Linkage To Care

I chose Pender’s Health Promotion Model (HPM) as the mid-range theory that I believe that can aid me as an APRN in preventing and minimizing unnecessary Emergency Room visits and to empower patient and families to be a more active partner in their care, increase compliance to health teachings, early recognition of potential emergencies and knowing when a situation warrants a visit to the Emergency Room. I have noticed and realized too many visits that could have been prevented should the patient and family have had more education and complaint with medications, timely follow up visits, and had open communication with their health care provider. I saw the value and potential of recognizing and knowing about patient’s complex background can shed light on knowing what they value most, their degree of motivation, their

Due to gaps in policy oversight, the percentage of minorities living with HIV and AIDS in the United States remains high. It has remained high due in part to policies that were implemented during the early 90’s, emblematically The Ryan White Care Act, along with in policy makers for their failure to recognize the special needs and factors that pertain to minority groups, specifically African Americans and Non-white Hispanics. The racial disparities that have historically plagued these minority groups were initially overlooked in the policy making and implementation process. In turn, it is no disheartening wonder that certain figures and data are now representative of the minority demographic; example:

HIV/AIDS Disparity among African Americans Health disparities are the differences in accessing and receiving quality of health care provided to different populations (book). The multiple causes of disparities may include gender, race, ethnicity, sexual orientation, stigma or socioeconomic status. One of the common disparities in the US is among African American women who are infected by the human immunodeficiency virus (HIV) and its viral successor, acquired immune deficiency syndrome (AIDS). There is no clear answer as to why disparity is an ongoing problem within the population but factors that contribute to this epidemic include race itself, poverty or low income and lack of access to care

There are many health problems that we face globally and each of them are important for us to be aware of and to take precautions and measures to prevent and treat such diseases that affect our global population. HIV/AIDS is a disease that is spread through direct contact with body fluids from a person who is infected with the virus, these fluids include blood, semen, rectal fluid, vaginal fluids and breast milk. There are an approximate 35 million people living with the disease globally as of 2015 and about 1 million of those people are children under the age of 15 (Aids.gov, 2016). There are approximately 1.2 million people in the U.S. living with the disease and of those individuals many became infected with HIV by needle or syringe sharing,

The prevalence of HIV in the African American community is unmatched by any other population. African Americans accounted for 49% of all HIV related deaths in 2010 (CDC, 2014). In my specialty area of family practice, I have encountered only one non-minority patient with HIV; all others have been African-American. This population needs to be of high consideration for disease education. African Americans are typically unaware of resources available to prevent the transmission of this disease, as well as testing available to them in their communities. African American children, especially, are at greater risk for HIV due to lack of knowledge and earlier age of engaging in sexual intercourse. They are typically unaware that their behavior can yield such a negative outcome (CDC, 2012). Many urban schools lack proper funding to accommodate a sexual education curriculum. It is of increased importance to raise awareness, educate and provide a plan of care for the African American teenage and adult population, as the incidence of this disease rises daily.

I worked directly with the HIV/AIDS population as well as individuals whose behaviors place them at high risk for becoming infected. I am currently the Supervisor for the AIDS Institute Linkage and Navigation Program where I am responsible for overseeing the delivery of services. These services encompass but are not limited to entitlements, referral to agencies that assist with identifying appropriate housing, referral to medical, mental health and substance use services. I also, oversee treatment adherence services which support clients in their readiness to begin (ARV) antiretroviral therapy and maintain adherence to their prescribed medication for treatment for HIV/AIDS.

The Chicago Department of Public Health exemplifies a public health department that is extremely proactive and supportive of initiatives to eradicate or significantly decrease the incidence of HIV in the City of Chicago. To this end, the Chicago Department of Health monitors the incidences of new cases in the city, while constantly monitoring the progression or regression of the conditions of patients already affected by the HIV virus. Statistical data is collected through the avenue set up for health care providers to report all pertinent information about newly diagnosed HIV or an unusual turn of events with old HIV cases. furthermore, the Chicago Department of Public health ( CDPH) through its monitoring programs is able to identify threats, determine which health care services are need in a community and the target population. For example, in the month of November, their target segments were gays and bisexual African American men because both groups were disproportionately impacted by the HIV outbreak during the previous summer. Impressively, the CDPH has links to addresses where HIV testing is done free of charge and reports are confidential. Most importantly, the result is shared with the department to help the department further enhance the efficiency of the HIV task force of the CDPH. Furthermore, the CDPH is very efficient in the dissemination of information either through links on their website, advertisement, or pamphlets to name a few. Moreover,

First, we need to raise awareness of the prevalence of HIV in Baton Rouge by posting flyers saying how the capital has one of the highest prevalence of HIV in the country and that HIV is no longer a death sentence with modern medicine available. Also, list a plethora of clinics and free HIV testing centers on the flyers if people are interested in getting tested. We also need to create efficient and committed HIV advocacy organizations and advertise them around Baton Rouge for those with HIV who are seeking help. Even so, a study in Canada constructed a trial run consisting of using HIV-positive peer counselors administering seven 2-hour counseling sessions to small groups of gay and bisexual men. The goal of these sessions was to help reduce the prevalence of HIV transmission and high-risk sexual behaviors through implementing motivational interviewing, behavioral skills, and information about HIV (Hart et al. 1). When the trial run was finished, there were some impressive results. No doubt, there was a significant reduction in a number of men participating in sex without a condom with all status partners by 30 percent. Also, there was a significant reduction in loneliness, sexual compulsivity, and fear of being sexually rejected for insisting on condom use, by which these factors heavily contribute to sexually high-risk behaviors (Hart et al. 11).

The Chicago Department of Public health exemplifies a public health department that is extremely proactive and supportive of initiatives to eradicate or significantly decreasing the incidence of STI/HIV /AIDS in the City of Chicago. To this end, the Chicago Department of Health monitors the incidences of new cases in the city, while constantly monitoring the progression or regression of the conditions of patients already affected by the HIV virus. Statistical data is collected through the avenue set up for health care providers to report all pertinent information about newly diagnosed HIV or an unusual turn of events with old HIV cases. furthermore, the Chicago Department of Public health ( CDPH) through it monitoring programs is able identify threats, determine which health care services is need by a community and the target population. For example in the month of November their target segments were gays and bisexual African American men, because both groups were disproportionately impacted by the HIV outbreak during the previous summer,

CCM-based interventions, which include care managers, mental health integration, and patient education, are most likely to be implemented successfully because they effectively address several important barriers to care and are endorsed by physicians. Practices considering the adoption of interventions that received less support should educate physicians about the benefit of the interventions and attend to physician concerns prior to implementation. A focus on interventions that address systems-related barriers is needed to overcome all barriers to care (Henke et al.,

Ms. Okoro took the lead in identifying the number of visit that are related to none crises concerns in our crises clinic; She identified and collected data that indicated that at least 33% of patients visit is related to medication refills. This information was utilized in to develop a work group that Ms. Okoro was part of the team that worked to revamp the general mental health walk in clinic and how to appropriately staff the access clinic with a goal

HIV is highly prevalent among the United States population, primarily affecting African Americans of all economic levels and age groups. HIV is transmissible through sexual contact and damages the immune system as it interferes with the individual’s capability to fight off any infections or illnesses. Health inequalities that greatly affect the high rates of HIV include but are not limited to: higher rates of poverty, lack of awareness, intercourse within the same sex, having anxiety towards getting tested for STD’s or HIV, as well as being fearful of “coming out”. Local, state, and nationwide organizations are designed to inform and provide assistance to those who have been diagnosed with HIV/AIDS. S.A.A.F. (Southern Arizona AIDS Foundation)

According to the CDC (2015), more than one million people are living with HIV in the United States, and more than 50,000 become newly infected each year. Unfortunately, one in five Americans living with HIV are unaware of their infection. I believe using the strategy which stresses the use of the 10 essential services of public health will help reduce the incidence of HIV in our

During an HIV baseline evaluation, the health care provider explains the benefits and risks of HIV treatment and discusses ways to reduce the

The first cases of AIDS that were reported in the United States began in the early 1980s. Today, more than 1.1 million people are living with HIV. In response to this HIV epidemic, at least 35 states have implemented HIV-specific criminal laws that penalize HIV-positive people for exposing others to the virus. These laws impose criminal penalties to HIV positive people that knowingly and potentially expose others to the virus. The Ryan White Comprehensive AIDS Resources Emergency Act, also known as the CARE Act, provides states with funds for AIDS treatment and care. In 1990, the CARE Act required every state to certify that its “criminal laws were adequate to prosecute any HIV-infected individual who knowingly exposed another person to HIV.” Criminal laws regarding potential HIV exposure vary largely from state to state. Some federal legislation addresses the criminal penalties for intentional exposure such as through blood donation. CDC and Department of Justice researches found that, “ by 2011, a total of 67 laws explicitly focused on persons living with HIV had been enacted in 33 states… In 24 states, laws require persons who are aware that they have HIV disclose their status to sexual partners and 14 states require disclosure to needle-sharing partners.” The criminal laws vary as to what behaviors are criminalized or result in additional penalties. The criminal statutes regarding intentional exposure to AIDS for Louisiana, Mississippi, Arkansas, Alabama ,Georgia, and