...Alise E. Jenkins May 24th, 2015 HCA-515 Health Care Models Analysis Hypothetical Case (basic details only): The patient is 72 year old female who smokes. She complains of extreme fluid retention in lower two limbs and lower abdomen. Breathing is difficult and she is only able to sleep while sitting erect in a reclining chair. Patient has underlying conditions: Obesity, Coronary Artery disease, Edema, Hypertensions, Dyslipidemia, Ischemia, and hx of quadruple Coronary Artery Bypass Graft. Current dx: Heart Failure Medical Model: A number of tests would be performed to analyze the extent of damage of the heart. An electrocardiogram would be one of the first tests performed to check the electrical activity of the heart and detect any type of ischemia (AHA, 2015). The tests would include X-Rays CT, and MRI scans. Also “Angiography that would allow imaging of the blood vessels” (AHA, 2015). Essentially it is creating a map of the heart. Ultrasound evaluations, echocardiograms, would also help define the amount of damage to the heart. Treatments for heart failure can vary due to underlying causes. However in most cases drugs are used to aid the symptoms. These drugs can include “beta-blockers, ACE inhibitors, and also a diuretic to help rid the body of excess fluid buildup” (CDC, 2015). Mechanical devices can be implemented into the heart too. These devices include pacemakers and defibrillators. These two mechanisms help improve...
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...The Department of Health and Human Services (2000), defines health disparities as unequal burdens in disease morbidity and mortality rates experienced by ethnic/racial groups as compared to the dominant group (USDHHS, 2000). The organization asserts that the causes of health disparities are multifactorial which includes poor education, poverty, inability to access health care, limited health coverage ,health behaviors of the minority group, and other environmental factors (USDHHS, 2000). Most of these factors are related to access to health care. According to Cohen (2007), the elimination of health disparities requires attention to the physical, mental, social as well as political context in which health occurs or is threatened...
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...high-quality healthcare depends upon where you live. Throughout rural America, nearly 50 million people face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the healthcare disparities and access concerns that are already elevated in rural communities. High poverty rates and job loss in the current economic recession highlight the challenges of accessing health care and rising health care costs in rural areas. Rates of poverty are higher, with fifteen percent of people in rural areas living below the poverty level compared to twelve percent of people in urban areas. The rural economy is dominated by small businesses, which are struggling as the cost of healthcare continues to skyrocket. In the current recession, the rural economy is losing jobs at a faster rate than the rest of the nation, and loss of jobs can lead to loss of healthcare coverage. In particular, rural communities dependent on manufacturing have lost nearly five percent of their jobs since the recession began. Many rural residents work part-time, seasonally, or for themselves, making them less likely to have private, employer-sponsored health care benefits. Research shows that ninety percent of farmers have insurance coverage; one-third purchased it directly through an insurance agent...
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...Diversity in the Workplace We live in a society today that is culturally diverse. With this diversity of the population, comes the need for a diverse and culturally competent nursing workforce to care appropriately for patients. The purpose of this paper is to examine diversity in the workplace, its importance to nursing as a profession and its impact on the delivery of culturally competent nursing care. Importance of Diversity in the Workplace Huston (2014) reveals that age, gender, customs, religion, physical size, physical and mental capabilities, beliefs, culture, ethnicity, and skin color are all forms of diversity. Despite the shift in demography of today’s society, which reflects an increasingly culturally diverse population (Phillips and Malone, 2014), the majority of nurses in the workforce are white, middle-aged females (Mattson, 2009). Making the nursing workplace more heterogeneous, diverse and representative of the population (Phillips and Malone, 2014), helps to promote quality of care and decrease disparities in healthcare (Huston, 2014). Maier-Lorentz (2008) adds that diversity in the workplace fosters cultural competency, which is vital to the provision of holistic and optimal care to this diverse patient population. Summary of One Aspect of Diversity One aspect of Diversity in the workplace is Generational diversity. With the current aging nursing population averaging forty-years of age (Mason, Leavitt and Chaffee, 2014), the current nursing...
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...United States is facing the need to provide nursing care to an increasing diverse patient population with a nursing workforce that, in itself, is impacted by generational, ethnic and gender differences. The purpose of this paper is to present the importance of diversity in the workplace and delivering culturally competent nursing care, the impact of gender diversity, and the misrepresentation of minorities in the nursing profession. Importance of diversity in the workplace America is a kaleidoscope of cultures, religions, races, and nationalities. The USA Quick Facts from the US Census Bureau shows the following 2011 population statistics: White 63.4%, Hispanic/Latino 16.7%, Black/Afro-American 13.1%, Asian 5.0%, American Indian & Alaska Native 1.2%, and Native Hawaiian/Pacific Islanders. 0.2%. In 2012 minority population increased to 37% and is projected that minorities will be the majority by 2043. Mason, Leavitt & Chaffee (2012) pointed out that as our population “continues to grow and increase its diversity, it is important that the nursing workforce reflect these changes to effectively meet patient care needs and ensure cultural competency” (p. 378). Cultural assessments must be part of the nurse’s health assessment. To be culturally competent nurses need to be aware of their own culture, and the diverse culture of their colleagues and patient populations (Maier-Lorentz, 2008). Culturally competent nursing care is important for positive patient outcomes and patient ...
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...Emerging Standards of Care NUR 531 Emerging Standards of Care The impact of the varying demographics and the emergent multicultural humanity emphasizes the significance of cultural competence for the provision of quality care in this diverse society. Identifying and comprehending the beliefs, customs, practices, and values of a culture is essential for nurses and health care providers. Beyond the racial and ethnic group, classification that usually comes to mind with discussion of cultural diversity, other types of cultural diversity such as gender and organization affiliation warrants attention. This paper will discuss cultural competence in home health care/hospice, the people that receive service and issues of community vulnerability. Exploration of standards of cultural competence, potential impacts of delivery of care, and possible solutions to implement where standards are not being met will emerge. Cultural Competence According to Freidman, Bowden, and Jones (2003), people view culture as a model for our way of living, behaving, living, and feeling. An association between culture and heath practices is existent. In fact, culture is the most influential factor in determining health behaviors and beliefs (Campinha-Bacote, 2003). Cultural competence involves being aware of, and conversant on, and sensitive to the diverse cultures that exist in the population. Health care providers should not only embrace cultural diversity but must also strive for cultural...
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...of beliefs, values, and customs, which they refer to as their own culture. Also, the nurses’ perceptions as well as the control of pain are influenced by the nurses’ cultures since it influences their stereotypes and interpersonal communication patterns (Al-Atiyyat, 2009). The nurses should be attentive and sensitive to the patients’ own cultural background especially when they work in diverse society. Cultural incompetency can result in inadequate or inappropriate care due to miscommunication and the possibility to make inaccurate assessments. Thus, cultural competence is linked to improving the quality of pain management as part of the patient care provided (Al-Atiyyat, 2009). Patients with cancer pain should be cared by nurses who are culturally competent and who refrain from stereotyping while providing holistic care to patients. Campbell, Edwards, and Fillingim (2005) showed that there are no racial or ethnic differences in sensation threshold but the expression of pain is culturally-driven. The care provider should not impose their beliefs on the patients and they should be aware to the cultural differences in reports and treatment of pain (Al-Atiyyat, 2009). Only a few studies have addressed cultural factors on pain among patients with cancer. In a cohort study, Rabow and Dibble (2005) explored ethnic and country of origin differences in pain among outpatients with terminal and end-stage chronic illness among patients with cancer. Although patients of all ethnicities...
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...American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies that submit data to the State of California, only 2% of all the hospice enrollees...
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...as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state, dementia, palliative care Introduction Nutrients are introduced into the body in two ways: by enteral feeding through the digestive tract, and by parenteral feeding through a tube inserted in a vein in an arm or leg (peripheral line) or through the chest wall in...
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...Tuberculosis after having latent TB infection. TB bacteria usually stays in the lungs. Symptoms of tuberculosis includes: 1. Night sweats, fever. 2. Coughing or coughing up sputum/blood. 3. Chest pain, weakness, weight loss. 4. Chills, 5. Loss of appetite. Risk Factors of Tuberculosis: Tuberculosis spread easily, and anyone can get infected with TB. High risk people are the people who Were infected with TB bacteria before, and people with low immunity due to medical conditions. Some Other risks are: 1. Contact with a person infected with TB. 2. Visited a country where TB is very common or living in those countries. 3. Working or living where TB is more common, such as nursing home, prison/jail or in a homeless shelter. 4. Health-care workers who works with patients infected with Tuberculosis. Higher risk for being infected with TB: 1. Infected with HIV. 2. Children who are below the age of 5 3. Smoking cigarettes; alcohol/drug abuse. Some...
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...From Chronic to Critical: A Latino Family Confronts End-of-Life Decisions By Karen Peterson-Iyer Gabriela Rivera is an 80-year-old Puerto Rican immigrant, who lives alone in her rent-controlled apartment in New York City. She has lived in the United States for almost 40 years and speaks some English, albeit somewhat hesitantly. Her primary language is Spanish. Although she is now retired, for years Gabriela worked in a factory where she was exposed to a variety of industrial chemicals now considered toxic. Gabriela's husband died four years ago of a massive heart attack. She has six adult children, three of whom now live out of state. Gabriela is a devoted mother, calling her children as often as she can afford and even sending them homemade sweets. She raised her children through their teenage years in the same apartment in which she lives today. She is loath to leave it, although she now pays the rent only with great difficulty and substantial financial help from her children. Gabriela has long suffered from high blood pressure, which she controls with medication. She also has type-2 diabetes. When she was originally diagnosed with diabetes, she met once with a nurse who advised her on diet, exercise, and weight control, but Gabriela has found it difficult to adapt her traditional tastes in food and her lifestyle to the recommendations the nurse offered. Subsequently, Gabriela's doctor prescribed medication to help keep her diabetes under control. She tries to take her medication...
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...Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care A Roadmap for Hospitals Quality Safety Equity A Roadmap for Hospitals Project Staff Amy Wilson-Stronks, M.P.P., Project Director, Health Disparities, Division of Quality Measurement and Research, The Joint Commission. Paul Schyve, M.D., Senior Vice President, The Joint Commission Christina L. Cordero, Ph.D., M.P.H., Associate Project Director, Division of Standards and Survey Methods, The Joint Commission Isa Rodriguez, Project Coordinator, Division of Quality Measurement and Research, The Joint Commission Mara Youdelman, J.D., L.L.M., Senior Attorney, National Health Law Program Project Advisors Maureen Carr, M.B.A., Project Director, Division of Standards and Survey Methods, The Joint Commission Amy Panagopoulos, R.N., M.B.A., Director, Division of Standards and Survey Methods, The Joint Commission Robert Wise, M.D., Vice President, Division of Standards and Survey Methods, The Joint Commission Joint Commission Mission The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The inclusion of an organization name, product, or service in a Joint Commission publication should not be construed as an endorsement of such organization, product, or services, nor is failure...
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...The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine PREPUBLICATION COPY: UNCORRECTED PROOFS Copyright © National Academy of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. 65815 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number 0-309-XXXXX-X (Book) International Standard Book Number 0-309- XXXXX -X (PDF) Library of Congress Control Number: 00 XXXXXX Additional copies of this report are available from the National Academies...
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...A CLINICIAN’S HANDBOOK Talking With Your Older Patient NAT I O NA L INS TITU TE O N AGING NATIONAL I NS TI TUTES OF HEA LTH DEPARTM EN T OF HEA LTH A ND HUMA N S ERV I CES Contents Foreword 1 1. Considering Health Care Perceptions “I’m 30 . . . until I look in the mirror.” 3 2. Understanding Older Patients “Tell me more about how you spend your days.” 6 3. Obtaining the Medical History “What brings you here today?” 13 4. Encouraging Wellness “I’d like you to try this exercise routine.” 19 5. Talking About Sensitive Subjects “Many people your age experience similar problems.” 23 6. Supporting Patients With Chronic Conditions “Let’s discuss living with . . .” 36 7. Breaking Bad News “I wish I had better news.” 40 8. Working With Diverse Older Patients “Cultural differences, not divides.” 44 9. Including Families and Caregivers “What would you like your family to know?” 48 10. Talking With Patients About Cognitive Problems “You mentioned having trouble with your memory.” 51 11. Keeping the Door Open “Effective Communication” 58 Publications At-a-Glance 60 Services At-a-Glance Tear-Off Card Foreword Good communication is an important part of the healing process. Studies find that effective physician-patient communication has specific benefits: patients are more likely to adhere to treatment and have better outcomes, they express greater satisfaction with their treatment, and they are less likely to bring malpractice suits. Research also shows that...
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...IGOROTS * Home * IGOROT SONGS * IGOROT DANCE * IGOROT TRADITIONS * MONEY ON THE MOUNTAIN IGOROT TRADITIONS IGOROT TRADITIONS When we talk about Igorot identity and culture, we also have to consider the time. My point is that: what I am going to share in this article concerning the Igorot culture might not be the same practiced by the Igorots of today. It has made variations by the passing of time, which is also normally happening to many other cultures, but the main core of respect and reverence to ancestors and to those who had just passed is still there. The Igorot culture that I like to share is about our practices and beliefs during the "time of Death". Death is part of the cycle of life. Igorots practice this part of life cycle with a great meaning and importance. Before the advent of Christianity in the Igorotlandia, the Igorots or the people of the Cordilleran region in the Philippines were animist or pagans. Our reverence or the importance of giving honor to our ancestors is a part of our daily activities. We consider our ancestors still to be with us, only that they exist in another world or dimension. Whenever we have some special feasts (e.g., occasions during death, wedding, family gathering, etc.), when we undertake something special (like going somewhere to look for a job or during thanksgiving), we perform some special offer. We call this "Menpalti/ Menkanyaw", an act of butchering and offering animals. During these times we call them...
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