OSHA Inspection Legal Procedures

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OSHA Inspection Legal Procedures

(OSHA Inspection Legal Procedures)

OSH 3525, Legal Aspects of Safety and Health 1

Course Learning Outcomes for Unit IV Upon completion of this unit, students should be able to:

6. Outline employer rights and responsibilities following an OSHA inspection. 6.1 Discuss an employer’s options to contest OSHA citations and penalties.

Reading Assignment OSHA’s Field Operations Manual (FOM): Chapter 7: Post-Citation Procedures and Abatement Verification Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Unit Lesson When an Occupational Safety and Health Administration (OSHA) inspection results in citations and penalties, employers can react in many different ways, including disbelief, anger, and confusion about what is required. However, there are some specific requirements that all employers must follow, and some options that are available under the Act. Employees also have some rights after the inspection is complete and citations and penalties have been issued. Many discussions about what can be done after an inspection has been completed are limited to employers, and the rights of employees are not considered.

The OSHA inspection process is supposed to be transparent to employees. This means that the employer has to post any citations that were issued by OSHA. The citations must be posted in the location where the violation(s) occurred, or nearby, and must remain posted for at least 3 days or until the violation(s) have been abated, whichever is longer. Some employers mistakenly believe that they do not have to post the citation notice if they are going to contest the citations. This belief is incorrect. The citation notice must be posted whether the employer is going to contest the citations or not. These posting requirements are specified in 29 CFR 1903.16. Employers can be further cited and penalized if they fail to post a copy of the original citations. Additionally, any abatement certification documents, abatement plans, progress reports, and a notice of informal conference made by the employer to OSHA

concerning the citations must be posted so employees can see the responses. The Act provides both employers and employees with certain rights after the completion of an inspection. These rights are designed to ensure that both the employer and employee have the ability to contest citations and penalties that they believe are unfair. There are several processes available ranging from informal discussions to formal legal proceedings. The employer may decide to simply accept and abate all the citations and pay the proposed penalties. If the

UNIT IV STUDY GUIDE

(OSHA Inspection Legal Procedures)

Employer Rights and Responsibilities after an OSHA Inspection

(US Dept. of Labor, 2011)

Employer chooses this option, they must complete the abatement prior to the abatement date specified in the Notice of Citations and Penalties and pay the penalty(ies). 29 CFR 1903.20 provides a process for both employers and employees (or their representative) to request an informal conference with the area director, or their representative. An employee may desire to have an informal conference because they believe their safety or health concerns were not adequately addressed by the OSHA inspection. An employer may desire the informal conference because they believe the citations and penalties were too harsh, because they do not understand some part of the citation or penalty, or to highlight some additional information about their health and safety program(s) to the area director that they believe may mitigate the severity of the citations and penalties. In some cases, the area director may agree to reduce the severity and/or amount of the penalty(ies). If this occurs, an informal settlement agreement may be reached and further litigation avoided.​

It should be noted that employees, or their representatives have the right to participate in any informal conference. This is the reason a notice of an informal conference must be posted in or near the area where citations occurred. Many health and safety experts recommend that an employer always request an informal conference after citations and penalties are issued. Employers must remember that the informal conference does not delay the 15 working days that the employer has to file a notice of contest. Therefore, the employer must schedule the informal conference early enough to allow time to file a Notice of Contest, if necessary. If the employer does not file a Notice to Contest within 15 working days, the citation becomes a final order. This means that the area director can no longer change the seriousness of citations or the penalties because they have become final orders.​

The ability of the employer or employee to formally contest citations, penalties, and abatement dates is extremely important for ensuring due process is provided. The contest process means the employer or employee does not have to accept the views of the compliance officer(s) and the area director without any ability to defend themselves or challenge what is perceived as an inadequate or over reactive response to an employee complaint. An employer or employee does not have to contest every citation and penalty. In fact, in most cases, only a portion of the citations and penalties are challenged. Once a formal notice to contest is filed, the case is in litigation and the area director cannot take any additional actions until the case is heard by an administrative law judge (ALJ) assigned to the case.​

There are many federal agencies that use ALJs. The ALJs that hear contested OSHA citations are from the Occupational Safety and Health Review Commission (OSHRC). The OSHRC was created along with OSHA after the Act was passed. It should be noted that the OSHRC is an independent organization, separate from OSHA and the Department of Labor. This separation was by design to make sure there is no undue influence over the OSHRC. This helps ensure the hearings are impartial. We will study the OSHRC and ALJs in more detail in Units VI and VII.​

The Citation and Notification of Penalty document will specify state abatement dates for each citation. The dates are set by the compliance officer performing the inspection based on his/her best estimate of the time required to complete the abatement. Employers have the right to formally petition for an extended abatement date if they believe they will not be able to meet the original date. 29CFR 1903.1 contains specific requirements for filing a Petition for Modification of Abatement Date (PMA).​

The final document OSHA requires for citations is abatement certification. Abatement certification is required for all citations that have become final orders, except “quick-fix” items that were corrected during the inspection. 29CFR 1903.19 contains specific requirements for abatement certifications. The regulation includes some more extensive documentation for more serious violations. The Citation and Notification of Penalty will typically specify which violations require additional certification. The area director may require an abatement plan to be submitted for some violations, especially if the abatement is complicated or may take an extended period of time. The area director may also require the abatement plan to include interim measures to protect employees during the extended abatement process. If an abatement plan is required, the employer may be required to periodically submit progress reports.

OSH 3525, Legal Aspects of Safety and Health 3

(OSHA Inspection Legal Procedures)

UNIT x STUDY GUIDE

Title

References Missling, T. (2011, July 28). US Department of Labor [Digital image]. Retrieved from https://flic.kr/p/afYuLP Occupational Safety and Health Administration. (n.d.). Purpose and scope, 29 CFR § 1903.1. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9605 Occupational Safety and Health Administration. (n.d.). Posting of citations, 29 CFR § 1903.16. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9621 Occupational Safety and Health Administration. (n.d.). Abatement verification, 29 CFR § 1903.19. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9624

Occupational Safety and Health Administration. (n.d.). Informal conferences, 29 CFR § 1903.20. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9628

Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Suggested Reading If you are interested in learning more about inspections and abatement, review the resources below: Occupational Safety and Health Administration. (n.d.). All about Occupational Safety and Health

Administration. Retrieved from https://www.osha.gov/archive/Publications/osha2056.html Occupational Safety and Health Administration. (n.d.). Employer rights and responsibilities following a federal

OSHA inspection. Retrieved from https://www.osha.gov/Publications/osha3000.pdf Occupational Safety and Health Administration. (n.d.). OSHA inspections. Retrieved from

https://www.osha.gov/Publications/osha2098.html Occupational Safety and Health Administration. (n.d.). OSHA’s abatement verification regulation. Retrieved

from https://www.osha.gov/Publications/Abate/abate.html Occupational Safety and Health Administration. (n.d.). Petitions for modification of abatement date. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9619

Learning Activities (Non-Graded) OSHA has a hierarchy of controls that must be used for abatement of hazardous conditions. You can view OSHA’s Hierarchy of Controls at the website below: https://www.osha.gov/dte/grant_materials/fy10/sh-20839-10/hierarchy_of_controls.pdf Review the Hierarchy of Controls, and summarize the different types of abatement techniques that would fit into each category.

 
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Comparative Analysis of Energy

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Comparative Analysis of Energy

(Comparative Analysis of Energy)

Name:

 Date:

 Instructor’s Name:

 Assignment: SCIE211 Phase 4 Lab Report

 Title: Comparative Analysis of Energy

 Instructions: You will write a 1-page lab report using the scientific method.

When your lab report is complete, post it in Submitted Assignment files.

 Part I: Using the lab animation, fill in the data table below to gather your data, and use it to help you generate your hypothesis, outcomes, and analysis.

Energy Source Fuel (Coal)/Uranium Needed (tons) CO2 Emissions
(tons)		 Sulfur Dioxide and Other Emissions (tons) Radioactivity mSv (millisievert) Solid Waste (tons) Accidents
Coal
Nuclear

Part II: Write a 1-page lab report using the following scientific method sections:

  • Purpose
    • State the purpose of the lab.
  • Introduction
    • This is an investigation of what is currently known about the question being asked. Use background information from credible references to write a short summary about concepts in the lab. List and cite references in APA style.
  • Hypothesis/Predicted Outcome
    • A hypothesis is an educated guess. Based on what you have learned and written about in the Introduction, state what you expect to be the results of the lab procedures.
  • Methods
    • Summarize the procedures that you used in the lab. The Methods section should also state clearly how data (numbers) were collected during the lab; this will be reported in the Results/Outcome section.
  • Results/Outcome
    • Provide here any results or data that were generated while doing the lab procedure.
  • Discussion/Analysis
    • In this section, state clearly whether you obtained the expected results, and if the outcome was as expected.
    • Note: You can use the lab data to help you discuss the results and what you learned.

Provide references in APA format. This includes a reference list and in-text citations for references used in the Introduction section.

Give your paper a title and number, and identify each section as specified above. Although the hypothesis will be a 1-sentence answer, the other sections will need to be paragraphs to adequately explain your experiment.

When your lab report is complete, post it in Submitted Assignment files.

 
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Fundamentals of Epidemiology Knowledge

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Fundamentals of Epidemiology Knowledge

(Fundamentals of Epidemiology Knowledge)

Question 1 .

The first step in any epidemiological investigation is to ____.

Answer

understand causation establish risk factors track trends and determine if particular diseases are increasing or decreasing in the population describe the population demographically by age, race, sex, education, and other relevant indicators

Question 2 .

One of the important concepts from the Nuremberg Code is that of ____, which means that the subject understands the scope of the study and can make an informed decision to participate.

Answer

informed consent voluntary consent beneficence primary agent

Question 3 .

A disease or condition that affects a greater than expected (normal) number of individuals within a population, community, or region at the same time is referred to as an ____.

Answer

epidemic endemic outbreak epidemic threshold

Question 4 .

The normal occurrence of a disease or condition common to persons within a localized area is known as a(n) ____.

Answer

transmission pandemic endemic epidemic

Question 5 .

Reproductive health studies ____.

Answer

the role of genetics in disease development the occurrence and risk factors for disease such as cancer, heart disease, and diabetes that are slow to develop but span many years the distribution and risk factors for injuries, either accidental or intentional normal reproductive processes and problems that can occur including infertility, birth defects, and low birth weight

Question 6 .

The course of a disease, if left untreated, is referred to as ____.

Answer

transmission control measure natural history geographic pattern

Question 7 .

Physical, biological, social, cultural, and behaviors that influence health are known as ____.

Answer

risk factors health-related states agents determinants

Question 8 .

James Lind (1716-1794) observed the effect of time, place, weather, and diet on the spread of disease by ____.

Answer

comparing sick persons to well persons applying the germ theory to public health introducing randomization when conducting clinical trials applying the germ theory to hygiene practices

QUestion 9

The aspect of consistency means that ____.

Answer

an increasing amount of exposure increases the risk the association should be compatible with existing theory and knowledge the association is consistent when results are repeated in studies in different settings using different methods the findings agree with currently accepted understanding of pathological processes

QUestion 10

The modern epidemiologic triangle includes groups of populations, causative factors, and ____.

Answer

alternate explanations risk factors results coherence

Question 11

For chronic diseases, the time between exposure and symptoms is called the ____ period, which can range from a few months to many years.

Answer

latency incubation temporal plausibility

Question 12

Risk factors or exposures that we think might affect the outcome are known as ____.

Answer

indirect causes direct causes dependent variables independent variables

QUestion 13

Identifying diseases prior to the clinical stage means that prevention efforts can begin immediately. Because the disease is already present, this is an example of ____ prevention.

Answer

primary secondary tertiary quaternary

QUestion 14 The time between infection and clinical disease is referred to as a(n) ____.

Answer

a plausible period temporal period incubation period latency period

Question 15 .

A proportion measured over a period of time is known as a ____.

Answer

period prevalence prevalence proportion point prevalence rate

Question 16

The representation of a numerator as a fraction of a denominator is known as a(n) ____.

Answer

proportion rate incidence rate specific rate

Question 17 .

Prevalence equals ____.

Answer

incidence times duration of disease incidence divided by duration of disease incidence plus duration of disease incidence divided by duration of disease times 100

Question 18 .

While many people are used to hearing proportions represented as a percentage, many population samples in epidemiology are often presented per ____.

Answer

1,000 10,000 100,000 1,000,000

.Question 19 .

By definition, the disease or condition used to identify a case is determined by the ____.

Answer

hypothesis conclusion prevalence incidence

Question 20 .

A person in the population or study group identified as having the particular disease, health disorder, or condition under investigation is known as a ____.

Answer

person time case suspect case proportion

QUestion 21:

The number of new cases of disease in a specified time (usually one year) divided by the population “at-risk” to develop the disease is known as ____.

Answer

prevalence proportion incidence rate contingency case severity

Question 22 .

The number of existing cases of disease divided by the population is known as ____.

Answer

crude rate person time incidence rate prevalence proportion

Question 23 .

If a bacterium carries several resistance genes, it is called a ____.

Answer

multidrug resistant drug or super-drug multidrug resistant bacterium or superbug resistant bacterium or streptococcus bacterium killer bacterium or deadly bacterium

.Question 24 .

The disease carrier of most concern is known as a(n) ____, which is an infected person who never gets clinically ill, but can transmit the etiologic agent to others.

Answer

healthy or passive carrier pregnant carrier convalescent carrier active carrier

Question 25 .

____ is the transmission of a disease from mother to child during pregnancy or delivery.

Answer

Horizontal transmission Vertical transmission Lateral transmission Polar transmission

Question 26

There is ____ in the overall crude death rate in the United States from the year 1900 until 1996.

Answer

a definite increase a slight decrease hardly any change a clear decline

Question 27 .

The probability of death due to infectious disease in sub-Saharan Africa is ____%, but only ____% in developed countries, such as the United States.

Answer

22; 1.1 35; 10 66; 11 50; 22

Question 28 .

One of the most important emerging problems with the control of infectious diseases has to do with ____.Answer

deadly parasitic infections antibiotic resistant viral infections antibiotic resistant bacterial infections vaccine resistant viral infections

Question 29 .

A(n) ____ is an infected individual capable of transmitting disease during and after clinical disease.

Answer

convalescent carrier passive carrier active carrier inactive carrier

Question 30 . ____ is the transmission of a disease from person to person, and may be directly from one person to another, or indirectly from one person through an intermediate item to another person.

Answer

Horizontal transmission Vertical transmission Quick transmission Polar transmission

 
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Managing OSHA Compliance Challenges

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Managing OSHA Compliance Challenges

(Managing OSHA Compliance Challenges)

BOS 3525, Legal Aspects of Safety and Health Unit I to Unit VIII Assignment

We received a non-formal complaint recently from one of your current employees. The complaint alleges that employees there are performing welding operations on stainless steel in an area with inadequate ventilation.

This employee also states that they frequently “cough up” black sputum, and that they are worried about the health consequences caused by this lack of ventilation.

The complaint further states that no air sampling has been performed to evaluate the employees’ exposures to welding fumes. And, that when asked for respirators, they were given “dust masks” with one strap, which were purchased at the local hardware store. The effectiveness of these dust masks for the exposure that is present is also in question.

Part 1

Draft a letter in response to the complaint. Your letter should summarize why you believe the complaint is invalid and no on-site inspection is required. Keep in mind, simply stating that the complaint is invalid is not adequate. You must support your opinions in the letter.

Part 2

(Answer the following question on the page 2 of your word document) Answer the questions below in a few sentences.

1. Where does this type of complaint fit on OSHA’s Priority criteria?

2. What factors could have made this complaint non-formal rather than formal?

3. What steps could you take as the employer to identify the employee who filed the complaint? 4. What factors could result in this complaint being reclassified as a formal complaint?

Save both parts of this assignment in one word document to submit for grading.

Unit II Assignment

Discussion Question(Managing OSHA Compliance Challenges)

Question 1

Under what conditions can an employee be denied access to the opening conference, walk-around, and closing conference? Your response should be at least 75 words in length.

Question 2

If the OSHA compliance officer requests documents that are not related to a formal complaint, what options do you believe the employer has? Your response should be at least 75 words in length.

Question 3

If OSHA determines that an employer’s response to a non-formal complaint is adequate, what options does the employee filing the non-formal complaint have? Your response should be at least 75 words in length.

Question 4

Can an employee request that an attorney or union representative attend a private conference with the compliance officer? If the union demands to have a representative present, does the employee have to comply? Your response should be at least 75 words in length.

Unit II Assignment(Managing OSHA Compliance Challenges)

You receive a follow-up call from the area director saying the employee filing the original non-formal complaint has provided additional information about the alleged health situation and submitted a formal complaint using the OSHA-7 form, making the complaint a formal complaint. A few days later, an OSHA compliance officer shows up at your facility to perform a comprehensive inspection. The compliance officer presents the proper credentials, and you verify that the compliance officer is employed by OSHA and assigned to the local office.

During the opening conference, the compliance officer provides you with the formal complaint, alleging that employees are exposed to hazardous concentrations of metal fumes in welding areas of the plant, that you have not performed any air sampling to determine exposure levels, that adequate ventilation is not present in welding areas, and that adequate respiratory protection has not been provided to welders. As a part of the inspection, the compliance officer requests the following documents:

  •  Chemical inventory list;
  •  OSHA 300 logs;
  •  Hazard Communication Program, including training records;
  •  any sampling data that you have;
  •  Respiratory Protection Program, including medical clearance letters and training records;
  •  written hazard assessment for personal protective equipment (PPE) used at the facility;
  •  Safety Data Sheets (SDSs) for the metals you use in the production process and any welding rods/wire used in the welding area; and
  •  any other written programs you have that are required by an OSHA regulation.

The compliance officer takes a walk-through tour of the facility, spending extra time in the welding areas. During the walk-through, the compliance officer points out several issues believed to be apparent violations. The issues are as follows:

  •  Heavy haze is present in the welding area.
  •  Individuals wearing half-mask air-purifying respirators have full beards.
  •  Employees are using chemicals that could be injurious to the eyes, and no emergency eyewash is present.
  •  Eyewash is present in another area of the plant that is covered in dust, and there is no indication of recent operation or inspection.
  •  Employees are using chemicals that could be absorbed through the skin and are not using any gloves.
  •  Employees are performing maintenance inside a press with no lock-out/tag-out applied.
  •  No written lock-out/tag-out program is available at the time of the inspection.
  •  Welding operation is performed near flammable materials, and no fire watch present.
  •  There is no record of training for fork truck drivers.
  •  Extension cords are stretched across walkways.
  •  Three containers are present in the plant with no label present on any of the containers.
  •  An employee could not find a SDS for the chemical he or she was using.

The compliance officer asks for a private conference room and a list of non-managerial employees. He tells you that he intends to interview four non-managerial employees before leaving for the day. He also states that he will return the next day to collect some air samples at the facility.

You are worried about the number of citations and penalties that you may face. Provide a document summarizing the steps you would take as soon as the compliance officer leaves, and the steps you believe you could have taken during the walk-through that may have resulted in a quick-fix penalty reduction.

Your document must be at least three pages in length, not counting the title or reference pages. You must also include at least one reference using appropriate APA style.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit III Assignment(Managing OSHA Compliance Challenges)

You receive a document (linked below) by certified mail. After reading the document, prepare a response that summarizes the approach you would take to the citations and penalties that have been proposed. Be sure to include the following in your response:

  •  Steps you are required to take,
  •  Options available to you,
  •  Contacts you would make, and
  •  Documentation necessary to respond to the citations and penalties.

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited and a reference provide using APA style.  Click here to access the OSHA citation document for this assignment. Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit IV Assignment(Managing OSHA Compliance Challenges)

Based on the Citation and Notification of Penalty letter you received in Unit III, prepare a document that summarizes at least five actions you would take as soon as possible after you reviewed the letter. For each of the actions, you must state the following:

  •  the exact action,
  •  why you believe the action is required for the citations and penalties,
  •  how you believe the actions will assist in responding to the citations and penalties, and
  •  resources you would use to accomplish the action.

You must support your actions with reliable sources. Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited, and a reference must be provided using APA style.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Unit V Assignment(Managing OSHA Compliance Challenges)

You managed to schedule an informal conference with the area director at the regional OSHA office four days after you receive the Notice of Citations and Penalty. Based on the citations and penalties you received in Unit III, prepare a document that lists the citations and penalties you wish to discuss with the area director.

You should summarize what you are trying to accomplish in regard to each citation/penalty you choose, to include:

  •  The information you will use to try and accomplish your goal,
  •  The information you will take with you to the meeting, and
  •  Who will accompany you to the meeting.

You must support your actions with reliable sources. Your grade will be based on your ability to present a case to your professor (serving as the area director) to reduce either the severity of some citations, or the amount of some penalties. If you simply state that you accept the citations and penalties as written, you will receive a minimal score on the assignment.

Your response must be a minimum of two pages in length, not including the title page and reference page. You must use at least one reference in the paper. All sources must be cited in the text and on the reference page, using APA style.

 

Unit VI Assignment(Managing OSHA Compliance Challenges)

You fail to reach an informal settlement agreement with the area director. You file a Notice to Contest within the required 15-day period. Your case is assigned to an administrative law judge (ALJ). Prepare a document summarizing the case you will submit to the ALJ. The document should discuss the following at a minimum:

  •  Which citations and penalties you would contest,
  •  the reasoning behind each contested citation and/or penalty,
  •  Documents you would bring to the hearing,
  •  Individuals you would use at the hearing,
  •  How the case before the ALJ differs from the informal conference,
  •  What information will be presented before the ALJ that was not presented in the informal conference, and
  •  What information you would request from OSHA as part of discovery.

You must support your actions with reliable sources. Your grade will be based on your ability to present a case to your professor, serving as the ALJ, to reduce or vacate either the severity of some citations or the amount of some penalties. If you simply state that you accept the citations and penalties as written, you will receive a minimal score on the assignment.

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited in the text and on the reference page, using APA style.

Unit VII Assignment(Managing OSHA Compliance Challenges)

Assume that a fatality occurred at your facility one month prior to the OSHA inspection. Review the citations and penalties that were assessed to your facility, and respond to the following questions:

• Which of the citations could be referred to the U.S. DOJ for criminal proceedings?

• What conditions would have to be met before the citations could be referred for criminal proceedings?

• Which individuals working at your facility could face criminal charges under the Act?

• What would be the maximum prison sentence and fines that any individual would face?

• What would be the maximum fine that the company would face?

• If you were facing criminal charges under the Act, what would be your best defense?

• How could you involve the OSHRC in the criminal case(s)?

Your response must be a minimum of two pages in length, using at least one reference. All sources must be cited in the text and on the reference page, using APA style.

Unit 8- Question Answer

1. Summarize the procedures required to achieve Star status under OSHA’s Voluntary Protection Program (VPP).

2. Describe the role that Challenge Administrators play in the OSHA Challenge voluntary cooperative program.

3. Provide your opinion as to which OSHA voluntary cooperative program would be the most beneficial to a small business that prints business cards and letterhead.

4. Discuss the benefits that OSHA alliances provide to employers and workers in general industry.

 
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Data Integrity and Ethics

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Data Integrity and Ethics

(Data Integrity and Ethics)

Part 1: Mastrian: Chapters 2, 5, 8, 11, 17, and 19

Question 1
Data are dirty when there are errors such as:

  • Duplicate entries

  • Incomplete or outdated records

  • Both duplicate entries and incomplete or outdated records

  • None of these are correct.

Question 2
Reliable information comes from:

  • Reliable or clean data

  • Authoritative sources

  • Credible sources

  • All of these are correct.

Question 3
The awareness and understanding of a net of information and ways that information can be made useful to support a specific task or to arrive at a decision is called:

  • Acquisition

  • Dissemination

  • Knowledge

  • Information

Question 4
Which statement best reflects the definition of information?

  • It can be used for a variety of purposes.

  • No errors exist in the data or information.

  • It is whole, complete, correct, and consistent data.

  • It is processed data that have meaning.

Question 5
When processing data into information, it is important that the data:

  • Have integrity and quality

  • Reflect human inconsistencies

  • Contain raw facts

  • Contain duplicate facts

Question 6
What do organizational BYOD (Bring Your Own Device) policies typically include?

  • The device must be issued by the organization.

  • The device is subject to routine audits.

  • Both the device must be issued by the organization and the device is subject to routine audits.

  • None of these are correct. Outside devices are forbidden according to HIPAA.

Question 7
The intent of HIPAA was to:

  • Curtail healthcare fraud and abuse and enforce standards for health information

  • Guarantee the security and privacy of health information

  • Assure health insurance portability for employed persons

  • All of these are correct.

Question 8
Which social conventions about right and wrong human conduct are so widely shared that they form a stable general agreement?

  • Ethics

  • Confidentiality

  • Values

  • Morals

Question 9
New technologies in digital communications, electronic health records, and telehealth raise issues related to:

  • Comprehensiveness of care

  • The digital divide

  • Justice and fidelity

  • Privacy and confidentiality

Question 10(Data Integrity and Ethics)
Which principle of ethics has a nursing educator violated in failing to correctly teach his/her students how to calculate medication dosages?

  • Autonomy

  • Confidentiality

  • Justice

  • Nonmaleficence

Question 11
In the design of human technology interface, what best describes the factor(s) to consider?

  • Task and cost

  • Medical opinion

  • Nursing opinion

  • User proficiency

Question 12
The users see the effects of their actions on the technology when you bridge the:

  • Gulf of execution

  • Gulf of understanding

  • Gulf of evaluation

  • Gulf of assessment

Question 13
Videoconferencing technology:

  • Is easy to use

  • Allows professionals to communicate more effectively and frequently with in-home patients

  • Must be used for telehealth

  • None of these are correct.

Question 14
Task analysis examines:

  • The number of tasks involved

  • How the user approaches the task in order to accomplish it

  • What the needed output is

  • All of these are correct.

Question 15
A cognitive walkthrough:

  • Observes the steps users take to use the interface to accomplish typical tasks

  • Detects problems early in the design process

  • Is the least expensive method

  • All of these are correct.

Question 16
Online communication among healthcare teams is called:

  • Order entry management

  • Electronic communication and connectivity

  • Clinical decision making

  • Reporting and population health management

Question 17
Patient data in an electronic health record (EHR) includes demographics, medical and nursing diagnoses, and:

  • Medication lists

  • Allergies

  • Test results

  • All of these are correct.

Question 18
Positive impacts noted with using an informatics system to manage patients with chronic illness include:

  • Guidelines adherence

  • A decrease in emergency department visits

  • Improved provider documentation

  • All of these are correct.

Question 19
The benefits of EHR use recognized in early studies include all of these, except:

  • Increased delivery of guidelines-based care

  • Enhanced capacity to perform surveillance and monitoring for disease conditions

  • Reduction in medication errors

  • Improved workflow

Question 20(Data Integrity and Ethics)
Organizations with the authority to accredit EHRs:

  • Test EHRs

  • Compare EHRs against NIST standards

  • Develop and test EHRs

  • Both test EHRs and compare EHRs against NIST standards

Question 21
What is not a goal of evidence based practice?

  • Improve professional satisfaction

  • Decrease practice variability

  • Increase patient safety

  • Eliminate unnecessary cost

Question 22
What is an important factor to assess when determining if it is possible to implement a study?

  • Contextual meaning

  • Number of people in the study

  • Available technology

  • Established guidelines

Question 23
Context of care evidence may be gathered from:

  • Audit and performance data

  • The culture of the organization

  • Local or national policy

  • All of these are correct.

Question 24
Sources of evidence for practice include:

  • Synthesis of knowledge from research

  • Retrospective or concurrent chart reviews

  • Clinical expertise

  • All of these are correct.

Question 25
What indicates that a healthcare professional recognizes the value of providing evidence-based care?

  • Provides the same care as always

  • Includes research as part of current practice

  • Is offended when patient asks about a new treatment

  • Fails to effectively evaluate sources of information

Question 26
Which statement best describes caring as defined by Watson’s Theory of Human Caring?

  • Caring is cognitive energy focused on changing data into knowledge in a patient encounter.

  • Caring is conscious awareness of one’s strengths and limitations in a patient encounter.

  • Caring is healing consciousness and intentionality to care and promote healing.

  • Caring is the focus of the energy on efficient completion of assessment and diagnosis in a patient encounter.

Question 27(Data Integrity and Ethics)
Patient-centered care means that practitioners should focus on:

  • The subjective experience of patients

  • Data gathered by technology

  • Objective signs and symptoms

  • Their interpretation of the patient’s experience

Question 28
When professionals observe their work for a different perspective and generate insights about how healthcare services and processes could be improved, they are practicing:

  • Centering

  • Bracketing

  • Reflection

  • All of these are correct

Question 29
Clearing the mind of preconceived notions and expectations based on a patient’s diagnosis is known as:

  • Centered caring

  • Bracketing

  • Active listening

  • Healing consciousness

Question 30
Anne has a very busy personal life and is worried about her parents who live 100 miles away and are in failing health. She works as a physical therapist in a rehabilitation unit in a metropolitan hospital.She is the primary therapist for six patients today, one more than the ideal staffing pattern of five. Before entering the room of a particularly anxious patient, Anne takes a few moments to breathe deeply, clear her mind, and review the patient’s EHR on her tablet. She carries the tablet into the room and sets it aside. She moves toward the patient and smiles, making eye contact, and greeting the patient by name. She sits at the bedside and chats with the patient for a brief moment and then performs her assessment. Anne is practicing:

  • Transcendent presence
  • Physical presence
  • Carative presence
  • Cognitive presence
 
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Health Insurance Models Comparison

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Health Insurance Models Comparison

(Health Insurance Models Comparison)

Health Insurance Matriz

Health Insurance Matrix

HCS/235 Version 7

 1

Health Insurance Models Comparison

Health Insurance Matrix

As you learn about health care delivery in the United States, it is necessary to understand the various models of health insurance to develop important foundational knowledge as you progress through the course and for your role as a future health care worker. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers. Fill in the following matrix. Each box must contain responses between 50 and 100 words and use complete sentences.

(Health Insurance Models Comparison)

Model Describe the model How is the care paid or financed when this model is used? What is the structure behind this model? Is it a gatekeeper, open-access, or combination of both? What are the benefits for providers in using this model? What are the challenges for providers in using this model?
Health Maintenance Organization (HMO) . A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

 

 Health maintenance organizations represent “pre-paid” or “capitated” insurance plans in which individuals or their employers pay a fixed monthly fee for services instead of a separate charge for each visit or service. The monthly fees remain the same, regardless of types or levels of services provided. Services are provided by physicians who are employed by, or under contract with, the HMO. You’ll select a Primary Care Physician who will be the first point of contact for your healthcare. You are encouraged to build a strong relationship with your PCP because they will connect you to specialists or other health care providers. Your PCP will be able to see the total picture of your overall health. With an HMO plan, your out-of-pocket medical costs and monthly premiums will generally be lower than with other types of plans. If you are someone who doesn’t see a lot of specialists or would like having your care coordinated through a PCP, then you might save more money with an HMO plan. Tight controls can make it more difficult to get specialized care

As an HMO member, you must choose a primary care physician (PCP). Your PCP provides your general medical care and must be consulted before you seek care from another physician or specialist. This screening process helps to reduce costs both for the HMO and for HMO members, but it can also lead to complications if your PCP doesn’t provide the referral you need
Preferred Provider Model . A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network . You pay more if you use doctors, hospitals, and providers outside of the network Rather than prepaying for medical care, PPO members pay for services as they are rendered. The PPO sponsor (employer or insurance company) generally reimburses the member for the cost of the treatment, less any co-payment percentage. In some cases, the physician may submit the bill directly to the insurance company for payment. The insurer then pays the covered amount directly to the healthcare provider, and the member pays his or her co-payment amount. The price for each type of service is negotiated in advance by the healthcare providers and the PPO sponsor(s). Free choice of healthcare provider

PPO members are not required to seek care from PPO physicians. However, there is generally strong financial incentive to do so. For example, members may receive 90% reimbursement for care obtained from network physicians but only 60% for non-network treatment. In order to avoid paying an additional 30% out of their own pockets, most PPO members choose to receive their healthcare within the PPO network.

 Out-of-pocket costs generally limited

Healthcare costs paid out of your own pocket (e.g., deductibles and co-payments) are limited. Typically, out-of-pocket costs for network care are limited to $1,200 for individuals and $2,100 for families. Out-of-pocket costs for non-network treatment are typically capped at $2,000 for individuals and $3,500 for families. And they have a free choice of healthcare provider.

 More paperwork and expenses than HMOs

As a PPO member, you may have to fill out paperwork in order to be reimbursed for your medical treatment. Additionally, most PPOs have larger co-payment amounts than HMOs, and you may be required to meet a deductible. Less coverage for treatment provided by non-PPO physicians

As mentioned previously, there is a strong financial incentive to use PPO network physicians.
Point-of-Service Model A Point of Service (POS) plan is a type of managed healthcare system that combines characteristics of the HMO and the PPO. Like an HMO, you pay no deductible and usually only a minimal co-payment when you use a healthcare provider within your network. You also must choose a primary care physician who is responsible for all referrals within the POS network. If you choose to go outside the network for healthcare, POS coverage functions more like a PPO. No “gatekeeper” for non-network care

If you choose to go outside the POS network for treatment, you are free to see any doctor or specialist you choose without first consulting your primary care physician (PCP). Of course, you will pay substantially more out-of-pocket charges for non-network care.

 POS coverage allows you to maximize your freedom of choice. Like a PPO, you can mix the types of care you receive. There is no minimal co-payment. Also when you choose to use network providers, there is generally no deductible. As well as no healthcare cost paid out of your own pocket Substantial co-payment for non-network care

As in a PPO, there is generally strong financial incentive to use POS network physicians. For example, your co-payment may be only $10 for care obtained from network physicians, but you could be responsible for up to 40% of the cost of treatment provided by non-network doctors. Thus, if your longtime family doctor is outside of the POS network, you may choose to continue seeing her, but it will cost you more.
Provider Sponsored Organization A Provider-Sponsored Organization (PSO) is a type of managed care plan that is operated by a group of doctors and hospitals that form a network of providers within which you must stay to receive coverage for your care. People with Medicare can choose to get their Medicare benefits through a PSO. PSO receives a fixed monthly payment to provide care for Medicare beneficiaries. PSOs may be developed as for-profit or not-for-profit entities of which at least 51 percent must be owned and governed by health care providers (physicians, hospitals or allied health professionals). PSOs may be organized as either public or private entities The gatekeeper would be Medicare in the United States can be defined as ‘ A group of doctors, hospitals, and other health care providers that agree to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. This type of managed care plan is run by the doctors and providers themselves, and not by an insurance company
High Deductible Health Plans and Savings Options A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. You have the freedom to see any health care provider, including specialists, without a referral, although you will save money if you see in-network providers. This is especially important since instead of a copay, you will be paying the full cost of a doctor’s visit or service until you satisfy your deductible Others can contribute to your HSA. Contributions can come from various sources, including you, your employer, a relative and anyone else who wants to add to your HSA. High deductible plans also allow you to meet health plan stipulations that your community may have. By having yourself and your family covered with health insurance, you can be in compliance with specific laws that require insurance coverage. You have high deductible requirement. Even though you are paying less in premiums each month, it can be difficult – even with money in an HSA – to come up with the cash to meet a high deductible.

You have unexpected healthcare costs. Your healthcare costs could exceed what you had planned for, and you may not have enough money saved in your HSA to cover expenses.

 
 
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Interprofessional Staff Update On HIPAA

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Interprofessional Staff Update On HIPAA

(Interprofessional Staff Update On HIPAA)

Social Media Use In Health Care

Prepare A 2-Page Interprofessional Staff Update On HIPAA And Appropriate Social Media Use In Health Care

Introduction

Health professionals today are increasingly accountable for the use of protected health information (PHI). Various government and regulatory agencies promote and support privacy and security through a variety of activities. Examples include:

  • Meaningful use of electronic health records (EHR).
  • Provision of EHR incentive programs through Medicare and Medicaid.
  • Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) rules.
  • Release of educational resources and tools to help providers and hospitals address privacy, security, and confidentiality risks in their practices.

Technological advances, such as the use of social media platforms and applications for patient progress tracking and communication, have provided more access to health information and improved communication between care providers and patients.

At the same time, advances such as these have resulted in more risk for protecting PHI. Nurses typically receive annual training on protecting patient information in their everyday practice. This training usually emphasizes privacy, security, and confidentiality best practices such as:

  • Keeping passwords secure.
  • Logging out of public computers.
  • Sharing patient information only with those directly providing care or who have been granted permission to receive this information.

Today, one of the major risks associated with privacy and confidentiality of patient identity and data relates to social media. Many nurses and other health care providers place themselves at risk when they use social media or other electronic communication systems inappropriately. For example, a Texas nurse was recently terminated for posting patient vaccination information on Facebook. In another case, a New York nurse was terminated for posting an insensitive emergency department photo on her Instagram account.

Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care.

This assessment will require you to develop a staff update for the interprofessional team to encourage team members to protect the privacy, confidentiality, and security of patient information.

Demonstration of Proficiency

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

  • Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
    • Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
    • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
  • Competency 2: Implement evidence-based strategies to effectively manage protected health information.
    • Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
    • Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
  • Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
    • Follow APA style and formatting guidelines for citations and references.
    • Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling.

Preparation

(Interprofessional Staff Update On HIPAA)

To successfully prepare to complete this assessment, complete the following:

  • Review the infographics on protecting PHI provided in the resources for this assessment, or find other infographics to review. These infographics serve as examples of how to succinctly summarize evidence-based information.
    • Analyze these infographics, and distill them into five or six principles of what makes them effective. As you design your interprofessional staff update, apply these principles. Note: In a staff update, you will not have all the images and graphics that an infographic might contain. Instead, focus your analysis on what makes the messaging effective.
  • Select from any of the following options, or a combination of options, the focus of your interprofessional staff update:
    • Social media best practices.
    • What not to do: Social media.
    • Social media risks to patient information.
    • Steps to take if a breach occurs.
  • Conduct independent research on the topic you have selected in addition to reviewing the suggested resources for this assessment. This information will serve as the source(s) of the information contained in your interprofessional staff update. Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources.

Instructions

(Interprofessional Staff Update On HIPAA)

In this assessment, assume you are a nurse in an acute care, community, school, nursing home, or other health care setting. Before your shift begins, you scroll through Facebook and notice that a coworker has posted a photo of herself and a patient on Facebook. The post states, “I am so happy Jane is feeling better. She is just the best patient I’ve ever had, and I am excited that she is on the road to recovery.”

You have recently completed your annual continuing education requirements at work and realize this is a breach of your organization’s social media policy. Your organization requires employees to immediately report such breaches to the privacy officer to ensure the post is removed immediately and that the nurse responsible receives appropriate corrective action.

You follow appropriate organizational protocols and report the breach to the privacy officer. The privacy officer takes swift action to remove the post. Due to the severity of the breach, the organization terminates the nurse.

Based on this incident’s severity, your organization has established a task force with two main goals:

  • Educate staff on HIPAA and appropriate social media use in health care.
  • Prevent confidentiality, security, and privacy breaches.

The task force has been charged with creating a series of interprofessional staff updates on the following topics:

  • Social media best practices.
  • What not to do: Social media.
  • Social media risks to patient information.
  • Steps to take if a breach occurs.

You are asked to select one of the topics, or a combination of several topics, and create the content for a staff update containing a maximum of two content pages. When distributed to interprofessional team members, the update will consist of one double-sided page.

The task force has asked team members assigned to the topics to include the following content in their updates in addition to content on their selected topic(s):

  • What is protected health information (PHI)?
    • Be sure to include essential HIPAA information.
  • What are privacy, security, and confidentiality?
    • Define and provide examples of privacy, security, and confidentiality concerns related to the use of the technology in health care.
    • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
  • What evidence relating to social media usage and PHI do interprofessional team members need to be aware of? For example:
    • How many nurses have been terminated for inappropriate social media usage in the United States?
    • What types of sanctions have health care organizations imposed on interdisciplinary team members who have violated social media policies?
    • What have been the financial penalties assessed against health care organizations for inappropriate social media usage?
    • What evidence-based strategies have health care organizations employed to prevent or reduce confidentiality, privacy, and security breaches, particularly related to social media usage?
Notes
  • Your staff update is limited to two double-spaced content pages. Be selective about the content you choose to include in your update so that you are able to meet the page length requirement. Include need-to-know information. Leave out nice-to-know information.
  • Many times people do not read staff updates, do not read them carefully, or do not read them to the end. Ensure your staff update piques staff members’ interest, highlights key points, and is easy to read. Avoid overcrowding the update with too much content.
  • Also supply a separate reference page that includes 2–3 peer-reviewed and 1–2 non-peer-reviewed resources (for a total of 3–5 resources) to support the staff update content.
Additional Requirements
  • Written communication: Ensure the staff update is free from errors that detract from the overall message.
  • Submission length: Maximum of two double-spaced content pages.
  • Font and font size: Use Times New Roman, 12-point.
  • Citations and references: Provide a separate reference page that includes 2–3 current, peer-reviewed and 1–2 current, non-peer-reviewed in-text citations and references (total of 3–5 resources) that support the staff update’s content. Current mean no older than 5 years.
  • APA format: Be sure your citations and references adhere to APA format. Consult the APA Style and Format page for an APA refresher.
 
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Information Technology and Systems for Healthcare

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HI 300: Information Technology and Systems for Healthcare

Information Technology and Systems for Healthcare

Questions from Unit 2 graded assignments

Reminders about academic writing & plagiarism

Week 4 Assignment Review

Discussion Board Example

Investigate clinical decision support applications and provide a summary of at least two of the applications that you find. Please provide facts about each of the applications and answer the following questions:

What does the application do?

How does the application help the user?

VisualDx is a unique clinical decision support system that delivers diagnostic answers where and when physicians need them.

Scenario: Imagine that you are the Director of Health Information for a large hospital. As Director, you sit on various institution-wide committees which govern the organization’s policies. You have seen issues arise that cause you to propose changes in policies, procedures and operations across the hospital. Therefore, you have decided to create a proposal to the CEO and Board of Directors, which you will develop in collaboration with committee teams.

Unit 4 Assignment Breakdown

Task #1: Evaluate, implement and manage electronic applications/systems for clinical classification and coding.

Select two (2) applications/systems for clinical classification and coding (e.g., encoders, computer assisted coding (CAC), etc.) and

Appraise each vendor in terms of:

capacity to evaluate quality coding practices;

possible implementation considerations/issues; and

systems management challenges and training needs

Provide support for one (1) system that you find as the “best option“

explain why this is the best option.

Task #2: Evaluate the accuracy of diagnostic and procedural coding.

Consider the principles and applications of classification systems (e.g., ICD-10, HCPCS) and medical record auditing used within a clinical documentation improvement (CDI) program. Appraise the value and challenges of a quality CDI program by:

defending the need for ongoing CDI program support; and

critique at least three (3) challenges in the CDI process.

Make connections between auditing, accurate diagnostic and procedural coding with classification systems, and CDI programs

Your executive summary should reflect upon the need for CDI and best practices for ensuring compliance.

Task #3: Advocate information operability and information exchange.

Critique one (1) interoperability issue that is possible within the health information exchange (HIE) (e.g., patient identity matching).

Appraise at least three (3) best practices that address the issue.

Information Technology and Systems for Healthcare

Brainstorming – Task #3

Health Information Exchange

The need to exchange accurate, complete and timely information.

Patient identify matching

Best practices to ensure interoperability (3)

Need for standards and common vocabularies

Tip #1: What is interoperability in healthcare? https://www.himss.org/library/interoperability-standards/what-is-interoperability

Video Tip #2 Video explanation of interoperability https://youtu.be/PaWcU7rqqyA Video Tip #3: Video explanation of interoperability

Tip #4: Interoperability Examples https://www.healthcareitnews.com/news/health-it-interoperability-example

Task #4: Evaluate health information systems and data storage design.

Evaluate at least three (3) health information systems (HIS)

select the best health information system

why, explain with rationale

Evaluate at least three (3) data storage designs (e.g., onsite, cloud)

select the best data storage design for disaster recovery purposes

why, explain with rationale

Brainstorming – Task #4

Health Information Systems (HIS) Examples:

Specific examples: Phillips Intellispace Console, Archimedes IndiGO, and Diagnosis One

Data Storage Design Examples:

Onsite, Hybrid, Cloud, Tape, Disc

Cost, Disaster Recovery, Oversight

Tip #2: Different Types of health information systems www.floppybunny.org/robin/web/virtualclassroom/chap12/s2/systems1.pdf

Tip #4: Disaster Recovery Planning https://www.healthmgttech.com/best-practices-in-healthcare-disaster-recovery-planning.php

Task #5: Manage clinical indices/databases/registries.

Evaluate three (3) managerial challenges (as hospital’s Director of Health Information) related to:

clinical indices, databases, and registries

Recommend three (3) best practices or policies related to:

management of secondary data sources

Brainstorming – Task #5

Understanding the difference b/t primary and secondary data sources.

Maintaining security and confidentiality

Need to ensuring data quality

Need for clinical documentation (CDI) program

Need for interoperability

Need for compliance with laws, regulations, and accreditation standards.

Need for audit processes

Video Tip #1: Video about Patient Registries https://www.youtube.com/watch?v=_3ZPZ0EKVCE

Task #6: Evaluate data from varying sources to create meaningful presentations.

With respect to data warehousing, appraise at least two (2) approaches in data warehouse design that supports:

quality data management from varying sources;

processing/storage of data throughout the warehouse model;

meaningful output into the presentation layer

Summarize your recommendations in the executive summary.

Chapter 4

15

Brainstorming – Task #6

Top-down, Bottom-Up and Hybrid

Cost, data quality, data marts, data mining

Give a summary of the 2 you choose

Tip #1: Data warehouse design approaches

Tip #2: Data warehouse Overview presentation

Unit 4 Assignments

Discussion

Submit Unit 4 Assignment

Quiz

 
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Maladaptive Immune Response Mechanisms

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Maladaptive Immune Response Mechanisms

(Maladaptive Immune Response Mechanisms)

Maladaptive Responses to Immune Disorders

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance-abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

Consider immune disorders, such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?

To prepare:

  • Review Chapter 5 and Chapter 7 in the Huether and McCance text, as well as the Yi, et al, article in the Learning Resources. Reflect on the concept of maladaptive responses to disorders.
  • Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, and/or systemic lupus E (SLE).
  • Think about the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then, compare the resulting maladaptive and physiological responses of the two disorders.
  • Consider the types of drugs that would be prescribed to patients to treat symptoms associated with these disorders and why.
  • Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Consider how your selected factor might impact the disorder. Then, reflect on how your selected factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce any negative side effects.

Questions to be addressed in my paper:

  1. A brief description of the pathophysiology of the immune disorders you selected.
  2. Explain how the maladaptive and physiological responses of the two disorders differ.
  3. Then, describe the types of drugs that would be prescribed to patients to treat symptoms associated with these immune disorders and why.
  4. Explain how the factor you selected might impact the pathophysiology of each disorder as well as the effects of prescribed drugs.
  5. Explain any measures you might take to help reduce any negative side effects.
  6. Summary with Conclusion

Maladaptive Immune Response Mechanisms

REMINDERS:

1)      2-3 pages (addressing the 5 questions above excluding the title page and reference page).

2)      Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.

3)     Make headings for each question.

RESOURCES:

Readings

  • Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
    • Chapter 5, “Innate Immunity: Inflammation and Wound Healing”This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound-healing process.
    • Chapter 6, “Adaptive Immunity”This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.
    • Chapter 7, “Infection and Defects in Mechanisms of Defense”This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder: HIV/AIDS.
    • Chapter 8, “Stress and Disease”This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.
    • Chapter 39, “Structure, Function, and Disorders of the Integument”This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.
    • Chapter 40, “Alterations of Integument in Children”This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.
  • Poole Arcangelo, V., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
    • Chapter 8, “Principles of Antimicrobial Therapy”This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents, such as penicillin
    • Chapter 12, “Fungal Infections of the Skin”This chapter explores the pathophysiology of several fungal infections of the skin, as well as related drug treatments. It also examines the importance of patient education when managing these infections.
    • Chapter 14, “Bacterial Infections of the Skin”This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.
    • Chapter 32, “Urinary Tract Infection”This chapter covers drugs used to treat urinary tract infections. It also identifies special considerations when treating geriatric patients, pediatric patients, and women.
    • Chapter 35, “Sexually Transmitted Infections”This chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment.
    • Chapter 48, “Human Immunodeficiency Virus”This chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.
  • Yi, H., Shidlo, A., & Sandfort, T. (2011). Assessing maladaptive responses to the stress of being at risk of HIV infection among HIV-negative gay men in New York City. Journal of Sex Research, 48(1), 62–73.
    Retrieved from the Walden Library databases.This study assesses behaviors and attitudes toward HIV based on knowledge about infection and advances in medical treatment. It also examines the impact of maladaptive responses to the stress of HIV risk.
  • Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011. Retrieved from http://www.expert-reviews.com/doi/abs/10.1586/eri.11.125 

    This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact the selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.

  • Drugs.com. (2012). Retrieved from www.drugs.comThis website presents a comprehensive review of prescription and over-the-counter drugs, including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Media

  • Laureate Education, Inc. (Executive Producer). (2012b). Antimicrobials. Baltimore, MD: Author.This media presentation outlines principles of antimicrobial therapy.

Optional Resources

 
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Cultural Diversity In Health& Illness

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Cultural Diversity In Health& Illness

HCA 340 Cultural Diversity In Health & Illness
Healthcare Administration

HCA UNIT 3

1. The nurse is observing a healing ceremony performed by people of the American Indian culture. What is a characteristic of this ceremony?

a. Sound

b. Quiet

c. Herbal teas

d. Hallucinogenic plants

2. A patient of the American Indian culture tells the nurse that the medicine man is consulted when an illness develops. How does a person become a medicine man?

a. Know the interrelationships between people, the earth, and the universe

b. Understand the ways of plants and animals

c. Perform special ceremonies

d. All of the above.

3. What is the difference between the modern physician and the medicine man when determining the cause of an illness?

a. The medicine man looks for the physical cause of the problem

b. The medicine man looks for the spiritual cause of the problem

c. The medicine man studies the patient’s past medical history to determine the cause of the illness

d. The medicine man studies the dietary practices of the person being seen

4. In which American Indian tribe are meditation and herbs used to create a trance to provide the vision of the evil that causes an illness?

a. Hopi

b. Sioux

c. Navajo

d. Cherokee

5. Which Navajo American Indian divination method will women practice to diagnose the cause of a disease?

a. Singing

b. Listening

c. Motion in the hand

d. Stargazing

6. What is the purpose of sand paintings when diagnosing illness in the Navajo American Indian culture?

a. Creates symbolic representations of the client and family

b. Ensures that appropriate payment is made by the family

c. Provides an atmosphere of calm for the medicine man

d. Determines the cause and treatment of the illness

7. The nurse is conducting a medication history with a patient from the Oneida American Indian culture. Which remedies would the nurse include as part of this history?

a. Witch hazel

b. Comfrey

c. Skunk oil

d. All of the above.

8. A patient that is of the American Indian culture is waiting to be seen in a non-Indian Health Service facility. What concern might this patient have about receiving health care through this route?

a. Conflict between his or her perception of the illness and what the physician diagnoses

b. Easier to receive medical care through emergency departments rather than private physicians

c. Receive better health care from mainstream medical services

d. Concern that medical insurance won’t cover all the medical costs

9. Which action would the nurse take when assessing a patient of American Indian culture?

a. Remaining quiet and recognizing the importance of nonverbal communication to seek  information

b. Asking detailed questions regarding the presenting symptoms

c. Asking indirect questions about the reason for seeking health care

d. Ensuring that no one beyond the medical provider and the client discuss what has brought the client to seek care

HCA 340 Cultural Diversity In Health & Illness
10. Which is a concept of holism in traditional Chinese medicine?

a. Integration of the body with the external environment

b. Energy fields that create health or disease

c. Local pathology as separate from the body

d. Harmonic balance that creates illness

11. Which action would a patient, who practices Ayurvedic medicine, take to reestablish harmony and balance in the body?

a. Sit in the sun

b. Speak to a doctor

c. Yoga

d. Ingest a substance to cleanse the body of substances that cause disease

12. The nurse is planning care for a group of community members who follow Ayurveda medicine. What beliefs about this form of health care would the nurse need to keep in mind while  planning this care?

a. All things in the universe are joined together.

b. Human beings contain elements that can be found in the universe.

c. All people are born in a state of balance.

d. All of the above.

13. A patient of the Asian culture tells the nurse that an alteration in yin and yang will lead to disease. Which variable can affect the body’s yin and yang?

a. Clothing

b. The weather

c. Social class

d. Improper food preparation

14. Why does the Chinese physician focus on palpating a patient’s pulse?

a. It is considered the storehouse of the blood.

b. It indicates a specific treatment.

c. It can help to cure a patient.

d. It determines the time of death.

15. A belief of Ayurvedic medicine is the concept of doshas. What is a characteristic of this concept?

a. Combine space and air to control nutritional preferences

b. Blend fire and water to balance mental capacities

c. Are constantly formed and reformed by food, activity, and bodily processes

d. Use water and earth to regulate hormonal balance

HCA 340 Cultural Diversity In Health & Illness
16. While assessing the health history of a patient who is an Asian/Pacific Islander, what will the  nurse identify as a leading cause of death for people from this culture?

a. Malignant neoplasms

b. Influenza and pneumonia

c. Alzheimer’s disease

d. Chronic lower respiratory diseases

17. Why does poor health continue to occur among immigrant Asian populations?

a. Poor working environments and crowded living conditions

b. Refusal of Western medicine to treat Asian immigrants

c. Inability to tolerate Western medications

d. Low number of health care workers of Asian origin

18. How would a patient from the Black culture treat poison ivy?

a. Sprinkling crushed bluestone powder on the affected area

b. Placing a mixture of garlic, onions, and parsley on the site

c. Placing clay in a dark leaf over the affected area

d. Rubbing Vicks Vaporub on the area

19. In the Black culture, what would be used to treat colds?

a. Sassafras tea

b. Hot lemon water with honey

c. Hot toddy made of tea, honey, lemon, peppermint, and alcohol

d. All of the above.

20. Why are folk remedies still used today in the Black community?

 

a. Tradition of quality care and treatment by healers

b. Acknowledgement of the African heritage

c. Rituals associated with folk remedies

d. Close proximity of hospitals in the community

21. What would be a benefit of following the African food tradition of geophagy?

a. Dirt is high in calcium

b. Pica is an accepted cultural practice

c. Red clay is rich in iron

d. Starch is sweet and dry

22. For which reasons might a patient of the Black culture and of the Muslin religion refuse insulin to treat diabetes mellitus?

a. Because any injectable medication is forbidden

b. If it has a pork base

c. Because it implies the person has not led a holy life

d. During Ramadan

HCA 340 Cultural Diversity In Health & Illness
23. Which is a health statistic of significance to Black or African Americans when compared to all races?

a. A lower incidence of breast cancer

b. Lower percentages of low birth weight infants

c. A lower crude birth rate

d. Lower male death rates from homicide

24. Who does the nurse recognize as being the leading authority figure within the Black familial structure?

a. Female

b. Minister

c. Male

d. Oldest adult child

25. Why would some patients of the Black culture resent using health clinics for care?

a. Prescription medications are given out only to those seen first.

b. Cheaper accessible health care is regarded as demeaning.

c. A day’s work may be lost in waiting to be seen by a physician.

d. There are not enough clinics to focus on Black health problems.

 
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