The document discusses recommending short-term acute rehab for a patient with difficulty walking due to mobility issues. Acute rehab facilities can provide intensive therapy programs tailored to the patient using specialized equipment to help them regain function quickly. Most insurances will approve rehab stays that meet admission criteria like participating in multiple therapies daily. Acute rehab is beneficial for safely restoring patients to their prior levels of functioning and reducing risks of falls or injuries from prolonged decreased mobility.
Pre engagement comments indicate any activities that have occurreYASHU40
A medical social worker received an order to conduct a SBIRT (screening, brief intervention, and referral to treatment) with a 47-year-old male patient in the hospital. The social worker met with the Spanish-speaking patient and used an assessment tool called the AUDIT to evaluate the patient's alcohol use. The patient was open to the intervention and acknowledged that drinking had contributed to his hospitalization. He expressed a goal of abstaining from alcohol for one year. The social worker provided support and referral information. In their impressions, the social worker felt compassion for the patient's struggles with alcoholism and loss. They questioned whether brief interventions through SBIRT can effectively encourage behavior change.
Psychological care of veterans (seminar)reflection post youYASHU40
The seminar discussed the psychological issues faced by veterans including PTSD, depression, and substance abuse. It emphasized the importance of an integrated care approach using evidence-based therapies to treat veterans' mental health needs. Key challenges included understanding differences between military and civilian culture to best support veterans transitioning back to civilian life.
1. The patient, a 54-year-old with leukemia, requests hastened death from the medical staff during a home visit due to feeling a loss of control over his deteriorating condition and not knowing how much time remains.
2. The medical staff evaluates the patient's decision-making capacity and explores the root causes of his suffering while intensifying treatment of his symptoms.
3. The staff member responds empathetically to the patient's emotions but does not agree to assist with hastened death, instead searching for alternative options that respect both patient autonomy and professional integrity.
This document provides information on suicide prevention. It defines suicide and related terms like suicidal ideation and self-injury. It discusses how common patient suicide is for mental health professionals. Risk factors for completed suicide are outlined, including past attempts, mental illness, and access to lethal means. Common myths about suicide are debunked with facts. Warning signs of suicide are identified, including changes in mood, talk, and behavior. Crisis intervention strategies and screening tools like the C-SSRS are described. Throughout, statistics and examples are given to support the key points.
This document provides an overview of cognitive therapy. It discusses Aaron Beck, the founder of cognitive therapy, and his background and influences. Beck developed cognitive therapy in the 1960s as an alternative to psychoanalysis, focusing on how a person's thinking affects their feelings and behaviors. Cognitive therapy views psychological disorders as stemming from dysfunctional thought patterns and cognitive distortions, rather than underlying unconscious desires. The document outlines seven common cognitive distortions identified by Beck and discusses how cognitive therapy aims to identify and change faulty assumptions and core beliefs through restructuring distorted thinking.
Acceptance and Commitment Therapy as a Web-based Intervention for Depressive ...Tejas Shah
To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control
condition.
This document summarizes a presentation on the Collaborative Assessment and Management of Suicidality (CAMS) model. It discusses the current reductionist approach to suicide risk, and introduces CAMS as an alternative that targets suicidality as the primary focus of assessment and intervention. The document provides an overview of the CAMS model and evidence for its effectiveness. It also discusses examples of establishing suicide-specific services and using CAMS within community mental health teams.
Dr Murray is a Chartered and Registered Health Psychologist with an interest in social inequalities in health, wellbeing in medical students and doctors, and doctor patient communication. She has a long-standing interest in the wellbeing of healthcare professionals and since starting work at Barts and the London she has been developing her research in the area of moral injury. As well us undertaking research on this issue, she works with NHS staff to develop workshops and seminars which focus on psychological wellbeing and moral injury. Her early research was in chronic pain and its effect on doctor-patient communication and she has a background in psychological intervention in cardiac care and training NHS staff in communication skills. She Health Psychology to MBBS students and Physician Associates at Barts and she is course leader for the iBSc in Medical Education.
Pre engagement comments indicate any activities that have occurreYASHU40
A medical social worker received an order to conduct a SBIRT (screening, brief intervention, and referral to treatment) with a 47-year-old male patient in the hospital. The social worker met with the Spanish-speaking patient and used an assessment tool called the AUDIT to evaluate the patient's alcohol use. The patient was open to the intervention and acknowledged that drinking had contributed to his hospitalization. He expressed a goal of abstaining from alcohol for one year. The social worker provided support and referral information. In their impressions, the social worker felt compassion for the patient's struggles with alcoholism and loss. They questioned whether brief interventions through SBIRT can effectively encourage behavior change.
Psychological care of veterans (seminar)reflection post youYASHU40
The seminar discussed the psychological issues faced by veterans including PTSD, depression, and substance abuse. It emphasized the importance of an integrated care approach using evidence-based therapies to treat veterans' mental health needs. Key challenges included understanding differences between military and civilian culture to best support veterans transitioning back to civilian life.
1. The patient, a 54-year-old with leukemia, requests hastened death from the medical staff during a home visit due to feeling a loss of control over his deteriorating condition and not knowing how much time remains.
2. The medical staff evaluates the patient's decision-making capacity and explores the root causes of his suffering while intensifying treatment of his symptoms.
3. The staff member responds empathetically to the patient's emotions but does not agree to assist with hastened death, instead searching for alternative options that respect both patient autonomy and professional integrity.
This document provides information on suicide prevention. It defines suicide and related terms like suicidal ideation and self-injury. It discusses how common patient suicide is for mental health professionals. Risk factors for completed suicide are outlined, including past attempts, mental illness, and access to lethal means. Common myths about suicide are debunked with facts. Warning signs of suicide are identified, including changes in mood, talk, and behavior. Crisis intervention strategies and screening tools like the C-SSRS are described. Throughout, statistics and examples are given to support the key points.
This document provides an overview of cognitive therapy. It discusses Aaron Beck, the founder of cognitive therapy, and his background and influences. Beck developed cognitive therapy in the 1960s as an alternative to psychoanalysis, focusing on how a person's thinking affects their feelings and behaviors. Cognitive therapy views psychological disorders as stemming from dysfunctional thought patterns and cognitive distortions, rather than underlying unconscious desires. The document outlines seven common cognitive distortions identified by Beck and discusses how cognitive therapy aims to identify and change faulty assumptions and core beliefs through restructuring distorted thinking.
Acceptance and Commitment Therapy as a Web-based Intervention for Depressive ...Tejas Shah
To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control
condition.
This document summarizes a presentation on the Collaborative Assessment and Management of Suicidality (CAMS) model. It discusses the current reductionist approach to suicide risk, and introduces CAMS as an alternative that targets suicidality as the primary focus of assessment and intervention. The document provides an overview of the CAMS model and evidence for its effectiveness. It also discusses examples of establishing suicide-specific services and using CAMS within community mental health teams.
Dr Murray is a Chartered and Registered Health Psychologist with an interest in social inequalities in health, wellbeing in medical students and doctors, and doctor patient communication. She has a long-standing interest in the wellbeing of healthcare professionals and since starting work at Barts and the London she has been developing her research in the area of moral injury. As well us undertaking research on this issue, she works with NHS staff to develop workshops and seminars which focus on psychological wellbeing and moral injury. Her early research was in chronic pain and its effect on doctor-patient communication and she has a background in psychological intervention in cardiac care and training NHS staff in communication skills. She Health Psychology to MBBS students and Physician Associates at Barts and she is course leader for the iBSc in Medical Education.
This book provides detailed descriptions of cognitive behavioral therapy techniques. It aims to fill a gap in training students and practitioners by providing a comprehensive collection of CBT methods in one volume. The book also seeks to address the increasing misapplication of techniques due to a lack of understanding of how to properly implement them. It takes an inclusive approach, including both cognitive and behavioral techniques. The goal is to equip readers with knowledge of the complexities of faithfully applying these evidence-based psychotherapy techniques.
Supershrinks: An Interview with Scott Miller about What Clinicians can Learn ...Scott Miller
The document summarizes an interview between Dr. David Van Nuys and Dr. Scott Miller about what really works in therapy. Some key points:
1) Dr. Miller argues that while different therapeutic approaches work, there is little evidence that diagnostic categories predict treatment outcomes or what approach works best for a specific diagnosis.
2) Research shows that on average, clients who receive treatment improve more than 80% of untreated clients, but debates over diagnostic systems and treatment approaches obscure this fact.
3) The rise of managed care and evidence-based practices has intensified debates over diagnoses and approaches, even though these factors have little bearing on outcomes according to research.
4) Dr. Miller advocates shifting the
The study of supershrinks (Chow, 2014)Scott Miller
Dissertation by Daryl Chow studying the difference between top performing and average psychotherapists. The study documents the role that deliberate practice plays in the effectiveness
Nursing diagnoses identify a patient's response to disease or medical conditions and are formulated based on a nurse's assessment of the patient. They describe the patient's needs and are used to guide nursing care, prioritize patient needs, and facilitate communication between nurses. When developing nursing diagnoses, nurses consider assessment findings and choose the appropriate diagnosis from an accepted list like NANDA. Diagnoses are written with the diagnosis statement, a related-to statement indicating why that diagnosis applies to the patient, and an as-evidenced-by statement with specific examples from the patient's assessment.
Using Mindfulness & Acceptance Based Therapy for Treating BEDMichael Puhala
The document discusses using acceptance and commitment therapy (ACT) to treat binge eating disorder (BED). ACT differs from traditional cognitive behavioral therapy by not trying to change thoughts and feelings, but rather accepting them. It uses mindfulness and metaphors to target experiential avoidance. BED is characterized by recurrent binge eating episodes where a person feels lack of control over eating. Triggers for binges include emotions and unstructured time. ACT can help people commit to values-based actions and accept unpleasant private experiences. Research studies show promise for using ACT to address obesity and BED.
The document reviews a study that examined the efficacy of cognitive processing therapy (CPT) in treating military-related PTSD in veterans. The study found that CPT significantly improved reexperiencing and emotional numbing symptoms for veterans compared to a wait-list control group. While behavioral avoidance and hyperarousal symptoms did not show differential improvement, the study provides initial evidence that CBT can be an effective treatment for PTSD in combat veterans.
This document summarizes Abhi Dalal's presentation on South Asian American mental health. Some key points include:
- Cultural factors like collectivism and family dynamics can create barriers for South Asian Americans seeking mental health care.
- Mindfulness, gratitude, and compassion were presented as strategies for managing emotions and navigating cultural differences.
- Experiences like dating risks, controlling relationships, and balancing family responsibilities with individual needs were discussed in the context of mental health. The presentation aimed to start a dialogue around making mental health care more culturally relevant for South Asian Americans.
This document provides an introduction to a paper that will compare and evaluate the effectiveness of cognitive behavioral therapy (CBT) and group psychotherapy in treating antisocial personality disorder. It defines antisocial personality disorder and discusses its causes, symptoms, diagnosis, and challenges in treatment. The paper will investigate CBT and group psychotherapy theories, analyzing their effects on treating antisocial personality disorder and comparing their advantages and disadvantages.
This document outlines Marc Imhotep Cray's presentation on communication skills in clinical medicine. It discusses how communication impacts diagnosis, adherence, patient satisfaction, physician satisfaction, and malpractice litigation. It presents techniques for engaging patients, demonstrating empathy, educating patients, and enlisting patients in their own healthcare. These include asking open-ended questions, acknowledging emotions, explaining diagnoses and treatments clearly, and discovering patients' perspectives. The goal is to improve outcomes through effective physician-patient relationships and partnerships.
Using Sense of Coherence and 'ikigai' for holistic view of Humanity's respons...K Raman Sethuraman
Humanity's responses to the Covid-19 pandemic has been variable and often chaotic. This presentation attempts to use 'Sense of coherence' and 'Ikigai' as 2 lenses to gain a holistic perspective of the varied human responses to the pandemic crisis of 2020.
Comprehension or understanding, Manageability or coping-behavior, and Meaningfulness are the three components of Sense of Coherence (SOC), first proposed by Antonovsky. Ikigai is a Japanese concept of one's 'Purpose of Life', which has been modified by a life-coach from the West. Using SOC and Ikigai, we can try to get a holistic understanding of the varied responses of humanity across the globe.
1. The document provides information on clinical assessment and diagnosis of psychological disorders. It discusses various assessment tools including clinical interviews, tests, and observations that are used to evaluate a client's behavior and determine if it meets criteria for a known disorder.
2. Standardized assessment tools are important to have reliability and validity. Clinical interviews allow an in-depth exploration of a client's history and current issues. Psychological tests evaluate traits, symptoms, and cognitive abilities.
3. Assessment data is used to form a diagnosis based on the DSM classification system to determine if a client matches criteria for a known disorder and identify an appropriate treatment plan.
DQ 1 Response 1 As health care is advancing, there have been man.docxelinoraudley582231
DQ 1 Response 1
As health care is advancing, there have been many essential right concerning patients. The process of dying is very complex and it consequences are complicated. If one dies, the individual will not come back again. Therefore, individual with living will may promote care providers’ guideline to their destiny. It will prevent any litigation that may affect the care provider and the organization. Healthcare industry has now got involved or it is now involving spiritual treatment. Spiritual health care may have close relationship with end of life. The essential aspect to spiritual health care may include emotions, feelings, and assumptions of an individual. Therefore, it is very important to guide such essential concerning patient desire to have evidence. Sometimes patient do not want their family members to witness such desire because of the emotional consequences. Every patient knows the kind of pain their feeling and if this individual desire to end this suffering, others may not understand. Hence parent and family of a patient should not interfere in such situation. I can imagine a patient with a serious accident and is subjected to life support machine based on the patient’s unresponsive reaction. This patient has gone through treatment day and night for more than years. Such situation worsens the patient pain and suffering but who else can feel what the patient is feeling? Parent should decide on what they would do to their child regardless. In my opinion, the child will depend on the parent to survive living healthy. It would be very painful if the parent income -wise is poor. Which will lead the child to go through painful life. Therefore, parent knows their situation at hand and they need to make their own decision regardless.
Reference
Balk, E. D: Closing the gaps on efforts to improve healthcare quality at the end-of-life.
Russell, D: Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life by the Committee on Approaching Death: Addressing Key End of Life Issues. Washington, DC: National Academies Press, 2014. 638 pages.
Response 2
Assess the ethical issues surrounding end-of-life decisions. How has the living will affected medical response and why is this important for guiding end-of-life decisions? Should families be able to impact how and if a person's living will is carried out? Should parents have the right to choose to end the life of their child if the child has Down Syndrome?
Living wills are very important. They are legal documents that lay out decisions that the patient has made for their health care in the event that they are unable to make decisions anymore. Decisions that are made could include if the patient wants to be resuscitated or kept on life support. Furthermore, a living will can have the patients in regards to pain management or organ donation. (Mayo Clinic Staff, 2017) This is way if the patient’s family or friends do not agree it goes back to the patient’s .
A presentation designed to inform health care workers about the components and importance of advance directives, with specific information for Massachusetts residents.
The legal authority to make decisions about withdrawing life-sustaining treatment depends on the patient's competence and wishes. For incompetent patients, legally authorized decision-makers include substitute decision-makers like family or an advance directive. In Australia, decisions must consider the patient's best interests based on values, goals, and medical recommendations. In complex cases, courts may provide guidance. Withdrawing treatment requires consent from competent patients or substitute decision-makers considering the patient's wishes and best interests.
Ethical PrinciplesEthics are guided by the core principles to wh.docxgitagrimston
Ethical Principles
Ethics are guided by the core principles to which most of our society agree. The devil is in the details, however, as we will see in specific instances.
Autonomy
The principle of autonomy ties into patients' rights to self-determination, or the right to make their own fully informed choices about their care; treatments they may accept or reject; and the ultimate consequences of their choices. The freedom to choose our own course of action is highly cherished in our society. However, what if the choice involved taking a life, whether by suicide or homicide? What happens when one person's desires or choices bump up against another's? These gray areas are the turf on which ethical issues play out. An example of an ethical dilemma surrounding autonomy occurs when a patient denies a lifesaving medical treatment. What if the person refusing treatment is legally a child who refuses chemotherapy for a curable cancer, all because of religious beliefs? Does the child know that without treatment death is likely? Does the child understand death well enough to make the choice? What if the parents are making this choice on behalf of their child, which is often the case? Does the principle of autonomy extend to treatments that are curative and life-saving, yet conflict with deeply held religious or personal beliefs? What role should government play in order to protect its citizens, even from themselves? Autonomy can be a minefield of conflicting values, views, and actions.
Beneficence
The principle of beneficence requires that all actions taken on behalf of a patient are designed to provide good outcomes. Seem obvious? Focus on the question of what constitutes a "good outcome." A 76-year-old man has fallen on ice, struck his head, and has suffered severe brain damage from the resultant bleeding into the brain. He is still able to respond to painful stimuli, breathe on his own, and maintain blood pressure and other bodily functions. However, the cerebral cortex is permanently damaged. The family and the physician huddle to discuss what steps to take next. What is the beneficent approach? It is possible to sustain life in this patient since his brain stem is intact and he does not meet the criteria for brain death. Should he be given fluids and nutrition through tube feedings? If he develops pneumonia, should it be treated? Should he be left alone with minimal comfort measures to see what his body will do as the injury unfolds? Should all interventions be withheld? Would it do the patient more harm to continue all measures, or to stop all measures? What are the patient's wishes, as expressed by his surrogate, in a situation such as this? Beneficence can be a tricky concept, since what is helpful and indicated in one situation may be a terrible choice in another. The question of the definition of "good outcome" may be wildly different from various perspectives of the family, the physicians, the patient himself, and the hospital.
Non-malfe ...
Reply 1There is not a single specific point in an illness, whe.docxcarlt4
The document discusses several reasons why many elderly patients do not die at home as is their preference for end-of-life care. Cultural taboos or not wanting to burden family can influence a patient's choice. Additionally, the physical issues requiring nursing care that occur at the end of life make dying at home difficult. Limited Medicare coverage for in-home care and high costs also present barriers. As nurses, supporting patients' end-of-life wishes involves coordinating spiritual care, clarifying care plans, and acting as a liaison between patients and families. Ensuring comfort and that wishes are followed provides a positive experience.
Ethical Dilemma In the documentary The Invisible.docxhumphrieskalyn
Ethical Dilemma
In the documentary The Invisible Patients, Jessica, a nurse practitioner for home-limited patients, is faced with several ethical dilemmas. For example, Jessica provides care for an elderly couple named Wink and Patty Sherrill. Both Patty and Wink are prescribed narcotics to manage their arthritis pain. During a routine urine drug screen, it is discovered that Patty does not have any trace of her pain medication in her system, yet she is still having her narcotic prescription refilled regularly. This obviously raises concerns for medication diversion. Patty is presumably giving her narcotics to her husband or selling her narcotics, which is a clear violation of her pain contract. She is banned from her primary care MD’s practice, which causes her great difficulty in finding another healthcare provider. Jessica feels that it is her responsibility to provide care for this couple.
This scenario raises the ethical dilemma of beneficence versus nonmaleficence. The principle of beneficence is “the duty to do good and prevent or remove harm" (Hamric, Hanson, Tracy, O'Grady, 2014, p. 337). Prescribing narcotics to those experiencing chronic pain and disability is a necessary and beneficent act of healthcare providers. The principle of nonmaleficence is “the duty not to inflict harm or evil” (Hamric et al., 2014, p.337). Prescribing narcotics to a patient who is suspected of narcotics diversion has the potential to cause harm to the person who is taking the narcotics illicitly. Jessica must now decide which principle to follow and which principle to potentially break. Jessica decides that even though Patty is abusing her prescription, she does in fact still need her narcotics and continues to prescribe the pain medicine.
My
Solution
In this scenario, I would not continue to prescribe Patty narcotics. Since she is not taking her pain medications but still seeking refills, she is abusing her prescription and the trust placed in her. If she is diverting her narcotics to her husband and/or selling them on the street, this places Wink and/or the narcotic abuser at risk for health complications such as respiratory depression, constipation, drug dependence, increased tolerance, and narcotic withdrawal in the future. I believe Wink has a legitimate need for pain medications, but he should be honest and open with Jessica about the need to increase his pain medications or try different modalities if his pain is not properly controlled. Regardless of motive, illegally diverting narcotics is a breach in contract and should not be overlooked.
If I were presented with this scenario, I would have talked with Patty and Wink about Patty’s narcotic diversion and sought an alternative solution to continuing to prescribe narcotics. If Patty were in fact giving her narcotics to her husband to help control his pain, I would adjust Wink’s medications and pain management strategy. If they were selling their excess n.
1 day agoJessica Dunne RE Discussion - Week 10COLLAPSET.docxoswald1horne84988
1 day ago
Jessica Dunne
RE: Discussion - Week 10
COLLAPSE
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population Health
INITIAL POST
Resource Allocation for an Aging Population
Technological advances in medicine and preventative care means that Americans are living longer lives than ever before. Hayutin, Deitz, and Mitchell (2010) assert that by the year 2030 Americans over the age of 65 will account for 20% of the population. There will soon be more elderly Americans than children, and the number of working adults is expected to decrease concurrently. This shift in the population will yield significant economic, political and social challenges. Healthcare needs are also changing. Death and disability rates are declining, yet the incidence of chronic illness within the elderly population continues to rise (Hayutin, Deitz, & Mitchell, 2010). Crippen and Barnato (2011) contend that 20% of the population assume 80% of all healthcare-related costs. As much as 75% of these costs are attributable to chronic diseases (Crippen & Barnato, 2011). Revenues for healthcare are projected to decrease while expenditures are expected to increase. Healthcare providers, policymakers, and industry experts need to work towards solutions that will optimize healthcare dollars and create sustainability for future generations.
Ethical Considerations
The dynamics of healthcare are complicated; financial resources seem insignificant when making life and death decisions. Nonetheless, resources are finite, and therefore, distribution and allocation of funds must be ethical. According to Craig (2010), the theory of distributive justice requires that people with the same health needs have equitable access to all available resources. However, distributive justice also requires that the associated costs also be shared equitably. Fairness is another ethical principle that should be applied in the allocation of healthcare resources. Policies that are fair must be transparent, understandable, and there must be regulatory process to address complaints and resolve conflicts. The idea that healthcare is a human right is outlined in the declaration of independence which guarantees citizens the right to life, liberty, and the pursuit of happiness. The need of the patient should also be considered. A burn patient needs plastic surgery more than a patient that wants rhinoplasty (Craig, 2010).
Nurses provide the best possible care to every single patient regardless of gender, ethnicity, sexual orientation, ability to pay, or age. The American Nurses Association (2012) provides ethical guidelines for nurses to employ in their practice. Provisions one, two, and three promote the principle of beneficence, and the obligation nurses have to advocate for the best interests of their patients. Provisions seven, eight, and nine focus on providing social justice for clients through practice and policy (American Nurses Association, 2012). Nurses should also promote aut.
Artificial Nutrition And Hydration At The End Of LifeScott Faria
This document summarizes a review article about artificial nutrition and hydration at the end of life. It discusses the legal, ethical and clinical considerations surrounding providing or withdrawing artificial feeding and hydration for older adults near death. It outlines key court cases like Cruzan and Schiavo that have established precedents, and reviews concepts like living wills, palliative care, and perspectives from medical organizations. While legally documented wishes should determine treatment, emergency situations can complicate decision making for incompetent patients without advance directives.
Published April 2017
Part of hospital test scenarios, escalation to ethics committee
Patients with a terminal illness who communicate their wish to die to a nurse shall receive appropriate care that is in line with institutional procedures, local laws, and their personal preferences. A nurse should be able to rely on the support of the institution he or she works for in terms of training, clear line of responsibility for such decisions, and unambiguously communicated expectations defined in organizational procedures. Assisted suicide is legal in Switzerland and several other European countries, in several states in the U.S., and in Canada. The mental capacity of the patient has to be considered in addition to locally applicable laws. Medical Power of Attorney is helpful if the patient previously described his or her wishes regarding end-of-life decisions and became incapacitated in the meantime. Financial toxicity, in addition to dubious effectiveness, contributes to the reluctance of some patients to undergo aggressive and invasive therapies. German physician Albert Moll in his book Medical Ethics (1902), argues that aggressive care in incurably ill patients is unethical. Healthcare staff, including nurses, can conscientiously object to assisting with suicide.
· You must respond to at least two of your peers by extendinLesleyWhitesidefv
· You must respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts and supporting your opinion with a reference. Response posts must be at least 150 words. Your response (reply) posts are worth 2 points (1 point per response). Your post will include a salutation, response (150 words), and a reference.
· Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.
· Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years—no websites or videos to be referenced without prior approval
· Responses must be posted in APA format for Canvas to receive full grades. Automatic deduction of 10% if not completed.
Worldview & Decision-Making
Sejal Patel
St. Thomas University
NUR 421: Nursing Practice in Multicultural Society
Professor Kathleen Price
November 02, 2021
Worldview & Decision-Making
The sudden neurological injury that is not likely to recover puts the person in denial if the person is somewhat conscious. It is hard to accept for even family that sudden change in care given stage. Those patients have physical problems like paralysis of facial muscles or losing sensation in the face, altered sense of smell or taste, loss of vision, swallowing difficulties, dizziness, ringing in the ear, and hearing loss. They also have altered consciousness, intellectual problems, cognitive problems, Executive functioning problems, communication problems, behavioral changes, emotional changes, sensory problems, and degenerative issues.
The majority of persons who have suffered substantial brain damage will need rehabilitation. They may have to relearn basic abilities like walking and to talk. The objective is to increase their ability to carry out everyday tasks. Rehabilitation includes a group of people who master different specialties to help patients maintain living activity. An occupational therapist, who supports the person learning, relearn or improving skills to perform everyday activities—a physical therapist who helps with mobility and relearning movement patterns, balance, and walking. The social worker or case manager facilitates access to service agencies, assists with care decisions and planning, and facilitates communication among various professionals, care providers, and family members. A rehabilitation nurse assists with discharge planning from a hospital or rehabilitation center by providing continuous rehabilitation care and services. Speech and language therapist supports the person to improve communication skills and use assistive communication devices if necessary. A recreational therapist helps the patient with Time management and leisure activities. We can also use music therapy and aroma therapy to relax patients who face incurable health conditions.
Advance directives are an essential part of hea ...
"This is how i want to die" DPT Study Day 16th September 2011Hospiscare
The document discusses advance care planning (ACP) and its importance in end-of-life care. It defines ACP as a voluntary process where patients discuss future medical treatment preferences with healthcare providers. Key points include:
- ACP allows patients to communicate their values and wishes should they become unable to make decisions later.
- Triggers for initiating ACP include prognosis from chronic illness or a "gut feeling" from clinicians. Sensitive conversations are important.
- Documents like Preferred Priorities of Care and Advance Decisions to Refuse Treatment can record a patient's wishes if properly completed.
- Valid advance decisions must be specific, signed/witnessed, and state they apply even if life is at
This book provides detailed descriptions of cognitive behavioral therapy techniques. It aims to fill a gap in training students and practitioners by providing a comprehensive collection of CBT methods in one volume. The book also seeks to address the increasing misapplication of techniques due to a lack of understanding of how to properly implement them. It takes an inclusive approach, including both cognitive and behavioral techniques. The goal is to equip readers with knowledge of the complexities of faithfully applying these evidence-based psychotherapy techniques.
Supershrinks: An Interview with Scott Miller about What Clinicians can Learn ...Scott Miller
The document summarizes an interview between Dr. David Van Nuys and Dr. Scott Miller about what really works in therapy. Some key points:
1) Dr. Miller argues that while different therapeutic approaches work, there is little evidence that diagnostic categories predict treatment outcomes or what approach works best for a specific diagnosis.
2) Research shows that on average, clients who receive treatment improve more than 80% of untreated clients, but debates over diagnostic systems and treatment approaches obscure this fact.
3) The rise of managed care and evidence-based practices has intensified debates over diagnoses and approaches, even though these factors have little bearing on outcomes according to research.
4) Dr. Miller advocates shifting the
The study of supershrinks (Chow, 2014)Scott Miller
Dissertation by Daryl Chow studying the difference between top performing and average psychotherapists. The study documents the role that deliberate practice plays in the effectiveness
Nursing diagnoses identify a patient's response to disease or medical conditions and are formulated based on a nurse's assessment of the patient. They describe the patient's needs and are used to guide nursing care, prioritize patient needs, and facilitate communication between nurses. When developing nursing diagnoses, nurses consider assessment findings and choose the appropriate diagnosis from an accepted list like NANDA. Diagnoses are written with the diagnosis statement, a related-to statement indicating why that diagnosis applies to the patient, and an as-evidenced-by statement with specific examples from the patient's assessment.
Using Mindfulness & Acceptance Based Therapy for Treating BEDMichael Puhala
The document discusses using acceptance and commitment therapy (ACT) to treat binge eating disorder (BED). ACT differs from traditional cognitive behavioral therapy by not trying to change thoughts and feelings, but rather accepting them. It uses mindfulness and metaphors to target experiential avoidance. BED is characterized by recurrent binge eating episodes where a person feels lack of control over eating. Triggers for binges include emotions and unstructured time. ACT can help people commit to values-based actions and accept unpleasant private experiences. Research studies show promise for using ACT to address obesity and BED.
The document reviews a study that examined the efficacy of cognitive processing therapy (CPT) in treating military-related PTSD in veterans. The study found that CPT significantly improved reexperiencing and emotional numbing symptoms for veterans compared to a wait-list control group. While behavioral avoidance and hyperarousal symptoms did not show differential improvement, the study provides initial evidence that CBT can be an effective treatment for PTSD in combat veterans.
This document summarizes Abhi Dalal's presentation on South Asian American mental health. Some key points include:
- Cultural factors like collectivism and family dynamics can create barriers for South Asian Americans seeking mental health care.
- Mindfulness, gratitude, and compassion were presented as strategies for managing emotions and navigating cultural differences.
- Experiences like dating risks, controlling relationships, and balancing family responsibilities with individual needs were discussed in the context of mental health. The presentation aimed to start a dialogue around making mental health care more culturally relevant for South Asian Americans.
This document provides an introduction to a paper that will compare and evaluate the effectiveness of cognitive behavioral therapy (CBT) and group psychotherapy in treating antisocial personality disorder. It defines antisocial personality disorder and discusses its causes, symptoms, diagnosis, and challenges in treatment. The paper will investigate CBT and group psychotherapy theories, analyzing their effects on treating antisocial personality disorder and comparing their advantages and disadvantages.
This document outlines Marc Imhotep Cray's presentation on communication skills in clinical medicine. It discusses how communication impacts diagnosis, adherence, patient satisfaction, physician satisfaction, and malpractice litigation. It presents techniques for engaging patients, demonstrating empathy, educating patients, and enlisting patients in their own healthcare. These include asking open-ended questions, acknowledging emotions, explaining diagnoses and treatments clearly, and discovering patients' perspectives. The goal is to improve outcomes through effective physician-patient relationships and partnerships.
Using Sense of Coherence and 'ikigai' for holistic view of Humanity's respons...K Raman Sethuraman
Humanity's responses to the Covid-19 pandemic has been variable and often chaotic. This presentation attempts to use 'Sense of coherence' and 'Ikigai' as 2 lenses to gain a holistic perspective of the varied human responses to the pandemic crisis of 2020.
Comprehension or understanding, Manageability or coping-behavior, and Meaningfulness are the three components of Sense of Coherence (SOC), first proposed by Antonovsky. Ikigai is a Japanese concept of one's 'Purpose of Life', which has been modified by a life-coach from the West. Using SOC and Ikigai, we can try to get a holistic understanding of the varied responses of humanity across the globe.
1. The document provides information on clinical assessment and diagnosis of psychological disorders. It discusses various assessment tools including clinical interviews, tests, and observations that are used to evaluate a client's behavior and determine if it meets criteria for a known disorder.
2. Standardized assessment tools are important to have reliability and validity. Clinical interviews allow an in-depth exploration of a client's history and current issues. Psychological tests evaluate traits, symptoms, and cognitive abilities.
3. Assessment data is used to form a diagnosis based on the DSM classification system to determine if a client matches criteria for a known disorder and identify an appropriate treatment plan.
DQ 1 Response 1 As health care is advancing, there have been man.docxelinoraudley582231
DQ 1 Response 1
As health care is advancing, there have been many essential right concerning patients. The process of dying is very complex and it consequences are complicated. If one dies, the individual will not come back again. Therefore, individual with living will may promote care providers’ guideline to their destiny. It will prevent any litigation that may affect the care provider and the organization. Healthcare industry has now got involved or it is now involving spiritual treatment. Spiritual health care may have close relationship with end of life. The essential aspect to spiritual health care may include emotions, feelings, and assumptions of an individual. Therefore, it is very important to guide such essential concerning patient desire to have evidence. Sometimes patient do not want their family members to witness such desire because of the emotional consequences. Every patient knows the kind of pain their feeling and if this individual desire to end this suffering, others may not understand. Hence parent and family of a patient should not interfere in such situation. I can imagine a patient with a serious accident and is subjected to life support machine based on the patient’s unresponsive reaction. This patient has gone through treatment day and night for more than years. Such situation worsens the patient pain and suffering but who else can feel what the patient is feeling? Parent should decide on what they would do to their child regardless. In my opinion, the child will depend on the parent to survive living healthy. It would be very painful if the parent income -wise is poor. Which will lead the child to go through painful life. Therefore, parent knows their situation at hand and they need to make their own decision regardless.
Reference
Balk, E. D: Closing the gaps on efforts to improve healthcare quality at the end-of-life.
Russell, D: Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life by the Committee on Approaching Death: Addressing Key End of Life Issues. Washington, DC: National Academies Press, 2014. 638 pages.
Response 2
Assess the ethical issues surrounding end-of-life decisions. How has the living will affected medical response and why is this important for guiding end-of-life decisions? Should families be able to impact how and if a person's living will is carried out? Should parents have the right to choose to end the life of their child if the child has Down Syndrome?
Living wills are very important. They are legal documents that lay out decisions that the patient has made for their health care in the event that they are unable to make decisions anymore. Decisions that are made could include if the patient wants to be resuscitated or kept on life support. Furthermore, a living will can have the patients in regards to pain management or organ donation. (Mayo Clinic Staff, 2017) This is way if the patient’s family or friends do not agree it goes back to the patient’s .
A presentation designed to inform health care workers about the components and importance of advance directives, with specific information for Massachusetts residents.
The legal authority to make decisions about withdrawing life-sustaining treatment depends on the patient's competence and wishes. For incompetent patients, legally authorized decision-makers include substitute decision-makers like family or an advance directive. In Australia, decisions must consider the patient's best interests based on values, goals, and medical recommendations. In complex cases, courts may provide guidance. Withdrawing treatment requires consent from competent patients or substitute decision-makers considering the patient's wishes and best interests.
Ethical PrinciplesEthics are guided by the core principles to wh.docxgitagrimston
Ethical Principles
Ethics are guided by the core principles to which most of our society agree. The devil is in the details, however, as we will see in specific instances.
Autonomy
The principle of autonomy ties into patients' rights to self-determination, or the right to make their own fully informed choices about their care; treatments they may accept or reject; and the ultimate consequences of their choices. The freedom to choose our own course of action is highly cherished in our society. However, what if the choice involved taking a life, whether by suicide or homicide? What happens when one person's desires or choices bump up against another's? These gray areas are the turf on which ethical issues play out. An example of an ethical dilemma surrounding autonomy occurs when a patient denies a lifesaving medical treatment. What if the person refusing treatment is legally a child who refuses chemotherapy for a curable cancer, all because of religious beliefs? Does the child know that without treatment death is likely? Does the child understand death well enough to make the choice? What if the parents are making this choice on behalf of their child, which is often the case? Does the principle of autonomy extend to treatments that are curative and life-saving, yet conflict with deeply held religious or personal beliefs? What role should government play in order to protect its citizens, even from themselves? Autonomy can be a minefield of conflicting values, views, and actions.
Beneficence
The principle of beneficence requires that all actions taken on behalf of a patient are designed to provide good outcomes. Seem obvious? Focus on the question of what constitutes a "good outcome." A 76-year-old man has fallen on ice, struck his head, and has suffered severe brain damage from the resultant bleeding into the brain. He is still able to respond to painful stimuli, breathe on his own, and maintain blood pressure and other bodily functions. However, the cerebral cortex is permanently damaged. The family and the physician huddle to discuss what steps to take next. What is the beneficent approach? It is possible to sustain life in this patient since his brain stem is intact and he does not meet the criteria for brain death. Should he be given fluids and nutrition through tube feedings? If he develops pneumonia, should it be treated? Should he be left alone with minimal comfort measures to see what his body will do as the injury unfolds? Should all interventions be withheld? Would it do the patient more harm to continue all measures, or to stop all measures? What are the patient's wishes, as expressed by his surrogate, in a situation such as this? Beneficence can be a tricky concept, since what is helpful and indicated in one situation may be a terrible choice in another. The question of the definition of "good outcome" may be wildly different from various perspectives of the family, the physicians, the patient himself, and the hospital.
Non-malfe ...
Reply 1There is not a single specific point in an illness, whe.docxcarlt4
The document discusses several reasons why many elderly patients do not die at home as is their preference for end-of-life care. Cultural taboos or not wanting to burden family can influence a patient's choice. Additionally, the physical issues requiring nursing care that occur at the end of life make dying at home difficult. Limited Medicare coverage for in-home care and high costs also present barriers. As nurses, supporting patients' end-of-life wishes involves coordinating spiritual care, clarifying care plans, and acting as a liaison between patients and families. Ensuring comfort and that wishes are followed provides a positive experience.
Ethical Dilemma In the documentary The Invisible.docxhumphrieskalyn
Ethical Dilemma
In the documentary The Invisible Patients, Jessica, a nurse practitioner for home-limited patients, is faced with several ethical dilemmas. For example, Jessica provides care for an elderly couple named Wink and Patty Sherrill. Both Patty and Wink are prescribed narcotics to manage their arthritis pain. During a routine urine drug screen, it is discovered that Patty does not have any trace of her pain medication in her system, yet she is still having her narcotic prescription refilled regularly. This obviously raises concerns for medication diversion. Patty is presumably giving her narcotics to her husband or selling her narcotics, which is a clear violation of her pain contract. She is banned from her primary care MD’s practice, which causes her great difficulty in finding another healthcare provider. Jessica feels that it is her responsibility to provide care for this couple.
This scenario raises the ethical dilemma of beneficence versus nonmaleficence. The principle of beneficence is “the duty to do good and prevent or remove harm" (Hamric, Hanson, Tracy, O'Grady, 2014, p. 337). Prescribing narcotics to those experiencing chronic pain and disability is a necessary and beneficent act of healthcare providers. The principle of nonmaleficence is “the duty not to inflict harm or evil” (Hamric et al., 2014, p.337). Prescribing narcotics to a patient who is suspected of narcotics diversion has the potential to cause harm to the person who is taking the narcotics illicitly. Jessica must now decide which principle to follow and which principle to potentially break. Jessica decides that even though Patty is abusing her prescription, she does in fact still need her narcotics and continues to prescribe the pain medicine.
My
Solution
In this scenario, I would not continue to prescribe Patty narcotics. Since she is not taking her pain medications but still seeking refills, she is abusing her prescription and the trust placed in her. If she is diverting her narcotics to her husband and/or selling them on the street, this places Wink and/or the narcotic abuser at risk for health complications such as respiratory depression, constipation, drug dependence, increased tolerance, and narcotic withdrawal in the future. I believe Wink has a legitimate need for pain medications, but he should be honest and open with Jessica about the need to increase his pain medications or try different modalities if his pain is not properly controlled. Regardless of motive, illegally diverting narcotics is a breach in contract and should not be overlooked.
If I were presented with this scenario, I would have talked with Patty and Wink about Patty’s narcotic diversion and sought an alternative solution to continuing to prescribe narcotics. If Patty were in fact giving her narcotics to her husband to help control his pain, I would adjust Wink’s medications and pain management strategy. If they were selling their excess n.
1 day agoJessica Dunne RE Discussion - Week 10COLLAPSET.docxoswald1horne84988
1 day ago
Jessica Dunne
RE: Discussion - Week 10
COLLAPSE
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population Health
INITIAL POST
Resource Allocation for an Aging Population
Technological advances in medicine and preventative care means that Americans are living longer lives than ever before. Hayutin, Deitz, and Mitchell (2010) assert that by the year 2030 Americans over the age of 65 will account for 20% of the population. There will soon be more elderly Americans than children, and the number of working adults is expected to decrease concurrently. This shift in the population will yield significant economic, political and social challenges. Healthcare needs are also changing. Death and disability rates are declining, yet the incidence of chronic illness within the elderly population continues to rise (Hayutin, Deitz, & Mitchell, 2010). Crippen and Barnato (2011) contend that 20% of the population assume 80% of all healthcare-related costs. As much as 75% of these costs are attributable to chronic diseases (Crippen & Barnato, 2011). Revenues for healthcare are projected to decrease while expenditures are expected to increase. Healthcare providers, policymakers, and industry experts need to work towards solutions that will optimize healthcare dollars and create sustainability for future generations.
Ethical Considerations
The dynamics of healthcare are complicated; financial resources seem insignificant when making life and death decisions. Nonetheless, resources are finite, and therefore, distribution and allocation of funds must be ethical. According to Craig (2010), the theory of distributive justice requires that people with the same health needs have equitable access to all available resources. However, distributive justice also requires that the associated costs also be shared equitably. Fairness is another ethical principle that should be applied in the allocation of healthcare resources. Policies that are fair must be transparent, understandable, and there must be regulatory process to address complaints and resolve conflicts. The idea that healthcare is a human right is outlined in the declaration of independence which guarantees citizens the right to life, liberty, and the pursuit of happiness. The need of the patient should also be considered. A burn patient needs plastic surgery more than a patient that wants rhinoplasty (Craig, 2010).
Nurses provide the best possible care to every single patient regardless of gender, ethnicity, sexual orientation, ability to pay, or age. The American Nurses Association (2012) provides ethical guidelines for nurses to employ in their practice. Provisions one, two, and three promote the principle of beneficence, and the obligation nurses have to advocate for the best interests of their patients. Provisions seven, eight, and nine focus on providing social justice for clients through practice and policy (American Nurses Association, 2012). Nurses should also promote aut.
Artificial Nutrition And Hydration At The End Of LifeScott Faria
This document summarizes a review article about artificial nutrition and hydration at the end of life. It discusses the legal, ethical and clinical considerations surrounding providing or withdrawing artificial feeding and hydration for older adults near death. It outlines key court cases like Cruzan and Schiavo that have established precedents, and reviews concepts like living wills, palliative care, and perspectives from medical organizations. While legally documented wishes should determine treatment, emergency situations can complicate decision making for incompetent patients without advance directives.
Published April 2017
Part of hospital test scenarios, escalation to ethics committee
Patients with a terminal illness who communicate their wish to die to a nurse shall receive appropriate care that is in line with institutional procedures, local laws, and their personal preferences. A nurse should be able to rely on the support of the institution he or she works for in terms of training, clear line of responsibility for such decisions, and unambiguously communicated expectations defined in organizational procedures. Assisted suicide is legal in Switzerland and several other European countries, in several states in the U.S., and in Canada. The mental capacity of the patient has to be considered in addition to locally applicable laws. Medical Power of Attorney is helpful if the patient previously described his or her wishes regarding end-of-life decisions and became incapacitated in the meantime. Financial toxicity, in addition to dubious effectiveness, contributes to the reluctance of some patients to undergo aggressive and invasive therapies. German physician Albert Moll in his book Medical Ethics (1902), argues that aggressive care in incurably ill patients is unethical. Healthcare staff, including nurses, can conscientiously object to assisting with suicide.
· You must respond to at least two of your peers by extendinLesleyWhitesidefv
· You must respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts and supporting your opinion with a reference. Response posts must be at least 150 words. Your response (reply) posts are worth 2 points (1 point per response). Your post will include a salutation, response (150 words), and a reference.
· Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.
· Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years—no websites or videos to be referenced without prior approval
· Responses must be posted in APA format for Canvas to receive full grades. Automatic deduction of 10% if not completed.
Worldview & Decision-Making
Sejal Patel
St. Thomas University
NUR 421: Nursing Practice in Multicultural Society
Professor Kathleen Price
November 02, 2021
Worldview & Decision-Making
The sudden neurological injury that is not likely to recover puts the person in denial if the person is somewhat conscious. It is hard to accept for even family that sudden change in care given stage. Those patients have physical problems like paralysis of facial muscles or losing sensation in the face, altered sense of smell or taste, loss of vision, swallowing difficulties, dizziness, ringing in the ear, and hearing loss. They also have altered consciousness, intellectual problems, cognitive problems, Executive functioning problems, communication problems, behavioral changes, emotional changes, sensory problems, and degenerative issues.
The majority of persons who have suffered substantial brain damage will need rehabilitation. They may have to relearn basic abilities like walking and to talk. The objective is to increase their ability to carry out everyday tasks. Rehabilitation includes a group of people who master different specialties to help patients maintain living activity. An occupational therapist, who supports the person learning, relearn or improving skills to perform everyday activities—a physical therapist who helps with mobility and relearning movement patterns, balance, and walking. The social worker or case manager facilitates access to service agencies, assists with care decisions and planning, and facilitates communication among various professionals, care providers, and family members. A rehabilitation nurse assists with discharge planning from a hospital or rehabilitation center by providing continuous rehabilitation care and services. Speech and language therapist supports the person to improve communication skills and use assistive communication devices if necessary. A recreational therapist helps the patient with Time management and leisure activities. We can also use music therapy and aroma therapy to relax patients who face incurable health conditions.
Advance directives are an essential part of hea ...
"This is how i want to die" DPT Study Day 16th September 2011Hospiscare
The document discusses advance care planning (ACP) and its importance in end-of-life care. It defines ACP as a voluntary process where patients discuss future medical treatment preferences with healthcare providers. Key points include:
- ACP allows patients to communicate their values and wishes should they become unable to make decisions later.
- Triggers for initiating ACP include prognosis from chronic illness or a "gut feeling" from clinicians. Sensitive conversations are important.
- Documents like Preferred Priorities of Care and Advance Decisions to Refuse Treatment can record a patient's wishes if properly completed.
- Valid advance decisions must be specific, signed/witnessed, and state they apply even if life is at
Janice Keller, a 62-year-old woman, was diagnosed with Non-Hodgkin's Lymphoma in 2011. Over four years, her cancer progressed and her health declined despite treatments. In her final year, Janice expressed a desire to stop treatment and focus on quality of life. Her husband, as her medical power of attorney, wanted her to continue treatment. The medical team recognized the discrepancy between Janice's wishes and her husband's decisions. They conducted family meetings to ensure her husband made choices in Janice's best interest, but an ethical dilemma emerged if he could not. Current research finds end-of-life decision making to be a common oncology ethical issue.
• Result List • Refine Search • 1 of 1 Title .docxodiliagilby
This article discusses the complex issue of euthanasia from ethical, religious, and legal perspectives. It defines euthanasia as intentionally ending a life to relieve suffering. There are debates around active versus passive euthanasia and voluntary versus nonvoluntary euthanasia. Religiously, views range from allowing refusal of treatment to prevent needless suffering, to opposing euthanasia due to the sanctity of life. Legally, courts have allowed refusal of treatment but not physician-assisted suicide, though Oregon passed a law allowing it for terminally ill patients. Overall there are many viewpoints on this controversial issue with no consensus.
The objective of Advance Care Planning (ACP) is to help
ensure that patients receive medical care that is aligned with their
values, goals and preferences.
This document discusses palliative care, hospice care, and end-of-life planning. It defines palliative care as treating people with serious illnesses through managing symptoms and improving quality of life. Hospice care provides medical care, pain management, and emotional/spiritual support for those facing a life-limiting illness. The document encourages having early conversations with loved ones about one's end-of-life wishes through completing advance directives that appoint a healthcare agent and document treatment preferences. It provides tips on involving loved ones, preparing, storing, and sharing advance directives to ensure one's wishes are followed.
Assessing Employees’ Understanding of Liability Protections for .docxfestockton
Assessing Employees’ Understanding of Liability Protections for Physicians and Facility
A case of Three Mountains Regional Hospital
Keri King
Deliverable 2
Physician Liability Protection Question 1
In case no fee is charged, does the responsibility of the malpractice carrier change?
In the event a fee is not charged, the responsibility of the malpractice carrier does not change. The reason is that the practitioner would be deemed to have executed the procedure in question. In the context, the expectation would be that the physician endeavors to meet the highest standards of care. If the responsibility was to change, however, the notion would be that the practitioner is motivated by pay to adhere to practice guidelines, which should not be the case.
2
Physician Liability Protection Question 2
Do Good Samaritan laws present an effect of a physician’s protection from legal action?
Good Samaritan laws have an effect of protection of healthcare professionals from legal actions in certain specific circumstances. One such circumstance is during provision of care in emergency circumstances. In legal context, emergency situations may involve the element of confusion and the physician may, therefore, engage in a malpractice against their wish (Bertoli & Grembi, 2018). The laws mentioned previously, however, do not offer protection to physicians in all other circumstances of offering care and physicians should, therefore, exercise caution.
3
Physician Liability Protection Question 3
What is the nature of liability incurred by a physician as a result of diagnosing a patient and recommending treatment without usual diagnostic tests?
Diagnosing a patient without a usual test amounts to neglect of the duty of care to decide the treatment to give to a sufferer. The reason is that a range of ailments can feature similar symptoms and would, therefore, be inappropriate for a medic to settle on treatment without confirmed laboratory results. In like manner, the physician in question would also be liable for breaching the duty of care in administration of treatment. The breach of duties would grant a patient the right of action for negligence.
4
Physician Liability Protection Question 4
In case treatment will be unavailable owing to the patient being uninsured, what would be the use of diagnostic testing?
Usually, treatment is not available to patients that are not insured. In the context, however, diagnostic tests may still be available to the patients despite the absence of insurance, the rationale being that test results may be applied for treatment of the patient in the facility if payment is availed (Schneider, 2017). In a similar manner, the results may be used in another medical facility where a client could be having a cover. In both cases, prior testing saves a client from potential danger of escalation of their problem without knowledge of the disorder they are suffering from.
5
Physician Liability Pr ...
Fredrick P. Niemann, Esq. is an elder law attorney with nearly 30 years of experience. He discusses the importance of advance healthcare planning through living wills and healthcare directives. These documents allow individuals to specify their healthcare wishes and appoint an agent to make decisions if they become incapacitated. Without such documents, families may end up in costly and stressful legal battles over medical care. Niemann emphasizes communicating one's values and appointing an agent to ensure wishes are followed.
write a response for each answer as a discussion clas that we have t.docxMelvinaLeepercy
write a response for each answer as a discussion clas that we have to response to each others
I will copy and past all my classmate answers about many diffirent topic and u have to write a simple comment under each one; there is 5 answers need a response
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Kentucky has changed how it is offering health care coverage by requiring its citizens to use the federal health exchange to shop for coverage rather that kynect. This means that its citizen would have to enroll in Medicaid or shop for health insurance under the federal Affordable Care Act, meaning that about 500,000 of Kentucky’s citizen will have to switch over. Advocate of this move believe that it will allow Kentucky to save a substantial amount of money while still allowing citizens to enroll in qualified health plans. Opponents of this movement think that it will cause confusion and coverage loss for those who switch over, such as dental and vision. It is also question whether or not money will be saved because healthy people will be required to pay monthly premiums. Other problems are the lockout of coverage for people who do not pay and would be require to volunteer 20 hours a week just to be able to keep Medicaid coverage. However Governor Bevin defends his plan by saying that the lock out feature and volunteering will just make Kentucky’s citizen more responsible.
The advocate are speaking more from the social gospel characterization because they do believe that everyone should receive some type of health insurance even though it is not the best. Everyone should take of everyone. The opponents seem to be speaking from the puritan side because they feel like it is your own personal responsibility and decision to take care of your health insurance. They seem more individualistic.
State government, California specifically has been a major player in the implementation of the 2010 ACA by giving consumers a tax credit through the market place.
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There are a myriad of obstacles that Robert Banes faced while receiving care for his health problems. Robert is a poor minority, who lacked the resources to fund his medical treatment. Aside from his socioeconomic status and the issues that pertained to that, in regards to his treatment options, the article talked about Robert’s failure to acknowledge his disease, as well placing it at the forefront of his priorities, and his Doctor’s, for lack of better words, lack of empathy to his terminal illness. In the article, he stated that while Doctor’s did tell him about the extent to which the disease was and would take a toll on his survival, he said that that is as far as it went; doctor’s basically told him, you’re dying, but failed to go into detail on how to combat or alleviate the issue.
I would argue that Robert had various avenue’s that he could have reached out to for help, however, it seems to be that he was just uninterested in getting the help. While his lack of interest in his own health was indeed a contributing factor to his .
This document discusses patient autonomy and physician obligations at end of life. It examines two case studies of young women with terminal illnesses who are maintaining autonomy in different ways. Brittany Maynard is moving to Oregon to pursue physician assisted suicide, while Lauren Hill focuses on raising cancer awareness and playing basketball. The document argues that physicians should support patient choices to die with dignity as long as they are competent. It also stresses the importance of advance care planning and conversations with loved ones to ensure wishes are followed.
Similar to Q 1 a providers obligation is to do no harm. healing the patient (20)
April 19, 2018 Course #Title MATU-203 – Introduction.docxYASHU40
April 19, 2018
Course #/Title: MATU-203 – Introduction to Statistics
Assignment Title: Final Class Project
Week Assessment Occurs: Week 8
Total Points for Assignment: 200 points
Criteria
EXEMPLARY
PROFICIENT
DEVELOPING
EMERGING
NOT COMPLETE
Part 1
Collection of Data
36-40
The paper fulfills all
instructions for Part 1. All
questions are thoroughly
answered and answers
demonstrate excellent
understanding of all topics.
30-35
One or two of the
required elements for
Part 1 is missing,
incomplete or
underdeveloped. Most
questions are
thoroughly answered
and answers
demonstrate good
understanding of all
topics.
20-29
Three required elements
for Part 1 are missing,
incomplete or
underdeveloped. Some
questions are thoroughly
answered but some lack
detail, and answers
demonstrate good
understanding of most,
but not all, topics.
1-19
Four or more required elements
for Part 1 are missing,
incomplete or underdeveloped.
Most questions are not
thoroughly answered and most
answers demonstrate poor
understanding of most topics.
0
Part 1 is missing from
submission, or its
contents are not a
response to the
assignment directions,
or the attempt is
confusing or incorrect
to the point of being
inadequate.
Part 2
Organization of
Data
36-40
The paper fulfills all
instructions for Part 2. All
data and statistics are
presented clearly and are
correct. All graphs are
presented correctly and
clearly with proper labeling.
All questions are thoroughly
answered and answers
demonstrate excellent
understanding of all topics.
30-35
One or two of the
required elements for
Part 2 is missing,
incomplete or
underdeveloped. Most
data and statistics are
presented mostly
clearly and are mostly
correct. Most graphs
are presented correctly
and clearly with proper
labeling. Most
questions are
thoroughly answered
20-29
Three required elements
for Part 2 are missing,
incomplete or
underdeveloped. Some
data and statistics are
presented somewhat
clearly and are somewhat
correct. Some graphs are
presented correctly and
clearly with somewhat
proper labeling. Some
questions are thoroughly
answered but some lack
detail, and answers
1-19
Four or more required elements
for Part 2 are missing,
incomplete or underdeveloped.
Most data and statistics are not
presented clearly or are not
correct. Most graphs are not
presented correctly and/or
clearly and/or don’t have proper
labeling. Most questions are not
thoroughly answered and most
answers demonstrate poor
understanding of most topics.
0
Part 2 is missing from
submission, or its
contents are not a
response to the
assignment directions,
or the attempt is
confusing or incorrect
to the point of being
inadequate.
April 19, 2018
and answers
demonstrate good
understanding of all
topics.
demonstrate good
understanding of most,
but not al.
APUS Assignment Rubric Undergraduate Level
EXEMPLARY
LEVEL
4
ACCOMPLISHED
LEVEL
3
DEVELOPING
LEVEL
2
BEGINNING
LEVEL
1
POINTS
FOCUS/THESIS
Student exhibits a clear understanding of the assignment. Work is clearly defined to help guide the reader throughout the assignment. Student builds upon the assignment with well-documented and exceptional supporting facts, figures, and/or statements.
Establishes a good comprehension of topic and in the building of the thesis. Student demonstrates an effective presentation of thesis, with most support statements helping to support the key focus of assignment
Student exhibits a basic understanding of the intended assignment, but the formatting and grammar is not supported throughout the assignment. The reader may have some difficulty in seeing linkages between thoughts. Student has limited the quality of the assignment.
Exhibits a limited understanding of the assignment. Reader is unable to follow the logic used for the thesis and development of key themes. Assignment instructions were not followed. Student’s writing is weak in the inclusion of supporting facts or statements. Paper includes more than 25% quotes, which renders it unoriginal.
4
SUBJECT KNOWLEDGE
Student demonstrates proficient command of the subject matter in the assignment. Assignment shows an impressive level of depth of student’s ability to relate course content to practical examples and applications. Student provides comprehensive analysis of details, facts, and concepts in a logical sequence.
Student exhibits above average usage of subject matter in assignment. Student provides above average ability in relating course content in examples given. Details and facts presented provide an adequate presentation of student’s current level of subject matter knowledge.
The assignment reveals that the student has a general, fundamental understanding of the course material. Whereas, there are areas of some concerning in the linkages provided between facts and supporting statements. Student generally explains concepts, but only meets the minimum requirements in this area.
Student tries to explain some concepts, but overlooks critical details. Assignment appears vague or incomplete in various segments. Student presents concepts in isolation, and does not perceive to have a logical sequencing of ideas.
4
CRITICAL THINKING
Student demonstrates a higher-level of critical thinking necessary for undergraduate level work. Learner provides a strategic approach in presenting examples of problem solving or critical thinking, while drawing logical conclusions which are not immediately obvious. Student provides well-supported ideas and reflection with a variety of current and/or world views in the assignment
Student exhibits a good command of critical thinking skills in the presentation of material and supporting statements. Assignment demonstrates the student’s above average use of relating concepts by using a variety of factors. Overall, student provides ade.
Appropriate TopicsThe Research Report, select one of the fo.docxYASHU40
Appropriate Topics:
The Research Report, select one of the following research areas:
i) 5G Networks
ii) Serverless Computing
iii) Blockchain
iv) 3D Printing
vii) Artificial Intelligence
viii) Internet of Things (IoT)
ix) Medical Technology
Introduction
Literature Review
Methodology Specifics (comparative analysis)
Findings and Results
Conclusion and Future Recommendations
References - APA
Appendices
Your
paper is to have a title page, introduction, well defined literature review(body), findings, conclusion, and reference pages. The paper must be at least 2,500 words.
Use
graphs, charts, tables or figures.
The research paper must be at least 2,500 words supported by evidence (citations from
peer-reviewed sources).
Note: the research should be thorough and exhaustive.
A minimum of five
(5) peer-reviewed journal citations
are required.
Formatting should be double-spaced, one-inch boarders, no extra space for headings, no
extra white space, no more than two levels of heading, page numbers, front and back
matter). Extra white space use to enhance page count will negatively affect student grade.
The research paper
must only
include materials derived solely from peer reviewed
journals or peer reviewed conference proceedings. Newspapers, websites (URLs),
magazines, technical journals, hearsay, personal opinions, and white papers
are NOT
acceptable citations.
All images, tables, figures are to be included in the appendices and
IS NOT
included in the 15-page requirement. This means appendices are not included in the 15 pages requirement.
A total of at least 15 full pages is required (no extra whitespace).
Formatting Details
Margins
The left-hand margin must be 1inches (4 cm.). Margins at the right, top, and bottom of the page
should be 1.0 inch. (See exception for chapter title pages below.) The Research Report text may
be left-aligned (leaving a ragged right edge) or may be both left- and right-aligned (justified).
Line Spacing
Double-spacing is required for most of the text in documents submitted during the Research
Report process.
Paragraph Spacing
The text of the document is double-spaced. There should be no extra spaces between paragraphs
in sections, however, indent the first line of each paragraphs five spaces.
Page Numbering
All pages should have page numbers in Arabic numerals in the upper right-hand corner.
Type Style
The body text, the student should use 12-point Times New Roman. Text for the cover page may
be larger but should not exceed 14-point size. Text for the chapter title text should be 14-point
size. Be consistent in the use of typefaces throughout the document. Do not use a compressed
typeface or any settings on the word processor that would decrease the spacing between letters or
words. Sans serif typefaces such as Helvetica or Arial may be used for relatively short blocks of
text such as chapter headings and captions but should be avoided in long passages of text as the.
Archaic sapiens, Neandertals and the Last 10,000 YearsWhat.docxYASHU40
Archaic sapiens, Neandertals and the Last 10,000 Years
What physical and cultural adaptations allowed the genus
Homo
to migrate throughout the world? Did these adaptations help or harm
Homo
?
Once
Homo
migrated, what happened to the different species within this genus? Why is there only one species that is in the
Homo
genus? What is the evidence to support your claim?
.
Applying Evidence-Based Practice”Population groups with differe.docxYASHU40
Evidence-based practice guidelines should be applied when managing illnesses for patient populations that are at risk due to cultural, religious or ethnic differences. These population groups may exhibit different illness behaviors and beliefs. Guidelines should be applied across all ages to properly manage illnesses for at-risk patient populations with consideration for cultural factors that influence health behaviors.
Applying Learning Theory to LifePrior to beginning work on t.docxYASHU40
Applying Learning Theory to Life
Prior to beginning work on this activity read all of the required reading, review the content from weeks one through three, visit the website
http://selfdeterminationtheory.org (Links to an external site.)
, and review the Instructor Guidance. This week you will be discussing the multiple perspectives about how we learn, based on your developing knowledge about learning theory, and how it affects your own ability to perform at desired levels.
Required elements:
Explain behaviorism, cognitivism, constructivism, and humanism as applied to learning.
Suggested template
.
Summarizes at least two sub-theories/ideologies within each framework.
Examples include:
From behaviorism
associative learning, classical conditioning, operant Conditioning, conditioning, extinction, and ratio/interval schedules
From cognitivism
schema theory, memory development, elaboration theory (i.e. Bloom’s taxonomy), cognitive load theory, and social learning/cognitive theory.
From constructivism (conceptions of knowledge are derived from the process of constructing individual interpretations of one’s experiences)
cognitive constructivism, dialectical (social) constructivism, zone of proximal development, and discovery learning
From humanism
motivational theories of learning (i.e. self-determination theory, Maslow’s hierarchy of needs), experiential learning, and Steiner pedagogy or Waldorf education.
List and briefly explain a minimum of two theoretically supported strategies, that we have learned about during the past weeks, that you think would most help you to increase
your own
learning success.
List and briefly explain a minimum of two theoretically supported strategies, that we have learned about during the past weeks, that you think would most help someone in your personal or professional circle.
Apply basic methods of psychological research skills to this content by synthesizing supporting evidence from at least three scholarly sources from the Ashford University Library that defend the strategies you have chosen.
The Applying Learning Theory to Life paper
Must be seven to eight double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the
Ashford Writing Center (Links to an external site.)
.
Must include a separate title page with the following:
Title of [paper, project, etc.]
Student’s name
Course name and number
Instructor’s name
Date submitted
Must use headings and sub-headings.
See example. (Links to an external site.)
Must use appropriate research methods (e.g. use of the Ashford library) and skeptical inquiry (
http://www.criticalthinking.org/ (Links to an external site.)
).to support the content inclusions.
Must begin with an introductory paragraph that introduces what you will be outlining in your paper.
Must end with a conclusion that reaffirms the learn.
Apply the Symbolic Interaction Perspective to ImmigrationD.docxYASHU40
Apply the
Symbolic Interaction Perspective
to Immigration
Define the symbolic interaction perspective
How do symbols through words contribute to the perception of immigrants in a negative way?
What do
some
Americans fear when it comes to immigration or immigrants?
.
April is a fourth grader with a language impairment, but no physical.docxYASHU40
April is a fourth grader with a language impairment, but no physical impairment. Her performance on norm-referenced measures is 1.5 standard deviations below the mean for her chronological age. April has good decoding skills, but has difficulty with reading comprehension, semantics, and morphological processing. One accommodation that is prescribed in the IEP is the use of visual cues to support comprehension when learning new skills. She lacks organizational skills for writing and struggles with word choice. She receives services from a speech and language pathologist who is working with her on understanding word parts, vocabulary, and multiple meanings of words. You instruct April in a resource classroom with five other fourth grade students who also struggle with reading and written expression.
Communication goals in IEP:
April will identify at least five key content vocabulary words from an assigned reading using text with Mayer-Johnson symbols in Proloquo2go software and text to speech software with 90% accuracy over 10 consecutive trials.
April will write a definition for up to five key content vocabulary words from an assigned reading with 90% accuracy on a rubric over 10 consecutive trials.
April will use up to five key content vocabulary words in written sentences that use the word correctly in context, and include correct spelling, punctuation, and grammar with 90% accuracy over 10 consecutive trials.
Part 1: 3 Day Unit Plan
Use the “3 Day Unit Plan Template” to complete this assignment.
Create an English language arts (ELA) unit plan for your resource classroom based on Arizona or your state's ELA fourth grade literacy standards specific to vocabulary acquisition and use. Includethe following in the unit plan:
Strategies to enhance students’ language development and communication skills in the Multiple Means of Representation section.
Strategies and technologies that encourage student engagement and the development of critical thinking and problem-solving skills in the Multiple Means of Engagement section.
Using details from the case study, address April’s needs in the Differentiation sections of the Multiple Means of Representation, Multiple Means of Engagement, and Multiple Means of Expression.
Specifically, incorporate the following into the unit plan to meet April’s needs:
The use of the AAC systems and assistive technologies planned in April’s goal to support her communication and learning.
Differentiated formative and summative assessments that measure April’s progress on the IEP goals in Part 1.
Part 2: Rationale
Provide a 250-500 word rationale that explains:
Why the instructional choices specifically meet April’s needs.
How the selected augmentative and alternative communication systems assistive technology used in the lesson plan is appropriate for meeting April’s needs.
Support your work with 2-3 scholarly resources.
This assignment uses a rubric. Review the rubric prior to beginning the .
Approximately 1000 words.Synthesizing the theories (you do not.docxYASHU40
Approximately 1000 words.
Synthesizing the theories (you do not need to draw from ALL the theories/readings), use at least three readings to develop your own view that describes and understands the relationship between technology and society. In developing your view, take the most important and persuasive parts of the existing theories and explain them. In the end, be sure to clearly articulate and define the relationship between technology and society: which has more power or control? How do they relate to one another?
Journal of Communication ISSN 0021-9916
O R I G I N A L A R T I C L E
The Social Life of Wireless Urban Spaces:
Internet Use, Social Networks, and the Public
Realm
Keith N. Hampton, Oren Livio, & Lauren Sessions Goulet
Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA
This study explores the role of urban public spaces for democratic and social engagement.
It examines the impact of wireless Internet use on urban public spaces, Internet users, and
others who inhabit these spaces. Through observations of 7 parks, plazas, and markets in 4
North American cities, and surveys of wireless Internet users in those sites, we explore how
this new technology is related to processes of social interaction, privatism, and democratic
engagement. Findings reveal that Internet use within public spaces affords interactions with
existing acquaintances that are more diverse than those associated with mobile phone use.
However, the level of colocated social diversity to which Internet users are exposed is less
than that of most users of these spaces. Yet, online activities in public spaces do contribute
to broader participation in the public sphere. Internet connectivity within public spaces
may contribute to higher overall levels of democratic and social engagement than what is
afforded by exposure within similar spaces free of Internet connectivity.
doi:10.1111/j.1460-2466.2010.01510.x
Internet access in public parks, plazas, markets, and streets has been made possible
through the proliferation of broadband wireless Internet in the form of municipal
and community wi-fi (e.g., NYC Wireless) and advanced mobile phone networks
(e.g., 3G). The experience of wireless Internet use in the public realm contrasts with
traditional wired Internet use, which is confined primarily to the private realm of the
home and the parochial realm of the workplace. An extensive literature has addressed
the influence of Internet use on the composition of people’s social networks
(Hampton, Sessions, & Her, in press), their engagement in political, voluntary, and
other organizational activities (Boulianne, 2009), and their interactions within home
and workplaces (Bakardjieva, 2005; Quan-Haase & Wellman, 2006). But, Internet
use in the public realm has remained relatively unexplored. This type of use carries
with it significant implications for urban planning, the structure of community, and
the nature of democracy.
Inte.
Approaches to Forecasting Policy Outcomes Please respond to th.docxYASHU40
"Approaches to Forecasting Policy Outcomes" Please respond to the following:
Provide a real or hypothetical public policy issue and select an appropriate criterion for policy prescription to use in deciding a policy's (a) effectiveness, (b) efficiency, (c) adequacy, (d) equity, (e) responsiveness, and (f) appropriateness. Provide at least two reasons why you selected the criterion.
.
Apply the course concepts of the dark side of self-esteem and .docxYASHU40
Apply the course concepts of the
dark side of self-esteem
and
moral hypocrisy
to this type of behavior. What do you conclude about people who behave in such a way? Hint: Explicitly use each concept by name and also give a one sentence definition of it before explaining how the concepts apply to these people.
.
Apply information from the Aquifer Case Study to answer the foll.docxYASHU40
Apply information from the Aquifer Case Study to answer the following discussion questions:
Discuss the Mrs. Gomez’s history that would be pertinent to her difficulty sleeping. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
Describe the physical exam and diagnostic tools to be used for Mrs. Gomez. Are there any additional you would have liked to be included that were not?
Please list 3 differential diagnoses for Mrs. Gomez and explain why you chose them. What was your final diagnosis and how did you make the determination?
What plan of care will Mrs. Gomez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
THe example is uplaod
.
Apply appropriate elements of the U.S. legal system and the U.S. Con.docxYASHU40
Apply appropriate elements of the U.S. legal system and the U.S. Constitution to business scenarios for impacting decisions in authentic situation
Apply concepts of ethics, morality, and civil and criminal law to business scenarios for informed corporate decision makingAnalyze the basic elements of a contract and a quasi-contract for their application to commercial and real estate scenarios
Differentiate between the various types of business organizations for informing rights and responsibilities
.
APA format Analysis of the Culture using a Culturally Competent.docxYASHU40
APA format
"Analysis of the Culture using a Culturally Competent Model"
1. Use "giger and davidhizar transcultural assessment model" to evaluate the jewish population.
2. Explain the model.
3. Apply this model to the jewish cultural group.
4. Using this model, develop a plan of care at it relates to culturally diverse needs of this cultural group (jewish).
· Include 2-3 highest priority health care needs.
· Use an interdisciplinary approach including community resources, governmental organizations, non-for-profit organizations, outreach centers, religious organizations and hospital provided community activities and professional associations like nursing and health care associations.
Identify other Health Care Professionals that should be included in your plan (interdisciplinary)
NOTE: use the background information from the attachment below for the jewish population in nursing titled "assignment culture part 1"
.
APA less than 10 similarityWeek 7 Discussion Question Chapter.docxYASHU40
APA less than 10 % similarity
Week 7 Discussion Question: Chapter 29, Mental Health Disorders
Part One
: Hypochondriasis can be a problem for older adults. What situations contribute to hypochondriasis and what interventions can nurses provide that will address this problem in older adults?
.
APPLE 13Business Analytics Plan for BIAM300Author Miguel .docxYASHU40
APPLE 13
Business Analytics Plan for BIAM300
Author: Miguel Canales
Date: March 16, 2020
SECTION 1: Company Background and Strategy
Organization Name
Apple Inc.
1.2. LexisNexis Dossier
Strategic Positioning Diagram
Product Innovation
Explanation of Product Innovation Positioning
In Apple Company, the main aspect behind its growth is product innovation. The main two factors for the success of Apple Company is creating ideas as well as testing their products. Without the several innovations that the company implement the company will still grow since it has loyal customers that use their existing products. The organizations might not consist new clients, so that they can get new clients they need to develop new ideas. Development and research are the main key performance indicator that are advantage to the company. Carrying out research to find out what kind of products the clients need and providing the exact products that people need is what improve the organization strategic position. Researching on what type of products the market need will assist Apple Company to develop products needed by their customers. Assessing the company additional Key Performance Indicator under the current innovation is what offers advantages to the organization (Elmansy, 2016).
SMART Objective for Strategic Positioning
The most relevant section in product innovation is the testing of the products. Ensuring that products and that the products are operating properly is an important factor for the organization business to improve. The technology is the main strategy is the main performance indicator that assist to meet their objectives. Coming up with a state product art to maintain their clients happiness and ensure that they expect for the company to come up with new and well improved products. Through coming up with technology that is easy and dependable to utilize will be an advantage to the organization all the products need to be made with the inclusion of the client and what the client will require. Having the clients to test the company products is also an important thing that the company should practice (Elmansy, 2016).
Customer Intimacy
Explanation of Customer Intimacy Positioning
Another necessary section of Apple organization is the client intimacy. Customer intimacy is mostly concerned on the understanding of client problems. It is important that the Apple Company understand the client wants before the clients, either to be a new product or to be an improved product. Apple Company is organizing their products in the need of client’s need. Since Apple Company have more loyal clients, it is an evidence that the company offer relevant products to their clients. Tracking the client’s incidents as the key performance indicators that is utilize in this region. The Apple Company provides several way to offer assistances to the clients when there is an issue with some of their products.
SMART Objective for Customer Intimacy
What assist Apple organizat.
APAless than 10 similarityWeek 4 Discussion Question .docxYASHU40
APA
less than 10 % similarity
Week 4 Discussion Question: Chapter 13, Comfort and Pain Management
With the realization that pain is highly prevalent among older adults, please answer the following questions:
Part Two
: What is the prevalence of pain in older adults? How will you, as a nurse, be more aware of
pain issues related to older adults and what will the nurse incorporate into practice to alleviate these
issues?
.
APA Style [Sources, included] single-spaced, one to two-page paper r.docxYASHU40
APA Style [Sources, included] single-spaced, one to two-page paper responding to the prompt: What should be the primary roles of higher education institutions in our society?
Include:
Knowledge enterprise, research, continuing our democracy, and Source of expertise as primary roles.
.
Application Case Siemens Builds a Strategy-Oriented HR System.docxYASHU40
Application Case Siemens Builds a Strategy-Oriented HR System
Siemens is a 150-year-old German company, but it’s not the company it was even a few years ago. Until recently, Siemens focused on producing electrical products. Today the firm has diversified into software, engineering, and services. It is also global, with more than 400,000 employees working in 190 countries. In other words, Siemens became a world leader by pursuing a corporate strategy that emphasized diversifying into high-tech products and services, and doing so on a global basis.
With a corporate strategy like that, human resource management plays a big role at Siemens. Sophisticated engineering and services require more focus on employee selection, training, and compensation than in the average firm, and globalization requires delivering these services globally. Siemens sums up the basic themes of its HR strategy in several points. These include:
A living company is a learning company.
The high-tech nature of Siemens’ business means that employees must be able to learn on a continuing basis. Siemens uses its system of combined classroom and hands-on apprenticeship training around the world to help facilitate this. It also offers employees extensive continuing education and management development.
Global teamwork is the key to developing and using all the potential of the firm’s human resources.
Because it is so important for employees throughout Siemens to feel free to work together and interact, employees have to understand the whole Siemens process not just bits and pieces. To support this, Siemens provides extensive training and development. It also ensures that all employees feel they’re part of a strong, unifying corporate identity. For example, HR uses cross-border, cross-cultural experiences as prerequisites for career advances.
A climate of mutual respect is the basis of all relationships—within the company and with society.
Siemens contends that the wealth of nationalities, cultures, languages, and outlooks represented by its employees is one of its most valuable assets. It therefore engages in numerous HR activities aimed at building openness, transparency, and fairness, and supporting diversity.
Assignment Content
Read
“Application Case: Siemens Builds a Strategy-Oriented HR System” in Ch. 3 of
Human Resource Management
.
Write
350- to 700-word response to the following after reading the case:
Identify examples of at least four strategically required organizational outcomes, and four required workforce competencies and behaviors for Siemens, based on the information in this case.
Identify at least four strategically relevant HR policies and activities that Siemens has instituted to help human resource management contribute to achieving Siemens’ strategic goals.
Discuss the following regarding Siemens' strategic goals:
What overall goals does Siemens want to achieve?
What must Siemens do operationally to achieve its goals?
What empl.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh - RAYH...
Q 1 a providers obligation is to do no harm. healing the patient
1. Q-1
A provider's obligation is to do no harm. Healing the patient
from whatever ails them is a holistic healing process. Advanced
directives are a large part of the healthcare process as well, and
should be discussed earlier and more often than they actually
are (House & Ogilvie, 2020); (White, 2019). Advanced
directives are essentially the wishes of the patient when they
were made when the patient was in a fully coherent mental state
and was able to make their own decisions (House & Ogilvie,
2020); (White, 2019). These are the direct wishes of the patient
to be followed when the patient themselves are either
incapacitated or incoherent (House & Ogilvie, 2020); (White,
2019).
State and federal legislation affect advanced directives in the
way that family members can override them when the patient is
incapacitated as they are the next of kin or the emergency
contact (House & Ogilvie, 2020). Each state has some variations
to this loophole, but they mostly stay the same amongst the
states (House & Ogilvie, 2020). Some believe that this loophole
has arisen due to the massive increase in litigation especially in
healthcare (House & Ogilvie, 2020).
There are many ethical dilemmas that occur when allowing for
such a loophole and having advanced directives at the same
time. A perfect example is from my work in an MSICU
yesterday (2/17). I had a patient who coded last Sunday and was
extubated Tuesday. The patient is no longer neurologically
intact, now on dialysis, and we suspect an anoxic brain injury
that has left the patient lethargic, drowsy, unable to follow
commands, and opens his eyes to his name but does not track.
The family originally brought in a Living will and Advanced
Directive when the patient arrived that clearly stated DNR
status and refusal of lifelong treatments. However, once the
patient began to code, the wife rescinded everything. As
healthcare professionals we are now stuck, as there is
2. appropriate documentation to validate the DNR, but as the
patient is now incapacitated the next of kin now has medical
decisional making capacity. So at this point, she wanted
everything done. Fast forward a few days to 2/17, I am
explaining to the wife and sister that his prognosis is poor,
dialysis isn't helping, his quality of life is how he is presenting
now, and I even relayed the fact that the patient clearly said he
did not want any of this. The wife acknowledged his advanced
directive, but stated: "We need to do everything anyway".
The ethical dilemma has presented as such: we are going against
the patient's wishes, especially with futile and end-of-life care,
while the wife has the power and authority to change any
medical decision that was made previously. We, as healthcare
professionals, are now forced to prolong this patient's suffering
out of fear of retaliation and litigation.
In my practice, I have always reasonably accommodated the
patient's spiritual practices regardless of what they were. We
have had sermons in the ICU patient's rooms, as well as
celebrations of life, or spiritual rituals.
In my opinion, if that's what the patient wanted, then so be it,
we have to respect their wishes, even if we don't agree with
them.
References:
House, S.A., Ogilvie, W.A. (2020). Advance
Directives. StatPearls Treasure IslandStatPearls Publishing.
Retrieved from:
https://www.ncbi.nlm.nih.gov/books/NBK459133/
White, G. (2019). Do not postpone discussing advanced
directives. CMAJ : Canadian Medical Association Journal =
Journal de l’Association Medicale Canadienne, 191(28), E796.
https://doi-org.lopes.idm.oclc.org/10.1503/cmaj.72212
Q-2
The grieving process is altered in patients who have dementia
living with a spouse (Hovland, 2018). This is suspected because
the outcome of dementia usually ends up being failure to thrive
3. due to cognitive decline (Hovland, 2018). The spouse
recognizes the end result, and pre-emptively begins to grieve as
they become aware of the end result of the disease (Hovland,
2018). The stages of grief differ in each individual in terms of
intensity, duration, speed, and accpetance to move onto the next
stage (Hovland, 2018). Some people take it well, while others
do not, and my need support from family, friends, or healthcare
team members (Hovland, 2018).
The nurse practitioner can offer many options for support for
both the patient and the spouse, especially once the information
has been obtained of advancing metastatic cancer (Mughal,
Azhar, Siddiqui, 2020). Palliative care, respite care, or hospice
placement can be offered as the criteria is met for hospice
placement with a life threatening illness, futile care, and/or
failure to thrive (Mughal, Azhar, Siddiqui, 2020). The etiology
of hospice admission could be either dementia, or the advanced
metastatic cancer (Mughal, Azhar, Siddiqui, 2020).
In terms of actually offering these options to the spouse, careful
conversations would need to be had regarding what hospice is,
what they do, and what they can offer (Mughal, Azhar, Siddiqui,
2020). I usually begin this conversation with the idea that the
goal now has changed from treating and curing, to making the
patient as comfortable as possible. A common question I usually
get asked in the MSICU is "well how long will it take?" as in
how long will it take for the patient to expire, and I usually
answer "Only God knows, and all we can do is what the patient
wants us to do". However, I also explain that if the patient
persists for an extended time, hospice lasts up to 6 months in
Florida, and can be extended at any time. Also, I am sure to
mention that if they need a break, or begin suffering from
caregiver fatigue, that hospice offers respite care as well, where
the patient can be moved into the hospice home and the fmaily
member can take a break. I belive that the patient being
comfortable is just as important as the family members involved
being able to take care of themselves as well.
Usally these conversations are difficult to begin, but once the
4. explanation process starts, it ususally sets in with teh family
members that this si the best course of action tso theeir loved
one can die with dignity.
References:
Hovland, C. (2018). Welcoming death: Exploring pre-death
grief experiences of caregivers of older adults with
dementia. Journal of Social Work in End-of-Life & Palliative
Care, 14(4), 274–290. https://doi-
org.lopes.idm.oclc.org/10.1080/15524256.2018.1508538
Mughal, S., Azhar, Y., Siddiqui, W.J. (2020). Grief
Reaction. StatPearls Treasure Island StatPearls
Publishing. Retrieved from:
https://www.ncbi.nlm.nih.gov/books/NBK507832/
Q-3
Providers must address the advance directives to their patients
to determine the future medical care when the patient becomes
incapable of making medical decisions. Advance Directives are
described as the legal mechanisms that reinforce the
fundamental professional and moral responsibilities of health
care providers and institutions to promote and to protect patient
autonomy, welfare, and dignity (Armstrong & Silverman, 2017,
p. 224). There are two types of advance directives namely the
living will and the health care proxy. The living will is also
known as instructional directives that define the type of
decision that should direct the patient’s care. The second type
of advance directive is the health care proxy that is often called
a durable power of attorney for health care. It is an individual
that is selected by the patient to make decisions.
Some states have a state-authorized portable order. State-
authorized portable orders are described as a specialized form
of an identifier such as a do not attempt to resuscitate bracelets
or necklaces that are authorized by state law or a state medical
director that translates to the patient’s preference regarding
5. specific life-sustaining treatment decisions into portable
medical orders (National Archieves and Records
Administration, 2020). Oregon’s Physician Orders for Scope of
Treatment (POST) and New York’s Medical Orders for Life-
Sustaining Treatment (MOLST) are some of the examples of the
state- authorized portable orders that aim to make the patient's
desire more easily available to emergency medical personnel
(National Achieves and Records Administration, 2020). Some of
the ethical or spiritual dilemmas that patients and families
encounter during these discussions are unethical
experimentation, life-prolonging treatment, life-sustaining
treatment, and medical orders of end-of-life care. For example,
providers support that each person has the right to determine
what medical treatment they will receive including what life-
sustaining treatment should be provided if an individual has a
terminal issue. Providers need to ensure that they know the
current state laws, living wills and durable power of attorney,
they are considerate of the patient’s cultural beliefs and practice
and should discuss the issue of life- sustaining measures with
each of their patients before medical emergency happens or
before institutionalization to prevent ethical dilemma during
end-of life care.
References:
Armstrong, K. & Silverman, R.D. (2017). Medical- Legal
Concepts: Advance Directives and Surrogate Decision Making.
S.C. McKean, J.J., Ross, D.D. Dressler, D.B. Scheurer
(Eds). The Principles and Practice of Hospital Medicine 2nd
edition (pp. 224-230). Mcgrawhill education.
American Academy of Family Physicians (2020). Ethics and
6. Advance Planning for End-of-Life Care. Retrieved from
https://www.aafp.org/about/policies/all/ethics-advance-
planning.html
National Archives and Records Administration, (2020). Federal
register: Informed consent and advance directives. Retrieved
from
https://www.federalregister.gov/documents/2020/05/27/2020-
10264/informed-consent-and-advance-directives
By Lesley Kadlec, MA, RHIA, CHDA, and Annessa Kirby
We hear so much about the amount of data available in
healthcare today. But we are just beginning to understand the
importance of analyzing that data to make decisions. As
buzzwords like “information governance” and “data analytics”
are becoming more mainstream, the analysis of data is becoming
an expectation—a requirement, in fact—for
healthcare organizations. It is no longer an acceptable practice
to ask for information and not do anything with it. In
order to continue to be progressive in healthcare and to meet the
“triple aim” we need to analyze and use healthcare
data more effectively to produce the kind of outcomes in
healthcare that are needed and that our consumers expect.
Given this lofty goal, the members of the AHIMA Informatics
7. and Data Analytics Task Force were asked to share some
thoughts about how HIM professionals are putting this
expectation into action. One task force member started with
sharing some background definitions: “In general, informatics is
the natural progression of health information
management. Webster’s definition of informatics is: the
collection, classification, storage, retrieval and disseminatio n of
recorded knowledge. HIM has been doing that even with the use
of paper records—providing the records to other
people—and natural progression into the electronic world, free
text, structured data fields.”
Resoundingly, the overwhelming feeling of the team members
echoed the importance of HIM to the progression of
informatics and data analytics in healthcare organizations. One
of the respondents stated, “We are the profession who
has this knowledge to manage and analyze data accurately. We
have the text book knowledge and best practice
experience (and) can contribute to the informatics war, the new
terminology, the new demand and broader aspects and
domains of healthcare.” In fact, another member went on to say
that “Our profession needs to emphasize that we
understand the data and what it is saying. It justifies that we are
needed for that [type of new role]. HIM professionals
make the best data analysts because they truly understand the
8. data!”
One of the members also mentioned that HIM is the perfect
middleman. So, we looked up “middleman” and found this
book called “The Middleman Economy” and the editorial about
it on this link. It states:
“Middlemen are more prevalent—and more important—than
ever. Agents, brokers, dealers, and resellers get a bad rap,
but they play a crucial role in almost every platform today—
including the ones that were meant to cut them out of the
transaction. As a result, being an effective middleman has
become an even more valuable skill than it was in the past.”
The book’s author, Marina Krakovsky, outlines six roles to
embrace and execute to be an effective middleman:
9. While an HIM professional could play all of these roles within a
24-hour period, the role that seems to complement HIM
the most is that of the Concierge. “The Concierge reduces
hassles and helps clients make good decisions in the face of
information overload.” Sound familiar? Our clients could be the
patient, the clinician, the health information exchange
organization, the payor, the federal government… the list goes
on and on.
So what does all of this mean for today’s HIM professional?
One task force member summed it up best: “[There is] huge
potential in the direction that HIM is going toward. It will take
time to convince people of the value that we as HIM
professionals hold. The return on investment needs to be
envisioned and the HIM profession needs to be sold—[HIM
professionals must be the] lobbyists in making the change
happen in today’s healthcare environment.” Another task
force member described our value and the value of data as being
able to “…bring about a proactive versus a reactive
approach. Being able to identify and mitigate the ‘why’ and be
proactive for these situations can have a financial impact
10. on facilities. HIM can prove this benefit of a proactive
approach.”
We’re in an economy—whether the financial, housing, or
healthcare sector—where convenience is expected. When
online shopping, we expect websites such as Amazon.com to
know our preferences because of what we’ve clicked on in
the past. We expect our social media accounts such as Facebook
to remember our password and only show us posts
from friends and businesses that we’ve demonstrated preference
for within the website. All of this convenience is based
on data. Amazon and Facebook have made the data meaningful
to the consumer. Healthcare is in the process of doing
the same thing. Person-centric care is an expectation, not just a
quality measure. HIM is the perfect and essential
middleman. We just need to put ourselves in the right light.
Lesley Kadlec ([email protected]) is a director of practice
excellence and Annessa Kirby
([email protected]) is practice council manager at AHIMA.
Q-1
I would recommend a short term acute rehab for the patient due
to the patient's difficulty walking. This difficulty in mobility is
one admission criteria, but we can expand this to include
problems in the activity of daily living, and transfers (Bielecki
& Tadi, 2020). The other side is that there are special pieces of
equipment that can help the patient advance quickly that are
11. unable to be obtained at the home such as a Hoyer lift (Bielecki
& Tadi, 2020). However, there are requirements that the patient
has to be able to perform or agree to. Such requirements include
being able to participate in at least three therapies a day, three
hours of therapy for five days a week, and is agreeable to
participate (Bielecki & Tadi, 2020).
If the patient can meet the criteria, most insurances will issue
precertification or speak with the case manager to apply the
patient's benefits to a rehab facility, and most of the time the
insurance will elect to pay for a rehab stay (Smith, Kulhari,
Wolfram, & Furlan, 2017).
I have found acute rehabilitation facilities to be highly
beneficial for many reasons. These facilities are able to provide
intense training programs that are patient-specific and designed
to bring the patient back to their prior level of functioning as
quickly as they can. I would not want to see a patient who has
been deconditioned to the point of motility issues return to the
hospital because of a fall, or a subsequent injury from a fall.
Also, there is the timing aspect. For example, home health has a
limited amount of availability per week, so this patient may
only receive three one-hour sessions per week, increasing the
time it takes for the patient to return to their prior level of
functioning. This increase in return time also increases the risk
of an injury due to decreased mobility. While rehab facilities
can perform multiple rehab sessions per day for these patients
to quickly return their lost strength.
I would evaluate each patient individually, but in my opinion, I
would still elect to send this patient to an acute rehab facility in
order to gain his strength back as quickly as possible. There are
some things we can weigh against the decision such as
evaluation of the patient's home status. For example, if the
patient had the ability to even have the specialized equipment in
the home, or family members who were physical therapists. I
think this would be the only exception to where I would change
my mind and write for home health.
References:
12. Bielecki, J.E., Tadi, P. (2020) Therapeutic Exercise. StatPearls
Treasure Island StatPearls
Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/book
s/NBK555914/
Smith, A. L., Kulhari, A., Wolfram, J. A., & Furlan, A. (2017).
Impact of Insurance Precertification on Discharge of Stroke
Patients to Acute Rehabilitation or Skilled Nursing
Facility. Journal of Stroke and Cerebrovascular Diseases, 26(4),
711–716. https://doi-
org.lopes.idm.oclc.org/10.1016/j.jstrokecerebrovasdis.2015.12.0
37
Q-2
A safe discharge would depend on the patient, the home
situation, and the patient needs. If a patient is recovering slowly
it could be beneficial for them to go to a rehab facility for help
and supervision. The patient isn’t ambulating well and if he
lives alone that wouldn’t be a safe discharge as this could
increase risk of falls, decreased mobility, and deconditioning.
PT/OT would be beneficial to the patient to improve mobility
and safety. Requirements include the need of therapy for 3
hours of therapy for 5-7 consecutive days for physical therapy,
occupational therapy, and speech/language therapy, they need
nursing assistance with specialized training, a case manager,
and the expectation that the patient will benefit from therapy
(Forrest, et al., 2019). I would begin with getting a PT/OT
consult in the hospital and assess for general patient safety. I
would use their recommendations to guide my decision and
recommend the appropriate services. I would then ask about
home life and what type of house he has, what help he has at
home, and if he had a plan with getting help if he lived alone
(such as having a friend/family stay with him). I would then
assess patient’s cognitive function and the ability to safely
decide on what he wants. If he was deemed safe to go home
with home health services, then I would be ok with sending him
13. home with that. He would get the help he needs, and someone
would be able to check on him. There is a benefit of less chance
of complications with being at home versus in a facility. The
rehabilitation at home and in a facility of knee replacements
was evaluated and shown there was no significant difference
besides the reduced post-discharge complications (Buhagiar, et
al.,2017). If the patient isn’t safe to go home and requires
intensive rehabilitation and continuous supervision then the
rehabilitation facility would be the safest discharge for the
patient.
Buhagiar MA, Naylor JM, Harris IA, et al. Effect of Inpatient
Rehabilitation vs a Monitored Home-Based Program on
Mobility in Patients With Total Knee Arthroplasty: The HIHO
Randomized Clinical Trial. JAMA. 2017;317(10):1037–1046.
doi:10.1001/jama.2017.1224
Forrest, G., Reppel, A., Kodsi, M., & Smith, J. (2019). Inpatient
rehabilitation facilities: The 3-hour rule. Medicine, 98(37),
e17096. https://doi.org/10.1097/MD.0000000000017096
Q-3
A 72-year-old male with a past medical history for
hypertension, congestive heart failure, chronic back pain, and
diabetes is admitted to the hospital for hypotension suspected
from a possible accidental overdose. What are the criteria for
discharge? Explain the importance of utilizing hospital
recommendations and teachings. List some meaningful
community resources in the response.
Discharge planning is characterized as a development of an
individualized discharge plan of the patient before leaving the
hospital to ensure that the patients are discharged at the right
time and that adequate resources are given after discharge
(Alper et. al, 2020). Patient cognitive status, activity level, and
functional status, nature of the patient’s current home and
suitability for patient’s conditions, family support,
14. transportation from the hospital to home and follow - up visits,
and the availability of services in the community to assist the
patient with ongoing care are some of the factors that providers
consider when deciding where to send the patient after
hospitalization. One of the hospital standards when discharging
patients in the hospital is a discharge summary. A discharge
summary is an important tool that is written by the discharging
physician that is usually reliable and standardized to ensure that
there will be clear communication about the hospital
course(Sponsler,2017, p. 94). The recommended components of
the discharge summary are the primary and secondary
diagnoses, pertinent test results, pending results, patient’s
condition at discharge, recommended additional workup or
treatment plan, a complete list of the reconciled medications,
follow-up arrangements, resuscitation status, documentation of
patient education and identification and contact information for
the sending and receiving providers (Sponsler,2017, p. 94). In
this case, providers need to ensure that the medication is
reconciled properly and the instructions are clear to prevent any
errors or adverse effects such as hypotension to the patient.
Patients need to be educated and instructed on how to prevent
falls while at home and to make sure that the patient is capable
of safely preparing and taking their medications on time. Also,
providers need to identify any pending results and follow -up
appointments after discharge. It is also important that patients
who have the chronic condition is well-informed about their
disease, the disease process and what can they do to prevent
further exacerbation or hospitalization. Some of the community
resources such as adult day health, pharmacies that offer blister
packs, medication therapy management, and those pharmacies
that deliver medications at home are available in elderly or
disable patients.
References:
Alper, E., O’Malley, T.A. & Greenwald, J (2020). Hospital
discharge and readmission. Retrieved
from https://www.uptodate.com/contents/hospital-discharge-
15. and-readmission#H8
Sponsler, K.C. (2017). Care transitions at hospital discharge.
S.C. McKean, J.J., Ross, D.D. Dressler, D.B. Scheurer
(Eds). The
Principles and Practice of Hospital Medicine 2nd edition (pp.
90-96). Mcgrawhill education.