...next generation to come. Therefore, the Patient Self-Determination Act is the main issue which affects our society. Generally speaking, the Patient Self Determination Act (PSDA) in most hospitals, nursing homes, home health agencies, and HMO’s routinely provide information on advance directives at the time of admission. They are required to do this by federal law. The PSDA simply requires that most health care institutions do the following: give you at the time of admission a written summary of your health care decisions-making rights, the facility’s policies with respect to recognizing advance directives, and ask you if you have an advance directive, and document that fact in your medication record. On the contrary, many physicians were not in favor of a policy for patient self determination because they felt that this would decrease their authority regarding medicine, interfere with the patient-physician relationship, and be one more legal regulation (General Accounting Office (GAO) Letter Report, 1995). However, the American Medical Association supported the policy. Some hospitals were concerned about the execution of the policy as they believed that it was appropriate to give medical advice but not legal advice. Although most maintstream religions do not feel that withdrawing life support is in opposition to their beliefs, there were concerns about appropriate stopping points. First of all, the current medical practice in the United...
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...regulations have on providers and hospitals. Once we are done learning, we will all be able to relate situations we see or have seen in our own lives and communities. AHRQ Snapshot Dedicated to improving quality, safety, efficiency, and effectiveness of health care, AHRQ continues to build the knowledge base for what works and what doesn’t work in health care by working with public and private sectors and translates the information into everyday practice and policymaking. (AHRQ, 2013). The impact of AHRQ’s research is essential and very beneficial as people are able to understand the many ways to improve service delivery in the health care arena as well as addressing any other areas of need. Some major areas that have been under research such as information technology, health care utilization and costs, medication safety, disaster preparedness, illness prevention and other special needs in specific populations. Other focus areas are comparing the effectiveness of treatments, quality improvement and patient safety, prevention and care management and health care value. Current Laws and Regulations Faced by Health Care Industry As we all know, the government currently spends billions of dollars regulating health care services. These regulations speak to...
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...Nursing practice is ruled by many legal concepts. It is important for nurses to know the legal aspect of Nursing; because nurses are accountable for their professional judgments and actions. Accountability is a crucial concept of professional nursing practice and the Knowledge of laws that legalize and affect nursing practice is needed for two reasons: first to ensure that nurses’ decisions and actionsLegal aspect of Nursing Nursing practice is ruled by many legal concepts. It is important for nurses to know the legal aspect of Nursing; because nurses are accountable for their professional judgments and actions. Accountability is a crucial concept of professional nursing practice and the Knowledge of laws that legalize and affect nursing practice is needed for two reasons: first to ensure that nurses’ decisions and actions are consistent with legal principles and second to protect nurses from legal responsibility. What are the functions of law in nursing? The law serves a number of functions in nursing: it helps structure nursing actions in the care of clients are legal. It helps establish the boundaries of independent nursing action. It assists in maintaining a standard of nursing practice by making nurses accountable under the law. There are three sources of laws that affecting nurses: Federal Regulation, Criminal and Civil law and State law. Federal Regulations have a great impact on nursing practice for example The Health insurance portability and accountability Act (HIPAA)...
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...medical treatment is administered. The information should include the risks and advantages of any medical treatment that concerns the patient. * Is an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment, alternatives to the treatment and prognosis if not treated by a health care provider. Four Major Elements of Informed Consent 1. Competence. This refers to a patient’s capacity for decision-making. One is considered competent when (a) one has made a decision (b) one has the capacity to justify one’s choice – competence here requires some process of deliberation, justification, and an articulation of why one has made this particular choice; (c) one does not only justify one’s choice but does so in a reasonable manner. 2. Disclosure. This refers to the content of what a patient is told or informed about during the consent negotiation. Then patient must be informed and must understand the information concerning medical treatment to be undertaken, so that a moral decision can be made. The disclosure of the information must be conducted in such a way that the patient understands the whole process and is aware of the possible outcomes of his or her normal choice. Should there be a language barrier between the physician and the patient; an interpreter might be consulted to communicate the pertinent information. 3. Comprehension. This refers to whether the information...
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...12/15/2014 | This paper concerns the ethical basis for advance directives, or “Living Wills”; the value of these advance directives to the patients, their families; and the authorities that these advance directives give the above mentioned interested parties. | Contents Application Paper on Advance Directives 3 Abstract of Application Paper 3 Advance Health Care Directives 3 The Natural Death Acts 3 Legal Precedents for Advance Directives 3 Advance Health Care Directives: 4 California’s Advance Directive Law 4 The Natural Death Acts 5 Inception and Legal Basis 5 Current situation of N.D.A.s 5 Value of Advance Directives to Patient, Family, and Caregiver 6 Value to Author or Patient 6 Health Care Facility 6 Are Advance Directives Really Effective? 7 Living Will Example 8 References 13 Application Paper on Advance Directives Abstract of Application Paper This paper will examine the short history of Advance Directives in California, the other states that have added A.D.s, and what the legal basis and historical basis for these acts are. Previous to the Advance Directives, very similar laws are Natural Death Acts. In this report I will review some of the similarities, and differences between the A.D.s and the N.D.A.s. In the 1970s, with the modernization of health care facilities, some patients, especially sick or elderly, would disagree with standards of care of hospitals they receive when they are afflicted by Alzheimer’s, or Trauma...
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...nursing standards, she is not working as an advocate for her patient, Mr. E at this situation (Code of Ethics - the Division of State Documents, 10.27.19.02). The patient already signed advanced directive against life saving measures almost seven years ago, at the time of admission to a nursing home, with the help of patient advocate; but Dr G. is planning patient care in opposition to Mr.E’s active advance directive and his expressed objections to the medical care. There are numerous issues to consider in this case study. The nurse has to review her professional role according to code of ethics and nursing standards in relation to advance directives and medical power of attorney. The nurse also has to consider the patient’s right to privacy and confidentiality according to HIPPA Policy. The issues in contemporary healthcare facilities are sometimes the statues can be vague, and issues can be in conflict with own personal beliefs in most areas. A) State Regulations and Nursing Standards of practice There are specific Maryland state regulations and nursing standards regarding patient rights in this case study. However, the most relevant regulation is that, the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient (Nursing code of Ethics: Interpretation and Application, ©2010 Provision 3) 1. Health care workers have to disclose or release patient health information only if it is requested by law. Nurse...
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...Ethical and Legal issues in Nursing The nursing profession is very complex. Every day nurses deal with patients and medical care. There are some days when ethics and legal issues play a role. We were given examples of the legal complexities of nursing through two case studies we were to evaluate. For this paper we will discuss the legal responsibilities of nursing, how personal and societal values can influence ethical decision-making and how the ANA’s Code of Nursing Ethics would influence the final decisions. Legal Responsibilities of Nurses Nursing boards are governmental state agencies responsible for regulating the nursing practice. A nursing license obtained through state nursing boards validates that nurses have met standards for providing high quality care. Nurses are legally held accountable for administering medications accurately, educating patients and public on health issues, advocating for the patient regarding health care, and serving as a liaison between the patient and the physician. Professional standards are determined by Standards of Practice Acts and the American Nurses Association’s Code of Ethics. As professionals, nurses must also be familiar with ethical responsibilities and protect the rights of their patients and families. As the definition of liability has continued to expand through the judicial system, courts of laws have placed higher standards on the profession of nursing. Many times professional...
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...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 consent to or decline medical treatment - even if the declination results in death. In 1990, Congress passed the Patient Self Determination Act (PSDA), which was established after the Supreme Court’s ruling in Cruzan v Missouri Department of Health in which it was found that it was acceptable to require "clear and convincing evidence" of a patient's wishes for removal of life support (Koch,...
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...particular kind of law – drafted, debated, and voted on by a group of legislators. This is of course, not correct. There are many other sources of law. There is the federal constitution, and the constitution of each state. There is law made through regulatory agencies (administrative law) and there is law made by judicial decision (common law). This combination of approaches and interests leads to the rich fabric that is simply described as healthcare law. Common Law Contract Law: Contract law is at the heart of healthcare delivery. Insurance companies enter into contracts with patients, providers, facilities, and governments (state and federal). Doctors and hospitals enter into contracts with one another. Unions and employers enter into contracts with one another. Contract workers have employment contracts. All equipment in facilities is acquired and maintained through contracts. Most importantly, the doctor patient relationship is a contract with special duties. The primary source of contract law is common law. Common law is developed through court decision. Court decisions (within the same jurisdiction) are binding on future courts....
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...Knowledge Area Module VI Contemporary Issues and the Ethical Delivery of Health Services Student: Harold Taitt, harold.taitt@waldenu.edu Student ID # A00293212 Program: Ph.D. Health Services Specialization: Health Management and Policy Faculty Mentor: Dr. Robert Hoye, robert.hoye@waldenu.edu Faculty Assessor: Dr. Jim Goes, jim.goes@waldenu.edu Walden University May 10, 2013 Abstract Breadth Component In this age of rapidly evolving technological advances, many of the legal and ethical issues that are challenging the delivery of health care and the health care profession are new. As we confront the legal, moral, and ethical aspects of health care, we are seldom faced with decisions that require or are resolved by simple right or wrong answers (Edge & Kreiger, 1998). In the Breadth component of KAM VI, I focus on several ethical theories and how those theories influence the way ethical issues and concerns are addressed and managed in the allocation and delivery of health care services. I critically assess and evaluate those theories, concepts, and derivative principles as they impact important decisions and the implications of those decisions within the context of social change and with special emphasis on health care management and policy. In addition, I discuss the key assumptions on which the selected theories are constructed, compare and contrast the writers’ interpretations across theories, and conclude by providing a critical commentary on the merits of the selected...
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...access the models 2.2 How can we understand complexity, interdependence and fragmentation? Weisbord’s Six-Box Organisational Model 7S Model PESTELI Five Whys Content, Context and Process Model Soft Systems Methodology Process modelling Process flow Influence diagram Theory of Constraints (TOC) 22 25 25 27 29 30 32 34 36 37 38 39 40 40 42 43 45 46 47 48 48 50 54 54 55 56 56 58 2.3 Why do we need to change? SWOT analysis 2.4 Who and what can change? Force field analysis ‘Sources and potency of forces’ ‘Readiness and capability’ Commitment, enrolment and compliance Organisation-level change interventions Total Quality Management (TQM) Business Process Reengineering (BPR) Group-level change interventions Parallel learning structures Self-managed teams Individual-level change interventions Innovation research Securing individual behaviour change Managing Change in the NHS 2.5 How can we make change happen? Organisational development (OD) Organisational learning and the Learning Organisation Action research Project management 60 60 63 66 68 Part 3 Reflections on evidence 3.1 3.2 3.3 3.4 Assistance with using available evidence Developing an evidence base Developing...
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