Posts in category: Uncategorized

 Conflict in Ethical Principles  

Three to four ideas with a speaker note, a power point ( one slide) about  conflict in ethical principle regarding gender reassignment hormone treatment

I am a tutor of nursing 

Overview

For Assignment 2, you will assess the ethical aspects of a healthcare industry managerial practice.  This analytical paper provides you with an opportunity to think critically about the challenging ethical and moral issues routinely faced by healthcare managers and introduces you to the four principles of medical ethics and the ethical code of the American College of Healthcare Executives (ACHE).

Description

Background
You are a member of your organization’s ethics committee.  At this month’s meeting of the committee, two issues were discussed.  The CEO has asked you to brief the new board chair on the importance of ethics in healthcare, how they differ from other industries, and how they apply to these specific circumstances.  Select one of the two following scenarios as the focus of your analysis.

Case 1: Hospital Policy on Influenza Immunization
The Centers for Disease Control and Prevention (CDC) have issued an advisory that the coming “flu season” is expected to be unusually severe.  CDC projects a potentially historic level of illness and flu-related deaths.

Response to this, the president of the medical staff has recommended that hospital staff, employees, and volunteers receive mandatory influenza immunizations.  With exceptions for those who are allergic and anyone with a valid religious prohibition against vaccination, those who refuse the immunization would not be allowed to work. There is a small, but vocal, contingent of employees (including some nurses who are advocating for unionization of the nursing staff) who object to this policy, stating it is an infringement on individual rights and patient self-determination.

Three questions to answer are below.
1. What issues should be considered in establishing this policy?
2. To what groups is responsibility owed?
3. What will you recommend to the hospital Board and C-Suite?

Case 2: Balancing Needs
Your facility is a critical access hospital (CAH) serving a largely rural catchment area.  The next nearest hospital, a comprehensive medical center is several hours distant.

During the monthly utilization review, the emergency department medical director noted a marked increase in cases of renal distress and failure, and that many of these patients do not have health insurance.  They have been treated in accordance with the Emergency Medical Treatment and Active Labor Act (EMTALA), the federal statute that requires hospitals to assess and stabilize anyone presenting for emergency services, regardless of ability to pay.

The chief of medical services responds that end-stage renal disease requires ongoing evaluation and treatment, but that this is neither covered by EMTALA nor does the current medical staff have a specialist in this field.

Three questions to answer are below.
1. What issues should be considered in addressing this situation?
2. To what groups is responsibility owed?
3. What will you recommend to the hospital Board and C-Suite?

Paper Expectations and Requirements
The case scenarios reflect the types of situations you may encounter as a leader in health care. They are complex and offer no clear options or solutions. Therefore, your research should include at least five scholarly sources.

Overall, the paper should use separate major section headings. As necessary, sub-section headings should be included. The paper should include responses to the three points below.
1. Summarizes the relevant issues raised by the case.
2. An explanation of why those issues raise ethical concerns.
3. How the ACHE Code of Ethics or a similar professional code of ethics can be used to determine the proper response by a healthcare leader.

Also, whether select either Case 1 or Case 2, the paper should answer each of the questions identified under each case. Regarding the use of sections headings described above, here is a suggested to consider. You may want to use a major section heading and three subsection headings that provide answers to the three questions under either Case 1: Hospital Policy on Influenza Immunization or Case 2: Balancing Needs.

Paper Format
1. A title sheet, abstract, body of the paper, and reference list are all required for this paper.  The body of the paper should include 1,000 to 1,200 words.
2. The paper should use MS Word and in 7th Edition APA format, with 1-inch margins on all sides, double-spaced and 12 pt. Times New Roman font.

General Comments Regarding Grading
Assignment 2 is worth 20 points. Grading will be based on the requirements and expectations provided in the above sections and the Grading Rubric will be used as a guide.

 Discuss the differences between non-parametric and parametric tests. Provide an example of each and discuss when it is appropriate to use the test. Next, discuss the assumptions that must be met by the investigator to run the test 

Attention Wizard Kim Week 11 Finals on Capstone. Be Careful with this finals.

                  Week 11 Discussion: Job Search Application, and Interview Process 2 pages 

Week 11 Finals Assignment : Practicum Journal Entry 3 pages APA format 7th ed. 

The Medication Paper Final Draft

This week, you will submit a paper on a specific medication that has recently been approved for use (within the last two years) and is widely prescribed within the United States. ( Ubrelvy )

The medication should have been chosen by you during week 2 and approved by your instructor by week 3.

Your paper must be a minimum of seven pages, not including your title or reference pages. You should include at least five recent references (published within the last five years), and the paper must be presented in APA format (see rough draft requirements in week 6).

The paper must include the following content information:

• Manufacturing company
• Brand name
• Indication
• First in class, or not first in class
• Common side effects profile
• Known contradictions

Make sure you explain the special considerations that your chosen drug has on the unique populations/client groups listed below. Special considerations should include absorption, clearance/elimination, distribution, metabolism half-life, loading dose, route of drug administration, and steady state.

Pediatric Patients

Pediatric patients are not little adults. There are special pharmacokinetic and pharmacodynamics variations in this patient group. Their reaction to medication can be very unpredictable. Accurate dosing is the key due to their limited body mass.

Geriatric Patients

Geriatric patients have altered pharmacokinetic and pharmacodynamics responses to medication. The process of aging and disease will change how the body responds to drug therapy. Memory limitations and increased sensitivity to drug therapy may cause unique problems with this population.

Patients With Renal Dysfunction

Many medications are excreted through the renal glands or metabolized and excreted renally. Dosage adjustment is the key in this population. Many agents may cause nephrotoxicity.

Patients With Liver Dysfunction

Liver disease produces alterations in the physiology of the drugs’ pharmacokinetics in the body. Special attention should be given to all drugs used in this client population

Obese Patients

Obese patients have alterations in their pharmacokinetic and pharmacodynamic response to medication. Many comorbidities and altered nutritional status can be seen as responses to taking these medications. Accurate dosing is paramount.

Pregnancy/Lactation

Pregnancy and lactation can be challenging. Concerns of effects to the unborn fetus must be considered. Will treating the mother harm the unborn fetus or nursing infant?

FEEDBACK 

.do not forget your purpose statement which is always the last sentence of the introduction paragraph.                 

Write a 6 page research paper with the instructions provided.

1.Reflect on the current roles of advanced practice nurses in healthcare as the care providers at the front line of disease management and health promotion in primary care and many other specialty settings. 

2.What do you think are some effective tactics for APN strategic positioning regarding pay equality? 

3.Should APNs position themselves as lower-cost providers who provide better care or push for comparable worth, same service and same pay?

Below is an article that provides great practical information that highlights how provider productivity is calculated in the clinical setting, which is important to know as future nurse practitioners.

Calculating Your Worth: Understanding Productivity and Value- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/ 

By the due date Assigned, write a 1-2 page paper addressing the sections below of the research proposal.

Methodology

•     Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
•     Sampling Strategy
•     Research Design: Type (e.g., Quasi-Experimental), description, and rationale for selection.

Please do the following in its entirety: 

Answer all question please. 

Please  sure to use a cover sheet and please submit a reference page with  your assignment. Late assignments will not be accepted. NO EXCEPTIONS PLEASE!!!!

1.Apatient is having cardiac enzymes drawn to rule out a Myocardial Infarction.

  a) What are the clinical indication and nursing implications for the following enzymes and their importance as a marker for Myocardial Infarction?

    CK 

    CK-MB 

     Myoglobin and Troponin 1.

2.A patient has chest pains and is worried of having a second Myocardial Infarction.

     a) What are the discriminating differences between chest pains from angina pectoris  versus the pain associated with Myocardial Infarction.