All posts by : chebby

Division and classification

Decision-making is a constant process for those in leadership roles. An effective leader must be able to understand the daily problems that arise and present solutions beneficial to the organization, employees, and associated community or stakeholders. In a health care organization, this includes patients and their families. In a 1,000-1,250-word paper, discuss the aspects that help leaders make effective and ethical decisions in health care.

1. Discuss the importance of sound decision making in health care. Describe the potential consequences of poor or uniformed decision making as a leader.
2. Define evidence-based decision making. Explain how this is applied in health care and why it is important.
3. Explain what the term data driven decision making Discuss what types of data are used for making decisions in health care and why it is important for a leader to use data when making a decision.
4. Discuss how regulatory or organizational guidelines help shape how leaders make decision in health care.
5. Describe the role of ethics in decision making. Explain steps a leader can take to promote ethical decision making. How can a leader address ethical conflicts that arise during the decision-making process?

A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state (CALIFORNIA)? 

Expectations

Initial Post:

• Due: Friday, November 13
• Length: A minimum of 250 words, not including references
• Citations: At least 2 scholarly reference in APA 7th ed from within the last 5 years

 A 37-year-old woman G2P2 presents with a lump in her left breast. Her husband noticed it recently and she is concerned, especially as she had an aunt that had breast cancer and thinks that a great-grandmother or some other ancestor may have died of breast cancer as well. Both of her children (9 and 7) were delivered without complication and she breastfed “for well over a year” with each. She has no other significant PMH or allergies. She is 5’ 6” tall, weighs 144 pounds and has a BMI of 22 and works as an office manager. She is a non-smoker, considers herself to be an “almost” vegetarian and has a glass of wine many evenings with dinner. She has regular physicals and is up to date on pap smears which have always been normal. Meds include a daily multi-vitamin and occasional acetaminophen for tension headache or ibuprofen during her period. Upon examination, the lump is discovered. It is firm and near the surface and no other masses are discovered. The lump is aspirated, and an opaque liquid is removed. Following this procedure, the lump has vanished. What is the differential diagnosis? What would be any further screening or treatment options? What is her risk of developing breast cancer? 

Over the next two decades, 78 million Americans will grow old.  That’s the largest number ever in the US. 

At present, there are around 16,000 nursing homes with 1.7 million beds and about a 15 percent vacancy rate. (See: CDC – Resources on Nursing Home Care). 

Clearly, unless the nation undertook a massive building program, there will be many, many more old people than the number of available LTC beds.  

So what are we going to do with all the geezers like me? 

Are LTC beds the only place to put us?  Are there other alternatives that are more cost-efficient?  Given issues of quality  — either perceived or actual —  in many LTCs, do we really even want to keep traditional nursing homes as an option?  What might old people really want?   What are younger people willing to support financially?  What role might pharmaceutical products have in managing age-related issues? What would be the best way for people to age out into death?  

What role does culture play in this discussion?  How do other nations address this issue?

As we think about answers to those questions, there is another level of analysis that looks at the ethics of old age. For example, do you think that everyone has the right to use all the Medicare services they want – regardless of the decisions made about their health when they were younger? In other words, should all old people share an equal right to Federally supported healthcare even if they did not share the same level of responsibility in their earlier choices regarding food, exercise, drugs, and alcohol? 

A second question to consider is whether or not the Government should have any voice in restricting one’s personal choices about dying.  Should everyone have the right to die when they want to, regardless of the situation or reasons?  (Consider researching Compassion and Choices Organization for more insight) Who and how should an end-of-life decision be made when the person is not in possession of their full faculties? 

Lots to ponder this week…

Consideration: This is a repeated story but still useful for this discussion. In the late 1800’s statisticians estimated based on population growth the US would be completely covered, inches deep in horse manure. They did not anticipate the automobile. Similarly, if you went back 120 years and asked farmers what they needed most they would likely say; “a bigger horse that ate fewer oats” they did not account for new technology like a tractor or combine.

When thinking critically about the need for services for the growth in the elderly population perhaps “building more beds” is as fallacious as assuming more horses. What new innovation on the horizon will change the demand forecasting? 

http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_10/index.html

ABOVE IS THE CASE STUDY

Write a 1- to 2-page summary paper that addresses the following:

• Briefly summarize the patient case study, including each of the three decisions you chose for the patient presented. Support your decisions with evidence-based literature. Be specific and provide examples.
• What were you hoping to achieve with the decisions you recommended for the patient case study? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

Reflect: What words come to mind when you hear the word “pediatric trauma”? Please write down a few words or a few sentences. 

Research: Answer the questions below using the articles below and other sources such as the internet and your textbooks. 

1. List 5 potential nursing diagnoses for a child involved in a Motor Vehicle Accident ( I.e hit by a car)? 

2. What are the differences between pediatric vs. adult trauma? Consider aspects such as physiology, communication, legal issues, age, and types of injuries. 

3. Identify at least 3 interdisciplinary team members that may be involved in a pediatric trauma beginning with the onset of injury to home care. 

4. What assessments/diagnostic imaging should be considered/performed? 

5. What is  acute compartment syndrome?

6. Describe the 5 “P’s” of compartment syndrome and how the relate to the pediatric patient.

7. Why is early detection of compartment syndrome important?

8. What else could cause symptoms similar to compartment syndrome?

9. How is acute compartment syndrome treated and what does this mean for the patient?

10. Why can identifying compartment syndrome in children be particularly difficult?

Choose one of the following discussion question options and answer all questions related to it. Please review the Discussion Rubric for detailed requirements of your posts. When you click Reply, change the subject line to read either Option 1 or Option 2.

Option I:

Compare the similarities and differences among assessing health and health behaviors of individuals, families, and communities.

What role does technology play in health assessment, promotion, and prevention and what frameworks are available to nurses to assess and diagnose health and health behaviors? Provide examples.

Option 2: 

Go to the Agency for Healthcare Research and Quality (AHRQ) website of the U. S. Preventative Services Task Force (USPSTF). https://epss.ahrq.gov/ePSS/about.jsp

Click the link “Browse by Topic” on the left navigation panel to display the full list of topics. At the top of this page are four tabs: View All, Counseling, Preventive Medication and Screening. Click on the tab “Screening” for a list of all screening topics. Choose a specific screening recommendation relevant to your area of expertise or one that interests you*. Summarize the recommendation including grade and rationale.

What are the benefits and challenges of health risk screenings?

critical thinking

reply1

According to the Health Determinants video, the determinants of health are biological and genetic makeup, individual behavior, social interactions and norms, and physical environment. The video introduced an elderly man named James who lives in a low-income neighborhood and does not have close access to the grocery store to buy fresh fruits and vegetables. Therefore, his environment puts him at risk for getting diabetes because he gets most of his food from convenience stores and fast food restaurants. Interventions to solve health disparities involve information, policies and programs. The intervention proposed for James is to introduce a subsidized farmers market that is walking distance in his neighborhood for low-income seniors (Determinants of Health, 2020). 

           In my experience, I know an elderly individual who is in the same situation as James from the video. She currently does not live near a supermarket and has to take the bus which is more difficult now because of COVID. I have convinced her son to move her to another apartment complex that has a market attached to the first floor so it is walking distance. I believe that the change in environment would benefit her health.

reply2

ne of the patient encounters in which I experienced a health disparity, that was a determinant of the patient’s health was when I attended a patient in a marginalized minority who was unable to pay for her medical bills. Being from a low-income household that has been disadvantaged for a long time, the patient experienced a disparity in health conditions due to their social and economic history. There was credible proof that this patient, who was from a disadvantaged low-income group, faced systemic barriers to receiving quality and affordable health care (Adler et al., 2016).

The state of health of this patient was very serious and emergency medical attention was needed to save her life.  Any delay in providing this patient with basic treatment would minimize her chances of survival. However, by being a victim of health inequality, an opportunity came up to assist her to gain access to healthcare services (Wilhelm & Allen, 2018).I exploited the opportunity and acted by engaging the hospital social worker to help her secure healthcare services without the financial burden and. However, the social worker responded but failed to provide a comprehensive solution to this patient, making my efforts to help the patient futile. The social worker did not provide the financial assistance and only requested for crowd funding to be organized to raise the costs of the healthcare service (Marmot, 2018).

Should such a case present itself the next time, I would consider seeking intervention from the hospital management to put such a patient under persons with special interests who require affirmative health care services. I would also encourage such patients to secure public health insurance to enable them to access medical services without having to pay out of pocket. Such a different approach to a similar situation in the future will help me achieve a positive outcome in solving the challenges caused by health disparities and achieving health equity for all populations.