Working in an emergency room gives rise to ethical dilemmas. Due to time restraints and the patient’s cognitive impairment and lack of medical history, complications can and do occur. The nurse has very little time to get detailed patient information. He or she must make a quick assessment and take action based on hospital protocol. The organized chaos of the emergency room presents unique ethical challenge, which is why nurses are required to have knowledge of ethical concepts and principles.Create a 15-minute oral presentation (3–4 pages) that examines the moral and ethical issues related to triaging patients in an emergency room.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
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Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.       

Explain the health care policies that can affect emergency care.
Recommend evidence-based decision-making strategies nurses can use during triage.

Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.       

Describe the moral and ethical challenges nurses can face when following hospital policies and protocols.
Explain how health care disparities impact treatment decisions.

Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.       

Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.
Correctly format citations and references using APA style.

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

How does a triage nurse decide which patient gets seen first?
How does health disparity affect the triage nurse’s decision making?
What ethical and moral issues does the triage nurse take into account when making a decision?
What are triage-level designations?

Assessment Instructions 
  
Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.
The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

Directions
Create a 15-minute presentation (3–4 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.
Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.
Explain how health care disparities impact treatment decisions.
Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?
Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?
Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.

Additional Requirements
Your presentation should meet the following requirements:

Written communication: Written communication should be free of errors that detract from the overall message.
References: Include a reference section with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.
APA format: Resources and citations should be formatted according to current APA style and formatting.
Length: 3–4 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.
Font and font size: Times New Roman, 12-point.

Tools of the Trade
Briefly describe one of the tools or best practices of strategic planning or execution (implementation) (SWOT, Service-Value Chain, Appreciative Inquiry, etc.). Provide a URL/web link or reference for that tool or best practice that contains more information. The challenge will be to not repeat any of the tools or resources.
Demonstrate insightful thought and critical analysis about the approach. Propose an improvement.

Anticipating Change
Identify a disruptive innovation in healthcare (i.e. one that completely changed the market). Why was t revolutionary?  How did it change healthcare?  How can you be prepared for change?
NOTE:  The concept of disruptive innovation can be confusing. It is not a better method to do something, but a new and different way that often causes the disappearance of what it replaces. Think of photography; the emergence of digital technology virtually destroyed the film industry (e.g., Kodak).

Assignment:
Annotation of a Qualitative Research Article
Submit: Annotation of a Qualitative Research Article
This week, you will submit the annotation of a qualitative research article on a topic of your interest. This annotation is a precursor to the annotated bibliography assignment due in Week 10. 
An annotation consists of three separate paragraphs that cover three respective components: summary, analysis, and application. These three components convey the relevance and value of the source. As such, an annotation demonstrates your critical thinking about, and authority on, the source topic. This week’s annotation is a precursor to the annotated bibliography assignment due in Week 10.
An annotated bibliography is a document containing selected sources accompanied by a respective annotation of each source. In preparation for your own future research, an annotated bibliography provides a background for understanding a portion of the existing literature on a particular topic. It is also a useful first step in gathering sources in preparation for writing a subsequent literature review as part of a dissertation. 
Please review the assignment instructions below and click on the underlined works for information about how to craft each component of an annotation. 
It is recommended that you use the grading rubric as a self-evaluation tool before submitting your assignment.
By Day 7
· Annotate one qualitative research article from a peer-reviewed journal on a topic of your interest.
· Provide the reference list entry for this article in APA Style followed by a three-paragraph annotation that includes: 
o A summary
o An analysis
o An application as illustrated in this example
· Format your annotation in Times New Roman, 12-point font, double-spaced. A separate References list page is not needed for this assignment.
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· Sample paper to assist with assignment
Thomée, S., Dellve, L., Härenstam, A., & Hagberg, M. (2010). Perceived connections between information and communication technology use and mental symptoms among young adults-a qualitative study. BMC Public Health, 10(1), 66.
Summary
The topic of the qualitative study by Thomée, Dellve, Härenstam & Hagberg (2010) is “Perceived connections between information and communication technology use and mental symptoms among young adults”. The authors of this study were aimed on discovering a possible link between the use of information and communication technologies (ICT) and unhealthy mental conditions, including major depressive disorder (MDD), stress, and sleep disorders. This study doesn’t have a theoretical basis, because it is focused on creating a theory of how ICT may cause unhealthy mental conditions (Thomée et al., 2010).  Some previous studies have identified that frequent use of the internet, email, messengers, and computers, is associated with unhealthy mental conditions, however causal mechanisms were not identified (Thomée et al., 2010). Hence, the authors of this study conducted a semi-structured interview with 32 young adults who reported high ICT. Participants were divided into 2 groups. The first group consisted of 28 high computer users, while the second group consisted of 20 high mobile phone users (Thomée et al., 2010). 
The semi-structured interviews were conducted by the main author of the research. The author used qualitative interviews, which means that participants were asked open questions about connection between ICT and unhealthy mental conditions. In addition, the participant’s mental condition was assessed by a physician (Thomée et al., 2010). The data acquired during the interviews was analyzed with a qualitative content analysis. These researchers created the model based on the analyzed data. The model presented possible paths for associations between ICT use and mental symptoms. It was found that the main cause of negative mental conditions is high quantitative use of computers and smartphones (Thomée et al., 2010). Participants who used computers for a long periods of time reported that they were stuck in different unproductive activities such as web surfing and playing games. As a result, they had a feeling of the wasted time. Some participants also claimed that high use of ICT leads to feeling of loneliness (Thomée et al., 2010). In addition, long use of computers may have impact on physiological health. 
In both groups, several people have reported perceived connection between high ICT use and different mental symptoms, including depression. Some of the participants had stress and sleep disturbances that are also associated with MDD. Six men and six women were diagnosed with a various psychiatric disorders. Four participants were diagnosed with a mild depression, while two participants were diagnosed with a moderate depression (Thomée et al., 2010). 
The authors claimed that physiological problems foster the depression. Participants with long periods spent using mobile devices reported similar problems. It can be explained by the fact that not responding to SMS or calls may cause a feeling of guilt (Thomée et al., 2010). The researchers also claimed that another possible factor causing depression is that people prefer to tell bad news via SMS than face to face. In addition, it was mentioned that certain technological factors like electromagnetic radiation may affect mental condition (Thomée et al., 2010). It is important to mention that some participants claimed that ICT is not a primary cause of depression and that depression should be associated with a working activities that are often done with a help of computers. The authors note that some studies have found a direct connection between high psychological demands at work and risks of MDD development (Thomée et al., 2010). 
Analysis
The research question is well framed because it addresses a specific problem, and significant because it the problem it addresses is significant (Burkholder et al., 2016). Due to the rapid development of ICTs, it is important to conduct studies focused on discovering potentially negative impacts of computers and smartphones. The authors have provided a brief description of previous articles, hence relation of the research question to existing body of knowledge is quite strong (Thomée et al., 2010). According to some previous studies, 75% of 16-24-year-old Swedes used internet every day and more than 90% had computers. Another study described by the authors claim that ICTs provided both opportunities and risks, including negative impact on physiological and psychological condition (Thomée et al., 2010). Moreover, emailing and chatting were associated with depression and created symptoms that directly lead to MDD.  According to the APA (2013), stress, sleep disorders, loneliness, apathy, guilt, and depression are all criteria that can be used in diagnosing MDD in patients. These were all symptoms described by participants in this study (Thomée et al., 2010). Therefore, this article makes a significant contribution to an existing body of knowledge by providing detailed information about high ICT use and depression. 
The authors didn’t use any theory while conducting their research; instead these researchers derived their theory from the results of their research. This means that they used the inductive method (de Vaus, 2001). The research was aimed on interpreting answers to open-ended questions. All stages of the research were described in detail and in scientific language (Thomée et al., 2010). The research methods used in this qualitative study were therefore appropriate. The first method used was observation with a help of semi-structured interviews. The second method was interpretation that was made by coding of information acquired during the interviews and creating a model. Hence, the authors have used all methods appropriate to answer the research question (Thomée et al., 2010). 
It is also worth noting that the sample size used was not very big, but the amount of participants is enough for a qualitative study. It is possible that the study results were influenced by bias, because analysis and interviews were made by the main author (Thomée et al., 2010). Moreover, there are also some limitations presented in this study. Participants belonged to high achieving academic programs and their socio-economic status was not considered (Thomée et al., 2010). These specific issues pose some threats to generalization of the results. 
Finally, there were inclusion criteria used for participants. Only those who reported about high computer or mobile phone exposure and had at least two of the following symptoms: depression, stress, and sleep disturbances could become participants (Thomée et al., 2010). Here, there was a self-reporting, self-selecting sample of participants. Because almost all people in modern society use smartphones and computers, and only participants who claim to suffer from certain symptoms were considered, there would appear to be a link that might not be causal. Similarly, however, any variable could be used in the place of ICTs and might result in similar findings, regardless of the actual causation. Therefore, to insure more accurate results, it would be more effective to conduct research on people with high ICT use, and analyze how many of these people have symptoms of MDD, depression, stress, sleep disorders, or other unhealthy mental conditions.
Application
This article addresses a meaningful gap in the other sources in this field, because it is focused on researching influence of modern technologies on mental condition. As discussed in the article, there are numerous problems directly and indirectly associated with smartphone and computer use (Thomée et al., 2010). Thus, the article fills a gap in the literature, because it is aimed on discovering connection between depression, sleep disorders, stress and ICT’s. The impact of ICT’s can be quite significant, because they can be used to avoid social interactions or even cause a psychological addiction. Modern technologies reduce the amount of real life communication, and this lack of communication may be related to high rates of MDD among young adult population (Thomée et al., 2010). Furthermore, communication over the internet is far different from real life communication, and the main difference is anonymity. People tend to act antisocially when they are protected by anonymity (Grigg, 2010). This can, of course lead to additional symptoms of depression, as antisocial behavior towards others, or anonymous cyberbullying, can affect the mental condition of the target.  
It can be claimed that this article informs future researches on depression by providing a valuable information about how ICT’s can contribute to the development of MDD and other related symptoms such as sleep disorders and stress. As mentioned above, MDD is often associated with sleep disorders and other unhealthy conditions, so it should be considered as a complex problem (APA, 2013). In addition, the qualitative methods used in this article can be applied to find out what factors participants perceive as the most contributing to development of their MDD. Hence, qualitative interviews can be potentially helpful for identifying the major causes of MDD. Methods used in this research can also be applied to codify the qualitative interviews and create a model describing relation between different factors and MDD.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Burkholder, G. J., Cox, K. A., & Crawford, L. M. (2016). The scholar-practitioner’s guide to research design. Baltimore, MD: Laureate Publishing.
de Vaus, D. A. (2001). Research design in social research. Thousand Oaks, CA: Sage.
Grigg, D. W. (2010). Cyber-aggression: definition and concept of cyberbullying. Australian Journal of Guidance and Counselling, 20(02), 143-156.
Thomée, S., Dellve, L., Härenstam, A., & Hagberg, M. (2010). Perceived connections between information and communication technology use and mental symptoms among young adults-a qualitative study. BMC Public Health, 10(1), 66.

Case Study 1: Emerging Wireless Technology in the Healthcare Industry

The medical industry is a good example of an industry that must balance the security issues associated with wireless technologies with the business value added from wireless technologies.
Read the Information Week article about emerging wireless medical technologies titled, “Emerging Wireless Medical Technology Gets FCC Blessing” located at http://www.informationweek.com/healthcare/mobile-wireless/emerging-wireless-medical-technology-get/240000836.
Read the Information Week article about how wireless and mobile devices will change the healthcare practices titled, “Strategy: How Mobility, Apps and BYOD Will Transform Healthcare” located in the online course shell.
Write a four to five (4-5) page paper in which you:

Summarize the current and emerging wireless medical technologies.
Describe the wireless components needed for added business value in the healthcare environment.
Assess the additional staffing and support requirements needed to support the wireless technologies.
Analyze the potential technical and regulatory problems with implementing a wireless network in a healthcare organization and describe the mitigation methods to overcome these potential problems in the healthcare industry.
Use at least three (3) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

Compare and contrast wireless systems and their recent advances.
Evaluate the application of Wireless LANs, MANs, and PANs.
Use technology and information resources to research issues in wireless networks.
Write clearly and concisely about wireless computing topics using proper writing mechanics and technical style conventions.