REPLY 1

It’s important for nurses to provide culturally competent care. It’s important to assess the importance of a client’s culture/ethnicity (and their accompanying beliefs and values) when planning, providing, and evaluating care. Nurses’ practice must incorporate cultural needs and beliefs into their nursing practice to provide care that is individualized for the client and appropriate to the client’s needs (Cultural Awareness and Influences on Health: NCLEX-RN, 2020).

In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis, and many believe that speaking of it may bring bad luck or a poor outcome (Ritter & Graham, 2017, P. 235). Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable (AMA, 2020). After completing a cultural assessment, if the patient holds this belief, I would respect the cultural practice and withhold the information. 

The patient would be encouraged to specify preferences regarding the communication of medical information, preferably before the information becomes available (AMA, 2020); it’s important to honor a patient’s request not to receive certain medical information or to convey the information to a designated surrogate, provided these requests appear to represent the patient’s genuine wishes (AMA, 2020). For the family who believes this, “decisions and communication are often considered the responsibility of the oldest male in the family, and can be seen as a moral obligation for that person to act in that capacity” (Ritter & Graham, 2017, P. 235). 

For health care providers to balance the patient’s right to know with respect to the cultural practices and beliefs of the family, it’s important to: assess the amount of information the patient is capable of receiving at a given time, and tailor disclosure to meet the patient’s needs and expectations in keeping with the individual’s preferences; Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information (AMA, 2020). 

In short, each year, the United States becomes more diverse, with people of different races and religions, and with differing beliefs about medicine and medical care. As nurses, we owe it to our patients to provide them with the best care possible in ways they find appropriate (Reed, 2017).

References

AMA. (2020). Withholding Information from Patients. Retrieved from https://www.ama-assn.org/delivering-care/ethics/withholding-information-patients

Cultural Awareness and Influences on Health: NCLEX-RN. (2020). Retrieved from https://www.registerednursing.org/nclex/cultural-awareness-influences-health/

Reed, C. (2017). Cultural Competence. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2017/07000/Cultural_Competence.5.aspx

Ritter, L.A., & Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and

Bartlett Learning. ISBN: 9781284021028

REPLY 2

        Health is viewed as a cultural concept, and culture determines how we perceive the world. Therefore, respect for cultural practice in Asia is predetermined because culture helps shape how both the patient and the healthcare provider perceive illness and what they believe to be its cause (Fowler et al., 2011). I will only respect the culture if I lack the knowledge and skills of delivering bad news, the appropriate provision of optimal care to a dying patient, and the compassion to ensure that the patient retains his or her self-worth even at the time of his or her death. 

      According to Rosenberg et al. (2017), negative information should be briefly relayed to patients. The author recommends that the information be rehearsed to communicate the bad news concisely and how the healthcare team is committed to the patient’s support and treatment at the terminally ill stage. A good example of a prognosis that should be delivered to the patient, especially by word of mouth, is as follows: ‘The tests done on your collected samples have confirmed that your condition arose from a malignant tumor (sad news). Therefore, I have informed a radiotherapist and the oncologist to speak with you about the condition and then advise you further. Once I receive the recommendations from their examinations on you, I will decide on what best treatment to give to you (doing something about it). As things unfold, I will always be around to discuss with you on how we will go on with the treatment.’ Maintaining a silent observation at this point will lead to the patient’s psychological condition’s best results (Sarafis et al., 2014). Therefore, I will respect the culture, but any information that must reach the patient will always be delivered just as the profession prescribes.

        Healthcare providers can balance the patient’s right to know their prognosis concerning their cultural practices and beliefs. To achieve such a balance, healthcare personnel should always try hard to become culturally sensitive (Chaet, 2016). Such sensitive care can be achieved through creating awareness, avoiding assumptions, and learning about other cultures. In any social issue, the first step is always to be aware. Any competent healthcare provider must always be endowed with culturally sensitive care. A good nurse or doctor will always strive to become culturally sensitive personnel while letting others understand their line of duty (Swihart & Martin, 2020). Secondly, a good healthcare provider should always avoid making assumptions because it is always important not to assume matters that you are not familiar with. Making such assumptions can cause a breakdown of trust and rapport between the healthcare provider and the patient. Lastly, a good doctor or nurse should always learn about other cultures. Learning a patient’s culture includes their medical history, medications, and current symptoms. Learning different cultures will involve immersing oneself in the culture of others. 

     In conclusion, it is always essential to have a truthful and open communication between the patient and the medic. Such open communication will enhance trust in the relationship and respect for autonomy. On the other hand, not fully disclosing information to the patient is an ethical breach because it brings the clash between the physician’s duty of promoting the patient’s health and the physician’s respect for the patient’s autonomy.

References:

Chaet, D. H. (2016). AMA Code of Medical Ethics’ Opinions Related to Discrimination and Disparities in Health Care. AMA Journal of Ethics, 18(11), 1095-1097.

Fowler, F. J., Levin, C. A., & Sepucha, K. R. (2011). Informing And Involving Patients To Improve The Quality Of Medical Decisions. Health Affairs, 30(4), 699–706. https://doi.org/10.1377/hlthaff.2011.0003

Rosenberg, A. R., Starks, H., Unguru, Y., Feudtner, C., & Diekema, D. (2017). Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness. JAMA Pediatrics, 171(11), 1113–1119. https://doi.org/10.1001/jamapediatrics.2017.2568

Sarafis, P., Tsounis, A., Malliarou, M., & Lahana, E. (2014). Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice. Global Journal of Health Science, 6(2), 128. https://doi.org/10.5539/gjhs.v6n1p128

Swihart, D. L., & Martin, R. L. (2020). Cultural Religious Competence In Clinical Practice. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK493216/

All replies must be constructive and use literature where possible.

Your assignment will be graded according to the grading rubric.

 

Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.

 

Assignment:

Write a 750-word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Address the following questions:

• Describe the purpose of the Flannigan et al. (2014) study and why this study is important to advancing nursing knowledge.
• According to the study narrative and Figures 1, 2, & 3 in the Flannigan et al. (2014) study, describe the three formulas used in the prediction of mean weight for PICU patients. Which formula best estimates the weight for children under 1 year of age? Provide a rationale for your answer.
• Describe one potential clinical advantage and one potential clinical problem with using the three novel formulas presented in Exercise 14 see Figures 1, 2, & 3 in a PICU setting.

Assignment Expectations

Length: At least 750-words; answers must thoroughly address the questions in a clear, concise manner.

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.

References: Use at least one APA style in-text citations and references for all resources utilized to answer the questions.

  

Instructions – 

• Please be prepared to present a 10-minute pitch 

· You are free to choose your own PowerPoint template, develop an A3, and/or include any other Lean tools in your pitch, but ensure the panel can visualize everything 

• The presentation has a time limit of 10 minutes (the panel will cut you off at 12 minutes) – Straight to the point please …. Cannot exceed 10 minutes

• A brief question & answer session will follow the presentation

• The content and delivery of the presentation will be scored

SCENARIO- Hypothetical 

· The facility had three safety events involving a patient receiving blood transfusions of the wrong blood type. All three patients died. Two (2) patients received their transfusions on a medicine unit and the other patient received his transfusion on a surgical unit. After a root cause analysis, it was found that transfusion orders for each patient were meant for other patients. Additionally, it was found that in two of the cases there were blood specimen labeling errors. 

• In the six (6) months before the deaths of these three patients, the facility had received ten (10) patient safety event reports (JPSR) related to blood labeling errors, but all were caught before a patient was harmed. When staff were interviewed about the event, many reported that communication between clinical staff has always been an issue. Several of the physicians interviewed stated that it is not uncommon for the Laboratory to make errors because nothing is ever done to correct them. The Medical Center Director has met with the staff members. They all report feeling really bad that this happened. They believe in the care they provide and only want to do a good job.

MUST INCLUDE – NEED Graphs and visual aid 

1. Identify an interdisciplinary team-based improvement project based on the root cause analyses of the safety events. During the pitch, identify why you selected the project and which safety issues are addressed. 

2. Include a draft of the problem statement you plan to share with the Medical Center Director, which also discusses two (2) associated high reliability principles. 

3. Discuss how will you manage and lead these projects through to completion. 

4. Identify the improvement methodology you plan to use to address and track the safety failures. 

5. Is there any data that you need? Discuss which databases you plan to pull it from. 

6. Identify any tools and/or resources you will you need to implement your plans and manage the activities of your team. Include how you plan to train the teams to carry out the improvements. 

7. Discuss how will you ensure sustainability once the project deliverable are deployed and implemented. 

8. Explain how you would use change management to prepare the Care or Service Line to accept, implement, and sustain the improved processes.

9. Discuss how you plan to incorporate dashboards and graphical reports into your tracking and sustainability plan. 

10. Finally, discuss how you plan to close out the project. Include how you will confirm that all project requirements have been met and how your project benefits the experience of the veterans at MEDVAMC.

Time-Sensitive – Will pay top dollar… 

DUE BY: Tuesday, AUGUST 11, 2020 by NOON –  CST – (NO EXECPTIONS)