We can work on Improving Hypertension among African American Adults

Clinical scholarly Project: Improving Hypertension among African American Adults using Text Message
Reminder to Encourage Aerobic Exercise.
Essential 1: Scientific underpinning for Practice
The Doctor of Nursing Practice [DNP] program prepares nurses to incorporate nursing science with knowledge
of biophysical, psychosocial, ethics, and organizational as a foundation for their highest level of nursing
practice. Addressing future and current issues in nursing requires a strong scientific foundation and developing
and evaluating new practices based on nursing theories and theories from other disciplines (American
Association of Colleges of Nursing [AACN], 2006). The DNP Essential I is applied to my project which is using
text message reminder to encourage adult African Americans ages 19 to 65 to do aerobic activity to control
Hypertension. DNP essential 1 is applied here because the project is based on evidence from previous
research of using text messaging to improve hypertension. This implies that regular exercise will decrease high
blood pressure and as such decrease cardiovascular events.
The doctoral project will utilize health belief model (HBM) which is based on behavioral change. The theory
addresses the readiness of an individual to change their health behaviors based on their beliefs which includes
perceived susceptibility, perceived benefits, perceived severity, and perceived barriers (Hoseini et al., 2014).
This theory allows clear understanding of the factors affecting the decision of an individual towards prevention
of a disease. Previous studies depict that increasing the perceived severity of hypertension lead to greater
reduction in both systolic and diastolic blood pressure (Hoseini et al., 2014). In my DNP role, I will educate my
patients based on evidence-based practice on the non-pharmacological and low-cost ways of managing
hypertension and other chronic diseases to improve outcomes.
Essential II – Organizational and Systems Leadership for Quality Improvement and Systems Thinking
DNP graduates are prepared to adequately add to nursing science by assessing, interpret, and scattering proof
into practice. DNP graduates have an obligation to acclimatize nursing science and practice with patients’
complex requirements. The principal abilities required in creating clinical practice rules incorporate creating
evidence-based intercessions and assessing practice results (AACN, 2006). This essential is demonstrated in
leading and partnering with other stakeholders to ensure that the CSP project is successful and participants
protected. The DNP project provides an opportunity to put clinical practice guidelines, evidence-based
intervention, and the ability to evaluate practice outcomes. The DNP role ensures accountability in the quality
of care and management of hypertension in all patients and their families. The DNP leadership role also
ensures quality improvement and patient safety using advance communication skills (AACN, 2006).
Essential III- Clinical Scholarship and Analytical Methods for Evidence-Based Practice
The DNP graduate apply scholarship and research by integration and dissemination of new knowledge and
translation of research into practice (AACN, 2006). This essential prepares a DNP graduate on how to use
analytical methods to appraise existing literature to determine the best evidence. This essential applies to the
CSP project with the extensive literature search to find the best evidence for this project. To use this essential,
the DNP graduate must demonstrate how to use information technology to collect accurate data, analyze data,
design evidence-based interventions, predict outcomes, and identify gaps in evidence. DNP essential III will
enable the use of quality improvement processes to educate other stakeholders and organizations about the
CSP findings. Therefore, the current project allows DNP graduate to exercise their skills and knowledge to
facilitate meaningful organization-wide healthcare delivery changes. As one of the technologies tipped to
improve the quality of care provided, text messaging presents an opportunity to introduce a cutting-edge
technology that enhances healthcare while working hand-in-hand with the communities to develop policies and
initiatives at improving the quality of care and outcomes (American Association of Colleges of Nursing, 2006).
Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and
Transformation of Health Care
This DNP essential prepares advanced practice nurses to use technology and information systems to improve
patient care and provide leadership in healthcare organizations as well as academics. It also equips nurses in
evaluation of legal and ethical issues in healthcare regarding information technology, communication networks,
and patient care knowledge (AACN, 2006). This essential applies to the clinical project by integrating the use of
text message in management of hypertension. Low-cost mobile technology has the potential to motivate adults
to engage in daily aerobic exercise (walking) and thus prevent mortality and morbidity caused by hypertension
(Chow et al., 2015). Thus, the use of technology helps to provide low-cost, safe, and efficient care.
1/25/2021 Order 335266479
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Moreover, the project will utilize SPSS to analyze and interpret the data for this project. The project will also
utilize the use of computer to store information about the subjects, the use of teaching documents, and mobile
phones for auto reminder for aerobic activity. Technology is central to protected, productive, patient-focused
care. The use of technology facilitates direct communication and interaction between health care providers and
the patients. DNP must utilize technology innovations for efficient patient care to make the right clinical
decision based on the available evidence.

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The United States is home to probably the most infamous and productive chronic executioners ever. Names, for example, Ted Bundy, Gary Ridgeway, and the Zodiac Killer have become easily recognized names because of the awful idea of their violations. Quite possibly the most productive chronic executioners in American history is John Wayne Gacy. Nicknamed the Killer Clown on account of his calling, Gacy assaulted and killed in any event 33 adolescent young men and youngsters somewhere in the range of 1972 and 1978, which is one of the most elevated realized casualty tallies. Gacy’s story has become so notable that his wrongdoings have been included in mainstream society and TV shows, for example, American Horror Story: Hotel and Criminal Minds. Criminological science has, and proceeds to, assume a significant part in the settling of the case and distinguishing proof of the people in question. John Wayne Gacy’s set of experiences of sexual and psychological mistreatment was instrumental in provoking specialist’s curiosity of him as a suspect. John Wayne Gacy was brought into the world on March 17, 1942, in Chicago, Illinois. Being the lone child out of three kids, Gacy had a stressed relationship with his dad, who drank vigorously and was frequently injurious towards the whole family (Sullivan and Maiken 48). In 1949, a project worker, who was a family companion, would caress Gacy during rides in his truck; be that as it may, Gacy never uncovered these experiences to his folks because of a paranoid fear of requital from his dad (Foreman 54). His dad’s mental maltreatment proceeded into his young grown-up years, and Gacy moved to Las Vegas where he worked momentarily in the rescue vehicle administration prior to turning into a funeral home specialist (Sullivan and Maiken 50). As a funeral home chaperon, Gacy was vigorously associated with the treating cycle and conceded that one night, he moved into the final resting place of an expired adolescent kid and touched the body (Cahill and Ewing 46). Stunned at himself, Gacy re-visitations of Chicago to live with his family and graduates from Northwestern Business College in 1963, and acknowledges an administration learner position with Nunn-Bush Shoe Company. In 1964, Gacy is moved to Springfield and meets his future spouse, Marlynn Myers. In Springfield, Gacy has his subsequent gay experience when a colleague unsteadily performed oral sex on him (London 11:7). Gacy moves to Waterloo, Iowa, and starts a family with Myers. Nonetheless, after routinely undermining his significant other with whores, Gacy submits his initially known rape in 1967 upon Donald Vorhees. In the coming months, Gacy explicitly manhandles a few different young people and is captured and accused of oral homosexuality (Sullivan and Maiken 60). On December 3, 1968, Gacy is indicted and condemned to ten years at the Anamosa State Penitentiary. Gacy turns into a model prisoner at Anamosa and is allowed parole in June of 1970, an only a brief time after his condemning. He had to move to Chicago and live with his mom and notice a 10:00PM time limit. Not exactly a year later, Gacy is accused again of explicitly attacking a high school kid yet the young didn’t show up in court, so the charges were dropped. Gacy was known by numerous individuals locally to be an eager volunteer and being dynamic in local area legislative issues. His part as “Pogo the Clown” the jokester started in 1975 when Gacy joined a neighborhood “Carefree Joker” comedian club that consistently performed at raising money occasions. On January 3, 1972, Gacy submits his first homicide of Timothy McCoy, a 16-year old kid making a trip from Michigan to Omaha. Asserting that McCoy went into his room using a kitchen blade, Gacy gets into an actual fight with McCoy prior to wounding him consistently in the chest. Subsequent to understanding that McCoy had absentmindedly strolled into the stay with the blade while attempting to get ready breakfast, Gacy covers the body in his unfinished plumbing space. Gacy conceded in the meetings following his capture that slaughtering McCoy gave him a “mind-desensitizing climax”, expressing that this homicide was the point at which he “understood passing was a definitive rush” (Cahill and Ewing 349). Very nearly 2 years after the fact, Gacy submits his second homicide of a unidentified teen. Gacy choked the kid prior to stuffing the body in his storeroom prior to covering him (Cahill 349). In 1975, Gacy’s business was developing rapidly and his craving for youngsters developed with it. Gacy regularly baited young fellows under his work to his home, persuading them to place themselves in binds, and assaulting and tormenting them prior to choking them (Cahill 169-170). A large portion of Gacy’s homicides occurred somewhere in the range of 1976 and 1978, the first of this time occurring in April 1976. Large numbers of the adolescents that were killed during this time were covered in an unfinished plumbing space under Gacy’s home. For the rest of the homicides, Gacy confessed to losing five bodies the I-55 scaffold into the Des Plaines River; notwithstanding, just four of the bodies were ever recuperated (Linedecker 152). In December 1978, Gacy meets Robert Jerome Piest, a 15-year old kid working at a drug store and offers him a work at Gacy’s firm. Piest educates his mom regarding this and neglects to restore that night. The Piest family records a missing individual’s report and the drug specialist advises police that Gacy would no doubt be the man that Jerome addressed about a work. When addressed by the police, Gacy denied any inclusion in Piest’s vanishing. Nonetheless, the police were not persuaded, and Gacy’s set of experiences of sexual maltreatment and battery provoked the police to look through his home. Among the things found at Gacy’s home were a 1975 secondary school class ring with the initials J.A.S., different driver’s licenses, cuffs, garments that was excessively little for Gacy, and a receipt for the drug store that Piest had worked at. Throughout the following not many days, agents got numerous calls and tips about Gacy’s rapes and the secretive vanishings of Gacy’s workers. The class ring was in the end followed back to John A. Szyc, one of Gacy’s casualties in 1977. Futhermore, after analyzing Gacy’s vehicle, agents found a little group of strands looking like human hair, which were shipped off the labs for additional investigation. That very night, search canines were utilized to identify any hint of Piest in Gacy’s vehicle, and one of the canines showed that Piest had, truth be told, been available in the vehicle. On December 20, 1977, under the pressure of consistent police reconnaissance and examination, Gacy admits to more than 30 homicides and advises his legal counselor and companion where the bodies were covered, both in the unfinished plumbing space and the stream. 26 casualties were found in the unfinished plumbing space and 4 in the stream. Gacy is captured, indicted for 33 killings, and condemned to death by deadly infusion. He endeavored a madness request yet was denied, and was executed on May 10, 1994. There were a few legal pointers that examiners used to attach Gacy to the killings. A portion of these include fiber examination, dental and radiology records, utilizing the decay cycle of the human body, and facial reproduction in recognizing the people in question. Examiners discovered filaments that took after human hair in both Gacy’s vehicle and close to the unfinished plumbing space where the bodies were covered. Notwithstanding these hair tests, examiners likewise discovered strands that contained hints of Gacy’s blood and semen in a similar zone. Blood having a place with the casualties was found on a portion of the filaments, which would later straightforwardly attach Gacy to the wrongdoings. The filaments in Gacy’s vehicle were investigated by scientific researchers and coordinated Piest’s hair tests. Besides, the hunt canines that established that Piest had been in Gacy’s vehicle showed this by a “demise response”, which told examiners that Piest’s dead body had been within Gacy’s vehicle. Out of Gacy’s 33 known casualties, just 25 were ever indisputably recognized. A considerable lot of Gacy’s casualties had comparative actual depictions and were hence difficult to distinguish by simply asking people in general. To recognize the people in question, specialists went to Betty Pat Gatliff, a pioneer in scientific science and facial recreation. Facial reproduction is the way toward reproducing the facial highlights of a person by utilizing their remaining parts. Certain facial highlights, for example, facial structures, nasal design, and generally face shape can be helpful in recognizing a casualty even long in the afterlife. By utilizing these highlights, and with the assistance of program, measurable specialists can make a picture of an individual’s face, which is instrumental in distinguishing casualties after their bodies have rotted. Facial reproduction should be possible in a few measurements. Two-dimensional facial reproductions is utilized with skull radiographs and depend on pre-passing photos and data. Notwithstanding, this isn’t really ideal in light of the fact that cranial highlights are not generally noticeable or at the correct scale (Downing). To get a practical and more exact portrayal of the casualty’s face, a craftsman and a legal anthropologist are generally vital (Downing). Three-dimensional facial remaking is finished by models or high goal, three-dimensional pictures. PC programs can make facial reproductions by controlling checked photos of the remaining parts and use approximations to reproduce facial highlights. These will in general deliver results that don’t look fake (Reichs and Craig 491). Some of the time, examiners will utilize a strategy called superimposition as a method for facial reproduction. Sadly, it’s anything but a regularly utilized technique, as it expects agents to have some information about the character of the remaining parts they are managing. By superimposing a photo of a person over the skeletal remaining parts, examiners can check whether the facial highlights line up with the anatomical highlights, permitting them to recognize a casualty. On account of John Wayne Gacy’s casualties, specialists had the option to utilize facial recreation to distinguish nine of the bodies found in the unfinished plumbing space. The accompanying realistic shows the facial recreations of these nine casualties: Since facial remaking was sufficiently not to distinguish the entirety of the v>

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