Addressing Childhood Obesity: Role of Family Nurse Practitioners, Lecture notes of Financial Accounting

Download Addressing Childhood Obesity: Role of Family Nurse Practitioners and more Lecture notes Financial Accounting in PDF only on Docsity! 1 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) Chamberlain University: Family Nurse Practitioner Track NR506NP Healthcare Policy and Leadership 2 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) A brief overview of this measure is that the USA and Worldwide there has been a dramatic increase of those that are obese and thus having secondary medical conditions such as hypertension, type 2 diabetes, myocardial infraction and stoke to name a few physical consequences. Obesity also plays a negative connotation with the psychosocial health of youth by negative self-evaluation, bullying, social stigma, symptoms of depression and anxiety (Hoedjes et al., 2018). According to the CDC the obesity rate of 18.5% which affects around 13.7 million children and adolescents ages 2-19: to breakdown further by age group this consist of 13.9% ages 2-5 years old, for those aged 6-11 years the percentage is higher around 18.4%, further increasing with age for those 12-19 years with a 20.6% (Centers for Disease Control and Prevention, 2019). The purpose for WCC specifically targets those 3-17 years old that were seen by a primary care provider i.e., family nurse practitioner or OB/GYN with a year, this assessment touched on the following topics: documentation of body mass index percentile, nutrition & physical activity education/counseling (National Committee for Quality Assurance, 2020). I selected this particular measure because it is dramatically increasing every year within the USA, but also because it greatly affects my family and culture: Hispanics specific percentage is 25.8 %, one of the highest throughout all minority groups (Centers for Disease Control and Prevention, 2019). Due to the high prevalently of this issue throughout the USA it has become one of our nations primary concern within out health care system, the National Committee for Quality Assurance has a performance of Effectiveness of care: Weight Assessment and 5 tools such as Choose My Plate as a resource for examples and nutrition details on food groups and specific foods for a healthy eating tips and habits to implement for a healthy weight (Centers for Disease Control and Prevention, 2020a). Choose My Plate consist of 5 categories fruits, vegetables, grains, dairy, and protein foods: recommended intake for fruits ranges from 1-1 ½ cups for ages 2-8, they further break down past 8 years old into girls and boys ages 9-18 recommendations which is 1 ½ for girls and boys ranges 1 ½ - 2 cups (USDA Center for Nutrition Policy & Promotion Food & Nutrition Service, 2020). In addition, I would recommend they download the Choose My Plate app to keep track of their intake, see examples, and portion control would be documented for further evaluation. I would also give the website they could go to go to access this resource online, if they did not have access to these resources as an FNP I would provide print out booklets. Another way I could measure these interventions is to have one on ones with the patient and their parents, information tends to be left out if they feel uncomfortable talking about a topic if one or the other is there. Intervention Three Education on Physical Activity In addition to the previously mentioned topics and interventions, physical activity would also be discussed and addressed. Likewise fostering a healthy relationship with different physical activities as children so they are then accustomed to these things and carry it on into adolescents & adulthood (Centers for Disease Control and Prevention, 2018). Education on the role physical activity has on their physical and mental health is critical for patients and their families. Physical activity is important for overall physical such as better sleep, over all function, and feelings & mental benefits include reduces anxiety and depression; which ends up reducing and/or eliminating chronic diseases (Centers for Disease Control and Prevention, 2020b). As an FNP I will use the following physical activity suggestions based on the CDC recommendations: for 6 ages 3-5 “active play” which is optimal to incorporate everyday physical activities throughout the day; for ages 6-17 at least 1 hour or more of moderate-vigorous physical (running/soccer) activity daily (or 3 days out of the week) is recommended for this age group, some examples of activities that strengthen muscles i.e., push-ups while activities that strengthen bones are jumping rope or gymnastics (Centers for Disease Control and Prevention, 2020c). Other interventions I could do as a FNP to measure the effectiveness of the above interventions is to have the patients and their family start journaling as a way to measure their intake, how they are feeling mentally and physically so we can see if their needs to be any adjustments, and they will be able to reflect on their days and weeks to make sure they are staying on track to achieving/maintain a healthy lifestyle; upon every follow up the journal would be brought to appointments so I could talk and see their progress and answer any questions or address any concerns. Improved Patient Outcomes The previously mentioned interventions 1) Early Screening, 2) Education on Nutrition and 3) Education on Physical Activity these selected interventions presented above will result in improved patient outcomes. The USPSTF previously found evidence that early screening with BMI chart is acceptable measurement to utilize to improve overall outcomes by such “improvements in weight status for up to 12 months”, along with low to no harm for using screening tools which is optimal and has a moderate net benefit (United States Preventive Services Taskforce, 2017). While education on nutrition has a profound impact on improved patient outcome; nutritional education & counseling in many cases can be more beneficial to improved patient outcomes than medication alone has (Baute et al., 2018). Physical activity is also a “medication” to aid in patient outcomes, it is safe to say that proper activity hold great value in conjunction with the other interventions and on its own it still has the potential to 7 improve patient outcomes, even independently from weight loss it also reduces chances for other chronic disease such as type 2 diabetes (Matthews et al., 2017). Cost Savings The selected interventions presented above will result in cost savings for the practice by using early screenings to id overweight & obese patients, educating them on nutrition and physical activity, prevent further resources used at the practice on chronic diseases and having to provide other treatments such as medications, machines and other outsource resources. These should be my "go to" at all times, the lease invasive/ potential for harmful effects for patients and their families. This saves further visits by these patients(in terms of insurance reimbursement), that ends up opening up more appointments for others with different or the same issues that need assistance, turnover essential will be improved not only saving cost but also adding to practice funds at the same time (services provided) since payouts for each visits differs based on these two modalities. Value vs volume, enhancing patient experience and reduce and/or stabilize costs per capita (Verma &Bhatia , 2016). Patient Ratings My selected interventions presented above will result in improved patient ratings and satisfaction by helping them improve their overall mental and physical health, but it will aid them in fixing the root of the cause i.e., eating habits and physical activity it is for most cases a cure instead of Band-Aid such as medications to masque the underlining issue this for most will eliminates it. Their satisfaction and overall rating will also increase because education on nutrition and physical activity takes time and is customized for every patient and what they have access to. Companies such as Medicare are opting to base reimbursement amounts based on patient ratings and satisfaction (Lindsay, 2017). Thus increasing over value of the practice, and 10 Severe Obesity after Intensive Lifestyle Treatment and at 1-Year Follow-Up. Obesity Facts, 11(2), 116–128. https://doi.org/10.1159/000487328 Lindsay, R. W. (2017). Linking Reimbursement to Patient Satisfaction. JAMA Facial Plastic Surgery, 19(3), 173–174. https://doi.org/10.1001/jamafacial.2016.1866 Matthews, A., Jones, N., Thomas, A., Berg, P. V. D., & Foster, C. (2017). An education programme influencing health professionals to recommend exercise to their type 2 diabetes patients – understanding the processes: a case study from Oxfordshire, UK. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-2040-7 National Committee for Quality Assurance. (2020, August 5). Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents. NCQA. https://www.ncqa.org/hedis/measures/weight-assessment-and-counseling-for-nutrition- and-physical-activity-for-children-adolescents/. United States Preventive Services Taskforce. (2017, June 20). Recommendation: Obesity in Children and Adolescents: Screening: United States Preventive Services Taskforce. Recommendation: Obesity in Children and Adolescents: Screening | United States Preventive Services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/obesity-in- children-and-adolescents-screening. USDA Center for Nutrition Policy & Promotion Food & Nutrition Service. (2020). All About the Fruit Group. ChooseMyPlate. https://www.choosemyplate.gov/eathealthy/fruits. Verma , A., & Bhatia , S. (2016). A Policy Framework for Health Systems to Promote Triple Aim Innovation. HealthcarePapers. https://pubmed.ncbi.nlm.nih.gov/27009582/. 11