Moral Dilemmas And Ethical Decisions Assignment

Create a 15-minute oral presentation (3–4 pages) that examines the moral  and ethical issues related to triaging patients in an emergency room.

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.

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. Moral Dilemmas And Ethical Decisions Assignment
• 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.

Preparation

Search the Capella library and the Internet for scholarly and  professional peer-reviewed articles on best practices in triage nursing.  You will need at least three articles to use as support for your work  on this assessment.

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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. Moral Dilemmas And Ethical Decisions Assignment

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. Moral Dilemmas And Ethical Decisions Assignment

Assessment 1 Instructions: Applying Ethical Principles

Heart Failure Clinic Resourcing Plan Assignment

Write a 3–4 page evidence-based resourcing plan for one component of the Heart Failure Clinic.

It is important for the nurse leader to have not only a basic  understanding of the budget process, but to understand how to work with  variances in staffing, patient loads, and supply costs in order to meet  the needs of the patients, without compromising the funding process of  the clinic.

By successfully completing this assessment, you will demonstrate  your proficiency in the following course competencies and assessment  criteria:

• Competency 3: Apply management strategies and best practices for  health care finance, human resources, and materials allocation  decisions to improve health care delivery and patient outcomes.
  • Apply evidence-based management strategies and best practices for resourcing health care services.
  • Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
• Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
  • Apply legal and professional standards for resourcing outpatient services.
• Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
  • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style. Heart Failure Clinic Resourcing Plan Assignment
    

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Instructions

Deliverable: Develop one component of an evidence-based resourcing plan.

Scenario:

The hospital leadership team has already allocated the major  capital expenditures for the heart failure clinic, such as the facility,  legal services, IT, and security services. However, as a member of the  nurse team, you have been asked to develop one component of a resourcing plan for the next leadership meeting.

You may use any combination of documents (for example, a  spreadsheet or a table) in addition to explanatory information to convey  information clearly and succinctly.

Choose  one of the following:

Budget:

• Apply evidence-based management strategies and best practices for resourcing health care services.
  • Identify the business plan budget categories and subcategories (not necessarily the actual cost) to establish a new clinic.
  • Start-up expenses.
  • Examine fixed and variable costs.
  • Capital budget items.
    • Examples: salary and benefits, staffing mix, specialized equipment or materials, et cetera.
  • Contingency fund and parameters.
• Apply legal and professional standards for resourcing outpatient services.
  • Explain the alignment to best practices and professional standards for cost effective outpatient services.
  • How will uninsured or underinsured patients be managed?
• Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
  • What data resources and tools analyze costs, health insurance, and hospitalization services?
  • How will billing be handled?
  • How will you determine if outpatient management is cost-effective?
  • How does transparency impact the consumer? Heart Failure Clinic Resourcing Plan Assignment

Staffing Plan:

• Apply evidence-based management strategies and best practices for resourcing health care services.
  • Identify the disciplines and skill mix needed for appropriate staffing.
  • Estimate staffing requirements by discipline and staffing ratios (evidence-based).
  • Develop a sample staffing schedule.
  • How will you staff to meet corporate diversity goals or the needs of diverse patients?
  • Explain how delegation, collaboration, negotiation will affect staffing plan.
    • How does a union contract affect the staffing plan or schedule?
      • Examine the Nurse Practice Act for your state.
        • How does the Nurse Practice Act affect your staffing plan?
• Apply legal and professional standards for resourcing outpatient services.
  • Align your staffing plan to best practices, the Nurse Practice  Act for your state, scope of practice, and the Joint Commission  standards for outpatients.
• Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
  • How will you know if staffing is cost-effective?
  • How will you know if staffing mix or schedule impacts patient outcomes?

Additional Requirements

• Written communication: Written communication should be free of errors that detract from the overall message.
• APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
• Length: The plan should be 3–4 pages in content length, double-spaced.
• Font and font size: Times New Roman, 12 point.
• Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards. Heart Failure Clinic Resourcing Plan Assignment

Assessment 1 Instructions: Preliminary Care Coordination Plan

Develop a 3-4-page preliminary care coordination plan for an individual in your community with whom you choose to work. Identify and list available community resources for a safe and effective continuum of care.

NOTE: You are required to complete this assessment before Assessment 4.

The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for an individual in your community as you consider the patient’s unique needs; the ethical, cultural, and physiological factors that affect care; and the critical resources available in your community that are the foundation of a safe plan for the continuum of care.

As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.

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Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Adapt care based on patient-centered and person-focused factors.
  • Analyze a health concern and the associated best practices for health improvement.
• Competency 2: Collaborate with patients and family to achieve desired outcomes.
  • Establish mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient. Assessment 1 Instructions: Preliminary Care Coordination Plan
• Competency 3: Create a satisfying patient experience.
  • Identify available community resources for a safe and effective continuum of care.
• Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
  • Write clearly and concisely in a logically coherent and appropriate form and style.

Preparation

Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

As you assume your expanded care coordination role, you have been tasked with addressing the specific health concerns of a particular individual within the community. You decide to prepare a preliminary care coordination plan and proceed by identifying the patient’s three priorities for health and by investigating the resources available in your community for a safe and effective continuum of care. Assessment 1 Instructions: Preliminary Care Coordination Plan

To prepare for this assessment, you may wish to:

• Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
• Allow plenty of time to plan your patient clinical encounter.
• Be sure that you have a patient in mind that you can work with throughout the course.

Note: Remember that you can submit all, or a portion of, your draft plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Instructions

Note: You are required to complete this assessment before Assessment 4.

This assessment has two parts.

Part 1: Develop the Preliminary Care Coordination Plan

Complete the following:

• Identify a health concern as the focus of your care coordination plan. Possible health concerns may include, but are not limited to:
  • Stroke.
  • Heart disease (high blood pressure, stroke, or heart failure).
  • Home safety.
  • Pulmonary disease (COPD or fibrotic lung disease).
  • Orthopedic concerns (hip replacement or knee replacement).
  • Cognitive impairment (Alzheimer’s disease or dementia).
  • Pain management.
  • Mental health.
  • Trauma.
• Identify available community resources for a safe and effective continuum of care.

Part 2: Secure Individual Participation in the Activity

Complete the following:

• Contact local individuals who may be open to an interview and a care coordination plan addressing their health concerns. The person you choose to work with may be a colleague, community member, friend, or family member.
• Meet with the individual to describe the care coordination plan session that you intend to provide. Collaborate with the participant in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to the plan.
• Establish a tentative date and time for the care coordination plan session. Document the name of the individual and a single point of contact, either an e-mail address or a phone number.

Document Format and Length

For your care coordination plan, you may use the Care Coordination Plan Template [DOCX], choose a format used in your own organization, or choose a format you are familiar with that adequately serves your needs for this assessment. Assessment 1 Instructions: Preliminary Care Coordination Plan

• Your preliminary plan should be 3–4 pages in length. In a separate section of the plan, identify the person you have chosen to work with, and be sure to include his or her contact information.
• Document the community resources you have identified using the Community Resources Template [DOCX].

Supporting Evidence

Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.

Grading Requirements

The requirements, outlined below, correspond to the grading criteria in the Preliminary Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

• Analyze your selected health concern and the associated best practices for health improvement.
  • Cite supporting evidence for best practices.
  • Consider underlying assumptions and points of uncertainty in your analysis.
• Establish mutually agreed-upon health goals for the care coordination plan, in collaboration with the selected individual.
• Identify available community resources for a safe and effective continuum of care.
• Write clearly and concisely in a logically coherent and appropriate form and style.
  • Write with a specific purpose with your patient in mind.
  • Adhere to scholarly and disciplinary writing standards and current APA formatting requirements.

Additional Requirements

Before submitting your assessment, proofread your preliminary care coordination plan and community resources list to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan. Be sure to submit both documents.

CORE ELMS

Important note: The time you spend securing individual participation in this activity and the time you spend presenting your final care coordination plan to the patient in Assessment 4 must total at least three hours. Be sure to log your time in the CORE ELMS system. The CORE ELMS link is located in the courseroom navigation menu.

Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course. Assessment 1 Instructions: Preliminary Care Coordination Plan

EBP Proposal Plan Power Point Presentation Assignment

The dissemination of an evidence-based practice project proposal is an important part of the final project. Dissemination of your project to a local association or clinical site/practice informs important stakeholders of evidence-based interventions that can improve clinical practice and ultimately patient outcomes.

For this assignment, develop a professional presentation that could be disseminated to a professional group of your peers.

Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation. EBP Proposal Plan Power Point Presentation Assignment

Include the following in your presentation:

1. Introduction (include PICOT statement)

2. Organizational Culture and Readiness

3. Problem Statement and Literature Review

4. Change Model, or Framework

5. Implementation Plan

6. Evaluation Plan

7. Conclusion

You are required to cite a minimum of six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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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.

You are required to submit this assignment to turnitin. Please follow rubric.

Evidence-Based Practice Project: PICOT Paper

Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services. EBP Proposal Plan Power Point Presentation Assignment

A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital’s reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.

Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers information on the various aspects of health and medicine, such as their care’s effectiveness and their empathy levels. According to Xesfingi & Vozikis (2016), patient satisfaction is a healthcare quality’s measure given that it provides insight into the provider’s success at realizing the patient’s care expectations, and is also a key patients’ perspective behavioral intention’s determinant. While satisfaction has always been an important factor when delivering any form of a service, it has recently gained prominence or primacy within the healthcare space, especially at this time when the healthcare industry is fast shifting towards patient-centered models. According to Vocera’s 2016 ‘Rise of the Chief Experience Officer’ report, about 64% of the interviewed healthcare professionals stated that their healthcare organizations prioritize patient satisfaction in a similar extent to which they value clinical workflow and patient safety improvements. Increasingly, patients are demanding a larger claim in their healthcare, with the expectation that their healthcare providers will attain a certain service level.

Healthcare quality is increasingly becoming a universal issue, making the healthcare industry to undergo rapid transformations. According to Asamrew, Endris and Tadesse (2020), the rapid transformations are primarily driven by the need to realize its patient population’s ever-increasing needs and demands, instead of the traditional professional practice standards-based needs. In their study of a patient’s satisfaction score with a specialize hospital in Ethiopia, the researchers determined that patient-healthcare provider interaction and general facility amenity-related factors explained about 96.4% of the variability in the net overall satisfaction score. The hospital’s inpatient pharmacy services, the availability of laboratory, radiology and pain management services, and good quality services provided by the hospital physicians positively influenced patient satisfaction scores. Additionally, availability of accommodation rooms, toilet cleanliness, and dietary services had significant association with the patient satisfaction levels. In yet another study, Son and Yom (2017) classifies the factors impacting on ED patient’s satisfaction levels into three interrelated forces, including predisposing characteristics, enabling resources and need. First, the predisposing characteristics include demographic factors (age, sex, marital status and past illness), social structure (education and employment), and belief (subjective health, perceived social class and attitude towards health service – quality and status). Secondly, then enabling resources include family (income and type of health insurance) and community (type of hospital, mode of arrival, time taken, delayed or missed treatment and frequency of visiting the ED). Finally, the need factors include reason for visit and service received. Joe Greskoviak, president and chief operating officer at Press Ganey, categorizes the factors into communication, provider empathy, and care coordination (Heath, 2016). All these points are interrelated and affect each other.

Delayed or missed treatments have become a notorious phenomenon in most hospitals. In a recent research by Asheim et al., (2019), it was discovered that the prolonged ED stay was associated with a higher probability of being discharged from the ED without admission to the hospital and that there was no significant difference in hospitalization length for the admitted patients. Thus, the researchers concluded that prolonged ED stay was not associated with increased risk of death. However, many studies have determined that delayed or missed treatments are strongly associated with decreased patient satisfaction levels and reduced revenue for hospitals. Furthermore, ED overcrowding also reduced emergency care quality by prolonged patient total length of stay, increased rate of patients left without being seen, ambulance diversion, decreased patient satisfaction, decreased revenue collection, and etcetera (Wang et al., 2017). According to Wand (2019), the lengthy documentation and assessment processes, timeliness of consultations and delays in decisions about patient disposition in ED can lead to reduced ED patient satisfaction levels and frustrations by ED staff and hospital executives. As noted above, the complications are primarily caused by the hospital’s reliance on combined data resources and manual entry status updates when tracking patients and their records – all of which cannot meet the healthcare service demand for the many patients, leading to reduced patient flow in the ED, overcrowding, and delayed and missed treatments. EBP Proposal Plan Power Point Presentation Assignment

Technology can significantly help hospitals solve the mentioned complications. Primarily, by installing a RTLS, an automatic patient tracking system in the ED, hospitals can significantly increase the patient flow in their EDs (Drazen & Rhoads, 2011). According to Garie Fallo, the Western Reserve Hospital’s CNO, a technology suite can help improve care efficiency in EDs and boost patient satisfaction scores by 90% through streamlining the clinical workflow (Heath, 2016). With an automatic patient tracking system, patients would not need to stop at any stage for manual tracking, stipulating that there would be neither delays, prolonged wait times on stretchers, nor family waiting. Rather, the process would appear more satisfied, with a very seamless move to the ED room. Thus, right from their arrival, the patients would have a higher satisfaction with the provided services. The side-effect of the high satisfaction scores, according to a review of various peer-reviewed publications on the importance of patient satisfaction carried out by Prakash (2010), includes improved patient loyalty and retention, reduced vulnerability to price wars or bargains, consistent improvement in revenue and profitability, increased staff morale with reduced staff turnover, reduced risk or malpractice suits and accreditation issues, and increase personal and professional satisfaction. Consequently, by installing the proposed RTLS, hospitals can improve the ED patient’s satisfaction levels. Specifically, RTLS, compared to the manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services. EBP Proposal Plan Power Point Presentation Assignment

References Asamrew, N., Endris, A. A., & Tadesse, M. (2020). Level of Patient Satisfaction with Inpatient Services and Its Determinants: A Study of a Specialized Hospital in Ethiopia. (J. Haughton, Ed.) Journal of Environmental and Public Health, 2020(Article ID 2473469), 1-12. Asheim, A., Nilsen, S. M., Carlsen, F., Næss-Pleym, L. E., Uleberg, O., Dale, J., et al. (2019, December). The Effect Of Emergency Department Delays On 30-Day Mortality in Central Norway. European Journal of Emergency Medicine, 26(6), 446-452. Boehm, L., & Petty, K. (2016). The Rise of the Healthcare Chief Experience Officer. Vocera’s Experience Innovation Network. Boulos, M. N., & Berry, G. (2012, June 28). Real-Time Locating Systems (RTLS) In Healthcare: A Condensed Primer. International Journal of Health Geographics, 11(25). Drazen, E., & Rhoads, J. (2011, April). Using Tracking Tools to Improve Patient Flow in Hospitals. Retrieved May 30, 2021, from California Health Care Foundation (Online): https://www.chcf.org/wp-content/uploads/2017/12/PDF-UsingPatientTrackingToolsInHospitals.pdf Heath, S. (2016, May 24). Patient Satisfaction and HCAHPS: What It Means for Providers. (Xtelligent Healthcare Media, LLC) Retrieved May 30, 2021, from Patient Engagement HIT (Online): https://patientengagementhit.com/features/patient-satisfaction-and-hcahps-what-it-means-for-providers Prakash, B. (2010). Patient Satisfaction. Journal of Cutaneous and Aesthetic Surgery, 3(3), 151–155. Son, H., & Yom, Y.-H. (2017). Factors Influencing Satisfaction With Emergency Department Medical Service: Patients’And Their Companions’Perspectives. Japan Journal of Nursing Science, 14, 27–37. Wand, T., Crawford, C., Bell, N., Murphy, M., White, K., & Wood, E. (2019, July). Documenting The Pre-Implementation Phase For A Multi-Site Translational Research Project To Test A New Model Emergency Department-Based Mental Health Nursing Care. International Emergency Nursing, 45, 10-16. Wang, H., Kline, J. A., Jackson, B. A., Robinson, R. D., Sullivan, M., Holmes, M., et al. (2017, October). The Role Of Patient Perception Of Crowding In The Determination Of Real-Time Patient Satisfaction At Emergency Department. International Journal for Quality in Health Care, 29(5), 722–727. Xesfingi, S., & Vozikis, A. (2016, March 15). Patient Satisfaction With The Healthcare System: Assessing The Impact Of Socio-Economic And Healthcare Provision Factors. BMC Health Services Research, 16(94). EBP Proposal Plan Power Point Presentation Assignment