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Foster care is a harsh reality for many children in our society. After reading Chapter 15, answer the following questions:
How is the effectiveness of Foster Care often inhibited?
At Coachella Valley California, three factors prohibit the effectiveness of foster care: communities, children, and families.
Communities: the families of children placed in foster care live in an environment characterized by structural deficiencies and poverty, or basic needs believed to characterize stable communities. Often, these families lack basic needs such as employment opportunities, adequate housing and job skills and the means to offer sufficient clothing, food, and medical care. Dangerous surroundings, housing inadequacy and economic deprivation pose the greatest obstacle to a successful foster care. Abandonment is the prime reason for placing children under foster care: inadequate housing is the key element tied to it (Berrick, 2009). Families living in these challenging financial straits demonstrate concrete needs like sufficient food. Even…
Berrick, J.D. (2009). Take me home: Protecting America's vulnerable children and families. Oxford: Oxford University Press.
Pers, J.S. (2010). Government as a parent: Administering foster care in California. Berkeley: Institute of Governmental Studies, University of California.
Lindsey, D. (2013). The Welfare of Children. New York: Oxford University Press.
Curtis, P.A., Dale, G., & Kendall, J.C. (2009). The foster care crisis: Translating research into policy and practice. Lincoln: University of Nebraska Press in association with the Child Welfare League of America.
eview scenario: •A recent policy implemented Anytown's Department Job Family Services issue child endangerment. Any household documented offense domestic violence, child abuse, drug alcohol related offenses committed mother, father, guardian, / caregiver, result removal child children home
Anytown's Department Job Family Services
On the surface, a 'zero tolerance' policy regarding domestic abuse and drug abuse for children might seem warranted. After all, it is better to be 'safe than sorry' regarding the welfare of a child. Additionally, there have been many highly-publicized cases of child abuse over the years in which protective services did not follow up on cases where abuse was going on in the home. Theoretically, having a zero-tolerance policy would protect the department's reputation as well as children. However, removing children from foster care is a serious decision and cannot be regarded as a precautionary measure. Only severe, legally-classified actions of abuse can justify the…
Foster care. (2005). American Academy of Child and Adolescent Psychology. Retrieved:
Foster care. (2012). Children's Law Center. Retrieved:
Barber and Delfabbro report that research has determined that children with physical and mental disabilities fare better in institutional settings, where the continuity in care-to-need structure is in place and the consistency in structured routine seems to better serve the individual (p. 7).
Thus, best practice in foster care should begin with a careful assessment of each child's suitability for placement. here the child suffers from serious emotional or behavioural problems, regular foster care services are unlikely to be sufficient. Such children are likely to need either supervised group care or one of the forms of intensive, therapeutic foster care described in the literature (see Hudson, Natter and Galaway 1994, for a review) (Barber and Delfabbro, 2003, pp. 7-8)."
Adam Pertman (2000) says that America has become an "adoption nation," and that this has been a good thing for children who would otherwise be long-term placements in less desirable…
Barber, James G., and Paul H. Delfabbro. Children in Foster Care. New York: Routledge, 2003. Questia. 8 Mar. 2008 http://www.questia.com/PM.qst?a=o&d=104246712 .
Brittain, Charmaine, and Deborah Esquibel Hunt, eds. Helping in Child Protective Services: A Competency-Based Casework Handbook / . New York: Oxford University Press, 2004. Questia. 8 Mar. 2008 http://www.questia.com/PM.qst?a=o&d=102653512 .
Community Assessment: Foster Care Youth Needs
What is a community assessment? A community assessment is a process by which a collaborative partnership gathers information on the current strengths, concerns, needs, and conditions of children, families, and the community. The information comes from many sources -- especially parents and family members -- and is elicited by many techniques, including interviews, focus groups, and scanning demographic data collected by local agencies. Because many types of partners participate in a community assessment -- strategic planners, program staff, administrators, teachers, parents, and other community members -- the resulting information is broad, accurate, and useful (North Central egional Educational Laboratory, n.d.). Chiefly, such assessments focus on local assets, resources, and activities as well as gaps, barriers, or emerging needs. The process of identifying and appraising this information will help a collaborative partnership with addressing a social problem, such as foster care youth in…
Collins, M., Spencer, R., & Ward, R. (2010). Supporting youth in the transition from foster care: formal and informal connections. Child Welfare, 89(1), 125-143
Hope and A Future, Inc. (2010). Foster care statistics. Retrieved from http://azhope.com/about/foster-care-statistics.php
Krinsky, M. (2010). A not so happy birthday: The foster youth transition from adolescence into adulthood. Family Court Review, 48(2), 250-254. doi:10.1111/j.1744-1617.2010.01306.x
Norris, D.S., & Schwartz, C.L. (2009). Needs Assessments: An Integrated Assignment in Civic Service. Journal of Teaching in Social Work, 29(4), 373-382. doi:10.1080/08841230903022027
(2006). Cildren and Yout Services Review, Vol. 28, 1459-1481.
Te study in tis researc piece evaluated te adult education, employment and financial successes (or failures) of 659 adults (20 to 33 years of age) wo ad gone troug intermediate and long-term foster care stays in teir yout. Tese kinds of studies are important for present and future agencies because a fuller understanding of sortcomings -- and strengts -- in policy and judgment can lead to better care and more productive lives for alumni of foster care. Wen visited and surveyed, many of te 659 individuals (alumni) ad completed ig scool not in formal education but via a GED; ence one-tird of te 659 ad incomes at or below te poverty level and "more tan one in five" ad been omeless following foster care (Pecora, et al., 2006, p. 1459). Te Nortwest Foster Care Alumni Study investigated te lives of alumni…
home care. Child Welfare, 87(6), 71-91.
This study leads with the assertion that multiple foster care placements are detrimental to "brain growth, psychological adjustment, and mental development" (which the American Academy of Pediatrics reported in 2000) (Eggertsen, p. 71). Eggertsen's research also claims multiple foster care placements contribute to an individual's "instability… [and] behavioral disturbances" and leads to "impaired school functioning." The question most apt in this context is, how can an adult -- who has been placed in multiple family settings during an unstable childhood and adolescence -- be expected to succeed in educational and career pursuits? Brain growth is a vital part of psychological and physiological development, but when the brain is not fully mature and functioning normally the child may be headed for a troubled adulthood, according to the literature.
This study involved 6,432 children (3,183 females; 3,140 males) who had been placed in foster care homes during the years 2000, 2001, and 2002 in Utah. The average age of participants was 8.17 but they ranged up to 20 years of age (p. 72). Of the 6,432 children, 4,917 had been removed from urban areas and placed in rural areas, and 1,426 had been removed from rural areas and transplanted to urban environments. As to the health issues, "Participants with major health problems were more than 60% more likely" to have been placed in multiple foster homes. Unhealthy bodies certainly are less apt to have success in school and in later life -- hence one of the results of this study aid in understanding poor performance in school. The existence of mental health problems "…more than doubled the likelihood" that an individual had experienced 3 or more placements (p. 73). The theoretical framework for this research is that multiple placement experiences for foster youth lead to stunted intellectual and emotional growth -- and those factors in many cases prevent an individual from solid education and training experiences.
The authors examined the outcomes of children who were kept with their siblings and those who were separated from their siblings and compared those with a stable arrangement from ones who were initially placed together and later separated. Partial support was found for the policy of keeping siblings together in foster care; the results suggest that the policy is positive for a unique subset of siblings, or those who initially show a low level of behavior problems. ompared to siblings in continuous placement, either together or apart, siblings in disrupted placement with high initial behavior problems had fewer problems, while siblings in disrupted placement with low initial behavior problems had more problems. These findings stress the importance of examining the relationships between siblings and the potential risk of separation and placement shifts before early placement decisions are made.
Marzick, a.B. (2007) the foster care ombudsman: applying an international concept to…
Children today are often abused while in foster care, opposing the goal to create a temporary, safe, homelike setting to protect and nurture children who are unable to live with their biological parents due to reasons such as abuse, neglect, or abandonment. This abuse is frequently worse than the reasons they were initially removed from their parents' care. There is now an internationally based innovative concept called the foster care ombudsman that may be a part of the solution. Child welfare ombudsman offices in California, Rhode Island, and New Jersey, as well as international locations are described in this report. The author also emphasized how a foster care ombudsman can complement class action litigation of foster care abuse claims. "When strongly statutorily defined, properly funded, and well-staffed, foster care ombudsman offices can serve as a complement to class action litigation and, more importantly, as a source of child welfare reform and protection for foster children," concluded Marzick.
McGuinness, T.M, & Schneider, K. (2007) Poverty, child maltreatment, and foster care. Journal of the American Psychiatric Nurses Association 13(5): 296-303.
In general, children are maltreated at considerably higher rates when they are living in poverty. Child welfare officials normally hear of children in foster care because they are neglected by parents who are struggling with poverty effects, such as homelessness, incarceration, HIV, and substance abuse. The authors reviewed the disadvantages experienced by young children in foster care, 36 months and younger. They found the common risks to include low birth weight, prenatal substance exposure, and prematurity. Substance abuse, for example, showed to be a major negative effect. Those children with prenatal substance exposure may be at high risk for a number of problems, including motor control and perceptual defects, even when they are raised with adequate care after birth. In addition, the child welfare agency had only an 11% screening for early intervention, despite the multiple risks as well as established mandates for screening. The system that is to protect and care for maltreated children lags behind in improving the well-being of its children. There appears to be a need for a middleperson who can be specifically in charge of this need. One example in California is a federally and state funded program that employs nurses to coordinate healthcare between the child welfare system and healthcare providers. This foster care nurse role evolved due to the growing recognition of the many health and developmental issues seen in child welfare and the lack of timeliness in addressing these problems.
2). Parents can also use DVDs for training in the home; by using a DVD as a means of providing in-service training to foster parents at home, the research showed that they "gained confidence in their ability to understand and handle their child's anger outbursts" and moreover, this was "notable" because it is not easy for parents to "look past the stresses caused by a child with explosive anger" (Pacifici, p. 7).
Review of Literature: Professionalizing Foster Care
Dr. Thomas aldcock, a university instructor at Trent and Nipissing Universities and a foster parent himself, writes that making foster care more professional is "a long overdue reform in child welfare." riting in Canada Online (www.ica.net) aldcock insists that the first priority should be to recognize the "changing problems of the children coming into care," and the importance of providing those children with the "best possible quality of care." Secondly as far…
Chipungu, Sandra Stukes; and Bent-Goodley, Tricia B. (2004). Meeting the Challenges
Of Contemporary Foster Care. The Future of Children.
Connolly, Marie. (2003). Kinship Care: A Selected Literature Review. Submitted to The Department of Child, Youth and Family, New Zealand.
Marquis, Robyn A., Leschied, Alan W., Chiodo, Debbie, and O'Neill, Arlene. (2008).
A large number of these youth are not prepared to be independent, regardless of their maturity level; they do not have the skills and services in place to do so. Having to live on one's own maximizes the stresses and personal challenges and requires skills that are even difficult for those who have never been in foster care. Not only are these young adults moving to independence without positive support, they have rarely been given the safety net needed. Nor has it ever been clearly recognized and resolved that these youths are facing the trauma of losing a family twice in their short lives -- both times forcefully. This is a syndrome now given the term called "remourn," since so many foster youths experience this second loss of family support and care.
The Chafee Act is a start in the right direction, but it is not enough given the number…
Browne, D. (2002) Health care needs of children in the foster care system. Journal of Youth and Adolescence. 31(1), 57-66.
Casey Family Programs. (2003) the Northwest Foster Care Alumni Study Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study. Retrieved March 10, 2010 from http://www.casey.org /Resources/Publications/NorthwestAlumniStudy.htm
Child Welfare League of America (Nd) Programs and Resources for Youth Aging Out of Foster Care. Retrieved March 2, 2010 from http://www.cwla.org/programs/fostercare/agingoutresources.htm
Chipungu, S.S. & Bent-Goodley, T. (2004) Meeting the Challenges of Contemporary Foster Care. The Future of Children 14(1). 75-94
From being exposed to such an unhealthy environment at an impressionable age, many negative effects occur (Weldon, 2001). This is because since more children are entering foster care in the early years of life when brain growth and development are most active. The younger a child may be, psychological effects become even more profound, and during the first 3 to 4 years of life, many traits are established, strengthened, and made permanent (Weldon, 2001). These traits include personality, leaning processes, and coping with stress and emotions. When a child is exposed to negative environmental conditions during the development of the brain and nervous system, serious effects will occur (Weldon, 2001). Finally, a child having no dominating parental figure during the early years of development may lead to a child never being able to receive nurture from any other person. This effect is the most devastating effect that foster care has…
Albers, E., Reilly, T., & Rittner, B. (1993). Children in foster care: Possible factors affecting permanency planning. Child and Adolescent Social Work Journal 10: 329-
Pecora, P., Williams, J., Kessler, R., Downs, C., O'Brien, K. & Morello, S. (2003). Assessing the Effects of Foster Care. Retrieved July 22, 2007, at http://www.casey.org .
Katz, L. (1987). An Overview of Current Clinical Issues in Separation and Placement. Child and Adolescent Social Work 4: 209-225.
National Adoption and Foster Care Statistics. (2004). Administration for Families and Children.
foster children face, especially when they become emancipated and begin to live life on their own. It has often been suggested that many more African-American children are in foster care than are children of other races. In order to understand whether or not this is accurate, a thorough review of available literature on the topic is necessary. Literature on this topic will include statistics, gender differences, and cultural diversity.
The problem statement concerns the disproportionate number of African-American children who are represented in the child welfare system, and who are not adequately prepared to leave foster care through emancipation. The logical assumption would be that something is lacking in the foster care environment that causes great difficulty for children once they begin to live on their own. It is the intent of the literature review to show whether or not is accurate, and what may be lacking in the foster…
Amaro, H., Fried, L.E., Cabral, H., & Zuckerman, B. (1990). Violence during pregnancy and substance use. American Journal of Public Health. 80(5), 575-579.
Bandura, A. (1965). Influences of models' reinforcement contingencies on the acquisition of imitative responses. Journal of Personality and Social Psychology. 1, 589-595.
Barden, J. (January 6, 1991). After release from foster care, many turn to lives on the streets. New York Times. 1.
Bartels, L. (August 8, 1997). Foster care rate high state second nationally for percentage of kids not living with parents. Denver Rocky Amount News. 16A.
I like this approach to dealing with kids in foster care. The ultimate goal should be to have a little contact with the system as possible. The foster families and the birth families should work together to make sure that the child has the safest and most healthy environment possible that includes the birth family. The goal in the end is to help the families with whatever issues they are having so that they are able to care for their children once again. This approach will probably not work for every child and every family but it should be used as much as it possible.
Challenges to Working in a Bureaucracy
Working within a bureaucracy can be a very challenging thing to do. Bureaucracies are often laden with rules and regulations that have to be overcome in order to get things accomplished. A lot of times these rules and regulations…
Concurrent Planning. (2012). Retrieved from http://glossary.adoption.com/concurrent-planning.html
DePanfilis, D. & Salus, M.K. (2003). Child Protective Services: A Guide for Caseworkers.
Retreived from http://www.childwelfare.gov/pubs/usermanuals/cps/cps.pdf
The Therapeutic Alliance. (n.d.). Retreived from http://amhd.org/About/ClinicalOperations/MISA/Training/Therapeutic%20Alliance%
Does Foster Care Have an Effect in Children Physically, Mentally, Emotionally and Socially?
Today, there are almost 438,000 children placed in foster care in the United States and more than 687,000 children were assigned to foster care during 2016 (Foster care, 2016). The research to date also indicates that children in the United States remain in foster care on average almost 2 years and at least 6% have been in foster care for 5 years or more (Foster care, 2018). Although there is a near consensus that foster care provides a superior environment for young people compared to institutionalization, a growing body of scholarship cites the adverse effect that the experience can have on children’s physical, mental, emotional and social growth. The purpose of this paper is to provide a review of the relevant literature concerning these issues, followed by what can be done to help these young people avoid…
Almas, A. N., Degnan, K. A., Walker, O. G. et al. (2015, May). The effects of early institutionalization and foster care intervention on children’s social behaviors at the age of eight. Social Development, 24(2), 225–239.
Clausen, J. M., Landeverk, J., Ganger, W. et al. (1998). Mental health problems of foster children. Journal of Child and Family Studies, 7(3), 283-329.
Foster care. (2018). Children’s Rights. Retrieved from http://www.childrensrights.org/news room/fact-sheets/foster-care/
Ghera, M. M., Marshall, P. J., Fox, N. A. et al. (2009). The effects of foster care intervention on socially deprived institutionalized children’s attention and positive affect: results from the BEIP study. The Journal of Child Psychology and Psychiatry, 50(3), 246-253.
Stott, T. (2012). Placement instability and risky behaviors of youth: Aging out of foster care. Child and Adolescent Social Work Journal, 29, 61–83.
Windsor, J., Benigno, J. P., Wing, C. A. et al. (2011, July/August). Effect of foster care on young children’s language learning. Child Development, 82(4), 1040–1046.
One of the objectives of foster care should be to provide as any parent or guardian should provide, which means getting foster care youth ready for the adult world. When a youth graduates from the foster care program, ideally that youth will have all of the skills and tools needed to survive on his or her own.
eilly (2003) identified some of the issues that foster care youth face when they exit foster care. They are generally thrown into the real world without a lot of training, but forced to fend for themselves without adult guidance. The result, eilly notes, is a series of negative outcomes that seem commonplace to foster care youth. Among other issues, they are often unable to meet basic living expenses, and struggled to earn enough money to do so, or to obtain health care. One of the key issues that eilly notes is…
Cook, R. (1994). Are we helping foster care youth prepare for their future? Children and Youth Services Review. Vol. 6 (3-4) 213-229.
Courtney, M. & Heuring, D. (2005). The transition to adulthood for youth "aging out" of the foster care system. In On your own without a net, ed. D. Osgood. University of Chicago Press: Chicago.
Federal Reserve. (2002). Financial literacy: An overview of practice, research and policy. Federal Reserve Bulletin. Vol. 88 (445).
Lusardi, A. (2008). Household saving behavior: The role of financial literacy, information and financial education programs. Federal Reserve Bank of Cleveland. Retrieved November 17, 2014 from http://www.clevelandfed.org/our_region/community_development/events/seminars/20080425_fin_lit/lusardi_paper.pdf
Domestic Issues With Student Affairs
There are numerous ethical issues to consider when a resident hall director speculates about taking home over semester break a foster care student who has nowhere else to go. The vast majority of these ethical issues pertain to concepts of propriety and the fair, equitable treatment of that student. Additionally, these ethical issues also pertain to the resident hall director and his or her ability to maintain his or her job.
One of the more eminent ethical issues that the aforementioned resident hall director would have to consider in such a scenario pertains to the welfare of the student. In fact, the welfare of such students should always take priority for any resident hall director. Caring for students is designed so that caretakers "provide safe, healthy, and discrimination free environments for teaching, learning, and scholarship for students, employees, and visitors" (University of Hawaii, 2015). The…
Schuh, J.H., Jones, S.R., Harper, S.R., and Associates. (2011). Student services: A Handbook for the profession. San Francisco, CA: Jossey-Bass.
University of Hawaii. (2015). Strategic directions. http://blog.hawaii.edu / Retrieved from
exiting out of the foster care system and consistent research points to the value of a support network in helping them do so.
Law necessitates that foster children exit the foster care system between the ages of 16-18. However, study after study shows the difficulties that these individuals face upon release. Many of them are unable to throw themselves into independence and very few are able to grapple with the struggles of life. tudies and analysis (* e.g.) show that most of these individuals are unemployed,50% leave foster care without a high school diploma, 7% were incarcerated in a state prison, 2% reported experiencing homelessness, 30% experience health problems, 32% need health care, and 55% have no type of health insurance. Further studies (*e.g.) show that youths with more foster care placements are more likely to have encountered violence in their dating relationships, were more likely to have spent time…
Hycner, RH (1985) Some guidelines for the phenomenological analysis of interview data, Human Studies 8, 279-303
Alternative and Traditional Therapeutic Methods and Interventions:
The Treatment of Children in Foster Care
Children who live in a foster care environment often have emotional difficulties that must be dealt with by their caregivers. It is true that some of these children also have physical disabilities and ailments, but most of these physical problems can be handled more easily than some of the emotional scars that these children carry. Many of these emotional scars run very deeply, and they deal with issues and topics that no child should have to face, especially from their families.
Because of the difficult times that many of these children experienced before they came to foster care, and because of the pain and scars that they now carry from their previous conflicts and experiences, many of these children are involved in different kinds of therapy and intervention strategies. These strategies are designed to help children…
Bickman, L. (1993, March). Evaluation and research issues surrounding systems of care for children and families. Paper presented at the Sixth Annual Research Conference on Children's Mental Health Services, Tampa, FL.
Blatt, S.D. & Simms, M. (1997). Foster care: Special children, special needs. Contemporary Pediatrics, 14(41), 109-129.
Blumberg, E., Landsverk, J., Ellis-MacLeod, E., Ganger, W. & Culver, S. (1996). Use of the public mental health system by children in foster care: Client characteristics and service use patterns. Journal of Mental Health Administration, 23(4), 389-405.
Chernoff, R., Combs-Orme, T., Risley-Curtiss, C. & Heisler, A. (1994). Assessing the health status of children entering foster care. Pediatrics, 93(41), 594-601.
D., further discusses the social implications of foster care on the overall financial education and life-skill ability of aged out foster care children. According to his research, the average income of an aging-out youth is less than $6,000, which is drastically less than the federal poverty amount of $7,890. This author proposes that the only means of ending the cycle and allowing foster care children the opportunity to gain the necessary financial knowledge is through government funded job and life-skills programs that prepare these children to enter the real world.
Unfulfilled Promise: The Dimensions and Characterics of Philadelphia's Dropout Crises
This report by Ruth Neild and Robert Balfanz further emphasizes the need for high school retention rates among foster care children. According to this report, it can be predicted whether a student will drop out of high school, the primary institution where financial education is given, by their 8th grade…
Anderson, Gary (2003). Aging Out of the Foster Care System: Challenges and Opportunities for the State of Michigan. Michigan Applied Public Policy Research Program.
Atkinson, Melinda (2008). Aging Out of Foster Care: Towards a Universal Safety Net for Former Foster Care Youth. Harvard Civil Rights-Civil Liberties Law Review, 43, 183-212.
Collins M, Clay C, Ward R (2008). Preparing Our Kids for Education, Work and Life. The Boston Foundation.
Neild, Ruth & Balfanz, Robert (2006). Unfulfilled Promise: The Dimensions and Characteristics of Philadelphia's Dropout Crisis, 2000-2005. Philadelphia Youth Transitions Collaborative.
sufficient health care for runaway teenagers is a topic of grave concern to most in the medical and social professions, both nationally and in the state of California. With limited treatment options, higher risks of STD's, HIV, and other diseases, improper prenatal care, and a lack of community care options, runaway teens receive grossly inadequate health care. This paper will address those concerns, specifically in the state of California, as well as offering possible solutions to the problem, and will examine the role of the registered nurse in the solutions presented.
It is important to note that the life of a runaway teenager is filled with health risks and danger. Marie and Cheri are just one example. They were 13 when they ran away from home in an attempt to escape a drug addicted father who sexually abused them. With only $200 between them, their food supply and housing was…
Advanced Practice Registered Nurses Council. (2004). Information on APRNs. APRNs. Retrieved from Advanced Practice Registered Nurses Council on March 03, 2003. Web site: http://www.scnurses.org/A_P_Council/aprns.asp
American Civil Liberties Union. (May 14, 2003). Letter to the House Urging Opposition to the Musgrave Amendment to HR 1925, the Runaway, Homeless, and Missing Children Protection Act. Retrieved from American Civil Liberties Union website on March 3, 2004. Web Site: http://www.aclu.org/news/NewsPrint.cfm?ID=12643&c=225
California Board of Registered Nurses. (Fall, 2003). What is the RN Scope of Practice? The BRN Report, 15(2), 7-9.
California Office of the Attorney General. (2002). 2002 Reports of Missing Children by County. Sacramento, CA: California Department of Justice.
Lost Boy by Dave Pelzer:
The foster care system in the United States has long been a subject of much negative attention. In many ways, individuals who were part of this system were regarded in a negative way, and were placed upon a great deal of stigma. The Lost Boy, a book that discusses this subject from a highly personal perspective, aims to explain both the internal and external aspects of the system and how it can affect those within it, referring not just to the children who must be part of the system, but also to the adults that knowingly involve themselves within it. The Lost Boy, just as any great book written on a little known subject thus has a great impact on the individuals who read it and on the society in affects. This novel discusses a journey, seen from the eyes of a child and from…
Craft, C. (2012). Dave Pelzer Is a Famous Foster Kid. About.com. Retrieved January 17, 2012, from .
Naar-King, S. & Ellis, D.A. & Frey, M.A. (2004). Assessing children's well-being: a handbook of measures. Wayne State University. Retrieved January 17, 2012, from .
No Author. (2012). David Pelzer Book Review. Retrieved January 17, 2012, from .
Pelzer, D. (1997). The Lost Boy. Library of Congress Publication.
Lost Boy: A Foster Child's Search for the Love of a Family
David J. Pelzer is a child-abuse survivor who has shared his experiences as a public speaker and an author. He tells his own story in a series of three books. Pelzer is the son of an alcoholic and extremely abusive mother and he lived his life moving frequently in and out of foster homes. Pelzer is a strong advocate against child abuse and his personal accounts help to bring awareness to many. Pelzer was married and had one child. He is divorced from his first wife, but has remarried.
Pelzer's second book, The Lost Boy: A Foster Child's Search for the Love of a Family, covers Pelzer's turmoil during his teen years and is the sequel to the first of a trilogy titled, A Child Called It. It is the true story of a child who suffered abuse…
Pelzer, David. The Lost Boy: A Foster Child's Search for the Love of a Family. Health Communications, 1997.
'ealism-quality' approaches to leadership in the real world of social services
I have described myself as a 'realism-quality' leader who believes on the need to be task specific. I try to set realistic goals that are achievable and conceivable for my subordinates. This type of leadership is very useful when dealing with some of the challenges that arise in the context of a nonprofit organization that focuses on children in foster care. Very often, parents are initially not prepared for the difficulties that may arise when coping with a child with severe behavioral, emotional, or psychological issues.
One example of a 'realistic' approach that I had to take was when a foster mother assumed the care of a child but was not able to take full control over the situation and left the child's care for part of the day to her adult daughter, who frequently arrived…
Gelfand, Michelle J., Lisa M. Leslie, Kirsten Keller, & Carsten K.W. Dedreu. (2008). Cultures of conflict.
Tsasis, Peter. (2009). The social processes of interorganizational collaboration and conflict in nonprofit organizations. Nonprofit Management and Leadership. 20 (1).
Nursing Home Facilities: A Solution for Long-Term Care
Nursing home facilities offer a unique setting for long-term care of elderly persons. Serving as places of residence where the elderly person can obtain assistance with daily living and with medical needs, the nursing home acts exactly as its name suggests—as a home wherein nursing care is provided on a daily basis. This paper will describe the setting of the nursing home, where it falls on the long-term care continuum, how family and friends can play a supportive role, what the role of public relations is in the nursing home, and how oversight of the nursing home is provided by government or other organizational agencies.
Long-Term Care Continuum
The nursing home typically falls at the end of the long-term care continuum spectrum. This spectrum can include four stages: 1) aging in place, which consists of self-care, home support, and adult…
Biblical Worldview: How Genesis 1:26-27 Affects My Choice of Professions
A belief that is foundational to the Christian faith is that people are made in the image of God as explicated in Genesis 1:26-27. Given this centrality, it is reasonable to posit that this biblical worldview also affects Christians' choices of professions in varying degrees. To gain some fresh insights into this issue, this paper provides an explanation concerning how this belief affects my relation to people in my chosen vocation of foster parent and group home director, followed by a summary of the research and important findings concerning this biblical worldview in the conclusion.
The unique status of humankind is clearly established early on in the Old Testament in the Genesis 1 account. For instance, the New International Version (NIV) of Genesis 1:26 states that:
Then God said, "Let us make mankind in our image, in our likeness, so…
Blatt, Susan Mcnair. A Guidebook for Raising Foster Children. Westport, CT: Bergin and Garvey, 2000.
Peterson, Anna L. Being Human: Ethics, Environment, and Our Place in the World. Berkeley, CA: University of California Press, 2001.
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
U.S. Health Care Reforms
Objectives of reform of the health care system should align to improve quality, access and cost in health care. The intricacy of the health care system necessitates balancing the three variables while considering the individual's viewpoint. To achieve this equilibrium, health care programs ought to satisfy safety, actuarial and economic principles that should be under proper application and management for successful reforms. Evidently, there exist various problems within the system. These include poor price controls, over-insurance, lack of transparencies in health care cost and delivery, inappropriate actuarial risk classifications and improper safety net structures. This explication highlights health care reform principles and discusses incremental solutions for quandaries in the American health care system.
Health care reforms ought to strive to encourage the fundamental economic principle of demand and supply. Over-insurance, increase of mandated benefits, control of prices, increased malpractice costs and dependence on third…
Healthcare: Clinical Integration
What is clinical integration
History of clinical integration
Goals of clinical integration
Importance of clinical integration
New payment models
Barriers to clinical integration
Lack of practitioner alignment
Lack of interoperability
How to achieve success in clinical integration
The future of health care systems
Physician acquisitions vs. clinical integration
HIEs -- solution to clinical integration?
Policy makers are beginning to appreciate the fact that only systemic change can effectively change, for the better, the manner of health care delivery in the U.S.; and that anything less would only alter the system's edges - with little or no substantial effect on cost-control, innovation-promotion, effectiveness of reward incentive schemes, coordination and coverage (AHA, 2010). Clinical integration has been found to be crucial to the change needed for the achievement of the aforementioned goals (AHA, 2010). Despite…
AHA. Clinical Integration -- the Key to Real Reform. Trend Watch. Retrieved from [HIDDEN]
Athena Health. (2014). History of the Clinical Integration Model. Athena Health. Retrieved from https://www.athenahealth.com/knowledge-hub/clinical-integration/clinical-integration-model.php
eHealth Initiative. (2012). The Rise of the Private Health Information Exchange and Changing Role of Public Exchanges. eHealth Initiative. Retrieved from [HIDDEN]
Fridsma, D. (2013). Interoperability Vs Health Information Exchange: Setting the Record Straight. Health IT Buzz. Retrieved from http://www.healthit.gov/buzz-blog/meaningful-use/interoperability-health-information-exchange-setting-record-straight/
Beard, C., Weisberg, .B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
This study shows how traditional methods of approaching patients with information can cause confusion and thus create barriers to accessing patient knowledge in primary care settings. The study focused on working with primary care patients suffering from anxiety and how they reacted to cognitive bias modification (CBM) for that anxiety. Upon initial discussion of the treatment, most participants showed that they understood. However, it was clear by the end of the treatment that the program was not clarified enough to patients prior to treatment and that created a knowledge barrier that caused the treatment not to work as successfully as previously tested. Better methods for communicating the treatment within the primary care setting must be developed to bring down these…
Beard, C., Weisberg, R.B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
Beckman, H.B., Wendland, M., Mooney, C., Krasner, M.S., Quill, T.E., Suchman, A.L., & Epstein, R.M. (2012). The impact of a program in mindful communication on primary care physicians. Academic Medicine, 87(6), 815-819.
Cheung, P.T., Wiler, J.L., Lowe, R.A., & Ginde, A.A. (2012). National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries. Annals of emergency medicine, 60(1), 4-10.
Crabtree, B.F., Nutting, P.A., Miller, W.L., McDaniel, R.R., Stange, K.C., Jaen, C.R., & Stewart, E. (2011). Primary care practice transformation is hard work: insights from a 15-year developmental program of research. Medical care, 49(Suppl), S28.
Healthcare Management -- Discussion Questions
Communication strategies are very important when it comes to promoting the practice of healthcare delivery and ensuring that customer service is offered at the highest level. If a person does not communicate well it can harm him or her both personally and professionally. However, that is still a rather isolated issue that is generally considered to be self-limiting in nature. With companies, and especially with healthcare companies, the issue of poor communication is much larger and more significant. As a healthcare worker, a person has to be able to communicate information to patients, families, and other healthcare workers (Nutbeam, 2000). When a person is a manager in a healthcare setting, though, there is much more pressure to make sure that everyone gets the information they need in a timely manner and that the communication preferences as addressed in such a way that each and every…
Arora, V.M., Manjarrez, E., Dressler, D.D., Basaviah, P., Halasyamani, L., & Kripalani, S. (2009). Hospitalist handoffs: A systematic review and task force recommendations. Journal of Hospital Medicine, 4(7): 433- 440. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575739/
Mercuri, R.T. (2004). The HIPAA-potamus in health care data security. Security Watch. Communications of the ACM, 47(7): 25-28. Retrieved from http://www.notable-software.com/Papers/HIPAA.pdf
Moskop, J.C., Marco, C.A., Larkin, G.L., Geiderman, J.M., & Derse, A.R. (2005). From Hippocrates to HIPAA: Privacy and confidentiality in emergency medicine -- Part I: Conceptual, moral, and legal foundations. Annals of Emergency Medicine, 45(1): 53-59. Retrieved from https://www3.acep.org/assets/0/16/898/904/2196/2280/C798499F-59F2-42A3-A23A-A575767D4234.pdf
Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3): 259-267. Retrieved from http://heapro.oxfordjournals.org/content/15/3/259.long
Unintended Consequences of Health Care Reform
Consequences of Health Care Reform
My discussion is related to the individual mandate of the Patient Protection and Affordable Care Act (PPACA) of 2010.
The policy problems addressed by the Patient Protection and Affordable Care Act (PPACA) of 2010 are the high cost of health insurance that is untenable for low and middle income earners and the discretionary criteria for enrollment and coverage exercised by medical and health insurance carriers. The PPACA is an excellent policy solution to these issues in the United States and, absent socialized medicine, is a robust response to what has been an intractable and escalating problem in the U.S. Many people who have unable to obtain medical insurance are now able to do so.
The Patient Protection and Affordable Care Act was designed to significantly reduce the number of people who are uninsured through the provision of a continuum…
Christian Worldview Nursing
Health care in the West and worldwide has undergone very extreme changes over the past decades. However, the basic principles of nursing like caring for the sick and elderly have remained consistent. While technology has changed radically since the days of Florence Nightingale, Christian caring in the nursing profession is still a foundational principle. It is this foundational principle that I seek to express in my ministering to my patients.
Christian Worldview and the Integration of Beliefs, Values, Ethics and Service
The definition of nursing for me symbolizes a set of beliefs, values, ethics and service. Nursing is after all a calling and a vocation, not just a job. In Judith Anne Shelly's book Called to Care, she defines nursing as distinct from medicine, even though the two occupy domains that are close together.
She defines it in a way that I find very familiar and similar…
Salt and light. (2012). Journal of Christian Nursing, 29(2), 74.
Shelly, J.A., & Miller, A.B. (2006). Called to care: A christian worldview for nursing. (2nd ed.).
Downer's Grove, IL: Intervarsity Press.
GBMC Healthcare Hospital. The main issue relates to privacy and confidentiality issues considered essential components of fostering trust between healthcare consumers and providers. The issue arose the GBMC hospital did not strictly follow the rules of privacy and confidentiality. Because of its lack of complete control on the privacy issues, many pieces of private information of patients were stolen and compromised.
Although GBMC hospital has been committed for 75 years to ensuring patient healthcare information is used to fulfill appropriate needs as provided by consent or law, but with the advent of the electronic health record and the transfer of an individual's health information through electronic media, including the Internet, the need for privacy and confidentiality protection takes on new meanings and challenges for the GBMC.
As medical science and technology continue to mature, and new data is being created that, when accessed, could be used to discriminate against an…
Courtney S. Campbell, The Crumbling Foundations of Medical Ethics, Theoretical Medicine and Bioethics, Volume 19, Issue 2, April 1998, Pages 143-152
Roberto, M. And Flynn, E.P., Issues in Medical Ethics, Medicine, Health Care and Philosophy, Volume 1, Issue 2, 1997, Pages 188-189
The study was reported as qualitative and to have been conducted by the 'Australian National Health and Medical Research Council' research study. It is stated as follows of the study: "The nursing insights indicate that an understanding of end-of-life care in hematology needs to be set in a trilogy of overlapping models (labeled functional, evolving, and refractory) that address the complexity of issues associated with professional and hospital culture." (McGrath, 2007)
Findings include the development of a working model focused on enabling the "integration of palliative care into adult hematology. The model is accredited the development of a new language for understanding and fostering the integration of palliative care and hematology." (McGrath, 2007)
One reason that palliative care is so important for hematology patients are necessary provisions of informed consent and other end-of-life issues. That is because many of these issues have to do with factors related to survival and…
Finlay, Ilora (2001) UK Strategies for Palliative Care. JR Soc Med 2001;94. Online available at: http://jrsm.rsmjournals.com/cgi/reprint/94/9/437.pdf
Audrey, Suzanne et al. (2008) What Oncologists Tell Patients About Survival Benefits of Palliative Chemotherapy and Implications for Informed Consent: Qualitative Study. BMJ 2008, 337:a752. Online available at: http://www.bmj.com/cgi/content/full/337/jul31_3/a752
McGrath, Pam D. (2007) Description of an Australian Model for End-of-Life Care in patients with Hematological Malignancies. Oncology Nursing Forum. Vol.43 No.1 2007. Online available at: http://ons.metapress.com/content/w1l1mx43646772k3/
Maganto, Vincente Valentin, Gonzalez, Maite Murillo and Moreno, Maria Valentin (2004) Continuous Care in the Cancer Patient: Palliative Care in the 21st Century. Clinical and Translational Oncology. Vol. 6 No. 7 October 2004.
Barak concludes by suggesting that the issue and concept of diversity take on a "special urgency" in human service healthcare organizations among the organization as a whole and staff, and that the organization review its quality of service and commitment to the community in order to truly impact the lives of diverse populations.
Managing Diversity: Best Practices
H Management often works off of the ideals of 'best practices.' This concept is discussed in the next article, "Managing the Diversity evolution: Best Practices for the 21st Century Business." Aronson takes a more general approach to diversity but one that can be applied directly to the healthcare industry nonetheless. Aronson points out many of the trends previously identified with regard to diversity problems in the nation's business climate as a whole. In particular the author points out that diversity issues may stem from a number of causes including cultural differences and systematic…
Aronson, D. (2002). "Managing diversity revolution: Best practices for the 21st century."
Civil Rights Journal, 6(1):46
Barak, M.E.M. (2000). "The inclusive workplace: An ecosystems approach to diversity
Management." Social Work, 45(4):339
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
Scope of Training
Large health care organizations will undoubtedly have a large scope of training. The investments and systems approach is beneficial for companies who can realize economies of scale. Through economies of scale the unit cost for each selective individual trained decreases. This ultimately allows the cost of investments and systems to be spread throughout the entire organization. The systems approach is particularly beneficial as it creates and distills consistent behavior throughout the entire organization. Each individual that is trained is usually receiving and absorbing the same information as their peers. This insures the continuity of the business and its underlying operations. The scope will depend primarily on the needs of the business. In some instances, training may involve the entire health care organization while in other instances; it may only require a select department. In either case, investments in systems allows for the most efficient use of…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Fang, D., Wilsey-Wisniewski, S.J., & Bednash, G.D. (2006). 2005-2006 enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: American Association of Colleges of Nursing
3) Levsey, K.R., Campbell, D., & Green, A. (2007). Yesterday, Today, and Tomorrow; Challenges in Securing Federal Support for Graduate Nurses. Journal of Nursing Education, 46(4), 176-183
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Convenient Care Clinics
How do Convenient Care Clinics (CCC) fit into the hierarchy of health care delivery systems?
With the exorbitant costs of modernized health care delivery coming to the forefront of the national debate, and the continued effects of a prolonged economic recession restricting the options of countless Americans, the role of Convenient Care Clinics (CCCs) has significantly expanded during the last decade. As opposed to a full-scale hospital or comprehensive medical facility, CCC's are typically small practices located in strip malls and shopping centers, serving local communities by treating uncomplicated or minor illnesses, tending to basic injuries, and providing preventative health care services. While CCCs represent level of competition to major hospitals and other large-scale health care providers, by enabling patients to obtain medication and treatment without visiting the emergency room, in all actuality CCCs are an integral component of the nation's evolving hierarchy of health care delivery…
Schmit, J. (2006, August 28). Could walk-in retail clinics help slow rising health costs?. USA Today. Retrieved from http://usatoday30.usatoday.com/money/industries/health/2006-08 - 24-walk-in-clinic-usat_x.htm
Turton, T.H., Ryan, S., Miller, K., Counts, M., & Nash, D.B. (2010). Convenient care clinics: The future of accessible health care. Convenient Care Association White Paper, (September), 1-23. Retrieved from http://www.ccaclinics.org/images/stories/downloads/whitepaperfordistribution.pdf
Wynter, C., & Leifer, J. (2008). Dealing with the emergence of convenient care retail clinics: A guide for health centers. National Association of Community Health Centers, (June), 1- 26. Retrieved from http://iweb.nachc.com/Downloads/Products/ST_RETAIL_08.pdf
Diabetes Foot Care
Qualitative esearch Critique: Diabetes Foot Care
Sue Flood (2009) saw a need to examine the nurse-patient interaction in relation to diabetes foot care outcomes, in part because at least one health care organization (Agency for Healthcare esearch and Quality) has concluded that diabetes care received by patients often do not meet best practice standards. The impact of substandard care includes a 45 to 85% difference in the incidence of foot ulcers and amputations, as reported by the U.S. Centers of Disease Control and Prevention. The author further justified this study based on the ongoing global obesity and diabetes epidemics.
Flood (2009) decided to examine the nurse-patient interactions because this relationship has been shown to have a significant impact on patient outcomes. This represents the primary assumption the author tests in her study. The four components of nurse-patient interactions are: (1) affective support, (2) health information, (3) decisional…
Flood, L.S. (2009). Nurse-patient interactions related to diabetes foot care. MEDSURG Nursing, 18(6), 361-370.
Technology and Healthcare
Please see the attached case and answer 1a with it. also answer questions 2 and 3
Implementing a syndromic surveillance system & Case Study 3: Selection of a patient safety strategy
How the projects address current problems in health informatics
One of the most common problems with implementing a new informatics system is creating a cohesive network. In "Case Study 13: Implementing a syndromic surveillance system," all of the hospitals involved in the IT overhaul had different systems, with different vendors and data sets. There were also radically different levels of knowledge and willingness amongst staff members to devote time, money, and manpower to support the new interface. Federal grants would support the initial implementation, but it still needed to be financially sustainable and the staff needed to know how to analyze the data correctly at all of the member hospitals. Each hospital had widely different patient…
Anshari, Muhammad & Mohammad Nabil Almunawar. (2011). Evaluating CRM implementation in healthcare organization. International Conference on Economics and Business
Information. IPEDR, 9: 30-34. Retrieved:
Electronic medical records (EMR). (2005). Open Clinical. Retrieved:
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Health Care -- Philosophy of Graduate Nursing Education
In many senses, the nurse practitioner (NP) takes the profession of nursing to the next level. While the treatment of illness important, the NP also has broader focus of total well-being, including wellness, rights, education and preventative medicine for the patient, his/her family, and local, state, national and global communities. Consequently, in addition to treating the physical ailments of a patient, the modern NP must be clinically and intellectually excellent, an eternal student and teacher who fulfill numerous roles in nearly every health care situation.
A crucial aspect of nursing is the caregiver's relationship with the patient. Patient education is an important aspect of nursing and when carried over to the NP role, patient education greatly improves treatment because the patient has a greater understanding of the reasons for treatment and is likelier to effectively participate in treatment. A NP is a…
Personal Healthcare Technology
Sunrise Hospital and Medical Center and the Sunrise Children's Hospital
The Sunrise Hospital and Medical Center, which includes the Sunrise Children's Hospital, is an approximately 55-year-old facility located in Southern Nevada; it serves the greater Las Vegas area and the surrounding communities. The Sunrise Health and Medical Center is proud of its quality initiatives to ensure patient safety and comfort, including direct approaches to pharmaceutical safety such as safe medication dosing via smart pump technology, and bar coding on medications. As well, the Sunrise Health and Medical Center does not discriminate with respect to HIV / AIDS or in any manner related to employment, program participation, admission and/or treatment.
Sunrise has been rated as the most popular area hospital for 15 years in patient surveys. As well, Sunrise Health and Medical Center has developed community outreach programs for health education in a variety of areas, often based…
Appari, A., & Johnson, M.E. (2010). Information security and privacy in healthcare: Current state of research. International Journal of Internet and Enterprise Management, 6 (4), 279-314. Retrieved from http://www.ists.dartmouth.edu/library/501.pdf
Ayanian, J.Z., & Weissman, J.S. (2002). Teaching hospitals and quality of care: A review of the literature. The Milbank Quaterly, 80(3), 569-593. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690120/pdf/milq0080-0569.pdf
Baker, J.J., & Baker R.W. (2000). Health care finance: Basic tools for nonfinancial managers. Gaithersburg, MD: Aspen
Byington, R., Keene, R., Masini, D. (2006). The impact of federal and state funding levels on strategic decisions and how those decisions affect patient care. The Internet Journal of Healthcare Administration. (4)2. Retrieved from https://ispub.com/IJHCA/4/2/5827
The UNC Health Care System runs a teaching hospital that publishes its mission statement, statement of core values, and nursing philosophy on the organization's Web site at < http://www.unchealthcare.org/site/Nursing/nurseleadership/visionvalues >. The mission is stated briefly as: "to be a leader in providing compassionate, quality care focusing on the unique needs of patients and their families." Key words in the mission statement include "compassionate," "quality care" and "unique needs." The core values of the UNC Health Care System's nurses include five main elements. Those elements include "My patient," "My team," "My Hospital," "My Community," and "My Profession." Phrasing these five main values in terms of "my" helps the nurse to feel like an integral part of the organization.
Furthermore, the nursing philosophy of the UNC Health Care System is outlined as being a reflection of the vision and values of the organization as a whole. The main principles of…
East Carolina University College of Nursing (2012). Philosophy of the college of nursing. Retrieved online: http://www.nursing.ecu.edu/philosophy.htm
UNC Health Care System (2007). Nursing mission, core values, philosophy. Retrieved online: http://www.unchealthcare.org/site/Nursing/nurseleadership/visionvalues
Defined as the philosophical study of right and wrong action, Ethics is a predominant subject of concern in nursing (Michael Dahnke, 2006). Being presented with various situations, the ethical and cultural problems are a serious concern faced by the nursing and healthcare staff which needs to be catered to day in and out. There is no time tested methodology that can be applied here, since the every patient is different, with a different background history, therefore the ethical and cultural implications of each decision would also vary.
Importance of Ethical Theory to Nursing
Defining what is right and wrong is a very subjective approach and even that can change from scenario to scenario. Therefore it is important to have some form of umbrella under which the functioning of nurses takes place. It is under this rationale that the importance of ethical theory emerges in front of us.
DuAnne Foster Edwards, R.M. (1999, Feburary). The Synergy Model: Linking Patient Needs to Nurse Competencies. Retrieved September 30th, 2011, from American Association of Critical Care Nurses: http://www.aacn.org:88/wd/certifications/content/synpract2.pcms?pid=1&menu=
Green, D.B. (2001, July). Medical Ethics. Retrieved September 30th, 2011, from Priory.com: http://priory.com/ethics.htm
Michael Dahnke, H.D. (2006). Defining Ethics and Applying the Theories. In P.M. Vicki D. Lachman, Applied Ethics in Nursing (p. 3). New York: Springer.
Samar Noureddine RN, M. (2001). Development of the ethical dimension in nursing theory. International Journal of Nursing Practice, 2-7.
In some respects, the challenges faced by leaders in health care organizations do not vary from those faced by leaders in other organizations. The balance between patient outcomes, the disparate groups of subject matter experts and the challenges presented by operating in a highly regulated and litigious industry, in addition to the life-and-death consequences of the organization's work highlight the need for unique leadership in health care. Resources are finite and fleeting, crises are manifold and constraints are many. The health care leader must have an acute sense of how to bring all of these different resources together -- this means having in-depth knowledge but also a feel for how all the pieces come together and how different changes will affect the organization's outcomes.
Leading people is a far different challenge compared with managing resources, because attention must be paid to the needs of the workforce. Yet, because the workforce…
Annison, a. (1998). Trust matters: New directions in health care leadership. France: Artech House.
Plsek, P. & Wilson, T. (2001). Complexity, leadership and management in health care organizations. British Medical Journal. Vol. 323 (7315) 746-749.
Porter-O'Grady, T. & Malloch, K. (2007). Quantum leadership: A resource for health care innovation. Sudbury, MA: Jones and Barlett Publishers
Treasure, T. (2001). Redefining leadership in health care. British Medical Journal. Vol. 323 (7324) 1263.
Furthermore, most universities are private or receive private aid as well as public financing in the case of state-run medical schools, thus management of care is taught and passed on through private institutions.
In terms of economic support, even nationally funded systems or 'free' systems are dependent upon taxes and other forms of public aid -- health care always 'costs' in some way. Health care organizations are for-profit businesses in the U.S. And make up 34% of health care payments and costs within the national system (Koehlmoos 2008). Out-of-pocket payments make up 15%, and Medicare and Medicaid 17% and 16% respectively (Koehlmoos2008). The selling of services to hospitals and physicians dominates the bulk of money spent on care in the U.S. Of the funds allocated to health care delivery, 33% of all the money spent on health care goes to hospitals, 23% to physician services. Healthcare is the largest industry…
Koehlmoos, Tracey Lynn (2008). U.S. Health Care: Roemer Model. Lecture 2: HSCI 609
Comparative International Health Systems George Mason University. Retrieved 1 Sept 2008 at http://gunston.gmu.edu/healthscience/InternationalHealth/USHealthCareRoemerModel.ppt.
Kangaroo Care and Premature Babies
Kangaroo care entails holding a full term infant or premature so that there is a skin-to-skin contact between the newborn and the individual holding it. Individuals practice kangaroo care for premature infants for approximately two to three hours every day over a certain period. This takes place during early infancy, and the parent holds the baby against her bare chest. Medically stable babies can receive kangaroo care for up to any period since there is no maximum duration for them (Feldman et al., 2002).
Most parents may keep their babies in their arms for hours each day. According to research carried out, kangaroo care is essential as close bodily contact between the infant and the mother helps to stabilize the heartbeat, breathing and temperature of the premature infant. This is crucial as premature babies always have problems in harmonizing their heart and breathing rate. Mothers…
Aucott, S., Donohue, K., Atkins, E., & Marilee, C (2002). Neurodevelopmental Care In The
Nicu, 8, 298 -- 308.
Dodd, L. (2003). Effects of kangaroo care in preterm infants,
Feldman, R., Weller, A., Sirota, L., & Eidelman, A. (2002). Skin-to-Skin Contact (Kangaroo Care) Promotes Self-Regulation in Premature Infants: Sleep -- Wake Cyclicity, Arousal Modulation, and Sustained Exploration, Vol. 38 (2), 194 -- 207.
Sonic Healthcare's Marketing Tactics And Strategies
Sonic Healthcare is a medical facility that offers diagnostic services. These include Pathology and adiology. The company traces its roots back in 1992 when a young accountant, Michael Boyd bought into a small company that was at the verge of collapsing. He gradually increased his share ownership and later appointed Dr. Colin Goldschmidt, who is histo-pathologist to take charge of the company as the CEO. Sonic Healthcare took the pathological dimensions during this time. Ever since, the company has adapted several strategies that have propelled it to be one the leading facilities in the entire world. This paper seeks to explore some of the strategies used by this company.
Tactics / Strategies elating to Marketing Mix
Product / Service related
Sonic Healthcare has a clearly defined niche of operations as a pathological and radiological Centre. The healthcare facility opted to concentrate on a narrow…
Jobson's Year Book of Public Companies, (1999), Volume 71, New York, NY: Dun & Bradstreet Marketing Pty, p.872.
Business Review Weekly: BRW, (2000), Volume 22, Issues 26-29, Texas, TX: Business Review Weekly, p.31.
BRW., (2006), Volume 28, Issues 13-24, Texas, TX: Business Review Weekly, P.124
Positive prognosis for Sonic Healthcare, Retrieved from: http://www.austrade.gov.au/Positive-prognosis-for-Sonic-Healthcare
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
Ethics of care is one of the normative ethical theories, and examines the things that make actions perceived to be wrong or right. Developed in the second part of the 20th century by feminists, its emphasis is about the importance of a person's response to various things. Instead of considering what is just and fair, the person is asked to consider how to respond. There are generally universal standards as to how to respond to specific statements, acts, and situations. However, this is considered by those who follow ethics of care to be a morally problematic statement. The reason behind this is that it attempts to make every person and situation the same. It breeds indifference and blindness to the true person and situation, which implies a lack of caring. That lack of care is highly significant, because one has to care about themselves and others in order to work…
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
Advisory Board Web site. (2004). Available at: http://www.advisory.com .
Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.
American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
Community Teaching Plan
Community Teaching Work Plan Proposal
Directions: Develop an educational series proposal for your community using one of the following four topics which was chosen within your CLC group:
Primary Prevention/Health Promotion
Secondary Prevention/Screenings for a Vulnerable Population
Planning Before Teaching:
Estimated Time Teaching Will Last:
Three 2-hour sessions
Location of Teaching:
Athens Community Health Department
Supplies, Material, Equipment Needed:
Laptop; digital projector; screen
Community and Target Aggregate:
Athens Community Health Department, Athens, Georgia
Secondary Prevention/Screenings for a Vulnerable Population
Session I: Sources of Vulnerability
Session II:Implications for Healthcare Providers
Session III: Innovative Practice; Gordon's Functional Health Patterns Assessment
Epidemiological ationale for Topic (statistics related to topic):
The literature on vulnerable people clearly indicates that the special needs of these populations and the ubiquitous barriers to quality care access lead to traceable disparities in the provision of healthcare and in their health outcomes…
Agency for Healthcare Research and Quality (AHRQ). National healthcare disparities report 2008. Chapter 3, Access to healthcare. Washington: AHRQ; 2008. Retrieved http://www.ahrq.gov/qual/nhdr08/Chap3.htm
Edelman, C.L. And Mandle, C.L. (2006). In D. Como, L. Thomas (Eds.), Health Promotion Throughout the Lifespan. St. Louis, Missouri: Mosby.
Media and Health Policy Processes
There is no doubt that politics plays a crucial role in healthcare legislation and reforms in the United States. After all, the U.S. Congress passes laws, and so automatically any proposed legislation is passes or fails due to how political representatives act on the law. Professor Thomas Oliver (John Hopkins University) makes that point abundantly clear in his scholarly article. This paper references Oliver's article and a peer-reviewed piece in the journal Economics, Management, and Financial Markets (Boubacar, 2006).
The Patient Protection and Affordable Care Act
It should be noted that when Barack Obama ran for election among his major points was the need to reform healthcare policies in America -- and the need to create new laws and policies. He was elected by a wide margin and he set out to develop legislation that could bring meaningful reform and could provide insurance for an…
Boubacar, I, and Foster, S. (2014). Analysis of Small Business Owners' Perception of the Patient Protection and Affordable Care Act: Evidence from Wisconsin Farmers.
Economics, Management, and Financial Markets, 9(1), 11-20.
CNN. (2009). Obama calls for health-care reform in 2009. Retrieved June 13, 2014, from http://www.brandnewz.com .
O'Keefe, E. (2014). The House has voted 54 times in 4 years on Obamacare. Here's the full list. The Washington Post. Retrieved June 13, 2014, from http://www.washingtonpost.com .
Magnet Status for Hospitals
The purpose of this white paper is to explain and advocate for hospitals to seek out and obtain magnet status from the American Nurses Credentialing Center (ANCC). The magnet serves the dual purpose of proving that a hospital operates at a high level and it creates a number of internal and external benefits. While no hospital should be complacent or lackadaisical about their performance and progress, achieving magnet status per the ANCC guidelines is a high honor and it will bring prestige and recognition to the hospital.
Summary of Magnet Status & its Benefits
As briefly mentioned in the introduction, the magnet status of hospitals is given, rescinded and regulated by the American Nurses Credentialing Center. The magnet recognition is similar to other industry standards and certifications both in the healthcare industry and outside of it in that it shows that hospitals are operating up to…
ANCC. (2014, June 20). FAQS: About Magnet. FAQS: About Magnet. Retrieved June 20, 2014, from http://www.nursecredentialing.org/Magnet2014FAQ-About
Quality of Care: Healthcare eform
Health care reform legislation is expected to reduce health care spending by $590 billion over 10 years and lower premiums by nearly $2,000 per family by slowing the annual growth rate in national health expenditures. Discuss how this savings will be accomplished and what potential sacrifices in health care delivery may be experienced. Is the figure of $590 billion when calculated over a ten-year period really a significant savings?
The Affordable Care Act (ACA) was designed to make healthcare more accessible to a wider array of Americans and also more equitable in its method of delivery. Some of its provisions included requiring all adults (with some hardship exemptions) to have healthcare or pay a penalty. The hope was that expanding the risk pool of young, healthy insured who might otherwise forgo coverage would support the costs of some of the other provisions of the bill,…
Carroll, A. (2014). Why increasing access to healthcare does not save money. The New York
Times. Retrieved from:
Keefe, C. (2014). I'm an Obama supporter. But Obamacare has hurt my family. The Washington
The relationship between cost and quality in health care is not a constant, but in general, higher costs are associated with the most modern equipment and drugs. However, to fully understand the connection between cost and quality, the term "quality" needs to be defined, and in addition the cost drivers need to be understood. There are many cost drivers in health care that are not related to quality -- profits, administrative expenses, superfluous regulatory burden, information asymmetry, lack of competition and more. Among the cost drivers that are related to quality are paying higher wages to acquire and retain the best staff, investment in equipment, facilities and supplies, information technology investments, innovation, and regulations that serve to improve quality. Thus, while there is some correlation between and quality, it is not necessarily a strong correlation, and furthermore there may be instance where higher costs have nothing at all…
ANA (2015). Statement of purpose. American Nurses Association. Retrieved June 23, 2015 from http://nursingworld.org/FunctionalMenuCategories/AboutANA/ANAsStatementofPurpose.html
Berwick, D., Nolan, T., & Whittington, J. (2008). The triple aim: Care, health and cost. Health Affairs. Vol. 27 (5) 759-769.
FDA (2014). What we do. Food & Drug Administration. Retrieved June 23, 2015 from http://www.fda.gov/AboutFDA/WhatWeDo/
Fenton, J., Jerant, A., Bertakis, K. & Franks, P. (2012). The cost of satisfaction. JAMA Internal Medicine. Vol. 172 (5) 405-411.
esource Allocation in a Home Health Care Agency
As the U.S. population continues to show growth in the senior and elderly generations, a corresponding increase in health care agencies and facilities will reflect the increased demand for health and nursing services. Growth is particularly anticipated in the home health care industry as the "boomer" generation is geared toward independent living far into their lifetimes at unprecedented rates (Cubanski, 2014). Competition between these home health care agencies is expected to heat up, as economists say, since demand for quality care will be bolstered by the rise of the upper socio-economic strata in the U.S. (Varkevisser, et al., 2009). What this means for home health care administration and management is an elevated need to ensure that resource allocation exhibits the stewardship demanded by the marketplace (Cubanski, 2014).
How does your health care facility manage resource allocation?
In order to create a forward…
Bottrell, M.M. (2013, Summer). Ethics Quality Helps Build Healthy Organizations. Organizational Health, 19. Retrieved from http://www.ethics.va.gov/docs/integratedethics/art_bottrell_orghealth_v19_2013.pdf
Cubanski, J., Swoope, C., Damico, A., and Neuman, T. (2014, January 9). Health care on a budget: The financial burden of health spending by Medicare households. Retrieved from http://kff.org/medicare/issue-brief/health-care-on-a-budget-the-financial-burden-of-health-spending-by-medicare-households/
Heman, B. (2015, July 28). CMS projects higher healthcare spending growth through 2024. Centers for Medicare & Medicaid Services (CMS). Modern Healthcare. Retreived from http://www.modernhealthcare.com
Sussman, J.H. (2003). Strategic budgeting: A healthcare imperative. Kaufman Hall. Retreived from http://www.healthleadersmedia.com/content/128519.pdf
Watson Human Care Theory
The Significance of Watson Human Care Theory in handling dying patients
It is imperative to integrate a psychosocial treatment strategy in handling dying patients. This is based on the knowledge that dying patients could have lost hope leading to depreciation of an illness. In any case, most of the acute illnesses could have been contained at the primary stage of development. Healing or ailing is primarily managed by the mind and not the techniques applied in the medical arena. This study is critical in proving the essentiality Jean Watson's theory of human caring. I will heavily relate to the study to respond to necessities of a dying patient. In particular, the discussion will analyze how the theory is significant in exploring the comfort levels required in the general treating and healing process.
I replicate my approach from an article I adopted from the Danish…
Brunjes, C. (2012). Using the Power of Hope to Cope with Dying: The Four Stages of Hope (Google eBook). New York: Linden Publishing
Byrne, A., & Byrne, D. (1992). Psychology for Nurses: Theory and Practice. New York:
Chesnay, M., & Anderson, B. (2008). Caring for the Vulnerable: Perspectives in Nursing
isk management in healthcare organizations includes activities that integrating the recognition of risks, assessments of risks, coming up with strategies to be used and mitigation of these risks that have been identified. The focus on this paper is how to proactively prevent risks in healthcare organizations. The area of focus in financial risk management is risks that are managed using trade financial instruments such financial management systems, appropriate EM, coding, billing, collections, general accounting, budgeting, expense management, managed care contract strategy and vendor relations processes. isks are unavoidable and are present in every human situation .T he most common concept that appears in all definitions of risks is the uncertainty of the outcomes involved in the risks. Due to the uncertainty of the nature of risks the healthcare systems should have proactive measures in place to ensure that these risks are prevented and do not take place at…
University of California (2008). Ways to Reduce Risk. Retrieved March 24, 2014 from http://map.ais.ucla.edu/go/1000570
ECRI Institute ( 2010). Sample Risk Management Plan for a Community Health Center Patient Safety and Risk Management Program. Retrieved March 24, 2014 from http://bphc.hrsa.gov/ftca/riskmanagement/riskmgmtplan.pdf
Berg H., (2010). Risk Management: Procedures, Methods and Experiences. Retrieved March 24, 2014 from http://gnedenko-forum.org/Journal/2010/022010/RTA_2_2010-09.pdf
The World Bank Group, (2014).Better Risk Management Can Unlock Opportunities, Prevent Crises, and Protect Poor amidst Disasters and Shocks, Says World Bank . Retrieved March 24, 2014 from http://www.worldbank.org/en/news/press-release/2013/10/06/better-risk-management-unlock-opportunities-prevent-crises-protect-poor-amidst-disasters-shocks
Sunrise Foster Senior Community
The Older American Act (OAA) was signed into law by President Lyndon Johnson on August 14, 1965. The purpose of the law was to provide for the needs of an increasing number of older persons in the United States. The specific objectives of the law included strategies to maintain the dignity and welfare of older individuals. To accomplish this, the law created a vehicle for organizing, coordinating, and providing these services and opportunities not only for the older individuals themselves, but also for their families (Administration on Aging, 2011).
In 2011, Congress is considering reauthorization and some amendments to the OAA to take effect in 2012. Specifically, three mechanisms are under scrutiny to be involved in this process: Administration on Aging (AoA)-convened Listening Forums; OAA eauthorization Input Events; and Direct Input via the AoA Website or Mail.
In order to carry out the mandates of the…
Administration on Aging (2011). Older Americans Act and Aging Network. Department of Health and Human Services. Retrieved from: http://www.aoa.gov/aoaroot/aoa_programs/oaa/introduction.aspx
Binstock, R.H. (1991, Summer/Fall). From the great society to the aging society - 25 years of the Older American Act. Generations, Vol. 15, Iss. 3.