Cultural competence is “a process for addressing disparities, based on race, ethnicity, and culture” (Isaacs et al., 2005, p. 5). Nurses must be culturally competent to provide effective and therapeutic care for patients.  It is part of a holistic treatment process. 

How does culture shape an individual’s view of mental health?

Every culture has a different way of looking at mental health and its own way of explaining mental illness which is based on a set of beliefs and practices. Due to shame and stigma associated with mental health illness and individual’s cultural beliefs, what culture has taught them on what to approach and what to avoid, a person may tend not to discuss their mental health challenges and ask for help (Gopalakrishnan, 2018). Furthermore, due to cultural influences on mental health, it may affect the way a person may describe their symptoms because of fear of being mistreated and discriminated.

Discuss why culture competence is important to nursing?

 Cultural competence is the mainstream of a great nurse- patient relationship. It helps the growth and development of nurses while also incorporating relevant societal values. Cultural competence is important in nursing care because it gives nurses the ability to provide the best health care to patients while demonstrating cultural awareness for their beliefs, race, and values. Cultural competence in nursing is necessary because it leads to significant satisfaction of care on the side of the patient and the key point is help nurses to have broader knowledge base of different cultures, communicate, and interact with their patient effectively.

What steps can a nurse take to be culturally competent?

Cultural competence is the capacity to recognize, respect and respond with appropriate words and actions to the needs and concerns of individuals from different ethnicities, social classes, genders, ages, or religions. The steps that nurses can take to be culturally competence includes cultural knowledge, cultural awareness, avoid making assumptions, build trust and rapport, educate patients about medical practices, and practice active listening (Sperry, 2012). Overcoming language barriers would also be beneficial for nurses to effectively communicate with patient by checking with facility for translator availability and using pictures and hand gesture to communicate when needed.

 Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria. 

In addition, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

1. A 45-year-old woman presents to the emergency room complaining of decreased urine output, weakness, and generalized fatigue. The patient has a history of poorly controlled type 2 diabetes mellitus, hypertension, and heart disease. The doctor orders a full urine panel and complete blood count (CBC).

a.  What urine test might you expect to be included, and what would these tests tell you about the patient’s condition?

b.  Based on the blood results, the patient is diagnosed with renal failure. What results would be most informative in making this diagnosis, and what abnormal physiology could create this result?

The patient asks you if her previous health history has contributed to her developing renal failure. How would you respond to her in a professional way that would encourage her to follow the specified treatment regimen?

2. APA Style

3. 3 paragraphs of 3 sentences each

4. 2 references not older than 2015

Create a Power Point presentation about the negative effects of TV in children

Include:

– How it affects their vision, their opinion, and their physical activity.

3-4 slides not including the title one.  

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.

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.

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 resource.
       • 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.

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 1 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

• Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA template: Use the APA Style Paper Template [DOCX] as the paper format and use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Use correct spelling, grammar, and punctuation.
• References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
• 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.

If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, do not hesitate to ask faculty or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.

case study

Jenna and Chris Smith are the proud parents of Ana, a 5–day–old baby girl born without complications at Community Hospital. Since delivery, the parents have bonded well with Ana and express their desire to raise her as naturally as possible. For the Smiths, this means breastfeeding exclusively for the first six months, making their own baby food using pureed organic foods, and not allowing Ana to be vaccinated.

The Smiths are college educated and explain they have researched vaccines and decided the potential harms caused by them far outweigh any benefits. They point to the rise in autism rates as proof of the unforeseen risk of vaccines. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, including online mommy–blogs that detail how vaccines may have caused autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate Ana, despite the recommendations of the medical community.

Dr. Kerr begins by stating that while vaccines have certainly sparked controversy in recent years, she strongly recommends that Ana become fully vaccinated. Dr. Kerr explains that vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in child mortality over the past century. For example, the decreased incidence of infection with the potentially fatal Haemophilus influenzae type b, has resulted from routine immunization against that bacterium. Similarly, epidemics such as the recent outbreak of measles are usually associated with individuals who have not been vaccinated against that pathogen.

Dr. Kerr goes on to endorse the general safety of vaccines by informing Ana’s parents that safety profiles of vaccines are updated regularly through data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS, a nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, is accessible to the public at https://vaers.hhs.gov/index. This system allows transparency for vaccine safety by encouraging the public and healthcare providers to report adverse reactions to vaccines and enables the federal government to monitor their safety. No vaccine has been proven casual for autism spectrum disorder (ASD), or any developmental disorder. On the contrary, many studies have shown that vaccines containing thimerasol, an ingredient once thought to cause autism, do not increase the risk of ASD.

Finally, Dr. Kerr reminds the Smiths that some children in the general population have weakened immune systems because of genetic diseases or cancer treatment, for example. It may not be medically feasible to vaccinate such children. Other children are too young to receive certain immunizations. Instead, these children are protected because almost all other children (and adults) have been vaccinated and this decreases their exposure to vaccine–preventable illnesses (VPIs). This epidemiological concept is known as “herd immunity.” As more parents refuse immunization for their healthy children, however, the rate of VPIs will increase. This puts vulnerable children at significant risk of morbidity and mortality. Routine childhood immunization contributes significantly to the health of the general public, both by providing a direct benefit to those who are vaccinated and by protecting others via herd immunity. Dr. Kerr concludes by stating that after considering the risks versus the benefits of immunization, most states require vaccinations before children can attend school. Parents may decide not to vaccinate under specific circumstances, however, which vary by state.

Jenna and Chris Smith confirm their understanding of what Dr. Kerr has explained, but restate that they do not want Ana vaccinated at this time. Dr. Kerr is perplexed as to what to do.

Watch the following 2 Frontline Videos, links posted here: The movie identified seven issues affecting our current healthcare system:

https://www.pbs.org/video/frontline-sick-around-the-world/ (Links to an external site.)

https://www.pbs.org/wgbh/frontline/film/sickaroundamerica/

seven issues affecting our current healthcare system:

1. Paying more, getting less
2. Treating the whole person
3. Preventing Disease
4. Overmedication
5. Overtreatment
6. An entrenched system
7. Reimbursement

Please create a thoughtful and supported post addressing the points below. Let us all do our best to create thoughtful discussions and an open forum for all opinions.

• Pick 4 of the issues listed above and answer the following questions:
  • How are these issues affecting our current system (spending/debt, Medicare, ACA, population health)?
  • Who is responsible for these issues and correcting them?
  • How can these issues be improved whether at a local/state (community health department), national (USDHHS), or global level (WHO)?
  • Which of these issues fall under the Strategic Goals of the USDHHS and Healthy People 2020?
  • What can we do as nurses?
• Your post should be at least 400 words.
• Use chapters 3 and 5 in your text and at least one scholarly article (not Wikipedia or a website).

Please be sure to validate your opinions and ideas with citations and references in APA format.

The post and responses are valued at 75 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.

Learning Resources

Required Readings

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Bipolar and Related Disorders”

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 23, “Emergency Psychiatric Medicine” (pp. 785–790)
Chapter 31, “Child Psychiatry” (pp. 1226–1253)

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Learning Objectives

Students will:

• Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients
• Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare:

• Review the Learning Resources concerning emergency psychiatric medicine.
• Consider a case where an adult client had a psychiatric emergency. If you have not had a personal experience with an adult client who had a psychiatric emergency, you can conduct an internet or library search to identify one. 

Post:

• Briefly describe the case you selected.

• Explain how you would treat the client differently if he or she were a child or adolescent.

• Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

Provide a minimum of three academic references no more than five years old . 

Support your approach with evidence-based literature in APA Format and proper citation, including introduction and conclusion.

REPLY1

Understanding the health care system at a local level means that you are aware of the culture that resides within and what causes and effects are in place for that local community. This is important when implementing evidence-based practice to ensure the health care system is functioning and providing to address the needs in a local, community, and on a neighborhood level. In the community and facility selected for the change project, as evidenced by my preceptor there are over 200 children that have asthma most using and needing controlled medication. This information is generated through a combined department of health and education system, which can filter and scan for children with health needs, based on diagnosis’ entered in the system. In speaking with several parents there are many who state their child are not asthmatic, and they “just have colds”, or that their child’s symptoms occurred only once or twice in their lifetime. Although incidents of asthma can occur once their diagnosis goes on in the system throughout their lifetime as children. School health officials get notification alerts (shown to me by the preceptor) of prior hospitalizations and diagnosis of asthma. This system allows the nurses within the school to address and follow up with children and their caretakers. Research tells us there are 770 visits to the emergency department in relation to asthma in Washington Heights (Pichardo, 2016). The department of health continues to make parents aware through campaigns such as Your Child’s Asthma Is Always There, Even When They Seem Perfectly Fine, to help them understand and remind them that asthma is a disease process that can be triggered at any given time, and not all children experience the same symptoms of severity, many children can live life without the use of controller medication whereas others need it to keep asthma in a dormant phase. Taking proper measures is important in the prevention of flare ups and hospitalizations. Families with the understanding that their children do not have asthma, because their symptoms have temporarily left them, can many times place their child at risk for emergency calls while in school, if they do not have inhalers or medication to keep them controlled. The Washington Heights/Inwood network has a mission to find and help treat children with asthma in the community, schools, clinics, and daycare organizations (Asthma Community Network, n.d.). As you can see, the community has some resources that aims to help children with asthma, and helping these children go deeper than the outside community it start in the home and within the school system to address these concerns. Together I hope to reinforce teaching and come up with solutions and/or strengthening the ones already in place by finding and filling gaps.

References

Asthma Community Network. (n.d.). Washington Heights/Inwood network for asthma, New York presbyterian hospital snapshot. https://www.asthmacommunitynetwork.org/node/3331

Pichardo, C. (2016, November 25). Take these 2 steps to protect your asthmatic child, city says. Washington Heights & Inwood. Dna info. https://www.dnainfo.com/new-york/20171027/norwood/woman-raped-during-bronx-drug-deal-police

REPLY2

It is very important to understand the health care system at a local level because this will aid the nurse in determining if the new EBP will apply to the health care setting. Evidence-based practice significantly improves the quality and safety of healthcare, enhances patient outcomes, and reduces cost. EBP includes lifelong problem-solving approaches to how healthcare is delivered and integrates the best evidence from high quality studies. When planning an evidence based practice implementation, we must first understand and identify the challenges facing the healthcare system. Inadequate and delayed implementation of current evidence into practice has contributed to medical errors, safety issues, and patient deaths (Harris et al., 2015).

In talking to my preceptor about the increased rates in central venous catheter infections, she agreed that this is a recurring problem in many dialysis clinics, as she rounds in 8 different clinics. She has observed nurses performing inadequate catheter care, and has stopped to correct and guide them as to what they are missing or doing wrong. Other times she has asked patients questions about their plan for the catheter removal, catheter care, or access placement and the patients are clueless and unaware of what needs to be done, or the reason why it needs to be removed or well cared for. She agrees that this is a topic that needs to be addressed thoroughly with nurses and patients as well.

References

Harris, C., Garrubba, M., Allen, K., King, R., Kelly, C., Thiagarajan, M., … Farjou, D. (2015). Development, implementation and evaluation of an evidence-based program for introduction of new health technologies and clinical practices in a local healthcare setting. BMC Health Services Research, 15, 575. http://doi.org/10.1186/s12913-015-1178-4

 Please reply to the following student post adding some extra in=formation relate to this post

Less than 10 % similarity

APA

short answer. 

 To best understand the concepts of ethics, define the following terms:        

Utilitarianism, Egoism, Relativism, and Absolutism and  write a hypothetical situation where each of the defined terms above is utilized.  

Utilitarianism is a theory that focuses on the overall happiness of many. It encourages nurses to adopt actions that promote positive outcomes in healthcare (Baragona, 2016). Therefore nurses work towards minimizing the actions that prejudice the interest of the patients. A nurse working at an emergency setup will give care to a patient who has high chances of survival based on the severity of the injury.

Ethical egoism postulates that people act in furtherance of their self-interest about morality. Therefore, a nurse will push to get a study leave even if the department faces a shortage because they focus on achieving a certain goal based on their self-interest (Meyers, 2018). Relativist ideology argues that healthcare providers should offer passionate care to those professing morals and beliefs contrary to their own (Baragona, 2016). For instance, a nurse should take care of a female who has secured illegal abortion and is bleeding profusely despite believing that abortion is morally wrong.

Absolutism theorists postulate that God-given laws are the absolute truth. Nurses prescribing to this line of thought use the immutable truth to decide (Baragona, 2016). In the discussions regarding euthanasia, they do not agree to undertake procedures leading to a patient’s death because the holy scriptures prohibit them.

References

Baragona, S. G. (2016). Christian nonprofit CEOs: Ethical idealism, relativism, and motivation.

Meyers, C. (2018). The professional ethics toolkit. John Wiley & Sons.