This week, students will be completing a paper to address the following two case studies.

Greg Case Study:

Peggy and Gary had been married for five years, and had been trying to have a child. They had undergone artificial insemination and in vitro fertilization, but each pregnancy had resulted in a miscarriage. Peggy and Gary decide that surrogacy was their best option and placed an advertisement in the local college newspaper.

Josephine, a 21-year-old college student, answered the advertisement. At the time, she was dating a man named Jerry who she loved very much and hoped to marry. But Jerry had recently broken up with Josephine. Hoping to trick Jerry into marrying her, Josephine agreed to be the surrogate for Peggy and Gary. Using Peggy and Gary’s zygote, Josephine underwent in vitro fertilization and became pregnant. During the pregnancy Josephine underwent routine medical examinations, as required by the surrogacy contract. During one of the examinations, a genetic screening test was performed and it was discovered that the child had Down Syndrome. Peggy and Gary did not desire to have a child with Down Syndrome and in accordance with the surrogacy contract paid Josephine to undergo an abortion. In addition, Josephine contacted Jerry, telling him that she was carrying his child. Not wanting to be a husband or father at a young age, Jerry paid Josephine for an abortion as well. He then transferred to another school in a different state.

As a college student who could use the cash, Josephine gladly took the money for the abortion. But because of religious reasons she did not have an abortion and carried the child to term. She never told Peggy, Gary, or Jerry that she delivered a child. Unfortunately, being a single mother and college student was too much for Josephine. At three months, she took the child, whom she called Greg, to the local hospital and surrendered him under the state’s Safe Haven law.  

Address the following questions:

1. Shortly after the child was surrendered, Jerry found out that Josephine had delivered a child, which he thought was his. Jerry’s parents completed the paperwork necessary to adopt Greg, because they could not fathom the idea of someone else raising their grandchild. Should Jerry’s parents be allowed to adopt Greg? Explain and support your answer.
2. Shortly after the child’s second birthday, Greg needed to have minor surgery to correct an intestinal problem. Part of the pre-surgery laboratory work involved determining the child’s blood type. The blood typing indicated that it was biologically impossible for Jerry to have fathered Greg. Jerry and Jerry’s parents are now suing Josephine. Should Josephine have to pay the amount of money it cost to raise and support Greg? Explain and support your answer.
3. As part of her testimony in the lawsuit, Josephine discloses the truth about Greg and the surrogacy pregnancy. Although enraged, Jerry’s parents felt it necessary to contact Peggy and Gary. When Peggy and Gary learn that their biological child had actually been born, they petitioned the court to have their child returned to them and to award them custody. How should the court decide? Should the child remain with Jerry’s parents or be given to Peggy and Gary? Explain and support your answer.

Baby Fae Case Study

On October 14, 1984, Baby Fae was born two weeks premature, with hypoplastic left heart syndrome (a condition that at the time was 100 percent fatal). Baby Fae’s mother, Teresa Beauclair, was presented with two options; keep the child in the hospital or take the child home. Teresa opted to take the child home, and was preparing to go through the dying process until Dr. Leonard Bailey presented her with a third option. The highly experimental surgery involved replacing Baby Fae’s heart with that of a baboon. Dr. Bailey had been investigating the possibility of cross-species transplantation and discussed his research with Teresa, gaining her consent to the operation. As you can image, the medical procedure was publicized across the United States and animal rights activists were outraged and protested.

While initially, the operation appeared to be successful, Baby Fae’s organs started to fail, leading to her death 21 days after the transplant surgery was performed. In announcing her death at a press conference, Dr. Bailey stated, “Infants with heart disease yet to be born will someday soon have the opportunity to live, thanks to the courage of this infant and her parents.” One year later, the first human to human heart transplant was performed in a child. Dr. Bailey credits the success, in part, to the information and experience that was gained by performing the xenotransplant (Cross-species) procedure.

Address the following questions:

1. What is your initial reaction to this case? What ethical concerns does this case bring up in relation to: autonomy, nonmaleficence, beneficence, fidelity, and justice? Explain and give specific examples.
2. The study of animal research has led to many advances in diabetes, cancer, neurological conditions, and cardiac. Currently, pig and bovine valves are still used in heart surgeries. Do you feel research on animals is necessary in the medical field? Explain your answer.
3. If you were caring for baby Fae, how could the following information effect your interaction with the parents, and possible care of the child? Do you feel information about the family: their past, current status, and criminal record, should be publicized or shared? Explain your answers.

After the transplant, NBC news released this information:

“NBC News has learned the identity of the child’s parents. We will respect their wishes and not name them. However, certain aspects of their past might be relevant to some of the medical controversies in this case. According to relative and court records, the couple was never married. They had separated by the time the infant was born. Both have had trouble with the law in the state they came from, the father for disorderly conduct, and the mother for passing bad checks. They had little money when the baby was born.”

• For each of these cases an APA formatted paper must be used, and should include a title page, level headings, references and citations.
• This assignment should include at least 3 references and
• Should be at least three pages in length for each case (six pages, not including title page and references).
• Students should address the proposed questions providing ample detail, examples, and additional support.

1) **********minimum 2 full pages ( not words)**************************** (cover or reference page not included) 

2)¨**********APA norms 

3)********** It will be verified by Turnitin and SafeAssign 

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Read well. Paper should be 1 page, and done differently 2 times (copy and paste is not accepted) you must answer the question four times on different pages in the same document (Word)

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 The gerontological nurse working in a long-term care facility is responsible to administer psychoactive medications for older adults for conditions such as depression, anxiety, bipolar disorder or psychosis. 

1) Select one class of drug or 1 medication used for the treatment of the mentioned conditions 

2) discuss important nursing considerations (at least three) when given this medication due to its side effects, drug interaction or food interaction 

Write a five pages paper , not including reference, doubled spaced ,time new roman ,12 fonts  paper without plagiarism about the following topics :

1. Personal cell phone use of cell phone use in nursing clinical arena 

2. How it affects the patient’s integrity and respect .

No PLAGIARISM AND PAPER MUST BE IN APA FORMAT .

Workflow Assessment for Health IT Toolkit   Workflow can be defined as a term used to describe the action or execution of a series of tasks in a prescribed sequence (McGonigle, & Mastrian, 2015). 

Workflow tools can help make it easier to redesign workflow and aid in the application of health information technology (U.S Department of Health and Human Services, n.d). 

For the purpose of this discussion three workflow tools were selected which include benchmarking interviews and usability evaluation.  Benchmarking  Benchmarking is a process of evaluating metrics or best practices from other organizations (either related or unrelated to your own) and then applying them to your organization (U.S Department of Health and Human Services, n.d). 

Benchmarking is an important tool that facilitators can use to motivate a practice to engage in improvement work and to help members of a practice understand where their performance falls in comparison to others. Benchmarking can stimulate healthy competition, as well as help members of a practice reflect more effectively on their own performance. Benchmarking can be done by reaching out to peers at other facilities and finding out what they do and if it works well. My facility has many other sister and we are the bigger where we encounter most of the problem. The common system that all we use is the point click care.  What I going to do is to contact all the leader of the entire facility sister, so we can have a meeting to debate about each system in place in each facility. I would want to physically see how the design of their system works and if the charting works well. Because nurse has to be involve in and informatics technology process, I would bring with me 2 to 3 clinical managers nurses to see the charting, so they could also see the new idea and give feedback on their feelings about it. Based on the information gathered I would plan a process to implement the new ideas into the charting system at our facility.  

Interviews provide a means of eliciting information from a group of individuals regarding their opinions, behavior, or knowledge (U.S Department of Health and Human Services, n.d). Here the interview involves 2 to more people and during the interview, data are collected and most of the time, it is the interviewee who provide data Here, I will set up an interview with 2 to 3 leaders form the sister facility where I will ask questions about sensitive issues, to determine users’ needs on the systems and to clarify some of my questions question.  

Usability evaluation  A usability evaluation is conducted to determine the extent to which a system is easy to use or “user friendly.” (U.S Department of Health and Human Services, n.d). Here I will determine if the new system is useful to user and if it is easy for to use it before implementation. Here I will determine the goal of my evaluation, what will be evaluated and how? For that I will choose some main staff from each sister facility who will conduct the survey to the rest of the staff to see how easy it is for them to use the informatics system. Based on the result, I will see what the areas of improvement before the implementation.  The article I will be use the information to improve workflow within your organization is:  Improvement of workflow and processes to ease and enrich meaningful use of health information technology (Singh & al., 2014).  In this article the author develop a self-contained workflow toolkit that uses ‘universal visual language’ and recognizes that most practices lack the required expertise and often need external assistance because the current methods (using esoteric charts or various software packages11 that require long and steep learning curves) are alien to health care workers and are, therefore, perceived to be barriers (Singh & al., 2014). It is a well established fact that, in any setting or industry, better management of work processes leads to improved value. Education and training of stakeholders in this management skill needs appropriate tools. The toolkit particularly addresses the ‘system-based practice’ and ‘practice-based learning and continuing improvement’ (Singh & al., 2014). Base on that, I will educate staff by using that pictorial tool for assessing the current and continuing redesigns of future workflows for achieving staff comfort, efficiency, communication, organization, productivity, effectiveness, safety, and satisfaction of patients and staff, all without having to seek outside help.  According to Caspi (2015), it is clear that informatics nurses will continue to be instrumental players in the analysis, implementation, and optimization of advanced information systems and emerging technologies that aim to improve the quality of patient care, while reducing costs.     

Caspi, H. (2015). The significant impact of nursing informatics on workflow, productivity. Healthcare Dive. Retrieved from https://www.healthcaredive.com/news/the-significant-impact…workflow…/387301  McGonigle,  D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of  knowledge (4th ed.). Burlington, MA: Jones and Bartlett  Learning. Chapter 13, “Workflow and Beyond Meaningful Use”     Singh, R. Singh, A., Singh, R., Singh, R. (2014). Improvement of workflow and processes to ease and enrich meaningful use of health information technology. DOI: 10.2147/AMEP.S53307. Retrieved form Walden library.   U.S department of health and human services (n.d.b). Workflow Assessment for Health IT Toolkit.http://healthit.ahrq.gov/portal/server.pt/community/health_it_tools_and_resources/919/workflow_assessment_for_health_it_toolkit/27865

Instructions

Using the information from the interview you conducted in Week 2, list in descending order the support needs of your participant. Also discuss how to implement objectives of Healthy People 2020 to increase wellness. Give examples of appropriate interventions of the professional caregiver, for example, the nurse.

Submit your findings in a 4- to 5-page Microsoft Word document.

Support your responses with examples.

On a separate references page, cite all sources using APA format.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.