Which leadership style might work best for a manager whose firm is force to make cost cutting decisions and why? Autocratic leadership would suite the situation mentioned in the question above.

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Which leadership style might work best for a manager whose firm is force to make cost cutting decisions and why? Autocratic leadership would suite the situation mentioned in the question above.

 

Identify each of the following as a programmed, or a non-programed decision: A. Reordering printer cartridges-programed B. Selecting a cell phone provider- non-programed C. Buying your favorite toothpaste or shampoo at the supermarket- programed D. Selecting a college to attend- non-programed E. Filling your car with gasoline-non-programed 8. From what sources might a leader draw his power? A leader my draw his or her power from many sources. These sources include,position,expertise,experience, also personality,kindness, fairness, to humorousness,entergeticness and enthusiasticness. Which leadership style might work best for a manager whose firm is force to make cost cutting decisions and why? Autocratic leadership would suite the situation mentioned in the question above. This style of leadership lets the implementation of the companys choice. The decision was not made by him/her and must be passed to who it affects either way. 9. Why is a strong corporate culture important to a companys success? A organization with a strong corporate culture, everyone knows and supports the same principles and values. To achieve its goals, a business must also provide structure, which result from the managements function of organizing. How might the corporate culture be linked to leadership style? Corporate culture is typically shaped by the leaders who founded the company and by those who have succeeded them. Managers use rituals, symbols, ceremonies, and stories to reinforce corporate cultures.Pg. 280 4,7,10 4. On what five factors are compensation policies usually based? 1. What competing companies are paying 2. Government regulations 3. Cost of living 4. Company profits 5. Employee productivity Name at least three employment benefits that are required by law and three more that are voluntarily by firms. Requiered 1. Social Security 2. Unemployment 3. Medicare Voluntary 1. Vacation 2. Profit Sharing 3. Health Insurence…; Pg. 246 7,8,9 7. Identify each of the following as a programmed, or a non-programed decision: A. Reordering printer cartridges-programed B. Selecting a cell phone provider- non-programed C. Buying your favorite toothpaste or shampoo at the supermarket- programed D. Selecting a college to attend- non-programed E. Filling your car with gasoline-non-programed 8. From what sources might a leader draw his power? A leader my draw his or her power from many sources. These sources include,position,expertise,experience, also personality,kindness, fairness, to humorousness,entergeticness and enthusiasticness. Which leadership style might work best for a manager whose firm is force to make cost cutting decisions and why? Autocratic leadership would suite the situation mentioned in the question above. This style of leadership lets the implementation of the companys choice. The decision was not made by him/her and must be passed to who it affects either way. 9. Why is a strong corporate culture important to a companys success? A organization with a strong corporate culture, everyone knows and supports the same principles and values. To achieve its goals, a business must also provide structure, which result from the managements function of organizing. How might the corporate culture be linked to leadership style? Corporate culture is typically shaped by the leaders who founded the company and by those who have succeeded them. Managers use rituals, symbols, ceremonies, and stories to reinforce corporate cultures.Pg. 280 4,7,10 4. On what five factors are compensation policies usually based? 1. What competing companies are paying 2. Government regulations 3. Cost of living 4. Company profits 5. Employee productivity Name at least three employment benefits that are required by law and three more that are voluntarily by firms. Requiered 1. Social Security 2. Unemployment 3. Medicare Voluntary 1. Vacation 2. Profit Sharing 3. Health Insurence…

The Epidemiology of Alcohol Abuse and Alcoholism

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Introduction

According to Alcohol Concern Organisation (2015) more than 9 million people in England consume alcoholic beverages more than the recommended daily limits. In relation to this, the National Health Service (2015) actually recommends no more than 3 to 4 units of alcohol a day for men and 2 to 3 units a day for women. The large number of people consuming alcohol more than the recommended limits, highlights the reality that alcoholism is a major health concern in the UK which can lead to a multitude of serious health problems. Moss (2013) states that alcoholism and chronic use of alcohol are linked to various medical, psychiatric, social and family problems. To add to this, the Health and Social Care Information Centre (2014) reported that between 2012 and 2013, a total of 1,008,850 admissions related to alcohol consumption where an alcohol-related disease, injury or condition was the primary cause for hospital admission or a secondary diagnosis. This shows the detrimental impact of alcoholism on the health and overall wellbeing of millions of people in the UK. It is therefore vital to examine the aetiology of alcoholism in order to understand why so many people end up consuming excessive alcohol. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) (n.d.) supports this by stating that learning the natural history of a disorder will provide information essential for assessment and intervention and for the development of effective preventive measures. This essay will also look into the different public health policies that address the problem of alcoholism in the UK. A brief description of what alcoholism is will first be provided.

What is Alcoholism?

It is safe to declare that alcoholism is a lay term that simply means excessive intake of alcohol. It can be divided into two forms namely; alcohol misuse or abuse and alcohol dependence. Alcohol misuse simply means excessive intake of alcohol more than the recommended limits (National Health Service Choices 2013). A good example of this is binge drinking.

Alcohol dependence is worse because according to the National Institute for Health and Care Excellence (2011, n.p.) it “indicates craving, tolerance, a preoccupation with alcohol and continued drinking regardless of harmful consequences” (e.g. liver disease). Under the Diagnostic Statistical Manual of Mental Disorders (DSM)- 5, these two have been joined as one disorder called alcohol use disorder or AUD with mild, moderate and severe sub-classifications (NIAAA 2015).

Genetic Aetiologic Factor of Alcoholism

Alcoholism is a complex disorder with several factors leading to its development (NIAAA 2005). Genetics and other biological aspects can be considered as one factor involved in the development of alcohol abuse and dependence (NIAAA 2005). Other factors include cognitive, behavioural, temperament, psychological and sociocultural (NIAAA 2005).

According to Goodwin (1985) as far as the era of Aristotle and the Bible, alcoholism was believed to run in the families and thus could be inherited. To some extent, there is some basis that supports this ancient belief because in reality, alcoholic parents have about four to five times higher probability of having alcoholic children (Goodwin 1985). Today, this belief seems to lack substantially clear and direct research-based evidence. On the other hand, studies also do not deny the role of genetics in alcoholism. With this view, it is therefore safe to argue that genetics is considered still as an important aetiologic factor in alcoholism.

The current consensus simply indicates that there is more to a simple gene or two that triggers the predisposition of an individual to become an alcoholic. Scutti (2014) reports that although scientists have known for some time that genetics take an active role in alcoholism, they also propose that an individual’s inclination to be dependent on alcohol is more complicated than the simple presence or absence of any one gene. The National Institute on Alcohol Abuse and Alcoholism (2008) states that there is no one single gene that fully controls a person’s predisposition to alcoholism rather multiple genes play different roles in a person’s susceptibility in becoming an alcoholic. The NIAAA (2005) further claims that the evidence for a genetic factor in alcoholism lies mainly with studies that involve extended pedigree, those that involve identical and fraternal twins and those that include adopted individuals raised apart from their alcoholic parents.

For pedigree studies, it is believed that the risk of suffering from alcoholism is increased four to seven fold among first-degree relatives of an alcoholic (Cotton 1979; Merikangas 1990 cited in NIAAA, 2005.). First degree relatives naturally refer to parent-child relationships; hence, a child is therefore four to seven times at higher risk of becoming an alcoholic, if one or both of their parents are alcoholics. Moss (2013) supports this by stating that children whose parents are alcoholic are at higher risk of becoming alcoholics themselves when compared to children whose parents are non-alcoholics.

A study conducted by McGue, Pickens and Svikis (1992 cited in NIAAA 2005) revealed that identical twins generally have a higher concordance rate of alcoholism compared to fraternal twins or non-twin siblings. This basically means that a person who has an alcoholic identical twin, will have a higher risk of becoming an alcoholic himself when compared to if his alcoholic twin is merely a fraternal twin or a non-twin sibling. This study further proves the role of genetics in alcoholism because identical twins are genetically the same; hence, if one is alcoholic, the other must therefore also carry the alcoholic gene.

The genetic factor in alcoholism is further bolstered by studies conducted by Cloninger, Bohman and Sigvardsson 1981 cited in NIAAA 2005 and Cadoret, Cain and Grove (1980 cited in NIAAA 2005) involving adopted children wherein the aim was to separate the genetic factor from the environmental factor of alcoholism. In these studies, children of alcoholic parents were adopted and raised away from their alcoholic parents but despite this, some of these children still develop alcoholism as adults at a higher rate than those adopted children who did not have an alcoholic biological parent (Cloninger et al., 1981 cited in NIAAA 2005 and Cadoret et al., 1980 cited in NIAAA 2005).

One interesting fact about aetiologic genetic factor is that although there are genes that indeed increase the risk of alcoholism, there are also genes that protect an individual from becoming an alcoholic (NIAAA 2008). For example, some people of Asian ancestry carry a gene that modifies their rate of alcohol metabolism which causes them to manifest symptoms such as flushing, nausea and tachycardia and these generally lead them to avoid alcohol; thus, it can be said that this gene actually helps protect those who possess it from becoming alcoholic (NIAAA 2008).

Environment as an Aetiologic Factor of Alcoholism

Another clearly identifiable factor is environment, which involves the way an individual is raised and his or her exposure to different kinds of activities and opportunities. The National Institute on Alcohol Abuse and Alcoholism (2005) relates that the genetic factor and the environmental factor have a close relationship in triggering alcoholism in an individual. This can be explained by the simple fact that even if an individual is genetically predisposed to becoming an alcoholic, if he is not exposed to a particular kind of environment which triggers activities that lead to alcohol intake, the likelihood of his becoming an alcoholic will be remote.

There are certain aspects within the environment that makes it an important aetiologic factor. According to Alcohol Policy MD (2005) these aspects include acceptance by society, availability and public policies and enforcement.

Acceptance in this case refers to the idea that drinking alcoholic drinks even those that should be deemed excessive is somewhat encouraged through mass media, peer attitudes and behaviours, role models, and the overall view of society. Television series, films and music videos glorify drinking sprees and even drunken behaviour (Alcohol Policy MD 2005). TV and film actors and sports figures, peers and local role models also encourage a positive attitude towards alcohol consumption which overshadows the reality of what alcohol drinking can lead to (Alcohol Policy MD 2005). In relation to this, a review of different studies conducted by Grube (2004) revealed that mass media in the form of television shows for instance has an immense influence on the youth (age 11 to 18) when it comes to alcohol consumption. In films, portrayals regarding the negative impact of alcohol drinking are rare and often highlight the idea that alcohol drinking has no negative impact on a person’s overall wellbeing (Grube 2004). In support of these findings, a systematic review of longitudinal studies conducted by Anderson et al. (2009) revealed that the constant alcohol advertising in mass media can lead adolescents to start drinking or to increase their consumption for those who are already into it.

Availability of alcoholic drinks is another important environmental aetiologic factor of alcoholism simply because of the reality that no matter how predisposed an individual is to become an alcoholic, the risk for alcoholism will still be low if alcoholic drinks are not available. On the other hand, if alcoholic beverages are readily available as often are today, then the risk for alcoholism is increased not only for those who are genetically predisposed to alcoholism but even for those who do not carry the “alcoholic genes”. The more licensed liquor stores in an area, the more likely people are to drink (Alcohol Policy MD 2005). The cheaper its price, the more affordable it is for people to buy and consume it in excess (Alcohol Policy MD 2005).

Another crucial environmental aetiologic factor is the presence or absence of policies that regulate alcohol consumption and its strict or lax enforcement. It includes restricting alcohol consumption in specified areas, enacting stricter statutes concerning drunk driving and providing for penalties for those who sell to, buy for or serve to underage individuals (Alcohol Policy MD 2005). It is worthy to point out that in the UK, the drinking age is 18 and a person can be stopped, fined or even arrested by police if he or she is below this age and is seen drinking alcohol in public (Government UK 2015a). It is also against the law for someone to sell alcohol to an individual below 18; however, an individual age 16 or 17 when accompanied by an adult can actually drink but not buy alcohol in a pub or drink beer, wine or cider with a meal (Government UK 2015a).

Policies to Combat Alcoholism

One public health policy that can help address the problem on alcoholism is the mandatory code of practice for alcohol retailers which banned irresponsible alcohol promotions and competitions, and obliged retailers to provide free drinking water, compelled them to offer smaller measures and required them to have proof of age protocol. It can be argued that this policy addresses the problem of alcoholism by restricting the acceptance, availability and advertising of alcohol (Royal College of Nursing 2012). Another is the Police Reform and Social Responsibility Act 2011 which is a statute that enables local authorities to take a tougher stance on establishments which break licensing rules about alcohol sale (Royal Collage of Nursing 2012).

There is also the policy paper on harmful drinking which provides different strategies in addressing the problem of alcoholism. One such strategy is the advancement of the Change4Life campaign which promotes healthy lifestyle and therefore emphasises the recommended daily limit of alcohol intake for men and women (Government UK 2015b). Another strategy within this policy is the alcohol risk assessment as part of the NHS health check for adults ages 40 to 75 (Government UK 2015b). This policy aims to prevent rather than cure alcoholism which seems to be logical for after all, an ounce of prevention is better than a pound of cure.

Conclusion

Alcoholism which includes both alcohol misuse and alcohol dependence is a serious health problem which affects millions in the UK. Its aetiology is actually a combination of different factors. One vital factor is genetics wherein it can be argued that some people are predisposed to becoming an alcoholic. For example, an individual is at higher risk of becoming an alcoholic if he or she has a parent who is also alcoholic. When coupled with environmental factors, the risk of suffering from alcoholism becomes even greater. Environment refers to the acceptability and availability of alcohol and the presence or absence of policies that regulate alcohol sale and consumption. Vital health policies such as Harmful Drinking Policy Paper advocated by the government, are important preventive measures in reducing the incidence and prevalence of alcoholism in the UK.

References

Alcohol Concern Organisation (2015). Statistics on alcohol. [online]. Available from:

https://www.alcoholconcern.org.uk/help-and-advice/statistics-on-alcohol/

[Accessed on 28 September 2015].

Alcohol Policy MD (2005). The effects of environmental factors on alcohol use and abuse. [online]. Available from:

http://www.alcoholpolicymd.com/alcohol_and_health/study_env.htm

[Accessed on 28 September 2015].

Anderson, P., de Brujin, A., Angus, K., Gordon, R. and Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: A systematic review of longitudinal studies. Alcohol and Alcoholism. 44(3):229-243.

Goodwin, D. (1985). Alcoholism and genetics: The sins of the fathers. JAMA Psychiatry. 42(2):171-174.

Government UK (2015a). Alcohol and young people. [online]. Available from:

https://www.gov.uk/alcohol-young-people-law

[Accessed on 28 September 2015].

Government UK (2015b). policy paper 2010 to 2015 government policy: Harmful drinking. [online]. Available from:

https://www.gov.uk/government/publications/2010-to-2015-government-policy-harmful-drinking/2010-to-2015-government-policy-harmful-drinking

[Accessed on 28 September 2015].

Grube, J. (2004). Alcohol in the media: Drinking portrayals, alcohol advertising, and alcohol consumption among youth. [online]. Available from:

http://www.ncbi.nlm.nih.gov/books/NBK37586/

[Accessed on 28 September 2015].

Health and Social Care Information Centre (2014). Statistics on alcohol England, 2014. [online]. Available from:

http://www.hscic.gov.uk/catalogue/PUB14184/alc-eng-2014-rep.pdf

[Accessed on 28 September 2015].

Moss, H.B. (2013). The impact of alcohol on society: A brief overview. Social Work in Public Health. 28(3-4):175-177.

National Health Service (2015). Alcohol units. [online]. Available from:

http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-units.aspx

[Accessed on 28 September 2015].

National Health Services Choices (2013). Alcohol misuse. [online]. Available from:

http://www.nhs.uk/conditions/alcohol-misuse/pages/introduction.aspx

[Accessed on 28 September 2015].

National Institute on Alcohol Abuse and Alcoholism (2015). Alcohol use disorder: A comparison between DSM-IV and DSM-5. [online]. Available from:

http://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf

[Accessed on 28 September 2015].

National Institute on Alcohol Abuse and Alcoholism (2008). Genetics of alcohol use disorder. [online]. Available from:

http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders/genetics-alcohol-use-disorders

[Accessed on 28 September 2015].

National Institute on Alcohol Abuse and Alcoholism (2005). Module 2: Etiology and natural history of alcoholism. [online]. Available from:

http://pubs.niaaa.nih.gov/publications/Social/Module2Etiology&NaturalHistory/Module2.html

[Accessed on 28 September 2015].

National Institute for Health and Care Excellence (2011). Alcohol-use disorders: Diagnosis, assessment and management of harmful drinking and alcohol dependence. [online]. Available from:

https://www.nice.org.uk/guidance/CG115/chapter/Introduction

[Accessed on 28 September 2015].

Royal College of Nursing (2012). Alcohol: policies to reduce alcohol-related harm in England. [online]. Available from:

https://www.rcn.org.uk/__data/assets/pdf_file/0005/438368/05.12_Alcohol_Short_Briefing_Feb2012.pdf

[Accessed on 28 September 2015.

Scutti, S. (2014). Is alcoholism genetic? Scientists discover link to a network of genes in the brain. [online]. Available from:

http://www.medicaldaily.com/alcoholism-genetic-scientists-discover-link-network-genes-brain-312668

[Accessed on 28 September 2015].

How is a Clinical Information system (CIS) a better solution to collecting and storing data? Consider the following:

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How is a Clinical Information system (CIS) a better solution to collecting and storing data?
Consider the following:

1, How is a Clinical Information system (CIS) a better solution to collecting and storing data?
2, Explain at least one way a Clinicals Information system is adaptable and accessible compared to a paper system.  What is the financial impact on an organization?

Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign

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Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign

Interprofessional practice requires that health care practitioners recognize that patient outcomes are better when there is a collaborative team approach in addressing patient health issues. Also, there are barriers to interprofessional practice that must be addressed among health care practitioners. The Interprofessional Education Collaborative (IPEC) is an initiative including multiple professions designed to advance interprofessional education so that students entering health care professions are able to view collaboration as the norm and seek collaborative relationships with other providers (IPEC, 2011).

This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.
To prepare:

Identify a professional nursing organization and review their position on inter-professional practice

Review the following case study:

Case Study:

Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.

The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.

Post at least 250 words (no introduction or conclusion)

an explanation of your understanding of interprofessional practice.

2. Also, explain the position on interprofessional practice for (The American Association of College of Nursing)

3 Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.

Resources

Bankston, K., Glazer, G., (November 4, 2013) “Legislative: Interprofessional Collaboration: What’s Taking So Long?” OJIN: The Online Journal of Issues in Nursing Vol. 19 No. 1.

DOI: 10.3912/OJIN.Vol18No01LegCol01

Hain, D., Fleck, L., (May 31, 2014) “Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign” OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript 2.

DOI: 10.3912/OJIN.Vol19No02Man02

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative

Buppert, C. (2015). Appendix 11-D: Sample Professional Services Agreement. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (417-422). Burlington, MA: Jones & Bartlett.

Buppert, C. (2015). Legal Scope of Nurse Practitioner Practice. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (37-78). Burlington, MA: Jones & Bartlett.

Causes of Childhood Asthma

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Introduction

This case study aims to review the causes of childhood asthma in the United Kingdom (UK) as well as worldwide and look at current guidelines used within the UK Ambulance Service, National Health Service (NHS) and global health care providers. Evaluating care pathways, treatment plans and management of the disease will increase awareness and ensure treatments are used effectively to avoid hospital admissions and unnecessary mortality amongst children.

Asthma is a chronic, or long-term condition that intermittently inflames the bronchi and narrowing the airways in the lungs. The inflammation makes the airways swell causing periods of wheezing, chest tightness, shortness of breath, and coughing (NHLBI, 2020). The Global Initiative for Asthma (GINA) describes asthma as “a heterogeneous disease, usually characterised by chronic airway inflammation.

According to Asthma UK, approximately 1.1 million children (1 in 11) in England are currently receiving treatment for asthma with an average of 3 children in every classroom having the disease and one child every 20 minutes being transferred to hospital for treatment (2020). Childhood asthma has a significant impact on school days lost each year, with 25,128 children in England under the age of 16 going to hospital in 2018 (NHS England, 2019).

The high number of children living with the disease puts a huge strain on the NHS including the Ambulance Service in this case study. These statistics highlight the ever-growing need for Health Care Professionals, families and children in the care of educators to fully understand the seriousness of childhood asthma and ensure appropriate treatment and care plans are put into place and utilised.


Case Presentation

In September 2019 a call was made via 999 to the North West Ambulance Service (NWAS) for a 6 year old male patient who had severe difficulty in breathing. It was categorised by the dispatcher as a Cat 2 red response. The patient was in school on the day of the incident and had been running outside when he was suddenly unable to catch his breath. The asthma attack was caused by suspected exercise-induced asthma (EIA) which is a reversible airway obstruction that is triggered by moderate to vigorous exercise (Rundell, Wilber and Lemanske, 2002). Exercise-induced asthma is thought to be related to the loss of heat and water from the airways during exercise which causes the airways to narrow, especially in exercise such as running which can provoke wheezing (Asperen and Mellis, 1997).

On arrival, the ambulance crew was directed to the school office where the patient was sat leaning forward in the tripod position, which is a position of comfort for a child in respiratory distress (Eicc.edu, 2020). He was a white British male, slim build and a normal height for his age group. The teachers on scene stated that they had given the patient three puffs of his Ventolin (Salbutamol) Inhaler, which was used with a spacer device. The inhaler is a plastic device that delivers the medication as an aerosol, and a spacer is a plastic tube that has a mouthpiece on one end and space to attach the inhaler onto the other end (Medical News Today, 2020).

A primary survey was undertaken using a stepwise approach which is a tool used by ambulance clinicians to assess a patient. The patient is assessed step by step checking Danger, Response, Catastrophic Haemorrhage, Airway, Breathing, Circulation, Disability, Expose (DR



ABCDE) (JRCALC, 2019 p.138). The child appeared to be alert with a pale complexion and was unable to speak in full sentences, only being able to tell the ambulance crew his name. He was tachypnoeic (fast respiration rate) of 40 beats per minute (BPM) and an audible wheeze could be heard from the patient on expiration, which is suggestive of lower airway narrowing and respiratory distress (Fergusson and Lawton, 2009, p17). On further examination, there was intercostal recession present, which in children of his age can be a sign of severe respiratory problems (Charters, 2017, p21). The ambulance crew quickly recognised that the patient was in significant respiratory distress and his oxygen level and pulse were quickly assessed. His oxygen level was 90 % on room air and his pulse was 135 BPM. High flow oxygen therapy at 15 litres was commenced, following JRCALC protocols (2019, P177). Asthma is categorised in to mild/moderate, severe and life-threatening in NICE guidelines (2019) (see appendix A) and this patient’s attack was showing as severe asthma. Paramedics usually carry out a Peak Expiratory Flow Rate test (PERF) to ascertain the degree of obstruction in the patient’s lungs, however as this was an acute severe attack the crew did not want to exacerbate the attack so refrained from carrying out this task.


A Nebuliser is a device that converts a solution of a drug into a fine spray which is then inhaled through a mask (British Lung Foundation, 2020). The patient was administered 5 milligrams of Salbutamol through the device which is a Selective beta2 adrenoreceptor stimulant drug. The Paramedic auscultated the patient’s chest and a widespread wheeze could be heard bilaterally. Post Salbutamol treatment the patient’s condition improved with oxygen saturations of 95% and a pulse of 125 BPM, and he was transferred to the ambulance. His mother arrived on scene and stated that the patient had been diagnosed with asthma when he was 5, there was no family history of asthma. She also advised that he was prescribed a corticosteroid preventer inhaler (ICS), but had not been taking this daily as instructed by his GP.

In the Ambulance, the patient still had an audible wheeze and looked in distress, so the decision was made to administer 250 micrograms of Ipratropium Bromide which is an antimuscarinic bronchodilator drug via nebuliser on route to the hospital. The EMT communicated with the Emergency Control Centre (EOC) via the radio so that the receiving hospital could prepare for the incoming patient.


Discussion

The patient discussed in this case was primarily assessed using the mnemonic DR



ABCDE which a clinical guideline used by ambulance clinicians is found in JRCALC (2019). This method of emergency assessment is utilised by most Health Care Professionals and is recommended by the Resuscitation Council (UK) in their clinical guidelines (Resus.org.uk, 2020). Paediatric assessment is done using a systematic approach and different methods are used both in the pre-hospital setting and within the health care system. Paediatric Education for Prehospital Professionals (PEPP) states that the best way to carry out a primary assessment in children is using the Paediatric Assessment Triangle (PAT) method which can be seen in Appendix B (PEPP, 2018 p5). According to PEPP, the triangle comprises of three main areas: Appearance of the patient, Work of breathing and Circulation to the skin. The paradigm was created by Drs Dieckmann, Brownstein, and Gausche-Hill to enable Health Care Professionals to rapidly assess the patient using visual and auditory senses.


There are many variations of paediatric scoring systems that have been developed worldwide, and Monaghan’s PEWS is one of the most simple and flexible systems (Gold, Mihalov and Cohen, 2014). The Paediatric Early Warning Score (PEWS) and paediatric track and trigger tools (PTTT) are now common tools used by health care professionals across the world since their introduction (Trubey et al., 2018). The Ambulance Service in the UK has moved away from PEWS and has now adopted the Paediatric Observations Priority Score (POPS) to use alongside Emergency Departments (ED’s) and can be found in the Manchester Triage System (MTS). MTS is a triage system used by both Ambulance Services and ED’s in the UK and around Europe (Health Research Authority, 2020). Early Warning Scores were designed to detect deterioration of the patient, whilst POPS has demonstrated an ability to aid detection of paediatric patients requiring hospitalisation and support discharge decision’s for children with minor illness.

The American College of Allergy, Asthma and Immunology (ACAAI) states that EIA is more likely if exercising in cold weather as opposed to humid climates. EIA should be treated with beta2-agonists and Inhaled corticosteroids (ICS), both are prescribed long-term asthma medications, however, it may take two to four weeks before corticosteroids reach their maximum effect (ACAAI, 2020). This patient was prescribed both medications by the GP but had not been taking his budesonide (preventer inhaler) regularly. This meant that the treatment was no longer effective for this patient and may have contributed to this episode. The National Review of Asthma Deaths published in 2014 by the Royal College of Physicians found that approximately 2,000 children are only using long-acting reliever inhalers on their own rather than with a steroid preventer which is putting them in danger of more severe attacks. The review also acknowledged that only 23% of people who had died from asthma had been given Personal asthma action plans (PAAPs). These personal plans help to improve all aspects of asthma care so that patients are better equipped to manage their symptoms and therefore less likely to be admitted to hospital for their asthma. Research has shown that people without a written asthma action plan are four times more likely to be admitted to hospital for their asthma, with three out of five children not having one. An effective asthma care plan should involve an asthma review, being on the right medication, awareness of how to use inhalers correctly and a written asthma action plan that can be given to schools (Asthma, UK).

The treatments of asthma in the pre-hospital setting within the ambulance service follow a stepwise approach according to JRCALC (2019). In severe asthma, the patient should be given high levels of Oxygen, followed by an oxygen driven nebuliser containing salbutamol. If no improvement Ipratropium Bromide by nebuliser and Intravenous steroids should be administered. In this case study steroids were omitted from the treatment, however, guidelines such as the GINA report show that systemic corticosteroids given early during treatment of acute asthma exacerbations were overall shown to be an effective way of managing asthma. Oral and intravenous steroids are of similar efficiency, with oral steroids being the preferred route in children (sign 158, 2019). A recent study carried out in China also looked at the difference between oral dexamethasone compared to oral prednisolone in the treatment of acute asthma exacerbations in children. The study found that both treatments had similar results however, children who had Dexamethasone had fewer side effects including vomiting compared with Prednisolone (Wei et al., 2019). In an article published in the Medical News Today (2018) another line of treatment for severe asthma is Magnesium Sulphate. This medication is a vasodilator and bronchodilator and can be given nebulised or by IV infusion. It is a safe treatment for children suffering from a severe acute asthma attack according to the most recent (2019) BTS/SIGN guidelines. The use of Magnesium Sulfate in the UK Ambulance Service is currently not indicated; however, the drug is routinely used in the Queensland Australia Ambulance Service protocols for treatment of severe life-threatening asthma (Ambulance.qld.gov.au, 2020).


Conclusion

Children around the world suffer from asthma exacerbation and attacks regularly, which can have an impact on their daily activities. If patients understand their condition and attempt to remove the triggers that cause attacks such as allergens, lost school days and hospital admissions will be reduced. Children with asthma should be prescribed regular ICS therapy by their practitioner as a preventative measure. Adherence to daily ICS therapy is a key determinant of asthma control to prevent future attacks from occurring (Hossny et al., 2016). Having a PAAP in place will also help patients stay in control of their asthma and acts as a guide for health care professionals and those in the care of the child in an emergency (Asthma UK, 2020). Schools should have the correct training and designated persons to deal with emergency medical situations including sudden asthma exacerbations. If the situation is dealt with appropriately it will reduce the severity of the attack.

Ambulance clinicians should ensure that paediatrics are assessed as quickly as possible and in a systematic approach. Using the PAT triangle method of the initial assessment will be an evaluation tool that will be easily implemented into future practice, as it takes only a few seconds and requires no equipment. Ensuring that clinicians use the POPS effectively and with every paediatric patient will enable rapid diagnosis of the most poorly patient and will allow ED’s to assess if the patient has deteriorated or improved.

Based on the evidence I have found treatments such as Magnesium Sulfate and oral Prednisolone may be of benefit to the patient’s in the long term, however, in the pre-hospital setting bronchodilators are the quickest most effective way of treating acute asthma attacks. Hydrocortisone should be given for treatment in moderate to severe asthma attacks and could have been administered in this case. Studies are continuing worldwide for the best treatment pathways of acute asthma and more research into if corticosteroids should be routinely administered by paramedics will be needed before they can be introduced as an out-of-hospital treatment.


Appendix A NICE Guidlines




Appendix B – The Pediatric Assessment Triangle and its components


References

A definition of screening, assessment, and treatment plan Discuss the need for crisis management when working with a client. What is the assessment process for identifying addictive disorders?

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A definition of screening, assessment, and treatment plan
Discuss the need for crisis management when working with a client.
What is the assessment process for identifying addictive disorders?

What considerations must be made for choosing an appropriate assessment tool?
A general overview of the substance use disorder criteria according to the DSM
A discussion about the potential problems that can arise when a counselor relies solely on the diagnostic criteria listed in the DSM for treatment planning
Include at least two examples of commonly used substance use disorder assessment tools.
Include a minimum of two scholarly sources in addition to the textbook.
When writing the paper, consider using the following level-one APA headings to help organize the content:

Definitions

Adam is a 10-year-old scheduled for discharge from the Emergency Department after a bicycle incident resulted in a fractured right ulna and radius. His arm has been casted is immobilized and in a sling.

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Adam is a 10-year-old scheduled for discharge from the Emergency Department after a bicycle incident resulted in a fractured right ulna and radius. His arm has been casted is immobilized and in a sling.

Adam is a 10-year-old scheduled for discharge from the Emergency Department after a bicycle incident resulted in a fractured right ulna and radius. His arm has been casted is immobilized and in a sling. Adam states My arm feels better now and I am sleepy. The pain medicine makes me feel like I will vomit. The RN is reviewing medications with Adam and his mother when the mother states We have a two (2) hour drive home from this emergency room. Can you give Adam something for nausea so he does not throw up in the car? The RN has already completed the discharge paperwork and the orthopedic physician who casted the arm has left the Emergency Department. The RN states No orders are available for Adam to have nausea medicine. I can give him another dose of pain medicine if you think that will help him sleep on the way home. Then he might not vomit.
Initial Discussion Post:
Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References citations and repeating the question do not count towards the 250 word minimum.

Why is accounting important for health care organizations?

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Why is accounting important for health care organizations?

 

accounting important for health care organizations 1. Why is accounting important for health care organizations? 2. Is it appropriate for health care organizations to make a profit? 3. Is it reasonable to assume that the numbers reported on financial statements will be precisely accurate? 4. Why is there a strong focus on liquid assets? 5. Who can restrict the use of the organization?s assets? Who can remove restrictions? 6. What is the difference between charity care and a bad debt?ORDER THIS ESSAY HERE NOW AND GET A DISCOUNT !!!accounting important for health care organizations 1. Why is accounting important for health care organizations? 2. Is it appropriate for health care organizations to make a profit? 3. Is it reasonable to assume that the numbers reported on financial statements will be precisely accurate? 4. Why is there a strong focus on liquid assets? 5. Who can restrict the use of the organization?s assets? Who can remove restrictions? 6. What is the difference between charity care and a bad debt?ORDER THIS ESSAY HERE NOW AND GET A DISCOUNT !!

Identify a plan that addresses legal and ethical issues in a health care policy.

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Identify a plan that addresses legal and ethical issues in a health care policy.

Your duties at 21st Century Solutions Health Care Hospital require you to interface with many different professionals, including physicians, nurses, and allied professionals in various areas of health care. The facility also has a new information technology management center, which handles all professional staffing solutions within the hospital. As part of the management protocols, the hospital has tasked you with tracking professional certifications, tracking legal issues within the hospital, and providing detailed monthly reports on the general functionality of the health administration department.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a six to eight (6-8) page paper in which you:

1.Provide a detailed summary of your hospital’s organizational structure. Include a tabulated description of the levels of professionals within the organization. Describe the duties of each major head within the organization. .

2.Provide a detailed hypothetical mission and value statement for the hospital. Provide a rationale for the development of your particular mission and value statement..

3.Outline a detailed feasibility plan for the hiring of nurses, physicians, and allied professionals. Provide a rationale for the chosen plan, and explain the main reasons why the plan in question would be suitable for use with different health care professionals..

4.Justify the use of information technology to increase patient services. Provide a summative table of some pros and cons of using information technology in an era of networking and security breaches..

5.Use at least five (5) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources..

Your assignment must follow these formatting requirements:

•Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions..

•Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. .

The specific course learning outcomes associated with this assignment are:

•Identify managerial issues related to the health care industry..

•Identify a plan that addresses legal and ethical issues in a health care policy. .

•Use technology and information resources to research issues in health care policy, law, and ethics..

•Write clearly and concisely about health care policy, law, and ethics using proper writing mechanics..

Click here to view the grading rubric for this assignment.

  1. Assignment 2: Organization and Management of a Health Care Facility
    Due Week 7 and worth 200 points

Your duties at 21st Century Solutions Health Care Hospital require you to interface with many different professionals, including physicians, nurses, and allied professionals in various areas of health care. The facility also has a new information technology management center, which handles all professional staffing solutions within the hospital. As part of the management protocols, the hospital has tasked you with tracking professional certifications, tracking legal issues within the hospital, and providing detailed monthly reports on the general functionality of the health administration department.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a six to eight (6-8) page paper in which you:

  1. Provide a detailed summary of your hospital’s organizational structure. Include a tabulated description of the levels of professionals within the organization. Describe the duties of each major head within the organization.
  2. Provide a detailed hypothetical mission and value statement for the hospital. Provide a rationale for the development of your particular mission and value statement.
  3. Outline a detailed feasibility plan for the hiring of nurses, physicians, and allied professionals. Provide a rationale for the chosen plan, and explain the main reasons why the plan in question would be suitable for use with different health care professionals.
  4. Justify the use of information technology to increase patient services. Provide a summative table of some pros and cons of using information technology in an era of networking and security breaches.
  5. Use at least five (5) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Identify managerial issues related to the health care industry.
  • Identify a plan that addresses legal and ethical issues in a health care policy.
  • Use technology and information resources to research issues in health care policy, law, and ethics.
  • Write clearly and concisely about health care policy, law, and ethics using proper writing mechanics.

Click here to view the grading rubric for this assignment.

Briefing Note

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A briefing note is a short paper (2-3 pages) that quickly and effectively informs a decision-maker about an issue. A useful briefing note distills often complex information into a short, well-structured document. You are to write a briefing note, as though you were a director within the civil service (Federal Ministry of Health). You are to provide your minister with a note detailing a situation that has arisen within the media overnight.

The purpose of this note is to present public sector writing practices for briefing notes. The focus is on both style, context, and content. Although style and technique are important when writing for public sector audiences, it is an appreciation of the context that will distinguish you as a writer of superior briefing notes.