Evaluate the success of tort law in providing solutions to 21st Century health care disputes.

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Evaluate the success of tort law in providing solutions to 21st Century health care disputes.

Paper , Order, or Assignment Requirements

Discussion 1

Development of U.S. Health Care in Hospitals Based on the Foundation of U.S. Law” Please respond to the following:

Part 1

From the scenario, relate the basic steps in the development of U.S. health law, leading up to the present, to you or an employer’s need for health insurance coverage in light of the provisions that the Affordable Health Care Act sets forth. Rationalize the fundamental way in which these laws play a pivotal part in understanding the roles that today’s health care administrators play.

Part 2

Analyze the transition of health care from the 18th Century leading up to the 21st Century. Evaluate the degree and quality of care established within 18th Century U.S. hospitals, as compared to the level of care seen in today’s hospitals. Examine the primary roles of progressive health care law in shaping the current modern environments.

 

Discussion 2

Part 1

Application of Tort Law in Health Care Project Management Protocols”  Please respond to the following:

From the scenario, analyze the development of health care project management predicated on tort law. Ascertain the major ways in which tort law provides solutions to health care concerns, in light of the complexities of 21st Century health care administration roles.

Part 2

Analyze the development of tort law from the concept and degree of negligence to the application of the law to strict / product liability. Evaluate the success of tort law in providing solutions to 21st Century health care disputes. Rationalize your answer by using any applicable legal precedents.

 

Discussion 3

Part 1

“Contracts and Antitrust Protocols Based on the Criminal Aspects of Health Care”  Please respond to the following:

From the scenario, differentiate between the concepts of criminal law, antitrust, and health care as they apply to U.S. health law in the 21st Century. Conceptualize the primary ways in which these laws apply to U.S. health care administrators.

Part 2

Analyze the general transition of U.S. health laws based on criminal misconduct in health care to the creation of contract laws, as predicated within the Sherman Antitrust Act. Evaluate the efficacy of the measures that the new contracts in question afford, and rationalize whether or not these improvements have provided optimal solutions to today’s complex concerns of integrity in health care performance.

What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting?

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What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting?

 

What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting? How will you leverage your experiences in the practicum to facilitate your development as a nurse leader-manager or informaticist?

Discussion: Preparing for Professional Transitions

Consider the following scenario:

Marcus recalls the beginning of his career, when he started as a nurse at Grand View Hospital. He had heard the organization was soliciting proposals from various companies so they could weigh the pros and cons associated with adopting a new health information technology system. He has been curious about the request for proposal (RFP) process ever since. Now, as he looks forward to new professional opportunities, he would like to ensure that he develops the skills and expertise needed to formulate an RFP.

What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting? How will you leverage your experiences in the practicum to facilitate your development as a nurse leader-manager or informaticist?

In this Discussion, you reflect on your aspirations and consider the transitions that may be required to achieve them. You identify professional development objectives and evaluate opportunities for achieving them through your experiences in the practicum.

Think about the professional role changes you have been undergoing or that you may undertake following completion of this MSN program.

Review the information related to professional development and role change in the Learning Resources, and conduct additional research as necessary to address any questions or concerns you may have.

Consider the following questions:

What types of professional positions interest you? Are they significantly different from the types of positions you have held in the past? If so, how?

What challenges are you likely to encounter as you transition into a new role?

What resources could help you to manage this change? Consider your inner resources (e.g., drawing on previous experiences, stress management), resources available to you through your relationships with others, and institutional supports.

Identify a patient scenario that has a cultural dimension. Were the cultural differences/needs of the patient, in relation to communication and engagement, acknowledged? If acknowledged, how were the needs acknowledged?

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Identify a patient scenario that has a cultural dimension. Were the cultural differences/needs of the patient, in relation to communication and engagement, acknowledged? If acknowledged, how were the needs acknowledged?

 

 

Nursing,

Choose a patient scenario and reflect on cultural differences, in particular how they may impact on establishing effective communication and/or engagement with the patient.

Cue questions to be considered
1. Identify a patient scenario that has a cultural dimension.
An example of this; you may be caring for a patient from a different culture to your own and this may have had a significant impact on your ability to communicate or engage effectively with them.

2. Why is it important to recognise and acknowledge cultural differences and needs?

3. Were the cultural differences/needs of the patient, in relation to communication and engagement, acknowledged? If acknowledged, how were the needs acknowledged?
or , if the cultural differences/needs of the patient were not acknowledged in what way were they not taken into account?
4. What were the consequences for the patient , others and yourself?

5. How did you fell about the situation? What was good/bad about the experience?

6. What have you learnt from this experience? Consider your new understanding of the situation and in particular the cultural dimensions of communication and engagement

7. What are the broader issues arising from this situation.
Scenario
A 40 years old man was admitted to the ward for right frontal lobectomy for glioblatoma . Past medical history of chronic renal disease and was diagnose of space occupying lesion.

1. Implement a variety of communication and interpersonal skills necessary for safe and effective care.
2. Deliver relevant health interventions within diverse settings.

BayCare Health System Evaluation

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BayCare Health System was originated in 1997 when many of the not-for-profit hospitals in the Tampa Bay area came together under one name united by a common mission. BayCare Health System joins with the public to a filled variety of services at 15 infirmaries and more than 300-unit locations all over Tampa Bay and Central Florida. Inpatient and outpatient amenities contain acute and primary care, urgent care, home care and behavioral health, as well as imaging and laboratory services (BayCare2017). If your traveling anywhere in the Central Florida area you will find a BayCare facility with professional team members ready to take care of all your medical needs.

BayCare’s vision statement is “BayCare is an extraordinary team leading the way to high-quality care and personalized customer-centered health (BayCare, 2017).’’ Their vision statement solely means that they recognize the significant role played by their astonishing team members. Without them, BayCare couldn’t attain its vision. On an annual basis, BayCare contributes in a Team Member Engagement Survey. In 2018, BayCare ranked at the 84

th

percentile for team member engagement (BayCare, 2017). Overall, the more advanced the score is, the happier the team members are.

The mission statement representing BayCare “is to improve the health of all the individuals they serve through high-quality and compassionate care.” The codes of conduct also known as the values are trust, respect and dignity and reflect their responsibility to achieve health care excellence for their communities (BayCare, 2017). Dependable with their undertaking and values, those who represent the health system are expected to follow the high standards of knowledgeable and moral behavior and conform the law. They also expect their sellers, consultants, servicers and suppliers to be funneled by these same standards and values when working with them. BayCare’s organization is undertaking driven, patient-focused and devoted to the values and procedure of Quality Improvement. The mission and principles provide a trend to their organization. Devotion to them is critical to their triumph.

The organizational structure of BayCare is organized by divisions, including the Hospital, Physician, Clinical Integrated Network, Ambulatory, Behavioral Health Insurance and Support divisions. During my seminar, I had the opportunity to work on the business side of the organization doing billing and coding. This plays a vigorous role in the association between health providers, patients and insurance corporations. During my practicum, my duties for billing and coding were to read, scrutinize patient records, and determine the correct codes for the patient’s records, using the proper code to bill insurance providers, having to keep track of patient data over multiple visits and also handling detailed code information.



BayCare targets their customer by a robust marque promise that lures people to try their brand, while a robust engrossment preps people to stay. Their marque is the face of organization, all the customers’ gets to experience on a day-to-day foundation whether it’s for inpatient or outpatient amenities. BayCare Health System uses two marking approaches to target their customers, alphanumeric and traditional. The establishment does a lot of digital advertising to apprise everyone about their association, but they also use traditional publicizing when you visit any of their amenities. Each month, BayCare Health System conducts classes for people that have altered types of health issues. For example, if you have anyone of these sicknesses such as, diabetes, high blood pressure, cancer, and depression, BayCare has classes to fit your agenda with competent instructors educating in these classes and passing out valued material. At BayCare Women’s Hospital, they have birthing classes for first time mom’s in which you can also sign up for the tour of the O.R. if you’re planning on having birth there. In the month of October, women that are over 45 years of age receives a free mammogram and breast examination. Generally, the company does a great job targeting and maintaining their brand, at any given time if you are a patient in anyone of their facilities there’s always someone to answer any questions you might have about your medical needs.

BayCare launch its first health insurance product, a Medicare Advantage (HMO) plan called BayCarePlus, which will be available to qualifying residents of Pinellas, Hillsborough, Pasco and Polk Counties. The Medicare Advantage is a kind of health insurance obtainable by secluded firms that deal with the federal government to provide Medicare Part A and B benefits. Most plans also offer prescription drug coverage (Medicare Part D). BayCare’s launch of an insurance strategy is one step in the evolution from the health care commerce’s current fee-for-service model to populace health. To meet the demands of keeping an entire population healthy, BayCare needs to align insurance, or payment, with delivery of care. And as the main not-for-profit health organization, BayCare is in a great position to provide an insurance plan that serves the needs of Tampa Bay patients and delivers a positive customer experience (BayCarePlus, 2018).

The leadership style employed by my immediate supervisor is the transformational leadership style. She is the face of BayCare. She upholds the BayCare standards and values, her main goal is to make sure the patient services have been met from the minute they get admitted to when they get discharged. In 2017 my immediate supervisor saw a need for an expansion at the Women’s Hospital a 24-hour Urgent Care was greatly needed. After seeing that the number of child birth’s increase by 100 babies versus the same time frame last year, she decided to present a proposal the president. After great consideration and research her proposal was approved by the board. The $1.5 million-dollar project is now completed and schedule to open August 1, 2019. The director assigns smart goals for all her employees that are attainable she consistently shares her vision with her employees. During monthly meetings she inspires and empowers her staff and ask for their input. The leadership provided under her management and care has shown to exceed expectations for which BayCare presents for itself.

One of the things I would change would be the billing and coding process. For one patient chart there’s at least ten essentials that must be done. It consumes a lot of time for a chart, in my opinion, everything needs to be on one screen instead of multiples, and this would eliminate the extra steps for the coder and saves time and labor dollars. I would also implement a plan that all schedule appointments are in alphabetical so that when the patients chart gets to the billing and coding department everything is in place for that individual.

One idea that BayCare could implement is having a back to school free physical each summer. Even though it’s free, the turn out would be great and fully appreciated by those same children who will become a patient at a BayCare facility at some point in the future. This would also help with customer service and the bottom-line profits. Because word of mouth is still the best advertisement, this will draw more customers to the organization and bring in more revenue.

My career goal is to work in Human Resources, but in order to accomplish that goal I must set some yearly goals for myself that are achievable. One-Year Goal: Increase my professional knowledge and training in the Human Resources field. My plan is to complete college classes and obtain a bachelor’s degree in one and half years to become more marketable for a position in Human Resources. Five-Year Goal: Is to obtain a position in Human Resources and continue to increase my knowledge and experience. Ten-Year Goal: I will be working towards a master’s degree in Human Resources and continue to elevate my position at BayCare.

The practicum experience for me has been great. The only suggestion I would make is for future students, please don’t wait until the last minute to secure your internship site. If you are working for a company that’s willing to have you intern with them, please start the process early.

References




  • BayCare

    . (2017, February 15). Retrieved from www.baycare.org.



  • BayCarePlus

    . (2018, October 18). Retrieved from www.baycareplus.org.

  • Prnewswire

    . (2018, October 15). Retrieved from www.prnewswire.com.

Development Of Advanced Practice Nursing Essay

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Advanced practice within nursing (APN) plays a big role in the future frontier for practices in the nursing field and its professional development. This mode of practice helps people view the field of nursing and the world in general in a different way, since it enables the public to question the current practices in nursing, it enables the creation of new knowledge in nursing, and helps in the improvement of delivery of services in the nursing field and other health care services. Hence, the continuous development and evaluation of advanced practice within nursing is of great significance to the nursing profession and the society at large.

In this paper, nursing roles and their developments are critically analyzed in order to understand the development and the concept of danced practice within nursing in the U.K and how it might be taken to the next level and serve the society better. Furthermore the implementation and evaluation of the APN are also described. A precise and collective effort ought to be established to ensure that professionals in the nursing field and the expertise is recognized and enhanced. Clinical supervision has in mental and psychiatric nursing has shown some improvement due to the development of practices within nursing. Education in practices within nursing and leadership roles evolution, only offers a temporary solution to the issue of advanced practices within nursing.

Discussion

Advance practice nursing involves a variety of roles within which a nurse is expected to perform at a higher level of hi/her profession. In the U.K one has no difficulties in identifying the roles of an APN, since there are different tittles established for such nurses. However, there is always confusion where the same title is given to different nurses performing different roles with varied intentions. The competencies in roles which involve domains of APN which are related to practices in clinics, research, education, professional development and organizational leadership are proper indicators of the APN roles compared to job titles (Gibson & Hooker, 2004). There is an agreement that, for APN roles to flourish there is need for graduate education collated with practice experience in the U.K, with such a combination the nursing sector will improve and patients will be well catered for.

There has been progress in the development of APN roles in the United Kingdom and this has been accelerated by some environmental factors. Other factors which have influenced the development of advance practice within nursing include local condition, health care system within the country, culture, APN community, the nursing experts or profession and the government.

The development, demand and acceptability of APN roles in U.K have been due to the values of the society, needs of the society for nursing and expectations of the society. For example there has been a wide acceptance of women in the workforce. The health care system in the U.K has influenced the development of APN roles through the variations of the demand and supply of care providers, economic pressures within the country thus affecting health care services and new trends in nursing practice (Hamric et al, 2000). Furthermore, the increased competition within health care providers and other players for better health services and care has also affected the development of APN roles.

The U.K government has played a significant role in developing and promoting APN roles in the country. The government has done these through allocating of funds to the program and coming up with crucial policies that enable the smooth running and implementation of the ideas and programs in health care delivery (Della, 2004). One such policy that has enabled the development of APN roles is where the government restricted working hours of some junior doctors and the improvement of primary health care and other health care services such as palliative care, which necessitated the introduction and implementation of new APN roles in different settings and capacities.

Though the development of advance practice within nursing in the U.K has been tremendous, the lack of proper definition of goals lead to the need of continuous assessment and follows up by the government. Some organizations come up with new APN role but they lack proper objectivity since they are not well defined. Research has shown that, many organizations do not consider the needs of the society in the local health care setting, so as to clearly define some of the roles of APN and how government priorities would be achieved in such a setting to improve health care within a certain society. Through ambiguous settings, APN roles are guided by expectations of stakeholders such as health care providers, nurses, managers, hence resulting to wide disparities on the interpretation and use of the roles of APN. This situation has caused crisis in the health care sector for example role conflict, acceptance of the APN roles by some stake holders and role overload. Moreover there is involvement of inexperienced people in the introduction of new APN roles thus leading to misinterpretation, titling, scope of practice, funding, under use of some roles and reporting systems. These are some of the hindrances that have been encountered in the development of APN roles in the health care system in the U.K. Houngblut (2002) stated that,

“Cognizance must be taken of the challenges for the development of advanced nursing practice and it is important that the challenges are explored and discussed. The developments in advanced nursing practice have taken place in response to contemporary healthcare delivery and the changes that have taken place have altered the way health care is perceived and delivered. These changes are welcome. However, APNs must ensure and demonstrate that outcomes are improved and that the needs of clients are met” (pg 78).

Another impediment that is mainly experienced in the development of advance practice in nursing is that nurses in the U.K have long not been valued. The valuing of expertise in nursing should be done in ways such as formalizing the advance practice roles. A nurse specialist is one of such roles that should be formalized. These are the people who are supposed to have expertise in the nursing field, are responsible of developing expert practices and specialist know how. Many of the nurses in these fields feel unsupported and lack role models. Therefore, the government and other stake holders should show some solidarity with nurses in order to provide better care services to patients (McGee, & Castledine, 2003).

The impact of APN

There have been substantial changes in the relationship between nurses and patients, over last few years since the inception of advanced practices in nursing in the U.K. The nation has supported the renewed efforts to establish a well organized nursing system in the country thus improving the services being provided by the nurses and the entire health care system. Clinical efficiency, quality services and proper governance in the nursing sector are some of the main strands of the government interest and drive to come up and modernize a proper nursing system. As a result of these efforts the patient-nurse relationship has improved tremendously (Ball & Cox, 2003). The development of new roles of nurses and also some postgraduate courses which have been supported by the government in the U.K has helped many nurses understand the concept of being a nurse and being good one in that matter. Nurses are now developing the character of holding patients’ hands and attending to them properly, thus developing the relationship between nurses and patients.

The extended roles of the nurses through advanced practices within nurses have helped in the relationship of nurses and patients. Such extended roles include drug prescription and other areas which have been traditionally delegated to other health professionals. These roles have increased the contact between patients and nurses and hence developing a good relationship. Classification of what a nurse is required to do and education provision and other frame-works are necessary in ensuring the safety of all concerned parties. However, it is important not to confuse these extended roles in nursing to those of expertise in nursing (Marsden et al, 2003). A survey done by Allen, evaluated 78 opinions of nurses involved in psychiatry in the U.K about their opinions on the extended roles of nurses and advanced practice and found out that, many of the nurses believed that such extended roles should not only be in medical tasks but should also be extended to other humanistic nursing roles. If there are such extended roles of nurses in the country, the nursing field will be more responsible and efficient.

Current state and the future of APN

The future of advance practice within nursing is closely attached to the future of the entire nursing field and to the needs, events and changes within the society and its environs.

Science and technology is one of the factors that have directly affected APN in U.K. The work of nursing and the entire health care system is squarely based on knowledge and technology has made it easier in acquiring of knowledge in many aspects. The knowledge required to guide and instill nursing practice is sourced from various areas including nursing research which mostly involves the use of the modern technology. If nursing education and other practices are to stay relevant in the constantly changing environment, they must also change with time (Bryant-Lukosius, 2004). With the current trend, nurses need to make educated guesses; they should turn problems to answers and learn how to be comfortable with ambiguity.

Specific challenges related to health continue to change every time. This signifies that, how nurses and other health practitioners respond to such challenges must also change with the trend. Health needs depends various aspects such as environment, demographic trends and epidemics. A country such as the U.K is expecting to see more growth in the number of elderly people in the coming future. Some nursing undergraduate programs within the U.K do not have enough theoretical content nor clinical exposure or experience with the elderly people. This shows that there is a serious challenge in the learning institutions to provide a curriculum which involves elderly patients, in the future. Whyte (2000) noted that,

“Educators need to comprehend the role that APNs will play in healthcare delivery in the next decade and beyond. APNs are required to exercise higher levels of judgment and decision-making in the clinical setting. Appropriate preparation, education and demonstrated competence to practice are integral to the success of the role of the APN in the designated area of practice. It is proposed that for the successful preparation of APNs, an innovative curriculum design is needed, where content is delivered within an interdisciplinary framework” (pg 23).

The current demographic trends and other special health needs, indicate that the government needs to come up with an appropriate policy and other organized actions that must be taken by nurses so as to meet the needs of the society. Training has to be established in institutions and also the specialization of personnel in all levels in order to give directions of the changes that research in nursing must take.

Conclusion

The development of advanced practice roles and opportunities through post graduate education can only enrich nursing practices. Education, regulating and defining the scope of nursing practices is very vital however, it is insufficient it is not the only thing needed to advance nursing practices as it is evident in the U.K. There must be equal opportunities being offered to nurses in developing their expertise in nursing practice (Bamford & Gibson, 2000). Supervision is one of the key tools that help nurses develop their expertise in practice and therefore it should be emphasized in the health care policy.

Many institutions and organizations which are committed in advancing nursing practices will be in future rewarded in different ways and means. While value is added to nurse through education, safe environment is created and people are able to be competent enough to handle patients with care. Advanced practice within nursing also cements the relationship between patients and nurses, hence patients are able to relate well with nurses.

Write Some similarities between US healthcare and Japan, Switzerland and France are:Some major differences in the healthcare of these countries and the United States.

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Write Some similarities between US healthcare and Japan, Switzerland and France are:Some major differences in the healthcare of these countries and the United States.

(add References)THEN RESPOND TO THE 2 POST BELLOW (150 words each) Post 1After reading about healthcare in other countries, I am almost grateful that we have the insurance that we do here in America. While some things seem better, many things to me sound worse than what we deal with now. Some similarities between US healthcare and Japan, Switzerland and France are:Some major differences in the healthcare of these countries and the United States:To me, these countries’ health systems seem very expensive to the average consumer, although the percentage spent on healthcare of the Gross Domestic Product is significantly smaller than the US, but France and Switzerland still rank as a couple of the most expensive healthcare systems in the world, at 11.6 and 11.7% respectively.(Pgs. 386, 387) Here in America, we, for now, have the option to at least choose who we want to be insured by, the kind of plan we want and how we want to spend our funds, as in higher premiums and cheaper copays, or vice versa. The French and Japanese are not given much choice. I would have to look at the average salary of a French citizen, but I don’t think I would like 20% of my pay going straight to insurance. Currently, I pay about 4% of my income towards my insurance. I know that America needs healthcare reform, but these other countries do, too. I think they are going in the right direction though, with concentrating more on generic pharmaceuticals and having the government regulate prescription drug prices, as in Switzerland. The United States healthcare system is run by the insurance companies and the pharmaceutical companies, not the government. I think they could take more governmental control while still giving the citizens some choices in their care.

LISTS, TUPLES, STRINGS, DICTIONARIES, AND BUILT-IN FUNCTIONS

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LISTS, TUPLES, STRINGS, DICTIONARIES, AND BUILT-IN FUNCTIONS

Kindy, M. (2008). Chapter 15: Programmer-defines Functions. Python 2: For Beginners Only. Edition1.0. Retrieved from https://cs118.kindy.net/p2fbo_20131230.pdf

Kindy, M. (2008). Chapter 16: Fruitful functions. Python 2: For Beginners Only. Edition1.0. Retrieved from https://cs118.kindy.net/p2fbo_20131230.pdf

Kindy, M. (2008). Chapter 17: Files. Python 2: For Beginners Only. Edition1.0. Retrieved from https://cs118.kindy.net/p2fbo_20131230.pdf

our SLP 3 assignment is about using files for persistent data:

Read Chapter 17, in the online book of “Python 2: For Beginners Only” and run all the examples and and collect all the running results from output by copying and pasting into a file named as “ITM205-SLP3-Examples-YourFirstnameLastName”
Finish the following exercises from “Python 2: For Beginners Only”:
Exercise 17.1, Exercise 17.2
Exercise-A: modify the examples code in Chapter 17.6 in “Python 2: For Beginners Only” to define a function as make_contact(file name) that generates a file named as “EmergencyContacts” using module anydbm and include 5 pair of name and phone number. And then define another function as print_contacts(file name) to print out all the contact in the given “file name”. Test them with your own data.

Exercise-B:

Put both function make_contacts(file name) and print_contacts(file name) into a file and create a module named as “contacts.py. Write another test program test.py that import your contacts.py as a module and use the functions inside and test them.

Create a submission file named as “ITM205-SLP3-Exercises-YourFirstNameLastName “ which contains source code and running results marked with exercise number.

Write a summary document in Microsoft Word format named as “ITM205-SLP3-Summary-YourFirstNameLastName” to show what you have accomplished.

Professional Development of Nursing Professionals

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Professional Development of Nursing Professionals

Professional Development of Nursing Professionals
| 1Unsatisfactory0.00%| 2Less than Satisfactory75.00%| 3Satisfactory83.00%| 4Good94.00%| 5Excellent100.00%| | 80.0 %Content| |
20.0 %Impact of the IOM Report on Nursing Education| Impact of the IOM report on nursing education is not offered.| Impact of the IOM report on nursing education is offered but incomplete due to the exclusion of relevant information.| Impact of the IOM report on nursing education is offered and accurate.

Impacts of Dehydration on the Body

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  • Helen McHugh



Why is dehydration and electrolyte imbalance a danger



?

Dehydration is described as ‘an excessive loss of water from body tissues’ (Mosby Elsevier, 2009) and it also affects an imbalance of electrolytes in the body. It can be very dangerous and even fatal as most of the physiological systems in the body are dependent on water levels and the changes in concentrations of the electrolytes will disturb almost every vital function of the body. (Martini & Nath, 2009)



How have the functions of the skin been impaired?

The body’s first line of defence has been breached, allowing pathogens and bacteria to penetrate the body as well as impairing its ability to regulate temperature, synthesis Vitamin D and loss of some senses i.e. touch, pressure.



How will the body try and repair the areas that have been burnt?

This will happen in three stages, Inflammation, Reconstruction and Maturation.


Inflammation

– this stage takes approximately 3 days and happens immediately the wound occurs. The inflammation causes an increased blood flow to surrounding tissues which produces erythema, swelling, heat and discomfort. As a defence response, different types of white blood cells called polymorphonuclear leucocytes arrive at the wound and are involved in the immune response to fight infection.


Reconstruction

– This stage can take from between 2 – 24 days and is a time of cleaning and temporary replacement of tissue. Polymorphs kill the bacteria and phagocytic macrophages digest the dead bacteria and clean the wound. Epidermal cells start to activate, new blood capillaries are developed and granulation tissue is laid down. Epithelial cells move over the granulation from the edges of the wound. When the wound is covered the epithelium thickens to 4-5 layers, forming the epidermis. The wound would then start to contract reducing in size.


Maturation

– This stage can take between 24 days to 1 year. This is the remodeling stage where collagen cells are reorganized and strengthened. The wound is still at risk during this stage and protection is necessary. (Koutoukidis, et al., 2013)



What could impede the body from successfully achieving this? Think of internal and external factors when you answer this.

Intrinsic- (Internal)

  • Health Status – Illnesses/Conditions/Diseases can affect healing, i.e. anaemia, immune disorders, cancer, diabetes.
  • Age – Older people take longer to heal due to slower metabolism, thinner skin and less elasticity of skin.
  • Bodybuild – Both Obese and Thin people can have various issues related to healing
  • Lifestyle factors – Smoking, Alcohol can have contraindications to healing
  • Nutritional status

Extrinsic (External)

  • Mechanical stress
  • Debris – scabs, necrotic tissue, and excess slough can all impair epithelial migration and supply of nutrient. Also prolongs inflammatory stage.
  • Temperature – Extremes can cause tissue damage
  • Desiccation or maceration – Both dryness and excess moisture can slow healing
  • Infection – Bacteria slows wound healing
  • Chemical stress


(Lumsden, 2014)



Mary undergoes debridement of the burns. What does this mean?

Debridement is the first step in cleansing. It is to remove dirt, foreign objects, damaged tissue and cellular debris from wound/burn which promotes healing and helps prevent infection.

(Mosby Elsevier, 2009)



The burns were subsequently grafted with a split skin graft. What layers of the skin are used for this graft?

A split thickness skin graft is a tissue transplant using both the epidermis and part of the dermis layer.

(Mosby Elsevier, 2009)

3.1

Admission Form

Acute Pain Observation Chart

Observation chart

Fluid Balance Chart

Medication Chart

Neurovascular Chart

Intravenous Drug Chart

Care Plan

Progress Notes

4.2



Define Hypertension and Arteriosclerosis

Hypertension – Elevated blood pressure consistently over 140/90

Arteriosclerosis – A thickening/ calcification of arterial walls and loss of elasticity in arterial walls. The result of this is reduced blood supply.

(Mosby Elsevier, 2009)


How are they often related?

High blood pressure (hypertension) can cause a build up of the muscular and elastic tissues of the arterial walls – hypertensive arteriosclerosis

(Mosby Elsevier, 2009)



Why is hypertension called the ‘Silent killer’

Hypertension is called the silent killer because it can often be asymptomatic, i.e. no symptoms are apparent. There is no single cause but there are possible risk factors.

(Mosby Elsevier, 2009)



Name three changes in your lifestyle that may help prevent cardiovascular disease in old age



.

Do not smoke, Eat healthy and exercise more.



Undesirable clot formation can occur as a result of endothelial damage due to arteriosclerosis. How does the body form undesirable clots within intact blood vessels?

If the endothelium of a blood vessel is rough it can encourage clinging of platelets which can be a risk factor for blood clotting (Thrombus)

The legs are particularly prone to the formation of blood clots and can be caused by blood pooling in the legs or slowly flowing blood especially in immobilized patients.

(Marieb, 2003)

5.2



At handover you are told a patient is cyanotic. What would you expect to observe? Define tissue hypoxia. Three conditions where this could occur.

Cyanosis presents as a bluish discolouration of the skin and mucous membranes caused by not enough oxygen in the blood and excess of deoxygenated blood.

I would expect to see a bluish colour on the skin of the patient, possibly on lips, nailbeds, tip of the nose, external ear and underside of the tongue.

Three conditions where this could occur are

  • Asthma
  • Emphysema
  • Heart failure



5.3 Describe the difference between tracheostomy and endotracheal intubation.

An endotracheal intubation is a flexible cuffed tube inserted via the

mouth or nostril

through the larynx into the trachea, whereas a tracheostomy is a surgical creation of an external opening into the

trachea

.

(Koutoukidis, et al., 2013)



5.4 Why will a patient who is anaemic complain of shortness of breath?

Being anaemic means that you do not have enough red blood cells in your body. The red bolos cells carry oxygen around the body and remove carbon dioxide. Fewer less red blood cells equals less oxygen which equals shortness of breath.

(Koutoukidis, et al., 2013)



5.5. What type of allergic reaction is suspected?

Anaphylaxis is suspected. This condition may be fatal.

Why has this caused problems with his breathing?

The upper respiratory tract is often involved with nasal congestion or sneezing and tightness in the throat may occur with significant airway obstruction. The patient can have bronchospasm or upper airway swelling

(S Shahzad Mustafa, 2013)



6.1 Sever appendicitis, what would be result if left untreated?

The appendix can perforate spilling the contents into the abdominal cavity causing peritonitis.

(Koutoukidis, et al., 2013)



6.2 Why does a lack of fibre in the diet encourage the formation of diverticula?

Faeces usually move along the large bowel with gentle peristalsis; however when there is insufficient fibre in the diet the faeces may become dry and is more difficult to move along with peristalsis. The intestinal muscles then have to perform strong contractions and generate high pressure. This high pressure may cause bulging pouches in the intestinal mucosa and these are called diverticula.

(Murtagh, 1995)



6.3 Explain why obstruction in the common bile duct causes interference with the digestion of some foods?

An Obstruction would prevent bile from entering the small intestine. The bile is needed to aid digestion and is needed to breakdown large fat globules into small ones. When the food is not digesting properly bile can back up into the gallbladder. It then becomes concentrated by removal of water and the cholesterol it contains may crystallize and form gallstones. Blockage of the common bile duct can also stop bile entering the small intestine and backing up into the liver and bile salts and bile pigments will begin to enter the bloodstream and as this circulates through the body the tissues will become yellow or jaundiced.

(Marieb, 2003)



6.4 What nursing observations of their skin, faeces and urine would support the diagnosis of an obstructed bile duct? Where would these observations be recorded



?

Bilirubin levels will increase in the blood and this can cause yellow, jaundiced skin, dark urine and pale coloured faeces. Itching of the skin may also occur.

Recorded in progress notes, fluid balance and bowel chart and observation chart, care plan and urinalysis.

(Marieb, 2003)



8.2 Adrenaline affects the sympathetic nervous system. Explain the effect on blood pressure, heart beat, breathing and the liver.

Blood Vessels – Constricts blood vessels In viscera and skin, increases blood pressure

Heart – Increases rate and force

Liver – Causes glucose to be released to blood.

All of these effects are part of the fight or flight response. The body alters its normal state to one of optimum performance in order for us to take flight (run faster) the heart beat starts to pound, our breathing gets deeper, driving oxygen around the body and glucose is released into the blood stream to give us energy.

(Marieb, 2003)



9.1 Explain why someone who is haemorrhaging, i.e. has falling systemic blood pressure/volume will have a decreased urine output.

When there is significant blood loss the blood pressure falls and the blood pressure in the renal artery will also fall. The body tries to raise the blood pressure by preventing further water and electrolyte loss. To do this the kidney secretes the hormone ‘renin’ which stimulates other hormones to cause vasoconstriction (Marieb, 2003)


References:

Koutoukidis, G., Stainton, K. & Hughson, J., 2013.

Tabbner’s nursing Care Theory and Practice.

6th ed. NSW: Elsevier.

Lumsden, S., 2014.

Wound Management – Class Notes.

Adelaide: s.n.

Marieb, E., 2003.

Essentials of Human Anatomy and Physiology.

7th ed. San Francisco: Pearson Education Ltd.

Martini, F. & Nath, J. L., 2009.

Fundamentals of Anatomy and Physiology.

8th ed. San Francisco: Pearson Education Inc.

Mosby Elsevier, 2009.

Mosby’s Dictionary of Medicine, Nursing and Health Professions.

8th ed. s.l.:Mosby.

Murtagh, J., 1995.

Diverticular Disease.

[Online] Available at:


http://www.nevdgp.org.au/info/murtagh/general/Diverticulardisease.htm


[Accessed 25th February 2014].

S Shahzad Mustafa, M., 2013.

Anaphylaxis Clinical Presentation.

[Online] Available at:


http://emedicine.medscape.com/article/135065-clinical


[Accessed 25th February 2014].

1

Analyze and discuss the relationship between quality and cost in health care in the United States, and research and identify how the Patient Protection and Affordable Care Act (PPACA) attempts to reduce costs and improve quality.

/in /by

Analyze and discuss the relationship between quality and cost in health care in the United States, and research and identify how the Patient Protection and Affordable Care Act (PPACA) attempts to reduce costs and improve quality.
Assignment 1

Health care costs in the United States continue to increase. Despite the high cost of care for health care in the United States, quality indicators and outcomes lag behind other countries when compared to certain dimensions of performance.

For this assignment, analyze and discuss the relationship between quality and cost in health care in the United States, and research and identify how the Patient Protection and Affordable Care Act (PPACA) attempts to reduce costs and improve quality. Based on your research of the PPACA, provide an argument for whether the PPACA has been a success in reducing costs and improving quality.

Note: Use APA style to cite at least 5 scholarly sources from the last 5 years.

Please submit your assignment.

For assistance with your assignment, please use your text, Web resources, and all course materials.