MSN 600 – Week 4 Peer Response 1 and 2

Peer Response 1

Hello Kamaljit,

This is a great post. Your culturally tailored intervention to manage hypertension among Asian Americans over 40 years is both timely and necessary, particularly in addressing the population-specific barriers to healthcare. One strength of this intervention is the incorporation of telehealth and bilingual materials, which are crucial to overcoming language barriers. However, expanding on how telehealth platforms can better accommodate non-English speakers could be beneficial. Telehealth platforms with built-in translation services or multilingual healthcare providers could further facilitate communication during virtual appointments (Jung et al., 2019). Another challenge to consider is digital literacy, especially among older adults. Have you explored offering digital literacy training to help patients navigate telehealth platforms more effectively?

Additionally, the integration of traditional medicine into the intervention is a wise approach, but it might even be more effective if community health workers (CHWs) were utilized. Since CHWs come from the communities they serve, they understand both the formal Western style of medicine and other preexisting cultural modes of receiving treatment; this aids in explaining and breaking barriers in the current health practices (Hodgins et al., 2021). Thus, engaging CHWs could complement the intervention even more through recasting messages and personally tailoring them to help the beneficiaries learn how to cope with lifestyle modifications.

You also highlighted the importance of community engagement through outreach and educational workshops. Activities such as the establishment of a series of peer support programs for patients who recovered from hypertension with other similar hypertensive patients being coached could be an additional potent form of this plan. Self-directed groups have been found to supplement central encouragement and devotion to health intercessions (Bera et al., 2023). Have you considered the long-term sustainability of such a program? Organizing the subsequent communication with clients according to a specific pattern to continue patient interactions might decrease the dropout rate. Overall, your culturally sensitive approach, combined with further refinements, has the potential to make a meaningful impact on hypertension management in this population.

References

Bera, O. P., Mondal, H., & Bhattacharya, S. (2023). Empowering Communities: A Review of Community-Based Outreach Programs in Controlling Hypertension in India. Cureus, 15(12). https://doi.org/10.7759/cureus.50722

Hodgins, S., Kok, M., Musoke, D., Lewin, S., Crigler, L., LeBan, K., & Perry, H. B. (2021). Community health workers at the dawn of a new era: 1. Introduction: tensions confronting large-scale CHW programmes. Health Research Policy and Systems, 19(S3). https://doi.org/10.1186/s12961-021-00752-8

Jung, M. Y., Lee, S., Thomas, S. B., & Juon, H.-S. (2019). Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups. Journal of Racial and Ethnic Health Disparities, 6(3), 584–593. https://doi.org/10.1007/s40615-018-00557-6

Peer Response 2

Hello Hamid,

Thank you for your post. Your proposed pressure ulcer prevention program is a strong and much-needed initiative, especially in skilled nursing facilities where pressure ulcers are a common concern. The plan to provide monthly education sessions combined with practical demonstrations is aligned with best practices for preventing pressure ulcers (Lavallée et al., 2019). However, one key suggestion is incorporating a “train-the-trainer” model. This approach allows nurses who receive the training to educate their colleagues, increasing the program’s reach and reducing the burden on staff. Studies show that train-the-trainer programs enhance learning retention and are a cost-effective way to disseminate knowledge across healthcare teams (Mette Andersen Nexø et al., 2024).

You also anticipate challenges in engaging bedbound patients, which is a valid concern, particularly for those with cognitive or physical limitations. Towards this end, involving the family and caregivers in the education program is a perfect way forward. However, through interactive means such as the use of tablets or other related devices, the programe might improve engagement even more. For example, accompanying recommendations related to repositioning techniques with videos increase the understanding of the information provided for patients who have difficulties with concentration or comprehension (Duplantier & Williamson, 2023). Have you thought of using such technologies to enhance the engagement of the patients?

Another critical aspect of any intervention program is continuous monitoring and feedback. An extended feature of the program might be quality improvement, where the staff could monitor the efficiency of the prevention techniques at frequent intervals. Audits and reflection would enable trainers and students to make improvements throughout the year to maintain the effectiveness of the chosen measures of pressure ulcer prevention. Also, there is an idea of including strict rules for staff rewards for their constant compliance with the prevention guidelines. This is very useful for motivation and long-term behavioral change.

References

Duplantier, S. C., & Williamson, F. A. (2023). Barriers and Facilitators of Health and Well-Being in Informal Caregivers of Dementia Patients: A Qualitative Study. International Journal of Environmental Research and Public Health, 20(5), 4328. https://doi.org/10.3390/ijerph20054328

Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing Pressure Ulcers in Nursing Homes Using a Care bundle: a Feasibility Study. Health & Social Care in the Community, 27(4). https://doi.org/10.1111/hsc.12742

Mette Andersen Nexø, Natassia Rosewood Kingod, Eshøj, S., Emilie Mølholm Kjærulff, Ole Nørgaard, & Tue Helms Andersen. (2024). The impact of train-the-trainer programs on the continued professional development of nurses: a systematic review. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-023-04998-4

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PEER RESPONSE 1:

BY: Kamaljit

The implementation of my evidence-based findings will focus on improving hypertension management among Asian Americans over 40 by increasing adherence to medication, diet, and exercise. This will be done through a culturally tailored intervention program that includes educational workshops, community outreach, and the use of technology such as telehealth. Educational materials will be provided in both English and the native languages of the target population to improve accessibility and comprehension (Zhou et al., 2020). I intend to collaborate with local healthcare providers and community leaders to facilitate this program, ensuring that the cultural needs of the population are met and that patients feel supported throughout their journey to better health.

One of the major anticipated challenges will be addressing language barriers, which can impede communication and understanding between healthcare providers and patients. According to Wong et al. (2021), a lack of proficiency in English can limit patients’ ability to follow medical advice and participate in their own healthcare. To overcome this challenge, bilingual healthcare providers or interpreters will be included in the intervention program to ensure that patients fully understand their treatment plans. Additionally, culturally sensitive materials will be created to resonate with the beliefs and values of the Asian American community, which should increase the likelihood of adherence to the proposed interventions.

Another anticipated challenge is resistance to Western medical practices, as many Asian Americans may prefer traditional medicine or holistic approaches to treatment. This resistance could reduce adherence to prescribed medications or lifestyle changes. To address this, the program will take a culturally inclusive approach that respects and incorporates traditional health practices where appropriate (Chun et al., 2022). By acknowledging the importance of these practices and providing education on how they can be combined with Western medicine, I aim to build trust and improve patient engagement. Engaging trusted community leaders to promote the program will also help bridge the gap between traditional and Western healthcare practices.

A third challenge will be low health literacy, particularly regarding the long-term consequences of untreated hypertension. Many patients may not fully understand the risks associated with poor blood pressure control or the benefits of adhering to treatment regimens (Kim et al., 2023). To overcome this, the program will include simple, easy-to-understand educational materials and workshops that emphasize the importance of maintaining good blood pressure control. Visual aids and interactive sessions will be used to convey key health information, making it easier for patients to understand their condition and the steps they need to take to manage it.

The successful implementation of the findings also requires addressing logistical barriers, such as access to healthcare and transportation. Some patients may have difficulty attending clinic visits due to financial constraints, lack of transportation, or work schedules. To overcome these challenges, telehealth options will be made available, allowing patients to consult with healthcare providers remotely (Johnson et al., 2021). This will not only increase access but also make it more convenient for patients to receive care, reducing the likelihood of missed appointments and ensuring continuity of care.

Finally, I anticipate challenges related to sustained patient engagement and long-term adherence to lifestyle changes. Maintaining patient motivation over time can be difficult, especially when dealing with chronic conditions like hypertension that require ongoing management. To address this, the program will include follow-up support through regular check-ins via phone or telehealth, and patients will be connected to community support groups where they can share their experiences and receive encouragement from peers (Lee et al., 2023). This social support network will help keep patients accountable and motivated, improving long-term outcomes.

PEER RESPONSE 2:

By: Hamid Ahmad

To implement the evidence-based findings from my PICOT question, I will begin by developing a comprehensive pressure ulcer prevention program. This program will include both monthly education sessions and practical demonstrations for nurses and bedbound patients in skilled nursing facilities. The sessions will focus on areas like proper repositioning techniques, skin care routines, and the use of pressure-relieving devices (Asiri, 2023). I will ensure that the education is straightforward and easy to follow, aiming to make it accessible to staff and patients alike.

MSN 600 – Week 4 Peer Response 1 and 2

One of the main challenges I anticipate is resistance from nursing staff due to time constraints and heavy workloads. Nurses may find it difficult to dedicate time for additional training on top of their regular duties (Alhammadi & Ogale, 2020). To overcome this, I plan to integrate the education sessions into existing meetings or shift changes, ensuring minimal disruption to their schedules. I will also emphasize the long-term benefits of the program, such as reducing the workload associated with treating pressure ulcers once they develop.

Another challenge could be ensuring patient participation, as some bedbound patients may have cognitive or physical limitations that make it hard for them to engage in the education program (Alhammadi & Ogale, 2020). To address this, I will involve family members or caregivers when possible and tailor the program to each patient’s abilities. Simple visual aids or video demonstrations could help make the content easier to understand.

Overall, overcoming challenges like staff resistance, patient engagement, and resource limitations will be critical to the program’s success. By integrating education into existing workflows and securing administrative support, I believe the program can significantly reduce pressure ulcer cases. This proactive approach will improve patient outcomes and overall care quality in the facility.