Patient Introduction

Kenneth Bronson is a 27-year-old male who was just admitted to the Medical Unit from the Emergency Department. He presented to the Emergency Department two hours ago with chest tightness, difficulty breathing, a productive cough for a week, and fever. Chest x-ray revealed right lower lobe pneumonia. IV was started of normal saline at 75 mL per hour. He is receiving oxygen at 2 L/min per nasal cannula. SpO2 on room air was 90%, which increased to 95% with supplemental oxygen. He had a temp of 102.6°F and was given acetaminophen 1,000 mg in the Emergency Department. Pharmacy just delivered the antibiotics to be given.

 

Discuss how the Tuskegee Study started out and the intent of the research (3 points).

o   Cite additional source(s) and include on reference page in APA (1 point)

·         What was unique about the population of Tuskegee, Alabama, as it relates to this study? (2 points)

·         Why do you believe Dr. Douglas chose Dr. Brodus and Miss Evers to participate in this study? (2 points)

8

·         Describe at least three distinct approaches Miss Evers used to convince the men of Tuskegee to participate in the study? (3 points)

·         For each activity by Miss Evers – identify if you feel the activity constituted use of coercion, power (implicit or explicit), advocacy, or a mixture of these and explain why? (6 points)

9

·         In what ways did the United States government use power to influence and propel this study to continue for several decades? (2 points)

·         In what ways did roles (e.g. physician, nurse), race, economics, education, or other factors contribute to this study continuing and to Miss Evers staying with the study? (6 points)

8

·         How do you feel about Miss Evers participation in the Tuskegee Study?  (2 points)

·         What would you have done the same or differently? (3 points)

·         Why? (3 points)

8

·         Locate another research study that violated ethical standards.

o   Describe the study itself (3 points).

o   Which ethical standards did it violate and how? (4 points)

o   Cite additional source(s) and include on reference page in APA (1 point)

8

·         Compare and contrast the ethical violations of the study you describe and the Tuskegee Study. In what specific ways are they similar or different?) (4 points)

4

·         Describe specific research ethics, laws or practices (names, descriptions of protections) that exist now to prevent the issues that arose from the Tuskegee Study and other unethical studies. (4 points)

o   Cite additional source(s) and include on reference page in APA (1 point)

5

·         Written as a paper in APA, not as a bulleted list of answers

·         Paper format (correct APA 7th ed.): font (½ pt), margins/double-spacing (½ pt), page numbers (½ pt), cover page & reference page formats (½ pt)

·         Correct spelling and grammar (4 points)

·         Citations & References (correct APA 7th ed – graded in sections above with these criteria): all references are cited in paper; each reference includes all required elements (author, year, title, journal name, volume, issue if available, page number or electronic locator, URL/doi

·         Turnitin score reflective of original thought (4 points)

10

Total

60

Write a 4–6-page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1.
In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

As a master’s-level health care practitioner, you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.
Competency Map
Use this online tool to track your performance and progress through your course.

• Assessment Instructions:  Propose an organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions.
  Note: Remember that you can submit all, or a portion of, your draft policy proposal to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
  Requirements
  The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.
  • Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
    • What is the current benchmark for the organization and the numeric score for the underperformance?
    • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
    • What are the potential repercussions of not making any changes?
      • What evidence supports your conclusions?
  • Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policy or law.
    • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
    • How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
    • How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting?
    • How can you ensure these strategies are ethical and culturally inclusive in their application?
  • Analyze the potential effects of environmental factors on your recommended practice guidelines.
    • What regulatory considerations could affect your recommended guidelines?
    • What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
  • Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
    • Why is it important to engage these stakeholders and groups?
    • How can their participation produce a stronger policy and facilitate its implementation?
  • Organize content so ideas flow logically with smooth transitions.
    • Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
  • Use paraphrasing and summarization to represent ideas from external sources.
    • Be sure to apply correct APA formatting to source citations and references.
  • Example Assessment: You may use the Assessment 2 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
    Policy Proposal Format and Length
    It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Web.
    Your policy should be succinct (about one paragraph). Overall, your proposal should be 4–6 pages in length.
    Supporting Evidence
    Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.
    Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.
    Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.
    Competencies Measured
    By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
  • Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
    • Analyze the potential effects of environmental factors on recommended practice guidelines.
  • Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
    • Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policies or laws.
  • Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, to inform health care laws and policies for patients, organizations, and populations.
    • Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
  • Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
    • Explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.
  • Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
    • Organize content so ideas flow logically with smooth transitions.
    • Use paraphrasing and summarization to represent ideas from external sources.

 

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5-page paper.

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
  • Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
• Competency 3: Apply ethical principles and academic standards to the study of health care.
  • Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
  • Discuss the effectiveness of the communication approaches present in a case study.
  • Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
  • Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
  • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Write following APA style for in-text citations, quotes, and references.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

1. Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
   • Select the case most closely related to your area of interest and use it to complete the assessment.
     • Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
   • Include the selected case study in your reference list, using proper APA Style and Format.
2. Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
   • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
   • Identify who is involved or affected by the ethical problem or issue.
   • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
     • Apply the three components outlined in the Ethical Decision-Making Model media.
   • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
     • Describe the factors that contributed to the problem or issue and explain how they contributed.
3. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The How Do I Find Peer-Reviewed Articles? library guide will help you locate appropriate references.
     • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
     • Review the Think Critically About Source Quality resource.
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.
4. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
5. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
6. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Apply the principles of effective composition.
   • Determine the proper application of the rules of grammar and mechanics.
8. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 1 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

• Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA template: Use the APA Style Paper Template [DOCX] as the paper format and use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Use correct spelling, grammar, and punctuation.
• References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, do not hesitate to ask faculty or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.

case study

 

Jenna and Chris Smith are the proud parents of Ana, a 5–day–old baby girl born without complications at Community Hospital. Since delivery, the parents have bonded well with Ana and express their desire to raise her as naturally as possible. For the Smiths, this means breastfeeding exclusively for the first six months, making their own baby food using pureed organic foods, and not allowing Ana to be vaccinated.

The Smiths are college educated and explain they have researched vaccines and decided the potential harms caused by them far outweigh any benefits. They point to the rise in autism rates as proof of the unforeseen risk of vaccines. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, including online mommy–blogs that detail how vaccines may have caused autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate Ana, despite the recommendations of the medical community.

Dr. Kerr begins by stating that while vaccines have certainly sparked controversy in recent years, she strongly recommends that Ana become fully vaccinated. Dr. Kerr explains that vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in child mortality over the past century. For example, the decreased incidence of infection with the potentially fatal Haemophilus influenzae type b, has resulted from routine immunization against that bacterium. Similarly, epidemics such as the recent outbreak of measles are usually associated with individuals who have not been vaccinated against that pathogen.

Dr. Kerr goes on to endorse the general safety of vaccines by informing Ana’s parents that safety profiles of vaccines are updated regularly through data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS, a nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, is accessible to the public at https://vaers.hhs.gov/index. This system allows transparency for vaccine safety by encouraging the public and healthcare providers to report adverse reactions to vaccines and enables the federal government to monitor their safety. No vaccine has been proven casual for autism spectrum disorder (ASD), or any developmental disorder. On the contrary, many studies have shown that vaccines containing thimerasol, an ingredient once thought to cause autism, do not increase the risk of ASD.

Finally, Dr. Kerr reminds the Smiths that some children in the general population have weakened immune systems because of genetic diseases or cancer treatment, for example. It may not be medically feasible to vaccinate such children. Other children are too young to receive certain immunizations. Instead, these children are protected because almost all other children (and adults) have been vaccinated and this decreases their exposure to vaccine–preventable illnesses (VPIs). This epidemiological concept is known as “herd immunity.” As more parents refuse immunization for their healthy children, however, the rate of VPIs will increase. This puts vulnerable children at significant risk of morbidity and mortality. Routine childhood immunization contributes significantly to the health of the general public, both by providing a direct benefit to those who are vaccinated and by protecting others via herd immunity. Dr. Kerr concludes by stating that after considering the risks versus the benefits of immunization, most states require vaccinations before children can attend school. Parents may decide not to vaccinate under specific circumstances, however, which vary by state.

Jenna and Chris Smith confirm their understanding of what Dr. Kerr has explained, but restate that they do not want Ana vaccinated at this time. Dr. Kerr is perplexed as to what to do.