...Advance Directives—research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for Healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? Briefly discuss a situation in which a Living Will might apply and would be of benefit to those involved. Once you have researched and discussed Advance Directives, draft a sample Living Will, indicating the type of content that should be found in such a document. Some students take this opportunity to prepare their own actual Living Will, and that certainly is encouraged. What Are Advance Directives? Advance directives are a written statement, made in advance by a legally competent adult, that appoint someone to make healthcare decisions if a person becomes incapable of making decisions and unable to communicate his or her wishes. Advance directives also provide instructions which define the type of treatment or care a person would want or not want under particular conditions. Doctors, other members of the healthcare team, family members and/or appointed “agents” use these documents to ensure that a person’s preferences are honored in a critical healthcare situation (National Hospice and Palliative Care Organization, 2008). Legal and Ethical Principles Legal Basis It is an accepted legal theory that a legitimately competent person is empowered to...
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...What are advance directives? Advance directives are extremely important. It is essential that everyone make some sort of arrangement before an unfortunate situation happens to them where these decisions will need to be made. An advance directive is basically a living will or a written statement in which people state the type and amount of care they wish to receive during a terminal illness and as death approaches. Medical Law and Ethics stated that “Advance directives limit the type and amount of medical care and treatment that patients will receive if they should become incompetent and have a poor prognosis. It is important that directives are placed in writing; it is not sufficient for a person to just tell someone what his or her wishes for treatment are. The courts typically enforce written advance directives.” (pg 313) There are four types of advance directives. They are a living will, durable power of attorney for healthcare, uniform anatomical gift act, and a do not resuscitate order. The living will is a “document that a person drafts before becoming incompetent or unable to make healthcare decisions.” The durable power of attorney for healthcare is “A legal document that empowers another person (proxy) to make healthcare decisions for healthcare for an incompetent patient. It goes into effect after the person becomes incompetent and only pertains to healthcare decisions.” The uniform anatomical gift act is a “law that allows persons 18 years or older and of sound mind...
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...Patient End-of-Life Care Wishes Introduction As a citizen in today’s fast paced and medically advanced society, it is imperative to have knowledge and understanding of Advance Directives and what role they play in patient care. In the scenario presented we find Mr. E who is a 67 year old male who lives in a nursing home and has presented to the ER with lung congestion. Mr. E. has a history of diabetes, poor vision, and hypertension, impaired hearing, and is delayed developmentally. After an initial assessment, the physician, Dr. K. has diagnosed the patient with pneumonia secondary to aspiration. Mr. E. has a fever and his oxygen saturation level is 88% on room air. Dr. K has admitted Mr. E to the ICU and has determined that he needs to be placed on a ventilator. When the doctor explains the situation, Mr. E. vehemently states that he does not want a ventilator. Mr. E. has an advance directive that outlines his wishes. Body As a nurse in the state of Indiana, it is a responsibility and standard to advocate for the patient while providing competent care according to the patient’s wishes. Indiana law upholds a patient’s written or spoken advance directive in the event that the patient is unable to make decisions regarding their healthcare. In the scenario, Mr. E.’s advance directive was disregarded by the healthcare personnel because he was deemed incompetent of understanding the seriousness of the situation. Thus, the physician and the nurse involved violated Indiana law regarding...
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...Sociological Theories LaWanda Blake CJS/240 December 2, 2011 Cayla Flowers A state, local, or federal program with elements that exemplify the application of social structure, social process and social conflict theories can be found in the public healthcare field. Advances in the contemporary social structure theories, social process theories, and social conflict theories, are found to be critical in the public healthcare field with the modernization of social change. With the development of such theories, it is imperative that the evaluation of understanding is engaged within social change. The integration of social theories into the public health field assert that the disadvantaged economic class are the only individual’s that benefit from these services as such resources are not needed for the upper class society. Formulation of program theories that take into account social determinants of health and the mobilization of diverse factors for change is a challenge for the application of social theory structures. According to Potvin, Gendron, Bilodeau, & Chabot (2005) “We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges”. Public health programs support the need for intervention in cases of psychosocial rehabilitation services and low threshold drug substitution treatment in supervised injection sites. As...
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...Guide Queensland Health Guide to Informed Decision-making in Healthcare Disclaimer The information within the Guide to Informed Decision-making in Healthcare is intended as a guide to good clinical practice. The law and service delivery environment is constantly evolving, so while every attempt has been made to ensure the content is accurate, it cannot be guaranteed. The information within this document should not be relied upon as a substitute for other professional or legal advice. ISBN 9781921707391 ©State of Queensland (Queensland Health) 2011 First edition February 2012 This work is licensed under a Creative Commons Attribution Non-Commercial 2.5 Australian license. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/2.5/au/ In essence, you are free to copy, communicate and adapt the work for non-commercial purposes, as long as you attribute the Patient Safety and Quality Improvement Service, Queensland Health and abide by the license terms. For further information, contact: Informed Consent Program Manager Patient Safety and Quality Improvement Service Centre for Healthcare Improvement, Queensland Health PO Box 152 Herston Queensland 4029 tel (+61) (07) 3646 9715 psq@health.qld.gov.au www.health.qld.gov.au/chi/psq/ For permission beyond the scope of this license contact: Intellectual property Officer Queensland Health GPO Box 48 Brisbane Queensland 4001 tel (+61) (07) 3234 1479 ip_officer@health.qld.gov.au Forward Patient-centred...
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...In the last 20 years there have been many remarkable scientific advances in healthcare science, which have made a vast difference in the diagnosis and treatment of many illnesses. There are also many potential advances in the field of healthcare science that will improve the quality of life for many people. Firstly, the Human Genome Project, which started in 1990 and was completed in 2003, allowed scientists to read the complete set of human genetic information and begin to understand the roles of our 23,000 genes. Genetic conditions are caused when DNA variants are inherited which results in a change in the functioning of one gene that affects the way the body works or develops. There are over 10,000 different genetic conditions, e.g. cystic...
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... In today’s society nursing has grown to fit the healthcare needs of society. We have grown by providing different nursing educational roles that will evolve healthcare as we know it. The advanced generalist education role is a clinical nurse leader. The American Association of Colleges of Nursing defines the clinical nurse leader role (CNL) as a leader in the healthcare system that delivers care across different settings within a Microsystems, using assimilation and application of research-based information to design, implement and evaluate the patients plan of care (Thompson, and Lulham, 2007). The Clinical Nurse Leader is further described as designing and implementing, and evaluating client care by coordination, delegation, and supervision of the care provided by the health care team (Thompson and Lulham, 2007). Thompson and Lulham (2007) states that the healthcare team in which supervision care is provided from the CNL include the license nurses, technicians, and other various health care professionals. American Association of Colleges of Nursing (2013) states that clinical nurse leaders are masters prepared nurses that involves risk anticipation for individuals and groups of patients, implementation of evidence based practice initiatives, team leadership, management and collaboration with other health care professional team members, and the use of information system and technologies to improve healthcare. The advance generalist advocates for patients, communities and the...
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...In 2010, the Patient Protection and Affordable Care Act were signed by the president. It is also known as the “Patient’s Bill of Rights,” which covers key elements such as healthcare coverage, cost and care. For example, it includes laws that allow young adults under age 26 to remain on their parents health insurance; insurance companies can no longer increase rates unreasonably without public justification, and patients can receive approved preventive healthcare at no cost (U.S. Department of Health and Human Services, 2013). There are more than three million nurses leading the healthcare labor pool today (Institute of Medicine, 2013). Therefore, with a legislative healthcare facelift this large, nurses will be on the front lines of this rapidly changing system. The Institute of Medicine (IOM) is a nonprofit organization that was asked to evaluate and provide recommendations on nursing in the United States (National Academy of Sciences, 2013). The goal of this paper is to discuss the impact of the IOM report on nursing in primary care, nursing education; and furthermore, the effect it has on of nurses as leaders. The IOM report developed four pivotal recommendations that focus on improving the future of nursing which in turn will remodel the health care system and improve patient outcomes (IOM, The Future of Nursing Summary, 2011). Key Message #1 According to the IOM report, the first recommendation is to maximize the “full potential of nurses”; therefore, increasing the...
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...Statement of Purpose Doctor of Nursing Practice Essay Luisa Walsh 2/18/2013 In today’s healthcare system, nursing is a challenging field as a result of rapid technological advances and changes in healthcare policies. As a dedicated nursing professional, with a great passion for learning, I strive to stay on top of these changes. I am determined to increase my knowledge to be an instrumental part of providing quality healthcare. The demands of nursing are high; however the rewards are even higher. Nursing requires both a supreme understanding of the science of health, and a caring bedside manner befitting only those who seek a position of such a personal involvement in the well-being of a patient. Academically, I will put forth all of my efforts into my studies. I will challenge myself, and work hard at all the obstacles that lay ahead. The combination of my past academic performance and personal standards of nursing excellence will provide the foundation of success in my Doctor of Nursing Practice (DNP) studies. It will require a great amount of time and energy; however I am excited to pursue this challenge. The rigorous and intense demands of the Doctorate program strongly match my capabilities. I have served in the armed forces and during my nursing career have provided care for many challenging situations such as veterans who suffer from Post-Traumatic Stress Disorder (PTSD). I am fully aware of what I need to do for any given situation and am able to manage stress in...
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...Advance Directives Irene was a 78-year-old female getting ready to leave for an appointment with her daughter. The nursing home staff assisted Irene out to her daughter’s car but then Irene collapsed. Concerned, the staff dialed 911 per facility protocol and made Irene comfortable, waiting with Irene’s daughter, for the ambulance to arrive. The ambulance personnel arrived to the scene and immediately proceeded with performing cardiopulmonary resuscitation (CPR). Do Not Resuscitate (DNR) Ethical Dilemma Irene’s daughter and nurse instantly stated that Irene was a DNR resident of the facility. Emergency personnel stated that they would have to view the DNR documents and would continue procedures until they examined the required paperwork. Irene’s nurse ran into the facility to grab her record; however, by her return the emergency personnel had already resuscitated Irene. There are many scenarios where ball dropping can occur in healthcare and it is at those times when ethical legal decision-making dilemmas appear. Marjorie is a 91-year-old female residing in a long-term care facility (Kase, 2013). Marjorie’s daughter filed a lawsuit against the long-term care facility and the hospital for attempting to resuscitate Marjorie and perform multiple and painful interventions to sustain her...
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...HealthCare Financing Cathy Jones HCA 515 9/9/2015 Market Based Approach 1. Who is provided access? Market based approach provides access to consumers and employers including large, small, and individual employers. All subjects encompass different needs and preferences. 2. How much coverage is provided? The amount of coverage varies per the need of the customer. It can provide as much or as little as they need. The qualifiers include but are not limited to the breadth of the coverage, the techniques in managing the services and the sharing of beneficiary amounts fluctuate. 3. How are the services paid for? They are paid for by the employer and consumer through high deductable health plans and Health Savings Accounts. 4. How does reimbursement apply? Employees are reimbursed through premiums with a set annual limit. One way is through Health Reimbursement Arrangement (HRA). These plans are popular because it allows the employer to reimburse employees tax free for their personal insurance premium and out of pocket medical expenses up to a certain limit. 5. Are there limitations on care? This approach does not serve everyone equally. Premiums and access to health insurance varies across the nation. Premiums vary with differences in the cost of living, what medical providers are in the area, and the pattern in health care practices. 6. What guides care decisions for patients? 7. What is the quality of services? This plan provides a...
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...main reasons we conduct research in healthcare. Health is a state of complete physical, social, and mental well-being. Health is not always just a personal choice, nor a biological issue, it is patterns of well being and illness within a society. There are four major ways that shape health, cultural patterns define health, cultural standards of health change over time, social inequality can affect people’s health, and society’s technology affects people’s health. Health begins in our homes, workplaces, schools, and communities. Health is determined by the resources around us, safety of workplaces, and cleanliness of air, food, and water. Sociological imagination and social research help advance knowledge and improve health by providing and involving the community, using research to create awareness of issues, and using policies to better people’s overall...
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...created to inform the nation on healthcare issues. The reports and findings of this group assist the divisions of healthcare in making knowledgeable decisions. The Robert Wood Johnson Foundation together with the IOM issued a special report called “The Future of Nursing: Leading Change, Advancing Health” There are four key messages the IOM focuses on: Nurses should practice to the full extent of their education and training, nurses should achieve higher levels of education of education and training through an improved education system that promotes seamless academic progression, nurses should be full partners with physicians and other health professionals in redesigning healthcare in the United States, effective workforce planning and policy making require better data collection and an improved infrastructure (IOM, 2010). The IOM recommends that by the year 2020, 80% of all nurses have a Bachelor of Science in Nursing (BSN). To achieve this recommendation, the nursing profession must decide that a BSN would be the entry-level into practice. There are multiple ways to achieve a nursing degree from Diploma, Associate Degree to Bachelor’s Degree. Students who have a four year degree in another field of study can easily obtain a nursing degree in an accelerated second degree bachelor’s program. Patient care has become more complex over the years, the more educated the nurse, the easier it will be to transition into an ever changing healthcare system. These nurses will readily...
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...shaped the health care delivery system in the United States. Knowledge of the history of health care is essential for understanding the main characteristics of the system as it exists today. For example, the system’s historical foundations explain why health care delivery in the United States has been resistant to national health insurance, which has been adopted by Canada and most European nations. Traditionally held American cultural beliefs and values, technological advances, social changes, economic constraints, and political opportunism are the main historical factors that have shaped health care delivery Because of these factors, health care in the United States is mainly a private industry, but it also receives a fairly substantial amount of financing from the government. However, government financing is used mainly ▪ Cultural beliefs and values • Self-reliance ▪ • Welfare assistance only for the most needy ▪ Social factors • Demographic shifts • Immigration • Health status• Urbanization ▪ Advances in science and technology • New treatments • Training of health professionals • Facilities and equipment Major changes driven by social, cultural, technological, economic, and political forces will be instrumental in shaping the future of medical services in the United States. These forces interact in a complex manner. Therefore, it is not always easy to attribute a change in health policy or the creation of a new program to any single factor. The beliefs and values...
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...Prof: Deryl Gulliford Neil Matte HSM 320 – Health Rights & Responsibilities Paper 2: Advance Directive DeVry University Date: 2/21/2016 The business of healthcare is a challenging environment in that it can be unpredictable and impacted by many variables. Thankfully, care facilities have protocol to follow in the event of certain emergencies and other occurrences. In this discussion, we will look at how there can be instances where a coverage gap in care can occur when the patient is no longer capable of making decisions for themselves. We will also talk about advance directives, how they can assist healthcare professionals and patients, in such cases. What are advance directives? An advance directive states the patients detailed intentions for care if they become incompetent or lose communicable capabilities. They may also indicate a representative to make decisions for them. There are several types of directives: • Living Will • Durable Power of Attorney • Do Not Resuscitate Order (DNR) • Uniform Anatomical Gift Act...
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