...with ankylosing spondylitis five years prior. Because of deterioration of patient’s left hip, a total hip replacement (THR) surgery is recommended by his rheumatologist. The patient has a past medical history of mild hypertension and anterior cruciate ligament repair to his right knee 12 years ago. Medications the patient is currently taking are Tenormin (Beta-blocker), Prednisone (Corticosteroid), and Ibuprofen (NSAID/ nonsteroidal anti-inflammatory drug). Physician’s referral consists of pre-surgery LE strengthening exercises, activities of daily living (ADL) training, and THR management education within 6 outpatient visits. Ankylosing spondylitis (AS) is a type of chronic inflammatory...
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...year old male that was hospitalized one month ago after a fall at home requiring right total hip replacement. Mr. Trosack reported no previous health history but has been diagnosed with hypertension and non-insulin dependent diabetes during hospitalization. Mr. Trosack is a widower, lives alone and manages the family-owned business with his brother. Currently ambulating with the assistance of a walker, Mr. Trosack has been in in-patient rehabilitation for the past 2 weeks. Healthcare Issues Related to Discharge Plan Three issues that must be addressed in Mr. Trosack’s discharge plan are safety, treatment compliance and psychological well-being. Mr. Trosack’s safety plays a pivotal role in determining the proper discharge plan. The safety of the environment Mr. Trosack will be discharged to must be evaluated to ensure that it will be conducive to his recovery and low risk for further injury. Compliance of Mr. Trosack’s treatment plan regarding not only his hip replacement but also his newly diagnosed hypertension and diabetes is another important issue. With no previous medical conditions, compliance with treatments and medications may prove to be difficult and cumbersome to Mr. Trosack. Adjusting to these changes and incorporating them into his activities of daily living is going to take time and strict adherence. Non-compliance can lead to a delay in recovery from his hip surgery as well as deterioration and instability related to his hypertension and diabetes. Mr...
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...location and availability. Likewise, sellers can keep up with the market, the can stay aware of the going rate, and see how their competitors are pricing their products. One of the most challenging things amongst hospitals and most health systems across the Country is proving the information that patients, payers and employers need in order to make educated purchasing decisions. Some hospitals in the United States provide calculators so that patients can estimate an out of pocket cost of any upcoming procedures. Other hospitals offer an all- inclusive service price if patients pay up front. The services included will consist of physician visits, hospital visits, and ancillary prices for more than 250 procedures. University of Utah Health Care post the physicians...
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...Mandatory Pre-op for Total Knee Replacement The decision to undergo elective knee surgery can be very stressful for many patients. It is important for patients to be well prepared. Total knee arthroplasty has increased by eighty-four percent from 1997 to 2009 (Fawzi, 2012, para. 1). By making the Pre-op Total knee Arthroplasty class mandatory patients and their family members will be more educated and prepared for surgery and recovery. During the class patients will be able to ask any questions they may have, learn how to better prepare for surgery and ways to prevent infection during their hospitalization. Physical therapist will also discuss exercises and pain management techniques. By using the John Hopkins evidence based practice model a change can be made in the pre-op process for all total knee replacement patients. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is defined as a problem-solving approach to clinical decision-making within a health care organization (Dearholt, & Dang, 2012, p. 4). Nurses often use this model to facilitate change within their organization....
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...up of layers of plaster or fiberglass (water-activated polyurethane resin) bandages molded to the body part that it encases. Indications * To apply uniform compression of soft tissues * To permit early mobilization * To correct and prevent deformities * To support and stabilize weak joints Types of Casts 1 Short and long -arm cast for the upper limbs. : Extends from below the elbow to the proximal palmar crease. 2 Gauntlet Cast (thumb spica): from below the elbow to the proximal palmar crease. 3 Short and Long-leg Cast for the lower limbs. 4 Body Cast: Encircles the trunk stabilizing the spine. 5 Spica Cast: Incorporates the trunk and extremity. 6 Shoulder spica: encloses trunk, shoulder, and elbow. 7 Hip spica: encloses trunk and a lower extremity and can be single or double. Single extends from nipple line to include pelvis and one thigh while double includes both thighs and lower legs. 8 Cast-brace: External support about a fracture that is constructed with hinges to permit early motion of joints, early mobilization, and independence. 9 Cylinder Cast: Can be used for upper or lower extremity e.g. fracture or dislocation of knee or elbow dislocation. Complications of Casts * Pressure of cast may cause necrosis, pressure sores, and nerve palsies. * Compartment syndrome * Cast syndrome associated especially of body cast, resulting to nausea, vomiting, and abdominal distention; superior mesenteric artery syndrome, resulting...
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...performing as well as countries such as India or Thailand, and also to provide insights on how to go about leveraging on certain medical procedures that China have a comparative advantage in performing. This study resulted in two findings. Firstly, there is a lack of hospitals with JCI accreditation which we found out was due to a lack of motivation from public hospitals to do so, and also a lack of transparency in the management of the Chinese hospitals. Secondly, we found that the three medical procedures with the biggest potential to spearhead the success of medical tourism in China are Heart Bypass Surgery, Hip Replacement Surgery and Traditional Chinese Medicine. Keywords: Medical Tourism China JCI Contents Page Chapter 1 Introduction 1 1.1 What is Medical Tourism 1 1.2 Reasons for the popularity of Medical Tourism 2 1.3 Why do patients seek care at medical tourism destinations? 4 1.3.1 Low Cost 4 1.3.2 Avoid Waiting lists 6 1.3.3 Procedure not available in home country 6 1.3.4 Procedures unavailable or restricted by society and/or legal system 7 1.3.5 Tourism and vacations 7 1.3.6 Privacy and Confidentiality 7 Chapter 2 Global Market overview of Medical Tourism Industry 8 2.1 Rise of Asian Medical Tourism demand 9 2.2 Medical Tourism Facilitator / Agents 10 2.3 International Medical Procedures Costing 10 2.4 International Healthcare Arbitrage 12 2.5 Problems pertaining to Medical Tourism 13 Chapter 3 Medical Tourism...
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...Epidaurus. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans travelled to spas from Germany to the Nile. Since the early nineteenth century, when there were no restrictions on travel in Europe, people visited neighboring countries in order to improve their health. At first, mere traveling was considered to be a good therapy for mental and physical well-being. In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. Later, mostly wealthy people began traveling to tourist destinations like the Swiss lakes, the Alps and special tuberculosis sanatoriums, where professional and often specialized medical care was offered. In this century, however, medical tourism expanded to a much larger scale. Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others quickly became the most popular destinations for medical tourists. Complicated surgeries and dental works, kidney dialysis, organ transplantation and sex changes, topped the list of the most popular procedures. It was estimated that in 2002, six hundred thousand medical tourists came to Bangkok and Phuket medical centers in Thailand, while approximately one hundred and fifty thousand foreign patients visited India during that time. From Neolithic and Bronze age wherein people used to visit neighboring countries for Minerals and Hot Springs , Today we have reached the era where Hospitals...
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...everyday life for many individuals. When social networking interferes with the health care industry, multiple problems may arise. Violating personal health information may occur with the slip of a key. Medical advice may be given with consequences. Social networks can be helpful, but may also be damaging. Having a policy within a facility will assist in reducing the risk of a privacy violation. A social network site is an online community for individuals to meet and share information along with discussing common interests. The issue arises from a health care professional violating patient privacy and other HIPAA laws within the social networking sites. Leaking patient information through these sites can be damaging to the patient and the physician at the same time. Social media sites tend to be relaxed and not always handled in a professional manor. This can lead to personal health information leaking through the sites. Although the leaks may not be intentional, they are still a violation of privacy laws protecting the patient. As a society, personal information that could possibly be damaging to a person is both personal and potential gossip. Not all leaks of personal health information are gossip, and damaging, but it could be for any person. The damage will reflect the person being spoken about and the medical facility that has treated the patient. When a simple slip of a health care facility staff member, such as a nurse, slips and mentions something regarding their...
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...Health care is driven by the health expenditures and monetary investments that come with bundled payments. As there are numerous methodologies in reimbursements and payment options the context of this paper will discuss how bundled payments work. What the pro and cons of a bundled payment system. The outline mechanisms underlying bundled payments and how it assists providers who are considering utilizing the payment options. As bundled payments are likely to become common in health care it is important as a future administrator to fully understand all aspects that come along with the payment system and how it will optimize and benefit your organization with a thorough understanding. The common usage of bundled payments in the healthcare system...
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...Successful discharge planning is not something that should be initiated when the patient is ready to go home, but should be discussed prior to the surgery being performed if possible. The total hip replacement that Mr. Trosack is recovering from was not a planned surgery so case management should have begun working on this once he was admitted to the floor postoperatively. Healthcare Issues and Their Importance There are numerous healthcare issues that must be considered in discharge planning for Mr. Trosack to ensure that medical, social and functional issues related to his recovery have been evaluated. Safety is a very important healthcare issue that must be addressed prior to discharge. As with most patients over the age of 65, Mr. Trosack is at high risk for a fall for various reasons. 33% of this age group experience one fall per year and commonly involve falling down stairs or steps (Heasley, Buckley, Scally, Twigg, & Elliott, 2005). He lives on the second floor of an apartment building that has no elevator so he must maneuver a long flight of steps to enter or leave his apartment. In addition to this, he has a small apartment that is cluttered with WWII .memorabilia and furniture which increase his chances of tripping and falling. Mr. Trosack has recently been diagnosed with hypertension and noninsulin dependent diabetes which will present another healthcare issue and result in a lifestyle change for him. Previously, he was not taking any prescription medications and...
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... This paper explores the reasons Kaiser is one of the top 100 hospitals, using research conducted online and offline, by using patient and customer feedback, and also by explaining how Kaiser Permanente achieves its quality of care to become a top hospital. Kaiser Permanente has marketed itself as one of the top 100 hospitals in the U.S., proclaiming their exceeded cares for those who are Kaiser Permanente Members. They have been administering healthcare for many years, through inpatient and outpatient care. A plethora of accolades in various categories shows Kaiser Permanente’s success in keeping long term patients under their provided care. Keywords: Kaiser Permanente Today’s Top 100 Hospitals In today’s world, people believe in researching who can provide the best quality service in the healthcare industry. We are keenly aware of how our health service is provided when we are struck with an illness or injury, which makes it imperative to learn who ranks among the top hospitals. Kaiser Permanente has been well known to give the best quality care for those who are Kaiser Permanente Members. They are known to be highly ranked in various aspects, ranging from internal medicine, cancer research, surgery, cardiology, orthopedic care, pediatrics, and geriatrics, to name a few. Back in the 80’s and 90’s, Kaiser Permanente was well known for its less than stellar reputation. At the time, it was not fathomable that Kaiser Permanente would be able to provide the...
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...HADM 339 – Essay Major themes in health care in Canada include access to services. Identify the issues, identify the changes you believe are needed and discuss the approach you would propose to implement these changes. Simply put, access in the health care sector refers to the ability for a patient to receive the care and services required to maintain a healthy quality of life. Access to health care services continues to be a key issue for Canadians and health policy makers.1,2 Key issues exist in several dimensions of the health care process, including access to a specialist, non-emergency surgery and non-emergency diagnostic testing. More specifically, it is the significant amount of time one will spend waiting for their opportunity to receive these services that remains a concern. Among those who had waited for specialist visits, 29% reported unacceptable waits. This was also true for 17% of patients who were waiting for a non-emergency surgery and 20% for those waiting for diagnostic testing.3 Median waiting times for all specialized services remained relatively stable between 2003 and 2005 at 3 to 4 weeks, depending on the kind of care. Approximately 18% of individuals who visited a specialist indicated that waiting for the visit affected their life, compared with 11% and 12% for non-emergency surgery and diagnostic tests respectively.4 Despite several efforts made by government agencies, access still remains one of the foremost issues identified. Billions...
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...Running Head: Self-Care Deficit Theory Concept Analysis: Self-Care ABSTRACT Dorothea Orem’s Self-Care Deficit Nursing Theory has been used as a basis for nursing care since she first proposed the theory in 1959. The focus of this paper is to define the Self-Care Theory in broad terms and to analyze the concept Self-Care Deficit Nursing Theory using the Chinn and Kramer “Integrated Theory and Knowledge development in Nursing” process. The SCDNT is an important theory in nursing and helps to guide the nursing process and improve patient care with measurable results. It is also an important theory for developing curriculum in nursing schools and has proved invaluable to care providers when performing self-care for others. 1 In 1959 Dorthea Orem, a nurse from Baltimore, Maryland, developed the theory of Self-Care defined as a condition that “in an adult is the absence of the ability to maintain continuously that amount and quality of self-care which is therapeutic in sustaining life and health, in recovering from disease or injury, or in coping with their effects. With children, the condition is the inability of the parent (or guardian) to maintain continuously for the child the amount and quality of care that is therapeutic “(Orem, 1995, p.53-54). Orem posited that to determine if people need nursing care then it is “ the inability of persons to provide continuously for themselves the amount and quality of required self-care because of situations of personal health” (Orem...
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...Implement and monitor nursing care for clients with acute health problems. Contribute to complex nursing care of clients. Administer and monitor medications. Administer and monitor IV meds. Assessment 2 Post-op Case Study Assessment 2 Question 1. Identify a minimum of 5 nursing actions, in order of priority you would perform related to above information. Mrs Abu has had a considerable change in her vital signs (blood pressure lowered, her pulse is rapid, her respirations increased and temperature has dropped) form the baseline taken before surgery. These findings alone would be reported to the Registered Nurse and monitored. But because of the changes in vital sings, coupled with Mrs Abu reporting light-headedness and nausea, plus her significant blood loss form the surgical wound, you would be assessing for hypovolemic shock which can be life threatening. As the nurse you would be seeking assistance immediately, assessing her airway, breathing and circulation. Applying oxygen, applying pressure at the surgical site and continuing to monitor (airway, breathing, circulation) and vital signs until help arrives. Mrs Abu should be given nil by mouth as she may return to surgery (Gulanick, Myers, Klopp, Galanes, Gandishar & Puzas 2003, p.329). Question 2. Complete the interventions and rationale in Mrs Abu's care plan related to the following diagnosis |Nursing Diagnosis |Interventions |Rationale ...
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...physicians may service as team leaders, they and other team members share responsibility, authority and mutual goal improving quality while lowering costs” (Butcher, L. 2013). The patient’s case scenario for this team based is elderly woman, in her early eighty’s’, who’s had both knee replaced. “Knee replacement also known as Knee athroplasty, can help relive pain and restore function in severely knee joints. During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint or metal alloys, high-grade plastics and polymers” (mayoclinic.com. 2013). This patient is at along term care facility and has been living there for a few months since the last knee replacement. Due to the replacements, patient now cannot walk and has no strength in both legs, which has caused major depression. Laying in bed majority of the time has caused bedsores to the buttocks. “Bedsores, also called pressure sores or pressure ulcers, are injuries to skin and underlying tissues that result from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heel, ankles, hips or buttocks” . Patient also has type 2 diabetes, which is a chronic condition that affects the way your body metabolizes sugar...
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