Healthcare Ethics and Healthcare Reform

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According to the American College of Emergency Physicians. (ACEP) (n.d.), “the enacted Affordable Care Act (PPACA) of 2010 has fueled ethical debate of several important controversial topics. Ethical issues of health care reform include moral foundations, cost containment, public health, access to care, ED crowding, and end-of-life issues.”

Review the following article:

ACEP. (n.d). The Ethics of Health Care Reform: Issues in Emergency – Medicine – An Information Paper. Retrieved from https://www.acep.org/life-as-a-physician/ethics–legal/ethics/the-ethics-of-health-care-reform-issues-in-emergency—medicine—an-information-paper/#sm.0000s5twwucmldpxvhb28muxrbrou

• From a healthcare administrator perspective, discuss the ethical and moral issues presented in this article. Do you agree or disagree? Explain your rationale in detail.
• What ethical ramifications should be considered in regard to future healthcare reform?

250 words

Assignment 1: Gastrointestinal Tract: Disorders of Motility

Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.

Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.

To Prepare

· Review this week’s media presentation on the gastrointestinal system.

· Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.

· Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.

· Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.

· 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 gastritis. Consider the epidemiology and clinical presentation of gastritis.

To Complete

Write a 2- to 3-page paper that addresses the following:

· Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.

· Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

This week’s topic  is :  The case of  “I can’t catch my breath”

John, a healthy twenty-eight year old electrical engineer, was driving home from work one evening when he experienced sudden stabbing pain in his right pectoral and right lateral axillary regions. He began to feel out of breath and both his respiratory rate and heart rate increased dramatically. As luck would have it, John passed a hospital each day on his way home and was able to get himself to the hospital’s emergency room. The emergency room physician listened to John’s breathing with a stethoscope and requested blood gas analysis and a chest x-ray. John answered a few of the doctor’s questions. The doctor noted that John had no history of respiratory problems but was a heavy smoker.

After viewing the chest radiograph, the doctor informed John that he had experienced a spontaneous pneumothorax, or what is commonly called a collapsed lung. The doctor explained that a hole had opened in John’s right lung and that this hole had allowed air to leak into the cavity surrounding the lung. Then, as a result of the lung’s own elastic nature, the lung had collapsed. The doctor said he could not be certain of the cause of thepneumothorax, but smoking cigarettes had certainly increased the likelihood of it happening. He told John he was fortunate the pneumothorax was small, which meant that relatively little air had escaped from the lung into the surrounding cavity, and it should heal on its own. He instructed John to quit smoking, avoid high altitudes, flying innon pressurized aircraft, and scuba diving. He also had John make an appointment for a re-check and another chest x-ray.

Case Background

Spontaneous pneumothorax occurs when a blister on the surface of the lung opens, allowing air from the lung to move into the pleural cavity. This occurs because alveolar pressure is normally greater than the pressure in the pleural cavity. As air escapes from the lung, the lung tissues will recoil, and the lung will begin to collapse. The lung will continue to collapse until the difference between the alveolar pressure and pleural pressure disappears or until the collapsing of the lung causes the opening to seal.

The pneumothorax decreases the efficiency of the respiratory system, which in turn results in decreased blood oxygen concentration, increased respiratory rate, and increased heart rate. If the pneumothorax is small, the air that escapes into the pleural cavity can be reabsorbed into the lung once the opening has sealed shut. If thepneumothorax is large, a needle or chest tube may have to be inserted into the pleural cavity to draw the air out and allow for the re expansion of the lung.

Utilizing the med terms you learned this week answer the following questions

Why was John instructed to avoid high altitudes and flying in non pressurized aircrafts?

That is, what are the effects of high altitudes and or decreased air pressures on the respiratory system.

Here are the discussion board requirements.

• The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source.
• classmates. 
• Plagiarism of any kind will result in a “0”.

Write a 2–4-page report on the concepts, processes, and tools needed to conduct a community health assessment, how to find the data, and how to validate the data. Explain the factors that can affect the health of a community, along with how to obtain that information.

Understanding community and state health care issues and concerns, the local resources available, and accessibility of those resources can inform health care practices and improve quality patient outcomes.  

Questions to Consider 

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

• What types of techniques and activities should be included in a community health assessment?
• How can these techniques and activities help determine both assets and gaps in health care services in a community?

Assessment Instructions :

Imagine you work for an organization that has decided to open a satellite facility in an underserved community. Your organization asks you to move to the new location and assist with some of the preliminary work. Part of this work is to determine the health care needs of the community. How will you do this? What information will you need to know? Where will you find the information?

Preparation

Search the Capella library or the Internet for peer-reviewed journal articles on how to conduct a community health assessment. You will need at least 3 resources to use in this assessment.

Directions

Develop a plan for a community health assessment in which you complete the following:

• Describe the type of data needed to make an informed community health assessment.
• Explain how the data will help determine the health care needs of the community.
• Describe your strategy for obtaining the necessary data.
• Explain the factors that impact the health and wellness of a community. (Hint: This is a very broad list. Think outside the box on this one!)
• Explain how you will obtain information on these factors for your specific community.
• Explain how you will determine if the data and information you obtain is valid and reliable.
• Format this assessment as a report that you would submit to a director or other organizational leader. You are still required to follow APA guidelines for in-text citations and references.

Additional Requirements

• Include a title page and reference page.
• Ensure your assessment is 2–4 pages in length.
• Use double-spaced, 12-pt., Times New Roman font. (Recommended)

            Assignment Information       

1.   Due Date                  Sunday, November 1, 2018                   11:59 PM    Points Possible                100       
2. Vila Health: Marketing Plan
   Overview
   Effective marketing plans begin with thorough external environmental  and internal organizational assessments, alignment with strategic plans,  and clear identification of directional strategies. The marketing plan  must reflect logic, cohesion, realistic interventions and costs, and  ideally work with the strengths and opportunities that fit the overall  context of the proposed service line. In this assignment, you will  develop a conceptual level marketing plan for St. Anthony Medical  Center’s Labor and Delivery service line, which is based on your  assessment. Additionally, the marketing plan will include evidence-based  recommendations and your creative insights regarding how to optimally  position and communicate the Labor and Delivery service line to  prospective consumers.
   Recall from your previous visit with the leadership team, that your  CEO has communicated a growth strategy for St. Anthony Medical Center.  The marketing director and leadership team have further determined that  the Labor and Delivery service will implement a market pull strategy  where consumers will be drawn to the organization based on some unique  feature or features of the service line (also known as differentiators).  You are competing against two other similar services at area hospitals,  so your marketing conceptual level recommendations will need to assure  that you have differentiated St. Anthony Medical Center’s Labor and  Delivery service in a competitive manner. Consider how a health care  organization might differentiate it’s service from a competitor (review  your Unit 2 readings or conduct research in the Capella University  Library on strategic marketing and differentiation strategies). You may  wish to reflect on some of the facets that you as a consumer consider  when selecting health care providers and organizations.
   Your marketing director and the Labor and Delivery unit manager would  like to discover your fresh perspective and recommendations. At a  conceptual level, given the organization’s desired target versus actual  performance, what suggestions might you offer to convert prospective  consumers into satisfied Labor and Delivery patients? Remember to assess  gaps between actual performance versus desired targets (review the  current Labor and Delivery budget to determine current versus targeted  number of deliveries, profit margin, and so forth).
   This all corresponds with steps four and five of Kotler’s Marketing Plan format in Health Care Marketing. Savvy interns will read the assignment scoring guides and construct an outline before beginning research for this activity.
   Last week, you were exposed to a lot of information about St. Anthony  Medical Center in general and the Labor and Delivery unit in  particular. You may want to consider reviewing those documents,  interviews and e-mails again while working on this unit’s assignment.
   Instructions
   Review the vision, mission, values statement, strategic directional  strategy for St. Anthony Medical Center, and assess the Labor and  Delivery service line offerings.
    
   • Conduct a gap analysis of St. Anthony Medical Center’s Labor and Delivery service relative to internal goals.
   • Construct a competitive analysis of St. Anthony Medical Center’s Labor and Delivery service relative to competitors.
   • Propose general or conceptual level recommendations to close gaps  such as missing services, missing marketing channels, suboptimal  profitability, and so forth.
   • Formulates insights or creative approaches that may be helpful in  construction of an action plan to implement the recommendations.
   • Submit your assignment by due date. Be sure to use current APA style and formatting throughout.