During the reign of President Barrack Obama of the United States, health reform was developed. It was on March 23, 2010, when the president, with his accorded power by the constitution, signed the reform into law. This reform was the Affordable Care Act (ACA) with the primary objective to ensure patient protection, and focusing on the expansion of coverage, controlling the costs of health care, and overly improve the quality of health. Primarily, this paper aims to discuss issues concerning taxation and the impacts of the impact on decision-making concerning the ACA reform. More importantly, the paper highlights how the affordable healthcare act is designated into the U.S. Federal Tax Law, with a deep examination of the landmark National Federal of Independent v. Sebelius case.
More precisely, the ACA was to provide comprehensive health insurance reforms. These reforms were intended to include tax provisions that influence individuals, families, insurers, tax attempt organizations, businesses, and business entities. Additionally, there was great concern about the tax provisions. They also contained critical changes, targeting the families and individuals who file taxes, highlighting employers and other organizations (Goodman & Flaherty, 2017). The law demands that the ACA projects the requirements of the employers on health coverage; also, the same law requires that individuals and families have health coverage that can be purchased on the insurance marketplace, making individuals eligible for the premium tax credit.
In the U.S., the “Patient Protection and Affordable Care Act (P.L. 111-148)” highlights that every citizen and legal citizens require to have health insurance. Based on this law, the states created state-oriented “American Health Benefit Exchanges” through which individuals could purchase coverage, using premium and cost-sharing credits. These were to be made available for families or individuals ranging between 133-400 percent of the federal poverty level, intending to create a separate exchange, targeting the small business and thus making them capable of purchasing the coverages (Goodman & Flaherty, 2017). It was also a requirement that employers pay penalties for the employees receiving tax credits for health insurance through the same Exchange. However, this one was done excluding the small employers while creating regulations that would regulate the health plans in the Exchanges in the personal or small group markets and expanding the Medicaid up to 133% of the federal poverty.
Additionally, the ACA aimed at addressing the challenges on American healthcare systems that the poor citizens hard felt. With this goodwill, Congress passed it in and become a law, whose target was the high cost of the insurance covers, the high cost of health care, and the increased population of the U.S. citizens who lacked a form of medical insurance (Barakat et al., 2017). Although millions of the population would benefit from this plan, the court imposed a challenge to the ACA. The opposition was immense from the Republicans with the arguments on overreach by the federal government. The challenge was on the reasons for imposing penalties on individuals who were not enrolled into a minimum form of health insurance and secondly on the law requirement to expand the Medicaid program, to offer coverage to the poor. The worst part of the act was that states that did not expand the plan would be subject to lose their federal funds for Medicaid.
Later in the year 2014, the ACA was subject to amendment, especially on the tax code. The amendment was based on minimum coverage provisions, providing a mandate on individual stipulations, especially those that did not purchase and maintain a minimum level of health insurance cover. These people were thus entitled to a tax penalty, which was payable in scheduled phases. However, this was faced by much opposition from the lawmakers; for instance, according to Chief Justice Roberts, “The Affordable Care Act does not require that the penalty for failing to comply with the individual mandate be treated as a tax for purposes of the Anti-Injunction Act (Banister, 2021).” This statement imposed much controversy, creating an anti-injunction act, seeking to explain the individual mandate on tax and whether this would be deemed tax. Besides, the ACA highlights the expansion of Medicaid and the employers' mandate to provide coverage to their employees, which was the only way to receive funds from the federal government.
Contrary, after the enactment of the ACA, Florida, with other states, rose against the program. They proceeded and brought actions in the United States District Court of Florida, seeking a declaration that the act was unconstitutional in various aspects. According to Roberts, “If a statute has two possible meanings, one of which violates the Constitution, courts should adopt the meaning that does not do so (Banister, 2021).” Not long, these states were also backed up by the support of thirteen more states, from the National Federation of Independent Businesses and individual plaintiffs Mary Brown and Kaj Ahburg. According to the latter plaintiffs, the ACA aspect of the individual mandate was beyond Congress's powers as stipulated by the Commerce Clause. Secondly, they argued that the expansion of Medicaid was unconstitutionally coercive, and lastly, the mandate on the employers interfered with the state sovereignty. This triggered the District Court to examine whether the plaintiffs had a strong stand that could be presented in the lawsuit (Cox et al., 2017). This was followed by determining Brown's stand to challenge the minimum coverage provision, which was purported due to her lack of health insurance. This meant that she had to seek financial arrangements, keeping compliance with the provision, which was to become effective from 2014.
Moreover, addressing the constitutional questions on the individual mandate, its ruling was that this was not a valid exercise of the Congress’ commerce or the taxing powers. Therefore, the act was held invalid, and that the mandate could not be served. Also, the District Court dismissed the state's challenge that focused on employers' mandates and judgments granted by the federal government on the expansion of Medicaid (Liang, 2020). This was after finding insufficient support for the contention and lack of constitutional coercion. However, this did not mean that the ACA would stop working altogether; instead, a panel of United States Courts of Appeal, specifically for the Eleventh Circuit, reached an affirmation on 2-to-1 the District Court’s holdings (DiMaggio, 2019). The holding was concerning the individual mandate and Medicaid expansion, reversing the District Court holdings. They finally agreed that individual mandate could be served simultaneously without invalidating the remaining part of the Affordable Care Act. Later, the American Health Care Act (AHCA) would be a perfect replacement for the ACA, an integration and correction of the flaws evident in the ACA of 2010.
References
Banister, J. (2021). The dissociations of John Roberts: National Federation of Independent Business v. Sebelius and the discontents of judicial supremacy. Argumentation and Advocacy, 57(2), 123-139.
Barakat, M. T., Mithal, A., Huang, R. J., Mithal, A., Sehgal, A., Banerjee, S., & Singh, G. (2017). Affordable Care Act and healthcare delivery: A comparison of California and Florida hospitals and emergency departments. PloS one, 12(8), e0182346.
Cox, C., Claxton, G., & Levitt, L. (2017). How affordable care act repeal and replace plans might shift health insurance tax credits. Health Reform.
DiMaggio, A. R. (2019). Political Power in America: Class Conflict and the Subversion of Democracy. SUNY Press.
Goodman, D., & Flaherty, S. (2017). Federal Subsidization of Health Insurance: The “Cadillac Tax” and Tax Credits in the Affordable Care Act and Beyond (Doctoral dissertation).
Liang, A. (2020). The 2014 Medicaid Expansion, Access to Care, and Heart Attack Mortality (Doctoral dissertation).
When assessing mental health and addiction issues, numerous instruments are used. Before executing the assessment process, we need to choose a client to help with this assignment. Therefore, we chose client 1, where two children have been taken into the care of the child welfare system. This was after the caregiver to these children appeared intoxicated on alcohol which is affecting the children. After the interview, the caregiver confirms that he has been drinking daily, but the thought was it would not affect the children. The reason for coming to the addiction assessment is to request the welfare to get the children back.
Some of the common tools used in the assessment of this client include CAGE, TWEAK, AUDIT, and MAST. The assessment done using CAGE is used by applying four questions, which doctors do to detect clients who have had alcohol dependency in their lifetime. The second tool for the assessment is the TWEAK, designed to overcome CAGE’s limitations, screening clients who have been in alcohol for many years. Also, going beyond CAGE and TWEAK is AUDIT, which screens all levels of problem drinkers; this useful even on drinkers who are not yet dependent on alcohol but with alcohol problems (Kuteesa et al., 2019). This tool is helpful as it is designed and validated for international use across cultures, populations, and languages. Lastly is the Michigan Alcohol Screening Test (MAST), designed to identify dependent drinkers in the adult population, especially those associated with heavy drinking. Based on these tools, the children's welfare will decide whether to give back the children to the client.
Part Two: Written Report
In assessing the addiction conditions of a drunker, it is essential to use some addiction tools. These tools help determine the history of a client’s drug use; through this exercise, it is possible to establish the severity of the drug use and the consequent disruption in biopsychosocial areas of an individual’s life. The clinician essentially aims to identify the addiction severity index (ASI) commonly done through interviews. As we had stated in the first section, we are dealing with client 1; we would seek to offer the client questionnaires during the intake. The reason for administering the questions is to find out the type of service the client is looking for (Matano et al., 2003). These questions are also useful in getting information about the client’s substance use pattern, which will be useful in planning treatment plans and, more importantly, determining the intervention program's suitability to this client.
However, to make this assessment successful, we need to appreciate the relevance of the tools used. As stated earlier in part one, these assessment tools include CAGE, TWEAK, AUDIT, and MAST. For the overall assessment, CAGE administers four questions in 1 to 2 minutes, used in primary-case settings, the importance of this tool is to detect clients who might have had signs of alcohol dependency in their lifetime. The latter role makes this tool so essential; however, associated with a limitation as it cannot do screening for hazardous drinkers who have not yet become dependent on alcohol (Matano et al., 2003). In the bid to overcome the limitation of CAGE, then the TWEAK tool is used; this tool can screen clients who are starting to drink more heavily but yet are not dependent on alcohol. The benefit of this tool in assessment is the capability to assess populations with mixed ethnicities.
Another screening tool is the AUDIT, which surpasses CAGE and TWEAK. This tool is outstanding as it assesses all levels of problem drinkers. The advantage of this tool is to screen clients who have not yet been dependent on alcohol, which is a common experience with the majority of drinkers but has hazardous drinking patterns. This tool collectively identifies clients with harmful use, hazardous drinking, and dependency on alcohol, with only 10-questions in a variety setting with a variety of populations. This tool is helpful with international populations, inclusive of different cultures and languages. Lastly is The Michigan Alcohol Screening Test (MAST); despite being one of the oldest tools, it is still useful in the current world. This tool is reliable in the screening test for alcohol problems, with the capability to identify dependent drinkers in the adult population. The questions used asked in this tool are directly associated with clients' self-appraisal of social, vocational, and family problems. All these questions are directed to the problems of heavy alcohol drinkers.
For effective interventions, it is essential to ensure that the screening is done effectively. The screening on substance abuse should provide accurate information on the client’s information. Based on our scenario, the client admitted to being a daily drinker, despite the thought that the drinking was not enough to cause a family problem (Straussner, 2004). However, from the neighbors' perspective, drinking has become hazardous, and children's care at risk. With the aid of the assessment tools, information about the client will be sought and adequate to understand how to cut the drinking. Also, the tools will help identify the severity of the addiction and the best treatment measure that would help recover from alcohol addiction.
References
Kuteesa, M. O., Cook, S., Weiss, H. A., Kamali, A., Weinmann, W., Seeley, J., ... & Webb, E. L. (2019). Comparing Alcohol Use Disorders Identification Test (AUDIT) with Timeline Follow Back (TLFB), DSM-5, and Phosphatidylethanol (PEth) for the assessment of alcohol misuse among young people in Ugandan fishing communities. Addictive behaviors reports, 10, 100233.
Matano, R. A., Koopman, C., Wanat, S. F., Whitsell, S. D., Borggrefe, A., & Westrup, D. (2003). Assessment of binge drinking of alcohol in highly educated employees. Addictive Behaviors, 28(7), 1299-1310.
Straussner, S. L. A. (2004). Assessment and treatment of clients with alcohol and other drug abuse problems. Clinical work with substance-abusing clients, 3-36.
The Future of Mergers and Acquisitions amid COVID-19
Introduction
In the face of the COVID-19, there has been economic unrest, resulting in companies' fallout. Globally, the pandemic has resulted in unrest, as evident in various market insecurities and decreased interest rates, adversely impacting investors and consumers' confidence. As a result, most of the companies are under great distress, and in most instances, they are consolidating. The efforts to help fight the pandemic are making issues even challenging for the companies, including lockdowns. These measures are putting the business operators in trade tensions, regulator pressure, creating uncertainties. Operation challenges are felt in company operations, and some of them are opting for a merger and acquisition (M&A) as an exciting path. This paper expounds on the acquisition and integration business amid the COVID-19 pandemic, an economic trend in the business world (Florio et al., 2018). Additionally, we will discuss the strategies that help keep competitive across the borders even with the set strict measures of coronavirus. More so, strategies have led to creating and maintaining treaties among firms and thriving firms across developed and developing nations.
Acquiring and Integrating Business
Amid COVID-19, decisions concerning the acquisition of companies have been common as a surviving option. However, it is essential to ensure that the acquisition process is efficient to avoid making the wrong acquisition decision. Commonly, the acquisition is far-reaching beyond the change of the company’s letterhead. Indeed it means to change or ending of career paths, change of jobs and others get lost, and new jobs are created. However, they go into suspension for the acquired companies, and employees worry about integrating into the new company culture. In most stances, acquisitions are disruptive events, which are never neutral and cause divestitures adding another level of employee disruption. The acquisition process means that a transaction is made between firms that one of them buys the controlling interest of another firm, with a primary goal of making it a subsidiary or combining it with its current business. When the acquisition process is well planned, the company achieves significant success (Augustsson, 2021). This is different from a merger, as two firms combine on a relatively equal basis. However, both processes are negatively affected by hostile takeovers, where the target firms respond negatively concerning the proposed transaction. Upon agreement, M&A takes place even across the borders, in different countries.
M&A is not a one-hour thing; but instead, it has to strategic and well-planned activity. The result of this process should be improved performance of the firms. Various reasons are primarily associated with acquisitions; some include reduced costs, especially enjoying economies of scale, purchasing the competitor in the same market as the acquiring firm for horizontal acquisition. Costs are reduced with vertical acquisitions, where the purchase involves suppliers or the distributors or more of the firm’s goods and services; the purpose of doing this is to increase the firm's scale and market (Feng et al., 2019). Gaining market power is achieved when a firm sells its products above the competitive prices or when the costs are below those of the primary competitors. The purpose of market power is to eliminate overcapacity by removing duplicate operations, raising antitrust issues, and thus companies might pay much for the acquisition process in pursuit of power. Other advantages of acquisition help foster growth, especially in fragmented industries with many other small competitors of equal size helping in the firm’s growth rate. Additionally, M&A help in learning to help build capabilities, which stands as the common reason for making decisions in the 21st century. Lastly, the acquisition is essential in managing risks and meeting other financial objectives amid the COVID-19 crisis. This is through diversification of operations, reducing dependence on the intensely competitive market, and giving shareholders more benefits.
More importantly, any successful M&A process must be strategic. This is achieved through careful screening, selection, and negotiation with the target firms. An informed evaluation is important before acquisition and merger; this is achieved through conducting due diligence. The purpose of due diligence is to carefully evaluate the target firms and verify the strategic and financial soundness of the reason for the transaction. The screening process examines the firm being acquired in terms of its value, synergies between the combined firms, and the price the acquiring firm is offering to the other firm after screening a firm that is most suitable combines. Therefore, it is essential to carefully integrate the newly acquired resources, which is the critical factor determining the success or failure of the merged firms. Integration is more successful if the team members of both firms are given the integration responsibility. More precisely, mergers of equals work best in situations where a new identity is created. However, there have been challenges in acquisitions, which need to be overcome. Some of these problems result from inadequate evaluations or paying too much. Other challenges result from excessive debts in the post-acquisition period and sometimes due to over-diversification. These are likely to cause failure in the acquisition, thus restructuring and focusing on the firm’s core business.
Competing Across Borders
Business operations have a goal of reaching the international market. Even amid the pandemic, some strategies can be harnessed to reach the international markets. This effort can be realized through sourcing of resources and supplies, expanding or developing new markets into the international market. In addition, focus on competitive rivalry in the foreign regions and leveraging core competencies and learning. However, the success of competition across borders is determined by choosing sufficient international strategies, which include global efficiencies, customization of goods and services for a particular host country.
Additionally, efficiency is achieved through ensuring low production and distribution costs, low labor costs, economies of scope and scale (Hill & Jones, 2011). Also, efficiency is met after the customization of products to meet local market tastes. Various strategies deployed include multi-domestic strategy, where the firm produces and sells unique products to different markets. Also, embrace the global strategy where standardized products are sold to different markets. The transnational strategy also works on unique and standardized products in different markets. These strategies help firms opening up into the global context advancing sales even during pandemics. However, these strategies need to be sustainable by eliminating all possible sources of failure.
Creating and Maintaining Alliances
In order to remain competitive across borders, it is essential to form alliances with firms in other nations. These include strategic plans to achieve long-term success with both developing and developed nations. There are various alliances that a firm can engage in, which include strategic alliance, corporate strategy, guided towards attaining competitive advantage rather through equity or non-equity alliance. Various reasons have been found to guide the development of strategic alliances; these alliances have been found advantageous to help firms enter restricted markets, thus overcoming trade barriers and avoiding major conflicts (Beals, 2021). Besides, alliances help in facilitating new products development and sharing uncertainties of entering new international markets. More importantly, firms enjoy access to complementary resources, gain market power and outsource important functioning activities.
When making these alliances, it is essential to understand the levels of the alliances. Some common levels include vertical strategic alliance, involving corporate partnerships across the values chain. Horizontal alliances, where the partners at the same stage of the value chain share resources and capabilities. This level enhances competition in the markets and shares risks resulting from uncertainties, especially from highly competitive markets (Beals, 2021). Further, the corporate levels, whose focus is on the product line to ensure firms' growth, are less costly. International strategies alliances are the most prominent when entering foreign markets and compete effectively in the new international market. These alliances also work well when managed risks, eliminating issues of trust, differences incorporated and national cultures, and unwillingness to share essential resources. These challenges can be overcome by selecting compatible partners.
Conclusion
In conclusion, the outbreak of COVID-19 has adversely impacted companies' operations. Some of the firms have been acquired; others merged to survive in the tough market. M&A have also positively and negatively affected the employees through the creation and loss of jobs. Besides, the success of the business is determined by the ability to integrate and operate smoothly. The purpose of the combination is to develop a strong firm that competes successfully in the market. Also, helping the company cross the borders makes alliances in other countries and enjoy market benefits. It is, therefore, to create strong and sustainable alliances to enjoy market benefits present in the other regions. Putting these strategies in practice will ensure success in operation even with the pandemic.
References
Augustsson, S. (2021). Business Growth by Mergers and Acquisitions: A Qualitative Study of Business Strategies: The Case of Smile Tandvård.
Beals, J. (2021). ″Mergers and Acquisitions after the Great Recession,″ Strategy 45(2)
Feng, Y., Wu, J., & He, P. (2019). Global M&A and the Development of the IC Industry Ecosystem in China: What Can We Learn from the Case of Tsinghua Unigroup?. Sustainability, 11(1), 106.
Florio, M., Ferraris, M., & Vandone, D. (2018). State-Owned Enterprises: Rationales for Merges and Acquisitions. CIRIEC Paper, (2018/01).
Hill, C. W., & Jones, G. R. (2011). Essentials of strategic management. Cengage Learning.
In Malaysia and Saudi, about 50% of medication and treatment failures result from poor medication adherence, leading to increased morbidity and mortality rates. The beliefs and perceptions of various patients are also related to chronic diseases such as hypertension, diabetes, renal failure, coronary artery disease, and asthma (Zhao et al., 2015). Therefore, a lack of knowledge on medicine usage and various misleading beliefs have resulted in improper medication adherence. Partnering with patients and providing patient education regarding medication can help improve their health outcomes. Therefore collaboration of nurses, doctors, and caregivers is vital as it helps patients adhere to prescribed medication (Paterick et al., 2017). It is important to note that educating patients has significant benefits for caregivers, patients, and health services.
This paper seeks to explain the importance of patient medication education both directly and indirectly. For instance, educating patients on medication matters will help them understand the purpose, effects and side effects, the warnings and instructions of a particular medication. This will help patients make informed decisions for their lives and know how to solve the issues related to medicine. The potential for improved health outcomes through patient education and self-management programs is enormous in the context of growing healthcare costs and startling future cost estimates. On the other hand, this research also outlines and explains the strategies that stimulate and enhance patient education and reduce the barriers concerning drug therapy education in healthcare settings. Some of the strategies include using technology in addressing learning issues, incorporating the indigenous languages while educating the patients. It is important to note that there are over 137 ethnic groups in Malaysia and Saudi. Therefore, engaging and partnering with healthcare through verbal and written instructions is a strategy to enhance medical education. This can also include a cultural assessment of education levels, core beliefs, and medication regimens, perceived causes of illness, successful therapies, and learning experiences. In general, this paper addresses issues concerning patient medication education and the skills that can be integrated into nursing practice to help reduce the related barriers.
Importance of Patient Medication Education
Patient education refers to the process of changing a patient's behavior by combining counseling, teaching, and behavior modification strategies to increase knowledge and enhance or maintain health. Patient education is one approach for patients and nurses to communicate, as it gives the necessary knowledge for improving patient care and potentially altering their health outcomes. However, recent literature has restated that improper utilization of drugs and medicine remains a global problem in developed and under-developed nations. According to research, public hospital nurses in Asia have a positive attitude toward patient education but cannot fully implement it. In order to improve patient education, a more comprehensive plan is needed to address staffing shortages, time constraints, and insufficient knowledge (Ross, 2019). In addition, the adverse clinical outcomes of the disease are contributed by the lack of poor medication adherence. Adherence refers to the extent to which patients take medication as prescribed or instructed by the healthcare provider or physician at the right time and the correct dosage.
There are certain beliefs and perceptions that patients have on medication adherence to some chronic diseases. This, however, primarily affects patients from communities suffering from hypertension and other related chronic diseases. This also may be because the caregivers and nurses lack information about the new medications. However, nurses can play an important role by developing innovations that can improve new medication education. It is important to note that educating patients concerning their medication will positively impact patients, health services, and caregivers. Therefore, patient education is significant on medication that nurses can help bring them out. Note that education involves the capacity to understand, seek and act on certain health information (Tan, 2020).
First, educating patients on medication helps them understand the purpose of a particular medicine. According to Majid (2020), the patient must have a clear understanding of what the treatment or drug intends to treat through the prescription of new medicine. Patients will be better able to appropriately take their medication if the review on prescription is well elaborated. Moreover, this is critical in cases where the drugs or medications are aimed to treat the start of symptoms like diarrhea, nausea, and headache. When speaking with patients, health care providers must convey critical details regarding the medications they're prescribing. This is the time to focus on the critical facts regarding treatment programs, such as the type of prescribed medicine, the reason the medicine is prescribed, the time the patient is supposed to take medication, and the time the patient should take medicine. (Majid, 2020). It's also essential to inform patients regarding the potential adverse impacts of various prescriptions. If unwanted symptoms emerge while taking prescription medication, patients unaware of side effects may fail to adhere to treatment procedures.
Second, education on medication on patients serves as a reminder and helps improve adherence to drugs. It is essential to note that one of the causes of nonadherence is forgetting. For instance, more than 50% of patients usually forget to take their prescribed medicine sometimes. However, nurses can play a role by helping the patients recall their treatment plans or regimens through text messages, email, postal mail, and voice messages. It usually comes out that patients who cooperate with nurses and other medical professionals to find out methods to adhere to drug treatment prescriptions have high chances of completing their drug regimes. To help patients understand their involvement in treatment, care providers use visual aids such as timetables and calendars that designate the periods and intervals at which patients have to take their medicines. Information about how people take their medications can also be found on medical charts, packaging, drug cards, and datasheets. In general, education medication helps remind patients of drug adherence, thus improving their well-being (Clough, 2017).
Third, education on medication is essential to patients, health systems, and caregivers as it helps patients understand the side effects of the prescribed drug. There is a need for nurses to discuss the possible and intended side effects of the medication. Significantly, this helps the patient make an informed decision on whether to take medication or not. It helps patients get insight into the undesired side health effects that may need intervention. Moreover, any medication can have side effects (University, 2020). Therefore, patients should be educated on the side effects associated with a particular medication. This helps them know what they should and should not do if they experience the related side effects. This, however, may include quitting or stopping the current medicine or taking other new medication. Evidently, patients may suffer unknowingly from other diseases accruing to increased morbidity and mortality rates without knowledge about the side effects. Therefore, nurses need to educate patients on the side effects of the drugs prescribed to help them deal with such issues.
Patient medication education is vital as it enhances checkups adherence. Healthcare providers offer psychological support to patients to encourage them to follow their prescriptions. Medical experts accomplish this by working with patients to ascertain how to integrate prescription programs into their lives. This is vital, especially for patients on complicated pharmaceutical regimens and those experiencing medicine adherence challenges that are uncontrollable. Most patients fail to adhere to the instructed medication because of their beliefs, perceptions, and apprehension about specific drugs. Therefore nurses need to recognize the root cause of adherence failure and how to overcome them. This, however, is done through scheduled follow-up activities, which help evaluate patients' progress based on the prescribed treatments. Nurses also schedule appropriate follow-up plans and visit before patients leaving the office (Nipp & Temel, 2017). This helps patients adhere to checkups, thus improving their health outcomes.
Education regarding medication helps nurses identify barriers that may cause patients to fail to comply with the treatment plans. For instance, the existence of a barrier may be removed by the assistance of the nurse or healthcare providers. In cases where barriers exist, the nurses and health caregivers help patients clearly understand how to overcome and solve such compliance barriers. Note that convincing patients to take their medication is about the effectiveness of the favorable interventions to their health (University, 2020). Therefore, education plays a role as nurses are provided with training about medication adherence promotions. Such educational tools empower healthcare providers to encourage desired health outcomes for the large populations that mainly demand medication services. Nurses and other healthcare providers must spend more time with patients to stimulate healthcare outcomes or results (Majid, 2020). The interaction between the nurses or doctors and the patient must be enthusiastic, attentive, motivated, and responsive to the individual patient's needs. The individual society members must engage in a vigorous, hearty interaction with the nurses to realize the benefits of health education.
Strategies to Enhance Patient Education and Reducing Barriers to Learning
Upon examining and appreciating the importance of patients’ medication education, various strategies have been put forward to enhance this education. Additionally, these strategies are critical at helping in reducing the barriers to learning; these are limitations that make education concerning drug therapy in health care unsuccessful. Pharmacologists have been obligated to ensure that their patients get quality education concerning drugs in the hospital pharmacy practice. As stated in the section above, this training allows patients to monitor drugs they take through education (Alomi et al., 2019). In this section, we will discuss various strategies that have been utilized in enhancing patients’ education. Additionally, the measures that can be used to eliminate the barriers might make education on drug therapy unsuccessful in health care settings. Although much importance has been expounded concerning patients' education, the primary role is to make patients responsible for their health status.
The target population on patients’ education is individual patients and families who need education through audio-visual methods, print, demonstration, or verbal instructions. Nurses and other education practitioners are tirelessly offering patients with education as they are the people who can manage their specific conditions and overall health if they have the resources, tools, and education on individualized care. There has been much emphasis on patients’ wellness and increased telehealth integration on personalized care in Malaysia and Saudi, thus becoming the most needed activity in the hospital environment. However, offering education on maintaining health is not like other education efforts; instead, it requires fully informed strategies to improve the overall education process. The effectiveness and success of these strategies are defined as increased levels of patients’ involvement and activation and ability to overcome their conditions.
Some of the strategies include leveraging technology in the delivery of education materials. Access to technological platforms across families and patients stands as one of the effective platforms that caregivers use to deliver educational resources to their patients. Through massaging and smartphones, medical practitioners make it possible for patients to improve patient education and ensure that patients have access to the library of resources through text messages and emails. These electronic media have aided in delivering education materials via secured links; patients can always have access to materials at the push of a button. Also, effectively and efficiently, cutting down paperwork through customized deliverables, categorizing them by conditions. The customization is made to fit specific genders, ages, and other variables using the readily available system. With the use of the available educational resources in nursing and pharmacy, information concerning drug therapy has been made readily available. It is the role of the medical professionals to ensure that written materials are also available to all individuals and are prepared to suit the reading levels of the target patients effectively. The use of electronic media has always proved to be the most effective strategy for offering educational materials to patients.
Further, talk to patients in their languages to eliminate the problem of the language barrier. The language barrier has proven to be the largest challenge hindering the success of doctor-patients communication. In Malaysia, the official language is Malay; however, this area has a complex multicultural population characterized by three major ethnic groups, the Malay, Chinese, and Indian races (Kaboudarahangi et al., 2013). Some Chinese speak Cantonese, Hokkien, and Mandarin; the Indians speak Hindi and Tamil, while the Malay has various accents. Apart from these races, the region has diverse cultural backgrounds with extensions from the rural to urban areas. This is a significant area of concern due to many indigenous speakers in various parts of the country who might not understand the MySE or the Malay and not understand the medical terms. The role of the doctors and other medical staff is to ensure the patients get education in the language they understand best. This can be achieved by adopting layman terms, hiring translators, and other accommodation services to suit patients from different races. Additionally, the education providers can strengthen engagement among this population by offering the education materials in their language. Working on overall and onetime investment in translation services can significantly improve patients' experience and empower them in their education. Similarly, care providers in Saudi have no option other than to offer written and verbal instructions to patients in the language they speak most of the time.
Additionally, involving family members and essential others in patient care, engaging loved ones' inpatient care treatment and education has its advantages. The family and loved ones in the care and education offer an extra eye and ears to digest important information. More importantly, involving the family offers an accountability mechanism to ensure that patients take the necessary steps to enrich their independent learning (Tan et al., 2017). This strategy works best with patients with cognitive issues, especially old age, to better comprehend the education offered. It is essential to treat each individual as a whole based on their specific care needs and lifestyle circumstances. These circumstances are directly translated to how they learn as well as cognitive limitations. Treating each individual in unique ways helps meet all the patients at an individual level, defining all learning challenges that affect the patients, such as physical and learning disabilities. This will ensure that the providers address each patient’s specific cognitive and sensory issues that directly affect the dispensation of education on health.
Closely related to engaging patients as a whole is to help bring all the elements together. This strategy is achieved through talking with patients at personal levels. This appreciates the difference between “Talk WITH your patients, not AT them.” The purpose of this strategy is to facilitate a successful dialogue with patients, helping in the simplification of terms rather than a complication of terms using medical-level vocabularies. Primarily is to offer the patients an opportunity to learn quickly and thus help bring all the elements of patients’ education together. Globally, GOMO Health has been at the forefront in helping care providers improve patients education across all populations (World Health Organization, 1998). More importantly, offering tangible insights on the maximization of care education. Getting close connections with patients helps build trust and confidence between the patients and care providers, identify challenges that hinder the learning process, and possible solutions.
Moreover, it is essential to have robust information concerning their cultures when dealing with medical therapies and education. This is achieved through performing a cultural assessment concerning the learning experiences, past and present success of therapies and medication regimes, values systems, core beliefs, the meaning of health and illness, perceived causes of illness, health care practices, and social organizations (Faizah, 2008). This assessment aims to ensure that the providers get a clear scope of how people in the region under study view concerning health. From this assessment, the providers can now determine the strategies that can effectively merge with the culture and thus attain success in care education. In Malaysia, cultural beliefs, religion, relationship orientation, hierarchies, and face consciousness impact learning views. Appreciating cultural differences is a strategy that helps in meeting education needs depending on patients’ beliefs.
For the success of education on patients, it is essential to ensure adequate availability of materials on medication instructions. These materials need to be up to date, offering information on how they can prevent medication errors. It is essential to collaborate with the health care setting, inpatients, and outpatients to develop medication lists that can be deemed error-prone (Alshammari et al., 2021). In recent days, the lack of patient education is considered a nurse's concern; thus, efforts have been put in place to ensure the availability of materials or resources and timely review with patients and those involved in personalized care. It is essential to make full use of the available resources, such as videotapes, verbal instructions, pictures, and healthcare providers. These strategies need to offer special attention to some specific groups, such as the adolescents, who need simplified directions for each medication and clarifications of information to avoid misinterpretations. These strategies overly help in improving well-being among patients.
Conclusion
In conclusion, patients’ medication education is an essential aspect in the contemporary world that helps enhance individual health. The purpose of this education is to equip patients with varying demographic characteristics to improve their well-being at personalized levels, more importantly, improving adherence to chronic diseases. Understanding issues related to health help in the improvement of treatment interventions with caregivers and the patients. There have been various barriers that have been faced in offering patients education, therefore a need to develop strategies that help minimize or eliminate these challenges. These strategies revolve around full utilization of the current day technology, reducing language barriers, involving families or significant others in the education, and offering this education at personalized levels with the patients. These strategies make information and other resources concerning medication at the disposal of every individual, thus improving the overall medical practice and thus reducing health-related complications and deaths.
References
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Alshammari, F. M., Alanazi, E. J., Alanazi, A. M., Alturifi, A. K., & Alshammari, T. M. (2021). Medication Error Concept and Reporting Practices in Saudi Arabia: A Multiregional Study Among Healthcare Professionals. Risk Management and Healthcare Policy, 14, 2395.
Clough, J. (2017). Educating patients about their medications: the potential and limitations of written drug information. American Journal of Medical Quality, 22(5), 384-385.
Faizah, A. M. (2008). Culture and learner beliefs: A study of three Malay postgraduate students. Asean Journal University of Education, 4(1), 127-142.
Kaboudarahangi, M., Tahir, O. M., & Kamal, M. (2013). Malaysia's three major ethnic group preferences in creating a Malaysian garden identity. Australian Geographer, 44(2), 197-213.
Majid, N. (2020). The Practice of Patient Education among Public Hospital Nurses in Malaysia. Environment-Behaviour Proceedings Journal, 5(15), 131-137.
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Tan, C. E., Jaffar, A., Tohit, N., Hamzah, Z., & Hashim, S. M. (2017). Exploring patients’ reasons for participation in a medical education home visit program: a qualitative study in Malaysia. Perspectives on medical education, 6(3), 182-188.
Tan, C. S. (2020). The Need of Patient Education to Improve Medication Adherence Among Hypertensive Patients. Malaysian Journal of Pharmacy (MJP), 6(1), 1-5.
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Zhao, S., Zhao, H., Wang, L., Du, S., & Qin, Y. (2015). Education is critical for medication adherence in patients with coronary heart disease. Acta cardiologica, 70(2), 197-204.
Can Smoking be prevented by Making Tobacco Illegal?
Introduction
Modern society is experiencing vast problems associated with substance abuse. One of the most abused substances is cigarette smoking, which is a mass phenomenon worldwide that has led to a lot of social concerns. Globally, there has been an increased number of smokers, which has translated to the increased number of preventable diseases, disabilities, and associated deaths. The prevalence of smoking can be closely attributed to the increase in cigarettes' cheap and mass manufacturing. With evidence from various statistics, smoking is a big challenge due to the increased levels of mortality among smokers due to its associated diseases—additionally, the undergoing health damage that involves the smokers and second-hand smokers breathing tobacco from the environment. Due to increased global smoking, there have been several suggestions to solve mass smoking, such as a smoking ban. As an intervention to reduce the fast-growing rates of smokers and minimize the dangers associated with smoking, tobacco should be made illegal.
There are different stands that exist on prevention smoking by making smoking illegal. A group of proponents has stipulated reasons that make them feel that making tobacco an illegal product in the United States would reduce cigarette consumption. However, smoking has been a controversial issue since the 16th century, with a vast number of supporters and critics. Those that support the ban on smoking have developed a list of supporting documents highlighting the need to ban smoking, making tobacco join the group of illegal substances consumed in this region (Fouad et al. 77). One of the key reasons why smoking needs to be banned is to reduce the risks associated with smoking and reduce the risks of direct smokers and second-hand smoke. A group of advocates campaigning for the ban of smoking have searched and highlighted the problems associated with smoking cigarettes to both active and passive smokers. According to a report generated by the centers for disease control and prevention, many health effects are associated with smoking to the people who encounter the smoke.
Smoking results in diseases and disability, and it affects almost arm every body organ. According to a report from the CDC, over sixteen million Americans are living with a disease caused by smoking. Smoking is severe to the extent of causing deaths and makes people live with a chronic smoking-related illness. Some of the feared diseases caused by smoking include cancer, stroke, heart disease, chronic obstructive pulmonary disease, and diabetes. Also, smokers are a high chance of contracting tuberculosis, some specific eye diseases, rheumatoid arthritis, and problems with the immune system. The most significant concern is second-hand smoke exposure, which adversely affects passive smokers (Kim et al., 2018). According to experts' reports, exposure to smoke has led to the death of thousands of non-smoking adults and infants every year. Among the adults, the effects of the smoke are causing stroke, lung cancer, and coronary heart diseases, while in children, smoke causes increased rates of sudden infant deaths syndrome, acute respiratory infections, severe asthma, slowed lug growth, and other related respiratory infections.
Additionally, there is a need to ban smoking from reducing its impacts on the environment. Smoking is one of the contributors to air pollution, which supporters of the ban argue that in places where smoking is banned, the air quality is good instead of cities and states that still allow smoking. Smokers are known to directly or indirectly impact the environment (Kim et al., 1981). The direct impact is on waste deposits; cigarette butts are non-biodegradable and sometimes clog water systems when thrown carelessly. Proponents state that banning smoking will lessen solid wastes associated with cigarette remains, which destroy the beauty of the environment, effects which also affect the water systems. On the other hand, smoking has far-reaching impacts on the environment, especially those associated with the possibility of fires. There have been various fire outbreaks of fires attributed to smoking, especially on highly flammable materials such as grassland forests. Reckless throwing of cigarette remains before they are entirely off might cause fires that consume large grass tracts and alter the environment.
Overly, a ban on smoking will help in reducing individual daily expenditure and improve work productivity. Banning smoking means cutting down all the expenses of purchasing cigarettes and lighters. In places where smokers are concentrated, especially in the workplace, needs an additional place for smokers, indoor smoking will also attract more ventilation. Cigarettes are also expensive, and addicts spend much of their cash buying them; therefore, a ban on tobacco will make them spend on other essential activities. Moreover, banning tobacco will improve the productivity of the smoker and those surrounding them; non-smokers are highly impacted by smoke and the bothersome smell (Laverty et al. 346). Banning smoking will ensure a good working environment and thus an increase in production. Through these efforts, getting sick is reduced, which is a strategy of avoiding healthcare costs. This can positively affect the economy by cutting the amount of GDP used in healthcare costs.
The impacts of tobacco on people cannot be assumed, and these factors need to be weighed out and thus take the necessary measures on smoking. This might include setting policies that help minimize the rates of smoking in the United States and globally. The reason for concern is due to the influence smoking portrays to the public and its influence on close associates with smokers. These effects are felt on pregnant women, young children, and men, whether passive or active smokers (Jamal et al. 53). There is, therefore, a need to come up with measures or interventions that will promote healthy living, such as banning smoking or regulating smoking to ensure that its effects are addressed partially or completely. These interventions might include policies or laws that govern smokers, protecting the passive as well as the environment, both physical and the working environment. Proponents will always stand with advocacies that encourage the banning of tobacco, which is used in making these cigarettes.
Additionally, in efforts to reduce the effects of smoking, the government needs to intervene. The intervention should be directed towards reducing the health impacts associated with smoking, such as slowing the growing health epidemics. More precisely, there is a need to develop control strategies that help minimize the global deaths that are expected to rise with the trends in smoking. Research by the National Library of Medicine predicts that by the year 2030, will be over 10 million annually (Sandford, 2003). Therefore, in order to reduce the risks and lower these prediction numbers, there needs to reach a sustainable agreement to reduce smoking rates. The public needs to adopt comprehensive tobacco control, ranging from a total ban on tobacco advertisements and promotions. Another control should include restricting smoking in public places and workplaces, increasing taxation on tobacco and its products, and including bold health warnings on tobacco consumption. Moreover, the proponents encourage the public to embrace smoking cessation and conduct education campaigns and tobacco regulation to standards acceptable by the community health department and not those from the smoke industry (Sandford, 2003). Legislations need to be based on voluntary controls to successfully implement measures that would gain support from the public and ensure proper enforcement.
The debate on banning tobacco is highly controversial, and the opposing side has a great deal to present concerning this issue. Indeed there feeling is that banning tobacco would not result in the prevention of smoking, but instead, the establishment of laws against smoking will be activation to the black market rise. The formulation of laws against tobacco will spread tobacco products into the states and cities illegally. Just to point out, the ban will stir up the prosperity of criminal organizations, such as the mafia and illegal gangs, which make a profit from tobacco sales, alcohol as well as other illicit substance to the users (Nuyts et al. 67). Without any single doubt, an increase in illegal activities translates to an increase in criminal activities, which has far-reaching implications to the general state, and the effects are felt countrywide, even globally. Additionally, the growing levels of illicit tobacco markets cause competition among the gangs, who lack a means of solving their differences amicably, thus resulting in violence and deaths. We can thus, state that the ban on tobacco will not be an adequate solution to smoking; instead, the creation of profitable terms would benefit the black market.
There are tangible examples of trials to ban tobacco from preventing smoking, which turned to be unsuccessful. In the United States, the federal government opted for a ban on the production and sale of alcohol in the 1920s, which failed terribly. Indeed, people had access to the prohibited substance through illegal sellers and cartels. Although the ban had been legislated, it was repealed after thirteen years of failure and inefficiency (McGirr 207). The law had more limitations in many perspectives, such as the lack of adequate measures that would help stop the spread of alcohol. Both alcohol and tobacco are substances used across the US with shared characteristics; thus, possible to compare the intention to ban tobacco by federal law. In the same way, the ban on tobacco would be an ineffective way of reducing the number of smokers.
Additionally, it is important to weigh a decision in multiple dimensions before moving forward. Indeed, the prohibition of smoking directly translates to the decrease in revenue gained by the government from the production and sale of cigarettes. According to Statista, in 2019 only, revenue from the sale of tobacco amounted to 12.46 billion US dollars, which is a highly significant value to the GDP of the country (Fouad et al. 82). Therefore, legislation banning the production of tobacco and the sale of cigarettes means that the country's economy will drop significantly. Moreover, the closure of factories that produce tobacco will directly result in tax growth to cater to incurred losses. With these underlying implications, banning tobacco production would force the government to legitimize the production activity to boost the country's economic status or the states.
Following the impacts associated with the ban of tobacco, there are many negativities as opposed to positivity. Banning smoking would sound like a violation of personal freedom and liberty, as it is argued that people need the autonomy to decide on the nature of life they would prefer living. Therefore, whether to stop smoking or not should be a personal decision or choice and not guided by legislation. Moreover, the legislation put in place is not sensible enough in stopping smokers, as they primarily focus on requests. They tell people to leave smoking, and the penalties for not leaving are highly favorable; therefore, these policies lack enough glimpse to make people stop smoking. Bearing in mind that banning smoking greatly impacts the efforts to ban smoking, the decision to either stop or continue smoking is left at a personal level (Gocmen 448a). The role of the legislating body should now be exclusively providing awareness on the side effects of tobacco on health and overall well-being and not banning the production.
The controversy on whether to ban tobacco or to keep it will not leave the debating arena soon. Indeed, more and more groups will always try to weigh out the advantages and challenges of smoking. Based on the healthy and the environmental impacts of smoking cigarettes, there will always a group that supports the ban of tobacco production. Similarly, another group will always argue that the burn of smoking will not prevent smoking, based on the facts concerning black markets and the collapse of the economic sector. Thus both preventing smoking and encouraging smoking will always cause problems. The only sure way to address tobacco is sensitization to improve awareness concerning the adverse effects of tobacco on health and well-being and thus encourage conscious smoking sensation.
Works Cited
Fouad, Heba, et al. "Estimated and projected prevalence of tobacco smoking in males, Eastern Mediterranean Region, 2000-2025." Eastern Mediterranean Health Journal 27.1 (2021): 76-82.
Gocmen, Semire Uzun. "Introduction of a Cigarette Smoking Cessation Strategy:‘Semire Uzun Gocmen Model’in Smoking Quitting." Biophysical Journal 116.3 (2019): 448a-449a.
Jamal, Ahmed, et al. "Current cigarette smoking among adults—United States, 2016." Morbidity and Mortality Weekly Report 67.2 (2018): 53.
Kim, A., et al. "Exposure to second-hand smoke and risk of cancer in never smokers: a meta-analysis of epidemiologic studies." International journal of environmental research and public health 15.9 (2018): 1981.
Laverty, Anthony A., et al. "Impact of banning smoking in cars with children on exposure to second-hand smoke: a natural experiment in England and Scotland." Thorax 75.4 (2020): 345-347.
McGirr, Lisa. "Alcohol Prohibition in the United States, 1920–1933, and Its Legacies." Dual Markets. Springer, Cham, 2017. 207-219.
Nuyts, Paulien AW, et al. "How can a ban on tobacco sales to minors be effective in changing smoking behaviour among youth?—A realist review." Preventive medicine 115 (2018): 61-67.
Comparison of Prescriptive Authority in Wyoming and Texas
Prescriptive authority is the concept that involves advanced nurse practice in which the practitioner can prescribe medication and therapy in clinical medicine. Full prescriptive authority is exercised by advanced nurse practitioners who work in Wyoming after meeting some recommended qualifications. However, full prescriptive authority faces some challenges and is not without opposition both inside the United States of America and on the international level. Autonomy, more accessible healthcare and realization of career aspirations are some of the arguments for full prescriptive authority and are enjoyed in states where this is practiced such as in Wyoming. Clearly outlined policies, plenty of direction and supervision are some of the pros of restricted prescriptive authority practiced in states such as Texas. The purpose of this work is to compare and contrast the regulations on prescriptive authority in the state of Texas and Wyoming and determine the state that is most suitable for a prosperous career in advanced nurse practice.
The authority of advanced practice nurses to offer medicine, equipment, or therapy prescriptions to a patient is referred to as prescriptive authority. In America, for an advanced practice nurse to have full prescriptive authority depends on several factors the chief of which is the prescriptive authority regulations of the state in which he or she wants to work in. Some states have restricted prescriptive authority which means that nurses cannot prescribe treatment and medication without the oversight of a physician (Mitchell & Spitz, 2015). In other states, nurses have moderated authority which means that they are allowed to carry out some prescriptions while are restricted in those that are deemed too complicated for advanced practice nurses to carry out (McGee, 2009). In the State of Texas, regulations dictate fully restricted prescriptive authority while in the State of Wyoming advanced nurse practitioners have full practice authority which means that they have full prescriptive authority.
One of the reasons the State of Wyoming has adopted the policy of full prescriptive authority is so that access to primary health care is increased for the majority of residents of the State. In this state, the only requirement is a compulsory 30 hours of training in pharmacology and drug therapy clinical management. An alternative prerequisite is phamacotherapeutic training of the same duration. Physician involvement is not required for nurse practitioner prescriptive authority in Wyoming. Also, Nurse Practitioners have the authority to prescribe schedule III-V controlled substances (Ambrose & Tarlier, 2013). Prescriptive authority allows nurse practitioners to prescribe legend drugs and controlled substances though registration for a DEA number is required.
Prescriptive authority has been a controversial topic in healthcare circles. Those against the issue assert that advanced nurse practitioners are not fully qualified with all the necessary knowledge to prescribe therapeutic and medical interventions appropriately. On the other side, due to the need to meet healthcare serviced demands, nurses are in some ways already prescribing medication albeit outside legal oversight. Therefore the crux of the issue is not whether nurses should prescribe but to what extent. Therefore, with the right system in which nurses gain credentials to prescribe medication and therapies under a regulated system and ultimately achieve the full potential of their practice.
There are benefits of practicing in the State of Wyoming as well as some risks associated with the full prescriptive authority. The benefits include the autonomy, and flexibility that a practitioner may have which would enable the practitioner to offer individualized primary healthcare services as opposed to physician practitioners who use a more generalized template. The higher number of advanced nurse practitioners compared with physicians also is an added advantage as healthcare services can reach more people including those whose access to health care is adversely affected by their low social-economic status. On the risks side, the most significant risk is the responsibility for making medical decisions that are often complex and can result in complications whenever insufficient experience, knowledge or guidance can lead to problems for the patient, the practitioner and their hospital (Gardenier, Thomas & O’Rourke, 2016). All in all, the greatest advantage of working in Wyoming as an advanced nurse practitioner is the available opportunities to make a difference in healthcare by realizing career aspirations and helping more people regain their health in the best way that fits them.
Practicing in the state of Texas under restricted prescriptive authority has its advantages and drawbacks. The major advantage is that with the authority to prescribe medication and therapies being the responsibility of the physician, the advanced nurse practitioner can provide supportive services that maximize the comfort of the patients (Tran, 2020). Having nurses’ authority to prescribe restricted helps in preventing situations where the advanced nursing practice may experience failure due to insufficient supportive infrastructure (Rapsilber, 2015). The disadvantage to having restricted prescriptive authority in place in Texas could be contributing to some practitioners becoming complacent and updating their knowledge only to remain competent instead of striving to meet their fullest potential (Barton, Hannum, Lindsey & Towle, 2021). Practicing in Texas is the safer option if an advanced nurse practitioner is not able to keep up with the quickly shifting landscape that is the healthcare legislation, where many healthcare workers find themselves in a constant dilemma over how to do their job.
The state of Texas fully restricts prescriptive authority while in the state of Wyoming full prescriptive authority is exercised. The advanced nurse practitioners in Wyoming is free to exercise their knowledge fully and can practice without oversight from a physician which enables them to reach more people who might otherwise have significant difficulty in accessing physicians who are fewer in number and thus more expensive. With an appropriate regulation system in place combined with proper support in terms of resources, access to knowledge and sufficient training/ career advancement opportunities full prescriptive authority is the best option for advanced nursing practice. The most significant barrier to the realization of this prospect is the complications that arise from rapidly changing legislation in the healthcare industry which becomes less of a problem if the burden is transferred to physicians. Practicing in the State of Texas is advantageous in that nurses enjoy the guidance of physicians in all matters but face the danger of stagnating career-wise due to the lack of motivation to explore the various full practice opportunity. As for me, practicing in Wyoming is the final goal but for now, I am content to gain knowledge, skills and experience in Texas under the guidance of physicians to feel more confident to eventually establish my own practice.
References
Ambrose, M., & Tarlier, D. (2013). Nurse Practitioners and Controlled Substances Prescriptive Authority: Improving Access to Care. Nursing Leadership,26(1), 58-69. doi:10.12927/cjnl.2013.23303
Barton, M. J., Hannum, B. C., Lindsey, M., & Towle, T. (2021). The Path Toward Full Practice Authority: One State’s Strategy. The Journal for Nurse Practitioners,17(2), 147-152. doi:10.1016/j.nurpra.2020.09.011
Gardenier, D., Thomas, S. L., & O’Rourke, N. C. (2016). Will Full Practice Authority Mean Higher Malpractice Premiums for Nurse Practitioners? The Journal for Nurse Practitioners,12(2), 78-79. doi:10.1016/j.nurpra.2015.11.013
McGee, P. (2009). Advanced practice in nursing and the allied health professions. Chichester, U.K.: Wiley-Blackwell.
Mitchell, K. A., & Spitz, A. (2015). Use of Advanced Practice Providers as Part of the Urologic Healthcare Team. Current Urology Reports,16(9). doi:10.1007/s11934-015-0535-5
Rapsilber, L. (2015). Connecticuts Journey to Full Practice Authority. The Journal for Nurse Practitioners,11(2), 272-273. doi:10.1016/j.nurpra.2014.10.033
Tran, A. Q. (2020). Full practice authority for nurse practitioners: is it right for Texas? (Doctoral dissertation).
Comprehensive assessment of drug addicts is an important step towards treating the person because it establishes the root of the problem allowing the medical practitioner to come up with the right diagnosis and treatment plan for the patient. One of the methods used to provide a comprehensive assessment be by inquiring about the client’s history of drugs. This is necessary to understand the extent to which the client has used drugs and how the abuse results in the disruption of his or her biopsychosocial parts of their life. Another essential aspect to look at is how often does the client take drugs; is it daily, weekly, or is there a trigger that makes him or her do drugs. The type of dosage used to administer the drug is also essential to determine the severity of the drug problem. Also, the age of the client is important because different age groups have different reasons for engaging in drugs and alcohol and require a different kind of treatment. This can affect the assessment if assumed. In addition, another good method of assessment that can supplement the medical and psychosocial review is the use of an Addiction Severity Index (ASI), which is structured in form of a questioner with questions that address the extent of adjustment issues in legal, medical, alcohol abuse, drug abuse, medical, employment or family areas.
When assessing Richard I will use an indirect approach, which means that I will not provoke him aggressively but instead, fact find by using other methods like the Addiction Severity Index to get information that he would otherwise refrain from talking about. This is because, according to the conversation he has with his employer, Richard seems to be unaware of his alcohol abuse and tends to blame it on the problems in his life. His employer indicates that it is not the first time he has shown up at work late, with the smell of alcohol, which means that this could be a long-term problem that requires treatment. Firstly, I will establish what kind of stimulants Richard abuses. There are two types of stimulants primary and secondary. Both have different effects on an addict. The administration method of primary stimulants affects the pattern of use of other drugs while the secondary stimulants are used by alcoholics to facilitate alertness and regulate the tranquilizing effects of a primary stimulant.
Some of the questions will be; how many times do take alcohol in a week? Do you find it hard to resist an alcoholic drink? Have you ever felt that you should stop drinking? Are you mad when your friends criticize your drinking? Have you felt bad or guilty about your drinking? Have you been late for important programs because you were drunk? Does it interfere with your day-to-day activities and affect others too? These are some of the questions that Richard will answer to help me assess his situation. While assessing I would put into consideration; his age, establish the root cause of his drinking problem, the duration he has been abusing alcohol, and the many time he takes alcohol. This will enable me to assess him better and provide a good recommendation on the kind of treatment he should undertake and whether or not he should continue working. If Richard has an underlying problem triggering his drinking, I will recommend that he goes for mandatory counseling and in the meantime work on probation until the counselor clears him. I would also advise him to join a sobriety group because hearing about others' experiences will help him get better.
Lucy is the type of client that is aware of her alcohol problem but is willing to quit. In fact, she has already quit and only requires a follow-up to prevent a relapse. Because she is not a first-time user, I would use a questionnaire to establish her weakness when it comes to alcohol, the company she spends time with, and her triggers. Some of the questions that will help me assess Lucy properly are; why do you feel the need to drink? What provokes you to drink? Do you drink alone or in the company of friends? Where do you hang out after quitting alcohol? Do you still have the same friends you had before quitting? Do you have an accountability partner? Are your family and friends supportive? What was the initial reason for drinking? These questions will help me establish the steps Lucy has taken after quitting to avoid a relapse. It is very easy for her to relapse because she is not new to it and the most contributing factor would be the friends that she keeps and whether she has someone to hold her accountable for her actions.
Just like many other alcohol abusers is willing to quit but without accountability, it is very easy for her to relapse. One alarming factor that I have already noticed is that she has decided to spend more time in a casino. This is disturbing because she just started the sobriety journey and is barely six months in and she is already engaging in activities that will tempt her to drink again. Casinos are not the best places for a recovering addict whether drugs or alcohol because both are readily available and in plenty. Consequently, the environment in a casino is an enticement for a recovering addict. It would not be surprising three months down the line if Lucy got addicted to gambling, because the environment is conducive, and winning in the games will motivate her to gamble more. In addition, Lucy is now feeling the urge to replace her alcohol addiction with something else, so gambling will serve as the next addiction. She might end relapsing and still have a gambling problem.
Now that I have established Lucy’s alcoholic problem, I would use the direct approach that involves rebuke and being truthful to a client without necessarily withholding information. I think she deserves to know that spending time in a casino will jeopardize the chances of her completely being sober. Playing slots is a completely new problem that Lucy is not ready to deal with and it would seem like she is avoiding addressing the source of the problem that initially pushed her to alcohol abuse but instead wants to engage in another activity that will develop a new addiction. She must be going through a psychological issue that needs to be addressed if she has the hopes of being completely sober. My recommendations for Lucy’s treatment would be, to see a psychologist that will help her deal with the root of her problem. I would also recommend a different activity, for instance, if she were active then outdoor activities would keep her distracted. I would also encourage her to develop new hobbies and make new friends help her focus on other things and hold her accountable.
Defining the Population Prone To Diabetes through Upstream Factors
Diabetes prevalence increased in the last decade all over the world. Defining the factors or causative agents responsible for diabetes prevalence is still debatable but attainable in the long run. When defined, the factors can help in formulating an action plan which would later explain the underlying reason for the prevalence of diabetes. The ever-increasing obesity rates is tied to the increasing diabetes incidences. Personalized medication for diabetes lineups and laboratory bio-markers are presently being advanced to define people susceptible to develop diabetes. After diagnosis these individuals can be examined and advised to change their everyday life (Tiwari, 2015). From a medical perspective, unaffordable medical expenses force majority of the people to take less effective medical programs as alternatives to fight off obesity and unhealthy nutrition. In terms of social conditions and factors of health, societal elements are the circumstances which impact birth, growth, work, lives and age. Increasingly, societal factors are being tied to type 2 diabetes due to the overwhelming evidence indicating that medical interventions have to center on biological and behavioral elements such as indications, nutrition and exercises. Nevertheless, it is vital to address the impact of physical and societal surrounding on low income, job security and literacy levels. Some government policies such as the patient protection policy insist on the collection of more data in order to develop or come up with better and effective ways of defining the population at a higher risk of developing diabetes. Collection of more data helps medics to develop proactive ways of making referrals and giving the patients the social provision they need to combat diabetes. This way, medical institutions are able to reduce health disparities among diabetic patients. Widening and accommodating more legislations on collection of data and integrating of social amenities would give medics and other health experts an advantage on managing diabetes conditions. Present medical reforms are geared towards providing susceptible people with improved and well-organized medical treatment through affordable medical insurance care (Rewers, & Ludvigsson, 2016). This way, people with a low income can afford some of the diabetes medication prescribed to them. Furthermore, the systematic checkups allow the public to assess their own health and of one finds out that he is at risk of developing diabetes, an informed decision can be made beforehand.
Recent studies have proved that social causes are directly connected to the development of diabetes among both adult and children populations. Scientific interventions have steadily evolved over time hence leading to better diabetes management especially as the increasing number of medics acknowledge the essence of social aspects in causing diabetes. More so, emerging evidence claims that diabetes brings about mental injury, incontinence and even cancer (Boles et al., 2017). The essence of comprehending diabetes and its comorbidities is to expose the underlying factors which later materialize into diabetes. Therapy which has been tried and tested to reduce primary and secondary diabetes complication have to be modified to fit the needs of the diabetic patient. Lifestyle alterations is one of the most effective ways of averting or suspending the extension of diabetes among the most vulnerable members of the community. Against this background, public hospitals have changed their perspective on diabetes treatment approach as they have increased and intensified the monitoring organizations at national centers.
Identifying Gaps in Diabetes Medical Care
Tracing patients’ improvement in diabetes medication is important for bettering and evaluating the quality of the medication received. Quality development plans and primary performance gauges are used to better the quality of the diabetes treatment received in order to reduce the gaps found during various treatment (King, & Li, 2016). Considering the intricacies that people with diabetes face, management of diabetes requires a multi-extended tactic. Researches have unveiled that commended goals for diabetes at an acceptable and healthy levels. For the sake of coming up with a solid solution that would ensure all the patients are considered as healthy and capable for making people recover at a faster rate. Additionally, one of the most convenient way of identifying the gaps is coming up with a complete registry which isolates admitted in the health care system from the rest of the population. In this particular context, medical care frameworks can be considered to be medics, a medical plan or a holistic delivery arrangement in a particular region. Registries are generated via diabetes-connected analysis, laboratories tests and prescribed information derived from records. Initial diabetes registries depended heavily on sited information. However the use of electronic data has become more reliable and common in defining the diabetes population all around the world. The capability to retrieve data from a personal level enables medical personnel to discover the quality of the medical care received and how one can improve his or her own medical health. Diabetes registries are an important aspect of bettering the lives of people and even closing the gaps on mistakes done on previous matters such as lack of adequate medication among the rest.
Limitation to the Present Diabetes Management Approaches and Recommendations
Diabetes medication and outcomes keeps on getting better with time due to improved information systems and better adaptation practices among diabetes populace. However, the key issues center on policies and incentives shaped to influence suitable diabetes medication. The betterment of the diabetes treatment is dependent on the corporation between the patient and the nursing personnel. On one end, the nurse role is to ensure that diabetes patients are given adequate attention and medication so that they can easily recover and improve their lives. Hence, the population care ought to motivate the patients to get better through proper engagement with the medication and health care frameworks. Also addressing patient centered outcomes has to be personalized based on the issues.
The chronic medication frameworks advices both patients and medics to connect with each other through conversations and solving the challenges faced in due time.
Conclusion
Diabetes population patterns, medical expenses and results has forced health care systems all over the world to put in place measures that will improve patients’ situation. Population health is key in comprehending the measures and interventions formulated to curb diabetes. The best indicators of diabetes are economic, societal and the surrounding in which people live. Consequently, the collaboration between the community and medical care helps to reduce the fatalities associated with diabetes and formulate more alternatives. The combination of efforts from the community-based initiatives and the government has made it possible to design policies based on multiple sectors. In any heath setting standardized diabetes mitigation measures such as ambulatory services have to be considered and measured against other risks such as data management and information systems. The most convenient delivery structures have to be place in order reduce diabetes.
References
Tiwari, P. (2015). Recent trends in therapeutic approaches for diabetes management: a comprehensive update. Journal of diabetes research, 2015.
Boles, A., Kandimalla, R., & Reddy, P. H. (2017). Dynamics of diabetes and obesity: epidemiological perspective. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1863(5), 1026-1036.
King, G. L., Park, K., & Li, Q. (2016). Selective insulin resistance and the development of cardiovascular diseases in diabetes: the 2015 Edwin Bierman Award Lecture. Diabetes, 65(6), 1462-1471.
Rewers, M., & Ludvigsson, J. (2016). Environmental risk factors for type 1 diabetes. The Lancet, 387(10035), 2340-2348.
Afshin, A., Micha, R., Khatibzadeh, S., Fahimi, S., Shi, P., Powles, J., ... & Mozaffarian, D. (2015). The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis. BMJ open, 5(5), e006385.
In the line of duty, healthcare providers need to offer the best services to their patients. Over many years, nurse practitioners and other medical staff have had challenges in meeting the needs of their clients, which forced them to embark on research. This research aims to collect, process, and implement the research findings to improve clinical practice; this is defined as evidence-based practice (EBP). Also, the EBP focuses on improving the work environment and patient outcomes (Shelton et al., 2018). Although many benefits have been assured with implementing evidence-based practices, the whole process has faced some challenges or barriers. These barriers are collectively affecting the implementation of the EBP in the healthcare setting. There is, therefore, a need to develop models that would help eliminate these barriers. This research highlights some barriers to implementing evidence-based practice in healthcare and the strategies for overcoming such barriers.
Some common barriers have been experienced following various attempts to implement evidence-based practice in healthcare. These barriers are broadly categorized as individual barriers and organizational barriers. Some of the common individual barriers include lack of professional characteristics, which entails little choice on EBP tools, as well as lack of professional autonomy concerning its implementation. Also, nurses lack awareness, knowledge, and skills concerning EBP implementation (Alatawi et al., 2020). Another challenge or barrier concerns the experience and attitude of nurse practitioners; this makes them resistant to change from the traditional practice to EBP. Though not so much a weighted barrier to implementing evidence-based practice, the language barrier stands out as an issue of concern. A good example of this is implementing the practice among the Chinese, who do not understand research written in the English language.
Additionally, the implementation of EBP is impacted adversely by organizational barriers. Some of these barriers include limited organization resources, especially with healthcare, which have been among the most significant barriers to implementing the EBP. A common resource that has been limited is access to computers and internet access at the workplace. Another challenge is the lack of support and supervision from the managers and other medical officials, who should be at the forefront of implementing EBP. Besides, there have been issues with inadequate time; as the implementation was deemed time-consuming, most healthcare would not opt-in for the implementation. It is through the inadequacy with time where, most nurse practitioners are not trained on implementing research into practice (Alatawi et al., 2020). Nurses, therefore, lack skills on how to incorporate evidence-based practice in their roles, thus low-quality services to patients.
Although these barriers have been persistent in most healthcare settings, some solutions can be sought. Some of the models offer long-lasting solutions to these challenges. They include stakeholder engagement to build trust and learn. Upon identification of the outcome measures, they can successfully implement EBP. Additionally, it is important to offer administrative support towards implementing the practice, which ranges from training and resources (Rickbeil & Simones, 2012). This part of the support needed, which determines the success of the project, administrators serve an important role in shaping the institution's culture. Changing how organization addresses change with the total involvement of all stakeholders is a sure way to achieve acceptance and, thus, implement EBP in the healthcare setting, which in turn yields quality outcomes on patients.
References
Alatawi, M., Aljuhani, E., Alsufiany, F., Aleid, K., Rawah, R., Aljanabi, S., & Banakhar, M. (2020). Barriers of implementing evidence-based practice in nursing profession: A literature review. American Journal of Nursing Science, 9(1), 35-42.
Rickbeil, P., & Simones, J. (2012). Overcoming barriers to implementing evidence-based practice: a collaboration between academics and practice. Journal for Nurses in Professional Development, 28(2), 53-56.
Shelton, R. C., Cooper, B. R., & Stirman, S. W. (2018). The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health, 39, 55-76.
Purpose: The purpose of my speech is to inform the audience about the importance of getting adequate sleep and what an individual can do to gain more sleep.
Thesis Statement: Our bodies need sleep; it is one of the unavoidable daily activities, as it is a key factor that contributes to individuals’ health and well-being.
Introduction
Grabbing Audience Attention
Incidences of inadequate sleep are common among students. Taking an example of a student studying for a big exam, which will happen the next day, and upon getting to bed after reading some adequate knowledge, a notification rings on the phone. Upon checking the notification, it catches attention, and the next time you check on the clock, it has passed over two hours. Now, the tie you are sleeping, you find that it is only 4 hours left for sleeping time; there is a question on whether this time is adequate for sleeping. Commonly, the sleeping time is between 6-9 hours, but this time is highly interrupted by social media platforms such as Tik Tok and YouTube.
According to the American Academy of Sleep Medicine and Sleep Research Society, the recommended time for sleep for adults 18-60 years is 7 hours each night (Consensus Conference Panel et al., 2015).
The reason for concern is that lack of adequate sleep is attributed to chronic conditions such as heart diseases, high blood pressure, and mental distress.
Background Information
The first discussion is on the consequences of insufficient sleep.
Secondly, is to address the benefits of having a good sleep at night.
Lastly, on methods to help get more sleep.
Body
Consequence of Sleep Deprivations
Lack of enough sleep is associated with a negative impact on the functioning of the night. Also, affects mental abilities and well-being (Hanson & Huecker, 2020).
Inadequate sleep is also associated with bad moods and poor brain functions, such as memory and decision making.
The Right Hours Of Sleep
According to medical experts, adults should target to get seven to eight hours of sleep each night.
Inadequate sleep can result in heart problems, such as blood pressure and heart attacks.
Sleeping has also been found to be an effective mood activator, helps one rest and rebuild energy.
Ensuring Adequate Sleep
It is essential to count the sleeping hours. This helps ensure a healthy sleeping habit, which can be achieved by making daily sleep or wake cycle.
Adequate exercise also improves the symptoms of insomnia and sleep apnea and the time spent in deep sleep.
Good eating and drinking habits are also contributors to good sleep.
Conclusion
Review of Main Points
Inadequate sleep has both long-term and short-term effects on human well-being. In the short term, inadequate sleep is attributed to poor memory, moods, and poor judgments, resulting in accidents. However, in the long term, lack of adequate sleep is associated with health complications such as heart diseases, diabetes, and obesity (Medic et al., 2017).
Sleep is much essential for the body; indeed, it helps individuals gain energy for the next day.
Closing Statement
Among the current youth, instances of inadequate sleep are on the rise. Most of them underrate the importance of good sleep. However, there is a need to reframe and take sleep seriously. A mind that receives adequate sleep benefits from good energy and a positive attitude.
References
Consensus Conference Panel, Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., ... & Tasali, E. (2015). Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine, 11(6), 591-592.
Craig, D. (2020). Health benefits of sleep Sleep. Sleep.
Hanson, J. A., & Huecker, M. R. (2020). Sleep Deprivation. StatPearls [Internet].
Medic, G., Wille, M., & Hemels, M. E. (2017). Short-and long-term health consequences of sleep disruption. Nature and science of sleep, 9, 151.
What do you think of the nurse manager’s response?
When the information about sharing of information is passed on at a meeting, silence follows, then the nurse manager responds by a question, “what is going on?” In the capacity awarded as a nurse manager, I think the person should be in a position to address all the problem that is affecting the overall operation of the nursing department. However, from the response, she reveals fear and shock about the unrest going on in the department. This reveals inadequate leadership skills, which has led to the inadequate transfer of information across the department. Simply, we can say that the nurse manager is, in a way, incompetent.
What information do you need?
Based on the case presented above, I would like to understand information flow within the healthcare sector. This can be achieved by evaluating the communication process starting from the sender to the audience. In this case, I will be anxious to understand the nature of the message originating from senders, how it is encoded, and channels used in transmitting the message, and whether the receiver communicates back to the sender. Also, it is important to evaluate the receivers’ capacity to analyze and interpret the message, which is one of the key attributes of communication (Finkelman, 2006). Understanding the communication process is a sure way to identify any pitfalls that make the flow of information between the nurses, making it possible to work on solutions.
What is the best way to frame the problem?
When addressing communication problems, it is essential to ensure that all the components that make up verbal and non-verbal communication are in place. The goal of this framework should be achieving productive communication, where the sender sends a message effectively and the message is received and understood as sent. In solution to this problem, the nurse manager should assess the message flow, from the factors that affect that might affect the sender of the message, such as attitude towards self and the receiver, the receivers readiness for the message, and the feedback they offer in relation to the message (Finkelman, 2006). More so, in framing the problem, it is essential to check on the context or environment in which communication occurs to avoid unnecessary distractions. Lastly, is consider the effectiveness of the medium used, as it greatly determines the success of the message and the feedback.
How might you go about assessing communication in the unit?
As commonly, known communication is one of the significant aspects of the healthcare sector. Basically, it is defined as the tool which ensures success in teamwork, and therefore a need before hiring nurses, which is essential to ensure that they are competent communicators. As a nurse manager, I would assess the communication effectiveness using communication assessment questions and methods (Lotfi et al., 2019). Although this assessment ought to be a periodic thing, it seems not to be done for this healthcare. For the assessment of the unit, I will point out indicators of staff communication problems, how free the staff is in expressing their feelings and opinions, and how they communicate to those in authority. More importantly, I would like to evaluate what happens if the message seems not understood or misinterpreted. Getting the right information about these prompts will help solve communication challenges.
What are strategies you might use to resolve the communication problems?
It is important, therefore, to work ways to improve communication and reach a solution to communication problems. As a nurse manager, I would ensure open communication channels to ensure an effective flow of information and achieve positive patient care outcomes. Some of the other strategies to include in the communication include incorporating feedback on communication needs and an assessment of non-verbal communication. Additional strategies include responding to questions of what and why and allocating time for communication. Another critical parameter is to ensure that negative news is not taken personally and offer non-defensive answers on contradicting issues (Silva et al., 2017). Other strategies include thinking before speaking, reporting situations accurately, appropriate eye contact, and more so sending important organizational information via the online platforms.
References
Finkelman, A. W. (2006). Leadership and management in nursing. Prentice Hall.
Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing open, 6(3), 1189-1196.
Silva, V. L. D. S., Camelo, S. H. H., Soares, M. I., Resck, Z. M. R., Chaves, L. D. P., Santos, F. C. D., & Leal, L. A. (2017). Leadership practices in hospital nursing: a self of manager nurses. Revista da Escola de Enfermagem da USP, 51.
Define the following abbreviations: CRC, GI, and RUQ. Define the difference between hepatitis vs. cirrhosis
CRC (colorectal cancer) refers to the type of cancer that develops in the human rectum or colon. It is usually associated with symptoms, such as fatigue, weight loss, change in colon movements, and bloody stool. The Gastrointestinal (GI) tract refers to a chain of hollow organs in humans that form a long and continuous passage from the mouth to the anus. These hollow organs comprise the moth, esophagus (food pipe), stomach, small and large intestine, and anus. The right upper quadrant (RUQ) refers to the uppermost quarter of the human right hand (Lacy et al., 2019). It comprises different organs, such as the small and large intestine, pancreas, gallbladder, kidney, and liver.
Please define the difference between hematochezia and melena. What possible diseases can cause hematochezia, which can cause melena?
Hematochezia refers to the passage of bloody stool. It is usually linked with lower gastrointestinal bleeding. Similarly, it can also be due to brisk upper gastrointestinal bleeding. On the other hand, melena refers to the excretion of black and tarry stool. Hematochezia usually originates in the lower gastrointestinal tract of the human colon. Some diseases have been realized to cause this condition, including benign tumors, ischemic colitis, internal hemorrhoids, colon cancer, anal fissures, diverticulitis, neoplastic polyps, and inflammatory bowel disease (IBD). On the other hand, melena usually occurs in the upper part of the gastrointestinal tract. It is caused by several diseases, such as Mallory-Weiss syndrome, peptic ulcers, stomach cancer, gastritis, and esophageal or gastric varices (Wan & Zeng, 2019). In newborn babies, melena occurs when the baby swallows blood during delivery. Top of Form
What does a stool guaiac test for? What does a stool culture test for?
Stool guaiac tests are clinically used to examine occult or hidden blood in the human stool sample. Since it is one of the most common fecal occult blood tests (FOBT), it has the potential to examine blood in stool that cannot be seen by human eyes (McCall, 2021). Similarly, a stool culture test is a medical test used to examine germs (for example, fungus or bacteria) in the human stool sample, which causes infection (World Health Organization, 2019).
What important diagnoses are the specialist trying to test for and rule out?
Hematochezia or melena. During the diagnosis of these disorders, the specialist will be trying to examine and pinpoint the presence of bacteria causing diseases. After that, the specialist will use the laboratory information to diagnose an infection of the patient's digestive system.
What are the 5 lab/tests/procedures the specialist is planning on performing in order to rule out the possible diagnoses?
Parasite and ova test – clinically, this test is used for the purpose of detecting parasites or egg (ova) in the stool sample. Ideally, this test is conducted in case the patient is experiencing symptoms linked with intestinal infection, such as fever, headache, frequent diarrhea, presence of mucus or blood in stool, nausea or vomiting, or acute abdominal pain.
White blood cell test – from the clinical perspective, this test is conducted to detect white blood cells or leucocytes in the stool sample. The presence of leucocytes will indicate the presence of inflammatory bowel disease or bacterial infection (Kronenberger, 2020).
H.Pylori Antigen test – This test is used to detect the presence of H.Pylori inside the digestive system, determine whether infections trigger the underlying digestive symptoms, and ascertain whether the treatment administered is working or not.
Faecal occult or hidden blood test – this test is used to check occult blood in a stool sample. If blood is found in the stool sample, it will indicate bleeding from the digestive tract because of conditions such as colorectal cancer, hemorrhoids, diverticulosis, polyps, or colitis.
Stool DNA test – this test is clinically used for the purpose of detecting abnormal DNA (deoxyribonucleic acid), which occurs because of colon cancer, colon polyps, or the presence of occult in a stool sample (Coll, 2019). Usually, this test is done on patients who do not experience any signs or symptoms.
References
In Coll, P. (2019). Healthy Aging: A Complete Guide to Clinical Management. Cham, Switzerland: Springer Press
In Lacy, B. E., In DiBaise, J. K., In Pimentel, M., & In Ford, A. C. (2019). Essential medical disorders of the stomach and small intestine: A clinical casebook.
KRONENBERGER, J. U. D. Y. (2020). JONES & BARTLETT LEARNING'S COMPREHENSIVE MEDICAL ASSISTING. S.l.: JONES & BARTLETT LEARNING.
McCall, R. E. (2021). Phlebotomy essentials. Burlington, MA: Jones & Bartlett Learning
Wan, X.-H., & Zeng, R. (2019). Handbook of Clinical Diagnostics. Singapore: Springer Press
WORLD, H. E. A. L. T. H. O. R. G. A. N. I. Z. A. T. I. O. N. (2019). Bench aids for the diagnosis of intestinal parasites. Place of publication not identified: WORLD HEALTH ORGANIZATION.
The Diabetes Education Center of Health Alliance Hospital is an outpatient program for children, adults and seniors that have been diagnosed with diabetes and also those who are pre-diabetic. The healthcare organization provides diabetes education classes to individuals and groups throughout the year in person and through virtual platforms to help patients manage their conditions (DEC, 2021). The programs are also designed to help family and friends adapt to living with diabetic patients and how to help them manage their condition. The intervention of a chief nursing officer would help improve the quality of care especially if positive leadership skills are used to enhance the quality of services provided in different departments.
Incorporating nursing leadership through the organization’s chief nursing officer would be an ideal fit as it would increase the efficiency in which nurses and other caregivers attend to their patients as well as improve on the quality of care provided. The Chief nursing officer is in a position to support the mission and vision for the organization because his administrative duties involve planning and overseeing the daily activities within the organization to ensure that everything goes according to plan (IOM, 2011). The mission and vision statement provides a guideline of what is expected from the stuff and also how to go about performing the duties assigned. The approach taken to accomplish the set objective must be in line with the mission and vision statement (Sherman, 2019). The chief nursing officer can therefore organize, direct and coordinate the medical services that the staff engage in to ensure that they are in line with regulations and policies set by the board in accordance with the mission and vision statement.
The chief nursing officer can also help implement positive philosophies and values within the organization. The chief nursing officer is required to maintain high patient and clinical care standards in different departments within the organization. The chief nurse must therefore ensure that patients receive the highest quality of medical care and in safe environments (Cummings et al, 2013). Other than leading by example, the chief nurse can liaison with the hospital management and other stakeholders to assist in the development of values that seek to enhance the quality of care and overall patient satisfaction with the services provided within the organization.
The role of nursing leaders within the organization with regard to patient and system costs include enhancing the quality standards in order to reduce medical errors. Medical organizations incur a lot of cost resolving medical errors and settling lawsuit. The nurse leader must therefore seek out ways to improve the quality of care no only within the organization but also through services offered to patients at home (Sherman, 2019). Training the staff on how to help patients without having to visit the organization will also help reduce the cost of treatment and further enhance customer satisfaction with the service provided.
The nurse leader is also expected to motivate employees and lead by example. Maintaining a positive attitude will communicate the importance of practicing good ethics when treating with patients (Finkelman, 2015). This will in turn communicate the importance of using the appropriate treatment and utilizing the resources available well. Using the right procedures will enhance the quality of care and reduce wastage of resources. It will also reduce the frequency in which diabetic and prediabetic patients visit the organization and thereby reduce the overall patient and system costs.
References
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., & ebrary, Inc. (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press.
Diabetic Education Center, (2021) “About the Diabetes Education Centre of Health Alliance Hospital” Westchester Medical Center Health Network
Finkelman A, (2015) “Leadership and management for nurses: Core competencies for quality care. Pearson education
Sherman, R. O. (2019). The nurse leader coach: Become the boss no one wants to leave. Rose O. Sherman Print
Wong, C.A., Cummings, G.G. & Ducharme, L. (2013) The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of Nursing Management 21 (5), 709–724. [WWW document] URL http://onlinelibrary.wiley.com/doi/10.1111/jonm.12116/abstract
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