Nutrition & Hydration/Persistent Vegetative State (PVS)

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Nutrition & Hydration/Persistent Vegetative State (PVS)

(Nutrition & Hydration/Persistent Vegetative State (PVS)) After studying the course materials located on Module 7: Lecture Materials & Resources page, answer the following:

Cure / care: compare and contrast.

Basic care: Nutrition, hydration, shelter, human interaction. Are we morally obliged to this? Why? Example Swallow test, describe; when is it indicated? When is medically assisted N/H indicated?
Briefly describe Enteral Nutrition (EN), including: NJ tube NG tube PEG Briefly describe Parenteral Nutrition (PN), including:

a. Total parenteral nutrition

b. Partial parenteral nutrition

Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
Case Study: Terry Schiavo (EXCEL FILE on Module 7: Lecture Materials & Resources page). Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not? Read and summarize ERD paragraphs #:  32, 33, 34, 56, 57, 58.
Submission Instructions: is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.  If references are used, please cite properly according to the current APA style. (Nutrition & Hydration/Persistent Vegetative State (PVS))

Nutrition & Hydration/Persistent Vegetative State (PVS)

Cure vs. Care: A Comparison

Cure and care are fundamental concepts in healthcare. Cure aims to eliminate disease and restore health. It involves medical interventions, treatments, and medications. For instance, antibiotics cure bacterial infections by eradicating bacteria. Care, however, focuses on comfort, well-being, and quality of life. It includes basic needs like nutrition, hydration, and emotional support. An example of care is providing palliative care to a terminally ill patient to ease pain and discomfort.

Basic Care: Moral Obligations

Basic care encompasses nutrition, hydration, shelter, and human interaction. Society holds a moral obligation to provide these essentials. Neglecting these needs can result in severe consequences, including death. For instance, a swallow test evaluates a patient’s ability to safely swallow food and liquids. It is indicated when there are signs of dysphagia, such as coughing while eating. Medically assisted nutrition and hydration are indicated when patients cannot meet their needs orally, such as in cases of severe dysphagia. (Nutrition & Hydration/Persistent Vegetative State (PVS))

Enteral Nutrition (EN)

Enteral Nutrition (EN) involves delivering nutrients directly into the gastrointestinal tract. This method is preferred when the digestive system functions properly but the patient cannot ingest food orally.

  • NJ Tube: A nasojejunal tube is inserted through the nose into the jejunum. It is used when gastric feeding is not tolerated.
  • NG Tube: A nasogastric tube is inserted through the nose into the stomach. It is used for short-term feeding.
  • PEG: A percutaneous endoscopic gastrostomy tube is placed directly into the stomach through the abdominal wall. It is used for long-term feeding.

Parenteral Nutrition (PN)

Parenteral Nutrition (PN) delivers nutrients directly into the bloodstream. It is used when the digestive system cannot be used.

  • Total Parenteral Nutrition (TPN): Provides all nutritional needs intravenously. It is used for patients with non-functioning gastrointestinal tracts.
  • Partial Parenteral Nutrition (PPN): Supplements oral intake or enteral nutrition. It provides partial nutritional support.

Bioethical Analysis of Nutrition and Hydration

The basic principle is to provide care that respects patient autonomy and beneficence. However, there are exceptions:

  1. When treatment is futile or does not benefit the patient.
  2. When treatment imposes a disproportionate burden relative to its benefits.

Case Study: Terry Schiavo

The Terry Schiavo case raises significant bioethical questions. Schiavo was in a persistent vegetative state, and her family was divided over continuing her PEG feeding. Ethical analysis should consider patient autonomy, quality of life, and medical futility.

Continuing PEG feeding in this case might not improve her quality of life or lead to recovery. Discontinuing it respects her previously expressed wishes and recognizes the burden of prolonged artificial nutrition.

Summary of ERD Paragraphs

  • ERD 32: Emphasizes the dignity of every human person and the obligation to provide basic care.
  • ERD 33: Stresses the need for competent decision-making in healthcare.
  • ERD 34: Highlights the importance of respecting patient autonomy and informed consent.
  • ERD 56: Discusses the moral obligation to provide food and water, even by artificial means, unless it is futile or burdensome.
  • ERD 57: Encourages the use of palliative care and comfort measures.
  • ERD 58: Clarifies the conditions under which artificial nutrition and hydration can be withheld or withdrawn.

In Terry Schiavo’s case, the analysis suggests discontinuing PEG feeding aligns with her wishes and the principle of not imposing disproportionate burdens. It respects her dignity and the quality of life considerations outlined in the ERD.

References

Florida Nurses Association. Barbara Lumpkin Institute. (n.d.). Retrieved from https://www.floridanurse.org/

 
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Euthanasia & Physician Assisted Suicide (PAS)

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Euthanasia & Physician Assisted Suicide (PAS)

Euthanasia & Physician Assisted Suicide (PAS)

(Euthanasia & Physician Assisted Suicide (PAS)) After studying the course materials located on Module 8: Lecture Materials & Resources page, answer the following:

  • Euthanasia Medical or Generic definition & Bioethical definition.
  • Describe pain and suffering within context of faith
  • Physician Assisted Suicide / Death ( PAS / PAD) Definition. Is it ethical?
  • Should we have the right to end our lives? Why yes or why not?
  • Better alternatives to PAS; compare and contrast each: Hospice Palliative care / Terminal sedation
  • Case studies.

Brief summary of: Hemlock Society Jacob Kevorkian & Britanny Maynard. Read and summarize ERD paragraphs #:  59, 60, 61.Submission Instructions: is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling. If references are used, please cite properly according to the current APA style

Euthanasia: Medical and Bioethical Definitions

Medically, euthanasia refers to the deliberate act of ending a person’s life to relieve suffering, often involving a physician administering a lethal dose of medication. Bioethically, euthanasia is viewed through the lens of moral principles, examining whether it respects human dignity, autonomy, and the sanctity of life.

Pain and Suffering within the Context of Faith

Within faith contexts, pain and suffering are often seen as part of the human experience, with redemptive value and a test of faith. Many religious perspectives emphasize compassionate care and support over measures to hasten death, viewing suffering as an opportunity for spiritual growth and community support.

Physician-Assisted Suicide / Death (PAS/PAD) Definition and Ethical Considerations

Physician-assisted suicide (PAS) or physician-assisted death (PAD) involves a doctor providing a patient with the means to end their own life, typically through prescribed medication. The ethicality of PAS/PAD is highly debated. Proponents argue it respects patient autonomy and alleviates suffering, while opponents contend it undermines the sanctity of life and could lead to a slippery slope of devaluing life, especially among vulnerable populations. (Euthanasia & Physician Assisted Suicide (PAS))

Right to End Our Lives: Ethical Considerations

The debate over whether individuals should have the right to end their lives hinges on autonomy versus the intrinsic value of life. Advocates for the right to die emphasize personal autonomy and the relief of unbearable suffering. Conversely, opponents argue that legalizing this right could lead to societal devaluation of life, particularly for the disabled and terminally ill.

Better Alternatives to PAS: Hospice, Palliative Care, and Terminal Sedation

Hospice and palliative care focus on providing comfort and improving the quality of life for terminally ill patients without hastening death. Hospice care offers comprehensive support, including pain management, emotional support, and spiritual care. Palliative care provides similar services but can be offered at any stage of illness, not just end-of-life. (Euthanasia & Physician Assisted Suicide (PAS))

Terminal sedation involves sedating a patient to alleviate intractable suffering, with the patient remaining unconscious until death occurs naturally. While not intended to hasten death, it allows patients to escape unbearable pain. Comparing these alternatives, hospice and palliative care focus on holistic support and pain relief, while terminal sedation addresses extreme cases of suffering when other methods fail.

Case Studies: Hemlock Society, Jacob Kevorkian, and Brittany Maynard

The Hemlock Society advocates for the right to die with dignity, providing education on end-of-life choices, including PAS/PAD. Jacob Kevorkian, known as “Dr. Death,” assisted terminally ill patients in ending their lives, sparking significant ethical and legal debates. Brittany Maynard, a terminally ill woman, chose to end her life under Oregon’s Death with Dignity Act, bringing national attention to the right-to-die movement.

ERD Paragraphs 59, 60, 61 Summary

ERD 59 emphasizes that euthanasia and PAS are morally unacceptable, as they undermine the respect for human life. ERD 60 discusses the importance of pain management and palliative care, encouraging efforts to relieve suffering without hastening death. ERD 61 highlights the need for compassionate care and the moral duty to avoid actions that intentionally cause death, affirming the value of life even in suffering. (Euthanasia & Physician Assisted Suicide (PAS))

Conclusion

The discussions on euthanasia, PAS/PAD, and end-of-life care revolve around balancing ethical principles, patient autonomy, and the sanctity of life. While there are no easy answers, a focus on compassionate, holistic care remains paramount. The case studies and ethical directives underscore the complexities and moral imperatives in these deeply personal decisions. (Euthanasia & Physician Assisted Suicide (PAS))

Reference

Euthanasia and Physician-Assisted Suicide:

Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA, 316(1), 79-90. https://jamanetwork.com/journals/jama/fullarticle/2532018

Pain and Suffering within the Context of Faith:

Sulmasy, D. P. (2006). The rebirth of the clinic: An introduction to spirituality in health care. Georgetown University Press. https://press.georgetown.edu/Book/Rebirth-of-the-Clinic

Hospice and Palliative Care:

National Hospice and Palliative Care Organization. (2021). Palliative care and hospice care. https://www.nhpco.org/palliativecare

Terminal Sedation:

Rietjens, J. A., van Delden, J. J., Onwuteaka-Philipsen, B. D., Buiting, H. M., van der Maas, P. J., & van der Heide, A. (2008). Continuous deep sedation for patients nearing death in the Netherlands: Descriptive study. BMJ, 336(7648), 810-813. https://www.bmj.com/content/336/7648/810

Hemlock Society, Jacob Kevorkian, and Brittany Maynard:

Quill, T. E., & Greenlaw, J. (2008). Physician-assisted death. Ethics in Medicine, University of Washington School of Medicine. https://depts.washington.edu/bioethx/topics/pad.html

The Brittany Maynard Fund. (2014). Brittany’s story. https://www.thebrittanyfund.org/brittanys-story/

Ethical and Religious Directives for Catholic Health Care Services (ERD):

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

 
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Management and Leadership – Veterans

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Management and Leadership – Veterans

(Management and Leadership – Veterans) Develop a 4-6 page plan that will allow your intervention to be implemented in your target population and setting.

Target population VETERAN. TOPIC PREVENTING HOMELESSNESS FOR VETERAN POPULATION Introduction

Management and Leadership

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented. Even the best intervention plan will not be effective without a sound and reasonable approach to implementing it. The implementation of the same intervention plan can vary drastically between different care settings, based on the culture of the care setting, the resources available, and the stakeholders involved in the project, as well as the specific policies already in place. A successful implementation plan blends contemporary and emerging best practices and technology with an understanding of the on-the-ground realities of a specific care setting and the target population for an intervention. By synthesizing these various considerations it is possible to increase the likely success of the implementation and continued sustainability of an intervention plan. (Management and Leadership – Veterans)

Preparations Read Guiding Questions: Implementation Plan Design [DOC].

This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment. As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. 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. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. What are the needs of your stakeholders that are relevant to your target population and need? What applicable health care policy and regulations are relevant to your target population and need? How will these considerations impact the development of your Intervention Plan Design assessment? How can you work these considerations into the development of your Implementation Plan Design assessment?

Instructions Note:

The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented. Your implementation plan design will be the third section of your final project submission. The goal for this is to design a plan that will allow your intervention to be theoretically implemented in your target population and setting. You should be able to preserve the quality improvement outcomes that you designed for your target population and setting while also ensuring that the intervention does not put undue stress on the health care setting’s resources or violate any policies or regulations. Provide enough detail so that the faculty member assessing your implementation plan design will be able to provide substantive feedback that you will be able to incorporate into the final draft of your project. At minimum, be sure to address the bullet points below, as they correspond to the grading criteria. You may also want to read the scoring guide and the Guiding Questions: Implementation Plan Design document (linked above) to better understand how each criterion will be assessed. In addition to the bullet points below, provide a brief introduction that refreshes the reader’s memory about your problem statement, as well as the setting and context for which this intervention plan was designed before launching into your implementation plan. Reminder: these instructions are an outline. (Management and Leadership – Veterans)

Your heading for this this section should be Management and Leadership and not Part 1: Management and Leadership.

Part 1: Management and Leadership

Propose strategies for leading, managing, and implementing professional nursing practices to ensure interprofessional collaboration during the implementation of an intervention plan. Analyze the implications of change associated with proposed strategies for improving the quality and experience of care while controlling costs.

Part 2: Delivery and Technology

Propose appropriate delivery methods to implement an intervention which will improve the quality of the project. Evaluate the current and emerging technological options related to the proposed delivery methods.

Part 3: Stakeholders, Policy, and Regulations

Analyze stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan. Propose existing or new policy considerations that would support the implementation of an intervention plan. (Management and Leadership – Veterans)

Part 4: Timeline

Propose a timeline to implement an intervention plan with reference to specific factors that influence the timing of implementation. Address Generally Throughout

Integrate resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

Communicate implementation plan in a way that clearly illustrate the importance of interprofessional collaboration to create buy-in from the audience. (Management and Leadership – Veterans)

References

U.S. Department of Veterans Affairs. (2021). VA Health Care: A System Worth Saving. Retrieved from https://www.va.gov/health/

Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA, 295(9), 1023-1032. https://jamanetwork.com/journals/jama/fullarticle/202422

 
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Reduction of medical errors

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Reduction of medical errors

Reduction of medical errors

Provide further suggestions on how their database search might be improved. Use 2 sources. The PICO(T) question is, “Among hospitalized patients, does using two identifiers compared to one reduce medical errors?” My clinical issue of interest is the reduction of medical errors. Medical errors are gaps in care that bear potential or actual capacity to harm the patient, such as inaccurate diagnosis and incomplete diagnosis (Aljabari & Kadhim, 2021). These have the ripple effect of inappropriate investigations and treatment, then adverse care outcomes (Aljabari & Kadhim, 2021). Some solutions to medical errors include proper identification of patients, thorough history taking, and comprehensive physical examination. One evidence-based method for patient identification is using two identifiers rather than one (Mroz et al., 2019). Therefore, I am prompted to investigate whether using two identifiers compared to one among hospitalized patients reduces medical errors. Search results discussion Regarding my search results, 19,600 articles appeared on the initial original search. As I added search terms such as two identifiers, one identifier, medical errors, and hospitalized patients using Boolean operators such as AND, NOT, and AND NOT, the number of articles appearing kept reducing. At first, they declined to 18,500, then to 17,200, and so on, in a declining trend. Strategies to optimize database search on my PICO(T) question

There are several strategies I can apply to optimize how effective a database search is while searching my PICO(T) question. These include having a specific search question, using Boolean operators, using more specific keywords, and using fewer synonyms (Degbelo & Teka, 2019). An example of a particular question is a PICO(T) question, which narrows down to a particular population, intervention, control, outcome, and timing. A more specific example is my PICO(T) question that reads, “Among hospitalized patients, does the use of two identifiers compared to one identifier reduce medical errors?” Besides, examples of Boolean operators are OR, AND, NOT, and AND NOT (Degbelo & Teka, 2019). Specific keywords, like particular search questions, direct the search further, optimizing it to give the best results. An example of keywords in my case includes “hospitalized patients,” “two identifiers,” “one identifier,” and “reduce medical errors.”

Lastly, using fewer synonyms helps fetch more search results, broadening your search outcome and choosing relevant resources (Degbelo & Teka, 2019). Applying such strategies helps to make the search process more effective and thorough. ReferencesAljabari, S., & Kadhim, Z. (2021). Common barriers to reporting medical errors. The Scientific World Journal, 2021, 1–8. https://doi.org/10.1155/2021/6494889 Links to an external site. Degbelo, A., & Teka, B. B. (2019). Spatial search strategies for Open Government Data. Proceedings of the 13th Workshop on Geographic Information Retrieval. https://doi.org/10.1145/3371140.3371142 Links to an external site.  Mroz, J. E., Borkowski, N., Keiser, N., Kennel, V., Payne, S., & Shuffler, M. (2019). Learning from medical error: Current directions in research and practice on medical error prevention. Academy of Management Proceedings, 2019(1), 18084.https://doi.org/10.5465/ambpp.2019.18084symposium    Links to an external site.

 
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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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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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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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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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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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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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