NR 503 Week 6: Epidemiological Analysis: Chronic Health Problem

Sample Answer for NR 503 Week 6: Epidemiological Analysis: Chronic Health Problem Included After Question

The widespread non-communicable respiratory illness known as chronic obstructive pulmonary disease  (COPD) is treatable and preventative. COPD is the collective term for emphysema and chronic bronchitis.  COPD is characterized by increasing tissue damage and persistent respiratory difficulties. The rising  expense of healthcare is linked to COPD, which has been a prevalent source of morbidity and mortality in  the United States. The aim of this study is to investigate COPD, covering its importance, strategies for  surveillance and reporting, epidemiology, screening, and guidelines. It will also have a strategy outlining  how the NP would handle the medical problem and the high readmission rates. 

Background Information and  Significance of the Health Issue

COPD is defined by an aberrant inflammatory response in the lungs and irreversible airflow restriction.  According to Hikichi et al. (2019), long-term exposure to harmful particles and gases, especially cigarette  smoke, triggers both innate and adaptive immune responses that lead to an aberrant inflammatory  response in COPD. Inflammatory cells, mediators, protease and antiprotease imbalance, and oxidative  stress are all elevated during the inflammatory response. The pathogenic pathways that cause  hypersecretion of mucus, ciliary dysfunction, anomalies in gaseous exchange, pulmonary hypertension,  and systemic consequences are the causes of the alterations associated with COPD. Mucus  hypersecretion is a hallmark of chronic bronchitis, whereas tissue damage is the hallmark of  emphysema.

Due to airway remodeling and the buildup of inflammatory exudates in the small airways, the small  conducting airways are the main location of airflow restriction. Longer expiration and more work of  breathing come from the inflammation-induced decrease of lung elastic recoil and the breakdown of  alveolar support (Hikichi et al., 2019). Persistent pulmonary hypertension and right ventricular  dysfunction are partly caused by pulmonary artery vasoconstriction and remodeling of the pulmonary  arteries. Heart failure develops as a result, worsening the diagnosis and raising the death rate.

Clinical Presentations

Patients with chronic bronchitis have a long history of developing dyspnea, a tardy nonproductive cough,  lung infections that come back frequently, and cardiorespiratory failure. According to Choi et al. (2019),  the physical examination revealed the following: cyanosis, edema, coarse rhonchi and wheezing, and the  utilization of accessory muscles for respiration. Emphysema patients, on the other hand, also have a long  history of increasing dyspnea, a tardy onset of productive cough, and respiratory failure. On physical  examination, the patients have a barrel chest and are frequently skinny. They also exhibit laborious  breathing, which is defined by pursed lips breathing and the employment of accessory muscles in a  hyper-resonant chest (Choi et al., 2019). Auscultation may also reveal wheezing and distant heart  sounds. 

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Stages

Stage 1: The majority of patients do not notice any changes in their lung function due to the minor symptoms. To widen your airways, your doctor may advise taking a bronchodilator medicine. As the primary cause of COPD, smoking will be discouraged, along with other lifestyle modifications such avoiding secondhand smoke.

Stage 2: When symptoms deteriorate to this point, most people seek medical help. You can feel short of breath when jogging or walking, and coughing and mucus production worsen. During this phase, doctors will often advise pulmonary rehabilitation so that you can learn how to control your COPD more effectively. To lessen potentially deadly flare-ups, doctors frequently administer oxygen and steroids.

Stage 3: Patients may not be able to perform basic tasks and frequently cannot leave due to their symptoms being so severe.

Stage 4: Oxygen blood levels become very low, which makes the risk of developing heart and lung failure very high. Flare-ups are often and can  be fatal. Individuals may need surgical intervention such as a lung transplant or removal of  large areas of damaged lungs air sacs

New Jersey Statistics

While COPD prevalence, hospitalization, death, and smoking rates are all lower in New Jersey than in  other states, the state’s readmission rate is higher than normal. It is ranked 10th out of all the afflicted  states nationally. According to data, the state has a 4.8% prevalence of adults with COPD who have been  diagnosed, with an incidence of 366,900 compared to the 5.8 million people in the country. According to  COPD (2018), the state’s COPD prevalence was greater in Blacks and Whites (4.9% and 4.6% ) respectively than in Hispanics (3.9%) and Asians (2.5%). In addition, 10608 patients in New Jersey had  readmission rates, with a 25% annual 30-day readmission rate. Nonetheless, the yearly death rate is 27.7  per 100,000 people, and the annual treatment costs are close to 1.02 billion US dollars. Its influenza  vaccination rate is greater than usual, but its pneumonia vaccination rate for COPD patients is lower than  average.

A Table Evaluating COPD Statistics for the United States and New Jersey

 New Jersey StatisticsNational Statistics
Prevalence4.8%5%
Incidence366,90012.5million
Readmission25%26.5%
Deaths/10000027.7%102.5%
Females5.1%5.9%
Males4.5%4.7%

Surveillance and Reporting

In order to track the prevalence of COPD, surveillance techniques have been introduced in New Jersey.  The CDC established the National Behavioral Risk Factor Surveillance System (BRFSS), which includes the  New Jersey Behavioral Risk Factor Survey (NJBRFS), to survey all of the state’s citizens (NJ gov, n.d.). To  help stratify the risk of getting COPD, NJBRFS identifies important behavioral risk variables such tobacco  use and exposure to lung irritants. Furthermore, the Center for Health Statistics and Informatics (CHS) of  New Jersey manages the New Jersey State Health Assessment Data (NJSHAD) System, which the state  created to offer on-demand access to public health datasets, statistics, and data about the state’s health  status (NJ gov, n.d). Public health status indicator reports, community profiles, health issues with  indicator reports, and other data and resources, including links to other data sources, partner  organizations, and more details about public health data related to an illness, are all included in NJSHAD.

Analyses from epidemiology

A Sample Answer For the Assignment: NR 503 Week 6: Epidemiological Analysis: Chronic Health Problem

Title: NR 503 Week 6: Epidemiological Analysis: Chronic Health Problem

WHAT

People over 40 years old are susceptible to COPD, a major non-communicable disease. But among  Americans, it has a high prevalence of morbidity and mortality. High readmission rates for afflicted  patients are frequently the result of disease aggravation. According to estimates, about 210 million 

people globally suffer with COPD, and over four million of those deaths make up around 9% of all deaths  (Safiri et al., 2022). According to reports, 90 percent of these fatalities happened in low- and middle income nations. Acute exacerbations of COPD, as determined by disability-adjusted life years, make the  disease the sixth most common cause of poor health in the world today. 

WHO

One of the main risk factors for COPD was tobacco use. Exposure to secondhand tobacco smoke at work,  being older than 50, and using biomass fuels were additional risk factors. According to Safiri et al. (2022)  COPD was more common in males than women, with prevalence of 35.6% in those over the age of 70.  The number of nonsmoker COPD patients is rising, which can be attributed to other risk factors  mentioned above. Patients with COPD exhibit poor treatment-seeking behavior, and the cost of  treatment makes it difficult to continue treatment. Exacerbations of the disease have a negative impact  on patients’ quality of life and accelerate the course of the illness; hospitalization costs associated with  severe exacerbations can range from 7,000 to 39,200 US dollars.

WHERE

The age prevalence of COPD was greater in high-income North America, South Asia, and Australia than in  Andean Latin America, high-income Asia Pacific, and eastern sub-Saharan Africa. The highest age standardized death rates from COPD were found in Oceania, South Asia, and East Asia, while the lowest  death rates were found in high-income Asia Pacific, Eastern Europe, and Andean Latin America (Safiri et al., 2022). The regions with the biggest increases in COPD age prevalence were the Middle East, North  Africa, and southern Latin America, while the regions with the biggest decreases were Eastern Europe,  East Asia, and high-income Asia. After better patient treatment throughout the same time period, COPD  death rates fell in all regions.

Furthermore, compared to urban populations, rural populations may be twice as likely to develop COPD  (16%), owing to a higher percentage of people with a history of smoking and increased exposure to  secondhand smoke. However, rural populations may also have less access to smoking cessation programs  that could avert the disease’s onset (Ruvuna & Sood, 2020). Rural inhabitants are also more prone than  urban ones to work in dusty occupations like crop farming, coal mining, and wood industries, which  increases their exposure to occupational hazards. In high-income nations, tobacco use has been linked to  more than 70% of COPD cases. As an illustration, household air pollution is a key risk factor for COPD,  accounting for 30–40% of cases in low- and middle-income countries.

WHEN

Over time, there have been a rising number of common cases of COPD. The regions with the highest  incidence were West Europe, South Asia, and East Asia (Safiri et al., 2022). Conversely, COPD has been a  major cause of death, with the largest rates of death occurring in East Asia, South Asia, and Western  Europe. Although the number of deaths has increased, the proportion of affected people has decreased.

WHY

Smoking tobacco exposes almost one billion people to a huge risk of developing COPD, particularly in  high-income nations like the USA. Moreover, air pollution and secondhand smoke have been linked to a  higher chance of COPD development, particularly in non-smokers (Ruvuna & Sood, 2020). One possible  explanation for the 13% increase in COPD diagnoses is occupational exposure to respiratory irritants  such paints, glues, and toxic metals. Remember that certain cases of COPD have been linked to genetic  abnormalities that make people more susceptible to chronic inflammation, such as antitrypsin deficiency  and Kartagener’s syndrome.

DIAGNOSTIC TEST

The primary diagnostic criteria for COPD are clinical suspicion and activity-related dyspnea, particularly  in patients with a history of risk factors. Spirometry is needed to establish the diagnosis in symptomatic  and at-risk people (Haynes, 2018). Spirometry can also be used to monitor illness development, check  treatment response, and modify medication. Fixed is a pulmonary function test that measures the  degree of airflow limitation and can determine whether an obstruction of the airway exists. According to  Yawn et al. (2019), the Global Initiative for Chronic Obstructive Lung Disease (GOLD) uses the forced  expiratory volume in the first second (FEV1) compared to forced vital capacity (FVC) ratio to diagnose  and grade the severity of COPD. Normal FEV1/FVC is 85%, but COPD is characterized by a decreased  volume in the first second of forced exhalation, which is 70%. An FEV1/FVC ratio of less than 70%, which  indicates the existence of airflow limitation, is required for a post-bronchodilator response in order to  validate the diagnosis. Individuals falling within GOLD group one have a FEV1/FVC ratio more than 80%,  whereas those in group two have a ratio between 50% and 80% (Yawn et al., 2019). Patients in group  three who have a FEV1/FVC ratio between 30 and 50% and patients in group four who have a ratio less  than 30% are further categorized by GOLD.

Utilized frequently as a screening tool is the COPD Assessment in Primary Care to Identify Undiagnosed  Respiratory Disease and Exacerbation Risk (CAPTURE) tool. The instrument comprises five inquiries along  with a peak expiratory flow (Yawn et al., 2021). The five questions are: has the patient been exposed to  any airway irritants; has his breathing changed during the season; does he have exertional dyspnea, and  if so, are their age-mates also experiencing it?; and has he had pneumonia or bronchitis in the past year?  For diagnosing clinically severe COPD, the test exhibited 89.7% sensitivity and 93.1% specificity with 95%  confidence interval widths across a variety of sample sizes (Yawn et al., 2021). The screening test did not  necessitate any additional diagnostic testing, so the cost was minimal.

PLAN

The key elements of managing COPD must be understood by an NP. According to Bollmeier and  Hartmann (2020), these include appropriate pharmacotherapy, support for quitting smoking, pulmonary  rehabilitation, and routine follow-up monitoring for disease progression. The NP should use the  GOLDABCD tool to guide treatment based on the severity of the disease. The mainstay of  pharmacotherapy is the use of bronchodilators, which are essential for the management of COPD at all  severity levels. Both short- and long-acting beta-blockers and antimuscarinics are common  bronchodilators. Ipratropium is a short-acting muscarinic antagonist (SAMA), while tiotropium is a long acting muscarinic antagonist (LAMA). Similarly, salbutamol is a short-acting beta-blocker, while  salmeterol is a long-acting beta-blocker.

If GOLD group A patients exhibit symptoms, the NP should provide a short- or long-acting bronchodilator  in addition to their prescription. For patients in group B, a LAMA or LABA is utilized as an initial  treatment. Patients in GOLD group C are advised to undergo LAMA monotherapy since it enhances lung  function and lowers exacerbations (Yawn et al., 2021). Finally, because of their complementary modes of  action, group GOLD group D patients are advised to begin initial therapy with LAMA and LABA in order to  reduce disease aggravation. The NP ought to be aware of the extra factors to be taken into account when  managing specific COPD cases (Yawn et al., 2021). For instance, in COPD GOLD group D patients with a  history of asthma and elevated blood eosinophil counts, the first-choice therapy regimen consists of  LABA plus inhaled corticosteroid (ICS) (Yawn et al., 2021).

An acute exacerbation of COPD must be recognized by the NP nurse, who must then start therapy right  once. As part of the immediate treatment, steps are taken to reverse airway blockage, guarantee  sufficient oxygenation, and address the underlying cause of the aggravation. Using oxygen  supplementation, bronchodilators, corticosteroids, antibiotics, and ventilator aid are all part of the  therapy (Bollmeier & Hartmann, 2020). To stop further exacerbations, she can also provide  pneumococcal and flu vaccinations.

As a non-pharmacological strategy to improve lung function, the NP must use pulmonary rehabilitation.  According to Bollmeier and Hartmann (2020), it is crucial to teach COPD patients breathing exercises  such as pursed lips breathing and strengthening their respiratory muscles in order to lower their risk of  dyspnea. To stop the progression of the disease, quitting smoking is one of the additional methods.  Drugs like varenicline and bupropion can be used to help with cessation. Exercise and a nutritious diet  enhance life quality and avert problems.

CONCLUSION

Tobacco users are frequently affected with COPD, a chronic respiratory disease. It is one of the major  causes of illness and mortality that has been found, and the number of cases may continue to climb.  Remarkably, there has also been an increase in COPD in nonsmokers linked to exposure to the  environment and air pollution. In order to detect and keep track of COPD cases, the state of New Jersey  has been essential. To deliver proper care and enhance patient outcomes, it is imperative to get familiar  with GOLD’s criteria for diagnosing and treating COPD cases.

References

Hartmann, A. P., and S. G. Bollmeier (2020). An overview on exacerbations in the treatment of chronic  obstructive pulmonary disease. AJHP, the official journal of the American Society of Health-System  Pharmacists, is published every four months and ranges from 259 to 268. 10.1093/ajhp/zxz306 can be  found here.

Park, Y. B., Kim, Y. H., Choi, J. Y., Yoo, K. H., Park, S. J., Jung, K. S., Yoo, K. H., & Yoon, H. K. 2020). Findings  from a KOCOSS Cohort of Female Patients with Chronic Obstructive Pulmonary Disease: Clinical Features.  International Journal: 15, 2217–2224; Chronic Obstructive Pulmonary Disease. 10.2147/COPD.S269579  can be accessed here.

COPD, 2018. Available at: 

https://www.copdfoundation.org/Portals/0/StateAssessmentCards/SAC__NJ_2018.pdf

J. M. Haynes. 2018). Basic testing and interpretation of spirometry for primary care physicians.  Respiratory therapy journal published in Canada: CJRT = Revue canadienne de la thérapie respiratoire:  RCTR, 54(4), 10.29390/cjrt-2018-017. 10.29390/cjrt-2018-017 is the doi.org link.

Gon, Y., Maruoka, S., Mizumura, K., and Hikichi, M. 2019). Chronic obstructive pulmonary disease (COPD)  caused by cigarette smoke: pathogenesis. S2129–S2140 in Journal of Thoracic Disease, 11(Suppl 17).  10.21037/jtd.2019.10.43 can be found at this link.

NJ, [n.d.” This link: https://www.nj.gov/health/chs/njshad

Ruvuna, L., and A. Sood. 2020). The study of the chronic obstructive pulmonary disease epidemic. 41(3),  315–327; Clinics in Chest Medicine. 10.1016/j.ccm.2020.05.002 can be found here.

Mansournia, M. A., Collins, G. S., Kolahi, A. A., & Kaufman, J. S.; Ahmadian Heris, J.; Safiri, S.; Carson Chahhoud, K.; Noori, M.; Nejadghaderi, S. A.; Sullman, M. J. M. 2022). Results from the 2019 Global  Burden of Disease Study on the burden of chronic obstructive pulmonary disease and the risk factors  associated with it in 204 countries and territories, 1990-2019. Clinical research edition of BMJ, 378,  e069679. The doi: 10.1136/bmj-2021-069679

Yawn, B. P.; Han, M.; Make, B. M.; Mannino, D.; Brown, R. W.; Meldrum, C.; Murray, S.; Spino, C.;  Bronicki, J. S.; Leidy, N.; Tapp, H.; Dolor, R. J.; Joo, M.; Knox, L.; Zittleman, L.; Thomashow, B. M.; &  Martinez, F. J. 2021). The protocol summary of the COPD assessment in primary care is called “CAPTURE:  Validation of Undiagnosed Respiratory Disease and Exacerbation Risk in Primary Care Study.” Chronic  Obstructive Pulmonary Diseases, 8(1), 60–75 (Miami, Fla.). What is the DOI for 

10.15326/jcopdf.2020.0155?

Mintz, M. L., Yawn, B. P., and Doherty, D. E. 2021). GOLD in Practice: Treating and Managing Chronic  Obstructive Pulmonary Disease in the Primary Care Environment. Journal of Chronic Obstructive  Pulmonary Disease: International Edition, 16, 289-299. 10.2147/COPD.S222664 can be accessed here.

Assignment

Purpose

The purpose of this assignment is:

  1. Integrate knowledge and skills learned throughout NR503 course
  2. Direct application of course objectives utilizing epidemiological analysis of a chronic health problem, along with state and national level data.

Activity Learning Outcomes

This assignment enables the student to meet the following course outcomes:

See weekly outcomes from Weeks 1-6.

Due Date

This assignment must be submitted by Sunday, 11:59 p.m. MT at the end of Week 6.

Total Points Possible

This assignment is worth 200 points.

Preparing the Assignment

Requirements

This paper should clearly and comprehensively discuss a chronic health disease. Select a topic from the list provided by your course faculty.

The paper should be organized into the following sections:

  1. Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.
  2. Background and Significance of the disease, to include: Definition, description, signs and symptoms. Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease. If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of…” This indicates a gap in surveillance that will be included in the “Plan” section of this paper.
  3. Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.
  4. Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s: What, Who, Where, When, Why. Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health. Include costs (both financial and social) associated with the disease or problem.
  5. Screening and Guidelines: Review how the disease is diagnosed and current national standards (guidelines). Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
  6. Plan: Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence connected to a resource such as a scholarly piece of research.
  7. Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
  8. The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
  9. Adhere to all paper preparation guidelines (see below).
Preparing the Paper
  1. Page length: 7-10 pages, excluding title page and references.
  2. APA format current edition
  3. Include scholarly in-text references throughout and a reference list.
  4. Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details. APA formatting required.
  5. Length: Papers not adhering to the page length may be subject to either (but not both) of the following at the discretion of the course faculty: 1.  Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.
  6. Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of original work for assignments.
ASSIGNMENT CONTENT
CategoryPoints%Description
Identification of the Health Problem 157.5%Comprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content.
Background and Significance of the Health Problem3015%Background and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state compared to national data. Evidence supports background. If the student discovers a gap in data (no state level data), this is stated within the section. A student created table is included using APA format. In the case of a gap in data the student will select two other sets of data to use in the student created table.
Current Surveillance and Reporting Methods3015%Current state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting. Supported by evidence.
Descriptive Epidemiological Analysis of Health Problem3517%Comprehensive review and analysis of descriptive epidemiological points for the chronic health problem. The 5 W’;s of epidemiological analysis should be fully identified. Supported by scholarly evidence.
Screening, Diagnosis, Guidelines3015%Review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented.
Plan of Action3015%Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. ;All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.
Conclusion157.5%The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. Includes scholarly references
18592%Total CONTENT Points = 185 pts
ASSIGNMENT FORMAT
CategoryPoints%Description
APA current ed.105%APA is consistently utilized according to the current edition throughout the paper.
Grammar, Syntax, Spelling53%The paper is free from grammar, unscholarly context or “voice” and spelling is accurate throughout.
158%Total FORMAT Points = 15 pts
200100%DISCUSSION TOTAL = 125 points

Rubric

NR503_Week 6 Chronic Health_Sept19

CriteriaRatingsPts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 185 PointsIntroduction of Healthcare Problem/Concern15 ptsExcellentComprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content.14 ptsV. GoodIdentifies the problem/concern with adequate but not in-depth presentation.12 ptsSatisfactoryIdentification of problem/concern is limited.8 ptsNeeds ImprovementImprovement- Identification of problem/concern is unclear.0 ptsUnsatisfactoryImprovement- Identification of problem/concern is unclear.15 pts
This criterion is linked to a Learning OutcomeBackground/Significance30 ptsExcellentBackground and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state (or other data sets) compared to national data. Evidence supports background. A student created table is included.27 ptsV. GoodBackground is complete, presents risk, disease impact and at least one set of incidence and prevalence statistics supported by evidence, for instance state data or national data is presented, but not both. Or, full data is presented but student table is not included.26 ptsSatisfactoryBackground missing one or more key points and at least one set of incidence and prevalence statistics are presented. Lack of evidence or limited presentation of the background. A table is included which may or may not be student created; may be limited in data.15 ptsNeeds ImprovementBackground missing more than one key point and at least one set of incidence and prevalence statistics are presented, or there is no supported evidence. Unclear conclusions or presentation. No student created table is included; or if included is limited in scope or is not student created.0 ptsUnsatisfactoryBackground and significance of the disease is not provided.30 pts
This criterion is linked to a Learning OutcomeSurveillance and Reporting30 ptsExcellentCurrent state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting. All writing is supported by evidence.27 ptsV. GoodState and national disease surveillance methods are reviewed, currently gathered types of statistics is scant, reporting requirements discussed. All writing is supported by evidence.26 ptsSatisfactoryState or national surveillance statistics are discussed as an overview, lacking detail / depth. Mandated reporting may be absent. Writing is supported by evidence but may be inconsistent.15 ptsNeeds ImprovementOne of either state or national disease surveillance methods reviewed; currently gathered types of statistics may be missing or information on whether the disease is mandated for reporting is missing. There is a lack of depth with inconsistent use of evidence.0 ptsUnsatisfactoryContent not discussed.30 pts
This criterion is linked to a Learning OutcomeDescriptive Epidemiology35 ptsExcellentComprehensive review and analysis of descriptive epidemiological points for the chronic health problem. The 5 W’s of epidemiological analysis should be fully identified. Supported by scholarly evidence.32 ptsV. GoodReview and analysis has depth in general but may be missing one of the 5 W’s OR may be scant in one area of the 5 W’s. All writing is supported by evidence.29 ptsSatisfactoryReview and analysis superficial in all of the 5 W’s OR may be scant or missing 2 or more of the W’s. Evidence is present but may not be throughout all content areas.18 ptsNeeds ImprovementReview and analysis is missing depth throughout all of the content areas. Evidence may or may not support the writing.0 ptsUnsatisfactoryNo analysis provided.35 pts
This criterion is linked to a Learning OutcomeScreening, Diagnosis, Guidelines30 ptsExcellentComprehensive review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented.27 ptsV. GoodAdequate review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests is presented.26 ptsSatisfactoryLimited review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests.15 ptsNeeds ImprovementMinimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. There is a lack of depth with inconsistent use of evidence.0 ptsUnsatisfactoryReview of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests not provided.30 pts
This criterion is linked to a Learning OutcomePlan30 ptsExcellentIntegrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.27 ptsV. GoodAn adequate, but not fully comprehensive, plan of action specific to the problem, and the geographic area is presented with 3 evidenced based actions that will be taken to address the impact, outcomes, or prevalence of the disease.26 ptsSatisfactoryA limited plan of action specific to the problem, and the geographic area, outcomes, or prevalence of the disease. Three actions or less may be presented with limited or little evidence.15 ptsNeeds ImprovementMinimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. Actions are minimal or unclear, or lack specificity, are not supported directly by evidence or are not direct actions the student can take in practice. There is a lack of depth with inconsistent use of evidence.0 ptsUnsatisfactoryPlan of action not provided.30 pts
This criterion is linked to a Learning OutcomeSummary/Conclusion = 185 Points15 ptsExcellentThe conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. Includes scholarly references.14 ptsV. GoodThe conclusion adequately and logically presents major points of the paper with clear direction for action, but lacks one major point or is not succinct. Includes scholarly references.12 ptsSatisfactoryThe conclusion is a limited review of key points of the paper, is not succinct, or lacks one or more major points of the paper or clear direction for action. Scholarly references may or may not be included.8 ptsNeeds ImprovementConclusion is unclear or significantly limited in overview of the paper. Scholarly references may or may not be included.0 ptsUnsatisfactoryNo Summary/conclusion is included.15 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points =15 PointsAPA 7th ed.10 ptsExcellentAPA is consistently utilized according to the 7th edition throughout the paper.9 ptsV. GoodOne or two errors in APA format8 ptsSatisfactoryThree-Five errors in APA format5 ptsNeeds ImprovementSix errors in APA format0 ptsUnsatisfactoryGreater than six errors in APA formatting.10 pts
This criterion is linked to a Learning OutcomeGrammar, Syntax, Spelling5 ptsExcellentThere are no grammar, unscholarly context or “voice” errors in the paper and spelling is accurate throughout.4 ptsV. GoodOne or two errors3 ptsSatisfactoryThree-five errors2 ptsNeeds ImprovementSix errors0 ptsUnsatisfactoryGreater than six errors5 pts
This criterion is linked to a Learning OutcomeLate penalty deductionsStudents are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.0 ptsMinus Points0 ptsMinus Points0 pts
Total Points: 200

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