This document discusses obesity rates in Latino communities in Miami-Dade County. It notes that Latino communities have higher rates of obesity due to factors like food insecurity, limited access to safe places for physical activity, and targeted marketing of unhealthy foods. To address this issue, the Consortium for a Healthier Miami-Dade holds community health fairs that provide education on healthy eating and exercise to Latino parents, with the goal of reducing childhood obesity rates. These fairs help underserved communities access preventative healthcare services and screenings. They also spark conversations that can encourage lifestyle changes to address high obesity rates.

1. Running head: SAFETY OF ELDERLY PATIENTS IN HOME
HEALTH CARE
1
SAFETY OF ELDERLY PATIENTS 3
Safety of Elderly Patients and Quality of Service in Home
Health Care
January 16, 2016
Safety of Elderly Patients and Quality of Service in Home
Health Care
Health care services offered to the elderly and frail patients face
numerous challenges whose issues pose a perpetual challenge to
planners of health care services. With the steady pressure
imposed on resources, it is apparent that subgroups are more
defined but the interventions are less targeted in assuring the
most possible benefit to the patients as consumers of the health
care services. The safety of elderly patients and quality of
service in home health care has unfortunately lacked the
appreciation of how diverse the older population is getting in
terms of the diversity of their health , cultural background, the
functional ability, the changing personal preferences,
limitations in resources, and the changing priorities of the
clients (Szantonet al., 2015). This calls for more attention to the
factors that would create meaningful needs and preferences of
this group of adult patients. Designing of programs should be

2. tailored to capture interventions that would address the issues in
the safety of elderly patients and quality of the services offered
in homes.
Nature and Extent of the Issue/Problem
Given the current situation in the handling of the home-based
healthcare services to the older adults, the frail patients risk
negative outcomes for the health services. The elderly
population forms a very significant group consuming health
resources in the acute care units as well as in community
settings. The formal systems used in handling the frail old
patients from homes and the families directly involved in the
care have not been aligned to address the apparent technical and
ethical issues in the service provision.
In reviews of health care issues touching, the frail older adults
have sought to address the effects of the delicate situation
facing the future of home-based health care. In essence, the
future challenges facing the care plan lack the creative solutions
in the testing and exploration of the suggestions made
concerning future priorities of home nursing and care (Siabani,
2015). In planning for providing home care for the elderly,
some of the most significant issues that have been lacking
include: planning of the various services offered, allocation of
support service resources, and aligning the cultural competence
during delivery of services.
People Affected by the Issue/Problem
Target Population
The old adult population group of patients has characteristic
features distinguishing it. They are individuals with diverse
preferences, unique care needs, and wide trajectories of health.
This population is part of the three generations that constitute a
family, in which most are over 65 years of age. This case
considers centenarian community, in which chances are that an
84 year old woman may be having a 65-year-old grandchild
who is supposed to take care of her at home. The US census in
2000 highlights there are 50,545 centenarians who reside in the
U.S. (United States Census 2010, 2010). This is a population

3. whose characteristics require support services in health care
possibly through home based care systems. At the moment, most
of these services are handled by equally frail family members.
Health Care Professionals
The elderly patients in the community are vulnerable to many
adverse events that may include errors in medication
administration, falls, and unprecedented requirement for
hospital admission. According to the American Nurses
Association (2011), almost a third of these older patients in
home health care are susceptible to possible medical and care
problems that often require specialized care and handling.
Therefore, the healthcare professionals targeted are individuals
with capabilities in evidence-based situation analysis in order to
promote patient safety as well as improve the quality of health
care with respect to the problems that are frequently observed in
home-based health care. According to Moral et al. (2015), some
of the characteristic roles of the professional caregivers targeted
include management of patient medication, handling fall
prevention, manage unprecedented hospital admissions,
management of wound and pressure ulcer, and create a sound
nurse work environment in order to ensure achievement
functional outcomes and quality of life.
Short- and Long-Term Effects of the Issue/Problem
Short-Term Effects
On short term, it is expected that if the associated risk factors
of poor home health care are not recognized, possible
medication errors are likely to lead to unprecedented
complications. These complications are likely to be escalated by
the inability to provide such patients with the needed accurate
information, educating them on such medications(Moral et al.,
2015) or prevention of home accidents (among other
complications they face), and the lack of a monitoring program
on the patients’ medication regimes.
In addition, it is possible that continued ignorance of patient
safety for the frail will diminish the value of attention to the at-
risk patients as an effective monitoring plan. This would

4. translate to inaccuracy in patient documentation and medical
reviews for individual patient encounters. On the contrary,
observing patient safety would lead to sufficient medication
reviews as well as collaboration between family members and
health care teams in preventing the possible adverse events
arising from poor health care management for the old and frail
patients (American Nurses Association, 2011).
Long-Term Effects
Long-term effect of the problem in handling patient safety is the
possible deterioration of health care management of the home
health care. Over time, it is possible that the health care teams
will lack the needed evidence-based information on factors
contributing to the errors observed in home health care (Siabani
et al., 2015). It follows that determination of appropriate
interventions for improving management of patient safety in
homes will be limited to remote research that lacks touch with
the target population. Unless addressed in good time, it is
possible that the goal of restoring or maintaining the physical
and mental wellness of patients and the quality of their lives
will be lost in the long run. In this case, it is possible that the
rate at which family members agree to have their patients
remain at home will reduce in preference for
institutionalization. Although most patients and their immediate
family members choose home environment over hospitalization,
the feasibility and safety of keeping such patients at home will
lack rationale with time. The declining patient safety and the
quality of home-based care highlight the lack of education and
assistance for caregivers including family members and
professional care providers.
Theoretical Framework for Understanding the Existence of the
Issue
The issue at hand is more of an ethical one than professional.
This can be understood in the eye of principlism. This is an
appropriate framework that would guide the confrontation of the
ethical issues surrounding the challenge of handling patient
safety and ensuring quality of home-based care of the frail

5. patient population. In particular, the issue at hand touches on
how health care systems make ethical decisions in situations
where elder caregivers such as those in the centenarian
community encounter. This assessment underscores that at the
most technical and scientific level of medicine and medical
services it remains as a direct interaction between human
beings. Therefore, the role of the physician in the diagnosing,
advising, and providing appropriate treatment remains within
the confines of a moral context (Moral et al., 2015).
Ethical Issues This Problem Raises in the Delivery of Health
Care
Several ethical challenges on resource allocation for ensuring
patient safety and quality care for the frail remain apparent with
the materializing future demand. Two important public policies
are of concern in this case: confidentiality and decision-making
capacity. In terms of confidentiality, family members as well as
caregivers engaged in eldercare are in contact with a reasonable
amount of classified information on patients. Such caregivers
have the obligation of ensuring confidentiality of such
information. It is not just about breeching such confidentiality
entrusted to them but it is also, about how they use such
classified information for self-benefit in a manner that will
affect the patient (Szanton et al., 2015).
Members of the elderly population, may or not have the
capacity to properly participate in a decision-making process.
This includes making both business and medical decisions; such
decisions may have long term effects on the future of the
patient. Therefore, providers of eldercare have the obligation of
focusing on the essential needs of the elderly, in terms of the
present as well as future needs without putting the individual’s
assets in jeopardy. This would mean that the interests of the
elderly person must always be considered in all decisions made
(Siabani, Driscoll, Davidson & Leeder, 2015).
Conclusion
In conclusion, the poor attention on the safety of elderly
patients in the centenarian community and the quality of care

6. services they receive is a result of the changing needs of the
elderly population. From an ethical dimension, it remains
questionable if the professionals are accommodative of
individual characteristics of the homes and families of patients.
It is expected that the frequency of falls, the decline in
functional abilities, the pressure ulcers (and other non-healing
wounds), and the adverse effects of poor medication
administration should be handled at home level to avoid
unplanned admissions in hospitals. If well handled, managing
this issue will have a global effect of reducing the undermining
effect of such hospitalizations, which will facilitate
achievement of other home health care goals. These include
safety in handling patients from home and the promotion of the
patients’ optimal well-being.
References
American Nurses Association. (2011). Code of ethics for nurses
with interpretive statements. Washington, DC: American Nurses
Publishing. Retrieved January 23, 2016, from
www.nursingworld.org/MainMenuCategories/ThePracticeofProf
essionalNursing/EthicsStandards/CodeofEthics.aspx
Moral, R.R. et al. (March 2015). Effectiveness of motivational
interviewing to improve therapeutic adherence in patients over
65 years old with chronic diseases: A cluster randomized
clinical trial in primary care. International Journal for
Communication in Healthcare, 98 (8). Pp. 977–983.
Siabani, S., Driscoll, T., Davidson, P.M., & Leeder, S.R. (May
5, 2015).Efficacy of a home-based educational strategy
involving community health volunteers in improving self-care
in patients with chronic heart failure in western Iran: A
randomized controlled trial. Eur J CardiovascNurs. Doi:
1474515115585651
Szanton, S. L. et al. (Jan, 2015). Innovative Geriatric Practice
Models: Preliminary Data. Journal of the American Geriatrics
Society, 63(2). Pp. 371-374.
United States Census 2010. (2010, November). Retrieved

7. January 23, 2016, from www.census.gov
Principles of Microeconomics
Unit II Discussion
How would the various factors that cause shifts in the supply
curve, such as technology and prices of resources, influence
each other?
Unit I Homework
Answer the following from the Problems Appendix in the back
of your textbook on pp. 351-352, and upload your answers
through Blackboard:
hapter 2: Questions 2, 3, 4, 6, and 8
Your completed Homework assignment should be at least three
to four pages in length. All sources used, including the
textbook, must be referenced; paraphrased and quoted material
must have accompanying citations. All references and citations
used must be in APA style.
Unit II Homework
Answer the following from the Problems Appendix in the back
of your textbook on pp. 353-354, and upload your answers
through Blackboard:
and 14
Your completed Homework assignment should be at least three
to four pages in length. All sources used, including the
textbook, must be referenced; paraphrased and quoted material
must have accompanying citations. All references and citations
used must be in APA style.
Unit III Homework

8. Answer the following from the Problems Appendix in the back
of your textbook on pp. 354-355, and upload your answers
through Blackboard:
Your completed Homework assignment should be at least three
to four pages in length. All sources used, including the
textbook, must be referenced; paraphrased and quoted material
must have accompanying citations. All references and citations
used must be in APA style.
Unit IV Homework
Answer the following from the Problems Appendix in the back
of your textbook on pp. 357, and upload your answers through
Blackboard:
-8
Your completed Homework assignment should be at least three
to four pages in length. All sources used, including the
textbook, must be referenced; paraphrased and quoted material
must have accompanying citations. All references and citations
used must be in APA style.
Unit IV Essay
Write a two-page essay that explains why in perfect
competition, there are no economic profits or losses in the long
run. Use a minimum of two academic journal articles from the
DUS Online Library. Your essay must be formatted in APA
style.
All sources used, including the textbook, must be referenced;
paraphrased and quoted material must have accompanying
citations. All references and citations used must be in APA
style.
1

9. Running Head: OBESITY IN LATINO COMMUNITIES
5
OBESITY N LATINO COMMUNITIES
Obesity in Latino Communities
Latinos living in the United States account for one-third of the
uninsured population and face numerous cultural, linguistic, and
financial barriers to accessing health care services. Community
health fairs have been developed to address the unmet need for
no- and low-cost services that target prevention and education
among underserved communities (Murray, Liang, Barnack-
Tavlaris, & Navarro, 2015). The Consortium for a Healthier
Miami-Dade is committed to building a consensus within the
Miami-Dade health community concerning efforts to promote
healthy lifestyles and chronic disease prevention, create a
supportive policy environment and enhance health care
information. Consortium initiatives are guided by the goals and

10. objectives established by Healthy People 2020. The Consortium
uses a prevention-based community planning approach to
improve health by offering community health fairs that provide
a comprehensive educational experience to bring awareness to
the benefits of healthy lifestyles and health promoting
environments and to increase the percentage of adults and
children who are at a healthy weight (The Florida Department of
Health, 2014). I chose to attend one of these health fairs due to
the high rate of obesity in the community, especially the
children. The health fair was tailored to this community by
using existing data and assessments of the community to
identify assets that support healthy living. This event provided
education to Latino parents about childhood obesity, and the
importance of healthy eating and physical activity, in a
culturally sensitive way.
The rate of obesity and overweight in Miami-Dade county
adults is 67.4%. Approximately 13% of high-school students
are obese and only 12% attend daily physical-education classes
at school, which is lower than the state rate of 44%. Poor diet
and physical inactivity contribute to the obesity problem. Only
22.1% of adults in the county meet the Federal government's
guidelines for fruit and vegetable consumption, and 24.5% of
the adult population reported no physical activity in the last 30
days (Centers for Disease Control and Prevention, 2013). A
major factor causing higher rates of obesity is the fact that
Latino communities experience higher rates of hunger and food
insecurity, limited access to safe places to be physically active
and targeted marketing of less nutritious foods
(stateofebesity.org, n.d); as it is the case in the community I
chose to survey. Health fairs are beneficial for all stakeholders.
Many individuals in this community have limited access to care.
Health fairs can be powerful outreach activities at which health
care workers can help reduce health disparities and improve
access to relevant screening and preventive care. For nurses,
attending health fairs is an excellent way to engage underserved
communities in caring for their health. These type of events

11. offer an opportunity to increase awareness and spark
conversation that could foster deeper contemplation and even
lifestyle change long after the health fair.
According to The University of Florida Health, when general
health concerns are addressed in a group setting, individuals
may be comforted by knowing others in the group share the
same concerns that they do; This can be an effective tool for us
physicians in successful health promotion. Several recent
studies observed that nearly half of health fair participants in
underserved and vulnerable communities do not have primary
care health professionals or health insurance. For them, the
immunizations, hypertension and blood glucose screenings and
education about diet and lifestyle may be the only such services
they receive (Ezeonwu & Berkowitz, 2014). A more recent 2011
study on blood pressure screenings at community health fairs,
published in the Journal of Community Nursing, looked at
outreach on hypertension. The article reported “nurse-operated
health fairs, crafted to identify those with high BP readings, are
promising as a simple and effective means in motivating
individuals to seek follow-up care.” (Burron & Chapman, 2011).
Targeting the challenges that stem from neighborhoods, schools,
workplaces that make it difficult to access healthy affordable
foods and be physically active is the first step in providing
underserved communities with the basic preventive services.

12. References:
Burron, A. & Chapman, L. (2011). The use of health fairs in
health promotion. Retrieved from: https://ufhealth.org/health-
fairs-and-screenings
Centers for Disease Control and Prevention (2013). Community
profile: Miami-Dade County, Florida. Retrieved from:
http://www.cdc.gov/nccdphp/dch/programs/communitiesputting
preventiontowork/communities/profiles/obesity-fl_miami-dade-
county.htm
Ezeonwu, M., & Berkowitz, B. (2014). A Collaborative
Communitywide Health Fair: The Process and Impacts on the
Community.Journal Of Community Health Nursing, 31(2), 118-
129 12p. doi:10.1080/07370016.2014.901092
Florida Department of Health (2014). Consortum for a hea;their
Miami-Dade. Retrieved from:
http://www.healthymiamidade.org/system/js/back/ckfinder/userf
iles/files/Consortium%20Strategic%20Plan%202014-
2017%20Final%20docx(1).pdf
Murray, K., Lang, A., Barnack-Tavlaris, J., & Navarro, A.
(2014). The reach and rationale for community health fairs.
Retrieved from: https://ufhealth.org/health-fairs-and-screenings
The State of Obesity (n.d). Obesity prevention in Latino
communities. Retrieved from:

13. http://stateofobesity.org/disparities/latinos/
University of Florida Health (n.d). Health fairs and screenings.
Retrieved from: https://ufhealth.org/health-fairs-and-screenings