Step 1 Do some research on the Affordable Care Act.  You can start with the government sponsored website, Health and Human Services Website (Links to an external site.), but find an additional resource as well. 

Step 2 After reading about payment sources in this week’s lesson, and conducting your research, address the following:

• Where does the Affordable Care Act fit into the overall U.S. health care payment system?
• How has it affected private insurance and Medicaid?
• Did it go far enough in providing access to health care for all U.S. citizens?  Too far?  Explain your position.

 Follow up discussion post please respond to below post to add information and expand ideas one page intext citation and reference.

Privacy is essential in all parts that involve communication, storage, and processing of data. In this case, hospitals should have a high level of confidentiality when it comes to patient’s health information records(English & Lewis2016). This discussion post will respond to how a health facility handled Jean’s health information. According to the right of privacy, a patient has the right not to have their personal information disclosed. Dr. Grant and the billing office violated the right to privacy of Jenna (Donna, Yilmaz, & Sarah, 2019). Jenna had told the billing office that she would not want the bill sent to her mother’s insurance instead to a college address, which the billing office agreed to do so. Later, after the software upgrade, the billing office sent the bill to the mother’s insurance, which violated Jenna’s right to privacy. On the other side, Dr. Grant disclosed that Jenna had visited the hospital, which she was not supposed to. Mrs. Peterson did not have the right to ask Dr. Grant why Jenna had visited some weeks ago; instead, she should have waited to hear from Jenna why she had gone there.

Putting into consideration how the incident transpired, Jenna has the right to sue for a confidentiality breach. In this case, she would sue them for breach of patient privacy, HIPAA noncompliance, and causing emotional distress. Mrs. Peterson should also sue the billing office for sending her a bill for a visit she did not know. For the organizations to prevent future confidentiality violations, they should use the following risk recommendations. First, it should give patient confidentiality a high priority whereby all parties in that organization should take responsibility. Second, the organization should have a dedicated privacy officer who would help the organization develop consequences for employees who breach patient confidentiality. Lastly, the organization should require that every staff sign a confidentiality agreement when first employed.

References.

Donna, K. H., Yilmaz, C. K., & Sarah, J. T. (2019). Health records and the law. Burlington, Massachusetts: Jones & Bartlett Learning.

The HIPAA Privacy Rule [Video file]. (2016, June 13). Retrieved January 30, 2021, from https://www.youtube.com/watch?v=y751i4QqP0g

HIPPA Security Series [PDF]. (n.d.).

Privacy. (2020, December 10). Retrieved January 30, 2021, from https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

 42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO2 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch. 

 Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. 

 Explain why prostatitis and infection happen. Also explain the causes of systemic reaction. 

BACKGROUND

Mrs. Maria Perez is a 53 year old Puerto Rican female who presents today due to a rather “embarrassing problem.” 

SUBJECTIVE

Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past 2 years, she has been having more and more difficulty maintaining her sobriety since the opening of the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during its grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past 2 years and she is concerned about the negative effects of the cigarette smoking on her health. 

She states that she attempts to abstain from drinking but she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much,” but she enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much. She currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight. 

Mrs. Perez is quite concerned today because she borrowed over $50,000 from her retirement account to pay off her gambling debts, and her husband does not know. 

MENTAL STATUS EXAM

The client is a 53 year old Puerto Rican female who is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. When you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation and self-reported mood. She denies visual or auditory hallucinations, and no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact; however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Diagnosis: Gambling disorder, alcohol use disorder

Decision Point One

Antabuse (disulfiram) 250 mg orally every morning

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Mrs. Perez reports to the office complaining of sedation, fatigue, and a “metallic taste” in her mouth, which “seems to be going away.” She also reports that she had just one drink about 5 days after starting the drug and thought that she would “die.” She reports that her face was red, and she felt that her heart would “pound right out of my chest.” 
• Mrs. Perez also reports that she continues to visit the casino but has not been spending as much money there. She has noticed that her cigarette smoking is increasing 

Decision Point Two

Continue current dose of Antabuse and refer to counseling for ongoing gambling issues 

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Mrs. Perez in 4 weeks and reports that she has met with the counselor, but she did not really like her. She also started going to a local meeting of Gamblers Anonymous 
• She states that last week, for the first time, she spoke during the meeting. She reports feeling supported in this group. She also reports that she is still smoking quite a bit

Decision Point Three

Explore the issue that Mrs. Perez is having with her counselor, encourage her to continue attending the Gamblers Anonymous meetings, and discuss smoking cessation options

The Assignment: 5 pages

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

In this assignment, students will pull together the capstone project change proposal components (Topic after discharge follow up) they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:     Exemplify professionalism in diverse health care settings.

2.2:     Comprehend nursing concepts and health theories.

3.2:     Implement patient care decisions based on evidence-based practice.

The topic is after discharge follow up, the facility is Perdue Medical Center a long term and rehab facility