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Assessment 3 Instructions: Analyzing a Current Health Care

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Assessment 3 Instructions: Analyzing a Current Health Care ... Course Navigation ? Janet Flynn Tutorials Support Log Out ? FACULTY 24 NEW Tiana SylvieBabers Akum COACH 1 ? Assessment 3 Instructions: Analyzing a Current Health Care Problem or Issue Write a 4-6-page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications. Introduction In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then you can analyze the problem and the people and systems it affects. You can examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem. Demonstration of Proficiency By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria: Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care. Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it. Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care. Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it. Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution. Competency 3: Apply ethical principles and academic standards to the study of health care. Analyze the ethical implications if a potential solution to a health care problem or issue was implemented. Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella's writing standards. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics. Write following APA style for in-text citations, quotes, and references. Instructions Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed. 1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976195_1 1/3 5/10/2021 Assessment 3 Instructions: Analyzing a Current Health Care ... Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2. Identify possible causes for the problem or issue. 2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it. Identify at least three scholarly or academic peer-reviewed journal articles about the topic. You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references. You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles. You may find the applicable Undergraduate Library Research Guide helpful in your search. Review the Think Critically About Source Quality to help you complete the following: Assess the credibility of the information sources. Assess the relevance of the information sources. 3. Analyze the health care problem or issue. Describe the setting or context for the problems or issues. Describe why the problem or issue is important to you. Identify groups of people affected by the problem or issue. Provide examples that support your analysis of the problem or issue. 4. Discuss potential solutions for the health care problem or issue. Describe what would be required to implement a solution. Describe potential consequences of ignoring the problem or issue. Provide the pros and cons for one of the solutions you are proposing. 5. Analyze the ethical implications if the potential solution (the one for which you provide pros and cons) were to be implemented. Provide examples from the literature to support the points you are making. Discuss the pros and cons of implementing the proposed solution from an ethical principle point of view. Describe what would be required to implement the proposed solution. Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: Assessment 3 Example [PDF]. Additional Requirements Your assessment should also meet the following requirements: Length: 4–6 typed, double-spaced pages, not including the title page and reference page. Font and font size: Times New Roman, 12 point. APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976195_1 2/3 5/10/2021 Assessment 3 Instructions: Analyzing a Current Health Care ... Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style. References: Integrate information from outside sources to include at least three scholarly or academic peerreviewed journal articles and three in-text citations within the paper. APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page. Organize your paper using the following structure and headings: Title page. A separate page. Introduction. A brief one-paragraph statement about the purpose of the paper. Elements of the problem/issue. Identify the elements of the problem or issue or question. Analysis. Analyze, define, and frame the problem or issue. Considering options. Consider solutions, responses, or answers. Solution. Choose a solution, response, or answer. Ethical implications. Ethical implications of implementing the solution. Implementation. Implementation of the potential solution. Conclusion. One paragraph. If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, do not hesitate to ask faculty or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions. SCORING GUIDE Use the scoring guide to understand how your assessment will be evaluated. VIEW SCORING GUIDE ? https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976195_1 3/3 5/10/2021 Resources: Evidence-Based Practice – NHS-FPX4000 - Apr ... Course Navigation ? Janet Flynn Tutorials Support Log Out ? FACULTY 24 NEW Tiana SylvieBabers Akum COACH 1 ? Resources: Evidence-Based Practice In health care, research is important. It helps you see what has worked and what has not worked effectively for wellness and patient care. It is important for you to explore research about evidenced-based practices in your areas of interest. This research will help you develop and demonstrate a professional health care perspective and expand your organizational, critical thinking, and problem-solving skills. Following resources provide information about evidence-based practice. Macias, C. G., Loveless, J. N., Jackson, A. N., & Srinivasan, S. (2017). Delivering value through evidence-based practice. Clinical Pediatric Emergency Medicine, 18(2), 89–97. Thomas, S. J. (2016). Does evidence-based health care have room for the self? Journal of Evaluation in Clinical Practice, 22(4), 502–508. Agency for Healthcare Research and Quality. (n.d.). EPC evidence-based reports. http://www.ahrq.gov/research/findings/evidence-based-reports/index.html https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976196_1 1/1 5/10/2021 Resources: Critical Thinking – NHS-FPX4000 - Apr 12 2021... Course Navigation ? Janet Flynn Tutorials Support Log Out ? FACULTY 24 NEW Tiana SylvieBabers Akum COACH 1 ? Resources: Critical Thinking How do you approach a situation within your organization and apply critical thinking skills to analyze it? What are the important skills you need for critical thinking? The following resources provide insights into critical thinking: Arli, S. K., Bakan, A. B., Ozturk, S., Erisik, E., & Yildirim, Z. (2017). Critical thinking and caring in nursing students. International Journal of Caring Sciences, 10(1), 471–478. Building Skills for Critical Thinking. Critical Thinking. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976197_1 1/1 5/10/2021 Course Navigation ? Activity: Socratic Problem-Solving Practice – ... Janet Flynn Tutorials Support Log Out ? FACULTY 24 NEW Tiana SylvieBabers Akum COACH 1 ? Activity: Socratic Problem-Solving Practice SOCRATIC PROBLEM-SOLVING PRACTICE Click the linked Socratic Problem-Solving Practice title above to walk through the steps of the Socratic problemsolving method. This learning activity is designed to support your understanding of the method. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_317897_1&content_id=_9976199_1 1/1 1 Applying Ethical Principles Learner’s Name Capella University NHS4000: Developing a Health Care Perspective Instructor Name August, 2020 Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 2 Applying Ethical Principles Health care professionals often face ethical problems during their practice that require them to use their moral values and principles when making decisions. The four fundamental principles of health care ethics—autonomy, beneficence, nonmaleficence, and justice—act as yardsticks for fair and ethical decision-making. These ethical principles are widely accepted in the field of health care. Medical practitioners and health care administrators often use these principles to make decisions when faced with complex situations involving patients. Overview of the Case Study Betsy is a dedicated pediatric nurse known for the care and concern she shows her patients. Her neighbor and friend, Alice, lives with her husband and 4-year-old daughter, Shirley. Alice and her husband are followers of Christian Science, a belief that advocates spiritual healing and discourages most types of medical intervention. One day, when visiting Alice and Shirley, Betsy sees Shirley experience what seems like a seizure. The child suddenly becomes unresponsive and has a brief staring spell, with her eyes rolling upward. The episode lasts for 20 seconds, during which she seems completely unaware of her surroundings. While Shirley is having the seizure, Alice sits by her side and prays but takes no other action. Betsy is concerned about the little girl’s condition and probes her friend for details. Alice tells Betsy that Shirley used to have around 15–20 such episodes a day until a few months ago; this has now reduced to about 12. Alice attributes the improvement in Shirley’s health to her prayers and faith. However, this does not help Betsy feel comfortable about Shirley’s condition. She is almost certain that Shirley has epilepsy, which, if not treated on time, could have profound health implications. At the very least, she thinks Alice should have Shirley’s symptoms accurately diagnosed. Understanding the gravity of the situation, Betsy sets up a meeting with Shirley’s parents and Dr. Campbell, director of the neurology department at her hospital. She treats this meeting as Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 3 an intervention, and both she and Dr. Campbell express their concern for Shirley’s health. They stress on the fact that the improvement in Shirley’s symptoms does not necessarily mean she will be cured. They empathize with Alice and her husband’s reluctance on account of their religious faith but reiterate the importance of getting Shirley’s symptoms diagnosed. To prove their point, they present studies that describe how seizures can be indicative of illnesses such as epilepsy, which could negatively affect her cognition and behavior. Shirley’s parents are grateful that Betsy and Dr. Campbell are concerned about their daughter’s health but remain resolute about going against their faith. They believe that prayer will cure her. Betsy is faced with an ethical dilemma of whether she should respect the parents’ religious beliefs and not intervene in the matter or perform her moral obligation as a health care professional. Analysis of Ethical Issues in the Case Study In the case study, the main factor that led to Betsy’s ethical dilemma is Shirley’s parents’ refusal of medical assistance for their daughter owing to their Christian Science beliefs. When Betsy notices Shirley’s seizures, she thinks it is her duty to make sure Shirley receives medical attention. As she respects the religious faith and belief of Shirley’s parents, she decides to explain the risks that seizures could involve. She also includes Dr. Campbell in the conversation so that he could provide an objective opinion to make them understand the need for medical intervention. However, Shirley’s parents are certain that prayer will cure her seizures. Considering that their attitude could result in serious health implication for Shirley, Betsy is concerned about the little girl receiving appropriate medical attention (Baumrucker, et al., 2017). Using the Ethical Decision-Making Model to Analyze the Case Study The three components of the ethical decision-making model—moral awareness, moral judgment, and ethical behavior—can help analyze the ethical issue outlined in the case study. Whereas moral awareness is knowledge of the existence of an ethical dilemma, moral judgment Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 4 involves choosing between the right and wrong actions when posed with such a dilemma. Both moral awareness and moral judgment lead to ethical behavior. Ethical behavior is taking the right action to resolve a dilemma. Betsy’s moral awareness is reflected by the fact that she recognizes the circumstances surrounding Shirley’s condition. Her moral judgment is reflected by her decision to try to convince Shirley’s parents to get Shirley medical help because she believed that it was the right thing to do. Betsy’s ethical behavior constitutes the action she takes to resolve the dilemma. This, in turn, depends on her personal judgment and the four principles of health care ethics (autonomy, beneficence, nonmaleficence, and justice) she should abide by as a health care professional. Effectiveness of Communication Approaches in the Case Study Listening plays an important role in patient–physician communication. By listening to Alice, Betsy learns of the frequency of Shirley’s seizures and the reduction in their occurrence. She also learns that Alice and her husband believe that this reduction is due to their prayers and faith in Christian Science. Therefore, active listening helps Betsy understand the situation better. Betsy is aware that if she decides to get medical help for Shirley without the consent of Shirley’s parents, she would be violating their right to informed consent and overstepping her boundaries as a health care professional. So, she decides to present them with the information they need to make an informed decision. She maintains an open communication with Shirley’s parents while explaining the impact of seizures on their daughter’s health. She stresses the importance of immediate diagnosis of Shirley’s seizures. Thus, by being respectful of Shirley’s parents’ emotions and providing them with complete information about the problem, Betsy communicates the situation to them in an effective manner. During the discussion with Shirley’s parents, both Betsy and Dr. Campbell are empathetic toward Alice and her husband’s reluctance to get the necessary medical help for their Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 5 daughter on account of their religious faith. Betsy seems to have involved Dr. Campbell so that he could share his objective expert opinion based on his experience in dealing with patients who have similar symptoms. She probably thought that Shirley’s parents would change their decision if Dr. Campbell reiterated that Shirley could develop severe cognitive problems (such as learning difficulties and memory deficits) or behavioral problems (such as irritability, anxiety, hyperactivity, and mood swings) if her seizures are neglected. However, they were unable to convince Shirley’s parents to get Shirley medically diagnosed. Although Betsy followed a systematic approach while dealing with the issue at hand, it seems to have been ineffective as Shirley’s parents continued to stand by their faith in prayer. However, listening patiently to patients’ problems and showing empathy and genuine care while communicating with them are some lessons that health care professionals can take back from this case study. Resolving the Ethical Dilemma by Applying Ethical Principles The four ethical principles of autonomy, beneficence, nonmaleficence, and justice are often employed to resolve ethical dilemmas related to health care. Autonomy refers to accepting and understanding patients’ values, beneficence refers to acting for the welfare of patients, nonmaleficence refers to not doing harm to the patient, and justice refers to treating patients fairly without bias. The ethical dilemma that Betsy faces in this case involves three of the four basic principles of medical ethics. In the case study, the ethical dilemma is caused by the conflict between the principles of autonomy on the one hand and beneficence and nonmaleficence on the other. Betsy preserves the autonomy of Shirley’s parents by respecting their religious beliefs and not coercing them to get the girl correctly diagnosed. She further ropes in Dr. Campbell to try to explain to them the importance of getting an accurate diagnosis. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 6 Approaching Child Protective Services—a social service agency run by the government to counsel and support children and their families and promote child welfare—could be considered by Betsy as an ethical means to resolve the dilemma. As Betsy is obligated to help Shirley get medical care (beneficence) and prevent any harm that might be caused from ignoring her seizures (nonmaleficence), she could seek intervention from Child Protective Services. Although involving Child Protective Services could result in overriding the ethical principle of autonomy, Betsy might have to take this decision keeping Shirley’s best interests in mind (Baumrucker et al., 2017). Conclusion The four principles of health care ethics can be applied by health care professionals to analyze and resolve ethical dilemmas. In the case study, Betsy has to decide between respecting Shirley’s parents’ religious beliefs and performing her moral obligation as a health care professional by helping Shirley seek medical care. The proposed solution involves upholding the principles of autonomy, beneficence, and nonmaleficence to resolve Betsy’s ethical dilemma. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 7 References Baumrucker, S. J., Easterday, J., Stolick, M., McCall-Burton, M., Adkins, R. W., Winiger, D., & Cook, C. (2017). Ethics roundtable: Parental autonomy and the minor patient. American Journal of Hospice & Palliative Medicine, 34(3), 287–292. http://journals.sagepub.com.library.capella.edu/doi/pdf/10.1177/1049909115608812 Capella University (2018). NHS-FP4000 Exemplar Sample Ethical Case Study. Capella Website: xxx. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 1 Applying Ethical Principles Learner’s Name Capella University NHS4000: Developing a Health Care Perspective Instructor Name August, 2020 Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 2 Applying Ethical Principles Health care professionals often face ethical problems during their practice that require them to use their moral values and principles when making decisions. The four fundamental principles of health care ethics—autonomy, beneficence, nonmaleficence, and justice—act as yardsticks for fair and ethical decision-making. These ethical principles are widely accepted in the field of health care. Medical practitioners and health care administrators often use these principles to make decisions when faced with complex situations involving patients. Overview of the Case Study Betsy is a dedicated pediatric nurse known for the care and concern she shows her patients. Her neighbor and friend, Alice, lives with her husband and 4-year-old daughter, Shirley. Alice and her husband are followers of Christian Science, a belief that advocates spiritual healing and discourages most types of medical intervention. One day, when visiting Alice and Shirley, Betsy sees Shirley experience what seems like a seizure. The child suddenly becomes unresponsive and has a brief staring spell, with her eyes rolling upward. The episode lasts for 20 seconds, during which she seems completely unaware of her surroundings. While Shirley is having the seizure, Alice sits by her side and prays but takes no other action. Betsy is concerned about the little girl’s condition and probes her friend for details. Alice tells Betsy that Shirley used to have around 15–20 such episodes a day until a few months ago; this has now reduced to about 12. Alice attributes the improvement in Shirley’s health to her prayers and faith. However, this does not help Betsy feel comfortable about Shirley’s condition. She is almost certain that Shirley has epilepsy, which, if not treated on time, could have profound health implications. At the very least, she thinks Alice should have Shirley’s symptoms accurately diagnosed. Understanding the gravity of the situation, Betsy sets up a meeting with Shirley’s parents and Dr. Campbell, director of the neurology department at her hospital. She treats this meeting as Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 3 an intervention, and both she and Dr. Campbell express their concern for Shirley’s health. They stress on the fact that the improvement in Shirley’s symptoms does not necessarily mean she will be cured. They empathize with Alice and her husband’s reluctance on account of their religious faith but reiterate the importance of getting Shirley’s symptoms diagnosed. To prove their point, they present studies that describe how seizures can be indicative of illnesses such as epilepsy, which could negatively affect her cognition and behavior. Shirley’s parents are grateful that Betsy and Dr. Campbell are concerned about their daughter’s health but remain resolute about going against their faith. They believe that prayer will cure her. Betsy is faced with an ethical dilemma of whether she should respect the parents’ religious beliefs and not intervene in the matter or perform her moral obligation as a health care professional. Analysis of Ethical Issues in the Case Study In the case study, the main factor that led to Betsy’s ethical dilemma is Shirley’s parents’ refusal of medical assistance for their daughter owing to their Christian Science beliefs. When Betsy notices Shirley’s seizures, she thinks it is her duty to make sure Shirley receives medical attention. As she respects the religious faith and belief of Shirley’s parents, she decides to explain the risks that seizures could involve. She also includes Dr. Campbell in the conversation so that he could provide an objective opinion to make them understand the need for medical intervention. However, Shirley’s parents are certain that prayer will cure her seizures. Considering that their attitude could result in serious health implication for Shirley, Betsy is concerned about the little girl receiving appropriate medical attention (Baumrucker, et al., 2017). Using the Ethical Decision-Making Model to Analyze the Case Study The three components of the ethical decision-making model—moral awareness, moral judgment, and ethical behavior—can help analyze the ethical issue outlined in the case study. Whereas moral awareness is knowledge of the existence of an ethical dilemma, moral judgment Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 4 involves choosing between the right and wrong actions when posed with such a dilemma. Both moral awareness and moral judgment lead to ethical behavior. Ethical behavior is taking the right action to resolve a dilemma. Betsy’s moral awareness is reflected by the fact that she recognizes the circumstances surrounding Shirley’s condition. Her moral judgment is reflected by her decision to try to convince Shirley’s parents to get Shirley medical help because she believed that it was the right thing to do. Betsy’s ethical behavior constitutes the action she takes to resolve the dilemma. This, in turn, depends on her personal judgment and the four principles of health care ethics (autonomy, beneficence, nonmaleficence, and justice) she should abide by as a health care professional. Effectiveness of Communication Approaches in the Case Study Listening plays an important role in patient–physician communication. By listening to Alice, Betsy learns of the frequency of Shirley’s seizures and the reduction in their occurrence. She also learns that Alice and her husband believe that this reduction is due to their prayers and faith in Christian Science. Therefore, active listening helps Betsy understand the situation better. Betsy is aware that if she decides to get medical help for Shirley without the consent of Shirley’s parents, she would be violating their right to informed consent and overstepping her boundaries as a health care professional. So, she decides to present them with the information they need to make an informed decision. She maintains an open communication with Shirley’s parents while explaining the impact of seizures on their daughter’s health. She stresses the importance of immediate diagnosis of Shirley’s seizures. Thus, by being respectful of Shirley’s parents’ emotions and providing them with complete information about the problem, Betsy communicates the situation to them in an effective manner. During the discussion with Shirley’s parents, both Betsy and Dr. Campbell are empathetic toward Alice and her husband’s reluctance to get the necessary medical help for their Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 5 daughter on account of their religious faith. Betsy seems to have involved Dr. Campbell so that he could share his objective expert opinion based on his experience in dealing with patients who have similar symptoms. She probably thought that Shirley’s parents would change their decision if Dr. Campbell reiterated that Shirley could develop severe cognitive problems (such as learning difficulties and memory deficits) or behavioral problems (such as irritability, anxiety, hyperactivity, and mood swings) if her seizures are neglected. However, they were unable to convince Shirley’s parents to get Shirley medically diagnosed. Although Betsy followed a systematic approach while dealing with the issue at hand, it seems to have been ineffective as Shirley’s parents continued to stand by their faith in prayer. However, listening patiently to patients’ problems and showing empathy and genuine care while communicating with them are some lessons that health care professionals can take back from this case study. Resolving the Ethical Dilemma by Applying Ethical Principles The four ethical principles of autonomy, beneficence, nonmaleficence, and justice are often employed to resolve ethical dilemmas related to health care. Autonomy refers to accepting and understanding patients’ values, beneficence refers to acting for the welfare of patients, nonmaleficence refers to not doing harm to the patient, and justice refers to treating patients fairly without bias. The ethical dilemma that Betsy faces in this case involves three of the four basic principles of medical ethics. In the case study, the ethical dilemma is caused by the conflict between the principles of autonomy on the one hand and beneficence and nonmaleficence on the other. Betsy preserves the autonomy of Shirley’s parents by respecting their religious beliefs and not coercing them to get the girl correctly diagnosed. She further ropes in Dr. Campbell to try to explain to them the importance of getting an accurate diagnosis. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 6 Approaching Child Protective Services—a social service agency run by the government to counsel and support children and their families and promote child welfare—could be considered by Betsy as an ethical means to resolve the dilemma. As Betsy is obligated to help Shirley get medical care (beneficence) and prevent any harm that might be caused from ignoring her seizures (nonmaleficence), she could seek intervention from Child Protective Services. Although involving Child Protective Services could result in overriding the ethical principle of autonomy, Betsy might have to take this decision keeping Shirley’s best interests in mind (Baumrucker et al., 2017). Conclusion The four principles of health care ethics can be applied by health care professionals to analyze and resolve ethical dilemmas. In the case study, Betsy has to decide between respecting Shirley’s parents’ religious beliefs and performing her moral obligation as a health care professional by helping Shirley seek medical care. The proposed solution involves upholding the principles of autonomy, beneficence, and nonmaleficence to resolve Betsy’s ethical dilemma. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 7 References Baumrucker, S. J., Easterday, J., Stolick, M., McCall-Burton, M., Adkins, R. W., Winiger, D., & Cook, C. (2017). Ethics roundtable: Parental autonomy and the minor patient. American Journal of Hospice & Palliative Medicine, 34(3), 287–292. http://journals.sagepub.com.library.capella.edu/doi/pdf/10.1177/1049909115608812 Capella University (2018). NHS-FP4000 Exemplar Sample Ethical Case Study. Capella Website: xxx. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 1 Analyze a Current Health Care Problem or Issue Learner’s Name Capella University NHS4000: Developing a Health Care Perspective Instructor Name August, 2020 Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 2 Analyze a Current Health Care Problem or Issue Patient safety, as discussed in the previous assessment, is an important element of quality health care. This assessment will expand upon patient safety issues that occur when patients are exposed to inadvertent harm or injury while receiving medical care. Health care organizations should maintain and develop a safety culture to prevent patient safety issues. Patient safety culture is defined as a system that promotes safety by shared organizational values of what is important and beliefs about how things work. It also encompasses how these values and beliefs interact with the work unit, organizational structures, and systems to produce behavioral norms (Ulrich & Kear, 2014). As such, care should be taken to improve the infrastructure of health care organizations. Improving patient safety should be discussed and addressed by every individual associated with public health care. Elements of the Problem/Issue Research shows that while getting treated at health care organizations, patients might be at risk of experiencing the harm or injuries associated with medical care. The most likely causes of patient safety issues are preventable adverse events, which are adverse events attributable to error. These errors can be classified as diagnostic errors, contextual errors, and communication errors (Ulrich & Kear, 2014). Diagnostic errors take place when health care professionals provide a wrong or delayed diagnosis or no diagnosis at all (James, 2013). An example of a wrong diagnosis is a health care professional diagnosing a patient with gastric troubles when the patient is actually experiencing a heart attack. An example of a delayed diagnosis is a patient not being notified of an abnormal chest X-ray, thereby delaying diagnosis of a serious medical condition. An example of a missed diagnosis is a patient not being diagnosed with heart failure despite warning symptoms. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 3 Contextual errors occur when health care professionals fail to consider their patients’ personal or psychological limitations while planning appropriate care for them. An example is a health care professional’s failure to recognize that basic follow-up discharge instructions may not be understood by patients with cognitive disabilities (James, 2013). It is important for health care professionals to be aware of their patients’ mental and physical abilities before they formulate a plan of care. Communication errors occur when there is miscommunication or lack of communication between health care professionals and patients (James, 2013). They can cause severe harm to patients. An example of this is a nurse failing to tell a surgeon that a patient experienced abdominal pain and had a drop in red blood cell count after an operation, resulting in the death of the patient due to severe internal bleeding. Limited health care knowledge; language barriers; and auditory, visual, and speech disabilities could also lead to communication errors and cause safety issues. Analysis As a medical transcriptionist, it is important for me to be aware of potential transcription errors and privacy standards, which affect patient safety. Errors like these pose dangerous risks; therefore, it is necessary to have an overall quality evaluation of the transcribed documents. Also, I must ensure that serious difficulties in transcription resulting from poor-quality voice files are reported immediately to the manager, who will then convey this to the health care professionals involved in the process. This will help ensure that patient safety is not compromised. Context for Patient Safety Issues With the advancement of medical technology, health care processes have become extremely complex. Health care professionals are required to stay up to date with a lot of new Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 4 knowledge and innovations obtained from research. This often overburdens them as there is a need to apply the learning from research in their practice. Also, at the individual level, there is a dearth of well-balanced continuing education programs, which has resulted in a lack of attention to patient safety among health care professionals. At the system level, organizations fail to deliver optimum health care as a result of being understaffed, an inability to provide appropriate technology, and ineffective execution of patient care transfer (James, 2013). Overcrowding and understaffing delays initiation of treatment and puts critically ill patients at significant risk. All of these factors contribute to a rise in patient safety issues. Populations Affected by Patient Safety Issues Patients with a psychiatric history are also a vulnerable group of people who face patient safety issues because their psychiatric records are often combined with their current symptoms. Patients with a documented history of psychiatric illness may avoid seeking health care services as they feel that their care will be based on their past record of illnesses and not their present needs. Therefore, psychotherapists should implement measures such that their psychiatric data is concealed from their medical records before it is shared with the third party, which helps protect patients’ confidentiality (Shenoy & Appel, 2017). Considering Options Patient safety in hospitals can be achieved by creating a culture of safety that involves effective communication, correct managerial leadership styles, and the use of Electronic Health Records (EHRs). Effective communication while passing patient-specific information from one health care professional to another is essential in ensuring continuous and safe patient care. Training the team could likely improve consistent successful communication and help prevent errors. Standardizing critical content that needs to be communicated by the initial health care professional ensures safe transfer of care (Farmer, 2016). Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 5 It is essential for leadership teams to adopt organizational strategies that would improve patient safety and transform their organizations into reliable systems for enhanced patient satisfaction. They should set strategic safety goals, which could include adhering to standards of health, assessing quality, using patient satisfaction reviews, and analyzing adverse event reports to determine improvement in safety issues (Parand et al., 2014). An EHR is another potential solution to prevent patient safety issues. It is a digital record of a patient’s medical information that includes history, physical examination, investigations, and treatment (Ozair et al., 2015). It helps manage multiple processes in the complex health care system and prevents errors. EHRs utilize less storage space compared to paper documentation and allow an infinite number of records to be stored. In addition to being cost-effective and preventing a loss of records, EHRs help conduct research activities and provide quick data transfer (Ozair et al., 2015). Solution In health care, because transmission of information takes place among different people and electronic devices, there is a high likelihood of errors occurring. For example, transcription errors (which occur due to poor audio quality or the lack of a quality evaluation process) can be prevented by using recording equipment with good sound quality and by maintaining proofreading and quality checks. However, integrating transcription processes with the HER system helps prevent errors, helps access the required information faster, and allows health care professionals to take accurate decisions about patients’ care. Implementation An EHR is an important mechanism for improving patient safety. Its advancement has made it a viable option to prevent medical errors. However, the use of EHRs has certain ethical implications such as security violation, data inaccuracies, lack of privacy and confidentiality, and Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 6 challenges during system implementation. Security violation takes place when patients’ confidential health information is accessible to others without their permission. To avoid security violation, data should not only be password protected but also encrypted to restrict access to unauthorized individuals. Firewalls and antivirus software should be used to protect data (Ozair et al., 2015). Though EHRs improve patient safety by reducing medical errors, data inaccuracies are increasing. Loss of data during data transfer leads to inaccuracies that affect decision-making related to patient care. A problem of concern related to data inaccuracy is medical identity theft, which leads to incorrect information being filed into a person’s medical record, which in turn leads to insurance fraud and wrong billing (Ozair et al., 2015). In health care, information that is shared during physician–patient interactions should be kept confidential and should be made inaccessible to unauthorized individuals. Enabling rolebased access controls based on user credentials will restrict access to the EHR system to authorized users. The user should also be made aware that he or she is responsible for any information that he or she misuses (Ozair et al., 2015). As EHR is a complex software, there is a high likelihood that software failure may result in inaccurate recordings of patients’ data. Therefore, EHR system implementation may have ethical implications due to the violation of data integrity (Ozair et al., 2015). EHRs can safeguard patient confidentiality by using various methods that prevent security breaches. In addition to this, creating reminders that ask for a confirmation before accessing confidential information can help protect data. A nesting system could be developed, which would allow, for example, a health care professional from a specific specialty clinic to access patient records by signing into the specialty domain (Shenoy & Appel, 2017). These methods will enable the safe and efficient use of EHRs and ensure patient safety. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 7 Conclusion Patient safety involves preventing the risk of harm or injuries to patients by establishing a safety culture and providing high-quality medical care. Health care organizations must understand patient safety issues and find solutions for these issues by designing systems that prevent errors from occurring. Potential solutions include effective communication, changes in leadership style, and the use of EHRs. The ethical implications of these solutions should be considered before implementing them in a health care setting. It is also important that health care professionals undergo continuous education and effective training, provide appropriate medical care, prevent errors, and follow safety practices to improve clinical outcomes. Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 8 References Farmer, B. M. (2016). Patient safety in the emergency department. Emergency Medicine, 48(9), 396–404. https://mdedge.com/emed-journal/article/113659/trauma/patient-safetyemergency-department Flood, B. (2017). Safety of people with intellectual disabilities in hospital. What can the hospital pharmacist do to improve quality of care? Pharmacy, 5(3). https://ncbi.nlm.nih.gov/pmc/articles/PMC5622356/ James, J. T. (2013). A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety, 9(3), 122–128. http://dx.doi.org/10.1097/PTS.0b013e3182948a69 Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in Clinical Research, 6(2), 73–76. http://dx.doi.org/10.4103/2229-3485.153997 Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality and patient safety: A systematic review. BMJ Open, 4(9). http://dx.doi.org/10.1136/bmjopen-2014-005055 Shenoy, A., & Appel, J. M. (2017, April). Safeguarding confidentiality in electronic health records. Cambridge Quarterly of Healthcare Ethics, 26(2), 337–341. https://searchproquest-com.library.capella.edu/docview/1882434628?pqorigsite=summon&https://library.capella.edu/login?url=accountid=27965 Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of excellent health care delivery. Nephrology Nursing Journal, 41(5), 447–456, 505. https://searchproquest- Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 9 com.library.capella.edu/docview/1617932572/fulltextPDF/1486CC30B3624B3CPQ/1?ac countid=27965 Copyright ©2020 Capella University. Copy and distribution of this document are prohibited. 1 Medication Errors Student’s Name Institutional Affiliation Professor’s Name Course Number Date 2 Introduction Medication errors are any preventable activities that may result in the patient being harmed due to inappropriate medication, yet the medication is under the control of the healthcare professional. Research of medication errors provides a significant basis through which these errors can be addressed, and the patients' safety is dealt with by reviewing the roles of the healthcare personnel. Medication errors occur among healthcare professionals due to fatigue, human error, user errors, and lack of experience. All these causes have a solution; however, errors in the medical field cannot be completely erased. Measures can be put in place to minimize the possibility of these adverse mistakes occurring. To promote a culture of safety within the healthcare facilities, a study on medication errors would provide a foundation through which various interventions can be developed. Di, S. E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D., & Di, M. M. (May 01, 2018). Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian Journal of Critical Care Medicine, 22, 5, 346-352. The study's main purpose was to determine the impact of nurse’s behavior, attitude, training needs, and knowledge to prevent medication errors in the emergency department. Errors in the medication occur frequently in the emergency unit due to the high number of patients needing urgent care, and these patients need drugs frequently. This article is very relevant given that there are many errors in the emergency department caused by several factors. Findings from the study highlight that to reduce the medication errors in the emergency unit, it is vital to invest in training programs for the nurses and provide further education on how to deal with these errors. Education shall expand their knowledge of critical care patients and minimize the possibility of these people dying in the emergency section. 3 Statistical findings showcase that nurses in the critical care unit, regardless of their experience, need regular awareness and education to inform them how to prevent medication errors. I found that lack of knowledge, poor attitude and inadequate training contribute heavily to nurses making errors. Addressing these needs a collaborative effort from the hospital management to ensure that health professionals are equipped with all they need to provide quality services. Donaldson, L. J., Kelley, E. T., Dhingra-Kumar, N., Kieny, M.-P., & Sheikh, A. (April 29, 2017). Medication Without Harm: WHO's Third Global Patient Safety Challenge. The Lancet, 389, 10080, 1680-1681. In almost 60years, medication errors are still a challenge that continues to cause harm to the safety of patients worldwide. Given that this is a global phenomenon, this paper sought to minimize this harm by recommending four areas that would be of use to medical professionals today. These four areas include working environment, written communication, training, education, and medical procedures. These recommendations from the policy paper are relevant because these areas are part of systematic challenges that result in the healthcare professional making these mistakes. Besides these recommendations in the article, it is evident that the health leaders, regulators, and healthcare practitioners must become more determined to minimize these errors through facilitating training and regularly educating the healthcare providers. I learned from the source tat medication errors have been a huge challenge for many years and the systemic challenges still persist to date. Findings from the source shows that medication errors can only be eliminated through a continuous process of improving health systems. 4 Elliott, R., Camacho, E., Campbell, F., Jankovic, D., St James, M. M., Kaltenthaler, E., ... & Faria, R. (2018). Prevalence and economic burden of medication errors in the NHS in England. Rapid evidence synthesis and economic analysis of the prevalence and burden of medication error in the UK. The article's main objective is to use public error rates to estimate the number of medication errors in primary care homes and secondary care in England. It also sought to understand the number of errors that would cause harm to the patients and cause a burden in terms of costs to the healthcare systems. This source is relevant because it revealed that errors mostly occur in primary care homes, care homes, and secondary care in England. Among the errors identified, a huge percentage was considered minimal harm while a small percentage contributed to moderate and severe harm. Understanding these common errors from prescribing to administration errors can be crucial in ensuring that they are avoided. Given that these errors can burden victims, it provides the important reason why nurses and other health professionals are needed to be diligent when caring for patients. I learned from the source that medication not only hamper the safety of the patients but also burdens them economically. Knowledge from this source will provide insights on how these burdens resulting from medication errors impacts on the quality of health and their future. Johnson, M., Sanchez, P., Langdon, R., Manias, E., Levett-Jones, T., Weidemann, G., Aguilar, V., Everett, B. (January 01, 2017). The impact of interruptions on medication errors in hospitals: an observational study of nurses. Journal of Nursing Management, 25, 7, 498-507. 5 The major purpose of the study was to explore the interruption that medical professionals face from medication preparation to administration and their effects. Findings from the study highlighted that interruptions frequently occur in the hospital, and these consequences are mostly medication errors that jeopardize the safety of the patients. The many procedures present mainly cause part of these interruptions within the respective hospitals. Doctors, for instance, are regularly interrupted by the nurses on other matters happening within the hospital, some of which are not even related to patient care. This frequent confusion of the nurses contributed to procedural failures and resulted in clinical errors. I found the source relevant because it confirmed that nurses face frequent clinical errors and procedurals failures that cause medication errors. I also learned that hospitals need to continue focusing on identifying ways to minimize the challenges nurses face, including educating nurses on how to avoid these mistakes. Procedures and other systems within the hospitals need to be reduced to minimize the possibility of interruptions that could be costly to patients. Lapkin, S., Levett-Jones, T., Chenoweth, L., Johnson, M., & Johnson, M. (October 01, 2016). The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of Nursing Management, 24, 7, 845-858. The purpose of the study was to determine how effective interventions were put in place to improve patient safety by reducing medication errors using data from systematic reviews. Despite various interventions to deal with medication errors, there are still massive administration cases within the various hospitals. Reviews of these interventions highlight that errors are still high, showing that these interventions have not adequately addressed the issue. A 6 study on the ten electronic databases by independent reviewers highlighted that six of the databases needed to be revamped and new strategies employed, such as using bar code technology to minimize medication errors. I found the source useful because it offers insights into the challenges that make various medication errors ineffective. Information of this nature would be crucial in ensuring that effective intervention methods are created, and the chances of medication errors are addressed. I also learned that interventions alone cannot eliminated medication errors and that constant changes needs to be done to minimize the occurrences of these errors. Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2021). Medication Dispensing Errors and Prevention. In StatPearls. StatPearls Publishing. The study's main objectives were to identify the most common medication errors, identify points where errors are most likely to occur, and outline strategies for preventing medication errors. With many prescriptions being given within the country, it is most likely that practitioners make mistakes when prescribing drugs; this study is relevant in ensuring that people do not lose trust in the healthcare systems and the deaths are minimized. In the United States, medical errors are a common cause of death among people even though healthcare professionals work hard to ensure that the citizens get quality healthcare. Huge demand for healthcare services is one reason why the chances of committing errors are high. The increased chances of errors within the healthcare system are due to the presence of systemic problems. Even though healthcare professionals commit these errors, they do so because healthcare has not been modified to address these issues. However, practitioners at all-time are needed to observe due diligence to prevent an error resulting in adverse drug events. Summary of what I learned 7 In preparing this annotated bibliography, there a number of things that I learned. These include: • When preparing an annotated bibliography, one needs to have several intellectual skills including informed library research and concise exposition • One also needs to locate different books, articles or periodicals which contain information about his or her topic. • One also needs to choose those articles or books that give different perspectives on the topic. The main contributions of the sources I chose is that they helped me in understanding how medication errors can be prevented by putting in place certain interventions. The sources also revealed that errors mostly occur in primary care homes, care homes, and secondary care. These sources enhanced my knowledge about this topic because I was able to learn that systemic challenges are the key reasons for medication errors and that modification is needed to deal with these challenges. 8 References Di, S. E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D., & Di, M. M. (May 01, 2018). Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian Journal of Critical Care Medicine, 22, 5, 346-352. Donaldson, L. J., Kelley, E. T., Dhingra-Kumar, N., Kieny, M.-P., & Sheikh, A. (April 29, 2017). Medication Without Harm: WHO's Third Global Patient Safety Challenge. The Lancet, 389, 10080, 1680-1681. Elliott, R., Camacho, E., Campbell, F., Jankovic, D., St James, M. M., Kaltenthaler, E., ... & Faria, R. (2018). Prevalence and economic burden of medication errors in the NHS in England. Rapid evidence synthesis and economic analysis of the prevalence and burden of medication error in the UK. Johnson, M., Sanchez, P., Langdon, R., Manias, E., Levett-Jones, T., Weidemann, G., Aguilar, V., ... Everett, B. (January 01, 2017). The impact of interruptions on medication errors in hospitals: an observational study of nurses. Journal of Nursing Management, 25, 7, 498507. Lapkin, S., Levett-Jones, T., Chenoweth, L., Johnson, M., & Johnson, M. (October 01, 2016). The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of Nursing Management, 24, 7, 845-858. Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2021). Medication Dispensing Errors and Prevention. In StatPearls. StatPearls Publishing.