Assignment: Off-Label Drug Use in Pediatrics

Children, like adults, deal with variety of health issues, but they also have issues that are more prevalent within their population. One issue that significantly impacts children is the prescription of drugs for off-label use. As an advanced practice nurse, how do you determine the appropriate use of off-label drugs in pediatrics? Are there certain drugs that should be avoided with pediatric patients?

This assignment, you examine the practice of prescribing off-label drugs to children. You also explore strategies for making off-label drug use safer for children from infancy to adolescence, as it is essential that you are prepared to make drug-related decisions for pediatric patients in clinical settings.

Effective Communication

The Joint Commission reported that [poor] communication was the root cause of 66% of Sentinel Events between 1995-2005. Examine the communication and collaboration in your workplace. Include these aspects:

• The components necessary for effective interpersonal communication.
• Discuss the importance of interprofessional collaboration.
• Apply components of interpersonal communication to interprofessional collaboration.
• Discuss strategies to promote interprofessional collaboration.
• Describe effective strategies to build interprofessional teams.
• Cultural competence

Assignment Expectations:

Length: Between 1500 and 2000 words

Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

CASE STUDY

 Mrs. Smith was a 73-year-old widow who lived alone with no significant social support. She had been suffering from emphysema for several years and had had frequent hospitalizations for respiratory problems. On the last hospital admission, her pneumonia quickly progressed to organ failure. Death appeared to be imminent, and she went in and out of consciousness, alone in her hospital room. The medical-surgical nursing staff and the nurse manager focused on making Mrs. Smith’s end-of-life period as comfortable as possible. Upon consultation with the vice president for nursing, the nurse manager and the unit staff nurses decided against moving Mrs. Smith to the palliative care unit, although considered more economical, because of the need to protect and nurture her because she was already experiencing signs and symptoms of the dying process. Nurses were prompted by an article they read on human caring as the “language of nursing practice” (Turkel, Ray, & Kornblatt, 2012) in their weekly caring practice meetings.

The nurse manager reorganized patient assignments. She felt that the newly assigned clinical nurse leader who was working between both the medical and surgical units could provide direct nurse caring and coordination at the point of care (Sherman, 2012). Over the next few hours, the clinical nurse leader and a staff member who had volunteered her assistance provided personal care for Mrs. Smith. The clinical nurse leader asked the nurse manager whether there was a possibility that Mrs. Smith had any close friends who could “be there” for her in her final moments. One friend was discovered and came to say goodbye to Mrs. Smith. With help from her team, the clinical nurse leader turned, bathed, and suctioned Mrs. Smith. She spoke quietly, prayed, and sang hymns softly in Mrs. Smith’s room, creating a peaceful environment that expressed compassion and a deep sense of caring for her. The nurse manager and nursing unit staff were calmed and their “hearts awakened” by the personal caring that the clinical nurse leader and the volunteer nurse provided. Mrs. Smith died with caring persons at her bedside, and all members of the unit staff felt comforted that she had not died alone.

Davidson, Ray, and Turkel (2011) note that caring is complex, and caring science includes the art of practice, “an aesthetic which illuminates the beauty of the dynamic nurse-patient relationship, that makes possible authentic spiritual-ethical choices for transformation—healing, health, well-being, and a peaceful death” (p. xxiv). As the clinical nurse leader and the nursing staff in this situation engaged in caring practice that focused on the well-being of the patient, they simultaneously created a caring-healing environment that contributed to the well-being of the whole—the emotional atmosphere of the unit, the ability of the clinical nurse leader and staff nurses to practice caringly and competently, and the quality of care the staff were able to provide to other patients. The bureaucratic nature of the hospital included leadership and management systems that conferred power, authority, and control to the nurse manager, the clinical nurse leader, and the nursing staff in partnership with the vice president for nursing. The actions of the nursing administration, clinical nurse leader, and staff reflected values and beliefs, attitudes, and behaviors about the nursing care they would provide, how they would use technology, and how they would deal with human relationships. The ethical and spiritual choice making of the whole staff and the way they communicated their values both reflected and created a caring community in the workplace culture of the hospital unit.

Critical thinking activities

Based on this case study,  please answer the consider the following questions, apa format, more thatn 300 words and NO PLAGIARISM. Thank you in advance.

1. What caring behaviors prompted the nurse manager to assign the clinical nurse leader to engage in direct caring for Mrs. Smith? Describe the clinical nurse leader role established by the American Association of Colleges of Nursing in 2004.
2. What issues (ethical, spiritual, legal, social-cultural, economic, and physical) from the structure of the theory of bureaucratic caring influenced this situation? Discuss end-of-life issues in relation to the theory.
3. How did the nurse manager balance these issues? What considerations went into her decision making? Discuss the role and the value of the clinical nurse leader on nursing units. What is the difference between the nurse manager and the clinical nurse leader in terms of caring practice in complex hospital care settings? How does a clinical nurse leader fit into the theory of bureaucratic caring for implementation of a caring practice?
4. What interrelationships are evident between persons in this environment—that is, how were the vice president for nursing, nurse manager, clinical nurse leader, staff, and patient connected in this situation? Compare and contrast the traditional nursing process with Turkel, Ray, and Kornblatt’s (2012) language of caring practice within the theory of bureaucratic caring 

 

Prepare a 2-page interprofessional staff update on HIPAA and appropriate social media use in health care.

As you begin to consider the assessment, it would be an excellent choice to complete the Breach of Protected Health Information (PHI) activity. The will support your success with the assessment by creating the opportunity for you to test your knowledge of potential privacy, security, and confidentiality violations of protected health information. The activity is not graded and counts towards course engagement.

Health professionals today are increasingly accountable for the use of protected health information (PHI). Various government and regulatory agencies promote and support privacy and security through a variety of activities. Examples include:

• Meaningful use of electronic health records (EHR).
• Provision of EHR incentive programs through Medicare and Medicaid.
• Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) rules.
• Release of educational resources and tools to help providers and hospitals address privacy, security, and confidentiality risks in their practices.

Technological advances, such as the use of social media platforms and applications for patient progress tracking and communication, have provided more access to health information and improved communication between care providers and patients.

At the same time, advances such as these have resulted in more risk for protecting PHI. Nurses typically receive annual training on protecting patient information in their everyday practice. This training usually emphasizes privacy, security, and confidentiality best practices such as:

• Keeping passwords secure.
• Logging out of public computers.
• Sharing patient information only with those directly providing care or who have been granted permission to receive this information.

Today, one of the major risks associated with privacy and confidentiality of patient identity and data relates to social media. Many nurses and other health care providers place themselves at risk when they use social media or other electronic communication systems inappropriately. For example, a Texas nurse was recently terminated for posting patient vaccination information on Facebook. In another case, a New York nurse was terminated for posting an insensitive emergency department photo on her Instagram account.

Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care.

This assessment will require you to develop a staff update for the interprofessional team to encourage team members to protect the privacy, confidentiality, and security of patient information.

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: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
  • Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
  • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
• Competency 2: Implement evidence-based strategies to effectively manage protected health information.
  • Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
  • Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
• Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
  • Follow APA style and formatting guidelines for citations and references.
  • Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling.

Preparation

To successfully prepare to complete this assessment, complete the following:

• Review the infographics on protecting PHI provided in the resources for this assessment, or find other infographics to review. These infographics serve as examples of how to succinctly summarize evidence-based information. 
  • Analyze these infographics, and distill them into five or six principles of what makes them effective. As you design your interprofessional staff update, apply these principles. Note: In a staff update, you will not have all the images and graphics that an infographic might contain. Instead, focus your analysis on what makes the messaging effective.  
• Select from any of the following options, or a combination of options, the focus of your interprofessional staff update:
  • Social media best practices.
  • What not to do: Social media.
  • Social media risks to patient information.
  • Steps to take if a breach occurs.
• Conduct independent research on the topic you have selected in addition to reviewing the suggested resources for this assessment. This information will serve as the source(s) of the information contained in your interprofessional staff update. Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources.

Instructions

In this assessment, assume you are a nurse in an acute care, community, school, nursing home, or other health care setting. Before your shift begins, you scroll through Facebook and notice that a coworker has posted a photo of herself and a patient on Facebook. The post states, “I am so happy Jane is feeling better. She is just the best patient I’ve ever had, and I am excited that she is on the road to recovery.”

You have recently completed your annual continuing education requirements at work and realize this is a breach of your organization’s social media policy. Your organization requires employees to immediately report such breaches to the privacy officer to ensure the post is removed immediately and that the nurse responsible receives appropriate corrective action. 

You follow appropriate organizational protocols and report the breach to the privacy officer. The privacy officer takes swift action to remove the post. Due to the severity of the breach, the organization terminates the nurse.  

Based on this incident’s severity, your organization has established a task force with two main goals:

• Educate staff on HIPAA and appropriate social media use in health care.
• Prevent confidentiality, security, and privacy breaches.

The task force has been charged with creating a series of interprofessional staff updates on the following topics:

• Social media best practices.
• What not to do: Social media.
• Social media risks to patient information.
• Steps to take if a breach occurs.

You are asked to select one of the topics, or a combination of several topics, and create the content for a staff update containing a maximum of two content pages. When distributed to interprofessional team members, the update will consist of one double-sided page.

The task force has asked team members assigned to the topics to include the following content in their updates in addition to content on their selected topic(s):

• What is protected health information (PHI)?
  • Be sure to include essential HIPAA information.
• What are privacy, security, and confidentiality?
  • Define and provide examples of privacy, security, and confidentiality concerns related to the use of the technology in health care.
  • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
• What evidence relating to social media usage and PHI do interprofessional team members need to be aware of? For example:
  • How many nurses have been terminated for inappropriate social media usage in the United States?
  • What types of sanctions have health care organizations imposed on interdisciplinary team members who have violated social media policies?
  • What have been the financial penalties assessed against health care organizations for inappropriate social media usage? 
  • What evidence-based strategies have health care organizations employed to prevent or reduce confidentiality, privacy, and security breaches, particularly related to social media usage?

Notes

• Your staff update is limited to two double-spaced content pages. Be selective about the content you choose to include in your update so that you are able to meet the page length requirement. Include need-to-know information. Leave out nice-to-know information. 
• Many times people do not read staff updates, do not read them carefully, or do not read them to the end. Ensure your staff update piques staff members’ interest, highlights key points, and is easy to read. Avoid overcrowding the update with too much content.
• Also supply a separate reference page that includes 2–3 peer-reviewed and 1–2 non-peer-reviewed resources (for a total of 3–5 resources) to support the staff update content.

Additional Requirements

• Written communication: Ensure the staff update is free from errors that detract from the overall message.  
• Submission length: Maximum of two double-spaced content pages.
• Font and font size: Use Times New Roman, 12-point.
• Citations and references: Provide a separate reference page that includes 2–3 current, peer-reviewed and 1–2 current, non-peer-reviewed in-text citations and references (total of 3–5 resources) that support the staff update’s content. Current mean no older than 5 years.
• APA format: Be sure your citations and references adhere to APA format. Consult the Evidence and APA page for an APA refresher.