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The major objective of informed consent is to give the patient an opportunity play a role in his health care decision. The law requires physicians to get an informed consent of their patients before any medical procedure. The patient has a right to be informed and to be made aware of the nature of the procedure, available alternatives to the medical operation, the risks, benefits and uncertainties related to the operation as well as the patient's acceptance of the operation.
For a patient's consent to be valid, he must be considered competent to voluntarily make the decision (Edwards, 1998). However, there are conditions that may render a patient incompetent to make treatment decisions. In the case of Mr. Jones who has been diagnosed with Alzheimer's disease, the law provides for an option. According to section 5 article a of the National Conference of Commissioners;
"A surrogate may make…… [Read More]
ere those rights violated in the case of Robert Courtney's unlawful behavior? Yes those rights were violated in several ways. First, the information Courtney's patients received was both false and incomplete. They did not realize they were not getting what they paid for; they were treated shabbily by a man who specialized in providing fraudulent medications. Second, the patients getting prescriptions from Courtney were not given the opportunity to take part in treatment decisions; in this case, it would have been impossible for Courtney to show them the truth without opening himself up for investigation. Thirdly, Courtney's patients were not treated with respect, in fact they were discriminated against through the delivery of phony, watered-down medications.
hat role did Courtney have as a patient advocate? Did he uphold that obligation? He certainly did not prove to be an advocate; rather he engaged in criminal activities while putting on the…… [Read More]
Patient Rights and Informed Consent
The relevant legal issues at stake in this case are those related to the question of whether Mr. Jones is indeed incompetent and if Mr. Jones is indeed incompetent then what is the authority that should be assigned to the surrogate daughter of the patient in this case. The hospital physician and staff must avoid legal liability and ensure that they are in adherence to relevant laws and regulations informing the proper actions in this particular case. The patient has a legal right to be fully informed on any treatment that is considered and has the right to either provide consent or alternatively to refuse to consent to any proposed treatment. In this particular case, Mr. Jones has been found to have the condition of Alzheimer's and to be incompetent. Proof has been provided for the treating physician and nursing staff of Mr. Jones incompetency.…… [Read More]
" (South Australia, p. 8)
This demonstrates the balance which is necessary in protecting the rights of the patient and simultaneously ensuring that physicians have the freedom necessary to perform to the best of their abilities. In a respect, this underscores the nature of the strategies used for the protection of patients' rights. The intention is primarily to provide a basic forum for the constructive interaction of patient and physician with legal recourse serving as a failsafe. So is this implied by the LSCSA, which indicates that the demands of existing Patients' Rights standards are designed to make the physician actively accountable to the patient's interests. Therefore, the LSCSA indicates a strategy for preserving the right to consent, reporting that "although the first step usually should be to speak to the doctor or other health care provider who has treated the patient, if any doubts remain, a patient should not…… [Read More]
Patient Centered Medical Homes
In the 1960s, the medical home concept referred to as patient centered medical home was developed.In order to reform the healthcare in the U.S.; the patient centered medical homes are evolving as a centerpiece of efforts (Bates, 2010). Basically, PCMH can be defines as a primary care model that offers coordinated and comprehensive care to the patients in order to improve health outcomes. PCMH is also recognized by the National Committee for Quality Assurance (NCQA). Patient centered medical homes can be portrayed as a team of people working together in form of a community. The purpose is to improve the health as well as healing of the people in that community. In comparison with the primary care, PCMH is more responsive towards the needs of local patients.
PCMH offers a number of benefits including complementary nutrition as well as wellness counseling along with providing prevention education…… [Read More]
The key ethical issues raised in the case study involving the SARS research, were that the center for disease control wanted blood samples from individuals who may have come into contact with the index case—i.e., the person who had SARS. If that person was on, say, a flight, the center wanted information from as many people on that flight as possible. The point was not to contact individuals to alert them of any danger, as they would have already passed out of danger or been placed into the hospital if they were in danger by the time they were located. The point was merely to obtain data so that the center could better understand the disease and how it spread. Thus, the key ethical issues involved obtaining consent from the participants in the study. Every participant in a study has a right to take part or not take part in…… [Read More]
Patient acuity system provides the nurses and other healthcare practitioners in health cares' information that can guide them in their attention towards the patients. The nurses track information and then weigh them in accordance to the urgency of assessment. The basis that the nurses use is the complexity of the level to which patients are unwell. An example is the determination of whether the patients immediately require ventilation and those who do not need any. The nurses are able to pick on the various patients in the healthcare and then record the data. In a single healthcare, there are many patients with different degrees of illnesses. As a result, they all require varying levels of evaluations from the nurses. It is, therefore, imperative that the nurses spread their attention appropriately to avoid any inconveniences. This system helps the nurses to determine the attention that patients require within a short period.…… [Read More]
ight to Life
For all human beings death is one of the most intricate truths to cope with. In spite of this, people take decisions to finish their lives, which in turn result in ending their pain and suffering. This practice is known as euthanasia, or even commonly called as assisted suicide by those who are against the practice completely.
However, whatever term we may use to label it, it is an issue that society should become more familiar with. For instance few countries like Switzerland have legalized the practice and extend great support to those who want to end their lives so as to get away from the detriment of their disorders. However, this practice is only legal and offered only to those who are going through terminal illnesses or vegetative states. Although there are many controversies that surrounds euthanasia, there are numerous religious activists and humanitarian groups that…… [Read More]
This can be as relatively minor as a night without sleep every few weeks or a continual struggle to sleep every night. Curing insomnia by just trying to Google a response to the problem only unleashes a flood of websites that offer all sorts of over-the-counter and prescription medications. The person wants to find relaxation techniques and also understand how they can overcome the insomnia on their own without having to take the trouble of going into a physician's clinic. In choosing which website to trust, using the evaluation criteria provided will be very useful. An example of a website that meets the criteria as defined is WebMD.com. Let's take a look at this website to see why. First, the website makes it clear they have an editorial policy, and their mission and purpose are to provide accurate, valid healthcare information to its website visitors. The WebMD Medical eview Board…… [Read More]
Fact sheet on end-of-life care. American Psychological Association. http://www.apa.org/pi/eol/factsheet1.pdf
Fact sheet on end-of-life care, published by the American Psychological Association discusses the adult's mental health needs near the end of life and the obstacles they confront to having a comfortable death.
Foley, K.M., (1995). Pain, Physician assisted dying and euthanasia. Pain 4, 163-178.
Foley discusses how access to and delivery of pain treatment are seriously deficient in the present health care systems in the United States. The author advocates expanding services and resources to care for the dying patient.
Isaacs, S.L. And Knickman, J.R (1997). To improve health and health care. San Francisco, CA: Jossey ass.
Isaacs and Knickman examine programs of the Robert Wood Johnson Foundation, a health care philanthropy. They reports its history, evaluates its effect, and discusses lessons learned as well as provide a frank discussion of why some problems can't be easily solved.
Langer, G. (2003,…… [Read More]
ights and esponsibilities
How do the rights and responsibilities of patients differ from the rights and responsibilities of employees? How are they similar?
Until recently, patient responsibilities were seldom directly 'spelled out' in the American healthcare system. This changed with the passage of HIPAA in 1996. HIPPA "sets forth policies and standards for how patient information, including doctors' notes, medical test results, lab reports, and billing information may be shared" (Torrey, 2012, HIPPA). It gives patients the right to access their information and demands that patient data be treated in a secure fashion. Also under the law, patients have a right to informed consent over the procedures they undergo, so that they or a designated caregiver can make decisions about what they perceive to be their best interests. Ultimately, the healthcare system must serve the needs of patients, not physicians and other healthcare employees. That is why patients must give…… [Read More]
Patient Access to Experimental Drugs
Experimental drugs are being used in treating cancer and other life-threatening diseases in the hopes that effective cures and treatments can be identified. There are however, ethical questions relating to the use of experimental drugs and this work seeks to answer the question that asks whether patients should have access to experimental drugs and to answer why or why they should not have this access.
Experimental drugs have carved inroads to treating cancer patients and most recently; this has been reported in the form of a drug that serves to "neutralize two mechanisms cancers need to survive." (Coghlan, 2012) The new drug is Cabozantinib. This drug is reported by one individual interviewed in this study to have been used by a family member who died while taking the drug for non-small cell carcinoma in the form of lung cancer. When asked the question…… [Read More]
On this matter, House Democratic Leader Nancy Pelosi stated, "Congressional leaders have no business substituting their judgment for that of multiple state courts that have extensively considered the issues in this intensely personal family matter." (Euthansia and Terri Schiavo b). Federal Judge James Whittemore heard the Schiavo case and ruled on March 22, 2005 that the Schindlers had not established a "substantial likelihood of success" at trial and refused to order the reinsertion of Terri Schiavo's feeding tube. Two days later, the United States Supreme Court would deny the Schindler's request to hear the case. Terri died on March 31, 2005.
This paper has presented only the most noted court rulings and proceedings regarding the Schiavo case. "Nineteen different judges at various times considered the Schindler's request on appeal in six state courts. All have sided with Michael Schiavo" (Euthanasia and Terri Schiavo b). In the absence of a living…… [Read More]
Patient, Mr. D., is a 74-year-old male Caucasian, married and retired. Mr. D. complains of dizziness and weakness. Type-2 diabetes was diagnosed in 1994, hypertension in 2002, and arthritis in 2007. Mr. D. is currently taking 20mg Lipitor/daily; 81 mg Aspirin/daily; 333mg Calcium/daily; 5mg zinc/daily, and 500mg Vitamin C/3X day. He denies any drug or herbal use, and uses 650 mg of Tylenol for pain as needed. He has no known food allergies, does not use tobacco or illicit drugs, but has a family history of diabetes and heart disease with both mother and father. His general health acuity is strong (bowels, urinary, etc.), but has occasional slurred speech, weakness in right lower limb, syncope, vertigo, and vision fluctuations. Mr. D. reports that his wife complains he asks the same question repeatedly within a short time period.
Areas for Focused Assessment- The combination of syncope, vertigo, vision, and memory issues…… [Read More]
ight to die think it is ironic, when we consider history, that in the middle Ages all the most joyful events took place at the cemetery and this scandalized nobody. How different things are today. The attitude of our culture to death, to a large extent, reveals its attitude to life. There is an almost total contradiction of what death means when seen through the eyes of the eligion or seen through the eyes of our world.(Milton D. Heifetz)
Fundamentally, our society sees no meaning in death whatsoever. We live under the idea that the meaning and value of life is within life itself without any reference to anything outside the visible, tangible world. Our gods have become happiness, self-fulfillment, and empowerment. But death is a fact and a fact that even the unbeliever has to face. One reaction has been to cut down on the unpleasantness of death and…… [Read More]
A Patient's Rights
There are a number of lists to go by when it comes to the patient's "Bill of Rights," including a patient's rights under the Affordable Care Act. In the American Cancer Society "Patient's Bill of Rights" it begins with the right every patient has to "…accurate and easily-understood information about your health plan, health care professionals, and health care facilities' (www.cancer.org). Of course a patient also has the right to choose health care providers and when it comes to emergency services, a patient has a right to be "…screened and stabilized using emergency services" when injured or seriously ill; so that when one's health is in jeopardy, access to emergency services can be a vital and stabilizing experience (www.cancer.org).
A patient also has the right to be part of decisions regarding what treatment is appropriate, and a patient has a right to be respected and treated…… [Read More]
These studies demonstrate that there are several factors associated with patient noncompliance, regardless of the disease being treated. Medication side effects represent only one of these issues. Nurse practitioners could help to resolve many of these issues by being proactive and asking questions about side effects in patients at risk for becoming noncompliant. They may also be able to predict noncompliance in patients that are prescribed medications with known side effects. By informing the patient of the side effects and giving them practical ways to cope with them, the nurse practitioner can play an active role in helping to eliminate patient noncompliance.
Education was found to play an important role in patient noncompliance. The overall educational level of the patient was found to be important. The nurse practitioner can take positive action by being aware of the patient's overall educational background. Extra care must be taken with those of low…… [Read More]
Right to Die
For the last few decades, the issue of a person's right to choose the time and method of his or her own death has been one of passionate debate in the United States, with emotions running high on both sides of the controversy as the meanings of liberty and freedom of choice, the morality of taking one's own life, the ethics of people involved in such actions, and the laws related to this issue take center stage in the arguments.
Since civilization began, suicide has existed in one form or another, with varying degrees of acceptance, such as the ancient Greeks who held tribunals for elderly people who requested to die, and if approved, were given hemlock and during the first century B.C. actually held annual banquets where the elderly were allowed to attend and drink poison if they felt they had lived long enough.
Moreover, "traditional…… [Read More]
Rights and Responsibilities for a Member of the Nursing Union in Minnesota recent MSNBC Health article on the state of the nation's health noted that despite the nation's joblessness crisis, nursing remains woefully understaffed as a profession across the nation. The current shortage of a few hundred thousand RNs could reach a staggering 750,000 by 2020, given the aging population and rate of retirement in the 'Baby Boom' generation. The danger of this scenario, of a rapidly aging population and a rapidly retiring nursing profession, is highlighted by a recent lawsuit waged against the esley Hospital in Kansas in July of 2000. There, a jury awarded a $2.7 million malpractice settlement to the family of a woman who almost died due to chronic nursing understaffing at the hospital. Thus, the nursing shortage has costs for both hospitals as well as patients that could prove disastrous. (Johnson, 2004) shortage of nurses…… [Read More]
DIAGNOSIS AND TREATMENT PLAN
Diagnosis and Disease Processes
Using an appropriate patient assessment form (Sample Forms, 2013), D.M. has been found to have uncontrolled Type 2 diabetes, hypercholesterolemia, uncontrolled hypertension, chronic anemia, and probable hypothyroidism (Sample Forms).
Diabetes Type 2
is most probably on a poorly controlled diet of high cholesterol and high simple sugars. Diabetes mellitus type 2 is a metabolic disease wherein the body is not able to properly use ingested food because of insulin resistance. If more simple or refined sugars are consumed, the less the body is able to process them as nutrients. These tend to stay and float in the blood stream, un-used, and in this condition, they cause trouble in the different parts of the body. These include the end organs, such as the brain, the eyes, the kidneys, the heart, and even the feet. A poorly controlled diet and the lack…… [Read More]
The modern nurse must then be willing to move beyond a simple catch-all of medical jargon and bureaucracy and become someone who is both supportive and critical of the system. This may seem dichotomous, but in reality is not. The system is designed with beneficence in mind -- to help the patient at all costs. It is thus up to the nurse advocate to ensure that that actually happens (Sheldon, 2009).
Undertake assessments which are sensitive to the needs of the patient- Assessment is one of the key factors in management of clinical medicine. The nurse is often at the forefront of that process simply due to the logistical nature of the situation -- taking vitals, preparing the patient for blood work, etc. However, it is in two particular areas that the nurse can be most effective when assessing the actual needs of the patient; culturally and when questions are…… [Read More]
Consider the case of Mr. a, the irrational quadriplegic who has little movement from the neck down, and lives in a nursing home. He is irrational in his behavior, and often demands very explicit forms of treatment, and then rejects or refuses these treatments or other treatments. He has become violent on occasion, and has created problems between patients and staff. He has been expelled from one nursing home, and may be from another. The home is bound to treat him, as he desires care and chose the nursing home. However, if he harms staff or other patients in any way, the nursing home is bound to provide a safe environment, and Mr. A is a detriment to the health and safety of others. In that case, the facility can refuse treatment for the good of the many, rather than the good of one patient. The author of the article…… [Read More]
" (Bernall, 1992, p. 19)
Though historically this role could have strained the nurses professional relationships with other health care professionals, and especially doctors the modern medical industry has afforded a new way of understanding the role, including an emphasis of such a nursing role in medical school. (Bernall 1992, p. 22)
As this belief has proven to be a long-standing one, it is therefore important to explore a greater understanding of the application of its use in patient care. The particular example of the mentally handicapped / epileptic patient is important as the complicated nature of these possibly debilitating diseases often leaves patients feeling helpless to contribute to their own general health and wellness. In one study the application of a nurse, for the specific role of advocacy was used to study it effects of the patients health and wellness outcomes.
A nurse functioning as patient advocate for 21…… [Read More]
HEALTH CAE Management (STATEGIC OPEATIONS PLAN
Developing an Overall Operations Plan
According to Organizations (2005), developing an overall development plan requires one to take into consideration the overall vision and objectives of the organization. The process takes into consideration the internal and external environment demands that influence the realization of the operational efficiency. Therefore, it entails taking into consideration aspects like determining the resources required for the success of the process, developing the most effective strategies, assessing the risk associated with the developed strategies, and coming up with methods of evaluating the success of the adopted strategies. The process also considers the resources required to facilitate the growth of the clinic.
Typical Patient Experience
Providing exemplary medical care does not engage or meet the needs of the clients. Patients consider exemplary medical care as a mandatory requirement for all hospitals. This necessitates the adoption of the patient experience to…… [Read More]
ights Accused 1.Fully defined due process origins, Completed 90-100% accuracy, 2.Fully explained due process protects accused abuses federal government. Complete 90-100% accuracy, thoroughness, logic, Used (3) reference directed.
Due process was one of the first rights that were created in the U.S. constitution. The history of due process comes from the year 1355 when the phrase was coined at the time when there was the first government. The Great Charter of the Liberties of England statute stated that no man would be imprisoned or prevented from enjoying their freedom or liberty or be outlawed or exiled unless by lawful judgment that is passed or by the law of the land. Several years later in the 28th year of the reign of King Edward III, it became a declaration that no man was allowed to be deprived of their property, be imprisoned, disinherited or killed without being charged by the due…… [Read More]
Biology -- Patient Scenario
What are the components of physical examination? Describe each component.
Physical examination consists of 5 basic components after obtaining a patient's description of the history of his/her systems. First, the provider observes the patient for physical signs of disease and evaluates such factors as mobility, posture, facial expression, alertness, responsiveness to stimuli and changes in skin color (Jarvis, 2011, pp. 33, 127-9). Secondly, one must take a patient's vital signs, including blood pressure, heart rate, breathing rate and temperature, and compare the patient's results with the reference ranges (Jarvis, 2011, pp. 136-150). Third, one must perform auscultation, using a stethoscope to listen to the patient's lungs, heart and bowel (Jarvis, 2011, p. 118). Fourth, one performs percussion by tapping on the patient's chest and abdomen to listen for sounds indicating normal conditions, fluid, excess air, size of the lungs and size of the affected area (Jarvis,…… [Read More]
right to die. The writer uses analytical skills to dissect and argue several right to die cases that have been presented in court in America. The writer discusses the ethics of the practice as well as presents ideas about the future "right to die" arguments and cases. There were eight sources used to complete this paper.
Through the advances of medical science people are living longer than ever before. Those who are chronically ill are being helped in the quest to alleviate symptoms and those who might have become ill in the past are being cured. The medical science advances have also allowed those who would have died in the past from head injuries, car crashes, gun shots wounds and other accidents to live. All of the advances that have been made have worked in favor for millions of people who otherwise would have died. The advances are also providing…… [Read More]
The concept of patient autonomy, as opposed to medial paternity, is one that has gained much ground in recent years; "... about 30 years ago, issues began to appear that were difficult to solve using traditional ethics. New medical and reproductive technologies, research controversies, and a societal ethos that questioned all authority posed difficult questions." (Czaplyski, Larry, 2002)
At issue in this paper is the meaning and significance of patient autonomy and the way in which is relates to medical paternity. As the discussion will outline, the case for patient autonomy is not only ethically valid but also essential for the moral and practical balance in the medical profession. Underlying this view is the fact that the issue of patient autonomy does not exist in isolation or in the medical field alone - but relates to other issues and ethical problems in the society at large. These larger…… [Read More]
Responsibilities of Nurses to Patients
Why is it important
The role of nurses has a direct implication on the patients. For example, nurses observe and provide direct care to the patients. The physicians give orders and thus are the role of the nurses to implement (Aiken et al., 2014). Often, the work of the physicians is not complete without the help of the nurses. The nurses are responsible for changing clothes and giving the medications to patients. Often, the patients are unable to do basic tasks, and therefore the roles of nurses become very important. Nurses keep medical records for the patients and therefore give medications to the patients in time and monitor their progress.
Another important role of the nurse is assessing the response of the patients to medications. Keep the records for the progress of patients is an invaluable practice. The records help the nurses to monitor how…… [Read More]
patient is a 35-year-old (male?), he was diagnosed with diabetes twenty five years ago at the age of ten years old, he claims that this is hereditary in his family. He has one sister who has Type 2 diabetes and a brother who has type 1 diabetes. He manages his diabetes and other illnesses from home and through a medical clinic; for most of his life he has known he has diabetes and manages to regulate it through insulin shots, glucose tablets as well as through the right nutrition, however he claims that this is difficult and there are most days where he experiences draw backs. Many complications have arisen from his diabetes. This patient was selected because of the certain case he has in regards to his diabetes and other complications which had developed from it. His treatment and management also includes an extensive study. At the young age…… [Read More]
Right to die in America [...] impact of a client's decision to end their life, and the counselor's role in the process.
END OF LIFE DECISIONS
The right for a person to take their own life is a highly volatile issue debated passionately in the courts. A counselor involved in with a client that wishes to take their own life must examine their own beliefs, along with the needs and emotions of their client. Is the client emotionally able to make a rational decision to end his or her own life? Is the client terminally ill, or do they have some valid reason for wanting to end their lives? A counselor should always consult with a mental health professional, especially if there are any extraordinary circumstances connected with the case, such as a history of mental illness or confusion, or a history of depression with the client. Their wish to…… [Read More]
Anti) Right to Die
Science and technology has allowed humans to treat a myriad of diseases that were previously terminal. This is illustrated in the controversy over the case of Terry Schiavo, the Florida woman at the center of a right to die dispute between her husband and her parents.
Schiavo, who has been in a vegetative state for the past 13 years, brings a face to the legal question of when can a third party decide the fate of patients who cannot decide for themselves. According to Schiavo's husband, Terri would not want to live in her present state. Schiavo's parents, however, disagree (Stern and Goddard).
The conflict illustrates the lack of precedent regarding the legal status of patients like Terri Schiavo. There are many more like her, who are comatose, unconscious and with no hope of recovery. Science and technology has allowed humans to treat a myriad of…… [Read More]
Structured interviews of the subjects were conducted at the end of each individual set of simulation runs to obtain triangulation data.
Video segments were coded by nursing experts.
Statistical and content analyses of the data were conducted.
All nurses were female. Males may have provided different response. The sample may have been too small; only 10 individuals of each handedness were involved. The sample was extracted from only one environment, the participants were familiar with environment. Replication of various other environments may have provided different response. The repeated measures design may have influenced response second time around.
I found details of structured interview to be too vague. The best accounts of experimental studies are those that reader can replicate. Many of the steps of this study were sufficiently elaborate for repllication, but I found details of interview questions vague and incompletely elaborated upon so that one left with…… [Read More]
It is also likely that once trained, many of these individuals lose focus on the key importance of their role -- possibly being distracted by homework, school, families, or other life issues. This type of individual did not take the job of Patient Escort because of a true overriding need to help others, true empathy, but because of the convenience of the position.
Job Specifications -- Hiring Procedures -- First, the position description should be rewritten. It should emphasize personality and characteristics that focus on empathy, kindness and be very clear about what is expected. This job does not require a college student, or even a High-School graduate (except perhaps for Hospital procedures). It requires someone who has care capacity and is overwhelmingly cheerful, kind, and truly likes people. Often, this is not a characteristic of the young, or the upwardly mobile. The personnel director might check with some of…… [Read More]
Patient Electronic Access
The objective of this study is to investigate the application of the electronic health record at the inner City health hospital. The goal of implementing the program is to allow patients to have easy access to their health data and information to assist them sharing their health information with other healthcare and personal care providers. This study investigates the application of Measure 1 Stage 1 for the City Health organization. Following the benefits of the electronic health records, the City Health has decided to implement the new program. The program will allow patients to access their information on demand through PH (personal health record). However, the City Hospital will be able to derive benefits from the program by setting aside $170,000 for the implementation costs and $90,500 maintenance expenses. Moreover, the City Hospital should organize a training program for the staff to make the program be successful.…… [Read More]
Patient’s chief complaint: A man aged 69 comes to the emergency room with a sharp pain to his chest’s left side, lasting between 30 and 40 mins and then subsiding.
History of present illness: The pain has woken him up thrice in the last 7 days. He claims the pain first started roughly six months ago. Initially, however, the pain used to surface only occasionally, commonly while he was doing gardening. The patient’s past medical history reveals a diagnosis of hypertension twenty-five years back.
Precipitating/alleviating factors: The patient has been smoking a half-cigarette pack daily for the last forty-five years.
Family History: The patient has lost two brothers and his dad to heart disease. The patient does not report any other significant illness history in the family.
Social History: His typical pastimes include sharing a drink with pals and gardening.
Review of Systems: From a physical examination of…… [Read More]
Evidence Based Practice
University of Illinois Evidence Based Medicine Resources: Lessons Learned
From the search resources I learned that in evidence based medicine, patient values comprising of their unique concerns, preferences, and expectations introduced to the clinical encounter ought to be integrated in determining the ideal care for patient. This integration will guarantee that the individual patient’s clinical state, the clinical setting and best patient outcome prevail in ideal decisions on optimal service delivery to the patient (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996).
The second aspect learned is that in order to integrate Evidence-Based Nursing and clinical care, there is the need for a basic comprehension of the attributes related to the inherent published evidence. Resources in Evidence-Based Practice are categorized in a hierarchy relating to the quality of the research or evidence. In Evidence-Based Practice, decisions making on best care to patient are not just basically guided by…… [Read More]
Patient’s chief complaint, reason for visit
Ms. Richards arrived complaining that she was experiencing severe anal pain, so much so that using a tissue was also proving impossible. She claimed the pain began a couple of days earlier and has aggravated considerably since.
History of Present Illness
Ms. Richards arrived complaining of anal pain which commenced a couple of days earlier and has aggravated since. With regard to her intimate relationships, Ms. Richards states that though she has a boyfriend, their relationship isn’t serious as the two are also seeing other people. According to internal assessment reports, patient has normal hair distribution, an intact perineum, and intact urethral meatus without any discharge or inflammation. However, patient experiences unbearable pain on vaginal opening palpation, redness, and edema. Further, a mass has been identified on the right, with spontaneous, dark-yellow, smelly secretion with palpation over the Bartholin's glands.
Physical examination…… [Read More]
espiratory Care: Scenario
One of the most difficult ethical scenarios which may arise is when a patient is not fully compliant with treatment. In one of the cases I observed, a child had recently been diagnosed with asthma. Unfortunately, the parent was not able to offer the child the ideal environment for coping with his asthma. The parent and child lived in a very dusty environment and it was difficult for the parent to bring the child in for regular checkups. The child was frequently taken to the emergency room because of difficulties in controlling his asthma. There was heavy reliance upon inhaled corticosteroids and other medications primarily intended for short-term use. The parent was also reluctant to allow the child to participate in regular activities such as sports. The child was overweight and this caused a spiral of problems for the child: not being able to participate in normal…… [Read More]
Merrill, in the UK. Following his experience with heart surgery using innovating surgical techniques, the physician noted the problems he experienced in understanding all of his alternatives compared to a simpler earlier procedure, and finally trusted to the advice of his cardiologist to surgically intervene. In response to the experience, Dr. Merrill emphasized that, "As a physician talking to colleagues, I had the best information possible under the circumstances. But it wasn't the same as my hernia repair. The experience brought home to me the realization that the progress of medicine has made informed consent impossible -- even for me" (Merrill 1999: 190).
ationale of Study
Taken together, the foregoing issues indicate that there is an ongoing need for an assessment of knowledge levels of informed consent among perioperative nurses and operating department practitioners. Perioperative nurses and operating department practitioners, though, are frequently subjected to an enormous amount of stress…… [Read More]
Theories in nursing generally center on the relationship of four concepts -- nursing, environment, person and health. These concepts are interrelated and impact one another in diverse ways, often seen in issues of nursing when problems arise that require analysis. The issue of alarm fatigue is one problem in nursing that touches on each of these four concepts. Alarm fatigue can be defined as exhaustion that occurs for nurses when they are exposed to many alarms throughout their shift, which causes "sensory overload" and the nurses to develop a "non-existent response to alarms" (Horkan, 2014, p. 83). Complacency and dissension can follow in the nursing workplace as too many alarms for nurses can render them unresponsive.
Alarms are needed in nursing because they alert nurses and care providers to emergency situations that require immediate action and intervention, especially in the intensive care unit. However, nurses and staff work…… [Read More]
Patient-centered care is the goal of many healthcare organizations, but the ability of an organization to deliver patient-centered care is influenced by a number of factors both internal and external. Business practices, regulatory requirements, and reimbursement all can impact patient-centered care in any healthcare organization. Promoting patient-centered care requires an organizational culture committed to this paradigm, which also needs to be embedded in the mission and values of the organization.
Executives and administrators create the organizational culture that promotes patient-centered care. All leaders in the organization are responsible for using patient-centered practices and communications styles in their interactions with patients and their families. Furthermore, administrators oversee the policies and procedures that directly impact the culture of care. Analyzing areas of weakness within the organizational structure and culture via established assessments like the Patient-and Family-Centered Care Organizational Self-Assessment Tool, it is possible to create multidisciplinary teams that promote the organization’s…… [Read More]
The Argument -- She Could be Given a Transplant
I could not find a prohibition against liver transplants for those 70 or over, but there is a good deal of information in the literature supporting transplants for older people. In the PubMed section of the National Institutes of Health a study of 1,446 "consecutive liver transplant recipients was conducted" and 241 elderly patients (over 60) in that group were compared with younger counterparts. The conclusion: "Low-risk elderly patients fare as well as younger patients after liver transplantation" (Levy, et. al, 2001).
Meanwhile, Dr. Gerald S. Lipshutz, assistant professor of surgery at the David Geffen School of Medicine at the University of California reports the results of the findings at the orld Transplant Congress in 2006. In a study of 62 patients (Group I) between the ages of 70-79 that had received liver transplants -- compared with a group of 864…… [Read More]
The cases of Todd vs. Mr. Gomez
When dealing with a situation in which communications between a patient and a physician is difficult -- for example, if the patient has limited English proficiency or is deaf -- inevitably barriers are created which prevent a fully patient-centered communications process. Physicians often cite limited time as a reason for being insufficiently patient-focused. In the case study of Todd, the interaction was challenging because of the lack of the presence of an ASL interpreter. This was a lose-lose situation for both the patient and the physician. The physician was frustrated because of the extra time needed to complete the interaction by writing everything down; the patient was frustrated because of the fact the physician often misunderstood him and tried to lip-read as a shortcut or ask him yes and no questions which did not sufficiently address his concerns.
Perhaps the area…… [Read More]
Medical ethics and rules like the Hippocratic oath are fairly clear-cut when applying them to real-world solutions and situations. However, there are some situations where the "right answer" can be elusive and people will sometimes go against their own self-interest. Such seems to be the case with Mr. Simpson. He has weak lungs and his doctors and family morbidly fear that if/when he gets the flu again, it will literally kill him. However, even with this being the case, Mr. Simpson refuses to get the flu show under the auspices that he could end up getting the flu as a direct result of the shot despite assurances that this will not happen. Of course, this can absolutely happen in real life but that argument is not a factor in this case study as it is assumed he cannot possibly contract the virus. While Mr. Simpson is obviously not making the…… [Read More]
As a part of its responsibility to monitor federal agency compliance with Section 501, the U.S. Equal Employment Opportunity Commission (EEOC) collects and compiles data regarding agencies' hiring and advancement of workers with disabilities. At the time of hiring, federal agencies provide employees the opportunity to self-disclose that they have a disability, on a Standard Form 256 (SF-256); the numbers of people who so identify are reported to the EEOC. In1979, EEOC officially designated certain disabilities as targeted disabilities in its Management Directive 703 issued on December 6, 1979, which in 2003 was superseded by Management Directive 715. MD 715 defines targeted disabilities as "Disabilities that the federal government, as a matter of policy, has identified for special emphasis in affirmative action programs. They are: 1) deafness; 2) blindness; 3) missing extremities; 4) partial paralysis; 5) complete paralysis; 6) convulsive disorders; 7) mental retardation; 8) mental illness; and 9) distortion…… [Read More]
Growth at Stryker
Stryker has been around for more than half a century and it was all started with the company's founding doctor's vision and initial selling of inventions and his general orthopedic practice. Since then, the success and growth of Stryker has continued to grow with leaps and bounds. While Stryker as a company has encountered challenges and issues over the years such as class action lawsuits and hot competition, their growth strategy seems to be on point and heading in the right direction (Stryker, 2014).
Stryker basically started up in the 1940's and was hitting its stride in the 1960's and much of the 1970's. However, things changed greatly when Lee Stryker and his wife died in a plane crash in 1976. Even so, the company went international just before that and hit $17.3 million USD in sales after that. The board of directors unanimously christened…… [Read More]
There are a number of concerns faced by patients in the hospital. One that is not often discussed but that can play a real factor in treatment is the burnout experienced by nurses. Even during short-term hospitalization, the burnout that nurses face can potentially result in improper care to the patient. Addressed here is whether this is something that has been seen with patients experiencing short-term hospitalization, based on how satisfied they are with their nurses. Literature regarding burnout will be examined, and a survey will be undertaken in order to discover whether patients are having good experiences with the nurses who care for them during their short-term hospitalizations. By discovering whether the patients are happy with the care they are receiving and determining whether that nurse may have been suffering from burnout, it will be possible to draw conclusions regarding whether the nurse's burnout status affected proper…… [Read More]
Patient Intake ecord
Patient's Name: Perez, B
Date of Birth: 06/XX/1985
Occupation: egistered Nurse
Marital Status: Single
Phone [HIDDEN] Private
Chief Complaint: Bell's palsy
History of Present Illness:
The patient states she first felt numbness on her tongue 10 days ago. When she woke up in the morning and was cleaning her teeth, the water was dripping from her mouth. Her right eye was not able to close completely, and she felt numbness on the right side of her face.
The patient consulted with her doctor who confirmed the diagnosis as Bell's palsy; her doctor prescribed prednisone for 14 days. The patient came to see me on 8/29/2013. The patient states she has pain and numbness on the right side of her face, drooling, loss of the ability to taste, and her right eye cannot fully open or close and has excessive tearing.…… [Read More]
Mitigating isks from Dementia
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…… [Read More]
Employee's Rights to Health and Safety in the Workplace
The objective of this study is to analyze the rights of employees to health and safety in the workplace in regards to the scenario as follows:
DoRight has recently been hired as the President of the "Universal Human Care Hospital," where he oversees all departments with over 5,000 employees and over 20,000 patients at the medical facility. He has been provided with a broad set of duties and oversight of numerous departments, including business development, customer services, human resources, legal, patient advocacy, to name a few. He has managers in each department that he supervises and who work with him to address the needs of the various internal and external stakeholders of the hospital. Dr. DoRight discovers that some patients within the hospital have been dying as a result of a variety of illegal procedures by doctors and nurses, and negligent…… [Read More]
However, the screening of patients for these conditions necessitates the inclusion of brief screening questions into a health systems review at the medical visit because patients may be embarrassed or unwilling to show concerns or talk about their mental distress or health. The inclusion of the questions into the health systems review can help to facilitate early discovery and intervention and communicating to patients about concerns on their overall health. Many people with these mental conditions tend be unwilling to consult their care providers because of the stigma linked to the conditions and the lack of effective treatments available (Haddad, Buszewicz & Murphy, n.d.).
The other approach that can be taken to screen for these conditions is to administer validated screening measures in the waiting room. In this case, the screening measures even as brief scales have been identified to be effective in discovering the problems. The validated screen measures…… [Read More]
The Importance of Patient Identifiers
Adverse events as a consequence of medical treatment are now recognized to be a significant source of morbidity and mortality around the world (World Health Organization [WHO], 2005). Somewhere between 3 and 5% of all hospital admissions in the United States result in an adverse event, and in 1999 it was estimated that the majority of the 44,000 to 98,000 deaths caused annually by medical mistakes could have been prevented (reviewed by Leape, 2000, and WHO, 2005).
The sources of adverse events can be divided into clinical practice, defective or poorly maintained products, improper procedures, or an organizational system. The World Health Organization (2005) concluded that systemic failures are the primary source of adverse events, and can be attributed to a particular organization's patient care strategy, culture, attitudes toward managing quality of care and risk prevention, and the ability to learn from mistakes.…… [Read More]
A person should always have the opportunity to die with dignity and perhaps even "discover the meaning of one's life" as pointed out by Pythia Peay.
At the very least, those that hold contrasting opinions on euthanasia should be able to come to an agreement that medical treatment must never be superseded by moral treatment. Even though the science of medicine is often highly specialized, it must never go against the moral ideals of the terminally-ill patient. Undoubtedly, there are many risks associated with euthanasia, but in the end, it should be the patient who decides. But in cases where the patient cannot respond nor make decisions, a living will appears to be the best solution, for this document clearly states the wants and desires of the person in case their lives turn for the worse and if they end up connected to a machine in order to stay alive,…… [Read More]
Of course, there are negative implications to patient empowerment. Not all patients will understand the nuances and aspects of their disease, and they may make emotional or uniformed decisions about their healthcare that could negatively affect the outcome of their treatment or disease. They also may not accept the diagnosis of a professional, even though it is correct, and demand more costly tests or confirmation, instead of quickly entering the treatment they need. This could actually lead to more patient mortality, due to lack of understanding, mistrust, and even miscommunication. Patient empowerment is a great tool for many patients, but some many misunderstand or misuse it to the detriment of their own health. Patients can empower themselves by reading more about their illness, asking questions, and demanding more information from their healthcare providers, so they can make informed decisions about their healthcare.
Editors. "Partnering for Patient Empowerment." Northwestern University.…… [Read More]
One solution of this issue can be that the closest most guardians is given the permission and right to take the decision about the life of the patient who is not able to communicate or express his wish. The guardian who should be responsible to take this decision should be the one who will be having direct impact of the death of the patient.
Community & Health Care esolution
Different communities have varied opinions in regard to right to die for geriatric. Although few of the countries have legalized this matter and have given the right to patient to decide whether he wanted to live more or not, but still there are campaigns in those countries that do not support the way patients should be given death and is also considered another way of committing suicide. Communities think if the right is legalized it will give doctors the right do…… [Read More]
Thus, if any of us was one of the "actors', we would be tempted to judge each alternative in a subjective manner. If we were the patients, the AECL board or the hospitals we would want Therac-25 to be approved. If we were the public or FDA we would want the equipment out of the market.
The main alternative to the reality would have been for AECL to take under consideration a software error. One other alternative would have been for the company to assign more accurate probabilities for hazard occurrence, while running the Fault Tree Analysis. Finally, the third alternative would have been to use a better method to determine hazard occurrence. A better method is a method that would have been capable to return higher risks associated with the use of Therac-25 and which would have determined AECL to adjust the equipment. The first alternative is superior to…… [Read More]
If I found myself in a conversation with a citizen from a country where healthcare is socialized, I would be more than likely to speak with candor by expressing my disapproval for the nature of America's healthcare industry. As the same time, I would connect this to the more general nature of America's economy, political culture and socioeconomic hierarchy. The healthcare industry's monetarily-based exclusivity is consistent with most other aspects of public life in America such as the distribution public services, access to education and infrastructural maintenance. The way that Americans experience all of these things is highly subject to socioeconomic status. That said, I would explain quite simply that this constitutes one of the single greatest flaws in American public governance.
Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports…… [Read More]
Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
eflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction…… [Read More]
CERNER software is built to allow for an enterprise-wide view of a patient\'s clinical information in order to coordinate patient care and document at which point care was delivered especially in acute patient settings. Using the software providers will have access to the right information and at the right time within the clinical workflows in order to make the best possible decision regarding patient care (Curry, 2010). In acute patient settings, it is vital that a nurse has the right information before they start attending to a patient. This is mainly beneficial to ensure that they understand the patient\'s condition or problem before they can begin to offer care. Using the CERNER software, it is easy for a nurse to access this information and make informed decisions based on the information that has been entered regarding the patient’s condition. In acute care, real-time information is vital to the provision of…… [Read More]