Comment 1

The pillars of principalism represent the four areas of consideration that must be weighed when faced with an ethical dilemma. I would rank the four ethical principles in the following order:

1.)    Nonmaleficence

2.)    Beneficence

3.)    Respect for autonomy

4.)    Justice

I believe that nonmaleficence, or the principle of not causing harm or purposeful wrongdoing onto others should be the highest ranking ethical principle (Grand Canyon University, 2015). Nonmaleficence is a core medical ethical standard but can also be applied on a broader spectrum throughout society. In a Christian, biblical narrative I believe nonmaleficence to be one of the strongest ethical pillars as well. Numerous biblical teachings and several the 10 commandments of Christian faith relate to the core concept of nonmaleficence (“Bible List Of The Ten Commandments,” 2017). Any consideration of nonmaleficence is likely to involve an examination of beneficence since they can often be considered inseparable. Beneficence is the principle of providing benefits to others. Respect for autonomy is the patient’s right to choose what happens to their body. Though this seems pretty straight forward, there is possibility for dilemma in cases where an individual is unable to make autonomous decisions. Autonomy can be seen as the limiter on how far a clinician can medically intervene for a patient. Justice is the principle of fair and equal benefits and treatment among all people. Justice may require an analyzed approach and comparison and is therefore in the lowest ranking but nonetheless a significant and crucial pillar.

Comment 2

Similar to how the U.S. has placed the respect for autonomy as the highest of the four principles, I too rank autonomy as the most important biomedical ethics principle. I believe that first and foremost, what happens to the body of an individual is the decision of that individual, assuming that those decisions do not cause harm to anyone else.

I rank nonmaleficence as my second most important principle of ethics because I don’t believe anyone should intentionally cause harm to others.  

The ranking of the last two principles, for me, is slightly less clear. Beneficence and justice are tied in third. When I see the term “prevent” as in prevent harm, I want to rank beneficence higher on my list, but I need further consideration. In consideration of justice, the fair distribution of benefits is of extreme importance and is no small issue. It is of huge importance, but it is not what I think of when I initially think of ethics.

In relation to the Christian biblical narrative, I believe the order of importance for the principles would be: beneficence, justice, nonmaleficence, and respect for autonomy. I believe this would be the order because in the beginning, God provided benefits that were balanced and distributed fairly to all (beneficence and justice). This resulted in Shalom, a peaceful and orderly state. Nonmaleficence I believe would be ranked third because we were (are) not to cause harm to others. Finally, I believe respect for autonomy would be last in the Christian biblical narrative because all living things had what they needed, and they believed and trusted in God to provide all their needs. 

Writing that autonomy would be ranked last in the Christian biblical narrative when I ranked it first really surprised me and is making me think about how these principles of ethics can be interpreted and determined to be more or less important based on the approach.

  

Module 4 DQ 1 and DQ 2

Tutor MUST have a good command of the English language

These are two discussion questions

Your DQ1 and DQ2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please

Tutor MUST have a good command of the English language

Sources need to be less than five years old and journal/scholarly articles. 

No textbook or direct quotes 

Topic 1 DQ 1

Reliability and validity are often misunderstood and not given much notice in research articles. Using any example, demonstrate how you would correctly describe these two terms to a nurse prepared at a bachelor’s degree level or below. Then describe why the reliability and validity of a study is important for translation.

Topic 2 DQ 1

What are the criteria for selecting qualitative versus quantitative resources in relation to your literature review? Which method(s) of research are you selecting? Why?

 Healthcare professions work in various environments to fulfill their roles and responsibilities to provide healthcare services. Pick a healthcare profession and an environment they work within and discuss the role they play within that environment along with the interaction they have with other healthcare professions and patients. How does their role impact other healthcare professions and patients if they make a mistake? Finally, discuss why interdisciplinary healthcare teamwork is important to a healthcare organization and patients. 

My Profession: Administrator in NICU in hospital or Administrator in Pediatric Office

Project 1: Promoting Health Care Quality  

In this course, you develop a comprehensive Course Project: Promoting Health Care Quality. 

To initiate this project, this week you examine the systems and structures of an organization with which you are familiar. 

Organizational Systems and Structures Evaluation 

When a problem related to health care quality and patient safety arises, there can be an inclination to focus on a specific event rather than to examine the larger context surrounding it. Analyzing the systems and structures within an organization provides a foundation for generating a fuller understanding of how and why the event occurred and for developing strategies to address the underlying issues. Perhaps more importantly, such an analysis can be used to proactively identify potential challenges and improve organizational systems and structures in order to promote positive outcomes. In the first section of your Course Project, you analyze the systems and structures of a health care organization with which you are familiar. 

To prepare:  Identify a health care organization with which you are familiar; one that you will be able to sufficiently analyze to complete the full scope of the Course Project.

 Select two or more of the following frameworks: o Learning organizations o Complex adaptive systems (CAS) o Clinical microsystems o Good to great o 

The 5 Ps You may use the same frameworks that you addressed in this week’s Discussion. 

 With these frameworks in mind, analyze the systems and structures of the organization. Be sure to research and consider: o Mission, vision, and values o Strategic plan, goals, and objectives, if possible o Key operational processes and patterns o Information technology use o Organizational priorities and investments, as indicated by financial data.

Section 1: Organizational Systems and Structures Evaluation  As you continue your evaluation of a health care organization, it is essential to pay attention to culture. Organizational culture provides the context in which all interactions and processes occur, and is therefore central to any effort to enact change.  To prepare: •Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of the Course Project). •In addition, consider the ideas and information exchanged in this week’s Discussion. Continue to analyze essential elements of organizational culture and evaluate the influence of culture on the ability to achieve goals within your selected organization.   

 To complete:  Write a 4- to 5-page paper in which you: 

•Provide a description of the organization you selected 

•Present your analysis of the organization with attention to: 

•Its mission, vision, values 

•Strategic plan, goals, and objectives 

•Key operational processes and patterns 

•Information technology use 

•Organizational priorities and investments, as indicated by financial data 

•The essential elements of the organization’s culture 

•The influence of culture on meeting organizational goals.

Required Readings  

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.  •Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226) 

•Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280) Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.   Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.  

•Chapter 3, “General Concepts in Quality” (pp. 45–82) See the six aims for quality 

proposed by the Institute of Medicine (IOM).   Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.