Community Health Project

Community considerablyness Project- Part whizz Identifying the Projects Focus Kathleen Rogers King Walden University November 26, 2012 Community health Project-Part One -Identifying the Projects Focus This paper pass on identify a prodigious wellness issue and a particular community for a wellness trouble plan. concord for the significance of this wellness issue, and rationale for the picking of this population get out be presented. present slightly the population lead be examined and discussed in regards to maven asset and one ch completelyenge of this particular population.An burn down to come up to the issue and the rationale for this choice bequeath be provided with a minimum of quint steal references. health Issue and people Defined as turn in prior(prenominal) to 37 weeks gestation (ACOG, 2008), preterm acquit ventures about 12% of bloodlines in the unite States. Preterm bear is an primary(prenominal) creation health precedency costing all(pre nominal) over $26. 2 one million million in 2005 according to the prove of Dimes (2011) track on preterm hold. Prematurity is the second tip cause of death in children below 5 years, and the single most important cause of death in the kickoff month of life ( knock against of Dimes, 2011).More than 15 million babies be born to a fault soon, with 1 in 8 babies born ill- dated every year worldwide of these, over 1. 1 million preterm babies die ascribable to complications of prematurity (CDC, 2012). The cost of the first year of kin for a preterm babe is 10 times great than for term infants (Howson, Kinney & Lawn, 2012). reassert and Rationale Women and infants are a open population. Maternal mortality and morbidity disproportionally affect vulnerable populations of women, such(prenominal)(prenominal) as those liveliness in poverty, facing racial and heathenish discrimination, and having limited language skills (Anderson & Stone, 2013).From a public health perspectiv e infant mortality is considered the measuring stick for determining the health of the population, whereas agnate mortality is the divider in the midst of wealth and poverty (Anderson, 2013). Eliminating racial, ethnic, and socioeconomic disparities is critical for quality health tuition offsprings (Shi & Stevens, 2010). Preterm births go on to a greater ex tent than often among certain racial and ethnic ag crowds with non- Latino black lets being 1. 5 times more likely to allow a preterm baby, and that baby 3. times more likely to die than a non-Hispanic discolor baby (CDC, 2012). Sadly, although 90% of preterm babies in high-income countries will survive, 90% of preterm babies born in low-income countries will die (Presem & McDougall, 2012). The implications of being born too soon extend beyond the neonatal period and throughout the life cycle, resulting in serious consequences such as rational palsy, and chronic lung disease, as well as, psychological impairment, le arning difficulties, poor health, vision and audience loss (Institute of Medicine, 2007).In general, the more immature the preterm infant, more life- realize is needed, the essays of re-hospitalization are greater, and the burden of sprightliness problems more significant (IOM, 2007). Assets and Challenges Preventing preterm birth carcass a challenge (CDC, 2012). There is no test that can accurately omen a preterm birth, very little is know about the causes and mechanisms of preterm birth, or about how to block a preterm birth, and few effective obviating(prenominal) strategies are available ( shew of Dimes, 2012 WHO, 2009 IOM, 2007).Once a woman is pregnant, most of the interpositions to disallow preterm birth except delay onset long full to administer steroids to the m early(a) to encourage keep back respiratory distress in the infant after birth and transfer the m some other and fetus to a hospital for the appropriate level of wish (IOM, 2007). Studies indicate that umteen of the factors associated the preterm birth frequently fall out together, peculiarly in minority women, or those who exhaust low socioeconomic status (IOM, 2007).Medical conditions such as chronic hypertension, diabetes, infections, and stress are associated with preterm birth, as are any taradiddle of a preterm birth in a previous gestation, a family recital of preterm birth, infertility, and a pregnancy of twins or triplets (IOM, 2007). whatsoever significant gains to be make in the study of preterm birth will be in the area of measure and eliminating disparities (IOM, 2007). Feasible, sustainable, cost-effective bearing solutions can be made available by collaboration, cooperation and alignment of function (WHO, 2012).Clinical research continues to identify ways to prevent preterm deliveries. For example, a progesterone medication (17-alpha hydroxyprogesterone caproate or 17P) may prevent preterm birth among women who harbour had a prior preterm birth (CDC, 201 2). Approaches and Interventions Addressing preterm birth is now an urgent priority for ambit the WHO, Millennium outgrowth Goal 4 (WHO, 2012). Reducing child deaths by two-thirds by 2015 requires a rapid expansion of our international commitments to put on change (WHO, 2012).Collaborative and partnership management clay sculptures have evolved for addressing effect and legal profession programs such as, the World health placements Every Woman, Every fry, Global strategy for Women and Childrens Health, March of Dimes, Save the Children, born(p) too Soon, The Partnership for Maternal, Newborn & Child Health (PMNCH), and the United Nations Millennium Development Goals (MDGs 4 & 5) which aim to save the lives of 16 million women and children by 2015 (Howson et al, 2012 WHO, 2009).Nationally, the fabric is complete since 1980, the CDCs tidy mountain series has been based on cell nucleus public concepts population surveillance, population health, prevention and primordia l interjection, identification of root causes, outcome assessment, and continuous feedback so that interventions can be adjusted appropriately (Manderscheid, 2009). To achieve the Healthy People objectives, it is essential to monitor advancement regularly to ensure the resources are direct appropriately and effectively (Shi & Stevens, 2010).A set of ten measurable leading health indicators (LHIs) was developed, which similarly reflect the risks of preterm birth these are animal(prenominal) activity, obesity, tobacco use, substance abuse, sexual behavior, mental health, injury and violence, environmental quality, immunization, and accession to health care (Shi, 2010). Implementation and Rationale Implementing priority, establish-based interventions for prevention include reduce unplanned adolescence pregnancies, goldbrick time gaps amidst births, un well-informed pre-pregnancy lading (underweight or obesity), substance abuse (e. g. tobacco use) and chronic disease (e. . dia betes, hypertension). Screening for infective sexually transmitted disease (e. g. HIV, syphilis), and implementing archean treatment can also help reduce the incidence of preterm labor (WHO, 2012). Internationally, all countries need to ensure universal access to comprehensive antepartum care, quality childbearing services and emergency obstetric care (WHO, 2012). In addition, workplace policies need to bear on healthy pregnancies and reduce the risk of preterm birth including regulations to protect pregnant women from physically demanding work, and pic to harmful pollutants (WHO, 2012).Greater provision for life-saving medications, supplies and services, as well as the resources and policies are needed to modify women and children adequate access to health care, peculiarly skilled care at the time of birth (WHO, 2009). Empowering, and educating girls, providing health promotion, access to care for cost-effective interventions in contraception, and encouraging unfairness fami ly planning can summation the likeliness of healthy planned pregnancies, and improve preterm birth prevention according to the WHO, natural in addition Soon Global Action score on Preterm Birth (Presem & McDougall, 2012).In addition, Kangaroo Mother occupy (skin to skin incubation with mother) can rebuff preterm deaths in half saving an estimated 450,000 babies a year (Presem & McDougall, 2012). The provision of inexpensive antenatal corticosteroids and antibiotics is estimated to reduce the risk of breathing difficulties in premature babies, saving around 370,000 lives a year (WHO, 2012). Fontenot and Collins Fantasia (2012) concluded that 100mg of progesterone vaginally every night between 24 and 34 weeks gestation resulted in visit incidence of preterm labor, birth, and delivery.Approach and Action A upstart obligate in The Lancet (2012), claims from a panel of experts, that five proven interventions could bring forth lowering preterm birth rates of 5 percent across 39 high-resource countries, including the United States, by 2015, and would prevent prematurity for 58,000 babies a year and $3 billion in health and economic costs (March of Dimes, 2012) * Eliminating early cesarean section deliveries and inductions of labor un slight aesculapianly indicated * Decreasing embryo transfers during assisted fruitful technologies * Helping women quit smoking Providing progesterone supplementation to women with high risk pregnancies * cervical cerclage for spoiled women with short(p) cervix uteri. The majority of preterm births occur spontaneously with no known cause, unused-made studies show that a short cervix is the single best prognosticator of preterm birth. Slager and Lynne (2012) envision screening for shortened cervical length, a universal risk factor, in alinement with a proven clinical intervention by transvaginal ultrasound.Although not available in all areas, transvaginal ultrasound is the most safe method to evaluate cervical length , it is instal to be most effective for risk estimates under 30 weeks gestation, and predictive results were modify by combining with obstetric history (Slager, J. & Lynne, S. , 2012). The combination of positive fetal fibronectin (fFN) examen and cervical length less than 25 mm is a strong predictor of impending preterm birth (Tharpe, Farley, & Jordan, 2013).As a MSN educator, my mark will be to educate nursing, midwifery, and medical students in the principles and methods of assessment, prevention and early intervention of preterm birth indicators. On the Perinatal circumscribed Care Unit of my employment, a new system of antenatal education will be proposed to administration detailing the benefits of group antepartum care in reducing low birth weight in premature babies (Massey, Schindler Rising, & Ickovics, 2006). focalization maternity antepartum Care ModelCentering Pregnancy group prenatal care is an innovative model of care for addressing the complex psycho accessib le needs of the mother and her family. Centering Pregnancy prenatal care promotes relationship-centered care, facilitates learning, develops vernacular support, and strengthens the opportunities for communication and nurturing among women. Centering Pregnancy prenatal care encourages social networking, supportive relationships with their significant other are developed, women experience less stress, fewer pregnancy complications, and fewer untoward neonatal outcomes (Massey et al, 2006).Research indicates that prenatal social support has been associated with improved fetal growth and greater infant birth weight. Good social support can improve birth outcomes measured in longer gestations and significantly larger babies, increase womens confidence, satisfactiveness, and increase self-nurturing (Massey, 2006). Centering Pregnancy is a model for group prenatal care that results in perinatal outcomes that equal or glide by prenatal traditional care, especially for teens, and other c ultures accustomed to group support (Anderson, 2013).Centering Pregnancy exemplifies an evidence-based best practice for nurse-midwives. This model places all three components of prenatal care- risk assessment, education, and support- into the group setting. It fosters a sense of empowerment as prenatal group members are support to take responsibility for their own health care and group members are further to seek information about healthy behaviors and common concerns of pregnancy, which builds a partnership between patient and provider (Massey, 2006).Translating this model of providing prenatal care for our hospitalized notional antepartum patients is the approach I intend to take because the evidence for improved outcomes with group care for high-risk women seems compelling, and may even be a future model of care for other countries, and women of diverse cultures (Tandon, Colon, Vega, Murphy, & Alonso, 2012). References American College of Obstetricians and Gynecologists (ACOG ). (2008). Use of progesterone to prevent preterm birth. Obstetrics and Gynecology, 112, 963-965. American mental Association. (2010).Publication manual of the American Psychological Association. (6th. ed. ). Washington, DC. Anderson, B. , & Stone, S. (2013). topper practices in midwifery, using the evidence to implement change. Springer Publishing. New York, NY. Centers for Disease chair and Prevention (CDC). (2012). Preterm Birth. Retrieved from http//www. cdc. gov/reproductivehealth/maternalinfanthealth/PretermBirth. htm Fontenot, H. B. , Collins Fantasia, H. (2012). Vaginal progesterone to prevent preterm birth in high-risk women. Nursing for Womens Health. Association of Womens Health, Obstetric and Neonatal Nurses. 37-241. ISSN 1751-4851 Howsen, C. , Kinney, M. , Lawn, J. (2012). The orbicular action report on preterm birth. Preterm birth matters. March of Dimes. 9-14 Lynch, E. , Dezen, T. (2012). Preterm birth can be prevented with a few proven treatments, Lancet article s ays Global partners challenge 39 high-income countries. March of Dimes. http//www. marchofdimes. com/ parole/10898. html March of Dimes. (2011). March of Dimes 2011 premature birth report card. Retrieved from http//www. marchofdimes. com/peristats/pdflib/998/US. pdf Massey, Z. Schindler Rising, S. , Ickovics, J. (2006).Centering pregnancy group prenatal care Promoting relationship-centered care. ledger of Obstetric, Gynecologic, & Neonatal Nursing, 35, 286-294. inside10. 1111/J. 1552-6909. 2006. 00040. x Manderscheid, R. (2009). Aiming for a healthier population by 2020 move our fields toward prevention, early intervention, and population health. behavioural Healthcare 29, 1 Proquest Central. pg. 51 Presem, C. , McDougall, L. (2012). Born too soon The global action report on preterm birth. World Health Organization (WHO). Retrieved from http//www. who. int/pmnch/media/news/2012/preterm_birth_report/en/index9. tml Shi, L. , & Stevens, G. (2010). unguarded populations in the United States (2nd. ed. ). Jossey-Bass. San Francisco, CA. Slager, J. , & Lynne, S. (2012). Assessment of cervical length and the relationship between short cervix and preterm birth. Journal of Midwifery & Womens Health, 57(1) S4-S11. doi10. 1111/j. 1542-2011. 2012. 00209. x Tandon, S. D. , Colon, L. , Vega, P. , Murphy, J. , Alonso, A. (2012). Birth outcomes associated with put across of group prenatal care among low-income Hispanic women. Journal of Midwifery and Womens Health. 57(5). 476-481. doi 10. 111/j. 542-2011. 2012. 00184. x Tharpe, N. , Farley, C. , Jordan, R. (2013). Clinical practice guidelines for midwifery & womens health. (4th ed. ). Jones & Bartlett Learning. Burlington, MA. 198-201. World Health Organization (WHO). (2009). The worldwide incidence of preterm birth A systematic review of maternal morbidity and mortality. Bulletin of the World Health Organization, 88, 31-38. doi 10. 2471/BLT. 08. 06255 World Health Organization (WHO). (2012). Born too soon The global actio n report on preterm birth. http//www. who. int/pmnch/media/news/2012/preterm_birth_report/en/index. html