Advocacy for patients is important to ensure that they are receiving the proper care (Helbig, 2018), and when they can’t voice for themselves, we, as nurses, should stand up for them and make sure the proper care and needs of our patients are given if at any time it is denied or is in need of investigation or proper resources. Communication and collaboration are key in the work environment in order to provide patient-centered care (Helbig, 2018).

I had an experience where the patient was seen and the doctor determined she had not been taking her medication as prescribed and had not attended PT.  The doctor came out of the room and instructed me to document non-compliance and to discontinue her treatment at the office.  I asked him what the problem was and asked if I could talk to the patient and see what may be the cause.  He gave me permission and I was able to determine the issues within twenty minutes.  As he was seeing another patient, I waited until he was done and asked to speak to him.  I explained to him the issue was the patient was in the hole with medication through Medicare and could not afford it, and was also having problems with transportation.  He gave instruction to document the result and find the resources and samples of medications the patient needed and we would supply them until she was out of the hole. Had I not intervened or advocated for the patient, she would have been labeled non-compliant as well as had to go through the process of looking for another doctor. 

Use the image in “Discussion Question Resource: Chest X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due to infection with Mucor. Refer to the “Module 4 DQ Chest Xray” resource in order to complete the following questions.

Critical Thinking Questions

1. Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.
2. Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.
3. What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

                               Competency Assignment 2

Personal Health Records (PHRs) are designed to give consumers access and control of their health information.  PHRs are tools that give consumers a view of their health care data, either from information they have entered, information linked to their health care provider, or information generated from insurance claim data.

As Personal Health Records (PHRs) proliferate, the consumer is faced with many choices.  PHRs offered through insurance plans and employers limit the consumer choices but they do provide links to clinical data.  Stand-alone web-based PHRs offer more features but with little interface to the patient’s current clinical information.

While there are numerous Personal Health Record products available, the industry is still at an introduction to growth stage.  There are no established standards such as those available with electronic medical records and no agency that certifies the offerings.  The consumer must rely on their own criteria in choosing a product.

Some of the criteria that have proven to be critical for electronic medical records and for health web site services can be combined to apply them to PHRs.  They include: privacy, security, usability, portability, completeness, vendor reliability, and access/availability.

1. Availability/Access:  This refers to the consumer’s ability to access and manage their personal record via the Web.  Access also includes minimal accessibility standards defined by the W3C and by federal laws (508 compliance).
2. Completeness: This refers to the information fields available in the records.  The basic PHR should capture, demographics, health behaviors, social history, family health history, allergies, medications, lab results, past medical care, current existing conditions, physician information, insurance information, etc.
3. Privacy: Web site has published privacy policy that protects individually identifiable information (no disclosure without consent).  Privacy refers to policies that protect the unauthorized secondary usage of information.  The PHR should indicate if it meets HIPAA security requirements.
4. Security: This refers to the technical protections available on the system including passwords, authentication mechanisms, secure connections, etc.  In an ideal situation, the site should have a consumer-accessible audit log to see who has viewed the information.  The site should also provide details of if/when the consumer is notified about breaches of security.  Are you aware of the site security through policies and symbols?
5. Usability: This refers to the features available on the site. The PHR should provide the ability for a non-technical or not IT-related individual to easily join, navigate, and enter information. The level of jargon on the site as well as navigation links can influence the perceived usage.  A novice user should be able to successfully complete registration, information entry, printing, saving, and information retrieval. Is there help or support available? Is the information presented using “common language” or is it full of jargon (Basically, can you grandmother understand it? Can someone with an 8th grade reading level understand it?)
6. Portability: This refers to the consumer’s ability to move records out of the current provider to others.  This feature can be both via paper or electronic. Is the information portable – do you have to print it?  Can you electronically download any of the information?  Can you email the information?
7. Vendor reliability: This refers to the reliability and history of the vendor.  A new service may not have the ability to continue business operations and has a high chance of closure.  Vendors linked to or partnering with sponsoring national organization provide more stability.

Use the criteria provide to evaluate, search for a PHR.  You may be able to use the one affiliated with YOUR HEALTH INSURANCE (now is a good time to find out if they have one). Or, you can find one from http://myphr.com

Write a report that includes:

1. Overview of the PHR
2. Who is the target consumer?
3. Evaluation of the PHR using the 7 listed criteria (a paragraph on each)
4. Recommendations for improving the PHR
5. Conclusion

Instructions:

1. Please answer all the following questions: 

Community to be used (Miami or Fort-lauderdale Florida)

Instructions:

1. Please answer all the following questions: 
   • What facilities are available for the homeless in your community? How do people access these resources?
   • What is the demographic make-up of the homeless population in your community? Primarily male or female? Family? Ethnic group?
   • What is your risk of becoming homeless? What resources would you draw on if tomorrow you woke up with no job and no housing?
   • What physical illnesses or disorders are specific to homeless people in your area? What are the greatest risks?

• Please answer all questions in a discussion APA Format including references.