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Neurotransmitters and Receptor Theory Sample Paper

Transmission of electrical impulses from one neuron across the synapse to a different neuron or a cell is facilitated by neurotransmitters. Examples of neurotransmitters that facilitate central nervous functions include amino acids (GABA, aspartate, and glutamate), amines (catecholamines, acetylcholine, and serotonin), peptides (neuropeptide Y) and gases such as nitric oxide (Sheffler, Reddy & Pillarisetty, 2020). These neurotransmitters have specific receptors which bind to psychopharmacologic agents to either cause agonistic or antagonistic actions as illustrated hereafter.

Agonist-to-antagonist Spectrum of Action of Psychopharmacologic Agents

            Psychopharmacologic agents are drugs used in the management of a wide spectrum of psychiatric disorders including behavioral disorders, depression, anxiety or stressor-related conditions. The drugs can either exhibit agonistic or antagonistic activities at the receptor site (Katzung, 2018). While agonists activate the receptors, antagonists block the receptors. For example, in the etiology of Schizophrenia, the Dopamine hypothesis is widely accepted. It is believed that excess Dopamine neurotransmission causes the Schizophrenic symptoms.

This has been evidenced by the presence of higher levels of Dopamine receptors in Schizophrenic patients. Management of Schizophrenia therefore utilizes drugs that block the Dopamine receptors (antagonists) for example Chlorpromazine (Katzung, 2018). Contrarily, the pathophysiology of neurodegenerative diseases such as Parkinson disease (PD) reveals decreased dopamine levels and receptor (Katzung, 2018). Therefore, dopamine agonists such as Levodopa are used in the management of PD.

Partial agonists bind and activate receptors but only have partial efficacy (Berg & Clarke, 2018). An example, used as an anxiolytic is Buspirone. Partial agonists exhibit both agonistic and antagonistic actions for example, while Buspirone is a partial agonist for 5HTA1 receptors; it’s an antagonist for D2 receptors (Katzung, 2018)). Therefore, it can be used both as an anxiolytic and antidepressant drug. Inverse agonists bind to receptors however, produces effects opposite to the agonist (Berg & Clarke, 2018). Naltrexone, a partial inverse agonist is used in the management of opioid addiction.

G-coupled proteins and Ion-gated Channels

            G-protein receptors and ligand gated ion channels are both cell surface receptors. They are both found on the membrane of the cells. While ligand gated ion channels are controlled by neurotransmitters to release ions, a G-protein depends on the second messenger system to act (Miller & Lappin, 2020).

Therefore, due to the difference in the mechanism of stimulation, ligand gated ion channels take less time (milliseconds) to be activated compared to G-protein receptors which take a bit longer time (seconds). Additionally, examples of ligand gated ion channels include nicotinic acetylcholine receptors and GABA A receptors while G-coupled receptors examples include muscarinic acetylcholine receptors and adrenoceptors (Katzung, 2018; Miller & Lappin, 2020).

Role of Epigenetics in Pharmacologic Action

            It has been shown that the gene environment influences its expression. Epigenetics, an emerging scientific area is the study of how the environment, child development, aging or diet influences the changes in gene expression (Ganesan et al., 2019). Epigenetic variations have been linked to multiple conditions such as a variety of cancers and psychiatric disorders.

Therefore, understanding the multiple epigenetic mechanisms and pathways involved is the key to treating such conditions. Drugs such as Decitabine have been used as epigenetic anticancer drugs (Ganesan et al., 2019). This drug manipulates the epigenetic changes and genes therefore, capable of halting the neoplastic progression. Currently, the epigenetic drugs are used alongside routine therapy, an approach which has produced myriad beneficial effects.

Significance of the Information

            The information about the pharmacology of drugs is crucial in healthcare. A competent care provider must know the mechanism of actions and potential adverse effects of the drugs. For example, in the management of PD, the nurse must be aware of the pathophysiological mechanisms; the dopamine levels and its receptors. In this case, a nurse is aware that Dopamine agonists are indicated for the management and Dopamine antagonists would worsen the effects.

References

• Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: Inverse agonism and functional selectivity. The International Journal of Neuropsychopharmacology, 21(10), 962–977. doi:10.1093/ijnp/pyy071
• Ganesan, A., Arimondo, P. B., Rots, M. G., Jeronimo, C., & Berdasco, M. (2019). The timeline of epigenetic drug discovery: from reality to dreams. Clinical Epigenetics, 11(1), 174. doi:10.1186/s13148-019-0776-0
• Katzung, B. (2018). Basic & clinical pharmacology (14th ed.). New York: McGraw-Hill.
• Miller, E. J., & Lappin, S. L. (2020). Physiology, Cellular Receptor. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554403/#_NBK554403_pubdet_
• Sheffler, Z. M., Reddy, V., & Pillarisetty, L. S. (2021). Physiology, Neurotransmitters. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK539894/

NorQuest College NFDN 1002 Assignment 2: Teaching Plan Example

One of the most crucial aspects of the nursing process is developing a teaching plan. The patient’s active participation in the care process and compliance with instructions are the goals of patient teaching. The paper describes a teaching plan for Mr. Goldblum, a 72-year-old male with an ischemic stroke who has difficulty swallowing, speech and cognition. Patient education is a continuous process until the participants attain their goals, change their goals, or recognize that the goals will not enable them to meet their learning objectives (Anekwe & Rahkovsky, 2018). A stroke is a life-changing event that needs adjustments; therefore, comprehensive teaching is crucial.

Assessment Data and Learning Needs

The teaching plan will cover impaired communication and impaired swallowing. Due to the chronic pattern of stroke, the patient and family need to be trained on the patient’s various deficits, how to improve them, and the need to be patient because the patient may never fully recover to the pre–stoke state (Pierpoint & Pillay, 2020). For example, they are trained on the need for thickened fluids for dysphagia and to protect the airway.

The rationale for this is the request by the patient to take regular fluids despite having difficulty swallowing. Training to improve communication is a crucial need to enhance the achievement of the understanding of the priority need. Alternative communication techniques help to overcome the problem of speech disturbance (Mitchell et al., 2021). The family members later learn to use the tools to enhance communication.

Priority Learning Need and Diagnosis

Improvement in swallowing is the priority patient need. Difficulty swallowing compromises the airway by causing aspiration, which may lead to death. The nursing diagnosis is insufficient knowledge on the management of post-stroke impaired swallowing related to a lack of understanding of the interventions evidenced by the patient’s insistence to take regular foods. The goal is that at the end of the ten sessions, the patient demonstrates feeding methods and decisions that are appropriate to his situation with aspiration prevented. The outcome is the collaboration of the patient with the multidisciplinary care team in making appropriate feeding decisions.

Domains of Learning

The best suitable teaching methods will include psychomotor and cognitive learning. Psychomotor learning will include training the patient and the caregiver on the optimal position that prevents aspiration and methods of improving swallowing. The maneuvers are head turned to the weak side for unilateral pharyngeal paralysis, head back for decreased posterior propulsion of tongue, and lying down on either side for reduced pharyngeal contraction. The patient will be taught how to coordinate the muscles and sensory stimulation techniques to improve swallowing. Cognitive learning will emphasize scheduling of the meals, the preferred food consistency, and other characteristics such as temperature and type.

Barriers to Learning

Communication impairment is a crucial barrier to learning. Difficulty understanding will impede cognitive learning because the patient will not understand the rationale of the feeding decisions we are making for him. Speech difficulty will impair feedback from the patient regarding the teaching and raise any clarifications or concerns. The danger to this is imposing interventions that the patient is uncomfortable with.

Teaching Plan

The training will be done in the patient’s room, in the presence of the caregiver or family. The sessions will be held daily from 8:30 – 9:30 am for one hour for ten days. Later the patient will be referred to an occupational therapist, and early morning is chosen because the patient will not be fatigued. The session will be one hour because the process requires patience. The teaching resources A pen and paper are needed for the patient to write down what he cannot articulate.

The patient and caregiver will be taught about meal scheduling for cognitive learning. The patient should have a minimum of thirty minutes before meals to reduce fatigue and enhance swallowing. The caregiver should be patient with him and avoid distractions during feeding. Alcohol-free moisturizers will be indicated before and after meals to counteract the effects of dry mouth. They will teach appropriate food temperature is either cold or warm to stimulate salivation and that water should be chilled. The level of deficit determines food consistency, and for this patient level, three thickened fluids are indicated for enhanced swallowing. The food shall be placed on the unaffected side of the mouth.

Psychomotor training will include patient positioning, helping the patient with head control, and manual stimulation of the lips to close or open by applying lips or chin pressure. Applying ice on the weak parts of the tongue and stroke the cheek with a tongue blade to improve tongue movement and control. The patient will be scheduled for an exercise program that effectively increases appetite levels by releasing endorphins from the brain.

Evaluation of Learning

Evaluation of the psychomotor domain learning will be by demonstrating appropriate patient positioning and having control. Secondly, the effectiveness of the training will be marked by the caregiver demonstrating appropriate stimulating methods for the lips, tongue, and cheeks (Steigleder et al., 2019).

The patient understanding will mark the effectiveness of cognitive learning, the rationale for the level III feeds, and agreeing to take them. Secondly, the patient and caregiver will be active participants in formulating the treatment plan. During this process, they will demonstrate understanding by strategically scheduling feeding times and types of feeds, choosing appropriate food temperatures, and using the moisturizer. A quiz capturing the teaching areas will gauge their level of understanding.

Analysis of the Teaching process

A patient teaching plan increases patient understanding of a condition and benefits nurses by allowing them to plan their time efficiently. Patient education aids in managing chronic diseases by informing and involving patients in care guides and lifestyle modifications. The patient adopts positive coping mechanisms, and the family is empowered on how to take care of the patient and undertake therapy sessions with them.

A teaching plan helps systematically deliver concepts and skills in a way that does not overload the patient. The nurse does the prior organization of sessions and contents to be covered. Training, especially for chronic patients, ensures the patient’s compliance with the management plan even on discharge. Breaking down information in a manner that the patient understands without distortion or omission challenges using a teaching plan (Steigleder et al., 2019). Secondly, the patient’s state regarding age, culture, cognitive awareness, and attitude affects the patient’s reception of the training.

Conclusion

Teaching planning is an integral part of a nurse’s patient diagnosis. The plan is tailored- based on patient presentation. The teaching plan addresses post-stroke impaired swallowing training incorporating psychomotor and cognitive domain learning. The setting and contents are pre-determined to provide a sense of direction for the nurse. Patient cognitive impairment is the primary barrier to goal achievement. Patient education empowers them and the caregivers to participate actively in the care process.

References

Anekwe, T. D., & Rahkovsky, I. (2018). Self-management: a comprehensive approach to the management of chronic conditions. American Journal of Public Health, 108(S6), S430-S436. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302041r

Mitchell, C., Gittins, M., Tyson, S., Vail, A., Conroy, P., Paley, L., & Bowen, A. (2021). Prevalence of aphasia and dysarthria among inpatient stroke survivors: describing the population, therapy provision and outcomes on discharge. Aphasiology, 35(7), 950-960. https://doi.org/10.1080/02687038.2020.1759772

Pierpoint, M., & Pillay, M. (2020). Post-stroke dysphagia: An exploration of initial identification and management performed by nurses and doctors. South African Journal of Communication Disorders, 67(1), 1-13. http://dx.doi.org/10.4102/sajcd.v67i1.625

Steigleder, T., Kollmar, R., & Ostgathe, C. (2019). Palliative care for stroke patients and their families: barriers for implementation. Frontiers in Neurology, 10, 164. https://doi.org/10.3389/fneur.2019.00164

NFDN 1002 Assignment 2: Teaching Plan Instructions

Scenario – Mr. Goldblum

Mr. Goldblum is 72 years old and lives in a continuing care facility. He has had a recent ischemic stroke and has right-sided weakness. He was also diagnosed with difficulty swallowing. He has a history of hypertension, treated with Ramipril 10 mg daily. He has recently been started on Coumadin due to the stroke, and has an INR performed weekly. He is on Level 3 thickened fluids. He does not like the thickened fluids and has been asking for regular fluids. His speech was affected by the stroke and at times he is difficult to understand.

Introduction

Clearly identified who the client is. Provided a clear succinct outline of the teaching plan. A brief summary of what was learned from the experience is clearly provided.

3points

Limited information provided on the client. Outline of the teaching plan is incomplete and a summary of what was learned from the experience is unclear and/or one of the components listed is missing.

2points

Is missing two of the following: Identified the client. Provided an outline of the teaching plan and a brief summary of what was learned from the experience

1points

No introduction was provided.

0points

Assessment Data & Learning Needs

2 accurate & appropriate learning needs identified and supported by assessment data (rationale) that is comprehensive and concise based on the case study.
3points
2 basic learning needs identified and supported by assessment data (rationale) that is satisfactory and based on the case study.
2points
Identifies only 1 learning need OR learning needs identified are inaccurate or inappropriate and/or assessment data (rationale) is non-specific or incomplete based on the case study.
1points
Learning needs and assessment data (rationale) are inadequate, irrelevant or absent.
0points
Priority Learning Need & Diagnosis
Identifies priority learning need. Writes an appropriate nursing diagnosis that includes all components of a nursing diagnosis.
2points
Priority learning need is inaccurate or inappropriate. Includes nursing diagnosis but is missing components.
1points
Does not identify priority learning need and/or nursing diagnosis.
0points
Goal
Goal is relevant, appropriate and based on the priority health need.
2points
Goal is satisfactory, basic and based on the priority health need.
1points
Goal is inadequate, irrelevant or absent.
0points
Expected Outcome (SMART Criteria)
Expected outcome is relevant, appropriate, based on the learning needs and is related to the nursing diagnosis and contains all elements of SMART criteria
2points
Expected outcome is inaccurate or inappropriate, and is not related to the learning need and/or nursing diagnosis and/or is incomplete re: SMART criteria.
1points
Expected outcome is irrelevant or absent.
0points
Learning Domain
Information identified is accurate, prioritized and appropriate for the case study. Includes literature reference.
3points
Information identified is satisfactory, prioritized and/or somewhat appropriate for the case study. Includes reference.
2points
Information identified is off topic, and/or inappropriately prioritized for the case study. May or may not include reference.
1points
Information is inadequate, irrelevant or absent.
0points
Barriers to Learning
Chosen barriers are accurate and relevant for the section. Rationale is comprehensive and concise.
3points
Chosen barriers are somewhat accurate and relevant for the scenario. Rationale is satisfactory and basic.
2points
Chosen barriers are non-specific or off topic. Rationale is limited or absent.
1points
Chosen barriers are inappropriate, inadequate or absent.
0points
Teaching Plan: Educational Content
Comprehensive, concise and relevant information is provided for the section. Education content is appropriate and meaningful to the case study. Literature support provided.
3points
Satisfactory and basic information is provided for the section. Education content is somewhat appropriate and/or relevant to the case study. Adequate literature support provided.
2points
Information is minimal and/or limited for the section. Educational content is off topic or not always appropriate to the case study. Minimal literature support.
1points
Information is inadequate, irrelevant or absent. No literature support.
0points
Teaching Plan: Teaching Methods
Teaching methods are appropriate and relevant for the teaching plan. Literature support provided.
3points
Teaching methods are satisfactory and appropriate for the teaching plan. Adequate literature support provided.
2points
Teaching methods are non-specific or incomplete and are off-topic or not appropriate. Minimal literature support.
1points
Teaching methods are inappropriate, off-topic or absent. No literature support.
0points
Teaching Plan: Teaching Resources
Resources are appropriate, insightful and relevant to the teaching plan. Literature support provided.
3points
Resources are basic and satisfactory, and/or somewhat relevant to the teaching plan. Adequate literature support provided.
2points
Resources are minimal, limited and/or may not be relevant to the teaching plan. Minimal literature support.
1points
Resources are inadequate, irrelevant or absent. No literature support.
0points
Evaluation of Learning
Criteria is comprehensive, accurate and relevant for the section.
3points
Criteria is basic, satisfactory and appropriate for the section.
2points
Criteria is non-specific or incomplete. Evidence is off-topic, limited or not appropriate.
1points
Criteria is inappropriate, inadequate or absent.
0points
Reflection of the Teaching Process
Comprehensive, concise and relevant arguments are provided to highlight the importance of teaching plans.
3points
Satisfactory and basic arguments are provided to highlight the importance of teaching plans.
2points
Non-specific or incomplete arguments are provided related to the importance of teaching plans.
1points
Content is inappropriate, inadequate or absent.
0points
Reflection: Strengths and weaknesses of using the teaching plan.
Comprehensive, concise and relevant information is provided. Content is clear, appropriate and meaningful.
3points
Satisfactory, basic and appropriate information is provided. Content presented is somewhat clear and/or missing strengths or weaknesses
2points
Information presented is minimal. Content may be off topic and/or not appropriate.
1points
Information is inadequate, irrelevant or absent.
0points
Reflection: Benefits of using a teaching plan in future practice.
Comprehensive, concise and relevant information is provided. Content provided is clear, appropriate
3points
Satisfactory, basic and appropriate information is provided. Benefits presented are vague.
2points
Benefit information presented is minimal. Content may be off topic and/or not appropriate
1points
Information is inadequate, irrelevant or absent.
0points
Conclusion
Presents a logical, clear, concise summary of main points; presents clear recommendations on changes to be made next time teaching this topic
3points
Provides a conclusion but does not summarize main points and/or recommendations on changes to be made next time teaching this topic.
2points
Does not adequately explain findings or recommendations on changes to be made next time teaching this topic
1points
Conclusion not provided
0points
Grammar/Sentence Structure
Free from writing convention errors
1points
Many/Significant writing convention errors
0points
APA Formatting
Free from APA formatting errors
1points
Many/significant APA errors
0points

NFDN_1002_Teaching_Plan_Assignment.docx.pdf

NFDN_1002_Teaching_Plan_Rubric_2020.pdf

NFDN_1002_TEMPLATE_ASSIGNMENT_2_TEACHING_PLAN_(4)

NHS-FP6004 Assessment 2 Policy Proposal

NHS-FP6004 Assessment 2 Policy Proposal

Draft a written proposal and implementation guidelines for an organizational policy that you believe would help lead to an improvement in quality and performance associated with the benchmark metric for which you advocated action in Assessment 1.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guidelines change proposals that will enable a team, unit, or the organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

Assessment Instructions for NHS-FP6004 Assessment 2 Policy Proposal

In this assessment, you will build on the dashboard benchmark evaluation work you completed in Assessment 1.

PREPARATION

After reviewing your benchmark evaluation, senior leaders in the organization have asked you to draft a policy change proposal and practice guidelines addressing the benchmark metric for which you advocated action.

In their request, senior leaders have asked for a proposal of not more than 2–4 pages that includes a concise policy description (about one paragraph), practice guidelines, and 3–5 credible references to relevant research, case studies, or best practices that support your analysis and recommendations. You are also expected to be precise, professional, and persuasive in justifying the merit of your proposed actions.

When creating your policy and guidelines it may be helpful to utilize the template that your current care setting or organization uses. Your setting’s risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your care setting does not have these resources, there are numerous appropriate templates freely available on the Internet.

PROPOSAL REQUIREMENTS for NHS-FP6004 Assessment 2 Policy Proposal

Note: The tasks outlined below correspond to grading criteria in the scoring guide.

In your proposal, senior leaders have asked that you:

• Explain why a change in organizational policy or practice guidelines is needed to address a shortfall in meeting a performance benchmark prescribed by applicable local, state, or federal health care laws or policies.
  • What is the current benchmark for the organization? What is the numeric score for the underperformance?
  • How might the benchmark underperformance be affecting the quality of care being provided or the operations of the organization?
  • What are the potential repercussions of not making any changes?
• Recommend ethical, evidence-based strategies to resolve the performance issue.
  • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
  • How would these strategies ensure improved performance or compliance with applicable local, state, or federal health care laws or policies?
  • How would you propose to apply these strategies in the context of your chosen professional practice setting?
  • How would you ensure that the application of these strategies is ethical and culturally inclusive?
  • Does your policy encompass the key components of your recommendations?
• Analyze the potential effects of environmental factors on your recommended strategies.
  • What regulatory considerations could affect your recommended strategies?
  • What organizational resources could affect your recommended strategies (for example, staffing, finances, logistics, and support services)?
  • Are your policy and guidelines realistic in light of existing environmental factors?
• Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.
• Identify colleagues, individual stakeholders, or stakeholder groups who should be involved in further development and implementation of your proposed policy, guidelines, and recommended strategies.
  • Why is it important to engage these colleagues, individual stakeholders, or stakeholder groups?
  • Do your proposed guidelines help colleagues, individual stakeholders, or stakeholder groups understand how to implement your proposed policy?
  • How might engaging these colleagues, individual stakeholders, or stakeholder groups result in a better organizational policy and smoother implementation?
  • Are your proposal and recommended strategies realistic, given the care team, unit, or organization you are considering?
• Communicate your proposed policy, guidelines, and recommended strategies in a professional and persuasive manner.
  • Write clearly and logically, using correct grammar, punctuation, and mechanics.

Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.

• Did you cite an additional 3–5 credible sources to support your analysis and recommendations?

SUGGESTED RESOURCES

The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The NHS-FP6004 – Health Care Policy and Law Library Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

Ethical Decision-Making to Improve Quality Performance

This interactive media applies an ethical decision-making process to a workplace health care issue in a hypothetical scenario, which may give you some ideas about how to incorporate ethical considerations into your policy change.

Organizational Ethics Decision-Making Process in Health Care.

This short briefing outlines issues related to quality-related policy development and the potential solutions offered by new regulations such as the Medicare Access and CHIP Reauthorization Act (MACRA) and the ACA.

• • Whitlock, R. (2016, April 15). United States: Talking about the challenge of quality in health care policy development. Mondaq Business Briefing.

NHS-FP6004 Assessment 2 Policy Proposal Example

Statistics show there are preventable measures to reduce falls and avoid them from reoccurring. Typically, 700,000 and 1 million patients fall in hospitals yearly, as stated by the Agency for Healthcare Research and Quality.

Data reports show that many of the patients who fail are not seriously hurt, however, fall rate injuries are substantial. The Joint Commission data shows an average growth in a hospital’s overhead costs for an injury that is fall-related costs the hospital more than $13,000, and the patient’s time spent increases by an average of 6.27 days.

Also, research shows that between 30 and 51 percent of falls result in an injury. (Butcher, 2017) Mercy Medical dashboard metrics data showed an increase in falls and documentation errors due to the mistakes of employees in the years 2015 and 2016.

Many factors can lead to high fall rates, such as poor communication between staff, incorrect documentation, and poor nurse assessments. This policy proposal should be considered to decrease the number of falls and prevent the possibility of falls from occurring. Furthermore, this will increase overall performance, the likelihood of meeting targets, and effective patient care delivery.

Ethical Evidence-Based Strategies

Improving the performance of this benchmark can be accomplished through various ways to decrease preventable falls. Strategic planning will provide a direction in making tough decisions for Medical Mercy Center to deliver superior service to their patients and prevent falls, reducing readmission rates. This policy proposal will support MMC’s leadership to acknowledge a weakness within the organization and implement ways to improve those areas of underperformance.

A lack of communication between staff has caused the fall rates to increase in the center. The “SBAR” concept (situation, background, assessment and, recommendations) is a great tool for maintaining effective communication. Communicating with the staff by using the “SBAR” concept will significantly reduce the chances of miscommunication from the staff and decrease any preventable falls from happening again.

Each time a nurse assesses a patient, using the SBAR concept will support them in identifying the patient’s situation, background, and application recommendations. This will be a great resource in which nurses can then contribute to an enhanced assessment and recommendations on what the patient will need for future treatment. (Lee., Dong,  Lim, Poh., & Lim, 2016).

Strategies should be established for patients who are at risk for falls, which are known to cause injuries to patients. There also should be ways to alert employees if patients are falling more often or patients that could potentially be at risk of falling. Implementing a color-coded system identifying a patient as a fall risk will support decreasing falls and educating new staff about the program.

Proposed Policy

A policy is brought to the attention of the stakeholders and leaders of Mercy Medical due to the systematic failure of reoccurring falls. It is up to the leaders of this organization to bring about change to increase patient satisfaction and patient safety. It is vital to take in the necessary strategies to reduce falls from transpiring. These strategies can contribute to influencing high-quality patient care. (Rawlins, 2014)

Competent staff will support the decrease of stress brought on by an increased workload and the pressures of being short-staffed. Having a knowledgeable team would help when chaotic situations arise and patient care is jeopardized.

It would help relieve the pressures towards a single employee and help to keep each other accountable as a team and decrease unnecessary shortcuts made by an employee. Requiring reporting of fall incidents will help the organization find the areas of weaknesses within the staff and organization. Putting into practice inquiring about the employees’ needs will create a stress-free environment.

Alerts should be issued to patients who are at high risk for falls. Using a color-coded system identifying the fall risk will help employees lessen repeated falls. Educating patients and staff members about the fall prevention policy would be vital in applying safe practices. (Morse,2018)

Conclusion

Human errors are common, but they can be avoided by focusing on education and implementing safe practices. Mercy Medical does not have to be a part of patient fall statistics. Implementing these policies within the organization will provide exemplary safe practices to serve as a role model for organizations and those within the organization.

It’s up to the leaders at Mercy Medical to set the right policies and make impacting changes that would enhance the quality of patient care. We may never be able to prevent patient falls completely, but with strategic efforts and skilled decision-making, we will provide our staff with the best opportunities to minimize falls and maximize patient care.

MMC Fall Prevention Policy

Effective date: October 14, 2019

I. PURPOSE:

To reduce and avoid falls by medication, ensuring proper nurse assessments and reducing risks to provide excellent quality care and correct usage of preventive and protective measures

II. POLICY:

1. All patients should be adequately assessed and classified as to what type of fall risk they are identified when being admitted according to the policy and procedures of Mercy Medical. If any patients are considered high fall risk, all alerts, preventative, and protective measures are considered and must be put in place to ensure proper
2. If a patient has a fall, the fall must be reported and documented in the system and a written report.
3. All staff and leadership must be notified of an unlikely event and must be handled appropriately with the necessary actions for the patient to be taken care
4. The patient must be adequately informed and given instructions and a detailed summary of the

III. Procedure:

1. If an unlikely event occurs, the fall must be reported to the manager and director.
2. An incident report must be filled out on the detailed location, type of fall and description of the
3. A thorough patient follow-up must ensue and all safety precautions should be taken into effect.
4. A follow-up meeting should be held with the manager and all leadership, including staff, to ensure the incident does not occur

NHS-FP6004 Assessment 2 Policy Proposal Resources

Butcher, L. (2017, June 1). The No-Fall Zone. Retrieved from https://www.hhnmag.com/articles/6404-Hospitals-work-to-prevent-patient-falls.

Lee, S. Y., Dong, L., Lim, Y. H., Poh, C. L., & Lim, W. S. (2016). SBAR: towards a common interprofessional team-based communication tool. Medical Education, 50(11), 1167– 1168. https://doi-org.library.capella.edu/10.1111/medu.13171

Morse, J. M. (2008). Preventing patient falls: Second edition. Retrieved from https://ebookcentral-proquest-com.library.capella.edu

Rawlins, M. D. (2014). Engaging with health-care policy. The Lancet, 383, S7-8. doi:http://dx.doi.org.library.capella.edu/10.1016/S0140-6736(14)60048-9

NHS-FPX 4060 Assessment 3 Disaster Recovery Plan

When it comes to NHS-FPX 4060 Assessments, rest assured we can help you complete all the tasks, from assessment 1 to assessment 4. Here we have shown you assessment 3 instructions as well as sample paper. Use the sample paper to assess the quality of work we can deliver to you anytime. Chat us for more information. Or simply place your order and let us work it out for you.

Assessment 3 Instructions: Disaster Recovery Plan

• Develop a disaster recovery plan to lessen health disparities and improve access to community services after a disaster. Develop an oral presentation, 6 pages, for the Vila Health system, city officials, and the disaster relief team.

Professional Context

Nurses perform a variety of roles and their responsibilities as health care providers extend to the community. The decisions we make daily and in times of crisis often involve the balancing of human rights with medical necessities, equitable access to services, legal and ethical mandates, and financial constraints.

In the event of a major accident or natural disaster, many issues can complicate decisions concerning the needs of an individual or group, including understanding and upholding rights and desires, mediating conflict, and applying established ethical and legal standards of nursing care. As a nurse, you must be knowledgeable about disaster preparedness and recovery to safeguard those in your care. As an advocate, you are also accountable for promoting equitable services and quality care for the diverse community.

Nurses work alongside first responders, other professionals, volunteers, and the health department to safeguard the community. Some concerns during a disaster and recovery period include the possibility of death and infectious disease due to debris and/or contamination of the water, air, food supply, or environment. Various degrees of injury may also occur during disasters, terrorism, and violent conflicts.

To maximize survival, first responders must use a triage system to assign victims according to the severity of their condition/prognosis in order to allocate equitable resources and provide treatment. During infectious disease outbreaks, triage does not take the place of routine clinical triage.

Trace-mapping becomes an important step to interrupting the spread of all infectious diseases to prevent or curtail morbidity and mortality in the community. A vital step in trace-mapping is the identification of the infectious individual or group and isolating or quarantining them. During the trace-mapping process, these individuals are interviewed to identify those who have had close contact with them. Contacts are notified of their potential exposure, testing referrals become paramount, and individuals are connected with appropriate services they might need during the self-quarantine period (CDC, 2020).

An example of such disaster is the COVID-19 pandemic of 2020. People who had contact with someone who were in contact with the COVID-19 virus were encouraged to stay home and maintain social distance (at least 6 feet) from others until 14 days after their last exposure to a person with COVID-19. Contacts were required to monitor themselves by checking their temperature twice daily and watching for symptoms of COVID-19 (CDC, 2020).

Local, state, and health department guidelines were essential in establishing the recovery phase. Triage Standard Operating Procedure (SOP) in the case of COVID-19 focused on inpatient and outpatient health care facilities that would be receiving, or preparing to receive, suspected, or confirmed COVID- 19 victims. Controlling droplet transmission through hand washing, social distancing, self-quarantine, PPE, installing barriers, education, and standardized triage algorithm/questionnaires became essential to the triage system (CDC, 2020; WHO, 2020).

This assessment provides an opportunity for you to apply the concepts of emergency preparedness, public health assessment, triage, management, and surveillance after a disaster. You will also focus on evacuation, extended displacement periods, and contact tracing based on the disaster scenario provided.

Demonstration of Proficiency

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

• Competency 1: Analyze health risks and health care needs among distinct populations.
  • Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community.
• Competency 2: Propose health promotion strategies to improve the health of populations.
  • Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts.
• Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
  • Explain how health and governmental policy affect disaster recovery efforts.
• Competency 4: Integrate principles of social justice in community health interventions.
  • Explain how a proposed disaster recovery plan will lessen health disparities and improve access to community services.
• Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
  • Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

Preparation for NHS-FPX-4060 Assessment 3 Disaster Recovery Plan

When disaster strikes, community members must be protected. A comprehensive recovery plan, guided by the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, is essential to help ensure everyone’s safety. The unique needs of residents must be assessed to lessen health disparities and improve access to equitable services after a disaster.

Recovery efforts depend on the appropriateness of the plan, the extent to which key stakeholders have been prepared, the quality of the trace-mapping, and the allocation of available resources. In a time of cost containment, when personnel and resources may be limited, the needs of residents must be weighed carefully against available resources.

In this assessment, you are a community task force member responsible for developing a disaster recovery plan for the Vila Health community using MAP-IT and trace-mapping, which you will present to city officials and the disaster relief team.

To prepare for the assessment, complete the Vila Health: Disaster Recovery Scenario simulation.

In addition, you are encouraged to complete the Disaster Preparedness and Management activity. The information gained from completing this activity will help you succeed with the assessment as you think through key issues in disaster preparedness and management in the community or workplace. Completing activities is also a way to demonstrate engagement.

Begin thinking about:

• Community needs.
• Resources, personnel, budget, and community makeup.
• People accountable for implementation of the disaster recovery plan.
• Healthy People 2020 goals and 2030 objectives.
• A timeline for the recovery effort.

You may also wish to:

• Review the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, which you will use to guide the development of your plan:
  • Mobilize collaborative partners.
  • Assess community needs.
  • Plan to lessen health disparities and improve access to services.
  • Implement a plan to reach Healthy People 2020 goals or 2030 objectives.
  • Track community progress.
• Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.

NHS-FPX-4060 Assessment 3 Disaster Recovery Plan Instructions

Every 10 years, The U.S. Department of Health and Human Services and the Office of Disease Prevention and Health Promotion release information on health indicators, public health issues, and current trends. At the end of 2020, Healthy People 2030 was released to provide information for the next 10 years.

Healthy People 2030 provides the most updated content when it comes to prioritizing public health issues; however, there are historical contents that offer a better understanding of some topics. Disaster preparedness is addressed in Healthy People 2030, but a more robust understanding of MAP-IT, triage, and recovery efforts is found in Healthy People 2020. For this reason, you will find references to both Healthy People 2020 and Healthy People 2030 in this course.

Complete the following:

13. Develop a disaster recovery plan for the Vila Health community that will lessen health disparities and improve access to services after a disaster. Refer back to the Vila Health: Disaster Recovery Scenario to understand the Vila Health community.
    • Assess community needs.
    • Consider resources, personnel, budget, and community makeup.
    • Identify the people accountable for implementation of the plan and describe their roles.
    • Focus on specific Healthy People 2020 goals and 2030 objectives.
    • Include a timeline for the recovery effort.
14. Apply the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework to guide the development of your plan:
    • Mobilize collaborative partners.
    • Assess community needs.
      • Use the demographic data and specifics related to the disaster to identify the needs of the community and develop a recovery plan. Consider physical, emotional, cultural, and financial needs of the entire community.
      • Include in your plan the equitable allocation of services for the diverse community.
      • Apply the triage classification to provide a rationale for those who may have been injured during the train derailment. Provide support for your position.
      • Include in your plan contact tracing of the homeless, disabled, displaced community members, migrant workers, and those who have hearing impairment or English as a second language in the event of severe tornadoes.
    • Plan to lessen health disparities and improve access to services.
    • Implement a plan to reach Healthy People 2020 goals and 2030 objectives.
    • Track and trace-map community progress.
      • Use the CDC’s Contract Tracing Resources for Health Departmentsas a template to create your contact tracing.

Describe the plan for contact tracing during the disaster and recovery phase.

NHS-FPX-4060 Assessment 3 Disaster Recovery Plan Graded Requirements

The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point:

• Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and recovery efforts in the community.
  • Consider the interrelationships among these factors.
• Explain how your proposed disaster recovery plan will lessen health disparities and improve access to community services.
  • Consider principles of social justice and cultural sensitivity with respect to ensuring health equity for individuals, families, and aggregates within the community.
• Explain how health and governmental policy impact disaster recovery efforts.
  • Consider the implications for individuals, families, and aggregates within the community of legislation that includes, but is not limited to, the Americans with Disabilities Act (ADA), the Robert T. Stafford Disaster Relief and Emergency Assistance Act, and the Disaster Recovery Reform Act (DRRA).
• Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve the disaster recovery effort.
  • Consider how your proposed strategies will affect members of the disaster relief team, individuals, families, and aggregates within the community.
  • Include evidence to support your strategies.
• Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
  • Develop your presentation with a specific purpose and audience in mind.
  • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

MUST INCLUDE !!!!!

1. Provides a concise, accurate description of the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community. Clearly describes the interrelationships among these factors.
2. Explains how a proposed disaster recovery plan will lessen health disparities and improve access to community services. Provides clear insight into how principles of social justice and cultural sensitivity help to ensure health equity for individuals, families, and aggregates in the community.
3. Explains how health and governmental policy impact disaster recovery efforts. Articulates the logical policy implications for community members linked to specific policy provisions.
4. Presents specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts that are well-supported by with relevant and credible evidence. Articulates the implications and potential consequences of proposed strategies.
5. Organizes content with clear purpose/goals. support main points, assertions, arguments, conclusions, or recommendations with relevant and evidence-based sources (published within 5 years).

Disaster Recovery Plan Sample Paper

Name (Presenter) Institution Affiliated

Introduction and Objectives

• Disaster Recovery Plan-An approach to preserve an organization during and

after an emergency or disastrous event.

• Disaster-A catastrophic event that causes significant damage or deaths

Objectives

• Discuss Determinants of Health
• Identify the needs of the community and develop a recovery plan
• Discuss the tools and personal resources to implement it
• Discuss principles of social justice and cultural sensitivity
• Describe the obstacles that health and disaster recovery initiatives face
• How to avoid communication barriers, and improve inter-professional

collaboration

Determinants of Health

• Definition-Factors that affect health of a population
• At Vila Health Community, the factors include the following
• Economic status-The need to reduce health disparity as a

target of the plan

? Health services-Reduced access to health services after a

disaster

? Physical environment

• Policy making-affects health of patients (Healthy People, 2020)

The Needs of the Vila Health Community

? The purpose of the disaster strategy plan for Villa Health Community is to lessen health disparities and improve access to services after a disaster

? Derived needs from the main the purpose of the disaster strategy plan include

? Favorable public policies

? Improved public services

? Health services

? Education

? Transport and communication

Tools To Implement the Disaster Recovery Plan

MAP-IT Framework

?   MAP-IT (Mobilize, Assess, Plan, Implement, Track) is a tool for planning and evaluating public health interventions

?   It involves all stakeholders

?   Assessment means that the effort will start

from the reality of the community

Change of Command 

?   The basic ingredient of any recovery plan

?   Involvement of different agencies in addition to the community emergency response

?   Determining the leading agencies in the

recovery process

Disaster Recovery Members and Recovery Timeline

Disaster Recovery Members

? Selection of executive and team members

? Introduction of the parties to the region (McGinnis, 2021)

? Allocations of various roles to different members

General Disaster Recovery Plan Timeline

? Stipulation of the extend of recovery plan implementation

? Keep track of timing of major activities to be implemented during different phases of recovery (McGinnis, 2021)

Barriers to Safety Health and Disaster Recovery Efforts

? Cultural barriers-Rigidity in beliefs (religion) and language

differences

? Economic barriers

? Financial constraints

? Social barriers

? Poor collaboration between the disaster management team

? Ineffective communication among the disaster management team

? Lack of an integrated disaster management system

Proposed Disaster Recovery Plan and Benefits

? The purpose of the proposed disaster recovery plan is to reduce health

disparities and improve access to services through

? Focusing on the most disadvantaged groups (Stafford & Wood, 2017)

? Narrowing Health gaps

? Reducing the social gradient

? Recovery plan inclusive of all patients irrespective of their demographics (reduces disparity) (Stafford & Wood, 2017)

? Infrastructure improvement-improve access to services (Yu et al., 2017)

? The DR plan ensures that the critical areas necessary for return to normalcy

are handled (CDC, 2020).

Social Justice and Cultural Sensitivity

? Equity, as a principle of social justice is applied in healthcare

? Care is given based on the need

? Cultural sensitivity-Enables delivery of culturally competent care

? Ability to acknowledge cultural norms of patients-skill of a care

provider

? Enables provision of a nonbiased care to a diverse group (CDC,

2020)

? Fairness in provision of care irrespective of the differences-

equity

Health and Governmental Policies

? Federal Emergency Management Agency [FEMA] (2017) outlines

the policies

? Example-Presidential Policy Directive 8-whole community

involvement

? Disaster Recovery Reform Act of 2018 -prepares a nation for a future

disaster

? Impact on recovery efforts are as follows

? Encourages collaboration among community-shared responsibility

? Policies support creation of a national preparedness goal

? Identification of loopholes to be addressed

Overcoming Communication Barrier

? Non-functional communication that may result during a disaster

includes

? Problem coordinating radio communication

? No contact with first responders the first few hours

? Language boards

? Kwik point Medical Translator

? Mobile apps to inform the emergency center (Abbas & Norris, 2018)

? Activate emergency alarms

? Use of social media to reach a massive population (Abbas & Norris, 2018)

How to Enhance Inter-professional Collaboration (IPC)

? Various professions displayed by the case

? Health care workers, administrators, financial officers

? EMTs, police, fire department team

? Disorganization during the catastrophe reveals a poor IPC

? Delegation of duties help (Digregorio et al., 2019)

? Implementation of IPC education in schools

? Proper disaster plan-specify role of each participant

Conclusion

? Economic status, physical environment and policies determine

their health

? Cultural, economic and social factors can be barriers to disaster

recovery efforts

? Proposed plan-reduce health disparity; improve health access

? Governmental or state policies significantly affect health

? Language boards, cell phones, social media enhance communication

? Delegation, IPC education, proper disaster plan enhance IPC

References

?    Abbas, R., & Norris, T. (2018). Inter-Agency Communication and Information Exchange in Disaster Healthcare. ISCRAM, 2- 7.

?    Centers for Disease Control and Prevention. (2020). Emergency Preparedness and Response. Retrieved from CDC: https://emergency.cdc.gov/

?    Department of Economic and Social Affairs. (2019). Population and Vital Statistics Report: Statistical Papers Series A Vol.

LXXI. New York: United Nations.

?    Digregorio, H., Graber, J. S., Saylor, J., & Ness, M. (2019). Assessment of inter-professional collaboration before and after a

simulated disaster drill experience. Nurse education today (79, 194-197.

?    Federal Emergency Management Agency (FEMA). (2017). Pre-Disaster Recovery Planning Guide for Local Governments.

FEMA Publication FD 008-03, 5-10.

?    Healthy People. (2020). Determinants of Health. Retrieved from U.S Department of Health and Human Services: https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

?    McGinnis, J. M. (2021). Healthy people 2030: A compass in the storm. Journal of Public Health Management and Practice:

JPHMP, Publish Ahead of Print(6), S213–S214. https://doi.org/10.1097/phh.0000000000001328

?    Stafford, A., & Wood, L. (2017). Tackling health disparities for people who are homeless? Start with social determinants.

International Journal of Environmental Research and Public Health, 14(12), 1535. https://doi.org/10.3390/ijerph14121535

?    Yu, S. W. Y., Hill, C., Ricks, M. L., Bennet, J., & Oriol, N. E. (2017). The scope and impact of mobile health clinics in the United States: a literature review. International Journal for Equity in Health, 16(1), 178. https://doi.org/10.1186/s12939-017- 0671-2

VILA HEALTH Disaster Recovery Scenario (NHS-FPX-4060 Assessment 3: Disaster Recovery Plan)

For a health care facility to be able to fill its role in the community, it must actively plan not only for normal operation, but also for worst-case scenarios which could occur. In such disasters, the hospital’s services will be particularly crucial, even if the specifics of the disaster make it more difficult for the facility to stay open.

In this scenario, you will resume your role as the senior nurse at Valley City Regional Hospital. Like many facilities within the Vila Health network, Valley City Regional serves as the primary source of health care for a wide area of North Dakota. As such, it is even more imperative than usual that it stay open and operational in all situations. Doing this means planning and preparation.

The administrator of the hospital, Jennifer Paulson, wants to talk to you about disaster preparedness and recovery at Valley City Regional. But first, you should read some background information about events in Valley City in the past few years, including the involvement of the hospital.

ARTICLE:

HOPE FOR THE BEST, PLAN FOR THE WORST

Op-ed by Anne Levy, Valley City Herald

Valley City has had a great year, growing on a number of fronts. But all of our growth and success exists in the shadow of the recent past, a case of recent wounds slowly healing and fading to scars.

No one who was in Valley City two years ago will ever forget the catastrophic derailment of an oil-tanker train and the subsequent explosion and fire. While fatalities were fewer than they could have been, six residents of our city lost their lives. Nearly two hundred were hospitalized, and much of the city was temporarily evacuated. Several homes near the railroad tracks were leveled, and our water supply was contaminated by oil leakage for several months.

Life has resumed, and we have begun to thrive again, in our fashion. But the nagging feeling recurs: When the disaster struck, were our institutions properly prepared? No one wakes up in the morning expecting a train derailment, of course. But responsible institutions think about things that could go wrong within the realm of possibility, and make a plan. Many individuals performed brave, inspired, selfless service in the chaos of the derailment, but it is clear in retrospect that much of the work was improvised, disorganized, and often circular or at cross-purposes.

For the first two hours of the crisis, the Valley City Fire Department was caught unprepared by the damage to the city water supply caused by the explosion, which was more extensive than had been considered possible. The Fire and Police departments had trouble coordinating radio communications, and a clear chain of command at the scene between departments was painfully slow to emerge. The hospital was woefully understaffed for the first six hours of the crisis, taking far too long to find a way to bring additional staff and resources onto the scene. The city health department was unacceptably dilatory in testing the municipal water supply for contaminants.

A call from the Herald’s offices to City Hall confirmed that the city’s disaster plan is over a decade old, and is unfortunately myopic both in the events it considers as possible disasters and in the agencies it plans for. It is of utmost importance to the future of our city that this plan be revised, revisited, and expanded. All city agencies should review their own disaster plans and coordinate with the city for a master plan. The same goes for crucial non-government agencies, most especially the Valley City Regional Hospital. Of course, this all exists in the shadow of budget cuts both at city hall and the hospital.

The sun is shining today, without a cloud in the sky. This is the time to make sure we are ready for the next storm, so to speak, to hit our city. No one knows what the next crisis will be or when it will come. But we can count on the fact that no one will get up that morning expecting it.

FACT SHEET:

Valley City, ND, Demographics – NHS-FPX-4060 Assessment 3: Disaster Recovery Plan

Population: 8,295 (up from 6,585 in 2010 census)

Median Age: 43.6 years. 17.1% under age 18; 14.8% between 18 and 24; 21.1% between 25 and 44; 24.9% 46 – 64; 22% 65 or older.

Officially, residents are 93% white, 3% Latino, 2% African-American, 1% Native American, 1% other.

—additionally, unknown number of undocumented migrant workers with limited English proficiency

Special needs: 204 residents are elderly with complex health conditions; 147 physically disabled and/or use lip-reading or American Sign Language to communicate.

Note that the Valley City Homeless shelter runs at  capacity and is generally unable to accommodate all of the city’s homeless population. Also, the city is in the midst of a financial crisis, with bankruptcy looming, and has instituted layoffs at the police and fire departments.

Valley City Region Hospital Fact Sheet

105-bed hospital (currently 97 patients; 5 on ventilators, 2 in hospice care.)

NOTEWORTHY: Both of VCRH’s ambulances are aging and in need of overhaul. Also, much of the hospital’s basic infrastructure and equipment is old and showing wear. The hospital has run at persistent deficits and has been unable to upgrade; may be looking at downsizing nursing staff.

Jennifer Paulson

Administrator, Valley City Hospital

Hello, thanks for stopping by. I hope you’re settling in well.

I’d been planning on talking to you about disaster planning in the near future anyway, but now it looks like it’s a lot more urgent. I’m not sure if you’ve heard, but the National Weather Service says we’re going to be at an elevated risk for severe tornadoes in Valley City this season. I’m taking that as a clear sign that it’s time we get serious about disaster planning.

And it’s not just me… The mayor just called me and asked the hospital to check our preparedness for a mass-casualty event, given recent qualms about the way the derailment was handled. For instance, did you see that op-ed in the paper about disaster planning?

Anyway. My particular concern is patient triage in the near term and recovery efforts over the next six months. As I work on a more formal response to the Mayor about where we’re at for this threat, I’d appreciate it if you could do some research and planning on this matter. Even if we dodge the bullet on these tornadoes, there’ll be something else in the future. We need to stop putting it off and get serious about our disaster planning.

What I’d like for you to do first is take some time to talk to a good cross-section of people here at the hospital about what happened last time, and about our disaster plan in general. Make sure you get people from administration as well as frontline care staff; after all, problems can be visible in one area but not another a lot of times.

So spread it around! Since you weren’t here for the train crisis, I think you’re in a unique position to have a fresh, unbiased outlook on it. Actually, first you might find it useful to take a look at the hospital fact sheet, just to brush up on our basics here.

After you’ve looked at the fact sheet and done some talking to people, I’d like you to swing back by and we’ll talk about next steps.

Thanks!

Kate McVeigh

RN

Hey there! Yeah, I think I have a minute or two to talk about the derailment. Wow. It’s crazy. I guess that’s been a while, but it still feels like it just happened. It’s all so vivid!

I was on shift when it happened, so I was here for the whole thing. The blast, the first few injuries, and then the wave. I think I was working for 16 hours before Heather, the former head nurse, told me to leave before I passed out.

I just remember a big jumble. We had waves of people coming in before we were really aware of what we were up against. Someone actually brought out the disaster plan but it was kind of useless. Just a bunch of words abou

1. Analyze the health care problem or issue.
   • Describe the setting or context for the problem or issue.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
2. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
3. Explain the ethical principles (Beneficence

NHS-FPX4000 Assessment 1 Developing a Health Care Perspective Case Study: To Vaccinate or not Vaccinate Children Example Paper

Child vaccination is a widely accepted routine worldwide. However, there are ethical considerations that involve a balance between a parent’s right in allowing vaccination or their children and the benefits to public health emanating from vaccination of children. While healthcare givers are alive to the benefits of vaccination of children, they have to contend with the right of children to accept or refuse a vaccine.

It is the responsibility of health professionals to clarify to patients the merits they stand to gain from a vaccine and why it is necessary. For example, it is unethical and unreasonable to administer a vaccine to a child when they/their parents have no understanding of the vaccine. It is recommended that such health workers should explain to parents why their children a vaccine and what they stand to lose if their child does not get the jab.

Case Overview

The case scenario, dubbed incident 10 talks about the Smiths family and their five-year old daughter Ana. The Smith’s take their child Ana to their pediatrician to discuss whether or not to vaccinate their daughter. The Smiths’ were concerned about rising number of cases of autism in vaccinated children. They are concerned that vaccinating their child might result in autism-something they would want to avoid at all costs.

Both Ana’s mother and father have prior education/information regarding importance of child vaccination. They have also widely researched this issue through online search on blogs and other social media sites. Being a trained medical professional, Dr. Kerr listened keenly to the concerns presented to him by the Smiths ‘before giving his informed opinion/recommendation about the need to have children vaccinated.

Dr. Kerr told the Smiths’ that the consequences of not vaccinating a child are far too severe compared to vaccinating a child. According to Dr. Kerr, there is no study that directly confirms or link vaccination to autism. On the contrary, the Dr. informed the Smiths’ that there are studies that prove that there is no connection between autism spectrum disorder and vaccination.

Dr. Kerr informed the Smith family that the federal government keeps track of any and all adverse effects that may come from a vaccine. Through the Vaccine Adverse Event Reporting System, the government tracks all vaccines as well as get feedback from people about any incidence from a vaccine. The Dr. explained to the Smiths’ that growing hesitation, opposition and uncertainty about childhood vaccines has created a resurgence of cases of vaccine-preventable diseases and illnesses. In the end, despite Dr. Kerr’s efforts to educate the Smiths’ on the importance of child vaccination. The Smiths’ chose not to vaccinate their daughter.

Ethical Issues in the Case Study

In the case study provided, Dr. Kerr faces a big dilemma after the Smiths’ family refused to vaccinate their daughter. Dr. Kerr knows that the refusal of the Smiths’ to have their daughter Ana vaccinated based on negative rumors is bad for the child.  By refusing to have their child vaccinated, the Smiths’ expose their child to dangerous diseases that are easily contained by a simple vaccination process. Refusal to vaccinate Ana exposes her to debilitating illnesses such as measles, mumps, polio, and meningitis.

Measles leads to swelling of the brain that can damage it and result in death while mumps can lead to permanent deafness. On its part, meningitis also leads to deafness and brain damage, while polio leads to permanent paralysis. These are some of the risks that the Smiths’ expose their daughter Ana by refusing to her get vaccinated. The Smiths’ are not only exposing their child to medical implications but also social implications such as exclusion and quarantine during disease outbreaks.

Ethical Decision-Making Model to Analyze the Case Study

Based on the Smith’s case study, moral judgment, moral behavior, and moral awareness are critical components of an ethical decision-making model. Concerning ethical awareness, the doctor, or any other healthcare professional faced with a similar situation must be alive to the existence of a dilemma. Regarding ethical judgment, the doctor must make the right judgments based on the situation at hand (Stenmark, et al., 2021). Ethical behavior is taking the right action to remedy the situation.

Based on the context of the Smiths’ family, it is incumbent upon Dr. Kerr to recognize that the Smiths’ family lack proper information and education regarding child vaccine. The Smiths’ are also not adequately aware of the risks they expose their daughter and other children by refusing to vaccinate Ana. The ethical behavior Dr. Kerr must adopt is to fully convince the Smiths’ to accept to have their daughter Ana vaccinated.

Effective Communication Approach

When she was presented with the problem, Dr. Kerr listened keenly and patiently to the Smiths’ as they narrated their dilemma. She listened all through out to how the Smiths’ arrived at the conclusion not to vaccinate their child Ana. Through active listening, Dr. Kerr was able to get the whole information from the Smiths’ and give them an informed response based on their dilemma.

Apart from keenly listening to the Smiths, Dr. Kerr also restrained herself from forcing or coercing Ana’s parent’s to get her vaccinated. This is a good professional behavior from the doctor because she knows that she has to respect a patient’s/client’s wishes and not imposing her own will on them even if she is right (Rainer et al., 2018).

Forcing or coercing the Smiths’ to have Ana vaccinated would have resulted in the exact opposite of her good intentions. For example, forceful vaccination or vaccinating Ana without her parent’s approval would have made the Smiths’ to lose faith in healthcare. Her approach of offering more information and education on child vaccine was more professional and bound to make the Smiths’ come to reason.

Applying Ethical Principles to Resolve Ethical Dilemma

The principles of autonomy, beneficence, nonmaleficence, and justice are key factors integral to resolving dilemmas when making decisions. Going by the case study of the Smiths’ family, Dr. Kerr clearly applied the principle of autonomy by giving the Smiths’ the opportunity to make their own decision after educating them and informing them of the consequences of not vaccinating their daughter.

Dr. Kerr also shows beneficence when she advises the Smiths to have their daughter vaccinated- her intentions are good for the patient. However, the Smiths’ action of refusing to have their daughter immunized despite having first-hand information from a qualified professional lacks beneficence as this action will harm their daughter. Concerning nonmaleficence, Dr. Kerr did not harm the patient in any way but to offer critical information that could save the life of Ana.

Conclusion

Healthcare professionals face situations of ethical dilemmas every day in their work. It is the responsibility of these healthcare professionals to know and understand the core principles of decision-making. Having understood the core principles of decision-making, the healthcare professionals must use them and apply them in making-critical decisions based on the conditions and situations faced by their patients/clients. The solutions offered must respect and observe the principles of autonomy, justice beneficence, and nonmaleficence.

References

Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.

Stenmark, C. K., Redfearn, R. A., & Kreitler, C. M. (2021). Self-efficacy and ethical decision-making. Ethics & Behavior, 31(5), 301-320.

NHS-FPX4000 Assessment 1 Developing a Health Care Perspective

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5-page paper.

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Also Read:

NHS-FPX4000 Assessment 2

Demonstration of Proficiency

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

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
  • Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
• Competency 3: Apply ethical principles and academic standards to the study of health care.
  • Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
  • Discuss the effectiveness of the communication approaches present in a case study.
  • Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
  • Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
  • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Write following APA style for in-text citations, quotes, and references.

NHS-FPX4000 Assessment 1 Developing a Health Care Perspective Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

1. Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
   • Select the case most closely related to your area of interest and use it to complete the assessment.
     • Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
   • Include the selected case study in your reference list, using proper APA Style and Format.
2. Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
   • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
   • Identify who is involved or affected by the ethical problem or issue.
   • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
     • Apply the three components outlined in the Ethical Decision-Making Model media.
   • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
     • Describe the factors that contributed to the problem or issue and explain how they contributed.

3. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The How Do I Find Peer-Reviewed Articles? library guide will help you locate appropriate references.
     • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
     • Review the Think Critically About Source Quality
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.

4. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
5. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
6. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Apply the principles of effective composition.
   • Determine the proper application of the rules of grammar and mechanics.
8. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style

NHS-FPX4000 Assessment 2 Capella

SOCRATIC PROBLEM SOLVING APPROACH https://campus.capella.edu/web/critical-thinking/b…

Create a 3-5-page annotated bibliography and summary based on your research related to best practices addressing a current health care problem or issue of interest to you.

In your professional life you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment.

Being adept at research will help you find the information you need. For this assessment, you will select and research a current health care problem or issue faced by a health care organization.

Demonstration of Proficiency

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

1. View the Assessment Topic Areas| Transcript media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

• 1. • Describe the health care problem or issue.
     • Describe your interest in the topic.
     • Describe any professional experience you have with this topic.

2. Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used.

• 1. • You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search.
     • Use keywords related to the health care problem or issue you are researching to select relevant articles.

3. Assess the credibility of the information sources you find.

• 1. • Determine if the source is from an academic peer-reviewed journal.
     • Determine if the publication is current.
     • Determine if information in the academic peer-reviewed journal article is still relevant.

4. Select four current scholarly or academic peer-reviewed journal articles published during the past three to five years that relate to your topic.
5. Explain the relevance of the information sources.

• 1. • Describe how the health care problem or issue is addressed in each source.
     • Discuss what kind of contribution each source provides on your selected topic.

6. Analyze the scholarly literature or academic peer-reviewed journal articles using the annotated bibliography organizational format.

• 1. • The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic.
     • List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
     • Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
     • Follow the reference with the annotation.

7. In your annotation:

• 1. • Identify the purpose of the article.
     • Summarize the source:

• 1. 1. • What are the main arguments?
        • What topics are covered?
     2. Include the conclusions and findings of the article.
     3. Write your annotation in a paragraph form. The annotation should be approximately 150 words (1 to 3 paragraphs) in length.

8. In a separate paragraph or two at the end of the paper, summarize what you learned from your research.

• 1. 1. List the main points you learned from your research.
     2. Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• • Assessment 2 Example [PDF].

Additional Requirements

• 1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
  2. Font and font size: Times New Roman, 12 point.
  3. APA Template: Use the APA template linked in the resources. Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOCX] for guidance.
  4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  5. Content: Provide a title page and reference page following APA style.
  6. References: Use at least four scholarly or academic peer-reviewed journal articles.
  7. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Note: Review the Applying Research Skills Scoring Guide for the grading criteria applied to this assessment.

NHS-FPX4000 Assessment 2 Topic Areas

Selecting a topic for your written assessments can be challenging, but it’s important to make a thoughtful choice.

Choose a topic area of interest to you from the topic suggestions in this media piece. You will use this topic to complete Assessments 2 and 3. Be sure to select a topic that will be manageable for a written assessment.

To explore the chosen topic, you should use the Socratic Problem-Solving Approach, focusing on the sections specifically called out in the assessment guidelines.

NHS-FPX4000 Topic 1: Limited Access to Healthcare

Short Description:

Consumers face barriers to healthcare access for assorted reasons. For example: due to geographic location, provider availability, transportation issues and mobility.

Potential Intervention Approaches:

• Healthcare information online
• Telemedicine
• In–home healthcare services

Keywords for Articles:

online health information seeking, health care access, health information systems, consumer health information, chronic disease, health information search, health seeking behavior, rural nursing

references:

Bhandari, N. (2014). Seeking health information online: does limited healthcare access matter? Journal of the American Medical Informatics Association: JAMIA (1067-5027), 21 (6), p. 1113. https://www-ncbi-nlm-nih-gov.library.capella.edu/pmc/articles/PMC4215038/

Lee, K., Hoti, K., Hughes, J. D., & Emmerton, L. (2014). Dr Google and the Consumer: A Qualitative Study Exploring the Navigational Needs and Online Health Information-Seeking Behaviors of Consumers with Chronic Health Conditions. Journal of Medical Internet Research, 16(12), e262. http://doi.org.library.capella.edu/10.2196/jmir.3706

Ware, P., Bartlett, S. J., Paré, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., … Ahmed, S. (2017). Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interactive Journal of Medical Research, 6(1), e3. http://doi.org.library.capella.edu/10.2196/ijmr.4447

Pratt, D. (2015). Telehealth and telemedicine. Albany Law Journal of Science & Technology. (1059-4280), 25 (3), p. 495. http://www.lexisnexis.com.library.capella.edu/hottopics/lnacademic/?shr=t&csi=148364&sr=TITLE(%22Telehealth+telemedicine+in+2015%22)+and+date+is+2015

Topic 2: Healthcare Disparities

Short Description:

In 2010, the Federal Department of Human and Health Service (DHHS) launched the Healthy People 2020 goals to include a goal to eliminate health inequality/disparity.

Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity;

geographic location; or other characteristics historically linked to discrimination or exclusion” (Office of Disease Prevention and Health Promotion, 2017, p.1).

Potential Intervention Approaches:

• Federal goals
• Community health improvement plans
• Patient advocacy efforts
• “Triple Aim” for populations

Keywords for Articles:

health disparities, community health assessment, community health improvement plan, strategic planning, local health departments, health inequities

References:

Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/disparities

Shah G.H., & Sheahan J.P. (2016). Local health departments’ activities to address health disparities and inequities: Are we moving in the right direction? International Journal of Environmental Research and Public Health. 2016; 13(1):44. http://www.mdpi.com/1660-4601/13/1/44

Institute for Healthcare Improvement. (2017). Triple Aim for Populations. http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx

NHS-FPX4000 Assessment 2 Topic 3: Medication Errors

Short Description:

A medication error is a preventable adverse effect of a patient taking the wrong medication or dosage, whether or not it is evident or harmful to the patient. Medication errors can be a source of serious patient harm, including death.

Potential Intervention Approaches:

• Medical staff education
• Packaging improvements
• Patient medication safety training

Keywords for Articles:

medication administration, medication errors, medication safety

References:

Cohen, M. (2016). Medication errors (miscellaneous). Nursing. 46(2):72, February 2016. DOI: 10.1097/01.NURSE.0000476239.09094.06

Institute for Healthcare Improvement. (2017). Improve Core Processes for Administering Medications. http://www.ihi.org/resources/Pages/Changes/ImproveCoreProcessesforAdministeringMedications.aspx

Agency for Healthcare Research and Quality. (2012). Table 6: Categories of Medication Error Classification. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/match/matchtab6.html

Schmidt, K., Taylor, A., & Pearson, A. (2017). Reduction of medication errors: A unique approach. Journal of Nursing Care Quality. 32(2), April/June 2017, 150–156.

NHS-FPX4000 Assessment 2 Topic 4: Healthcare System Errors

Short Description: 

The health care system in the United States has been the subject of much debate as experts try to determine the best way to deliver high-quality care.

In Crossing the Quality Chasm, the Institute of Medicine (2001) called for the redesign of health care delivery systems and their external environments to promote care that is safe, effective, patient-centered, timely, efficient, and equitable.

Potential Intervention Approaches:

• Systemwide transformation
• Process redesign
• Electronic health records

Keywords for Articles:

multi-stakeholder collaboration, healthcare system redesign

References:

Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US).Agency for Healthcare Research and Quality.

(2017). Hospitals and Health Systems. http://www.ahrq.gov/professionals/systems/index.html

Roberts, B. (2017). Relationship-based care: The institute of medicine’s core competencies in action. Creative Nursing, 05/2016, 22(2).

Credits

1. Subject Matter Expert: Joan Vermillion
2. Interactive Design: Lori Olson
3. Media Instructional Design: Felicity Pearson
4. Instructional Design: Celina Byers
5. Project Manager: Alan Campbell

Resources: Research and Annotated Bibliographies

Top of Form

Bottom of Form

Content

• Print
• How do you approach a problem or issue within your organization? How often do you need credible information to solve a personal or professional problem? Credible information is information that is trustworthy.
• One of the best sources for credible information is the professional literature of the field you are studying; in your case, health care.
• Professional literature is research that has been written and reviewed by other people in your field.

The following resources can help you as you complete your research and seek out professional literature on a health care topic.

• • Gennaro, S. (2016). Why write? Journal of Nursing Scholarship, 48(2), 117.
  • National Institutes of Health, U.S. National Library of Medicine. (2017). Evidence-based practice and health technology assessment. Retrieved from https://www.nlm.nih.gov/hsrinfo/evidence_based_practice.html
  • Rollins, J. A. (2017). Healthcare: It’s “so complicated.” Pediatric Nursing, 43(2), 58, 102.

Each of the following Research Guides is written with a specific program in mind. The one for your program can provide insights about researching topics related to your field.

• • Nursing (BSN) Library Research Guide.
  • Public Health Undergraduate Library Research Guide.
  • Health Care Administration Undergraduate Library Research Guide.

The following resources provide specific information about annotated bibliographies.

• • What Not To Do: Source Material for the Annotated Bibliography | Transcript.
  • Sample Annotated Bibliography [PDF].

NHS-FPX4000 Assessment 3 Analyzing a Current Healthcare Problem or Issue Instructions

• Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that dema

NHS-FPX4000 Assessment 2 Capella

SOCRATIC PROBLEM SOLVING APPROACH 

Create a 3-5-page annotated bibliography and summary based on your research related to best practices addressing a current health care problem or issue of interest to you.

In your professional life you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment.

Being adept at research will help you find the information you need. For this assessment, you will select and research a current health care problem or issue faced by a health care organization.

NHS-FPX4000 Assessment 2 Capella Demonstration of Proficiency

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

1. View the Assessment Topic Areas| Transcript media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

• 1. • Describe the health care problem or issue.
     • Describe your interest in the topic.
     • Describe any professional experience you have with this topic.

2. Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used.

• 1. • You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search.
     • Use keywords related to the health care problem or issue you are researching to select relevant articles.

3. Assess the credibility of the information sources you find.

• 1. • Determine if the source is from an academic peer-reviewed journal.
     • Determine if the publication is current.
     • Determine if information in the academic peer-reviewed journal article is still relevant.

4. Select four current scholarly or academic peer-reviewed journal articles published during the past three to five years that relate to your topic.
5. Explain the relevance of the information sources.

• 1. • Describe how the health care problem or issue is addressed in each source.
     • Discuss what kind of contribution each source provides on your selected topic.

6. Analyze the scholarly literature or academic peer-reviewed journal articles using the annotated bibliography organizational format.

• 1. • The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic.
     • List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
     • Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
     • Follow the reference with the annotation.

7. In your annotation:

• 1. • Identify the purpose of the article.
     • Summarize the source:

• 1. 1. • What are the main arguments?
        • What topics are covered?
     2. Include the conclusions and findings of the article.
     3. Write your annotation in a paragraph form. The annotation should be approximately 150 words (1 to 3 paragraphs) in length.

8. In a separate paragraph or two at the end of the paper, summarize what you learned from your research.

• 1. 1. List the main points you learned from your research.
     2. Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• • Assessment 2 Example [PDF].

NHS-FPX4000 Assessment 2 Capella Additional Requirements

• 1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
  2. Font and font size: Times New Roman, 12 point.
  3. APA Template: Use the APA template linked in the resources. Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOCX] for guidance.
  4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  5. Content: Provide a title page and reference page following APA style.
  6. References: Use at least four scholarly or academic peer-reviewed journal articles.
  7. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
  8. NHS-FPX4000 Assessment 2 Capella

Note: Review the Applying Research Skills Scoring Guide for the grading criteria applied to this assessment.

NHS-FPX4000 Assessment 2 Topic Areas

Selecting a topic for your written assessments can be challenging, but it’s important to make a thoughtful choice.

Choose a topic area of interest to you from the topic suggestions in this media piece. You will use this topic to complete Assessments 2 and 3. Be sure to select a topic that will be manageable for a written assessment.

To explore the chosen topic, you should use the Socratic Problem-Solving Approach, focusing on the sections specifically called out in the assessment guidelines.

NHS-FPX4000 Topic 1: Limited Access to Healthcare

Short Description:

Consumers face barriers to healthcare access for assorted reasons. For example: due to geographic location, provider availability, transportation issues and mobility.

Potential Intervention Approaches:

• Healthcare information online
• Telemedicine
• In–home healthcare services

Keywords for Articles:

online health information seeking, health care access, health information systems, consumer health information, chronic disease, health information search, health seeking behavior, rural nursing

references:

Bhandari, N. (2014). Seeking health information online: does limited healthcare access matter? Journal of the American Medical Informatics Association: JAMIA (1067-5027), 21 (6), p. 1113. https://www-ncbi-nlm-nih-gov.library.capella.edu/pmc/articles/PMC4215038/

Lee, K., Hoti, K., Hughes, J. D., & Emmerton, L. (2014). Dr Google and the Consumer: A Qualitative Study Exploring the Navigational Needs and Online Health Information-Seeking Behaviors of Consumers with Chronic Health Conditions. Journal of Medical Internet Research, 16(12), e262. http://doi.org.library.capella.edu/10.2196/jmir.3706

Ware, P., Bartlett, S. J., Paré, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., … Ahmed, S. (2017). Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interactive Journal of Medical Research, 6(1), e3. http://doi.org.library.capella.edu/10.2196/ijmr.4447

Pratt, D. (2015). Telehealth and telemedicine. Albany Law Journal of Science & Technology. (1059-4280), 25 (3), p. 495. http://www.lexisnexis.com.library.capella.edu/hottopics/lnacademic/?shr=t&csi=148364&sr=TITLE(%22Telehealth+telemedicine+in+2015%22)+and+date+is+2015

Topic 2: Healthcare Disparities

Short Description:

In 2010, the Federal Department of Human and Health Service (DHHS) launched the Healthy People 2020 goals to include a goal to eliminate health inequality/disparity.

Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity;

geographic location; or other characteristics historically linked to discrimination or exclusion” (Office of Disease Prevention and Health Promotion, 2017, p.1).

Potential Intervention Approaches:

• Federal goals
• Community health improvement plans
• Patient advocacy efforts
• “Triple Aim” for populations

Keywords for Articles:

health disparities, community health assessment, community health improvement plan, strategic planning, local health departments, health inequities

References:

Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/disparities

Shah G.H., & Sheahan J.P. (2016). Local health departments’ activities to address health disparities and inequities: Are we moving in the right direction? International Journal of Environmental Research and Public Health. 2016; 13(1):44. http://www.mdpi.com/1660-4601/13/1/44

Institute for Healthcare Improvement. (2017). Triple Aim for Populations. http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx

NHS-FPX4000 Assessment 2 Topic 3: Medication Errors

Short Description:

A medication error is a preventable adverse effect of a patient taking the wrong medication or dosage, whether or not it is evident or harmful to the patient. Medication errors can be a source of serious patient harm, including death.

Potential Intervention Approaches:

• Medical staff education
• Packaging improvements
• Patient medication safety training

Keywords for Articles:

medication administration, medication errors, medication safety

References:

Cohen, M. (2016). Medication errors (miscellaneous). Nursing. 46(2):72, February 2016. DOI: 10.1097/01.NURSE.0000476239.09094.06

Institute for Healthcare Improvement. (2017). Improve Core Processes for Administering Medications. http://www.ihi.org/resources/Pages/Changes/ImproveCoreProcessesforAdministeringMedications.aspx

Agency for Healthcare Research and Quality. (2012). Table 6: Categories of Medication Error Classification. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/match/matchtab6.html

Schmidt, K., Taylor, A., & Pearson, A. (2017). Reduction of medication errors: A unique approach. Journal of Nursing Care Quality. 32(2), April/June 2017, 150–156.

NHS-FPX4000 Assessment 2 Topic 4: Healthcare System Errors

Short Description: 

The health care system in the United States has been the subject of much debate as experts try to determine the best way to deliver high-quality care.

In Crossing the Quality Chasm, the Institute of Medicine (2001) called for the redesign of health care delivery systems and their external environments to promote care that is safe, effective, patient-centered, timely, efficient, and equitable.

Potential Intervention Approaches:

• Systemwide transformation
• Process redesign
• Electronic health records

Keywords for Articles:

multi-stakeholder collaboration, healthcare system redesign

References:

Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US).Agency for Healthcare Research and Quality.

(2017). Hospitals and Health Systems. http://www.ahrq.gov/professionals/systems/index.html

Roberts, B. (2017). Relationship-based care: The institute of medicine’s core competencies in action. Creative Nursing, 05/2016, 22(2).

Credits

1. Subject Matter Expert: Joan Vermillion
2. Interactive Design: Lori Olson
3. Media Instructional Design: Felicity Pearson
4. Instructional Design: Celina Byers
5. Project Manager: Alan Campbell

Resources: Research and Annotated Bibliographies

Top of Form

Bottom of Form

Content

• Print
• How do you approach a problem or issue within your organization? How often do you need credible information to solve a personal or professional problem? Credible information is information that is trustworthy.
• One of the best sources for credible information is the professional literature of the field you are studying; in your case, health care.
• Professional literature is research that has been written and reviewed by other people in your field.

The following resources can help you as you complete your research and seek out professional literature on a health care topic.

• • Gennaro, S. (2016). Why write? Journal of Nursing Scholarship, 48(2), 117.
  • National Institutes of Health, U.S. National Library of Medicine. (2017). Evidence-based practice and health technology assessment. Retrieved from https://www.nlm.nih.gov/hsrinfo/evidence_based_practice.html
  • Rollins, J. A. (2017). Healthcare: It’s “so complicated.” Pediatric Nursing, 43(2), 58, 102.

Each of the following Research Guides is written with a specific program in mind. The one for your program can provide insights about researching topics related to your field.

• • Nursing (BSN) Library Research Guide.
  • Public Health Undergraduate Library Research Guide.
  • Health Care Administration Undergraduate Library Research Guide.

The following resources provide specific information about annotated bibliographies.

• • What Not To Do: Source Material for the Annotated Bibliography | Transcript.
  • Sample Annotated Bibliography [PDF].

NHS-FPX4000 Assessment 2, Healthcare Disparities Sample Approach

Health Disparities

Brief Problem Description

The World Health Organization defines health disparities as “systematic differences in the health status of different population groups” (WHO, 2018). Often, populations portray different factors regarding healthcare services accessibility, where fundamental considerations such as socio-cultural and economic considerations play a significant role in determining how they access quality healthcare.

The World Health Organization (WHO) recognizes social factors like education, employment status, gender, ethnicity, and income levels as essential determinants of how people access healthcare services. In this sense, socioeconomic disparities contribute to the unfairness and exclusion of the population in mainstream healthcare services.

Personal Experience and Interest in the Topic

My interest in the topic relies massively on my working experience with communities facing various socio-economic constraints. I have worked with community-based health organizations targeting to empower rural communities and promote health awareness. I have had opportunities to interact with people struggling with poverty, geographical isolation, low income, and low-level education. Undoubtedly, these disparities affect how people access quality care services. Therefore, I became interested in researching the topic to obtain insights into scientifically proven interventions to reduce inequalities.

Potential Interventions Include:

• Health promotion/advocacy programs
• Quadruple Aims for health equality
• Community improvement strategies
• Multi-disciplinary strategies

Identifying Peer-reviewed Journals

In this section, I leveraged my research knowledge to identify peer-reviewed scholarly publications that I believe should help me develop and support my proposed intervention plan. In addition to using resources that were accessible through the University library portal, I also conducted a search on external databases relevant to nursing, among them Google Scholar, Medline, and CINAHL.

For better search results, I implemented information outlined in the BSN Library Research Guide and learned vital information on how to aggregate and segregate the different internet resources. Once I was conversant with how to navigate through the library and database materials, I managed to refine and filter my search results to obtain only the appropriate scholarly resources.

Further, I used the University Library to access such credible databases as ProQuest and Ebscohost, which also provided some credible resources. By narrowing my search area nursing and health sciences, I was able to obtain only resources relevant to my nursing program.

Assessing Credibility and Relevance of Information Sources

While the University’s portal has specific features that make it easy to access quality scholarly materials on any topic, one must refine the search to obtain the most relevant, recent materials. One can obtain credible resources by simply inputting critical topic words in the University library portal. During my search, some of the keywords I used included health disparities, healthcare access, community health improvement plan, social determinants of health, among others. The search engines have functionalities that enables one to filter the keywords and to tick checkboxes for peer-reviewed and scholarly sources for more refined search results.

To further refine my search outcomes, I sorted the articles based on publication date, from the most recent to the oldest. Additionally, the search engines have a publication date tab that allows one to customize the search range by year of publication, thus making it easier to obtain recent articles. Given the dynamic health environment, only recent peer-reviewed articles with relevant, contemporary nursing and healthcare information must be used in developing an intervention plan. For this reason, I limited my search range to studies published within the last five years.

Peer Reviewed Academic Journals Annotated Bibliography

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

This scholarly article by Garzon-Orjuela et al. (2020) identified and synthesized strategies that facilitate the reduction of health inequalities. The researchers defined healthcare inequalities as differences in health among people or society (Carzon-Orjuela et al., 2020). The background of the study involved reflections on the governments’ interventions or incentives that focus on equity to enhance progress or eliminate health disparities.

One of the strengths of this scholarly journal is that the researchers delved into an in-depth systematic search strategy to select scholarly articles from reputable databases. The researchers indicated many interventions from scientific journals, including multi-disciplinary and team performance, telemedicine, communication between providers, and educational outreach interventions as potential approaches to addressing healthcare inequalities.

Arguably, this research is relevant, up-to-date, and reliable in presenting the various interventions for addressing health inequalities. Firstly, this article is a peer-reviewed scholarly journal and consolidates information from many scholarly articles. Undoubtedly, the study’s findings apply when addressing concerns of inadequate measures to address health inequalities. For instance, the researchers earmarked multi-disciplinary cooperation, multi-sectoral cooperation, technological advancements, and teamwork as scientifically proven approaches to reduce health disparities. As a result, it is possible to apply these interventions in various healthcare contexts.

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, And Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840 

The scholarly article narrowed down health disparities to racial factors that affect how populations access healthcare services. In this sense, the researchers sought to establish the causes of racial inequalities in the US by utilizing quantitative and qualitative data collection and analysis strategies. The study was part of a  sequential mixed-methods study conducted in the US’s Veterans Health Administration (VHA) care system.

The study’s participants were 53 healthcare providers working at three sites in the VHA. The recruitment strategy for the respondents relied on email communication between the researchers and healthcare professionals (potential participants). Essentially, the study identified several patients, providers, healthcare system, and social structural factors that facilitate racial disparities in access to healthcare services. The researchers concluded that understanding racial healthcare disparities is fundamental in informing interventions to addressing health inequalities.

This study is credible because it is peer-reviewed, current, and relies on insights from reputable researchers. Apart from these considerations for determining a reliable scholarly source, the study’s findings apply to inspiring measures to address racial disparities in healthcare. For instance, the investigators suggested openness among healthcare providers as the most profound strategy for reducing racial disparities.

Transparency among healthcare professionals entails various aspects, including effective communication, meaningful relationships, unbiased operations, and positive workplace perceptions. Arguably, these suggestions are vital in addressing workplace stress emanating from racial stereotypes.

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8 

This scholarly journal provides insights into the impact of multi-component community-based health promotion interventions in reducing health discrepancies by focusing on socio-economic status (SES). Therefore, the researchers conducted a comprehensive review to consolidate information about closing the gaps within populations to alleviate healthcare inequalities. The systematic review strategy relied on thorough screening of reputable scholarly article databases such as PubMed and PsycINFO.

Undoubtedly, this research is credible and reliable because it has satisfied peer-review considerations. The systematic review earmarked community-based interventions as vital tools for socio-economic equality in health behavior and status outcomes. The researchers argued that the subsequent community-based interventions for addressing health inequalities should reduce price barriers, promote physical and mental health, and create a healthier environment necessary to support health changes (Nick & von dem Knesebeck, 2020). Arguably, the study’s findings present ideal approaches to address health disparities in different social contexts.

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y 

This scholarly article provides insights into the Quadruple Aim to address the rising economic and social pressures facilitating health inequalities. In this sense, the Quadruple Aim approach includes interventions like improving patient experience, reducing cost, advancing population health, and improving provider’s experiences. For purposeful research, the investigators conducted 10 case studies in three Canadian provinces of Nova Scotia, Ontario, and British Columbia to investigate experiences of primary care and public health collaboration.

The ability to focus articulate current scholarly findings and peer-review criteria render this study credible and reliable. The research identifies provider capacity building, community-based health promotion programs, outreach interventions, and regional immunization management as fundamental approaches for addressing health inequalities in the three Canadian provinces.

Also, researchers identified inadequate collaboration, resource constraints, geographical challenges, and varying organizational goals as barriers to effective strategies for addressing health inequalities. The study concluded that the Quadruple Aims are profound strategies to promote health quality by addressing socio-economic challenges within Canadian populations. The measures presented in the study apply to other nations because they are scientifically proven and tested.

Lessons from the Annotated Bibliography

After preparing an annotated bibliography, I learned that health inequalities pose challenges to countries and communities because they affect how population sections access healthcare services. I realized that the World Health Organization recognizes health disparities as a critical issue in the global health sector.

Some of the causes of health inequalities, as stipulated by the World Health Organization (2018), include economic status, education level, race, ethnicity, gender, and income level. Therefore, governments target alleviating poverty, racial inequalities, illiteracy, and geographical constraints that limit access to health services.

Fortunately, scholarly studies identify community-based strategies, multi-disciplinary cooperation, health advocacy programs, health promotion, capacity building, and fiscal interventions as possible means of realizing health equality. According to Valaitis et al. (2020), these approaches form the basis of the Quadruple Aims for improving patient experience and reducing health costs. Although nations may develop area-specific policies to reduce health disparities, it is crucial to rely on scientific study findings when conceptualizing ideal measures to address causal factors to health inequalities.

References

Garzón-Orjuela, N., Samacá-Samacá, D., Luque Angulo, S., Mendes Abdala, C., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

Gollust, S., Cunningham, B., Bokhour, B., Gordon, H., Pope, C., & Saha, S. et al. (2018). What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Health Care Providers Perceive Causal Attributions. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 004695801876284. https://doi.org/10.1177/0046958018762840

Nickel, S., & von dem Knesebeck, O. (2020). Do multiple community-based interventions on health promotion tackle health inequalities? International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01271-8

Valaitis, R., Wong, S., MacDonald, M., Martin-Misener, R., O’Mara, L., & Meagher-Stewart, D. et al. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08610-y

World Health Organization, WHO. (2018). Health inequities and their causes. Retrieved 25 July 2021, from https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes.

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem

Current Health Problem: Medication Errors

Medication use is undoubtedly the most important aspect of patient care worldwide. With the increased and widespread use of medications comes an increased risk of harm. For instance, there are approximately 6800 prescription medications in the United States, not to mention the countless over-the-counter medications (Tariq et al., 2022).

This, combined with the numerous herbal medications and health supplements used to treat various conditions, raises the risk of harm to consumers. As a result, the Medical Product Safety Commission established goals to focus on overall patient treatment improvement and ensuring the appropriate use of medical products (USDHHS, 2020). According to the Medical Product Safety Commission, medical products include drugs, biological products, and medical devices.

Although there is no universally accepted definition, the National Coordinating Council for Medication Error Reporting and Prevention (2021) defines medication errors as a preventable event that may result in inappropriate medication use or patient harm when the medication is in the control of the healthcare provider, patient, or consumer.

The good news, as suggested by the definition, is that medication error is a preventable action, and thus the go-ahead for all stakeholders to work in unison to integrate and coin preventive interventions. This paper aims to describe the context of a medication error, its causes, the populations affected, and why it is essential. A further discussion of the problem’s potential solutions and ethical implications follows.

Description of Medication Errors and Possible Causes

While interventions have been put in place to reduce the occurrence of medication errors, they have yet to be eliminated. The question that the majority would ask is the reason for the perpetual occurrence of medication errors. Before delving into the causes of medication errors, it is critical to understand their classification.

Medication errors can be classified in a variety of ways, including the stage in the sequence of medication use, the type of errors, the severity, and whether the act is the result of omission or commission (WHO, 2018). Medication errors can occur at any stage of the medication use process, including prescription, transcription, dispensing, administration, and monitoring (WHO, 2018). Based on the type, medication errors are classified as wrong dosage, frequency, route, or patient (WHO, 2018).

A further classification includes acts of commission, such as giving the incorrect dosage of a drug, and acts of omission, such as forgetting to administer a drug (WHO, 2018). Regarding severity, medication errors are classified into levels 0 through 6, with level 0 being a non-medication error and level 6 being a fatal error (Gates et al., 2019). These approaches to categorizing medication errors are mutually exclusive, and there is no strong evidence to support a particular classification criterion, particularly in primary care facilities.

Several studies have delved into examining the factors that contribute to medication errors. According to a Commonwealth Fund International Health Policy Survey, 11% of patients experienced medication errors due to the following risk factors: poor coordination of care, multimorbidity and hospitalization, and cost-related barriers to medical services or medicines (Walsh et al., 2018).

In summary, the survey categorized the key factors associated with medication errors into the following categories: healthcare provider-related, patient-related, work environment-related, and computer system-related. According to the survey, healthcare provider-related factors include a lack of therapeutic training, insufficient knowledge of the patient and the drug, fatigue, emotional burden, inadequate perception of the risk, and poor communication with patients (Walsh et al., 2018).

Patient-related risk factors include, but are not limited to, (1) individual characteristics such as literacy and language barriers and (2) clinical issue complexity such as polypharmacy, multimorbidity, and high-risk medications (Walsh et al., 2018). Work environment-related factors include workload and time pressures, distractions, a lack of standardized protocols, insufficient resources, and physical work environment issues such as lighting.

Medication-related factors such as packaging, labeling, and naming of medicines as well as computerized information system issues such as difficult processes, inadequate design, and lack of accuracy of patient records, are all strongly linked to medication errors (Walsh et al., 2018). While all factors contribute to some degree to the risk of a medication error, some have been shown in studies to play a much larger role in medication error causation than others.

Distractions in the workplace are a significant contributor to the vast majority of medication errors. Tariq et al. (2022) attribute over 75% of medication errors to distraction. Physicians are tasked with many tasks, including history taking, physical examination of patients, ordering laboratory tests, and patient education. Amidst all this, they are asked to write drug orders and prescriptions. A lapse in judgment may occur in the rush to write orders and prescriptions, resulting in medication errors (Tariq et al., 2022).

Physicians may scribble drug orders quickly, not paying attention to dosages, frequency, or route, potentially leading to medication errors. Furthermore, while the percentage of contribution is not known, distortions are a common cause of medication errors. The term “distortions” refers to the physicians’ poor penmanship, abbreviations, and misunderstood symbols. Clearly, these contributing factors are largely avoidable with a little forethought and meticulousness.

The Context of Medication Errors, its Significance, and the Population Affected

Medication error is a worldwide issue that affects all levels of care. Due to the morbidity, mortality, and financial implications of medication errors, it is a significant public health issue that must be addressed. It is estimated that 7000-9000 people die each year in the United States as a result of medication errors (Tariq et al., 2022).

Besides the mortality, hundreds of thousands of patients experience but do not report an adverse reaction or a drug complication (Tariq et al., 2022), suggesting that the problem may be more widespread than statistics indicate. In terms of financial implications, the United States spends approximately $40 billion per year to treat patients who have medication error-associated problems (Tariq et al., 2022). Aside from the monetary cost, medication errors cause significant physical and psychosocial pain, not to mention patient dissatisfaction and growing distrust of healthcare services (Tariq et al., 2022).

In other countries, such as the United Kingdom, a study estimated the prevalence of medication errors to be 12% in all primary care patients, with a higher rate of 38% among patients aged 75 and older (Assiri et al., 2018). A study in Sweden estimated the medication prevalence rate to be 42% nationwide, and in Mexico, it was discovered that 58% of prescriptions contained errors (Assiri et al., 2018). The high prevalence rates and consequences of medication errors provide sufficient impetus for the quest for solutions.

Medication error is an enduring problem for the pediatric and elderly population.  Children who have not reached the talking stage are more likely to suffer medication errors due to their inability to communicate whether they are experiencing any medication side effects, if they have an allergy or when they last took the medication (Nkurunziza et al., 2018).

Furthermore, caregivers, often parents, may be anxious about their children’s deteriorating symptoms or, in some cases, lack knowledge of the medication and may administer higher dosages in the hope of achieving a faster clinical remission (Nkurunziza et al., 2018). In addition, some pediatric drug formulations are sweet, such as Ibuprofen syrup, which has an orange flavor, and risks being consumed in excess, potentially resulting in overdosage.

To assess the severity of the problem in the pediatric population, Feyissa et al. (2020) estimate that 41.8% (n=136) of 325 pediatric patients admitted to the pediatric ward and diagnosed with infectious diseases during the data collection period had at least one medication error during their hospital stay. The elderly are another population group that is at high risk of medication errors. This is due, in part, to the elderly population’s multiple morbidities, which necessitate polypharmacy.

Medication errors occur at varying rates among the elderly population. Most studies, however, assign nearly constant factors associated with medication errors in the elderly, such as age ?65 years, ?7 days of hospital stay, presence of comorbidity, and polypharmacy (Gebre et al., 2021). While medication errors occur in other populations, the elderly and children account for the vast majority of the cases.

Potential Solutions

Several studies have explored ways to improve the quality of medication prescription and administration in primary care settings. Educational programs, computer technology, and clinical pharmacists are common strategies used in multifaceted interventions. The education of healthcare providers and patients about medications has been a key area of research in reducing medication errors.

Educating a care provider about medications leads to improved adherence to clinical guidelines, which reduces errors (Mieiro et al., 2019). Similarly, educating patients about their medications and allowing patients to self-administer medications has been proven to be safe and effective in reducing medication errors (Mieiro et al., 2019). The use of automated information systems, such as computerized provider order entry (CPOE) systems, has the potential to reduce medication errors.

The CPOE systems include alarm devices that detect incorrect dosages, frequency, and routes, as well as reduce medication errors caused by physicians’ poor penmanship (Mieiro et al., 2019). Implementation requires an effective information system, hardware, and software, a health informatics group, and the participation of care providers and patients (Mieiro et al., 2019).

Clinical pharmacists assist with medication reviews and reconciliation, which entails checking for potential drug-drug interactions, correcting medication discrepancies, and developing interventions that lead to increased identification and resolution of medication-related problems. People are shifting to technologizing medication processes to reduce medication errors as technology in healthcare becomes more prevalent. However, these interventions are used in tandem because no study has proven that one strategy is superior to others.

Ethical Implications for the Implementation of Potential Solutions

The interventions used to help reduce medication errors must, at the very least, adhere to four ethical principles: autonomy, beneficence, nonmaleficence, and justice. The concepts of autonomy and right to self-determination recognize patients’ rights to make independent decisions and take actions that they deem appropriate.

Educating patients about the possibility of medication errors allows them to make informed decisions about seeking treatment if a medication error occurs (McMillan, 2019). The concept of beneficence and nonmaleficence may cause a conflict for the caregiver when balancing the projected benefits with the patient’s potential risks. Because medications have the potential to cause harm to patients, caregivers should take the necessary precautions to keep patients safe (McMillan, 2019).

While nonmaleficence refers to not harming the patient, it is difficult to completely assure the patient of no harm because all medications have the potential to cause harm to some degree. Justice, on the other hand, refers to treating patients fairly and equally. All patients, regardless of race or other characteristics, receive the best care possible, and if they have a medication-related problem, they are also treated without discrimination.

Conclusion

While medication error is a serious global health concern, it is potentially avoidable. Every country experiences some level of a medication error, which varies depending on the country’s economic situation and the importance placed on health in that country. Effective interventions to prevent medication errors are available worldwide; however, complete elimination has yet to be achieved. The advancement in technology that has resulted in the revolutionization of healthcare offers great hope for the fight against medication errors. However, it should be noted that a single intervention is rarely sufficient and that multifaceted interventions are frequently required.

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem References

Assiri, G. A., Shebl, N. A., Mahmoud, M. A., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, error-related adverse events, and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8(5), e019101. https://doi.org/10.1136/bmjopen-2017-019101

Feyissa, D., Kebede, B., Zewudie, A., & Mamo, Y. (2020). Medication error and its contributing factors among pediatric patients diagnosed with infectious diseases admitted to Jimma University Medical Center, southwest Ethiopia: Prospective observational study. Integrated Pharmacy Research & Practice, 9, 147–153. https://doi.org/10.2147/IPRP.S264941

Gates, P. J., Baysari, M. T., Mumford, V., Raban, M. Z., & Westbrook, J. I. (2019). Standardizing the classification of Harm Associated with medication errors: The Harm Associated with Medication Error Classification (HAMEC). Drug Safety: An International Journal of Medical Toxicology and Drug Experience, 42(8), 931–939. https://doi.org/10.1007/s40264-019-00823-4

Gebre, M., Addisu, N., Getahun, A., Workye, J., Gamachu, B., Fekadu, G., Tekle, T., Wakuma, B., Fetensa, G., Mosisa, B., & Bayisa, G. (2021). Medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital, West Ethiopia: A prospective observational study. Drug, Healthcare and Patient Safety, 13, 221–228. https://doi.org/10.2147/DHPS.S328824

McMillan, J. (2019). Grounded ethical analysis. Journal of Medical Ethics, 45(1), 1–2. https://doi.org/10.1136/medethics-2018-105272

Mieiro, D. B., Oliveira, É. B. C. de, Fonseca, R. E. P. da, Mininel, V. A., Zem-Mascarenhas, S. H., & Machado, R. C. (2019). Strategies to minimize medication errors in emergency units: an integrative review. Revista Brasileira de Enfermagem, 72(suppl 1), 307–314. https://doi.org/10.1590/0034-7167-2017-0658

Nkurunziza, A., Chironda, G., & Mukeshimana, M. (2018). Perceived contributory factors to medication administration errors (MAEs) and barriers to self-reporting among nurses working in pediatric units of selected referral hospitals in Rwanda. International Journal of Research in Medical Sciences, 6(2), 401. https://doi.org/10.18203/2320-6012.ijrms20180276

Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/

US Department of Health and Human Services. (2020). Medical product safety. Healthypeople.gov. https://www.healthypeople.gov/2020/topics-objectives/topic/medical-product-safety

Walsh, L. J., Anstey, A. J., & Tracey, A. M. (2018). Student perceptions of faculty feedback following medication errors – A descriptive study. Nurse Education in Practice, 33, 10–16. https://doi.org/10.1016/j.nepr.2018.08.017

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem Instructions

• Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
   • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
   • Identify possible causes for the problem or issue.
2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
   • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
     • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
     • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
     • You may find the applicable Undergraduate Library Research Guide helpful in your search.
   • Review the Think Critically About Source Quality to help you complete the following:
     • Assess the credibility of the information sources.
     • Assess the relevance of the information sources.

3. Analyze the health care problem or issue.
   • Describe the setting or context for the problem or issue.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
4. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
5. Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
   • Describe what would be necessary to implement the proposed solution.
   • Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
   • Provide examples from the literature to support the points you are making.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 4 Example [PDF].

NHS-FPX4000 Assessment 4 Analyzing a Current Healthcare Problem Additional Requirements

Your assessment should also meet the following requirements:

• Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
• Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
• References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

• Title page. A separate page.
• Introduction. A brief one-paragraph statement about the purpose of the paper.
• Elements of the problem/issue. Identify the elements of the problem or issue or question.
• Analysis. Analyze, define, and frame the problem or issue.
• Considering options. Consider solutions, responses, or answers.
• Solution. Choose a solution, response, or answer.
• Ethical implications. Ethical implications of implementing the solution.
• Implementation. Implementation of the potential solution.
• Conclusion. One paragraph.

Competencies Measured:

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

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

• • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.

• Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

• • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.

• • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.

• Competency 3: Apply ethical principles and academic standards to the study of health care.

• • Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented

• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

• • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

• • Write following APA style for in-text citations, quotes, and references.

Scoring Guide

Assessment_4_scoring_guide_6398fa1e1fc79.pdf