Tag: Nursing

  • [Solved] SOAP Note 2 Week 5

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    Executive Solution Overview

    1. Review the SOAP note resources provided in the course content. 2. Read the Case Study: Begin by carefully reading the case study provided below. Pay close attention to the patient's background, medical history, and presenting complaint. 3. Download the SOAP Form: Access the attached SOAP form….

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    Assignment Prompt & Instructions

    1. Review the SOAP note resources provided in the course content.

    2. Read the Case Study: Begin by carefully reading the case study provided below. Pay close attention to the patient's background, medical history, and presenting complaint.

    3. Download the SOAP Form: Access the attached SOAP form. This form will serve as your template for documenting the patient encounter.

    4. Complete the SOAP Form: Using the information from the case study, fill out the SOAP form to the best of your ability. Ensure that you provide details for each section: Subjective, Objective, Assessment, and Plan. **Any part of the assessment not mentioned in the case study is considered normal.**

    5. Thoroughness is Key: Aim to complete each section of the SOAP form as comprehensively as possible. Include relevant information obtained from both the patient's subjective account and objective observations.

    6. Submit Your Completed SOAP Note: Once you have filled out the SOAP form, submit your completed document according to the instructions provided by your instructor. **Include at least 1 reference.**

    **CASE STUDY: Pain in Right Upper Quadrant and Back**

    Reason for Seeking Care

    Y.C. is a 35-year-old woman who is 6 months pregnant and presents to her obstetrics appointment with complaints of periodic pain in the right upper quadrant and mid-back. This pain tends to accompany nausea and sometimes episodes of vomiting. The woman indicates she feels somewhat feverish at times but has not taken her temperature.

    **History of Present Illness and Health History**

    A 35-year-old pregnant woman, G1P0 presents for her routine obstetric examination at 28 weeks. The woman appears her stated age and appears to be somewhat uncomfortable due to reported back pain and right upper quadrant pain. This pain started approximately 1 week prior and comes and goes throughout the day and night. The patient reports a hot bath is the only relieving measure. The pain does not respond to repositioning, OTC pain medication, or other measures. The woman reports nausea with the pain and occasional vomiting also associated with the pain. The woman’s history includes polycystic ovary syndrome and chronic sinusitis with a deviated septum repair. Current medications include only prenatal vitamins.

    **Physical Examination**

    – General: Well-nourished, woman who appears age stated. The woman’s weight gain has been as expected with pregnancy.
    – Head: Denies vision problems, and does not wear glasses or contact lenses. History of sinus problems but no current concerns. Occasional nasal stuffiness was reported with pregnancy.
    – Neck: No masses, thyroid smooth and symmetrical.
    – CV: Heart rate and rhythm regular, no murmur. Peripheral pulses are equally palpable in all four extremities. Heart rate 78, blood pressure 128/62.
    – Lungs: Breath sounds equal bilaterally, clear to auscultation.
    – Abdomen: No hepatomegaly, abdomen slightly rounded related to pregnancy, denies constipation. Currently has sharp pain in RUQ and radiating to back. The gallbladder is palpable and the patient reports tenderness.
    – Neuro: Denies changes in mood or memory, gait is steady. Is oriented to person, place, time, and situation.
    – Skin: No rashes or wounds. Skin smooth and dry.
    – GU: Patient denies any problems with urination.

    – 2 years ago

  • [Solved] WK 6 RESP EPID

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    – 2 years ago **files (1)** – ## WK6Blog.docx **## WK6Blog.docx** Blog: Critiquing Sources of Error in Population Research to Address Gaps in Nursing Practice ![A person in blue scrubs holding a tablet AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-6-resp-epid) As a …

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK6Blog.docx

    **## WK6Blog.docx**

    Blog: Critiquing Sources of Error in Population Research to Address Gaps in Nursing Practice

    ![A person in blue scrubs holding a tablet AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-6-resp-epid)

    As a DNP-educated nurse, part of your role will be to identify the differences, or gaps, between current knowledge and practice and opportunities for improvement leading to an ideal state of practice. Being able to recognize and evaluate sources of error in population research is an important skill that can lead to better implementation of evidence-based practice.

    In order to effectively critique and apply population research to practice, you should be familiar with the following types of error:

    **Selection Bias**

    Selection bias in epidemiological studies occurs when study participants do not accurately represent the population for whom results will be generalized, and this results in a measure of association that is distorted (i.e., not close to the truth). For example, if persons responding to a survey tend to be different (e.g., younger) than those who do not respond, then the study sample is not representative of the general population, and study results may be misleading if generalized.

    **Information Bias**

    Information bias results from errors made in the collection of information obtained in a study. For example, participants’ self-report of their diet may be inaccurate for many reasons. They may not remember what they ate, or they may want to portray themselves as making healthier choices than they typically make. Regardless of the reason, the information collected is not accurate and therefore introduces bias into the analysis.

    **Confounding**

    Confounding occurs when a third variable is really responsible for the association you think you see between two other variables. For example, suppose researchers detect a relationship between consumption of alcohol and occurrence of lung cancer. The results of the study seem to indicate that consuming alcohol leads to a higher risk of developing lung cancer. However, when researchers take into account that people who drink alcohol are much more likely to smoke than those who do not, it becomes clear that the real association is between smoking and lung cancer and the reason that those who consume alcohol had a higher risk of lung cancer was because they were also more likely to be smokers. In this example, smoking was a confounder of the alcohol-lung cancer relationship.

    **Random Error**

    The previous three types of errors all fall under the category of
    _systematic errors_, which are reproducible errors having to do with flaws in study design, sampling, data collection, analysis, or interpretation.
    _Random errors_, on the other hand, are fluctuations in results that arise from naturally occurring differences in variables or samples. While unavoidable to a small degree even under the most careful research parameters, these types of errors can still affect the validity of studies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259874)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-6-learning-resources?module_item_id=6259874)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 5, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part II” (pp. 106-128)

    Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 10, “Data Interpretation Issues”

    · Enzenbach, C., Wicklein, B., Wirkner, K., & Loeffler, M. (2019).
    [Evaluating selection bias in a population-based cohort study with low baseline participation: The LIFE-Adult-StudyLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=137275246&site=ehost-live&scope=site&custid=s6527200).
    _BMC Medical Research Methodology_,
    _19_(1), Article 135. https://doi.org/10.1186/s12874-019-0779-8

    · Khalili, P., Nadimi, A. E., Baradaran, H. R., Janani, L., Rahimi-Movaghar, A., Rajabi, Z., Rahmani, A., Hojati, Z., Khalagi, K., & Motevalian, S. A. (2021).
    [Validity of self-reported substance use: Research setting versus primary health care settingLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=152444700&site=ehost-live&scope=site&custid=s6527200).
    _Substance abuse Treatment, Prevention, and Policy_,
    _16_(1), Article 66. https://doi.org/10.1186/s13011-021-00398-3

    · Karr, J. E., Iverson, G. L., Isokuortti, H., Kataja, A., Brander, A., Öhman, J., & Luoto, T. M. (2021).
    [Preexisting conditions in older adults with mild traumatic brain injuries. \
    _Brain Injury_, 1–9](https://waldenu.instructure.com/courses/155998/files/12410807?wrap=1) [Download Preexisting conditions in older adults with mild traumatic brain injuries. Brain Injury, 1–9](https://waldenu.instructure.com/courses/155998/files/12410807/download?download_frd=1). Advance online publication. https://doi.org/10.1080/02699052.2021.1976419

    To Prepare:

    · Review this week’s Learning Resources, focusing on how to recognize and distinguish selection bias, information bias, confounding, and random error in research studies.

    · Select a health issue and population relevant to your professional practice and a practice gap that may exist related to this issue.

    · Consider how each type of measurement error may influence data interpretation in epidemiologic literature and how you might apply the literature to address the identified practice gap.

    · Consider strategies you might use to recognize these errors and the implications they may have for addressing gaps in practice relevant to your selected issue.

    By Day 3 of Week 6

    **Post** a cohesive scholarly response that addresses the following:

    · Describe your selected practice gap.

    · Explain how your treatment of this population/issue could be affected by having awareness of bias and confounding in epidemiologic literature.

    · Explain two strategies researchers can use to minimize these types of bias in studies, either through study design or analysis considerations.

    · Finally, explain the effects these biases could have on the interpretation of study results if not minimized.

    By Day 6 of Week 6

    **Respond** to
    **at least two** colleagues
    **on two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence, or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Vivian

    ·
    **Practice Gap Selected**

    · The gap exists due to inadequate and infrequent treatment of hypertension in patients 65 years and older in primary care settings. Many times, healthcare professionals fail to follow the proper therapeutic processes for this age group, and it can lead to poor results for the patient.

    ·
    **Influence of Bias and Confounding on Treatment**

    · With respect to this practice guideline gap, it matters how bias and confounding affect treatment and its results. For instance, there is selection bias when strategies are based on patients who show up foor appointments and are health conscious, as this does not depict the whole population of older adults suffering from hypertension. Some older patients may unintentionally exaggerate medication compliance for various reasons, making compliance assessment more difficult (Khalili et al., 2021). Other chronic illnesses prevalent in older populations, like diabetes or obesity, may result in blurring of the use and effectiveness of the treatment. Thus, this may lead to under-treatment or over-treatment (Friis & Sellers, 2021).

    ·
    **Strategies to Minimize Bias**

    · Minimizing selection bias is best achieved by employing random control trials (RCTs). RCTs are beneficial because they issue randomization, which theoretically gives every participant an equal chance of being given the intervention. This significantly lowers the impact of confounding factors and strengthens the validity of causative conclusions regarding the treatment of hypertension in the elderly (Friis & Sellers, 2021).

    · Similarly, researchers may use multivariate techniques, for example, logistic regression or propensity score matching, to account for confounding factors statistically(Curley, 2024). The greater the number of confounding factors, such as age, sex, lifestyle, and other medical issues, that are removed, the greater the real impact of the hypertension interventions.

    · Implications of Bias if Not Minimized

    · The literature’s biases and other external factors affecting treatment need to be addressed before coming up with a management plan for hypertension for older adults. For example, there could be selection bias in which patients who visit the clinic are overrepresented and this is a real problematic scenario because these patients have been given a better chance of recovery than they actually have. Older patients might ignore reporting their medication adherence due to recall and social desirability, undermining the effectiveness of the intervention (Khalili et al., 2021). If present, Other conditions, such as diabetes and obesity, affect the validity of the expected outcomes and can result from the hypertension management strategies and cause adverse effects on the treatment (Friis & Sellers, 2021).

    · References

    · Curley, A. L. C. (Ed.). (2024). Population-based nursing: Concepts and competencies for advanced practice (4th ed.). Springer.

    · Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

    · Khalili, P., Nadimi, A. E., Baradaran, H. R., Janani, L., Rahimi-Movaghar, A., Rajabi, Z., Rahmani, A., Hojati, Z., Khalagi, K., & Motevalian, S. A. (2021). Validity of self-reported substance use: Research setting versus primary health care setting. Substance Abuse Treatment, Prevention, and Policy, 16(1), Article 66.
    [https://doi.org/10.1186/s13011-021-00398-3\
    Links to an external site.](https://doi.org/10.1186/s13011-021-00398-3)

    ·

    ·

    ## image1.jpeg

    **## WK6Blog.docx**

    Blog: Critiquing Sources of Error in Population Research to Address Gaps in Nursing Practice

    ![A person in blue scrubs holding a tablet AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-6-resp-epid)

    As a DNP-educated nurse, part of your role will be to identify the differences, or gaps, between current knowledge and practice and opportunities for improvement leading to an ideal state of practice. Being able to recognize and evaluate sources of error in population research is an important skill that can lead to better implementation of evidence-based practice.

    In order to effectively critique and apply population research to practice, you should be familiar with the following types of error:

    **Selection Bias**

    Selection bias in epidemiological studies occurs when study participants do not accurately represent the population for whom results will be generalized, and this results in a measure of association that is distorted (i.e., not close to the truth). For example, if persons responding to a survey tend to be different (e.g., younger) than those who do not respond, then the study sample is not representative of the general population, and study results may be misleading if generalized.

    **Information Bias**

    Information bias results from errors made in the collection of information obtained in a study. For example, participants’ self-report of their diet may be inaccurate for many reasons. They may not remember what they ate, or they may want to portray themselves as making healthier choices than they typically make. Regardless of the reason, the information collected is not accurate and therefore introduces bias into the analysis.

    **Confounding**

    Confounding occurs when a third variable is really responsible for the association you think you see between two other variables. For example, suppose researchers detect a relationship between consumption of alcohol and occurrence of lung cancer. The results of the study seem to indicate that consuming alcohol leads to a higher risk of developing lung cancer. However, when researchers take into account that people who drink alcohol are much more likely to smoke than those who do not, it becomes clear that the real association is between smoking and lung cancer and the reason that those who consume alcohol had a higher risk of lung cancer was because they were also more likely to be smokers. In this example, smoking was a confounder of the alcohol-lung cancer relationship.

    **Random Error**

    The previous three types of errors all fall under the category of
    _systematic errors_, which are reproducible errors having to do with flaws in study design, sampling, data collection, analysis, or interpretation.
    _Random errors_, on the other hand, are fluctuations in results that arise from naturally occurring differences in variables or samples. While unavoidable to a small degree even under the most careful research parameters, these types of errors can still affect the validity of studies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259874)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-6-learning-resources?module_item_id=6259874)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 5, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part II” (pp. 106-128)

    Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 10, “Data Interpretation Issues”

    · Enzenbach, C., Wicklein, B., Wirkner, K., & Loeffler, M. (2019).
    [Evaluating selection bias in a population-based cohort study with low baseline participation: The LIFE-Adult-StudyLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=137275246&site=ehost-live&scope=site&custid=s6527200).
    _BMC Medical Research Methodology_,
    _19_(1), Article 135. https://doi.org/10.1186/s12874-019-0779-8

    · Khalili, P., Nadimi, A. E., Baradaran, H. R., Janani, L., Rahimi-Movaghar, A., Rajabi, Z., Rahmani, A., Hojati, Z., Khalagi, K., & Motevalian, S. A. (2021).
    [Validity of self-reported substance use: Research setting versus primary health care settingLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=152444700&site=ehost-live&scope=site&custid=s6527200).
    _Substance abuse Treatment, Prevention, and Policy_,
    _16_(1), Article 66. https://doi.org/10.1186/s13011-021-00398-3

    · Karr, J. E., Iverson, G. L., Isokuortti, H., Kataja, A., Brander, A., Öhman, J., & Luoto, T. M. (2021).
    [Preexisting conditions in older adults with mild traumatic brain injuries. \
    _Brain Injury_, 1–9](https://waldenu.instructure.com/courses/155998/files/12410807?wrap=1) [Download Preexisting conditions in older adults with mild traumatic brain injuries. Brain Injury, 1–9](https://waldenu.instructure.com/courses/155998/files/12410807/download?download_frd=1). Advance online publication. https://doi.org/10.1080/02699052.2021.1976419

    To Prepare:

    · Review this week’s Learning Resources, focusing on how to recognize and distinguish selection bias, information bias, confounding, and random error in research studies.

    · Select a health issue and population relevant to your professional practice and a practice gap that may exist related to this issue.

    · Consider how each type of measurement error may influence data interpretation in epidemiologic literature and how you might apply the literature to address the identified practice gap.

    · Consider strategies you might use to recognize these errors and the implications they may have for addressing gaps in practice relevant to your selected issue.

    By Day 3 of Week 6

    **Post** a cohesive scholarly response that addresses the following:

    · Describe your selected practice gap.

    · Explain how your treatment of this population/issue could be affected by having awareness of bias and confounding in epidemiologic literature.

    · Explain two strategies researchers can use to minimize these types of bias in studies, either through study design or analysis considerations.

    · Finally, explain the effects these biases could have on the interpretation of study results if not minimized.

    By Day 6 of Week 6

    **Respond** to
    **at least two** colleagues
    **on two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence, or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Vivian

    ·
    **Practice Gap Selected**

    · The gap exists due to inadequate and infrequent treatment of hypertension in patients 65 years and older in primary care settings. Many times, healthcare professionals fail to follow the proper therapeutic processes for this age group, and it can lead to poor results for the patient.

    ·
    **Influence of Bias and Confounding on Treatment**

    · With respect to this practice guideline gap, it matters how bias and confounding affect treatment and its results. For instance, there is selection bias when strategies are based on patients who show up foor appointments and are health conscious, as this does not depict the whole population of older adults suffering from hypertension. Some older patients may unintentionally exaggerate medication compliance for various reasons, making compliance assessment more difficult (Khalili et al., 2021). Other chronic illnesses prevalent in older populations, like diabetes or obesity, may result in blurring of the use and effectiveness of the treatment. Thus, this may lead to under-treatment or over-treatment (Friis & Sellers, 2021).

    ·
    **Strategies to Minimize Bias**

    · Minimizing selection bias is best achieved by employing random control trials (RCTs). RCTs are beneficial because they issue randomization, which theoretically gives every participant an equal chance of being given the intervention. This significantly lowers the impact of confounding factors and strengthens the validity of causative conclusions regarding the treatment of hypertension in the elderly (Friis & Sellers, 2021).

    · Similarly, researchers may use multivariate techniques, for example, logistic regression or propensity score matching, to account for confounding factors statistically(Curley, 2024). The greater the number of confounding factors, such as age, sex, lifestyle, and other medical issues, that are removed, the greater the real impact of the hypertension interventions.

    · Implications of Bias if Not Minimized

    · The literature’s biases and other external factors affecting treatment need to be addressed before coming up with a management plan for hypertension for older adults. For example, there could be selection bias in which patients who visit the clinic are overrepresented and this is a real problematic scenario because these patients have been given a better chance of recovery than they actually have. Older patients might ignore reporting their medication adherence due to recall and social desirability, undermining the effectiveness of the intervention (Khalili et al., 2021). If present, Other conditions, such as diabetes and obesity, affect the validity of the expected outcomes and can result from the hypertension management strategies and cause adverse effects on the treatment (Friis & Sellers, 2021).

    · References

    · Curley, A. L. C. (Ed.). (2024). Population-based nursing: Concepts and competencies for advanced practice (4th ed.). Springer.

    · Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

    · Khalili, P., Nadimi, A. E., Baradaran, H. R., Janani, L., Rahimi-Movaghar, A., Rajabi, Z., Rahmani, A., Hojati, Z., Khalagi, K., & Motevalian, S. A. (2021). Validity of self-reported substance use: Research setting versus primary health care setting. Substance Abuse Treatment, Prevention, and Policy, 16(1), Article 66.
    [https://doi.org/10.1186/s13011-021-00398-3\
    Links to an external site.](https://doi.org/10.1186/s13011-021-00398-3)

    ·

    ·

    ## image1.jpeg

  • [Solved] WK 6 RESP DATA

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – 2 years ago **files (1)** – ## WK6DIS.DATA.docx **## WK6DIS.DATA.docx** Self-Study: Comparing Counts (Chi Square) Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you th…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK6DIS.DATA.docx

    **## WK6DIS.DATA.docx**

    Self-Study: Comparing Counts (Chi Square)

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373771)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 254–267)

    · Salkind, N., & Frey, B. (2019). Statistics for people who (think they) hate statistics (7th ed.). SAGE Publications.

    · Chapter 5, “Creating Graphs: A Picture Really Is Worth a Thousand Words” (pp. 110–115)

    · Chapter 18, “Chi-Square and Some Other Nonparametric Tests: What to Do When You’re Not Normal” (pp. 337–342, 345–346)

    ·
    **Document:** [Creating Charts in Excel (Excel)](https://waldenu.instructure.com/courses/157739/files/12465866?wrap=1) [Download Creating Charts in Excel (Excel)](https://waldenu.instructure.com/courses/157739/files/12465866/download?download_frd=1)

    ·
    **Document:** [Critical Assessment, Appendix E: Research Evidence Appraisal Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465989?wrap=1) [Download Critical Assessment, Appendix E: Research Evidence Appraisal Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465989/download?download_frd=1)

    ·
    **Document:** [Critical Assessment, Appendix G: Individual Evidence Summary Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465864?wrap=1) [Download Critical Assessment, Appendix G: Individual Evidence Summary Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465864/download?download_frd=1)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Niedz, B. (2024). Inferential comparison of counts (chi square) [Video]. Walden University Canvas. https://waldenu.instructure.com

    [Optional Resources](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Conner, C. (2018).
    [_Evaluating the impact of an early warning scoring system in a community hospital setting_ Links to an external site.](https://scholarworks.waldenu.edu/dissertations/4846/) (Publication No. 10747387) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global. https://scholarworks.waldenu.edu/dissertations/4846/

    · Moradkhani, B., Mollazadeh, S., Niloofar, P., Bashiri, A., & Oghazian, M. B. (2021).
    [Association between medication adherence and health-related quality of life in patients with chronic obstructive pulmonary diseaseLinks to an external site.](https://doi.org/10.1186/s40780-021-00222-x).
    _Journal of Pharmaceutical Health Care and Sciences, 7_(1). https://doi.org/10.1186/s40780-021-00222-x

    · Owusu, M. (2023).
    [_Language barrier: An unmet challenge for low screening of colorectal cancer among Hispanic Americans in TexasLinks to an external site._](https://scholarworks.waldenu.edu/dissertations/14412/) (Publication No. 30567908) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global. https://scholarworks.waldenu.edu/dissertations/14412/

    **To prepare:**

    · Read and view the Learning Resources.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Find the Chi Sq in Moradkhani et al. (2021), Conner (2018), or Owusu (2023) from the Optional Resources, and critique its use in the study.

    · Tania

    · In the dissertation by
    **Conner (2018)** titled
    _Evaluating the Impact of an Early Warning Scoring System in a Community Hospital Setting_, the Chi-square (χ²) test was used to examine whether implementing an Early Warning Scoring (EWS) system influenced the frequency of rapid response team (RRT) activations, intensive care unit (ICU) transfers, and code blue events. Specifically, the test compared pre- and post-intervention frequencies to assess the EWS system’s effectiveness.

    · Conner reported a statistically significant decrease in code blue events post-intervention, with a Chi-square value of χ² = 4.60, p = 0.032. The use of the Chi-square test was appropriate, given that the variables in question (e.g., occurrence of code blue events) were categorical. This statistical approach is useful in determining whether distributions of categorical variables differ from one another across groups (Sedgwick, 2019). The results suggest that the EWS system may have had a beneficial impact on identifying patient deterioration earlier and reducing critical incidents.

    · However, while the statistical test was suitable, several limitations should be addressed. Most notably, effect size measures, such as Phi coefficient or Cramér’s V, were not reported. Without these, it's difficult to determine the practical or clinical relevance of the findings. A statistically significant result (p < .05) does not automatically imply a strong or meaningful association (Lakens, 2021).

    · Additionally, Conner did not clearly discuss whether the assumptions of the Chi-square test—particularly the requirement for expected frequencies of at least 5 per cell—were met. Failure to meet these assumptions can reduce the validity of the results. Also, the Chi-square test does not account for confounding factors such as staffing levels, patient acuity, or seasonal trends. A multivariate analysis, such as logistic regression, could have helped control for these potential confounders and provided more robust conclusions (Sharma et al., 2020).

    · Despite these caveats, Conner’s use of the Chi-square test effectively illustrated key patterns and associations between EWS implementation and critical event reduction. To fully inform evidence-based practice, future studies should incorporate effect size reporting, assumption verification, and complementary statistical analyses to better interpret both statistical and clinical significance.

    ·

    ·
    **References**

    · Conner, C. (2018).
    _Evaluating the impact of an early warning scoring system in a community hospital setting. (_ Publication No. 10747387) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global.
    [https://scholarworks.waldenu.edu/dissertations/4846/Links to an external site.](https://scholarworks.waldenu.edu/dissertations/4846/)

    · Lakens, D. (2021). Sample size justification. Collabra:
    _Psychology, 7_(1), 1–16.
    [https://doi.org/10.1525/collabra.33267Links to an external site.](https://doi.org/10.1525/collabra.33267)

    · Sedgwick, P. (2019). Understanding the chi-squared test.
    _BMJ, 364_, l1296.
    [https://doi.org/10.1136/bmj.l1296Links to an external site.](https://doi.org/10.1136/bmj.l1296)

    · Sharma, A., Minh Duc, N. T., Luu Lam Thang, T., Nam, N. H., Ng, S. J., Abbas, K. S., … & Huy, N. T. (2020). A consensus-based checklist for reporting of survey studies (CROSS).
    _Journal of General Internal Medicine, 36_(10), 3179–3187.
    [https://doi.org/10.1007/s11606-021-06737-1Links to an external site.](https://doi.org/10.1007/s11606-021-06737-1)

    ·

    **## WK6DIS.DATA.docx**

    Self-Study: Comparing Counts (Chi Square)

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373771)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 254–267)

    · Salkind, N., & Frey, B. (2019). Statistics for people who (think they) hate statistics (7th ed.). SAGE Publications.

    · Chapter 5, “Creating Graphs: A Picture Really Is Worth a Thousand Words” (pp. 110–115)

    · Chapter 18, “Chi-Square and Some Other Nonparametric Tests: What to Do When You’re Not Normal” (pp. 337–342, 345–346)

    ·
    **Document:** [Creating Charts in Excel (Excel)](https://waldenu.instructure.com/courses/157739/files/12465866?wrap=1) [Download Creating Charts in Excel (Excel)](https://waldenu.instructure.com/courses/157739/files/12465866/download?download_frd=1)

    ·
    **Document:** [Critical Assessment, Appendix E: Research Evidence Appraisal Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465989?wrap=1) [Download Critical Assessment, Appendix E: Research Evidence Appraisal Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465989/download?download_frd=1)

    ·
    **Document:** [Critical Assessment, Appendix G: Individual Evidence Summary Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465864?wrap=1) [Download Critical Assessment, Appendix G: Individual Evidence Summary Tool (Word document)](https://waldenu.instructure.com/courses/157739/files/12465864/download?download_frd=1)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Niedz, B. (2024). Inferential comparison of counts (chi square) [Video]. Walden University Canvas. https://waldenu.instructure.com

    [Optional Resources](https://waldenu.instructure.com/courses/157739/pages/week-6-learning-resources?module_item_id=6373771)

    · Conner, C. (2018).
    [_Evaluating the impact of an early warning scoring system in a community hospital setting_ Links to an external site.](https://scholarworks.waldenu.edu/dissertations/4846/) (Publication No. 10747387) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global. https://scholarworks.waldenu.edu/dissertations/4846/

    · Moradkhani, B., Mollazadeh, S., Niloofar, P., Bashiri, A., & Oghazian, M. B. (2021).
    [Association between medication adherence and health-related quality of life in patients with chronic obstructive pulmonary diseaseLinks to an external site.](https://doi.org/10.1186/s40780-021-00222-x).
    _Journal of Pharmaceutical Health Care and Sciences, 7_(1). https://doi.org/10.1186/s40780-021-00222-x

    · Owusu, M. (2023).
    [_Language barrier: An unmet challenge for low screening of colorectal cancer among Hispanic Americans in TexasLinks to an external site._](https://scholarworks.waldenu.edu/dissertations/14412/) (Publication No. 30567908) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global. https://scholarworks.waldenu.edu/dissertations/14412/

    **To prepare:**

    · Read and view the Learning Resources.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Find the Chi Sq in Moradkhani et al. (2021), Conner (2018), or Owusu (2023) from the Optional Resources, and critique its use in the study.

    · Tania

    · In the dissertation by
    **Conner (2018)** titled
    _Evaluating the Impact of an Early Warning Scoring System in a Community Hospital Setting_, the Chi-square (χ²) test was used to examine whether implementing an Early Warning Scoring (EWS) system influenced the frequency of rapid response team (RRT) activations, intensive care unit (ICU) transfers, and code blue events. Specifically, the test compared pre- and post-intervention frequencies to assess the EWS system’s effectiveness.

    · Conner reported a statistically significant decrease in code blue events post-intervention, with a Chi-square value of χ² = 4.60, p = 0.032. The use of the Chi-square test was appropriate, given that the variables in question (e.g., occurrence of code blue events) were categorical. This statistical approach is useful in determining whether distributions of categorical variables differ from one another across groups (Sedgwick, 2019). The results suggest that the EWS system may have had a beneficial impact on identifying patient deterioration earlier and reducing critical incidents.

    · However, while the statistical test was suitable, several limitations should be addressed. Most notably, effect size measures, such as Phi coefficient or Cramér’s V, were not reported. Without these, it's difficult to determine the practical or clinical relevance of the findings. A statistically significant result (p < .05) does not automatically imply a strong or meaningful association (Lakens, 2021).

    · Additionally, Conner did not clearly discuss whether the assumptions of the Chi-square test—particularly the requirement for expected frequencies of at least 5 per cell—were met. Failure to meet these assumptions can reduce the validity of the results. Also, the Chi-square test does not account for confounding factors such as staffing levels, patient acuity, or seasonal trends. A multivariate analysis, such as logistic regression, could have helped control for these potential confounders and provided more robust conclusions (Sharma et al., 2020).

    · Despite these caveats, Conner’s use of the Chi-square test effectively illustrated key patterns and associations between EWS implementation and critical event reduction. To fully inform evidence-based practice, future studies should incorporate effect size reporting, assumption verification, and complementary statistical analyses to better interpret both statistical and clinical significance.

    ·

    ·
    **References**

    · Conner, C. (2018).
    _Evaluating the impact of an early warning scoring system in a community hospital setting. (_ Publication No. 10747387) [Doctoral dissertation, Walden University]. ProQuest Dissertations and Theses Global.
    [https://scholarworks.waldenu.edu/dissertations/4846/Links to an external site.](https://scholarworks.waldenu.edu/dissertations/4846/)

    · Lakens, D. (2021). Sample size justification. Collabra:
    _Psychology, 7_(1), 1–16.
    [https://doi.org/10.1525/collabra.33267Links to an external site.](https://doi.org/10.1525/collabra.33267)

    · Sedgwick, P. (2019). Understanding the chi-squared test.
    _BMJ, 364_, l1296.
    [https://doi.org/10.1136/bmj.l1296Links to an external site.](https://doi.org/10.1136/bmj.l1296)

    · Sharma, A., Minh Duc, N. T., Luu Lam Thang, T., Nam, N. H., Ng, S. J., Abbas, K. S., … & Huy, N. T. (2020). A consensus-based checklist for reporting of survey studies (CROSS).
    _Journal of General Internal Medicine, 36_(10), 3179–3187.
    [https://doi.org/10.1007/s11606-021-06737-1Links to an external site.](https://doi.org/10.1007/s11606-021-06737-1)

    ·

  • [Solved] week 5.5

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    – You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
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    – 2 years ago **files (4)** – ## PEEPEXPERIENCEinstructions.docx – ## actionplantogoby.docx – 33125755PM.pdf – NU456JOURNALANALYSISEXEMPLAR1.pdf **## PEEPEXPERIENCEinstructions.docx** **Don’t do Clinical Experience Journal Start at Project Summary.** **Will be sent to Turnitin.com. No AI please!** *…

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    – 2 years ago

    **files (4)**

    – ## PEEPEXPERIENCEinstructions.docx

    – ## actionplantogoby.docx

    – 33125755PM.pdf
    – NU456JOURNALANALYSISEXEMPLAR1.pdf

    **## PEEPEXPERIENCEinstructions.docx**

    **Don’t do Clinical Experience Journal Start at Project Summary.**

    **Will be sent to Turnitin.com. No AI please!**

    **Project Summary**

    Where was your PEEP implemented, what location?
    **Queen City Women’s Health Clinic, Selma, Dallas County, Alabama**

    What date(s) was your PEEP implemented?
    **March 27, 2025 at 9 AM**

    Who was involved and/or in attendance for your PEEP implementation? Include your preceptor. My preceptor and an OBGYN physician were present along with twelve female clients

    Healthy People 2030 topic and objective being addressed by your project (include suffix).

    **Teaching Methods/Activities/Materials Evaluation**

    Discuss whether or not the teaching methods/activities/materials you chose to use during your live education/implementation were appropriate for your audience?

    What you would change about your teaching methods/activities/materials if implementing a similar project in the future?

    **Outcome Evaluation and Results**

    List your four behavioral objectives and state whether each was achieved.

    What methods did you use evaluate your behavioral objectives? Discuss how you accomplished each of your four behavioral objectives.

    What you would change about your evaluation plan if implementing a similar project in the future?

    **Teacher Performance Evaluation and Results**

    What were the results of your teacher performance evaluation? Include specific data such as ratings, comments from participants, etc.

    What you would change about your teacher performance evaluation if implementing a similar project in the future?

    **Projected Impact on Clinical Practice Facility**

    What impact will your PEEP project have on the staff, clients, clinical facility, and the community?

    Identify specific examples of changes that you expect to take place in the coming weeks to months as a result of your PEEP project.

    **Suggestions for Continued Practice Enhancement**

    Identify specific recommendations for continued education for your chosen population.

    Support with evidence-based recommendations and references to earn credit.

    Consider the following:

    Is more education needed on this topic?

    Would a simulated activity and/or experience help to better apply the knowledge?

    What other related topic would be the “next step” for this group? Did the audience or your preceptor mention another topic of interest? How would this related topic enhance or build upon the knowledge presented in your current PEEP?

    **Products Created by the Student **(This should be separate)**

    **Attach the product(s) created for your PEEP to the assignment submission link.**

    **Product(s) must be designed and created by the student.**

    **Your product should include the Healthy People 2030 topic and objective and behavioral objectives**.
    **(Increase the proportion of women who receives early and adequate prenatal care – MICH-08; Topics: Pregnancy and Childbirth)**

    **References must be cited on the product you created using correct 7th edition APA and include a minimum of four references: two professional websites and two evidence-based articles from peer-reviewed scholarly journals. Don't forget in-text citations.**

    **References**

    Cite the evidence-based recommendations and references utilized for your suggestions for continued practice enhancement.

    This is an example to show you what an ideal assignment should look like. Do not copy this exemplar as this is considered plagiarism. NU456JOURNALANALYSISEXEMPLAR.pdf

    **## actionplantogoby.docx**

    5

    ACTION PLAN AND PROPOSAL

    **Project Title and Description**

    This project “Importance of Early and Adequate Prenatal Care “aims to deliver important prenatal health messages to pregnant women spanning various economic levels. This will be implemented March 25 at Queen City Women's Health, located in a rural low-income area. My Healthy People 2030 Objective: Increase the proportion of women who receives early and adequate prenatal care – MICH-08, Topics: Pregnancy and Childbirth. Most patients who visit Queen City Women's Health have difficulty obtaining early treatment and sufficient prenatal care. Multiple delivery barriers exist because healthcare facilities are limited due to financial constraints, location barriers, and a lack of public awareness about prenatal care. Others include transportation barriers and a lack of understanding about the importance of prenatal care. Culture-related factors, which include language limitations and various health belief systems, contribute to accessing prenatal healthcare problems among patients. One aspect remains unclear about the reasons that cause specific women to delay their medical care. Without appropriate prenatal medical attention, pregnant mothers endure obstetric conditions without a diagnosis, leading to potential harm for them and their babies such as preterm birth or maternal death (Peahl et al., 2020).

    The educational initiative provides important information about maternal care needs to expect mothers. This project gives expecting women access to necessary resources for achieving improved pregnancy health outcomes. Participants will learn the importance of regular prenatal checkups, scheduling methods, and care access information. Pregnant people will learn how to navigate healthcare systems by discovering inexpensive healthcare providers while gaining comprehension of healthcare operations. My Healthy People 2030 strives to enhance prenatal

    care among birthing individuals. The plan will teach useful strategies that help individuals surmount obstacles to achieve better maternal health outcomes. Regular visit attendance to healthcare professionals, along with healthcare education, leads to better prenatal care and minimizes pregnancy-associated health complications.

    **Behavioural Objectives**

    The following SMART (Specific, Measurable, Attainable, Relevant and Time-bound) objectives are focused on improving participants’ knowledge and actions as far as prenatal care is concerned and will guide the teaching session: At the end of the session, 90% of the participants, as measured through a post-session survey, will be able to list at least three benefits of early prenatal care. Participants will also participate in an interactive group discussion to identify two common barriers to accessing prenatal care and propose one solution to overcome each barrier. Additionally, through a short quiz, 80% of the participants will correctly recall the recommended schedule for prenatal visits and key milestones for each trimester. Lastly, before the end of the session, at least 80% of participants will schedule their next prenatal appointment before exiting the event. Their registration will be confirmed by sign-up sheets or verbal confirmation.

    **Teaching Strategies**

    Several strategies will be integrated within the teaching session to ensure effective communication about the importance of prenatal care. In the first part, the PowerPoint presentation will serve as a method of explaining key concepts in a structured lecture-based way using charts and statistics. One function of this method is especially helpful for justifying the

    schedule of prenatal visits and outlining the advantages of early care. This strategy is a clear delivery of information; however, without support from engaging activities, it can be too passive, and participants may struggle to stay attentive if it is dense or delivered too quickly. To help curb this, however, Visual aids will be included to help with retention, and the pace of the curriculum will be adjusted to help your comprehension.

    Furthermore, participants will be asked to participate in an interactive group discussion to engage in active practice. This strategy facilitates open dialogue where participants share personal experiences and work together to discover common barriers to accessing prenatal care. This approach is collaborative, helping participants solve the problems encountered while using the concepts discussed in their daily situations. However, discussions may be off track or too long, and all participants will not feel comfortable contributing in a group setting. In order to remedy this, the facilitator will help keep the conversation on track and have a safe space for everyone to participate.

    There will also be a question-and-answer session, allowing people to ask any questions and promote two-way communication. However, there may be time constraints to the depth of the discussion. Lastly, a brochure or handout summarizing important points will be distributed as a reference after the session. While it is a great takeaway, it only works if participants review it later. As such, the brochure should be concise and visually compelling to keep the reader interested.

    **Outcome Evaluation**

    For the short-term evaluation and analysis, a quiz administered at the end of the session, with questions specifically geared toward determining the participant's understanding of the benefits of early prenatal care and the recommended schedule for prenatal visits, will be the evaluation method. The quiz will be a mix of true/false and multiple-choice tests to assess the students' retention of the information. Participants will also be asked to verbally commit to scheduling their next prenatal appointment before leaving the event. It is a measurable outcome of their engagement and motivation to focus on prenatal care.

    For long-term evaluation and analysis, participants will receive follow-up calls or texts 2-4 weeks after the session asking if they attend their prenatal appointments. That will help us determine if the session had some lasting effect on their decision to seek early and consistent prenatal care. The audience will find these evaluation methods suitable because they measure both the acquisition of knowledge and change in behaviour, offering an integrated gauge of how successful the session was in driving positive health outcomes.

    **Teacher Performance Evaluation**

    Evaluating my performance as a teacher is essential, so I will implement two strategies: self-reflection and participant feedback. These evaluation methods, which incorporate a balance between internal reflection and external inputs, are particularly suitable for this purpose. By integrating internal and external evaluations, I can ensure future improvements in my teaching and the quality of future sessions.

    The first strategy is to keep a self-reflection journal post-session. In this journal, I will evaluate the overall flow of the presentation, my ability to engage with participants and possible areas for improvement. Through this reflective practice, I aim to critically analyze the methods I use to teach and my strengths and weaknesses. By reviewing my delivery, pacing, and whether I responded to participants' needs, I can continually refine my delivery for future sessions to improve my teaching.

    The second strategy is to administer an anonymous participant feedback survey at the end of the session. In the end, participants will be asked to rate different aspects of the session, from the clarity of content to the efficiency of the teaching methods. Both Likert scale questions to quantify feedback and open-ended responses to provide more detailed insights will be included in the survey. I will gather direct feedback from the participants to get their external perspective of the session, determine how well it served their needs, and how it can be improved.

    **Content outline**

    1. Introduction to Prenatal Care

    A. What is prenatal care?

    a. Prenatal care is the care a woman receives during pregnancy to ensure good outcomes for both her and her baby. Regular checkups, tests and assessments monitor pregnancy progression and detect potential complications early. Additionally, the visits allow healthcare professionals to teach pregnant women about important components of maintaining a healthy pregnancy, including diet, lifestyle changes and warning signs (Peahl & Howell, 2021).

    B. Healthy People 2030 Objective – MICH 08 strives to increase the proportion of women receiving early and adequate prenatal care, as it recognizes the critical function of this care for improving maternal and infant health outcomes.

    2. Benefits of Early and Adequate Prenatal Care

    a. Prenatal care significantly reduces the risks for mothers and babies when it begins in the first trimester and continues until birth. Healthcare professionals can monitor essential health signs, including blood pressure, weight gain, and fetal development. Healthcare providers can treat conditions such as gestational diabetes or preeclampsia before these conditions become life-threatening. Early prenatal care helps patients maintain their overall wellness while staying updated on necessary medical treatments and keeping nutrition and mental health in check (Leal et al., 2020).

    3. Common Barriers to Accessing Prenatal Care

    a. Research shows prenatal care delivers helpful results, yet many women face real challenges in obtaining these services. Financial challenges represent a major difficulty that mostly affects women patients: the majority of women can not afford prenatal care, let alone insurance coverage, and this hinders their access to essential medical services. Women from rural and underserved parts of the country experience transportation obstacles that prevent them from obtaining prenatal care services as scheduled. Other patients have time constraints since they work full-time and raise children, making it hard to spare some time for prenatal visits. (Ahinkorah et al., 2021).

    3. Prenatal Care Schedule and Key Milestones

    a. During the first trimester, women are advised to visit antenatal to confirm pregnancy, check vital signs and perform other laboratory investigations. Another visit is to be made in the second trimester to monitor the baby's general growth, check for congenital anomalies, and check on the mother's well-being. The third and fourth trimesters. The visits are more frequent, starting with the fortnight to weekly. The baby's growth is monitored, and the mother's well-being is assessed through vital signs. Other important investigations done include the obstetric ultrasound. (Van De Griend et al., 2020).

    5. Encouraging Commitment to Prenatal Care

    a. For women who need prenatal care, encouraging and motivating their commitment is important for the mother's and baby's immediate and long-term health outcomes. Healthcare providers can provide practical strategies to help women stay on track with their appointments, such as flexible scheduling options, reminders and education about the importance of each visit. Furthermore, overcoming individual barriers is essential to greater access and compliance.

    **References**

    Ahinkorah, B. O., Ameyaw, E. K., Seidu, A. A., Odusina, E. K., Keetile, M., & Yaya, S. (2021). Examining Barriers to Healthcare Access and Utilization of Antenatal Care Services: Evidence from Demographic Health Surveys in Sub-Saharan Africa.
    _BMC Health Services Research_,
    _21_, 1-16.

    Leal, M. D. C., Esteves-Pereira, A. P., Viellas, E. F., Domingues, R. M. S. M., & Gama, S. G. N. D. (2020). Prenatal Care in the Brazilian Public Health Services.
    _Revista de Saúde Pública_,
    _54_, 08.
    [https://doi.org/10.11606/s1518-8787.2020054001458](https://doi.org/10.11606/s1518-8787.2020054001458)

    Peahl, A. F., & Howell, J. D. (2021). The Evolution of Prenatal Care Delivery Guidelines in the United States.
    _American Journal of Obstetrics and Gynaecology_,
    _224_(4), 339-347.
    [https://doi.org/10.1016/j.ajog.2020.12.016](https://doi.org/10.1016/j.ajog.2020.12.016)

    Peahl, A. F., Gourevitch, R. A., Luo, E. M., Fryer, K. E., Moniz, M. H., Dalton, V. K., … & Shah, N. (2020). Right-sizing Prenatal Care to Meet Patients' Needs and Improve Maternity Care Value.
    _Obstetrics & Gynecology_,
    _135_(5), 1027–1037.

    Van De Griend, K. M., Billings, D. L., Frongillo, E. A., Messias, D. K. H., Crockett, A. H., & Covington-Kolb, S. (2020). Core Strategies, Social Processes, and Contextual Influences of Early Phases of Implementation and Statewide Scale-up of Group Prenatal Care in South Carolina.
    _Evaluation and Program Planning_,
    _79_, 101760.

    **33125755PM.pdf**

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    **NU456JOURNALANALYSISEXEMPLAR1.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu456journalanalysisexemplar1-pdf)

    **NU456JOURNALANALYSISEXEMPLAR1.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu456journalanalysisexemplar1-pdf)

    **## PEEPEXPERIENCEinstructions.docx**

    **Don’t do Clinical Experience Journal Start at Project Summary.**

    **Will be sent to Turnitin.com. No AI please!**

    **Project Summary**

    Where was your PEEP implemented, what location?
    **Queen City Women’s Health Clinic, Selma, Dallas County, Alabama**

    What date(s) was your PEEP implemented?
    **March 27, 2025 at 9 AM**

    Who was involved and/or in attendance for your PEEP implementation? Include your preceptor. My preceptor and an OBGYN physician were present along with twelve female clients

    Healthy People 2030 topic and objective being addressed by your project (include suffix).

    **Teaching Methods/Activities/Materials Evaluation**

    Discuss whether or not the teaching methods/activities/materials you chose to use during your live education/implementation were appropriate for your audience?

    What you would change about your teaching methods/activities/materials if implementing a similar project in the future?

    **Outcome Evaluation and Results**

    List your four behavioral objectives and state whether each was achieved.

    What methods did you use evaluate your behavioral objectives? Discuss how you accomplished each of your four behavioral objectives.

    What you would change about your evaluation plan if implementing a similar project in the future?

    **Teacher Performance Evaluation and Results**

    What were the results of your teacher performance evaluation? Include specific data such as ratings, comments from participants, etc.

    What you would change about your teacher performance evaluation if implementing a similar project in the future?

    **Projected Impact on Clinical Practice Facility**

    What impact will your PEEP project have on the staff, clients, clinical facility, and the community?

    Identify specific examples of changes that you expect to take place in the coming weeks to months as a result of your PEEP project.

    **Suggestions for Continued Practice Enhancement**

    Identify specific recommendations for continued education for your chosen population.

    Support with evidence-based recommendations and references to earn credit.

    Consider the following:

    Is more education needed on this topic?

    Would a simulated activity and/or experience help to better apply the knowledge?

    What other related topic would be the “next step” for this group? Did the audience or your preceptor mention another topic of interest? How would this related topic enhance or build upon the knowledge presented in your current PEEP?

    **Products Created by the Student **(This should be separate)**

    **Attach the product(s) created for your PEEP to the assignment submission link.**

    **Product(s) must be designed and created by the student.**

    **Your product should include the Healthy People 2030 topic and objective and behavioral objectives**.
    **(Increase the proportion of women who receives early and adequate prenatal care – MICH-08; Topics: Pregnancy and Childbirth)**

    **References must be cited on the product you created using correct 7th edition APA and include a minimum of four references: two professional websites and two evidence-based articles from peer-reviewed scholarly journals. Don't forget in-text citations.**

    **References**

    Cite the evidence-based recommendations and references utilized for your suggestions for continued practice enhancement.

    This is an example to show you what an ideal assignment should look like. Do not copy this exemplar as this is considered plagiarism. NU456JOURNALANALYSISEXEMPLAR.pdf

    **## actionplantogoby.docx**

    5

    ACTION PLAN AND PROPOSAL

    **Project Title and Description**

    This project “Importance of Early and Adequate Prenatal Care “aims to deliver important prenatal health messages to pregnant women spanning various economic levels. This will be implemented March 25 at Queen City Women's Health, located in a rural low-income area. My Healthy People 2030 Objective: Increase the proportion of women who receives early and adequate prenatal care – MICH-08, Topics: Pregnancy and Childbirth. Most patients who visit Queen City Women's Health have difficulty obtaining early treatment and sufficient prenatal care. Multiple delivery barriers exist because healthcare facilities are limited due to financial constraints, location barriers, and a lack of public awareness about prenatal care. Others include transportation barriers and a lack of understanding about the importance of prenatal care. Culture-related factors, which include language limitations and various health belief systems, contribute to accessing prenatal healthcare problems among patients. One aspect remains unclear about the reasons that cause specific women to delay their medical care. Without appropriate prenatal medical attention, pregnant mothers endure obstetric conditions without a diagnosis, leading to potential harm for them and their babies such as preterm birth or maternal death (Peahl et al., 2020).

    The educational initiative provides important information about maternal care needs to expect mothers. This project gives expecting women access to necessary resources for achieving improved pregnancy health outcomes. Participants will learn the importance of regular prenatal checkups, scheduling methods, and care access information. Pregnant people will learn how to navigate healthcare systems by discovering inexpensive healthcare providers while gaining comprehension of healthcare operations. My Healthy People 2030 strives to enhance prenatal

    care among birthing individuals. The plan will teach useful strategies that help individuals surmount obstacles to achieve better maternal health outcomes. Regular visit attendance to healthcare professionals, along with healthcare education, leads to better prenatal care and minimizes pregnancy-associated health complications.

    **Behavioural Objectives**

    The following SMART (Specific, Measurable, Attainable, Relevant and Time-bound) objectives are focused on improving participants’ knowledge and actions as far as prenatal care is concerned and will guide the teaching session: At the end of the session, 90% of the participants, as measured through a post-session survey, will be able to list at least three benefits of early prenatal care. Participants will also participate in an interactive group discussion to identify two common barriers to accessing prenatal care and propose one solution to overcome each barrier. Additionally, through a short quiz, 80% of the participants will correctly recall the recommended schedule for prenatal visits and key milestones for each trimester. Lastly, before the end of the session, at least 80% of participants will schedule their next prenatal appointment before exiting the event. Their registration will be confirmed by sign-up sheets or verbal confirmation.

    **Teaching Strategies**

    Several strategies will be integrated within the teaching session to ensure effective communication about the importance of prenatal care. In the first part, the PowerPoint presentation will serve as a method of explaining key concepts in a structured lecture-based way using charts and statistics. One function of this method is especially helpful for justifying the

    schedule of prenatal visits and outlining the advantages of early care. This strategy is a clear delivery of information; however, without support from engaging activities, it can be too passive, and participants may struggle to stay attentive if it is dense or delivered too quickly. To help curb this, however, Visual aids will be included to help with retention, and the pace of the curriculum will be adjusted to help your comprehension.

    Furthermore, participants will be asked to participate in an interactive group discussion to engage in active practice. This strategy facilitates open dialogue where participants share personal experiences and work together to discover common barriers to accessing prenatal care. This approach is collaborative, helping participants solve the problems encountered while using the concepts discussed in their daily situations. However, discussions may be off track or too long, and all participants will not feel comfortable contributing in a group setting. In order to remedy this, the facilitator will help keep the conversation on track and have a safe space for everyone to participate.

    There will also be a question-and-answer session, allowing people to ask any questions and promote two-way communication. However, there may be time constraints to the depth of the discussion. Lastly, a brochure or handout summarizing important points will be distributed as a reference after the session. While it is a great takeaway, it only works if participants review it later. As such, the brochure should be concise and visually compelling to keep the reader interested.

    **Outcome Evaluation**

    For the short-term evaluation and analysis, a quiz administered at the end of the session, with questions specifically geared toward determining the participant's understanding of the benefits of early prenatal care and the recommended schedule for prenatal visits, will be the evaluation method. The quiz will be a mix of true/false and multiple-choice tests to assess the students' retention of the information. Participants will also be asked to verbally commit to scheduling their next prenatal appointment before leaving the event. It is a measurable outcome of their engagement and motivation to focus on prenatal care.

    For long-term evaluation and analysis, participants will receive follow-up calls or texts 2-4 weeks after the session asking if they attend their prenatal appointments. That will help us determine if the session had some lasting effect on their decision to seek early and consistent prenatal care. The audience will find these evaluation methods suitable because they measure both the acquisition of knowledge and change in behaviour, offering an integrated gauge of how successful the session was in driving positive health outcomes.

    **Teacher Performance Evaluation**

    Evaluating my performance as a teacher is essential, so I will implement two strategies: self-reflection and participant feedback. These evaluation methods, which incorporate a balance between internal reflection and external inputs, are particularly suitable for this purpose. By integrating internal and external evaluations, I can ensure future improvements in my teaching and the quality of future sessions.

    The first strategy is to keep a self-reflection journal post-session. In this journal, I will evaluate the overall flow of the presentation, my ability to engage with participants and possible areas for improvement. Through this reflective practice, I aim to critically analyze the methods I use to teach and my strengths and weaknesses. By reviewing my delivery, pacing, and whether I responded to participants' needs, I can continually refine my delivery for future sessions to improve my teaching.

    The second strategy is to administer an anonymous participant feedback survey at the end of the session. In the end, participants will be asked to rate different aspects of the session, from the clarity of content to the efficiency of the teaching methods. Both Likert scale questions to quantify feedback and open-ended responses to provide more detailed insights will be included in the survey. I will gather direct feedback from the participants to get their external perspective of the session, determine how well it served their needs, and how it can be improved.

    **Content outline**

    1. Introduction to Prenatal Care

    A. What is prenatal care?

    a. Prenatal care is the care a woman receives during pregnancy to ensure good outcomes for both her and her baby. Regular checkups, tests and assessments monitor pregnancy progression and detect potential complications early. Additionally, the visits allow healthcare professionals to teach pregnant women about important components of maintaining a healthy pregnancy, including diet, lifestyle changes and warning signs (Peahl & Howell, 2021).

    B. Healthy People 2030 Objective – MICH 08 strives to increase the proportion of women receiving early and adequate prenatal care, as it recognizes the critical function of this care for improving maternal and infant health outcomes.

    2. Benefits of Early and Adequate Prenatal Care

    a. Prenatal care significantly reduces the risks for mothers and babies when it begins in the first trimester and continues until birth. Healthcare professionals can monitor essential health signs, including blood pressure, weight gain, and fetal development. Healthcare providers can treat conditions such as gestational diabetes or preeclampsia before these conditions become life-threatening. Early prenatal care helps patients maintain their overall wellness while staying updated on necessary medical treatments and keeping nutrition and mental health in check (Leal et al., 2020).

    3. Common Barriers to Accessing Prenatal Care

    a. Research shows prenatal care delivers helpful results, yet many women face real challenges in obtaining these services. Financial challenges represent a major difficulty that mostly affects women patients: the majority of women can not afford prenatal care, let alone insurance coverage, and this hinders their access to essential medical services. Women from rural and underserved parts of the country experience transportation obstacles that prevent them from obtaining prenatal care services as scheduled. Other patients have time constraints since they work full-time and raise children, making it hard to spare some time for prenatal visits. (Ahinkorah et al., 2021).

    3. Prenatal Care Schedule and Key Milestones

    a. During the first trimester, women are advised to visit antenatal to confirm pregnancy, check vital signs and perform other laboratory investigations. Another visit is to be made in the second trimester to monitor the baby's general growth, check for congenital anomalies, and check on the mother's well-being. The third and fourth trimesters. The visits are more frequent, starting with the fortnight to weekly. The baby's growth is monitored, and the mother's well-being is assessed through vital signs. Other important investigations done include the obstetric ultrasound. (Van De Griend et al., 2020).

    5. Encouraging Commitment to Prenatal Care

    a. For women who need prenatal care, encouraging and motivating their commitment is important for the mother's and baby's immediate and long-term health outcomes. Healthcare providers can provide practical strategies to help women stay on track with their appointments, such as flexible scheduling options, reminders and education about the importance of each visit. Furthermore, overcoming individual barriers is essential to greater access and compliance.

    **References**

    Ahinkorah, B. O., Ameyaw, E. K., Seidu, A. A., Odusina, E. K., Keetile, M., & Yaya, S. (2021). Examining Barriers to Healthcare Access and Utilization of Antenatal Care Services: Evidence from Demographic Health Surveys in Sub-Saharan Africa.
    _BMC Health Services Research_,
    _21_, 1-16.

    Leal, M. D. C., Esteves-Pereira, A. P., Viellas, E. F., Domingues, R. M. S. M., & Gama, S. G. N. D. (2020). Prenatal Care in the Brazilian Public Health Services.
    _Revista de Saúde Pública_,
    _54_, 08.
    [https://doi.org/10.11606/s1518-8787.2020054001458](https://doi.org/10.11606/s1518-8787.2020054001458)

    Peahl, A. F., & Howell, J. D. (2021). The Evolution of Prenatal Care Delivery Guidelines in the United States.
    _American Journal of Obstetrics and Gynaecology_,
    _224_(4), 339-347.
    [https://doi.org/10.1016/j.ajog.2020.12.016](https://doi.org/10.1016/j.ajog.2020.12.016)

    Peahl, A. F., Gourevitch, R. A., Luo, E. M., Fryer, K. E., Moniz, M. H., Dalton, V. K., … & Shah, N. (2020). Right-sizing Prenatal Care to Meet Patients' Needs and Improve Maternity Care Value.
    _Obstetrics & Gynecology_,
    _135_(5), 1027–1037.

    Van De Griend, K. M., Billings, D. L., Frongillo, E. A., Messias, D. K. H., Crockett, A. H., & Covington-Kolb, S. (2020). Core Strategies, Social Processes, and Contextual Influences of Early Phases of Implementation and Statewide Scale-up of Group Prenatal Care in South Carolina.
    _Evaluation and Program Planning_,
    _79_, 101760.

    **33125755PM.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/33125755pm-pdf)

    **NU456JOURNALANALYSISEXEMPLAR1.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu456journalanalysisexemplar1-pdf)

    **## PEEPEXPERIENCEinstructions.docx**

    **Don’t do Clinical Experience Journal Start at Project Summary.**

    **Will be sent to Turnitin.com. No AI please!**

    **Project Summary**

    Where was your PEEP implemented, what location?
    **Queen City Women’s Health Clinic, Selma, Dallas County, Alabama**

    What date(s) was your PEEP implemented?
    **March 27, 2025 at 9 AM**

    Who was involved and/or in attendance for your PEEP implementation? Include your preceptor. My preceptor and an OBGYN physician were present along with twelve female clients

    Healthy People 2030 topic and objective being addressed by your project (include suffix).

    **Teaching Methods/Activities/Materials Evaluation**

    Discuss whether or not the teaching methods/activities/materials you chose to use during your live education/implementation were appropriate for your audience?

    What you would change about your teaching methods/activities/materials if implementing a similar project in the future?

    **Outcome Evaluation and Results**

    List your four behavioral objectives and state whether each was achieved.

    What methods did you use evaluate your behavioral objectives? Discuss how you accomplished each of your four behavioral objectives.

    What you would change about your evaluation plan if implementing a similar project in the future?

    **Teacher Performance Evaluation and Results**

    What were the results of your teacher performance evaluation? Include specific data such as ratings, comments from participants, etc.

    What you would change about your teacher performance evaluation if implementing a similar project in the future?

    **Projected Impact on Clinical Practice Facility**

    What impact will your PEEP project have on the staff, clients, clinical facility, and the community?

    Identify specific examples of changes that you expect to take place in the coming weeks to months as a result of your PEEP project.

    **Suggestions for Continued Practice Enhancement**

    Identify specific recommendations for continued education for your chosen population.

    Support with evidence-based recommendations and references to earn credit.

    Consider the following:

    Is more education needed on this topic?

    Would a simulated activity and/or experience help to better apply the knowledge?

    What other related topic would be the “next step” for this group? Did the audience or your preceptor mention another topic of interest? How would this related topic enhance or build upon the knowledge presented in your current PEEP?

    **Products Created by the Student **(This should be separate)**

    **Attach the product(s) created for your PEEP to the assignment submission link.**

    **Product(s) must be designed and created by the student.**

    **Your product should include the Healthy People 2030 topic and objective and behavioral objectives**.
    **(Increase the proportion of women who receives early and adequate prenatal care – MICH-08; Topics: Pregnancy and Childbirth)**

    **References must be cited on the product you created using correct 7th edition APA and include a minimum of four references: two professional websites and two evidence-based articles from peer-reviewed scholarly journals. Don't forget in-text citations.**

    **References**

    Cite the evidence-based recommendations and references utilized for your suggestions for continued practice enhancement.

    This is an example to show you what an ideal assignment should look like. Do not copy this exemplar as this is considered plagiarism. NU456JOURNALANALYSISEXEMPLAR.pdf

    **## actionplantogoby.docx**

    5

    ACTION PLAN AND PROPOSAL

    **Project Title and Description**

    This project “Importance of Early and Adequate Prenatal Care “aims to deliver important prenatal health messages to pregnant women spanning various economic levels. This will be implemented March 25 at Queen City Women's Health, located in a rural low-income area. My Healthy People 2030 Objective: Increase the proportion of women who receives early and adequate prenatal care – MICH-08, Topics: Pregnancy and Childbirth. Most patients who visit Queen City Women's Health have difficulty obtaining early treatment and sufficient prenatal care. Multiple delivery barriers exist because healthcare facilities are limited due to financial constraints, location barriers, and a lack of public awareness about prenatal care. Others include transportation barriers and a lack of understanding about the importance of prenatal care. Culture-related factors, which include language limitations and various health belief systems, contribute to accessing prenatal healthcare problems among patients. One aspect remains unclear about the reasons that cause specific women to delay their medical care. Without appropriate prenatal medical attention, pregnant mothers endure obstetric conditions without a diagnosis, leading to potential harm for them and their babies such as preterm birth or maternal death (Peahl et al., 2020).

    The educational initiative provides important information about maternal care needs to expect mothers. This project gives expecting women access to necessary resources for achieving improved pregnancy health outcomes. Participants will learn the importance of regular prenatal checkups, scheduling methods, and care access information. Pregnant people will learn how to navigate healthcare systems by discovering inexpensive healthcare providers while gaining comprehension of healthcare operations. My Healthy People 2030 strives to enhance prenatal

    care among birthing individuals. The plan will teach useful strategies that help individuals surmount obstacles to achieve better maternal health outcomes. Regular visit attendance to healthcare professionals, along with healthcare education, leads to better prenatal care and minimizes pregnancy-associated health complications.

    **Behavioural Objectives**

    The following SMART (Specific, Measurable, Attainable, Relevant and Time-bound) objectives are focused on improving participants’ knowledge and actions as far as prenatal care is concerned and will guide the teaching session: At the end of the session, 90% of the participants, as measured through a post-session survey, will be able to list at least three benefits of early prenatal care. Participants will also participate in an interactive group discussion to identify two common barriers to accessing prenatal care and propose one solution to overcome each barrier. Additionally, through a short quiz, 80% of the participants will correctly recall the recommended schedule for prenatal visits and key milestones for each trimester. Lastly, before the end of the session, at least 80% of participants will schedule their next prenatal appointment before exiting the event. Their registration will be confirmed by sign-up sheets or verbal confirmation.

    **Teaching Strategies**

    Several strategies will be integrated within the teaching session to ensure effective communication about the importance of prenatal care. In the first part, the PowerPoint presentation will serve as a method of explaining key concepts in a structured lecture-based way using charts and statistics. One function of this method is especially helpful for justifying the

    schedule of prenatal visits and outlining the advantages of early care. This strategy is a clear delivery of information; however, without support from engaging activities, it can be too passive, and participants may struggle to stay attentive if it is dense or delivered too quickly. To help curb this, however, Visual aids will be included to help with retention, and the pace of the curriculum will be adjusted to help your comprehension.

    Furthermore, participants will be asked to participate in an interactive group discussion to engage in active practice. This strategy facilitates open dialogue where participants share personal experiences and work together to discover common barriers to accessing prenatal care. This approach is collaborative, helping participants solve the problems encountered while using the concepts discussed in their daily situations. However, discussions may be off track or too long, and all participants will not feel comfortable contributing in a group setting. In order to remedy this, the facilitator will help keep the conversation on track and have a safe space for everyone to participate.

    There will also be a question-and-answer session, allowing people to ask any questions and promote two-way communication. However, there may be time constraints to the depth of the discussion. Lastly, a brochure or handout summarizing important points will be distributed as a reference after the session. While it is a great takeaway, it only works if participants review it later. As such, the brochure should be concise and visually compelling to keep the reader interested.

    **Outcome Evaluation**

    For the short-term evaluation and analysis, a quiz administered at the end of the session, with questions specifically geared toward determining the participant's understanding of the benefits of early prenatal care and the recommended schedule for prenatal visits, will be the evaluation method. The quiz will be a mix of true/false and multiple-choice tests to assess the students' retention of the information. Participants will also be asked to verbally commit to scheduling their next prenatal appointment before leaving the event. It is a measurable outcome of their engagement and motivation to focus on prenatal care.

    For long-term evaluation and analysis, participants will receive follow-up calls or texts 2-4 weeks after the session asking if they attend their prenatal appointments. That will help us determine if the session had some lasting effect on their decision to seek early and consistent prenatal care. The audience will find these evaluation methods suitable because they measure both the acquisition of knowledge and change in behaviour, offering an integrated gauge of how successful the session was in driving positive health outcomes.

    **Teacher Performance Evaluation**

    Evaluating my performance as a teacher is essential, so I will implement two strategies: self-reflection and participant feedback. These evaluation methods, which incorporate a balance between internal reflection and external inputs, are particularly suitable for this purpose. By integrating internal and external evaluations, I can ensure future improvements in my teaching and the quality of future sessions.

    The first strategy is to keep a self-reflection journal post-session. In this journal, I will evaluate the overall flow of the presentation, my ability to engage with participants and possible areas for improvement. Through this reflective practice, I aim to critically analyze the methods I use to teach and my strengths and weaknesses. By reviewing my delivery, pacing, and whether I responded to participants' needs, I can continually refine my delivery for future sessions to improve my teaching.

    The second strategy is to administer an anonymous participant feedback survey at the end of the session. In the end, participants will be asked to rate different aspects of the session, from the clarity of content to the efficiency of the teaching methods. Both Likert scale questions to quantify feedback and open-ended responses to provide more detailed insights will be included in the survey. I will gather direct feedback from the participants to get their external perspective of the session, determine how well it served their needs, and how it can be improved.

    **Content outline**

    1. Introduction to Prenatal Care

    A. What is prenatal care?

    a. Prenatal care is the care a woman receives during pregnancy to ensure good outcomes for both her and her baby. Regular checkups, tests and assessments monitor pregnancy progression and detect potential complications early. Additionally, the visits allow healthcare professionals to teach pregnant women about important components of maintaining a healthy pregnancy, including diet, lifestyle changes and warning signs (Peahl & Howell, 2021).

    B. Healthy People 2030 Objective – MICH 08 strives to increase the proportion of women receiving early and adequate prenatal care, as it recognizes the critical function of this care for improving maternal and infant health outcomes.

    2. Benefits of Early and Adequate Prenatal Care

    a. Prenatal care significantly reduces the risks for mothers and babies when it begins in the first trimester and continues until birth. Healthcare professionals can monitor essential health signs, including blood pressure, weight gain, and fetal development. Healthcare providers can treat conditions such as gestational diabetes or preeclampsia before these conditions become life-threatening. Early prenatal care helps patients maintain their overall wellness while staying updated on necessary medical treatments and keeping nutrition and mental health in check (Leal et al., 2020).

    3. Common Barriers to Accessing Prenatal Care

    a. Research shows prenatal care delivers helpful results, yet many women face real challenges in obtaining these services. Financial challenges represent a major difficulty that mostly affects women patients: the majority of women can not afford prenatal care, let alone insurance coverage, and this hinders their access to essential medical services. Women from rural and underserved parts of the country experience transportation obstacles that prevent them from obtaining prenatal care services as scheduled. Other patients have time constraints since they work full-time and raise children, making it hard to spare some time for prenatal visits. (Ahinkorah et al., 2021).

    3. Prenatal Care Schedule and Key Milestones

    a. During the first trimester, women are advised to visit antenatal to confirm pregnancy, check vital signs and perform other laboratory investigations. Another visit is to be made in the second trimester to monitor the baby's general growth, check for congenital anomalies, and check on the mother's well-being. The third and fourth trimesters. The visits are more frequent, starting with the fortnight to weekly. The baby's growth is monitored, and the mother's well-being is assessed through vital signs. Other important investigations done include the obstetric ultrasound. (Van De Griend et al., 2020).

    5. Encouraging Commitment to Prenatal Care

    a. For women who need prenatal care, encouraging and motivating their commitment is important for the mother's and baby's immediate and long-term health outcomes. Healthcare providers can provide practical strategies to help women stay on track with their appointments, such as flexible scheduling options, reminders and education about the importance of each visit. Furthermore, overcoming individual barriers is essential to greater access and compliance.

    **References**

    Ahinkorah, B. O., Ameyaw, E. K., Seidu, A. A., Odusina, E. K., Keetile, M., & Yaya, S. (2021). Examining Barriers to Healthcare Access and Utilization of Antenatal Care Services: Evidence from Demographic Health Surveys in Sub-Saharan Africa.
    _BMC Health Services Research_,
    _21_, 1-16.

    Leal, M. D. C., Esteves-Pereira, A. P., Viellas, E. F., Domingues, R. M. S. M., & Gama, S. G. N. D. (2020). Prenatal Care in the Brazilian Public Health Services.
    _Revista de Saúde Pública_,
    _54_, 08.
    [https://doi.org/10.11606/s1518-8787.2020054001458](https://doi.org/10.11606/s1518-8787.2020054001458)

    Peahl, A. F., & Howell, J. D. (2021). The Evolution of Prenatal Care Delivery Guidelines in the United States.
    _American Journal of Obstetrics and Gynaecology_,
    _224_(4), 339-347.
    [https://doi.org/10.1016/j.ajog.2020.12.016](https://doi.org/10.1016/j.ajog.2020.12.016)

    Peahl, A. F., Gourevitch, R. A., Luo, E. M., Fryer, K. E., Moniz, M. H., Dalton, V. K., … & Shah, N. (2020). Right-sizing Prenatal Care to Meet Patients' Needs and Improve Maternity Care Value.
    _Obstetrics & Gynecology_,
    _135_(5), 1027–1037.

    Van De Griend, K. M., Billings, D. L., Frongillo, E. A., Messias, D. K. H., Crockett, A. H., & Covington-Kolb, S. (2020). Core Strategies, Social Processes, and Contextual Influences of Early Phases of Implementation and Statewide Scale-up of Group Prenatal Care in South Carolina.
    _Evaluation and Program Planning_,
    _79_, 101760.

    **33125755PM.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/33125755pm-pdf)

    **NU456JOURNALANALYSISEXEMPLAR1.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu456journalanalysisexemplar1-pdf)