Assessment 1 Analysis of Position Papers for Vulnerable Populations

Assessment 1 Instructions: Analysis of Position Papers for Vulnerable Populations

Develop a 4-6 page position summary and an analysis of relevant position papers on a health care issue in a chosen population.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Position papers are a method to evaluate the most current evidence and policies related to health care issues. They offer a way for researchers to explore the views of any number of organizations around a topic. This can help you to develop your own position and approach to care around a topic or issue.

This assessment will focus on analyzing position papers about an issue related to addiction, chronicity, emotional and mental health, genetics and genomics, or immunity. Many of these topics are quickly evolving as technology advances, or as we attempt to push past stigmas. For example, technological advances and DNA sequencing provide comprehensive information to allow treatment to become more targeted and effective for the individual. However, as a result, nurses must be able to understand and teach patients about the impact of this information. With this great power comes concerns that patient conditions are protected in an ethical and compassionate manner.

Position papers are a way for individuals, groups, and organizations to express their views and intentions toward a specific issue. In health care, many position papers address specific policies, regulations, or other approaches to care. As a master’s-prepared nurse, you should feel empowered to express and advocate for your own views on policy and care matters. This is especially important when it comes to populations you or your organization cares for that are not receiving the quality, type, or amount of care that they require.

An important skill in creating a position paper or policy proposal is the ability to analyze and synthesize others’ views about the population or issue of interest to you. By synthesizing the positive and negative views of an issue, you can become better equipped to strengthen your own arguments and respond to opposing views in an informed and convincing way.

Professional Context

An important skill in creating a position paper or policy proposal is the ability to analyze and synthesize others’ views about the population or issue of interest to you. By synthesizing the positive and negative views of an issue, you can become better equipped to strengthen your own arguments and to respond to opposing views in an informed and convincing way.

Scenario

For this assessment, pretend you are a member of an interprofessional team that is attempting to improve the quality and outcomes of health care in a vulnerable population. For the first step in your team’s work, you have decided to conduct an analysis of current position papers that address the issue and population you are considering.

In your analysis, you will note the team’s initial views on the issue in the population as well as the views across a variety of relevant position papers. You have been tasked with finding the most current standard of care or evidenced-based practice and evaluating both the pros and cons of the issue. For the opposing viewpoints, it is important to discuss how the team could respond to encourage support. This paper will be presented to a committee of relevant stakeholders from your care setting and the community. If it receives enough support, you will be asked to create a new policy that could be enacted to improve the outcomes related to your chosen issue and target population.

The care setting, population, and health care issue that you use for this assessment will be used in the other assessments in this course. Consider your choice carefully. There are two main approaches for you to take in selecting the scenario for this assessment:

You may use one of the issues and populations presented in the Vila Health: Health Challenges in Different Populationsmedia piece. For this approach, you may consider the population in the context of the Vila Health care setting, or translate it into the context in which you currently practice or have had recent experience.
You may select a population and issue that is of interest to you and set them in the context of your current or desired future care setting. While you are free to choose any population of interest, the issue you choose should fall within one of the following broad categories:
- Genetics and genomics.
  - Sickle cell, asthma, multiple sclerosis, myasthenia gravis.
- - Type 1 diabetes, systemic lupus erythematosus (SLE), congenital neutropenia syndrome.
- - Arthritis, any type of cancer or lung or heart disease, obesity.
- - Abuse of alcohol, prescription drugs, tobacco, illegal substances.
- Emotion and mental health.
  - Post-traumatic stress disorder (PTSD), depression, eating disorders, psychosis.

Note: If you choose the second option, contact your faculty to make sure that your chosen issue and population will fit within the topic areas for this course.

Instructions

For this assessment, you will develop a position summary and an analysis of relevant position papers on a health care issue in a chosen population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your assessment submission addresses all of them. You may also want to read the Analysis of Position Papers for Vulnerable Populations Scoring Guide and Guiding Questions: Analysis of Position Papers for Vulnerable Populations [DOC] to better understand how each grading criterion will be assessed.

Explain a position with regard to health outcomes for a specific issue in a target population.
Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Example assessment: You may use the Assessment 1 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Submission Requirements

Length of submission: 4–6 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive. No abstract is required.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your initial position on the issue, as well as a minimum of 2–3 sources of scholarly or professional evidence that express contrary views or opinions. Resources should be no more than five years old.
APA formatting: Use the APA Style Paper Template [DOCX] and the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Design evidence-based advanced nursing care for achieving high-quality population outcomes.

- Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
- Evaluate the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population.
Competency 2: Evaluate the efficiency and effectiveness of interprofessional interventions in achieving desired population health outcomes.

- Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
Competency 3: Analyze population health outcomes in terms of their implications for health policy advocacy.

- Explain a position with regard to health outcomes for a specific issue in a target population.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.

- Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner.
- Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Health Challenges in Different Populations

VILA HEALTH ® ACTIVITY

Introduction

Different populations in varying social contexts face a variety of medical challenges. Certain problems are more prevalent in a big city, for instance, while others might be more common in a small town. Similarly, the details of a person’s life may leave them more exposed to a given health problem.

In this simulation, you will meet three different people from various social contexts, and learn about the health challenges they face. You may choose one of these contexts to follow throughout this course; so feel free to read as many or as few of these as you feel appropriate.

Carl Alomar, Urban Veteran

Carl Alomar, 36, was admitted with signs of acute opiate withdrawal.

I was admitted to St. Anthony Medical Center when I came into the emergency room a total mess. I was sick to my stomach, had really bad muscle cramps, kept throwing up, had to go to the bathroom all the time. I tried to tell them it was the flu at first… but they saw through that pretty fast and got it out of me that it was withdrawal, and that I was trying to get off of Oxycontin cold turkey.

I’m taking another stab at detox. I don’t know. I don’t really expect it to help much, since it hasn’t before. But I don’t know what else to do. I don’t have a choice. I can’t keep doing this or I’m not going to live to be 40.

I got my leg shredded by an IED in Iraq in ’07, and the army doctors were really worried about pain management. And that meant Oxycontin. It was supposed to be temporary, but it wasn’t. And it’s just been downhill since then, especially after my medical discharge. I just kind of slid after that. I had trouble getting used to life out of the army, and my leg was messed up, and I was medicated pretty heavily all the time. Oxycontin, usually, but I couldn’t always get it and sometimes I was out on the street trying to buy the next best thing. That always scares me… but not enough to keep me from doing it.

People were good about favoring vets for job openings, but I had trouble staying in them— aside from my leg and all the medication, I just wasn’t in a very good place in my head then. Or now. I have a job now, doing security at a warehouse, but I think I’m on pretty thin ice with them. I try not to come into work high, or take anything when I’m there, but you know how it goes.

My wife left a couple of months ago. I know I’ve got to stop this or I’m just done.

I wish I could get into one of the VA rehab programs, but they’re the VA, they’re useless. The waiting list is months. If I waited months, I’d be out on the street. Or just dead. I don’t have any choice but to just try to white-knuckle my way through stopping on my own.

Now that you’ve read Carl’s story, you may have some thoughts.

Do you think Carl’s situation is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other veterans living in urban areas.

This question has not been answered yet.

Kevin Millard, Rural LGBTQ Teen

Kevin Millard, 17, came into the clinic with minor injuries after a fight at school.

I got into a fight in the bathroom with Bob Heaney, Justin Collins, and Brad Kelzer. There were three of them but I held my own. They’re not going to mess with me anymore.

They were giving me crap for using the boy’s bathroom. But that’s who I am, and I’m tired of pretending and hiding it. I usually try not to go into the bathroom unless I know nobody’s in there, just to avoid trouble, but I went in today and Heaney and those guys were in there. They just started in on me, calling me freak, asking me to show them how I was going to use the urinal. I told them to knock it off and they didn’t, and then we started pushing. I don’t remember who threw the first punch.

This is the first time I’ve had to fight, but stuff’s been really hard and weird all year. I decided this year I was going to stop hiding and start living as the person I really am. But I didn’t know it’d be so hard. I don’t do much now, and my grades are in the toilet.

The biggest thing is that I feel so alone. There’s nobody in town who’s going through what I’m going through. I have all these questions and I never know where to take them. My mom and dad try to help, but there’s so much they don’t understand. I came home from school last week just crying my head off because Mr. Rossum, my science teacher, kept using my old name even when I kept saying to him “I’m not Kathy anymore, I’m Kevin.” My mom, she mostly doesn’t want to rock the boat, so she asked me if I couldn’t just be understanding that Mr. Rossum’s from another generation and just doesn’t get it. Her saying that just made me feel terrible because she wants to be understanding to this mean old guy but not to me.

I don’t know, maybe they’re all right and I’m just a freak. I mean, they can’t all be wrong.

Now that you’ve read Kevin’s story, you may have some thoughts.

Do you think Kevin’s issue is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other GLBTQ youth in rural areas.

This question has not been answered yet.

Delia Jensen, Elderly Home Health Care

Delia Jensen, 79, an immunocompromised cancer patient. She lives at home alone, and is visited daily by a home health care nurse.

I guess I’m as good as I can be today. My pain’s still there, but it’s not as bad as it can be some days, and I’m far enough out from the last round of chemo that the nausea’s gone. So that’s good.

But it’s just hard. It’s hard living with this checklist of things I have to do to keep from getting some kind of infection. Wash my hands, sure, I can do that. I should be doing that anyway! But I’m not used to having to do it so much! And I lose a lot sleep worrying about what would happen if I got an infection- on top of all the sleep I’m losing worrying about cancer.

It just gets to be a lot. Cooking for myself and washing all the produce. And I’m at the mercy of Sara, my daughter, helping to get groceries for me since I can’t really go out into crowds like that. I don’t mean to complain! She’s been a blessing. but she’s a busy woman and as much as she helps, she has to fit it in between the rest of the things she does in her life- going to work, taking care of the kids. And then every time she comes over, it’s hard for her to have to deal with all the cleanliness, too. She spends a lot of time here when I’m at my worst, right after chemo, but that means that she has less time to spend other times.

It’s also hard for Sara to bring the kids over, because of germs. So feel like I never see my grandkids, right when I really need to see them. We talk on Skype, and that helps a little, but it’s not the same. I used to have a lot of friends at the senior center, but I think I was just making people feel uncomfortable, going there in a surgical mask and washing my hands all the time. I can’t even have a cat for company!

Now that you’ve read Delia’s story, you may have some thoughts.

Do you think Delia’s issue is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other elderly members of the community who are receiving home health care.

This question has not been answered yet.

Conclusion

You have completed the Population Health Resources activity. These suggestions should give you an idea of other resources you can locate and include in your annotated bibliography.

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Analysis of Position Papers for Vulnerable Populations Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Explain a position with regard to health outcomes for a specific issue in a target population.	Does not explain a position with regard to health outcomes for a specific issue in a target population.	Attempts to explain a position related to health outcomes, but the position is either unclear, or does not link to a specific issue in a target population.	Explains a position with regard to health outcomes for a specific issue in a target population.	Explains a position with regard to health outcomes for a specific issue in a target population, and identifies assumptions on which the plan is based.
Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.	Does not describe the role of an interprofessional team.	Describes the role of an interprofessional team, but does not fully explain its role in facilitating improvements for a specific issue in a target population.	Explains the role of the interprofessional team in facilitating improvements for a specific issue in a target population.	Explains the role of the interprofessional team in facilitating improvements for a specific issue in a target population. Acknowledges challenges that the team may face in working together or in facilitating improvements.
Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.	Does not explain the evidence or positions of others related to a specific issue in a target population.	Explains the evidence and positions of others related to a specific issue in a target population, but does not evaluate the value of these sources, or fails to relate how the sources will support a team’s approach to improving the quality and outcomes of care.	Evaluates the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.	Evaluates the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).
Evaluate the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population.	Does not explain the evidence or positions of others related to a specific issue in a target population.	Explains the evidence and positions of others related to a specific issue in a target population, but does not evaluate the value of these sources, or fails to relate how the sources are contrary to the team’s approach for improving the quality and outcomes of care.	Evaluates the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population.	Evaluates the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Impartially responds to conflicting data and other perspectives in a way that creates buy-in.
Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner.	Does not communicate Does not communicate an initial viewpoint regarding a specific issue with a target population, and the paper is unstructured and difficult to follow logically.	Communicates an initial viewpoint regarding a specific issue in a target population, but the synthesis of existing positions or the structure of the paper is unclear.	Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner.	Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner. Identifies specific strategies or approaches used to ensure clear communication.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.	Does not integrate relevant sources to support assertions; does not correctly format citations and references using current APA style.	Sources lack relevance or are poorly integrated, or citations or references are incorrectly formatted.	Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style.	Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style. Citations are free from all errors.

Assessment 1 Analysis of Position Papers for Vulnerable Populations