Malpratice

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Report Issue

For this assignment, you are asked to prepare a reflection paper on the topic   of the unit lesson. Discuss the need for hospital and physician professional   liability coverage (malpractice insurance) in American health care today. Make   sure to cover the following points:

  • Why is malpractice coverage so extremely expensive today?
  • Do you feel that the need for liability insurance adds to or detracts from        the patient care that is provided?

Your response should be at least one page in length. All sources used,   including the textbook, must be referenced; paraphrased and quoted material   must  have accompanying citations per APA standards

 
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Diagnostic Analysis

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Knee Injury Case Study

A 15-year-old gymnast has noted knee pain that has become progressively worse during the past several months of intensive training for a statewide meet. Her physical examination indicated swelling in and around the left knee. She had some decreased range of motion and a clicking sound on flexion of the knee. The knee was otherwise stable.

StudiesResults
Routine laboratory valuesWithin normal limits (WNL)
Long bone (femur, fibula, and tibia) X-rayNo fracture
Arthrocentesis with synovial fluid analysis
AppearanceBloody (normal: clear and straw-colored)
Mucin clotGood (normal: good)
Fibrin clotSmall (normal: none)
White blood cells (WBCs)<200 WBC/mm3 (normal: <200 WBC/mm3)
Neutrophils<25% (WNL)
Glucose100 mg/dL (normal: within 10 mg/dL of serum glucose level)
Magnetic resonance imaging (MRI) of the kneeBlood in the joint space. Tear in the posterior aspect of the medial meniscus. No cruciate or other ligament tears
ArthroscopyTear in posterior aspect of medial meniscus

Diagnostic Analysis

The radiographic studies of the long bones eliminated any possibility of fracture.

Arthrocentesis indicated a bloody effusion, which was probably a result of trauma. The fibrin clot was further evidence of bleeding within the joint. Arthrography indicated a tear of the medial meniscus of the knee, a common injury for gymnasts. Arthroscopy corroborated that finding. Transarthroscopic medial meniscectomy was performed. Her postoperative course was uneventful.

Critical Thinking Questions

1. One of the potential complications of arthroscopy is infection. What signs and symptoms of joint infection would you emphasize in your patient teaching?

2. Why is glucose evaluated in the synovial fluid analysis?

3. What are special tests used to differentiate type of Tendon tears in the knee? Explain how they are performed (Always on boards)

 
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how local application of heat will support the healing process

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When tissue is injured, due to overuse or strain, nerve cells send pain messages through the spinal cord to the brain. Other nerves send messages from the brain to tighten the muscles in the injured area. While the muscle tightness acts as a way to protect an injury from, the spasm also causes more secondary to the inhibition of the flow of oxygen and nutrients to the injured area. Heat therapy can be very beneficial to an injured area as local application results in vasodilatation, which increases the blood flow, brings nutrients, oxygen and white blood cells to the area to clean up the damage and stimulate healing.

Describe in your own words how local application of heat will support the healing process. Give the pathophysiology, indications, contraindications, methods, and nursing care for heat application. Cite any research sources you use to support your answers.

Please make an initial post by midweek, and respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Please check the Course Calendar for specific due dates.

 
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-Recommending An Evidence-Based Practice Change

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Assignment: Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

  • Reflect on the four peer-reviewed articles you critically appraised in Module 4.
  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.

The Assignment: (Evidence-Based Project)

Part 5: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

  • Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
  • Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
  • Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
  • Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
  • Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
  • Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
  • Add a lessons learned section that includes the following:
    • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    • An explanation about what you learned from completing the evaluation table (1 slide)
    • An explanation about what you learned from completing the levels of evidence table (1 slide)
    • An explanation about what you learned from completing the outcomes synthesis table (1 slide)
 
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Overview of Transcultural Nursing

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Case Study, Chapter 7, Overview of Transcultural Nursing

1. Mrs. Perez, 32 years of age, is a Hispanic patient who is admitted for early stage cancer of the uterus. The surgeon stated that in order to treat Mrs. Perez’s cancer successfully, the uterus will need to be removed surgically through a procedure called a simple hysterectomy leaving the ovaries, fallopian tubes, and vagina. The surgeon requests that the nurse make arrangements for an interpreter, so they can both use the interpreter’s services. The patient only speaks Spanish, but her mother and one of the patient’s sisters are bilingual. They are currently visiting the patient. Her husband is also visiting and he only speaks Spanish. The patient’s two children are with her sister Maria. The family stated they are devout Catholics and request to see a priest while in the hospital. Today is Ash Wednesday. 

  1. Which interpreter is the most appropriate choice to communicate with Mrs. Perez and why?
  2. After critically analyzing the cultural influences, what nursing actions are appropriate for the patient?

2. The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. 

  1. What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting?
  2. Identify culturally sensitive issues to be discussed in the staff meeting.
  3. One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?
 
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When explaining to the patient and family about polycystic kidney disease, the nurse should explain what characteristics about an autosomal dominant genetic disease?

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Case Study, Chapter 8, Overview of Genetics and Genomics in Nursing

1. A patient who is 38 years of age is diagnosed with autosomal dominant polycystic kidney disease, a hereditary disease that results in fluid-filled cysts occupying space in the kidneys. The cysts can interfere with the function of the kidney and may burst and cause bleeding inside the kidney. The patient with polycystic kidney disease may or may not have a berry aneurysm of a blood vessel in the brain that could lead to bleeding and death, cysts on the ovaries, and a mitral valve prolapse (in females) that can lead to dysrhythmias (irregular heart rhythms), or diverticula (outpouching of the bowel) that are susceptible to infection and inflammation and may lead to gastrointestinal bleeding. The patient is susceptible to retaining fluid in the abdomen so the abdomen is large to constipation, and to hypertension. There is no cure for the disease. The patient receives supportive care for the various symptoms or complications the patient may have. 

  1. When explaining to the patient and family about polycystic kidney disease, the nurse should explain what characteristics about an autosomal dominant genetic disease?
  2. How does variable expression of genetic characteristics play a role in the course of polycystic kidney disease and how can the nurse further predict the level of the disease?
  3. Identify the roles of the nurse in integrating genetics in the nursing care provided for the patient.

2. Mr. Wayne is a 38-year-old man with a significant family history of elevated cholesterol levels. His father died at age 42 from a massive heart attack secondary to elevated cholesterol and triglycerides, and two of his older siblings are currently taking medications to lower their cholesterol levels. Mr. Wayne makes an appointment to discuss his risk for hypercholesterolemia. The nurse recognizes that Mr. Wayne is at risk for familial hypercholesterolemia because this is an autosomal dominant inherited condition.

  1. Describe the pattern of autosomal dominant inheritance.
  2. Mr. Wayne asks what chance his children have of developing familial hypercholesterolemia. How should the nurse respond?
  3. Explain the phenomenon of penetrance observed in autosomal dominant inheritanc
 
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“Managers Balance” Forum Post

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Select ONLY ONE question listed below to write an essay for this week’s discussion forum.

1.  From Chapter 7, p 182-191, Darr (2011, p. 150) writes, “Managers must achieve the difficult balance between loyalty to the organization and fidelity to their personal ethic and professional integrity. How far should a manager go in following the crowd or in standing alone?”.  Address this question with details and supporting/opposing opinions.

2.  From Chapter 7, whistle-blowing is discussed.  Define the term whistle-blowing.  Identify positive and negative outcomes of whistle-blowing for the party who exposed the issue(s).

No formal format required, 200-250 words required. This is a very short forum post, simple and to-the-point answer needed on

 
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Writing A Treatment Plan (Experienced In Social Work Writing)

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Need help with all questions listed in assignment. Please provide in APA Format with References listed. Attached Case Study.

reference 1#

https://www.socialworker.com/feature-articles/ethics-articles/to-record-or-not-to-record-the-ethics-of-documentation/

Reference #2

Kirst-Ashman, K. K., & Hull, G. H., Jr. (2018). Understanding generalist practice (8th ed.). Stamford, CT: Cengage Learning.

  • Chapter 6, “Planning in Generalist Practice” (pp. 224–254)
  • Chapter 16, “Recording in Generalist Social Work Practice” (pp. 599–656)

Everything that social workers do is an intervention; therefore, social workers develop treatment plans so that they can outline the purpose of treatment, assist in giving the client direction in the treatment process, allow the social worker to collaborate with the client, and help social workers and clients mark progress toward goals. Depending on where you work as a social worker, your funding source may be dependent upon your treatment plan. 

In this Assignment, you develop a treatment plan for a client. In real practice, you should never create a treatment plan without conducting a more thorough assessment and then collaborating with the client to mutually agree on goals and steps to implement the plan. For the purpose of this Assignment, however, you explain how you might go about this process.

To prepare: Watch the video case study found in the Learning Resources. Then, go to the Walden Library and review literature related to interventions for this type of client or problem. Use this information to help develop an individual or family treatment plan for the identified client (Amy, Mrs. Bargas, or Bargas family) with whom you have chosen to work from the case study.

By Day 7

Submit a 3- to 4-page paper in which you:

  • Identity the client.
  • Describe the problems that need to be addressed.
  • Explain how you would work with the client to identify and prioritize problems.
  • Identify the related needs based on the identified problems.
  • Describe how you would utilize client strengths when selecting a strategy for intervention.
  • Identify at least two treatment plan goals.
  • Create at least one measurable objective to meet each goal.
  • Explain the specific action steps to achieve objectives.
  • Discuss evidence from the research literature that supports your intervention choices.
  • Describe what information is important to document in a treatment plan and explain why.
 
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Define ethics and explain the difference between ethics and laws. (1 paragraph–including in-text citations and references in proper APA format)

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INSTRUCTIONS:

Please answer the following 8 questions.

Suggested answer length is notated behind the question.

Answer questions underneath the questions on this document.

1. Define ethics and explain the difference between ethics and laws. (1 paragraph–including in-text citations and references in proper APA format)

2. What is the difference between administrative and biomedical ethical issues. (2 paragraphs–including in-text citations and references in proper APA format)

3. List the steps to managers’ problem solving methodology? (refer to week 1.) (1 paragraph including in-text citations and references in proper APA format)

4. When might an ethics audit be necessary? Briefly describe the three steps associated with it. (1 paragraph including in-text citations and references in proper APA format)

5. The American College of Healthcare Executives (ACHE) is a well-know health services management professional association. According to the ACHE, explain the responsibility/ obligation of a health care executive. (2 paragraphs including in-text citations and references in proper APA format)

6. What is the fiduciary responsibility of health care executives and managers. (2 paragraphs including in-text citations and references in proper APA format)

7. Describe at least three examples of conflicts of interests. Explain how conflicts of interests can present ethical dilemmas for managers/ executives. (3 paragraphs including in-text citations and references in proper APA format)

8. Read the case study below and answer the following questions. (1 1/2 – 2 pages including in-text citations and references in proper APA format).  Your answers to each question should be based on your reading of Darr. If necessary, you may refer to the text. Your answers should demonstrate your understanding of the terms as well as your ability to apply them to the case of Baby K (given the limited facts provided.) 1)Discuss what makes this an ethical dilemma. 2)Discuss the implications of this study in terms of the moral principles described in chapter 1. Respect for persons: Did the hospital/ physicians allow the parents to be autonomous in their decision-making? Do you see any elements of paternalism on behalf of the physicians? Beneficence: Did the hospital/ physicians act beneficently? Nonmaleficence: Did the hospital/ physicians consider nonmaleficence? Justice: Did the hospital act in a just way? Baby K was born at Fairfax Hospital in Northern Virginia on October 13, 1992. Although her face was beautiful, the top of her head was flat. She had no brain The baby’s mother knew from the 16th week of her pregnancy that Baby K’s brain had not developed. Baby K had no cerebrum and no cerebellum, but she did have a normal brain stern. The mother was told that babies with “anencephaly”- from the Greek words for negative (an) and brain (enkephalos) – cannot see, hear, or feel anything no matter how long they live. Baby K would have no thoughts, and she would never achieve “personhood.” If she were born alive, her brain stem would prompt her heart to beat and her lungs to pump air in and out of her body. Baby K, like other babies with anencephaly, would be “born dying” but would not be technically brain dead. Anencephaly is one condition, perhaps the only one, that all doctors agree is futile to treat. The general consensus among medical, legal, and other experts is that heroic measures should not be used to keep such babies alive. But Baby K’s mother balked. She wanted to keep her baby alive no matter what the cost. She was motivated by a strong and sincerely held religious belief that “all life is precious” and that a higher being, rather than herself or the doctors or the law, should decide how long her baby would live. Baby K held on (most babies with anencephaly die within the first few days of their lives) and finally left the hospital when she was seven weeks old. No neonatal intensive care unit (NICU) would accept her, so she went to a nursing home.

 
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Assessing and Planning Care for an Elderly Person

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In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

By the due date assigned, choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature.

Download a patient questionnaire. This form should be used as an example.

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

  1. Tinetti Balance and Gait Evaluation
  2. Katz Index of Activities of Daily Living
  3. Assessment of Home Safety
  4. The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate reference

 
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