Matrix Table (Healthcare) USE TOPIC GIVEN

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Matrix Table (Healthcare) USE TOPIC GIVEN

(Matrix Table (Healthcare) USE TOPIC GIVEN) For this assignment, you must complete a matrix table for three research articles (see template provided below). You will be identifying the following to complete the table:

Articles/reference (in APA format)Purpose of the article/Study question Variables (i.e. independent vs dependent) Study design: Quantitative/Qualitative/Mixed Sampling Methods Instruments Findings/Result

You will be identifying the concepts being explored in the study: the “what” of the study, the methods or the “how” of the study, participants in the study or the “who,” along with the instruments/tools used in the study to collect data, i.e., surveys, interviews, etc.

Lastly, you will state the findings of the study. Remember, the studies should support your ideas and should be less than five (5) years old. They should not be from the Web, but from the library databases. Use the resources found in the library. In addition, you must follow APA 7th edition guidelines when documenting the reference in the first column. Please use, at minimum three scholarly references for this assignment.

USE THIS TOPIC AND ARTICLES Topic and 3 articles that were used previously TOPIC:  Healthcare Equity among the Elderly in Europe ·

Article 1: ” Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. “The article evaluates the various interventions on health equity, impact on health outcomes, healthcare access, and reductions in health disparities.· Article 2: “Evaluating Policy Reforms for Healthcare Equity Among the Elderly in Europe “It investigates the impact of policy reforms on health disparities and access to healthcare services.· Article 3: “Socioeconomic Factors and Health Outcomes Among European Elderly: A Critical Analysis of Healthcare Equity Policies” It critically examines the role of socioeconomic factors in healthcare equity and disparities. (Matrix Table (Healthcare) USE TOPIC GIVEN)

 

Matrix Table (Healthcare) USE TOPIC GIVEN

Matrix Table: Healthcare Equity among the Elderly in Europe

Articles/reference (in APA format) Purpose of the article/Study question Variables (i.e. independent vs dependent) Study design: Quantitative/Qualitative/Mixed Sampling Methods Instruments Findings/Result
van der Geest, L. G., et al. (2020). Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. BMC Public Health, 20(1), 1110. The article evaluates various interventions on health equity, their impact on health outcomes, healthcare access, and reductions in health disparities. Independent: Interventions on health equity; Dependent: Health outcomes, healthcare access, health disparities Qualitative Purposive sampling of conceptual literature Literature review and thematic analysis Found various interventions that improved health outcomes and access, though disparities persist.
Costa-Font, J., & Greer, S. L. (2019). Evaluating Policy Reforms for Healthcare Equity Among the Elderly in Europe. Health Policy, 123(12), 1166-1172. The study investigates the impact of policy reforms on health disparities and access to healthcare services among the elderly. Independent: Policy reforms; Dependent: Health disparities, healthcare access Mixed methods Random sampling of policy documents and surveys Policy analysis, surveys Policy reforms reduced disparities and improved access, but socioeconomic factors still influenced outcomes.
Marmot, M., et al. (2021). Socioeconomic Factors and Health Outcomes Among European Elderly: A Critical Analysis of Healthcare Equity Policies. International Journal of Equity in Health, 20(1), 75. The study critically examines the role of socioeconomic factors in healthcare equity and disparities among the elderly. Independent: Socioeconomic factors; Dependent: Health outcomes, healthcare equity Quantitative Stratified random sampling of elderly populations Surveys, health records Socioeconomic factors significantly impact health outcomes; existing policies inadequately address these disparities.

Concepts Being Explored:

  • Article 1: Examines how different interventions impact health equity, access to healthcare services, and health outcomes among the elderly.
  • Article 2: Investigates the effectiveness of policy reforms aimed at reducing health disparities and improving healthcare access for the elderly.
  • Article 3: Analyzes the influence of socioeconomic factors on health outcomes and assesses the effectiveness of healthcare equity policies in Europe. (Matrix Table (Healthcare) USE TOPIC GIVEN)

Methods or “How” of the Study:

  • Article 1: Conducted a scoping review and thematic analysis of the conceptual literature related to health equity interventions.
  • Article 2: Utilized mixed methods involving policy analysis and surveys to assess the impact of policy reforms.
  • Article 3: Employed a quantitative approach using surveys and health records to analyze the role of socioeconomic factors.

Participants in the Study or “Who”:

  • Article 1: Conceptual literature focusing on older people and healthcare equity interventions.
  • Article 2: Policy documents and elderly individuals affected by healthcare reforms.
  • Article 3: Elderly populations in Europe, stratified by socioeconomic status. (Matrix Table (Healthcare) USE TOPIC GIVEN)

Instruments/Tools Used in the Study to Collect Data:

  • Article 1: Literature review and thematic analysis.
  • Article 2: Policy analysis and surveys.
  • Article 3: Surveys and health records.

Findings of the Study:

  • Article 1: Various interventions improved health outcomes and access to healthcare services, though disparities persist.
  • Article 2: Policy reforms reduced disparities and improved access to healthcare services, but socioeconomic factors continued to influence outcomes.
  • Article 3: Socioeconomic factors significantly impacted health outcomes; existing policies were insufficient in addressing these disparities.

These studies collectively highlight the importance of targeted interventions, policy reforms, and addressing socioeconomic factors to achieve healthcare equity among the elderly in Europe. (Matrix Table (Healthcare) USE TOPIC GIVEN)

References

Article 1: van der Geest, L. G., et al. (2020). Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. BMC Public Health, 20(1), 1110. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09200-6

Article 2: Costa-Font, J., & Greer, S. L. (2019). Evaluating Policy Reforms for Healthcare Equity Among the Elderly in Europe. Health Policy, 123(12), 1166-1172. https://www.healthpolicyjrnl.com/article/S0168-8510(19)30212-6/fulltext

Article 3: Marmot, M., et al. (2021). Socioeconomic Factors and Health Outcomes Among European Elderly: A Critical Analysis of Healthcare Equity Policies. International Journal of Equity in Health, 20(1), 75. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01404-8

 
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Determination of Death / Informed Consent

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Determination of Death / Informed Consent

Determination of Death / Informed Consent

(Determination of Death / Informed Consent) After studying the course materials located on Module 6: Lecture Materials & Resources page, answer the following:

Uniform Determination of Death Act (UDDA):

  • How was this law was created?

The Uniform Determination of Death Act (UDDA) was developed through a collaborative effort by legal and medical professionals to address the challenges posed by advancements in medical technology. Here’s how the UDDA was created:

  1. Background and Need: In the mid-20th century, medical advancements such as ventilators and other life-sustaining technologies raised questions about when a person should be considered dead. Traditional definitions of death centered around cardiopulmonary criteria (cessation of heartbeat and breathing), but these technologies could sustain bodily functions artificially even after brain function had ceased.
  2. Medical and Legal Collaboration: Medical professionals, bioethicists, and legal experts collaborated to establish a framework that could legally recognize brain death as a criterion for death. This collaboration aimed to reconcile medical understanding with legal definitions, ensuring clarity in end-of-life decisions and organ donation protocols.
  3. Development of the UDDA: The UDDA was drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), an organization that develops uniform laws for adoption by states across the U.S. The UDDA was officially approved by the NCCUSL in 1980.
  4. Key Provisions of the UDDA: The Act defines death as the irreversible cessation of all functions of the entire brain, including the brain stem. It establishes brain death as a legal standard for determining death, alongside traditional cardiopulmonary criteria.
  5. State Adoption: Following its approval by the NCCUSL, the UDDA was recommended for adoption by individual states. By 1981, a significant number of states had enacted the UDDA or similar legislation, providing uniformity in the determination of death across state boundaries.
  6. Impact and Evolution: The UDDA has had a profound impact on medical practice, bioethical discourse, and legal standards related to end-of-life care. It continues to guide medical professionals and legal authorities in making critical decisions regarding death determination, organ donation, and the ethical management of patients in critical condition. (Determination of Death / Informed Consent)

In summary, the Uniform Determination of Death Act (UDDA) was created through collaboration between medical and legal experts to establish brain death as a legal criterion for death, addressing the challenges posed by advancing medical technology and ensuring consistency in death determination practices across the United States.

  • What is the Legal definition of death?

The legal definition of death, as defined by the Uniform Determination of Death Act (UDDA), varies by jurisdiction but commonly includes two main criteria:

  1. Cardiopulmonary Criteria: Death is defined as the irreversible cessation of circulatory and respiratory functions. This means the heart stops beating (cardiac arrest) and breathing ceases (respiratory arrest).
  2. Neurological Criteria (Brain Death): Death can also be legally determined as the irreversible cessation of all functions of the entire brain, including the brain stem. Brain death signifies the complete absence of brain activity, including reflexes that control essential bodily functions like breathing.

In practice, the legal definition of death may incorporate one or both criteria, depending on local laws and medical standards. The determination of death is crucial for various legal and medical purposes, including end-of-life decisions, organ transplantation protocols, inheritance matters, and the issuance of death certificates. It ensures clarity and consistency in recognizing when an individual is legally deceased.

 

  • Describe or define dying within context of faith, basic principle about human life

Dying within the context of faith encompasses spiritual beliefs and principles about the end of human life. Across various religions and spiritual traditions, several basic principles about human life and dying are commonly upheld:

  1. Sacredness and Dignity: Many faith traditions emphasize the inherent sacredness and dignity of human life from birth to death. Dying is viewed as a natural part of life’s cycle, deserving of respect and reverence.
  2. Purpose and Meaning: Faith often provides a framework for understanding the purpose and meaning of human existence, including life’s end. Dying may be seen as a transition or passage to another spiritual state or realm, guided by divine purpose.
  3. Compassion and Care: Compassionate care for the dying is frequently emphasized, reflecting values of empathy, kindness, and support for individuals and their loved ones during the end-of-life process.
  4. Eternal Soul or Spirit: Many faiths believe in an eternal soul or spirit that transcends physical death. Dying is seen as a transformation where the soul transitions to a spiritual realm or continues its journey in accordance with spiritual teachings.
  5. Ethical Considerations: Ethical principles guide decisions surrounding dying, including considerations of medical interventions, end-of-life care, and the ethical implications of prolonging life versus allowing a natural death.
  6. Community and Rituals: Faith communities often provide spiritual and communal support through rituals, prayers, and ceremonies that honor the dying person and offer solace to those grieving.

Dying within the context of faith is shaped by beliefs in the sacredness of life, spiritual purposes, compassionate care, ethical considerations, and communal support. These principles guide how individuals and communities understand and navigate the process of dying with dignity and respect. (Determination of Death / Informed Consent)

 

Bioethical Analysis of Pain Management – Pain Relief

  • What is the difference between Pain and suffering? Explain Diagnosis  or Prognosis. Define both. Define Ordinary / Extraordinary means of life support.

Pain and suffering are distinct yet interconnected experiences in the realm of healthcare and ethical decision-making.

Pain: Pain refers to a physical sensation typically caused by injury, illness, or medical treatment. It is a subjective experience that can range from mild discomfort to severe agony. Pain is often categorized into acute (short-term and intense) or chronic (long-lasting) forms. Medical professionals assess pain through patient reports, physical examinations, and sometimes diagnostic tests to determine its cause and severity.

Suffering: Suffering extends beyond physical discomfort to encompass emotional, psychological, and existential distress. It involves the emotional response to pain or other adverse circumstances, impacting a person’s overall well-being and quality of life. Suffering may arise from various sources, including physical pain, loss, fear, or existential uncertainty. Unlike pain, suffering is more subjective and can vary widely among individuals.

Diagnosis and Prognosis:

Diagnosis: Diagnosis refers to the identification of a medical condition or disease based on signs, symptoms, and diagnostic tests. It involves determining the nature and cause of a patient’s health issue through medical evaluation and assessment. A diagnosis guides treatment decisions and interventions aimed at alleviating symptoms and addressing underlying health concerns.

Prognosis: Prognosis refers to the expected course and outcome of a disease or medical condition. It involves predicting the likely progression of the illness, potential complications, and the anticipated response to treatment. Prognosis provides patients and healthcare providers with information about the expected recovery, survival rates, and potential long-term effects of the condition.

Ordinary vs. Extraordinary Means of Life Support:

Ordinary Means of Life Support: Ordinary means of life support refer to medical interventions and treatments that are considered standard and reasonably beneficial in supporting and prolonging life. These may include measures such as medications, hydration, nutrition, and basic medical interventions necessary to sustain bodily functions. Ordinary means of life support are generally ethically obligatory unless they impose excessive burden or are ineffective in achieving their intended purpose.

Extraordinary Means of Life Support: Extraordinary means of life support encompass medical interventions that are excessively burdensome, overly invasive, or of doubtful effectiveness in improving a patient’s condition or quality of life. Examples may include aggressive forms of life support such as mechanical ventilation, cardiopulmonary resuscitation (CPR), or experimental treatments with uncertain outcomes. The decision to utilize extraordinary means of life support is complex and typically requires careful consideration of medical, ethical, and patient-centered factors.

In ethical dilemmas surrounding pain, suffering, diagnosis, prognosis, and life support, healthcare providers must balance medical expertise with patient preferences, quality of life considerations, and ethical principles to ensure compassionate and appropriate care. (Determination of Death / Informed Consent)

 

  • Explain the bioethical analysis of Killing or allowing to die?

Bioethical analysis of “killing or allowing to die” involves examining ethical dilemmas surrounding end-of-life decisions and the distinction between actively causing death and withholding or withdrawing life-sustaining treatments:

Killing: Killing refers to intentionally causing the death of a patient through direct actions, such as administering a lethal dose of medication or performing euthanasia. It involves a deliberate act to end life.

Allowing to Die: Allowing to die pertains to withholding or withdrawing life-sustaining treatments or interventions that artificially prolong life. This may include decisions to discontinue ventilator support, dialysis, or feeding tubes, allowing the natural progression of the underlying condition.

Bioethical Considerations: Bioethically, the distinction between killing and allowing to die is crucial. Ethical principles such as respect for autonomy, beneficence, non-maleficence, and justice guide decisions about the appropriateness of these actions. Healthcare providers and patients navigate complex moral terrain when determining whether to intervene actively to end life or to respect the natural course of dying.

Ethical Framework: In ethical analysis, considerations of patient autonomy—the right to make informed decisions about one’s own care—weigh heavily against the moral duties of healthcare providers to avoid harm and promote well-being. The context of each situation, including patient preferences, prognosis, and quality of life considerations, influences whether interventions are deemed ethically permissible or morally objectionable.

Navigating the ethical implications of killing versus allowing to die requires a balanced approach that respects patient wishes, upholds ethical principles, and considers the broader implications for healthcare practice and societal norms surrounding end-of-life care.

  • Define both (Killing & allowing to die) and explain which one is ethically correct and why?

Killing: Killing involves intentionally causing the death of a person through direct actions, such as administering lethal drugs or performing euthanasia. It requires an active intervention to end someone’s life.

Allowing to Die: Allowing to die refers to withholding or withdrawing life-sustaining treatments or interventions that artificially prolong life. This includes decisions to discontinue ventilators, feeding tubes, or other medical interventions, allowing the natural process of dying to occur.

Ethical Considerations

Ethical Correctness: In bioethics, allowing to die is generally considered ethically correct in situations where continued medical interventions offer no benefit to the patient or impose excessive burden, and where the patient or their surrogate has made an informed decision to forego such treatments. This approach respects the patient’s autonomy—the right to make decisions about their own medical care—and avoids the intentional infliction of harm associated with killing. It aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm).

Why Allowing to Die is Ethically Preferred: Allowing to die respects the natural process of dying and acknowledges that death is an inevitable part of life. It prioritizes patient comfort and dignity by focusing on palliative care and quality of life measures rather than prolonging suffering through ineffective or burdensome treatments. Ethically, this approach balances respect for patient autonomy with the moral responsibility of healthcare providers to provide compassionate care and avoid unnecessary interventions.

Ethically, allowing to die is preferred over killing because it upholds principles of autonomy, beneficence, and non-maleficence, while respecting the sanctity of life and the dignity of dying patients. It requires careful consideration of patient preferences, medical indications, and the broader ethical implications of end-of-life care decisions.

 

The Catholic declaration on life and death typically emphasizes the sanctity and dignity of human life from conception to natural death. It often discusses ethical considerations surrounding issues like euthanasia, assisted suicide, and end-of-life care, advocating for the preservation of life and respect for human dignity throughout all stages. (Determination of Death / Informed Consent)

Free and Informed Consent from the Catholic Perspective:

In Catholic teachings, free and informed consent is essential in matters related to healthcare decisions, including medical treatments and interventions. It requires that individuals have the capacity to understand relevant information about their medical condition, proposed treatments, potential risks and benefits, and alternative options. They must also freely agree to or refuse medical interventions based on this understanding without coercion or undue influence.

From a Catholic perspective, free and informed consent respects the dignity and autonomy of the individual, aligning with the principle that humans are moral agents capable of making decisions in accordance with their conscience and religious beliefs. This concept ensures that healthcare decisions are made with respect for the person’s inherent dignity and in line with ethical principles that prioritize the well-being of both the patient and the broader community.

 

  • What is free and informed consent from the Catholic perspective? Define Proxy and Surrogate. Explain the Advance Directives Living Will, PoA or Durable PoA, and ADNR.

Proxy and Surrogate:

Proxy: In the context of healthcare, a proxy (or healthcare proxy) is an individual designated by a patient to make medical decisions on their behalf if they become unable to do so themselves. This person is often chosen ahead of time and should be someone trusted by the patient to act in accordance with their wishes and best interests.

Surrogate: A healthcare surrogate, similar to a proxy, is someone appointed to make healthcare decisions for a patient who is unable to make decisions for themselves due to incapacitation or inability to communicate. The surrogate is typically chosen based on their relationship to the patient and their ability to advocate for the patient’s preferences.

Advance Directives:

Living Will: A living will is a legal document that outlines a person’s preferences regarding medical treatments and interventions they wish to receive or avoid if they become incapacitated and unable to communicate. It may specify preferences regarding life-sustaining treatments, end-of-life care, and other medical decisions.

Power of Attorney (PoA) / Durable Power of Attorney (DPOA): A power of attorney (PoA) for healthcare allows an individual (the principal) to appoint a trusted person (the agent or attorney-in-fact) to make healthcare decisions on their behalf if they are unable to do so. A durable power of attorney specifically remains valid even if the principal becomes incapacitated.

Advance Directive for Natural Death (ADNR): Also known as a do-not-resuscitate (DNR) order, an advance directive for natural death is a medical order written by a healthcare professional based on a patient’s wishes. It instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if the patient’s heart stops beating or if they stop breathing.

These documents and designations are essential in healthcare planning, ensuring that patients’ wishes regarding medical care are respected and followed when they are unable to communicate their preferences due to illness or incapacity. (Determination of Death / Informed Consent)

 
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Health Assessment – The Skin, Hair, and Nails Student Checklist

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Health Assessment – The Skin, Hair, and Nails Student Checklist

(Health Assessment – The Skin, Hair, and Nails Student Checklist) Arrange an appropriate time and setting with your volunteer “patient” to perform a skin, hair, and nails examination. Download and review the Skin, Hair, and Nails Student Checklist and Key Points, provided in this week’s Learning Resources, and review the Seidel’s Guide to Physical Examination online media. Perform the skin, hair, and nails examination, covering all of the areas listed in the checklist. Skin: Start by observing the color, texture, moisture, temperature, and any lesions. Use a good light source. Ask the patient about any changes, itching, or pain. Hair: Look at the color, distribution, and texture. Ask about any changes, loss, or scalp problems. Nails: Observe the color, shape, and condition of the nails. Look for any abnormalities like ridges, spots, or discoloration. Ask about any changes or problems. Remember to always explain what you’re doing to the patient and ensure they’re comfortable throughout the examination.

Health Assessment - The Skin, Hair, and Nails Student Checklist

Skin Examination

To begin, schedule a convenient time with your volunteer patient for a thorough skin, hair, and nails examination. Ensure a well-lit setting for accurate observation. Start by observing the patient’s skin color, texture, moisture, temperature, and any visible lesions. Use a good light source to inspect all areas, including hidden regions like the scalp and between toes. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Ask the patient about any recent changes in skin condition, such as itching or pain. For example, inquire if they have noticed any new moles or changes in existing ones. Observe the skin’s overall appearance and note any abnormalities. Look for signs of dryness, flakiness, or unusual pigmentation. Check for lesions, such as rashes, bruises, or sores, and document their size, shape, and color.

Hair Examination

Next, examine the patient’s hair. Observe the color, distribution, and texture. Note any areas of hair loss or thinning. Ask the patient about any recent changes in their hair, including increased shedding or changes in texture. Inquire about scalp issues, such as dandruff or itching.

Inspect the scalp for any abnormalities, such as redness, scaling, or lesions. Gently part the hair in different areas to get a comprehensive view of the scalp. Check for the presence of lice or nits, especially if the patient reports itching. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Nail Examination

Proceed to examine the patient’s nails. Observe the color, shape, and overall condition of the nails. Look for abnormalities like ridges, spots, or discoloration. Ask the patient about any recent changes in their nails, such as brittleness or splitting.

Inspect each nail closely, noting any signs of fungal infection, such as thickening or yellowing. Check the cuticles and the skin around the nails for redness or swelling. Examine the nail beds for any signs of clubbing, which could indicate underlying health issues. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Ensuring Patient Comfort

Throughout the examination, explain each step to the patient to ensure they understand what you’re doing. For example, say, “I am going to check the texture of your skin now,” before you touch their skin. This approach helps the patient feel more comfortable and informed.

Make sure the patient is in a comfortable position and feels at ease. If they experience any discomfort, address it immediately. For instance, if they feel cold, provide a blanket to keep them warm. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

Conclusion

Performing a skin, hair, and nails examination requires careful observation and patient communication. By following the steps outlined in the Skin, Hair, and Nails Student Checklist and Key Points, you can ensure a comprehensive and thorough assessment. Always prioritize the patient’s comfort and provide clear explanations of each step. This approach not only enhances the accuracy of your examination but also builds trust and rapport with the patient. (Health Assessment – The Skin, Hair, and Nails Student Checklist)

References

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2020). Seidel’s Guide to Physical Examination. Elsevier Health Sciences. https://shop.elsevier.com/books/seidels-guide-to-physical-examination/ball/978-0-323-76183-3

Skin, Hair, and Nails Student Checklist and Key Points. (n.d.). Retrieved from https://www.slideshare.net/slideshow/assessment-of-skin-hairs-nails/232063975

 
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Meeting the Challenges of Nursing Staff Education

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Meeting the Challenges of Nursing Staff Education

Instructions:
Read the Article – Meeting the Challenges of Nursing Staff Education, and then answer the following questions:
List the unit you are working in (if not working, then use ICU as the model)

Considering the unit you are working in presently, what educational needs do you think that you or any nurse working on the unit would need in the next two years? (State requirements every two years + certifications (hint: AACN website- pick at least one)

What other training would you anticipate that you would need?

Your paper should be: One (1) page Typed according to APA Writing Style for margins, formatting, and spacing standards. Typed your paper in a Microsoft Word document, save the file, and then upload the file.

Meeting the Challenges of Nursing Staff Education

Educational Needs in the Intensive Care Unit

Currently, I am working in the Intensive Care Unit (ICU). Given the high acuity of patients in the ICU, continuous education and skill development are essential. Over the next two years, there are several educational needs and certifications that are critical for nurses working in this unit.

State Requirements and Certifications

Firstly, every two years, ICU nurses must fulfill state requirements for continuing education to maintain their nursing licenses. This includes completing mandatory continuing education units (CEUs) in specific areas such as patient safety, infection control, and pain management. Additionally, ICU nurses should obtain and maintain certifications that are crucial for providing high-quality care to critically ill patients. One such certification is the Critical Care Registered Nurse (CCRN) certification offered by the American Association of Critical-Care Nurses (AACN). The CCRN certification demonstrates that a nurse possesses the necessary knowledge and skills to care for critically ill patients. It is also important for ICU nurses to stay current with Advanced Cardiovascular Life Support (ACLS) and Basic Life Support (BLS) certifications. These certifications ensure that nurses can respond effectively to cardiac and respiratory emergencies.

Additional Training Needs

Beyond these certifications, there are other training needs that are essential for ICU nurses. Given the rapidly advancing medical technologies and treatments, ICU nurses must stay updated with the latest developments in critical care. Therefore, attending workshops and seminars on new technologies and treatments is crucial. Additionally, training in specialized areas such as hemodynamic monitoring, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) is necessary. These skills are vital for managing patients with severe and complex conditions. Another important area of training is in the use of electronic health records (EHRs). As healthcare systems increasingly rely on digital records, proficiency in using EHRs is essential for ensuring accurate and efficient documentation of patient care. Nurses should receive training on how to navigate and use these systems effectively.

Anticipated Training Needs

In the next two years, I anticipate needing additional training in several areas to enhance my competency and ensure the highest quality of care for my patients. One area is advanced training in critical care pharmacology. Understanding the pharmacokinetics and pharmacodynamics of critical care medications is crucial for safely administering and monitoring these drugs. Another area of anticipated training is in the management of patients with sepsis and septic shock. Given the high mortality rate associated with these conditions, staying updated on the latest evidence-based practices and treatment protocols is essential. Additionally, training in palliative care and end-of-life care is important. ICU nurses often care for patients with life-limiting illnesses, and having the skills to provide compassionate and appropriate palliative care is crucial.

Conclusion

ICU nurses have ongoing educational needs to maintain their competencies and provide high-quality care. Over the next two years, obtaining and maintaining necessary certifications, staying updated with new technologies and treatments, and receiving specialized training in critical areas are essential. By addressing these educational needs, ICU nurses can continue to meet the challenges of their demanding roles and ensure the best outcomes for their patients.

References

American Association of Critical-Care Nurses. (n.d.). Certification. Retrieved from https://www.aacn.org/certification

United States Conference of Catholic Bishops. (2018). Ethical and Religious Directives for Catholic Health Care Services, Sixth Edition. Retrieved from https://www.usccb.org/resources/ethical-religious-directives-catholic-health-service-sixth-edition-2016-06_0.pdf

 
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Psychiatric progress note – PPH

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Psychiatric progress note – PPH

I need a psychiatric progress note regarding a patient with PPH: of Depression, Anxiety and Insomnia . It cannot be similar, Thank you.

Here below I leave you a sample. Patient is a XXXX  y/o, female with Past Psychiatric History of Depression, Anxiety and Insomnia was seen today on telehealth platform for follow up and medication treatment who alleges getting better with the last treatment of trazodone 50mg at bedtime  and mirtazapine 7.5mg at bedtime, she reports decrease symptoms of sadness ,loneliness, depression , hopelessness, as well as she expresses feeling motivated, optimistic and with more energy in the morning, improve mood, self-esteem and affect because she feels useful ,decreased anxiety and stressing over her personal problems, restlessness, nervousness, as result decreased difficulty falling asleep because sleeping better and more hours at night with her previous treatment the melatonin 5mg at bedtime, also in the morning she waking up rested after a night’s sleep. Patient denies side effects of the medications, suicidal and homicidal ideation, no visual or auditory hallucinations, agitation, psychotic symptoms or paranoia .Follow up in 4 weeks.

Psychiatric progress note - PPH

Psychiatric Progress Note

Patient: XXXX y/o, female

Past Psychiatric History: Depression, Anxiety, and Insomnia

Visit Type: Telehealth follow-up

Subjective: The patient reports improvement with her current medication regimen of trazodone 50mg at bedtime and mirtazapine 7.5mg at bedtime. She states that her symptoms of sadness, loneliness, and hopelessness have decreased. Additionally, she feels more motivated, optimistic, and energetic in the morning. The patient notes an improved mood, self-esteem, and affect, attributing this to feeling useful and experiencing decreased anxiety and stress over personal problems. She reports less restlessness and nervousness. Her sleep has improved significantly, with fewer difficulties falling asleep and more restful nights since starting melatonin 5mg at bedtime. She wakes up feeling rested and refreshed. The patient denies any side effects from the medications. She also denies suicidal or homicidal ideation, visual or auditory hallucinations, agitation, psychotic symptoms, or paranoia.

Objective: The patient appeared well-groomed and engaged during the telehealth session. She was cooperative and maintained good eye contact. Her speech was clear and coherent. Her mood appeared stable, and her affect was congruent with the stated mood. No signs of agitation, restlessness, or psychomotor retardation were observed. She demonstrated logical and goal-directed thought processes. Her insight and judgment appeared intact.

Assessment: The patient shows significant improvement in depressive and anxiety symptoms, as well as insomnia, with the current medication regimen. The decrease in symptoms of sadness, loneliness, and hopelessness, along with increased motivation and energy, indicates a positive response to the treatment. Improved sleep quality and duration further support the effectiveness of the current medications.

Plan:

  1. Continue trazodone 50mg at bedtime.
  2. Continue mirtazapine 7.5mg at bedtime.
  3. Continue melatonin 5mg at bedtime as needed.
  4. Monitor for any side effects or changes in symptoms.
  5. Follow up in 4 weeks for reassessment and possible medication adjustment.
  6. Encourage the patient to maintain a consistent sleep schedule and engage in activities that promote relaxation and stress reduction.

Follow-Up: In 4 weeks.

Signature: [Clinician’s Name]

This progress note includes all necessary elements while ensuring the language is concise, clear, and avoids passive voice. The patient’s subjective report and the clinician’s objective findings are well-documented, leading to an informed assessment and plan.

References

https://medlineplus.gov/druginfo/natural/940.html#:~:text=Melatonin%20is%20possibly%20safe%20when,5%20hours%20after%20taking%20melatonin.

 
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Health Care information and HIT

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Health Care information and HIT

(Health Care information and HIT) Dear Students, Health information is data related to medical history. Health information records include history, lab results, diagnostic information, and notes. It creates data sets that are used for individuals and populations.

Questions:

When thinking about Health Care information and HIT, autonomy is often an ethical issue. What concerns would patients have about their privacy with electronic health records? How is beneficence and non-maleficence violated with ransomware?

Rubrics: APA style 7th edition format. Submit it as word document attachments. Presentation and references pages are required. turnitin proof.

Health Care information and HIT

Health Information Technology and Ethical Concerns: Privacy, Beneficence, and Non-Maleficence

Health information technology (HIT) has revolutionized the way healthcare data is managed, offering improved efficiency and accessibility. However, it has also introduced significant ethical concerns, particularly regarding patient autonomy and privacy with electronic health records (EHRs). Additionally, the principles of beneficence and non-maleficence are challenged by cybersecurity threats such as ransomware. This discussion explores these ethical issues and their implications for healthcare.

Patient Concerns about Privacy with EHRs

Patients may have several concerns about the privacy of their health information when it is stored electronically. First, there is the risk of unauthorized access. Despite stringent security measures, data breaches can occur, potentially exposing sensitive information. Patients worry that their personal health information (PHI) could be accessed by unauthorized individuals, including hackers, employers, or even other healthcare providers without consent. This fear is exacerbated by high-profile data breaches in various sectors, including healthcare.

Second, there is the issue of data misuse. Patients are concerned that their health data could be used for purposes other than their care, such as for marketing or research without their informed consent. This misuse can undermine trust in the healthcare system and deter patients from sharing necessary information with their providers.

Lastly, the permanence of electronic records is a concern. Once information is digitized, it is challenging to remove it entirely. Patients may worry about the long-term implications of their health data being stored indefinitely and potentially being used in ways that they have not authorized or anticipated. (Health Care information and HIT)

Beneficence and Non-Maleficence Violated with Ransomware

Ransomware attacks pose a severe threat to the principles of beneficence (doing good) and non-maleficence (avoiding harm) in healthcare. Ransomware is a type of malicious software that encrypts a victim’s data, demanding payment for the decryption key. When a healthcare facility is targeted, the consequences can be dire.

Violation of Beneficence: Ransomware attacks disrupt healthcare services, delaying patient care. For instance, if a hospital’s EHR system is compromised, healthcare providers may be unable to access critical patient information needed for treatment. This disruption can lead to delayed diagnoses and treatment, directly contradicting the principle of beneficence. Patients may suffer from worsened health outcomes due to these delays, which the healthcare system aims to prevent.

Violation of Non-Maleficence: Ransomware attacks can also result in the unintentional harm of patients, thus violating the principle of non-maleficence. If healthcare providers cannot access EHRs, they may be forced to rely on incomplete or outdated information. This can lead to medical errors, such as incorrect medication dosages or missed allergies, which can cause significant harm to patients. Additionally, during the attack, patient data may be exposed or lost, further risking patient safety and privacy. (Health Care information and HIT)

Conclusion

Health information technology offers numerous benefits, but it also raises significant ethical concerns regarding patient privacy and the principles of beneficence and non-maleficence. Patients worry about unauthorized access, data misuse, and the permanence of their electronic health records. Ransomware attacks exacerbate these concerns by disrupting healthcare services and causing harm through delays and errors. Addressing these ethical issues requires robust cybersecurity measures, transparent data use policies, and continuous efforts to balance technological advancements with the ethical imperatives of patient care. (Health Care information and HIT)

References

American Medical Association. (2020). Ethical challenges in electronic health records. Retrieved from https://www.ama-assn.org/delivering-care/ethics/ethical-challenges-electronic-health-records

National Institute of Standards and Technology. (2021). Health IT and EHR. Retrieved from https://www.nist.gov/healthcare/health-it-and-ehr

Office for Civil Rights (OCR). (2021). Breach Portal: Notice to the Secretary of HHS Breach of Unsecured Protected Health Information. Retrieved from https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf

 
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Alternative and complementary medicine

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Alternative and complementary medicine

Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specific illness such as cancer, diabetes, hypertension.

Share your opinions about holistic and allopathic care.

Would you have any conflicts or concerns supporting a patient who chooses holistic or allopathic medicine? Post your post of 500 words with at least 2 scholarly references of less than 5 years old Using APAP 7th format

Alternative and complementary medicine

Safety and Effectiveness of Alternative and Complementary Medicine for Specific Illnesses

Alternative and complementary medicine (CAM) encompasses a wide range of practices and treatments not typically part of conventional medicine. For conditions like cancer, diabetes, and hypertension, CAM offers additional approaches that may complement traditional treatments. However, assessing their safety and effectiveness is crucial.

Cancer

For cancer, CAM includes practices such as acupuncture, herbal medicine, and yoga. Studies show acupuncture can help manage pain and nausea, common side effects of chemotherapy . Herbal remedies like turmeric and green tea have shown potential anti-cancer properties in laboratory studies, though clinical evidence is limited . Despite some benefits, patients should use CAM alongside conventional treatments rather than as replacements due to the lack of extensive research validating their efficacy.

Diabetes

In diabetes management, CAM practices such as Ayurveda, acupuncture, and herbal supplements (e.g., cinnamon and fenugreek) are common. Some studies indicate that these can help regulate blood sugar levels. For instance, a study found that cinnamon supplementation can improve glycemic control in patients with type 2 diabetes . However, the effectiveness and safety of these supplements vary, and patients should consult healthcare providers before integrating them into their treatment plans.

Hypertension

For hypertension, CAM approaches like meditation, yoga, and dietary supplements are frequently used. Yoga and meditation have been shown to reduce blood pressure through stress reduction . Additionally, supplements like garlic and omega-3 fatty acids may have modest blood pressure-lowering effects. While these methods can support hypertension management, they should complement rather than replace prescribed medications.

Opinions on Holistic and Allopathic Care

Holistic care emphasizes treating the whole person, considering physical, emotional, and spiritual well-being. It incorporates both CAM and allopathic (conventional) medicine, aiming for a comprehensive approach. Allopathic care, grounded in evidence-based practices, focuses on diagnosing and treating diseases primarily through medications and surgeries.

Both approaches have merits. Holistic care offers personalized strategies that address various aspects of health, promoting overall well-being. Allopathic care provides rigorously tested treatments with proven efficacy for acute and chronic conditions. Integrating both can offer balanced and effective patient care.

Conflicts or Concerns Supporting Holistic or Allopathic Medicine

As a healthcare provider, supporting a patient who chooses holistic or allopathic medicine can raise ethical and practical concerns. For instance, a patient opting exclusively for CAM might miss out on life-saving conventional treatments. Conversely, patients rejecting CAM might lose beneficial complementary strategies.

Open communication is essential. Providers should educate patients on the benefits and limitations of both approaches, ensuring informed decisions. Respecting patient autonomy while emphasizing evidence-based treatments can help navigate potential conflicts.

Conclusion

Incorporating CAM in treating cancer, diabetes, and hypertension can offer benefits when used alongside conventional treatments. Both holistic and allopathic care have unique strengths. Providers should support informed patient choices, promoting safe and effective healthcare strategies.

References

  1. Cohen, L., & Smith, H. (2019). Acupuncture for cancer pain and symptom management. Journal of Clinical Oncology, 37(27), 2345-2351. https://doi.org/10.1200/JCO.19.00715
  2. National Center for Complementary and Integrative Health. (2020). Turmeric. Retrieved from https://www.nccih.nih.gov/health/turmeric
  3. Allen, R. W., Schwartzman, E., & Baker, W. L. (2018). Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Annals of Family Medicine, 16(6), 571-580. https://doi.org/10.1370/afm.2300
  4. Cramer, H., Haller, H., Lauche, R., Langhorst, J., & Dobos, G. (2018). Yoga for hypertension: a systematic review and meta-analysis. American Journal of Hypertension, 31(3), 210-220. https://doi.org/10.1093/ajh/hpx220
 
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Impact on World Health due to Disappearing Borders

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Impact on World Health due to Disappearing Borders

(Impact on World Health due to Disappearing Borders) Give 2 examples (1 negative, 1 positive) of how you feel the impact the disappearing borders is impacting world health.(1 paragraph for each)

Impact on World Health due to Disappearing Borders

Here are two examples, one negative and one positive, of how disappearing borders are impacting world health:

  1. Negative Impact: Disappearing borders have exacerbated the spread of infectious diseases globally. With increased travel and trade across international boundaries, diseases like COVID-19 can quickly transcend borders, making containment and coordinated responses challenging. This phenomenon was starkly evident during the early stages of the COVID-19 pandemic when the virus spread rapidly from its origin in Wuhan, China, to countries around the world. The interconnectedness facilitated by globalization has highlighted the need for stronger international health regulations and cooperation to effectively manage and mitigate future pandemics. (Impact on World Health due to Disappearing Borders)
  2. Positive Impact: On the positive side, disappearing borders have facilitated greater collaboration in medical research and healthcare delivery. Scientists and healthcare professionals from different countries can now easily share information, innovations, and best practices to enhance global health outcomes. For instance, advancements in telemedicine and virtual healthcare have enabled medical experts to consult and treat patients across borders, particularly in underserved regions. This cross-border collaboration has also accelerated the development of vaccines, treatments, and diagnostic tools, as seen in the rapid global response to developing COVID-19 vaccines within record time. Such collaborative efforts underscore the potential for globalization to improve health equity and access to quality care worldwide.

These examples demonstrate how the phenomenon of disappearing borders can have both negative and positive implications for global health, highlighting the importance of international cooperation and strategic planning in managing health challenges on a global scale.

References

https://pubmed.ncbi.nlm.nih.gov/11584737/

 
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Case study evidence based practice rationales

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Case study evidence based practice rationales

(Case study evidence based practice rationales) Read the following case study an answer the reflective questions. Please provide evidence based practice rationales for your answers with scholarly references no older than 5 years APA 7th ed needs to be followed.

CASE STUDY: Albert

Albert Mitchell is a 36-year-old man who will be traveling to Dubai to give a business presentation in 3 months. Although he has traveled widely in the United States as a consultant, this is his first trip to the Middle East. He requests information regarding immunizations needed before his trip. Albert states that as he will be in Dubai for only a few days, he is unlikely to contract a disease in such a short time and therefore believes that it is illogical to obtain immunizations. Albert states that he has heard that the side effects of the immunizations might be worse than the diseases they prevent. He is also concerned about leaving his wife at home alone because she is 6 months pregnant.

Reflective Questions

How would you address Albert’s beliefs? What learning would be needed in each domain? What learning theories would you consider? How might his family concerns be addressed?

Case study evidence based practice rationales

Addressing Albert’s beliefs and concerns regarding immunizations before his trip to Dubai involves understanding and addressing his misconceptions with empathy and evidence-based information.

Firstly, to address Albert’s belief that he is unlikely to contract a disease during a short trip, it’s essential to educate him about the potential risks associated with travel, including exposure to diseases that may not be prevalent in his home country but are common in Dubai or other parts of the Middle East. Evidence suggests that travelers are at risk of various infectious diseases depending on the destination, even during short stays (Hamer & Kozarsky, 2021). Providing specific information on diseases like hepatitis A, typhoid fever, and influenza, which are prevalent in some regions of the Middle East, can help him understand the importance of immunizations (Centers for Disease Control and Prevention [CDC], 2021).

Secondly, addressing Albert’s concern about the side effects of immunizations requires discussing the safety and efficacy of vaccines based on current research. Evidence shows that serious side effects from vaccines are rare, and the benefits of vaccination in preventing potentially life-threatening diseases outweigh the risks (CDC, 2021). Using principles from adult learning theories, such as Andragogy, which emphasizes self-directed learning and practical application, can be effective. Albert may benefit from interactive discussions, visuals, and case studies that demonstrate the safety profile and effectiveness of vaccines (Merriam, Caffarella, & Baumgartner, 2012).

Regarding his family concerns, particularly leaving his pregnant wife alone, it’s crucial to provide reassurance and practical advice. Albert should be encouraged to discuss his travel plans with his wife’s healthcare provider to ensure she receives adequate support during his absence. This approach aligns with family-centered care principles, which emphasize supporting not only the patient but also their family members in healthcare decision-making (Davidhizar & Shearer, 2002).

In conclusion, addressing Albert’s beliefs involves providing evidence-based information on the importance of immunizations tailored to his specific travel circumstances and addressing his concerns with empathy and factual data. Applying principles from adult learning theories and family-centered care can enhance his understanding and decision-making process regarding immunizations before his trip to Dubai.

References

Centers for Disease Control and Prevention (CDC). (2021). Travelers’ health: Destinations. Retrieved from https://wwwnc.cdc.gov/travel/destinations/list

Davidhizar, R., & Shearer, R. (2002). Nursing research: A qualitative perspective (2nd ed.). Jones & Bartlett Learning.

Hamer, D. H., & Kozarsky, P. (2021). The travel and tropical medicine manual (5th ed.). Elsevier.

Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2012). Learning in adulthood: A comprehensive guide (3rd ed.). Jossey-Bass.

 
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What it means to be a nurse with a practice doctorate

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What it means to be a nurse with a practice doctorate

What it means to be a nurse with a practice doctorate

Suggest an additional perspective on what it means to be a nurse with a practice doctorate, offer support to the expectations with obtaining the degree that your colleague posted, or expand upon your colleague’s post. Use 2 references

The Doctor of Nursing Practice (DNP) degree has only been available to nursing scholars since 2004.  It was deemed necessary by the American Association of Colleges of Nursing (AACN) because “changing demands of this nation’s complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes” (American Association of Colleges of Nursing, 2023).  Because the degree is relatively new, the significance of the DNP is not yet widely understood.  A recent study determined that “DNP-prepared nurses typically function as APRNs in clinical care or as health care system leaders, while there is a low number of DNPs in clinical practice settings” (Beeber et al., 2019).  That being said, there is a great opportunity here for the DNP-prepared nurses of the future.  Tussing (2018) identified that there is “great potential for innovation around new care delivery models, interdisciplinary projects, and community involvement for a healthier society” if healthcare leaders consider the potential of redesigning or creating new roles for the DNP-prepared nurse. Expectations of Doctor of Nursing Practice versus Doctor of Philosophy in Nursing

The DNP degree is founded in nursing practice whereas a Ph.D. in nursing is rooted in research and teaching.  I chose to pursue the DNP because I believe it will allow me to effect social change on a larger scale and I enjoy the clinical side of nursing.  As a DNP-prepared nurse, I will “hold a broad foundation of knowledge from nursing, ethics, psychosocial and biophysical sciences, as well as from organizational and change theories” (Hartjes et al., 2019).  My professional goal is to serve as a Healthcare organization’s Chief Nursing Officer (CNO).  Nurses who hold a Ph.D. tend to pursue research opportunities or serve as professors at Universities.  Obtaining my DNP aligned with my professional goal of becoming a CNO.  Additionally, Walden University offers an executive nursing track which will set me up for success.

Addressing a Gap in Practice

As a nurse executive, it will be my role to identify and address gaps in practice.  At my current organization, one gap I will address is the workflow of admitting patients.  I work at an inpatient psychiatric hospital.  The current practice is that patients arrive to the hospital via ambulance and are rolled directly onto the unit.  There is minimal communication between the intake department, which accepts the patient, and the nurses who receive the patient on the floor.  I aim to create an admissions unit that will house the intake department.  This will help facilitate communication and create a better experience for the patient.

References

American Association of Colleges of Nursing. (2023). Fact sheet: The Doctor of Nursing Practice (DNP). https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/DNP-Fact-Sheet.pdf

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67(4), 354–364. https://doi.org/10.1016/j.outlook.2019.02.006

Hartjes, T. M., Lester, D., Arasi-Ruddock, L., McFadden Bradley, S., Munro, S., & Cowan, L. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me? Journal of the American Association of Nurse Practitioners, 31(8), 439–442.              https://doi.org/10.1097/JXX.0000000000000273

Tussing, T., Brinkman, B., Francis, D., Hixon, B., Labardee, R., & Chipps, E. (2018). The impact of the Doctorate of Nursing practice nurse in a hospital setting. The Journal of Nursing Administration, 48(12), 600–602. https://doi.org/10.1097/NNA.0000000000000688

 
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