It’s important I meet the competencies…!

Overview 

  

Create a 15-minute oral presentation (3–4 pages) that examines the moral and ethical issues related to triaging patients in an emergency room.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:  

• Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.       
  • Explain the health care policies that can affect emergency care.
  • Recommend evidence-based decision-making strategies nurses can use during triage.
• Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.       
  • Describe the moral and ethical challenges nurses can face when following hospital policies and protocols.
  • Explain how health care disparities impact treatment decisions.
• Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.       
  • Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.
  • Correctly format citations and references using APA style.

Assessment Instructions 

  

Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

• One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.
• The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

Preparation

Search the Capella library and the Internet for scholarly and professional peer-reviewed articles on best practices in triage nursing. You will need at least three articles to use as support for your work on this assessment.

Directions

Create a 15-minute presentation (3–4 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.

Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

• Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.
• Explain how health care disparities impact treatment decisions.
• Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?
• Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?
• Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.

Additional Requirements

Your presentation should meet the following requirements:

• Written communication: Written communication should be free of errors that detract from the overall message.
• References: Include a reference section with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.
• APA format: Resources and citations should be formatted according to current APA style and formatting.
• Length: 3–4 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.
• Font and font size: Times New Roman, 12-point.

 

A Nursing theory is a set of concepts, definitions, relationships, and propositions derived from nursing models (Smith & Liehr, 2008). A conceptual model is a visual method of representing a set of causal relationships between factors that were believed to impact one or more biodiversity targets (Morgan, 2005). One of the main differences between the two is that a theory is based off research questions and study variables, while a conceptual model is used to guide research and can be tested and changed. Nursing theories are made up of conceptual models. Nurses like Virginia Henderson, Martha Rogers, Dorothea E. Orem, Betty Neuman, Hildegard Peplau, Madeleine Leininger, Patricia Benner, have created theories to help better understand the nursing profession. From different point of views, we can build our own concepts of what this career is about. Understanding this and extracting the best of each theory, we, as nurses, can take the level of healthcare to its maximum.

Betty Neuman developed the System Model, which is a nursing theory that focuses on the way that a patient responds to environmental stressors. These stressors include the intrapersonal, interpersonal, and extrapersonal types. It also involves the use of different levels of nursing prevention intervention (primary, secondary and tertiary levels) in order to maintain the highest level of wellness in the patient.  Nursing involves being concerned with the whole person, including the patient’s state of mind, which involves stress levels.

By applying nursing theories, effective nursing care can be provided for patients. An example in nursing practice in which Neuman’s theory would be effective is in treating patients that suffer from diseases with no cure, such as Multiple sclerosis (MS). This is an autoimmune disease of the central nervous system. It can take a toll on the patient’s emotions. The goal of treatment is to control the symptoms to be able to provide a better quality of life to the patient. For the patient, being able to speak about their situation to someone that would understand, such as a nurse, can help relieve stress. Nurses can ask and teach the patients to rest more, avoid certain foods, protect themselves from the sun, and other methods to help reduce fatigue and stress (Ahmadi & Sadeghi, 2017). By putting an importance on stress levels in a patient, the patient’s standard of life will improve. Reducing and preventing stress will help improve sleep patterns and reduce anxiety and depression. Also, being stressed, the body uses energy that is needed in order to maintain the immune system, and protect the body from illness, so through preventing it, immune systems will be stronger.

During the last 5 weeks, you have explored various body systems: neurological, cardiovascular, respiratory, and hematological. These four systems work together along with other body systems to complete a myriad of functions. For this reason, when disorders occur within one body system, it can create potentially devastating effects throughout the entire body. For instance, Parkinson’s disease is a disorder of the central nervous system, yet its alterations actually affect multiple body systems from the cardiovascular system to the gastrointestinal system. In this Assignment, you examine alterations associated with disorders, as well as the impact of the alterations on multiple body systems.

To Prepare

• From the list below, select a disorder of interest to you:
  • Alzheimer’s disease
  • Asthma in children
  • Chronic obstructive pulmonary disease (COPD)
  • Congestive heart failure
  • Hepatic disease (liver disease)
  • Hypertension
  • Hyperthyroidism and hypothyroidism
  • Seizures
  • Sepsis
• Identify alterations associated with your selected disorder. Consider the pathophysiology of the alterations. Think about how these alterations produce pathophysiological changes in at least two body systems.
• Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact the pathophysiology of the alterations you identified, as well as the diagnosis and treatment of your selected disorder. 
• Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology and clinical presentation of your selected disorder.

To Complete

Develop a 5- to 10-slide PowerPoint presentation that addresses the following:

• Describe your selected disorder, as well as associated alterations. Explain the pathophysiology of the alterations, including changes that occur in at least two body systems.
• Explain how genetics, gender, ethnicity, age, and behavior might impact the pathophysiology of the alterations you identified, as well as diagnosis and treatment of your selected disorder.
• Construct a mind map for the disorder you selected. Include the epidemiology, pathophysiology of alterations, risk factors, and clinical presentation, as well as the diagnosis and treatment of the disorder.

4 references not more than 5 years

Assignment: Adaptive Response

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately, they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately, she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred later in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

• Review the three scenarios, 
• Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.
• Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to constructing a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

• For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.
• Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.
• APA citation 3 to 4 references within 5 years