Managing Chronic Disease in the Primary Care Setting
Managing Chronic Disease in the Primary Care Setting
Order Instructions:
For this paper, the writer must pay attention to details as indicated below. The writer cannot use any articles older than 5 years and APA is critical throughout the paper.
Managing Chronic Disease in the Primary Care Setting
Caring for clients with a chronic illness will mean multiple visits and careful managing of their plan of care to include medications, screening exams, and referral. More than 75% of all health care costs in the United States due to chronic illness. The impact that this has on the healthcare system is staggering. With the population aging and more chronic illness occurring, it has never been more important to properly manage this epidemic through the use of cost-effective, evidence based care where it begins: In the primary care setting.
In a 4 page APA paper minimum with a minimum of three APA references,
• Discuss the impact of chronic disease on health care as a whole.
• Examine how evidence based plans of care can reduce the health care cost burden placed on Americans and discuss cost effectiveness achieved by the use of evidence based plans of care.
• Discuss the role that advanced practice nurses play in caring for patients with chronic illness from the standpoint of health promotion, medication management, and symptom management, and the importance of this role.
Assignment Requirements
The finished Assignment should be a 4 page minimum descriptive and exploratory essay, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained. (But must remember to include title page and reference page in APA)
Before finalizing your work, you should:
• be sure to read the Assignment description carefully (as displayed above)
• utilize spelling and grammar check to minimize errors; and
• review APA formatting and citation information found online, or elsewhere in the course.
Your Assignment should:
• follow the conventions of Standard American English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th edition format for organization, style, and crediting sources including:
• properly formatted header
• 12-point, double-spaced, Times New Roman font
• use of in-text citations
• title page and reference page
• use of headings (if applicable)
Resources:
Artnak, K. E., McGraw, R. M., & Stanley, V. F. (2011). Health care accessibility for chronic illness management and end-of-life care: A view from rural America. Journal Of Law, Medicine & Ethics, 39(2), 140–155.
Hunt, L., Kreiner, M., & Brody, H. (2012). The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Annals Of Family Medicine, 10(5), 452–460.
Lindsay, S., Kingsnorth, S., & Hamdani, Y. (2011). Barriers and facilitators of chronic illness self-management among adolescents: A review and future directions. Journal of Nursing & Healthcare of Chronic Illnesses, 3 (3)186–208.
Newsom, J., Huguet, N., McCarthy, M., Ramage-Morin, P., Kaplan, M., Bernier, J., & … Oderkirk, J. (2012). Health behavior change following chronic illness in middle and later life. The Journals Of Gerontology. Series B, Psychological Sciences And Social Sciences, 67(3), 279–288.
Pai, Ahna L.H., & Ostendorf, H. (2011). Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: A literature review. Children’s Health Care, 40(1), 16–33.
Strunk, J. A., Townsend-Rocchiccioli, J., & Sanford, J. T. (2013). The aging Hispanic in America: Challenges for nurses in a stressed health care environment. MEDSURG Nursing, 22(1), 45–50.
SAMPLE ANSWER
Order Instructions:
For this paper, the writer must pay attention to details as indicated below. The writer cannot use any articles older than 5 years and APA is critical throughout the paper.
Managing Chronic Disease in the Primary Care Setting
Caring for clients with a chronic illness will mean multiple visits and careful managing of their plan of care to include medications, screening exams, and referral. More than 75% of all health care costs in the United States due to chronic illness. The impact that this has on the healthcare system is staggering. With the population aging and more chronic illness occurring, it has never been more important to properly manage this epidemic through the use of cost-effective, evidence based care where it begins: In the primary care setting.
In a 4 page APA paper minimum with a minimum of three APA references,
• Discuss the impact of chronic disease on health care as a whole.
• Examine how evidence based plans of care can reduce the health care cost burden placed on Americans and discuss cost effectiveness achieved by the use of evidence based plans of care.
• Discuss the role that advanced practice nurses play in caring for patients with chronic illness from the standpoint of health promotion, medication management, and symptom management, and the importance of this role.
Assignment Requirements
The finished Assignment should be a 4 page minimum descriptive and exploratory essay, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained. (But must remember to include title page and reference page in APA)
Before finalizing your work, you should:
• be sure to read the Assignment description carefully (as displayed above)
• utilize spelling and grammar check to minimize errors; and
• review APA formatting and citation information found online, or elsewhere in the course.
Your Assignment should:
• follow the conventions of Standard American English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th edition format for organization, style, and crediting sources including:
• properly formatted header
• 12-point, double-spaced, Times New Roman font
• use of in-text citations
• title page and reference page
• use of headings (if applicable)
Resources:
Artnak, K. E., McGraw, R. M., & Stanley, V. F. (2011). Health care accessibility for chronic illness management and end-of-life care: A view from rural America. Journal Of Law, Medicine & Ethics, 39(2), 140–155.
Hunt, L., Kreiner, M., & Brody, H. (2012). The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Annals Of Family Medicine, 10(5), 452–460.
Lindsay, S., Kingsnorth, S., & Hamdani, Y. (2011). Barriers and facilitators of chronic illness self-management among adolescents: A review and future directions. Journal of Nursing & Healthcare of Chronic Illnesses, 3 (3)186–208.
Newsom, J., Huguet, N., McCarthy, M., Ramage-Morin, P., Kaplan, M., Bernier, J., & … Oderkirk, J. (2012). Health behavior change following chronic illness in middle and later life. The Journals Of Gerontology. Series B, Psychological Sciences And Social Sciences, 67(3), 279–288.
Pai, Ahna L.H., & Ostendorf, H. (2011). Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: A literature review. Children’s Health Care, 40(1), 16–33.
The incidence of diabetes is rising rapidly over time. Patients with diabetes are at higher risk of developing post-operative complications such as hyperglycemia or hypoglycemia which in turn contribute to increased morbidity and mortality and length of hospital stay in patient with diabetes undergoing surgery. Therefore, it is extremely important for nurses to take vigilant care of patients with diabetes undergoing surgery. This paper will describe the guidelines of peri-operative management of patient with diabetes and why it is important for nurses to follow these guidelines. Moreover, observations at clinical placements as compared to the findings in peer reviewed research articles will also be discussed in this paper.
Introduction
Diabetes is a metabolic disorder in which blood glucose levels remain high above normal. Patients with diabetes undergoing surgery may have specific needs, particularly in relation to blood glucose control and healthcare professionals such as nurses need to be able to assess and manage these individuals to ensure optimum surgical outcomes. Moreover, the metabolic impact of surgery, pre-op fasting and disruption in insulin therapy contribute to poor glycemic control which in turn leads to increased mortality and morbidity. To deal with this issue, it is always necessary for nurses to follow guidelines for perioperative management of diabetes for the diabetic patients. However, the problem is that most nurses and other professionals are likely to overlook these guidelines, thus placing the patient at a health risk.
Methods
This study involved the use of national database CINAHL Complete, which is available publically and through Australian Catholic University library. This study was conducted by gathering the results from medical research particularly from peer-reviewed journal articles.
Results
The results indicate that the level of awareness among nurses and other professionals such as anesthetists with regard to perioperative guidelines has increased over the last three decades.
Synopsis of literature
According to Marchant et al (2009), patients with uncontrolled diabetes are at greater risk of developing post-operative complications when compared with patients with controlled diabetes. Merchant et al (2009) suggested that healthcare professionals should monitor blood glucose levels pre-operatively as it is independent predictor of morbidity and mortality in patient with diabetes undergoing surgery. However, they also recommend healthcare professionals to monitor HbA1c levels to assess the risk of post-operative complications. Moreover, HbA1c level less than 7% is associated with lower risk of post-operative complications (Kerry, Scott & Rayman, 2013).
On the other hand, Holt (2012) reviewed the available data on pre and post-operative needs of patient with diabetes. He stated that it is very crucial for nurses to conduct appropriate pre-operative assessment of patient with diabetes at the earliest opportunity. However, not only blood glucose levels or Hb1Ac levels should be assessed, but also a complete patient history and examination should be carried out as further backed up by Dhinsa, Khan & Puri (2010). This allows time to assess adequacy of patient’s control of their diabetes and instigate action if needed. This minimizes the risk of post-operative complications such as hyperglycemia. In addition, Holt (2012) also explored that patients with poorly controlled diabetes experience more post-operative pain as compared to patients with well controlled diabetes.
Dhinsa, Khan & Puri (2010) explored the clinical guidelines for peri-operative management of patient with diabetes in their article. They mainly discuss the post-operative complications of patient with diabetes and nursing interventions. According to Dhinsa, Khan & Puri (2010), it should be nurse’s first priority to keep patient pain-free as to minimize the effect of body’s stress response to pain on blood glucose levels. This is further supported by Holt (2012) who argued that body’s stress response inhibit insulin secretion as well as increase insulin resistance. Nevertheless, stress due to surgical interventions not only raise the blood glucose levels in patient diagnosed with diabetes but also in patients without pre-operative diagnosis of diabetes as stated by Dhinsa, Khan & Puri (2010).
Dhatariya (2012) explains some clinical guidelines for patients with diabetes. He suggests it is preferable to place patients with diabetes early on theatre list to reduce the patient’s fasting time. This is because pre-operative fasting and discontinuation of oral hypoglycemic agents can cause hypoglycemia. It is also recommended that elective surgery should be postponed if pre-operative glycemic control is poor (Dhatariya, 2012). Dhatariya (2012) also argues that it is necessary for the nurses to work with the patient and the patient’s family to help them with adhering to the part of the preoperative guidelines that are beyond the nurse’s domain. These include the pre-surgery fasting (Learning Zone, 2012).
Discussion
During my clinical placements, I noticed that not all patients are tested for diabetes before surgery. This is a major issue as not all patients are aware of whether they have diabetes or not. In addition to this, I have observed that despite the fact that patients whose diabetic status is already known, the nurses are likely to overlook the symptoms of hyperglycemia such as itching skin, fruity breath, and confusion. It is difficult to identify usual warning signs of poor glycemic control while patient is unconscious which is potentially life-threatening and the nurses therefore need to do this before the patient is in sedated. Furthermore, when measuring blood glucose levels, the patient’s type of diabetes and type of antidiabetic medication they are on were overlooked, thus placing the patient at a much higher risk. I have seen that blood glucose checks are not performed while patient is in operation theatre, however, which goes against he guidelines as discussed by Campbell (2011). Discharge education for patient with diabetes plays an important role in their well-being post-operatively such as teaching patient about signs and symptoms of hyperglycemia, wound infection and wound non-healing. However, I have seen very few nurses in post anesthesia care unit giving discharge education to patients with diabetes which is also argued by Rutan and Sommers (2012). The other issue that is observable at the clinical placements is the fact that the different healthcare personnel are fully aware of the recommended guidelines. Other staff such as the anesthetists who also play an important role in the surgery process are also likely to be ignorant of the most up-to-date guidelines for preoperative care for patients with diabetes. All these factors work together to bring in a problem that can affect the post surgery results.
In this regard, even if the surgical team is able to fully adhere to the peri-operative care from the time that the patient is at the hospital, they are not able to do the same for the patient when he or she is not at the hospital. This includes the pre admission time where pre surgery fating is part of the peri-operative care. To implement the peri-operative care in a comprehensive manner, some aspects of the hospital’s operations will need some changes. First, there is a need for a better support system to help the patient and the patient’s family with regard to the part of the preoperative care that they are responsible for, such as pre surgery fasting. Secondly, the nurses need to update their knowledge of the full process of preoperative care. Thirdly, the hospitals should develop policies which will make it easier for healthcare personnel to identify surgery patients with diabetes and who do not already know they have diabetes.
References
Campbell, A. (2011). Pre-Operative Fasting Guideunes For Children Having Day Surgery. Nursing Ohildren And Young People, 23, 4 , pp. 14-21.
Dhinsa, B., Khan, W., & Puri, A. (2010). Management of the patient with diabetes in the perioperative period. Journal Of Perioperative Practice, 20(10), 364-367.
Rutan, L., & Sommers, K. (2012). Hyperglycemia as a risk factor in the perioperative patient. AORN Journal, 95(3), 352-363. doi:10.1016/j.aorn.2011.06.010
Dhatariya, K. (2012). Perioperative management of adults with diabetes: why do we need guidance?. British Journal Of Hospital Medicine (17508460), 73(7), 366-367.
Holt, P. (2012). Pre and post-operative needs of patients with diabetes. Nursing Standard, 26(50), 50-56.
Kerry, C. S., Scott, A., & Rayman, G. (2013). Daily temporal patterns of hypoglycaemia in hospitalized people may reveal potentially correctable factors. Diabetic Medicine, 30, 12 , 27-38.
Learning Zone. (2012). Pre and post-operative needs of patients with diabetes. Nursing Standard. 26, 50 , pp. 50-56.
The American Cancer Society estimates that by the end of 2012, more than 226,000 women will be diagnosed with breast cancer and more than 241,000 men will be diagnosed with prostate cancer (American Cancer Society, 2012a; American Cancer Society 2012b). With such prevalence of women’s and men’s cancers, patient education and preventive services are essential. In clinical settings, advanced practice nurses must assist physicians in educating patients on risk factors, preventive services, and for patients diagnosed with cancer, on potential drug treatments. The clinical implications of women’s and men’s cancer greatly depend on early detection, which is primarily achieved through preventive services. In this Assignment, you consider the short-term and long-term implications of cancer and drug treatments associated with women’s and men’s health, as well as appropriate preventive services.
To prepare:
•Select a type of cancer associated with women’s or men’s health such as breast, cervical, or ovarian cancer in women and prostate cancer in men.
•Locate and review articles examining the type of cancer you selected.
•Review the U.S. Preventive Services Task Force article in the Learning Resources. Think about available preventive services that providers might recommend for patients at risk of this type of cancer.
•Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how these factors might impact decisions related to preventive services.
•Consider drug treatment options for patients diagnosed with the type of cancer you selected including short-term and long-term implications of the treatments.
To complete:
Write a 2- to 3- page paper that addresses the following:
•Describe available preventive services that providers might recommend for patients at risk of the type of cancer you selected.
•Explain how the factors you selected might impact decisions related to preventive services.
•Describe drug treatment options for patients diagnosed with the type of cancer you selected. Explain the short-term and long-term implications of these treatments.
SAMPLE ANSWER
Introduction
Research indicates that 2 million of men in the US are prostate cancer survivors. It is the most common cancer among the male, followed by skin cancer. According to the American Cancer Society, there are about 220,800 cases of prostate cancer annually, which claims about 27,540 lives every year. According to statistics, it is estimated that every one male in every seven will be diagnosed with prostate cancer in his lifetime. Prostate cancer is the cancer of the prostate gland, which is found in males. The gland is located below the urinary bladder. The size of the gland changes with age, and has been found to grow rapidly in puberty. This rapid growth in puberty is fueled by increased concentration on male hormones (androgens). The medical terminology of cancer in the prostate gland is referred to adenocarcinoma. Other types of prostate gland include sarcomas, cell carcinomas, transitional cell carcinomas, and neuroendocrine tumors. Some of the cancer spread rapidly whereas others grow slowly (Burdelski et al., 2015).
Preventive services
The early prostate cancer is usually asymptomatic and is known to have no symptoms. However, at an advanced stage, prostate cancers have symptoms such as difficulties when passing urine due to a weakened urine system. The patient tends to have frequent urination especially during the night. In some cases, blood traces are present in urine. Additionally, the male individual could suffer from erectile dysfunction, chronic pain in the hips, spine, and chest. The patient may also have weakness and numbness in the feet and legs, loss of bowel or bladder control due to the altered nervous system, especially the spinal cord (Ingersoll et al., 2015).
Early screening is one of the preventive measures applied in management of prostate cancer. Early detection is important because it facilitates a quick application of intervention to protect the patient from further complications. Prostate cancer screening is usually done by measuring the prostrate-specific antigen (PSA) in the patient’s concentration. Digital rectal Exam has also been widely used where the physician inserts their finger into the rectum to evaluate the size and texture of the prostate gland. Some medications proposed to reduce risk for prostate cancer including, 5-alpha reductase inhibitors that inhibits the conversion of the enzyme testosterone to dihydrotestosterone (DHT) enzymes that induces prostate cancer. Recent studies have identified an effective prostate cancer vaccine known as Sipuleucel-T. The vaccine works by boosting the immune system, which fights prostate cancer cells (Thalgott et al., 2015).
The current evidence based risk factors include embracing a healthy lifestyle. This implies that the individual should feed on a low fat diet by avoiding high intake of meat, oils, dairy products, and nuts. This is because high intake of fats is associated with high risk of prostate cancer. Elderly males should be advised to consume more plant meals than animal meals. More fruits, vitamin, mineral supplements, and seafood should be included in the diet. Physical activeness must be encouraged among the individuals. Studies indicate that active people have low risk of prostate cancer. This is because exercising help in keeping the body in good shape (Gupta et al., 2015).
Risk factors influence of preventive services
There are risk factors that affect prostate cancer. Risk factor includes factors that aggravate chances of developing the healthcare complication. The different types of cancer have varying risk factors with a few having unknown risk factors. One of the main risk factors for prostate cancer includes age, geographical location, ethnic background, sexually transmitted diseases, genetic factors, vasectomy, and exposures in the work place, lifestyles, and family history. This paper evaluates the two main risk factors that affect the decisions for preventive care (Tomioka et al., 2015).
Age is one of the main risk factors of prostate cancer, which is more common in men above 65 years of age, but very rare in the young male of below 40 years. This age group often lack adequate knowledge and information. This acts as barrier to the adoption of preventive services such as early screening, life style modification and medication adherence. Prostate cancer has also been found to be common in African-American men than in other ethnic groups. Prostate cancer is less common in the Latino’s and Hispanics. Cultural values and beliefs are key hindrances to the adoption and integration of the aforementioned preventive services (Nakazawa et al., 2015).
In some community, such as African American, it is actually a taboo to discuss genitalia matters in public, and especially so if the physician is of the opposite sex and of younger age than the service user. This implies that the disease is detected late, and interventions are given when the disease has reached its unmanageable stage. Other barriers associated with these two risk factors are time constraints and low staff levels, which results to an unanimous theme during counseling on current evidence, based practices of preventive services (Burdelski et al., 2015).
Drug treatment for prostate cancer
If the prostate cancer is diagnosed and staged effectively, it is important for the patient to empower to make informed decisions. Several drug treatment options are associated treatments with prostate cancer. These include active surveillance or watchful waiting where prostate cancer growth is monitored closely with DREs and PSA. This is because some prostate cancers are benign and may not need to treat the condition. Radiation therapy involves the use of high energy to destroy the cancerous cells. Cryosurgery is used to treat the first prostate cancer stage and involves the freezing of the cancerous cells (Gupta et al., 2015).
Chemotherapy is often used as anti-cancer drugs, which are often injected in the vein in the blood circulatory system. This therapy is important if the cancer has spread throughout the other body organs. Hormone therapy involves the use of hormone blockers or suppression therapy to suppress the conversion of testosterone to cancer inducing enzyme. Bone directed therapy and vaccine therapy have been successful in treating prostate cancer. The decision of treatment should be based on the patient’s general health condition, age, stage of cancer, preferences and the expected side effects.
Short term and long-term implication of prostate cancer
Short-term effects include fatigue and extreme tiredness. In some cases, fecal inconsistencies may occur due to the inflammation if the rectum. This often results in urgency to urinate, diarrhea, cramps, and blood in the patients stool. Other short term effects include the possibilities of blood transfusion and pulmonary embolism In some cases, the issue of erectile dysfunction can occur, low libido and infertility and urinary leakage (Burdelski et al., 2015).
The long-term side effects include erectile dysfunction, narrowing of the joint between the urethra and the urinary bladder, which causes the frequent urge of urination. Men under hormonal therapies are at risk of muscle and mineral loss (osteoporosis) which makes the patient become more vulnerable to fractures. The most common long-term effect is emotional instability, which is associated with loss of fertility and erectile dysfunction. Most men diagnosed with erectile dysfunction tend to be angry, anxious and in denial. Their self-esteem is usually reduced especially if the illness affects their sex life and finances (Gupta et al., 2015).
References
Burdelski, C., Menan, D., Tsourlakis, M., Kluth, M., Hube-Magg, C., & Melling, N. et al. (2015). The prognostic value of SUMO1/Sentrin specific peptidase 1 (SENP1) in prostate cancer is limited to ERG-fusion positive tumors lacking PTEN deletion. BMC Cancer, 15(1). https://www.doi:10.1186/s12885-015-1555-8
Gupta, D., Trukova, K., Popiel, B., Lammersfeld, C., & Vashi, P. (2015). The Association between Pre-Treatment Serum 25-Hydroxyvitamin D and Survival in Newly Diagnosed Stage IV Prostate Cancer. PLOS ONE, 10(3), e0119690. https://www.doi:10.1371/journal.pone.0119690
Ingersoll, M., Lyons, A., Muniyan, S., D’Cunha, N., Robinson, T., & Hoelting, K. et al. (2015). Novel Imidazopyridine Derivatives Possess Anti-Tumor Effect on Human Castration-Resistant Prostate Cancer Cells. PLOS ONE, 10(6), e0131811. https://www.doi:10.1371/journal.pone.0131811
Nakazawa, T., Tateoka, K., Saito, Y., Abe, T., Yano, M., & Yaegashi, Y. et al. (2015). Analysis of Prostate Deformation during a Course of Radiation Therapy for Prostate Cancer. PLOS ONE, 10(6), e0131822. https://www.doi:10.1371/journal.pone.0131822
Thalgott, M., Rack, B., Eiber, M., Souvatzoglou, M., Heck, M., & Kronester, C. et al. (2015). Categorical versus continuous circulating tumor cell enumeration as early surrogate marker for therapy response and prognosis during docetaxel therapy in metastatic prostate cancer patients. BMC Cancer, 15(1). https://www.doi:10.1186/s12885-015-1478-4
Tomioka, A., Tanaka, N., Yoshikawa, M., Miyake, M., Anai, S., & Chihara, Y. et al. (2015). Risk factors of PSA progression and overall survival in patients with localized and locally advanced prostate cancer treated with primary androgen deprivation therapy. BMC Cancer, 15(1). https://www.doi:10.1186/s12885-015-1429-0
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Principles of Health and Social Care Practice
LO1 Understand how principles of support are implemented in health and social care practice
1.1 Explain how principles of support are applied to ensure that individuals are cared for in health and social care practice
1.2 Analyse the benefit of following a person-centred approach with users of health and social care services
1.3 Explain ethical dilemmas and conflict that may arise when providing care, support and protection to users of health and social care services.
1.4 Explain ethical dilemmas and conflict that may arise when providing care, support and protection to users of health and social care services.
LO2 Understand the impact of policy, legislation, regulation, codes of practice and standards on organisation policy and practice
2.1 Explain the implementation of policies, legislation, regulations and codes of practice that are relevant to own work in health and social care.
2.2 Explain how local policies and procedures can be developed in accordance with national and policy requirements.
2.3 Evaluate the impact of policy, legislation, regulation, and codes of practice on organisational policy and practice.
LO3 Understand the theories that underpin health and social care practice
3.1 Explain the theories that underpin health and social care practice.
3.2 Analyse how social processes impact on users of health and social care services.
3.3 Evaluate the effectiveness of inter-professional working
LO4 Be able to contribute to the development and implementation of health and social care Organisational policy.
4.1 Explain own role, responsibilities, accountabilities and duties in the context of working with those within and outside the health and social care workplace.
4.2 Evaluate own contribution to the development and implementation of health and social care organisational policy.
4.3 Make recommendations to develop own contributions to meeting good practice requirements.
Background Info – Summative assessment to be handed in on 1-07-13
Today, we live side by side with people from different ethnic, cultural, social, and religious backgrounds. We are becoming increasingly aware of the fact that we live in a multi-ethnic and multi-cultural society. Depending upon where we live, work, or which services we access in the community, we have probably seen changes to our communities over a period of time. We are increasingly aware of the differences and similarities among ourselves and others, in relation to; age, gender, ethnicity, culture, religious beliefs and practices, social and economic status, educational and occupational backgrounds, disability, sexual orientation, health, and the impact of illness.
In everyday life, we may find our long held ideas about ourselves as well as others challenged when we encounter people from diverse cultural backgrounds. Our levels of understanding about other cultures may vary. In some instances our observations may be superficial and our knowledge less developed, based on media representations or limited encounters with people from different ethnic and cultural backgrounds. In other cases, it may be that through personal and professional contact we have been able to establish over time an understanding of others from diverse backgrounds. In modern urban environments, it is likely that cultural diversity is an obvious reality for all of us, yet we must acknowledge our level of awareness and sensitivity, or lack of it, in order to demonstrate our respect for others.
Valuing diversity is an essential aspect of living and working in a multicultural society. As professionals in health and social care, we need to become aware of the cultural influences on health, health behaviours, and illness and recovery, and translate that awareness into culturally congruent care practice. We need to develop the knowledge, skills and attitudinal responses to meet the health needs of the people in the communities we serve with respect, sensitivity and the competence required.
Due to these changes, different rules and legislations have been put in place to care for and protect care users from being discriminated against and to give them the best possible care. Due to varied services offered to the care users, it is important to have inter-professional working among different professionals providing service to them. The focus of care delivery has also become more holistic with care users social interactions and needs are taken into consideration during care planning and delivery. The care providers do face situations where an ethical dilemmas and conflicts do arise as they have to deal with people from varied backgrounds and experiences.
Assessment For Module
Write an essay of 3000 words (bearing in mind the learning outcomes) attempt the questions above. LO 1.4 (pg. 4) and LO4 (pg. 5) needs to be based on the provided relevant case studies. The final submission of summative assignment covering LO1, LO2, LO3 and LO4 is by 1st of July 2013.
You need to use one of the following case scenarios in order to answer LO 1.4.
1. A pregnant woman is killed from injuries sustained in a car wreck, but the foetus may still be able to sustain life by keeping the mother on life support. The wife had always said she would not want to be kept alive on life support if there was no reasonable expectation of full recovery. Should she be put on life support when her family knew she did not want that and it would be at great expense to the family, and when the woman is already clinically dead?
2. Mrs M is a service user in the residential care home. She is 67 years old. She likes to smoke and drink whisky, which has caused serious problem to her health by having lung cancer. Despite the advice and recommendations of the doctors, the social worker and the manager of the care home she cannot cease this habit.
Lately Mrs M has been suffering from acute pains. The painkillers prescribed by the doctor are not working effectively to relieve the pains of Mrs M. The doctor is refusing to prescribe stronger painkillers because of their serious adverse effects and possible addiction. But the manager and staffs cannot see Mrs M suffering by screaming and wandering throughout the premises asking for help.
3. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the foetus. She refused to accept blood or blood products and rejected the surgery as well.
You need to use the Case Study below to answer LO 4
Case Study
“Rio Ross was found dead clutching a Winnie the Pooh toy in July 2007.
An inquest found the 14-month-old baby from Bristol died from an overdose of heroin, cocaine and methadone.
He died two months after social workers were warned that his mother Sabrina, a former prostitute, was using crack and heroin on top of her methadone, and a month after drug workers agreed to let the pregnant woman take the drug substitute without supervision.
A case review by Bristol Safeguarding Children Board, which represents all the agencies supposed to protect children, details a series of failings by social services, drugs agencies, and police, who did not alert their child abuse team when they found the mother and baby at the scene of a drugs raid.
Despite listing four critical decisions which left Rio in danger, a summary of the report concluded that no one agency was to blame.
But in November, Government watchdog Ofsted ruled that the review itself was inadequate, and ordered a fresh probe, which will report next month.
Sabrina Ross, 30, was jailed for five years in June after admitting manslaughter of her son. Her second child, born in December, was placed into foster care.
Bristol City Council said no staff had been disciplined in connection with the failure to protect the child. A spokesman said a reconsideration of its review of the case would be submitted to Ofsted next month. On Friday, the council’s director of children’s services, Heather Tomlinson, announced plans to take early retirement, which a spokesman said was entirely unconnected to the review.”
Ref: (The Telegraph, Jan 2009)
Task scenario: You were working as part of the health and social care team dealing with this family before the incident occurred, but now you are reflecting on how you could have helped further to prevent this incident from occurring. Use further sources as required to answer the questions.
You must imagine yourself in any one of the below roles (a-e), and consider what your role, accountabilities and duties were leading up to the event (4.1); consider whether you could have contributed to the development/implementation of any organisational policies to prevent the incident (4.2); and consider how you will contribute to good practice in the future (4.3).
a) Safeguarding Officer
b) Social Worker
c) Social Care Regulatory Inspector
d) Social Care Compliance Officer
e) Substance Misuse Nurse
SAMPLE ANSWER
Principles of Health and Social Care Practice
Introduction
Communities and societies have the right to access to good quality health care. Despite the people diversities, they at some point require medication or social support services. Therefore, it becomes prudent for the service providers to put in place appropriate strategies to reduce risks and hazards. There is also need to maintain privacy of service users and promote awareness on diseases and many other social issues that affect people since principles of health and social care practice are built on this, hence the focus of this paper.
LO1 Implementation of principles of support in health and social care practice
1.1
In health and social care setting, the major principal is providing quality support to users. Users should remain confident and assured of receiving quality health care services for their wellbeing (Healy, 2011). Health care providers must be aware of their roles and the rights of the patients as well as their personalities (Healy, 2011). There application is also manifest by upholding to diversity and equality when providing care. Health providers must ensure that they provide quality care to all patients without discrimination. Even though, patients’ beliefs, culture, norms, and values do vary, health providers should not discriminate them based on any demographic factors. Upholding to human dignity and worth as well shows how the principles of support are applied. Other ways include; empowering patients through such approaches as the person-centered approach by tailoring health with their needs and desires (Healy, 2011). Allowing patients to make informed choices, embracing social justice, integrity, and assessing risks before taking a certain step of action, are other ways of applying the principles (Fish & Karban, 2014). Service users should as well be allowed to access to different health care needs or treatments without restraint. Systems must be working properly for these principles to be applied well. Employees must have better training, must work closely with the service users, should have effective communication skills to share and get valuable information from the service users before providing care (Healy, 2011).
1.2
All servicer users need protection from any likely harm in health and social care setting. Some of the harms service users risk experiencing includes financial, physical, emotional, and psychological harm. For instance, physical harm can occur in case a mentally challenged person attacks a fellow patient or even an employer. There are various ways of protecting patients from such kinds of harms. One way to avoid these harms is for the organization to set policies and procedures to guide in management of the harms (Healy, 2011). For instance, mentally ill patients should be placed in specific rooms to deter their movement. Another way is to allow personalized care planning. Such programs will help to reduce emotional and psychological harms. Risk assessment and management is also a suitable way to manage these harms. Through risk assessment, the organization can identify the in advance potential risks and come up with appropriate remedies. Other ways include making referrals to other facilities with equipment and facilities, raising an alert, ensuring good record keeping, partnering with other people and institutions to manage the harm. For instance, psychologists can partner with health and social care institutions to provide counseling and therapist services to emotional and depressed service users.
1.3
Among many approaches, it is prudent for care providers to follow the person-centred approach in providing care to patients. Under this approach, client needs, values, and desires are considered when providing health and social care (Broady, 2014). One of the benefits of this approach is that it empowers the clients, hence promote quick recovery, as the client feels valued and respected (Markwick, 2013). The approach as well improved the psychological, physical, and emotional health of the patient. Furthermore, the approach increase openness something that fosters delivery of better health care. When values and desires of the patient are met, they are able to cooperate. This in turn makes the work of the care provider easier.
1.4
During their service delivery, health and social care providers experience various incidences of ethical dilemma and conflicts. These conflicts sometimes hamper delivery of quality health care. Even though, these organizations have policies they require to oblige, certain occasions may require ignoring the same. This therefore, results to an ethical dilemma as abiding to an alternative decision option leads to conflict. Common ethical dilemma scenarios and incidences include deciding between the welfare of the client versus that of the public, gaining informed consent, an individual choice verse the rights of others and limitation of confidentiality among others. A good scenario to demonstrate ethical dilemma and conflict of interest health and care provider face is the case of Mrs. M. This 67-year-old has refused to quit smoking despite suffering from lung cancer. She has as well refused to heed to the advice of the doctors. Even though she has the right to make choices, the choice is not in tandem with the public good. This therefore, creates an ethical dilemma situation since; it is the responsibility of care providers to ensure that the user leads a better live. Furthermore, an ethical dilemma is experienced when doctors stop giving her stronger medication to worsen her situation but care providers show empathy to her sufferings, and seek for assistance. This therefore, creates conflicts among the doctors and care providers. There seems to be no trust between these two. Similarly, it is also unethical to refuse to seek informed consent from Mrs. M whether she should be given the painkiller or left to suffer. However, it is also unethical for the care givers to refuse to take action and leave Mrs. M suffer and eventually dies without assisting her.
LO2 Impact of policy, legislation, regulation, codes of practice and standards on organisation policy and practice
2.1
At the work place, policies, regulation, legislation, and codes of practice and standards provide guideline on the way to execute daily activities. Implementation of these policies, legislations, and other requirements remains critical to foster smooth operations and delivery of health and social care. In the organization I work, policies are implemented after a thorough research is done. This is to ensure that the policies and regulations add value to all the stakeholders. Sometimes they are interpreted to ensure that everyone understands them. When implemented, supervisors coordinate to ensure they are well applied. Some of the policies include, reporting on duty in time, attending seminars and training, and wearing uniform while on duty. Codes of practice includes, remaining professional, upholding to integrity, honest, respect, autonomy, and embracing diversity (Healy, 2011). Laws such as Data Protection Act and Control Of Substance Hazardous to Health Regulation (COSSH) are taught and providers expected to adhere to them always.
2.2
There is always need for local and national policy requirements to conform to another or to enhance service delivery. However, this is not always the case. This can be achieved through creation/development of working documents that will help provide information on the various health or social issues at the local level (Healy, 2011). Another way is through establishing of local demographics to ensure that they are factored in when coming up with these policies. It is also important for leaders at both local and national level and other stakeholders to consult and make agreement on various issues. There is also need to modify some of the policies to meet certain requirements of some organisations at both local and national level.
2.3
The codes of practice, regulation, policies, and codes of ethics established impacts on the organizational policy and practice in different ways. The motivation or purpose of these policies and laws is always to improve the quality of health and social care (Healy, 2011). Improvement of services is evidenced with reduced health problems, reduces discrimination, less waiting times and experienced staffs. The policies as well foster standardization that contributes to adherence to ethics and codes of practice. Other benefits of the policies, legislation, and regulation are that they allow clear expectations and ensure protection of both the service users and staff. For instance, users are protected through such laws that require data privacy, confidentiality and informed consent laws. Employees as well can easily sort redress of issues of their concern.
Despite these benefits, the policies as well may have negative impacts. The cost of formulating and enforcing as well as implementing the policies is high. Period of transition is also elongated and this may cause disruption of services, there is also higher chance for the administration to experience some burden in enforcing the laws. On some occasions, service closure is likely to be experienced jeopardizing provision of health and social care services.
LO3 Theories that underpin health and social care practice
3.1
Different theories exist that apply in both health and social care practice. Some of these theories include psychodynamics, behaviorism, psychosocial theories, social systems, and developmental theories such as Freud, psychosexual stage theory, Piaget’s cognitive developmental stage theory and Eriknson’s psychological stage theory. Health and social care providers must understand different aspects pertaining to age, the culture, and the stage of development among others that help in provision of care (Carlson et al., ; Neil, 2010). Dynamic psychology focuses on human behaviors, their emotions, feelings, and their relationship to early experience. Social workers and health care providers can use these theories to understand the psychology of people, hence render appropriate care.
3.2
Different social processes have different impact on the users of health and social care services. Social processes includes gender, education levels of people, the culture, employment rates, attitudes and values people hold through socialization, resource distribution, sexuality and opportunities available. For instance, if people are literate, their level of understanding is higher, hence has the ability to learn easily and take precautionary measures quickly than illiterate people. These social processes therefore, may lead to isolation, domination, inequality, exclusion, stigmatization, marginalization, and discrimination. For instance, people with low level of income are likely to be discriminated when it comes to accessibility of health care compared to those high levels of income. Isolation as well may happen especially when the people perceive themselves or their culture to be superior to others’ cultures affecting the quality of care.
3.3
Inter-professional working relationships have been embraced in health and social care settings. This approach requires professionals to collaborate to render higher standard of care (Addy, Browne, Blake, & Bailey, 2015). Professional understands their roles as they learn for one another. For instance, in a health care setting, Nurse, GP, physiotherapist, occupational therapists, and assistants can collaborate in their work, while in social care, carer, and social workers can as well collaborate. One benefit of this work arrangement contributes to achievement of agreed outcomes, improves the quality of relationships, ensures care continuity, ensures provision of holistic care, and enhances easy identification of professional goals (Day, 2013). Furthermore, this arrangement acts as a safety net when it comes to provision of care. The other benefit is resource conservation. Resources such as infrastructure can be shared
LO4 Development and implementation of health and social care Organisational policy
4.1
As a health care provider, I have a role and responsibility to promote delivery of better health care to all patients. All patients deserve equal treatment. I have to create a cordial working relationship through effective communication. Furthermore, is my responsibility to respect all service users and all stakeholders, uphold to autonomy, respect other people rights, and be honest when rendering health care. I have the duty to uphold to good practice when rendering services such as keeping health records well and embracing codes of ethics. In the incidence where a 20-year-old Black Hispanic woman with pregnancy refused to accept transfusion of blood, I have the responsibility to engage her and persuade her to accept. I also have the right to inform her on the consequences of her decisions. She has her right and if she insists, I will have to take the next step of forwarding the case to the senior health provider to ensure that I am not to blame for her future complications in case they occur.
4.2
I have contributed on several occasions in development and implementation of health and social care organizational policy and believe that through such contributions, remarkable changes have manifested. I take time to read existing policies and other content to understand them before initiating changes. Through reading, I am able to identify areas that require amendments. I also express ideas frankly on what I feel require adjustments. I also participate in consultations as experienced in the case of a 20-year woman that refused a blood transfusion. I had to share this with my seniors. I also adhere to quality assurance systems, get involved in clinical governance, as well as contribute in the process of making decisions.
4.3
Every organisation must put in place mechanisms to achieve good practice requirements to deliver quality health and social care services. My recommendations to meet good practice are herein. Organizations should have clear codes of ethics and professionalism and ensure compliance. Continuous training of employees as well as service users on health and care is paramount to improve service provision. It is also important for the institutions providing health and social care services to be accredited before being granted a go ahead to render services. The organization should also open avenues to share ideas and views from users and service providers. Listening and providing feedback will go ahead to build positive working condition that will contribute to delivery of quality services. Decision-making should be open to all the people for them to have a sense of belonging as experienced in the case, I sort further direction from the seniors when I reached a stalemate. This will improve the level of satisfaction and performance. Peer support and supervision is also critical to improve service delivery. People should also be each other keeper and should share with one another good practice.
Conclusion
It is the responsibility of all stakeholders to contribute to high quality services. Principle of support has explicitly provided a platform of ensuring that appropriate services are provided. Service givers need to be competent to render quality services respecting the rights of patients and others. Similarly, other users must as well respect the service providers. Codes of ethics, regulations, laws, and policies set require proper implementation. All stakeholders should take part in their implementation to warrant success. As a health practitioner, I must remain committed, respect other people rights and adhere to codes of ethics to deal with issues such as ethical dilemma and conflicts. My motivation is to impact positively on anybody provided they are of human race.
References
Addy, C. L., Browne, T., Blake, E. W., & Bailey, J. (2015). Enhancing Interprofessional Education: Integrating Public Health and Social Work Perspectives. American Journal Of Public Health, 105S106-S108.
Broady, T. (2014). What is a person-centred approach? Familiarity and understanding of individualised funding amongst carers in New South Wales. Australian Journal Of Social Issues (Australian Social Policy Association), 49(3), 285.
Carlson, P et al., ; & Neil, R. (2010). Psychology: The Science of Behaviour. United States of America: Person Education. pp. 453–454.
Day, J. (2013). Interprofessional Working: An Essential Guide for Health and Social Care Professionals, Thomson Learning, 2013. ISBN: 978-1408074954
Fish, J., & Karban, K. (2014). Health Inequalities at the Heart of the Social Work Curriculum. Social Work Education, 33(1), 15-30.
Healy, J. (2011). Improving Health Care Safety and Quality (Law, Ethics and Governance), Ashgate, 2011. ISBN: 978-0754676447
Markwick, A. (2013). Person-centred planning and the recovery approach. Learning Disability Practice, 16(7), 31.
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Legal and ethical aspects of Generalized Allied Health
Legal and ethical aspects of Generalized Allied Health and Community Services provision
Order Instructions:
write an essay that focuses on the legal and ethical aspects of generalized Allied Health and Community Services provision, using practical examples wherever possible.
Consider the following in your essay:
Principles and practices for upholding the rights of the client, including children and young people
Principles and practices of confidentiality
Principles of access and equity relevant to provision of community services
Principles of ethical decision-making
(1500 words)
SAMPLE ANSWER
Introduction
The allied healthcare workforce remains an essential element in the healthcare fraternity since the demand for these services increase immensely with the ageing of the population, an increase in emphasis on multidisciplinary delivery care and the increasing burden of chronic diseases. Allied health professionals include dietitians, physical therapists, radiographers, occupational therapists, and speech-language pathologists (Aliakbari, Hammad, Bahrami, & Aein, 2015). It is, therefore, essential to note that allied health professionals are healthcare workers equipped with formal education on clinical matters and are credentialed through licensure, certification and registration. These health practitioners are therefore expected to deliver high-quality patient care services that are geared towards identifying, preventing, and treating diseases, disorders and disabilities.
On the other hand, the law and ethics plays a fundamental role since they ensure that workers are committed towards practicing positive values. The workforce is also guided by the law and ethics in ensuring that they abide by the standards that have been enacted. Ethics refers to the values and belief systems within the allied healthcare workforce since they entail the regulations that are put in place to ensure the society is prevented from harms and that they can live healthy lifestyles (Aliakbari, et.al). Ethics has the capacity to promote training and education since it assists individuals to develop their skills to compete and to achieve the response to moral actions. Metaethics, which entails moral judgments and decision-making process, involves a critical and analytical thinking on considering what is good, right, or ethical within the practice. This paper, therefore, seeks to identify the ethical aspects of the generalized Allied Health and Community Service in the provision of health care service to a community.
Legal and Ethical Aspects of Generalized Allied Health and Community Services Provision
It is essential to note that ethics has the ability to guide the standards of moral judgment and professional development. The allied healthcare workforces are expected to remain accountable to patients, employees, public, and the entire profession. This, therefore, requires that the allied health care providers have a solid understanding of the legal and ethical proponents they face in their fields of practice (Castro-Atwater, & Hohnbaum, 2015). Allied Health Care Practitioners, therefore, have the responsibility to ensure that adequate care to all patients, ensure that confidentiality is maintained including autonomy.
With this, it is essential to note that in this professional practice, there are times when legal duties may be breached during practice. The ever changing values in the healthcare sector, the society, and behaviors in science typically point out to the need that allied medical practitioners are equipped with the ethical and legal issues and learn how to appropriately respond to such situations.
Legal Aspects of Generalized Health
Within legal frameworks, it is essential to mention that there are statutory laws that are defined within the healthcare fraternity that includes some jurisdictions. For instance, in the USA, there are some states that allow an individual to employ the services of an attorney of welfare in making medical treatment decisions in the case the person becomes incompetent (Castro-Atwater, & Hohnbaum, 2015). This clearly indicates that every individual has the right to decide on matters health in their own lives without any interference. They also have the right to choose a suitable medical treatment method that suits them and is consensual.
Case law also remains another element in monitoring the ethical standards of allied health care professional within the medical profession. As a result of this, several instances have been heard particularly of patients refusing to undertake medical treatments, and the use of embryos that are frozen for IVF. In some states, nobody has the right to consent treatment for an incompetent adult, a factor that forces the courts to make declarations mainly for the interests of patients including the overall medical practice (Drake, & Drake, 2010). It is, therefore, essential to note that nurses need sound understanding associated with the legal and ethical principles in order to make appropriate judgments that are in line with the law. This can be best understood through the implementation of stringent education and teaching procedures before practicing in Allied Health and Community Services Provision to ensure that the practitioners apply the required principles in health care and ethics.
Ethics;
Ethics according to sources are the philosophies that determine the right and wrong as related to an individual’s actions and decisions. However if this is applied in a Generalized Allied Health and Community Services Provision Program, it has the capacity to compete with other realities such as the increase in responsibilities, and time constraints that are put upon the allied healthcare professionals (Drake, & Drake, 2010). It is essential to note that the manner in which individuals interpret ethics like beliefs, and morals. It is also vital to mention that ethics remains a general concern that is implied by the laws and standards of practice.
One major ethical issue that stands out in practice is confidentiality. In this, there has been a considerable amount of worry in providing services to the society particularly when it comes to the divulgence of patient’s information (Huff, & Furchert, 2014). Maintaining and protecting patient’s privacy and confidential information remains a matter that is covered by the law and is governed by the regulatory body of the health fraternity. It is, therefore, important to patients are given the freedom to make their decisions in regards to confidentiality and are allowed to consider who to share the information with efficiently.
Principles and Practices of Confidentiality
A patient’s right to privacy remains a paramount factor that is enshrined in the Protection Act, and additionally it is a Human Right Act. Confidentiality, therefore, requires an individual to respect a person’s right to privacy. It is also essential that respect to human relationships is adhered to in sharing personal information (Huff, & Furchert, 2014). Allied medical practitioners are also required to appreciate the importance of maintaining confidentiality to the society and individuals.
It is, therefore, essential that allied medical health professionals maintain physical and administrative functions that ensure confidential information is protected against unauthorized access. There should be proper structures placed towards ensuring that individuals are informed how their health information is used and disclosed and that they have access to information as well (Noriega, & Drew, 2013). A written authorization from the patients should also be provided that ensures that information is disclosed for required purposes.
Principles of Access and Equity
Given the essence of these principles, to provide quality health care to the community, there are several responsibilities and laws that need to be adhered to substantially. The actions that are required to be observed include allowing every person to access allied health care regardless of their origin, sex, disability, language, birth, culture and sexual orientation (Noriega, & Drew, 2013). The allied health care facilities also have the obligation of ensuring that services are delivered and developed on the basis of fairness on the patients. Efforts should also be made that ensure factors such as disability, religion, race, gender, cultural background, or even sexual orientation do not lead to the unequal treatment of patients seeking care.
Principles of Ethical Decision-Making
In the field of practice, allied healthcare professionals are bound to encounter several ethical issues. An ethical dilemma remains one of the complex situations that emerge from the conflicts that arise between complying with the moral obligations (Suk Bong, Ullah, & Won Jun, 2015). Nurses are therefore required to conduct ethical and decision-making processes required in directing moral actions in situations.
This, therefore, requires practitioners to involve the use of moral components such as the basis, claim, evidence, warrant, rebuttal and ethical decision making in order to resolve conflicts efficiently. Allied healthcare professionals are at all times required to promote the independence of patients by respecting their informed decisions concerning their care.
Conclusion
The allied healthcare workforce remains an essential element in the healthcare fraternity since the demand for these services increase immensely with the ageing of the population, an increase in emphasis on multidisciplinary delivery care and the increasing burden of chronic diseases. These health practitioners are therefore expected to deliver high-quality patient care services that are geared towards identifying, preventing, and treating diseases, disorders and disabilities. In order to achieve this, the allied healthcare workforces are expected to remain accountable to patients, employees, public, and the entire profession. This, therefore, requires that allied health care providers consider both the legal and ethical issues that revolve around the provision of quality health services to the community.
The legal aspects require that legal frameworks are permanently adhered to in practice. It is, therefore, essential to note that nurses need sound understanding associated with the legal and ethical principles in order to make appropriate judgments that are in line with the law. On the other hand, ethics requires that the allied health care facilities maintain the required ethical standards in practice. It is, therefore, necessary to note that the manner in which individuals interpret ethics like beliefs, and morals. In addition to this, ethics should remain a universal concept that is governed by the law and regulate the standards of practice. These factors, therefore, remain indispensable in providing quality healthcare services to the community by the allied healthcare providers.
References
Aliakbari, F., Hammad, K., Bahrami, M., & Aein, F. (2015). Ethical and legal challenges associated with disaster nursing. Nursing Ethics, 22(4), 493-503. https://www.doi:10.1177/0969733014534877
Castro-Atwater, S. A., & Hohnbaum, A. H. (2015). A Conceptual Framework Of “Top 5” Ethical Lessons For The Helping Professions. Education,135(3), 271-278.
Drake, B. H., & Drake, E. (2010). Ethical and Legal Aspects of Managing Corporate Cultures. California Management Review, 30(2), 107-123.
Huff, C., & Furchert, A. (2014). Computing Ethics Toward a Pedagogy of Ethical Practice. Communications Of The ACM,57(7), 25-27. https://www.doi:10.1145/2618103
Noriega, P., & Drew, M. T. (2013). Ethical Leadership and Dilemmas in the Workplace. Consortium Journal Of Hospitality & Tourism, 18(2), 34-48
Suk Bong, C., Ullah, S. E., & Won Jun, K. (2015). Ethical Leadership And Followers’ Attitudes Toward Corporate Social Responsibility: The Role Of Perceived Ethical Work Climate. Social Behavior & Personality: An International Journal, 43(3), 353-365. https://www.doi:10.2224/sbp.2015.43.3.353
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NUR 209 M6A3: Obstetric Patient Pain Management and Care Paper rubic
APA format ,write a six (6) to ten (10) page paper exclude cover and references page that addresses the comfort and pain relief need of the antepartum intrapartum and postpartum patient
A minimum of three (3) current professional references must be provided. Current references include professional publication or valid and current website dated within five (5) years. Additional, a textbook that is no more than one (1) edition old may be used
the paper consists of (2)parts
Use a 12 font size double space APA format for citations ,references and overall format
Avoid plagiarism. Paper one : look at the cause and management interventions of discomfort and pain during pregnancy, labor birth and recovery from birth .Part two (2) is a component of a teaching plan the register nurse would use to assist an antenatal patient make an informed decision regarding pain relief measures to be used during labor and birth.
Part A : Identify and explain (2) sources of the antepartum patient ,intrapartum patient and postpartum patient during an uncomplicated pregnancy ,labor and recovery from the birthing process’s Part B : Identify one (1) pharmacological and two (2) non pharmacologic pain management measures for the intrapartum patient. Explain the benefits and risk of these pain management measures
one more part thanks for your patience.
Part 2 In order for the woman to make an inform decision regarding pain relief measures to be used in the intrapartum period ,the information needs to be provided in the antepartum period. Before finalizing a teaching plan for the pregnant woman ,her history needs to be assessed to determine any variables that may affect content of teaching plan .For example ,are there any language /barriers that will affect care provided during labor and birth.Before finalizing a teaching plan for the pregnant woman ,her history needs to be assessed to determine any variables that may affect you the content of the teaching plan .For example ,are there any language variables /barriers that will affect care provided during labor and birth.? A . Identify three (3) variables unique to the pregnant patient that need to be considered when developing a specific pain management teaching plan for the antepartal patient preparing for labor and birth. Provide an explanation why each of these three (3) variables preparing for labor and birth. Provide an explanation why each of these three (3) variables need to be considered when developing a teaching plan for an obstetric patient . B. Select two (2) non -pharmacologic pain relief options used in the intrapartum period . For each option, explain three (3) specific points information related to this pain relief option that need to be taught to the patient . Include rationales for each piece of content regarding why you would need to incorporate this information.
For part A is identify and explain 2 sources of pain for the antepartum patient intrapartum ad postpartum patient during an uncomplicated pregnancy labor ,and recovery from birthing process. . I miss out pain on top
include I part 2 A provide an Explanation why each of these three (3) variables need to be considered when developing a teaching plan an obstetric patient . I repeated it 2 above .
SAMPLE ANSWER
Obstetric Patient Pain Management and Care
PART 1
Pain would occur in pregnancy and delivery regardless of whether there are complications or not. It is possible to categorize such pain on the basis of the stages where patients experience it. Pains could occur at the ante-natal, intra-natal, and also at post-natal stages. Sources of pain vary from those that are expected; not necessarily in disease, to those resulting from complications. Also, pains could be specific to pregnancy and delivery or non-specific to the processes. Examples of pains that could occur in various stages of pregnancy and delivery include a headache and backaches. Nerve entrapment, abdominal stretching, and trauma are potential sources of pain in pregnancies and non-complicated deliveries.
Abdominal stretching is usually intense as from the third trimester of pregnancy (National Partnership for Women and Families, 2010). The uterus stretches in such a way that it accommodates the enlarging fetus, and in the process, it occupies most of the abdominal cavity. At late antenatal stages, the uterus would have extended to levels just slightly below the sternum, and its positioning would be pressurizing the fundus (National Partnership for Women and Families, 2010). The stretching also has a substantial impact on ligaments. The structures have to bear the weight of the fetus, and their pulling could result in back pains (March of Dimes Foundation, 2013). Round ligament pains and Braxton-Hicks contractions happen following the straining of the ligaments (McDermott, 2015). Usually, the pains begin at the ante-natal stage, continues throughout labor and still retain effects at the post-natal stage. Such pains constitute most of the experiences of labor in women (National Partnership for Women and Families, 2010). Abdominal stretching also has an effect on pelvic expansion. At the antenatal stage, the pelvic is constantly expanding in preparation for childbirth. The stretching is also a source of pain during delivery and accounts for a significant portion of labor pains. Abdominal stretching also causes difficulties in processes such as breathing and urination. An expanded uterus pressurizes both the diaphragm and the bladder, and the situation results in the impairment of breathing and urination. Also, the stretching of the vagina and the cervix could cause significant swelling and pains on the perineum (National Partnership for Women and Families, 2010). Under normal circumstances, stretching fades away through the post-partum stage and women would only experience mild discomfort as structures regain their normal sizes. At the post-partum stage, pain and discomfort are mainly from mild spasm that characterize the process of regaining normalcy. Uterine prolapse, rectocele, and cystocele are sources of pains in the post-natal stage, and they bear link with earlier abdominal stretching (Romano, Cacciatore, Giordano, & Rosa, 2010, Pg. 22).
Nerve injury could also result in pain in pregnancies and deliveries that are non-complicated. Nerves that are likely to bear injury include the femoral, sciatic, lateral femoral cutaneous, obturator and the lumbosacral plexus. Such injuries could result from compression, traction, transection, as well as vascular injury. Most of the injuries would occur at childbirth following events such as prolonged abduction and hyperflexion of the hips. Physical injuries that hurt such nerves during antenatal and post-natal stages would also cause pain.
Pharmacological and Non-Pharmacological Approaches of Managing Intrapartum Pain
Pethidine is a strong and fast acting analgesic drug that could be useful in the relieve of intrapartum pain. It is an opioid and it works by mimicking endorphins. Endorphins stimulate their receptors to mediate pain, and their substitution with opioid drugs limit pain mediation. Opioid receptors occur in the brain and the spinal cord, and opioids interact with them to block the transmission of pain signals. However, the drug only alleviates the sensation of pain, but it does not eliminate the causal factor for such pain. Pethidine is beneficial in that it achieves effects within a short period not exceeding twenty minutes. It is also possible to take the drug through a variety of routes, hence making it applicable to a broad range of patients. Common routes of pethidine administration include intramuscular and subcutaneous injections, as well as an oral intake as tablets. The drug is also advantageous in that patients can take it either with food or without. Disadvantages of pethidine include its inducement of drowsiness in patients. Also, the drug is contraindicated in patients with constipation, yet the condition is common among obstetric patients.
Non-pharmacological interventions for the management of intrapartum pain include positive conditioning of the clinical environment and acupuncture. The former method involves minimization of distractions and creating a peaceful environment for relaxation. The method is cheap, easy to administer, and it applies to most types of obstetric patients. However, it has a low degree of efficiency, especially in comparison with the pharmacological techniques. As such, it would be risky to depend on the method alone for pain management. Acupuncture is beneficial in that it causes relaxation in patients and gives them a soothing sensation that minimizes the effect of labor pains. Unlike most of other procedures, acupuncture offers a desirable sensation that patients may yearn to experience. However, acupuncture is associated with risks such as loss of consciousness and the possibility of the emergence of sores at the site of administration (NHS Choices, 2015). The method also creates substantial predisposition of the acquisition of infections. Besides, organ injury may occur, and only qualified personnel should apply it.
PART 2
Considering particular factors that apply to patients before educating them is a move to offer high-quality obstetric care. Different pain management techniques used in obstetric care vary in the effect they have on patients. Some would be appropriate for a particular type of patients but inappropriate for others. Patients are likely to benefit from educations that address their concerns to satisfaction. As such, educators should convert their broad range of information into forms that are most helpful to their clients.
Patient history and examinations should be the focus of obstetric care educators. Some patients could present with occurrences that are not normal, especially regarding the use of medications. Before advocating for a particular anesthetic pharmacological methods of pain management, educators should evaluate their patients to establish the appropriate of such medications. The educators should use patient history to either approve or disapprove the necessity of using anesthetic drugs. For example, anesthetic drugs could cause adversities in patients with obesity, diabetes, preeclampsia, HELLP syndrome, and hypertensive disorders associated with pregnancy. Important health conditions for educators to consider in their patients include the status of the lungs, heart, and airway. Such history would be vital in determining the form of obstetric care that clinicians would offer to their clients.
Educators should also assess the needs of their patients and consider them against the available resources. For instance, some women may have medical conditions that would suggest an indispensable need for analgesic or anesthetic interventions. Educators should purpose to offer recommendations to patients who are in need of them. Some healthy women may not need pain relieving medications, and educators would focus on other areas of care provision rather than exploring the drugs. Also, educators should learn the financial ability that their patients have so as to determine how accessible quality care is to them. For patients who may not meet the financial costs of standard care, educators would offer advice on insurance policies that the patient would consider in overcoming the challenge.
It would also be important for patient educators to consider the obstetric history of their patients. For instance, women who would have had complications in their previous deliveries might require anesthetic medications depending on the nature of their difficulties. Also, close monitoring of patients who have never given birth would be necessary. The educators would familiarize such patients on the issues to expect. For instance, they could inform them on the nature of pain and the best strategies for minimizing it. Giving such information would allow the patients to make necessary arrangements such as financial and behavioral preparations.
TENS (Transcutaneous electrical nerve stimulation) is among common non-pharmacological methods that are used in managing pain in obstetric patients at the intrapartum level. The method involves the placement of four soft pads on the back of the patient and then running a gentle electric current to induce a massaging effect to the patient (Johnson, Paley, Howe, & Sluka, 2015).
It would be necessary for the patient to know the mechanism by which the method works. Informed patients are likely to cooperate and facilitate the use of the technique for pain relief. TENS work by creating a tingling sensation that stimulates the body to produce endogenous endorphins (Guy’s and St, Thomas’ NHS Foundation Trust, n.d., Pg. 4). Patients are likely to accept methods if they understand them fully.
Also, it would be important for the patient to know the benefits of using TENS in pain management. Such benefits include the handiness of the tool whereby one can control it effectively. Also, the method has no side effects to the newborn, making it a safe approach. Patients would rely on the benefits for them to consider exploiting the method.
The patient should also learn the shortcomings of the method. TENS is limited in that its effect is reduced if it is not started early enough. Also, there is a possibility of patients showing allergic reactions to the electrolytes used in TENS. Informing the patient on the disadvantages of the method would allow them make informed decisions.
The positions that patients assume when giving birth is also a non-pharmacological approach to managing intrapartum pains. Clients should understand the positions that would lead to minimal injury. The understanding would help them avoid unnecessary injuries.
The clients need understanding the benefits of applying the technique in managing pain. The benefits include shortened labor periods and its concurrent applicability of other methods. Knowing the advantages would enable patients determine whether they would need applying the technique.
Also, the patients should understand the shortcomings of the technique. For instance, none of the positions would alleviate pain completely. Again, the patient would require support from other persons for the method to work. Understanding the shortcomings would allow patients make informed choices.
National Partnership for Women and Families. (2010). Journey to Parenthood: your body in the third trimester of pregnancy National Partnership for women and families. Retrieved from http://www.childbirthconnection.org/article.asp?ck=10507
Romano, M., Cacciatore, A., Giordano, R., & La Rosa, B. (2010). Postpartum period: three distinct but continuous phases. Journal of Prenatal Medicine, 4(2), 22–25.
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• Review “Gastrointestinal Disorders” of the Burns et al. text.
• Review the provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
Case Study 2:
Victoria is a 15-year-old who complains of chronic sore throat and bad taste in her mouth. Her height and weight are appropriate for age and she remains on the same growth trajectory since infancy. Abdominal examination and chest examination are negative. History reveals frequent burping and occasional feelings of regurgitating food. Diet history reveals she eats a balanced diet, but her primary sources of fluids are coffee, tea, and carbonated drinks.
SAMPLE ANSWER
GASTROINTESTINAL DISORDERS
GASTROESOPHAGEAL REFLUX DISEASE
A female adolescent reports chronic sore throat accompanied by bad taste in her mouth. Her growth trajectory has been consistent since birth and the body mass index is normal. Both abdominal and chest examinations are normal. History taking reveals frequent burping and regurgitating of food reported to be occasional. On further history taking, she reports that she takes a balanced diet, but her common sources of fluids are coffee, tea and carbonated drinks.
The diagnosis for this patient is gastroesophageal reflux disease (GERD). This is characterized by symptoms such as heartburn, regurgitating of food, sore throat that doesn’t go away for a while and bad taste in the mouth among other signs (TeensHealth, 2015). Although occasional regurgitation of food may be common to everyone, it is a classic sign of GERD especially when it is not associated with nausea. WebMD (2015) defines gastroesophageal reflux as “the return of the stomach’s contents back up into the esophagus”. WebMD further suggests carrying out a special x-ray test known as barium-swallow radiograph that would help rule out other possible problems.
Treatment and management
If GERD is left untreated, serious pathologic changes in the esophageal lining may occur which may develop into more complicated disorders. For this mild case, early treatment would be appropriate which would include Proton pump inhibitor (PPI) such as Omeprazole 20mg once a day before meals for four weeks (PDRHealth, 2015) This would provide a more rapid symptom control and better healing. The chronic sore throat and bad taste in her mouth would be addressed by educating the patient some diet and lifestyle changes such as reducing or avoiding fluids and foods containing caffeine and nicotine and carbonated snacks, taking smaller but frequent meals and eating two to three hours before bedtime.
Differential diagnosis
A patient presenting with the above symptoms would also be suffering from stomach ulcers which would be due to bacteria H.Pylori. The bacteria increase the acid content in the stomach, therefore presenting similar symptoms as GERD.
Inked item M6A3: Pain Management for the Obstetric Patient Paper
Helping a woman manage discomfort and pain associated with pregnancy, labor, birth and recovery from birth is an essential role of the registered professional nurse.
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that addresses the comfort and pain relief needs of the antepartum, intrapartum and postpartum patient.
A minimum of three (3) current professional references must be provided. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.
The paper consists of two (2) parts and must be submitted by the close of week six.
Part one (1) looks at the causes and management interventions of discomfort and pain during pregnancy, labor, birth and recovery from birth. Part two (2) is a component of a teaching plan the registered nurse would use to assist an antenatal patient make an informed decision regarding pain relief measures to be used during labor and birth.
Part 1
A. Identify and explain two (2) sources of pain for the antepartum patient, intrapartum patient, and postpartum patient during an uncomplicated pregnancy, labor, and recovery from the birthing process.
B. Identify one (1) pharmacologic and two (2) non pharmacologic pain management measures for the intrapartum patient. Explain the benefits and risks of each of these pain management measures.
Part 2
In order for the woman to make an informed decision regarding pain relief measures to be used in the intrapartum period, the information needs to be provided in the antepartum period.
Before finalizing a teaching plan for the pregnant woman, her history needs to be assessed to determine any variables that may affect the content of the teaching plan. For example, are there any language variables/barriers that will affect care provided during labor and birth?
A. Identify three (3) variables unique to the pregnant patient that need to be considered when developing a patient specific pain management teaching plan for the antepartal patient preparing for labor and birth. Provide an explanation why each of these three (3) variables needs to be considered when developing a teaching plan for an obstetric patient.
B. Select two (2) non-pharmacologic pain relief options used in the intrapartum period. For each option, explain three (3) specific points of information related to this pain relief option that needs to be taught to the patient. Include rationales for each piece of content regarding why you would need to incorporate this information.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format.
SAMPLE ANSWER
Part 1a; sources of pain in antepartum, intrapartum and postpartum
The period between when a child is conceived and the period a child is born is referred to antepartum. During this period, the expectant mother undergoes numerous morphological as well as physical changes as the child develops. This is why it is important to attend prenatal clinics so that the nurses can assess these morphological changes to determine if they are normal of putting the expectant mother at risk. Patient should be taught on ways to maintain physical activeness and appropriate nutrition. Most health complications experienced by the antepartum patient is attributable to changes in body hormones, including progesterone levels, estrogen, gonadotrophin and lactogen. The two main sources of pain are abdominal pain and pelvic pain. The abdominal pain is due to the stretching of the uterine muscles and expansion of the ligaments to accommodate the growing fetus. This process is often accompanied by other physiological disturbances such as nausea and fatigue. The pelvic pain also occurs due to the enlargement of the abdomen area which causes the pelvic bones adjust accordingly to support the increase of the growing abdomen (Sandra, Judith, & Jean, 2015).
Intrapartum occurs when one is undergoing labor. This natural process comprises the expulsion of the fetus, the placenta, and membranes. Sources of pain during this time arise due to the uterine contractions. The contractions are progressive with the cervix dilation. Picotin and prostaglandin hormones normally stimulate the pains. The uterine contraction pain and intensity increases as the baby is about to be expelled. The contractions increase with activities that increase myometrial such as walking. Initially, the pain occurs in the form of cramping just like when one is undergoing menstruation and increases with time. The first hours of labor, the expectant mother is able to control the pains, as they are usually mild. The intrapartum patient can be taught on effective strategies to manage the pain (Demirel et al., 2013).
Postpartum refers to the period just after birth, mainly the first four hours following birth. This period is described by excitement and joy, but also pain due to the hemorrhages that may have occurred during the birth. The main sources of pain are lacerations that could have occurred during giving birth process. In some cases, the uterine cramping can continue and pain in the lochia rubra. Pain management during this stage is controlled using narcotics, anti-inflammatory analgesics that are non-steroidal and where necessary, topical antiseptics could be applied (Chaillte et al., 2014).
Part 1b; pain management for intrapartum
The pain management in intrapartum can be controlled following pharmacological and non-pharmacological interventions. Following pharmacological approaches, the nurses can provide the patient with sedatives to help the patient relax. However, these medications should be used with caution because the sedative often present adverse effects to the baby and the mother. In many cases, the use of sedatives makes the mother relax, and feel drowsy. This could present difficulties in concentrating especially when pushing the baby. The cardiovascular effects are also associated with alteration of the cardiovascular system. This includes lowering of the heart rate, which is often linked with difficulties in child’s breathing and even reflexes after birth. These medications must be avoided and should only be given when necessary and in small dosages. Additionally, these medications must never be administered to a patient who is about to deliver (Sandra, Judith, & Jean, 2015).
In the late stage of intrapartum, the best intervention is non-pharmacological intervention. The nurses must provide the patient with techniques that will enable them cope with pain, fear, and anxiety that results. One of the techniques that can be applied is controlled breathing technique. This intervention is important because it relaxes the muscles, which are often tensed. Anxiety induces endocrinal system, which produces hormones that cause the muscles to become tense. Tense muscles cause interference with the contractions of the uterine wall, leading to a complication during delivery. Counseling intervention has also been associated with increased relaxation of the uterine muscles (Green, 2011).
Nurses should constantly encourage the expectant mother by constantly verbalizing the patient ability to cope with the pain and the delivery process. If available, the patient can be encouraged to participate in activities that divert their focus form pain. These include activities such as walking, massage and the use of the birth ball. The patient should be well educated on about the gestation period and what to expect during the labor process. This way, the expectant mother becomes psychologically prepared about the process. Thus, it can face the whole process with confident. Anxiety is believed to stimulate the endocrinal system where the brain stimulates the production of the adrenal corticoid hormones, which is often associated with the reduction of blood flow to important body structures such as the fetus and the placenta. Evidence based research indicates that an informed patient has less tension which increases blood flow to the fetus and to the muscles during the uterine contraction process and during delivery (Chaillte et al., 2014).
Part 2a; variables considered when designing a teaching plan
Nurses are mandated in empowering patients so that they can case manage their healthcare complications. The process of case management and teaching is challenged by various factors, including cultural barriers, patient literacy and linguistic barriers are some of the barriers that affect a successful outcome of a teaching plan. The first key variable that should be assessed is cultural values and respects. This is because cultural values determine if the patient will follow the set interventions or cultural aspects interfere with the established interventions. For instance, in some cultures, the patient is not allowed to take some types of food during pregnancy or even to carry out vital activities during pregnancy period (Green, 2011).
The patient medical history is important. This is especially valuable in order to understand previous consumption of medication to avoid adverse interactions. In some cases, the expectant women can be consuming harmful drugs such as opiods, smoking, and heroin. These drugs are associated with adverse effects such as Fetal Alcohol Spectrum Disorders, which associated with numerous neuropathologies. Patients who are addicted should be treated using diazepam and other necessary support (Sandra, Judith, & Jean, 2015).
The patient medical history is also very important. This involves the history of relatives. This is because some health complications are inherited and genetic. Other relevant information includes number abortions, the number sexually transmitted infections (STIs). The number of previous pregnancies, existing children, and their health status of the children must be recorded. In the first and the second trimester, pain is an indication of an issue with the physiological process, and if the pain is very severe, the physician should be consulted. In the last trimester, pain is an indication of labor. Labor pain varies from person to person and is unique. Mother’s reaction to pain differs according to the patient physiological preparedness. Patient should be empowered effectively to ensure that they could manage the disease comfortably and with ease (MartÃnez et al., 2012).
The common factors during this process are fear and anxiety experienced by the patients. The emotional status of the parent determines their ability to cope with anxiety the first time mothers because of the fear of unknown as well as cultural belief. It is important to understand these variables because they facilitate in designing of the patient education plan. Additionally, different stages of labor will require different approach to manage pain. For instance, the first trimester time pain can be manageable, but in the last trimester, the dilation of the cervix and contractions of the uterine walls could require non-pharmacological intervention such as breath relation technique or massage (Demirel et al., 2013).
Part 2b Non-pharmacological pain management
Evidence based research indicates that the best intervention to manage anxiety is through breath relaxation. Anxiety arises when the patient is inadequately informed about the processes and physiological activities during the gestation period. Anxiety can also arise due to mixed emotions of excitement and fear. The interventions should ensure that patient integrity is sustained; this can be done by drawing curtains when attending to an expectant woman to ensure that privacy is maintained. The reduction of exposure indicates respect and promotes the patient relationship with the staff (Chaillte et al., 2014). This mutual relationship makes the patient feel more comfortable and more relaxed, reducing the rate of anxiety. It is also important to value cultural beliefs and values give the patient sense of belonging, which empowers the patient to manage pain. The breath relaxation technique enables the patient cope with anxiety, which helps in managing pain because it helps relax muscles. This is because tense muscles cause interference of fetal descent, which is often associated with increased fatigue. The fatigue increases pain perception negatively affecting patient ability to cope. It also increases mother’s confidence improving their ability to cope with pains (Demirel et al., 2013).
The use of massage enables pain relief especially during the initial stage of labor. The source of pain during this stage is due to dilation of the cervix caused by the hypoxia or the contractions of the uterine muscles. The aim of this intervention is to ensure that patient verbalizes pain relief indicating that the patient is coping with uterine contractions. It also facilitates the process of voiding. Full bladder increases pain intensity and discomfort. The massage enables pain distraction, and can be coupled with other destruction activities such as watching TV, music, or talking (Chaillte et al., 2014).
Demirel, I., Ozer, A., Atilgan, R., Kavak, B., Unlu, S., Bayar, M., & Sapmaz, E. (2013). Comparison of patient-controlled analgesia versus continuous infusion of tramadol in post-cesarean section pain management. J Obstet Gynaecol Res, 40(2), 392-398. doi:10.1111/jog.12205
Green, C.J. (2011). Maternal newborn: Nursing care plans. Jones and Bartlett Learning. Burlington
MartÃnez, B., Canser, E., Gredilla, E., Alonso, E., & Gilsanz, F. (2012). Management of Patients with Chronic Pelvic Pain Associated with Endometriosis Refractory to Conventional Treatment. Pain Practice, 13(1), 53-58. https://www.doi:10.1111/j.1533-2500.2012.00559.x
Sandra, M., Judith A, D., & Jean, W. (2015). CNE SERIES. Pain Management in the Post-Operative Pediatric Urologic Patient. Urologic Nursing, 35(2).
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2020 Objectives 5th paper.
Write a 2-3 page (not including title and reference) paper in 6th edition APA format.
Select one of the Healthy People 2020 objectives and identify how biological risk, environmental risk, and behavioral risk contribute to family health risks for that objective. What are the three major public health problems in your community; how does this impact the health of families?
SAMPLE ANSWER
The Healthy people 2020 is an initiative that aims at promoting health services and disease prevention through bringing together individuals and agencies to work together so as realize the numerous goals and objectives set out by the initiative. One of the objectives of the initiative is to minimize the rate of transmission of HIV among adults and adolescents. According to a statistics report released in 2006, per 100 persons living with HIV, 4.6 new transmissions are reported annually. The objective is to minimize this from 4.6 to 3.5 transmissions by the end of 2020. This is to be achieved through adhering to the numerous set up national programs and a number of enactments such as policies and laws. (In Stanhope & In Lancaster, 2014, pg 683)
There are number of risks that contribute to family health risks when it comes to the realization of the objective. These risks range from environmental, behavioral to biological risks. Behavioral risks are the major factor that contributes to family risks when it comes to the transmission of HIV. Epidemiological data asserts that behavioral activities such as practicing of unprotected sex are the main means of HIV transmission in both adults and adolescents. Other risk behaviors such as sharing of injecting equipments, blood transfusion and breastfeeding of babies by HIV positive mothers have also been noted as being leading causes of transmission. These behavioral activities account up to 90% of the new cases of HIV diagnosed every day. The biological risks have been found to affect mostly the adolescents. Girls have been the most vulnerable ones. Before puberty, the exocervix of girls is usually lined with a single layer of columnar cells which leaves them vulnerable to HIV. In young women, HIV usually remains asymptomatic and this also increases the risk of transmission since it is unnoticed and involving in some behavioral activities will lead to the transmission of the disease without noticing. Environmental risks, although not a major factor, also play a role in this. This usually happens when injecting or such sharp objects are dumped recklessly. People can come across these objects, which can be in an accidental manner, and if these objects had come across HIV infected blood, then there is a possibility of HIV transmission. All these risks can contribute to family health risks since after one member of the family is infected, then the rest of the members are at a risk especially if the necessary precautions such as avoiding the sharing of sharp objects and toothbrushes are not adhered to. (Fan, Conner & Villarreal, 2011, pg 122)
My community, just like many other communities, faces some public health problems. Firstly, most health facilities around have poor infrastructures and limited resources. This has greatly hindered families from accessing quality healthcare for example people who need chemotherapy treatment and x-ray services have to wait for long periods of time before accessing these services. Secondly, there is limited awareness when it comes to certain diseases such as the sexually transmitted diseases and nutritional related diseases. With this limited awareness, most families are left at a high risk of contracting such diseases. Lastly, the cost of treatment in most health facilities is usually very costly and since my community is majorly made up of low class members of the socio-economic status, this has greatly affected the health of most families. The costly treatment, leads to many people seeking for the rather cheap over-the-counter treatment. This has led to an increased number of health-related deaths. (Finkel, 2011, pg 12)
References
Fan, H., Conner, R. F., & Villarreal, L. P. (2011). AIDS: Science and society. Sudbury, Mass: Jones and Bartlett Publishers.
SLP: Second Part
Many healthcare programs have modified their operational design and culture to one of being patient-centered while being fiscally viable. As part of your interview of a healthcare manager or executive selected for module 1 discuss how the program was or will be transformed to be patient-centered.
In your discussion please address the following questions.
1. How was the program restructured or re-engineered to adapt to internal and external factors impacting it?
2. What internal and external factors were considered in the transformation?
3. What were the barriers or obstacles were encountered (e.g. internal politics, economics, resource limitations, time constraints, etc.).
4. What is the potential impact on the program of technology, legislation, etc on the services provided on the program.
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