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Advanced Practice Nursing
Advanced Practice N's in the Home Health Care Arena
Identification of the phenomenon.
There is an urgent need for APN services in the home health care environment. That is the pivotal position this paper proposes to pursue. In a general sense, it is clearly evident that there is an urgent need for quality home care that exceeds the minimum expectations of patients and their families; this need exists because excellence and integrity in the delivery of home health care can help erase (and overshadow) the negative publicity perpetuated by incidents of malpractice, of gross incompetence, and of scandalous acts of patient abuse at the home care level. There can be no equivocation on the issue of the existing demand by consumers for the highest quality of service available when it comes to home health care; the cost of health care has been going up and up, and…
Centers for Medicare & Medicaid Services (2002). Home Health Care: Improving
Quality, Tightening Standards. http://www.cms.hhs.gov .
Fischer, Linda (1997). Lessons in Home Health. RN, 60, 55-57.
Head, Barbara J. Ph.D., R.N.; Maas, Meridean, Ph.D., R.N., FAAN; & Johnson,
Asthma is a respiratory tract disease reported to afflict about 300 million persons worldwide and is projected to increase (CCHMC, 2010). It is characterized by chronic and recurring inflammation and obstruction of the airways, expressed by wheezing or coughing. It was reported to be the leading chronic ailment among children (AsthmaCure, 2010). About 50% of cases subside when these children reach age 13 or 14. In the meantime, those who are stricken must contend with current knowledge that symptoms remain totally incurable. Nonetheless, these can be substantially controlled with adequate and proper education, treatment and management plan set up by a supervising physician. An important part of the success is sufficient knowledge about the disease and faithful adherence to the treatment and management plan (AsthmaCure).
Discharge and Education Plan
This includes the treatment plan itself and the correct use of the nebulizer and metered dose inhaler for home use…
AsthmaCure (2010). Some facts and statistics about asthma. AsthmaCure.com.
Retrieved on July 20, 2014 from http://www.asthmacure.com/2010/12/asthma-facts-statistics
CCHMC (2010). Management of acute exacerbation of asthma in children. Health Policy & Effectiveness Program Evidence-Based Guideline. Retrieved on July 20, 2014 from http://www.cincinnatichidrens.org/workarea/downloadAsset%3Fid%3D87871
Kovesi, T., et al. (2010). Achieving control of asthma in pre-schoolers. Canadian Medical
1) How are incidents of abuse, neglect, exploitation or injury reported internally?
The agency seeks to promptly respond and solve issues of abuse, neglect, exploitation and injury. It is the responsibility of the client/member to report any incident to the agency through the administrative office or through the immediate supervisor. Members are given contact information like agency phone numbers, email address, and fax. Incidents must be reported immediately in order to allow the agency to respond to the situation immediately. It is the responsibility of the supervisory board to assess any incidents and come up with a reasonable solution to the situation. Members are allowed to verbally communicate any incidents as well. Family members can walk into the agencies premises within 24 hours of an incident and report it. Any incident is recorded in the Incident Report DD-191 form.
The form captures details of the type of incident…
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
egistered nurses are both qualified, educated, and certified to provide a high quality of various care services that an individual may need in a home setting or elsewhere. Hence, providing these practitioners with the power to certify and provide home care is a solution to an overwhelming problem that has plagued the health care environment in recent years. Nursing practitioners, as a result of the nature of their work, are closely connected to the needs of individual patients. This means that they, more than many other health care providers and institutions, are able to assess the needs of individuals, their households, and the level of care they require. This places them in a position to accurately determine the need and/or of such individuals to obtain long-term home care and when such home care becomes unviable. As such, registered nurses who serve individuals in the home setting are able to maintain…
AARP Public Policy Institute. (2013). FAQs. Retrieved from: http://assets.aarp.org/rgcenter/ppi/ltc/ltss_faq.pdf
Brassard, A. (2011). Removing Barriers to Advanced Practice Registered Nurse Care: Home Health and Hospice Services. AARP Public Policy Institute. Retrieved from: http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/removing-barriers-advanced-practice-registered-nurse-home-health-hospice-insight-july-2012-AARP-ppi-health.pdf
Doty, P. (2000, June). Cost-Effectiveness of Home and Community-Based Long-Term Care Services. U.S. Department of health and Human Services. Retrieved from: http://aspe.hhs.gov/daltcp/reports/2000/costeff.htm
Lynch, M., Estes, C., and Hernandez, M. (2007, June). Long-Term Care Policy Option Proposal: Consumer Controlled Chronic, Home, and Community Care for he Elderly and Disabled. Georgetown University Long-Term Care Financing Project: Working Paper No. 4. Retrieved from: http://ltc.georgetown.edu/forum/4lynch061107.pdf
The emphasis is on normal, everyday activities provided for residents. According to the authors, however, little research has been conducted to investigate the actual effect of such activities and settings upon residents. The assumption is that such settings have a better effect that traditional institutions, but there is little empirical research to support this.
Hence, Verbeek et al. (2010) conducted a study to compare small-scale living with regular care in nursing homes in the Netherlands. Interestingly, they found no significant difference between the quality of life experienced by residents in traditional institutional settings and those in small-scale living facilities. Furthermore, there was also no significant difference in the job satisfaction levels of nursing staff between both types of institution was found. Another important aspect, namely neuropsychiatric symptoms and agitation were also significantly similar for both institution types. According to the authors, a difference was found in the satisfaction level of…
Gaugler, J.E. (2005, Mar.). Family Involvement in Residential Long-Term Care: A Synthesis and Critical Review. Aging and Mental health, Iss. 9, vol. 2. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247412/
Lyness, J.M., Yu, Q., Tang, W., Tu, X., and Conwell, Y. (2009, Dec.). Risks for Depression Onset in Primary Care Elderly Patients: Potential Targets for Preventive Interventions. American Journal of Psychiatry. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982671/
Simonazzi, a. (2009, Jun). Home care and cash transfers. Effects on the elderly care-female employment trade-off. Retrieved from: http://www.aiel.it/bacheca/SASSARI/papers/simonazzi.pdf
Verbeek, H., Zwakhalen, S.M.G., Van Rossum, E., Ambergen, T, Kempen, G.I.J.M., and Hamers, J.P.H. (2010, Nov.). Dementia Care Redesigned: Effects of Small-Scale Living Facilities on Residents, their Family Caregivers, and Staff. American Medical directors Association. Retrieved from: http://www.unimaas.nl/hcns/websiteVW/publications/Publication%20scans/Verbeek.%20Dementia%20care%20redesigned.pdf
Passion Home Health is a provider of home health care services in Camarillo, CA. The company`s challenge typically revolves around a shortage of care workers given the number of clients. There are two sides to this issue - one is the demand side. That challenge can be addressed in a different ways, but ultimately the goal of management is to have as many clients as possible for the capacity that it has. Thus for this task, the challenge will be on the supply side, for labor. It will be assumed that there will be sufficient demand for whatever the optimal labor configuration is going to be.
Care givers come in a number of different varieties, with different degrees of training. They typically visit the home site of the client. They perform a variety of duties for the client, including sometimes daily chores, for other care givers more of physiotherapy,…
Leisure World Business Plan
Startup living-assistance firm Leisure World is seeking to enter into the long-term care market as a provider of in-home caregivers. The company will seek to market itself as an alternative to the nursing home, and will use daytime television advertising as its primary mode to reaching a target of families with aging loved ones. Expenses for the organization will include insurance and certification costs, material resources, labor and advertising. Management will proceed from a top-down approach.
Description of the business
Leisure World is an alternative to nursing and long-term care facilities. For many families, the decision to find assistance for care with aging loves ones can be an extremely difficult one, both financially and emotionally. Relegating a family member to a nursing home can be both heartbreaking for the family and psychologically devastating to a loved one who must now endure the end stages of life…
Caring for the Old
The End of Life Care
End of life care refers to the total care of a person that has an advanced illness that is incurable and does not equate with death. This end of life care can last for a number of weeks, months or even years depending on the state an individual is.it is usually the care which helps those that have advanced, progressive and illnesses that can not be cured to live life as well as possible until they meet their death. End of life care makes it possible for the patient and their family to get supportive and palliative care needs identified and met throughout the last phase when they are living and into the bereavement period. Supportive care is care which helps a patient and the family to cope with the condition and the treatment of that condition right from the pre-diagnosis…
Boswell, Kahana & Worth-anderson, 2006). Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults. Retrieved April 30, 2014 from http://www.case.edu/artsci/soci/documents/Spiritualityandhealthylifestylebehaviors.pdf
U.S. Department of State, (2012).Legal & Financial Issues In Caregiving for Older Adults. Retrieved April 30, 2014 from http://www.state.gov/m/dghr/flo/142266.htm
American Society of Clinical Oncology (ASCO), (2014). Caregiving Considerations. Retrieved April 30, 2014 from http://www.cancer.net/navigating-cancer-care/older-adults/caregiving-considerations
The Joanna Briggs Institute, (2011). Age-friendly nursing interventions in the management of older people in emergency departments. Retrieved April 30, 2014 from http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=7127
The majority of communities in Alaska are separated by vast distances and the distance from many communities to the nearest medical facility is equivalent to the distance from New York to Chicago (Indian Health Service Alaska Area Services, 2011).
A study funded by AOA examined issues affecting access to home- and community-based long-term-care services among AI/ANS. Study results indicated that home healthcare was one of the most frequently needed services among AI/ANS. Further, 88% of the services sometimes, rarely, or never met the need, and 36% of services were rarely to never available (Jervis, Jackson & Manson, 2002). Only twelve tribally operated nursing homes exist in the U.S., and these rely predominantly on funding from Medicaid and tribal subsidies. Many tribes would like to have nursing homes but are blocked by state certificate-of-need requirements, Medicaid licensing requirements, and lack of commercial financing. The lack of alternate medical resources, whether private…
Alaska Area Indian Health Service. (2011). Indian Health Service. Retrieved from http://www.
Goins, R.T. & Spencer, S.M. (2005). Public health issues among older American Indians and Alaska natives. Generations, 29(2), 30-33.
Indian Health Service Alaska area services. (2011). Indian Health Service. Retrieved from http://www.ihs.gov/FacilitiesServices/areaOffices/alaska/dpehs/documents/area.pdf .
Vignola began his career as an architect in ologna and supported himself by painting and making perspective templates for inlay craftsmen, later traveling to Rome to work and study. His talent and skill was utilized by the papacy, including Pope Julius III and the papal family of the Farnese. He worked with Michelangelo and was deeply influenced by his style.
It is believed that Cardinal Gianfrancesco Gambara commissioned Vignola to design the Villa Lante in 1566. The first casino was completed immediately, but the second one was not finished until after 1587 when the Cardinal passed away. The two casini differ mainly in the style of frescoes. The first casino uses a riotous highlight of color used to highlight the architecture, while the second casino was done in a more classical style of fresco and plaster sculpture combination.
The gardens of the Villa Lante incorporate water features in "a visual…
Coffin, D.R. 2003. Pirro Ligorio: The Renaissance Artist, Architect, and Antiquarian. Pennsylvania: Penn State Press.
Lees, Frederick. 1997. The Chateau de Vaux-le-Vicomte. Architectural Record. pp. 413-433.
Pater, Peter. 1976. Renaissance Rome. California: University of California Press.
Rogers, Elizabeth Barlow. 2001. Landscape Design: A Cultural and Architectural History. New York: Harry Abrams, Inc.
This gives Toronto investors a competitive advantage in mining investing, which will be reflected in a home bias. As Van Nieuwerburgh & Veldkamp (2007) explain, home investors have a bias because they have information that non-home investors do not have. These information asymmetries persist, even with today's global information pipelines. The cost of information can be quite high, despite the relatively rapidity of its diffusion among global investors.
There are other potential explanations. Campbell and Kraussl (2007) posited that international investing carries with it the perception of increased downside risk. This can come from time zone differences, speed of information diffusion or translation issues in non-English-speaking markets. hatever the concern, it is reasonable that international investing suffers as a result of increased perceived risk, even if that perception is not born out by reality.
Another possible explanation is that investors are irrational. hile the rational investor may understand that international…
Coval, J. & Moskowitz, T. (1999). Home bias at home: Local equity preference in domestic portfolios. Journal of Finance. Vol. 54, 6, 2045-2073.
Van Nieuwerburgh, S. & Veldkamp, L. (2007). Information immobility and the home bias puzzle. NBER Working Paper. Retrieved November 27, 2009 from http://pages.stern.nyu.edu/~lveldkam/pdfs/homebias.pdf
Campbell, R. & Kraussl, R. (2007). Revisiting the home bias puzzle: Downside equity risk. Journal of International Money and Finance. Vol. 26, 7, 1239-1260.
Ahearne, A., Griever, W. & Warnock, F. (2004). Information costs and home bias: An analysis of U.S. holdings of foreign equities. Journal of International Economics. Vol. 62, 2, 313-336.
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Health Care Marketing
Marketing is the management and social process of identifying, anticipating and satisfying the needs of present and potential customers while making long-term profits. The choice of marketing techniques may vary in the marketing of services from the marketing of products, but the basic principles and concepts of marketing are equally important and relevant in both, and apply across the spectrum of products and services, into the home health care industry. Successful marketing regards the customer as the focal point of business. In the many businesses, selling is often misunderstood as marketing. Selling is a micro function which means offering existing products at an agreed price, while marketing is a macro function which governs many other tactical areas. Marketing includes:
Collecting, storing and analyzing important information regarding markets, competition and future trends.
Segmenting the market and identifying specific needs of different customers.
Adjusting existing products and creating new…
Steckler A, Allegrante JP, Altman D, et al. Health education interventions strategies: recommendations for future research. Health Ed Q. 1995;22:307-328.
Cowan EL. In pursuit of wellness. Am Psychol. 1991;46:404-408. As quoted in: Murdaugh, Carolyn L. Vanderboom, Catherine. Individual and community models for promoting wellness.Journal of Cardiovascular Nursing. 04/01/1997.
Study of Post-Acute Care, A Final Report, HCFA No. 17-C98891 (University of Minnesota, School of Public Health, Institute for Health Services Research and Policy, October 1993), p. i. As quoted in: Murdaugh, Carolyn L. Vanderboom, Catherine. Individual and community models for promoting wellness.Journal of Cardiovascular Nursing. 04/01/1997.
Home health care presents opportunities and challenges. Chain Drug Review. 05/26/1997.
Innovative Nursing Care Delivery Models a.This website detailed profiles 24 successful innovative nursing care delivery models. These profiles developed part a research project conducted Health Workforce Solutions LLC (HWS) funded obert Wood Johnson Foundation (WJF).
Innovative nursing care model: The Care Transitions Intervention
Innovative nursing care model
I chose the Care Transitions Intervention Model on which to focus because of the increasing importance of geriatric care in the field of nursing. Although my organization serves the needs of persons of all ages, elderly patients are an increasingly large proportion of the patient base. The Model stresses the need for the empowerment and self-care even of patients with high-risk conditions. The Care Transitions Intervention Model allows elderly patients the maximum amount of mobility and autonomy possible given the limits of the patient's condition and enables them to stay in a home setting as long as possible. As its name suggests, the…
Care Transitions Intervention. (2013). Innovative Care Models. Retrieved:
Kurt Lewin Change Model. (2013). Change Management Coach. Retrieved:
Strategic Management of a Healthcare Facility in St. Louis
In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms…
1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.
2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]: http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm
3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html
4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html
Transitional Care of Older Adults Hospitalized with Heart Failure Experiment
Naylor, M.D., Brooten, D., Campbell, R.L., Maislan, G.,, McCauley, K.M. Schuartz, J. Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized Trial.
This article has an interesting approach to summarizing the experiment that was conducted. Instead of a formal abstract, the article instead summarizes the design and outline in several sections. These sections include objectives, design, setting, participants, intervention, measurements, results, and conclusions. The sections that are listed replace the standard format for an abstract that condenses the design and the findings into one formal section. Personally, I prefer the organization of this format better as it more clearly illustrates all of the factors in the research in a clear and easily identifiable format.
Analysis of the Introduction
The authors of this research do state the problem that they are researching in a clear and coherent manner. The…
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.
Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
hat should be the Vision and Mission of Healthcare Professionals in…
Administration on Aging. (2010). A Statistical Profile of Black Older Americans Aged 65+.
Retrieved April 2, 2014, from http://www.aoa.gov .
Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
Centers for Disease Control and Prevention. (2007). The State of Aging and Health in America
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.
In terms of socio-demographic characteristics, the literature collated regarding nursing home care does not…
Leadership & Management, Health Care
Leadership & Management in Health Care
President Clinton's Secretary of Health and Human Services, Donna Shalala, used to tell a story about her mother, who was 86 at the time but still a full-time attorney representing several clients who lived in nursing homes. She would tell Shalala, "Donna, I don't care whether they are good nursing homes or bad nursing homes, you have to watch them like a hawk" (Cited in White House, 1998, quoted by Hovey 2000, 43). Clinton's presidency was very aware of health care issues, even if it was unable to solve them. Shalala's remarks were delivered at a press conference regarding nursing home regulation; arguably, under the current administration, issues of health care for the aged have gotten more problematical rather than less.
Despite relatively little action regarding health care for the aged by the federal government, there is little…
Fox-Grage, W., & Shaw, T. (2000, April). The crisis ahead in long-term care. State Legislatures, 26, 30. Retrieved June 30, 2004, from Questia database, http://www.questia.com .
Froeschle, M.L., & Donahue, P.M. (1998). Academic health care: Leadership in time of change. Journal of Leadership Studies, 5(4), 60. Retrieved June 30, 2004, from Questia database,
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…
Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.
Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.
Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.
Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
health care for the disabled. The writer explores the health care stages that are available for the disabled in every stage of life. The writer uses published works from various sources to illustrate and underscore the need for solid health care access for all disabled individuals in the nation. There were six sources used to complete this paper.
"Different stages of available health care for people with disabilities"
The issue of health care has been a hot topic of debate in this country for many years. Health care costs are skyrocketing, available services are dwindling and the public is screaming with outrage and demand for improvements to the entire health care system. While those who can speak for themselves are having no trouble voicing their upset about the current state of the nation's health care system, there is a population that cannot always speak up. The disabled in this country…
HEALTH CARE DECISIONS FOR THOSE WHO CANNOT CARE FOR:DIANE COLEMAN THEMSELVES. Congressional Testimony; 4/19/2005
Congressional Testimony. 04-19-2005
LONG-TERM HEALTH CARE:MARK R. MEINERS
Congressional Testimony; 4/19/2005
Within this section of Chapter One, a historical perspective of NHS will be provided. This discussion will identify problem areas that have emerged in relation to NHS with an attempt made to address the manner in which such problems have historically influenced reform efforts.
With the passage and associated provisions of the NHS Act of 1946, NHS was implemented in the UK in 1948. The NHS Act of 1946 served as the means by which a pattern of health service finance and provision was established in the UK following World War II (Baggot, 1998). According to Baggot, on the basis of the Act, the principle of collective responsibility by the state for the establishment of a comprehensive health service system was introduced, allowing for the planned use of services by the entire population at no cost. It was also intended that equality of access to services would be…
Baggott, R. (1998). Health and Health Care in Britain. London, Macmillan,
Barlow, M. (1998). The Fight of My Life. Toronto: Harper Collins
BMA Central Consultants and Specialists Committee (1990). Guidance on Clinical
Directorates London: BMA.
Community Dementia Care and the Chronic Care Model
nd-Stage Dementia valuation Proposal
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model.
In 2013 an estimated 5.0 million Americans over the age of 65 suffered from Alzheimer's disease (Alzheimer's Association, 2013). Although the U.S. Centers for Disease Control and Prevention (CDC) considers dementia/Alzheimer's to be the fifth leading cause of death among adults 65-years of age or older, careful examination of Medicare claims data revealed that dementia is probably right behind cardiovascular disease as the second leading cause of death for this age group (Tinetti et al., 2012). Most of these patients would prefer to die at home, not only because of comfort concerns, but due to the higher quality of care that tends to be provided by informal and paid caregivers in this setting (reviewed…
Eloniemi-Sulkava and colleagues (2009) evaluated patients at baseline using the Barthel Index and Neuropsychiatric Inventory (NPI) (see Appendix). The Barthel Index (Stone, Ali, Auberleek, Thompsell, & Young, 1994; University of Iowa Healthcare, n.d.) and NPI (Cummings et al., 1994) were administered again at 6 and 12 months into the study and will be used in the current study to track ADL and BPSDs using the same intervals. PQOL will represent a composite score obtained using the Color Analog Scale for pain (Santos & Castanho, 2013) and the Quality at the End of Life Scale (QUAL-E) (National Palliative Care Research Center, 2005) (see Appendix). In cases of severe cognitive impairment, completion of the QUAL-E may depend on family caregivers. FCQOL will be evaluated using the Zarit Burden Scale (Regional Geriatric Program Central, 2014) (see Appendix). The success of the intervention, as perceived by family caregivers and providers, will be assessed using the questionnaires developed by Morita and colleagues (2013). The goal of these questionnaires will be to evaluate how effective the community palliative intervention was in improving the knowledge and skills of palliative care, increasing access to specialized services, coordinating care services, and increasing deaths at home. This evaluation will be performed following the death of the patient or the end of the study period, whichever comes first. The validity and reliability of the questionnaires developed by Morita et al. (2013) have not been evaluated, but should prove informative and provide context for the other findings.
A review of interventions designed to improve the quality of community palliative care has revealed mixed findings, but the trend is in the desired direction of reducing the number of patients dying in hospital wards, ICUs, and hospice facilities. CCM has garnered the interest of researchers interested in improving palliative care outcomes for patients, family caregivers, and providers alike, and have begun to study the efficacy and quality of interventions, including CCM. This proposal provides justification for implementing CCM for end-stage dementia patients residing at home and details an evaluation strategy that can be implemented to determine the efficacy, effectiveness, and quality of the care provided. In contrast to many other studies, however, this proposal places equal value on the experiences of patients, family caregivers, and providers alike, in addition to the more common outcome measures of BPSDs and institutional admissions. The methods of data gathering will involve the review of patient records and several instruments designed
Web Health Care
Located in Wichita, Kansas, Via Christi Health is the agency that serves the eponymous region through the site via-christi.org. Via Christi provides care through hospitals, outpatient centers, senior communities, and in-home care for individuals in Kansas. The services the agency provides a VCMA directory, which encompasses a search for physicians through Via Christi Medical Associates and the Via Christi Clinic, along with the Via Christi Hospitals. Via Christi Medical Associates is a group of fifty family practitioners, while Via Christi Clinics offer family care and immediate care. The thirteen clinics have been in place since 1948, 160 hired physicians, and encompassed 40 specialties. Via Christi agency offers a directory and location of special centers, which includes burn center, cancer care, cardiac care, and cystic fibrosis. As well, there's epileptology, neurosciences, obstetrics and gynecology, and occupational health services. Moreover, individuals are able to look up care for pediatric…
Via Christi Hospitals: VCFM Residency. (n.d.). VCFM Residency. Retrieved December 3, 2011, from http://www.vcfm.net/details/via-christi/
HMR Clinic Program Weight Loss Surgery Weight Loss Class Corporate Wellness HMR at Home Meal Replacements ~ Via Christi Weight Management Wichita Kansas. (n.d.). HMR Clinic Program Weight Loss Surgery Weight Loss Class Corporate Wellness HMR at Home Meal Replacements ~ Via Christi Weight Management Wichita Kansas. Retrieved December 3, 2011, from http://www.viachristiweightmanagement.com/
Via Christi Clinic - Multi-practice medical care in Wichita, KS . (n.d.). Via Christi Clinic - Multi-practice medical care in Wichita, KS . Retrieved December 3, 2011, from http://www.viachristiclinic.com/
Via Christi to open cancer center | Wichita Eagle. (n.d.). Local and breaking news for Wichita and Kansas | The Wichita Eagle and kansas.com. Retrieved December 3, 2011, from http://www.kansas.com/2011/06/24/1906153/via-christi-to-open-cancer-center.html
affordable Care Act (also known as the ACA or Obamacare) on the elderly
Obamacare: Its impact upon the elderly
The impact of the Affordable Care Act (ACA) (often called 'Obamacare') upon America is often discussed by politicians as if it had a uniform impact upon all citizens. However, the ACA's effects have been relatively disparate, depending upon the nature of the population. This paper will specifically focus upon the impact of the ACA on the elderly of a variety of socio-economic categories.
One of the criticisms of the American healthcare system before the passage of the ACA was the spiraling cost of entitlement programs such as Medicare, the federally-provided health insurance program for seniors. "One good result of all this [ACA] is that the burden of Medicare for taxpayers in future years has been drastically lowered. In fact, the day Barack Obama signed the ACA into law he cut the…
ACA. http://www.hhs.gov/healthcare/rights / Accessed November 6, 2014.
FAQ: What retirees and seniors need to know about the ACA? NPR. October 11, 2013.
http://www.npr.org/2013/10/11/231101137/faq-what-retirees-and-seniors-need-to-know-about-the-affordable-care-act Accessed November 6, 2014.
Goodman, John. What seniors have to fear from Obamacare? Forbes. October 28, 2014.
Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of 'personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Ormond, Wallin, and Goldenson report in the work entitled: "Supporting the Rural Health Care Safety Net" (2000) state: "The policy - and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces…
Healthcare and Healthcare Insurance Country Report: India (2004) Tata Consultancy Services and Microsoft. WebHealthCentre.com. 2004 August. Online available at http://download.microsoft.com/documents/customerevidence/7144_WebHealth_CS.doc
Expert Panel Meeting: Health Information Technology (2003) Agency for Healthcare Research and Quality (AHRQ) 23-24 July 2003. Online available at http://www.ahrq.gov/data/hitmeet.htm
Silberman, P. And Slifkin, R. (nd) Innovative Primary Case Management Programs Operating in Rural Communities: Case Studies of Three States. Working Paper No. 76 North Carolina Rural Health Research and Policy Analysis Program.
Ormond, Barbara a.; Wallin, Susan Wall; and Goldenson, Susan M. (2000) Supporting the Rural Health Care Net. 15 May 2000 Urban Institute
the Allied health care staffing agency is a staffing agency that focuses on the niche of the nursing jobs within the healthcare industry in Chicago
The Allied healthcare staffing agency works to recruit registered nurses belonging to all medical Specialties, Practical Nurses that are licensed also called LPNs, Nursing Assistants that are certified also called CNAs and Specialists from the allied health sciences. These professionals would be hired both from the area of the metro city as well as the suburbs and placed within the hospitals, the neighborhood medical centers, Adult care facilities, clinics, and rehabilitation centers.
The mission of the Allied Healthcare Staffing Agency is to provide the best opportunities of employment both to its collaborators which are the local healthcare organizations as well as serving the entire nursing community to provide amply amount of job opportunities to choose from in a time when the turnover of…
Bureau, U.C. (2000). Census 2000 Demographic Profile Highlights:. chicago illinois, fact sheet .
commerce, U. d. (2010). bear facts, state illinois. bureau of economic analysis .
directory, a. h. (2010). free stats & national stats. Retrieved september 7, 2011, from american hospital directory: www.ahd.com
Lindberg, R.C. (1991). To Serve and Collect: Chicago Politics and Police Corruption from the Lager Beer Riot to the Summerdale Scandal. chicago: praeger publications.
The problems facing Medicare recipients and the federal government almost seem to be overwhelming. There are proponents of a plan to privatize Social Security and health insurance, placing the onus on the individual to pay for his own health care through savings specifically for this. Some others would have the program go through the private HMOs who have, in the past, contained the costs of care by having primary care physicians manage a patient's care and purposely keeps the costs of care down.
As with Medicaid, the recipients of Medicare would have difficulty obtaining health care without this program. The recipients would most likely have no other health insurance. The trend being what it is, a lot of individuals retiring today are fortunate to have pensions from their companies, much less health benefits. ithout a national health insurance plan, like Medicare, those individuals would have to pay for health care…
Kay, Joseph. "Bush Plans renewed Assault on Medicaid." World Socialist Website. 8 Feb. 2005.
13 Aug. 2005. http://www.wsws.org/articles/2005/feb2005/medi-f08.shtml .
Kay, Joseph. "U.S.: States, Federal Government Prepare Massive Medicaid Cuts." World
Socialist Website. 11 May 2005. http://www.wsws.org/articles/2005/may2005/medi-m11.shtml .
This is necessary to provide a seamless platform on which health solutions can be effectively integrated and deployed. Without using such a platform, the development of electronic health care facilities will be more difficult to deploy. In other words, Tele-health is part of the overall healthcare ICT (Information Communications Technology) solutions that enables healthcare to be pushed out to the edge, for local delivery, and to be more evenly, efficiently and effectively distributed.
Broadband communication is the underlying technology of choice when discussing electronic applications. It is certainly important for inter-healthcare provider communications delivering sufficient bandwidth capacity between sites. The delivery of home care electronic should not rely on the broadband technology is not universally accessible, particularly in rural and remote areas, and it can also be prohibitively expensive. Some broadband technologies can be delivered to remote locations, such as satellite-based technology, but this is impractical and too costly to…
Goldberg, a. (2002, April 29). Internal Report: Telehealth, Privacy, & Health Care: Review, Expectations & Proposals. Goulston & Storrs, Boston, MA.
Lovata, F. (2000, May 21-24). Telemedicine via the Internet: Successful Program Strategies. American Telemedicine Association Conference,
Puskin, D., Mintzer, C., & Wasem, C. (1997). Chapter 14, Telemedicine: Building Rural Systems for Today and Tomorrow. In P. Brennan, S. Schneider, & E. Tornquist (Eds.), Information Networks for Community Health. (p. 276). Computers in Health Care Series. Springer-Verlag.
Telecommunications: Protecting the Forgotten Frontier. (2001, August). SC Magazine-Info Security News, 12 (8), 36-40.
Social, Cultural, And Political Influence in Healthcare Delivery
Social, cultural, and political inequalities are detrimental to the health and healthcare system of the U.S. This is because the U.S. is one of the most multicultural, overpopulated, diverse and undergoing rapid economic growth. The federal government has embarked on efforts geared at addressing unsustainable costs of health care in the U.S. With the leadership of the current president, Barrack Obama, initiatives of containing health care costs will evaluate and explore strategies to contain the growing costs of health care based on a system-wide while enhancing the value and quality of health care (Ubokudom, 2012). The apparent system of health care is rife with opportunities of minimizing waste, delivering coordinated, effective care, and improving well-being and health of all Americans. The government in collaboration with care providers must prioritize cost effective containment strategies with the greatest possibility for political success and non-partisan…
Albrecht, G.L., Fitzpatrick, R., & Scrimshaw, S. (2013). Handbook of social studies in health and medicine. London: Sage Publications.
Armstrong, E.G. (2011). The health care dilemma: A comparison of health care systems in three European countries and the U.S. Singapore: World Scientific.
Bale, J.R., Stoll, B.J., & Lucas, A.O. (2013). Improving birth outcomes: Meeting the challenge in the developing world. Washington, DC: National academies press.
Buseh, A.G. (2008). Empowering resilience: Improving health care delivery in war-impacted African countries: a case study of Liberia. Lanham, Md: University Press of America.
Employer Healthcare Benefit Plans
More than half of the American population is covered by a comprehensive health plan of one type or another. That's approximately 160 million people. The programs that come under the above mentioned coverage include the likes of employer sponsored plans and other government initiatives for instance Medicaid and Medicare, a small proportion of health insurance which is purchased on individual basis may also be included in this. If we proceed to explain employer sponsored health programs, government initiatives and individual healthcare benefits individually, then briefly we can say that the employer benefit plans mostly comprise of group plans and are called "the employee welfare benefit plans"
Table of Contents
The Estimated Effects of PPACA on Coverage
The Number of Uninsured Decreases by 53%
Four Million Children Will Gain Coverage
The Individual Mandate Contributes Most to educing the Number of Uninsured
Manning W. And Marquis S, "Health Insurance: The Tradeoff Between Risk Pooling and Moral Hazard," Journal of Health Economics, Vol. 15, No. 5, October 1996, pp. 609 -- 639.
Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A, and Marquis MS, "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment,"
American Economic Review, Vol. 77, No. 3, June 1987, pp. 251 -- 277.
Pauly MV and Herring BJ, "An Efficient Employer Strategy for Dealing with Adverse Selection in Multiple-Plan Offerings: An MSA Example," Journal of Health Economics, Vol. 19,
In doing so, organizations:
advance the idea of public assurance that the organization is concerned for patient safety and the quality of care present a safe and capable work environment that adds to worker satisfaction negotiate in regards to sources of payment for care in regards to data on the quality of care pay attention to patients and their families, value their rights, and connect them in the care process as partners produce a culture that is open to learning from the timely reporting of unfavorable events and safety concerns set up joint leadership that sets precedence's for and unremitting leadership for quality and patient safety at all points (Introduction, n.d.).
In 2012 Joint Commission made quite a few changes to the 2012 accreditation decision rules. These rules present the consistent structure that the Joint Commission uses to deliver an accreditation decision limiting unpredictability or prejudice. The first thing that…
2012 Accreditation Decision Rules. (2011). Retrieved from www.jcrinc.com/common/PDFs/fpdfs/.../JCP-01-12-S8.pdf
About Joint Commission International. (2011). Retrieved from http://www.jointcommissioninternational.org/About-JCI/
Common Questions and Answers Regarding JCI Accreditation, Clinical Laboratories, and These Standards. (n.d.). Retrieved from http://www.jointcommissioninternational.org/common/pdfs/jcia/QuestionsandAnswer
THE SIX STAKEHOLDES GOUPS FO IVEVIEW EGIONAL MEDICAL
The six stakeholder groups for the iverview egional Medical Center are as follows: clerical staff, medical laboratory technicians, nurses, housekeeping staff, patients, and physicians. The hospital is comprised of 700 people who all play as stakeholders for the hospital.
TAGETS MAKET OF EXISTING POGAMS AND THE GAPS IN MC MAKETING STATEGY
An addition added to the MC is the Heartburn Treatment Center. A nurse manager is utilized in the Heartburn Treatment which is similar to that of the management model used in the ED. PH monitoring, which uses the Bravo capsule, is considered one of the diagnostic procedures. This procedure is used on qualified patients, and the Nurse First program stressed the role of the hospital's commitment to the care of the patient. Usually, the nurse is the first person viewed by the patient in the ED, not individuals that…
Swayne, L.E., Duncan, J., & Ginter, P.M. (2009). Strategic management of healthcare organizations (6th ed.). San Francisco: Jossey-Bass.
Cohn, K.H. & Harlow, D.C. (2009). Field-tested strategies for physician recruitment and contracting.
Healthcare for Mentally Impaired Patients
Probing what information is available about the current status of placement or accommodation and level of personal healthcare available to mentally impaired and emotionally disturbed individuals, it is clear that the analysis is as diverse as there are different mental illnesses. While statistics on managed care treatment for people with severe and disabling mental illnesses are sparse, it is evident that the financial responsibility to care for and house these patients is enormous.
According to Dr. David Satcher, the Surgeon General (1999), approximately 20% of the U.S. adult population has a mental illness. He says, "These illnesses include anxiety disorders, mood disorders, anorexia nervosa, and severe cognitive impairment. More serious mental illnesses include ipolar disorder and schizophrenia. Mental illness accounts for 15% of overall burden of disease -- more than malignant cancer and respiratory diseases -- and as far back as 1996 the direct cost…
Boulard, G. (2000, April). Forgotten Patients the Mentally Ill. State Legislatures, 26, 12. Retrieved February 13, 2004, from Questia database, http://www.questia.com .
Callahan, D. (1993, October) Minds and hearts: priorities in mental health services.
The Hastings Center Report.
Fox, M. & Kim, K. (2004, January) Evaluating a Medicaid Home and Community-based Physical Disability Waiver. Family and Community Health. Vol 27: 37.
The pathways scheme aims to offer opportunities for every grade of practitioner. This is part of a national process that anticipates quality improvement as a continuously evolving process.
Achieving fair and equal access to professional development for nurses and healthcare providers in the private sector has been difficult in the past. Education has sometimes been viewed as expensive and time-consuming, with staff release for learning difficult to achieve especially acute staff shortages are a definable obstacle already to effective treatment provision. However, it is vital to the principle of performance improvement and the pursuit of standardizing quality outcomes that healthcare provision be based on the active pursuit of staff excellence. This is to be seen as a far more desirable approach to personnel orientation than the imposition of sanctions for poor performance. Central to this is the need for improvement of the local facility's knowledge economy. To this extent, knowledge…
Burgess, M.M. (2003). What difference does public consultation make to ethics? Electronic Working Papers Series. W. Maurice Young Centre for Applied Ethics, University of British Columbia.
Cho, I. & Park, H. (2003). Development and evaluation of a terminology-based electronic nursing record system. Journal of Biomedical Informatics, 36(4), 304-312.
Cooymans, M.P.M. And Hintzen, E.F.M. (2000) Winst en Waarden. Deventer and Den Bosch: Samson.
DoH. (2004) Quality Standards. The Department of Health.
Adult Day Care Industry
ABC Adult Day Care will be a mid-sized company, which will provide adult day care services to the residents of Boston. This mid-sized adult care facility will serve adults aged fifty years and above. It will provide community-based day health services for the elderly and disabled. Services offered include living assistance, nursing, therapy, meals, and social activities. Their services will be secure and safe, presenting the elderly with an excellent place where their caring services will be met. ABC Adult Day Care will be a privately held organization headed by its founder, Ben Stevenson. Mr. Stevenson has extensive experience in strategic business planning. His advanced knowledge and interest in business are the driving force behind his business. A few employees who have extensive experience in adult care fields will support the daily operations of the facility. With the rising rate of inflation, many American families struggle…
Bryan, C.J., & Rudd, M.D. (2011). Managing suicide risk in primary care. New York: Springer Pub. Co.
Cooper, P.D. (2010). Health care marketing: A foundation for managed quality. Gaithersburg, Md: Aspen Publishers.
Davis, C. & Lynn, J. (2010). Start your own senior services business: Adult day-care, relocation service, home-care, transportation service, concierge, travel service and more. Irvine, Calif.: Entrepreneur Press.
Fitzpatrick, J.J., Glasgow, A., & Young, J.N. (2013). Managing your practice: A guide for advanced practice nurses. New York: Springer Pub. Co.
Mission, Vision, And Values of Healthcare Organizations
This paper discusses four healthcare organizations in the best way about their missions, visions and value. The featured four healthcare organizations include Nightingale Home Care Inc., Scripps Home Healthcare, Sharp Home Health Care, and Vitas Hospice. This discussion seeks to compare and deliberate on these three specific areas of management about the organization. Some of the important aspects with which the company seeks to deliberate on the matters at hand include the issues of leadership and how the same seeks to deliberate in making work potentially possible. In this case, the stakeholders of interest are the patients who are the recipients of the services offered by these hospitals.
Differences in the Selected Organizations
Nightingale Home care's mission is to assisted San Diegans achieve quality healthcare through environmental alteration and modern technology. This mission is coined out of the desire to set an example…
L.K. Abraham's book Mama Might Be Better off Dead: The Failure of Health Care in Urban America. The critique includes topics such as the book's purpose, the book's scrutiny of the different healthcare aspects with regards to America's poor, and reactions of readers to the work. The focus of the book is on healthcare as of and upto 1994, the publication date; it does not take into consideration and/or discuss the healthcare changes as of the Affordable Care Act, also known as 'Obamacare'.
Topic of Book
This book's main topic is the effectiveness of healthcare in the United States (U.S.) with regards to the poor as of 1994; it also addresses particular formalities of American healthcare. Many of these issues have been addressed with the recent Affordable Care Act.
Purpose of the Book
L.K. Abraham's Mama Might Be Better off Dead offers a profound, unsettling view of the human aspects…
Abraham, LK. Mama Might Be Better Off Dead: the Failure of Health Care in Urban America. 1994. Chicago: University of Chicago Press.
Mama Might Be Better Off Dead: The Failure of Health Care in Urban America." (n.d.). Retrieved April 26, 2015, from http://www.press.uchicago.edu/ucp/books/book/chicago/M/bo3620077.html
'Mama Might Be Better Off Dead.' The human face of health care. (1993). Health PAC Bulletin, 23(4), 30-33. Retrieved April 26, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/10133594
Manning & Grosso. (2011). Doctor of Nursing Practice Students Advocating For Health Care Access, Quality, and Reform: From the Virtual Classroom to Capitol Hill. (33). Retrieved April 27, 2015, from http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1032&context=nursfp
Health Care -- Regulatory Scheme and Licensure Requirements -- Operating a Health Care Organization
California's licensing process for health care organizations is governed by the State's Health and Safety Code, with responsibility for licensing, licensing, inspecting, regulating and/or certifying shouldered by State and Federal agencies. In a straightforward yet rigorous process aided by online application packets and checklists, these agencies are intent on ensuring compliance with State and Federal laws and regulations.
The process for becoming licensed to operate as a health care organization in California is governed by §1200 -- 1209 of the California Health and Safety Code (California State Legislature, 2003). These code sections broadly deem the term "clinic" or "primary care clinic" to mean an "organized outpatient health facility," whether a community clinic, free clinic, specialty clinic or clinic corporation required to be licensed (California State Legislature, 2003). The requirements and processes outlined in these code sections…
foundational issues at hand for our culture is the provision of health care for all. Challenging the standard by limiting health care for the elderly is a substantial ethical question. (Etzioni, 1988, pgs. 168-174) Yet, regardless of the bargaining power of organizations who advocate for the elderly the limitations are being made, in more covert and less effective ways. Regardless of public opinion the system we have now adopted is inefficient and not only do the elderly suffer, but all others who are not offered services in economically feasible ways suffer.
The system will continue to be based upon capitalistic standards as long as benefits exist in a manner that provides profits for cutting corners on standard preventative care and offering substantially overblown services to those who can afford to pay for it or who have no voice to say no. (Lamm, 1989, pgs. 158-162) Providing care in such a…
Kutter, Robert. (1988), 'National Insurance Should Fund Long-Term Care."
Lamm, Richard. (1989) "The Elderly Cannot Be Guaranteed Full Access to Health Care."
Sager, Alan. (1988) "The Elderly Should Be Guaranteed Full Access to Health Care."
A sense of futility and deep despondency are the primary drivers of the patient's approach to his self-care. These emotions are mirrored by his wife, and further complicated by the exhausting circumstances of being a primary caregiver to a depressed and declining patient. It is doubtful that either the patient or his wife are getting enough sleep, eating well -- within the dietary restrictions -- or following a healthy regimen of moderate exercise. The pattern of behaviors described and observed indicate that both the patient and his wife are overwhelmed by difficulties of managing the disease and the centrality of the disease in their life.
To address head-on the emotional fatigue and hopelessness that the couple face, it is imperative to provide examples of other patients and their spouses who have or are successfully dealing with the same disease at a comparable level of severity. Examples must show…
Diseases and Conditions: Heart Failure. Mayo Clinic. Retreived from http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/definition/con-2002
Hoyt, R.E. & Bowling, L.S. (2001, April 15). American Family Physician, 63(8), 1593-1599. Retrieved from http://www.aafp.org/afp/2001/0415/p1593.pdf
sleeping under a rock the issue of health care in the United States has been on the minds of everyone. In a society where health costs have spiraled, employer sponsored health insurance is rapidly disappearing, and millions are going untreated the overall issue of health care has everyone concerned (ichmond, 2005). Virtually no one is untouched by its reaches.
Over the last several decades the federal government has become increasingly more active in the health care field and now it is being proposed that this involvement may become more extensive as federally funded health insurance is being proposed. This involvement by the national government began during the New Deal when Social Security was originally enacted and has increased gradually ever since (James G. Haughton, 1968). Some of this involvement is obvious such as Medicare and Medicaid but other forms of involvement are less obvious such as research funding and regulatory…
Baranoff, E. (2009). Issues and Global Trends in Social Security. In E. Baranoff, Risk Management for Enterprises and Individual. Irvington, NY: Flat World Knowledge.
Callan, P. (2007). Will Higher Education pass: A test of leadership. Change, 39.
Chan, S. (2010, April 7). Bernanke Says Nation Must Take Action Soon to Shape Fiscal Future. New York Times, p. B3.
Congressional Budget Office. (2006). Immigration Policy in the United States. Washington D.C.: U.S. Government.
The group has addressed numerous specific issues that have resulted in new or improved language in the newly instituted regulations. Additionally, the group suggested a revised certification period of six months for the new regulations. They reminded me that one size does not fit all. Like a new ship needs a "shake down cruise" to work out details, so does the waiver agency staff and the department as a whole. This period will allow us to introduce the human factor into the Waiver Program. This will allow some of the holistic providers of the indigenous peoples of the state to substitute specific professional experience for educational degrees, on a case-by-case basis. In this way, we can allow the input of indigenous practitioners into the bureaucratic process so that the services can be custom fitted to the clients in their community.
To sum up, I would like to thank the Governor's,…
Planned change in the eldercare advocacy organization
In the coming years, many countries will experience a dramatic shift in healthcare infrastructure due to an expanding elderly population size. However, the changes may vary across countries depending on many factors such as the kind of social welfare available in each country, the political environment which determine policies, the level of healthcare available and individual expectations in each country. Due to this wide variance, the innovations within this space will also vary greatly. What this means to the healthcare manager is that managing innovations becomes very hard (Shlutz, Andre & Sjovold, 2015 p 42). This also impacts on performance management which is fast gaining popularity in the public sector as a means to improve on accountability. Unfortunately, it has been cumbered by a series of challenges in its implementation; this is in spite of the frameworks developed over the last couple of…
Towards of the goal of fulfilling the mission to "help those we care for to experience the best life possible," nursing services provided at the Sarah Neuman Center include:
Twenty-four nursing in a secure residential setting.
Twenty-four medical coverage supported by onsite and on-call physicians.
Onsite medical specialist consulting services.
Individualized therapy sessions, to include speech therapy, physical therapy, art and music therapy.
Nutritional services supported by staff dietitians.
Onsite pharmaceutical and laboratory services. (Sarah Neuman, para. 9)
Patients that require long-term residential care are often transferred to the Bronx nursing home which provides all of the above services, in addition to highly individualized care services and therapies for "more complex clinical needs" (Bronx, para. 4). These needs include-but are not limited to-progressive Alzheimer's, severe vision impairment, severe speech and swallowing impairments, and chronic kidney disease requiring hemodialysis.
Structural Support of Mission
That each facility essentially provides the same services…
"Bronx." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Manhattan." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Sarah Neuman." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Research Institute on Aging." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January,
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…
Field, Marilyn Jane & Cassel, Christine K. (1997). Approaching Death: Improving Care at the End of the Life. National Academic Press.
This work emphasizes the necessity to improve end of life care as a way to help ease fears about death and reduce anxiety which would create a more negative death experience within the nursing home. Additionally, this work shows the negative impact of over treating symptoms that are relating to oncoming death which cause patients unnecessary stress and pain in their last few days.
anson, Laura C. (2003). Improving Nursing ome Care of the Dying: A Training Manual for Nursing ome Staff. Springer Publishing Company.
This handbook for physicians emphasizes taking a multi-disciplinary approach to caring for the dying, which also encourages nursing home staff to learn from the lessons seen in hospice care. This includes taking a strategy of main management, rather than resuscitation in order to provide…
Hall, Sue; Longhurst, Susan; & Higginson, Irene. (2009). Living and dying with dignity: a qualitative study of the views of older people in nursing homes. Age and Aging. 38(4):411-416.
This study works within the established fact that most older people who reside in nursing homes will eventually die there. Thus, it examines an empirically-based model of dignity, defined through psychotherapy as a way to help increase the individual perceived levels of dignity within individuals in a nursing home setting. Results shows that issues attacking individual dignity is not necessarily related to the perception of death, but more towards illness-related concerns and the decline of their social role when dealing with various illnesses.
Henderson, Lori. (2009). Variables affecting death anxiety. Le Moyne College. Retrieved
Lois Gerber emphasizes the duties and responsibilities of community health nurses in homes. And Gerber also explains the flexibility and freedom that community health nurses have within the context of their service. hen a professional healthcare professional is providing services away from the authoritarian environment of a hospital or clinic, that nurse who serves in a home setting needs to be strong on self-motivation, "self-reliance," and must be "adaptable" and a strong self-starter (Gerber, 2012). This paper reviews the details of what skills and experiences a community nurse must have in order to be effective.
hat a Community Nurse Must Know and Offer in terms of Services
A community nurse's obligations and resources are unique in that the nurse has far more autonomy, and far more "control over" the situation in a home healthcare environment, Gerber explains on page 19. The training that a community nurse has gone through it…
Gerber, L. (2012). Community health nursing: A partnership of care. Lippincott's 2012
Nursing Career Directory. Retrieved May 13, 2015, from http://www.nursingcenter.com .
-Mother can attend cancer support groups and receive advice and education through other channels regarding proper methods of providing care and improving quality of life for her husband
-Son can explore employment options as well as discuss various needs and responsibilities with his parents in order to determine his most effective utilization within the changed family dynamic
-Father can provide the levels of self-care that come easily, but should educate himself regarding his condition and ease care by allowing others to help when necessary
-Provide educational materials/answer questions for both mother and father
-Assist son with psychological transition of increased responsibility/familial dependence
-Instruction of proper care techniques for mother and father regarding father's condition
Levels of comfort and competence in new family roles should be easily assessed in regular visits through brief questioning. Monitoring father's health through standard vital sign and other appropriate tests will…
Stoval Home Products case https://secure-research-payment.com/beta/writer/writer_order_detail/index/A2024221
Thank you for using our product and contacting us with your concerns regarding the stain on your white Sportique jacket. At Stovall, we pride ourselves on researching every customer problem and responding accordingly.
While we have every confidence in our product, White-n-Brite Liquid Bleach, the product is not effective if not used in accordance with the directions on our label and on the labels of the products being laundered. In this case, the care instructions for the Sportique jacket indicate "Do not use bleach." I have verified this with the manufacturer SporTTogs. White-n-Brite's label instructs that customers that they should "always check manufacturers' care tags and directions for cleaning instructions." In addition, you pointed out that you used our bleach "in the treated areas around the stains." White-n-Brite's label states, "Do not use White-n-Brite Liquid as a spot remover," thus we can not pay your…
Bowman, J. (2002, August 21). Writing Negative Messages. Homepages at WMU. Retrieved May 04, 2011, from http://homepages.wmich.edu/~bowman/badnews.html
Christensen, G.J. (2005, September 19). Letters...We get stacks of letters and business notes.
Retrieved May 04, 2011, from http://www.csun.edu/~vcecn006/lettr.html
Erdman, K.M., & Hildebrandt, H.W. (1998). Stovall home products: Practicing prudence to avoid liability. Business Communication Quarterly, 61(1), 152-163. Retrieved May 04, 2011, from http://www.businesscommunication.org/publicationsNew/bcqNew/casesNew/Stovall.pdf
care in regards to EM when patients go from outpatient to inpatient to specialists
The CMS (Centers for Medicare and Medicaid Services) uses the phrase 'care transition' to refer to patient transference between care settings (like hospitals, nursing facilities, home care, primary care, specialist care, or long-term patient care). Care coordination throughout the continuum of healthcare proves critical to patient treatment management, execution and assessment. Transferring health information of patients from one care location or level to another during patient transfers guarantees care continuity and fosters effective patient treatment. Direct communication between different healthcare providers is vital to smooth patient transition across healthcare settings. Partial knowledge of patient health details and absence of an EH (electronic health record) that may be accessed anywhere will restrict acute care professionals' capacity of accessing the patient's community pharmacy and ambulatory care records, especially if the professional is not the patient's primary…
Rupal Patel Mansukhani, Mary Barna Bridgeman, Danielle Candelario, & Laurie J. Eckert. (2015). Exploring Transitional Care: Evidence-Based Strategies for Improving Provider Communication and Reducing Readmissions. Pharmacy and Therapeutics, 690-694.
Sharon Silow-Carrol. (2012). Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals. Commonwealth Fund.
Ruth E. Mathias and a.E. Benjamin (2003) report that social workers are becoming increasingly concerned about elder abuse in long-term care settings (p. 174). A study conducted by these social scientists/authors, reveals that Medicaid related agency care demonstrates no harmful or increase in the abuse suffered by elderly people receiving care through private agencies, but that there is little social worker oversight, and because of that, reports and information supporting that fact can be misleading at this point in time (p. 174). Mathias and Benjamin reported, too, that direct care provided by family members was proven to be less abusive to the elderly than services rendered by state and private providers (p. 174).
The most concentrated areas of consumer complaints reported was the difficulty in scheduling services, language barriers, and high care-giver/assistant turnover (p. 174). These are areas of concern, because the elderly are often suffering levels of dementia that…
Litwin, H., & Zoabi, S. (2004). A Multivariate Examination of Explanations for the Occurrence of Elder Abuse. Social Work Research, 28(3), 133+. Retrieved July 31, 2008, from Questia database: http://www.questia.com /PM.qst?a=o&d=5007316778' target='_blank' REL='NOFOLLOW'>
..significantly below the maximum of $3,000 per day" (and more like $300 to $350).
And fourth, in about 22% of the cases where nursing homes were in serious violation of regulations - and causing harm to their patients - "there was no record" of sanctions at all.
Conclusion: Given the widespread problem reviewed here in this paper, it seems reasonable that the federal government (with oversight by the Congress) should implement the recommendations of the GAO. One, there should be new legislation requiring the CMS administrator to "collect civil money penalties more expeditiously"; two, the policy of punishing nursing home violators needs to be greatly strengthened and enforced; three, the oversight of nursing homes that are frequently in violation of regulations should be expanded; and four, enforcement "data systems" need to be improved, so Congress and CMS administrators have up-to-date information on which nursing homes have received sanctions, how much…
Baisden, Harry. "Senate Panel Proves Nursing Home Failures." AHA News 36.36 (2000): p. 7.
Government Accountability Office. "Report to the Ranking Minority Member, Committee on Finance, U.S. Senate: Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not
Deterred Some Homes from Repeatedly Harming Residents." Retrieved September 2, 2007, at http://www.gao.gov/cgi-bin/getrpt-GAO-07-241 .
Lee, Christopher. "Arizona Veterans' Services Director Quits Amid Scandal." The Washington
Management Performance Within Elderly Care Homes in Gibraltar
The elderly nursing community in Gibraltar is dispersed and characterized by different institution specific challenges and particularities. The current project assesses the general level of leadership competencies within three pre-selected institutions, the management performance assessments of employees, the basic leadership skills required and formulates a series of recommendations as to how these competencies could be obtained. The approach is predominantly a quantitative one, combining various research methods, such as the questionnaire, the case study and structured interviews.
With the aging of the population, more pressure is placed on the health care system throughout the world, and Gibraltar is no exception. As 15.41 per cent of its population is aged over 65 years (Website of the Central Intelligence Agency, 2015), a question arises regarding the country's ability to provide adequate care for its aging population. In this sense then, the current project sets…
Arras, John, D. (1995). Bringing the Hospital Home. Baltimore: Johns Hopkins University.
Barker, A.M., Sullivan, D.T., Emery, M.J., (2006) Leadership competencies for clinical managers: the Renaissance of transformational leadership, Jones & Bartlett Learning
Benner, P. (1982). Novice to Expert. Am J Nurs, 82(3):402-7
Booyens, S.W., (1998) Dimensions of nursing management, Juta and Company Ltd.
Hawaiian elde cae pofessionals impove patient eldecae sevices to Japanese nationals, taking into consideation Japanese cultual noms and expectations
Caegiving fo eldely paents in Japan
Japan has witnessed a significant gowth in its elde population. In the yea 1950, 4.9% of the Japanese population was aged 65 yeas and above. This figue inceased to 14.8% (1995). By 2025, it is estimated to gow to 25.8% (Yamamoto & Wallhagen, 1997). Japan's 'vey old' population goup (aged 85 and above) is swiftly inceasing in numbe. It has been pojected that by 2025, the nation's 'vey old' population will account fo 4.3% of its total population -- a five-fold ise in thee decades. Futhemoe, it was pojected that as many as 2.62 million Japanese would be suffeing fom senile dementia by the yea 2015; the 1990 estimate fo senile dementia was about one million individuals (11WSA 1996).
Change in the pecentage of Japan's…
references, and Arrangement of End-of-life Care and Decision-Making among Japanese-American Older Adults, ProQuest LLC.
National Asian Pacific Center on Aging. (1998). Growing APA elderly population adds urgency to improving health services. Asian Pacific Affairs, 6 (Dr. 2-3.
SALDOV, M., KAKAI, H., McLAUGHLIN, L. & THOMAS, A. (1998). Cultural barriers in oncology: Issues in obtaining medical informed consent from Japanese-American elders in Hawaii, Journal of Cross-Cultural Gerontology 13: 265-279.
Sato, S. (2015). THE IMPACT OF GENDER AND CULTURAL FACTORS ON THE PATTERNS OF ELDER CARE SERVICE UTILIZATION AMONG FAMILY CAREGIVERS OF JAPANESE ANCESTRY IN THE STATE OF HAWAII, ProQuest LLC
SOROCCO, K.H. (1998). BECOMING A HEALTH ACTIVE OLDER ADULT: THE EFFECTS OF A WORKSHOP FOR JAPANESE-American OLDER ADULTS. ProQuest Information and Learning
Healthcare/Statistics/Human esources Leadership
Human esource Management in Healthcare
The article taken into consideration in this assignment is Home Care: The Fastest Growing Low-Wage Industry by Candace Howes. In accordance to Howes (2015), essentially all the growth and development in the Long-standing Services and Supports industry is encompassed in home and community-based services that are progressively being more subjugated by the fast-growing for-profit home care agency industry where charters are making considerable and noticeable progress (Howes, 2015). In contradiction of nurses' aides in hospitals and nursing homes, who are undertaking, in fact, similar jobs, home care workers employed by these agencies and by public entities are not covered under the FLSA (Fair Labor Standards Act). In turn, this makes it prohibitive for them to link with unions and repudiating them the right to minimum wage and overtime protection (Howes, 2015).
I agree that home-care health nurse aides ought to be eligible…
Casto, R. (2015). Why Are Statistics Important in the Health Care Field? Livestrong. Retrieved 11 January, 2016 from: http://www.livestrong.com/article/186334-why-are-statistics-important-in-the-health-care-field/
Curtis, E. A., de Vries, J., & Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306.
Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard,27(41), 35-39.
Howes, C. (2015). Home Care: The Fastest Growing Low-Wage Industry. New Labor Forum 2015, Vol. 24(2) 98-10.
cultural diversity issues and its impact on nursing professionals' practice. It assesses a client hailing from a different culture, and employs information derived from the assessment determining and reflecting on health practices and beliefs of the client's culture. Lastly, nurses' role in the care of patients hailing from diverse backgrounds care is analyzed, and a conclusion is drawn.
Client Interview Data
Client's health beliefs in relation to cultural diversity
The client comes from a family-focused background, in which she plays the role of chief household organizer and attends to her family and their needs. She believes one ought to lead a life of a good and virtuous individual, and support one's family, particularly in times of need. In her opinion, sickness must be tended to, for preserving life. She believes in healthcare professionals and services they offer, for leading a healthy life. She is comfortable having healthcare professionals take care…
American Nurses Association. (1998). Discrimination and Racism in Health Care. Silver Spring, MD: American Nurses Association.
Anderson, L. (2012, October 10). Cultural Competence in the Nursing Practice. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competence-nursing-practice
Coe, S. (2013, January 15). Cultural Competency in the Nursing Profession. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competency-nursing-profession
Graue, M., Dunning, T., Hausken, M. F., & Rokne, B. (2013). Challenges in managing elderly people with diabetes in primary care settings in Norway. Scand J Prim Health Care, 31(4), 241-247.