Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources.  Some answers may require you to do additional research on the Internet or in other reference sources.  Choose your sources carefully.

3. Consider the discussion and any insights you gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

1. Locate an article that discusses a bioethics issue. First, provide a summary of the article and the bioethics issue being presented. Next, discuss what ethical actions the nurse should take in relation to the issue being presented. Also, discuss possible legal issues that the nurse should be aware of. This section should include at least 1 outside reference and your textbook and should be at least 1 ½ pages long.

2. Analyze the following case study and then answer the following questions:

You are working on the Operating Room and the trauma alert goes off. You respond to the ER to provide support. Once in the ER, you receive report that an 89 year old male is coming in with a self-inflicted GSW (Gun Shot Wound) to the head.  You listen to the radio traffic between the ER and ambulance to get an idea what kind of surgery you need to set up for and what will be needed as far as lines and fluid.  Here is the report:

HR: 121

B/P: 60/45

Saturation: 93%

Patient is intubated and non-responsive. Right pupil is fixed and dilated. Paramedic also states there is a large extended family headed to the ER. The patient lost his wife of 60 years 1 week ago and left a note stating that he is too heartbroken to go on. The patient and family arrive. The neurosurgeon discusses that their father’s potential outcome, even with surgery, is not good. The family still insists that the neurosurgeon complete the surgery.

1. What are the ethical and legal issues in this case study. Be specific and support your response with references

Once you have the patient in the room and you are prepped and ready for surgery, the phone rings. You receive word that the patient signed DNR orders two days ago.

1. As the OR nurse what are your legal and ethical issues now? Was the patient of sound mind when he signed this order? Do you honor the DNR or the family’s wishes? Explain and support your response.  

Your response to this case study should be at least 2 pages and include 2 outside references and your textbook.

Please submit one paper which includes both assignments.

There are 2 discussions: Topic 1 & Topic 2 (They both require references please) 

Discussion Topic 1: Third-party Payment 

How does third-party payment distort the market for health care? If it is so distorted why does every wealthy country insist on using third-party intermediaries to purchase health care? Why do we carve out a separate payment program for our elder citizens? 

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism 

please.

Discussion Topic 2: Medicaid and Medicare 

Summarize ways in which health insurance fails, as people get older. Distinguish between Medicaid and Medicare. Determine whether your state has expanded Medicaid. Why would states choose not to participate in Medicaid expansion?  

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism please

Write an executive summary that outlines the government’s impact on health reform in the U.S. healthcare delivery system. As part of your executive summary, also provide a brief analysis of the ethical principles that must be addressed within health reform in order to create a more equitable healthcare system. 

Your essay should be a minimum of two pages in length. Any sources used should be cited and referenced in APA format.

PRICE IS FIRM WITH BUDGET

  

Across health care settings, many different terms are used to describe the same or similar conditions. For example, a bed sore may alternatively be called a pressure sore, a pressure ulcer, or a decubitus ulcer. While it may be fairly manageable for a nurse to make the connection among these terms, the same cannot be said for a computer system. Nurses have the ability to reason and reflect upon their clinical knowledge. Computer systems are linear, relying on user input to output information. When diverse terms are used, systems are unable to make the connections between the data. For this reason, the health care industry is vigorously moving towards the standardization of terminologies.

Learning Resources

Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.

· Chapter 8, “Standardized Nursing Terminology”

This chapter introduces the problems related to terminology and vocabulary standardization across the broader health care field. Nursing-specific.

· Review Chapter 7, “Health Data Standards: Development, Harmonization, and Interoperability”

Health standards, rules, and definitions are requirements for effective and efficient electronic health records (EHRs). This chapter explains various options for these areas and discusses how they can be incorporated into EHRs.

· Appendix A, “Overview of the Clinical Care Classification System”

In this chapter, the authors describe challenges in health care related to clinical care classification and terminology standards. These issues are analyzed and possible solutions are overviewed.

Scherb, C. A., & Weydt, A. P. (2009). Work complexity assessment, nursing interventions classification, and nursing outcomes classification: Making connections. Creative Nursing, 15(1), 16–22. 

Retrieved from the Walden Library databases.

The authors of this article discuss the Work Complexity Assessment (WCA), a process that allows nurses to better understand interventions for patient care. The connection between the WCA, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) are also discussed.

Truran, D., Saad, P., Zhang, M., & Innes, K. (2010). SNOMED CT and its place in health information management practice. Health Information Management Journal, 39(2), 37–39. 

Retrieved from the Walden Library databases.

This article focuses on the Systemized Nomenclature of Medicine – Clinical Terminology (SNOMED CT) and how it can be used to support electronic health records (EHRs). The authors describe how SNOMED CT can contribute to EHR improvement with regard to patient safety, quality care delivery, and decision support functionality.

Cimino, J. J. (1998). Desiderata for controlled medical vocabularies in the twenty-first century. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415631/ 

Discussion: James Cimino’s Desiderata

Desiderata is a Latin word that translates to “something that is wanted or needed.” It is obvious that James Cimino had this translation in mind when he created his “Desiderata for Controlled Medical Vocabularies.” In his work, Cimino outlines 12 desiderata he believes the health care community should consider when constructing medical vocabularies. He also highlights the need to control the vocabulary used within terminology sets, as well as the requirements for doing so.

For electronic health records (EHR) and clinical decision support systems (CDS) to truly be successful, Cimino, along with many other health care professionals, expresses the vital need to standardize and control the terminology being used in health care settings.

For this Discussion, you will use one of Cimino’s desiderata (or themes) to critically appraise a nursing terminology set:

Cimino’s 12 themes for the 21st century:

· Vocabulary content

· Concept orientation

· Concept permanence

· Nonsemantic concept identifiers

· Polyhierarchy

· Formal definitions

· Reject NEC “Not Elsewhere Classified”

· Multiple granularities

· Multiple consistent views

· Representing context

· Graceful evolution

· Recognize redundancy

To prepare:

· Review the article “Desiderata for Controlled Medical Vocabularies in the Twenty-First Century” in this week’s Learning Resources. Consider how each theme aims to control the vocabulary used by nursing terminologies.

· Reflect on prominent standardized nursing terminologies sets, such as NIC, SNOMED, SABA, NANDA, and NOC. How might these terminologies compare to the requirements outlined in Cimino’s 12 themes?

· Select one nursing terminology set and one of Cimino’s themes to further examine. Does the terminology align with the requirements of this theme? Why or why not?

By Day 3

Post a brief description of the nursing terminology set and theme you selected. Explain whether this terminology aligns with the requirements and why. Provide terminology and vocabulary examples to support your answer. 

· For this discussion I choose NANDA and Formal definitions. (If it difficult, you can choose NANDA and another one of the 12 Cimino’s Theme’s.

· APA Style, 500-600 words minimum, Master Degree Quality Discussion/assignment work. 

· Please follow the instructions and read the part that say “to prepare” before do the paper. 

. Deadline: 4/18/18 at 8:00pm ET.

· For this discussion I choose NANDA and Formal definitions. (If it difficult, you can choose NANDA and another one of the 12 Cimino’s Theme’s.

· APA Style, 500-600 words minimum, Master Degree Quality Discussion/assignment work. 

· Please follow the instructions and read the part that say “to prepare” before do the paper.   

 

 Managing Health Care Quality

Imagine that you are a hospital administrator at the Sunlight Hospital in California. The main complaint among the patients is the quality of care. Your job is to understand the state of the hospital, create value, increase efficiency, and turn the facility into a local hospital of choice. Whenever you are making visits in various wards to meet the employees and the patients, you hear how the patients love the hospital, but they would like to see certain improvements in care. The employees seem to be very busy executing their duties and not interacting much with the patients. The hospital board has asked you to compile a report of your findings and suggested strategy for achieving the hospital’s current goals.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a four to six (4-6) page paper in which you:

1. Classify five (5) measurements of quality of care in a hospital, and justify the major reasons why you believe these measurements matter to patients in their process of choosing a hospital for emergency or inpatient care.
2. Specify four (4) main features in health care organizations that can be used to design a successful quality improvement plan. Articulate the significant manner in which the specified features can lead to failure or success of quality of care in Sunlight Hospital.
3. Suggest the salient reasons why quality of care would add value to and create a competitive advantage for the Sunlight Hospital. Justify your response.
4. Use four (4) recent (within the last five [5] years) quality academic resources in this assignment.
   Note: Wikipedia and other websites do not qualify as quality academic resources.

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

• Propose methodologies that have been proven to increase value in health care delivery systems
• Examine leadership and management frameworks that are most applicable to a certain organization type within the health care industry.
• Craft a strategic plan that leads to a competitive advantage within a certain market.
• Use technology and information resources to research issues in health care management.
• Write clearly and concisely about health care management using proper writing mechanics.