Discussion 1: Evidence Base in Design NURS 6050

Discussion 1 Evidence Base in Design NURS 6050

Mental health and substance abuse are issues that continue to impact public health and need for effective strategies based on effective legislations at state and federal levels. The H.R bill 7316 focuses on amending Public Health Service Act to offer for the establishment or operation of an Emergency Mental Health and Substance Use Training and Technical Assistance Center with the aim of dealing with mental health issues associated with substance use disorders. The legislation is essential because of increasing prevalence of substance abuse, especially associated with mental health cares across the country. The rise in emergency mental health cases is the reason for the drive by representative Rose Max from the 11th Congressional district who seeks to ensure that there are designated centers explicitly for emergency mental health and substance abuse technical training for healthcare providers and facilities with the aim of enhancing overall care delivery and increased accessibility (Congress.GOV., 2020). The representative introduced the bill in the last Congress and aims at improving the training that professionals get in evaluating and implementing treatment for mental health issues and substance abuse emergencies.

The need to train professionals is critical so that they can possess the necessary skills, especially in emergency centers to treat mental health and substance abuse patients. There is a significant need to increase access to the specially trained professionals in healthcare settings, especially in mental health practices and situations. through effective training of the professionals, they will be self-aware and enhance their stress coping mechanisms while developing the willingness to health mental health and substance abuse patients who visit their practice settings (Stephenson, 2020). Through the training, the professionals would acquire critical skills and offer high quality care for better mental health patients. Existing studies have consistently portrayed mental health patients as lacking resources, access to emergency care intervention and face stigma from society (Stephenson, 2020). They are always considered as “attention-seeking” and drug abuse seen as a way for individuals to “waste time” of the healthcare professional. However, effective training will ensure that the health care professionals, especially those dealing with mental health patients, have adequate training and expertise as well as resources to handle their duties. By educating the professionals, they will have a positive and different mindset when dealing with mental health and substance abuse patients in their practice setting.

The Centers for Disease Control and Prevention (CDC) estimates that overdose involving opioids kills close to 80,000 individuals each year. The overdose pandemic impacts efforts to stop the spread of COVID-19 and ensure that more Americans have mitigations to reduce substance abuse and seek mental health interventions (CDC, 2021). Substance abuse contributes to costly social, physical, mental and public health problems, especially increased cost of spending on health care among low-income families and individuals. these include domestic and sexual violence, crime and homicide and teenage pregnancy among other public health concerns. Therefore, helping individuals with mental health problems emanating from substance abuse incidences is essential to lowering the negative effects associated with their use.

A majority of these patients require mental health services due to the effects of the drugs that they are using. The implication is that having the legislation and ensuring that a center exists to train mental health providers like psychiatrists will be essential in addressing the issue. The evidence shows the need to support the proposed policy as it will help in reducing the overall public health expenditure and improving access to emergency care for these individuals (Stephenson, 2020). Mental health care remains a neglected area and such an initiative demonstrates the serious efforts to tackle the problem for better patient outcomes

References

Centers for Disease Control and Prevention (CDC) (2021 March 25). Data Overview:

The Drug Overdose Epidemic: Behind the Numbers. https://www.cdc.gov/opioids/data/index.html

Congress.GOV. (2020). H.R.7316 – To amend the Public Health Service Act to provide for the

establishment or operation of a center to be known as the Emergency Mental Health and Substance Use Training and Technical Assistance Center. https://www.congress.gov/bill/116th-congress/house-bill/7316

Healthy People 2020 (2020). Chapter 40: Substance Abuse (SA).

https://www.cdc.gov/nchs/data/hpdata2020/HP2020MCR-C40-SA.pdf

Stephenson, J. (2020). Drug overdose deaths head toward record number in 2020, CDC

warns. JAMA Health Forum,1(10), pp. e201318-e201318.

This is insightful Hyacinth. Evidence based healthcare system is on the rise and the individuals involved in the care processes should be able to apply different approaches to give quality services. Nursing and the general healthcare provision should incorporate different factors that ensure that patients are treated with utmost respect (Ciarrocchi, 2019). In other words, nursing is a profession where the care that is provided should be evidence based. As such, we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became their culture of care (Goode & Landefeld, 2018).

The Bill H.R.4647 took political approaches to ensure that different individuals could have affordable medical cover. In other words, it offered medical cover for pre-existing conditions just like the Affordable Care Act. The bill was proposed way back before the Affordable Care Act, which continues to help different people from all social-economic classes. Bill H.R.4647 has enabled many people with preexisting health condition to obtain affordable care from different healthcare institutions (Lawson, 2020). The Bill is believed to have saved many people from expensive medical coverage that existed before. It has also enhanced healthcare delivery process. It is believed that some of the elements in the Bill H.R.4647 were used in the formulation of Obamacare, which continues to provide insurance cover to many people in the United States of America. The passage of the Bill was characterized by many political activities including debates in the Congress as well as the involvement of different political actors and policy-makers. The bill has facilitated quality healthcare delivery and the expansion of medical cover to over 30 million Americans.

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References

Ciarrocchi, D. P. (2019). Leading in Disaster: A Qualitative Study on the Role of the Emergency Manager (Doctoral dissertation, Northcentral University). Retrieved from: https://search.proquest.com/openview/05a526f2ed4827bc2a376fc49f013b87/1?pq-origsite=gscholar&cbl=18750&diss=y

Goode, C. A., & Landefeld, T. (2018). The Lack of Diversity in Healthcare. Journal of Best Practices in Health Professions Diversity, 11(2), 73-95. Retrieved from: https://www.jstor.org/stable/26894210?seq=1#metadata_info_tab_contents

Lawson Jr, E. (2020). Professional Quality of Life and Career Sustaining Behavior of Employee Assistant Professionals (Doctoral dissertation, University of Louisiana at Monroe). Retreved from: https://search.proquest.com/openview/0f7ee438d709adef5afafbd636e2720b/1?pq-origsite=gscholar&cbl=18750&diss=y

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

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Evidence Base in Design

With the rise in opioid addiction, health care practitioners are ethically required to look at the causes and prevention. One attributing factor that is often overlooked is the proper storage and disposal of prescribed narcotics. “Storing opioids in the open or not disposing of unused opioids increase the availability for misuse by others” (Reddy and De la Cruz, 2019). In order to combat this epidemic, advanced practice nurses and physicians could enlist the help of policymakers. However, it is beneficial to give the implementation of policies room for adjustments necessary in order to be most effective (Tummers and Bekkers, 2014). I will describe a health care policy proposed to alleviate certain problems with opioid misuse.

 On June 10th, 2019 the house of representatives, Bonamici, Kuster, Wild, Johnson, and Dingell proposed the “Safe Disposal of Opioids Act of 2019”. This is a bill to amend the Comprehensive Addiction and Recovery Act of 2016. It authorizes “the Attorney General in coordination with the Administrator of the Drug Enforcement Administration, the Secretary of Health and Human Services, and the Director of the Office of National Drug Control Policy, to award grants to covered entities to establish or maintain disposal sites for unwanted prescription medications, and for other purposes” (Bonamici, Kuster, Wild, Johnson, & Dingell, 2019). The “Safe Disposal Act of 2019” directs the Department of Justice to assist by means of grants and awards. The bill also to impose fees on the sale of opioids. However, the Department of Health and Human Services will establish discounts to patients to ensure they are not responsible for those fees.

I believe there is evidence to support this policy because when you look at addiction statistics such as socioeconomic status and age, you have to wonder how so many teens have access to narcotics. The “Safe Disposal Act of 2019” will mandate proper use and disposal in order to decrease family access to narcotics. Opioid addiction affects many families around the world. This is a national crisis. This policy will also decrease the number of opioid-related deaths related to improper use. This policy is a positive game changer for public health.

References

Bonamici, Kuster, Wild, Johnson, & Dingell. (2019, June 10). H.R.3171 – Safe disposal of opioids act of 2019. Congress.org. https://www.congress.gov/bill/116th-congress/house-bill/3171/text?q=%7B%22search%22%3A%5B%22health+policy%22%5D%7D&r=31&s=1

Reddy, A., & de la Cruz, M. (2019). Safe Opioid Use, Storage, and Disposal Strategies in Cancer Pain Management. The Oncologist, 24(11), 1410–1415. https://doi-org.ezp.waldenulibrary.org/10.1634/theoncologist.2019-0242

Tummers, L., & Bekkers, V. (2014). Policy Implementation, Street-level Bureaucracy, and the Importance of Discretion. Public Management Review, 16(4), 527–547. https://doi-org.ezp.waldenulibrary.org/10.1080/14719037.2013.841978

RE: Discussion – Week 7
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On February 13, 2020,  H.B. 5886- Vaping Prevention on College Campuses Act of 2020 was introduced to the House (Congress.gov, n.d.). Congressman Eliot Engel introduced the bill due to a recent spike of college students who are vaping. It instructs federal agencies such as the Department of Education and the Department of Health and Human Services to create a toolkit to help colleges reduce e-cigarette use among their students. The kit includes; visual aids related to the hazards of e-cigarette use, teaching resources to prevent use, and a plan to stop use on campus. Additionally, a directory of providers that treat nicotine addiction will be included (Engel authors legislation to reduce vaping on college campuses, 2020).

E-cigarettes heat a liquid turning it into an aerosol that is inhaled into the lung. The fluid may contain substances such as nicotine, tetrahydrocannabinol (THC), and cannabinoid (CBD) oils, flavoring, and additives. In January 2020, the Centers for Disease Control and Prevention (CDC) reported 2,668 hospitalizations or deaths related to e-cigarette, or vaping, product use-associated lung injury (EVALI). Of those cases, thirty-seven percent were age eighteen to twenty-four years old (CDC Centers for Disease Control and Prevention, 2020).

In 2011, e-cigarette use among those aged eighteen to twenty-four was 6.9%; however, in 2014, the usage among this age group rose to 14.3%. This age group stated the main reason they began using e-cigarettes was due to peer pressure. Additionally, this age group believes that e-cigarette use is less detrimental than traditional cigarette use (Wallace & Roche, 2018).

Additional factors that make e-cigarette use popular among the youth include; advertising aimed at the youth, appealing flavors, easy to hide devices, and the ability to provide high levels of nicotine. While the ability to deliver high concentrations of nicotine is attractive to the youth, it is very harmful. Nicotine is very addictive and can impair brain development, which lasts through the mid-twenties (King, Jones, Baldwin, & Briss, 2020).

I believe there is enough evidence to support this bill. The number of injuries or deaths among college-aged students is staggering. The attitudes related to e-cigarettes are detrimental to the well-being of the youth. While the toolkit may not wholly stop e-cigarette use, hopefully, the information will make this age group stop and think about the lasting effects of e-cigarette use.

References

CDC Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Retrieved April 5, 2020, from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Congress.gov. (n.d.). Retrieved April 5, 2020, from https://www.congress.gov

Engel authors legislation to reduce vaping on college campuses. (2020). Retrieved April 5, 2020, from https://engel.house.gov/latest-news/engel-authors-legislation-to-reduce-vaping-on-college-campuses/

King, B., Jones, C., Baldwin, G., & Briss, P. (2020). The EVALI and youth vaping epidemics- implications for public health. The New England Journal of Medicine, 382(8), 689-691. doi: 10.1056/NEJMp1916171

Wallace, L. & Roche, M. (2018). Vaping in contexts: Links among e-cigarette use, social status, and peer influence for college students. Journal of Drug Education, 48(1/2), 33-53. doi: 10.1177/0047237918807706

Response 1

Hi Jennifer, your post caught my attention, this is a topic of conversation in our county’s community health initiative. A recent study conducted in my county showed that a large percentage middle school and high school children were vaping. This has become a quickly rising epidemic for our youth. E-cigarettes were initially designed to be an alternative to assist smokers in smoking cessation, however most users do not make the transition to cessation (Buus, Alzoubaidi & Jamous, 2019). Evidence is showing that e-cigarettes are causing harm to users, creating adverse effects on lung tissues and cardiovascular toxicity (Buus, Alzoubaidi & Jamous, 2019).

The CDC statistics are staggering.  In the United States, sixty-eight deaths have occurred due to vaping as of February 2020 (CDC, 2020). The majority of users are male, the median age is 24 years old (CDC, 2020). These statistics are worrisome, especially when we know it is affecting our children. I absolutely support the H.R. 5886 Bill-Vaping Prevention on College Campuses Act of 2020. I believe that this should be amended to include middle and high school prevention as well. Prevention must begin early on if it is going to be effective.

Reference

Buus, D., Alzoubaidi, M., & Jamous, F. (2019). Vaping Induced Lung Injury: A Case Report. South Dakota Medicine : The Journal of the South Dakota State Medical Association, 72(10), 446–449.

CDC (Center for Disease Control and Prevention (2020). Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. Retrieved on April 6, 2020 from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

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