology Open, 7(2), 2055102920933072. https://doi.org/10.1177/2055102920933072

Thomas, K., Nilsson, E., Festin, K., Henriksson, P., Lowén, M., Löf, M., & Kristenson, M. (2020). Associations of psychosocial factors with multiple health behaviors: A population-based study of middle-aged men and women. International Journal of Environmental Research and Public Health, 17(4), 1239. https://doi.org/10.3390/ijerph17041239

Yatim, H. M., Wong, Y. Y., Lim, S. H., Hassali, M. A., Hong, Y. H., Dali, A. F., & Neoh, C. F. (2018). Evaluation of a group-based hypertension self-management education programme among hypertensive community dwellers. European Journal of Integrative Medicine, 24, 79-84. https://doi.org/10.1016/j.eujim.2018.10.016