Nursing

Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection
Subjective Data Collection: 17 of 17 (100.0%)
Hover To Reveal…
Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.
Found:
Indicates an item that you found.
Available:
Indicates an item that is available to be found.
Category
Scored Items
Experts selected these topics as essential components of a strong, thorough interview with this patient.
Patient Data
Not Scored
A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case. Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection
Confirmed Guardian’s Relationship

Finding:
Asked about relationship with patient

Finding:
Reports being Zachary’s mother
(Found)
Pro Tip: Confirming the patient’s relationship with their guardian ensures that you’re observing legal and ethical protections for patient privacy and that you’re speaking with someone who has access to their information.
Example Question:
Are you your son’s guardian?
Reason for Visit

Finding:
Established reason for visit

Finding:
Reports bringing Zachary in for a wellness visit
(Found)
Pro Tip: Determining the reason for a visit in the patient’s own words ensures that you understand what the patient wants from the visit. It also allows you to correctly document the visit’s purpose.
Example Question:
What bring you in to the clinic today?
Feeding

Finding:
Asked about Daanis’ feeding practices Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection

Finding:
Reports breastfeeding Zachary
(Found)
Pro Tip: Feeding, diet, and nutrition are key components of infant wellness and have a direct impact on their development and health. Guardians and caretakers’ descriptions of how and what an infant is eating will allow you to detect and make sense of any developmental delays.
Example Question:
Are you breastfeeding your son?

Finding:
Reports offering both breasts
(Found)
xxxxx
Example Question:
Does your mother put your son down for naps?

Finding:
Reports that Zachary wakes up frequently on Tuesday and Thursday nights
(Available)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development.
Example Question:
Does your son have trouble sleeping? Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection

Finding:
Asked about sleep safety

Finding:
Reports Zachary sleeps in a cradleboard or a bassinet
(Found)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development.
Example Question:
Where does your son sleep?

Finding:
Reports that Zachary sleeps swaddled on his back
(Found)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development.
Example Question:
Do you swaddle your son?

Finding:
Reports that Zachary sleeps in an empty bassinet
(Found)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection.
Example Question:
Does your son sleep with anything?

Finding:
Reports that Zachary sleeps in Daanis’ room
(Found)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development.
Example Question:
Do you sleep with your son?

Finding:
Denies cosleeping with Zachary
(Available)
Pro Tip: Sleep and routine are key components of infant wellness. Insufficient, restless, or excessive sleep directly impacts an infant’s growth and development.
Example Question:
Do you cosleep with your son?
Elimination

Finding:
Asked about elimination

Finding:
Reports Zachary urinates 5 or 6 times a day
(Found)
Pro Tip: Elimination is a key component of infant wellness. The frequency and quality of an infant’s feces, urine, spit up, and vomit provide important information about their diet, health, and development.
Example Question:
How often does your son urinate?

Finding:
Reports Zachary defecates 3 times a day at most
(Found)
Pro Tip: Elimination is a key component of infant wellness. The frequency and quality of an infant’s feces, urine, spit up, and vomit provide important information about their diet, health, and development.
Example Question:
How often does your son defecate?

Finding:
Reports Zachary spits up infrequently
(Available)
Pro Tip: Elimination is a key component of infant wellness. The frequency and quality of an infant’s feces, urine, spit up, and vomit provide important information about their diet, health, and development Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection.
Example Question:
How frequently does your son spit up?

Fxx
Pro Tip: Healthy infants usually develop along a predictable timeframe. Delayed or absent developmental milestones can be a sign of health conditions, disorders, or the need for changes in the guardian’s feeding practice, sleep schedule, and health promotion behavior.
Example Question:
What kinds of noises is your son making?

Finding:
Asked about auditory developmental milestone

Finding:
Reports that Zachary turns to look at noises
(Found)
Pro Tip: Healthy infants usually develop along a predictable timeframe. Delayed or absent developmental milestones can be a sign of health conditions, disorders, or the need for changes in the guardian’s feeding practice, sleep schedule, and health promotion behavior.
Example Question:
Does your son look when he hears something?

Finding:
Asked about gross motor developmental milestone

Finding:
Reports not purposefully doing tummy time
(Found)
Pro Tip: Healthy infants usually develop along a predictable timeframe. Delayed or absent developmental milestones can be a sign of health conditions, disorders, or the need for changes in the guardian’s feeding practice, sleep schedule, and health promotion behavior.
Example Question:
Are you familiar with tummy time?

Finding:
Reports that he seems to be able to lift his head
(Found)
Pro Tip: Healthy infants usually develop along a predictable timeframe. Delayed or absent developmental milestones can be a sign of health conditions, disorders, or the need for changes in the guardian’s feeding practice, sleep schedule, and health promotion behavior.
Example Question:
How often does your son lift his head up?
Maternal Health

Finding:
Asked about maternal health

Finding:
Reports busy personal schedule
(Found)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
What is your schedule like?

Finding:
Reports that mother is helping with childcare
(Available)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
Are you the only adult who lives in your home?

Finding:
Reports drinking sufficient water
(Found)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
How much water do you drink?

Finding:
Reports eating healthy, high-calorie diet
(Available)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
How is your diet and appetite doing?

Finding:
Reports insufficient sleep
(Found)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection.
Example Question:
Do you get enough sleep?

Finding:
Asked about breast health

Finding:
Reports breasts feeling full before feeding
(Available)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
Do your breasts feel full before feeding your son?

Finding:
Reports breasts don’t always feel empty after feeding
(Available)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
Do your breasts ever feel empty?

Finding:
Denies frequent breast leaking
(Found)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
Have you noticed your breasts leaking at all?

Finding:
Denies breast and nipple pain
(Available)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
Do you have breast pain?

Finding:
Asked about maternal mental health

Finding:
Reports feeling overwhelmed
(Found)
Pro Tip: A caretaker’s health and wellbeing has a significant impact on the health of their child, especially when they are a breastfeeding mother.
Example Question:
How are your mood and energy right now?

Finding:
Reports minimal support network outside of family Zachary LaFontaine Infant Well Visit Shadow health Subjective Data Collection

Research Paper – Topic Identify a patient care problem with an impact on budget as a financial management issue in a hospital organization
Use this rubric to guide your work on the Financial Issues Assignment.
NOTE: All assignments and discussion posts are expected to be completed on time.
Tasks Target Acceptable Unacceptable
Article Synthesis
(25 pts)
Clear and strong synthesis and critical analysis of 2 peer-reviewed articles related to the identified financial management issue. Include how literature is applicable to the identified financial issue
(25 pts
General statements of article synthesis, missing one article summary, no application to the identified financial issue.
(15 pts) No synthesis of articles of financial management issue
(0 pts)
Interviews
(20 pts) Interviews (minimum of 2) contain salient information on the financial issue in the organization, contains details of measures taken to address the issues, future steps that have been planned to resolve the issue, statistics and other information to illustrate the financial issue. Utilization of current literature to further support and explain the identified issue
(20 pts) Only one interview conducted to address the financial issue, missing details of measures taken to address the issues, future steps that have been planned to resolve the issue, statistics and other information to illustrate the financial. Missing additional literature to further support and explain the identified issues
(10 pts) No interviews conducted to address the financial issue. No details of measures taken to address the issues, future steps that have been planned to resolve the issue, statistics and other information to illustrate the financial. No additional literature to further support and explain the identified issues
(10 pts)
Financial Analysis
(25 pts) Provides detailed analysis of the financial problem and explanation of potential budget impact. Identification of the role of the nurse in the process of analysis of the information needed for budget development. Supports financial analysis with peer-review publications.
(25 pts) General or no discussion of analysis of the financial problem, no explanation of potential budget impact. Identification of the role of the nurse in the process of analysis of the information needed for budget development. Does not supports financial analysis with peer-review publications.(15 pts) No analysis of the financial problem and no explanation of potential budget impact. Identification of the role of the nurse in the process of analysis of the information needed for budget development. Not supported with peer-review publications.
(0 pts)
Solutions to Financial Issue
(20 pts) Describes at least two solutions to the identified problem, provides a background for selection of these solutions including expert opinions and current literature. Discusses a process for implementation of these strategies. Identify a specific nursing role in the creation of the solution
(20 pts)
Missing at least two solutions to the identified problem, does not provides a background for selection of these solutions including expert opinions and current literature. Does not discusses a process for implementation of these strategies. Identify a specific nursing role in the creation of the solution
(10 pts)
No solutions to the identified problem, provides a background for selection of these solutions. Missing expert opinions and no current literature. Missing a process for implementation of these strategies. Missing a specific nursing role in the creation of the solution
(0 pts)
APA format
(10 pts) Articles and lists the APA references correctly. Introduction and conclusion. This includes grammar, spelling, and punctuation as well as formatting – no errors. (10 pts) Articles and lists the APA references correctly. Missing introduction or conclusion. This includes grammar, spelling, and punctuation as well as formatting – 1-3 errors. (6pts) Articles and lists the APA references correctly. Missing introduction and conclusion. This includes grammar, spelling, and punctuation as well as formatting – more than 3 errors. (0 pts)
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Solution
Financial Health Problem Analysis
Healthcare is a demanding service to the patients, which is highly focused on the quality, health, wellbeing of the patient clients. The care programs are usually knitted to provide cost-effective care that is safe, of high quality, and that is effective in contributing to the patient’s health and independence. The healthcare providers and the patient should have their efforts merged to enhance the achievement of the goals. This paper will discuss the financial impact of catheter-associated urinary tract infections (CAUTIs) on the patients and organizational budgets that also affect care quality.
In our workplace, CAUTIs are becoming a major concern for both the patients and healthcare providers due to the high levels of financially disproportionate care, influencing activities that increase the financial cost of care. Some of the adverse care processes that may have resulted from the CAUTIs among the patients include extended hospitalization, increased management cost for the CAUTIs, compensatory services to the patients for the hospital-acquired infections, and increased length of recovery period that affects their independence. All these factors have been thus contributing additional costs to the healthcare providing institution and the patient or caregiving team of the patients and therefore should be addressed by the hospital in controlling the surging budgets due to the financial implications.
Various studies have been conducted to ascertain the financial implications of hospital-acquired infections such as CAUTIs on the patient care process. The first peer-reviewed research by Hutton et al. (2018) evaluates the economic impact of catheter-associated urinary tract infections (CAUTIs) prevention programs in nursing homes. The randomized clinical trial was set in a community-based nursing home facility for patients with indwelling urinary catheters. The researchers used an infection prevention program as an intervention that would be compared to the standard care and used measurements such as costs of intervention, cost-effectiveness ratio, and general health outcomes of the patients. The research’s results indicated that the intervention contributed to less cost of care compared to the placebo. The results showed that the cost of treating the disease reduced by $54,316 in a year which amounted to a $34,037 net savings on the cost of care. The research results supported the hypothesis that CAUTIs increased the cost of care, and preventive interventions against the acquired infections would directly impact cost reduction. As seen through the study, the key cost-saving avenues were reduced CAUTI hospitalizations and reduced CAUTIs care, which impacted on $39,180 and $15,136 savings, respectively. From this research article and study, it is evident that catheter-associated urinary tract infections contribute to increased cost of care, and the application of preventive care programs would reduce the rates of infection that would reduce the cost of care for both the hospital and the individual patients.
Another article, Smith et al. (2019), discusses the hospitals’ health economic burden of urinary catheter-associated infections. The researchers used a decision-analytic model to estimate the annual prevalence of CAUTIs and CLABSIs and how they are closely associated with the excess economic health burden. The study researchers conducted scenario and probabilistic sensitivity analyses on health and economic benefits for catheter infections preventions. Through the model, CAUTIs were estimated to be 42,967 while CLABSIs were estimated to be 7529. The hospital-onset infections were found to be 38,084 and 2,524, respectively. According to the study results, CAUTIs contributed to 45,717 excess bed days, 1467 deaths, and 10,471 lost QALYs in a year. Every percent reduction for catheter-associated infection prevalence, there would be a £9,800 saving on direct hospital costs, which would amount to £54.4 million in a year and an additional £209.4M in economic value. The results indicate that the increased prevalence of CAUTIs and CLABSIs increases the cost of care and the general economic health burden in a country.
The healthcare organization members play a very important role in reducing the key factors that contribute to financial loss over the increased cost of care. In establishing the situation in the hospital, I interviewed two healthcare providers; the chief nursing officer and the intensive care unit manager. Ms. Morris is the CNO of the hospital and has various responsibilities attached to the quality patient care and general managerial roles of the organizational functions. The chief nursing officer has the administrative role in maintaining quality clinical and patient care standards, including access to safe medical care, increased patient satisfaction, and reduced hospital-acquired infections through quality nursing practices. The chief nurse works closely with the management in designing quality improvement initiatives and installing the right infrastructure, among other resources, that can help improve the patient outcome. Ms. Morris also ensures proper implementation of organizational rules and policies through the administrative roles. According to Ms. Morris, addressing the issue of CAUTIs in the hospital has taken over four years since the discussion was brought on board. The chief nursing officer acknowledged that the organization only embraced one initiative of having the standard rules pinned on the doors of the care units to remind the nurses on things to follow in reducing hospital-acquired infections such as CAUTIs. The initiative was short-lived. According to her, the organization believes that some initiatives such as regular educational programs are expensive to adopt. Her perceptions on the financial impact of CAUTIs and the control measures differed with the organizational financial managers. She believed that CAUTIs contributed to increased cost of care through delayed discharge, readmissions, and litigation that are costly for the organization. Ferguson et al. (2018) support Morris’ ideology that a decrease in CAUTIs improves patient outcomes, which impacts on financial benefits to the organization. The financial team considered control initiatives expensive and ineffective in changing a “normal” occurrence in the healthcare process.
Joe is the unit manager of the ICU and is responsible for managing operations within the care unit and ensuring that the members of the ICU staff conform to the nursing and clinical standards to improve patient care. According to Joe, the organization prevented visits by non-clinical visitors to the intensive care unit to avoid contamination to the patients who require standard care for early recovery and reduced the prevalence of infections. He also acknowledged the use of mail reminders and memos on the notice boards to remind the healthcare providers of the nursing standards for controlling infections. The initiatives, according to Joe, contributed to a negligible improvement in CAUTIs. The foreseen organizational problems that block efforts to address the issue are resistance to changes and the high cost of the quality improvement initiatives. According to Vaishnavi et al. (2019), fear of change is a key contributor to adopting quality improvement initiatives in the healthcare system. Joe challenges the foreseen financial difficulties by showcasing the benefits that would be accrued on reducing CAUTIs. According to him, the hospital will reduce hospitalization, and thus beds will be occupied by new clients, readmissions will also decline, and the intervention will help control other conditions such as CLABSIs and SSIs. He observes that initiatives such as educational programs and the production of manuals may be done twice a year, thus less expensive but with positive financial savings.
The organization’s financial analysis closely links with the information from the chief nursing officer and the ICU manager. The organization receives about 4000 catheter patients for urinary tract surgery in a year. With a prevalence rate of 20%, about 800 patients develop complications related to CAUTIs. Of those diagnosed while in the hospital, about 500 are forced to have a three-day stay in the hospital for control and management. When the cause of hospitalization is established to be CAUTIs, the hospital caters for the hospital stay. Averagely, the hospital stay is $2,607, and thus the hospital usually loses $3,910,500 in a year through the extended hospital stay. According to Ferguson (2018), the CMS requires the healthcare providing hospitals to cater for expenses on the development of HAIs, including CAUTIs. About 5% of the patients are readmitted to the hospital, and according to the hospital’s policy, the patient covers 80% of the care while the hospital covers the rest. The 200 readmitted patients thus the organization lose $312,000 in a year through readmissions. Other costs associated with the CAUTIs condition include poor reputation that leads to a low number of clients, treatment procedures, and decreased trust among the patients. The minimum cost of treatment of CAUTIs, according to AHRQ (2019), is $4,694, meaning that the organization averagely loses over $5 million on treating the CAUTIs patients. Generally, the organization loses over $10 million in treating CAUTIs in a year, a cost about 500 times the cost of the common interventions for HAIs.
Various interventions should be used to counter CAUTIs and reduce financial stress to the organization. Nurse-driven protocols are one of the strategies that can effectively control CAUTIs. According to Berto (2019), the nurse-driven protocols provide the nurses with autonomy, enabling them to make decisions based on their scope of practice. This initiates a healthy working environment whereby the nurses own the responsibility and control their practice. A systematic review by Durant (2017) established that nurse-driven protocols effectively controlled CAUTIs, leading to a great reduction in the prevalence of infections in healthcare centers. This can be applied to my workplace through management, which involves a change of leadership approach in empowering the nurses to control their nursing practices. Another approach is through nurse education. Nurse education entails refreshing courses on hygiene, catheter insertions, catheter management, and other standards of practice that can enhance CAUTIs control. Through a study, Jones et al. (2019) established that regular training on catheter insertion and management contributed to a significant decrease in CAUTIs. The education program can be done for the new nurses in the hospital and twice every year as a reminder for the non-entry nurses. In collaboration with the management, the chief nursing officer should contract trainers and facilitate reading materials for the effective implementation of quality improvement initiatives. This intervention may require financing but generally cannot go beyond $200,000 in a year which is far more cost-effective than the financial constraints contributed by the CAUTIs.
References
AHRQ. (2019). Estimating the Additional Hospital Inpatient Cost and Mortality Associated With Selected Hospital-Acquired Conditions. Agency for Healthcare Research and Quality. https://www.ahrq.gov/hai/pfp/haccost2017-results.html
Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American journal of infection control, 45(12), 1331-1341.
Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing, 38(6).
Hutton, D. W., Krein, S. L., Saint, S., Graves, N., Kolli, A., Lynem, R., & Mody, L. (2018). An economic evaluation of a catheter?associated urinary tract infection prevention program in nursing homes. Journal of the American Geriatrics Society, 66(4), 742-747.
Jones, L. F., Meyrick, J., Barth, J., Dunham, O., & McNulty, C. A. M. (2019). Effectiveness of behavioral interventions to reduce urinary tract infections and Escherichia coli bacteremia for older adults across all care settings: a systematic review. Journal of Hospital Infection, 102(2), 200-218.
Jones, L. F., Meyrick, J., Barth, J., Dunham, O., & McNulty, C. A. M. (2019). Effectiveness of behavioral interventions to reduce urinary tract infections and Escherichia coli bacteremia for older adults across all care settings: a systematic review. Journal of Hospital Infection, 102(2), 200-218.
Smith, D. R., Pouwels, K. B., Hopkins, S., Naylor, N. R., Smieszek, T., & Robotham, J. V. (2019). Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: a probabilistic modeling study. Journal of Hospital Infection, 103(1), 44-54.
Vaishnavi, V., Suresh, M., & Dutta, P. (2019). A study on the influence of factors associated with organizational readiness for change in healthcare organizations using TISM. Benchmarking: An International Journal.

Basic Concepts in Public Health Statistics- Topic 1 DQ 1
QUESTION-TOPIC 1 DQ 1
Statistics is an important component of public health. Explain the relevance of statistics in the planning, implementation, and evaluation of a health promotion intervention. How do you envision using statistics in your current or future career?
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Solution
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Evidence-Based Practice Project
Assessment Description
Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
Identify the selected model or framework for change and discuss its relevance to your project.
Discuss each of the stages in the change model/framework.
Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
Evidence-Based Practice Project
You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN0 Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.
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How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?
How should the nurse address these concepts to ensure health promotion activities are culturally competent?
Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that addresses the cultural issue.
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Solution
Nursing Bias and Stereotypes
How the community health nurse recognize bias, stereotypes, and implicit bias within the community
Unconscious or implicit bias refers to negative or positive stereotypes and attitudes activated involuntarily and automatically, that influence an individual’s behaviors, decisions, and understanding without his or her voluntary control of awareness (Alspach, 2018). A community health nurse recognizes implicit bias and stereotypes within the community when patients receive substandard care because of their ethnicity or race or when providers demonstrate unequal treatment recommendations to and lack empathy toward minority patients.
Alspach (2018) indicates that implicit bias is manifested in four major areas; treatment decisions, provider-patient interactions, patient health outcomes, and treatment adherence. How a provider communicates, including body language, verbal cues, and nonverbal behavior( frequency of eye contact and physical proximity) might manifest subconscious bias. Bias can negatively influence whether patients return for or seek care, adhere to treatment protocols, and possibly affect care outcomes.
How a nurse should address these concepts
The nurse can address implicit bias and stereotyping to ensure culturally competent health promotion activities through perspective-taking. According to Edgoose et al. (2019), perspective-taking involves considering experiences from the viewpoint of the individual being stereotyped. This can entail consuming media about those experiences, such as watching documentaries, reading novels, and listening, and having direct interactions with individuals from different cultural backgrounds. Increased face-to-face contact with individuals who are culturally different from you undermines implicit bias.
Strategies that I can employ to reduce cultural dissonance and bias
Individuation, partnership building, and affirming egalitarian goals are strategies that I can use to minimize cultural dissonance and bias to deliver culturally competent care. Endgoose et al. (2019) allege that individuation involves collecting specific information about the individual you are interacting with to avert group-based stereotypic inferences. A person’s social identities intersect with numerous social groupings, for instance, related to race and ethnicity. Within these multiplicities, an individual can find shared identities that bring them close to these groups, including common interests ( for example, sports teams) or shared experiences (for example, parenting) (Edgoose et al., 20190. The nurse can use individuation to help inform clinical decisions by utilizing what the nurse knows about the unique, specific, and specific attributes of a person.
Partnership building involves approaching the interaction between the patient and the provider as collaborative, patient-centered efforts, rather than the provider directing the patient. In this approach, both parties are required to agree on health problems, treatment goals and roles, and priorities of care (Alspach, 2018).
Affirming egalitarian goals involves expressing my commitment to provide optimal care to all patients and correcting disparities in care. According to Alspach (2018), studies on affirming egalitarian goals demonstrate that providers are highly receptive to acknowledge and modify their biases when they express their commitments to deliver the best possible care to every patient and to share in the obligation to correct disparities in care.
References
Alspach, J. G. (2018). Implicit Bias in Patient Care: An Endemic Blight on Quality Care. Critical Care Nurse, 38(4), 12-16. https://doi.org/10.4037/ccn2018698.
Edgoose, J., Quiogue, M., & Sidhar, K. (2019). How to Identify, Understand, and Unlearn Implicit Bias in Patient Care. Family Practice Management, 26(4), 29-33.

Evidence-Based Practice In Public Health-PHN-652-Topic 1 DQ 1
QUESTION-PHN 652 Topic 1 DQ 1
Discuss the sources of evidence for public health nurses. How can this evidence be applied to support evidence-based practice? Cite at least two sources of evidence in your response.
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Solution
Discuss the Sources of Evidence for Public Health Nurses
Evidence-based practice in public health involves integrating science-based interventions with community preferences for population health improvement. There are numerous sources of evidence, such as the Guide to Community Preventive Services, also referred to as “The Community Guide.” The community guide contains evidence-based recommendations for services, policy, and community health programs from the Community Preventive Services Task Force. It helps the nurses to identify evidence-based interventions, their implications on the population and also assists nurses in identifying evidence gaps in policies and practice. Other sources include reports from community and health organizations and scientific and other academic journals that provide findings following interventions. Organization reports provide insight on the current status of issues in the community and the expected future trends. They may also provide recommendations for future interventions/actions based on the current trends. The reports also compare different Scientific databases, for example, PubMed, Medline, CINAHL, among others, also act as sources of evidence. From such databases, public health nurses can access recently published scientific materials, including randomized controlled trials and systematic review studies, which they can use as evidence (Brownson et al., 2018).
How can this Evidence be applied to Support Evidence-based Practice?
To apply the evidence in evidence-based practice, public health nurses have to follow a series of steps to identify and use the best available research. The initial step involves identifying an existing issue in the community that needs to be addressed. Following identification of the issue, the nurse should identify the best available evidence that can be used to address the issue. The identified evidence should be critically appraised to determine the best way to implement it and make modifications where necessary. The nurse should then implement the interventions and evaluate the outcomes to determine their effectiveness (Oliver et al., 2017).
References
Brownson, R. C., Fielding, J. E., & Green, L. W. (2018). Building capacity for evidence-based public health: reconciling the pulls of practice and the push of research. Annual review of public health, 39, 27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972383/
Oliver, K. A., de Vocht, F., Money, A., & Everett, M. (2017). Identifying public health policymakers’ sources of information: comparing survey and network analyses. European journal of public health, 27(suppl_2), 118-123. https://academic.oup.com/eurpub/article/27/suppl_2/118/2907852?login=true

Polypharmacy is a common concern, especially in the elderly.

Discuss three risk factors for polypharmacy. Explain the rationale for why each listed item is a risk factor.
Discuss three action steps you can take in your clinical practice to prevent polypharmacy.

Root Cause Analysis and safety improvement plan
For this assessment, you can use a supplied template to conduct a root-cause analysis. The completed assessment will be a scholarly paper focusing on a quality or safety issue pertaining to medication administration in a health care setting of your choice as well as a safety improvement plan.
As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences. The baccalaureate nurse’s role as a leader is to create safety improvement plans as well as disseminate vital information to staff nurses and other health care professionals to protect patients and improve outcomes.
As you prepare for this assessment, it would be an excellent choice to complete the Quality and Safety Improvement Plan Knowledge Base activity and to review the various assessment resources, all of which will help you build your knowledge of key concepts and terms related to quality and safety improvement. The terms and concepts will be helpful as you prepare your Root-Cause Analysis and Safety Improvement Plan. Activities are not graded and demonstrate course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Apply evidence-based and best-practice strategies to address a safety issue or sentinel event pertaining to medication administration. ;
Create a viable, evidence-based safety improvement plan for safe medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
Competency 3: Identify organizational interventions to promote patient safety.
Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Professional Context
Nursing practice is governed by health care policies and procedures as well as state and national regulations developed to prevent problems. It is critical for nurses to participate in gathering and analyzing data to determine causes of patient safety issues, in solving problems, and in implementing quality improvements.
Scenario
For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
The specific safety concern identified in your previous assessment pertaining to medication administration safety concerns.
The readings, case studies, or a personal experience in which a sentinel event occurred surrounding an issue or concern with medication administration.
Instructions
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan [DOCX] template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration.
Create a feasible, evidence-based safety improvement plan for safe medication administration.
Identify organizational resources that could be leveraged to improve your plan for safe medication administration.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current 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 but keep in mind that your Assessment 2 will focus on safe medication administration.
Assessment 2 Example [PDF].
Additional Requirements
Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan pertaining to medication administration.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to current APA style.
Root-Cause Analysis and Safety Improvement Plan Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization. Does not identify the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization. Identifies the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization. Analyzes the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization. Analyzes the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization, noting the degree to which various elements contributed to the safety issue or sentinel event pertaining to medication administration.
Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration. Does not describe evidence-based and best-practice strategies pertaining to medication administration. Describes evidence-based and best-practice strategies but their relevance to the safety issue or sentinel event pertaining to medication administration is unclear. Applies evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration. Applies evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration, detailing how the strategies will address the safety issue or sentinel event pertaining to medication administration.
Create a viable, evidence-based safety improvement plan for safe medication administration. Does not create a viable, evidence-based safety improvement plan for safe medication administration. Creates a safety improvement plan for safe medication administration that lacks appropriate, convincing evidence of its viability. Creates a viable, evidence-based safety improvement plan for safe medication administration. Creates a viable, evidence-based safety improvement plan for safe medication administration that makes explicit reference to scholarly or professional resources to support the plan.
Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration. Does not identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration. Identifies existing organizational resources, but their relevance and usefulness to quality and safety improvement for safe medication administration are unclear. Identifies existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration. Identifies existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration, prioritizing them according to potential impact.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contain errors in grammar or punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar or punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes or paraphrasing. Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.
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Solution
Root-Cause Analysis and Safety Improvement Plan
Medication errors are unfortunate realities within the US healthcare system that continues to occur at alarming rates. These events impact all the healthcare stakeholders, including patients, families, healthcare providers, and insurers (Treiber & Jones, 2018). To curb this quality and safety issue, the Joint Commission requires hospitals to occasionally conduct an analysis of sentinel events. One of the commonly utilized processes in the exercise is the root cause analysis (RCA) (Hibbert et al., 2018). Healthcare institutions can optimize patient care through the RCA process and enact measures to mitigate adverse events that compromise patient safety. For example, this easy will review a medication error case involving a 29-year-old female patient treated in an obstetric emergency department. I will employ RCA to identify the root cause of the problem and use the findings to develop a safety improvement plan.
Analysis of the Root Cause
A 29-year-old female at 33 weeks gestation with a history of gestational hypertension presented to the obstetric emergency at midnight with shortness of breath, blurry vision, severe headache, and right upper abdominal pain. She also reported nausea and vomiting in the past three hours. The patient reported the onset of the symptoms to be five hours ago and was associated with a gradual increase in lower extremity edema. The patient is currently taking labetalol prescribed two weeks ago when she was diagnosed with gestational hypertension. Vital takings indicated elevated blood pressure and a significant weight gain since her last check-up five days ago. Diagnostic tests showed excess proteins in the urine and decreased levels of platelets in the blood, indicating a pre-eclampsia diagnosis. The physician ordered IV magnesium sulfate to prevent seizures, injuries to the baby’s brain, and preterm labor by relaxing smooth muscle tissues. The hospital has a standard protocol that requires magnesium sulfate to be administered as 4-gram IV and 10-gram IM regimen in each buttock. The prescription was communicated to the nurse verbally, who prepared it incorrectly due to the rash caused by the urgency of the situation. The poster on magnesium sulfate’s preparation previously placed on the drug preparation room had become faded and had not yet been replaced. Therefore, the nurse relied on her memory during the preparation of the prescription and did not countercheck the medicine with another nurse as per the hospital protocol. Twenty minutes later, the patient started becoming lethargic. She reported severe muscle weaknesses, fatigue, flushing, and dizziness. The attending nurse suspected these to be side effects of magnesium sulfate. She consulted another nurse and repeated the dose strength aloud to her, who crosschecked it from a printed chart and picked up the error in the already administered drug. The case was reported to the senior obstetric resident, who immediately prescribed IV Calcium gluconate, an antidote for magnesium sulfate. She was also put on oxygen therapy and iv fluids.
In this medication error case, several factors contributed to the problem. These include communication deficits among medical staff members, poor implementation of safety and quality protocols, and non-adherence to the implemented protocols by healthcare workers. To start with, the physician verbally provided the order for magnesium sulfate administration to the nurse. Verbal communication of prescriptions poses a significant risk of errors. There is also a deficiency in the hospital protocols regarding the standard protocol through which medications should be communicated. Secondly, the facility management’s poor implementation of safety protocols is evident where the chart displaying magnesium sulfate’s preparation in the drug preparation room had become faded and has not yet been replaced. Therefore, the nurse prepared the medication relying on her memory. In addition, despite standard protocols to countercheck the dose of high-risk medicine, the nurse overlooked the protocol and administered the drug without counter-checking the dose. This indicates poor adherence to the already implemented hospital safety protocols.
Application of Evidence-Based Strategies
Various studies focusing on medication errors have resulted in multiple evidence-based recommendations for addressing the issues. The factors contributing to medication error in the current case can be addressed through evidence-based approaches. Communication deficits among medical staff members can be addressed rough implementation of communication protocols in a healthcare facility (Treiber & Jones, 2018). It is essential to have a standardized protocol for communication among care providers to ensure passing of accurate information regarding patient medication administration. These can help prevent errors arising from verbal communication of prescriptions (Mutair et al., 2021).
Poor implementation of safety and quality protocols within an organization can impair adherence by healthcare workers. Once implemented, policy actions need to be put in place to inform and educate the providers on how to integrate the recommendations into practice; resources have to be provided to facilitate the adoption of the practice and surveillance and monitoring protocols to enhance adherence (Hibbert et al., 2018). In addition, policies on how to deal with non-adherence are essential. For instance, in the current case, poor protocols regarding how and when the faded charts regarding the protocols should be replaced contributed to the medication error. Ensuring that staff members can readily access essential updates and protocol changes can help in adherence to the safety protocols. Besides, poor monitoring of the protocols resulted in mistakes. The attending nurse intentionally failed to follow the hospital protocol regarding
crosschecking medication dose with another nurse before administering the prescription. If there was proper monitoring of adherence to the safety and quality protocols, such errors could be prevented. Poor knowledge regarding the medicine could have contributed to error as well. There is therefore a need for regular training of nurses about medication risks and the newly developing therapies. As direct caregivers and care coordinators in multidisciplinary care teams, nurses are involved in medication administration in most parts of their practice. They need to be informed on high-risk medications requiring extra caution during administration.
Improvement Plan with Evidence-Based and Best-Practice Strategies
The quality improvement plan that should be implemented in the facility to address the discussed medication error scenario should focus on issues identified in the case. These include both improvements of the current protocols and implementation of new protocols. First, to promote better communication of prescriptions among physicians and nurses, there is a need to implement standard prescription communication channels, such as written or electronic communication. This ensures nurses can refer to the prescription written by the physician and confirm it to prevent the risk of errors (Rudzewicz, Houseman & Hipskind, 2021).
Secondly, to improve access to the already implemented safety protocols regarding drug administration, there is a need for new policies to enhance access, such as electronic availability of drug charts and quality maintenance of wall charts to ensure information is visible thus reliable by the providers (Hibbert et al., 2018). Besides, the facility needs to introduce policies enabling regular training of nurses on the newly developing pharmaceutical products and their safety risks. Finally, the facility also needs to implement surveillance areas to monitor nurse adherence to the already implemented medication administration safety and quality measures. This plan aims to enhance security in medication administration by promoting better communication among providers and commitment to the readily implemented protocols (Tariq et al., 2018).
The plan implementation will take four weeks. The first week will entail developing the policy changes by a multidisciplinary team. The second and third weeks will entail resource consolidation, while implementation will occur in the fourth week.
Existing Organizational Resources
The organization resources that will help improve the plan’s implementation and outcome include a multidisciplinary care team consisting of physicians, nurses and nurse informaticists. Besides, the facility library materials, including computers, will be essential in disseminating data on the current protocol to the care providers. Financial resources will help fund research studies to help prepare educational programs on current developing therapies. The existing surveillance resources will help monitor adherence to the new protocols.
Conclusion
Despite the increasing prevalence of medication errors and their adverse effects, they are preventable through evidence-based practices. However, the first step in addressing the issue is establishing the causes of the problem. This helps design a targeted plan to resolve the issue.
References
Hibbert, P. D., Thomas, M. J., Deakin, A., Runciman, W. B., Braithwaite, J., Lomax, S., … & Fraser, C. (2018). Are root cause analyses recommendations effective and sustainable? An observational study. International Journal for Quality in Health Care, 30(2), 124-131. https://doi.org/10.1093/intqhc/mzx181
Mutair, A. A., Alhumaid, S., Shamsan, A., Zaidi, A. R. Z., Mohaini, M. A., Al Mutairi, A., … & Al-Omari, A. (2021). The Effective Strategies to Avoid Medication Errors and Improving Reporting Systems. Medicines, 8(9), 46. https://doi.org/10.3390/medicines8090046
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2021). Medical error reduction and prevention. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2018). Medication dispensing errors and prevention. https://europepmc.org/article/NBK/nbk519065
Treiber, L. A., & Jones, J. H. (2018). After the medication error: Recent nursing graduates’ reflections on adequacy of education. Journal of Nursing Education, 57(5), 275-280. https://doi.org/10.3928/01484834-20180420-04

A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:
Blood Chemistries
Na: 147
Cl: 110
K: 4.0
Arterial Blood Gases
pH: 7.33
PCO2: 48
HCO3: 27
PO2: 96
Urinalysis
Urine Specific Gravity: 1.040
Address the following:
Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.
What specific electrolyte disturbance does the patient have?
What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
If the patient had an increase in her potassium level, for what clinical manifestations would the nurse monitor?
What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.
What are the three major mechanisms of pH regulation?
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Solution
Acid-Base and Electrolyte Case Study
In the case scenario, a nurse manages an 85-year-old female patient with a history of breathing difficulties for two days. The patient is lethargic, skin is dry and warm, and has a reduced urine output. Blood chemistry results include Cl-110, Na-147, and K- 4.0. Arterial Blood Gas results include pH-7.33, HCO3-27, PCO2-48, and PO2- 96. The Urine Specific Gravity is 1.040.
Abnormal Laboratory Findings in the Results
Abnormal lab findings in the blood chemistries include elevated sodium and chloride levels at 147mmol/L and 110 mmol/L, respectively. The normal range for sodium is 135-145 mmol/L, while for chloride is 98-106 mmol/L (Kovesdy, 2017). A high sodium level indicates a decrease in total body water (Kovesdy, 2017). An imbalance in chloride levels indicates dehydration, metabolic acidosis, nephrotic syndrome, renal failure, and diabetes insipidus.
In the ABG results, the pH is low at 7.33, which indicates hydrogen ions deficit. The reference pH range is 7.35-7.45. The patient has a high PCO2 at 48, indicating excess levels of carbonic acid in the blood due to respiratory disorders (Hamilton et al., 2017). The reference range of PCO2 is 35-45 mmHg. The HCO3 is slightly above the normal range of 22-26 mmol/L, indicating high bicarbonate levels in the blood. The reference range of HCO3 is 22-26 mmol/L (Hamilton et al., 2017). In addition, the patient has an increased urine gravity, above the reference range of 1.005-1.025, meaning that there is a high urine concentration from dehydration.
Specific Electrolyte Disturbance
The electrolyte disturbances present in the patient include hypernatremia and hyperchloremia based on high sodium and chloride levels.
Clinical Manifestations With the Electrolyte Abnormality
Clinical features expected with hypernatremia include cognitive dysfunction, generalized body weakness, and signs of dehydration such as dry mucous membranes, dry skin, abnormal skin turgor, high heart rate, and reduced urine output (Qian, 2019). Manifestations that may occur with hyperchloremia include irregular heart rate, elevated blood pressure, edema, muscle weakness, tingling sensations, confusion, and seizures.
Clinical Manifestations to Monitor If There Is a High Potassium Level
Clinical manifestations that the nurse would assess for in elevated potassium levels include chest pain, difficulties in breathing, nausea, vomiting, muscle weakness, tingling sensations, body weakness, and tall T waves on ECG (Kovesdy, 2017).
Blood Gas Abnormality Seen In the Patient
Respiratory acidosis with metabolic compensation is the blood gas abnormality evident in the patient based on her Arterial Blood Gas results. Respiratory acidosis is diagnosed when there is an excess of carbonic acid when CO2 levels in the blood rise over 45 mm Hg (Hamilton et al., 2017). The pH is below the reference range, indicating acidosis. The PCO2 is above the normal range meaning that the acid-base problem is a respiratory cause (Hamilton et al., 2017). The HCO3 is slightly above the normal range, indicating that the kidneys are compensating for the imbalance through excretion of hydrogen ions and retention of bicarbonate ions to correct the acidosis.
Three Major Mechanisms of pH Regulation
The major pH regulation mechanisms include chemical buffer systems, respiratory and kidney mechanisms. Chemical buffers include bicarbonate acid, phosphate, and plasma proteins (Quade et al., 2021). The bicarbonate buffer system is vital to maintaining acid-base balance in the body because CO2 and HCO3 can be regulated separately. Respiratory mechanisms regulate CO2 through alveolar ventilation in the lungs (Quade et al., 2021). The kidneys regulate Hydrogen ions concentration whereby they excrete the ions to maintain an acid-base balance. Kidneys eliminate non-volatile acids.
References
Hamilton, P. K., Morgan, N. A., Connolly, G. M., & Maxwell, A. P. (2017). Understanding Acid-Base Disorders. The Ulster medical journal, 86(3), 161–166.
Kovesdy C. P. (2017). Updates in hyperkalemia: Outcomes and therapeutic strategies. Reviews in endocrine & metabolic disorders, 18(1), 41–47. https://doi.org/10.1007/s11154-016-9384-x
Qian, Q. (2019). Hypernatremia. Clinical journal of the American Society of Nephrology: CJASN, 14(3), 432–434. https://doi.org/10.2215/CJN.12141018
Quade, B. N., Parker, M. D., & Occhipinti, R. (2021). The therapeutic importance of acid-base balance. Biochemical Pharmacology, 183, 114278. https://doi.org/10.1016/j.bcp.2020.114278

Assessment Instructions: Robbing the Dead: Is Organ Conscription Ethical?
• Write a 2-3 page paper that examines the moral and ethical considerations of organ conscription policies and theories.
Scarcity of Medical Resources
For this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where the needs for health care outstrip available resources, we regularly face decisions about who should get which resources.
There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.
But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining the consent of the donor or his or her family. Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy all people would share the burden of providing organs after death and all would stand to benefit should the need arise, the policy is fair and just.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
• Competency 1: Articulate ethical issues in health care.
articulate the moral concerns surrounding a policy of organ conscription.
Articulate questions about the fairness and justness of organ conscription policy.
Explain the relevance and significance of the concept of consent as it pertains to organ donation.
Evaluate alternative policies for increasing available donor organs.
• Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
Exhibit proficiency in clear and effective academic writing skills.
References
Munson, R. (2014). Intervention and reflection: basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.
Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615.
Instructions
Do you consider the policy of organ conscription to be morally sound?
Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.
In your paper, address the following:
• On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?
• Is the policy truly just and fair, as supporters claim? Explain.
• Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.
Submission Requirements
• Written communication: Written communication is free of errors that detract from the overall message.
• APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines.
• Length: 2–3 typed, double-spaced pages.
• Font and font-size: Times New Roman, 12 points.
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Solution
Robbing the Dead: Is Organ Conscription Ethical?
The demand for organ transplantation outstrips supply with statistics showing that over 20 Americans die each day while waiting for an organ donation. The scarcity of organs means that there is a need for rationing, a strategy that many believe would enhance the availability of organs. With over 140,000 patients requiring organ transplants, the debate about ethical issues on organ conscription remains a controversial issue with many supporting the need for such laws while others oppose (Lewis et al., 2021). Conscription implies that people who die should donate their organs to save the lives of thousands that require transplants. Proponents assert that the advantages of organ conscription are more than individual decisions of donation (Levin, 2019). The decision of if this is right or wrong demonstrates ethical and moral dilemmas which form the basis of this paper. The paper advances that organ conscription is not ethical because it denies the demised individual inherent autonomy and consent rights.
Moral and Ethical Concerns
The almost-universal embracing of cadaveric organ donation is founded on express consent by a donor when not dead, either through an official voluntary opt-in or informal discussion based on the perceptions of the family. However, irrespective of the success of the current explicit consent about the transplantation models, the imbalance between the supply and demand continues to raise calls for the implementation of laws to validate presumed consent with facilities for opt-out as a way of increasing the availability of organs to meet demands (Rudge, 2018). Such organ conscription laws are not only unethical but raise concern about the possible trajectory that facilities and providers can take based on the thriving black market that exists today. The current opt-in system is ethical and moral because it implies that one must get consent from the individual or their family members before organs are removed and donated (Lewis et al., 2021). Having an opt-out system implies that consent is presumed and means that all people have the intent to donate organs when they die.
The realm of consent is an ethical aspect that cannot be ignored in this discussion. Retrieval of organs using conscription faces ethical hurdles since it bypasses consent to get organs from a deceased individual. The right to autonomy and consent does not end when one dies. That right should be respected despite the occasioned death. While having a conscription policy would help in meeting the rising demand, it will negate the essence of inherent dignity and respect for autonomy and consent by the dying individual and their next of kin (Munson, 2017). The policy would negate the individual’s autonomy and relationship with his body
Fairness and Justness of Organ Transcription Policy
Having a national organ transcription policy may not be the best solution to the country’s organ shortage problem. Nations like Spain, Australia and even Italy have an opt-out policy on organ conscription. However, they still face shortages in organ donations since the decision to donate one’s organ when dead constitutes moral and ethical facets and not legal trajectory (Rudge, 2018). Each ten minutes an individual is added to the list requiring transplants of different organs with at least twenty individuals dying while waiting for an available organ. The implication is that consent remains a core aspect of an effective organ transplant policy.
Having a conscription policy would be unfair and unjust for the dead individuals and their families since they will not have the chance to accept if their kin’s body and its organs should be separated (Prabhu, 2019). Such a policy amounts to the confiscation of organs with no consent from the deceased or the family. The implication is that policymakers must attempt to offer increased awareness about the current problem with emphasis that the donor reserves the right to give their organs based on effective information and informed consent.
Relevance and Significance of Consent related to Organ Donation
Consent is a critical aspect of expressing one’s inherent human dignity and autonomy or independence. Through consent, potential organ donors make the choice and exercise their rights over their bodies. The ethical theory of natural law assumes that there is goodness in human beings (Prabhu, 2019). By giving these individuals autonomy, they can make the best decisions not just for themselves but for the positive impact on society. Utilitarianism implores individuals to make decisions based on the greater benefits to the majority. Therefore, allowing these individuals and their families to exercise consent would enable society to get organ donors that seek the good of society even after their demise. Lack of consent implies that the donors have no choice or option as humans. consent should not be presumed but obtained based on biomedical principles like autonomy, beneficence and justice (Prabhu, 2019). Further, religious beliefs should be respected as they form a critical part of any ethical and moral action in society.
Alternative Policies to Increase Availability of Donor Organs
The increasing availability of donor organs remains a challenge for the healthcare industries, even if one on board some of the policy alternatives discussed in research work by Munson and other researchers. While policies like Required Response Laws targeted mainly at drivers and Organ Protection before Consent model provide clear incentives for organ donation, they still raise ethical and even practice questions (Munson, 2017). For instance, the Organ Protection before Consent may lead to compromised care provision for individuals in ambulatory care so that their organs can be accessed, more critically without their consent (Munson, 2017). The best policy alternative is to enhance public awareness and education about the benefits of individuals accepting to donate their organs when they die, especially unexpected through accidents or other short illnesses. Public awareness from a utilitarian perspective may increase the readiness for one to donate their organs when they die.
Conclusion
Conscription policy on organ donation raises ethical and moral concerns and should not be implemented as it would amount to depriving the dead of their rights to their organs. The current policy of opting-in is sufficient despite the present shortage. The best way is to increase public awareness about the need to embrace organ donation when one dies as this will constitute consent and acceptance.
References
Levin, S. B. (2019). Why Organ Conscription Should Be off the Table: Extrapolation from
Heidegger’s Being and Time. Sophia, 58(2), 153-174.
https://doi.org/10.1007/s11841-017-0589-6
Lewis, A., Koukoura, A., Tsianos, G. I., Gargavanis, A. A., Nielsen, A. A., & Vassiliadis, E.
(2021). Organ donation in the US and Europe: The supply vs demand imbalance. Transplantation Reviews, 35(2), 100585. https://doi.org/10.1016/j.trre.2020.100585.
Munson, R. (2017). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston,
MA:Wadsworth
Prabhu, P. K. (2019). Is presumed consent an ethically acceptable way of obtaining organs for
transplant? Journal of the Intensive Care Society, 20(2), 92-97. https://doi.org/10.1177/1751143718777171
Rudge, C. J. (2018). Organ donation: opting in or opting out? The British Journal of General
Practice: The Journal of the Royal College of General Practitioners, 68(667), 62–63.
https://doi.org/10.3399/bjgp18X694445