Assignment #1

[Name of Student]

[Name of Professor]

[Name of Class]

[Day Month Year]

The Difference between Japanese the US and Healthcare System

The Japanese healthcare system is much more comprehensive for its citizens and universal in the system than that of the US. By this, it means it provides care for all citizen with relatively low cost and few appointment requirements. Moreover, the non-citizens can apply for national health insurance programs if they have lived for one year in Japan. Generally, the US healthcare system covers fewer services such as dental care, basic preventive services are readily available in Japan. While services for example magnetic imaging scans and blood tests are comparatively inexpensive and easy to get. In Japan, one has to pay $100 for an MRI neck scan comparing with $1,200 in the US. In the US, millions of people have no access to healthcare while in Japan citizens can walk into a doctor's clinic when they required. On the other hand, life expectancy in Japan is over four years greater than that of the US because it stresses preventive medicine.

Assignment 1

Assignment 1

Name

[Institutional Affiliation(s)]

Author Note

Assignment 1

Medical insurance companies have to observe policies for their services to be available to their clients. Ethically, a doctor has to report to the insurance company after a complete examination of the person regarding their condition. It is also essential for them to report whether the person meets the qualification criteria to avail of the health insurance plan or not. Dr. M. has to report to the health insurance company regarding the health status of Dr. J. After a complete examination, he came to know that his friend, Dr. J. does not meet the qualification criteria to avail of the health insurance plans.

There are two options for Dr. M. first, in fulfillment of his duties, he has to report to the health insurance company regarding the actual status of the client. In such circumstances, his friend's family would have to go through a financial crisis and the care plans and treatment would be very expensive for him to manage. Second, he has to help his friend, in this regard, he has to keep this a secret between them and has to violate the duties assigned to him. Preferably, he would have to report the actual status of the client to the health insurance company. In this way, he would follow the ethics, values, and rules of the insurance company and his duty obediently.

In a given scenario, if it would be a situation for me, then I would prefer the needs of my friend. Ethically, providing an opportunity for someone to take the facilities of healthcare is a good deed. Therefore, helping my friend in his financial crisis situation would be my preference in this given scenario. I have not experienced such a situation before, however, I would suggest that ethics and values are equally important but to take care of your friends, particularly their health, is also important. Health is the basic human right therefore, helping Dr. J. would give me an inner satisfaction.

Ethical standards are designed in the healthcare profession to implement safe and secure policies for clients and healthcare providers. Health insurance companies offer certain plans and packages for their clients and they usually charge high prices to their non-registered organizations and individuals. Respecting patient's autonomy is an essential principle of healthcare services; therefore, the client is important rather than a company or organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a28k9e994so","properties":{"formattedCitation":"(Santoro, 2019)","plainCitation":"(Santoro, 2019)"},"citationItems":[{"id":1154,"uris":["http://zotero.org/users/local/p8kwKNoG/items/MYGJFK7Y"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/MYGJFK7Y"],"itemData":{"id":1154,"type":"article-journal","title":"The Ethics of Insurance Industry Step Therapy Policies: A Medical Profession Ethics Approach","container-title":"Business and Professional Ethics Journal","page":"339-351","volume":"38","issue":"3","author":[{"family":"Santoro","given":"Michael A."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Santoro, 2019). Following the rule of justice, I would have to prefer my job and assigned duty and have to accurately report to the company, regarding the condition of my client. Whereas healthcare providers follow the principles of delivery of healthcare services irrespective of their financial conditions. Therefore, being a doctor, the health of my client is important when compared to the rules of the health insurance company.

I would have another option which is, to provide a certificate to the company with the accurate condition of my client, and request them to offer healthcare services. In this case, obligations of the duty would be fulfilled however, if the company would reject the insurance plan, then it would be difficult for the client to manage his health in financial crises. Since the first decision is more appropriate and morally good, so, I would offer a helping hand to my friend in a sense by hiding his actual reports. In this way, he would be able to take the opportunities and plans of the Health Insurance Company to avail of their healthcare services. I have learned that ethics and values are important in the delivery of healthcare services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1pcf7shtg1","properties":{"formattedCitation":"(Bourdette et al., 2016)","plainCitation":"(Bourdette et al., 2016)"},"citationItems":[{"id":1155,"uris":["http://zotero.org/users/local/p8kwKNoG/items/CSRPIV6Q"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/CSRPIV6Q"],"itemData":{"id":1155,"type":"article-journal","title":"Practices of US health insurance companies concerning MS therapies interfere with shared decision-making and harm patients","container-title":"Neurology: Clinical Practice","page":"177-182","volume":"6","issue":"2","author":[{"family":"Bourdette","given":"Dennis N."},{"family":"Hartung","given":"Daniel M."},{"family":"Whitham","given":"Ruth H."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bourdette et al., 2016). Morally, obligations of the duty come first but it is equally important to take care of the patient's needs.

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Bourdette, D. N., Hartung, D. M., & Whitham, R. H. (2016). Practices of US health insurance companies concerning MS therapies interfere with shared decision-making and harm patients. Neurology: Clinical Practice, 6(2), 177–182.

Santoro, M. A. (2019). The Ethics of Insurance Industry Step Therapy Policies: A Medical Profession Ethics Approach. Business and Professional Ethics Journal, 38(3), 339–351.

Assignment 1: Health Policy And Law Basics

Health Policy and Law Basics

[Name of the Writer]

[Name of the Institution]

Health Policy And Law Basics

Introduction

I would be using “Free Market Perspective” for opening a new ambulatory care center in my city.

Example I

Free Market Perspective in opening an ambulatory center will be highly economical and a better source of attention because I would be using innovation and the trends that are highly recommended and required within the market. I will introduce the avenues on the basis of the analysis of the drawbacks of the other ambulatory centers within my city. It will attract not only a majority of people, but it will direct me in future about the management and the planning to facilitate the general public.

Example II

Adhering to Free Market Perspective, I would be using the competition instinct for attracting a greater number of patients. The maintenance of care standards along with quality will allow me to make up a mark. Moreover, it will also be a source of advertisement, attracting maximum interests. Competition will not only gain me personal profit adhering to the official spectrum, but it will create a standard for the other market members.

Advantages and Disadvantages

Pros

The free market perspective allows an individual to innovate. Individuals have the freedom of creating new ideas and new services along with the introduction of new products. It is not only confined to production, but it also infers competition, adhering to the consistent profit in the companies. It is an important and productive component of the free market. (Swanson, et, al. 2018)

The free market perspective will be a better option for business timeline because it determines the winners and losers. It will allow attracting more number of patients with positive expectations. (Laws, et, al. 2018).

Cons

One of the greatest disadvantages of the free market is “unemployment”. Due to certain set standards and obeying to the "professionals," so a lot of people will not be able to work in the ambulatory center. (Laws, et, al. 2018).

Merit good is a major disadvantage because the new products and the substandard assumptions will not allow a particular industry to become a part of the market. As a result, there would be a high economic standard in the ambulatory standards, and the rural or the poor class would not be able to avail the facilities. (Laws, et, al. 2018).

Components of the three sources of law related to healthcare initiative

Code of Federal Regulations

The code of federal regulations refers to the codification of the permanent and general rules that are titled to address the broad areas of a subject. (Swanson, et, al. 2018). These regulations are updated once each year. The title 42, address the health requirements and the implication of certain policies that are relevant to the healthcare center. It refers to the Medicare certification, quality reporting, Medicare payment resources and emergency preparedness.

Health Reforms

It refers to the Affordable Care Act and Patient Protection that brings about health reforms legislation in order to increase the monitoring and prevention programs. (Swanson, et, al. 2018). The law acts as a guide in adhering to certain core standards of health, reflecting the planned use of funds, funding opportunities and the recipients of awards. Some major components are, "HHS (Health And Human Services) Prevention and Public Health Fund," "National Public Health Improvement Initiatives" and "National Prevention Strategy."

The American Action Forum

It is a code of Tort Reforms; the legislature can cap the damages and make reforms about the payment of damages. (Laws, et, al. 2018). It refers to amend joint and several liabilities that allow the plaintiff to collect money from anyone who is found liable neglecting the degree of liability. AAF (African American Fund) is concerned with the tort reforms that are related to medical malpractices in order to define the effect of limiting liability on the costs of healthcare that is paid by the employees and the employer.

References

Laws, M. B., Lee, Y., Taubin, T., Rogers, W. H., & Wilson, I. B. (2018). Factors associated with the patient recall of key information in ambulatory specialty care visits: Results of an innovative methodology. PloS one, 13(2), e0191940.

Swanson, J., Easter, M., Brancu, M., Workgroup, V. M. A. M., & Fairbank, J. A. (2018). Informing federal policy on firearm restrictions for veterans with fiduciaries: risk indicators in the post-deployment mental health study. Administration and Policy in Mental Health and Mental Health Services Research, 1-11.

Assignment 1: Social Impact Of Population Growth

Assignment 1

Social Impact of Population Growth

Your Name (First M. Last)

Instructors Name

School or Institution Name (University at Place or Town, State)

Date

Social Impact of Population Growth

Introduction

Population is this has increased rapidly between 1900 and 2000 and this increase is considered to be three times greater than the growth rate in entire human history. According to report of UN population has grown up to seven billion which is six times greater than the rate of one million; just two hundred years ago. This human growth has impacted all the globe in terms of water scarcity, increased pollution and carbon foot print. This increase in pollution has contributed to destruction of forests, burning of fossil fuels and factory pollutions, which have increased the emission of harmful gases that have become cause of depletion of ozone layer and increase in earth’s temperature. This issue of global warming has become matter of serious concern for the whole world.

According to predictions temperature of earth will increase from 1.5 to 4.5 by 2050; which is alarming. This increase will affect the all the natural resources and impact the humans life directly. Increased diseases, famine, drought meltdown of glaciers will be the major impacts of global warming. Developing countries will be hugely effected by this issue than developed countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"X1uJu6yX","properties":{"formattedCitation":"(\\uc0\\u8220{}Global Water Resources: Vulnerability from Climate Change and Population Growth | Science,\\uc0\\u8221{} n.d.)","plainCitation":"(“Global Water Resources: Vulnerability from Climate Change and Population Growth | Science,” n.d.)","noteIndex":0},"citationItems":[{"id":1184,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/IM2HVDLZ"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/IM2HVDLZ"],"itemData":{"id":1184,"type":"webpage","title":"Global Water Resources: Vulnerability from Climate Change and Population Growth | Science","URL":"http://science.sciencemag.org/content/289/5477/284","accessed":{"date-parts":[["2019",1,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Global Water Resources: Vulnerability from Climate Change and Population Growth | Science,” n.d.).

What are greenhouse gases? How do they contribute to global warming?

Greenhouse gasses refer to the harmful gasses that cause the greenhouse effect. This effect is considered as the number one cause of the global warming. Greenhouse effect originates from the bombardment of radiations on sun on the earth’s surface. These ultraviolet and infrared rays hit the earth surface and are reflected back out in the space by clouds and ice. Around 70% of this radiation is absorbed by the oceans and about 30 % reflects back. This 70% of radiation heats up the oceans and whole planet. Rocks, air and seas get warmed up and start to radiate thermal infrared radiation. This energy gets absorbed by the greenhouse gasses; carbon di oxide and methane. After absorbing this energy molecules of these gasses lit up and start to radiate heat energy in the lower atmosphere.

With the increase in population emission of greenhouse gasses has increased through deforestation, burning of fossil fuels and emission of gasses by the industries.

These greenhouse gasses GHG include hydro fluorocarbons, sulpher hexafluoride, per fluorocarbons, methane, nitrous oxide and CO2. Some scientists add water molecules to the list of gasses that contribute to the greenhouse effect. Emission of these gasses have skyrocketed in the recent history ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1t4zsixW","properties":{"formattedCitation":"(Lashof & Ahuja, 1990)","plainCitation":"(Lashof & Ahuja, 1990)","noteIndex":0},"citationItems":[{"id":1180,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/CWAXEZLW"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/CWAXEZLW"],"itemData":{"id":1180,"type":"article-journal","title":"Relative contributions of greenhouse gas emissions to global warming","container-title":"Nature","page":"529-531","volume":"344","issue":"6266","source":"www.nature.com","abstract":"IN the past few years, many workers have noted that the combined effect on climate of increases in the concentrations of a large number of trace gases could rival or even exceed that of the increasing concentration of carbon dioxide1–3. These trace gases, principally methane, nitrous oxide and chlorofluorocarbons, are present at concentrations that are two to six orders of magnitude lower than that of carbon dioxide, but are important because, per molecule, they absorb infrared radiation much more strongly than carbon dioxide. Indeed a recent study4 shows that trace gases are responsible for 43% of the increase in radiative forcing from 1980 to 1990 (Fig. 1). An index to compare the contribution of various 'greenhouse' gas emissions to global warming is needed to develop cost-effective strategies for limiting this warming. Estimates of relative contributions to additional greenhouse forcing during particular periods do not fully take into account differences in atmospheric residence times among the important greenhouse gases. Here we extend recent work on halocarbons5,6 by proposing an index of global warming potential for methane, carbon monoxide, nitrous oxide and CFCs relative to that of carbon dioxide. We find, for example, that methane has, per mole, a global warming potential 3.7 times that of carbon dioxide. On this basis, carbon dioxide emissions account for 80% of the contribution to global warming of current greenhouse gas emissions, as compared with 57% of the increase in radiative forcing for the 1980s.","DOI":"10.1038/344529a0","ISSN":"1476-4687","language":"en","author":[{"family":"Lashof","given":"Daniel A."},{"family":"Ahuja","given":"Dilip R."}],"issued":{"date-parts":[["1990",4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lashof & Ahuja, 1990).

Production of gasses:

Fact is that carbon dioxide is minor component in the atmosphere. Carbon dioxide is released through process of eruption of volcanos, respirations. Activities like deforestation, fossil feels and land changes. This minor component has contributed hugely to the climate change. Methane is a hydrocarbon that results from landfills, rice cultivation, animal manure, ruminant digestion and agricultural practices like use of pesticides. On molecular basis methane is more active in causing greenhouse effect in comparison to carbon dioxide.

Another gas nitrous oxide is produced from cultivation practices regarding the use of organic and commercial fertilizers, combustion, biomass, and nitric acid production.

Consequences:

Greenhouse gasses have always existed on this planet but due to over population, production of gasses has reached new abnormal level. Burning of coal and oil has increased the amount of CO2 in the atmosphere because these processes combine carbon with atmospheric oxygen and contributes to CO2. These gasses are increasing the temperature of earth.

Warmer conditions of earth lead to more evaporation and participation, as a result of which certain parts of the earth are becoming dryer and other warmer.

According to Fifth Assessment Report of the Intergovernmental Panel on Climate Change, 95% of human activity over the past 50 years have caused the global warming.

What kinds of economic, security, political, and other challenges do these emissions pose to the people of the developing world, and who are the biggest offenders?

Climate change will affect the all the countries, but developing poor countries will be its biggest victims. Around 60% of the world population is based in developing countries where temperature change will result in disastrous effects, not just economically but also in terms of scarcity of natural resources and natural calamities. According to report of World economic outlook, this climate change will create winner countries and loser countries in terms of economy. Continuous emission o GHGs have raised serious concerns in emerging economies as climate change will directly hit their economies. Effects and impacts of the climate change will not distribute equally among the countries. Poorest the country, more will be the suffering due to natural calamities. Major reason for this is their vulnerability to the negative impacts on natural resources, like waters, ecosystem, human health, fisheries and crop production.

Populations in these countries rely heavily on natural climatic conditions for their crops growth and survival. As they are already struggling economically they have low adaptive capacity for the development and implementation of such strategies. Developing countries have very low contribution to the climate change and in causing pollution but the will get effected at huge level.

One of the noticeable developing country of this list is Pakistan. It is number 7 on the list, on most vulnerable country to climate change, with a death toll 523.1 lives per year. Already Pakistan has suffered greatly due 141 extreme weather events i.e. floods, cyclones, storms, glacier outbursts and heat waves. In 2005 earth quake occurred that resulted in huge loss of human lives. In 2010 country faced horrendous devastation due to floods. These events forced their government to form National Disaster management authority to deal with the calamities that result from climate change. All these calamities effected the country hugely in terms of economy and scarcity of resources.

According to report of UNEP climate change in Pakistan has resulted in increased temperature and low levels of participation rates. It is predicted that likelihood of occurrence of major weather related events has increased, in terms of flooding. Considering the fact that it is developing country infrastructure is not adequate to deal with the climatic events. According to GCISC around 14 crops are already effected in country due to heat stress. And rainfall capacity has decreased that has resulted in 29 % increase in the requirement of water for irrigation purposes. Wheat yield has also decreased due to climate change. Coastal areas of city Baddin was flooded due to sea water, which has resulted in soil salinity. In areas of Rajhanpur cultivation and harvesting time has shifted backwards, that has resulted in the shortage of growing seasons for the farmers. Health issues like gastrointestinal, skin diseases have also increased in various poor regions of country. Desert areas of country are facing water shortage issues that has resulted in death of citizens and security issues due to scarcity. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JPfbOJ66","properties":{"formattedCitation":"(Akram & Hamid, 2014)","plainCitation":"(Akram & Hamid, 2014)","noteIndex":0},"citationItems":[{"id":1177,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/8YG4UWB6"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/8YG4UWB6"],"itemData":{"id":1177,"type":"article-journal","title":"Climate change: A threat to the economic growth of Pakistan","container-title":"Progress in Development Studies","page":"1-14","volume":"15","source":"ResearchGate","abstract":"Pakistan is recognized as a country with low income along with poor human development indicators. Although its contribution to greenhouse gas (GHG) emissions is miniscule in comparison with other countries (it contributes only about 0.8 per cent of the total GHG emissions), it is one of the major victims of the adverse effects of climate change. The present study is an attempt to explore the impacts of climate change on the economic growth of Pakistan by conducting a national level analysis for the period 1973–2011. It has been found that temperature (proxy for climate change) has a negative and significant relationship with GDP, as well as with productivity in the agricultural, manufacturing and services sectors. The severity of these negative effects is higher for the Agriculture sector as compared to manufacturing and services.","DOI":"10.1177/1464993414546976","shortTitle":"Climate change","journalAbbreviation":"Progress in Development Studies","author":[{"family":"Akram","given":"Naeem"},{"family":"Hamid","given":"Abdul"}],"issued":{"date-parts":[["2014",1,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Akram & Hamid, 2014)

Is there any way to control the growth of population on a global level?

Over population is the major issue that is contributed to the global warming. Thus measures need to be taken to control the population at global level. Lack of women empowerment has contributed greatly to the over population. Reproductive health should be provided to women all across the globe to control the birth rate. The UN population fund is already contributing to tackle the issue but these efforts are still not adequate. Knowledge about family planning should distributed freely. In the past Iran has introduced the family planning that has reduced the birth rate to 2.6 from 5.6 in period on one decade. Thus other countries should also introduce this plan to their public.

In general educating the public and introduction of incentives at governmental level can help in controlling the population.

Also developing countries lack structure and resources to implement these plans at their national level, so developed countries, understanding the severity of issue, should contribute to these developing countries in implementing birth control policies ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gXbash6y","properties":{"formattedCitation":"(\\uc0\\u8220{}5 possible solutions to overpopulation,\\uc0\\u8221{} 2017)","plainCitation":"(“5 possible solutions to overpopulation,” 2017)","noteIndex":0},"citationItems":[{"id":1175,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/I6K3KTG6"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/I6K3KTG6"],"itemData":{"id":1175,"type":"webpage","title":"5 possible solutions to overpopulation","container-title":"Positive News","abstract":"If population growth is unsustainable, are there humane ways to limit it?","URL":"https://www.positive.news/society/5-possible-solutions-overpopulation/","language":"en","issued":{"date-parts":[["2017",7,10]]},"accessed":{"date-parts":[["2019",1,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“5 possible solutions to overpopulation,” 2017).

Conclusion

Increase in populations has attributed to climatic change that has put eco system in danger. Significant impact of climatic change and global warming is evident in plants, animal and humans. These impacts are alarming especially in the developing countries. This damage cannot be reversed but taking measures to deal with impact can reduce the harmful effects of it in future. All countries should make policies to reduce carbon foot print. So that eco system and its species can be saved ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Z2TXpqlu","properties":{"formattedCitation":"(\\uc0\\u8220{}Fingerprints of global warming on wild animals and plants | Nature,\\uc0\\u8221{} n.d.)","plainCitation":"(“Fingerprints of global warming on wild animals and plants | Nature,” n.d.)","noteIndex":0},"citationItems":[{"id":1186,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/7U5IMCCM"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/7U5IMCCM"],"itemData":{"id":1186,"type":"webpage","title":"Fingerprints of global warming on wild animals and plants | Nature","URL":"https://www.nature.com/articles/nature01333","accessed":{"date-parts":[["2019",1,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Fingerprints of global warming on wild animals and plants | Nature,” n.d.).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY 5 possible solutions to overpopulation. (2017, July 10). Retrieved January 15, 2019, from https://www.positive.news/society/5-possible-solutions-overpopulation/

Akram, N., & Hamid, A. (2014). Climate change: A threat to the economic growth of Pakistan. Progress in Development Studies, 15, 1–14. https://doi.org/10.1177/1464993414546976

Fingerprints of global warming on wild animals and plants | Nature. (n.d.). Retrieved January 15, 2019, from https://www.nature.com/articles/nature01333

Global Water Resources: Vulnerability from Climate Change and Population Growth | Science. (n.d.). Retrieved January 15, 2019, from http://science.sciencemag.org/content/289/5477/284

Lashof, D. A., & Ahuja, D. R. (1990). Relative contributions of greenhouse gas emissions to global warming. Nature, 344(6266), 529–531. https://doi.org/10.1038/344529a0

Assignment 2: Health Insurance And Quality

Assignment Title:Health Insurance and Quality

Student Name:Eustace Koon

Professor Name:

Institution Name:

Course Title:Healthcare and Nursing

Date:

Health Insurance and Quality

Patient Satisfaction and Reducing Healthcare Cost

As a clinic manager, I am quite concerned about the dissatisfied patients of my care center. To overcome the problems my patients face here, I am proposing a few quality initiatives that can increase the satisfaction of care center patients and also potentially reduce the cost of healthcare access provided to the patients. Firstly, the patients and their accompanying family members/relatives/friends who come to the urgent care center should be provided with a well-furnished waiting room which is decorated with beautiful art-works; have proper lightning and informative charts regarding different medical issues and their cure.

There should be a cost-effective TV in the waiting room for the visitors so that they can go through the time smoothly during long waiting hours at the clinic. Moreover, there should be newspapers and interesting magazines, always placed on the table of the waiting room. These all measures for the refurbishment of the waiting room are necessary because according to research provided by Arneill & Delvin (2002), fully furnished and warm welcoming waiting rooms of a hospital positively influence the cognition of patients to think that the respective care center will provide them with quality treatment. All the cost for renovation of the waiting room should be covered through donations to save costs for the hospital.

Moreover, the staff working in urgent care center should be trained to equip them with proper knowledge regarding the care center facilities. For example, the staff should be aware of doctors' arrival and departure from the hospital. Guiding the patient to the right doctor is also the responsibility of the staff. They should also know about different diseases and their possible cure. A knowledgeable and informed staff that guide the patients rightly is what makes a staff highly qualified. Thus it will improve the patient's overall perception regarding the staff support provided to them along with the quality of the care center treatment.

Another quality initiative can be to provide state-of-the-art medical facilities for absolutely free of charge or at a meager price for the underprivileged and middle-class communities of the society. Their treatment costs should be covered through donations and charities. An initiative of the treatment for patients on a low cost or purely free will provide them with cost-saving opportunities in the form of no or fewer healthcare costs.

Medicare or Medicaid

One of the most significant concerns I noticed my patients experienced was the relatively small number of insurance facilities available at the healthcare center. I consider that the pay source in the form of insurance payments for the patients of the care center should come from Medicaid instead of Medicare. This is because it is an insurance policy that provides relief to people of almost all ages while Medicare is only for the people that belong to a single age-group (Marek et al., 2012). For example, Medicaid is for adults that have low-income and children that mostly belong from underprivileged communities while Medicare’s expensive insurance care is primarily for older people that are aged 65 and beyond. While the urgent care center looks to save the healthcare costs for patients, the insurance of Medicaid will thus be better for them as patients, especially young people, will get quality insurance services despite having low-income.

There are more insurance beneficiaries of Medicaid as compared to Medicare (Marek et al., 2012). For instance, there are more than seventy million beneficiaries of Medicaid insurance including more than 25 million children. In contrast, Medicare insurance has provided relief to less than sixty million people who are fewer in number than Medicaid. Therefore, regarding popularity among the general public, the insurance of Medicaid is more popular than Medicare.

References

Arneill, A. B., & Devlin, A. S. (2002). Perceived quality of care: The influence of the waiting room environment. Journal of Environmental Psychology, 22(4), 345-360.

Marek, K. D., Stetzer, F., Adams, S. J., Popejoy, L. L., & Rantz, M. (2012). Aging in place versus nursing home care: Comparison of costs to Medicare and Medicaid. Research in Gerontological Nursing, 5(2), 123-129.

Assignment 3

Research

Vision

The vision of the healthcare system is to provide quality care services for the children. It will contribute to the overall welfare of the children. The integrated clinical practice will incorporate education and research. The ideal healthcare system focuses on developing hope and building trust among patients.

Characteristics

The ideal healthcare system will encourage nurses to provide quality service by reimbursing. Paying them for their services will promote the provision of quality care. They will be evaluated according to their performance and the patient's feedback. The system will hire counsellors that will address the emotional issues and fears of the children CITATION Hea183 \l 1033 (Damberg, Sorbero, Lovejoy, Martsolf, Raaen, & Mandel, 2014).

The system will focus on minimizing the patient wait time and providing an immediate response. The nurse will spend at least 20 minutes with each child that will improve the quality of care CITATION Fra121 \l 1033 (Maurer & Smith, 2012). The goals also emphasize on providing a briefing on disease and treatment plan. The system will focus on eliminating discriminatory practices.

Implementation

The ideal healthcare system will acquire funds from the stakeholders. To ensure the provision of valuable services to the patients, the organization adopted evidence-based protocols and trained the healthcare staff to reduce the errors and increase the transparency of healthcare services. The institute will invest in the training and education of the staff CITATION UNI17 \l 1033 (UNICEF, 2017). Training will emphasize on ways for encouraging engagement of staff and building a positive patient-staff relationship.

Problems

The process of implementing an effective healthcare system involves challenges such as lack of funds and resources. Lack of staff engagement, leadership and skills are common challenges. To encourage nurses and staff the organization needs to provide better salaries and incentives. Risks of unintended consequences also contribute to challenges in the implementation of the ideal healthcare system.

References

BIBLIOGRAPHY Damberg, C. L., Sorbero, M. E., Lovejoy, S. L., Martsolf, G. R., Raaen, L., & Mandel, D. (2014). Measuring Success in Health Care Value-Based Purchasing Programs Findings from an Environmental Scan, Literature Review, and Expert Panel Discussions. Rand Health Quarterly, 4 (3), 9-15.

Maurer, F. A., & Smith, C. M. (2012). Community/Public Health Nursing Practice: Health for Families and Populations (Maurer, Community/ Public Health Nursing Practice) 5th Edition . Saunders.

UNICEF. (2017). For Every Child. Retrieved 03 18, 2019, from https://www.unicef.org

Assignment 3: Healthcare Quality

Assignment 3: Healthcare Quality

[Name of the Writer]

[Name of the Institution]

Assignment 3: Healthcare Quality

Quality Initiatives

In an organization, the role of the quality officer is to provide and ensure the best services and products related to healthcare in the hospitals. Being one of the largest healthcare organization, it is the ultimate goal to deliver the best standards of practice to the patients. These issues can be related to medical and non-medical factors (Sherwood & Barnsteiner, 2017). The three essential quality initiative in providing the best healthcare services and amenities to the patients would be; ensuring patient’s safety, efficient laboratory facilities, and introducing newer technologies.

Ensuring Patient’s Safety

Nearly four million people die every year due to healthcare negligence in healthcare organizations. Thus patient safety is the need for To provide the quality of patient care in the hospitals it is essential to maintain and develop the infrastructure, personnel competence, training quality, and efficiency of functioning. For achieving such a system, the patient-centered culture in a healthcare organization is essential. Foremost step for providing safety to the patient is by building a rapid method of response and compliance plan. Safe design of the hospital would help maintain the patient’s safety.

Efficient laboratory facilities

The testing and screening of the patient is an essential element in and the first step to quality treatment. If the diagnosis goes wrong, ultimately whole treatment is ruined, ultimately worsening the patient’s condition and aggravating the disease. By devising efficient testing services and screening for people, it would enhance the quality of service. The testing services could be enhanced by decreasing cost, increasing revenue and quality improvement.

Introducing Newer Technologies

Due to the advancement and uprooting of new diseases, it is inevitable to introduce and implement new machinery and equipment into the hospital along with new technologies. The new ways devised to treat the ailment is one of the vital factors in providing healthcare of the best quality. Other factors like maintaining cost efficiency and skilled personnel, new technologies could be implemented.

Factors for Cost Reduction

There are several factors which are detrimental in reducing the cost of healthcare services without decreasing the quality. The health system and hospitals increasingly face the issue of economic pressures due to increased competition, reimbursement and treatment planning. These issues are generally prevalent in non-profit, rural and urban organizations. Following strategies would help the organization to make the services cost-effective beside affecting the quality care:

Innovations and Staffing Policy

The innovation is the necessity of any organization, but in hospital care systems this is one of the most impactful steps in reducing the cost. Every healthcare organization essentially requires the refurbishment of employees/staff, interior, and technological renovation. The most significant expense is related to recruiting staff in the organization, therefore by reducing the resources and implementing only the required sources will help in maintaining the financial pressures (Sherwood & Barnsteiner, 2017).

Labor/Non-labor expenditure

The expenses of labor should be examined and minimized according to the need and requirement of the organization. The performance cost should be evaluated on a weekly bases and should be measured with the actual cost, i.e., examining the overtime and contract labor cost. While referring to the assessment of non-labor cost, it would be useful in cost-cutting strategy.

Employee Engagement

The hospital management should engage employees in maintain the cost effectively by informing them about the agenda of cost-cutting and grasping the ideas they have related to managing the expenditures. The employee should be well-informed of the ongoing financial status of the organization.

Reducing Irrelevant Expenses

It is much supportive to eliminate all the unnecessary costs-consuming operations which are not detrimental for the quality care services. This way the patient care would get enhanced and the entire amount would be spent on the better treatment and cure.

Targeting Growth Opportunities

By focusing on the expansion prospects in patient care, hospitals would be able to provide the patient with quality care and safety by utilizing resources in a relevant place.

Comparison of Healthcare Quality

Free Market Healthcare System vs. Single Payer Government System

The healthcare systems are provided by various organizations, for instance, the private and public sector. Besides, it is also provided by healthcare insurance and coverage. The two central healthcare systems include the free-market and single-payer systems and will be compared and contrasted in this section.

The system of Free-Market Healthcare is where healthcare providers and the patients determine the cost through an agreement for the services of healthcare. Irrespective of government intrusion or any other third-party, the patient and free-market decide their cost of treatment. The quality of the free-market system in healthcare can be determined by the following three examples:

The consumers have different choices provided by the healthcare professional. These professionals help the patients in choosing the services they want or do not aspire to have.

The consumers buy the treatment which is cost effective and is not over-priced, and they could sustain the treatment, along with the worth of the treatment.

This system further emphasizes on the effectivity of the cost and consumer relationship. They manage cost-cutting policies very efficiently, alongside with maintaining the quality of services.

Whereas, the healthcare system of single-payer is known as the government based healthcare system, where all the expenses are held by the government. The government affords the prices by the utilization of taxes and government funds. The following examples determine the quality of this healthcare system:

This is a single-tiered system, and without discrimination, the government covers the expenses of healthcare services to the patients. This system keeps the quality of care to high so that it is acceptable by every citizen.

This also helps in maintaining the affordability and accessibility to each and every citizen.

This system enhances the essential components of quality care, such that they focus diseases in the long run.

Common Laws for Quality Initiatives  

The common law was initiated due to the providence of quality healthcare in the United States (Ogrinc et al., 2015). The law quality initiatives which are still applicable in the twenty-first century for the quality of healthcare in the United States are as follows:

The commitment of practice contemplation in agreement with some fundamental trustworthiness. It focuses on if the present issue typifies abominable money related favorable position to an individual. Besides, it dismembers if the matter depicts abusing the prosperity providers.

The contemplative commitment of practice, such that encapsulates reasonable exercises to the best-preferred standpoint of the individual and the prosperity office. The establishment looks at whether the exercises of the prosperity providers work to the most major benefit of the prosperity association or something different (Ogrinc et al., 2015).

The commitment of practice of contemplation with the dimension of thought a standard sensible individual would in near conditions. It depicts the centrality of due steadiness for restorative administrations providers in treating the patients.

Importance of Healthcare Quality

1. The centrality of therapeutic services quality for the alliance is the essential prerequisite for the patients thought to enhance the diminished method for consideration to patients. The coalition has watchful about the best treatment working environments to fulfill our every single patient on the best fix to get their thriving in the long run (Mohammed et al., 2016). As of now, the situation of the enormity of social insurance nature of the association depends upon its incredible association structure to concentrate on all aspects of the competent organization's requirement for changes to update diminished therapeutic services quality at whatever point.

2. The alliance has begun towards quality activities through the choice of wellbeing care agents and other staff individuals to do each work effectively and adequately for the productivity of the quality social insurance. For instance, the informed and gifted medical attendants would be investigated most by a wide margin of schools and universities that have completed their nursing degree. This activity would expand the best quality social insurance associations. Additionally, the other case to give the significance of therapeutic services quality is the execution of cutting edge medicare advancement set up of the customary contraption. It would update the method for thought with noteworthy suitability by diminishing time in a first circumstance and operational framework.

3. The reputation of an organization is as vital as its revenue. Consequently, the enhancement of quality in healthcare will bring good name to the hospital and will be useful for its ranking (Mohammed et al., 2016). The medics and nurses are obliged to provide a hospitable environment along with the increased facilities in healthcare services. The proper name and word of mouth are important to build the reputation of an organization and professional. Therefore when a patient is treated well and with care, it will take the organization to heights through the feedback and word-spreading of the patient.

Plan to Protect Patient Information

The privacy and confidentiality of patients are essential to both, the patient and healthcare provider. The Health Insurance Portability and Accountability Act (HIPAA) is an act which ensures the privacy and safety of the patient’s information. Following are the steps which incorporate the action plan for the protection of patient’s information in hospitals

Data security is a critical component when it comes to the privacy of the patient. The patient trusts the hospital system with his information, so it is therefore obliged on the hospital administration to protect that information from everyone who is accessible to that data, including the IT guy. Different profiles could be created by the administrators, adding the devices of all lab assistants to the whitelist so that they open up the required data of the patient.

Encouraging security-culture in the whole organization by implementing the protected health information strategy devised by HIPAA. The culture can be incorporated into practice by awareness among the healthcare providers of all levels about ethics and moral principles. However, if someone breaches the rule and regulation of patient confidentiality, they should be penalized according to the healthcare laws.

Easy-access of the patient should be provided to their own records or data sets. As the record is most safe with the patient himself, so they should not be denied the access as it is against the law. The data should be stored into one database so that it is remotely accessed by all the parties specifically involved, i.e., the patient, doctor and medical facilitator related to the treatment.

It is turning the access into advantages of the patient after building the authorized policies and profiles related to the patient. This way a competitive advantage is given to the organization as a patient will be reliant on the hospital for getting access to his medical history and treatment purposes. The last step involves the intrusion of the patient into all the records and data sets through the hospital's database. Legal compliance gets easier when remote access is provided to all the parties. It further makes the process smoother and resulting in patient retention and quality care of the patient in the hospitals.

References

Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12-21.

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2015). SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. The Journal of Continuing Education in Nursing, 46(11), 501-507.

Sherwood, G., & Barnsteiner, J. (Eds.). (2017). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.

Assignment 4: Health Insurance And The Affordable Care Act

Title Page

Healthcare Plan

Healthcare plan

The plan will address lifestyle choices of employees with the aim of maximizing their health and welfare. Health economics also remains an important factor in the determination of the plan. It states that employees’ health is linked to productivity and efficiency of the organization. The company will offer health insurance to the employees for ensuring high operational efficiency. The common services that the plan will cover include screenings, routine immunization, counseling, preventive services for children and women.

Keeping in view, the financial constraints it is appropriate to adopt a health reimbursement plan. This will include offering a tax-free allowance to the employees on a monthly basis that they can use for covering health expenses. The employees would be able to buy health care that includes health insurance policies. The employees will continue to benefit from the plan until they make purchases. The company's strategy will be to adjust insurance cost from the wages of employees. The amount that the company will spend on employees health insurance will be compensated for their wages. This reflects that the cost of health insurance will be more on the workers CITATION Pri16 \l 1033 (Anand, 2016). The employers that offer health benefits to the employees manage to recruit and retain efficient workers. This will save the company from investing in the training and education of new employees.

Health economics also suggests that adoption of health insurance plan has positive impacts on organization due to the creation of effective workforce culture. The success of an organization is dependent on employees engagement and productivity. The evidence indicates that employees who receive better insurance benefits are satisfied with their work. Wellness benefits lower absenteeism and enhances productivity CITATION Pri16 \l 1033 (Anand, 2016).

Implications of the Affordable Care Act

Provision of health insurance coverage to employees was not possible for the small companies before the Affordable Care Act. Affordable Care Act provides significant benefits to small businesses as over 5.7 million small business employees are enrolled in ACA. The act allowed many small businesses to stabilize health cost and provide coverage to employees. It helps the firms to acquire affordable and comprehensive health insurance plans. ACA is effective for organizations that have at least 50 employees. The act not only emphasizes on providing healthcare care insurance coverage to the employees but also to their families CITATION For13 \l 1033 (Forbes, 2013).

Advantages

The firm can receive a tax credit by offering health insurance to their employees. The company that covers 50 percent of the employee health coverage will be eligible for gaining the credit. The businesses would be able to buy insurance easily. Availability of tax credits with easy conditions has improved the company's capacity for providing insurance plans CITATION For13 \l 1033 (Forbes, 2013).

The Affordable Care Act gives a leverage power to the businesses. The insurance companies will not be able to raise premium without justifying their actions. The states hold the power of blocking unreasonable increases in premium. The act has thus acted more in favor of businesses than the insurance companies. This prevents insurance companies from exploiting their positions or putting excessive burdens on the employer.

Disadvantages

The increase in the fee and Affordable Care Act taxes makes insurance plans expensive. The new fees introduced include insurer fee, risk adjustment fee, and transitional reinsurance fee. This means that the costs faced by the organizations will rise.

The reporting and compliance requirements change more often that means the company will have to address them. The new rules and changes in the previous ones demand that the company ensure their compliance. This will cause inconvenience to the employers. The process is time-consuming that may affect organizational efficiency.

References

Anand, P. (2016). Health Insurance Costs and Employee Compensation: Evidence from the National Compensation Survey. Health Economics.

Forbes. (2013). Is The Affordable Care Act Bad For Business? Retrieved 02 22, 2019, from https://www.forbes.com/sites/theyec/2013/04/22/is-the-affordable-care-act-really-bad-for-business/#2da8178969f9

Assignment 5: Public Health Preparedness

Public Health Preparedness

Student’s Name

Institution

Date

Introduction

Public health preparedness is an essential aspect in dealing with urgent issues at the hospital or in any healthcare facilities. The wellbeing of patients or people in general is associated with the provision of therapeutic needs, which guarantee quality help to patients and security. This must be done without considering sexual orientation or any similar issues with patients. It is therefore, important to have essential procedure to address threats such as terrorism or others within the hospitals to guarantee safety of all patients at the hospitals. This paper therefore, is looking at the methodology, which are very significant to the association to the connection with measures, which should be taken to ensure that safety of patients is guaranteed. It analyses the effects, which these procedures will have to the healthcare facilities during emergency.

Task 1: Examine the existing procedures related to at least four (4) of the ten (10) essential public health services. Focus on the principal effects that these procedures will have on your hospital during the emergency.

There are five principles methodology, which the hospital does, which are associated with the fundamental well being of patients. These methodologies are used to make decision regarding the element of security of every patient at the hospitals both inpatients and outpatients anytime there is a crisis at the hospital. The first methodology, which should be applied, is social order. It is therefore, important to have social order at the hospital to help in addressing any emergency CITATION May06 \l 1033 (Mayberry, Nicewander, Huanying, & Ballard, 2006). Social orders mean that there is relationship between patients and medical practitioners at the hospitals and also an elaborate structure of what should be done when such an emergency occurs. Public health preparedness is the mindfulness on people at hospital to join in help to go out to identify approaching risks in medical. The doctors, nurses and other medical practitioners should have the capacity to conform that they are capable to help patients when there is imminent risk.

Secondly, the doctors must also commit that patient to be attended to and treated faster to save lives. However, the treated should be faster to ensure that less congestion is created at the hospitals. This strategy is identified with the aspect of ensuring that the well being of patients are given priority. It is also accessing the adequacy, openness and the natural of populated and personal well being. As stated by Sena (2015) the strategy is meant to assist the hospital in managing the crisis in a way that will minimize risk and ensure that the situation does not explode beyond control. In case of terrorist activities at the hospital, the hospital has well equipped isolation center, which can be used to separate patients and also administer adequate treatment. At the isolation center, therapeutic services are offered and other medical services to limit the crisis and risk, which involved.

However, the management of the hospital has adopted the ten essential public health services and the most crucial are monitoring, enforce laws and regulations, which ensure public safety and hazard prevention of diseases or any outbreak CITATION Zua16 \l 1033 (Zuabi, Weiss, & Langdorf, 2016). In order to ensure that patients are provided with needed treated, the hospital require all doctors, nurses and other medical practitioners dealing with emergency cases to report to the duties. This is to ensure that the hospital has enough needed staffs to handle all emergencies. In case, of terrorist attack in the United States, medical staffs are required to report to duty as well.

Task 2: Specify the importance of continuing to evaluate patients, as stipulated by the Emergency Medical Treatment and Active Labor Act (EMTALA), during the emergency.

The Emergency Medical Treatment and Active Labor Act (EMTALA) were created in 1986 to ensure that patients receive treatment without any bias or failure during emergency season. The hospital should have continuous screening of patients to ensure that all patients who need medical attention are provided without any failure. Continuing evaluation of patients is important because it ensures that the ability of patients to pay is determined, the health status of every patient is known. This assist in the provision of medical services to patients since it ensue that patients who are in serious condition obtain medical attention first. It also helps the hospital to prevent any major casualties from occurring since, by establishing the need of every patients and the hospital would be able to provide the needed medical services to patients.

Task 3: Detail three (3) measures that you would use in order to maintain the electronic medical record system during the emergency.

In order maintain electronic medical record system even during emergency, there are several things, which need to be done. First measures would be to understand how the system operates by establishing who is accessing, and writing the records. It is also important to establish the security protocol, which involve login and out of the system and apply strict measures to avoid access to the system in case of emergency. According to (), the security of the hospital ICT system is essential in preventing the attack or minimizing the damages when terrorist attack happen. This includes limiting and monitoring people entering or working out of the hospitals. Therefore, the system should have automatic time out after a specific time of inactivity. The system should also have advanced requirement in login and access to the specific areas of the hospital to limit the use and the access of some areas of the hospitals. The clinicians may also have the power or the authority to override automatic time out, when there is an urgent need to enter certain entry during the day. It may sound reasonable; the clinicians at the hospitals should have the right to make changes of particular records. The data should have automatic lock to prevent any outside access or unauthorized access to the vital data at the time of emergency. The automatic lock ensures that only senior clinicians and the ICT manager would give access and therefore, this would ensure that the hospital data or the system is protected during the emergency. Since during emergency, the security of the hospital is the main issue and each department is required to play a critical role. In case of terrorist attack, the hospitals doors and other importance entrance to the building should have automatic override. This to limit the number of people entering the hospitals and making sure that at such risky hours, the chances of internal attack is limited.

However, other measures include establishing personal and practice policies against entry into the system. As stated by Mohammad (2014), there is a lot of recklessness and scrupulous when it comes to reading messages, which most time put the system at risk. It would be important to ensure that nobody is subscribe to any messages, because it is one of tricks being used by hackers to access the system. In order to keep the system secure, it would be important to remove anything which could generate messages to secure the healthcare data. It is also to makes sure that the health care records doing not generate any message unless it is an error message. And when it is an error message the IT team should solve it immediately to ensure that there is suspicious activity into the system. It is also important to get familiarized with tracking features of the electronic data or records is also one of the measures, which can help in limiting risk and it is important to take in case there is emergency CITATION May06 \l 1033 (Mayberry, Nicewander, Huanying, & Ballard, 2006). However, the ability to make quick and appropriate decision is very crucial during emergency and this should include securing data, apply ICT protocol in accessing or entry into the system. It would help the hospital to avoid wasting a lot of time to figure out whether there is a problem with the system at a time when swift action is required.

Task 4: Defend your position on the decision to accept health insurance during the emergency as a potential source of income for the facility. Provide support with at least three (3) examples that illustrate your position.

As the Vice President of the organization, there are several specific responsibilities, which depend on the requirement of healthcare facility. The Vice President has the responsibilities to communicate and implement the organizations’ mission and vision. He or she provides leadership, guiding, creating and evaluating the work of other executive in the organization CITATION Zua16 \l 1033 (Zuabi, Weiss, & Langdorf, 2016). However, the decision to accept the healthcare insurance during emergency as one of the sources of income for the organization is also considered to be very significant. First, it is the responsibility of the vice president to ensure that all patients get the help they need from the hospital and without finances; it would be difficult for the hospital to offer the medical need patients require during emergency. Accepting health insurance ensures that the organization is able to offer services to patients. Therefore, accepting insurance ensures that patients can obtain the medical attention they need and therefore, it is a key responsibility of the vice president.

Secondly, having enough cash at the hospital would facilitate the operations of the hospital during the emergency. The insurance coverage is good and it will make sure that any damages whether property of any other things are fully covered and therefore, the hospital would be able to continue operating even after a major crisis. This is because the insurance company usually pays for any insured damages and therefore, as a vice president of the hospital, accepts health insurance and any other insurance during the time emergency is an important responsibility. Without enough cash the hospital could be caught in an awkward situation and therefore, it would not be able to meet its objectives. It therefore, means that accepting healthcare insurance cover is important for the organization during emergency.

Task 5: Analyze the extent to which this emergency might affect the quality of care provided to the patients and the unimpeded operation of the organization.

The quality of healthcare is associated with the patient’s satisfactory and profitability CITATION Moh14 \l 1033 (Mohammad, 2014). During emergency, most healthcare facilities such as hospitals offer medical services to many patients during emergency and under strict condition with limited resources. The hospital is required to provide services to many patients with limited nurses, doctors and physicians. It affects the quality since the hospital would not be able to meet the demand of all patients. Some of the tests required to be done would not happen because of congestion and therefore, this would affect the quality of services. The patients will not be properly assigned to relevant doctors and the transfer will also be initiated at every point of treatment. This would therefore, affect the services being offered and most client would be satisfied.

References

BIBLIOGRAPHY Mayberry, R. M., Nicewander, D., Huanying, Q., & Ballard, D. (2006). Improving quality and reducing inequities: a challenge in achieving best care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1426185/ , 2-35.

Mohammad, A. (2014). Factors Affecting Medical Service Quality. Journal of Public Health , 12 (5), 2-18.

Sena, L. (2015). Hospital disaster emergency preparedness. Emergency Risk Management for Health , 2-18.

Zuabi, N., Weiss, ,. L., & Langdorf, M. (2016). Emergency Medical Treatment and Labor Act (EMTALA) 2002-15:. Review of Office of Inspector General Patient Dumping Settlements , 12-39.

Assignment: Assessing A Healthcare Program/Policy Evaluation

Health Care Policy Assessment

Submitted by

Affiliation

Date

The Affordable Care Act 2010

Healthcare Program/Policy Evaluation Analysis

Description

The Affordable Care Act or Obamacare approved by Congress on 2010. This program is to extend the insurance for those who do not have existing insurance under Medicare or Medicaid. It also cover employee’s health care insurance till job ends and must be in USA. e purpose of this legislation is to provide all US citizens , especially the poorest, with health coverage . To do this, this law requires all citizens to take out health insurance with a private insurer. Individuals who were already covered individually but whose police did not meet the requirements of Obamacare were invited to change their insurer at the end of 2014. Financial assistance was also granted to Americans with more modest income. Citizens who have not taken out any insurance have to pay a penalty since 2015

How was the success of the program or policy measured?

“The ACA is the most significant and complete health care reform endorsed since Medicare. The ACA has grew a net rise in the number of individuals with insurance, mainly through Medicaid expansion” (Center, Woods, Manchikanti, & Purdue , 2017).

According to Tate (2013) through the assessment, the association focused on the target group imagined under the Obamacare program for example workers in work place to acquire replies from them(Tate,2013).

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

According to research by Tate (2012) it is estimated that nearly 2.3 million people enrolled in this program.(Tate,2012). “Therefore, the ACA hasn't functioned well for the working and middle class who obtain much less funding, mainly those who earn more than 400% of the federal poverty level, who establish 40% of the populace and don't obtain any help”(Center, Woods, Manchikanti, & Purdue , 2017).

What data was used to conduct the program or policy evaluation?

The data from survey series completed in different US states give the evaluation of this program

What specific information on unintended consequences were identified?

Data on such significances involved the presence of support for the Obamacare program from most employees across the US due to the detrimental nature of the statute on this group of people (Tate, 2012). President Obama stated that the ACA if significant cost restraint, in that expenses would have been even much elevated if the ACA was not ratified(Center, Woods, Manchikanti, & Purdue , 2017).

What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

It include employees (target group) having coverage through ACA2010 along with those directed to manage matters of workers’ welfare in the USA (Milstead & Short, 2019).

Other type of stakeholders contain the insurance service providers who help in the implementation of this program (Patton et al., 2015). However , the employees are the major beneficiaries of ACA2010.

Did the program or policy meet the original intent and objectives? Why or why not?

Yes, ACA2010 accomplished its projected aims of providing health insurance over 2.3 million individuals. The health reform published in The Patient Protection and Affordable Care Act aims to increase the number of Americans who have access to affordable health insurance. This is achieved by expanding Medicaid to the poorest in America, by providing tax credits to small employers covering their employees, by providing tax credits to people who need help paying for their insurance, by reforming health care, by taxing health care and setting up regulated and competitive online health insurance exchanges (AKA marketplace) where individuals can buy insurance and receive financial support. (Barnett & Vornovitsky, 2016).

Would you recommend implementing this program or policy in your place of work? Why or why not?

Yes, I would recommend it to my work place instead of different insurance coverage because most workers are not able to get insurance coverage. The law obliges all taxpayers to subscribe to health insurance covering a minimum basket of services. People who do not have insurance provided by their employer must register for an exchange where they buy insurance. The government subsidizes some of the costs for the less fortunate. Those who do not do so must pay a penalty, which in 2016 was $ 695 or 2.5% of gross income (whichever is greater).

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation. Be specific and provide examples. Did the program or policy meet the original intent and objectives? Why or why not?

As a nursing practitioner, I would like to make a report on the basis of my data collected under journal of Health Affairs.in this way I can contact my co-workers, who changed from insurance to ACA2010. I would also like to make a comprehensive report on recommendations on the basis of my data and interviews so that our organization or government agencies may improve program

References

Barnett, J. C., & Vornovitsky, M. S. (2016). Health insurance coverage in the United

States: 2015. Washington, DC: US Government Printing Office.

Center, H., Woods, C. A., Manchikanti, L., & Purdue Pharma, L. P. (2017). A critical

analysis of Obamacare: affordable care or insurance for many and coverage for few? Pain physician, 20, 111-138.

Tate, N. J. (2012). ObamaCare Survival Guide: The Affordable Care Act and What it

Means for You and Your Healthcare. Humanix Books.

Assignment: Concept Analysis In The Literature

Title Page

Concept analysis in literature

Patient’s expression of satisfaction or dissatisfaction is a practical tool used for evaluating the quality of healthcare services provided by hospital. It is an effective indicator that provide patient’s judgment on the services delivered by healthcare providers. Wagner and Bear (2009) explains that, “patient satisfaction is an important indicator of quality of care, and healthcare facilities are interested in maintaining high levels of satisfaction in order to stay competitive in the healthcare market”. Patient perspective is crucial for determining the strengths and weaknesses of hospitals and clinics. Hospitals and healthcare organizations have adopted the practice of conducting surveys for analyzing patient perceptions regarding quality of care. The concept of patient satisfaction is long established in social sciences and medicine. Satisfaction can also be interpreted as healthcare providers ability of addressing patient’s needs CITATION Ros06 \l 1033 (Parse, 2006). Patient’s expression on satisfaction has direct implications for the healthcare providers and organizations.

Concept analysis approaches are presented by healthcare researchers for understanding the theoretical framework of the topic under discussion. Patient satisfaction can be seen as client’s behavior or responses towards staff’s competency and ability of handling them. According to the Maslow’s hierarchy needs satisfaction of the patient changes over time when the need arises. Rodgers introduced a progressive, evolutionary method for providing deeper analysis of the concept. Robust body of literature must be considered for defining the concept of choice. With growth of healthcare industry patient satisfaction has become essential criteria for organization’s survival. Healthcare institutes are thus motivated to supervise quality of care and initiate delivery enhancements that lead to high levels of patient satisfaction. Rather than relying on a fixed phenomena it is more appropriate to examine the dynamic process CITATION Jan18 \l 1033 (Ng & Luk, 2018). Formal thematic analysis is also practical method of determining the meaning and themes of patient satisfaction.

Attitude is a psychological predisposition used for determining the concept of patient satisfaction. The concept analysis reflects that patients expressed satisfaction when they find the services and responses of healthcare providers appropriate CITATION Pat10 \l 1033 (Patricia Cronin & Coughlan, 2010). Satisfaction is thus evaluated on the basis of patient’s views towards healthcare staff including doctors, nurses and consultants. Clients express satisfaction when they find staff compassionate, friendly, courteous, approachable and kind. The level of respect, individual attention and responsiveness are common factors considered by patients in sharing their views on satisfaction. The degrees of healthcare providers involvement in patient care is linked to patient satisfaction. Attitudes and behavior of providers has significant impact on patient’s participation in the process of treatment.

Competency and professional skills of providers are prominent factors that influence patient satisfaction. The concept analysis depicts that patient’s are more likely to relate their satisfaction with the professional competency of nurses and doctors CITATION Jan18 \l 1033 (Ng & Luk, 2018). It can be stated that patient’s satisfaction increase with the competency of healthcare providers. This indicates that providers that incorporate thinking and knowledge of their role in healthcare settings are professionally competent. They are capable of communicating the disease or treatment plan with the patient and help them throughout the process of diagnosis. Doctors and nurses that manage to apply professional behavior effectively receive positive patient’s views CITATION Deb081 \l 1033 (Wagner & Bear, 2008). Application of all aspects of nursing and doctors profession is more likely to yield high patient’s satisfaction. Clients value healthcare service according to the performance of the provider. Better performance reflects positive correlation with client satisfaction and vice versa.

Patient expectation is a common indicator used for evaluating their satisfaction. Healthcare organization evaluates how physician or nurse responds to client’s need for visiting the hospital. Patients often visit hospitals for in search for physician’s assurance or information. Physicians focusing on specific actions only leads to patient’s dissatisfaction CITATION Ros06 \l 1033 (Parse, 2006). Another criteria for evaluating satisfaction is by considering quality of communication. Doctors and nurses that are capable of conveying the disease, treatment plan and self-care in appropriate manner are more likely to attain client’s satisfaction. Patients expect to receive positive treatment from the staff. They feel positive when they believe that the physician has taken the problem seriously and provided adequate information regarding the disease CITATION Pat10 \l 1033 (Patricia Cronin & Coughlan, 2010). Patients exhibit high satisfaction when they find that the doctor has command on the medical issue and obtained all background information. Patients rate satisfaction according to physician’s competency of providing medical advice.

Healthcare settings that encourage client’s control in decision-making are more likely to attain satisfaction. Patient’s involvement in the process of medical treatment remains an effective criterion for evoking satisfaction. When clients are allowed to share their views, ideas, concerns and expectations regarding healthcare service they tend to be more satisfied CITATION Ros06 \l 1033 (Parse, 2006). Under such conditions patients are willing to accept doctor’s advice. Patient satisfaction is linked to time spent by healthcare providers on each visit. Increase in the length of visit is more likely to enhance client’s satisfaction. Patient rate high satisfaction when he believes that the care provider has given adequate time to the patient. Time affects the quality of client-doctor’s interaction and accuracy of treatment CITATION Deb081 \l 1033 (Wagner & Bear, 2008).

Today healthcare institutes need to maintain high levels of patient satisfaction for surviving in the competitive healthcare market. The concept of patient satisfaction continues to evolve as hospital’s criteria of evaluating it change over time. common indicators used for assessing satisfaction include; providers ability of addressing patient’s expectations, time spend on each visit, professional competency and quality of care.

References

BIBLIOGRAPHY

Ng, J. H., & Luk, B. H. (2018). Patient satisfaction: Concept analysis in the healthcare context. Patient Education and Counseling , 111, 1-7.

Parse, R. R. (2006). Concept Inventing: Continuing Clarification. Nursing Science Quarterly , 19 (4), 289.

Patricia Cronin, F. R., & Coughlan, M. (2010). Concept analysis in healthcare research. International Journal of Therapy and Rehabilitation , 17 (2), 62-68.

Wagner, D., & Bear, M. (2008). Patient satisfaction with nursing care: a concept analysis within a nursing framework. Journal Of Advanced Nursing , 692-701.

Assignment: Policy/Regulation Fact Sheet

Policy/ Regulation Fact sheet

Submitted by

Affiliation

Date

Medicare Access and CHIP Reauthorization Act (MACRA)

Briefly and generally explain the policy or regulation you selected.

Health informatics focuses on information systems, informatics and information technology as they are used for continuity of healthcare delivery. Medicare Access and CHIP Reauthorization Act (MACRA) was adopted in 2015 but enforced in 2018. MACRA started to promote EMR. It is American healthcare regulation that provides a new outline for compensating clinicians who effectively establish value over volume in patient care. It was enforced with the collaboration of HHs and CMS. MACRA offer new tools to provide best possible health care. The best thing of MACRA is its flexibility; participant can practice it according to location, size and population. There are two tracks for MACRA.

Advanced Alternative Payment Models (APMs)

The Merit-based Incentive Payment System (MIPS) (Health IT Legislation,2018)

Impact of the policy

Since its establishment, CHIP has shown positive effects in all aspects and has been successful. It is evaluated that it is. Achieved results of activities to promote MACRA participation. The household participation rate of children in the household has increased. In addition, the use of MACRA services has increased. In addition, the economic burden on medical expenses for low-income people has been reduced. MACRA is economical for low-income people. It is a safety net for medical insurance in difficult times, and CHIP Awareness is high, and the residual rate after joining CHIP is also high (Laws & Regulations,2019)

Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

MACRA revokes the Sustainable Growth Rate (SGR) Plan that has determined Medicare Part B reimbursement rates for physicians and replaces it with new ways of paying for care. That formula had formerly been used by the Centers for Medicare and Medicaid Services (CMS) to control outlay by Medicare on health services. The SGR method was applied to guarantee that the annual rise in the cost per Medicare receiver did not overdo that year’s gross domestic product (GDP) development. Through MACRA, Medicare doctor recompence is no more tied to economic growth; relatively, the compensation formula below MACRA emphases on quality care. Patient outcome measures are demarcated as modification in heath for individuals, groups ,etc. The result of this measure may be in form of death, readmission, and patient experience measures etc.

Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Centers for Medicare & amp; Medicaid Services (CMS) saw a sharp drop in the number of physicians and other clinicians retiring from Medicare participation in 2017.Whether it's an indication of more doctors want to stay in Medicare or as a result of a change in the opt-out process remains to be seen. "The numbers for 2015 and 2016 could represent the first wave of doctors who are withdrawing. The lower 2017 data may reflect the fact that physicians no longer need to produce affidavits to renew, "he said. (CMS data)

One theory that explains why the numbers have decreased is that under the Medicare Access Act and MACRA, suppliers no longer have to submit an affidavit of refusal. every two years. Now, once the doctors withdraw, it's indefinite unless they decide to join the program. Nevertheless, according to CMS data, the number of dropouts dropped to 3,732 in 2017. Doctors and clinicians who do not want to participate in Medicare sign an affidavit that prevents them from seeing beneficiaries submit their bills to CMS . The number of opt-outs was 3,500 in 2015 and 7,400 in 2016. Health informatics is a new and emerging profession. Delivery is responsible for the collection, storage of confidential medical data, the demand for skilled individuals to quickly hit the national supplement.

References

Laws & Regulations. Retrieve from: https://www.hhs.gov/regulations/index.html

Advanced Payment Models.(2019). Retrieve from: https://www.aanp.org/practice/practice-

management/quality-improvement/macra-mips

Health IT Legislation; 21st Century Cures Act( 2018).Retrieve from:

https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

Assignment: Strategies To Achieve Performance Excellence In Health Services Organizations



Strategies to Achieve Performance Excellence in Health Services Organizations

[Name of the Writer]

[Name of the Institution]

Strategies to Achieve Performance Excellence in Health Services Organizations

Introduction

Health Services Organization is an organization or institution which is composed of resources, and peoples that are capable of providing and delivering the healthcare services to make sure that the healthcare needs of the population are met. The health services organization consists

The patient

The team or individuals who are providing the care services

Infrastructure which should be helpful in providing safe and easily accessible services to the patients/individuals.

A health service organization should not only be catering the patient of the general population but also to the general families. Communities, and populations CITATION Goo06 \l 1033 (Goodwin, 2006). Since, their role in the certain designed community is not just limited to the care of the individuals and the patients but to a wide range of general families and communities, so an optimized and fully functional performance is necessary for them. There are multiple strategies and models which highly excel in the use of their designed strategies and methods to achieve performance excellence in your organization. But, here Baldrige framework will be used to achieve performance excellence in the selected HSO. This framework is used for the empowerment of an organization regardless of its size, manufacturing area, services. This will essentially help reach the government to

Show more competition in the markets

Achieve your goals

Improve the results of the strategy

The framework designed includes performance excellence. It includes

Criteria

Interested concepts and interrelated core values involved in the Performance Excellence

A maturation system that lets you know the maturation of your organization over the passage of time CITATION Gri15 \l 1033 (Griffith & Pope, 2015).

This will help the organization in providing a zero defective outcome, and zero patient harm as the only strategic goal for the performance excellence strategy.

Selected HSO and the incorporation of the Baldridge Criteria:

The Health Service Organization that will be used here for the incorporation of the Baldridge performance excellence will be Center For Advancing Health as this can greatly benefit through this in the term of general categories. In specifics, the criteria that would benefit from this will focus on leadership, workforce results that are involved in managing operations, customer measurement, and the overall analysis of the Center For Advancing Health Organization (CFAH). CFAH was founded in 1992, by Jessie Gruman (late) CITATION Jes10 \l 1033 (Gruman, 2010) and ever since it has aimed to increase the engagement and involvement of the people in health and health care. They are providing extreme health professionals to exceed the active participation in the healthcare of the patients.

The Center used the Engagement Behavior framework for all of their work. It involves a comprehensive list of all of the actions must take to benefit from the care. Their assurity consigns within the approach that every adult in the U.S should have the ability to perform these healthcare behaviors through proper knowledge and its practicality. The values and the vision of the mission from the CFAH are focusing on implementation of the actual results which can be vetted in against the results in the adults received by the healthcare provided by the Center. Here, we will perform one of the Baldridge Criteria for the Performance Excellence to the Center for Advancing Health. We will use the Strategic Planning. As the center is involved in activities that use knowledgeable research to teach the adults of the U.S, there is a strong need for the implementation of a good Strategic Planning. Strategic Planning will be used to set out straight priorities, help them properly focus on the energy and in the appropriate utilization of the resources they have been allotted, operations strength, make sure that all the stakeholders of the company and other employees are working towards a single and a common goal, which should be to increase the outcome results than the efforts being taken for the organization, and how it should adjust and react to a changing environment CITATION Bal05 \l 1033 (Progra., 2005).

Strengths and Weakness of the HSO depending upon the Baldridge Criteria:

According to the criteria that is selected for the CFAH, the CFAH holds one of the best methods of Central Engagement behavior framework which highly utilizes a control communication behavioral system among all the employees to ensure prioritized and resourceful planning.

Strengths:

Local Approach

Availability of the Experienced Physicians

Proper implementing techniques for teaching adults the knowledge of health care and its applicability.

High Skilled Strategists that will be used for the implementation of their Strategy

Prioritizing Fewer costs administration on the outsourcing events

Generating outcome through cluster transfer

Weaknesses:

Faulty strategic planning in the case of unforeseen circumstances

No reliable Ethical approval for the legal concerns that the general adult population can work on experienced healthcare practices.

No experienced demonstration through proper resource finalization and utilization

No strategy for teaching the adults the risks and concerns on the implementation of these methods.

Baldridge Recognition:

There are eligibility criteria which needs to be met in the case of any Health Services Organization to be associated with the Baldridge awards. The basic requirement that your organization should lie in one of the industries that include are nonprofit, healthcare, education, small business, service, and manufacturing. After going through the general criteria, the organization should meet all of the conditions that are mentioned below.

The Organization is headquartered in the United States

It has been in the foundation or existence for at least one-year duration

It has the capability of responding to all of the seven Baldrige Criteria's and can share the information on the criteria based practices.

The Operational practices and all of the major functions of the organization should be available in the United States for the Examination.

Implementation of the Steps:

However, as much as the Center for Advancing in Health fulfilled all of the eligibility requirements, there are some problems which are being faced when corresponded with the criteria for the Performance Excellence that included Leadership, Strategy, Customers, Measurement, analysis, and knowledge management, Workforce, Operations, and Results.

The Center was lacking in the appropriate measurements, analysis and knowledge management of the knowledgeable strategies which was affecting the results of the center. There were certain steps that involved complications and challenges within the implications. These steps were considered important in meeting the standards of Baldridge Recognition as there is a strong need for the fulfillment of the requirements and to be eligible for the Performance Excellence and lie within the seven designed criteria.

For the implementation of the steps, we analyzed the factors which were causing blackness in the commitments, increase in the costs, the delivery time of the individual events and Community Educating Programs of the Center, decline in the transfer rate and practicability of the knowledge. The implementation started with related data collection by the Manager Administration, collected the data for a month, analyzed it and made the effective measurements which were used to cause a problem in the measurement, analysis and the knowledge management. The implementation of this strategy should be kept to a group of 15 people maximum and done through multiple groups. Otherwise, it would make the analysis more complicated and challengeable.

Challenges:

During the implementation of those steps, there were certain steps that were occurred during the implementation of the steps. These challenges were Innovation, Operational Excellence and Human Capital. The challenges that were faced during the innovation was creating an innovation culture and environment among the employees and making them involved in intelligent and strategic risks taking and incorporating the innovation needs of the strategy into the workforce. For the Operational Excellence, the challenge was making sure that employees engagement to the productivity rises to a certain level, and assess the factors which were causing a decline in the engagement of the workforce. This factor was hard to discover because of inter-employees involvement. The Human capital challenges were to make sure that certain effective system for the performance management is involved, which provides development in the learning capabilities of the employees of the organization which at the end will ensure betterment in the measurement, analysis and the performance management of the operational workplace and the workforce as well. This challenge retaliated in making sure that employee engagement is raised by enhancing senior management effectiveness. This will create an open communication environment that will ultimately benefit the human capital in terms of high performance and a highly engaged workforce.

To address the challenges as described, in the future, as a caring administrator, I will certainly prefer to follow the Baldridge Criteria for Achieving Performance maximization in the prescribed servicing area. I will certainly pursue strong leadership skills among the workers, a healthy and researched strategy to ensure effectively and outcome targeted results, the best line of potential customers, performing and conducting measurement, analysis, and management of the data once every two weeks and after every month, create a highly engaging workforce which conducts open communication through which, an increase in the operational excellence would be highlighted. This will pursue a better outcome in the results of the Health Service Organization (HSO).

References

BIBLIOGRAPHY Goodwin, N. G. (2006). Managing Health Services. Section 2. Health care funding. Purchasing health services.

Griffith, J. R., & Pope, J. E. (2015). Understanding High-Reliability Organizations: Are Baldrige Recipients Models? Journal of Healthcare Management, 44-62.

Gruman, J. (2010). About Us. Retrieved from Center for Advancing Health: http://www.cfah.org/about/about-us

Progra., B. N. (2005). BALDRIGE in Health Care: Performance Excellence Delivers World-Class Results.

Assignment: The Role Of The Nurse Informaticist In Systems Development And Implementation

Role of Nursing Informatics

Submitted by

Affiliation

Date

Role of Nursing Informatics in System development and Implementation

Health informatics is an essential element of the medical and health system, including primary health. Every Malaysian citizen should have access to trained medical personnel to get quality early medical assistance as a starting point to this system. Usually, these medical professionals are the primary consulting professionals to the patients in a health system and will consult with the relevant experts as needed. In general, when a primary health care system fails, tertiary help centers will become overwhelmed.

The specialization of healthcare information technology (ICT) skills stimulates the interest and commitment of dentists and doctors in the development of healthcare information technology. Specialist qualifications provide a structured, modern way of developing expertise in healthcare information technology and information management, as well as a motivating career path.

The specialty of healthcare information technology provides nurses / physicians with a structured and modern way of developing their knowledge. It also provides a motivating opportunity to develop one's own career. The specific competence of healthcare information technology as a name best describes the breadth of the mission. It is not limited to information systems but also takes into account functional and accounting issues. The title link to eHealth links specific competence to national and EU target programs and covers the spectrum of activities for citizens.

Definition Analysis Design of the new system

Telemedicine and eHealth solutions are a growing part of healthcare organizations and processes. They currently range from professional consulting services to direct customer care and self-care solutions. Home measurement recording is on the rise and with the new national archiving solution, patients can view parts of their patient records themselves through secure network connections. Telemedicine solutions are considered to play an important role in client and patient empowerment.

As highly educated professionals, the contribution of physicians to the development and deployment of healthcare information technology and telemedicine solutions has been, and will continue to be, crucial. Feasibility studies on information systems have shown the need for greater involvement of physicians. Up until now, influencing has often been based on self-interest, and quite a few medical practitioners have other technical education besides medical education.

The specific competence of Healthcare Information Technology (eHealth) promotes the interest and commitment of physicians in the development of health care information technology. The aim is to create a network of expert doctors working in partnership with industry, research institutes and other actors. A network of highly qualified experts contributes to the effective exploitation of the professional and medical skills of doctors in the development of the field. International relations, and in particular the monitoring of developments, are important. (Nelson & Staggers, 2016).

The specialty of Healthcare Information Technology (eHealth) provides physicians with a structured, modern way of developing their health care information technology and information management skills and motivating career development opportunities.

Implementation /Goals

Nurses will;

be familiar with telemedicine, healthcare technology, information systems and e-health solutions and industry developments

be familiar with the goals and needs of the medical community and promote their consideration as technology is developed, acquired and used

Ability to lead and participate as an expert in the design, implementation, acquisition, deployment, training and development of e-Health solutions

be familiar with healthcare technology, telemedicine and e-Health solutions nationally and internationally, and their contribution to the healthcare environment

outline the role of information technology in generating health benefits and the importance of work aids such as decision support

have the capacity to promote eHealth solutions and participate in the national debate.

have the ability to participate in the evaluation of health care IT solutions and other related scientific research

Post-implementation support

Due to the project nature of the employment relationship, the new interdisciplinary nature of the competencies and the initial job profile, a large part of the services cannot be verified. The Services will be evaluated on a case-by-case basis, but the total will be for a total of two (2) years converted to full-time. In addition, at least five (5) years (minimum length of specialist medical qualification) work experience as a medical practitioner is required. The following are accepted as practical services:

health information technology, telemedicine or e-Health solutions projects, design assignments, workgroups, trainer, expert, development tasks in government information system assignments, either on a salaried basis or as expert in working groups or similar (including STM, THL and its predecessor STAKES) (McCormick & Saba, 2015).

researcher in the field of healthcare information technology, telemedicine or e-health solutions] as a medical expert in research institutes, colleges or companies in the field health information technology associations or clubs in the IT working groups of medical clubs and associations. (Saba, 2001).

Dental and the Medical Association in information systems jobs for the medical associations.

A doctoral dissertation that focuses on the field is also approved as a service for 6 months

Publishing health information technology

A practical service may consist of a service consisting of a combination of the aforementioned tasks, pieces or part-time tasks, which shall be individually defined in relation to the criteria of the other specific competencies. Nowadays, there are innovative service providers who have stepped forward with starting new technology experiments to allow more patients to be treated with a limited number of doctors. For example, tele-medical services are growing rapidly with some hospitals and primary health centers in western countries trying to reduce costs by providing consulting services to more patients through online or online portals which allows patients to submit their health-related questions to their online doctor for immediate response guarantee. Patients can also obtain permission to video consult with a doctor, chat over the phone with a registered physician, and send a rash picture, a worried mole and other symptoms for further examination. The techniques of consulting or consulting mentioned above are still in the early stages and are experimental and still need to be improved in our country.

References

McCormick, K., & Saba, V. (2015). Essentials of nursing informatics. McGraw-Hill Education.

Nelson, R., & Staggers, N. (2016). Health Informatics-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Saba, V. K. (2001). Nursing informatics: Yesterday, today and tomorrow. International Nursing Review, 48(3), 177-187.

Assisignment

Saniya Shahban

Instructor Name

Art 101

13 November 2019

Diet Analysis Project

A regular exercise and a balanced diet with a satisfactory amount of nutrients maintain the body to stay in good physical shape. Individuals of the United States do not eat food according to the recommended guidelines. It has led the foundations of unhealthy eating behavior and sedentary lifestyles among teenagers ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"iU5oN5d3","properties":{"formattedCitation":"(Commissioner)","plainCitation":"(Commissioner)","noteIndex":0},"citationItems":[{"id":196,"uris":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"itemData":{"id":196,"type":"article-journal","title":"Nutrition","container-title":"FDA","source":"www.fda.gov","abstract":"The Nutrition Facts Label on food packaging is an important and easy way to get essential information to help you make healthy food choices. These FDA Consumer Updates are also a great resource for more nutrition facts, and other helpful information about the food you eat.","URL":"http://www.fda.gov/consumers/consumer-updates/nutrition","language":"en","author":[{"family":"Commissioner","given":"Office","dropping-particle":"of the"}],"issued":{"date-parts":[["2019",4,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Commissioner). Ultimately, the body is not adapted to keep itself from infections and diseases. According to an estimate, cardiovascular disorders, hypertension and diabetes-associated diseases are prevalent in the communities and led to the disease burden. The only solution to reduce nutrition and physical related diseases is to adopt a healthy lifestyle as well as a balanced diet.

Dietary Intake Daily Logs

Day 1 Saturday

Food

Quantity

Fats

Carbohydrates

Proteins

Others

Breakfast

One glass juice

4 pcs slice with butter

1 glass water

1 glass

4 pcs

100 grams

150 g

0 g

Sugars 50 g

Lunch

One plate rice with lentils

One glass coke

1 glass water

1 plate

1 glass

100 g

200 g

100 g

Sugars 10 g

Dinner

One pizza

One cup tea

1 glass water

1 plate

1 Cup

100 g

200 g

120 g

Sugar 5 g

Day 2 Sunday

Food

Quantity

Fats

Carbohydrates

Proteins

Others

Breakfast

One glass Milk

4 pcs slice with 1 egg

1 glass water

1 glass

4 pcs

50 grams

150 g

70 g

Sugars 50 g

Dairy 100 g

Lunch

One burger with chicken

One glass coke

1 glass water

1 plate

1 glass

100 g

150 g

100 g

Sugars 10 g

Dinner

1 tortilla with

1 plate vegetables

One cup of tea

1 glass water

1 plate

1 Cup

1 tortilla

150 g

150 g

10 g

Sugar 5 g

Vegetables 100 g

Day 3 Monday

Food

Quantity

Fats

Carbohydrates

Proteins

Others

Breakfast

One cup of coffee

4 pcs slice with egg

1 glass

4 pcs

50 grams

150 g

70 g

Sugars 50 g

Lunch

One plate rice with chicken

One glass coke

1 glass water

1 plate

1 glass

100 g

200 g

100 g

Sugars 10 g

Dinner

One cup soup

One cup tea and one bowl sweets

1 glass water

1 cup

1 Cup

50 g

100 g

100 g

Sugar 15 g

Three-day Average

Intake

Fats

Carbohydrates

Proteins

Others

300 g

550 g

220 g

Water 1.5 L

Sugars 10 g

Vegetables no

Fruits no

300 g

450 g

180 g

1 L Water

200 g

450 g

270 g

Water 1 L

Average fats 266.6 g /day

Average carbohydrates 483.3 g / day

Average proteins 223.3 g / day

Water 1 L per day

Vegetables 33 g /day

Fruits 0 g / day

Dairy products 50 g / day

Energy Estimation Requirements

It is the average dietary energy intake that is required to be maintained to keep the body healthy, active and sound. It depends on the height, weight and level of physical activities we perform. According to my food intake, I need regular physical activity to maintain my weight and daily energy requirements.

Intake vs. Goals Report

Intake

Goals

Fats

Carbohydrates

Proteins

Others

Fats

Carbohydrates

Proteins

Others

300 g

550 g

220 g

Water 1.5 L

Sugars 10 g

65 g per day

300 g per day

50 g per day ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pQJHx5k5","properties":{"formattedCitation":"(Schilling)","plainCitation":"(Schilling)","noteIndex":0},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"itemData":{"id":200,"type":"article-journal","title":"New FDA Food Guidelines","author":[{"family":"Schilling","given":"Ray"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schilling)

Water 3.7 Liters

300 g

450 g

180 g

1 L Water

65 g ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"85fVQZpW","properties":{"formattedCitation":"(Commissioner)","plainCitation":"(Commissioner)","noteIndex":0},"citationItems":[{"id":196,"uris":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"itemData":{"id":196,"type":"article-journal","title":"Nutrition","container-title":"FDA","source":"www.fda.gov","abstract":"The Nutrition Facts Label on food packaging is an important and easy way to get essential information to help you make healthy food choices. These FDA Consumer Updates are also a great resource for more nutrition facts, and other helpful information about the food you eat.","URL":"http://www.fda.gov/consumers/consumer-updates/nutrition","language":"en","author":[{"family":"Commissioner","given":"Office","dropping-particle":"of the"}],"issued":{"date-parts":[["2019",4,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Commissioner)

300 g

50 g

Water 3.7 L

200 g

450 g

270 g

Water 1 L

65 g

300 g

50 g

Water 3.7 L

Activities Spreadsheet

Week 1

Weight

Exercise Total

Duration

Calories burn

Monday

55 Kg

Brisk walk

30 minutes

200 to 300 Cal

Tuesday

55 Kg

Walk

Jumps

15 minutes

15 minutes

100

150

Wednesday

55 kg

Walk

Planks

20 minutes

10 minutes

200

100

Thursday

55 kg

Brisk walk

30 minutes

300

Friday

55 kg

Brisk walk

30 minutes

300

Saturday

55 kg

Walk

Planks

jumps

15 minutes

10 minutes

10 minutes

200

100

100

Sunday

55 kg

Walk

Planks

25 minutes

10 minutes

300

100

Evaluation

A routine exercise and a balanced diet with an adequate amount of nutrients recoil the body to stay healthy. People of the United States do not consume food from the four major groups ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EpjgkjQz","properties":{"formattedCitation":"(Guthrie et al.)","plainCitation":"(Guthrie et al.)","noteIndex":0},"citationItems":[{"id":201,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"itemData":{"id":201,"type":"article-journal","title":"Nudging consumers toward better food choices: policy approaches to changing food consumption behaviors","container-title":"Psychology & Marketing","page":"501-511","volume":"32","issue":"5","author":[{"family":"Guthrie","given":"Joanne"},{"family":"Mancino","given":"Lisa"},{"family":"Lin","given":"Chung-Tung Jordan"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Guthrie et al.). This had led to the foundations of unhealthy eating behaviors among teenagers ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AGQHTgyX","properties":{"formattedCitation":"(Commissioner)","plainCitation":"(Commissioner)","noteIndex":0},"citationItems":[{"id":196,"uris":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"itemData":{"id":196,"type":"article-journal","title":"Nutrition","container-title":"FDA","source":"www.fda.gov","abstract":"The Nutrition Facts Label on food packaging is an important and easy way to get essential information to help you make healthy food choices. These FDA Consumer Updates are also a great resource for more nutrition facts, and other helpful information about the food you eat.","URL":"http://www.fda.gov/consumers/consumer-updates/nutrition","language":"en","author":[{"family":"Commissioner","given":"Office","dropping-particle":"of the"}],"issued":{"date-parts":[["2019",4,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Commissioner). Eventually, we have to join a gym or exercise in order to achieve healthy lifestyle goals. According to the guidelines, food should be taken sensibly ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CrO30zku","properties":{"formattedCitation":"(Schilling)","plainCitation":"(Schilling)","noteIndex":0},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"itemData":{"id":200,"type":"article-journal","title":"New FDA Food Guidelines","author":[{"family":"Schilling","given":"Ray"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schilling). Sufficiently taking fruits and vegetables, fats and oils, dairy products and carbohydrates can keep the body healthy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jw36QUtN","properties":{"formattedCitation":"(Nutrition)","plainCitation":"(Nutrition)","noteIndex":0},"citationItems":[{"id":198,"uris":["http://zotero.org/users/local/qnvKw9vm/items/JYXWK74Q"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/JYXWK74Q"],"itemData":{"id":198,"type":"article-journal","title":"How to Understand and Use the Nutrition Facts Label","container-title":"FDA","source":"www.fda.gov","abstract":"Learn how to understand and use the Nutrition Facts Label to make informed food choices that contribute to a healthy diet.","URL":"http://www.fda.gov/food/nutrition-education-resources-materials/how-understand-and-use-nutrition-facts-label","language":"en","author":[{"family":"Nutrition","given":"Center for Food Safety and Applied"}],"issued":{"date-parts":[["2019",8,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nutrition). It is suggested that food should be taken from all four groups. Major food groups are proteins, fats and oils, carbohydrates, vegetables and fruits ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"szOVhAUP","properties":{"formattedCitation":"(Guthrie et al.)","plainCitation":"(Guthrie et al.)","noteIndex":0},"citationItems":[{"id":201,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"itemData":{"id":201,"type":"article-journal","title":"Nudging consumers toward better food choices: policy approaches to changing food consumption behaviors","container-title":"Psychology & Marketing","page":"501-511","volume":"32","issue":"5","author":[{"family":"Guthrie","given":"Joanne"},{"family":"Mancino","given":"Lisa"},{"family":"Lin","given":"Chung-Tung Jordan"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Guthrie et al.). Food and nutrition are directly linked to the health status of the body. Food provides nutrients and energy to the body which is required for its proper functioning. Carbohydrates deliver instant energy to the body and proteins are required for the cell structure and muscles. Fats and oils are also important for the growth and activities of the cells ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"iNafgHUT","properties":{"formattedCitation":"(Commissioner)","plainCitation":"(Commissioner)","noteIndex":0},"citationItems":[{"id":196,"uris":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/PL8X7S5N"],"itemData":{"id":196,"type":"article-journal","title":"Nutrition","container-title":"FDA","source":"www.fda.gov","abstract":"The Nutrition Facts Label on food packaging is an important and easy way to get essential information to help you make healthy food choices. These FDA Consumer Updates are also a great resource for more nutrition facts, and other helpful information about the food you eat.","URL":"http://www.fda.gov/consumers/consumer-updates/nutrition","language":"en","author":[{"family":"Commissioner","given":"Office","dropping-particle":"of the"}],"issued":{"date-parts":[["2019",4,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Commissioner). Vegetables and fruits are required for the body as it provides minerals and vitamins. The most significant element of food is the water required by the body up to at least 3.7 Liters.

Certain health disorders are linked to nutrition and lifestyle. These disorders include cardiovascular diseases, diabetes and hypertension-related diseases. According to the food that I consume, it needs a lot of changes as per the recommended diet as it comprises average fats 266.6 g /day, average Carbohydrates 483.3 g / day, average proteins 223.3 g / day, water 1 L per day, vegetables 33 g /day, fruits 0 g / day, and dairy products 50 g / day. It does not come from all major food groups i.e. carbohydrates, fats, proteins, vegetables and fruits. My diet lacks dairy products, vegetables and fruits, and water intake is also insufficient. A balanced diet is a diet that is recommended to be consumed to keep our body healthy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RYLiYMTq","properties":{"formattedCitation":"(Schilling)","plainCitation":"(Schilling)","noteIndex":0},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HDAHW7LW"],"itemData":{"id":200,"type":"article-journal","title":"New FDA Food Guidelines","author":[{"family":"Schilling","given":"Ray"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schilling). My diet is very high in carbohydrates and fats (saturated fat), and it lacks fruits, fibers, and vegetables ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"68gk1E1w","properties":{"formattedCitation":"(Nutrition)","plainCitation":"(Nutrition)","noteIndex":0},"citationItems":[{"id":198,"uris":["http://zotero.org/users/local/qnvKw9vm/items/JYXWK74Q"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/JYXWK74Q"],"itemData":{"id":198,"type":"article-journal","title":"How to Understand and Use the Nutrition Facts Label","container-title":"FDA","source":"www.fda.gov","abstract":"Learn how to understand and use the Nutrition Facts Label to make informed food choices that contribute to a healthy diet.","URL":"http://www.fda.gov/food/nutrition-education-resources-materials/how-understand-and-use-nutrition-facts-label","language":"en","author":[{"family":"Nutrition","given":"Center for Food Safety and Applied"}],"issued":{"date-parts":[["2019",8,22]]},"accessed":{"date-parts":[["2019",11,14]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nutrition). Good sources for fats are olive oils, nuts and seeds. A good source for carbohydrates is bread, vegetables, and fruits ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"7xG7rvbS","properties":{"formattedCitation":"(Guthrie et al.)","plainCitation":"(Guthrie et al.)","noteIndex":0},"citationItems":[{"id":201,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Z8SCR53B"],"itemData":{"id":201,"type":"article-journal","title":"Nudging consumers toward better food choices: policy approaches to changing food consumption behaviors","container-title":"Psychology & Marketing","page":"501-511","volume":"32","issue":"5","author":[{"family":"Guthrie","given":"Joanne"},{"family":"Mancino","given":"Lisa"},{"family":"Lin","given":"Chung-Tung Jordan"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Guthrie et al.). Eggs and seeds are a good source of protein for our bodies. The average daily calorie intake recommended is 2000 to 2400 calories per day however, my calorie intake is above 4000 calories per day. A regular exercise and a balanced diet are significantly recommended for my daily routine. My nutritional goals are to consume a balanced diet to keep my body healthy and sound and to prevent myself from acquiring diseases that are more common and prevalent among communities and societies these days.

Works Cited:

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Commissioner, Office of the. “Nutrition.” FDA, Apr. 2019. www.fda.gov, http://www.fda.gov/consumers/consumer-updates/nutrition.

Guthrie, Joanne, et al. “Nudging Consumers toward Better Food Choices: Policy Approaches to Changing Food Consumption Behaviors.” Psychology & Marketing, vol. 32, no. 5, 2015, pp. 501–11.

Nutrition, Center for Food Safety and Applied. “How to Understand and Use the Nutrition Facts Label.” FDA, Aug. 2019. www.fda.gov, http://www.fda.gov/food/nutrition-education-resources-materials/how-understand-and-use-nutrition-facts-label.

Schilling, Ray. New FDA Food Guidelines. 2016.

Assisted Suicide

Aiding Suicide

Patric Roby

Institution

Introduction

Consistent advancement in technology and pharmaceuticals has always placed the medical community at a crossroads, when we talk about making life-threatening decisions. This paper will analyze healthcare professional positions concerning the doctor’s role in assisted suicide. Assisted Suicide tends to be a controversial topic which is the voluntary end of one's own life by taking lethal medicines with assistance of a physician. In other words, it is the service given by physician for terminating an ill patient who chooses death in a way by exercising the right to govern his own life. Assisted suicide can also be referred as active euthanasia whereas; Passive euthanasia is the act of removing medical machines and allowing the illness to take the patient’s life.

Most of the countries such as US have made physician-assisted suicide illegal and medical community does not encourage the practice of assisted suicide CITATION NSt14 \l 1033 (N Steck, 2014).This paper illustrates the different cases of patients, and opinions within the field of law and medicine. In some circumstances, doctors make logical decisions related to assisted suicide followed by a code of ethics. On the other hand, European counties have made assisted suicide legalized making active euthanasia challenging and the norms of medical professionalism.

Discussion

According to the principle of the sanity of life, human life is essential. Health care services work on the principle of sanity of life. Physician-assisted suicide is either aided by physician or other health care personnel, is considered only under the circumstances when it is clear that the patient is not going to get better and he/ she is in severe pain with every breath he/she takes. In United States, it is crime to help a person die. The main goal of any health care professional is to provide overall care to the patient. Overall care includes physical and psychological health of a person. Ethics in health care are important aspect which medical practitioner has to follow. Principles of health care ethics which provides guidelines to health-care professional for making best decisions in complicated situations. Autonomy, Beneficence, Justice, and Veracity are the principles of health care ethics put forth by James Childress and Beauchamp in 1985.

The principle of autonomy in health care means that the person has a right to have control over his/her body. A health care professional can only suggest or advise the treatment, a patient has all the right to take the decision CITATION Her14 \l 1033 (Herring, 2014). There are some circumstances when the patient is unaware and decisions are taken by their spouse or another family member. Assisted suicide does not work this way, one of the basic criteria of assisted suicide is that the patient should be of sound mind. In other words, patient should take the decision and should be aware of its consequences. According to the principle of autonomy, if the patient is aware of the situation and knows what would happen if he/she is injected with a lethal drug, assistive suicide is justified. If some health care personnel persuade a patient into assistive suicide, it is the violation of principle of autonomy and is a crime. The patient should be able to take his/her own decision according to personal beliefs and values.

The beneficence principle of ethics in health care means that the health care professional must do everything in his/ her power which will eventually benefit the patient CITATION Gil15 \l 1033 (Gillon, 2015). Death is inevitable for an individual suffering from a chronic condition. Thus, with no way to improve quality of life for such an individual, a life of pain is simply not worth it.. In severe chronic condition, patient is eventually going to die, and pain that a patient is suffering from is not worth it. Under such circumstances, assistive suicide benefits the patient by taking away his/ her pain. To understand the principle of benefit in assistive suicide, one should first understand the condition of the patient. The pain, suffering, and humiliation of patients can be so high that it is become unbearable, and is also affecting his/ her mental health. Eventually a patient loses will to live in the cases of assistive suicide.

The justice principle in health care focuses on equality in healthcare system. It is a key duty of health care professionals to treat each patient impartially, fairly, and equally. Principle of justice is linked with principle of beneficence and health care professional to give their best to benefit the patient. Principle of Veracity means that health care professionals should always tell truth to their patients. Telling a truth to the patient about his/ her health in the most human way possible is must for a physician CITATION GDB14 \l 1033 (GD Byrd, 2014). According to ethics of health care, the patient has a right to know the truth to understand his/ her troubles and conditions.

Like doctors, nurses also have code of ethics for patient care. Nursing staff learns about patient care with compassion to understand what better care is. With practices in the field, nurses learn to understand unique aspects of patient’s behavior and nature. Nurses are the individuals who are on the frontline, provide care to the patient. Nurses have to gain the trust of their patient to better understand their condition and provide best health care recommended and is advised by the physician CITATION Fin16 \l 1033 (Finkelman & Kenner, 2016). In assistive suicide, role of nurse is of great significance, this is because they spend more time with the patients, and are well aware of patient’s physical and mental health. In assistive suicide has to be aware of his condition and should understand the consequences of taking his life. If all the parameter of assistive suicide are met and patient is willing to go for an option of assistive suicide, nurses plays an important role either in assisting the procedure or changing the mind of their patient. When the patient has chronic decease and is wanting assistive suicide because of his unbearable condition and hopelessness, nurse can help the patient by providing good care and by changing the patient’s mind. Although convincing patients not to go for the option of assistive suicide is a role of mental health professional, nurses can also play part in helping the patient psychologically.

Conclusion

In this paper aspects of assistive or aiding suicide are linked with the ethics of health care their aspects are explained. Although, assistive suicide is illegal in United States, it is being practices in European countries and Canada. In assistive suicide, physician or other healthcare professional aid the patient in taking his/ her life. If the patient is not aware of his/ her condition, thinking of an assistive suicide is impossible. Moreover, patients have complete right to know their condition for peace of mind. There is a concept of Mercy Killing which means that a poor living thing who is in misery are killed to help them free from the nightmare of pain. Approach used in assistive suicide is similar to Mercy Killing concept up to some extent. Nurses can also help the patient by supporting their case when conveying the case of assistive suicide to the physicians.

References

BIBLIOGRAPHY Finkelman, A., & Kenner, C. (2016). Professional Nursing Concepts: Competencies for Quality Leadership. Jones & Bartlett Learning.

GD Byrd, P. W. (2014). A comparative analysis of moral principles and behavioral norms in eight ethical codes relevant to health sciences librarianship, medical informatics, and the …. Journal of the Medical Library Association.

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of medical ethics. Retrieved from https://jme.bmj.com/content/41/1/111.short

Herring, J. (2014). Medical law and ethics. Retrieved from https://books.google.com.pk/books?hl=en&lr=&id=N9JFAwAAQBAJ&oi=fnd&pg=PP1&dq=principle+of+autonomy+in+medical+ethics&ots=cdioM_jtxO&sig=-N0030Iw_8_1aMGmk3Dm22bCf5A

N Steck, C. J. (2014). Suicide assisted by right-to-die associations: a population based cohort study. International Journal of Epidemiology. Retrieved from https://academic.oup.com/ije/article/43/2/614/679913

Asthma

Asthma

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Asthma

Among many developed nations, the most commonly occurring disease in children is asthma ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6lu11xtA","properties":{"formattedCitation":"(Cardon & Palmer, 2003)","plainCitation":"(Cardon & Palmer, 2003)","noteIndex":0},"citationItems":[{"id":79,"uris":["http://zotero.org/users/local/YjWHJPzk/items/C5HMJLKJ"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/C5HMJLKJ"],"itemData":{"id":79,"type":"article-journal","title":"Population stratification and spurious allelic association","container-title":"The Lancet","page":"598–604","volume":"361","issue":"9357","source":"Google Scholar","author":[{"family":"Cardon","given":"Lon R."},{"family":"Palmer","given":"Lyle J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cardon & Palmer, 2003). It is also the most serious disease in adults and about one in thirteen people in America suffer from asthma (CDC, 2019). According to Center for Disease Control and Prevention (CDC) (2018), asthma rates have been significantly rising since 1980s among individuals of all ages, sexes and ethnic groups. However, it was found to be more common in children and adult females compared to males (CDC, 2019). According to World Health Organization (WHO), it is estimated that asthma along with chronic obstructive pulmonary disease (COPD) will be leading cause of death by the year 2020 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ujyNSTby","properties":{"formattedCitation":"(Masoli, Fabian, Holt, Beasley, & Program, 2004)","plainCitation":"(Masoli, Fabian, Holt, Beasley, & Program, 2004)","noteIndex":0},"citationItems":[{"id":81,"uris":["http://zotero.org/users/local/YjWHJPzk/items/T4JZ36EV"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/T4JZ36EV"],"itemData":{"id":81,"type":"article-journal","title":"The global burden of asthma: executive summary of the GINA Dissemination Committee report","container-title":"Allergy","page":"469-478","volume":"59","issue":"5","author":[{"family":"Masoli","given":"Matthew"},{"family":"Fabian","given":"Denise"},{"family":"Holt","given":"Shaun"},{"family":"Beasley","given":"Richard"},{"family":"Program","given":"Global Initiative for Asthma (GINA)"}],"issued":{"date-parts":[["2004"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Masoli, Fabian, Holt, Beasley, & Program, 2004).

Many medical, social and behavioral factors have been connected to development of asthma. A family history of asthma, tobacco smoke exposure, an allergy-linked condition and mother’s exposure to smoke during pregnancy increase the chances of developing the disease. This document will look at the pathophysiological mechanisms of chronic and acute asthma, the changes in arterial blood gas patterns during an exacerbation and the impact of unhealthy behaviour like smoking on pathophysiology of acute and chronic asthma.

Chronic and acute asthma exacerbation

Asthma is an obstructive diseases caused by inflammation of airways including trachea, bronchi and bronchioles ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"f2OO9bb5","properties":{"formattedCitation":"(Chung & Adcock, 2001)","plainCitation":"(Chung & Adcock, 2001)","noteIndex":0},"citationItems":[{"id":83,"uris":["http://zotero.org/users/local/YjWHJPzk/items/N92M4DQG"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/N92M4DQG"],"itemData":{"id":83,"type":"article-journal","title":"Pathophysiological mechanisms of asthma","container-title":"Molecular biotechnology","page":"213-232","volume":"18","issue":"3","author":[{"family":"Chung","given":"K. F."},{"family":"Adcock","given":"I. M."}],"issued":{"date-parts":[["2001"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chung & Adcock, 2001). There is no general definition for exacerbation. The episodes of progressive symptoms of asthma are termed as asthma exacerbation. Acute asthmatic exacerbation refers to severe and sudden worsening of related symptoms whereas chronic asthma exacerbation means persistence of these symptoms over a period longer than three months ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"f2OO9bb5","properties":{"formattedCitation":"(Chung & Adcock, 2001)","plainCitation":"(Chung & Adcock, 2001)","noteIndex":0},"citationItems":[{"id":83,"uris":["http://zotero.org/users/local/YjWHJPzk/items/N92M4DQG"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/N92M4DQG"],"itemData":{"id":83,"type":"article-journal","title":"Pathophysiological mechanisms of asthma","container-title":"Molecular biotechnology","page":"213-232","volume":"18","issue":"3","author":[{"family":"Chung","given":"K. F."},{"family":"Adcock","given":"I. M."}],"issued":{"date-parts":[["2001"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chung & Adcock, 2001).

A variety of mediators have been found to have pathological effects on asthma ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0B81dclf","properties":{"formattedCitation":"(Barnes & Drazen, 2002)","plainCitation":"(Barnes & Drazen, 2002)","noteIndex":0},"citationItems":[{"id":84,"uris":["http://zotero.org/users/local/YjWHJPzk/items/UVEEM2NX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/UVEEM2NX"],"itemData":{"id":84,"type":"chapter","title":"Pathophysiology of asthma","container-title":"Asthma and COPD","publisher":"Elsevier","page":"343-359","author":[{"family":"Barnes","given":"Peter J."},{"family":"Drazen","given":"Jeffrey M."}],"issued":{"date-parts":[["2002"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Barnes & Drazen, 2002). Leukotrienes, prostaglandins and histamines contract the smooth muscles of air passageway, cause leakage from micro vessels, increase mucous secretion and cause inflammation by attracting inflammatory cells ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"trCD3jvT","properties":{"formattedCitation":"(Busse, Banks-Schlegel, & Wenzel, 2000)","plainCitation":"(Busse, Banks-Schlegel, & Wenzel, 2000)","noteIndex":0},"citationItems":[{"id":82,"uris":["http://zotero.org/users/local/YjWHJPzk/items/XXVJMGX9"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/XXVJMGX9"],"itemData":{"id":82,"type":"article-journal","title":"Pathophysiology of severe asthma","container-title":"Journal of Allergy and Clinical Immunology","page":"1033-1042","volume":"106","issue":"6","author":[{"family":"Busse","given":"William W."},{"family":"Banks-Schlegel","given":"Susan"},{"family":"Wenzel","given":"Sally E."}],"issued":{"date-parts":[["2000"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Busse, Banks-Schlegel, & Wenzel, 2000).

Pathophysiological mechanisms of chronic asthma and acute asthma

Asthma ca be divided into two categories; atopic and non-atopic. Atopic is most common, extrinsic type of asthma caused by inflammation in response to IgE production which is triggered by the environment. Non-atopic, on the other hand is less common, intrinsic asthma caused by inflammation in response to local\self IgE.

Pathophysiology

Comparing the normal bronchiole to asthmatic bronchiole reveals thickened basement membranes, increased mucous production and goblet cells, increased eosinophils in mucous and tissue. It is also characterized by increased mast cells causing higher histamine release. Increase in other cell types including neutrophils and T-helper cells. Hypertrophy, increase in size due to constriction, is also observed in smooth muscle cells.

Main cells/causative agents: IgE antibodies, eosinophils, dendritic cells and T-helper cells. IgE antibodies bind with receptors on mast cells forming mast cells-IgE complex, this complex recognize allergens and begin release of histamine. Two types: T-helper 1 normally found in lungs, in asthma T-helper2 are up regulated in asthmatics, more T-helper2 than 1. 1 normally promote inflammation by increasing cell mediated immunity, however T-helper 2 cells increase inflammation by increasing humoral immunity, promoting antibody production.

Because of these changes asthmatic cells show three characteristics 1. Airflow obstruction, 2. Bronchiole hyper responsiveness because of histamine release, 3. Inflammation due to increase in neutrophils and other immune cells.

Mechanism

After an asthmatic person inhales an allergen, the allergen triggers a reaction. The allergen maybe engulfed by dendritic cells (DC) and activate the dendritic cells which is recognized by columnar epithelial cells which. The columnar epithelial cells release thymic stromal lymphocytes which will condition activated DC to produce chemokines to attract specifically T-helper 2 cells. Activated DC will activate t-helper cells to differentiate into T-helper 2 and will also secrete chemokines to attract the T-helper 2 to the bronchioles or the lungs. The activated T-helper 2 cells promote humoral immunity by stimulating plasma cells which will promote IgE production. IgE bind to mast cells to create IgE-mast cell complex. T-helper 2 also stimulate eosinophil production from bone marrows. Eosinophils amounts increase in the lungs through chemotactic activity. Inhaled allergen bind to IgE-mast cell complex and release histamine, prostaglandins and leukotrienes, which will stimulate smooth muscles of airways to pose constriction (bronchoconstriction). Every time the same type of allergen is inhaled, it triggers the whole process, hence leading to bronchoconstriction (Huether and McCance, 2015).

Impact of smoking behavior on pathophysiology

The Institute of Medicine found relationship between tobacco use and exacerbations of asthma. Tobacco smoke is considered active/passive universal irritant. Irritants are non-allergic chemical substances causing inflammation or bronchospasms. Tobacco smoke causes irritation and infection to upper airway and lower respiratory tract, respectively. Cigarette, fireplaces, campfires and industrial pollutants are various sources of smoke leading to asthma symptoms.

Smoking causes corticosteroid resistance with higher production of neutrophils or lesser eosinophils. Smoke leads to shortness of breath, coughing, wheezing or a combination of all repeating at regular intervals which is called asthma exacerbations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6lu11xtA","properties":{"formattedCitation":"(Cardon & Palmer, 2003)","plainCitation":"(Cardon & Palmer, 2003)","noteIndex":0},"citationItems":[{"id":79,"uris":["http://zotero.org/users/local/YjWHJPzk/items/C5HMJLKJ"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/C5HMJLKJ"],"itemData":{"id":79,"type":"article-journal","title":"Population stratification and spurious allelic association","container-title":"The Lancet","page":"598–604","volume":"361","issue":"9357","source":"Google Scholar","author":[{"family":"Cardon","given":"Lon R."},{"family":"Palmer","given":"Lyle J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cardon & Palmer, 2003). Some other symptoms include swelling, itching or increased pulse rate.

Treatment:

Budesonide inhalation is helpful in newly diagnosed patients reduce the exacerbation by fifty percent. Inhaled corticosteroids (ICS) do the same job in moderate doses. But in asthmatic patients with severe exacerbations, when ICS show no required results, budesonide is administered in high doses. In patients with a history of excessive exacerbations, a combination of budesonide and formoterol is used. Long-Acting Beta-agonists (LABA) and ICS together have proven to be beneficial in patients with severe disease symptoms. Other than the treatment strategies, some preventive measures have proven beneficial in reducing exacerbations. These preventive measures include

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Barnes, P. J., & Drazen, J. M. (2002). Pathophysiology of asthma. In Asthma and COPD (pp. 343–359). Elsevier.

Busse, W. W., Banks-Schlegel, S., & Wenzel, S. E. (2000). Pathophysiology of severe asthma. Journal of Allergy and Clinical Immunology, 106(6), 1033–1042.

Cardon, L. R., & Palmer, L. J. (2003). Population stratification and spurious allelic association. The Lancet, 361(9357), 598–604.

Chung, K. F., & Adcock, I. M. (2001). Pathophysiological mechanisms of asthma. Molecular Biotechnology, 18(3), 213–232.

Center for disease control and prevention. (2018). Asthma - Data and Surveillance. Retrieved from https://www.cdc.gov/asthma/asthmadata.htm

Huether, S. E., & McCance, K. L. (2015). Understanding Pathophysiology-E-Book. Elsevier Health Sciences.

Center for disease control and prevention. (2019). Asthma. Retrieved from https://www.cdc.gov/asthma/default.htm

Masoli, M., Fabian, D., Holt, S., Beasley, R., & Program, G. I. for A. (GINA). (2004). The global burden of asthma: Executive summary of the GINA Dissemination Committee report. Allergy, 59(5), 469–478.

Asthma

Asthma

[Name]

[Institution]

Author Note

Asthma

Question 1

How does the blood cell count leukocytosis affect patients with asthma?

Leukocytes are effectors and biomarkers that indicate the level of inflammation in the body. It increases the presence of leukocytes in the bloodstream upon inflammation, which results in leukocytosis, especially in response to asthma ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aYbMpqsi","properties":{"formattedCitation":"(Fessler et al., 2017)","plainCitation":"(Fessler et al., 2017)","noteIndex":0},"citationItems":[{"id":621,"uris":["http://zotero.org/users/local/0omESN17/items/R6FLQYTM"],"uri":["http://zotero.org/users/local/0omESN17/items/R6FLQYTM"],"itemData":{"id":621,"type":"article-journal","title":"House dust endotoxin and peripheral leukocyte counts: results from two large epidemiologic studies","container-title":"Environmental health perspectives","page":"057010","volume":"125","issue":"5","author":[{"family":"Fessler","given":"Michael B."},{"family":"Carnes","given":"Megan U."},{"family":"Salo","given":"Päivi M."},{"family":"Wilkerson","given":"Jesse"},{"family":"Cohn","given":"Richard D."},{"family":"King","given":"Debra"},{"family":"Hoppin","given":"Jane A."},{"family":"Sandler","given":"Dale P."},{"family":"Travlos","given":"Greg"},{"family":"London","given":"Stephanie J."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Fessler et al., 2017). A leukocytosis primarily observed in asthma patients is eosinophilia. It is characterized by elevated count of eosinophil in the blood means that the body’s immune system is hard at work trying to destroy the allergen that has entered the body ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nVPo9Hau","properties":{"formattedCitation":"(Heffler et al., 2017)","plainCitation":"(Heffler et al., 2017)","noteIndex":0},"citationItems":[{"id":623,"uris":["http://zotero.org/users/local/0omESN17/items/ZF2RHZGI"],"uri":["http://zotero.org/users/local/0omESN17/items/ZF2RHZGI"],"itemData":{"id":623,"type":"article-journal","title":"Point-of-care blood eosinophil count in a severe asthma clinic setting","container-title":"Annals of Allergy, Asthma & Immunology","page":"16-20","volume":"119","issue":"1","author":[{"family":"Heffler","given":"Enrico"},{"family":"Terranova","given":"Giovanni"},{"family":"Chessari","given":"Carlo"},{"family":"Frazzetto","given":"Valentina"},{"family":"Crimi","given":"Claudia"},{"family":"Fichera","given":"Silvia"},{"family":"Picardi","given":"Giuseppe"},{"family":"Nicolosi","given":"Giuliana"},{"family":"Porto","given":"Morena"},{"family":"Intravaia","given":"Rossella"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Heffler et al., 2017).

Question 2

How will the blood cell count and the presence of leukocytosis change your management with a patient with asthma?

Using the blood eosinophil count, the possibility of using POC technology to assess the primary biomarkers responsible for asthma can be managed. This can lead to a possibly better description of phenotypes associated with severe asthma. It can also lead to the prescription of precise biological therapies in a short amount of time ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LKIZgGab","properties":{"formattedCitation":"(Heffler et al., 2017)","plainCitation":"(Heffler et al., 2017)","noteIndex":0},"citationItems":[{"id":623,"uris":["http://zotero.org/users/local/0omESN17/items/ZF2RHZGI"],"uri":["http://zotero.org/users/local/0omESN17/items/ZF2RHZGI"],"itemData":{"id":623,"type":"article-journal","title":"Point-of-care blood eosinophil count in a severe asthma clinic setting","container-title":"Annals of Allergy, Asthma & Immunology","page":"16-20","volume":"119","issue":"1","author":[{"family":"Heffler","given":"Enrico"},{"family":"Terranova","given":"Giovanni"},{"family":"Chessari","given":"Carlo"},{"family":"Frazzetto","given":"Valentina"},{"family":"Crimi","given":"Claudia"},{"family":"Fichera","given":"Silvia"},{"family":"Picardi","given":"Giuseppe"},{"family":"Nicolosi","given":"Giuliana"},{"family":"Porto","given":"Morena"},{"family":"Intravaia","given":"Rossella"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Heffler et al., 2017).

Question 3

Is there anything she can do to decrease the exposure to the asthma trigger?

Any substances that can cause allergies, also known as allergens, can trigger asthma. If may occur through inhalation of such substances or coming in contact with them. The most common allergens that can trigger asthma are pollen, dust mites, pet dander, mold spores, cockroach waste, smoke, etc. Thus, the patient should follow the action plan devised by the doctor and identify and avoid asthma triggers which may worsen their asthma or bring on an attack.

Question 4

What specifics/symptoms/indicators would you tell the patient to look for in order for her to know to follow up in the office early in-clinic considering these factors to make sure she doesn't decline in the next month?

Suffering from frequent boughs of runny nose, sinus infections, acid reflux and sleep apnea can interfere with a patient’s asthma management action plan. Thus, these things should be relayed to the doctor at the earliest convenience to ensure that the patient does not decline the following month ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"G49TOnVl","properties":{"formattedCitation":"(Anagnostou & Turner, 2019)","plainCitation":"(Anagnostou & Turner, 2019)","noteIndex":0},"citationItems":[{"id":624,"uris":["http://zotero.org/users/local/0omESN17/items/257KZE2D"],"uri":["http://zotero.org/users/local/0omESN17/items/257KZE2D"],"itemData":{"id":624,"type":"article-journal","title":"Myths, facts and controversies in the diagnosis and management of anaphylaxis","container-title":"Archives of disease in childhood","page":"83-90","volume":"104","issue":"1","author":[{"family":"Anagnostou","given":"Katherine"},{"family":"Turner","given":"Paul J."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Anagnostou & Turner, 2019).

Question 5

Is this patient at risk of anaphylaxis?

Asthma patients tend to be at a high risk of suffering from anaphylaxis, as the two have a tendency to occur together frequently ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"L7235zXo","properties":{"formattedCitation":"(Anagnostou & Turner, 2019)","plainCitation":"(Anagnostou & Turner, 2019)","noteIndex":0},"citationItems":[{"id":624,"uris":["http://zotero.org/users/local/0omESN17/items/257KZE2D"],"uri":["http://zotero.org/users/local/0omESN17/items/257KZE2D"],"itemData":{"id":624,"type":"article-journal","title":"Myths, facts and controversies in the diagnosis and management of anaphylaxis","container-title":"Archives of disease in childhood","page":"83-90","volume":"104","issue":"1","author":[{"family":"Anagnostou","given":"Katherine"},{"family":"Turner","given":"Paul J."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Anagnostou & Turner, 2019). It can begin with something as commonplace as wheezing and difficulty breathing and escalate with time. Thus, ways to manage the occurrence of anaphylaxis is an essential part of any asthma management plan. It ensures that you are prepared about what to look for be able to treat anaphylaxis with ease.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Anagnostou, K., & Turner, P. J. (2019). Myths, facts and controversies in the diagnosis and management of anaphylaxis. Archives of Disease in Childhood, 104(1), 83–90.

Fessler, M. B., Carnes, M. U., Salo, P. M., Wilkerson, J., Cohn, R. D., King, D., … London, S. J. (2017). House dust endotoxin and peripheral leukocyte counts: Results from two large epidemiologic studies. Environmental Health Perspectives, 125(5), 057010.

Heffler, E., Terranova, G., Chessari, C., Frazzetto, V., Crimi, C., Fichera, S., … Intravaia, R. (2017). Point-of-care blood eosinophil count in a severe asthma clinic setting. Annals of Allergy, Asthma & Immunology, 119(1), 16–20.

Asthma

Asthma

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Asthma

Introduction

Asthma is basically a chronic inflammatory disorder that majorly affects the airways in many of the cells including mast cells, neutrophils and eosinophil. The individuals who are susceptible to this disease, in such people the inflammation in the airways causes continuous episodes of wheezing, chest tightness, and also coughing which is quite common during the night and also in the early hours of the morning. Mr. John is basically 35 years old who apparently seems quite healthy and currently, he is present in the downstairs of the emergency room for the agitation along with shortness of breath. His subjective data is as follows: he is mainly a 35 years old Hispanic male individual and currently, he works near a construction site, he immigrated to the United States of America some four years ago and now he lives in the city with minimum facilities. The data that we collected in the emergency room is as follow: the total height of Mr. John is 68 inches and his weight is some 165 pounds along with some muscular build, he also has long history of smoking. Currently, he takes over-the-counter pseudoephedrine for his hay fever and it is also found that Mr. John does not have any food or drug allergies.

Some of his vital signs also include a pulse of 100, respiratory rate of 29, his blood pressure is 150/85, he has an oral temperature of 98 degrees Fahrenheit and in room temperature, and his oxygen saturation is about 85% which further explains his hypoxia. These readings are basically an indication of the result of his decreased airflow in his air pipes that is a result of the inflammation in the airways along with bronchoconstriction. In the initial evaluation of the significant signs, it was observed that Mr. John was both mildly hypertensive and also tachycardia. His socioeconomic information and also his background put him at the risk of asthma. The past history of hay fever in the case of Mr. John also shows his susceptibility towards any kind of allergens and those allergens can be both food products and also drugs as well. Although according to Mr. John he don’t have any such allergic problem but by looking at his health history it is clear that he has allergies towards some food and drug products. Over the past few years, he experiences few exacerbations which require him to take steroids in order to control his ongoing condition. His exacerbations are further triggered by a viral upper respiratory infection, and last summer when the total count of pollen was high he experienced tightness in his chest along with symptoms of wheezing (Kudo et al., 2013).

Pathophysiology of Asthma

The airflow limitation in the asthma is quite obvious and it is a continuous problem in the patients, it is basically caused by a variety of changes in the airways of the individuals. These changes include bronchoconstriction, this is one of the most leading factors in the patients of asthma which further leads to the clinical sign in narrowing of the airways and also a subsequent interruption with the airflow. In the case of the exacerbations of the asthma muscle contraction in the bronchial smooth muscle occurs quite quickly in order to narrow down the airways when the individual is exposed to various allergens and drugs. Once the disease becomes more persistent and the inflammation in the airways become more progressive then certain other factors also involves and then the airflow in the body further becomes limited. These factors include edema, hyper-secretion of the mucus and also inflammation in the airways. Along with these inspissated mucus plugs are formed and also structural changes occur that includes the hypertrophy and also hyperplasia of the smooth muscles of the airways (Wark & Gibson, 2006).

Epidemiology

Recently due to the substantial increase in the prevalence of asthma worldwide many studies were done in order to determine the prevalence and also the various characteristics of this condition. There are many national and international studies that were done on the epidemiology of asthma in order to provide an insight into the epidemiology. For instance, there are many studies that proved that the epidemiology of asthma was somehow linked with the exposure to atmospheric soybean dust released during the cargo handling in the local ports (Subbarao et al., 2009).

Erikson Stage

According to the Erick stage, my patient is in the 6th stage of his age which is the intimacy and isolation stage. The stage is mainly focused on people who are between age 18-40 and my patient’s age is 35 years. As my patient is also suffering from asthma and due to asthma he often experiences breathlessness which is quite an uncomfortable experience. Therefore this stage is quite clear in my patient case because he not only lacks intimacy but at the same time he has completely isolated himself from friends and family.

Conclusion

Asthma is a disease that is common nowadays and not only adults but children are also suffering from this disease. There are various reasons on how and why it is becoming prevalent in the world population. Different people deal differently with asthma and most of the patients use inhalers. The reason that asthma becomes severe in many patients is that they ignore most of the early alarming signs of the disease due to which with the passage of time these signs get severe and it disturbs the overall lifestyle of the patient and this is quite apparent in my patient's case. He is a worker and his he did not focus on the early signs due to which the signs are now quite serious. Along with that if the patients have an early history of smoking then at that time the situation also gets worse. Therefore the patients must focus on the early signs of asthma and report to the healthcare provider before the situation gets out of hand.

References

Kudo, M., Ishigatsubo, Y., & Aoki, I. (2013). Pathology of asthma. Frontiers in microbiology, 4, 263.

Subbarao, P., Mandhane, P. J., & Sears, M. R. (2009). Asthma: epidemiology, etiology and risk factors. Cmaj, 181(9), E181-E190.

Wark, P. A. B., & Gibson, P. G. (2006). Asthma exacerbations· 3: pathogenesis. Thorax, 61(10), 909-915.

ASTHMA

ASTHMA

[Name of the Writer]

[Name of the Institution]

ASTHMA

Asthma is a problem that affects every age group. In fact, age is one of the factors that causes complications for the patient. Chronic asthma is a chronic inflammatory syndrome of the bronchial mucosa. It can cause variable airflow obstruction, airways constriction and hyper-responsiveness of the bronchial cavity. It is the bronchoconstriction stimuli and rises in mucus secretion on a cellular level. Pathophysiology of chronic asthma can damage the lungs through epithelial cells. Toxic neuropeptides and eosinophil are released at the early stages of asthma which put a negative and direct impact on the tissue causing high bronchial hyper-responsiveness. In addition, the patient faces difficulty in oxygenation because of the constriction of the airway. Just as in chronic asthma, the patient experiences airways constriction and acute asthma exacerbation. However, the number of cells contribute to the airways hypersensitivity in case of acute asthma exacerbation. These cells include B lymphocytes, basophils, eosinophil, mast cells, T helper 2 lymphocytes, neutrophils and dendritic. These cells can also cause an increase in secretions, edema, and bronchospasm by acting differently during the latest release of inflammatory cells. Chronic asthma attacks are less prominent than the acute asthma exacerbation because the patient has the fast asthmatic response of their inflammatory cells ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fEthIIZW","properties":{"formattedCitation":"(Program & Asthma, 2007)","plainCitation":"(Program & Asthma, 2007)","noteIndex":0},"citationItems":[{"id":801,"uris":["http://zotero.org/users/local/mlRB1JqV/items/DQSW63BF"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/DQSW63BF"],"itemData":{"id":801,"type":"book","title":"Section 2, Definition, Pathophysiology and Pathogenesis of Asthma, and Natural History of Asthma","publisher":"National Heart, Lung, and Blood Institute (US)","source":"www.ncbi.nlm.nih.gov","abstract":"Asthma is a common chronic disorder of the airways that involves a complex interaction of airflow obstruction, bronchial hyperresponsiveness and an underlying inflammation. This interaction can be highly variable among patients and within patients over time. This section presents a definition of asthma, a description of the processes on which that definition is based—the pathophysiology and pathogenesis of asthma, and the natural history of asthma.","URL":"https://www.ncbi.nlm.nih.gov/books/NBK7223/","language":"en","author":[{"family":"Program","given":"National Asthma Education and Prevention"},{"family":"Asthma","given":"Third Expert Panel on the Diagnosis and Management","dropping-particle":"of"}],"issued":{"date-parts":[["2007",8]]},"accessed":{"date-parts":[["2019",7,3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Program & Asthma, 2007).

Through hyperventilation, the patient faces issues with the arterial blood gas. It results in hypoxemia, which leads to respiratory alkalosis which means an increase in PH. Just like chronic asthma, the arterial blood gas get affected due to the exacerbations also. The expirations and inspirations become uneven. Inspirations become shorter while expirations become longer. This unevenness results in oxygenation that the patient receives. Patient having acute asthma exacerbation tries to trap air that causes respiratory disadvantage. It also results in respiratory acidosis due to the increase in CO2 and a decrease in tidal volume ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9XKtNbHD","properties":{"formattedCitation":"({\\i{}Asthma}, 2019)","plainCitation":"(Asthma, 2019)","noteIndex":0},"citationItems":[{"id":803,"uris":["http://zotero.org/users/local/mlRB1JqV/items/983TVIJ4"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/983TVIJ4"],"itemData":{"id":803,"type":"article-journal","title":"Asthma: Practice Essentials, Background, Anatomy","source":"eMedicine","abstract":"Asthma is a common chronic disease worldwide and affects approximately 24 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children.","URL":"https://emedicine.medscape.com/article/296301-overview","title-short":"Asthma","issued":{"date-parts":[["2019",6,24]]},"accessed":{"date-parts":[["2019",7,3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Asthma, 2019).

Five to ten percent of the population faces the issue of asthma, in which seven million are children. 250000 deaths happen worldwide due to chronic asthma each year. Chronic asthma and acute asthma have similar factors that create the issue. These are allergens, respiratory infections, and other environmental factors. Allergens include the exposure and sensitization to the dust mite. It becomes the main factor causing asthma in children. In addition animals like cats, dogs, and cockroach exposure can also cause asthma. During infancy, there are the chances of asthma due to the development of various respiratory viruses. Exposure to infection in early life weak the immune system which results in the development of asthma. Other environmental factors that cause chronic asthma and acute asthma exacerbation include; smoking, occupations, diet, and air pollution. Clinical manifestation includes coughing, wheezing, anxiety, tripodding, shortness of breath, tachypnea, and pale skin ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"SepCNXXn","properties":{"formattedCitation":"(Castillo, Peters, & Busse, 2017)","plainCitation":"(Castillo, Peters, & Busse, 2017)","noteIndex":0},"citationItems":[{"id":805,"uris":["http://zotero.org/users/local/mlRB1JqV/items/QSE4LYP5"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/QSE4LYP5"],"itemData":{"id":805,"type":"article-journal","title":"ASTHMA EXACERBATIONS: PATHOGENESIS, PREVENTION AND TREATMENT","container-title":"The journal of allergy and clinical immunology. In practice","page":"918-927","volume":"5","issue":"4","source":"PubMed Central","abstract":"Guideline-based management of asthma focuses on disease severity and choosing the appropriate medical therapy to control symptoms and reduce the risk of exacerbations. However, irrespective of asthma severity and often despite optimal medical therapy, patients may experience acute exacerbations of symptoms and a loss of disease control. Asthma exacerbations are most commonly triggered by viral respiratory infections, particularly with human rhinovirus (RV). Given the importance of these events to asthma morbidity and healthcare costs, we will review common inciting factors for asthma exacerbations and approaches to prevent and treat these events.","DOI":"10.1016/j.jaip.2017.05.001","ISSN":"2213-2198","note":"PMID: 28689842\nPMCID: PMC5950727","title-short":"ASTHMA EXACERBATIONS","journalAbbreviation":"J Allergy Clin Immunol Pract","author":[{"family":"Castillo","given":"Jamee R."},{"family":"Peters","given":"Stephen P."},{"family":"Busse","given":"William W."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Castillo, Peters, & Busse, 2017).

Diagnosis of chronic asthma includes CXRay, pulse oximetry, exposure to allergens, recurrent respiratory infections, and pulmonary function test. It is important to know the inspirations and expirations of the patient. If the person faces uneven inspirations and expirations then there can be the possibility of asthma. It can be measured through pulmonary function test and pulse oximetry. In addition exposure to allergens is a crucial factor which can be helpful to diagnose the problem. Treatment for the cause include corticosteroids, a personalized plan, and oxygen in case of emergency. On the other hand diagnosis of acute asthma exacerbation includes peak flow and pulmonary function test to identify the shortness of breath, wheezing, chest tightness, and coughing. It can be treated through the administration of oxygen and magnesium, corticosteroids, and bronchodilators ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"992kOM29","properties":{"formattedCitation":"(\\uc0\\u8220{}Understanding asthma pathophysiology, diagnosis, and management,\\uc0\\u8221{} 2015)","plainCitation":"(“Understanding asthma pathophysiology, diagnosis, and management,” 2015)","noteIndex":0},"citationItems":[{"id":802,"uris":["http://zotero.org/users/local/mlRB1JqV/items/8YPK4KMU"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/8YPK4KMU"],"itemData":{"id":802,"type":"post-weblog","title":"Understanding asthma pathophysiology, diagnosis, and management","container-title":"American Nurse Today","abstract":"Learn about new research findings and current treatment strategies for this common disorder.","URL":"https://www.americannursetoday.com/understanding-asthma-pathophysiology/","language":"en-US","issued":{"date-parts":[["2015",7,7]]},"accessed":{"date-parts":[["2019",7,3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Understanding asthma pathophysiology, diagnosis, and management,” 2015).

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References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Asthma: Practice Essentials, Background, Anatomy. (2019). Retrieved from https://emedicine.medscape.com/article/296301-overview

Castillo, J. R., Peters, S. P., & Busse, W. W. (2017). ASTHMA EXACERBATIONS: PATHOGENESIS, PREVENTION AND TREATMENT. The Journal of Allergy and Clinical Immunology. In Practice, 5(4), 918–927. https://doi.org/10.1016/j.jaip.2017.05.001

Program, N. A. E. and P., & Asthma, T. E. P. on the D. and M. of. (2007). Section 2, Definition, Pathophysiology and Pathogenesis of Asthma, and Natural History of Asthma. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK7223/

Understanding asthma pathophysiology, diagnosis, and management. (2015, July 7). Retrieved July 3, 2019, from American Nurse Today website: https://www.americannursetoday.com/understanding-asthma-pathophysiology/