Hospice Care Essays (Examples)

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Government Regulations Affecting Health Care in Hospice

Words: 6236 Length: 20 Pages Document Type: Essay Paper #: 8359913

Government Regulations and Hospice

Government Regulations Affecting Health Care in Hospice

Hospice

Regulations Affecting Health Care in Hospice

Impact of rules on Hospice services

Annotated Bibliography

This paper focuses on how government regulations impact hospice. The paper starts off with an introduction to the hospice system that was revived by a nurse, Cecily Saunders, who then went on to become a physician, establishing one of the first modern hospices. The concept of total pain is explained in some detail. The body of the paper then includes the studies that have been conducted on patients and caregivers in hospice systems as well as on people who died after they were diagnosed with terminal illness resulting in death in six months following the prognosis. The overall conclusion that can be drawn here is that while in Japan there is a marked need for improving the Day hospice system, the American hospice industry…… [Read More]

Works Cited

American Medical Directors Association. (n.d.). White Paper on Palliative Care And Hospice In Long-Term Care. Retrieved March 10, 2012, from American Medical Directors Association: http://www.amda.com/governance/whitepapers/palliative_care.cfm

Carlson, M.D., Morrison, R.S., Holford, T.R., & Bradley, E.H. (2007). Hospice Care: What Services Do Patients and Their Families Receive? Health Services Research, 42(4), 1672-1690.

Centers for Medicare & Medicaid Services. (2008). Medicare and Medicaid Programs: Hospice Conditions of Participation; Final Rule. Federal Register, 73(109), 32088-32220.

Christakis, N.A., & Escarce, J. j. (1996). Survival of Medicare patients after enrollment In hospice programs . The New England Journal of Medicine, 172-179.
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Health Care System Has Focused on the

Words: 2963 Length: 11 Pages Document Type: Essay Paper #: 36873509

health care system has focused on the prevention and cure of disease and illness. When people got sick, every bit of energy and finances went into trying to figure out how to stop it. This was true even when the patient had a disorder or a disease that was deemed incurable. For many years when someone got a disease in which there was no cure, it did not change the method of treatment. The medical community, the family and the patient continued to try every possible avenue to stop the progress. Often times the patient would submit to painful and disorienting treatments, because they didn't want to disappoint their family members or their doctors. At the same time the medical community was expanding the length of life so that many people were living longer than ever before. These two things began to clash. At what point do people stop trying…… [Read More]

References

Public health system suffers from chronic underfunding http://home.aigonline.com/content/0,1109,16263-694-ceo,00.html

NEWS FROM AROUND AFRICA http://www.hospicecare.com/Newsletters/july2003/page8.html

Healthcare & Medical Market in Morocco http://www.tradepartners.gov.uk/healthcare/morocco/profile/overview.shtml

What is Hospice? http://www.hospicefoundation.org/what_is/
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Model for Community Palliative Care

Words: 1740 Length: 6 Pages Document Type: Essay Paper #: 36797784

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…… [Read More]

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.

Discussion

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
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Health Care A the Different

Words: 2409 Length: 9 Pages Document Type: Essay Paper #: 52518976

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…… [Read More]

References

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.
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Diversity Important in Health Care

Words: 3805 Length: 14 Pages Document Type: Essay Paper #: 98981928

The Foundation called specific attention to the prospect of institutional and policy-level strategies to increase the participation of under-represented minorities in the health professions. In response, the Institute Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce came out with a report, entitled "In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce." The Committee consisted mostly of academicians, two of whom represented the nursing profession.

In its report, the Committee recognized the importance of increasing racial diversity among health professionals in order to improve access to care, greater patient choice and satisfaction and better educational experiences for practitioners, among other benefits. It also recognized the lack of strategies in reducing institutional and policy-level barriers among health profession educational institutions or HPEIs. In response to the lack, the Committee recommended that health professions education make a clear stand and mission on the…… [Read More]

BIBLIOGRAPHY

AHRQ (2007). The national healthcare disparities report, 2006. Agency for Healthcare

Quality and Research, Medscape. Retrieved on June 18, 2009 from http://www.medscape.com/viewarticle/552271

www.medscape.com

Alabama Nurse (2004). ANA Review: Institute of Medicine report on workforce diversity,
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Critique of a Hospice Health Promotion Plan

Words: 707 Length: 2 Pages Document Type: Essay Paper #: 14806907

Health Promotion Plan

Health Promotion in Hospice

The use of Dorothea Orem's Self-Care Theory as the framework for the health promotion plan, for improving depressive symptoms among hospice patients (Nursing Theories, 2012), is appropriate and consistent with a patient-centered care model. This model provides enough room for a gradient of patient self-care efficacy, from fully autonomous to unconscious, which is appropriate for the hospice setting. The author of Health Promotion in Hospice emphasized the need to increase the care efficacy of both hospice patients and their caregivers and mentioned how the role of a hospice nurse must remain fluid to constantly changing care needs of hospice patients. Under Orem's model there is thus a gradient of self-care need and autonomy that is negatively correlated and where deficits emerge the nurse must step in to meet these care needs.

I would also emphasize the concept of 'nursing client' discussed in Orem's…… [Read More]

References

Hirdes, J.P., Freeman, S., Smith, T.F., & Stolee, P. (2012). Predictors of caregiver distress among palliative home care clients in Ontario: Evidence based on the interRAI Palliative Care. Palliative & Supportive Care, 10(3), 155-63.

Murray, R.B., Zentner, J.P., & Yakimo, R. (2008). Health Promotion Strategies Through the Life Span. Upper Saddle River, NJ: Pearson Prentice Hall.

Ng, C.G., Boks, M.P., Roes, K.C., Zainal, N.Z., Sulaiman, A.H., Tan, S.B. et al. (2014). Rapid response to methyphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: A four-week, randomized, double-blinded, placebo-controlled study. European Neuropsychopharmacology, published online ahead of print 20 Jan. 2014, doi: 10.1016/j.euroneuro.2014.01.016.

Nursing Theories. (2012). Dorothea Orem's Self-Care Theory. Accessed 2 Mar. 2014 from http://currentnursing.com/nursing_theory/self_care_deficit_theory.html.
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Patients vs Healthcare Opinions

Words: 1774 Length: 5 Pages Document Type: Essay Paper #: 34987779

PATIENT & HEALTH POFESSIONAL PESPECTIVES

Patient & Professional Perspectives

Quality of care is a massive concern when it comes to healthcare in general. The issue is so multi-dimension and complicated. Even further, there are a lot of ideological bents and perspectives that further shape and form the issue as it exists today. A significant part of the paradigm mentioned above would be the perspectives of both patients and healthcare professionals as it relates to the aforementioned quality of care. Obviously, there are going to be some differences and similarities when talking to any large swath of patients or healthcare providers. The differences could be huge divides in some cases due to what is being expected being too different than what is able to be delivered given the resources or even the perspective or opinion of the healthcare professionals or providers. While there is no simple or neat answer to how…… [Read More]

References

Bagchi, A., af Ursin, R., & Leonard, A. (2012). Assessing Cultural Perspectives on Healthcare Quality. Journal of Immigrant & Minority Health, 14(1), 175-182.

doi:10.1007/s10903-010-9403-z

Butala, N. (2010). Perspectives on efficiency and quality in an ever changing system:

Healthcare 2010. The Yale Journal Of Biology And Medicine, 83(2), 93-95.
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Family Care Plan Nursing Family

Words: 782 Length: 3 Pages Document Type: Essay Paper #: 39760808



Family Interventions

-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

Nursing Interventions

-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

Evaluation

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…… [Read More]

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Jewish Client When Discussing Medical Care With

Words: 376 Length: 1 Pages Document Type: Essay Paper #: 44599599

Jewish Client

When discussing medical care with Sara, one must keep in mind that she is alone now, having been married for 50 years, but now widowed. She seems to have a rather active social circle, and is more of a middle-of -- the road practitioner of Judaism. Her belief system is likely sensitive to end-of-life issues, but she seems to be a candidate for hospice, rather than palliative care due to her age and the progression of her illness.

In response to Sara's initial decision to have surgery and treat the cancer with chemotherapy, medical personnel would be required to allow her this choice, but ensure that the principles of fidelity and benevolence are followerd. In other words, tell Sara the truth about odds and any prognosis, as well as side-effects. Inform her in a way that is non-paternalistic so that she may make up her own mind about…… [Read More]

REFERENCES

Edgedorf, L. (2005). Medical Ethics. New York: Greenhaven Pres.

Jewish Home Lifecare (2013). How Does Pallative Care Differ From Hospice Care? Retrieved from: http://www.jewishhome.org/our-services/palliative-care/how-does-palliative-care-differ-from-hospice-care
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A Concise Analysis of the Concept of Palliative Care

Words: 1233 Length: 4 Pages Document Type: Essay Paper #: 95709058

Palliative care is a specialty that is relatively new but that has evolved steadily over the past few decades. Its goal is providing advanced cancer patients with end of life care. Its rise was because of the public's growing dissatisfaction and concern with how dying patients were being taken care of in the 1960s and the 1970s (Cole, Carlin & Carlson, 2015). At the time, oncologists were mostly concerned with curative interventions and so did not give the necessary attention to end of life care. According to the studies that were done at the time, medical care that was given to the terminally ill was suboptimal or in some cases did not even exist. The father of palliative care, Dave Cicely Saunders, reported having the same experience. She was the founder of St. Christopher's Hospice, based in the United Kingdom. The facility was the first modern hospice (Cole, Carlin &…… [Read More]

Bibliography

alMahrezi, A., & AlMandhari, Z. (2016). Palliative Care: Time for Action. Oman Med J., 161 -- 163.

Bhatnagar, S., & Gupta, M. (2015). Future of Palliative Medicine. Indian J. Palliat Care, 95 -- 104.

Bruera E, Hui D. Integrating supportive and palliative care in the trajectory of cancer: Establishing goals and models of care. (2010). J Clin Oncol. 28:4013 -- 7

Cole TR, Carlin NS, Carson RA. (2015). Medical humanities: An introduction. Cambridge University Press. 1 stEdition. New York.
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Finite Health Care Resources Cutting Health Care

Words: 758 Length: 2 Pages Document Type: Essay Paper #: 46386841

Finite Health Care esources

Cutting health care costs is becoming a serious issue for the government and for medical corporations and patients throughout the U.S. today. There are several ways in which these costs can be cut, and one of those ways is to limit the life-extending care that is currently being provided to the elderly (Bond & Bond, 1994). This is not the same as limiting care that would improve their lives, but is only designed to limit the care that prolongs a life that already has little to no quality. However, it is not just the elderly who cost the country a great deal of money when it comes to medical care. Premature infants are also very expensive to keep alive, and an argument could be made that these infants should be allowed to expire, since they were not viable when they were born. It is a conundrum…… [Read More]

References

Bond J. & Bond S. (1994). Sociology and Health Care. NY: Churchill Livingstone.

Saunders, C.M. & Kastenbaum, R. (1997). Hospice Care on the International Scene. NY: Springer Pub. Co
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Comparing Five Health Care Services

Words: 1500 Length: 5 Pages Document Type: Essay Paper #: 83898893

elderly population is continues to rise nationally and this also true for the Sunnydale and Shadyville communities. In order to be prepared for both the rise in the aging population and any competition in the healthcare from Shadyville it is important to consider all potential providers. This paper will briefly look at the facets of nursing homes, assisted living, home health care, and hospice in this context.

Nursing homes

Nursing homes are the highest level of care for elderly adults outside of having them formally hospitalized (Santerre & Neun, 2012). The residents in nursing homes typically need significant help with their Activities of daily Living (ADLs). Nursing homes provide custodial care which means that the home assists with all daily activities including getting in and out of bed, providing assistance with feeding, bathing, and dressing. Most nursing homes also provide for activities for their higher functioning residents such as crafts,…… [Read More]

References

Ayalon, L., & Green, V. (2013). Social ties in the context of the continuing care retirement community. Qualitative health research, 23(3), 396-406.

Kelley, A. S., Deb, P., Du, Q., Carlson, M. D. A., & Morrison, R. S. (2013). Hospice enrollment saves money for Medicare and improves care quality across a number of different lengths-of-stay. Health Affairs, 32(3), 552-561

Kovner, C. T., Mezey, M., & Harrington, C. (2002). Who cares for older adults? Workforce implications of an aging society. Health Affairs, 21(5), 78-89.

National Hospice and Palliative Care Organization (2012). Figures: Hospice Care in America. Alexandria, VA: Author.
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Nurse Collaboration in Palliative Care

Words: 1794 Length: 5 Pages Document Type: Essay Paper #: 73487860

Nursing Ethics

While most hospitals seem to be well-run and most situations and scenarios are planned for in advance when it comes to what nurses should be doing, should not be doing and why, this is not always the case. Just one example of this would be situations where palliative care is probably or definitely called for in a given situation but there is not a defined or clear protocol as to when the palliative path should be started and what criteria should be used. Indeed, patients that are facing such a situation are typically terminal or they at least cannot be treated for what is ailing them. An easy example to point to would be a cancer patient whose disease is beyond what medicine can do for them. When there is an absence of leadership when it comes to palliative care protocols, it falls to nurses to collaborate, work…… [Read More]

References

Engel, J., & Prentice, D. (2013). The ethics of inter-professional collaboration. Nursing Ethics,

20(4), 426-435. http://dx.doi.org/10.1177/0969733012468466

Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Inter-professional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335.

http://dx.doi.org/10.1177/0969733012462048
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Elder Care the Baby Generation

Words: 5100 Length: 15 Pages Document Type: Essay Paper #: 76486184

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…… [Read More]

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

Matthias, R.E., & Benjamin, a. (2003). Abuse and Neglect of Clients in Agency-Based and Consumer-Directed Home Care. Health and Social Work, 28(3), 174+. Retrieved July 31, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001999500

Thorslund, M., & Parker, M.G. (1994). Elder Care in the Priorities Discussion. The Hastings Center Report, 24(5), 29+. Retrieved July 31, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5002212664
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Health Care and Organizational Case Study

Words: 1307 Length: 4 Pages Document Type: Essay Paper #: 68499611

Healthcare Organization Case Study

Health Care Organization Case Study

Banner Healthcare

Health Care Organization Case Study

Banner Healthcare represents a set of diverse healthcare related facilities that provide healthcare services to societies in USA and beyond. Banner seeks to establish a healthier life for communities through developing a healthy environment. Banner Healthcare is arguably the largest healthcare provider in the country. The organization spans seven states, including Arizona, California, Colorado, Nevada, Alaska, Nebraska and Wyoming. The organization operates 20 hospitals, including healthcare facilities. The organization offers such services as hospice care, home care and physician services. Banner Healthcare also provided $130 million as their contribution to charity. The organization is a healthcare leader in all the communities it offers its services. The agency has shown tremendous growth in the past years. They admit over 190 000 patients every year and have a workforce in excess of 29-000. The emergency departments…… [Read More]

Reference:

Banner Health, (2008). Here Now: Making a Difference. Retrieved from http://www.bannerhealth.com/_communityupdate/Banner_Health_Community_Update.pdf on 18 May 2016

Harrington, C. & Estes, C. (2008). Health Policy: Crisis & Reform in the U.S. Health Care Delivery System, 5th Ed. Jones & Bartlett Publishers

Wolf, J., Hanson, H. & Moir, M. (Eds.) (2011). Organization Development in Health Care: High Impact Practices for a Complex and Changing Environment. IAP
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Bereavement the Interest in Palliative Care or

Words: 2796 Length: 7 Pages Document Type: Essay Paper #: 73580195

Bereavement

The interest in palliative care, or counseling for bereavement comes to different people in different ways, and one doctor came into it through home care as long ago as 1975. The doctor had just finished working as a house staff in the University of California in San Francisco. Then he got a job at Massachusetts General Hospital as a physician. The doctor was placed at Chelsea Memorial health Center. This was a neighborhood health center in a poor multi-ethnic community, yet not a great distance away from MGH. The doctor had come to replace a person who had come from Britain for a working experience of a year in United States and had gone to the houses of a few elderly patients. In the beginning itself, it was suggested to the doctor by the senior that he visit two patients who were being cared by relatives at home. This…… [Read More]

References

A Compendium of Hospital-Based Palliative Care Practices. Retrieved from http://www.haponline.org/downloads/PPCN_Compendium_2004.pdf Accessed on 31 May, 2005

Austenfeld, Jennifer L. Stanton

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1467-6494.2004.00299.x;jsessionid=iVt_UOAe61_b?journalCode=jopy Accessed on 31 May, 2005

Bloomington School District. 20 November, 2002. Retrieved from http://www.shfsc.org/reports/BL2002.pdf Accessed on 31 May, 2005
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Care Case Study Slide 1 Footnotes There

Words: 1301 Length: 4 Pages Document Type: Essay Paper #: 2580470

Care Case Study

Slide 1 Footnotes

There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion present, but there was little alternatives for members of other cultures or religions.

Yet, today, there are now a much wider array of cultural elements available in assisted living homes and hospital facilities. Assisted living programs are regulated on the level of the state.

As such, different states have different types of programs and policies that impact the degree to which cultural characteristics are included or excluded within various assisted living facilities. Some programs encourage cultural elements of patients…… [Read More]

References

ALFA - Assisted Living Federation of America. (2009). Assisted Living Regulations and Licensing. Retrieved from http://www.alfa.org/State_Regulations_and_Licensing_Informat.asp

Medicare Payment Advisory Commission. (2011). Report to the Congress: Medicare Payment Policy. Retrieved from http://www.medpac.gov/documents/Mar11_EntireReport.pdf

National Caregivers Library. (2012). Independent Living Facilities. Retrieved from http://www.caregiverslibrary.org

Next Step in Care. (2012). Reducing the Stress of Hospitalization for Patients with Dementia and their Family Caregivers: A Guide. Family Caregiver Alliance. Retrieved from http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2449#researchpractice
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Care Rural Settings Continuum of

Words: 690 Length: 2 Pages Document Type: Essay Paper #: 7683624

As well as expanding patient's abilities to obtain primary care, virtually, telemedicine can enable patients in isolated locations to see specialists. When rural patients are connected to a hospital network such as the Grinnell egional Medical Center, they are able to access high-quality physicians through some of the more advanced healthcare technology available, although this is not always possible in a local healthcare system with fewer physicians and less access to high-level technology. Technology can still enable patients in a variety of settings to keep track of vital signs such as heart rate, blood pressure, and blood sugar, and to alert their physician immediately if their readings are abnormal.

While some surgeons have even performed procedures through virtual consults, certain aspects of medicine remain challenging to provide rural patients, such as physical rehabilitative services, which may require the patient to travel to receive the full benefit of the services. Patients…… [Read More]

References

Campbell, James D. (2001, May). Introducing telemedicine technology to rural physicians and settings. Journal of Family Practice. Retrieved January 27, 2011 at http://findarticles.com/p/articles/mi_m0689/is_5_50/ai_75244766/

Spath, Patrice. (2011). Community Continuum of Care planning.

Brown-Spath & Associates. Retrieved January 27, 2011 at http://www.brownspath.com/original_articles/cccplan.htm
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Caring for the Terminally Ill Patient

Words: 634 Length: 2 Pages Document Type: Essay Paper #: 69464243

population ages, it will become increasingly important to know how to care for the chronically ill and dying elderly patients. An article in American Family Physician details one of the problems that arises in such cases: denial. The article tells about an incident where a man who is in constant pain repeatedly goes to the doctor, but will not accept that his symptoms could be caused by cancer. When the doctor offers to make a referral to hospice for extra help, the patient adamantly refuses the care. At first the physician does not give up his potential persuasions, which include stressing the patient's personal responsibility concerning the need for loved ones to see him free of pain. Yet the same scenario continues until, unfortunately, the man dies.

The author of the article, Dr. Karen Ogle, explains that denial is a common coping mechanism in the terminally ill. People rely on…… [Read More]

Unforunately, notes Ogle, there will always be those idividuals who never want to accept the truth and remain in denial until they die, like this above-noted patient,. This is even when such people realize the negative effect this is having on their spouse, children and other family members and friends.

This is not wrong or bad. Everyone has his or her own way of "dying well." How a person is acting has a reason, even if it is unknown to the observer. However, in some instances, the most beneficial support the healthcare profession can offer is just to join with the patient and his or her family in the manner elected but not understood by outsiders. This often means to leave behind the usual "toolbox" of medical responses and instead rely on the basic goodness of humankind. As she concludes: "Caring for the dying is remarkably challenging work. It can also be remarkably rewarding. If we meet the deeper challenges requiring our presence as human beings, this work can be among the greatest privileges of being a physician."

Ogle, Karen. "Approaching a terminally ill patient in denial." American Family Physician, October 1999. [electronic version].
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Elderly Care

Words: 1299 Length: 4 Pages Document Type: Essay Paper #: 39198111

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…… [Read More]

References

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
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Life Care in the United

Words: 1208 Length: 4 Pages Document Type: Essay Paper #: 20114513

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…… [Read More]

Bibliography

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.
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Nursing Care Facility's Information Technology IT Improvements

Words: 1009 Length: 3 Pages Document Type: Essay Paper #: 78735678

Improving Health Care Delivery by Integrating Information Technology

In order to modernize the operations of their medical facility, Pleasant Manor nursing home should consider contracting to implement the Epic System of electronic medical record (EM) and practice management throughout their campus. A pioneer in the march towards digitization of health care records, "Epic makes software for mid-size and large medical groups, hospitals and integrated healthcare organizations" using proprietary software that efficiently "spans clinical, access and revenue functions and extends into the home" (Epic, 2012). In accordance with Pleasant Manor's stated mission to serve as an "expanded geriatric clinic that provides basic services for seniors, general practice, counseling and education programs, radiology, complete blood work, and an osteo-care unit for citizens of the outlying communities," the facility will make this transition with the goal of standardizing its procedures and streamlining its processes. Located on an expansive campus in the retirement community…… [Read More]

References

Epic Systems. (2012, August 13). Epic: Who we work with. Retrieved from http://www.epic.com/about-index.php

Freudenheim, M. (2012, Jan 14). Digitizing health records, before it was cool. The New York Times. Retrieved from http://www.nytimes.com/2012/01/15/business/epic-systems- digitizing-health-records-before-it-was-cool.html?pagewanted=all

Versel, N. (2013, November 05). Taking a close look at electronic health records. U.S. News: A

World Report, Retrieved from http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/11/05/taking-a-close-look-at-electronic-health-records
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Rural Healthcare Facilities Context of

Words: 5552 Length: 20 Pages Document Type: Essay Paper #: 48009947



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…… [Read More]

Bibliography

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
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Vulnerable Adults in Healthcare Settings

Words: 998 Length: 2 Pages Document Type: Essay Paper #: 24855774

Older people are associated with increased risk for hospitalisations due to illness or trauma (Seymore & Cannon, 2010). The nature and burden of the illness that the older person faces is related to the quality of health care services they may receive when admitted to a hospital or other clinical setting (Dossa & Capitman, 2010). In terminal cases, the patient may choose to engage Hospice services, either in the clinical setting or at home. The human rights of such patients are ethically fundamental in their quality of care through palliative care services (Brenna, Carr, & Cousins, 2007).

The care received in the clinical health care setting for elderly patients may be substandard due to staffing and regulation issues (Maas, Specht, Buckwalter, Gittler, & Bechen, 2008). There is a need to identify the failings in quality of care and promote the human rights of elderly patients in healthcare settings (Gittler, 2008).…… [Read More]

References

Barry, P., & Planalp, S. (2008). Ethical issues for hospice volunteer. The American Journal of Hospice and Palliative Care, 458-462.

Brenna, F., Carr, D., & Cousins, M. (2007). Pain management: a fundamental human right. Anesthesia and Analgesia, 205-221.

Dossa, A., & Capitman, J. (2010). Community-based disability prevention programs for elders: predictors of program completion. Journal of Gerontological Social Work, 235-50.

Gittler, J. (2008). Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: a survey of federal and state laws. Research in Gerontological Nursing, 264-284.
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Healthcare Hispanic Community and Healthcare This Paper

Words: 503 Length: 2 Pages Document Type: Essay Paper #: 76590063

Healthcare

Hispanic Community and Healthcare

This paper is an examination of how the Hispanic community experiences healthcare. The data from a number of articles related to the subject form the basis for the conclusions reached in the analysis.

One study looked at whether Hispanic-specific training should be included for healthcare worker training. It was found that there is a serious lack of training that is currently implemented regardless the community examined. Healthcare workers were unaware of social conventions that were normal among their Hispanic clients which limited the effectiveness of the healthcare treatment given. Because women were unable to discuss personal problems with male healthcare workers and males had similar issues with females, it was difficult for the various agencies to be truly effective. The recommendation, of course, was to include a training curriculum that included cultural training.

Another issue that Hispanic individuals faced is that they were underrepresented in…… [Read More]

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Health Care and the Disabled

Words: 2341 Length: 9 Pages Document Type: Essay Paper #: 97956325

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…… [Read More]

REFERENCES

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
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Home and Community-Based Care Today

Words: 4884 Length: 17 Pages Document Type: Essay Paper #: 5260119

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…… [Read More]

References

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
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Effect of Palliative Care on the Healthcare Professional and Family

Words: 2777 Length: 8 Pages Document Type: Essay Paper #: 30642976

Palliative Care on the Caregiver

Palliative care has several positive effects on the caregiver. These can be divided into emotional, social, psychological, and physical effects. First is the positive psychological effect that the caregiver such as the nurse, personal care worker, or family member to deal with the tough job. One study found that when patients died with unrelieved suffering, as nurses, they would also endure enormous suffering on their part Bailey, 2008.

The impact to the nurses is majorly because they had perceptions of suffering where they felt the patient was undergoing a difficult situation and they had feelings towards the patient since they feel they were unable to help the patient during the time of the patient's distress. They also have to endure feelings of failure since they bear the burden of the patient's unrelieved pain Barclay and Maher, 2010.

Some nurses also mentioned the impact of the…… [Read More]

References

BAILEY, F.A. 2008. "I Am Not Afraid of Dying. I Just Don't Want To Be There When it Happens." Medical Care, 46, 1195-1197.

BARCLAY, S. & MAHER, J. 2010. Having the difficult conversations about the end of life. BMJ: British Medical Journal, 341, 653-655.

BOYD, K. & MURRAY, S.A. 2010. Recognising and managing key transitions in end of life care. BMJ: British Medical Journal, 341, 649-652.

CAVANAUGH, T.A. 2008. Double-Effect Reasoning: Doing Good and Avoiding Evil, Oxford, Clarendon Press.
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Health Care Reform Several Years

Words: 2680 Length: 7 Pages Document Type: Essay Paper #: 13950798

Contracts with doctors often contain a clause which doesn't allow the doctors to discuss

Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).

The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…… [Read More]

Works Cited

Bennett Clark, Jane (1996, July). What you should ask your HMO.

Kiplinger's Personal Finance Magazine. pp. 92-93.

Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,

Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.
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Leadership and Management in Health Care

Words: 2758 Length: 9 Pages Document Type: Essay Paper #: 50597084

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.

Background

Despite relatively little action regarding health care for the aged by the federal government, there is little…… [Read More]

References

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, http://www.questia.com.

Hovey, W. (2000). The worst of both worlds: Nursing home regulation in the United States. Policy Studies Review, 17(4), 43. Retrieved June 30, 2004, from Questia database, http://www.questia.com.

Kahl, A., & Clark, D.E. (1986). Employment in health services: Long-term trends and projections. Monthly Labor Review, 109, 17+. Retrieved June 30, 2004, from Questia database, http://www.questia.com.
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Healthcare Reimbursement and Billing

Words: 1160 Length: 4 Pages Document Type: Essay Paper #: 91090578

Health Care Reimbursement and Billing

Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.

Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C

Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…… [Read More]

Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.

Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.

Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
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Effecting Changes in Healthcare Organizations Through Mission and Visions

Words: 616 Length: 2 Pages Document Type: Essay Paper #: 73332051

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…… [Read More]

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Healthcare Finance a Prospective Payment

Words: 914 Length: 3 Pages Document Type: Essay Paper #: 65027047

If the area wage index is greater than 1, the labor share equals 69.7%. The law requires the labor share to equal 62% if the area wage index is less than 1.0.

2) the wage adjusted labor share is added to the non-labor share of the standardized amount.

3) the wage adjusted standardized amount is multiplied by a relative weight for the DG. The relative weight is specific to each of 746 DG's (for fiscal year [FY] 2009) and represents the relative average cost of a beneficiary in one DG compared to another.

4) if applicable, additional amounts will be added to the IPPS payment for hospitals engaged in teaching medical residents, hospitals that treat a disproportionate share of low income patients, and for high cost outlier cases" (Acute Inpatient Prospective Payment System, 2009).

Physician services include office visits, surgical procedures, and other diagnostic services. These services are usually performed…… [Read More]

References

Acute Inpatient Prospective Payment System. (2009). Retrieved April 2, 2009, from Centers

for Medicare and Medicade Service Web site:

http://www.cms.hhs.gov/MLNProducts/downloads/AcutePaymtSysfctsht.pdf

Physician Services Payment System. (2008). Retrieve April 3, 2009, from MedPac Web site:
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Health Care Staffing Agency

Words: 3580 Length: 10 Pages Document Type: Essay Paper #: 5090774

Health Staff

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…… [Read More]

Works Cited

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.
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Organization of the U S Healthcare System

Words: 540 Length: 2 Pages Document Type: Essay Paper #: 31751846

Predict the economic impact (e.g., costs, benefits, efficiency, cost containment) on healthcare delivery at the local, state, national, or international level if the legislative bill were enacted.

This paper examines the economic impact upon the nation if the bill, the Palliative Care and Hospice Education and Training Act, were passed. Fundamentally, the economic impact of the bill would ultimately be a positive one. The bill proposes the necessity for better training and support for the clinicians who will ultimately work in palliative care. The bill represents a long-term investment: more expenditure to better train and educate these professional healthcare personnel, but with the understanding that definitive savings will be substantial. First of all, there's almost always a substantial amount of fiscal savings when the quality of care is improved; this has been demonstrated in a range of studies and is something which is experienced at the local and national level.…… [Read More]

References

Ascan.org. (n.d.). Evidence-based research: cost savings of palliative care to hospitals and the medicaid program. Retrieved from http://acscan.org/ovc_images/file/action/states/or/QoL/Cost_savings_of_Palliative_Care.

pdf
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Mission Viejo Healthcare

Words: 3473 Length: 13 Pages Document Type: Essay Paper #: 97092115

Healthcare Administration Mission Viejo Executive Summary

Over the last several years, the healthcare delivery environment has been continually evolving. This is because consumers are demanding efficient ways for receiving a variety of services. That is focused on reducing costs and enhancing quality. The result is that the entire system is continually changing to keep up with them. In the case of Golden Age Hospital (GAH), they are reaching a crossroads with rising number of seniors locally and nationally. This is in response to the rising demographic and many local facilities feeling overwhelmed. The new location can be utilized as an integrated business model that will achieve these larger objectives. In the long-term, this will make them more competitive and able to respond to changes in the way industry is operating. Those who are able to do this will see their employee turnover rates decrease and they can enhance the care…… [Read More]

References

Community Profile. (2014). City of Aliso Viejo. Retrieved from: http://www.cityofalisoviejo.com/wp-content/uploads/ApdxC_Community_Profile.pdf

Mission Viejo, California. (2015). U.S. Census. Retrieved from: http://quickfacts.census.gov/qfd/states/06/0648256.html

Rising Demand for Long-Term Care. (2014). CBO. Retrieved from: http://www.cbo.gov/publication/44363

Cuellara, A. (2006). Strategic integration of hospitals and physicians. Journal of Health Economics, 25 (1), 1-28.
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Home Health Care Services

Words: 654 Length: 2 Pages Document Type: Essay Paper #: 17095594

Visiting Nurse Service of New York provides in home health care services to numerous patients throughout the state of New York. It was founded by one of the most famous nurses of the 19th and 20th centuries, Lillian Wald. It is a not-for-profit organization that seeks to administer health care services at affordable rates to its burgeoning population of patients. As of yet, there are no plans to expand the practice outside the borders of New York.

Strengths

The lengthy history of this organization offers it a degree of familiarity and trust with its customer base. Additionally, Wald's involvement provides a degree of credibility within the healthcare industry as a whole.

Human esources: The storied history of this organization is partly responsible for its ability to attract myriad employees (approximately 15,000) (Hoover's, 2015), who are able to serve a broad spectrum of the population by speaking numerous languages.

Not-For-Profit Status:…… [Read More]

References

Gentiva Health Services. (2015). America's home healthcare and hospice leader. https://gentivacareers.silkroad.com Retrieved from https://gentivacareers.silkroad.com

Hoover's. (2015). Visiting Nurse Service of New York. www.hoovers.com Retrieved from http://www.hoovers.com/company-information/cs/competition.Visiting_Nurse_Service_of_New_York.85ae1ab929f68397.html

Visiting Nurse Service of New York. (2015). What is Home Care Research? www.vnsny.org http://www.vnsny.org/vnsny-research/what-is-home-care-research/
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Watson Theory of Human Caring

Words: 1820 Length: 6 Pages Document Type: Essay Paper #: 29055782

, 2007). The nurses at the medical-surgical, trauma, neurological, cardiovascular, cardiology and transplant sections directly and personally confront the various needs of families of the death of a loved one. One nursing author, Jane Felgen, set forth the usefulness of a grieving cart to respond to the needs of grieving families in her article, "A Caring and Healing Environment." Many nursing authors have written about the healing environment based on Nightingale's and Watson's work. One of these authors is Jane Felgen, who described the use of a grieving cart in her article, "A Caring and Healing Environment." It would enhance a milieu to facilitate the grief process (Whitmer et al.) and put to actual practice Watson's theory specifically in the end-of-life period.

Conclusion

As set forth in her theory of human caring, values, assumptions and 10 carative factors or clinical caritas, Jean Watson views the patient as a soul with…… [Read More]

BIBLIOGRAPHY

Dorn, K (2004). Caring-healing inquiry for holistic nursing practice: model for research and evidence- based practice. Topics in Advanced Practice Nursing eJournal, 4 (4).

Retrieved on May 31, 2010 from http://www.medscape.com/viewarticle/496363

Fawcett, J. (2002). Jean Watson's theory of human caring. De Sales University.

Retrieved on May 31, 2010 from http://www4.desales.edu/~sey0/watson.html
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Future of Healthcare Workers Running

Words: 1902 Length: 6 Pages Document Type: Essay Paper #: 59764202

Many of them who have worked for 20 years as nurses have gone up the managerial or corporate ladder. More and more nurses have chosen more paper work and less patient care by becoming supervisors, administrators and nursing directors and then retire or else proceed to another career if they are not yet retiring (enjamin).

Compounding the problem of shortage were a lack of surgical educational content and clinical experiences for nursing students, demands for professional nurses in ambulatory care surgical settings, and the difficulty itself of attracting and maintaining per-operative nurses (eyea, 2002). Managed care also required by more intense or complex illnesses and, thus, increased workloads and greater responsibility of nurses (enjamin, 2000). The situation correspondingly raised their level of "burn out." Hospital downsizing, managed care and an emphasis on outpatient services made the medical environment less dependent on nurses and more on facilities (enjamin).

Conclusion

The fast-aging…… [Read More]

BIBLIOGRAPHY

Benjamin, G.C. (2000). The nursing shortage in crisis in health care. Physician Executive: American College of Physician Executives. Retrieved from http://findarticles.com/p/articles/mi_m0843/is_5_26/ai_102340218

Beyea, S.C. (2002). AORN's response to the nursing shortage in perspective settings.

AORN Journal: Association of Operating Room Nurses, Inc. Retrieved from http://findarticles.com/p/articles/mi_mOFSL/is_2_76/ai_90749847

Brown, G. (2003). Nursing is critically ill: why? What can be done to help alleviate the nursing shortage. Minority Nurse Newsletter: Tucker Publications, Inc. Retrieved
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Ethical Analysis Looking Into Palliative Care Strategy

Words: 1650 Length: 5 Pages Document Type: Essay Paper #: 19570167

Ethical Analysis -- Strategy for Palliative Care

The sector for healthcare has, in the last 50 years, improved in its efforts towards cost minimization and service delivery enhancement. Some elements of improvement (such as automation) ensued from technological advances. However, other elements (such as strategy application) owe their establishment in the health sector to endeavors on the part of intelligent, like-minded people who understand life's worth, and that of minimal suffering when it comes to illness. Palliative care represents one such effort. It denotes a system targeted at delivering respite from painful, disturbing symptoms through the affirmation of life and considering death to be a process. Palliative care, as defined by the World Health Organization, is an approach, which enhances quality of life (QOL) of patients, suffering from life-threatening ailments, and their family via prevention and symptom relief. This, they achieve through early diagnosis, and proper assessment and pain treatment,…… [Read More]

References

Chambers, M. (2015) The Strategic Importance of Palliative Care Within the Irish Heath Service, The Irish Hospice Foundation, http://hospicefoundation.ie/wp-content/uploads/2013/01/The-strategic-importance-of-palliative-care-within-the-Irish-health-service-Perspectives-on-future-service-delivery.pdf (Retrieved;13,12,2015)

Fromme, E., Smith, M. (2015) Ethical Issues in Palliative Care, UptoDate, http://www.uptodate.com/contents/ethical-issues-in-palliative-care (Retrieved;13/11/2015)

Gabel, S. (2010) Ethics and values in Clinical practice: Whom do they help?, Mayo Foundation and Licence Information, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084645 / (Retrieved, 13/11/2015)

Policy Directive, (2010) Palliative Care Strategic Framework 2010-2013, Ministry of Health, NSW, http://www0.health.nsw.gov.au/policies/pd/2010/pdf/PD2010_003.pdf (Retyrieved:13/11/2015)
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A concise Analysis of Madeleine Leinegers Cultural Care Theory

Words: 1445 Length: 4 Pages Document Type: Essay Paper #: 38102238

Madeleine Leineger's Cultural Care Theory

Theories are made of interrelated ideas that systematically give a systematic view about a certain phenomenon (an event or fact that is observable) that can, then, be predicted, and explained. Theories entail definitions, concepts, propositionspropositions, and models. Theories are created on the basis of assumptions. There are two ways in which theories are derived; inductive and deductive reasoning. The theory of nursing is meant to describe, explainexplain, and predict the nursing phenomenon.

It should give the bases of the nursing practice a strong foundation, thereby assisting in further creation of knowledge and show the future direction that for nursing should take. Theory is of great significance as it guides us in our decisions of what we already know as well as what we ought to know. Theory describes the nursing practice, hence giving us the foundation of nursing. The merits of a definite theory body…… [Read More]

References

Current Nursing. (2012, January 28). Application of Theory in Nursing Process. Retrieved from Current Nursing: http://currentnursing.com/nursing_theory/application_nursing_theories.html

McFarland, M., & Eipperle, M. (2008). Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings. Contemp Nurse, 28(1-2), 48-63.

Raudonis, B., & Acton, G. (1997). Theory-based nursing practice. J Adv Nurs, 26(1), 138-45.

Wayne, G. (2014, August 26). Madeleine Leininger's Transcultural Nursing Theory. Retrieved from Nurse Labs: http://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/
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Orlando's Deliberative Process Nursing Theory Applied to the Hospice Setting

Words: 599 Length: 2 Pages Document Type: Essay Paper #: 29071427

End-of-Life Care: Scholarly Nursing Practice Choice

I am an advanced practice registered nurse (APN) board-certified to practice in adult care (ANP-BC). Currently, I am employed as a nurse practitioner (NP) in palliative care within a hospice setting. Accordingly, my scholarly nursing practice is focused on the care of individual patients in need of palliative care, many of whom are in need of end-of-life care.

The phenomenon of interest that I have chosen is end-of-life care. Compared to palliative care, end-of-life care is not provided for patients receiving curative treatments or undergoing a disease process that is life-altering (Petersen, Breakwell, & Callahan, 2014). End-of-life care encompasses the principles of palliative medicine, including a focus on the patient's and family's quality of life, optimal functioning, individual growth, and care planning; however, end-of-life care will also emphasize a patient's dignity during the dying process, comfort through effective pain management, and care of family…… [Read More]

References

Faust, C. (2002). Orlando's deliberative nursing process theory: A practice application in an extended care facility. Journal of Gerontological Nursing, 28(7), 14-8.

Petersen, C.L., Breakwell, S., & Callahan, M. (2014). Palliative and end-of-life care: Precepts and ethics for the orthopaedic population. Orthopaedic Nursing, 33(3), 127-34.
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The Success of Palliative Care in the US

Words: 692 Length: 2 Pages Document Type: Essay Paper #: 17528219

Enhancing Service Delivery in U.S. Healthcare System

Any rehabilitative and chronic system aims at a cost-effective healthcare. The move towards the consideration of alternative methods to provide health care for patients emanates from the federal spending of over $2.5 trillion in 2010. The figure represents 17.6% of the nation's gross domestic product. An aging American population has demanded the need for an innovative and creative patient health care delivery system from the U.S. health care system. The new system promises to provide quality health care in a cost-effective manner that includes end-of-life care.

End-of-Life Care Environment Health Care System

Currently, the U.S. health care system primarily focuses on the provision of aggressive acute care for patients admitted to an inpatient facility. An enormous chunk of the budget spent, close to 80%, in the final months of the patients, covered costly aggressive treatments, resuscitation efforts, and ventilator support. Despite the expensive…… [Read More]

Reference

McGrath, L. S., Foote, D. G, Frith, K. H., & Hall, W. M. Cost Effectiveness of a Palliative Care Program in a Rural Community Hospital. Nursing Economics. 2013 Jul-Aug; 31(4):176-83.
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Full Spectrum Health Care as a Core Competency

Words: 666 Length: 2 Pages Document Type: Essay Paper #: 28740999

Nurse Practitioners Providing the Full Spectrum of Health Care Services

As the National Organizatoin of Nurse Practitioner Faculty (NONPF, 2013) competencies indicate, full spectrum of health care services should include health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative care and end of life care. This is a standard that is vital to primary care nursing because patients expect and have a need to obtain each of these services, as they are all part of quality care.

As the study by Flanagan-Kaminsky (2013) points out, end of life care is something that more and more patients in the Veterans Affairs Hospice program and looking to receive (p. 69). This is just one example of the type of quality care that patients and their families expect from nurse practitioners and health care providers. Counseling is another aspect of this type of care and is included in the study…… [Read More]

References

Flanagan-Kaminsky, D. (2013). Intentional Anticipatory Mourning, Caregiver and Bereavement Support Program for Terminally Ill Veterans, Their Families & Caregivers in the VA Contract Home Hospice Program. Omega, 67(1-2): 69-77.

Manheim, C., Haverhals, L., Jones, J., Levy, C. (2016). Allowing family to be family:

end-of-life care in Veterans Affairs Medical Foster Homes. Journal of Social Work in End-of-Life & Paliative Care, 12(1-2).

Matthews, A. (2014). Care of military service members, veterans, and their families.
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Analyzing Elder Care Professionals

Words: 6936 Length: 20 Pages Document Type: Essay Paper #: 15648392

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…… [Read More]

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
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Advanced Care Planning Asessment

Words: 1164 Length: 3 Pages Document Type: Essay Paper #: 32411094

Cae Planning Analysis

In eality, sound healthcae-elated advanced planning is a continuous convesation, involving pioities, values, QOL (quality of life) and what one's life means. Tool kits, in this context, compise vaious self-help esouces, woksheets, and ecommendations. They aid individuals in pefoming the moe complex tasks of identifying, confiming, and shaing impotant facts with an individual faced with a seious ailment (Ameican Ba Association, 2005). Iespective of whethe the individual is teminally ill o suffeing fom an acute ailment o chonic, long-tem ailment, advanced cae planning (ACP) is capable of facilitating the alleviation of unnecessay suffeing, impoving QOL and offeing a bette gasp of decision-elated challenges faced by the ailing individual, his/he family, and othe caegives. Advanced cae plans may be implemented at any junctue in the patient's life and must be updated when changes occu in patient cicumstances. A peson who contacts a pogessive disease that leaves him/he disabled…… [Read More]

references? A Study of the U.S. Medicare Population. Medical care, 45(5), 386.

Centers for Disease Control. (2013). Advance care planning: ensuring your wishes are known and honored if you are unable to speak for yourself. Retrieved 16 February 2016 from http://www.cdc.gov/aging/pdf/advanced-care-planning-critical-issue-brief.pdf

Wehri, K. (2011). Living well at the end of life: a national conversation. Caring: National Association for Home Care magazine, 30(9), 38.
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Healthcare Right to Die Cruzan

Words: 1056 Length: 3 Pages Document Type: Essay Paper #: 22698371



In 2001, the trial court judge stated that clear and convincing confirmation demonstrated that Ms. Schiavo would have selected not to be given life-prolonging action beneath the conditions that were present. This decision was also confirmed by the Florida appeals court and the family was deprived of a hearing by the Florida Supreme Court. When Terri Schiavo's feeding tube was taken out for the second time, in 2003, the Florida legislature fashioned Terri's Law to supersede the court decision, and the tube was for a second time put back. This law was consequently stated an illegal breach of the separation of powers (Quill, 2005).

Terri Schiavo's case fascinated the nation for quite a bit of time during March of 2005 as the dying woman laid in Florida hospice. Mrs. Schiavo had been in a vegetative condition for many years, and her husband Michael Schiavo effectively asked the Florida state courts…… [Read More]

References

Calabresi, Steven G. (2006). The Terri Schiavo Case: In Defense of the Special Law Enacted by Congress and President Bush. Retreived October 6, 2010, from Web site:

http://www.law.northwestern.edu/lawreview/v100/n1/151/LR100n1Calabresi.pdf

Cruzan v. Director, Missouri Department of Health. (2010). Retrieved October 6, 2010, from Answers Web site:  http://www.answers.com/topic/cruzan-v-director-missouri -department-of-health

Cruzan v. Director, Missouri Department of Health et.al.497 U.S. 261 (1990). Retrieved October
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Provider Education Key to Improving End-Stage Dementia Care

Words: 486 Length: 2 Pages Document Type: Essay Paper #: 27844702

Blog -- APN Quality Improvement Project

Blog: Provider-Associated Barriers to Hospice eferrals

The process of writing the quality improvement project for improving hospice referrals for patients suffering from end-stage dementia care was very instructive. eading the relevant literature revealed which research questions in dementia care are considered important by scientists and care professionals and which questions have yet to be asked. Aside from helping to outline appropriate goals for the quality improvement project, this task revealed that end-stage dementia care is a relatively understudied area of medicine. Writing the literature review also uncovered a list of best practice recommendations for palliative care, in relation to dementia, which was previously unknown to me. Overall, writing the quality improvement project helped me collect best practice recommendations authored by dementia care experts and understand the state of research in palliative care for patients suffering from end-stage dementia. This in turn increased my proficiency…… [Read More]

References

Mitchell, S.L., Miller, S.C., Teno, J.M., Davis, R.B., & Shaffer, M.L. (2010). The Advanced Dementia Prognostic Tool: A risk score to estimate survival in nursing home residents with advanced dementia. Journal of Pain and Symptom Management, 40(5), 639-51. Doi: 10.1016/j.jpainsymman.2010.02.014.

Snyder, S., Hazelett, S., Allen, K., & Radwany, S. (2013). Physician knowledge, attitude, and experience with advance care planning, palliative care, and hospice: Results of a primary care survey. American Journal of Hospice & Palliative Care, 30(5), 419-24. Doi: 10.1177/1049909112452467.
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Death & Dying - Hospice

Words: 989 Length: 3 Pages Document Type: Essay Paper #: 41884798

During that time, I cannot recall mourning, but I cannot recall feeling much of anything else, either.

My grief returned more intensely than before at the graveside service.

Afterwards, I was exhausted by the emotional flood that I had experienced, but it is equally possible that the relief was more a function of all the energy that it had required not to release during the time between my father's death and his funeral. As powerful as the feelings of outright grief were some of the more unexpected feelings I began to experience in the next few weeks: feelings of anger at my father, anger at myself, shame, totally inexplicable feelings of hurt, and fear, and also relief.

A realized for the fist time, only weeks after my father's death, that I was angry at my father: angry that he'd refused the dialysis which could have prolonged his life; angry at…… [Read More]

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The Importance of Self Management Support in Healthcare

Words: 732 Length: 2 Pages Document Type: Essay Paper #: 26931955

Chronic Disease Self-Management and Nursing oles

The scoping review on self-care in the third chapter of Doran's book and Zavertnik's article are clear, precise, and articulated based on the individual objectives to be outlined in the entire parts of the material. The scope covers all central concepts of the study. The scope covers all the selected study areas, notably the selected study populations and the targets populations. Nonetheless, the common difference between the two is that the Doran review offers a rather larger scope unlike that offered in Zavertnik's review (Zavertnik, 2014). Much of Doran's review is within the range of the study participants, rather convenient in nature (Doran, 2011). In contrast, the scope is dispersed in Zavertnik's review. The two reviews elicit the desire to influence audience not just within the periphery of its study but from all over the spheres of the world. The definitions are detailed since…… [Read More]

References

Doran, D.M. (2011). Nursing Outcomes. The State of the Science. Second Edition. Soudberry, MA: Jones & Bartlett Learning

Zavertnik, J. E. (2014). Self-care in Older Adults with Heart Failure: An Integrative Review. Clinical Nurse Specialist: 19-32
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Health Care Leadership

Words: 725 Length: 2 Pages Document Type: Essay Paper #: 23835953

Leadership is paramount in the more globalized economic structure. Companies are now expanding into emerging markets at a very rapid pace. Competition from markets including China, India, and Brazil, now create a more competitive dynamic in regards to labor. Companies need leaders who can flourish irrespective of their geographic locations. Leaders now must also be cognizant of cultural values as they attempt to inspire and motivate their personnel. An awareness of individual leadership strength and weaknesses is therefore needed to navigate a constantly changing and dynamic environment. A self inventory of corresponding strengths and weaknesses will allow the future leader to be better prepared for many of the more complex aspects of leadership (Spillane, 2004).

While reading the leadership styles inventory, a litany of concepts emerged. For one, my style is not that of an authoritarian but rather that of a cooperative, collectivistic leader. I prefer to work alongside my…… [Read More]

References:

1) House, Robert J. (1971). "A path-goal theory of leader effectiveness." Administrative Science Quarterly (Johnson Graduate School of Management, Cornell University) 16 (3): 321 -- 339

2) Paul C. Dinsmore et al. (2005) The right projects done right! John Wiley and Sons, 2005. ISBN 0-7879-7113-8. p.35-42

3) Spillane, James P.; et al., Richard; Diamond, John (2004). "Towards a theory of leadership practice." Journal of Curriculum Studies 36 (1): 3 -- 34

4) Lewis R. Ireland (2006) Project Management. McGraw-Hill Professional, 2006. ISBN 0-07-147160-X p.110- 116
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ANA Nursing Code of Ethics ANA Code

Words: 1795 Length: 5 Pages Document Type: Essay Paper #: 61337630

ANA Nursing Code of Ethics

ANA Code of Ethics Applied to Current Practice Philosophy

The objective of this study is to discuss provisions one through nine of the ANA Code of Ethics and apply it to the current practice philosophy. A well this work will discuss provisions seven through nine of the ANA Code of Ethics and apply it to the current practice philosophy and answer how the two relate. The differences between professional responsibility and accountability in the nursing practice will be discussed and examples provided. Finally, this study seeks to answer after what has been learned in addition to readings and self-assessment activities what can be implemented in the practice that would strengthen this experience for one's peers and in terms of self-development on the Novice to Professional continuum.

The American Nurse Administration Code of Ethics Provision One states that the nurse practices, in all professional relationships "with…… [Read More]

References

Bamford, M, Wong CA and Laschinger H (2012) The Influence of Authentic Leadership and Areas of Worklife on Work Engagement of Registered Nurses. J Nurs Manag 2012 26 Apr. Retrieved from:   http://www.ncbi.nlm.nih.gov/pubmed/?term=nurse+ethics  

Butts, JB (nd) Ethics in Professional Nursing Practice. Chapter 3. Jones and Bartlett Publishers. Retrieved from:  http://www.jblearning.com/samples/0763748986/48986_ch03_pass3.pdf 

Code of Ethics for Nurses with Interpretive Statements (2010) Nursing World. Retrieved from: http://nursingworld.org/FunctionalMenuCategories/AboutANA/Leadership-Governance/Nursing-Code-of-Ethics.pdf

Dahnke, MD (2009) The Role of the American Nurses Association Code in Ethical Decision Making. Holist Nurs Pract 2009. Mar-Apr;23(2):112-9. Retrieved from:  http://www.ncbi.nlm.nih.gov/pubmed/19258853
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Resuscitate DNR as a National

Words: 2548 Length: 8 Pages Document Type: Essay Paper #: 87860891

When patients with chronic or acute illness in the setting of a severe chronic illness with a declining functionality so that death is expected within days to weeks, no CP will be initiated.

The keys to the policy are severely chronic illness as represented by the patient's declining functionality; and that death is imminent. It is a policy that advocates the right of a patient to forego life sustaining technology and intervention in what is constituted as legal death when the patient's heart stops and, without CP which could ostensibly revive the patient to life, is final death for the patient. The policy resolves decisions of the healthcare provider and the healthcare staff to act in response to the patient's cessation of life.

Today, unless a DN order is signed by the patient or the patient's family rights designee, then the hospital staff responds to the cessation of patient life…… [Read More]

Reference List

Dubbler, N. And Nimmons, D. (1993). Ethics on Call: Taking Charge of Life and Death

Choices, Harmony Books/Crown Publishers, New York: New York.

Jones, M. And Marks, L. (1999). Disability, Divers-ability, and Legal Change, Martins

and Nighoff Publishers, Kluwer Law International, The Hague, Netherlands.
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Transitioning From Closed to Open Systems How

Words: 1191 Length: 4 Pages Document Type: Essay Paper #: 45973265

Transitioning From Closed to Open Systems: How Effective Nurse Leaders Approach Problem Solving and Decision Making in Organizations

The objective of this study is to examine transitioning from closed to open systems and how effective nurse leaders approach problem solving and decision making in organizations. This study will utilize systems theory in identifying an issue or process that could be improved and apply knowledge and strategies related to systems theory.

The problem addressed in this study is the excessive trust vested in unlicensed personnel resulting in some to make decisions reserved to licensed health professionals.

Responsibilities of the Nurse Manager

It is reported that the licensed nurse manager or supervising nurse has the responsibility to "delegate professional responsibilities only to persons who are qualified by education, experience or licensure to carry out the responsibility." (New York Office of the Professions, Division of Professional Licensing Services, 2009, p.27) It is additionally…… [Read More]

Works Cited

2013 NACNS Annual Conference: Clinical Nurse Specialists Leading Innovation for Healthcare Change. April 2013. Vol. 27. No. 2. Retrieved from: http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1505534

Explanation of RN Scope of Practice and Nurse Practitioner Practice (1996) Board of Registered Nursing, Sacramento, CA. Retrieved from:   http://www.rn.ca.gov/pdfs/regulations/npr-b-19.pdf  

Health Care Liability and Inju8red Patients and Families Compensation. (2013) State of Wisconsin. Chapter 655. Retrieved from:   https://docs.legis.wisconsin.gov/statutes/statutes/655.pdf  

Nursing Guide to Practice (2009) New York Office of the Professions, Division of Professional Licensing Services. Retrieved from:   http://www.op.nysed.gov/prof/nurse/nurse-guide-april09.pdf
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Communication Nurse to Doctor

Words: 1938 Length: 6 Pages Document Type: Essay Paper #: 19907074

Communications

Effective communications between doctors and nurses has always been a high priority in the medical field, especially in an arena such as a hospital, health clinic or hospice. Communicating effectively between the nurses and the doctors is especially important in a hospice setting due to the fact that the patient is usually suffering the most; both with the physical and the emotional pain and suffering that is being experienced as the patient nears death.

One recent study determined that "doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients" (Mccullough, Mckinlay, Barthow, Moss, Wise, 2010, p. 482) and the treatment choices when facing death are decisions that should not be taken lightly, either by the involved nurses or the doctors. The decisions taking place in the hospice setting will often determine how much pain and suffering the patient will endure…… [Read More]

References

Basch, E.; (2010) The missing voice of patients in drug-safety reporting, New England Journal of Medicine, Vol. 362, Issue 10, pp. 865-869

Bezzina, A.J.; (2009) Prevalence of advance care directives in aged care facilities of the Northern Illawarra, Emergency Medicine Australia, Vol. 21, Issue 5, pp. 379 -- 385

Byrnes, J.; Braden, J.; James, G.; Broadus, T.; Owen, R.; (2011) Implementing an electronic medical record (EMR) in an integrated delivery system Sharp Healthcare (SHC) San Diego, California, accessed on September 25, 2011 at http://proceedings.amia.org/1alo2n/

David, S.E.; Ahmed, Z.; Salek, M.S.; Finlay, A.Y.; (2005) Does enough quality of life related discussion occur during dermatology outpatient consultations? The Journal of Dermatology, Vol. 153, pp. 997 -- 1000
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Nursing Literature

Words: 1675 Length: 5 Pages Document Type: Essay Paper #: 48611587

McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.

Are there any HIPAA concerns that are evident in this study?

Both caregivers and patients were required to sign informed consent documentation in order to participate in the study. Were any concerns related to HIPAA indicated in the protocol or procedures for conducting the study, those concerns would need to be delineated in the consent documents and explained to the participants. Since caregivers were an integral component to the hospice care and quality of life measures for patients, patient privacy could be maintained just as with any other medical or healthcare services.

What methods were put in place to ensure that the subjects were giving true informed consent?

The inclusion criteria and protocol for participating in the study required that patients and caregivers both be…… [Read More]

References

McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.

Rosedale, M., & Fu, M.R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors. Oncology Nursing Forum, 37(1), 28-33.
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Intervention Nursing Research Using the Cope Intervention

Words: 569 Length: 2 Pages Document Type: Essay Paper #: 70400760

Intervention

Nursing esearch

Using the COPE Intervention for Family Caregivers to Improve Symptoms of Hospice Homecare Patients: A Clinical Trial

This study was designed to test an intervention for hospice caregivers in order to help them better manage symptoms experienced by patients with cancer. The authors maintain that research indicates caregivers are unable to accurately assess and report the intensity of symptoms and overall quality of life (QOL) of patients with cancer and patients in hospice care.

Three symptoms, pain, dyspnea, and constipation, are commonly are seen in patients with advanced cancer. However, the author's site research that asserts that these symptoms are assessed inadequately and managed poorly in many patients. Pain and dyspnea have been found to create symptom distress, significantly affecting patient QOL.

The authors claim that caregivers must develop the skills needed to function effectively as part of the healthcare team. Building the knowledge base and teaching…… [Read More]

References

McMillan, S.C. & Small, B.J. (2007, March). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: A clinical trial. Oncology nursing forum, Vol. 34, Issue 2, 313-321. Retrieved January 20, 2012, from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&hid=14&sid=b3e07ee7-388a-4d19-97ef-163b481297fd%40sessionmgr15
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Jody Smith Application of the Moral MODEL& 8230

Words: 2443 Length: 5 Pages Document Type: Essay Paper #: 21510385

Jody Smith: Application of the Moral Model…

Applying Ethical Decision Making Model

"Jody Smith Case Study: Application of Thiroux's Moral Model"

The decision making model that will be applied in this work is the Moral Model (Thiroux 1977) and the case it will be applied to is the Jody Smith case. The reason this model was chosen is because the model lends itself best to a situation, such as Smith's where an impasse has been reached between the patients values and desires and that of family and the health care team. In this case the ethical dilemma is one clearly of informed consent as Smith has been excluded from conversations associated with her prognosis and care and this is contrary to her values and her identity. Without inclusion of this communication standard Smith has very little to go on regarding her prognosis and may be seeing her situation as insurmountable…… [Read More]

References

Burkhardt, M. & . (2008). Ethics issues in Contemporary Nursing. Clifton Park: Delmar.

Chorney, J., McGrath, P., & Finley, G. (2010). Pain as the neglected adverse event. CMAJ: Canadian Medical Association Journal, 182(7), 732. Retrieved from EBSCOhost.

Guido, G.W. (2010). Legal & Ethical Issues in Nursing (5 ed.). Vancouver, Washington: Julie Levin Alexander.

King, J.S., Eckman, M.H., & Moulton, B.W. (2011). The Potential of Shared Decision Making to Reduce Health Disparities. Journal of Law, Medicine & Ethics, 3930-33. doi:10.1111/j.1748-720X.2011.00561.x
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Nursing Organizational Change Project Analysis

Words: 2505 Length: 6 Pages Document Type: Essay Paper #: 6658800

Of course, as Medicare beneficiaries increase because of the number of baby boomers, the Medicare program may adjust. However, current hospice figures demonstrate that only about twenty percent of all elderly individuals that die are enrolled in hospice programs.

Implementation and Monitoring

The needs of this new program will require thorough training and once implemented, precise monitoring. "When you approach a problem in the way your work group functions, you're implementing an organizational change. By taking a critical look at your process, and using some theories from organizational design, you can fix the problem -- and change your organization to make quality more likely." (Derby, 1999) The training will be a key because of the potential requirements associated with the Hospice program that may require completely new skill sets for the majority of our staff. The fact is that many of our nurses may not have acquired the necessary skills…… [Read More]

References

Derby, Esther. (2002). Modeling Organizational Change. Retrieved on February 12, 2005, at http://www.estherderby.com/writings/modeling.htm

Hospice Benefits and Utilization in the Large Employer Market. Ed. Beth Jackson, Teresa Gibson, Joline Staeheli. March 2000. U.S. Department of Health and Human Services. Retrieved on February 12, 2005, from http://aspe.os.dhhs.gov/daltcp/Reports/empmkt.htm.

Rubenfeld, M. Gaie, & Scheffer, B.K. (1995). Critical Thinking In Nursing. Philadelphia: JB Lippencott.

Social Security Administration. (1993) "Social security programs in the United States." Social Security Bulletin 12/22/1993.
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ADN vs BSN Abstract High

Words: 1434 Length: 5 Pages Document Type: Essay Paper #: 60583369

Patients also say they want to awake and conscious when their pain is managed. The issue is that there are not many U.S. physicians and nurses who are certified to extend palliative care. There are only 33 physicians and only 41 nurses for every 10,000 patients (Peres).

The hospice movement has been changing the face of care for people at the end-of-life stage (Radulovic 2004). Hospices have been providing options and choices to these patients for the last three decades. The hospice movement began in the UK but spread to America in response to the need for more compassionate care for the dying and terminally ill. A hospice is not a place but a concept of palliative and support services for the terminally ill to be cared for primarily at home. A home can be the patient's residence or that of a loved one, a long-term care facility. It provides…… [Read More]

Bibliography

Bone, Roger C. Analysis of Indications for Intensive Care Unit Admissions. Chest:. American College of Chest Physicians, December 1993

Earl, C et al. "Rise in Aggressive Treatment." Trends in the Aggressiveness of Cancer Care Near the End of Life. Journal of Clinical Oncology:. Springhouse Corporation, 2007

Peres, Judith. U.S. End-of-Life Gets Passing Grade. Health Care Benchmarks and Quality Improvement: American Health Consultants, Inc., 2003

Radulovic, Jan.W. Trends in Hospice and Palliative Care in the United States and Kansas. Kansas Nurse: Kansas State Nurses Association, 2004
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Vocational Nurse in Multi-Disciplinary Palliative

Words: 516 Length: 2 Pages Document Type: Essay Paper #: 71585166



Most palliative care vocational nurses are generalists. However, there are specialties in palliative care, such as oncology and geriatrics. Hospice and palliative care nurses can become Certified Hospice and Palliative Nurses (CHPN).

Palliative nurses practice in a variety of settings. The most common setting is the patient's home. Palliative nurses also work in the hospice units of medical facilities, such as hospitals, nursing homes, and other long-term care settings. Patients typically die within a month of enrolling in a hospice program. In contrast, palliative care nurses are more likely to practice in long-term care facilities and have more extended involvement in their patients' end of life.

In order to be an effective palliative care nurse, the vocational nurse needs an understanding of a specific group of practice areas. Those areas include: pain management, end-stage disease process, loss and grief, and bereavement care. However, in addition to medical knowledge, palliative care…… [Read More]

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End-Stage Heart Disease Thee Study

Words: 337 Length: 1 Pages Document Type: Essay Paper #: 6838715

Other limitations which further hindered the analytical strength of the study, was the fact it was conducted only in one hospital.

The suggestions provided by the researchers in the conclusion of the study are both enlightening and appropriate to further study and methodology of care giving within hospice. The designers of this research propose the idea that hospice care should include attention towards a patient's physical symptoms, but also their psychological symptoms which are bound to be prevalent within the atmosphere of a hospice. Attention geared towards the patient's psychological wellness will greatly improve the quality of life which the patient must endure while awaiting the inevitable inside the hospice walls. These conclusions and suggestions, although somewhat of a transgression from the primary focus of the study, are important for the truth they hold within them.

eferences

McMillan, Susan C., Dunbar, Sandra, B., Zhang, Weihua. (2007). The prevalence of symptoms…… [Read More]

References

McMillan, Susan C., Dunbar, Sandra, B., Zhang, Weihua. (2007). The prevalence of symptoms in hospice patients with end-stage heart disease. Journal of Hospice and Palliative Nursing. 9(3).
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Sociology Social Work Questions Explain Why Children in

Words: 3101 Length: 8 Pages Document Type: Essay Paper #: 47993954

Sociology/Social Work Questions

Explain why children in the early-school-aged period may be especially vulnerable to fluctuations in self-esteem and feelings of "worthlessness."

Young children, in the early school aged years are in a developmental stage that is focused on feelings of identity and self-esteem (Nutbrown & Clough, 2009, p 191). It is during the early years of school that children begin to form concepts of identity through a sense of belonging as well as through the demonstration that they are needed by others in their community, and especially those they hold in high regard, peers and teachers. They seek to demonstrate for themselves that they play an important role in their own lives and communities to help them establish a sense of self. In other words they seek almost above all else to establish that they are valuable and have purpose in their community and especially in school as this…… [Read More]

References

Barker, E.D., Tremblay, R.E., Nagin, D.S., Vitaro, F., & Lacourse, E. (2006). Development of male proactive and reactive physical aggression during adolescence. Journal Of Child Psychology And Psychiatry, 47(8), 783-790. doi:10.1111/j.1469-7610.2005.01585.x

Craig, W.M., Vitaro, F., Gagnon, C., & Tremblay, R.E. (2002). The road to gang membership: Characteristics of male gang and nongang members from ages 10 to 14. Social Development, 11(1), 53-68. doi:10.1111/1467-9507.00186

Emanuel, E.J., & Emanuel, L.L. (1998). The promise of a good death. Lancet, 351(9114), SII21.

Hamachek, D. (1990). Evaluating self-concept and ego status in Erikson's last three psychosocial stages. Journal Of Counseling & Development, 68(6), 677-683.
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Compliance Issues in OIG 2012 Work Plan

Words: 625 Length: 2 Pages Document Type: Essay Paper #: 14779187

Compliance Oversight

As the compliance officer at ABC Hospital, one of my major tasks is to research the Office of the Inspector General (OIG) website to locate the 2012 plan with a view of identifying compliance issues under review by the OIG. Generally, the Office of the Inspector General Work Plan establishes several projects to be dealt with during the financial year by the Office of Audit Services and other agencies or departments. The Work Plan has considerable impacts on each of its major entities including the public health agencies. While the information in the Work Plan is offered on projects associated with issues that intersect departmental programs, some of these projects are statutorily mandated.

ole of OIG egarding Hospital Compliance

The Office of the Inspector General was established in 1976 by the U.S. Department of Health and Human Services to play a crucial role in the country's efforts toward…… [Read More]

References

Gossett, D. (2008, March 26). OIG Issues Guidelines for Hospital Compliance Programs.

Retrieved February 15, 2015, from http://corporate.findlaw.com/law-library/oig-issues-guidelines-for-hospital-compliance-programs.html

"Summary of the OIG 2012 Work Plan." (2011, October 6). Health Law News. Retrieved February 15, 2015, from http://www.hallrender.com/library/articles/924/100611HLN.html
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Sanford J Townsend-Rocchicciolli J horigan A & Hall

Words: 932 Length: 2 Pages Document Type: Essay Paper #: 48563261

Sanford, J., Townsend-Rocchicciolli, J.,Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70.

Describe the population for this study.

participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities. The participant had to be related to the patient with heart failure (HF), provide one activity of daily living, and/or assist the care recipient with two activities of daily living and do this voluntarily.

How was the sample selected? What are the strengths and weaknesses of this sampling strategy?

This was a convenience sample. The participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities and had to meet certain conditions. The strengths are that the researchers know and get precisely what they are looking for (in terms of qualifications of participants). The weaknesses are that…… [Read More]

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Nurse in the Provision of

Words: 1468 Length: 5 Pages Document Type: Essay Paper #: 98744504

It is related that "This patterns of delayed referral does more than deprive individuals of palliative care-it jeopardizes hospice programs themselves. To be financially viable, hospice programs, which receive per diem reimbursements, must be able to balance out the high initial costs of services to new patients with the lower costs of maintaining stabilized patients." (Open Society Institute - Project on Death in America, 2007) Finally, it is related that "high quality end-of-life care depends upon an integrated network of in-hospital, out-patient, home and nursing home services." (Open Society Institute - Project on Death in America, 2007) Issues requiring research which present barriers to the provision of comprehensive quality palliative care include the issues as follows: (1) How does the six-month eligibility requirement affect patient access to end-of-life care?; (2) What is the impact of delayed referrals on hospice services?; (3) Are there cost incentives within HMOs to rush patients…… [Read More]

Bibliography

Thomas, Keri Dr. (2003) Caring for the Dying at Home: Companions on the Journey. Chapter Five Excerpts. Online available at http://www.goldstandardsframework.nhs.uk/content/guides_and_presentations/Evidence_base.doc

Cramer, LD et al. (2003) Nurse's Attitudes and Practice Related to Hospice Care. J Nurs Scholarsh. 2003;35:249-255

Wright, K. (2002) Caring for the Terminally Ill: The District Nurse's Perspective. Br J. Nurs. 2002;11:1180-1185

Palliative Care (2007) Nursing Matters - Fact Sheet. Online available at http://www.icn.ch/matters_palliative.htm
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Program Budget and Cost Analysis

Words: 4858 Length: 16 Pages Document Type: Essay Paper #: 97749747

Program Budget and Cost Analysis

Line-Item Budget for an in-Service Dementia Care Training Program

Florida now requires all direct-care staff working with dementia patients to receive specialized training. The curricula offered must be vetted by the Training Academy of the University of South Florida's Policy Exchange Center on Aging, otherwise assisted living facilities, nursing homes, adult day care, and hospices will be unable to accept patients with dementia into their facilities. In order to meet these statutory requirements and improve patient care, an in-service training program in dementia care will be instituted for a hospice facility located in Florida.

The Hospice House in Cape Coral, Florida maintains 36 beds for patients with terminal illnesses. On average, a little over 60% of the residents suffer from dementia at any one time, which is consistent with national trends (Williams, Hyer, Kelly, Leger-Krall, and Tappen, 2005, p. 98). The number of patients tends…… [Read More]

References

CMS (Centers for Medicare & Medicaid Services). (n.d.). Hospice Center. CMS.gov. Retrieved 13 Mar. 2012 from www.cms.gov/Hospice/Downloads.2011_Aggregate_Cap.pdf.

Goyder, Judith, Orrell, Martin, Wenborn, Jennifer, and Spector, Aimee. (2012). Staff training using STAR: A pilot study in UK care homes. International Psychogeriatrics, published online ahead of print, p. 1-10. Retrieved 13 Mar. 2012 from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8473487.

Hobday, John, V., Savik, Kay, Smith, Stan, and Gaugier, Joseph E. (2010). Feasibility of internet training for care staff of residents with dementia: The CARES® Program. Journal of Gerontology Nursing, 36, 13-21.

Hyer, Kathryn, Molinari, Victor, Kaplan, Mary, and Jones, Sharmalee. (2010). Credentialing dementia training: The Florida experience. International Psychogeriatrics, 22, 864-873.
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Deaf Community and Its Need

Words: 3490 Length: 13 Pages Document Type: Essay Paper #: 23751505

Equally destructive is the attitude that communicating with the Deaf person may involve more time and effort than one wishes to expend" (Zieziula, 1998, p. 193).

Moreover, and perhaps one of the most important challenges related to this issue, a large percentage of deaf individuals do not trust the hearing society. "Historically, the dominant hearing culture has relegated deaf people to social categories such as "handicapped" and "outsider." The history of oppression and exclusion of the deaf community -- although with important variations depending on the countries -- and the ignorance and rejection of the natural and preferred means of communication of many of them is a well-known and many times denounced phenomenon," (Munoz-Baell & uiz, 1999, p. 1).

Finally, there is a real deficiency of information in Deaf culture regarding hospice and its related services. Finding appropriate facilities can be a time-consuming and frustrating process.

The program: breaking down…… [Read More]

REFERENCES

Berke, J. (2009). Deaf Awareness Week. Retrieved April 10, 2010, from the About.com Website: http://deafness.about.com/cs/events/a/deafawareness.htm

Deaf Community Health Workers Provide Education and Support to Deaf Patients, Facilitating

Access to Linguistically and Culturally Appropriate Care, Improving Patient Health

Knowledge and Adherence to Recommended Care. (2005.) Retrieved April 10, 2010, from the AHRQ Health Care Website: http://www.innovations.ahrq.gov/popup.aspx?id=2757&type=1&name=print
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Ethics as a New Graduate of Six

Words: 1279 Length: 5 Pages Document Type: Essay Paper #: 28819049

Ethics

As a new graduate of six months working night shift on a small cancer unit, I am faced with a dilemma. Mr. V has been in and out of the unit several times over the last few months. He has liver cancer and has gone through several episodes of chemotherapy. His wife has been staying with him since his admission. There are two RN's on this unit.

Mr.V recently joined the hospice program. His current admission is for pain control with orders to start a morphine drip to be regulated for pain control.

The only set parameters indicated by hospital policy are to decrease the drip when respirations are less than twelve breaths per minute. Mr. V has requested that the drip be increased several times during my shift. Even though he does not appear to be in any discomfort, I increase the drip. On my final round of…… [Read More]

Bibliography

Strevy, S.S. Myths & facts about pain. RN, 42-45. 1998, February.

C. Junkerman and D. Schiedermayer, Practical Ethics for Students, Interns, and Residents, 2nd Ed, Frederick, MD: University Publishing Group, 1998.

American Nurses Association. Code for Nurses With Interpretive Statements. Kansas City, MO: the Association. 1985.

Strevy, S.S. (1998, February). Myths & facts about pain. RN, 42-45.
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Elephant in the Room Project Is a

Words: 1776 Length: 5 Pages Document Type: Essay Paper #: 71607124

Elephant in the oom Project is a research that was conducted for the purpose of improving the efficiency of care through effective and compassionate communication with palliative care patients. The research recognized that nursing is not only a science but also an art that requires the development of both aspects unlike the increased emphasis on the development of nursing science. As suggested by the definition of the art of nursing, the existence of effective caring requires the establishment of a trusting and therapeutic relationship between nurses and patients. Such a relationship can only be developed through effective communication that will enable the patients to view nurses as warm, genuine, and empathic professionals. In order to achieve its goals, the elephant in the room project consisted of evidence-based practice and use of various data collection strategies, methodology and sample.

Evidence-Based Practice:

In palliative care, communication acts as an important factor in…… [Read More]

References:

Betcher, D.K. (2010, March/April). Elephant in the Room Project: Improving Caring Efficacy

through Effective and Compassionate Communication with Palliative Care Patients. MEDSURG Nursing, 19(2), 101-105.

"Communication." (n.d.). National Palliative Care Research Center. Retrieved March 6, 2012,

from http://www.npcrc.org/program/program_show.htm?doc_id=375935
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Population in the United States

Words: 580 Length: 2 Pages Document Type: Essay Paper #: 55697997

They are noo logner able to live; it is the etchial obligation of the hostpital staff to ensure that they die in peace. t is cruaical, tehore, we work towards and test methods for alleviating pain.

mplementation of 48-hour Pain Management System in Hospice Care

The American Pain Society (APS) issued a set of guidelines in the 1990s intended to standardize and improve pain management, thereby providing a framework for assessing care quality. n January 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to assess pain management as part of its accreditation process, through the use of evidence-based standards ( Gordon et al., 2002). n 2002, a set of six consensus pain management standards were revealed by a meta-analysis of 20 research studies from 1992-2001 (Gordon et al., 2002). These were (1) the use of a numeric or descriptive scale to represent pain intensity, (2) frequent pain…… [Read More]

Implementation of 48-hour Pain Management System in Hospice Care

The American Pain Society (APS) issued a set of guidelines in the 1990s intended to standardize and improve pain management, thereby providing a framework for assessing care quality. In January 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to assess pain management as part of its accreditation process, through the use of evidence-based standards ( Gordon et al., 2002). In 2002, a set of six consensus pain management standards were revealed by a meta-analysis of 20 research studies from 1992-2001 (Gordon et al., 2002). These were (1) the use of a numeric or descriptive scale to represent pain intensity, (2) frequent pain checks, (3) avoidance of intramuscular analgesics, (4) regular analgesic administration and preferably multimodal in nature, (5) keeping the patient informed about the pain management approach, and (6) treating with the goal of improving function and quality of life.

Such efforts to identify benchmarks or key performance measures (KPM) were intended to address many significant shortcomings related to effective pain management. A series of reports in the 1990s revealed these shortcomings and they included inadequate pain management, lack of coordinated care, and shortsightedness in terms of the long-term costs (Twaddle et al., 2007). In the past, palliative care would also be deferred until it became obvious the patient was dying. In essence,
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Incentives Increase the Quality of

Words: 11168 Length: 41 Pages Document Type: Essay Paper #: 71622257

¶ … Incentives Increase the Quality of Care Provided by Physicians

The Impact of Financial Incentives on Physician Behavior

In order to understand the current problem faced by physicians regarding Managed Care Organizations (MCOs), it is important to take a look into the background of the concern. Before managed care came about, indemnity plans and fee-for-service plans were dominant in the area of physician reimbursement. Payment for the services rendered by a physician was made regardless of the diagnosis made or the number of tests run. Individuals expected to pay the physician when their appointment was over, or they expected to make their co-payment and let their standard insurance company pick up the rest of the bill.

Over-billing -- charging either too much for the service provided, or charging for services that were never provided -- was a problem, because there were not any safeguards in place to stop physicians…… [Read More]