Creating Culturally Competent Health Care Organizations

Read chapter 9 of the class textbook and review the attached PowerPoint presentation.  Once done present an analysis of the following case study answering the questions below.

Mrs. Li Huan, a 79-year-old Chinese American widow who lives alone in New York City’s Chinatown recently had a cerebrovascular accident (CVA) or stroke. Mrs. Li has right-sided paralysis with partial loss of voluntary movement and sensation in her right arm and leg. Mrs. Li has weak facial muscles, difficulty with speech, and drooling. She experiences numbness and tingling in her arms and legs. Mrs. Li is going to a rehabilitation center known for delivering culturally competent interprofessional care where she is cared for by a team of credentialed health care providers: Dr. Indira Patel, nurse J.J. Johnson, physical therapist Mohammad Abu Said, dietician Maria Gonzalez, and Chinese American herbalist, Chen Minzhe.

(Note: In traditional Chinese culture, a person’s last name or surname is written first, followed by his/her first name. Therefore, the patient’s last name is Li and the herbalist’s last name is Chen. It is proper etiquette to call a person of Chinese background by his/her title, in this case, Mrs. Li and Mr. Chen until the individual gives you permission to use his/her first name. To further confuse matters, many acculturated Chinese Americans are likely to reverse their first and last names in the typical US or Canadian order. Therefore, it is important to ask the patient, “What is your first name? What is your last name?” Note the correct order on the patient’s chart for other members of the team.)

1. How do members of the interprofessional team assess Mrs. Li’s literacy, diet, and medications, including herbal medicines being provided by her herbalist, Mr. Chen?
2. How do the nurse and other members of the team determine if complementary or integrative treatments, such as medicinal herbs, are helpful, harmful, or neutral to Mrs. Li’s recovery?
3. If you were seeking advice or consultation from a traditional Chinese herbalist in your community, how would you locate one?
4. Why do patients seek treatment from alternative and integrative healers?
5. How can credentialed health care providers work collaboratively with Mr. Chen to ensure that prescription medicines and herbs are compatible and that there are no adverse or harmful interactions between various medicines?
6. What strategies would you recommend to promote Mrs. Li’s optimum functioning and health following her CVA? (Andrews & Boyle, Transcultural Concepts in Nursing Care, 7th Edition).

INSTRUCTIONS:

 APA format word document, Arial 12 font attached to the forum ,   If you don’t post your assignment in any of the required forums you will not get the points.  A minimum of 2 evidence-based references besides the class textbook no older than 5 years must be used.   the proper references no older than 5 years in two different days to verify attendance and as well make sure the references are properly quoted in your assignment.  A minimum of 800 words is required.  

Case Study, Chapter 10, Principles and Practices of Rehabilitation

1. Mrs. Adams, 72 years of age, is admitted to the rehab unit with the diagnosis of stroke. The stroke affected the limbic area in the brain, which has caused the patient to have emotional labiality (her mood changes rapidly because she misinterprets situations). As a result of the emotional labiality, she sometimes refuses to be repositioned or to participate in physical or occupational therapy. She sometimes also refuses to eat and drink. The patient’s right side is paralyzed and flaccid. She has no feeling on her right side. She has reddened areas on her coccyx and both heels at least 1 cm in diameter that do not go away with repositioning. She is incontinent of urine and stool. She has problems with communication called global aphasia (difficulties understanding speech and the written word and difficulties with speaking and writing). She is 5 feet tall and weighs 178 pounds. She has a tendency to develop skin tears because her skin is thin, and she has several bandages on her arms. The family states they are concerned because the staff on the previous medical-surgical unit would drag their mother up in bed when she slid down. The staff would chart when their mother refused to be repositioned and then would not reposition her for hours. 

1. Explain the pathophysiology of the risk factors that predispose Mrs. Adams to developing pressure ulcers?
2. What nursing measures need to be instituted for Mrs. Adams based on the information presented in the case study?

2. You are assigned to care for David Ramsey, a 22-year-old male patient who sustained a back injury secondary to being thrown from a motorcycle. He did not damage the spinal cord, but the computed tomography revealed a compression fracture at L-2 (lumbar area). David complains of severe lower back pain with numbness and tingling in the lower extremities. You identify the following nursing diagnosis: Impaired Physical Mobility.

1. What assessments are indicated based on this nursing diagnosis?
2. List other major nursing diagnoses based on David’s clinical presentation.

To Prepare:

• Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. 

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

 Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this Discussion, you will focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. You also will explore safe prescribing.

To prepare:

• Review your state’s process for obtaining prescriptive authority and associated fees
• Review the DEA website and review the process for obtaining a DEA number and associated fees.
• Review and select one of the following case studies and analyze the provider information:
  • Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.
  • Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices.

By Day 3

Post a brief summary of your case study and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.