Response to Chabala Benson in Health Care Order Instructions: Kindly view
Response to Chabala Benson in Health Care Sample Answer
Response to Chabala Benson
Hi Benson,
Your discussion is very informative. I agree with you that people with disability need evidence-based educational programs in order to empower patients on ways to self manage their health condition.
Response to Chabala Benson in Health Care
One approach to do so is by advising the patients on the available financial support systems. In the past, people with disabilities had limited options of medical coverage. The Affordable Care Act (ACA) is one of the important piece of legislation in supporting people with special needs. ACA has established provisions that have expanded health insurance coverage for people with special needs. As of September 2010, insurers should not deny coverage to people with special needs. The policy ensures that people with special needs get quality and coordinated care (CDC, 2016).
Response to Chabala Benson in Health Care Reference
CDC. (2016). The affordable Care Act Helps people with special needs. Retrieved from http://www.cdc.gov/hiv/policies/aca.html
Response to Dane Foster
Hi Foster,
I enjoyed reading your discussion. Research indicates that 56 million people in the USA are affected by disability. People with disabilities experience disparities in most health indicators such as mental health, violence, injuries and obesity. People with disabilities rarely get routine preventive medical care because of the limited availability of care, physical barriers, inadequate healthcare provider’s skills and prohibitive cost. Healthcare providers have a major role to play in order to improve access to care for people with disabilities. This includes increasing awareness of disability issue in order to promote inclusion of disability components and programs at a local level and in national policies. These efforts will promote strategies that will ensure that people with disabilities remain highly knowledgeable about their health conditions, and the healthcare providers protect the rights and dignity of the disabled people (World Health Organization, 2015).
Response to Chabala Benson in Health Care Reference
World Health Organization. (2016). Disability and Health. Retrieved from http://www.who.int/mediacentre/factsheets/fs352/en/
Patients Reimbursement within Thirty Day Readmission Order Instructions: Please, review the title page and reference page for proper writing and format.
Also on page 1 of this project my Professor send corrections.
Patients Reimbursement within Thirty Day Readmission
Please, make the corrections as she is asking.
The rest pages she didn’t reviewed, I am also attaching her requirements.
SAMPLE ANSWER
CHF Patients Reimbursement within Thirty-Day Readmission Introduction
Background
Reducing the rates of readmission is a national priority. It is estimated that readmissions cost the American Health care more than $ 15 billion annually (McIlvennan et al., 2015). The National Quality Forum initiated hospital readmissions reduction program (HRRP) aimed at reducing rehospitalization rates for three highly prevalent conditions: Heart Failure (HF), Acute Myocardial Infarction (AMI) and Pneumonia (Joynt & Jha, 2013). This is being implemented by providing incentives to hospitals that do not exceed a predetermined readmission rates (limit of 3%) while penalizing those that exceed (Bradley et al., 2013).
Significance of Healthcare problem and Patients Reimbursement within Thirty Day Readmission
One indicator used by Centers for Medicare and Medicaid Services (CMS) to check health facility’s quality of care is readmission rates. If a healthcare facility has high proportion of the patients readmitted within 30 days for any disease or condition, then this could be an indicator of inadequate care delivery (McIlvennan et al., 2015). CHF (congestive heart failure) patient care is estimated to consume a staggering 17 percent of the total national health expenditures and has this has called for reduction of CHF patient readmissions so as to cut down costs (Yanez et al., 2013).
Purpose of the study Patients Reimbursement within Thirty Day Readmission
HF (heart failure) is a chronic condition often accompanied by downstream complications collectively referred to as Congestive Heart Failure (CHF). The purpose of this study was to explore whether the reimbursement within thirty-day readmission is justifiable in case of CHF patients.
Patients Reimbursement within Thirty Day Readmission Review of the Evidence
The primary function of the heart is to pump blood to the rest of the body. When the heart has a defect, it does not circulate blood sufficiently and hence the kidney receives less blood and filters less fluid out of the circulation. As a result, fluid accumulates in major organs such as around the eyes, legs, the lungs and the liver, a condition technically referred to as congestive heart failure. (CHF). CHF is chronic disease with symptoms such as fatigue, sweating, swelling of the feet and around the eyes, and fast breeding. The disease alternates between stability and worsening and such unpredictable nature has an impact on the patient’s use of healthcare services and can often lead to preventable hospital readmissions and reimbursements (Yanez et.al, 2013).
CHF is the leading cause of hospitalization especially in geriatric population in the USA (Vinson et al., 1990). It affects about 5.8 million people. The issue of high readmission rates of CHF patients has high implication cost to the individual, family and the society. For instance, readmission rates for patients diagnosed with Congestive Heart Failure (CHF) accounts for $17.4 billion direct cost of care (Centers for Medicare and Medicaid, 2014). Although there is some progress in reducing mortality in patients diagnosed with CHF, readmission rates continues to rise with approximately 50% of the patients getting readmitted within 6 months of discharge (Committee of Presidents of Statistical Societies, 2012(Joynt & Jha, 2013)). Worse off, CHF accounts for about 17 percent of total USA national health expenditures (Yanez et al., 2013). This trend is projected to increase by five fold in the next decade if no interventions are put in place to manage the disease (Dearholt &Dang, 2012).
The USA hospitals are committed to improve the quality of care using innovative programs to strengthen linkage between the various stakeholders. However, most CHF patients are treated under inpatient option, and in addition to the many challenges involved when providing CHF patient care, CMS has placed a big burden on the hospitals by introducing an inappropriate one day length of stay admission and readmission within thirty days. CHF has a very high readmission rate in the USA which makes healthcare facilities prone to losses due to potential of becoming fully financially responsible for the CHF patients. AS a result health care facilities have re-engineered their sytems to avoid readmission costs (Mcllvennan et al., 2015)
For instance, Project RED (Re-engineered Discharge) is a research group at Boston University Medical Center that develops strategies used by healthcare facilities to reduce readmission rates. The aim of Project RED is to develop effective strategies in order to promote patient safety and to reduce readmission rates. The project RED re-engineered intervention is based on 12 mutually discrete components that reinforce on patient safety and patient satisfaction. Examples of these components include Visiting Nurse Services, Tele-Health services, and other community health programs. An intervention study conducted by project RED reported that patients in the intervention (i.e. Project RED) were less likely to return to hospital within thirty days of discharge (Jessup, 2014).
Replication of project RED in two separate studies was shown to significantly reduce the number of CHF patients readmitted hence reducing the cost of healthcare. The Duke University health system, led by Dr. Christoper O’connor was the first to provide the path to accountable CHF patient care in the 1990s. Dr. O’connor noted that there was poor coordination /communication between CHF patients and physicians and there was no access to primary heathcare for CHF patients. These two challenges, coupled with limited knowledge of CHF management at that time often led to unnecessary hospital visits. To address these challenges, Duke University began a program of CHF patient care improvement with three major initiatives, including the Duke Heart Failure Program, the Heart@home initiative, and Same Day access clinic (Hernandez et al., 2010).
The Duke Heart Failure Program used a strategy involving multidisplinary CHF care teams involving cardiologists, nurses, therapists, dieticians and pharmacists and well defined guidelines (Hernandez et al., 2010; Smith et al., 2014). The study reported that for patients enrolled in the program from July 1998 to April hospitalization decreased from 1.5 to 0 per patient .per year hence saving £8571 per patient per year as a result of reduced readmissions (Hernandez et al., 2010). In 2012, the Duke began another study after making some changes such as putting in place a healthcare team for each patient, improving communication and coordination between the teams and study sites and patient education on management of CHF (Hernandez et al., 2010). On the Same day access clinic study, Duke Researchers conducted a research study on registry data and found out that the risk of readmission was reduced by seeing a doctor within 7 days of hospitalization. This study was the basis for the launch of Same Day Access (SDA) that allowed CHF patients to see a specialist immediately without appointment (Duke Translational Medicine Institute, 2013). In these three studies the Duke Team showed that improved healthcare delivery can significantly reduce readmissions and reduce unnecessary reimbursements.
In another study, like Duke University, Colorado also re-designed its CHF care with specific focus on use of technological innovation to reduce the length of inpatient hospitalizations and reduce costly readmissions. Colorado adopted the thirty-day model 4 bundle. In this model, Colorado received a large sum from Medicare and then distributed it to healthcare providers and if their cost exceeded the set budget, Colorado absorbed the extra costs. This made Colorado accountable for post-acute care services and hospital readmissions and significantly reduced the latter (Herman, 2011). This proved that the 30-day readmission is an effective and ideal metric for assessing quality and patient safety.
Patients Reimbursement within Thirty Day Readmission Conclusion
The healthcare system in the USA is in the onset of seismic shifts. The continuing pressure from different stakeholders to increase healthcare access, increase coverage improve quality and minimize financial costs will eventually result in a more efficient healthcare system. CHF is a chronic disease that accounts for a substantial portion of treatment costs of cardiovascular defects in the USA. As such delivery of CHF patient care is set to evolve due to these seismic forces. Payers have increasingly shifted to value based reimbursements and this further affects an already struggling healthcare system. The facilities survival now lies on how well they will manipulate these financial and logististical forces to their own advantage. One of those ways will be to put measures in place so as to avoid unnecessary readmissions of CHF and other related conditions.
Patients Reimbursement within Thirty Day Readmission References
Bradley, E., Curry, L., Horwitz, L., Sipsma, H., Wang, Y., and Walsh, M. . (2013). Hospital Strategies Associated With 30-Day Readmission Rates for Patients With Heart Failure. . Circulation: cardiovascular Quality and Outcomes, 6(4), 444-450.
Centers for Medicare and Medicaid. (2014). Readmissions Reduction Program (HRRP).
Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and
Guidelines (2nd edition). Indianapolis, IN: Sigma Theta Tau International Lawton, G.
(2010).Tele-health delivers many benefits, but concerns linger. PT in motion journal.
Herman, B. (2011). The advantages and disadvantages of CMS bundle payment initiative: 8
responses. Beckers Hospital Review.
Hernandez, A. F., Greiner, M. A., Fonarow, G. C., Hammil, B. G., Yancy, C. W., Peterson, E. D., & Curtis, L. H. (2010). Relationship Between Early Physician Follow up and 30-day Readmission Among Medicare Beneficiaries Hospitalized for Heart Failure. JAMA, 303(17), 1716-1722.
Janice M. Vinson, M. W. R., Jane C. Sperry, Atul S. Shah, and Timothy McNamara. (1990). Early Readmission of Elderly Patients With Congestive Heart Failure. Journal of American Geriatirics Society, 38(12), 1290-1295. doi: 10.1111/j.1532-5415.1990.tb03450.x
Jessup, M. (2014). The Heart Failure Paradox: An Epidemic of Scientific Success: Presidential Address at the American Heart Association 2013 Scientific Sessions. Circulation, 129(25), 2717-2722.
Joynt, K. E., & Jha, A. (2013). A Path Forward on Medicare Readmission. J.Med, 368, 1175-1177.
Medicine, D. T. I. (2013). Same day access heart failure clinic provides inter-disciplinary research oportunities.
Smith, C., Piamjariyakul, U., Wick, J., Spertus, J., Russell, C., & Dalton, K. (2014). Multidisciplinary Group Clinic Appointments: The Self-Management and Care of Heart Failure (SMAC-HF) Trial. Circulation: Heart failure, 7(6), 888-894.
Yancy C. W. et.al. (2013). ACCF/AHA Guideline for the Management of Heart Failure: Executive Summary. Journal of American College of Cardiology, 62(16), 1495-1539.
Contemporary Healthcare Issues Paper Order Instructions: Identify a contemporary health care issue and write a paper (1,000–1,200 words) that describes how it impacts the organization from a business perspective.
Contemporary Healthcare Issues
Apply the following questions to generate your conclusions about how you would proceed:
1.Will there be differences between how for-profit organizations (versus nonprofit organizations) are impacted?
2.What are the perspectives and responsibilities of the financial management staff?
3.What rules, standards, and regulations related to the issue must the financial management of the organization address?
1
Unsatisfactory
0.00%
2
Less Than Satisfactory
65.00%
3
Satisfactory
75.00%
4
Good
85.00%
5
Excellent
100.00%
80.0 %Content
65.0 % Apply the Issues of Profit vs. Non-Profit, Perspectives and Responsibilities, and Rules and Regulations to the Chosen Health Care Issue
Does not demonstrate an understanding of the business concepts involved in the issue, including the implications. Does not address the three requirements specified in the assignment. Does not demonstrate critical thinking and analysis of the situation, and does not develop effective answers to the questions, with rationale.
Demonstrates only minimal understanding of the business concepts involved in the issue. Only minimally addresses the three requirements specified in the assignment. Demonstrates only minimal abilities for critical thinking and analysis of the case study, and develops weak answers to the questions, with minimal rationale
Demonstrates knowledge of the business concepts involved in the issue, but has some slight misunderstanding of the implications. Satisfactorily addresses only one of the three requirements specified in the assignment. Provides a basic idea of critical thinking and analysis for the questions, answers, and rationale.
Demonstrates acceptable knowledge of the business concepts involved in the issue. Satisfactorily addresses only two of the three requirements specified in the assignments. Develops an acceptable response and rationale for it. Utilizes some examples.
Demonstrates thorough knowledge of the business concepts involved in the issue, and their implications. Satisfactorily addresses all three of requirements specified in the assignments. Clearly answers the questions and develops a very strong rationale. Introduces appropriate examples.
15.0 % Integrates Information from Outside Resources into the Body of Paper
Does not use references, examples, or explanations.
Provides some supporting examples, but minimal explanations and no published references.
Supports main points with examples and explanations, but fails to include published references to support claims and ideas.
Supports main points with references, explanations, and examples. Application and description is direct, competent, and appropriate of the criteria.
Supports main points with references, examples, and full explanations of how they apply.
17.0 %Organization and Effectiveness
6.0 % Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
Contemporary Healthcare Issues Paper and Paragraph Development and Transitions
Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.
Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.
Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.
A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.
There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.
Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
Contemporary Healthcare Issues Paper Format
1.0 % Paper Format (1- inch margins; 12-point-font; double-spaced; Times New Roman, Arial, or Courier)
GCU template is not used appropriately or documentation format is rarely followed correctly.
GCU template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
GCU template is used, and formatting is correct, although some minor errors may be present.
GCU template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
2.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment.)
No reference page is included. No citations are used.
Reference page is present. Citations are inconsistently used.
Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.
Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and GCU style is usually correct.
In-text citations and a reference page are complete. The documentation of cited sources is free of error.
100 % Total Weightage
Contemporary Healthcare Issues Paper Sample Answer
Contemporary Healthcare Issues
In the modern world, health care has embraced various changes compelled by various emerging issues that are mushrooming every other day. These are contemporary issues ranging from social issues to health issues. Social issues include financial crisis, climate change, imbalanced income, terrorism, racism among others. Business sector considers upcoming technologies and globalization as contemporary issues faced by the modern business (Bruce et al., 2012). Health sector considers obesity, malignant diseases such as cancer, among others as contemporary health care issues (WHO, 2013).
Heath business entrepreneurs and the government face a significant challenge in addressing these modern health issues. The growth in population and the mushrooming of the chronic illnesses are some of the major challenges the parties have to come to terms with (WHO, 2013). Assessment of emerging new technology exhaustively with transparency and efficiency leads to increased cost in medical advancing which poses a big challenge (Bruce et al., 2012). Also, there is no clear way of putting in balance public health care providers and government health care providers. There is also uncertainty in pointing out the health workers to administer quality health services.
It is also of importance to note that it is far much difficult in balancing the indigenous and modern health care. The government therefore should seek for ways to come up with lasting solutions in addressing these challenges. It should lay down efficient measures in crafting a health system that prioritizes on addressing these problems (Bruce et al., 2012).
With governments facing low infant mortality rate and high life expectancy, it goes without saying that their population is increasing in leaps and bounds. Furthermore, ageing population seems to take a toll. This spells out high dependency ratio whose burden lies on the government of the day. In addition, aging predisposes development of chronic illnesses and therefore, it strains the government resources which makes it difficult to fund the health sector adequately. This is sad bearing it in mind that chronic illnesses are still at large (Bruce et al., 2012).Though there seems like there is no potential of reforming the health system, the stake holders ought to explore various avenues to find amicable solutions in order to reform the system comprehensively. In order to achieve this, it calls for collective efforts from all stake holders.
In addition, if the universal agreement is anything to go by, all heath care settings should see to it that they prioritize on management and prevention of chronic illnesses. However, this is met with serious challenges as there are no adequate funds. Such illnesses are like diabetes, hypertension and cancer (Bruce et al., 2012). The universal agreement aims at reaching the neediest population by providing appropriate links among affected parties and health care providers. This is a challenge in an environment stricken by shortage of quality health workers and poor patients.
The demographic nature of the nation poses a serious challenge in as far as maintaining a stable health care is concerned. Providing support for those with disability and those that are weak is more challenging than ever. This may be attributed to the changing of occurrence of diseases pattern and the demographic nature. Prior preventive measures can be taken earlier to curb this menace though it adds on health costs (Bruce et al., 2012).
Embracing new health technology has also been on the rise. Use of advanced health devices such radio scanners among other new technologies has seen the cost of health rising to the community. These require subsidy from the government. Assessment of new surgical and pharmaceutical products should be done comprehensively paying special attention to cost effectiveness. Private health facilities should come up with a criterion of embracing these new technologies for the benefit of the whole community (Bruce et al., 2012).
In the recent years it has been realized that the financial management team plays a big role in the overall management of healthcare organization. The core responsibility of these teams involves planning, acquisition and utilization of funds to maximize the efficiency and value of the health organization (Shanks, 2016). Some of the routine operations carried out by the financial institution involves availing cash for payment of employees as well as maintain cash to meet unexpected costs. In addition to providing funds, the financial organization provides the leadership members with the necessary information to make plans (Shanks, 2016). For example, a hospital may decide to buy new life support machine, in this case the financial management will help the hospital management to make the best decision as well as establishment of how the payment will be done for the machine.
Through maintenance of good health status, the financial institutions help in prevention of medical conditions that would incur huge expenses. This is usually achieved though screening tests for conditions such as cancer and heart disease and to encourage early management of these conditions before occurrence of complications. Finally, they are responsible for managing treatment costs incurred by the clients. Therefore, it is crystal clear that the financial management staff has a role to play in handling the challenges which are posed by some trends in the health care sector (Shanks, 2016).
In handling the new trends in health care, the financial institutions should formulate policies outlining the requirement for all individuals to attend screening services to enhance reduction of costs which would instead be used in management of the diseases in the event they occur (Shanks, 2016). Application of rules, law and regulations will go a long way in enhancing integrity, accountability and transparency and in the long run ensure proper managements are effected.
Contemporary Healthcare Issues Paper References
Bruce K.A, James A, G., Stephen R., George L. & Lesley M.R.(2012). Major challanges in health care ,Johnson’s publishers
Shanks, N. H. (2016). Introduction to health care management. Jones & Bartlett Publishers.
World Health Organization. Preventing chronic diseases: a vital investment. Geneva: WHO, 2012
15 APA REFERENCES IN TOTAL NOT OLDER THEN 5 YEARS. JOURNALS AND ARTICLES ONLY. ALL RESEARCH SHOULD BE VALID IN AUSTRALIA.
NOTE; MY NURSING SPECIALITY IS PERIOPERATIVE NURSING
AS IN EXAMPLE I AM ATTACHING ANOTHER STUDENTS WORK IN SAME SPECIALITY (PERIOPERATIVE) NURSING.
PLEASE GO THROUGH THE DOCUMENTS ATTACHED FOR ALL THE INFORMATION.
ONE FILES HAS QUESTIONS AND MARKING GUIDE.
SECOND FILE HAS READING AND ACTIVITIES FOR THE ASSESSMENT
THIRD FILES IS NNMBA WHICH TELLS THE LEGALITIES WHICH NEEDS TO BE CONSIDERED WHILE MAKING THE ASSIGNMENT
MAKE SURE TO FOLLOW THE MARKING GUIDE.
SAMPLE ANSWER
Peri Operative Nursing
Task 1- Safety issue
Perioperative refers to the practice of surgical procedure where patients experience surgical intervention. Perioperative nurses are tasked with the responsibility of taking care of the patient before, during and after the surgical intervention (Banschbach, 2016). During this time of surgery intervention and care, many safety issues many arise. According to Ford (2012), many safety issues such as emotional, physiological, and sociocultural safety issues may arise during the pre-operative, intra-operative, and post-operative phases of the surgical intervention because of the negligence of preoperative nurses.
Prior to the surgical procedure, perioperative nurses perform a patient assessment to evaluate the nursing care to be given in the operating room and after the patient returns to the nursing unit, or at home. This involves assessing the social, physical, and emotional needs of a patient. From the information obtained, the perioperative nurse can then predict the suitability of the surgical timing for the patient (Ford, 2012). However, studies have shown that during this assessment period, perioperative nurses are bound to making social mistakes that result in social safety issues. According to Steelman et al. (2013) perioperative nurses, at the interaction level with the patients, may fail to actively engage the patient’s family members who can furnish important information about the patient that can help in assessing the social and physical needs of the patient and consequently help in determining the care to be provided. In addition, Robinson (2016) states that sometimes the amount of and length of teaching recommended to a patient by the perioperative nurses is not sufficient enough to prepare the patient psychologically for the surgery type and procedure, leading to psychological safety issue during the intra-operative procedure where the patient can be more anxious and less cooperative.
According to the Nursing and Midwifery Board of Australia (2010), the information from pre-operative assessment helps in determining the surgery site and procedure for a patient. However, incorrect or insufficient information obtained from or about the patient can result in perioperative nurses recommending wrong site surgery for the patient, thereby resulting in physiological safety issue during the surgical intervention (Ford, 2012). Besides, insufficient or inaccurate information from the pre-operative assessment can result in verification errors, scheduling errors, medication error, and patient time-out errors (from the surgical room and out of hospital) (Steelman & Graling, 2013). Thus, wrong or insufficient pre-operative assessment can be a strong basis for physical, emotional, and social safety issues on the part of the perioperative nurses.
Further, according to the Nursing and Midwifery Board of Australia (2010), the information from the pre-operative assessment can be used in settling professional and legal issues concerning the surgical treatment of the patient as it depicts proof of the medical care provided. According to Steelman & Graling (2013), any documents completed by healthcare practitioners during the pre-operative assessment are legal documents and can be demanded by the court during legal proceedings concerning the health care of a patient. Thus, the pre-operative assessment should be undertaken with utmost care and keenness especially documentations such as pre-scribed medication, health care, and surgical areas. Ford (2012) adds that pre-operative assessment is part of the professional duty of perioperative nurses to the patients. And as such, accurate assessment and evaluation is a vital part of nursing practice as it forms the basis for efficient and safe care provided to patients.
References
Banschbach, K. S. (2016). Perioperative nurse leaders and their role in patient safety. AORN Journal, 104(2), 161-164
Ford, A. D. (2012). Advocating for perioperative nursing and patient nursing. Perioperative nursing clinics, 7(4), 425-432
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Robinson, L. N. (2016). Promoting patient safety with perioperative hand-off communication. Journal of PeriAnesthesia Nursing, 31(3), 245-253
Steelman, M., V. & Graling, P., R. (2013) Top 10 Patient Safety Issues: What More Can We Do? AORN Journal, 97(6), 679-701. Retrieved from: https://www.aorn.org/websitedata/cearticle/pdf_file/CEA13517-0001.pdf
Steelman, M., V., Graling, P., R., & Perkhounkova, Y. (2013). Priority patient safety issues identified by Perioperative nurses. AORN Journal, 97(4), 402-418
Task 2: Patient confidentiality and ethics in nursing
In their line of duty, perioperative nurses are bound to the duty of confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient is at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals. With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care. The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.
Additionally, in situations where the health condition of the patient deteriorates, health professionals find themselves in a dilemma state with regards to protecting the patient’s privacy whilst addressing the carers’ concerns about the patient’s condition (Price, 2015). For instance, patients that have undergone brain surgery are often mentally and physically unstable because of the nature of the surgery and as such are not in a position to interact with family as well as make important decisions concerning their health information, which could be confidential. At the same time, the patient’s family members might request to know about the health condition of the patient, being unaware and unfamiliar of the hospital procedure and policies and health care code of ethics regarding the application of confidentiality in their context (Ulrich et al., 2010). In this situation, disclosing the patient’s confidential health information to the family members can be a complex task. Thus, the nurse must obtain the patient’s permission about the information that can be shared, to who and under what circumstances to minimise possible misunderstanding with family member(s) as well as evade possible legal implications accompanying such (Olson & Stokes, 2016).
According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014). Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016). For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether. In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).
References
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20
Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.
Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68
Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41
Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11). doi: 10.1111/j.1365-2648.2010.05425.x
Task 3: Reflection
The perioperative period includes various processes and procedures that bring about multiple and challenging changes to a patient (Nursing and Midwifery Board of Australia, 2010). A major surgical intervention is accompanied with multiple stressful components such as worries about survival, length of admission to hospital, one’s physical condition after the surgery, separation from the family, and the financial implication, factors that significantly impact on a patient’s recovery (Gouin and Kiecolt-Glaser, 2012). For example, based on my reading, the patient revealed that during pre-operative phase, he experienced psychological stress and anxiety brought about by the thoughts of fear of death, physical deformity related with the surgical intervention, longer stays in the hospital, longer recovery period, and the cost of the whole surgical procedure and care. He affirmed that the fear, anxiety and stress slowed his recovery (Hudson & Ogden, 2016).
The physical environment of a patient such as lights and sounds can also affect a patient’s recovery (Nelson, et al., 2016). The patient also described the sounds from the equipment and people in the vicinity of the recovery unity as having affected his sleep and sensory, occasionally bringing back the thought of the surgery procedure. This deprived him of emotional peace. Besides, the patient described his confinement to the hospital bed in the recovery unit under the extensive monitoring machines as a painful and scary experience that distressed him (Hudson & Odgen, 2016). According to Gouin and Kiecolt-Glaser (2012), pain and distress during perioperative period can be influenced by emotions triggered by the physical environment factors result in physical changes in a patient, thus slowing his recovery period.
Surgery also results in inability on the patient. During the perioperative period, a patient is unable to engage in certain duties, responsibilities and activities. This leads them to have low self-esteem and feels insecure (Marks, 2015). The patient also described that during his recovery period, he experienced sudden changes in his social and family life as he could not return immediately to his normal life and perform the duties he valued most. This made him loose sense of self-esteem and raise insecurity concern on his part. Besides, having to live with a life-changing diagnosis for the rest of his life was traumatizing and frustrating altogether as it was associated with some form of isolation from friends and family. Nonetheless, he acknowledged the contribution of his carers (immediate family and clinicians) who gave him hope in life (Hudson & Ogden, 2016).
Having read the patient’s experience, I have come to appreciate the need for social and spiritual support for a patient undergoing major surgical intervention. The social support is crucial for enabling the patient understand the aftermath implications of the surgery and consequently prepare him on how to live with it. Spiritual support offers the needed help to a patient to have hope in life again during and after the surgery and treatment procedure (Hudson & Ogden, 2016). Conclusively, I have come to understand the need for perioperative nurses to understand the possible implications of the illness from the patient’s perspective to facilitate their recovery and offer the needed emotional support during their recovery period (Nelson et al., 2016).
References
Gouin, J., & Kiecolt-Glaser, K., J. (2012). The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Immunol Allergy Clin North America, 31(1), 81-93
Hudson, B., F. & Ogden, J. (2016). Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery- A Systematic Review and Meta-Analysis. Journal of PeriAnesthesia Nursing, 31(2), 118-133
Marks, R. (2015). Non-Operative Management of Knee Osteo-arthritis Disability. International Journal of Chronic Diseases & Therapy (IJCDT), 1(2), 9-16
Nelson, G., Altman, A., D., Nick, A., Meyer, A., L., Ramirez, P., T., Achtari, C., Antrobus, J., Huang, M., S., Wijk, L., Acheson, N., Ljungqvist, O., & Dowdy, C., S. (2016). Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery after Surgery (ERAS) Society Recommendations- Part 1. Gynecologic Oncology, 140(2), 313-322
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
We can write this or a similar paper for you! Simply fill the order form!
Healthcare Nursing Diagnosis Label or Patient Problem Order Instructions:
Healthcare Nursing Diagnosis Label or Patient Problem
Module 3
Each student will be assigned by the instructor to one (1) of the two (2) patient scenarios below for their initial post. Check the Course Announcements for your assignment.
Scenario 1
A 25-year-old Arab American man is one-day post-op following an appendectomy. There have been no post-surgical complications. He tells his family that he is “in terrible pain”, yet he reports ratings of 2 to 3 on 0-10 numeric rating scale to the nursing staff. He requests pain medication every two to three hours, and will not get out of bed or ambulate.
Scenario 2
A 60-year-old African American woman with metastatic ovarian cancer is experiencing chronic pain. Her pain ratings have been between 3 and 7 on the 0-10 numeric rating scale. Her vital signs remain within normal ranges. She is fully able to participate in her daily care. She describes herself as the matriarch of her family and looks forward to daily visits from her family even when her pain rating is high. Her church pastor calls and visits her several times per week. She anticipates discharge in a few days
Initial Discussion Post on Healthcare Nursing Diagnosis Label or Patient Problem
For your assigned scenario, address the following:
Identify and state a priority nursing diagnosis label for your assigned patient related to pain.
Develop and state three (3) nursing interventions for this nursing diagnosis label or patient problem. When planning individualized nursing interventions, consider the patient’s type of pain and cultural perspective.
Provide your rationale or reasoning for each intervention chosen.
Healthcare Nursing Diagnosis Label or Patient Problem Sample Answer
Health care providers are charged with the responsibility of ensuring that patients who have gone through surgical procedures have a faster return to their normal activities. To achieve this, the clinicians should have a clear outline of the priorities required for patient management. For patients that have been through an appendectomy such as the 25- year old Arab American presented in the case study, their care priorities include prevention of complications that are arise after surgical procedure such as infections, ensuring that they are comfortable through pain management, and providing them with essential information regarding the surgical procedure its prognosis, treatment as well as the potential complications that may come about.
Healthcare Nursing Diagnosis Label or Patient Problem
One of the nursing intervention that should be tailored for the patient presented in the case study is the management of the postsurgical pain. This intervention will involve assessing the patient’s pain, its location, and its severity on a scale of 0-10 (Pantaleao et al., 2015). Abdominal pain should be managed through the periodic placement of an ice bag on the abdomen for the first 24-48 hours after the procedure. This aids in soothing and relieving pain through nerve desensitization. Opioid analgesics such as morphine or codeine should also be administered to the patient. These are an effective agent for pain management although the patient should be monitored closely so that he does not develop tolerance or dependence of the drugs.
Healthcare Nursing Diagnosis Label or Patient Problem
Patients who have gone through appendectomy are also at the risk of developing deficient fluid volume. Pantaleao et al., (2015) enlighten that this arises mainly due to peritoneal inflammation which tends to sequester fluid. As an intervention, clinicians should provide the patient with clear liquids in small amounts after he has resumed his oral intake and also progress diet as tolerated. This is indicated in order to minimize the risk of gastric irritation and vomiting that cause fluid loss. In severe cases, the patient can be administered with IV fluids as well as electrolytes. This is recommended since it promotes rehydration and electrolyte balance.
Healthcare Nursing Diagnosis Label or Patient Problem
The other intervention for postsurgical patients is the prevention of infections which they are usually prone to. This can be done through monitoring of vital signs such as chills, fever, mentation changes, and patient reports on increased pain in the abdomen. This is an essential procedure because it provides an indication on the presence of abscess, sepsis, or peritonitis which is then managed accordingly in the right time.
Healthcare Nursing Diagnosis Label or Patient Problem Reference
Pantaleao, A., Karamessinis, L., Cooper, J., & Manworren, R. (2015). (108) Monitoring home pain management after laparoscopic appendectomy. The Journal of Pain, 16(4), S3.
1. Obtain an article from the New York Times, either the Science Times on Tuesday or another New York Times article from the last six months. The topic could be on a science innovation that impacts patient care or an article about what is happening with the Accountable Care Act (ACA otherwise known as Obamacare).
2. Copy the article and submit it with your paper.
3. The one page paper on the article must be written in APA format.
4. Here are some guidelines for the paper
a. Typed, with 1 inch margins, double-spaced in Times New Roman with a font size of 12
b. Include a cover page with Title of the paper and the author
c. The paper must be 1 page in length with 3 – 4 paragraphs
i. Paragraph 1 – Brief synopsis of the article
ii. Paragraph 2 – Three major points of the article
iii. Paragraph 3 – 4 – How the information impacts your work as a nurse, or the profession of nursing or the transformation of health care in our country
5. APA formatting
a. Type in Insert header a running head to include the title and page number
b. Cite the newspaper article at the bottom of the pager, use APA standard for citations
c. In the body of the paper include the correct citation for in-text citation
d. Use this link or other APA resource as a reference for correct citation of a newspaper article http://libguides.adelphi.edu/content.php?pid=356752&sid=3474108
6. Other
a. DO NOT PLAGIARIZE, use paraphrase to write the paper.
b. This is an individual assignment; do not copy from each other.
7. Grading Rubric
APA format for citations, cover page, running head 2 pts
Synopsis of article 2 pts.
Three major points of article 3 pts.
How the information impacts nursing/health care 3 pts. 10 pts
SAMPLE ANSWER
Title: What is happening with the Accountable Care Act
Student Name
Institution
Date
Synopsis
In the article on the New York Times by Paul Krugman, Obamacare is facing a serious challenge due to the inability of the supporting private insurance firms to offer their support. The anticipated intake of the insurance cover by the Americans has overwhelmed the private insurance companies supporting Obamacare and thus a significant challenge to Obamacare. This article presents the challenge with the Accountable Care Act despite there being many benefits and positive stories about the scheme (Krugman, 2016).
Three major points of the article
Despite the successes of Obamacare (Accountable Care Act), a political challenge looms. The election year in progress offers a significant challenge to the Accountable Care Act because the president’s legacy is tarnished by the Republican candidates as well as the party. This is why the fact that companies such as Aetna pulling out will definitely be a blow to Mr. Obama and his successor at the Democratic party candidature; Hillary Clinton.
The article brings out the success of Obamacare despite very high skeptics on the care program. The Obamacare scheme was expected to be very expensive and taxing on the American citizens but instead; this has not been the case. The scheme has operated for more than two years and indeed, more than 20 million Americans have benefited from the scheme. This was unprecedented.
There seems to be a deliberate scheme to frustrate the Accountable Care Act. Many states have alternative care programs aside from the expanded Medicaid and indeed, will likely not support the program when major donors pull out. Instead of making it affordable for the Americans to afford care, they are hiking the cost of insurance as a response to Americans pulling out of Obamacare.
Impact to nursing career
The article points out that the health care sector should often consider the cost of healthcare with regard to the duty of care. The article on Obamacare has led to the provision of quality services at affordable costs. Obamacare may not have solved all of America’s problems but it did bring about major hospital reforms (Oberlander, 2012). Regardless, the challenges with Obamacare may lead to a backlog of patient record processing especially with regard to payments.
Proposal in Healthcare Access Problem Order Instructions: Search for proposal(s) by your state(ARIZONA) governor to deal with a health care access problem and write a paper of 1,250?1,500 words that outline the elements of the current program and the governor’s proposals for improved access.
Proposal in Healthcare Access Problem
A minimum of three scholarly sources must be cited. Prepare this assignment according to the guidelines found in the GCU Style Guide located in the Student Success Center. This assignment uses a grading rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
1
Unsatisfactory
0.00%
2
Less Than Satisfactory
65.00%
3
Satisfactory
75.00%
4
Good
85.00%
5
Excellent
100.00%
80.0 %Content
80.0 % Content (80%)
Content is incomplete and omits most of the requirements stated in the assignment’s criteria. Major points are irrelevant to the assignment. No outside sources were used to support major points. Content is incomplete or omits some requirements stated in the assignment’s criteria. Major points are not clear and/or not persuasive. No outside sources were used to support major points. Content is adequate and meets most of the requirements stated in the assignment’s criteria. Major points are addressed. Research is evident. Content is comprehensive and accurate, definitions are clearly stated. Major points are stated clearly and are supported. Research is adequate, up to date, relevant, and addresses all of the issues stated in the assignment’s criteria. At least two relevant academic sources were cited. Content is comprehensive and accurate; definitions are clearly stated. Major points are stated clearly and are well supported. Research is adequate, up to date, relevant, and addresses all of the issues stated in the assignment’s criteria. Three or more relevant academic sources were cited.
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; the purpose is not clear.
Thesis and/or main claim are apparent and appropriate to the purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. The organization is disjointed.
Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.
Paragraphs are generally competent, but ideas may show some inconsistency in the organization and/or in their relationships to each other.
A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to the purpose.
There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.
Some mechanical errors or typos are present but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
The prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
The writer is clearly in command of standard, written, academic English.
3.0 %Format
1.0 % Paper Format (use of appropriate style for the major and assignment)
GCU template is not used appropriately or documentation format is rarely followed correctly.
GCU template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
GCU template is used, and formatting is correct, although some minor errors may be present.
GCU template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
2.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)
No reference page is included. No citations are used.
The reference page is present. Citations are inconsistently used.
The reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.
The reference page is present and fully inclusive of all cited sources. Documentation is appropriate and GCU style is usually correct.
In-text citations and a reference page are complete. The documentation of cited sources is free of error.
100 % Total Weightage
Proposal in Healthcare Access Problem Sample Answer
In recent times, it is essential to come up with effective strategies or proposals to improve the operations in the health sector. Adoption of these measures impacts the health sector positively by ensuring improved access to health care services to all people. The need to improve the type of health care received by the people has prompted the various states to come up with effective policies and proposals that lead to positive outcomes (Sommers et al, 2012). The health systems of different states have been designed to suit the best strategies and proposals forwarded and implemented in the best possible way. Arizona is among the many states that seek to modernize its Medicaid programs. In this case, the governor of Arizona State has taken that initiative to come up with the proposal and plans to enhance better access to healthcare. The governor gave a proposal of the AHCCCS care program that would revolutionize the health sector in Arizona. The major problem faced by the state is inadequate healthcare services that do not fit or attain the requirements of a modernized Medicaid program (Sommers et al, 2012). The plan unveiled by the proposal would, therefore, address the problems of health care access effectively.
The proposal by the Governor helped modernize and make major improvements to the AHCCCS Medicaid program of Arizona which has plans on addressing the issue of access to healthcare. During the proposal for the Medicaid program plan, various elements were identified to compose the care plan. The program focuses on various elements such as engagement, choice, responsibility, and accountability. The AHCCCS program resulting from the Governor’s proposal also focuses and aims to achieve some set objectives to revolutionize the healthcare sector (Jacobs & Callaghan.2013). Some of the issues focused on by the program include promoting quality of healthcare at subsidized costs, encouraging wellness, increasing individual responsibility and expansion of health technology. All these issues focus on ensuring better access to healthcare services in the Arizona state addressing the problems. The governor identified health costs as a major issue hindering the accessibility to health care services among the people in the state. In this case, the governor was of the opinion that the program should address the issue and ensure that the healthcare provider is quality and cost-effective in nature (Jacobs & Callaghan, 2013).
Through the program, people would be able to receive enhanced services not offered by the Medicaid program currently and allowing them to take charge of their individual health. The program also ensures the full protection of taxpayers in the state from fraud and rewarding individual responsibility with the aim of eliminating abuse in the health system (Jacobs & Callaghan, 2013). The steadfast commitment to focus on the vulnerable and provision of quality care for those in the state is essential when making plans for the program. Such measures are considered very innovative and help in solving the health care access problems experienced in the state by its residents. The Governor’s plan also helps promote access to health care services by allowing people to carry their savings from their account with them while moving from the Medicaid program (Blumberg et al, 2013). The strategies would help the easier transition of people in the state wanting to move to the private insurance companies from the Medicaid program. Individuals would thus be able to join the co-pays and deductibles world thus eliminating the possible problems and hindrances of health care access that are experienced in the Medicaid program.
The Governor would collaborate with the AHCCCS program in ensuring a modernized approach to communications is adopted in the health system of Arizona. The approach would be enhanced through innovative technology. The strategy would ensure patients get access to management tools for their chronic diseases and also manage aspects of urgent care online while interacting with primary care doctors (Blumberg et al, 2013). Such features of the proposal and plans for the program enhances better management of illness and accessibility to care, providers. The timely care is also made possible while patients in Arizona are protected from paying for appointments that are constantly missed while seeking healthcare services. Affordability of care and ensuring the quality of care is fundamental to improving the accessibility of healthcare and also its transformation in the Arizona state. The Governor proposes and implements the plan that encourages people to be proactive in nature while in the healthcare system of Arizona (Blumberg et al, 2013).
The Governor’s proposal to have a plan involving making changes on Arizona health system through cost containment would make it possible for the residents to access the services which were previously hindered by high costs (Sommers et al,2012). The Medicaid plans have ensured that residents of Arizona that live on a low-income would be covered as compared to previous times where they were left out. The proposal and plans have made it possible to cover even those below the poverty level through the elimination of spend-down category which cost the residents high medical bills thus limiting their access to healthcare services. The provision of care to those who need it most and having a responsible Medicaid program as proposed by the Governor would have positive impacts in the health sector (Sommers et al, 2012). In a nutshell, the effective implementation of plans would improve access to healthcare services for the residents of Arizona State.
Proposal in Healthcare Access Problem References
Blumberg, S. J., Ganesh, N., Luke, J. V., & Gonzales, G. (2013). Wireless substitution: state-level estimates from the National Health Interview Survey, 2012. National health statistics reports, (70).
Jacobs, L. R., & Callaghan, T. (2013). Why states expand Medicaid: Party, resources, and history. Journal of Health Politics, Policy, and Law, 38(5), 1023-1050.
Sommers, B. D., Baicker, K., & Epstein, A. M. (2012). Mortality and access to care among adults after state Medicaid expansions. New England Journal of Medicine, 367(11), 1025-1034.
Mike, a 35-year-old, was brought via ambulance to the emergency department after collapsing on the street. He was diagnosed with appendicitis and the surgical team was alerted to the potential surgery. The physician prepared to obtain informed consent and began discussing the simple effective surgery and the treatment with the patient. The RN was present at the bedside. The patient stated he did not want surgery. Based upon his beliefs as a Christian Scientist, it is against his practices. He requested a Christian Science practitioner. The patient rated his pain as 9 on 0-10 verbal pain scale so the RN prepared the narcotic analgesic to relieve the patient’s pain. The patient declined the medication. The RN believes the patient should accept the pain medication and have the surgery thinking “If it were me I would proceed with the surgery and treatments proposed by the surgeon.” The surgeon can be heard speaking to a colleague about how to go about changing the patient’s decision.
Initial Discussion Post:
Address the following:
1.State and discuss the legal and ethical considerations occurring in this scenario. Include supporting citations.
2.How can RNs support the patient’s decision when the beliefs of the patient are contrary their own? List three (3) interventions, with supporting rationales, the RN would perform to ensure the delivery of culturally sensitive care.
3.Identify one (1) additional major religion, in which the same circumstances might also require the RN to advocate for the patient’s refusal of surgery. Describe the beliefs behind why the identified religion could pose a moral conflict for a similar patient.
SAMPLE ANSWER
Legal and ethical consideration
In this case study, there is conflict between the nurse ethical responsibilities to her patient, legal responsibility to her employer and legal duty to the physician; which exposes the RN to professional risk. This is a challenging situation as there is inadequate guide in resolving such kind of dilemmas. For instance, the nursing standards and law are vague about rights to ethical decisions made by RNs. The code of ethics does not offer legal protection to RN who works as patient advocate (Hunt, 2013).
In this case, the role of the nurse is to remain cultural competent. The RN must respect the patient decision even when the patient’s decision is irrational or wrong. The RN should advise the patient about their clinical opinion without putting pressure on them to accept the RNs advice. While doing so, the RN should be careful not to use words and actions that disrespect the patient values and beliefs (Hinkle & Cheever, 2013).
RNs support to patient decision
The RN can offer support to patient’s decision by (Taylor, Lilis, LeMone, & Lynn, 2011);
Being an active listener
This is important as it helps establish mutual relationship and trust to the RN. It is a way for RN to show their concerns to the patient. The RN should ask the patient about their understanding of the health condition, which will help RN to address any misconceptions.
Explain medication detail
Most of the healthcare medical terms are jargons to ordinary people. It is important to discuss all the details associated with the medication, his risk level and programs which could help with the patient cost management and coping strategies.
Explore alternative approaches
Some of the patients could be comfortable to seek alternative medication such as herbal remedies or traditional healers. The RN must be thoroughly informed about the alternative medication because some of the treatment could be harmful. If considered as an alternative, the nurse can refer the patient to a certified practitioner. In Some cases, religious rituals such as prayers can be integrated into practice.
Example of major religion
An example of a religion that could possibly be holding similar doctrines is Muslim religion. Devout Muslims can reject medication containing alcohol such as those used during the peri-operative procedures, or medications made from pork derivatives. In medical situations which are not of emergency, the RN should educate the patient, but help them preserve their values and believes (Smith, 2013). This includes exploring other beliefs that do not contradict to their beliefs. These small accommodations could pay off the patient emotional well-being. Therefore, to remain culturally competent care, the RN must perform cultural assessment in order to understand their perception of illness and wellness (Kee, Hayes, & McCuistion, 2015).
References
Hinkle, J., & Cheever, K. (2013). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Hunt, R. (2013). Introduction to community based nursing (5th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). St. Louis, MO: Elsevier.
Taylor, C., Lilis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and science of nursing care (7th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Smith, L. (2013). Reaching for cultural competence. Nursing, 43(6), 30-38.
We can write this or a similar paper for you! Simply fill the order form!
Patient Protection and Affordable Care Act Please provide feedback on why you agree with this statement.
Patient Protection and Affordable Care Act
According to the American Nurses Association (ANA) Health Reform website, the passage of the Patient Protection and Affordable Care Act (PPACA), will affect millions of Americans. It will protect patients from being denied health insurance coverage because of pre-existing conditions and will give them better
access to preventative and primary services (American Nurses Association, 2017). Because nurses are the most trusted profession among clinicians, there is a great need for them to aid patients in accessing care and navigating the healthcare system. One way that nurses can help is in educating patients about provisions of the law. For example, inform that starting in 2016 patients will not be denied medical coverage because of a pre-existing condition. In
addition, educate them that free Medicare preventative services will be expanded and free preventative services to all women will be included. In addition, adult children up to age 26 will be included in their parent?s policies (American Nurses Association, 2016). Another way nurses can aid the public in this process is to encourage the uninsured to enroll in a health plan that meets their needs in the Health Insurance Marketplace (American Nurses Association, 2013). Start communicating with the young adults about their options and encourage them to sign up as well. I believe that one population that might have a problem in getting enrolled in the health plans are those who do not have experience using the web. Many local libraries are offering classes to aid communities in enrolling online. For example, the Cumberland County Library in Fayetteville, NC had a few events last year to teach the public about PPACA and how to sign up for health insurances. Nurses can make a crucial impact on the success of the PPACA initiave and continue to aid patients in their medical care.
American Nurses Association, Health Care Reform (2017). Keeping Health Care Healthy, Patients Informed. Retrieved from https://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/HealthSystemReform/Health-
Increasing PharmaceuticalCopayments This is your first teamwork assignment. Below are the instructions: Only need question #1 and #2 only. Other classmates will do #3 and #4 and conclusion.
Over the past few weeks, we have been reading and discussing the financing of healthcare. Some concepts tied closely to financing healthcare are a risk, demand, and elasticity. We have reviewed all these in our readings. So, now it is time to apply what we have learned!
In Week 5 you will find a link to this article: Campbell, J., Allen-Ramey, F., Sajjan, S., Maiese, E., and Sullivan, S. (2017) “Increasing Pharmaceutical
Copayments: Impact on Asthma Utilization and Outcomes. American Journal of Managed Care, v 17 n 10, pp 703-710.
AS A TEAM: Read the article and post a two – three-page analysis of the article. The analysis should include (1) a summary of the article, (2) identification
of the issues of risk for the pharmaceutical company AND for the patients, (3) a discussion on the impact of change in copayments on the increase or decrease
in demand (you may also want to touch on whether the need for the medication and available supply is impacted if demand is…l) and (4) an analysis of what
this article tells us about the elasticity of clinically recommended medication. Conclude your analysis with your thoughts on this: does medical necessity
make a service or product elastic or inelastic? Is demand ever stable in healthcare? If you are running a hospital, why are these questions important?
Your analysis should be clearly written and succinct. You can use bullet points and text. I am looking for original thought and analysis. What seems like a
basic article on utilization should give us a few insights into risk, demand, and elasticity. Let’s hear your point of view! Please make your document
cohesive. Grammar and spelling are important – so please edit before posting.
