All posts by : chebby

Over the weeks of this course we have covered a range of healthcare issues. Now, as we approach the last week of our course, please take a moment, step-back, and think about what we have learned. 

It’s been quite a journey through a tremendous amount of material. I hope you have found it of interest and of value.

As you think about all this, your final challenge is to try and bring it all together in response to the following question:

How might the ways in which we produce, deliver, and pay for care be changed in order to increase access, improve quality, and the cost of healthcare services? This is a VERY BIG question that begs for a simple answer. But we should not be tempted by such simplicity. If the answer was simple, we more than likely would have already implemented it.

Rather, we need to dig through the different layers and dimensions of the US healthcare system to be able to see some of the underlying challenges, issues, barriers, and real opportunities that are part of the “big picture.” 

So, from that big picture perspective, what would you change about the US healthcare system to make it better? Pick one aspect and support your decision with credible evidence. Provide the decision-making framework you applied to answer this question. Please include your evaluation of the likely unintended consequences of your idea.

Scenario: Safety
A 77, year old woman is hospitalized for management of her diabetes. She has a history of functional urinary incontinence and poor vision from the diabetes. The nursing staff observes her climbing over the side rails on numerous occasions at night en route to the bathroom. She is quite agitated during this time. The nursing assistant requests that you obtain an order for a body restraint at night to prevent her from falling out of bed.

• Should this patient be restrained to prevent injury?
• Would you request the order for a body restraint? Why, or why not?
• What other information is relevant to this case?
• What nursing interventions could be tried before considering a restraint?

 Think about an article that you have reviewed, is it consistent with the type of research (quantitative or qualitative) being reported in the article? Please explain. 

most recent article used

Tahan, H. M. (2020). Essential Case Management Practices Amidst the Novel Coronavirus Disease 2019 (COVID-19) Crisis: Part 2: End-of-Life Care, Workers’ Compensation Case Management, Legal and Ethical Obligations, Remote Practice, and Resilience. Professional case management.

Verhoeven, V., Tsakitzidis, G., Philips, H., & Van Royen, P. (2020). Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs. BMJ Open, 10(6), e039674.

one paragraph and use two reference and one should be text book  Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett. 

Please see attached the instructions for the power point.

Thank you

instructions from my professor:

1- How has the U.S.A risen to the top internationally to decrease abuse amongst pregnant women?.

note: the assignment is a discussion board.

        only one page answering the question.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg
2. BP: 172/98, HR 88, RR 26
3. 3+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl

Critical Thinking Essay 

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

RUBRIC

Attempt Start Date: 05-Oct-2020 at 03:00:00 AM

Due Date: 12-Oct-2020 at 02:59:59 AM

Maximum Points: 120.0

REPLY1

(This is the feedback from my professor to my prompt)

Marial, 

Thanks for sharing this situation with us and how you were able to show the integrative negotiation process that ended in a win-win situation and potential salary increase. This week we also learned about distributive negotiation and “fixed-pie.” Share with us in your own words what “fixed-pie” is and why it does/does not apply to your situation that illustrated integrative negotiation.

REPLY2

On this week’s task we have to research about integrative negotiation and bargaining. One of the main important things to do is to define the situation because it is important when helping to determine what you will be negotiating your issues to complete a solution. Interest are also the primary factor of integrative negotiation. Being able to identify your own interest and those of the other party and being able to find a solution for all parties it’s a good thing when it comes to negotiating. 

Food Server: Incorrectly submitted an order for a vegetarian couple, their meals were sent to the table with chicken.

Couple: Demanded to Speak to a manager.

Manager: invites them to have a conversation in a private location to listen to their concerns.

Couple: When they were finished addressing their concerns, they proceeded to add that a Birthday dinner was ruined as they were served chicken when they are vegetarians.

Food Server and Manager: Discussed with the couple different ways to compensate them for the unfortunate experience that took place. 

Couple: Explained they did not want a free or discounted meal, they wanted to ensure situations like that didn’t happen again and that employees have proper training. 

Manager: Proudly informed them of their rigorous training program. He also made sure to inform them that the servers are human, and they do make mistakes. 

Couple: Agreed with the manager but informed him that mistakes very dangerous like this shouldn’t happen.

Manager: Informed the general manager of the situation because they wanted to make things right even though the couple refused to any compensation. General manager sent the couple a $100 gift certificate and a formal letter of apology for failing to meet their expectations. 

Couple: Decided to accept that humans make mistake and took them up on the offer and gave the restaurant a second chance.

Aggressiveness is not inappropriate when negotiating integratively. Digging deeper to find relevant information and standing in what you believe in to be able to negotiate properly can really help. Also, separating the person from the problem and recognizing and understand that emotions are an inevitable part of the bargaining process. “everyone involved in the negotiation process works together to generate as many possible solutions to the problem as possible” (Friedman, 1998).

Summarize a contemporary society and examine the multidimensional challenges of defining health and quality health care delivery within contemporary societies.

Please use scholarly writing, cite at least three scholarly references, and use APA format.

Recommended articles

https://sustainabledevelopment.un.org/post2015/transformingourworld

https://content.iospress.com/articles/information-services-and-use/isu809

 Due October 25 at 11:59 PM

The Good Life

The final graded assignment is an 8-10 page paper on the question: what is the good life? This assignment will be completed in four parts, so you may want to use section headers to organize your paper. This paper is somewhat cumulative, so you may need to review material from previous weeks to prepare for this essay. Remember to explain the theories you reference with supporting citations to the textbook and online lectures before contrasting them in correct APA format. You may want to use examples to illustrate your understanding of key ideas in each theory. Use this APA Citation Helper as a convenient reference for properly citing resources.

Address the following in your paper:

1. The Consequentialism Debate: Compare and Contrast deontology and utilitarianism. Briefly discuss the differences between Bentham and Mill’s versions of utilitarianism. Discuss the political and ethical implications of utilitarianism.
2. Explain virtue ethics and care ethics and discuss how these approaches offer an alternative to the deontological and utilitarian focus on how we should act.
3. Explain existential ethics and briefly discuss the role of free will in ethical decision making. The explanation of existentialism should discuss the following ideas: authenticity, ambiguity, freedom, anxiety, and bad faith. 
4. Illustrate the theories discussed with examples, including situations relevant to your current or future career.

Use the following text book as your main reference:

Mitchell, H. B. (2015). Roots of Wisdom: A Tapestry of Philosophical Traditions, 7th. Cengage Learning, ISBN 9781285197128 

TOPIC: Oswego Outbreak Case Study

Read the “Oswego Outbreak Investigation,” located in the Topic Materials.

Part 1

Complete the following:

1. Using the line listing in the Excel “Oswego Line Listing Workbook,” calculate the attack rate ratios for each food item using the table in the Excel “Oswego Attack Rate Table.” Create a separate 2×2 table for the food item you think is responsible for the outbreak and interpret the attack rate ratio for this food item. Refer to the “Creating a 2×2 Contingency Table” resource for guidance.
2. Using the line listing in Excel “Oswego Line Listing Workbook,” construct an epidemic curve by the time of onset of illness. What does this curve tell you regarding the average incubation period, source, and transmission? 
3. Using the incubation range and clinical symptoms, identify potential infectious agents that could be responsible for the outbreak (refer to the Topic Material, “Compendium of Acute Foodborne      and Waterborne Diseases”). Discuss your rationale.

Part 2

In a 500-750 word paper, evaluate the situation and present your findings. Including the following:

1. Does this case meet the definition of an “outbreak?” Why or why not?
2. Identify the steps required to investigate an outbreak. How did these steps help in investigating the Oswego event? Include the relevant information needed for each step to be successful.
3. Discuss the possible routes of transmission for the expected agent.
4. Based on this information, what control measures would you recommend? State whether they are primary, secondary, or tertiary prevention strategies.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide.

You are required to submit this assignment to LopesWrite. 

STUDY MATERIALS

Read Chapters 3-5 and 18 in Gordis Epidemiology.

Read “Types of Surveillance,” located on the London School of Hygiene and Tropical Medicine website. URL:http://conflict.lshtm.ac.uk/page_75.htm

Read “WHO Report on Global Surveillance of Epidemic-Prone Infectious Diseases – Introduction,” located on the World Health Organization (WHO) website. URL: https://www.who.int/csr/resources/publications/introduction/en/

Read “CDC 24-7 Fact of the Week,” located on the Centers for Disease Control and Prevention (CDC) website. URL:https://www.cdc.gov/about/facts/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fabout%2Ffacts%2Fcdcfastfacts%2Fsurveillance.html

Read “Two by Two Tables,” by Sullivan, Dean, and Pezzullo, from OpenEpi: Open Source Epidemiologic Statistics for Public Health (2013), located on the OpenEpi website. URL: http://www.openepi.com/TwobyTwo/TwobyTwo.htm

Read “Goodness of Measurement: Reliability and Validity,” by Bajpai and Bajpai, from International Journal of Medical Science and Public Health (2014). URL: https://www.ejmanager.com/mnstemps/67/67-1380953319.pdf

Use the “Compendium of Acute Foodborne and Waterborne Diseases,” located on the Centers for Disease Control and Prevention (CDC) website, to assist in completing the Oswego Outbreak Case History assignment. URL: https://www.cdc.gov/eis/casestudies/xoswego.401.303.compendium.pdf

View “How to Create an Epidemic Curve,” by Martin (2016), located on the YouTube website. URL: https://www.youtube.com/watch?v=dn84ezAzV4k

View “Know How to Interpret an Epidemic Curve?” by Martin (2017), located on the YouTube website. URL: https://www.youtube.com/watch?v=7SM4PN7Yg1s

Explore the National Notifiable Diseases Surveillance System (NNDSS) page of the Centers for Disease Control and Prevention (CDC) website. URL: https://wwwn.cdc.gov/nndss/

Explore Public Health Surveillance and Data page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/surveillance/