Posted: November 12th, 2022

DQ2 BSN 410 MODULE 4

D4Q2
The World Health Organization (WHO) bases itself on working on “better health, for everyone everywhere.” Globally, there are 194 countries involved with the brilliance of WHO. That is a lot of humans coming together to work on making a healthier planet.
Data on Italy, as reported by the World Life Expectancy and Statista
Average Life Expectancy in Italy is 83 years old as compared to only 79 years old in the US.
Cause- Specific mortality in Italy is coronary heart disease. This issue appears to be the top cause in most countries around the world. The rate of heart disease in Italy is 42.2 cases 100,000 persons. Stroke, lung cancer, breast cancer and Alzheimer’s & Dementia round out the top five causes of death in Italy.
Neonatal mortality rate is 1.7 deaths per 1,000 live births. This is an impressive improvement from the rate in 1971 that was 20.2 deaths per 1,000 live births. The increase in providing adequate prenatal and post-natal care can be credited for this.
Maternal Mortality rate is currently 4 deaths /100,000 live births. Prior to the introduction to the universal health plan in the late 1970’s the maternal mortality rate was 2.5 times higher than now. Another factor impacting the low rate could be the declining number of births. The birthrate in Italy has declined dramatically in the past 50 years. Leading to a negative annual population growth of -1.2%.
Morbidity- Disease prevalence in Italy listed from the greatest down, Hypertension, Arthritis, Allergic Diseases, Diabetes, chronic bronchitis or COPD, Nervous Disorders, Heart diseases, Gastric diseases. Looking at the type of prevalence of these disease’s lifestyle may play a major role in this. 25% of men and 17% of women in Italy are smokers. This puts them at higher risk for many of the prevalent issues they face.
If offered a chance to help with one of these areas. I’ll focus on cause-specific mortality. Italy seems to have good public health control over the mother and child areas of healthcare. The statistic itself is low compared to that of the US, where the mortality rate is nearly double of that in Italy. Looking at risk factors is where I would want to start. Modifying behaviors that increase the risk of a cardiac death such as smoking. Providing nursing education programs, and maybe a community type program to increase the knowledge base for the link between smoking and heart disease.
References:
Elflein, John. “Topic: Diseases.” Statista, https://www.statista.com/topics/2070/diseases/.
“World Life Expectancy.” World Life Expectancy, https://www.worldlifeexpectancy.com/.
“Millennium Development Goals (Mdgs).” World Health Organization, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs).
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The average life expectancy in South Africa is now 62.8 years as of 2022 (Baffes, 2022). Sixty-seven years old for females and sixty-four years for males (Baffes, 2022). The covid-19 pandemic showed a decrease in growth by 1.47% in 2021 (Africa, 2022). However, a covid vaccine is now available for adults over 60 years of age which will help the life expectancy. HIV continues to be the highest mortality rate in South Africa, with 13.6 million people receiving antiretroviral therapy, an increase of 800,000 since 2003 (Africa, 2022). The neonatal mortality rate is currently at 11% per 1000, with no target goal met as of 2015 (Africa, 2022). In cases of infant mortality rate, they are at 23.6% per 1000 live births, with a target rate of 18 for 2015, which was not achieved (Africa, 2022). The maternal mortality rate is 141 for every 100,000 live births, with a target goal of 38 not achieved either (Africa, 2022). Education plays a vital role in patient care in the United States, and we must help other countries overcome these mortalities. If I were to make a mission trip to South Africa, my focus would be on mothers and babies. Having worked in Labor and Delivery and now in the neonatal ICU, I would love to use my skills to help better the outcomes of mothers and babies. Mothers need education and guidance to have positive outcomes in the end. My goal would be to help as many mothers and babies as possible and limit the mortality rate.
Reference:
Africa, S. S. (n.d.). Improving lives through data ecosystems. Statistics South Africa. Retrieved October 12, 2022, from http://www.statssa.gov.za/
Bell, T., & O’Grady, N. P. (2017). Prevention of central line–associated bloodstream infections. Infectious Disease Clinics of North America, 31(3), 551–559. https://doi.org/10.1016/j.idc.2017.05.007

BSN 415 DQ WEEK 4
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With the nursing shortage being a significant problem, nurse managers frequently deal with the issue of staffing floors to care for our patients. In ICUSD, our nurse-patient ratios are supposed to be 1:4 and our CNT 1:8. During COVID, we lost many of our nurses and CNTs. Our nurse manager is now faced with staffing issues daily. She decided to make nurse ratios 1:5 and CNT 1:12 most days. Several RN jobs, day and night shifts, are available, so few of these are covered. The nursing shortage has forced our nurse manager to make some hard decisions to staff our unit. She recently decided to move an RN from the day to the night shift for six weeks because our night shift suffers the most from this nurse shortage. This nurse was allowed to volunteer, but this decision also ensures we work short on the day shift, and if someone calls out, we are even shorter. Our nurse manager’s decision was difficult, but she had to cover both shifts. We have some contract and float nurses to help staff the different floors and units, but they are minimal and go to the floor with the most need. An incentive continues to award nurses and technicians who volunteer for extra shifts. Extra work incentives come with a price; many nurses burn out, leading to further nursing shortages as nursing staff continues to leave. “Demanding workloads and aspects of the work environment, such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organizational leadership within working environments for nurses, are known to be associated with burnout in nurses.” (Shah et al., 2021).
“The nursing shortage is one of the many issues that need attention and necessitates involvement of all health care parties.” (Gab & Ageiz, 2020). We can see the pros and cons of our nurse managers’ staffing decision to increase staffing ratios and move a day shift RN to night shift Short-term. She has to ensure the care provided on the unit is of quality, provide patient and family satisfactory care, achieve productivity goals, and address staff needs. This decision also leads to overworked and burnout of nurses. “Burnout continues to be reported by registered nurses across a variety of practice settings nationwide.” (Shah et al., 2021). Nurses must have improved working conditions, work-life balance, support from leadership, and better pay. Nurse values will help with burnout and retain nurses.

Reference
Gab Allah, A., Elshrief, H., & Ageiz, M. (2020). Developing strategy: A guide for nurse managers to manage nursing staff. Asian Nursing Research, 14(3), 178–187. Retrieved October 10, 2020, from https://doi.org/10.1016/j.anr.2020.07.004
Shah, M., MD, MSc, Gandrakota, N., MBBS, MPH, & Cimiotti, J. P., PhD, RN. (2021). Prevalence of and factors associated with nurse burnout in the us. JAMA. Retrieved October 10, 2022, from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775923

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