U.S. Health Insurance Portability and Accountability Act
U.S. Health Insurance Portability and Accountability Act (HIPAA)
Order Instructions:
formed Consent
The concept of informing participants of what they participating in during a research study along with informing them of all possible side-effects, or outcomes, of their participation has only been in place for the last 50 years. The Declaration of Helsinki was the first documentation to state that any research involving humans needs to include informed consent of participants.
Review the historic perspective studies listed in this week’s reading. Then summarize one of the following explaining its role in the development of ethical research practices:
U.S. Health Insurance Portability and Accountability Act (HIPAA)
Jesse Gelsinger – Gene Therapy Trial
Ellen Roche – Asthma Study
SAMPLE ANSWER
U.S. Health Insurance Portability and Accountability Act (HIPAA)
The following discussion will indulge in examining the role of U.S. Health Insurance Portability and Accountability Act (HIPAA) in the development of ethical research practices. One of the roles of HIPAA in the development of ethical research practices is enhancing education of health care researchers and patients. HPPAA suggests that the ability to share patient information across the continuum of health care increases the responsibility to protect that information. According to Nass, Levit, Gostin and Institute of Medicine (U.S.) (2009), not only should patients be informed about the practices for the use and disclosure of their information, but they must also be given written consent to use and disclose the information for treatment, payment and health care operations. Another role of HIPAA in development of ethical research practices is protection of patients involved in the research from harm and preserving their rights as an essential to ethical research practice (Nass, Levit, Gostin & Institute of Medicine (U.S.), 2009). This is because ethical health research is vital to improving human health and health care. Therefore, HIPAA requires research to obtain individual authorization in all situations where the individual to be studied may want to disclose information for the research.
HIPAA also has a role in developing ethical research practices by condemning discrimination and all other vices in conduction health care research. In fact, HIPAA provides that ethical research practice can only be felt if strict punishments are offered to those researchers who do not abide by the provisions of HIPAA and Privacy Rules (Grove, Burns & Gray, 2013). HIPAA dictates that failure to observe the set standards in research can lead to severe civil or criminal penalties, which can be as high as $250,000, and/or prison terms of 10 years for those who sell, transfer, or use individually identifiable health information for commercial advantage, malicious harm, or for personal gain.
Reference
Grove, S. K., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence. St. Louis, Mo: Elsevier/Saunders.
Nass, S. J., Levit, L. A., Gostin, L. O., & Institute of Medicine (U.S.). (2009). Beyond the HIPAA privacy rule: Enhancing privacy, improving health through research. Washington, D.C: National Academies Press.
We can write this or a similar paper for you! Simply fill the order form!
A 45-year-old wife of one of the staff physicians was admitted to the emergency room. She is intoxicated and loud. Her husband wants her admitted to the psychiatric unit. He has asked to have two other physicians that are his friends to sign the paper work to admit her. In New York State where the hospital is located two physicians can admit a patient against their will if they are a danger to themselves or others. You happen to be a neighbor and know that the couple is going through a divorce and the husband wants custody of the two children. You also know he is dating a nurse on another unit.
Differentiate between the ethical and legal implications of her admission. What actions will you take? Support your decisions with legal reasoning and case law.
Resources
Textbook Reading:
Essentials of Nursing Law and Ethics
Chapters
• Chapter 20: “Abusive Situations”
• Chapter 21: “Reproductive Services”
• Chapter 22: “Restraints”
• Chapter 23: “Emergency Psychiatric Admissions”
• Chapter 24: “Organ and Tissue Donation and Transplantation”
• Chapter 25: “Discharge Against Medical Advice”
SAMPLE ANSWER
Clinical Criteria for Determining Danger to Self
A divorce is defined as a court’s ruling to end a marital contractual agreement between marriage partners which exempts them from performing their marital obligations. In the United States, divorces are categorized in two forms: absolute divorce, which is also referred to as divorce a vinculo matrimonii, while the other is a limited divorce also known as divorce a menso et thoro (Kjervik & Brous, 2010). These forms of divorces are determined by various circumstances, for example, absolute divorce occurs when there is evidence showing misconduct or wrongdoing of either marriage partners. In this case, the facts show that the wife of the physician had taken some toxic substances harmful to her personal health and in addition, she was loud. Westrick and Dempski, (2008) argues that stressful situations such as divorces could make people depressed or suicidal. The woman in question must have developed depression and this is an equivalent of a psychiatric case. This means that the patient is dangerous and is at risk of harming herself as a result, she could have posed a serious danger to the other patients in the emergency room. Based on this argument, it becomes legal for the staff physician to convince two other physicians to sign the medical papers. The action is justifiable and of utmost good faith, hence ethical and legal ‘per se’.
Patients suffering from depression after a painful divorce are bound to abuse drugs in a suicidal attempt thus making them violent and at times loud but this again does not justify the reason for taking the patient to a psychiatric unit (Johnston & Roseby, 2007). Apparently, the husband to the patient wants to use the documents as prove that the wife has mental retardations so that he gains a leverage during the court proceeding. This will definitely be in his favor as he will be given the custody of their two children on the ground of the other party being mentally unfit. Such a case is reported in Laznosky v Lasnosky, where the Maryland Court of Appeal ruled in favor of the husband since the wife had been declared mentally unfit to retain the custody of their children (Kjervik & Brous, 2010). Even though the intentions of the husband might be malicious and heavily inclined towards his position as a staff physician, the wife can still put up a strong case protesting against her medical condition and she can still be considered to take custody of their two children. But again, assuming that the actions of the husband were in good faith, then it is legal, moral and ethical to take precautions when handling a patient who is intoxicated and loud.
Ackerman, (2006) elaborates that the directives for handling such patients require medical practitioner to take a clinical assessment of the patient after which the physicians can sign a form stating which unit to put the patient, either in accordance or as opposed to their will. Such an action is completely legal. On the other hand, it is unethical to infringe the rights of the patient as they have the privilege of deciding what is suitable for them. In fact the law states that it is unlawful to forcefully admit or detain a patient. The same case scenarios apply to contracts formed without the consent of the contractual parties. According to the rule of law, mental illness is not proof enough to be denied custody of the children during divorce because the children too have the legal obligation and a right to select a custodian parent (Schoenly & Knox, 2012). As a good neighbor, I second the physicians’ decision to take his wife to a hospital facility to get medical attention. However, the decision to confine her in the psychiatric unit is malicious. Based on this arguments balancing between ethics and legality of the admission process, I would advise that the patient be taken to an emergency unit so that the husband does not get a chance to use the medical documents to his advantage in the court proceedings.
References
Ackerman, M. (2006). Clinician’s Guide to Child Custody Evaluations. New York: John Wiley & Sons.
Johnston, J.R., & Roseby, V. (2007). In the name of the child. A developmental approach to understanding and helping children of conflict and violent divorce. New York: Free Press.
Kjervik, D. & Brous, A. (2010). Law and Ethics in Advanced Practice Nursing. London: Springer Publishing Company.
Schoenly, L. & Knox, C. (2012). Essentials of Correctional Nursing. Springer Series. London: Springer Publishing Company.
Westrick, S. & Dempski, K. (2008). Essentials of Nursing Law and Ethics. New York: Jones & Bartlett Learning.
We can write this or a similar paper for you! Simply fill the order form!
Upon reflection of this course, consider what you can do as a social change agent and scholar-practitioner. This class has challenged you to think beyond the individual-level influences of biology, behavior, and harmful organisms to embrace a broader perspective on health for populations. You have repeatedly seen how social determinants influence health of populations. That understanding carries an implicit challenge: What can you do as a scholar-practitioner?
Objectives
Students will:
• Compare two countries and their health problems
• Compare social and economic determinants for countries
• Analyze relationship between social and economic determinants in countries
Discussion, examine countries and their health problems.
A brief summary comparing the two countries and their health problems. Also, compare how the economic level and income inequality in each country influenced other social determinants (social dynamics, the status of women, education, or violence/homicide, etc.) for each country. Then, explain the impact of the determinants on the health outcome in each country. Expand on your insights utilizing the Learning Resources.
Please use a least 6 or the Articles below:
1. Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press.
-Chapter 10, “Violence: Gaining Respect” (pp. 129–144)
-Chapter 16, “Building the Future” (pp. 235–272)
2. Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: Historical roots of current public health challenges. Lancet, 374(9692), 817–834.
Retrieved from the Walden Library databases.
3. Biggs, B., King, L., Basu, S., & Stuckler, D. (2010). Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America. Social Science & Medicine, 71(2), 266–273.
Retrieved from the Walden Library databases.
4. Kyobutungi, C., Egondi, T., & Ezeh, A. (2010). The health and well-being of older people in Nairobi’s slums. Global Health Action, 3, 45–53.
Retrieved from Walden Library databases.
5. Norman, R., Schneider, M., Bradshaw, D., Jewkes, R., Abrahams, N., Matzopoulos, R., & Vos, T. (2010). Interpersonal violence: An important risk factor for disease and injury in South Africa. Population Health Metrics, 8, 32–43.
Retrieved from the Walden Library databases.
6. Rudan, I., Kapiriri, L., Tomlinson, M., Balliet, M., Cohen, B., & Chopra, M. (2010). Evidence-based priority setting for health care and research: Tools to support policy in maternal, neonatal, and child health in Africa. PLoS Medicine, 7(7), 1–5.
Retrieved from the Walden Library databases.
7. Shelton, J. D., Cassell, M. M., & Adetunji, J. (2005). Is poverty or wealth at the root of HIV? Lancet, 366(9491), 1057–1058.
Retrieved from the Walden Library databases.
8. Spiegel, J. M., & Yassi, A. (2004). Lessons from the margins of globalization: Appreciating the Cuban health paradox. Journal of Public Health Policy, 25(1), 85–110.
Retrieved from the Walden Library databases.
9. African Population and Health Research Center. (2011). Retrieved from http://www.aphrc.org/
10. Pan American Health Organization. (n.d.). Retrieved February 13, 2014, from http://new.paho.org/
11. The World Bank. (2014). Countries and economies. Retrieved from http://data.worldbank.org/country
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.
SAMPLE ANSWER
Practicing Public Health
Different countries face varied health problems. Kenya and South Africa are examples of the countries, which both share similar and different challenges when it comes to health matters. HIV/AIDS is a major problem facing at least 7 percent of Kenyan population, hence, affecting its development directly. The spread is rampant due to inadequacy of medical facilities and lack of funding making access to antiretroviral a tall order. Another health problem in Kenya is malaria where more than 70% of its population is susceptible to this disease. Besides all the diseases that cause death in Kenya, car accidents are still major perpetrators, where Kenya comes first before South Africa. Maternal mortality is another challenge in Kenya where women die while giving birth, as well as tuberculosis, which is also a leading cause of death (Biggs et al., 2010).
Health problems in South Africa are equally a big challenge. The people are provided with healthcare through the public hospitals and private hospitals. However, the public health system serves most of the citizens despite the fact that it receives very little challenges and is also underfunded. HIV/AIDS is a life-threatening problem in South Africa with more than 5.6 million people having contracted the disease. In addition, national insurance system is facing problems since there is unequal access to healthcare amongst different socio economic groups. Water and sanitation is another huge challenge facing the South Africans. Majority of the people are unable to access clean water. On average, 15 million people are not supplied with clean water. This has resulted into reports of diarrhea in children and outbreak of cholera. The people in South Africa live an average of 49.56 years. Besides all these health problems, some other contagious diseases in South Africa are Bacterial Diarrhea, Typhoid Fever, and Hepatitis A. Another health problem in South Africa is mental illness. Majority of the adults (16.5%) are suffering from a very serious mental problem. Some of the factors leading to mental problems in South Africa include excessive use of drugs. Other predisposing factors to mental problems include malaria, typhoid, fever, and HIV, which contribute to a large extent to the mental problem.
Economic level and income inequality in Kenya and South Africa has influenced social determinants like social dynamics, the status of women, education and violence/homicide. The South African general population is made up of all races hold a view that women in the society are less important. The men ever since time in memorial believes that women are not supposed to hold any position in the society hence are economically disadvantaged. In Kenya, all the important sectors that control the economy of the country are controlled by men. Not long ago, women were made to walk or keep distance behind men in some places as a sign of obedience. The women have, therefore, been subjected to so harsh conditions in that they have to ensure that basic needs are provided in the family a role that should be played by men.
In South Africa, Income differentials are a phenomenon that is manifest among individuals, regions and nations. The high presence of inequality in the society has had far reaching implications on the provision of education. Education is the main determinant of someone s economic status since without education one cannot access any professional job hence low income. This problem of Income inequality is manifested mostly in uneven and unequal access to education by majority of the people or to some extent access to very poor quality of education (Spiegel & Yassi 2004). Consequently, this leads to so much ignorance in the general public due to lack of information. These factors heighten the already existing inequality since the distribution of earnings is to a large extend determined by the level and distribution of schooling across population. In Kenya, inequality in income has led to variation in different class of people in terms of education, hence, poor economic growth, which eventually affects the country and the people at large due to poverty (Rudan et al., 2010).
In both Kenya and South Africa, poverty levels determine crime rates since they are the more invisible barriers to crime set up by social norms and social cohesion. Poverty leads to loss of trust in the government, hence, increase in criminal activities. It is, therefore, directly related to crime and prostitution in the society, which leads to various health problems. In Kenya, poor people have fewer cases of obesity and use of drugs. In South Africa, the children of poor parents have a significantly lower chance of becoming wealthy (Norman et al., 2010).
Kenya and South Africa face health problems due to economic inequality, which directly affects social determinants in the society. Lack of money to purchase food as a result of economic inequality translates into people suffering from malnutrition due to poor diet. In addition the parents get a problem in getting money to take care of their
Economic inequality in social, economical or political scenario in the society directly impacts on the health status of that society. Some of the symptoms of poor health status in a given society include death of very young children and death of mothers when giving birth (IMR and MMR). Besides preventable death in Kenya, there is persistence and resurgence of many infectious diseases. There is a high number of people who lose their lives due to tuberculosis and the problem is not improving due to poor economic status. In addition, Malaria is another challenging problem. The problem of malaria incidence has remained a challenge since the mid eighties. Economic inequality results into poor health services, which in turn accelerates the spread of the diseases like dysentery (Coovadia et al., 2009). The total number of children who lose their lives due to this problem is 0.6 million; the main reason being economic hardship. The problem of diarrhea in Kenya can only be avoided by the government providing clean water to every citizen and also by providing drugs that can stop the death of the patients. Cancer claims over 0.3 million lives per year and tobacco related cancers contribute to 50% of the overall cancer burden, which means that such deaths might be prevented by tobacco control measures (Kyobutungi, Egondi & Ezeh 2010).
These health revelations are alarming especially in the health provision to the public sector. The most disappointing scenario is that these revelations are not improving despite the various measures taken by the governments including investment in private health sectors and indications of the improvement of the gross domestic product. These challenges that affect people directly are the main causes of health problems in many countries that endanger the lives of many people.
References
Biggs, B., King, L., Basu, S., & Stuckler, D. (2010). Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America. Social Science & Medicine, 71(2), 266–273 Retrieved from the Walden Library databases.
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: Historical roots of current public health challenges. Lancet, 374(9692), 817–834.Retrieved from the Walden Library databases.
Kyobutungi, C., Egondi, T., & Ezeh, A. (2010). The health and well-being of older people in Nairobi’s slums. Global Health Action, 45–53. Retrieved from Walden Library databases.
Norman, R., Schneider, M., Bradshaw, D., Jewkes, R., Abrahams, N., Matzopoulos, R., & Vos, T. (2010). Interpersonal violence: An important risk factor for disease and injury in South Africa. Population Health Metrics, 8, 32–43. Retrieved from the Walden Library databases.
Rudan, I., Kapiriri, L., Tomlinson, M., Balliet, M., Cohen, B., & Chopra, M. (2010). Evidence-based priority setting for health care and research: Tools to support policy in maternal, neonatal, and child health in Africa. PLoS Medicine, 7(7), 1–5. Retrieved from the Walden Library databases.
Shelton, J. D., Cassell, M. M., & Adetunji, J. (2005). Is poverty or wealth at the root of HIV? Lancet, 366(9491), 1057–1058. Retrieved from the Walden Library databases.
Spiegel, J. M., & Yassi, A. (2004). Lessons from the margins of globalization: Appreciating the Cuban health paradox. Journal of Public Health Policy, 25(1), 85–110. Retrieved from the Walden Library databases
Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press.
We can write this or a similar paper for you! Simply fill the order form!
In week 3 there are various concepts that are covered, from exponents to quadratic equations. In your text for this week, page 1 states that quadratic equations can be used to determine the number of trees in a grove, the size of a tennis court, etc. Additional
application on this week’s topic include:
•Life insurance calculations for projecting death rates
•Throwing a ball in the air and determining the time till it reaches the ground
•Analyzing tumor volume and cell survival
•Impact of Insurance on Health Care
View the video: http://www.khanacademy.org/math/algebra/quadtratics/v/application-problem-with-quadratic-formula
Choose an application of one of the topics above that applies to your field of study (Healthcare) and write a short 1-2 paragraph APA-style paper about quadratic equations and your program of study. Try searching quadratic equations AND healthcare.
We can write this or a similar paper for you! Simply fill the order form!
Learning outcomes as follows: Examine multi professional diabetes services and illustrate an understanding of other professionals‘ roles and how these contribute to the service.
Identify and critically evaluate educational strategies for clients with diabetes in order to ensure effective self-management.
My case study is as follows:
Appendix A- Case Study
Case Study
A 69 year old patient, who suffers with type one diabetes, self administers insulin and has done for many years. When admitted to the ward for wound
management for leg ulcers, it became apparent that she regularly experienced hyperglycaemia and demonstrated poor technique when delivering her insulin, when this was discussed with the patient she did not seem to acknowledge there was a problem. It had been reported from the district nursing team that she had been non-compliant with bed rest at home. Due to the patients poor management of her diabetes and technique the nursing staff referred her to the diabetic nurses, dietician, tissue viability specialist and also the community mental health team.
We can write this or a similar paper for you! Simply fill the order form!
What must be done to intervene and ensure that history does not repeat itself for future populations? This week, you examine the impact of the historical roots of social disparities on health of populations in Africa and Latin America. As you go through this week’s Learning Resources, think about what we can learn from history. This week, you consider developing a policy in a country you selected and think about various issues in practicing population health.
Objectives
Students will:
• Analyze the impact of determinants on health outcomes for countries
• Analyze public issues in health literacy and cultural awareness
• Identify the relationship between health inequality and life expectancy in selected countries
• Identify efforts to reduce health inequities
• Analyze policy development and country support
For your Final Project, share some of your ideas on how you can use the knowledge and insights gained in this course to promote positive social change in your community and the world.
To prepare for the Final Project, review all the week’s Learning Resources and consider possible issues you might encounter when implementing a policy.
Final Project (7–10 pages):
In developing a policy in the country you selected, consider the following:
• Explain the rationale for selecting the country.
• Describe the social determinants of health in the country that you would need to address. Explain why you need to address these determinants.
• Explain the possible public issues you might encounter in health literacy and cultural awareness in this country.
• Describe the relationship between health inequality/inequities and life expectancy for the population in your selected country.
• Describe two current efforts in this country (you selected) to reduce health inequities.
• Explain how you might develop a health policy so that it gets the support of the country you selected. Note: Take into account the culture of the country.
Articles:
1. Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press.
Chapter 15, “Equality and Sustainability” (pp. 217–234)
2. Alles, M., Eussen, S., Ake-Tano, O., Diouf, S., Tanya, A., Lakati, A., . . . Mauras, C. (2013). Situational analysis and expert evaluation of the nutrition and health status of infants and young children in five countries in sub-Saharan Africa. Food and Nutrition Bulletin, 34(3), 287–298.
3. Baum, F. (2008). The Commission on the Social Determinants of Health: Reinventing health promotion for the twenty-first century? Critical Public Health, 18(4), 457–466.
4. Dankwa-Mullan, I., Rhee, K. B., Williams, K., Sanchez, I., Sy, F. S., Stinson, N., & Ruffin, J. (2010). The science of eliminating health disparities: Summary and analysis of the NIH summit recommendations. American Journal of Public Health, 100(Suppl. 1), S12–S18.
5. Jones, C. M. (2010). The moral problem of health disparities. American Journal of Public Health, 100(Suppl. 1), S47–S51.
6. Koh, H. K., & Nowinski, J. M. (2010). Health equity and public health leadership. American Journal of Public Health, 100(Suppl. 1), S9–S11.
7. Kruk, M. E., Porignon, D., Rockers, P. C., & Van Lerberghe, W. V. (2010). The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives. Social Science & Medicine, 70(6), 904–911.
8. Venkatapuram, S. (2010). Global justice and the social determinants of health. Ethics & International Affairs, 24(2), 119–130.
11. Rudan, I., O’Brien, K. L., Nair, H., Liu, L., Theodoratou, E., Qazi, S., . . . Campbell, H. (2013). Epidemiology and etiology of childhood pneumonia in 2010: Estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. Journal of Global Health, 3(1).
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700032/pdf/jogh-03-010401.pdf
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.
SAMPLE ANSWER
Introduction
The health status of every population in any country is a crucial towards the development of this country. A healthy population will be able to work together and constitute in development of the country while an unhealthy population will drag behind in development as more time is taken to improve this status. The health status, therefore, remains as a tough challenge in most of the developing countries most especially African countries and the Latin America (Frey,& Temple, 2009). Importantly, these countries are mostly faced with intellectual disabilities (ID) and thus, call for the nee of establishing national initiatives to handle this exclusive health need of its population. As such, this paper will focus on the health status of Guatemala country as one of the Latin American country, discuss the social factors affecting its health status and elaborate on public concerns that might be encountered when addressing the health literacy and cultural awareness. Moreover, the paper will look into the relationship between the life expectancy and health inequities of this country as well as the efforts made by this country to improve its health status.
Guatemala is the biggest and most populated country amongst the Central American countries. The population of this country is rapidly growing and young that is mainly a rural based population. However, it has been noted as a country with the poorest social outcomes compared to other Latin American countries as most of its children below five years suffer from chronic starvation and about 290 women pass away from the pregnancy difficulties (Centre for Economic and Social Rights [CESR], 2014). In addition, it has the lowest human progress that is based in terms of health, life expectancy and education outcomes as compared to the other countries.
As such, the health status of this country calls for serious attention to the whole globe and the associated professionals (CESR, 2014).In response to this, ICEFI
(InstitutoCentroamericano de EstudiosFiscales)That is a research body was formed. Together with Guatemalan specialists were mandated to research on the various ways to improve the political economy and health state of this country. After the research was conducted, a report was laid down that resolved that failure of economic progress and failure to realize the political rights of the Guatemalans was due to lack of political will by the ruling government to contribute more in preserving those rights (CESR, 2014).
Congruently, most of the Guatemalans are living in poverty especially, those in rural areas. Despite putting more effort in improving the health situations in Guatemala, it still remains to be amongst the countries that are having higher maternal mortality rate in Central America (CESR, 2014). The leading cause of this is the poor allocation of resources to the maternal health by the state making it hard to monitor and implement the right heath measures in the country.
The advancement of poor health situation in Guatemala has been accelerated by various factors that directly or indirectly favor these poor health status. Apparently, the major social determinants of health status in Guatemala is the political and socioeconomic factors (Marini, 2010). These factors comprises of the wide set of cultural, functional and structural features of social system that highly influence the people’s health on a daily basis. Further, the daily happenings on an individual also affect their health status as it is through this that determines the types of diseases that one contract. Additionally, society work plays a vital role in fighting or boosting the health status of any country and, therefore, it’s the role of the society set up organizations that aid in health promotion, treatment of diseases and disease prevention. However, the socioeconomic state of Guatemala is poorly run in that most of the people are poor especially those living in rural areas and, therefore, it is hard to set-up organizationsthat creates awareness to the members of the society.
Moreover, the political context of any country can either worsen the health status or make it better. This solely depends on the ruling governance, public policies, societal values and microeconomic policies (World Health Organization [WHO], 2012). It is the governmental role to make sure that there are sufficient resources in all health institutions. As such, poor governance in Guatemala aids in the deteriorating poor health services where there is under-funding of health institutions leading to poor service provision (WHO, 2012).
Correspondingly, the structure of the society influence the health status of every country that cuts across the making of the society as well as its cultural and social believes. Through this societal structure that determines what the society takes as good for them and what it abandons. Moreso, the social position of every individual determines how they get the access of the health services. This incorporates the education level and the income level of every individual is what regulates how each gets access of the health services. In Guatemala, the largest percentage of the sick people are poor and they are not in a position of accessing better health services as they are low-income earners(WHO, 2012).
Similarly, gender variation amongst the society plays a critical role in health due to its crucial effects on the development of hierarchies in the allocation of resources and division of labor (Ishida, 2009). Most of the jobs are allocated depending on the sex, and different values allocated to those roles for them to access and have control over crucial social protection possessions including; employment, education, and health services. Evidently, in Guatemala death rate is different across the gender since more women tend to die than men (Ishida, 2012). This trend is experienced as more deaths are caused by pregnancy complications.
To control all these problems, there rises need to educate the public on the health matters and create awareness to the community on the matters concerning their health. This is one of the ways that can be used to overcome all these un-favoring health determinants. As such, nurses are mandated to go out in the field, interact with the public, educate them and provide health care to them. However, despite this effort by every government, nurses and other professionals are faced with various difficulties as they carry out their awareness programs due to serving varied population of patients (Wittner, 2012). Amongst the many challenges facing nurses are based on the linguistic, language and literacy levels among the patients and members of the public. Although in the nurses are taught on how to handle all the difficulties associated with patients, this remains a difficult task to handle a diversified population of patients (Singleton, 2009).
Cultural competence being the skills of providers and organizations being in a position of distributing effective health care services without inconveniencing any patient is yet affected by this diversified population of the patients (Wittner, 2012). Due language barriers and low level of health literacy amongst the patients and members of the public, it becomes hard for the nurses to provide culturally competent services. Also, due to low literacy amongst the patients, it becomes hard for them to read any instructions given by physicians and during public awareness (Wittner, 2012).
Moreso, the cultural beliefs of every society plays a serious role in provision of the culturally competent services and, therefore, it is very important for the ones involved in providing these services to understand the culture of the public they are serving. In Guatemala, all these factors limits the interaction time between the service offers and the patients thus risking the lives of the patients suffering from chronic diseases who need more time. Equally, lack of cultural competence leads to the provision of poor health services and lack of satisfaction of the offered services due to low quality of patient to doctor interaction.
Finally, creation of awareness towards the public is in Guatemala is also challenged by the health care practices and beliefs in that some ethnic groups in the country does not believe in the science-oriented things (Baum, 2008). Therefore, this poses a great challenge to the people implementing the awareness programs to convince these people that workability of their mission. This becomes a hard task when dealing with the mentally challenged patients who believe that mental illness is brought by possession of evil spirits and, therefore means that the personnel dealing with such a person must fully understand the belief of every patient and be in a position of interfering with their beliefs in the correct way as they treat them.
It’s vividly clear that in the hardship associated in accessing the health services in Guatemala is led by unequal distribution of resources amongst its citizens. As such, it is simple for some people to settle hospital bills and access health services even from private hospitals whereas it is hard for others to access public hospitals (WHO, 2012). As a result, life inequity and social exclusion come up which tends to hinder the vast majority of the people from accessing better health services (Wright, 2009). Importantly, life inequities remain as the main hindrance in the provision better and improved health conditions in Guatemala. Significantly, life inequality is distributed on the basis of the socioeconomic levels of lives where the mortality rate of poor people is double than that of well-being people (Wright, 2009).
The life expectancy amongst the Guatemalans is also based on the life inequity, where the percentage of successful births is high for the rich people unlike for the poor ones (Jones, 2010). Moreover, the dissemination education amongst varies on the basis of the income distribution implying that children from well-being families gets quality education that improves their level of literacy. Besides, the increasing elderly population in Guatemala does not mean that they are living a comfortable life. The old population combined with the declining fertility rate in Guatemala has led to the deterioration of the economic, health and social life of the Guatemalans more is incurred when taking care of this old population (Jones, 2010). Consequentially, it is the role of the state government to minimize the gap between the living standards of the Guatemalans that will in turn boost their health, social and economic life.
Despite all these health challenges affecting the Guatemalan, its government has put several projects in an attempt of improving the health condition of its citizens. After the passing of the peace contracts in 1996, the new constitution of the Guatemalan stated that it an elementary right for every citizen to have access of a health care (Pena, 2013). Though it has remained a hard task for the government to implement this right, this government has tried to improve the health condition of its health institutions (Johnson, 2013). It has achieved this by improving its Ministry of Public Health and by involving other non-governmental organizations in the provision of better health services to its citizens. Moreover, the government setup a program (Expansion of Coverage program) that aims at improving the access of nutrition and health services to the poor people residing in the rural areas (World Bank Group [WBG], 2014). The program is implemented through the collaboration of government and various NGO’s where they are aiming at ensuring that they overcome the dominating life inequity amongst the poor people.
Conclusion
In general, therefore, the health state of any country solely depends on the ruling government that is held responsible for the provision of better health services and ensuring that they are easily accessible to every citizen. Also, the government should increase the number of professional doctors in the public hospitals to reduce the number of un-attended patients and to be able to handle the large population of the country. Similarly, for the health services and conditions of Guatemala to improve, the issue of life inequity must be handled and its effects controlled so as to improve its life expectancy. Consistently, cultural competence in the country as well as literacy and language barrier need to be addressed. In turn, this will ease the doctor’s and all involved party work as well as make public awareness effective thus, making the functionality of health institutions efficient.
References
Baum, F.,(2008). The Commission on the Social Determinants of Health: Reinventing health promotion for the twenty-first century? Critical Public Health, 18(4),
Centre for Economic and Social Rights,(2014). Center for Economic and Social Rights: Guatemala [Web at]
Ishida, K.S., (2012). International Perspectives on Sexual and Reproductive Health: Ethnic Inequality in Guatemalan Women’s Use of Modern Reproductive Health Care. In-Print.
Jones, C. M.,(2010). The moral problem of health disparities. American Journal of Public Health, 100(Suppl. 1), S47–S51.
Johnson, C.D.,(2013). Social capital: theory, measurement and outcomes. Nova Science Publisher’s, Inc.: Hauppauge, New York.
Literacy” OJIN: The Online Journal of Issues in Nursing. Vol. 14, No. 3, Manuscript 4.
Marini, A.,(2012). Three essays on economic determinants of child malnutrition
Pena, C. L.,(2013). Guatemala – Improving Access to Health Care Services through the Expansion of Coverage Program (PEC): The Case of Guatemala. Universal Health Coverage (UNICO) Washington, DC. Studies series; no. 19.
The World Bank Group, (2014). Improving Access to The Health Care Services through the Expansion of Coverage Program: The Case of Guatemala [Web at] <https://openknowledge.worldbank.org/handle/10986/13283 > Retrieved 20th, October 2014
Singleton, K.,& Krause, E.,(2009). “Understanding Cultural and Linguistic Barriers to Health
Wittner, J.G.,& Root, J.,(2012). Gendered Worlds. Oxford University Press, USA: New York.
Earlier in the course, the different population health outcomes of two culturally and economically similar neighbors (the U.S. and Canada) were considered. This week, the focus shifts to the eastern hemisphere and an examination of health inequalities between and within nations with large, diverse populations.
Both India and China had similar health outcomes at the end of WWII. Unlike India, China’s health improved tremendously over the next 30 years. When it did not have a focus on economic growth, China’s health achievements surpassed India. Since the economic reforms 30 years ago, health progress in China has not been growing as much. Today, India is booming and is home to some of the richest people in the world, but it is also home to more food insecurities than anywhere else in the world.
To prepare for this Assignment, review your Learning Resources this week. Consider how certain large populations within a single political entity can still display disparate health outcomes. Think about how areas such as Kerala can have remarkably different health outcomes than the countries they are in. What makes those areas different from the rest of the country?
The Assignment (3-4 pages):
Discussion questions:
• Describe two health outcomes for which India and China have had different experiences in the last half century.
• Explain the reasons for the disparities noted.
• Describe the experience for those outcomes in Kerala and suggest reasons for why they are similar or different from the rest of India.
• Expand on your insights utilizing the Learning Resources.
Articles:
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or spelling error
We can write this or a similar paper for you! Simply fill the order form!
Evidence based practice paper: Hand Hygiene in Healthcare setting
Order Instructions:
Describe a Clinical Problem that you see or have seen in practice. You will then revise or develop a policy, protocol, algorithm, or standardized guideline to be used in your practice site that is based on current research evidence. You are proposing the implementation of an intervention that is supported by research; thus you are proposing an evidence-based practice (EBP) project. You are not proposing a
study to be conducted in your agency.
Your final paper should be no more than 10 pages but your protocol, policy, or algorithm, and references for your project can be extra pages. This assignment is worth 100 points
Identify an area of interest: Is there a better way of doing something? Would another intervention based on research be more effective and improve patient outcomes? Is a policy, protocol, or algorithm in your agency out of date and in need of revision based on current research?
2. Provide some information (incidence of problem, morbidity and mortality rates, cost, etc.) from the healthcare literature and your agency that supports the fact that this is a patient care problem.
3. Review recent research and practice literature and select a specific intervention that might
address this patient care issue. The research-based intervention may be implemented in the form of a policy, protocol, algorithm, or standardized guideline that you could use to change patient care.
4. Identify what evidence-based intervention exists to improve current care in terms of patient, provider, or healthcare agency outcomes? Try to identify something for which you really
want an answer. You might get ideas from your unit nursing leader, other nurses, or patients
and families. Search current research journals online for interventions that have been studied.
5. Review a variety of evidence-based practice (EBP) Websites such as:
Professional Organization Websites Evidence-Based Guidelines
See Chapter 19 in Grove, Burns, and Gray (2013) textbook for more details on conducting EBP Projects and EBP websites.
6. Summarize what is known and not known about the problem area selected.
7. Revise or develop a policy, protocol, algorithm, or standardized guideline to be used in your practice site.
8. Provide a copy of the policy, protocol, algorithm, or standardized guideline with its references.
9. The steps of the protocol, policy, algorithm, or standardized guideline must be documented with current studies.
10. If a previous agency protocol or policy is revised, specify the changes made in the document.
11. Provide a reference list for your paper.
12. The references should include 7-10 quality research sources that support the intervention you have selected to implement in your practice site.
Grading Rubric
Introduction
Rubric
(0 – 10 Points)
Identifies problem in practice and the intervention to be used to address problem. Identifies the audience who will use the protocol, algorithm, or policy revised or developed.
Documents introduction.
Review of sources: What is known
(0 – 30 Points)
Summarizes or synthesizes current research knowledge that identifies what is known about the selected intervention.
Summary must be documented with studies from published sources.
Summary provides the knowledge base or research evidence for making a change in practice.
Review of sources: What is not known
(0 – 15 Points)
Summarizes or synthesizes what is not known in the area of the selected intervention.
Summary must be documented.
Section identifies the areas for further research.
Protocol, Algorithm, Policy, or Standardized
Guideline for Evidence-Based Project
(0 – 20 Points)
Provide a copy of the documented protocol, algorithm, policy, or standardized guideline. The steps of the protocol, algorithm, or policy are documented with current research sources.
Discuss your development of your protocol, algorithm, policy, or standardized guideline. If revised from previous agency protocol, identify the changes made.
(0 – 10 Points)
Indicate whether protocol or algorithm was developed; revised from an agency document; or obtained from a publication or website.
If based on existing document, include a copy of this document.
Briefly identifies any revisions you might have made to the existing document.
Format and Writing style is clear, complete, and concise. No grammar, sentence structure, or spelling errors. References APA (2010) Format. Limit the paper to 10 pages
(0 – 15 Points) The references need to include 7-10 published research sources. All sections of the paper must be documented with research sources. Include headings based on the paper guidelines.
Total Points Possible: 100
SAMPLE ANSWER
Evidence based practice paper: Hand Hygiene in Healthcare setting
Hand hygiene (HH) is known to prevent cross-infection in health care organizations, but there is poor adherence of health care workers to hand hygiene guidelines. Timely, easy access to both skin protection and hand hygiene is essential for satisfactory hand hygiene behavior. The use of alcohol-based hand rubs is necessary given that they are less irritating, they act faster, and require less time than traditional hand washing, and they also contribute to sustained improvement in compliance related to reduced rates of infection (Pittet, 2011). It is disquieting that the hospitalization of a patient may result in Hospital Acquired Infection (HAI), also known as nosocomial infection, and that poor hand hygiene is considered as a contributory factor. This paper provides an exhaustive description of hand hygiene; a Clinical Problem that I have actually seen in practice. Moreover, a standardized guideline is developed in this paper that would be used in my practice site and this standardized guideline is based on current literature evidence. In essence, I am proposing the implementation of an intervention that is supported by research; hence I am proposing an evidence-based practice (EBP) project.
The Clinical Problem of Hand Hygiene in Healthcare setting
Hand hygiene (HH) is the most effective and simplest measure for the prevention of nosocomial infections. In spite of advances in infection control as well as hospital epidemiology, the adherence of healthcare workers (HCWs) to the recommended HH practices is unacceptably low and patients remain susceptible to unintentional harm in health care settings (Maxfield & Dull, 2011). It is of note that the average adherence to HH recommendations varies amongst professional categories of HCWs, between hospital wards, according to working conditions, and according to the definitions utilized in various studies. In most instances, compliance to HH practices by HCWs is estimated as less than 50% (Boyce, 2014). In the United States, poor adherence has led to high mortality and morbidity considering that there are between 1.7 million and 2 million persons who get Hospital Acquired Infections every year, and 88,000 to 99,000 deaths are attributed to Hospital Acquired Infections every year (Al-Busaidi, 2013). Moreover, Hospital Acquired Infection affects almost 10 percent of hospitalized patients and it presents great challenges in hospitals. As a result, yearly medical expenditures have risen to roughly $4.5 billion in the United States (Al-Busaidi, 2013).
The practice of Hand Hygiene amongst health care workers is regarded as the single most clinical and cost effective measure for preventing nosocomial infection, a view that is recognized all over the world (Canham, 2011). The World Health Organization strongly stresses the vital need for HH during health care delivery in order to avoid possible infection as well as the consequent health problems; hence, the WHO’s Clean Care is Safe Care initiative launched in the year 2005. It is of note that this initiative provides new guidelines on HH training, observation, as well as performance reporting in health care settings (Kukanich et al., 2013).
The hands of nurses come in close contact with patients and they are usually contaminated through patient care, for instance while touching surfaces, materials or devices that are contaminated, or auscultation and palpation. As such, HH is seen as a cheap, vital, and most effective way to prevent cross infection (Cambell, 2010). This method is essentially aimed at saving lives and provides a safe treatment atmosphere for every health care worker and patient, irrespective of the setting. Bischoff (2000) stated that HH has to be considered after contact with high risk, infectious patients, and with contaminated materials or devices, as well as prior to invasive procedures. In essence, HH has to be advocated before a HCW begins work, at the end of her work, and after visiting the toilet/rest room. Even when nursing staffs spend a longer duration of time on HH, there hand hygiene technique is usually poor relative to other health care workers in terms of leaving large areas of the hand unwashed properly, including between fingers, nail beds, thumbs, as well as wrists (Maxfield & Dull, 2011).
Hand hygiene, in essence, is not just the responsibility of the nurses. Hand hygiene is a shared responsibility between patients, main leaders of the hospital, hospital administration, and other stakeholders. Boyce (2014) observed that patient involvement generally increases adherence to HH practice by 50 percent if, for instance, a straightforward question is asked of the HCW, like: have you washed your hands? Most patients think that asking health care workers to clean their hands before health care delivery is a disloyalty of trust. Moreover, some of them actually believe that they could be labeled as a troublemaker; hence, they choose not to ask. Patients typically feel reassured if they observe health care workers practice effective hand hygiene within the health care setting (Al-Busaidi, 2013).
Barriers to Hand Hygiene Practice in Health Care Settings
A lot of factors lie behind poor HH compliance amongst health care workers. Nursing staff members are ethically and professionally responsible for their actions. Nonetheless, some nursing staffs display low compliance since they perceive hand hygiene as not their problem; that it is instead something to do with the staffs of infection control. Moreover, nursing staffs usually fail to practice HH since they are very busy and they think that hand hygiene will take up their precious time (Canham, 2011). Additionally, they usually believe that gloves can be utilized as an alternative to HH, and this is a major misconception that contributes to poor adherence. Nurses often have the tendency of removing gloves without washing their hands. They also tend to use the gloves in delivering intended care to many patients. Even when nurses remove their gloves, just 20 percent of them actually wash their hands (Pittet, 2011).
Furthermore, nursing staff member usually avoid HH practice because they have the fear that skin problems for instance dermatitis might develop, particularly when alcohol hand-rubs are used in the hand hygiene practice – another misconception. They think that skin irritation occurs as a result of frequent HH practice (Whitby, 2006). Moreover, limited time, lack of organizational pledge to proper HH practice, increased workloads, lack of motivation, lack of role models amongst seniors or colleagues, under-staffing, and disagreement with protocols and guidelines all contribute to poor adherence to hand hygiene and infection control measures in health care settings. Maxfield and Dull (2011) observed that the dearth of hand hygiene facilities and products, for instance hand paper towels, non-antiseptic and antiseptic soaps, sinks, alcohol hand-rubs, and running water can also contribute to bad hand hygiene practice.
Another noteworthy barrier is a lack of awareness and scientific knowledge with regard to hand hygiene. Bischoff (2000) stated that the lack of appropriate infection control in training programs, where students watch their colleagues with patients, might actually result in bad HH practice. Otto and French (2009) in their study learned that the cultures and attitudes of nurses at work have a significant influence in clinical development of students, and for the students to be accepted in that culture, they have a tendency to follow their mentors and other health care workers. A case in point is that for a student to be perceived as being an effective team member, she/he tends to perform hand hygiene poorly and improperly, since this student wants to appear as busy as her mentors and believes that she does not have enough time to wash her hands (Al-Busaidi, 2013).
The behavior and attitudes of HCWs toward HH practice is an intricate issue that involves the perception of its efficacy, existing barriers, as well as beliefs and values of staffs. To attain high rates of compliance with hand hygiene practice, Otto and French (2009) suggested that those who default have to be disciplined as if they have breached hospital policy, and this should start with personal counseling to verbal warning, and at last to a written warning placed in the files of the defaulters.
Effective Hand Hygiene
Effective HH basically involves removing the visible soiling as well as the reduction of microbial colonization of the skin. The hands of HCWs could be contaminated by 2 sorts of pathogens: (i) resident – colonizing or normal – microorganisms, and (ii) transient – contaminating – microorganisms. Resident flora microorganisms are known to colonize the deeper layers of the skin, and unlike transient flora, they are not easy to remove mechanically; that is, through washing hands (Smith & Lokhorst, 2009). Luckily though, resident flora is less aggressive compared to transient flora, and is less likely to lead to serious infection. Examples of resident flora include negative staphylococci and Corynebacteria. It is of note that these bacteria are inclined to grow within the hair follicles and remain moderately dormant over time (Smith & Lokhorst, 2009).
Conversely, transient flora colonize the superficial layers of the skin for a short period of time. The nurses’ hands are frequently contaminated with transient flora through direct contact during every day patient care activities, equipment or environments. Nonetheless, transient flora can be removed easily through the use of mechanical methods, for instance friction in hand washing. Examples of transient flora include Candida species and Staphylococcus aurous. Transient flora are able to induce nosocomial infection amongst health care workers and patients (Al-Busaidi, 2013). Considering this information as regards resident and transient bacteria, effective hand hygiene practice either with the use of alcohol-based hand-rub or hand washing using antimicrobial soap, is clearly the way to reduce the risk of cross infection.
Research-Based Intervention in the form of a Standardized Guideline
Promotion of HH practices in health care settings is a significant challenge for infection control experts. Lectures and workshops, distribution of information flyers, performance feedback on adherence rates, and in-service education have all been linked to transient improvement. There is really not a single intervention that has repeatedly improved adherence to HH practices (Smith & Lokhorst, 2009). Given that nursing staff members are present twenty-four hours a day, seven days a week within the health care setting, it is of major importance to stick to HH standardized guideline and maintain patient safety. The following guideline should be followed by health care facilities.
Encourage effective hand washing
Effective hand washing, according to Pittet (2011), is the application of antimicrobial/antiseptic or non-antimicrobial/plain soap onto wet hands. The individual should then rub together both hands vigorously to form lather, and should cover base of the fingers, tops of the hands, all the surface of the palms, fingernails, wrists, thumbs, back of the fingers, and between fingers for a 60 seconds. The health care worker should ensure that his/her fingernails are short. Boyce (2014) reported that artificial fingernails are possible traps for bacteria and thus have to be avoided. Although chipped nail polish has the capacity of harboring bacteria, new nail polish on natural nails in fact does not worsen the microbial load. It is of note that wearing jewellery, for instance hand watches or rings, may actually bring about bacterial colonization on the skin beneath them. After the HCW has soaped and rubbed, she should rinse her hands thoroughly to remove all the lather on the hands. Hot water should not be used in rinsing given that it may lead to dryness of the skin (Al-Busaidi, 2013).
Hand drying is also of major importance in the prevention of cross infection in the health care setting since microorganisms are known to thrive in damp environments. Hand drying should be done before the HCW wears her gloves, as trapped moisture in the gloves may lead to irritation of the skin and increase the harboring of microorganisms (Whitby, 2006). Paper towels are very efficient in drying hands and the friction created whenever they are used actually improves the removal of microorganisms from the skin. The HCW must not touch the tap again after she has just washed her hands; she should use a paper towel in turning the water off. Even though hand driers are just as good as hand towels, paper disposable hand towels are generally more effective and are quicker. In essence, the friction that is produced through hand rubbing with soap vigorously and then hand drying using paper towels actually removes all the dirt as well as any loosely adherent flora; that is, small portion of resident flora and nearly all transient flora from hands (Smith & Lokhorst, 2009).
Encourage the use of alcohol hand-rub
There is sufficient evidence to recommend the alcohol hand-rub owing to its cost effectiveness and clinical benefits. Pittet (2011) pointed out that the likelihood of hand washing to wash away the skin’s fats and oils that are vital for healthy skin is less with the usage of hand-rub. Simply put, alcohol hand-rub will redistribute the lipids in the layers of the skin. In addition, alcohol hand-rub can dispense with paper towels. In his study, Cambell (2010) found that alcohol hand-rub actually consists of several emollients that are better tolerated by health care workers compared to hand washing. Cambell (2010) also found that quite a few factors including consistency, odor, and color of alcohol hand-rub products can influence health care workers’ acceptance of this product. Alcohol hand-rub dispensers could be positioned readily and accessed easily: at the bedside of patients, outside and inside of the rooms of patients, in waiting areas, next to computers, and even inside the nursing stations (Kukanich et el., 2013).
Effective usage of alcohol hand-rub basically implies that health care workers have to strictly comply with the manufacturer’s instructions, particularly with regard to the quantity used as well as the time required to completely fade away from the hands. In essence, the availability of alcohol hand-rub products at the point of care has to be supplemented by the availability of gloves in suitable sizes. From his study, Bischoff (2000) observed that hospitals that made clean gloves and alcohol-based hand rub readily available to HCWs saw improved compliance with hand hygiene.
Clarify misconceptions about the usage of gloves
To improve healthcare workers compliance with HH practice, it is of major importance to take into account the hindering factors and then turn them into factors that enhance compliance. The misconceptions of nurses regarding the use of gloves and skin complications should be clarified so as to attain a better compliance with HH practice. In essence, failure to remove gloves following contact with patient or between clean and dirty body site care for the same patient actually amounts to poor adherence to hand hygiene recommendations (Boyce, 2014). The nursing staffs need to be informed that it is ineffective to wash and reuse gloves between patient contact. Disinfection or hand washing has to be strongly encouraged following removal of gloves (Canham, 2011).
Provide Training and Education on Hand Hygiene
Proper education as well as follow-up training is key to identify situations in which HH is reasonable. Important educational materials that the hospital should use include the following: computer-assisted, interactive learning that is made available to the clinicians through the hospital’s intranet; and PowerPoint presentations and videotapes that illustrate the significance of good HH techniques in hospitals and other health care facilities. Hospitals should conduct educational programmes for employees that comprise instructions for appropriate method when using an alcohol-based hand-rub, or washing hands using water and soap. The hospital should make sure that health care workers comprehend the underlying principle for gloves and hand hygiene and can follow the best practices and enhance patient outcomes (Pittet, 2011).
Place promotional materials in noticeable areas
In essence, hand hygiene promotion posters should be placed in locations that are highly visible throughout the healthcare facility and a multi-modal campaign for improving performance should be initiated. Whitby (2006) pointed out that promotional material, for instance posters, could be placed in noticeable areas of the health care facility and they will be aimed at reminding patients, health care worker, as well as visitors about the significance of HH practice. In addition, the hospital can also place videos on the wards in order to show patients the importance of HH in the prevention of cross infection and to remind or ask health care workers to practice HH before health care delivery. In their study, Kukanich (2013) found that placing appropriate HH technique illustrations close to alcohol hand-rub dispensers or above sinks helped in improving compliance to hand hygiene. Moreover, Kukanich (2013) found that posters with pictures of renowned hospital physicians/personnel recommending hand hygiene also helped to improve compliance with hand hygiene in the health care facility. To motivate computer user to comply with hand hygiene practice, Smith and Lokhorst (2009) pointed out that messages on the subject of hand hygiene practice can be set on computer screensavers.
Hand Hygiene products should be always available, and in right places
The ward or unit manager should ensure that hand hygiene products are at all times available, and are actually in the right places. Some of these places include offices, nursing station, as well as outside and inside of all patient rooms. Studies have revealed that compliance by HCWs was substantially greater when alcohol-based rub dispensers were placed adjacent to the bed of patients compared to when they was just a single dispenser for every 4 beds (Al Busaidi, 2013). Moreover, in critical care settings, studies have indicated that the availability of alcohol-based hand-rub at the point of care actually minimized the time constraint related to HH during patient care and it predicted better adherence to HH practice. Pittet (2011) in a study of hand hygiene amongst doctors, learned that easy access to an alcohol-based hand rub was in fact an independent predictor of improved compliance to HH practice.
Recognize clinicians with good hand hygiene practice and create a culture of proper hand hygiene
It is of major importance for the health care organization to recognize nursing staff members with proper hand hygiene. This can be done, for instance, though announcement in the hospital’s newsletter. This will serve as a vital accolade that can actually encourage other nurses and health care workers to do likewise. The hospital should also create a culture that encourages staff members to remind each other as regards proper hand hygiene (Otto & French, 2009). In their study, Cambell (2010) found that when health care workers reminded each other and other health care workers to practice hand hygiene, there was a considerable increase in compliance to hand hygiene practice at the health care facility. All in all, the hospital should monitor compliance by HCWs with the recommended indications for HH, including real-time feedback to staff members.
Conclusion
In conclusion, the practice of Hand Hygiene amongst health care workers is regarded as the single most clinical and cost effective measure for preventing nosocomial infection. However, notwithstanding advances in infection control as well as hospital epidemiology, the compliance of clinicians with the recommended hand hygiene practices is unacceptably low and patients are very susceptible to inadvertent harm in health care settings. Hand hygiene is fundamentally aimed at saving lives and to provide a safe treatment atmosphere for every health care worker and patient, no matter the setting. In America, improper compliance with hand hygiene practices has led to high mortality and morbidity bearing in mind that there are more than 1.7 million persons who catch HAI every year, and over 90,000 deaths are attributed to HAI every year. Several factors actually contribute to poor hand hygiene compliance amongst clinicians. These include limited time, lack of organizational pledge to proper HH practice, increased workloads, lack of motivation, lack of role models, and under-staffing.
The proposed intervention as described in the guideline entails the following: making hand hygiene products always available and in the right places such as in nurse stations and at patient bedsides; and to recognize clinicians with effective hand hygiene practice and creating a culture of proper hand hygiene in the hospital. Moreover, the hospital should place promotional materials in noticeable areas, and provide education and training programs on the significance of proper and hand hygiene and how to actually practice effective hand hygiene.
References
Al-Busaidi, S. (2013). Healthcare Workers and Hand Hygiene Practice: A Literature Review. Diffusion, 6(1): 81-89
Bischoff, W. E. (2000). Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med. 160(7):1017-21
Boyce, J. M. (2014). Preventing Infections: It’s in Your Hands. Medscape Infectious Disease.
Cambell, R. (2010). Hand-washing compliance goes from 33% to 95% steering team of key players drives process, Healthcare Benchmarks and Quality Improvement 17:1, 5-6.
Canham, L. (2011). The first step in infection control is hand hygiene, The Dental Assistant, 42-46.
Kukanich, K. S., Kaur, R., Freeman, L. C., & Powell, D. A. (2013). Original Research: Evaluation of a Hand Hygiene Campaign in Outpatient Health Care Clinics. American Journal of Nursing, 113(3):36-42
Maxfield, D. & Dull, D. (2011). Influencing hand hygiene at spectrum health, Physician Executive Journal 37:3, 30-34.
Otto, M. & French, R. (2009). Hand hygiene compliance among healthcare staff and student nurses in a mental health setting, Mental Health Nursing 30, 702-704.
Pittet, D. (2011). Improving Adherence to Hand Hygiene Practice: A Multidisciplinary Approach. Emerging Infection Disease Journal, 7(2): 32-8
Smith, J.M. & Lokhorst, D.B. (2009). Infection control: can nurses improve hand hygiene practice?, Journal of Undergraduate Nursing Scholarship 11:1, 1-6.
Whitby M. (2006). Why healthcare workers don’t wash their hands: a behavioral explanation Infect Control Hosp Epidemiol; 27(5):484-92.
We can write this or a similar paper for you! Simply fill the order form!
Remember that is a continues paper and I have listed reference number for my previous paper under this topic to help understand this paper. This is my policy change paper and the writer must refer back to other papers base on the references provided to be able to understand how to respond to this paper. Hear below are detail instructions on how to go about this paper and its critical that the writer follow strictly the instructions. Take note that no reference can be before 2010 , they most all be from 2010 and above as the affordable care act was pass in 2010. Also remember that they are 2 SECTIONS A and B, and both sections must have separate reference list 4 in each section , listed at the end of that section.
SECTION A (1 pages)
Remember to include a minimum of 4 references at the end of each section.
To complete this paper correctly, the writer must look take a look at 111521,111489, 111623 and 111582 (section B), 111623, and 111542. To be exact any of my past papers regarding policy change proposal as I had mentioned at the beginning that this paper will be a continues assignment.
Explain the three cost-effective recommendations for the policy change proposal below which you plan to implement in your proposed policy change. Be sure the recommendations include a way to reach a global market.
Hear below are some guidelines from the Prof on how to respond to this section and also an example to follow.
Fellow students,
This week we are developing commendations that you will use in your Unit 9 policy change proposal to implement your policy change. Remember you are trying to develop relationships to understand & support your proposed change and will help to convince others to do the same. And we are using an expository style writing 🙂
For example:
Engaging in public health social media campaign to educate the public about the use of and need for APNs in health care, focusing on filling the disparity gaps
Utilize lobbying groups and professional organizations to educate the public that employing nurse practitioners improves xxxxxx
Apply the amendment change utilizing the Incremental Change option, because this will allow for not only time for stake holders to buy into the proposed change but it will also provide for evaluation of any positive or negative changes that can be reevaluated and redesigned along the way to complete implementation of the proposed change.
CW
Take note that you have to write in an expository style and Remember that the propose amendment is
The public policy problem is that section 2713 requires organizations to provide their workers with birth control as part of their insurance coverage. The public policy question is: should the federal government mandate that organizations can choose whether or not to provide contraceptive services to employees as part of their insurance coverage? The public policy resolution is an amendment to section 2713(a) (4) of PL 111-148 that would say: organizations – both for-profit and non-profit organizations – have the option of either offering their employees birth control as part of their insurance coverage or not to offer contraceptive services (Cauchi, 2014).
SECTION B (1 pages minimum).
Remember to also include 4 reference at the end of this section.
Since the implementation of a policy change proposal requires that it be communicated to a large number of stakeholders, do you think that there are drawbacks or advantages to the use of social media for this purpose?
The Staff of the Washington Post. (2010). Landmark: The inside story of America’s new health care law and what it mean for all of us. New Your, NY: Public Affair.
Policy Change in the Provision of Contraceptive Services
SECTION A
The public policy (section 2713) has a problem since it requires all organizations to provide their employees with birth control measures as part of their insurance coverage. Due to this challenge, the public resolved to amend section 2713(a) (4) of PL 111-148 in order to allow nongovernmental organizations to have an option of either providing their employees with birth control as part of their insurance coverage or not to offer contraceptive (Cauchi, 2014). This article will basically address ways in which this public policy change could be implemented since policy change implementation requires that it be communicated to a large number of stakeholders.
One of the ways of implementing this public policy change is by carrying out campaigns in the public especially through the social media. Public social media campaigns are very necessary since they educate the public and the organization on the pros and cons of providing birth control as part of insurance coverage. This would therefore allow the public to debate comprehensively on the issue and eventually make informed. Therefore, policy implementation has to address organizational, professional and social affairs around which that policy has to be implemented. The recommendations for the implementation process of the policy change therefore have to be cost-effective (Holly, Salmond & Saimbert, 2012).
According to Shi & Singh (2012), adoption of this policy would mean employing practitioners that are more public. In order to ensure that the public appreciates the need and urgency of this move, lobbying groups and professional organizations would be mobilised to educate the public on the need to have these reforms
Afifi et al., (2013) states that, since the organizations are the ones mandated to adopt this policy change, the amendment change would be applied through use of the incremental change option. This option will allow the organizations and any other stakeholder’s time to digest the reforms by weighing the advantages and disadvantages of the reforms
References
Afifi, A. A., Rice, T. H., Andersen, R. M., Rosenstock, L., & Kominski, G. F. (2013). Changing the u.s. health care system: Key issues in health services policy and management. San Francisco, Calif: Jossey-Bass.
Holly, C., Salmond, S. W., & Saimbert, M. K. (2012). Comprehensive systematic review for advanced nursing practice. New York: Springer Pub.
Shi, L., & Singh, D. A. (2012). Delivering health care in America: A systems approach. Sudbury, Mass: Jones & Bartlett Learning.
Shoniregun, C. A., Dube, K., & Mtenzi, F. (2010). Electronic healthcare information security. New York: Springer.
SECTION B
Since the implementation of a policy change proposal requires that it
be communicated to a large number of stakeholders, there are so many challenges and opportunities by this change in technology. First and foremost, privacy is a key factor in any health care system. Therefore, inappropriate sharing of information, and limits pertaining professionals has to be adhered to. How much that should be disclosed in relation to provision of contraceptives as a health care insurance cover is a factor that requires limits. According to Grol, Wensing, Eccles & Davis (2013), social media is still very young hence privacy is a feature that would be incorporated as this technology advances.
Marks (2012) states that the privacy of the patients, Health Insurance Portability and Accountability Act (HIPAA) regulations, and patient-professional boundaries has to be the guiding principles on what should be channeled through the social media. This is not an assurance at the moment for anyone using the social media for any form of campaign.
The social media also posses the challenge of evaluating the applications hence very few organizations are adopting them. However, more reports establish that the application is very easy to adopt only that it needs more labor in terms of human availability. Therefore in order to adopt this process more effectively, there need to be development of guidelines on how to use this social media by the organizations (Blas, Kurup & Światowa 2010).
However, according to Buse, Mays & Walt (2012), the social media is very effective since it reaches many people hence can be able to address a specific group of people especially those who use the social applications although some form of controlled analysis of social media is very necessary before establishing whether the approach is very effective . This would enable the campaign for implementation of the public policy change to reach a huge population of people.
References
Top of FormBottom of Form
Blas, E., Kurup, A. S., & Światowa Organizacja Zdrowia. (2010). Equity, social determinants and public health programmes. Geneva: World Health Organization.
Buse, K., Mays, N., & Walt, G. (2012). Making health policy. Maidenhead: McGraw Hill/Open University Press.
Holly, C., Salmond, S. W., & Saimbert, M. K. (2012). Comprehensive systematic review for advanced nursing practice. New York: Springer Pub.
In Grol, R., In Wensing, M., In Eccles, M., & In Davis, D. (2013). Improving patient care: The implementation of change in health care. Chichester, West Sussex: Wiley-Blackwell/BMJ Books.
Kawachi, I., Takao, S., & Subramanian, S. V. (2013). Global perspectives on social capital and health. New York, NY: Springer
Marks, R. (2012). Health literacy and school-based health education
We can write this or a similar paper for you! Simply fill the order form!
Drug Treatments for HIV/AIDS
While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?
To prepare:
• Review Chapter 48 of the Arcangelo and Peterson text, as well as the Krummenacher et al. and Scourfield articles in the Learning Resources.
• Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.
• Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.
• Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.
ASSIGNMENT PAPER:
WRITE
1) An explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.
2) Explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease.
3) Describe strategies to educate HIV positive patients on medication adherence.
4) What are the safety practices to reduce the risk of infecting others?
Readings/Recommended References (you may choose your own textbook or article for this paper
• Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
o Chapter 8, “Principles of Antimicrobial Therapy” (pp. 96–117)
This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents such as penicillin.
o Chapter 12, “Fungal Infections of the Skin” (pp. 141–149)
this chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.
o Chapter 14, “Bacterial Infections of the Skin” (pp. 158–172)
this chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.
o Chapter 32, “Urinary Tract Infection” (pp. 474–480)
This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.
o Chapter 35, “Sexually Transmitted Infections” (pp. 512–535)
this chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment.
o Chapter 48, “Human Immunodeficiency Virus” (pp. 748–762)
this chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.
• Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.
Retrieved from a collage Library databases.
This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.
• Drugs.com. (2012). Retrieved from http://www.drugs.com/
this website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
• Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011. Retrieved from a collage Library databases
this article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.
• Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314. Retrieved from a collage Library databases.
SAMPLE ANSWER
Drug Treatment for HIV/AIDS
When HIV/AIDS was first discovered, many people in the United States were dying in large numbers. Due to advancements in treatment of the disease in later years, patients infected with HIV/AIDS can now live longer. Proponents to drug treatment to HIV/AIDS have pointed out that the impact from drug advancement is phenomenal, as it gives a vision of having a free HIV/AIDS world. However, some critics point out that these advancements in treatment lead to complacency. Therefore, the paper will engage in discussing critical issues emanating from the overall drug treatment to HIV/AIDS.
The increasing number of cases of HIV/AIDS is attributed to the increased complacency due to more advanced drug treatment options. This is because, health professionals have quit creating awareness of the possible adverse effects of the disease. The people of the United States have the illusion that, due to continuous advancement in drug treatment against HIV/AIDS, they are likely not to contact the disease (Arcangelo & Peterson, 2013). The advertisements that were used to encourage youths to use contraceptives such as condoms to save them from the epidemic are no longer used, or are used in minimal magnitude. Advancement in drug treatment has also led to more emergence of homosexual and heterosexual relationships that have led people to indulge in sexual activities not knowing well that they are actually making themselves susceptible to the epidemic.
Health care professionals can diminish the perception and increase awareness of the realities of the disease by taking a stand in creating awareness on same-sex affairs that greatly spread HIV/AIDS. This is because, same sex relationships increases transmission of the sexual-related disorder such as syphilis and gonorrhea, which gives a means for more transmission of HIV /AIDS. Medical practitioners should increase awareness on drug abuse. Anyone who abuses drugs should be counseled and treated to help them stop using the drugs and preventing HIV/AIDS infections (Arcangelo & Peterson, 2013). This is because contracting the disease is faster in people who abuse drugs. Most preferably, health professionals should formulate programs that give each and every generation of young people with information and intervention that aid them to develop life-long skills for avoiding behaviors that could lead to HIV/AIDS infections (Mayer & Krakower, 2012). Strategies to educate HIV/AIDS patients on medication adherence are crucial as far as drug treatment on HIV/AIDs is concerned. The strategy includes self-assessment tools that include questions about mental health status, substance abuse, environmental factors that may influence a patient’s ability to adhere to ART (Antiretroviral therapy) (Arcangelo & Peterson, 2013). Another strategy that can be used is assessment on cognitive functioning and a patient’s attitude towards taking ART. The final strategy that can be used is assessment of all those areas paints of a patient’s overall readiness to begin and maintain ART.
There are safety practices to reduce the risk of infecting others with HIV/AIDS. One of the safety practices is use of condoms consistently and correctly. The practice extends to choosing less risky sexual behaviors. This is because anal sex is the highest-risk sexual activity more than oral sex. Use of pre-exposure prophylaxis daily can also prevent intensity of spreading the disease to other people (Krummenacher, Cavassini, Bugnon, & Schneider, 2011). If a partner is infected with the disease, he or she should be advised to get and stay on treatment. ART is medically recommended to reduce the amount of HIV virus (viral load) in blood and body fluids, which can greatly reduce chances of transmitting HIV to sex partners if taken consistently and correctly.
In summary, continuous improvement in drug treatment to HIV/AIDS will continue to pose dangers of HIV/AIDS to people as neglect and irresponsibility are brought by the improvements. However, this trend can be reversed if medical practitioners engage in strategies and programs to create awareness of the adverse effects of the disease, and to install and educate on best safety measures to prevent widespread of HIV/AIDS.
References
Arcangelo, V., & Peterson, A. (Eds). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.
Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine. 156(4), 312–314.
We can write this or a similar paper for you! Simply fill the order form!
