...health care system is complex and fragmented. Navigating the system to achieve maximum health outcomes is challenging for most consumers. Two concepts designed to overcome barriers to quality health care are the continuum of care and continuity of care. The continuum of care refers to the variety of health care services across the life span. Continuity of care refers to provider and informational consistency within those services. Integrated delivery systems are health care delivery entities working together to promote continuity and coordination of care across the health care continuum. Continuum of Care The health care delivery components in the public and private sector health care systems provide services from preconception to death resulting in a lifetime continuum of health care services. Health services are available for every stage of life, health, and even death. Your texts organize the health services delivery system into primary, secondary, tertiary, long-term, and palliative care. Within that framework, health care delivery services can be categorized as ambulatory, acute, or long-term. Ambulatory care, such as visits to a physician's office, is defined as care that does not involve admission to an inpatient facility. Preventive care such as immunizations or screening, wellness exams, and other routine care are part of the ambulatory care domain. Medical and surgical procedures provided in outpatient facilities also are considered ambulatory care. Acute...
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...Health Promotion In Nursing Practice As health care evolves and changes, the roles of nurses in health promotion and prevention have expanded greatly. The goal is to prevent disease from occurring rather than taking a reactive position of treating the client once disease has already occurred. Health defined by Edelman and Mandle is a state of physical, mental, spiritual, and social functioning that allows a person to reach their individual potential for optimal health (Edelman & Mandle, n.d.). In order to reach these goals, levels of prevention have been defined and nurses take an active role in the implementation of positive changes in clients’ lifestyle. On each level of the health promotion continuum, the nurse has to keep in mind the clients’ cultural and educational background to develop mutually agreed- upon goals. “Primary care providers, including nurse practitioners and other advanced practice nurses, now attempt to involve individuals and their families in the delivery of care, teaching individuals about individual responsibilities and lifestyle choices has become an important part of their job”(Edelman & Mandle, p. 9). These positive changes improve the quality of the clients’ and families lives. The three- levels of health care promotion are primary, secondary, and tertiary prevention. All of these levels fall under the wellness continuum. The purpose of this paper is to compare these three levels of health care promotion and give example of how each can...
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...of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through its support of “research utilization,” the integration of research into nursing curricula, and the education of nurse scientists. Sigma Theta Tau International, the Honor Society of Nursing, considers evidence-based nursing “as an integration of...
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...20 years of age die from life threatening diseases (Carter et al., 2004). So, what exactly is being done to help these children get through the endless treatments and to understand that death is a very real possibility in their future? Who is helping the loved ones who survive the sick child move on with their lives and deal with their loss? Pediatric palliative care nurses play a big part in helping sick children and the families of the children who do not make it get through this difficult situation. A team of medical professionals work along with the palliative care team to help the family and the sick child understand what is happening and to decide the best course of action for everyone...
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...Chapter 10, "Biomedical Research, Health Services Technology, and Technology Assessment" * Chapters 11, "Overview of the U.S. Health Services Delivery System" * Chapter 13, "Primary Care" * Chapter 14, "Secondary Care" * Chapter 15, "Long-Term Care" (pp. 349–369 only) * Chapter 16, "Tertiary Care" * Chapter 17, "Palliative Care" * Chapter 18, "The Care of Special Populations and Special Disorders" (pp. 399–406 only) * Chapter 19, "The Health Services Delivery System: How Managed Care Has Influenced Delivery" (Note: This chapter was assigned in a previous week; review it as needed with this week's focus in mind.) * Article: The Scan Foundation (2011). Improving the continuum of care: Progress on selected provisions of the affordable care act one year post-passage. http://www.thescanfoundation.org/improving-continuum-care-progress-selected-provisions-affordable-care-act-one-year-post-passage As you have learned, health care services are provided through a range of organizations. For this Discussion, you will consider how direct- and indirect-care organizations integrate by examining your own experiences as a health care consumer. Begin by brainstorming all the health care organizations that have helped to meet your health care needs within the last few months to one year. Consider the settings and providers you have visited, as well as how and when you have decided to utilize their services. Think about referrals and...
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...Web Review HCS 235 June 4, 2011 Abstract The Queen’s Medical Center is a private non-profit, acute medical care facility located in downtown Honolulu, Hawaii. Queen’s Medical center happens to be the largest private hospital on the Island of Oahu, Hawaii. This hospital is founded in 1859 by Queen Emma and King Kamehameha IV to ensure that the Native Hawaiians and the people of Hawaii receive the best quality of health care services. Queen’s medical center is also known as the referral hospital within the Pacific. Queen’s is accredited by the Joint Commission on Accreditation of Health Organizations (JCAHO) and affiliated with WHA Inc., the national health care alliance [ (Center, 2011) ]. The Queen’s Medical Center is well known on the Island of Oahu as providing the best medical care and putting patients first. In this paper I will give you the overview of the deliver services provided, how Queen’s Medical Center fits in the continuum of care, the resource options provided in the website, and my review of the website. Delivery Services Queen’s medical center delivers a variety of services through the hospital, emergency room, variety of specialty clinics, variety of physician practices, and resources provided by the Queen’s medical center. Queen’s medical center offers a variety of necessity treatment clinics and specialty physicians, ranging from kidney stone center, cancer clinics, and biomedical research offices (Queen's Medical Center, 2011) . The Queen’s...
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...blood products, albumin intravenous crystalloid administration invasive pressure monitoring. Respiratory homeostasis Mechanical ventilation, supplemental oxygen artificial airway (endotracheal tube, tracheostomy tube, oral pharyngeal airway) extra- corporeal membrane oxygenation or CO2 elimination diaphragmatic pacing. Renal homeostasis Homeostasis (continuous or intermittent) hemo-filtration peritoneal dialysis. Neurological homeostasis Cerebrospinal fluid drainage (may be palliative) intracranial pressure monitoring steroids, mannitol, hyperventilation anticonvulsants (probably would continue for palliative reasons). Endocrinology homeostasis Steroid (may be palliative) hormone supplementation or suppression (may be palliative). Treatment of infection Antibiotic, antifungal, antiparasitic, antiviral, medication (may be palliative). Neoplasm Anti- inflammatory medication (may be palliative)“Immune booster” medications cytotoxic medications (may be palliative) radiations therapy (may be palliative). Nutritional homeostasis Total parental nutrition frequent feeding via gastric or jejunostomy tube intravenous dextrose. “Routine” measures Frequent phlebotomy for laboratory tests frequent vital sign measurements radiological examination aggressive chest physiotherapy and endotracheal suctioning debridement of wounds. Neuromuscular blocking agents: (NMBAs) · Possess no sedative or analgesic activity and can provide no comfort to the patient when they are administered at the...
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...Janeak Burgess NUR 4216 FAMU A&M University Dr. Bronson The main focus of this paper, is the theory of patient-centered care with individuals that is diagnosed with Parkinson disease . Effective patient-centered care is for individuals with Parkinson Disease which requires participation from the family and health care providers for a successful care. Parkinson disease is a progressive neurodegenerative infection that affects an individual's motor system. Parkinson disease progresses in three stages: early, moderate, and advanced. As the disease progresses, the complexity of motor and non motor skills increases. Due to the progression of the degenerative symptoms, patients with Parkinson disease are dependent on others for care as...
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...rate of pediatric diagnoses of incurable and/or terminal illnesses across the Western world remains quite high, despite technological and scientific advances (Benini, Spizzichino, Trapanotto, & Ferrante, 2008). According to the Center of Disease Control and Prevention (CDC), 42,328 children died in the year of 2013. Due to the prevalence rate of pediatric mortality, the National Institute of Health (NIH) launched a campaign to increase the accessibility of palliative care for these children, to reduce the suffering of the terminal patient and his/her family (National Institute of Health, 2016). The World Health Organization (WHO) defines palliative care for children as a service that is provided to the terminally ill and their families to alleviate and prevent the suffering of both the patient and their loved ones. Palliative care addresses physical, spiritual, psychological, and social stressors in the family’s life from the time of the diagnosis to the death of the child. Following the death of the child, most palliative care organizations provide a type of bereavement support...
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...School of Nursing Hospice Hospice is a comprehensive, medically directed, team oriented program of care that emphasizes pain control and symptom management rather than curative treatment. It directs acceptance of death as a natural part of life and addresses the psychological and spiritual needs of the patient and family. This paper will outline the history of hospice, the effect it has on healthcare today, why it is important to nursing, how nursing is impacted by the availability of hospice services, and finally, what nursing has done to affect change related to hospice. History of Hospice Hospice was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who started working with the terminally ill in 1948 (NHCPO, 2015). Dr. Saunders later created the first modern hospice – St. Christopher’s Hospice in a residential suburb in London. Her approach was later introduced to healthcare professionals and chaplains in the U.S in 1963 during a lecture at Yale University. In 1969 Elizabeth Kubler-Ross contributed to the idea of hospice centered care in her book: On Death and Dying which highlighted the five stages of dying and a plea for home care as opposed to treatment in an institutional setting. In 1978, the United States’ Department of Health, Education and Welfare Task Force acknowledged the hospice concept as a means of providing more humane care for America’s terminally ill, while asking for federal support and reducing cost. By 1993 hospice became...
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...Continuum of Care Health care services in the U.S. include all services from prenatal care to Palliative care up to the last days of life (Barton, 2010). The way most Americans receive their initial health care is from their General Practice physician for some symptom that needs professional care. Depending on how severe the symptom, or symptoms, turn out to be, either a prescription is given to patient, blood work or X rays done, or admittance to an inpatient hospital. Heath care delivery varies, depending on you geographical region, race/ethnicity and SES (Shi, L. & Singh, D., 2012). Geographic In some rural areas, there is usually one hospital with a small inpatient unit, one source of ambulatory care, and all services are offered under one roof: inpatient, outpatient, nursing home (Wakefield & Linden, 2013). With 40 physicians, and more than 425 employees, Grinnell is one of the top rural medical centers in the greater Poweshiek County area of Iowa. Also on staff is a resident physician staff of 40 or more practitioners that provide services usually only offered in major healthcare centers (About Us, 2009). Race/Ethnicity Black Americans fall behind with their health due to mainly their SES, regardless of the “progress” that was made in the last decades. This race usually reports their health as fair or poor. Next is the is the Hispanic race, who may run into issues of accessing health care in America, due to immigration issues that my disqualify...
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...Health Care Reform and Heart Failure John Jones Heart Failure is the inability of the heart to pump enough blood to support all organs because the muscle of the heart wall is weakened and enlarged. The most common cause of heart failure (HF) is coronary artery disease (CAD); however, some common risk factors that lead to heart failure include heart defects present since birth, high blood pressure, heart valve disease, infection of the heart, abnormal heart rhythm and being overweight . In the United States about 5.7 million people have heart failure and is mentioned as a contributing cause in more than 280,000 deaths, that is one in nine deaths in 2009 and is the primary cause of death in more than 55,000 deaths each year. . (Roger, Lliyd-James, Benjamin, & Borden, 2012) Heart failure costs the nation $34.4 billion each year, including healthcare services, medications, and lost productivity. (Kochanek, Murphy, Minino, & Kung, 2011) Furthermore, adults admitted with a secondary diagnosis of heart failure rather than a primary diagnosis experienced a higher cost of hospitalization. (Wang, Zang, Ayala, Wall, & Fang, 2010) Early diagnosis is important in the treatment of heart disease in order to improve the quality of life, increase life expectancy for people with heart failure and ultimately reduce the fiscal burden to society. Evidence-based treatment involves taking medications, following a proper diet, reducing salt intake, monitoring weight daily...
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...essential role in leadership in the health care setting. This report explains how education is vital to advance nurses into a partnership with physicians to improve the health care system nationwide. Impact of IOM report on Education In 2010, recently signed into law by the president, was the Patient Protection and Affordable Care Act, which are referred to in this report as the Affordable Care Act (ACA). The ACA is expected to insure 32 million previously uninsured Americans. (“the future of,”2010) The nursing profession should be utilized to help build a health care system that will be focused on patient centered, safe, accessible, and affordable care. Nurses will need to practice to the full extent of their education. Florence Nightengale developed the concept of an educated workforce, modern nursing has reinvented itself a number of times as healthcare has advanced and changed. A well-educated nursing profession has helped make possible: Evolution of high technology hospital, possibility for physicians to combine office and hospital practice, shorter length of stay in hospital, reduce hours of physicians in residency to improve patient safety, improve access of care for poor and rural residents, respite and palliative care, including hospice patients. According to the IOM report, nurses must achieve higher levels of education and training to meet the changing needs of patient and the demands of an ever evolving health care system. IOM report: Impact on Practice ...
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...Caring Hospice Business Plan Bonita Lewis Central Methodist University COMPANY SUMMARY/CATCHY-SELLS Caring Hospice is a new hospice company in its start-up stages. It will offer compassionate and caring end of life care for terminally ill patients and their families in southeast Missouri. The company name “Caring Hospice” is catchy and easily remembered by consumers. The name indicates that this company will care for dying loved ones. MARKET ANALYSIS Caring Hospice will be located in Poplar Bluff, Missouri. This is the southeastern region of the state. It is comprised of poor communities where residents often are forced to travel as far as fifty miles or more for adequate health care. Market research shows there is a significant need for quality hospice care in this region, with only six competitors that travel to the homes of patients living in the rural counties (Yellow Pages, n.d). Caring Hospice will thrive for years to come simply due to the fact that it will bring care to the patients in their own homes. FINANCIALS The start-up budget includes a list of expenditures (Henderson, 2003). The expenses will be compiled of operating and non-operating costs (Dunham-Taylor & Pinczuk, 2010). The start-up costs will be paid with a new business loan the first 90 days. After this time, the business will be able to support itself with revenue from billing to Medicare, Medicaid, and private insurances (Hogan & Hartson, 2012). The estimated beginning...
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...program for individuals that require extended mental health care so they can transition back into community with the skills necessary to be successful in their recovery. The program offers 24-hour supervision from qualified staff and intensive individualized therapy, psychiatric services, nursing and medical support, case management, life skill enhancement, psychoeducational group therapy as well as creative arts therapies and leisure and recreational activities. CRCSI also provides The Phoenix Program, Adult Partial Hospitalization which is a client-centered program in which participating individuals take an active role in their recovery. The program provides services for individuals with severe and persistent mental illness that need more support than outpatient services offers but less than inpatient hospitalization. Additionally, CRCSI offers School Based Outpatient is a community based treatment alternative to traditional outpatient therapy services. CRCSI licenses a school as a satellite outpatient facility and places a therapist at the schools to meet the mental health treatment needs of students identified with behavioral health problems such as attention deficits, problematic classroom behaviors, peer interactions, as well as, family relationship, grief and loss and home behavioral problems and drug and alcohol assessment and...
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