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how does the integrity in the healthcare industry balance that with maintaining profitability?
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This week, you will conduct system selection, which requires completion of the following steps:
Assume that your healthcare organization has conducted an RFI, or a fact finding part of the system implementation and helps to select the potential vendors. It has requested information from vendors about their products and services. With the information gathered, the organization has screened the potential vendors and issues the RFP (request for proposal).
Download this RFP for EHR Implementation: UA_RFP-EHR. This is an actual RFP. Review the document and answer the following:
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II. ***Write the following information in a more clear and concise manner, as it would appear in the medical record. Include an appropriate subheading.
1. The patient walked 75 feet in the hallway of the hospital with the therapist lightly touching her back. She used a front-wheeled walker. The therapist was needed to help provide the patient with support to maintain balance.
2. The patient’s strength was 3/5 for the right biceps and 4/5 for the right triceps.
3. Upon arrival to therapy, the patient told you that she had been doing her HEP without any problems and really
felt like her ability to get in and out of bed has improved.
4. The patient said that her pain was 3/10 on a pain scale.
5. You performed an ultrasound to the dorsal aspect of the patient’s right foot. You used 3 MHz at 50% duty cyclewith the intensity set at 1.0 w/cm2.
6. The patient demonstrated the following range of motion measurements: active range of motion for the right elbow was 130° flexion and 10° of hyperextension.
7. Knee active range of motion was 100° flexion and lacking 10° of extension.
8. The patient propelled his wheelchair around the hospital, outside on the sidewalk, and up and down several ramps with you providing verbal reminders on trunk positioning for going up and down the ramps.
9. The patient was able to put her ankle-foot orthosis on and remove it independently. She was also able to independently check her skin for any irritated areas after she removed the orthosis.
10. You instructed the patient to perform 10 repetitions of each exercise as part of her home exercise program. The exercises included ankle pumps, quadriceps setting, short arc quadriceps strengthening from 45° to 0°, and heel slides.
11. During a busy morning in a hospital, you were working with a patient who told you that she was going to be discharged and wanted home health services, primarily physical therapy. After writing the note and moving on to the next patient, you realize that you did not document the patient’s desire for home therapy. What should you do? How would you document this entry into the medical record. Where should this information be placed? How might this be different if you were using an EMR?
12. When handwriting information in the medical record, you realize that you made an error in documenting the patient’s AROM. It should have been 125°, not 152°. Demonstrate how to correct this mistake.
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A 22 year old female with no previously known medical history presented to her primary care doctor for a 2 month history of intermittently increased spasticity of her upper extremities and intermittent paralysis of her lower extremities with no known cause.
She states that her symptoms seem to “come and go” without a known cause, usually worse in the mornings. Her biomedical engineering college professors have not been very accommodating to her symptoms, however, and have instructed her to be seen by her primary doctor to “rule out mental issues.” While discussing her symptoms, she also mentions that she noticed worsening blurriness with ophthalmalgia (pain) while moving her eye which is constant. She endorses a mild history of depression which began when she was 16 but which was never treated, around the same time that she was diagnosed with infectious mononucleosis.
Her family doctor, concerned about the intermittent nature of the symptoms, instructed her to attempt to stretch in the mornings before heading to class and to return in 2 weeks if her symptoms did not remit. Approximately 1 week after her primary visit, she began to experience severe, knife-like shooting pains in her bilateral upper and lower extremities, in addition to a severe headache. Her roommate, concerned, called an ambulance and the patient was immediately taken to the University Hospital. While at the University Hospital, she underwent an emergent MRI of the brain with contrast, which revealed significant demyelination (death of neurons) in the periventricular zones (in proximity to the lateral ventricles of the brain). Neurology was immediately consulted, and, after viewing her imaging and labs, was convinced that a chronic inflammatory process was occurring in this patient. The patient, prior to being discharged from the hospital after other disorders had been ruled out, was prescribed Gabapentin and asked to follow up with a neurologist as an outpatient.
Further outpatient imaging 3 months later revealed worsening demyelination in the brain and the initial stages of demyelination in the cervical and thoracic spinal cord sections; lumbar puncture testing was also performed, which was revealing of increased numbers of macrophages, CD8 T cells, and anti-myelin IgG antibodies, revealing of a diagnosis of Multiple Sclerosis.
Please answer the following questions:
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Week 2 Clinical Discussion Activity: Managing Quality, Safety, and Ethics in the Community
Now that you have completed the Sentinel City tour:
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Identify ONE strategy (for each link) through which you can prevent the spread of the common cold by breaking the chains:
a) Destroy the pathogen
b) Between the pathogen and reservoir
c) Between the reservoir and portal of exit
d) Between the portal of exit and transmission
e) Between transmission and portal of entry
f) From becoming a new host
In: Nursing
why children's suffer severe social isolation cannot
develop their social self in healthy manner ? can we (human) become
fully human beings without social interactions and effective
socialization? to interpret these, use the theories and ideas of
George H.mead and his sociological concepts
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Case Study
Many of you are a registered nurse. Since your graduation 3 years ago, you have worked as a full-time industrial health nurse for a large manufacturing plant. Although you love your family (spouse and one preschool-aged child), you love your job as well because a career is very important to you. Recently, you and your spouse decided to have another baby. At that time, you and your spouse reached a joint decision that if you had another baby, you would reduce your work time and spend more time at home with the children. Last week, however, the director of human resources told you that the full-time director of health-care services for the plant is leaving and that the organization wants to appoint you to the position. You were initially thrilled and excited; however, you found out several days later that you and your spouse are expecting a baby. Last night, you spoke with your spouse about your career future. Your spouse is an attorney whose practice has suddenly gained momentum. Although the two of you have shared child-rearing equally until this point, your spouse is not sure how much longer this can be done if the law practice continues to expand. If you take the position, which you would like to do, it would mean full-time work and more management responsibilities. You want the decision you and your spouse reach to be well-thought-out, as it has far-reaching consequences and concerns many people.
Writing Pompts
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describe the relationship of the principles of law, ethics, and the legal system as related to the U. S. public healthcare system
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CASE 11: Inappropriate Client Behavior
The management of Peak Performance Health and Wellness Club has received several emails and verbal complaints about an unidentified male club member allegedly masturbating while using the equipment in the club. The only description they have of the accused is that he is an older, white male with glasses. Jim Roberts is a personal trainer and is just about to start a morning session with a client. A young woman he knows and trusts comes up to Jim with a frantic expression. “Come quickly.” She can barely get the words out. “There’s a man on the stationary bike who is staring at a woman’s chest and masturbating.” Jim excuses himself from his session and goes to see for himself. The member points out the accused male, and Jim immediately contacts his department head and another male trainer, just in case there’s an incident. Jim taps the accused member on the shoulder. “Can I have a word with you?” The older man agrees, and they step over to the side. Jim knows this man and has had conversations with him in the past regarding his joint surgery and his postoperative rehabilitation. Jim believes he should be able to get to the bottom of this matter quickly. “A member reported to us that you were touching yourself inappropriately.” “What’s inappropriate? Your definition of inappropriate and mine might be completely different!” “Were you fondling yourself?” “What’s fondling? I don’t know what that means.” “You had your hands in your pants.” He shrugs. “So, we have to adjust ourselves. I can have my hand in my pants.” At this point Jim becomes frustrated and just comes out and asks, “Were you masturbating?” The member becomes very defensive and says, “I never do that, I can’t believe you accused me of that, I’m offended !” Jim asks the man to stay where he is. He knocks on the general manager’s (GM) door and quickly fills him in on the situation. Jim and his team escort the accused member to the GM’s office. The GM repeats the same line of questioning, and the man gives verbatim answers to the ones he gave Jim. Eventually, the GM gets as frustrated as Jim was and asks, “Were you masturbating?” The man puts his hand on his chest and an indignant expression on his face. He shouts, “I NEVER DO THAT! I demand to face my accuser; I have the right to face my accuser. I’ve been a member since this club opened! I can’t believe that you would suggest this.” At this point the GM is not amused or buying his story. He simply tells the man his membership will be on suspension pending an investigation. The member continues to argue but eventually calms down. He then asks, “How will you let me know your decision?” The GM tells him that the club will call him. “Can you e-mail me instead? Let me give you my personal e-mail.” The GM agrees and tells him that he’ll have to leave. After the member leaves, the GM tells Jim to close the door. He looks at Jim with a wry smile and says, “That guy is so guilty. He wants me to e-mail him privately so his wife won’t find out.” Jim goes upstairs with his boss to speak with the female member who reported the incident. When he finds her, she is with another female member. The second female member tells Jim that he was the same man that she saw masturbating on a treadmill and wrote an email about. Jim’s boss takes statements from the two female members so Jim can return to his now shortened session with his client.
CASE WRITE UP (PLEASE INCLUDE)
1 - Write a background statement
2- What are the major problems and secondary issues?
3- Your Role
4- Organizational Strengths and Weaknesses
5- Alternatives and Recommended Solution
6- Evaluation
THEIR IS AN EXAMPLE BELOW OF HOW THIS SHOULD LOOK!!!!
Case Write-Up
Background Statement
A Wiccan patient who visited a nondenominational community hospital was discussing her religious beliefs with her primary care nurse, Penny Baker, when suddenly another nurse, Ruth Goose, walked into the conversation and rudely stated, “Thou shalt not suffer a witch amongst you.” The Wiccan nurse felt offended and complained that she was discriminated in the hospital because of her religious beliefs.
Major Problems and Secondary Issues
The major problem is that the two nurses, Penny Baker and Ruth Goose, made the patient feel unwelcomed in the nondenominational community hospital because of her Wiccan religious beliefs. The secondary issues that the nondenominational community hospital may face is that the Wiccan patient is threatening to go to the media. This means that there may be news coverage that your hospital engages in religious discrimination. This may make people, especially Wiccans, look down on your medical services.
Your Role
In this case, I am the Vice President of Nursing Services. As stated in the text, it writes, “You are the Vice President of Nursing Services in a nondenominational community hospital, and you receive a complaint from a patient, who is a Wiccan.” The advantages of this role are that I can sit down with Penny and Ruth to let them know that religious discrimination is not to be tolerated while we are caring for the patients. The disadvantages of this role are that I must decide how I am going to discuss this matter with Penny and Ruth because they’re passionate about being against the Wiccan patient. I need to let Penny and Ruth know that our patient’s care matters above everything else, not what religion they practice.
Organizational Strengths and Weaknesses
As the Vice President of Nursing Services, my strengths are that I can hold a training on racial, ethnic, and religious diversity. This training can supplement nurses with the information they need to work in a diverse environment. Nurses need to know that they must treat their patients justly despite their identity. The weaknesses I may face are that the two nurses are very religious themselves. They may not listen to what I have to say about religious discrimination because the two nurses try to justify their act by saying, “She did the right thing. We don’t have to pray with witches. They worship Satan. It’s blasphemy. What’s next? Human sacrifice?”
Alternatives and Recommended Solution
As a solution for this problem, I will make sure to provide all the nurses working in the hospital with diversity training. It is important that I sit down with the nurses and make it clear that discrimination will not be tolerated while they are working in our hospital. I can also offer every patient visiting the hospital with a survey. The patient can fill out the survey to let us know how they felt about their stay. Nurses who’ve been accused of any sort of discrimination, will have to speak with management. We would keep these incidences of discrimination in a file, and it the dilemma does not change, I would have to begin writing up the nurses. Discrimination would not be tolerated while the patient is in the hospital trying to recover from a medical condition. I would also recommend Penny and Ruth write an official letter of apology to the Wiccan patient before she decides to go to the media. Writing the official letter of apology would be my first recommended solution to Penny and Ruth, so that the patient does not feel unwelcomed to our hospital’s services in the future.
Evaluation
If there are enough surveys to prove that our medical treatment is getting better and there are less patients coming from the patients about discrimination, then I would know that the instances of discrimination have stopped. The goal is to aid in the medical recovery of patients. Patients must also feel welcomed to our hospital services despite their identity. By getting fewer, or even better, no discrimination complaints, I would know that my diversity trainings and meetings have worked.
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Scenario #2 (Questions 6-10) - John badly scrapes his leg after falling off of his bike. Two days after his fall he thinks his leg may be infected.
Question 6 - What are some signs and symptoms of infection?
John sees the doctor and is given a broad spectrum antibiotic.
Question 7 - What does "broad spectrum" mean?
Question 8 - What is the term for an antibiotic that limits or slows growth of susceptible bacteria?
John's infection suddenly becomes more serious. The broad spectrum antibiotic is not effective. The doctor prescribes an aminoglycoside antibiotic.
Question 9 - What two areas of the body can suffer serious adverse effects from aminoglycosides?
After John begins receiving the aminoglycoside, his doctor wants John to have peak and trough levels drawn at the hospital lab.
Question 10 - What does a peak and trough measure?
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Name two ways a person with a developmental delay could be discriminated against in society and how might you go about supporting this person to understand their rights around these issues?
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How could you apply what you know about deductive, inductive, and causal arguments to the nursing field and to the field of medical science?
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