Economics and Decision Making in Health Care Course Competencies

Economics and Decision Making in Health Care Course Competencies

To successfully complete this course, you will be expected to:

  1. Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.

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  2. Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
  3. Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.
  4. Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.
  5. Apply various communication methods in order to clearly, effectively, and efficiently relate information to stakeholders and colleagues related to economic data, findings, and strategies.

Case Study on Biomedical Ethics in the Christian Narrative Essay

Case Study on Biomedical Ethics in the Christian Narrative Essay

The Ethical Theory of Principlism in Biomedical Ethics in the Christian Narrative Context: A Case Study

Introduction

The ethical theory of Principlism introduced by Beauchamp and Childress in the Principles of Biomedical Ethics is also sometimes referred to as the “Georgetown Approach.” It comprises of four main principles namely respect for (patient) autonomy, nonmaleficence, beneficence, and fairness or justice. Nonmaleficence refers to the act of healthcare workers not intentionally causing harm to their patients, while beneficence calls for healthcare workers to always work and do everything for the benefit of the patient (Encyclopedia.com, 2016; Page, 2012; McCarthy, 2003). The four major ethical principles above happen to be common to almost all the available ethical theories, aside from Principlism. They strive to harmonize ethical principles with socio-cultural and religious beliefs (Advanced Practice Toolkit, 2018) Case Study on Biomedical Ethics in the Christian Narrative Essay.

The principle of respect for autonomy dictates that the healthcare professional should respect the decision of care taken by a mentally competent and adult patient or relative of patient. The professional must not object to the decision even if it appears unsound and irrational. This means no healthcare professional has the moral authority to overrule the decision taken by a mentally sound patient or a competent relative concerning their care. Moreover, they must also first obtain consent for any procedure on the patient after thorough explanation of consequences (Encyclopedia.com, 2016; McCarthy, 2003). The ethical principle of fairness or justice on its part dictates that the health professional and the health institution have a distributive and criminal responsibility in so far as the patient’s condition and conduct are concerned. This is in relation to the patient’s condition and its interaction with other members of the society. Resources must be shared fairly (like available organs for transplantation), and matters like a patient intentionally attempting to infect another with a deadly disease (a criminal act) must be reported by the health worker to the relevant authorities (Encyclopedia.com, 2016; McCarthy, 2003).

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Applying the Four Principles: Case Study Part 1 (Chart)

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

Beneficence dictates that the physician do the best for James who now has kidney failure and not allow harm to befall him (nonmaleficence). Hence the decision to put him on immediate dialysis. Also, the suggestion by the physician to consider Samuel as a potential donor after failure to get a suitable one is an act of beneficence. However, the physician must also assess the potential risks to Samuel in donating a kidney to James, as required by the principle of nonmaleficence (Encyclopedia.com, 2016; Page, 2012; McCarthy, 2003) Case Study on Biomedical Ethics in the Christian Narrative Essay. The principle of autonomy states that Mike and Joanne as the parents of the minors have the last say in deciding what happens to them. It is them who must not only agree to the physician’s suggestions, but also give informed consent for any procedure (including dialysis) to be done. It is for this reason that Mike and Joanne’s decision to forego dialysis for James and take him to a faith healing crusade has to be respected by the physician. Additionally, the suggestion by the physician that Samuel be the organ donor to his twin brother is subject to approval and consent by both parents; as required by respect for autonomy (Encyclopedia.com, 2016; McCarthy, 2003). This means that the decision as to whether James will get one kidney from his brother or wait for God to perform his miracle on him is the parents’.
Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

To save James (nonmaleficence) and improve his quality of life (beneficence) the physician has suggested immediate dialysis. However, the parents must first give their consent for that to happen (autonomy). This is the same case with the suggestion of transplantation by the physician. The principle of justice and fairness requires that the physician and the health institution consider James with priority in the list of those waiting for transplantation based on the urgency of the situation.

 

Applying the Four Principles: Case Study Part 2 (Evaluation)

From a Christian standpoint, of the four ethical principles of Principlism the most pressing one in this case study is nonmaleficence. As stated above, this is the principle that states that no harm should be brought upon the patient by the actions of those taking care of him (Encyclopedia.com, 2016; McCarthy, 2003). This is consistent with a study that was conducted by Page (2012). In the survey conducted by the use of a questionnaire, it was found that student healthcare workers actually ranked nonmaleficence highest among the four principles. Conversely, they ranked beneficence or “truth-telling” as the least important (Page, 2012). Arguably, this is also the same factor that is motivating the religious parents of James and Samuel.  As such, their refusal to immediately allow James to undergo dialysis and opt for faith healing is informed partly by fear that the procedure (dialysis) might also harm James. Equally, the parents’ reluctance to buy into the idea that Samuel donates one of his kidneys to James is also a result of fear that Samuel may remain in a precarious health situation after donating his kidney. In all this, the general Christian view therefore is that God cannot allow harm to befall any of his creation.

From a Christian point of view, again, a Christian person might rank the four principles in order of priority from the highest to the lowest as follows: nonmaleficence, beneficence, justice, and autonomy. As explained above, a Christian will most likely view nonmaleficence as the most important of the four. This is because it is very unChristian to want to cause harm to another human being. Beneficence should come second for the simple reason that it is the opposite of nonmaleficence. Beneficence is the act of doing good to the other person and carrying out all activities with the intention of ultimate benefit to them, in the context of a patient and care giver (Encyclopedia.com, 2016; Page, 2012; McCarthy, 2003). For a Christian person, the act of not intending to do harm to the patient (nonmaleficence) is automatically supported by a need and wish to do what benefits the patient (beneficence). The third principle from the top in this hierarchy would be justice. For a Christian, after refusing to harm their “neighbor” and deciding to only do what benefits the said “neighbor,” the next thing they would want for this person is nothing but justice and fairness. He would want this person to be treated justly and fairly in terms of not only sharing available resources, but also preventing harm to them by those with criminal intent for instance. Lastly and at the bottom of the list would be respect for autonomy of decision by the patient or relatives Case Study on Biomedical Ethics in the Christian Narrative Essay.

Conclusion

The biomedical ethical theory of Principlism with its four principles of respect for autonomy, beneficence, nonmaleficence, and justice closely conforms to and agrees with common socio-cultural and religious preferences and beliefs. This makes it better placed to be a reference point in ethical decision-making in clinical practice.

References

Advanced Practice Toolkit (1 May 2018). Ethical Principles. Retrieved from https://www.advancedpractice.scot.nhs.uk/law-ethics/ethics/ethical-principles.aspx

Encyclopedia.com (2016). Principlism. Retrieved from https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/principlism

McCarthy, J. (2003). Principlism or narrative ethics: Must we choose between them? Journal of Med Ethics; Medical Humanities, 29(2), 65-71. Doi: 10.1136/mh.29.2.65

Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making? BMC Medical Ethics, 13(10). Doi: 10.1186/1472-6939-13-10 Case Study on Biomedical Ethics in the Christian Narrative Essay.

Moral Status Fetal Abnormality Case Study

Moral Status Fetal Abnormality Case Study

Based on \”Case Study: Fetal Abnormality\” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?
Remember to support your responses with the topic study materials Moral Status Fetal Abnormality Case Study.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears Moral Status Fetal Abnormality Case Study.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.

The Question of Moral Status: A Case of Fetal Abnormality and the Dilemma of Abortion versus Religious Beliefs

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Introduction

Moral status is the employment of ethical principles in the consideration of the importance of living things and their value, in as far as life is concerned (Gray, 2019). In an examination of the theories of moral status, some theorists clearly believe that life is equal regardless of the living thing under consideration, while others believe it is not. These theories have placed some sort of hierarchy or levels of consideration for moral standing. For example, Tauer (2001) quotes Warren in her1997 book Moral Status as considering all living things to be having the same moral standing (status). This is from human beings with complete full moral status (FMS) to the least significant single-celled organisms. This paper examines in this context the matter of a deformed fetus that is also likely to have cognitive deficiencies if carried to term.

The Christian View

The Christian view of the nature of human persons is that human beings right from conception are entitled to full moral status just by virtue of being a human being, all other considerations (like cognition status) notwithstanding (Gray, 2019; Studocu.com, n.d.). This view is compatible with the theory of moral status that is based on human properties (Studocu.com, n.d.). This is the religious or philosophical theory (Gray, 2019). The theory states that it is only human beings that possess moral status among all the other living things. All the others, including plants and animals, were created to serve the interests of the human being. It goes on to elaborate that the human person acquires this full moral status the moment that they are conceived in the womb. Thus according to this Christian and philosophical theory based on human properties, the status of a fetus and that of a grown complete human person with all cognitive functions intact is the same in as far as full moral status is concerned (Gray, 2019; Studocu.com, n.d.). This is related to the intrinsic human value and dignity in that the only characteristic for FMS is the fact of becoming a human being (at conception). What this implies is that this quality is innate or intrinsic, and human beings are conceived with it. In other words, human life is sacred right from conception Moral Status Fetal Abnormality Case Study.

The Theories Exhibited by Jessica, Marco, Maria, and Dr. Wilson in the Case Study

This case study involves a fetus that will not only be born with a deformity (lack of limbs), but also a 1 in 4 probability of having Down syndrome. This means that there is a high likelihood that the child will also be mentally challenged with cognitive (learning and thinking) deficiencies. From the case scenario, therefore, Jessica and Aunt Maria clearly subscribe to the religious/ philosophical theory of moral status based on human properties. As such, to them a human being possesses full moral status right from conception, regardless of their physical and mental deficiencies (Gray, 2019; Studocu.com, n.d.). Despite being concious of the reality of her precarious socio-economic status into which a mentally and physically challenged infant would impose further strain, Jessica still believes that “all life is sacred.” She therefore does not agree with Dr. Wilson’s view that aborting the baby is the best option. As for Aunt Maria, she is clearly religious and would not entertain any thought of terminating any life, whether already born or intra-uterine. She is clearly of the same theory as Jessica, which says that based on (intrinsic) human properties (of full moral status) all human life from conception is sacred. She characteristically therefore advises Jessica, despite the overwhelming medical evidence, to carry the pregnancy to term and play her role “as a mother.” Dr. Wilson on his part clearly subscribes to the moral status theory based on cognitive properties (Studocu.com, n.d.). Other authorities refer to this theory as the Kantian theory of moral status after Emmanuel Kant (Gray, 2019).  This particular theory of moral status holds that a living thing (human being) is only entitled to full moral status if they possess and can demonstrate “awareness, memory, understanding, and thinking.” This is capacity for cognition. Clearly, this being still a fetus it does not satisfy this criterion and hence it does not possess any moral status. But most importantly, the Kantian theory avers that this is essentially an “all-or-nothing position” (Gray, 2019). That is one either has cognitive ability or not, for possession of moral status. This fetus, from the medical tests, will certainly likely not have this cognitive capacity even if it s let to be born and grow (because of the possibility of Down syndrome). Dr. Wilson additionally belongs to the school of thought of the moral status theory based on relationships. He has a doctor-patient obligation which in this case does not confer moral status to Jessica’s unborn child (Studocu.com, n.d.). Finally, Marco – although apparently ambivalent – belongs also to the moral status theory of Kant that is based on cognitive properties. He “find[s] it difficult [that] the pregnancy and the … disabled child [will be] a burden and a barrier to their economic security and plans.” As such the fetus has no moral status because of the physical and possible cognitive disability.

My Position

I take the view that moral status in this case should be decided solely based on the theory of Kant or cognitive properties. The fetus either has cognitive potential (now) or cognitive ability (later) or not. This is what will confer moral status on it. I take this position as it will be in the best interest of the child to be aborted as a fetus rather than being born only to suffer the rest of their life. In fact, the moral status theory of sentience is in support of this (pain and suffering should not be caused to a living thing) (Studocu.com, n.d.). As the case study presents, however, the fetus has a significant likelihood of being born with Down syndrome-induced cognitive deficiency which they’ll carry for life. My theory position will thus influence recommendation for action in that letting the fetus live will be tantamount to condemning it to a lifetime of misery and suffering because of its physical and cognitive deficiencies Moral Status Fetal Abnormality Case Study.

Applying Ethical Frameworks in Practice

Applying Ethical Frameworks in Practice

Using the steps outlined in the decision-making models in your readings, select one ethical decision-making model and use the model to analyze the case provided.

Case Scenario:

A 6-year-old develops a high fever accompanied by violent vomiting and convulsions while at school. The child is rushed to a nearby hospital. The attending physician makes a diagnosis of meningitis and requests permission to initiate treatment from the parents. The child’s parents are divorced. The mother, who is not the biological parent of the child, has primary custody. She is a Christian Scientist who insists that no medical treatment be offered for religious reasons. The biological father, who resides in another state, is also contacted. He insists that treatment be given and seeks independent consultation from another physician.

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Assignment:

In a formal, written paper of 800-1,200 words, answer the following questions:

What is the ethical dilemma here? Describe the decision-making model you selected from your readings. How would you resolve this dilemma using the model? Include, at the end of your paper, a 200-word dialog in which you explain your decision to the family. (Remember to use language that the family would understand). A minimum of three references must be used.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

Brian Foster Chest Pain Shadow Health Assessment

Brian Foster Chest Pain Shadow Health Assessment

Introduction and Pre-brief

This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.

Tips and Tricks

The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.

Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Be sure to take advantage of the Cardiovascular Concept Lab to sharpen your skills prior to beginning this assignment. Brian Foster Chest Pain Shadow Health Assessment

Optimize your listening experience by using headphones with your computer and listen to both normal and abnormal sounds multiple times to improve your proficiency with recognizing subtle differences.

Often patients present with a specific complaint or problem. However, during the history and physical examination, a new problem may be discovered that takes precedence during the visit. Be alert to such a situation with this case study assignment Brian Foster Chest Pain Shadow Health Assessment

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The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.  Brian Foster Chest Pain Shadow Health Assessment.

 

 

Subjective Data Collection: 30 of 30 (100.0%)

Hover To Reveal…

Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.

  • Found:

    Indicates an item that you found.

  • Available:

    Indicates an item that is available to be found.

Category

Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this patient.

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

Chief Complaint

  • Finding:

    Established chief complaint

  • Finding:

    Reports sporadic chest pain

    (Found)

    Pro Tip: Chest pain can be a sign of many health problems, some serious and some less serious. It is important to follow up with discovery of chest pain by asking about its characteristics and severity. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    Do you have chest pain?

Brian Foster Chest Pain Shadow Health Assessment

History of Present Illness

  • Finding:

    Asked about onset of pain

  • Finding:

    Reports chest pain started appearing in the past month

    (Found)

    Pro Tip: Establishing the onset of a patient’s pain is essential in diagnosing its severity as well as the comfort of the patient.

    Example Question:

    When did your chest pain start?
  • Finding:

    Asked about location of pain

  • Finding:

    Reports pain is in center of the chest

    (Found)

    Pro Tip: Identifying the location of a patient’s pain is essential in determining which body systems are affected, the underlying cause of the pain, and how best to treat it. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    Where is the pain?
  • Finding:

    Reports pain does not radiate

    (Found)

    Pro Tip: Pain radiation is an important symptom that can be helpful in understanding the cause of pain and narrowing the diagnosis.

    Example Question:

    Does the pain radiate?
  • Finding:

    Denies arm pain

    (Found)

    Pro Tip: When combined with chest pain, arm pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing arm pain?
  • Finding:

    Denies shoulder pain

    (Found)

    Pro Tip: When combined with chest pain, shoulder pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing shoulder pain?
  • Finding:

    Denies back pain

    (Found)

    Pro Tip: When combined with chest pain, back pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing back pain?
  • Finding:

    Denies neck pain

    (Found)

    Pro Tip: When combined with chest pain, neck pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing neck pain?
  • Finding:

    Asked about duration of pain episodes

  • Finding:

    Reports each episode lasted “several” minutes

    (Found)

    Pro Tip: Knowing the duration of a patient’s pain gives you a more complete picture of its severity and potential impact on the patient’s health.

    Example Question:

    How long does your chest pain last?
  • Finding:

    Asked about frequency of pain

  • Finding:

    Reports 3 episodes in past month

    (Found)

    Pro Tip: Establishing a timeline for a patient’s symptoms can help you to better diagnose his condition and most effectively treat him.

    Example Question:

    How many times in the last month have you had chest pain?
  • Finding:

    Reports that episodes did not seem related

    (Available)

    Pro Tip: Asking your patient if the episodes seem associated can point to possible factors that aggravate the episodes or trigger symptoms, and can help narrow your diagnosis. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Did the episodes seem associated?
  • Finding:

    Asked about severity of pain

  • Finding:

    Reports current pain is 0 out of 10

    (Found)

    Pro Tip: For many patients, it is difficult to clearly describe pain. Asking Brian to rate his pain on a scale from 0 to 10 develops a consistent measure of pain severity.

    Example Question:

    How would you rate your pain on a scale of zero to ten?
  • Finding:

    Reports pain severity at its worst is 5 out of 10

    (Found)

    Pro Tip: For many patients, it is difficult to clearly describe pain. Asking Brian to rate his pain at its worst gives a clearer picture of the pain’s severity.

    Example Question:

    How would you rate your pain on a scale of zero to ten?
  • Finding:

    Asked about character of pain

  • Finding:

    Describes pain as tight and uncomfortable

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Can you describe your pain?
  • Finding:

    Denies crushing pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Is the pain crushing?
  • Finding:

    Denies gnawing pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Is the pain gnawing?
  • Finding:

    Denies burning pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Is the pain burning?
  • Finding:

    Asked about aggravating factors

  • Finding:

    Reports pain is aggravated by activity

    (Found)

    Pro Tip: Aggravating factors reveal further information about the nature of the pain and the body systems affected.

    Example Question:

    What makes the pain worse?
  • Finding:

    Pain occurred with yard work and taking stairs

    (Found)

    Pro Tip: Determining the activity that may have caused the patient’s complaint is crucial because it may reveal the root cause of the complaint.

    Example Question:

    What activity triggered the pain?
  • Finding:

    Pain does not worsen with eating

    (Available)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse when you eat?
  • Finding:

    Pain does not worsen after spicy foods

    (Available)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse after you eat spicy food?
  • Finding:

    Pain does not worsen after high-fat foods

    (Found)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse after you eat high-fat foods?
  • Finding:

    Asked about relieving factors

  • Finding:

    Reports pain relief with brief period of rest

    (Found)

    Pro Tip: It’s important to assess the nature of pain by asking about relief. Relieving factors can help narrow the body system and assist in a more accurate diagnosis. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    What relieves your pain?
  • Finding:

    Reports no medication to treat chest pain

    (Found)

    Pro Tip: It’s important to assess the nature of pain by asking about relief. Discovering any pain medication Brian takes can help you assess the nature and severity of his pain and avoid any unwanted medication interactions. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Did you take anything for the chest pain?

Medical History

  • Finding:

    Confirmed use of medications

  • Finding:

    Confirms medications

    (Found)

    Pro Tip: Determining what, if any, medications a patient is taking is a crucial element of a thorough health history and will help you avoid unwanted drug interactions.

    Example Question:

    What medications do you take?
  • Finding:

    Reports taking hypertension medication

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take medication for hypertension?
  • Finding:

    Reports taking hyperlipidemia medication

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take medication for hyperlipidemia?
  • Finding:

    Reports occasional ibuprofen use

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take over the counter medications?
  • Finding:

    Reports taking fish oil

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication or supplements will help you to treat your patient.

    Example Question:

    Do you take any supplements?
  • Finding:

    Denies aspirin regimen

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take aspirin?
  • Finding:

    Followed up on hypertension treatment

  • Finding:

    Medication is Lopressor

    (Found)

    Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions.

    Example Question:

    What medication do you take for hypertension?
  • Finding:

    Lopressor dose is 100mg

    (Found)

    Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.

    Example Question:

    What dose of medication do you take for hypertension?
  • Finding:

    Takes Lopressor once daily

    (Found)

    Pro Tip: The frequency with which a patient takes his medications is an essential element of the complete picture of his medication treatment plan. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    How frequently do you take medication for hypertension?
  • Finding:

    Followed up on hyperlipidemia treatment

  • Finding:

    Medication is Lipitor

    (Found)

    Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    What medication do you take for hyperlipidemia?
  • Finding:

    Lipitor dose is 20mg

    (Found)

    Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.

    Example Question:

    What dose of medication do you take for hyperlipidemia?
  • Finding:

    Takes Lipitor once daily

    (Found)

    Pro Tip: The frequency with which a patient takes his medications is an essential element of the complete picture of his medication treatment plan.

    Example Question:

    How frequently do you take medication for hyperlipidemia?
  • Finding:

    Takes Lipitor at bedtime

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication information, like at what time of day Brian takes Lipitor, will help you to treat your patient. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    What time of day do you take your lipitor?
  • Finding:

    Has taken Lipitor for 1 year

 

 

 

Objective Data Collection: 30 of 33 (90.91%)

  •  Correct
  •  Partially correct
  •  Incorrect
  •  Missed
 Inspected face
1 of 1 point
Appearance (1/1 point)
  •  No visible abnormal findings
  •  Rash or lesion
  •  Cyanosis
  •  Pallor
  •  Redness or flushing
  •  Evidence of trauma (scar, laceration, or bruising)
 Inspected for jugular venous distension
1 of 1 point
Height Of Venous Pressure (1/1 point)
  •  4 cm or less above the sternal angle
  •  More than 4 cm above the sternal angle
 Inspected chest
1 of 1 point
Symmetry (1/2 point)
  •  Symmetric
  •  Asymmetric
Appearance (1/2 point)
  •  No visible abnormal findings
  •  Rash or lesion
  •  AP diameter abnormal
  •  Intercostal retraction while breathing
  •  Excessive use of accessory muscles while breathing
  •  Pectus excavatum
  •  Skin growths (freckles or moles)
  •  Evidence of skin trauma (scar, laceration, or bruising)
 Inspected abdomen
0.67 of 1 point
 Inspected hands and fingernails
1 of 1 point
Right: Appearance (1/4 point)
  •  No visible abnormal findings
  •  Redness
  •  Moles or skin tags
  •  Masses (warts, cysts, or tumors)
  •  Freckles, birthmark, or other discoloration
  •  Excessive dry or flaking skin
  •  Purpura
  •  Scarring
  •  Laceration, lesion, or wound
  •  Bruising
  •  Rash
Right: Nail Changes (1/4 point)
  •  No visible abnormal findings
  •  Pallor
  •  Cyanosis
  •  Splinter hemorrhages
  •  Clubbing
Left: Appearance (1/4 point)
  •  No visible abnormal findings
  •  Redness
  •  Moles or skin tags
  •  Masses (warts, cysts, or tumors)
  •  Freckles, birthmark, or other discoloration
  •  Excessive dry or flaking skin
  •  Purpura
  •  Scarring
  •  Laceration, lesion, or wound
  •  Bruising
  •  Rash
Left: Nail Changes (1/4 point)
  •  No visible abnormal findings
  •  Pallor
  •  Cyanosis
  •  Splinter hemorrhages
  •  Clubbing
 Inspected lower extremities and toenails
1 of 1 point
 Inspect lower extremities for edema
1 of 1 point
 Tested capillary refill time
1 of 1 point

Education & Empathy : 5 of 6 (83.3%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

  • Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
  • Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
  • Brian Foster Chest Pain Shadow Health Assessment
  • Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient Brian Foster Chest Pain Shadow Health Assessment
 1 Symptoms
Followed Up
 2 Hypertension and High Cholesterol
Followed Up
 3 Exercise
Followed Up
 4 Diet
Followed Up
 5 Weight Gain
Not Encountered
 6 Family History
Followed Up

Documentation / Electronic Health Record

Vitals
Blood Pressure Left Arm BP 146/88; Right Arm BP 146/90
O2 Sat 98%
Pulse 104 BPM
Resp. Rate 19
Temperature 36.7C

Document: Provider Notes

T

The patient reports to the clinic because of chest pains xxxxx. He reports experiencing xxxxx. He describes the chest pain xxxxx. . He denies heartburn xxxx

Return to Canvas to complete your SOAP note for this assignment.

Objective

General Survey:

Respiratory: Breathing is xxx.

Gatrointestital: Round, xx. No xxxx. Tymphanic throughout. xxx palpable xxxx. Neuro: Alert and oriented. xxxx all extremities. Skin: Warm, pink, xxx tenting. EKG: Regular

Return to Canvas to complete your SOAP note for this assignment.

Assessment

Diagnosis; 1. Angina basal pectori xxx

Self-Reflection Activity Time: 8 min

Explain the clinical reasoning behind your decisions and tasks.

Student Response: xxxthe xxx

Explicitly describe the tasks you undertook to complete this exam.

Student Response: xx used xxx

What data did you use to base your decisions on for this patient assessment?

Brian Foster Chest Pain Shadow Health Assessment

Effective Approaches in Leadership and Management Paper Example

Effective Approaches in Leadership and Management Paper Example

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct Effective Approaches in Leadership and Management Paper Example.
Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.

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Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Effective Approaches in Leadership and Management Paper Example

Professionalism and Social Media Essay Sample

Professionalism and Social Media Essay Sample

Social media plays a significant role in the lives of nurses in both their professional and personal lives. Additionally, social media is now considered a mainstream part of the process for recruiting and hiring candidates. Inappropriate or unethical conduct on social media can create legal problems for nurses as well as the field of nursing.

Login to all social media sites in which you engage. Review your profile, pictures and posts. Based on the professional standards of nursing, identify items that would be considered unprofessional and potentially detrimental to your career and that negatively impact the reputation of the nursing field Professionalism and Social Media Essay Sample.

In 500-750 words, summarize the findings of your review. Include the following:

Describe the posts or conversations in which you have engaged that might be considered inappropriate based on the professional standards of nursing.

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Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the standards governing the profession of nursing at work and in their personal lives. Include discussion of how personal conduct can violate HIPAA or be considered unethical or unprofessional. Provide an example of each to support your answer.
Based on the analysis of your social media, discuss what areas of your social media activity reflect Christian values as they relate to respecting human value and dignity for all individuals. Describe areas of your social media activity that could be improved.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Professionalism and Social Media Essay Sample.

Developing an Advocacy Campaign

Developing an Advocacy Campaign

Application: Part 1 – Developing an Advocacy Campaign To prepare: 1. Select a population health issue of interest to you and identify the population affected by the issue. 2. Locate two scholarly articles, each of which provides a description of an effective health advocacy campaign that addresses your issue. The articles need to focus on two different advocacy campaigns. 3. Analyze the attributes of the two campaigns to determine what made them effective. 4. Reflect on a policy you could propose or suggest a change to a current policy to improve the health of the population you selected. 5. Consider how you could develop an advocacy campaign, applying the attributes identified in similar, effective campaigns. To complete: For the Part 1 application (approximately 3–4 pages of content with a title page and references in APA format) address the following: 1. Describe your selected population health issue and the population affected by this issue. 2. Summarize the two advocacy campaigns you researched in this area. 3. Explain the attributes that made those campaigns effective. 4. Begin to develop a plan for a health advocacy campaign that seeks to create a new policy or change an existing policy with regard to the issue and population you selected. Be sure to include in your plan:

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A description of the public health issue and proposed policy solution 1. Specific objectives for the policy you want to be implemented 2. Begin to substantiate of your proposed campaign by data and evidence. 3. Be sure to paste the rubric at the end of your paper. Developing an Advocacy Campaign

Patient’s Spiritual Needs: Case Analysis Essay

Patient’s Spiritual Needs: Case Analysis Essay

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about \”Case Study: Healing and Autonomy\” as the basis for your responses in this assignment.

Answer the following questions about a patient\’s spiritual needs in light of the Christian worldview.

In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient\’s autonomy? Explain your rationale.
In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James\’s care? Patient’s Spiritual Needs: Case Analysis Essay

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In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?
Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Patient’s Spiritual Needs: Case Analysis Essay.

Future of Nursing: Leading Change, Advancing Health Essay

Future of Nursing: Leading Change, Advancing Health Essay

In a formal Future of Nursing: Leading Change, Advancing Health Essay, you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

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Review your state’s progress report by locating your state and clicking on one of the six progress icons for: education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage.

In a Future of Nursing: Leading Change, Advancing Health Essay:

Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action? Summarize two initiatives spearheaded by your state’s Action Coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

A minimum of three scholarly references are required for this Future of Nursing: Leading Change, Advancing Health Essay assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This Future of Nursing: Leading Change, Advancing Health Essay assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit Future of Nursing: Leading Change, Advancing Health Essay assignment to Turnitin. Please refer to the directions in the Student Success Center. Note: use State of Florida