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Job Stress and Burnout among Intensive Care Unit Nursing Staff
In the last few centuries, we have witnessed major transformations in the health and nursing sector, especially regarding the scope of job and technological advances. The drastic change has not been without difficulties, the most notable of which is emotional stress. Such stress can compromise the safety of the patients and the health of the health care providers (Aiken et al., 2012). Stress can be defined as an internal or environmental event that an individual or social system can no longer adapt to. Stress comprises both psychic and organic changes that are of importance to the cognitive system. When confronted with stress, the human body automatically employs strategies in a bid to alleviate the damning effects of the situation. When these strategies fail, the result may be a burnout syndrome. This is basically the emotional exhaustion that comes as a…
Opening visiting hous in the Intensive Cae Unit Hamful o Helpful to the Patient
As the healthcae system stats making that move in the diection of a client-diven model, opening visiting hous ae becoming a topic of discussion and inteest. Studies that go all the way back to the 1970s has poduced agument and conjectue ove the pefect visiting pactices in the adult intensive cae unit. This liteatue exploes the effects of having a policy that is fo opening visiting hous and how it has an effect on the patients.
Accoding to vaious studies, eve since the 1970s, thee has been visiting pactices in intensive cae units (ICU) that goes all the way back to a time whee it was not talked about much. Ove the last 10 yeas, thee has not been enough eseach o data that could measue this issue of opening visiting hous being hamful o helpful…
references of patients in the intensive care unit and in a complex care medical. American Journal of Critical Care, 55-65.
Livesay, S.G. (2004). Nurses' perceptions of public visiting hours in neuroscience intensive care unit. Journal of Nursing Care Quarterly,, 182-189.
Neonatal Intensive Care Units
Phenomenon of Interest
The phenomenon of interest involved in the study relates around current and past healthcare environments, specifically within the neonatal care unit. It is a field that is very specific, but also very vulnerable to being negatively affected by any issues or snags within the delivery of neonatal care to infants and new mothers. Given the sensitivity of the field, this particular article aims to help increase the strength of healthcare strategies involved in caring for new babies. Benoit and Semenic (2014) are very clear in identifying their phenomenon of interest. Essentially, they explain that there are certain factors that influence success of neonatal care strategies in both positive and negative ways. Healthcare professionals often spread their biases regarding infants and breast feeding practices, which then influence the breastfeeding behaviors of the mother. This is especially true for cases seen in intensive care. The…
Benoit, Britney & Semenic, Sonia. (2014). Barriers and facilitators to implementing the baby-friendly hospital initiative in neonatal intensive care units. Journal of Obstetric, Gynecologic, and Neonatal Science, 0(2014), 1-11.
LoBiondo-Wood, Geri & Haber, Judith. (2009). Nursing Research: Methods and Critical Appraisals and Utilizations. Mosby.
The experience of Fumagalli et al.(2006) was similar: when open and flexible visiting hours were permitted, patients and visitors seemed more content (Fumagalli et al., 2006).
ICU staff, on the other hand, insist on maintaining restrictive visiting policies on the grounds that liberal visiting hours may distract caregivers, whilst increasing the patient's stress and risk of septic complications.
The issue remains an agonizing and constantly debated point of contention amongst physicians, nurses, visitors, and patients. Some practitioners insist that the decision to restrict visiting hours is neither caring nor compassionate (Fumagalli et al.,2006). On the other hand, as they themselves say their trial was small and larger randomized trials need to occur before conclusions are drawn. In the meantime, open and flexible visitation hours are constantly demanded, and permission, as constantly, withheld.
Berti, P., Ferdinando, D. & Moons, P. (2007). Beliefs and attitudes of intensive care nurses toward visits…
Berti, P., Ferdinando, D. & Moons, P. (2007). Beliefs and attitudes of intensive care nurses toward visits and open visiting policy Intensive Care Medicine, 33, 1060-1065,
Brannon, L. & Fesist, J. (207). Health Psychology. Thomson / Wadsworth, USA.
Fumagalli, S. Boncinelli, L., Lo Nostro, P. et al. (2006) Reduced Cardiocirculatory Complications With Unrestrictive Visiting Policy in an Intensive Care Unit
Circulation, 113, 946-952
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
The emphasis is on normal, everyday activities provided for residents. According to the authors, however, little research has been conducted to investigate the actual effect of such activities and settings upon residents. The assumption is that such settings have a better effect that traditional institutions, but there is little empirical research to support this.
Hence, Verbeek et al. (2010) conducted a study to compare small-scale living with regular care in nursing homes in the Netherlands. Interestingly, they found no significant difference between the quality of life experienced by residents in traditional institutional settings and those in small-scale living facilities. Furthermore, there was also no significant difference in the job satisfaction levels of nursing staff between both types of institution was found. Another important aspect, namely neuropsychiatric symptoms and agitation were also significantly similar for both institution types. According to the authors, a difference was found in the satisfaction level of…
Gaugler, J.E. (2005, Mar.). Family Involvement in Residential Long-Term Care: A Synthesis and Critical Review. Aging and Mental health, Iss. 9, vol. 2. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247412/
Lyness, J.M., Yu, Q., Tang, W., Tu, X., and Conwell, Y. (2009, Dec.). Risks for Depression Onset in Primary Care Elderly Patients: Potential Targets for Preventive Interventions. American Journal of Psychiatry. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982671/
Simonazzi, a. (2009, Jun). Home care and cash transfers. Effects on the elderly care-female employment trade-off. Retrieved from: http://www.aiel.it/bacheca/SASSARI/papers/simonazzi.pdf
Verbeek, H., Zwakhalen, S.M.G., Van Rossum, E., Ambergen, T, Kempen, G.I.J.M., and Hamers, J.P.H. (2010, Nov.). Dementia Care Redesigned: Effects of Small-Scale Living Facilities on Residents, their Family Caregivers, and Staff. American Medical directors Association. Retrieved from: http://www.unimaas.nl/hcns/websiteVW/publications/Publication%20scans/Verbeek.%20Dementia%20care%20redesigned.pdf
Futile medical care is the ongoing provision of medical treatment or care to a patient who does not show any hope of recovery. It is either that his condition is not curable and therefore the treatment that he is receiving is of no benefit. The common examples of these are that a surgeon is performing a surgery on a patient with terminal cancer. Patients who have terminal cancer have gotten the cancer spread all throughout their body. It is only until time that their organs will go into failure and they will pass away. Another example is of keeping brain dead people on life support for other reasons. As it would be expected, this is quite a sensitive area and it would involve arguments with the patient's relatives and friends.
It is understandable that the loved ones do want to do anything they can to keep the patient in front…
Appel, J. (2009). What's So Wrong with "Death Panels"?. [online] Retrieved from: http://www.huffingtonpost.com/jacob-m-appel/whats-so-wrong-with-death_b_366804.html [Accessed: 26 Jul 2013].
Doyle, D. (2010). WebmedCentral.com:: Baby K. A Landmark Case In Futile Medical Care. [online] Retrieved from: http://www.webmedcentral.com/article_view/969 [Accessed: 26 Jul 2013].
Gardent, P. And Reeves, S. (2009). Ethics Conflicts in Rural Communities: Allocation of Scarce Resources. [e-book] Lebanon, NH: University Press of New England. http://geiselmed.dartmouth.edu/cfm/resources/ethics/chapter-09.pdf [Accessed: 26th July, 2013].
Pomerance, J., Morrison, A., Williams, R. And Schifrin, B. (1989). Anencephalic infants: life expectancy and organ donation.. Journal of perinatology, 9 (1), pp. 33-37.
Flows in Health Care
Since the government had started the practice of handing over major departments to private sector like health care and education, these areas are now more focused on employing techniques that can draw major profit flow. On examining the three crucial aspects of profit earning such as the number of patients, quality of staff and management, we come to a conclusion that all three areas go side by side and need to be checked upon regularly (Michael, 2006 ).
The numbers of patients are important, to a hospital; patients are the customers who are taking advantage of the health care services provided by that respective hospital. Another item that is associated to the number of patients is the type of patients coming in which is directly associated with the services that a hospital is providing at that particular time. In order to earn more profit in this…
Del. Donna M., Christensen M.D. (Oct 2003). Women on the Cutting Edge of Health Care and Research. Ebony, 82.
Funtleyder, L. (2008). Healthcare Investing: Profiting from the New World of Pharma, Biotech, and Health Care Services. McGraw-Hill Professional.
Harry A. Sultz, Kristina M. Young. (2010). Health Care USA. New York: Jones & Bartlett Learning.
Leiyu Shi, Douglas A. Singh. (2011). Delivering Health Care in America. Jones & Bartlett Publishers.
Mortality prevention is certainly an area where the strongest interventions are most justified.
Bluegrass Hospital Quality of Care
Industry Comparison Quality of Care Standards
("Patient safety and," 2011)
1. Based upon the report card alone, the hospital is deficient in esophogeal resection, pancreatic resection, abdominal aortic aneurysm repair, coronary artery bypass grafts, craniotomies and acute myocardial infarctions. Gastrointestinal hemorrhages were just slightly above the national average and within the standard deviation.
2. As an administrative official, it is prudent to check the internal data charts personally at a departmental level to make sure the data is accurate and was collected correctly and without bias.
3. The QI teams would then determine the specific on site measures needed to rectify the problems and the level of interventions necessary. These interventions would be more stringent with regard to the above factors due to fact that patient mortality could be involved.
Catchpole, K.R., et al. (2007). Patient handover from surgery to intensive care: using formula 1 pit-stop and aviation models to improve safety and quality. Pediatric Anesthesia, 17, 470-478.
Pronovost, P.J. (2009). Reducing health care hazards: lessons from the commercial aviation safety team. Health Affairs, 476-489.
nationalized health care v. private insurers
During the past three decades, both Federal-funded healthcare programs like Medicare and private insurers have battled the rising tide of spending on personal health care with a variety of cost containment mechanisms. While other nations counter the fiscal onslaught with nationalized health care to provide universal coverage to its citizens, the United States struggles between partially funded nationalized care and a debilitating system of private insurance that denies patients proper care and undermines the moral codes of physicians. While the government continues to push health care towards the schism of corporate privatization, critics of the system unite with those un-served, proffering a viable transformation to medicate that would equal and exceed the private sector's ability to control the rate of spending growth, price aggressively for the services it covers, and provide health coverage to those citizens most desperately in need.
Currently, the United States…
Ibid, p. 935.
Ibid, p. 934.
Goel, Ashish. "For Whose Good?" Annals of Internal Medicine Online. June 7, 2005.
Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.
Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…
Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.
Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.
Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.
Attorneys, however, note that the suits are reflective of an increase in negligent doctors, who are hard pressed to serve a larger and more demanding patient load. Medical care is more costly and it is true that doctors fail to establish bedside relationships with their patients. Others point out that problems lie at the door of the insurance industry and management of hospitals (Committee, p. 1).
Because we discovered the problem in time, Mr. Jones was able to apologize and explain to the patients affected concerning the true nature of his outbursts. They did not have to pay for their treatment and none of them brought lawsuits against Mr. Jones or the hospital. We retained Mr. Jones, but advised him to notify the management if it appeared that there might be future outbursts. It is true that hospitals are much more diligent today because of risk management practices. Because of…
Abbott, R.L., Weber, P. And Kelley, B. (2005). Medical professional liability insurance and its relation to medical error and healthcare risk management for the practicing physician. American Journal of Ophthalmology. Vol. 140(6).
Committee to Study Medical Professional Liability and the Dellivery of Obstetrical Care, Institute of Medicine. (1989). Medical Professional Liabilityand the Delivery of Obstetrical Care: Vol I. Washington, D.C.: National Academy Press.
Grol, R. (2001). Improving the quality of medical care: Building bridges among professional pride, payer profit, and patient satisfaction. Journal of the American Medical Association. Vol. 286(20). 28 Nov 2001.
Harris, G. (2006). Senators to unveil new drug safety proposals. The New York Times. 21 Jun 2006. Retrieved January 14, 2008 at http://www.nytimes.com/2006/06/21/health/policy/21fda.html?_r=2&adxnnl=1&oref=slogin&adxnnlx=1200373850-0PNMhVh8RDTFqV4OOSZCpQ .
S. than in any other developed nation, yet the quality of care, even for those who are insured, is mediocre at best (Hawkins, 2007).
Doctors and hospitals often treat patients free of charge, if they do not have health insurance. However, that raises costs for other patients and makes healthcare and insurance even more costly. Most Americans recognize that the country's healthcare system is not sustainable and that without significant reform, it is headed for a complete meltdown.
In the U.S., identity theft is a major concern. Now, that, too, has gone into the medical arena. Medical identity theft is being described as the newest frontier in the ever-evolving crime of identity theft and presents a major opportunity for a wide range of criminals as the healthcare industry evolves into an electronic culture. Yet this environment is not properly protected by present law enforcement agencies and criminal offenses (Latour, 2007,…
Andrews, J. (2006). Where the jobs are: eldercare is already creating more jobs than there are people willing to do them. And the market is just heating up. Here's a look at where some of the greatest demand will be. Assisted Living 4(6) S6-9.
Hawkins, D.(12 February, 2007). Bush's Remedy Isn't a Cure; the President's health-care won't help those who need insurance most or the underinsured who can't afford primary care. Business Week Online
Institute of Medicine (2007). Preventing medication errors. National Academies Press, Washington, D.C.:
Lafferty, L. (2007). Medical identity theft: the future threat of health care fraud is now: lack of Federal Law Enforcement efforts means compliance professionals will have to lead the way. Journal of Health Care Compliance 9 (1) 11-21.
M.S. Healthcare Administration Exploration National quality performance improvement initiatives. The organizations noted focused specific areas research; study practices information dissemination national organizations public, private governmental sectors.
The stated aim of the Leapfrog Group is to track the "safety, quality and affordability of health care" (Mission, 2012, Leapfrog). It is designed to help consumers to make more informed healthcare decisions (Mission, 2012, Leapfrog). It 'rewards' high-performing organizations with strong ratings and, conversely, penalizes poorly-performing organizations with weak ratings -- or notes their failure to report data (Mission, 2012, Leapfrog). Participation is voluntary, but there is a strong incentive to participate in Leapfrog because of its reputation as a 'gold standard' of patient care measurements.
Leapfrog's mission was solidified thanks to a 1999 report by the Institute of Medicine which found that 98,000 Americans die every year from preventable medical errors (Mission, 2012, Leapfrog). The Leapfrog…
Kasprak, John. (2006). The Leapfrog Group Healthcare Initiative. OLR Research Paper.
Jha, Ashish K. (et al., 2008). Joint Commission Journal on Quality and Patient Safety
34(6):318 -- 25. Retrieved:
1.3. Summary of argument, Hypothesis
The role of leadership styles and their applicability to the success or failure of mergers, acquisitions and alliances is the focus of this research. Any leadership study, to be relevant, must also focus on the needs of those served by the organizations studies. That is why in the proposed Change Management Equilibrium Model have customer-driven processes at their center or core. The focus of the research to either validate or refute the model is based on consistency and collaboration as two factors that also serve to create greater levels of integration between the two or more healthcare providers merging or changing their organizational structures to better serve the market. This market orientation is what many public-ally-owned and operated healthcare providers struggle with, as often the source of funding becomes their "customer" or whom they serve (Brinkmann, O'Brien, 2010). Studies by AM esearch for example show…
Abbott, R., Ploubidis, G., Huppert, F., Kuh, D., & Croudace, T.. (2010). An Evaluation of the Precision of Measurement of Ryff's Psychological Well-Being Scales in a Population Sample. Social Indicators Research, 97(3), 357-373.
Faten Fahad Al-Mailam. (2004). Transactional vs. Transformational Style of Leadership-Employee Perception of Leadership Efficacy in Public and Private Hospitals in Kuwait. Quality Management in Health Care, 13(4), 278-284.
Antonakis, J., & House, R.J. (2002). The full-range leadership theory: The way forward. In B.J. Avolio & F.J. Yammarino (Eds.) Transformational and Charismatic Leadership, Volume 2, p. 3 -- 33. Boston: JAI Press.
Avolio, B.J., & Yammarino, F.J. (2002). Introduction to, and overview of, transformational and charismatic leadership. In B.J. Avolio & F.J. Yammarino (Eds.) Transformational and Charismatic Leadership, Volume 2, p. xvii -- xxiii. Boston: JAI Press.
This is because in most health facilities, the data is kept in a uniform way and the same is used for your next visit. According to the privacy law which applies to medical practitioners, confidentiality and privacy of the patient should not be compromised at all times. It is therefore important that when using health informatics, the management should respect the fundamental rights of the patient.
The national health care system can effectively improve its collaboration by adopting computer technologies and methodologies such as the soft systems methodology. It is therefore crucial for the government and the healthcare providers to join efforts in creating a better national health informatics system.
Ahuja MK, Carley KM. (1998)Network Structure in Virtual Organizations. Journal of Computer Mediated Communication. 1998;3(4)
Brown JE, Isaacs JS, and Krinke UB (2007) Nutrition Through the Life Cycle
Checkland, P., Holwell, S. (1993), "Information management and organizational processes:…
Ahuja MK, Carley KM. (1998)Network Structure in Virtual Organizations. Journal of Computer Mediated Communication. 1998;3(4)
Brown JE, Isaacs JS, and Krinke UB (2007) Nutrition Through the Life Cycle
Checkland, P., Holwell, S. (1993), "Information management and organizational processes: an approach through soft systems methodology," J. Of Info. Systems, Vol. 3 pp.3-16.
Connell, N.A.D. (2001), "Evaluating soft or: some reflections on an apparently 'unsuccessful' implementation using a soft systems methodology (SSM) based approach," Journal of the Operational Research Society, Vol. 52 No.2, pp.150-60.
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.…
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 .
HEALTHCAE & INFOMATION TECHNOLOGY
The state of healthcare in the United States is very much influenced and improved through the increased use of technology solutions. Whether it be the use of tablets, laptops, electronic healthcare records and some others, the use of technology has become more and more pervasive as the years and decades roll on. However, not everyone is sold on technology being a saving grace and those same people often think that technology solutions being added to healthcare actually do not help or that they make things worse rather than make them better. However, there is a cacophony of evidence that suggests and proves that electronic healthcare records, electronic administration and the use of information technology in a strategic and adept fashion actually makes things better over the long haul. This is true for patients, administrators, healthcare professionals and the wider network of providers that are typically also…
Bloomfield, G.S., Hogan, J.W., Keter, A., Holland, T.L., Sang, E., Kimaiyo, S., & Velazquez, E.J. (2014). Blood pressure level impacts risk of death among HIV
seropositive adults in Kenya: a retrospective analysis of electronic health records. BMC Infectious Diseases, 14(1), 1-20. doi:10.1186/1471-2334-14-284
Campbell, M. (2010). Technology in Healthcare: The Wave of the Future.
Ahdbonline.com. Retrieved 24 April 2015, from http://www.ahdbonline.com/issues/2008/may-2008-vol-1-no-4/350-article-350
Personal Healthcare Technology
Sunrise Hospital and Medical Center and the Sunrise Children's Hospital
The Sunrise Hospital and Medical Center, which includes the Sunrise Children's Hospital, is an approximately 55-year-old facility located in Southern Nevada; it serves the greater Las Vegas area and the surrounding communities. The Sunrise Health and Medical Center is proud of its quality initiatives to ensure patient safety and comfort, including direct approaches to pharmaceutical safety such as safe medication dosing via smart pump technology, and bar coding on medications. As well, the Sunrise Health and Medical Center does not discriminate with respect to HIV / AIDS or in any manner related to employment, program participation, admission and/or treatment.
Sunrise has been rated as the most popular area hospital for 15 years in patient surveys. As well, Sunrise Health and Medical Center has developed community outreach programs for health education in a variety of areas, often based…
Appari, A., & Johnson, M.E. (2010). Information security and privacy in healthcare: Current state of research. International Journal of Internet and Enterprise Management, 6 (4), 279-314. Retrieved from http://www.ists.dartmouth.edu/library/501.pdf
Ayanian, J.Z., & Weissman, J.S. (2002). Teaching hospitals and quality of care: A review of the literature. The Milbank Quaterly, 80(3), 569-593. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690120/pdf/milq0080-0569.pdf
Baker, J.J., & Baker R.W. (2000). Health care finance: Basic tools for nonfinancial managers. Gaithersburg, MD: Aspen
Byington, R., Keene, R., Masini, D. (2006). The impact of federal and state funding levels on strategic decisions and how those decisions affect patient care. The Internet Journal of Healthcare Administration. (4)2. Retrieved from https://ispub.com/IJHCA/4/2/5827
Kangaroo Care and Premature Babies
Kangaroo care entails holding a full term infant or premature so that there is a skin-to-skin contact between the newborn and the individual holding it. Individuals practice kangaroo care for premature infants for approximately two to three hours every day over a certain period. This takes place during early infancy, and the parent holds the baby against her bare chest. Medically stable babies can receive kangaroo care for up to any period since there is no maximum duration for them (Feldman et al., 2002).
Most parents may keep their babies in their arms for hours each day. According to research carried out, kangaroo care is essential as close bodily contact between the infant and the mother helps to stabilize the heartbeat, breathing and temperature of the premature infant. This is crucial as premature babies always have problems in harmonizing their heart and breathing rate. Mothers…
Aucott, S., Donohue, K., Atkins, E., & Marilee, C (2002). Neurodevelopmental Care In The
Nicu, 8, 298 -- 308.
Dodd, L. (2003). Effects of kangaroo care in preterm infants,
Feldman, R., Weller, A., Sirota, L., & Eidelman, A. (2002). Skin-to-Skin Contact (Kangaroo Care) Promotes Self-Regulation in Premature Infants: Sleep -- Wake Cyclicity, Arousal Modulation, and Sustained Exploration, Vol. 38 (2), 194 -- 207.
Elevating heads of beds for patients on mechanical ventilation
Along with the recommendations for removal of plaque, there is also a guideline made by CDC that for proper treatment to "elevate at an angle of 30 to 45 degrees the head of the bed of a patient at high risk for aspiration." The benefits elevation of the head of the bed is on the theory that then gravity will reduce the possibilities of regurgitation that exists in an overly distended stomach. The recommendation by CDC also clearly states that the patients should not be lying flat unless there is some clinical need for that. At the same time, some medical authorities feel that this is likely to make the patients uncomfortable, though the recommendation is from CDC. This makes them reduce the angle of laying the patients bed at a lower angle than the angle specified by CDC.…
Afessa, Bekele. (May, 2004) "From pro and con debate to evidence-based practice: ventilator- associated pneumonia" CHEST. Retrieved at http://www.findarticles.com/p/articles/mi_m0984/is_5_125/ai_n6094553 . Accessed on 20 July, 2005
Caffery, Lisa. "Preventing Ventilator associated Pneumonia" Retrieved from www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf+elevating+patient's+beds+for+ventilator+acquired+pneumonia&hl=en" http://www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf . Accessed on 20 July, 2005
Chulay, Marianne. (1 March, 2005) "VAP Prevention: The latest guidelines" Retrieved at http://rnweb.com/rnweb/article/articleDetail.jsp?id=149672Accessed on 20 July, 2005
Geyer, Sherree. "Breathing easy" Retrieved from www.matmanmag.com/matmanmag/jsp/articledisplay.jsp?dcrpath=AHA/PubsNewsArticleGen/data/0407MMH_FEA_Cover_Story&domain=MATMANMAG
Along the way, scholarly resources such as books, peer-reviewed journal articles and reputable websites will be used to create or support the opinions or answers given. The three questions that will be answered will include what basic types of healthcare everyone should have access to and why, a choice from thirteen risk factors that impact infectious disease and a recitation of how nurses can play a part in one or more of the millennium development goals (MDG) set forth for global health. While being too loose and generous with what people are entitled to and/or the depth and breadth of what nurses can truly do is a danger, to suggest that neither is worthy of consideration would be less than wise to assert as true.
Healthcare as a ight
The first essay question asks what types and forms of healthcare should be a given and a right to everyone regardless…
Carlton, E.J., Liang, S., McDowell, J.Z., Huazhong, L., Wei, L., & Remais, J.V. (2012).
Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bulletin Of The World Health Organization, 90(8), 578-
Clasen, T., Pruss-Ustun, A., Mathers, C.D., Cumming, O., Cairncross, S., & Colford, J.
Ineffective Communication Between Shifts in Acute Care Settings
A recent statistics of the adverse effects arisen from ineffective communication between shifts in acute care setting range from 2.6% to 7.6%, however, Okoniewska, et al. (2015) believes that the adverse effects on in-patients can be between 19% and 23%. (Classen, esar, Griffin. et al. 2011).
The Study aims to discuss the adverse effective arisen from ineffective communication between shifts within acute care settings.
Consequences of not solving the problem
Without implementing the strategies that can enhance effective communication between shifts in an acute healthcare setting, the issue can lead to mortality, readmission, and post-hospital adverse effects. Moreover, poor communication between shifts can lead to medication problems resulting to therapeutic errors. (Okoniewska, et al. 2015). Moreover, lack of intervention to address the problem can lead to medical errors, which can lead to patients' harms. Communication failure has also been identified as…
Aebersold, M., Averhart, V., Keenan, G., Kocan, M. J., Lundy, F., Tschannen, D. (2011). Implications of Nurse-Physician Relations: Report of a Successful Intervention. Nursing Economics. 29 (3):127-135.
Almost, J., Wolff, A., Mildon, B., Price, S., Godfrey, C., Robinson, S., . . . Mercado-Mallari, S. (2015). Positive and negative behaviors in workplace relationships: a scoping review protocol. BMJ Open, 5(2). doi:10.1136/bmjopen-2015-007685
Carlson, E. A. (2012). Improving Patient Safety Through Improved Communication and Teamwork. Orthopaedic Nursing, 31(3), 190-192.
Classen, D.C., Resar, R, Griffin. F, et al. (2011). "Global trigger tool" shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood). 30(4):581 -- 589.
In the U.S healthcare environment, the clinical practice guidelines are the effective healthcare protocol to enhance patient’s safety as well as achieving evidence-based practice. The clinical guidelines provide recommendations to the best available practice to assist clinicians and other healthcare professionals to deliver best and quality care. More importantly, the clinical practice guidelines are designed to optimize patients’ care using the systematic assessment and evidence based review to assess pros and cons of the alternative care options. The guidelines serve as the strongest resources to assist the healthcare professionals to make clinical decisions as well as incorporating evidence gained through practice and scientific investigations into patient practice. Healthcare organizations develop the guidelines in form and policies, which are endorsed across the organization to create a platform that employees will follow and holding employees accountable to achieve a standard of care.
Clabsi Hospital is one of the best healthcare organizations…
Extracorporeal Membrane Oxygenation is a procedure that allows for the oxygenation of a patient through the use of an external machine. Oxygen is required in order to keep a body healthy and alive. The definition of oxygenation is the amount of oxygen in the bloodstream of a patient. If the oxygen level drops below 90% a condition called hypoxemia occurs. Hypoxemia can be very serious and if not addressed within a short period of time can be fatal. Hypoxemia is diagnosed through cyanosis (the skin turning blue). Patients being treated with the EMCO procedure are usually longer-term patients (3-10 days) as compared to the short-term patients who receive a standard cadriopulmonary bypass which is a support that usually only lasts for a number of hours (not days).
According to odriguez-Cruz et al. The purpose of the ECMO is "to allow time for intrinsic recovery of the lungs and…
Adhikari, N.K.; Burns, K.E.; Friedrich, J.O.; Granton, J.O.; Cook, D.J.; Meade, M.O.; (2007). Effect of nitric oxide on oxygenation and mortality in acute lung injury: systemic review and meta analysis, BMJ; Vol. 334, pp. 779.
Bastin, A.J. & Firmin, R.; (2011) Extracorporeal membrane oxygenation for severe acute respiratory for failure in adults: NICE guideance, Heart, Vol. 97, Issue 20, pp. 1701-1703
Berryman, S.; (2010) Extracorporeal membrane oxygenation in a Scottish intensive care unit, Nursing in Critical Care, Vol. 15, Issue 5, pp 262 -- 268
Brower, R.G. & Krishnan, J.A.; (2000) High frequency ventilation for acute lung injury or acute respiratory distress syndrome, Chest; Vol. 118, pp. 795 -- 807.
Describe the following 4 types of costs:
Fixed- fixed costs are business costs, that are constant given a certain level of production
Variable- variable costs are cost that vary as output increases or decreases
Semivariable- an expense that contains a fixed component and a variable component.
Semifixed- costs that are constant within a defined level of activity but that can increase or decrease when activity reaches upper and lower levels
Dynamic Medical Suppliers, Inc. has sales of $300,000 for the calendar year of 2010. Its total variable costs equal $107,700. Calculate the contribution margin ratio, and determine whether it presents profit or loss to the organization
CM Margin Ratio= Contribution Margin/Sales
Sales of $300,000- Variable costs of $107,700= $192,300 Contibution Margin
Profit= ($300,000 x .641)- $115,000= Profit of $77,000 to the organization
You create the schedule for the nursing staff in the pediatric intensive-care unit. Your daily…
To gain more employees for the nursing staff, SKMC should increase their level of satisfaction by offering several incentives such as increased living expenses or better housing facilities. Moreover, they should include full medical coverage in the work contract. Regarding the foreign employees they should expand the annual leave from 42 days to at least 60 days in order for the abroad workers to be able to spend two full months with their families back home.
The management of Sheikh Khalifa Medical City might object to these propositions arguing the increased costs they would involve. However, their objection can be counteracted by the fact that satisfied personnel perform better at their jobs, leading to an increased quality of the services offered by SKMC and therefore to an increased number of patients and increased revenues and profits.
Emphasis on culture
To attract more foreign personnel within SKMC, the…
John M. Bryson, September 1995, Strategic Planning for Public and Nonprofit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement, Jossey-Bass Publishing, Revised edition
Janet Shapiro, Strategic Planning Toolkit, Civicus, World Alliance for Citizen Participation, http://www.civicus.org/new/default.asp?skip2=yes, last accessed on March 1, 2007
Jay Cooper, Acting Chief Executive Officer Sheikh Khalifa Medical City, Official Website of SKMC, http://www.skmc.gov.ae/,last accessed on March 1, 2007
International Hospital Recruitment Inc. Canada, Sheikh Khalifah Medical Center, 2004, http://www.ihrcanada.com/hospital/uae/sheikskhalifa_mc.htm , last accessed on March 1, 2007
Evidence-Based Protocol Implementation
Influencing Multiple Systems Through Evidence-Based Change as advance practice nurse, work informed factors direct reach, influence extends context labor. Likewise, propose a nurse leader influenced multiple systems, turn, impact groups.
Nurses are encouraged to utilize and incorporate in their daily practice evident-based practice. The Evidence-based practice (EBP) is considered to be a scientific standard that determines and guides on the best clinical measure (LoBiondo-Wood and Haber). EBP has grown in its relevance to clinical decision making and support to the nursing profession since it facilitates efficiency in provision of care and quick recovery to patients. Successful implementation of EBP calls for monitoring of existing practices, documentation of relevant procedures and evaluation of possible change practices in clinical and nursing care (LoBiondo-Wood and Haber).
Possible adjustments needful for patient's care protocol
Immediate care for patients coming from SICU is critical to their recovery from the procedure they undergo.…
Grossman, S., C. Bautista, and L. Sullivan. "Using Evidence-Based Practice to Develop a Protocol for Postoperative Surgical Intensive Care Unit Patients." Dimensions Of Critical Care Nursing 21.5 (2002): 206-14. Print.
LoBiondo-Wood, G., and J. Haber. Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. St. Louis: Mosby Elsevier, 2006. Print.
Melnyk, B., and E. Fineout-Overholt. Evidence-Based Practice in Nursing and Healthcare. Philadelphia: Lippincott, Williams and Wilkins 2005. Print.
Schmidt, N.A., and J.M. Brown. Evidence-Based Practice for Nurses: Appraisal and Application of Research. (Eds.) United States: Laureate Education, Inc. custom ed., 2012. Print.
Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…
Long Term Care Administration
What are some of the ethical issues in this case?
Mrs. Beaudoin appears to be in a real ethical dilemma given the fact that she does not have formal power of attorney and her husband also lives in the same facility with her with moderate dementia and is very frail. The ethical issue involved in this case is that Mrs. Beaudoin’s health is failing steadily. She is known to have cancer throughout her body, a failing heart, moderate dementia and diabetes type II. Due to the cardiac arrest she suffered after a short stay in the intensive care unit she subsequently suffered a severe brain injury occasioned by lack of sufficient oxygen. Since she cannot make healthcare decisions on her own and her husband is in a state that is just as bad, the ethical issue here is; who will make healthcare decisions and end of…
educe Patient Falls in a Hospital Environment
Method of Obtaining Necessary Approval(s)
Description of Current Problem
Explanation of Proposed Solution
esources equired for Implementation
isk and quality management is a fundamental and important aspect to many health care organizations and patient lives are often at stake. This is especially true in nursing facilities or hospitals that house elderly patients because of the level of direct patient interactions that occur on a daily basis and the specific needs of this population. There are many potential risks that can emerge from this population. Three common risks were identified from a literature review based on evidence-based practices. One common risk deals medication error and making sure patients receive the right dosage of the correct medication at the right time. Another risk that is becoming increasingly common is the risk of the spread of infection and in severe cases infections that are…
Colon-Emeric, C., Schenck, A., Gorospe, J., McArdle, J., Dobson, L., Deporter, C., & McConnell, E. (2006). Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative. Journal of the American Geriatrics Society, 1414-1418.
Renteln-Kruse, W., Krause, T., & Georgr, D. (2007). Incidence of In-Hospital Falls in Geriatric Patients Before andAfter the Introduction of an Interdisciplinary Team -- BasedFall-Prevention Intervention. The American Geriatric Society, 2068-2076.
Many patients epoted they pefe childen not visit so they could potect o shield childen fom the cisis associated with the ICU envionment.
The eseaches also identified citical illness as an impotant souce of disuption and stess fo family membes, and suggested that an open and moe flexible policy be adopted egadless. The eseaches suggest futhe studies ae necessay to detemine collaboative ways nusing staff and caegives could wok with families and patients to ceate a less stessful envionment fo childen's visitations. The study does point out nuses lack of time and ole secuity often contibute to poo attitudes about childen visiting adult patients. Positive inteventions howeve may be adopted to help impove elationships and the expeience childen have in the ICU envionment. This in tun may pomote moe holistic cae.
Aticle 4 - "The meaning of caing to nuses: an investigation into the natue of caing wok in an…
references of patients in the intensive care unit and in complex care medical unit." American Journal of Critical Care, 13(3): 194.
Wilkin, K., & Slevin, E. (2003- Jan). "The meaning of caring to nurses: an investigation into the nature of caring work in an intensive care unit." Issues in Clinical Nursing
Wilkstrom, A.C. & Larsson, U.S. (2003 - May). "Technology - an actor in the ICU: a study in workplace research tradition." Issues in Nursing.
Pain, 56(1), 95-101.
Andrews, K., & Fitzgerald, M. (1999). Cutaneous flexion reflex in human neonates: a quantitative study of threshold and stimulus-response characteristics after single and repeated stimuli. Developmental Medicine and Child Neurology, 41(10), 696-703.
Breau, L.M., McGrath, P.J., Stevens, B., Beyene, J., Camfield, C., Finley, G.A., Franck, K., Gibbins, S., Howlett, A., McKeever, P., O'Brien, K., & Ohlsson, A. (2006). Judgments of pain in the neonatal intensive care setting: a survey of direct care staffs' perceptions of pain in infants at risk for neurological impairment. he Clinical Journal of Pain, 22(2), 122-129.
Bruce, E., & Franck, L. (2005). Using the worldwide web to improve children's pain care. International Nursing Review, 52(3), 204-209.
Carbajal, R., Gall, O., & Annequin, D. (2004). Pain management in neonates. Expert Review of Neurotherapeutics, 4(3), 491-505.
Chow, S.C., & Liu, J.P. (1998). Design and analysis of clinical trials: concept and methodologies. New York: John Wiley…
Taddio, A., Katz, J., Ilersich, A.L., & Koren, G. (1997). Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet, 349(9052), 599-603.
Taddio, A., Goldbach, M., Ipp, M., Stevens, B., & Koren, G. (1995). Effect of neonatal circumcision on pain responses during vaccination in boys. Lancet, 345(8945), 291-292.
Weaver, S.A., Diorio, J., & Meaney, M.J. (2007). Maternal separation leads to persistent reduction in pain sensitivity in female rats. The Journal of Pain, 8(12), 962-969.
Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.
The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.
Background and Significance of the Problem
It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within…
Baird, J., ehm, ., Hinds, P., Baggot, C., Davies, B. (2016). Do you know my child?
Continuity of nursing care in the pediatric intensive care unit. Nursing esearch, 65(2): 142-150.
Barid et al. (2016) provide a grounded theory, qualitative assessment of seven parents and 12 nurses using in-depth interviews with participants, observational assessment, and documents from within the organization under scrutiny in order to "explore the delivery of continuity of nursing care in the PICU from the perspective of both parents and nurses" (p. 142). The researchers describe continuity of nursing as being very important to parents, as they feel that there is better consistency of quality care when there is consistency within the ranks of the staff in terms of how nurses treat patients, how prompt they are, how their persona is and how well they interact with patients and parents, etc. Through the conducting of interviews with parents,…
Baird, J., Rehm, R., Hinds, P., Baggot, C., Davies, B. (2016). Do you know my child?
Continuity of nursing care in the pediatric intensive care unit. Nursing Research, 65(2): 142-150.
Nursing Problem: Shortage of Nurses in Healthcare
The researcher works at Phoebe Memorial Hospital, where there is an extreme nursing shortage. Without an adequate amount of nurses, patient care and safety may turn out to be compromised, while nurses themselves may be stunned, upset, and dissatisfied. At the researcher's workplace, high patient-to-nurse ratios has been displaying that there is a lot of frustration and job burnout, which is linked to higher yield. At Phoebe, there is an inadequately staffed nursing force which has been discovered to play a negative part in patient results. In difference, studies have confirmed that hospitals like Phoebe Memorial Hospital with low nurse turnover are the ones that have the lowest rates of risk-adjusted death and severity-adjusted span of stay.
There is no very exact way of describing the concept of nursing shortage at the Phoebe Memorial Hospital Phoebe, but a report of this…
NURSING PROBLEM: SHORTAGE OF NURSES
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…
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.
In Puerto Rico I was a licensed respiratory therapist. When I moved to America, the license that I held was not valid to allow me to continue that line of work. I deliberated whether or not I wanted to pursue a respiratory care degree so as to return to this profession. It is a demanding activity and requires care and patience. However, as I thought about it and what I loved about it in Puerto Rico, I decided to take up this program here in the States. I feel it was the right decision because as soon as I did I fell right back in love with the profession. So, after being away from it for nearly a decade, I have returned to what I love to do, and I am very happy to be able to do it right here in Florida.
Being able to work in…
The progressive care unit (PCU) is a practice setting in which the researcher’s health care team is often failing to meet quality care objectives according to patient reporting on the hospital consumer assessment of healthcare providers and systems (HCAHPS). Opportunities for growth in quality care based on the HCAHPS of the PCU include topic areas related to patient inclusion as well as communication skills of the members of the healthcare team. Patient perception of quality is that the healthcare team in the PCU is unable to explain the care process in a way that the patient and family members feel comfortable with or that allows them to understand the care that is being provided to them. The researcher has first-hand experience with this challenge in the PCU and has heard first-hand from patients there that the care seems disjointed, that continuity is lacking, and how problematic it is for…
Disaster Management Plan
Emergency Needs Assessment
There are many tough decisions that hospital facilities have to make in the event of a disaster and preparation is one of the critical success factors in such a situation that can make a world of difference. For example, the delivery of critical care in the emergency department is critically important to identify the nature of critically injured patients and decide whom to attend to first and who needs medical attention at the earliest. Furthermore, in the event of a category 3 hurricane, such as Hurricane Victoria, such a disaster can greatly exacerbate the limitations of a hospital to provide the needed neurological intensive care services. This analysis will provide an overview of the steps that can be taken in the event of a major public emergency and the role that needs assessment and service rationing play in such an event.
Gilboy, N. (2012). Emergency severity index. Rockville, MD: Agency for Healthcare Research and Quality.
Michigan University. (N.d.). Vulnerability Assessment. Retrieved March 24, 2014, from http://www.michigan.gov/documents/7pub207_60741_7.pdf
Papastavrou, E. (2013). The ethical complexities of nursing care rationing. Health Science Journal, 346-348.
Schubert, M., Glass, S., Clarke, L., Aiken, B., & Sloan, D. (2008). Rationing of nursing care and its relationship to patient outcomes: the Swiss extension of the International Hospital Outcomes Study . International Journal for Quality in Health Care, 227-237.
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…
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
ethics regarding organ donation by brain-damaged people. The writer explores how a brain-damaged person is defined, and whether or not the donation of organs from that person is ethical. There were 15 sources used to complete this paper.
The field of medicine has advanced mankind to arenas never before thought possible. Today doctors can take entire organ systems out of one person and place them in another and the recipient can live for many years with transplanted organs. Hearts, lungs, kidneys, livers, eyes and many combinations of them are just a few of the organs that are transplanted worldwide today. As the medical community continues to advance age and quality of life the need for more organs has reached the critical stage. One of the most argued and passionate debates in the medical community today is whether or not it is ethical to remove organs in the case of a…
BROOKER Michelle, The gift of life after death., The Press (Canterbury, New Zealand), 08-10-2002, pp 3.
CAROL ANN CAMPBELL, Staff Writer, TV SHOW ANGERS ORGAN DONOR GROUPS., The Record (Bergen County, NJ), 11-13-1996, pp a09.
Author not available, [Thoughts of The Times] An Explanation of Brain Death., The Korea Times (Seoul, S. Korea), 02-09-2000.
Author not available, Pre-transplant brain-death test done on man in his 20s., Kyodo World News Service, 06-13-1999.
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…
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
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…
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
Innovative Nursing Care Delivery Models a.This website detailed profiles 24 successful innovative nursing care delivery models. These profiles developed part a research project conducted Health Workforce Solutions LLC (HWS) funded obert Wood Johnson Foundation (WJF).
Innovative nursing care model: The Care Transitions Intervention
Innovative nursing care model
I chose the Care Transitions Intervention Model on which to focus because of the increasing importance of geriatric care in the field of nursing. Although my organization serves the needs of persons of all ages, elderly patients are an increasingly large proportion of the patient base. The Model stresses the need for the empowerment and self-care even of patients with high-risk conditions. The Care Transitions Intervention Model allows elderly patients the maximum amount of mobility and autonomy possible given the limits of the patient's condition and enables them to stay in a home setting as long as possible. As its name suggests, the…
Care Transitions Intervention. (2013). Innovative Care Models. Retrieved:
Kurt Lewin Change Model. (2013). Change Management Coach. Retrieved:
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
Adult day care industry is well-known for providing social and basic health assistance to the elderly with physical and mental disabilities. The assistance provided in these adult day care centers include meals, hygiene services such as bathing and cleaning up, therapeutic activities and transportation. This industry is differentiated from nursing homes since adult day cares only operate during normal business hours and therefore do not include home or night care ACH National espite esource Center, 2004.
Companies in this industry depend on three major sources of finance which are grants from donor agencies, fees charged to clients or public funding from the government. Public funding represents 55% of product segmentation while client fees represent 26%. In the year 2013, the industry had gross revenue of 6.2 billion dollars representing an annual growth of 2%. 3,700 businesses operating in this industry made total profits of just over 396 million dollars. According…
ARCH National Respite Network & Resource Center. (2012). Building Blocks for Lifespan Respite: Federal Guide to Funding for Adult's and Children's Respite. (Lifespan Respite ed., Vol. 101): Chapel Hill.
ARCH National Respite Resource Center. (2003). Respite for Persons with Alzheimer's Disease or Related Dementia. (ARCH Factsheet ed., Vol. 55): Chapel Hill.
ARCH National Respite Resource Center. (2004). Adult Day Care: One Form of Respite for Older Adults. Chapel Hill: ARCH Factsheet Number, 54(1), 14.
IBIS World. (2013). Adult Day Care in the U.S. Industry Report OD5942. Retrieved November 10th, 2013, from http://www.ibisworld.com/industry/home.aspx
Ethical Analysis of Healthcare Rationing
The topic of health care rationing has been the subject of debate in the U.S. The last few years as government expenditures on health care have far exceeded budgeted levels. Central to the concern is the ethical issue over whether it is better if fewer Americans profit with a greater amount of health resource allocation or if the majority benefit to a lesser degree for an equity in health care benefits. In the essay, "We've Got To Ration Health Care," (author unknown) the position is taken that America would fare better to follow the course of health care action seen in other western countries, where it is considered better to ration medical procedures to the extent that a system provides "the highest possible level of basic health care that can be delivered to all the people." With the growing concern over health care rationing, and…
Cook, D & M. Giacomini. 1999. "The Sound of Silence: Rationing Resources for Critically Ill
Patients." Critical Care. 3: R1-R3.
Devettere, RJ. 1993, Feb. "Clinical Ethics and Happiness." Journal of Medical Philosophy.
Devettere, RJ. 2000. Practical Decision Making in Health Care Ethics: Cases and Concepts, 2nd ed. Washington, DC: Georgetown University Press.
Strategic human resource management:
Applications in a healthcare organization
It has been said that one of the great ironies of healthcare is that despite the fact it is an industry where the 'human' dimension is so important, the H department is often one of the most-overlooked aspects of healthcare organizations. "There is arguably no other labor-intensive industry that is so reliant upon a highly skilled, highly educated, high-cost, and high-in-demand workforce that literally makes life-or-death decisions every day. And yet, in many hospitals and health systems H remains an afterthought in the C-suite" (Commins 2013:1). However, the need for change is constant, and many organizations are finding they must 'adapt or die,' given the new realities they are facing. "by the federal healthcare law, the inevitable and growing shortages of skilled healthcare professionals, and the newfound and measurable importance of patient satisfaction scores for reimbursements will prompt…
Commins, J. (2013). Ready or not healthcare HR is going strategic. Health Leaders Media.
Retrieved from: http://www.healthleadersmedia.com/content/HR-266470/Ready-or-Not-Healthcare-HR-is-Going-Strategic
Kabene, S. (et al. 2006). The importance of human resources management in health care: A
global context. Human Resources Health, 4: 20. Retrieved from:
Healthcare Financial Management
To quote Jonathan Clark at the beginning of his article, "Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process." Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved evenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
In his comprehensive advisory article to improve the medical industry's revenue capturing capabilities, entitled Strengthening the evenue Cycle: A 4-Step Method for Optimizing Payment, Jonathan Clark provides a series of sensible solutions to the ongoing dilemma of payment optimization. David Hammer also provides guidance to healthcare finance professional in his article The Next Generation of evenue Cycle Management, by reminding them that the key performance indicators (KPIs) which dictated policy in previous years…
Clark, J. (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62(10), 44.
Hammer, D.C. (2007). The next generation of revenue cycle management. Healthcare Financial Management, 61(7), 49.
Seddon, J. (2008). Think system. Management Services, 52(2), 10.
Wilson, D.B. et al. (2004). 3 steps to profitable managed care contracts. Healthcare Financial Management, 58(5), 34.
Lee is only the first step in the process of building a team that is able to cover all aspects of Mrs. Lee's care. The team approach involving a social worker, nurse, physician, pharmacist, and physical therapist affords Mrs. Lee a full range of professionals attending to her various needs.
Although Mrs. Lee has a number of problems that need to be addressed the one problem that must be addressed immediately is her elevated blood pressure. Hypertension is an important risk factor for the development and worsening of many complications of diabetes and an elevated blood pressure is like walking around with a detonated bomb. Within moments, and with little warning, a diabetic patient can suffer a stroke or heart attack as a result of an elevated blood pressure. Well over fifty percent of diabetics suffer from hypertension and proper treatment of hypertension can minimize most of the tangential problems…
Calle-Pascual, A.L. (2002). A preventive foot care programme for people with diabetes with different stages of neuropathy. Diabetes Research and Clinical Practice, 111-117.
Caminal, J. And Barbara Starfield, et. al.(2004). The role of primary care in preventing ambulatory care sensitive conditions. European Journal of Public Health, 246-251.
Deichmann, R.E. (1999). Improvements in Diabetic Care as Measured by HbA1c After a Physician Education Project. Diabetes Care, 1612-1616.
Epstein, M. (1997). Diabetes and hypertension: the bad companions. Journal of Hypertension, 55-62.
Legal Ethics of E-Mail and Social Media and Its Applicability to the Healthcare Industry
Consequences of Social Media
Perils of Building an Online Network
Caution with Employee Email Accounts
Issues when Endorsing other Companies
Benefits of Social Media
Legal Ethics of E-mail and Social Media and its Applicability to the Healthcare Industry
Social media has without a doubt changed the way we live, the way we view the world and the way we interact with one another. This paper acknowledges the undeniable good that social media has given us, while identifying the many ways that it has created issues and intricacies for the healthcare industry at large. This paper discusses the benefits of social media for healthcare professionals, while identifying some of the dire consequences, the perils of an online network, the issues connected to an employee email account and the caution one must…
Americanprogress.org. (2004, July 2). The Civil Rights Act 40 Years Later. Retrieved from americanprogress.org: http://americanprogress.org/issues/women/news/2004/07/02/891/the-civil-rights-act-40-years-later/
Car, J. (2004). Email consultations in health care: 2 -- acceptability and safe application. Retrieved from nih.gov: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC514210/
Findlaw.com. (2010, April 6). How Private Are Personal Emails Sent Via Employer Computers? Retrieved from findlaw.com: http://blogs.findlaw.com/technologist/2010/04/how-private-are-personal-emails-sent-via-employer-computers.html
Miami.edu. (2005, May 14). Health Insurance Portability and Accountability Act of 1996 (HIPAA). Retrieved from miami.edu: http://privacy.med.miami.edu/glossary/xd_hipaa.htm
This is necessary to provide a seamless platform on which health solutions can be effectively integrated and deployed. Without using such a platform, the development of electronic health care facilities will be more difficult to deploy. In other words, Tele-health is part of the overall healthcare ICT (Information Communications Technology) solutions that enables healthcare to be pushed out to the edge, for local delivery, and to be more evenly, efficiently and effectively distributed.
Broadband communication is the underlying technology of choice when discussing electronic applications. It is certainly important for inter-healthcare provider communications delivering sufficient bandwidth capacity between sites. The delivery of home care electronic should not rely on the broadband technology is not universally accessible, particularly in rural and remote areas, and it can also be prohibitively expensive. Some broadband technologies can be delivered to remote locations, such as satellite-based technology, but this is impractical and too costly to…
Goldberg, a. (2002, April 29). Internal Report: Telehealth, Privacy, & Health Care: Review, Expectations & Proposals. Goulston & Storrs, Boston, MA.
Lovata, F. (2000, May 21-24). Telemedicine via the Internet: Successful Program Strategies. American Telemedicine Association Conference,
Puskin, D., Mintzer, C., & Wasem, C. (1997). Chapter 14, Telemedicine: Building Rural Systems for Today and Tomorrow. In P. Brennan, S. Schneider, & E. Tornquist (Eds.), Information Networks for Community Health. (p. 276). Computers in Health Care Series. Springer-Verlag.
Telecommunications: Protecting the Forgotten Frontier. (2001, August). SC Magazine-Info Security News, 12 (8), 36-40.
Being ill is never a simple thing. Besides the physical tolls a medical condition can take on a person's body, there are also many mental and psychological costs that affect a sick person. Nor do these physical and mental effects only harm the person with the medical condition. Research shows that family members and close friends of ill people will also be seriously affected by the condition. Illness is a physical, mental, sociological, and financial drain and, in some family units, an illness can destroy the fabric of the family itself. A person who is involved in the medical profession must have a clear understanding not only of medicine and what they need to do to cure or treat an illness; they must also be aware of the psychological issues that a patient deals with, along with the pressures which are placed upon members of their family. Nurses…
Bruce, B. et al. (2002). A multisite study of health professional's perceptions and practices of family centered care. The Journal of Family Nursing. (8:4). 408-29.
Harrison, T. (2010). Family centered pediatric nursing care: state of the science. Journal of Pediatric Nursing. (25:5). 335-43.
Raoufian, D. (2003). The power of family-centered care. The Journal of Family Nursing. (9:3).
Strategic Management of a Healthcare Facility in St. Louis
In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms…
1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.
2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]: http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm
3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html
4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html
Healthcare Data Compare Healthcare Grade of Maryland to Florida
Healthcare grades: The Commonwealth Fund
The Commonwealth Fund grades all states on access to healthcare, avoidable hospital use and costs, healthy lives, and prevention and treatment. For example, Pennsylvania ranks 12 on access: nearly
percent of nonelderly adult patients are insured and 92% of children. Florida has around 74% and Maryland around 83% of adults insured and 82 and 91% of children, approximately. In Pennsylvania, 86% of at-risk adults have had a checkup within two years versus 87 and 88% in Florida and Maryland respectively; 90% of patients in PA have not had to forego seeing a physician within the last two years because of cost versus 84% in Florida and 89% in Maryland (approximately). The low rates of insurance coverage in Florida reflect higher unemployment and poverty rates, combined with a higher percentage of workers who labor part-time and do…
State scorecard. (2011). Maps and Data. Retrieved September 26, 2011 at http://www.commonwealthfund.org/Maps-and-Data/State-Data-Center/State-Scorecard.aspx
All figures are rounded up or down, based upon the available data
Changes to Healthcare Practice and Delivery: A Study of Two Detroit, MI Healthcare Facilities Separated by Twenty Years
Changes to technology and to the political and regulatory landscape have led to many changes in the ways that businesses in all manner of industries operate. Increased communications capabilities, the shrinking size and cost for advanced technologies, and a variety of other changes have provided many businesses with an opportunity to operate more efficiently, and in so doing have also made many industries and markets more competitive. An examination of some typical businesses operating in these industries today as compared to their counterparts that were in operation twenty years ago provides ample evidence of the changes that have occurred and the ways in which businesses have adapted.
The healthcare industry has by no means been immune from these changes, but in fact has changed more than many other industries due…
Anderson, J. & Aydin, C. (2005). Evaluating the organizational impact of health care information systems. New York: Springer.
Armoni, A. (2000). Healthcare information systems: challenges of the new millennium. Hershey, PA: Idea Group.
Wager, K., Lee, F. & Glaser, J. (2009). Health care information systems: a practical approach for health care management. New York: Wiley.
Health Care Blog:
"Alycia-Care: Peace of Mind…a Sick Child on't Be Denied Health Coverage"
hen Alycia Steinberg found out that her baby girl had cancer, of course as a mother Alycia was very upset and worried for the health and for the life of her daughter Avey. The kind of cancer that little Avey had was also a very serious kind of cancer, leukemia, and so Alycia and her husband worried about two main problems. One, a child that was only two years old, and two, would the insurance company that the family has cover a pre-existing condition?
But because the Obama Administration managed to get the Affordable Care Act through Congress in 2010 -- and now the United States Supreme Court has ruled that the Affordable Care Act is constitutional -- Alycia and her husband can feel safe as far as their daughter's health is concerned because their insurance…
Salcido, Dori. (2012). Alycia-Care: Peace of Mind in Knowing a Sick Child Won't Be Denied
Health Coverage. Healthcare.gov. Retrieved July 7, 2012, from http://www.healthcare.gov .
The healthcare field is certainly a tricky topic to discuss, considering that it is riddled with debates regarding things like insurance, pharmaceutical use and the safety of many medical procedures. However, in the last ten years, the field of biotechnology has emerged as a force to be reckoned with in the realm of healthcare and economics. Several groundbreaking innovations have been made that have rattled the pre-existing constructs of these vital fields. Topics like laser surgeries and stem cell reproduction have become regular parts of every citizen's vocabulary, yet they still seem to been engulfed in quite a bit of controversy. Nevertheless, the lifesaving potential of these revolutionary endeavors cannot be overlooked. In fact, this massive potential has given way to the revolutionary amalgamation of nanotechnology and medicine: a field that is now referred to as nanomedicine. Research in this field is currently being conducted with some radical goals…
Bloomberg Businessweek. (2011). The Nanomedicine Laboratory. Retrieved November 23, 2011, from http://investing.businessweek.com/research/stocks/private/snapshot.asp?privcapId=108448530
Diaz, J. (2010, March). This Is the Future of the Fight Against Cancer. Retrieved November 23, 2011, from http://gizmodo.com/5501103/this-is-the-future-of-the-fight-against-cancer
Eaton, M. (2009). Nanomedicine: Industry-Wise Research. Journal of Nature Materials, 6 (1), 251-253.
Moghimi, S.M., Hunter, A.C., & Murray, J.C. (2005). Nanomedicine: Current Status and Future Prospects. The Journal of the Federation of American Societies for Experimental Biology, 19 (3), 311-330.
" (Harman, Flite, and ond, 2012) the key to the preservation of confidentiality is "making sure that only authorized individuals have access to that information. The process of controlling access -- limiting who can see what -- begins with authorizing users." (Harman, Flite, and ond, 2012) Employers are held accountable under the HIPAA Privacy and Security Rules for their employee's actions. The federal agency that holds responsibility for the development of information security guidelines is the National Institute of Standards and Technology (NIST). NIST further defines information security as "the preservation of data confidentiality, integrity, availability" stated to be commonly referred to as "the CIA triad." (Harman, Flite, and ond, 2012)
III. Risk Reduction Strategies
Strategies for addressing barriers and overcoming these barriers are inclusive of keeping clear communication at all organizational levels throughout the process and acknowledging the impact of the organization's culture as well as capitalizing on all…
Harman, LB, Flite, CA, and Bond, K. (2012) Electronic Health Records: Privacy, Confidentiality, and Security. State of the Art and Science. Virtual Mentor. Sept. 2012, Vol. 14 No. 9. Retrieved from: http://virtualmentor.ama-assn.org/2012/09/stas1-1209.html
Kopala, B. And Mitchell, ME (2011) Use of Digital health Records Raises Ethical Concerns. JONA's Healthcare Law, Ethics, and Regulation. Jul/Sep 2011. Lippincott's Nursing Center. Retrieved from: http://www.nursingcenter.com/lnc/cearticle?tid=1238212#P77 P85 P86 P87