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I have most of the paper written including required sources. What I need help with is the introduction and conclusion, and making sure the paper flows well overall and makes sense.
Competencies Measured
By successfully completing this assessment, you will demonstrate
your proficiency in the course competencies through the following
assessment scoring guide criteria:
Competency 1: Apply evidence-based practice to plan patient-centered care.
Develop an individualized personal care approach that
incorporates lessons learned from a population health improvement
initiative.
Competency 2: Apply evidence-based practice to design interventions to improve population health.
Propose strategies for improving the outcomes of a population
health improvement plan, or ensuring that all outcomes are being
addressed, based on the best available evidence.
Competency 3: Evaluate outcomes of evidence-based interventions.
Evaluate the outcomes of a population health improvement initiative.
Propose a framework that could be used to evaluate desired
outcomes of an approach to personalizing care for patients and areas
that could be applied to similar situations and patients in the future.
Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
Justify the value and relevance of evidence used as the basis for a personal care approach to a patient.
Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
Write content clearly and logically, with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.
For this assessment, you will apply the outcomes of the Population
Health Improvement Initiative (PHII) to a patient-centered care report.
Evaluate the outcomes of a population health improvement initiative.
Propose strategies for improving the outcomes of the population
health improvement plan, or ensuring that all outcomes are being
addressed, based on the best available evidence.
Develop an individualized personal care approach that incorporates
lessons learned from a population health improvement initiative.
Justify the value and relevance of evidence used as the basis for your personal care approach to your patient.
Propose a framework that could be used to evaluate desired
outcomes of your approach to personalizing care for your patients and
areas that could be applied to similar situations and patients in the
future.
Write content clearly and logically, with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.
Here is the case scenario:
At last week’s conference I spoke with Alicia Balewa, Director of
Safe Headspace. They’re a relatively new nonprofit working on improving
outcomes for TBI patients, and I immediately thought of Mr. Nowak. At
his last biannual cholesterol screening he mentioned having trouble with
his balance. This may be related to his hypertension, but he believes
it’s related to the time he was hospitalized many years ago after
falling out of a tree, and expressed distress that this might be the
beginning of a rapid decline.
Ms. Balewa will be on premises next week, and I’d like to set aside some time for you to talk.
I have a patient who might benefit from some of the interventions for
TBI and PTSD you recently studied. What populations did

your public
health improvement initiative study?
My father came home from Vietnam with a
kaleidoscope of mental health problems. That was the 1970s, when
treatment options for things like PTSD, TBI, and even depression were
very different. Since then there has been a lot of investment in
treatment and recovery for combat veterans. That’s excellent news for
veterans in treatment now, but they’re not looking at my dad, and how
his TBI and PTSD have affected him through mid–life and now as a senior.
That’s why I started Safe Headspace: to focus on older patients who are
years or decades past their trauma, and find ways to help them.
Exercise. We were able to persuade about half
of our participants — that’s around 400 people, mostly men ages 45–80 —
to follow the CDC’s recommendations for moderate aerobic exercise.
Almost everyone showed improvement in mood, memory, and muscle control
after four weeks. After that a lot of participants dropped out, which is
disappointing. But of the 75 who stuck with it for another three
months, muscle control improved 15%, mood improved 22%, and
short–to–medium term memory improved 61%. We didn’t specify what kind of
exercise, but we did ask them to record what they did every week, so
that data is available.
Second was medication and therapy. Most of
our participants didn’t receive any kind of psychotherapy in the years
immediately following their trauma, so we had everyone assessed by a
team of psychotherapists. As a result of those assessments, 40% of
participants started on anti–depressant medication and 9% started taking
anti–psychotics. Those who started taking medications now have regular
contact with a therapist to manage that care. With some help at home to
stick to the regimen, all but a few have successfully followed their
treatment plans. They’ve reported a 26% improvement in mood over six
months, and a 6% improvement in memory.
The third treatment I want
to mention is meditation. We only had a small group interested in
trying it, but the results were dramatic. We prescribed daily meditation
at home, just 10 to 15 minutes, with a weekly hour–long guided group
meditation for all 23 participants. After three weeks we lost two to
disinterest, but the other 21 showed improvements of over 70% in mood
and memory, and 32% in muscle control.
Sure. There are memory exercises for patients
in elderly care, and things like Sudoku and crossword puzzles. We didn’t
see any gains with those. Some of our participants preferred strength
training to aerobic exercise, and the only improvement we saw in that
group was in muscle control, but only 4%, which is significantly less
than the aerobic group.
I should also say that we were working
with a willing group of participants. They knew they needed help, and
were motivated to get it. One of the hurdles we see with veterans,
especially in older generations, is an unwillingness to acknowledge that
they have a problem. We haven’t had to wrestle with that because
everyone who volunteers to participate wants to be there.
Your
organization is intervening with people who have TBI and PTSD
simultaneously. We have a patient with moderate TBI suffered almost 40
years ago, but no history of PTSD. Have you separated your population
and studied each separately?
We haven’t, no. In some cases we could, for
those who come in with previous diagnoses and medical records. But we
have participants who either weren’t diagnosed, were under–diagnosed at
the time, or don’t have records to show us.