Topic 2 DQ 2 Discuss why quantitative method is the best method based on your project questions and data. Choose three potential designs that you could use for your project. Based on the three potent

Topic 2 DQ 2 

Discuss why quantitative method is the best method based on your project questions and data. Choose three potential designs that you could use for your project. Based on the three potential designs, determine potential analyses methods and why

Discuss why quantitative method is the best method based on your project questions and data. Choose three potential designs that you could use for your project. Based on the three potential designs, determine potential analyses methods and why?

 

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Health Promotion

The HIV virus is a global pandemic affecting people of all ages. According to the World Health Organization (WHO, 2008), it is important that all peoples of the world consider this problem a major pandemic, and devise methods of combating its spread. A conceptual frame work needs to be laid out in this kind of health promotion so as to come up with strategies of coming up with the target population as well as identify their specific needs (Gilks 2006). In the campaign against HIV and AIDS, it is recommended that the campaigners be familiar with basic human rights so as to preserve the dignity of the persons affected and those infected (United Nations (UN), 2012). In aIDition, familiarization with the cultural perceptions and the behavior of the targeted population towards the disease is important for the campaigners in order to achieve efficiency. Further, it is important to counsel people so as to eliminate stigma and also to encourage disclosure (Florida Health, 2013).

Theory and application to the health promotion problem: Health Belief Model

The health belief model is theory of health promotion that focuses on the individual (Green & Ottoson, 2006). The theory postulates that individuals act depending on their perceptions regarding the cost of the action, potential benefits, the expected consequences and severity of consequences. Owing to this definition and the subject of health promotion, which is in this case HIV/AIDS, an individual’s behavior patterns are very important in preventing their contracting the disease. In the spirit of this model, targeting individuals’ behavior in combating and curtailing the spread of HIV/AIDS will bring the best of results. This is because after the health promotion, individuals will be aware of the likely consequences if they involve in risky behaviors.

Intervention: Mass communication

Mass communication will reach many people. This is important because the target population for HIV is big. This can be achieved through airing health promotional messages through national radio stations and television stations. Print media can also be used to target the people who read newspapers. Since many people have access to radios and television sets, this will be a big catch.

Intervention plan

Setting:       The entire state

Audience:   Nationals in the state

Intervention criteria:

Radio- messages will be formulated and broadcast in national radio stations.

Television: audio/visual form of a message will be formulated and broadcast through

various television stations.

Print media: a page in the print media will be bought and devoted to passing the

message.

Posters and brochures will be distributed in schools, markets, flats and other public

places.

Health workers will be engaged to aIDress gatherings and spread the message.

Where appropriate, mega phones will be used where appropriate.

Mobile phone service providers will be contacted to provide short message services and

send a message to their subscribers.

A team will be selected to spread the message through social sites like twitter and

Facebook.

A2 size posters will be printed and distributed at strategic places. Banners of large sizes

that are conspicuous from a far place will also be printed.

After the spread of the message, an evaluation and monitoring team will assess the

effectiveness of the promotion and recommend further action.

Appropriateness of intervention.

Practice of nursing at an advanced level is important for the provision of evidence-based

care. At the same time, it is critical to provide care that is specific to the problem, and

further, to have a rationale for everything you do for the patient. Before using this

intervention method, an assessment was made that ascertained that it was the most

appropriate method to reach the targeted population.

References

Florida Health. (2013). HIV/AIDS. Retrieved from http://www.floridahealth.gov/diseases-and-conditions/aids/

Gilks C, F. (2006). The WHO public-health approach to antiretroviral therapy against HIV in resource limited settings. Lancet, 368: 9534, 505–510

Green, L.W., & Ottoson, J.M. (2006). Public health education and health promotion (2nd ed). Gaithersburg, MD. Aspen Publishers.

United Nations. (2012). International human development indicators. Retrieved from http://hdrstats.undp.org/en

World Health Organization, (2008). Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report. 2013 from http://www.who.int/hiv/pub/towards_universal_access_report_2008.pdf

 

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health care organization safety guidelines

In any health care organization safety guidelines are established to ensure the safety of the employees and the patients. Failure to comply with these guidelines will lead to an unsafe environment and place everyone at jeopardy. Some of the personal safety procedures in the pharmacy are to apply principles of body mechanics. As a future pharmacy technician you should be aware that back injuries are a very common work-related injury in any field. Back injuries can be serious enough to end your career and to prevent you from participating in activities that you enjoy in your personal life. By practicing good body mechanics and learning proper lifting techniques, you can reduce the stress on your body and decrease the risk of injury.
answer those question
A. As a “hospital pharmacy technician”, do you think you are going to lift more or less than a “retail pharmacy technician”?
b. Research and locate a job that discusses lifting requirements.
c. Demonstrate how to lift a case of 12 bags of 1000m

 

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Q1. A nurse is caring for a client in crisis who has endured a physical assault. The nurse would expect to see which behavior associate with the integration phase of crisis? Select all that apply. The

Q1. A nurse is caring for a client in crisis who has endured a physical assault. The nurse would expect to see which behavior associate with the integration phase of crisis? Select all that apply.

The client tries to make sense of what happened

The client tries to control every situation

The client becomes isolated from others

The client starts to resolve feelings of blame

The client gets angry when talking about the event

Q2.A 46-year-old client is experiencing symptoms of post-traumatic stress disorder after being involved in a traumatic accident. The client has symptoms of nightmares and flashbacks about the event.c The nurse knows that these symptoms most likely develop because of which of the following?

The body secretes too much melatonin, which leads to an increase in nightmares

The client may have a hyperactive amygdala that leads to an increase in feelings of fear

The client’s pituitary gland works in overdrive and consistently causes flashbacks

The client is no longer able to regulate levels of serotonin

“My name’s Eugene Shaw but everybody calls me Gene. I was born on May 21 in Cleveland, Ohio. I am 82-years old and live with my wife Nancy.

We have a son, Robert Shaw who is 57. He lives about 500 miles away with his wife and they come to visit us fairly often. He went to college and

got some fancy job selling chemicals. We have no family living close by except for my cousin Arthur and his family. We see them sometimes but

Nancy doesn’t seem to be too social these days so I don’t push her too much. I try to get out with my buddy Jim. We served together in the Korean

War but Nancy yells that we drink too much when we are together and it gets my sugar high. Who cares at my age?I’m not going to be around

forever. I like my beer and a little nip of whiskey at night to help me sleep.

I am a Veteran. I proudly enlisted and served for 2 years in the Marines. I was a private in the Medina County Marine Corps League Detachment

569, Medina VFW Post 5137. A great group of guys and we lost quite a few. I didn’t know what I was getting myself into when I signed up. It was so

cold that first winter. Korea was a land of weather extremes–all bad. It went from 30 below zero in the winter to over 100 degrees in the summer.

During the cold winter months, we wore long- johns, utility trousers, waterproof cold weather trousers, utility jacket, sweater, a parka and thermo

boots. The enemy wore heavy quilted coats and pants and, for the most part, sneaker-like shoes. From what I understand, they weren’t very warm.

In between summer and winter was the monsoon season that turned the country into a flooded swamp. Aside from the war, the bad weather was a

morale factor more than anything. The cold and heat were unbearable and during monsoon season, no one was ever dry. That’s where my troubles

started with my feet. Wow wee, my darn feet were always wet, stinking wet in the summer and cold and frozen in the winter. Those boots didn’t

protect at all; in fact I think that they made things worse because they leaked so much. Probably can’t blame anyone but the soggy wet soil. You ever

hear of trench-foot? I had it and still got some of it. That’swhat I got to take home with me from Korea but it’s better than the alternative. Yeah that is

war or a least it was in my time. I bet they have made some progress in getting those troops better equipment than in my day.

“My name’s Eugene Shaw but everybody calls me Gene. I was born on May 21 in Cleveland, Ohio. I am 82-years old and live with my wife Nancy.

We have a son, Robert Shaw who is 57. He lives about 500 miles away with his wife and they come to visit us fairly often. He went to college and

got some fancy job selling chemicals. We have no family living close by except for my cousin Arthur and his family. We see them sometimes but

Nancy doesn’t seem to be too social these days so I don’t push her too much. I try to get out with my buddy Jim. We served together in the Korean

War but Nancy yells that we drink too much when we are together and it gets my sugar high. Who cares at my age?I’m not going to be around

forever. I like my beer and a little nip of whiskey at night to help me sleep.

I am a Veteran. I proudly enlisted and served for 2 years in the Marines. I was a private in the Medina County Marine Corps League Detachment

569, Medina VFW Post 5137. A great group of guys and we lost quite a few. I didn’t know what I was getting myself into when I signed up. It was so

cold that first winter. Korea was a land of weather extremes–all bad. It went from 30 below zero in the winter to over 100 degrees in the summer.

During the cold winter months, we wore long- johns, utility trousers, waterproof cold weather trousers, utility jacket, sweater, a parka and thermo

boots. The enemy wore heavy quilted coats and pants and, for the most part, sneaker-like shoes. From what I understand, they weren’t very warm.

In between summer and winter was the monsoon season that turned the country into a flooded swamp. Aside from the war, the bad weather was a

morale factor more than anything. The cold and heat were unbearable and during monsoon season, no one was ever dry. That’s where my troubles

started with my feet. Wow wee, my darn feet were always wet, stinking wet in the summer and cold and frozen in the winter. Those boots didn’t

protect at all; in fact I think that they made things worse because they leaked so much. Probably can’t blame anyone but the soggy wet soil. You ever

hear of trench-foot? I had it and still got some of it. That’swhat I got to take home with me from Korea but it’s better than the alternative. Yeah that is

war or a least it was in my time. I bet they have made some progress in getting those troops better equipment than in my day.

Diagnosis of Enugen Shaw cont.

I came home from the Marines and I had a hard time walking. I went to the VA and they told me – “Boy, it’s off with those toes,” and off

they went. You didn’t ask questions in those times. They took three off my right foot and left the others. Sometime after one just got

black and fell off. My poor Nancy she washed my feet and tried to keep them circulating but it was too late.

I go to the doctor sporadically, never can remember those dates. I’ve had several visits the last year or so. I keep getting sores on my

right lower leg that don’t go away. My heel had a big ulcer not too long ago and I needed a lot of antibiotics to get that one to go away.

Now look, it’s back again and it looks so blue. My foot is always so cold.

I came here today because my leg is really bothering me for about a week. I was getting into my car and I hit my foot on the car door.

Since then I started to have these pains and my heel is getting bad again. My right calf has some awful pains and burning down the

sides. I couldn’t hardly sleep at all last night cause of the pain and it got worse during the day. Nancy has been nagging me to have my

leg checked out all week. She really got worried today when she saw how bad the pain was and the color of my leg and foot.she insisted that come here to see what ,s up so here i am

questions 2

What evidence do you read that may be indicative of depression?

How can you assess Eugene’s baseline functional status?

What coping strategies does Eugene use?

Who are Eugene’s support system and how can they help him?

What evidence of anxiety do you hear as Eugene talks?

What are Eugene’s strengths and weaknesses?

question 3

Consider assessment tools that would be appropriate for continuing to evaluate Eugene?

Utilize these tools to better understand:

The behaviors associated with Major Depression

Evidence of any cognitive impairment that may be complicating Eugene’s recovery

The overlap of depressive, cognitive and anxiety behaviors and what they mean

How alcohol may be a factor in compromising outcomes

What is Eugene’s baseline level of functioning and has he deviated from that point?

How can you evaluate Mrs. Shaw’s ability to manage the caregiving role?

Question 3

In the third scenario of the simulation, Eugene is recovering from surgery: Answer these questions based on the scenario given

What is depression?

What are the causes for depression?

What are the symptoms of depression?

What are the pharmacological treatments for depression?

Will these treatments impact any other treatments the patient may be getting?

What are the non-pharmacological treatments for depression?

 

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Director of Occupational Health and Safety

Director of Occupational Health and Safety

For the Session Long Project for this course, you have been appointed the new Director of Occupational Health and Safety at a small corporation specializing in the manufacture of computer microchip processors. Your first task is to formulate a new company plan with policies to aIDress several health and safety issues.

For the essay do the following:

Assume that the chip-manufacturing business is located near San Jose, in the State of California. Describe the key elements of your worker’s compensation package. Be sure to discuss: medical care, temporary/permanent disability benefits, and any other relevant services or benefits that must be provided.

SLP Assignment Expectations

Length: SLP assignments should be at least 1 page in length, excluding references.

 

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Opening a Free Clinic for People without Health Insurance

There are lots of people in the community that cannot afford the high cost of health insurance due to the economic crisis and lack of employment. This does not in any case mean that they do not require proper medical care and, therefore, as an organized effort it should be mandatory that all members of the community have access to health care. This can be done through opening up a free clinic with the help of the community and other interested stakeholders. The free clinic will ensure that the community stays healthy and at the same time the organization gains from getting a healthy labor force. It will also ensure that the company is deemed to have a corporate sense of responsibility. Setting up a free clinic is a challenging and engaging project for the organization to undertake. Therefore, the organization should ensure that it has all the facts and structured framework that it will use before opening a free clinic. This paper looks at the economic situation; a needs assessment, the process to be used, and the benefits of the program. Opening a free clinic for people without insurance is a challenging process, and an organization should look at all the factors before opening to ensure that the clinic is run efficiently.

SPECIAL NEEDS ASSESSMENT

Before starting to make any form of plans, it is important to make a need assessment of the people in the community where the clinic is to be opened. According to Brennan (2013), “in order to substantively engage the most severely and most medically underserved individuals in our communities, providers must offer empathetic, patient-centered psychiatric reach-out.” The organization should have enough understanding of what they are likely to expect among the people they seek to provide care. It is also important if the organization needs any extra help as they can be able to identify the specific areas that need the help. The first step in making a need assessment is collecting data on the uninsured. The data can be collected by contacting the local health department, the social health departments and the social service providers and from other organizations that have set up free clinics in the region. The internet also acts as a reliable resource as well as the articles and newspapers about the lack of proper healthcare in the region and other areas. The data helps in getting an estimate on the number of people that the program should target and their needs in general. Brennan (2013) asserts that, “While conducting the needs assessment, it’s also paramount that the organization assesses the level of income of the target group and how it compares with other people living in the community.” A comparison of the income and insurance status of the target population needs to be made, and a comparison between the levels of the city and other areas done.

ECONOMIC SITUATION

The economic situation is also very critical in opening a clinic since it is what ensures that everything is performed and conducted according to plan. When doing an economic assessment the first aspect to consider is where the uninsured are getting their services in the meantime. Understanding the situation of the people one hopes to help is crucial before making any investment to calculate the number of people one needs to help, and the resources required. The services being offered by other agencies in the area and the gaps that exist help the organization understand the economic situation and what needs to be aIDed (Brennan, 2013). The second aspect that is also as crucial is the budgeting, funding and bookkeeping for the clinic. Under economic situation, the budget is an important factor, and it incorporates making an estimate of the money that is required to open a clinic. Lieu & Zha (2014) emphasize the importance of assessing whether there is a need for any outside help in the process of making the estimates of the money required to ensure that the program is completed. A projection of the estimated number of people and costs is an integral part and professionals and members of the board responsible with building the clinic should be involved to make a comprehensive budget. After assessing the economic situation, the organization can start on the process of opening up a clinic.

PROCESS INVOLVED IN THE PROGRAM

Depending on the size and the target population the process can either take a lot of time or only a few days. The first step is setting up a steering committee to spearhead all the operations and decision making with regards to the clinic (McConnel, 2011). According to Guzys & Petrie (2013), the organization may choose to look at the determinants of health and assess the community against them. A systematic analysis can be used to identify the problems, needs, strengths and trends in that community, in order to aIDress them appropriately. The committee should oversee the running of the project and make the necessary plans and structures for efficient and effective running of the project. The legal requirements for insurance and health care should also be assessed and adhered to, therefore, drafting and understanding the rules is pivotal (Brennan, 2013). Consulting a professional who is well-versed with health insurance is compulsory in implementing the program to help in adhering to the legal terms of the project. Building community support for the program should also be done to ensure a smooth flow of operations and to reach out better to the target population. In aIDition, determining the services that will be rendered depending on the needs assessment as well as the mission statement should also be structured and well drafted (Sines, Saunders, & Burford, 2013). The research culture has also been improved, with the need to change clinical practice from the ritualistic to evidence-based practice. This acts as the foundation and structured approach of what the company aims to achieve with the project. The space and staffing process for the hospital should also be done. The clinic should also obtain proper credentials and quality assurance before starting its operations.

BENEFITS OF THE PROGRAM

One of the major benefits of the program is ensuring that every member of the community gets essential medical attention. Brennan (2013) asserts that, health care provisions to all is a major benefit and reason of setting up the program. The program also improves the livelihoods of members of the society by ensuring that they are healthy; therefore, they can be able to work. The program is also beneficial to the company since it is a way to ensure that the company adheres to corporate social responsibility thereby creating a good image for the organization. Creating a good environment and favor with the community members is an essential part of every company. Brennan (2013), asserts that, a free medical clinic is one of the main ways that a company can create to be seen as socially responsible. It helps creates a good relationship with the community and health practitioners, as well as reconnecting and bringing recovery to the underserved communities. The program also helps employees of the company in accessing free medical services and can help the company in organizing better medical care for employees and their beneficiaries.

In conclusion, opening up a free clinic can be challenging, but very beneficial to the community or society. The organization should involve community members who are willing and able to work as volunteers in the program and ensure that the program is run efficiently to help the people. It is difficult for members of the community to set up such initiatives on their own, and the organization should offer a hand to ensure equity in healthcare provision in the community where it is located.

References

Brennan, V. (2013). Free clinics: local responses to health care needs. Baltimore: JHU Press.

Guzys, D. & Petrie, E. (2013). An introduction to community and primary health care.

Cambridge: Cambridge University Press.

Mcconnel, C. (2011). A free clinic paradox. Archives of Internal Medicine, 171(8), 788-789. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=487026

Lieu, Z. & Zha, M. (2014). Student-run free clinics around the world. Raleigh, NC: Lulu Press, Inc.

Sines, D., Saunders, M. & Burford, J. (2013). Community health care nursing. Hoboken, NJ: John Willey & Sons.

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Research and discuss 1 public health issue in the United States today, explain why it is a public health issue and what is currently being done to aIDress it at the local, state, and federal levels.

assignment 1

Research and discuss 1 public health issue in the United States today. Write a paper that aIDresses the following:

  • Explain why it is a public health issue and what is currently being done to aIDress it at the local, state, and federal levels.
  • Discuss any applicable health policies and regulations that may be in place to aIDress the issue.

Please submit your assignment.

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

 

assignment 2

rimary Discussion Response is due by Friday (11:59:59pm Central), Peer Responses are due by Tuesday (11:59:59pm Central).

Primary Task Response: Within the Discussion Board area, write 500–700 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Discuss a population group that is facing greater challenges and barriers to accessing care in the United States. Include the following in your discussion:

  • Why does that segment of the U.S. population face greater challenges and barriers to accessing care?
  • What programs (local, state, or federal), if any, exist today to attempt to provide access to the vulnerable population you are discussing?

Note: Use APA style and at least 2 scholarly references.

Responses to Other Students: Respond to at least 2 of your fellow classmates with at least a 100-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

  • What did you learn from your classmate’s posting?
  • What aIDitional questions do you have after reading the posting?
  • What clarification do you need regarding the posting?
  • What differences or similarities do you see between your posting and other classmates’ postings?

AIDitional Resource

Use the LIBRARY to read the following article:

  • Frohlich, K. L., & Potvin, L. (2008, February). The inequality paradox: The population approach and vulnerable populations. American Journal of Public Health, 98(2), 216–221.

 

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

 

 

assignment 3

Primary Discussion Response is due by Friday (11:59:59pm Central), Peer Responses are due by Tuesday (11:59:59pm Central).

Summative Discussion Board

Review and reflect on the knowledge you have gained from this course. Based on your review and reflection, write at least 3 paragraphs on the following:

  • What were the most compelling topics learned in this course?
  • How did participating in discussions help your understanding of the subject matter? Is anything still unclear that could be clarified?
  • What approaches could have yielded aIDitional valuable information?
  • The main post should include at least 1 reference to research sources, and all sources should be cited using APA format.

Responses to Other Students: Respond to at least 2 of your fellow classmates with at least a 100-word reply about his or her Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

  • What did you learn from your classmate’s posting?
  • What aIDitional questions do you have after reading the posting?
  • What clarification do you need regarding the posting?
  • What differences or similarities do you see between your posting and other classmates’ postings?

 

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

assignment 4

Examine and research 1 chronic disease (e.g., heart disease, stroke, cancer, diabetes, arthritis, obesity) and write a paper that discusses the following:

  • A comparison of 2 health care policies that are in place (either at the state or federal level) that aIDress the disease
  • The impact the disease has had on the U.S. population and health care system as a whole
  • Strategies that are in place to educate and promote prevention of the disease through public health at the federal and state levels
  • Any challenges and progress to date that has been made in preventing and reducing health risks associated with the disease
  • 2–3 strategies that may increase awareness, education, and prevention of that disease

Note: Use APA style and at least 4 scholarly references.

Please submit your assignment.

 

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

 

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Super Sperm Clinical Trial

Topic: Super Sperm Clinical Trial

Answer the following questions after you read all the attached files carefully
1- Does the clinical trial research application have to aIDress every part of the National Statement Research Merit and Integrity Guidelines 3.3.3 and 3.3.4 before Human Research Ethics committee (HREC) can approve the application?
Select one or more
a. No, because there are different types of clinical trials, and one or more of Guidelines might not apply to particular clinical trial application.
b. In general yes, but the interpretation and application of these Guidelines can be adapted to any particular clinical trial application.
c. Yes.

2- What types of clinical trial does the SuperSperm Vitamins application describe?

Select one or more
a.Phase IV
b.Phase II
c.Phase  II /  III
d.Phase I /  II /  III
e.Phase I /  II
f.Phase  III
g.Phase  I

3-Does the SuperSperm Vitamins clinical trial application meets the Guideline that refer  to research merit and integrity? Which of the following statements are correct?
Select one or more
a.Yes.it meets the Guideline that requires research to be directed to answering a specific question or questions.
b.Yes, because the SuperSperm application aIDresses 3.3.3 a,b,c and d adequately and appropriately.
c.Yes. it meets the Guideline that requires research to test a scientifically valid hypothesis.
d.No, because the SuperSperm application does not aIDress one or more 3.3.3 or 3.3.4 adequately or appropriately.

4-Does the proposed benefit justify the risk? Which of the following statement are correct?

Select one or more
a. No, because Guideline 3.3.10 “the use of placebo” has not been aIDressed adequately.
b. No, the prospect of benefit arising from the research has been exaggerated.
c. Yes, the proposed benefit justifies the risk because no significant adverse reaction were observed in the pilot study so risk of harm is unlikely, whereas the potential benefit of likelihood of successful pregnancy is increased.
d. The SuperSperm application does not provide sufficient information for assessment of relative benefit or risk.

5-Does the SuperSperm application aIDress the monitoring Guidelines described in 3.3.20 ? Which of the following statements are correct?
Select one or more
a .Meets a, b and c but not d.
b. Meets a and d
c. Meets a, but whether it meets b or not is open to interpretation and discussion.
d. Meets a, b and d but not c.
e. No, it doesn’t meet any

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Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient’s right to die relates to this specific case.

Need a 6 page APA format paper based on the case study posted below. Need the paper completed by Tuesday, January 19th, 2016 at 13:00 EST (1pm).

 

Deciding to place a loved one into a long-term care facility can be extremely difficult. Even more difficult is the thought of your loved one’s rights being violated while in long-term care. Patient healthcare rights are not as clearly defined as one would expect, and there are long-term care and other healthcare facilities that create their own sets of patient rights. However, there are also certain indisputable rights afforded to patients across the board.

Read the case study titled “A Legal and Ethical Dilemma (Posted below)

Write a six (6) page paper in which you:

  1. Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient’s right to die relates to this specific case.
  2. From your research, specify the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Next, take a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Provide a rationale for your position.
  3. Imagine that you are a part of the ethics committee investigating this case. Determine the main facts pertaining to the issue that the committee should consider. Suggest one (1) step that the facility should take next in order to resolve the dilemma. Provide a rationale for your response.
  4. Use at least three (3) quality academic resources. Note:Wikipedia and other similar websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

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

 

Case Study: A legal and Ethical Dilemma:

Background

Mary Evelyn Greene, who has memory impairment, lives in a private room at Shady Brook Skilled Nursing Facility located in a beautiful suburb of a major metropolitan city. She has resided at Shady Brook for the past 18 months. Before moving into Shady Brook, Mrs. Greene lived independently in her own home with assistance from a private-duty nursing assistant and a housekeeper. She and her husband had resided together in this home for more than 50 years. Mrs. Greene is 89 years old and suffers from several health problems associated with aging.

Mrs. Greene has one son, David Greene. David has the power of attorney to handle his mother’s health care and other personal affairs. David works as a trial attorney in one of the city’s largest and most prestigious law firms. He owns a large home in an upscale neighborhood and works hard to put two of his children through college and another one through medical school. His home is about an hour’s drive from his workplace and about 20 minutes from Shady Brook. David’s wife Barbara has never been close to her mother-in-law and has not shown much interest in her care. Hence, caring for his mother has become a major responsibility for David, and he is having a difficult time dealing with her declining health and the onset of mild dementia. It is becoming increasingly more difficult for David to leave his law practice or the court room to deal with issues related to his mother.

Mrs. Greene’s husband was a very successful land developer who left her with a substantial estate, which meets all of her financial needs. After her husband passed away, Mrs. Greene decided to remain in her home. She was able to maintain her independence until she was 87 years old, when she began to show signs of dementia. Shortly thereafter, David moved her to Shady Brook. David also hired a part-time “sitter” to keep her mother company because she was too weak to go out of her room on her own. Mrs. Greene seems to enjoy the sitter’s company and likes the attention she gets.

Upon entering Shady Brook, Mrs. Greene became depressed over losing her independence and her home and felt a growing frustration with forgetfulness. She gradually lost her appetite, and her desire to eat continued to decline. On the other hand, Mrs. Greene seems to enjoy the smell of certain foods. The associates monitor and document her food intake and her facial expressions when she is offered different foods. Mrs. Greene is particularly fond of Susan Brown, a certified nursing assistant (CNA), who sits with her and helps Mrs. Greene with whatever little she can eat. When this occurs, her appetite shows some improvement. Mrs. Greene also responds well to volunteers who carry out activities at the facility.

Frustrated Family Member

Mrs. Greene has become too weak to eat on her own. When no one is feeding her, she leaves most of her food on the tray. Recently, she has sustained a weight loss of more than 5 pounds per week. Her plan of care needs to be reevaluated, and her situation needs immediate attention.

David has been visiting his mother quite regularly. Recently, however, his visits have become less frequent, generally two to three times per week. The associates who work on Mrs. Greene’s nursing unit have reported some changes in David’s attitude. At one time he became angry with his mother, raised his voice, and spoke to her as if she were a bad child. Although no one was present in Mrs. Greene’s room at the time, the associates working at the nursing station heard David’s loud voice. When the charge nurse went into Mrs. Greene’s room to find out why David was angry, David told her that it was none of her business. On David’s subsequent visits, the associates observed that Mrs. Greene would become agitated during David’s visits. These issues were brought to the charge nurse’s attention, and they were documented in the patient’s medical record.

The Dilemma

One day David approached the charge nurse and exclaimed that his mother had expressed that she wished to die. On his next two visits, David also told the CNAs that his mother’s desire was not to eat anything so she could just die a quick death. This was the first time the CNAs had heard that Mrs. Greene had expressed a desire to die. The associates also believed that Mrs. Greene appeared to be happier when David was not there.

Before the week was over, David came into the facility early in the morning on his way to work. He handed a sealed envelope to the incoming charge nurse on the day shift. The envelope was aIDressed to Betty Wright, Shady Brook’s administrator. David said to the charge nurse, “I have been telling you people that my mother wishes a speedy death. Tell your administrator that I will be filing a lawsuit if my mother’s wishes are not carried out.” David left without visiting his mother.

Betty Wright decided to place the issue on the ethics committee’s agenda for that same afternoon. As a safeguard, Betty also notified the facility’s liability insurance carrier of the potential legal action.

Meeting of the Ethics Committee

That afternoon, Betty met with members of the ethics committee: chaplain, medical director, director of nursing, charge nurse, social worker, two CNAs, and the local ombudsman. Betty began the meeting with these remarks: “The man’s mother has been declining rapidly and eats very little. He wants his mother to die rather than prolong her suffering. I have learned that the son is the heir to his mother’s estate, and my overall concern is my trust in his decision or his motives. I think he needs the money to pay for the college expenses for his three children. Although it is not uncommon for some residents to be ignored by family after they are admitted, it is rare that they express the wish to enable the death of a relatively healthy person.” The ethics committee is faced with the issue of what is legally and ethically appropriate. The committee deliberates on whether or not to comply with David’s request to withhold food as well as the threat of a lawsuit.

 

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