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Analyze the historical, ethical, and political contexts of healthcare policy and the consequences of policy implementation
DeVry NR506 Week 3 Your Policy-Priority Issue Latest 2017 January Your Policy Priority Issue Guidelines and Grading Rubric Purpose The purpose of this assignment is

to: a) identify and reflect upon key concepts related to your planning a policymaker call b) provide empirical evidence to support new insights gained regarding your

healthcare policy issue and the policymaking process, and c) present ideas in a clear, succinct, and scholarly manner. Course Outcomes This assignment enables the

student to meet the following course outcomes: (CO#1) Analyze application of theories to the development of policies that affect nursing and health care. (PO 9, 10)

(CO#3) Communicate with policymakers to advocate for effective policies that affect nurses and nursing, consumers, or the health care system. (PO 2, 3, 10) (CO#4)

Analyze the historical, ethical, and political contexts of healthcare policy and the consequences of policy implementation. (PO 6, 10) (CO#6) Investigate the

interrelationship between policy decisions and evidence-based practice. (PO4, 7, 10) Due DateSunday 11:59 p.m. MT at the end of Week 3 Total Points: 175 points

Requirements Assignment Criteria for Presentation: 1. Provide an introduction to your healthcare policy-priorityissue and the title or name of your legislator. 2.

Articulate key points under each of the Formulating a Healthcare Policy Ungraded Worksheet #1 sections. 3. Provide a critique of empirical evidence that supports your

chosen healthcare policy-priority issue and analysis. 4. Demonstrate the importance and impact of the chosen healthcare policy-priority issue to nursing. 5. Provide

concluding statements summarizingthe content. 6. The paper will be a minimum of 4 pages and a maximum offive pages in length,in APA format 6th edition,excluding the

title and reference page. Preparing the Paper After completing Formulating a Healthcare Policy Ungraded Worksheet #1, address all areas on the worksheet in the body of

a scholarly paper. Include a minimum of five (5) classic or current references published within the past 5 years. DeVry NR506 Week 5 Planning Your Visit Part A & B

Latest 2017 January Part A Planning Your Visit(Part A) Guidelines and Grading Rubric Purpose The purpose of this assignment is to: (a) identify communication

strategies that support an effective policy making-presentation/visit(CO #2);(b) deliver a message andmake recommendations (CO #2,3), and (c) communicate ideas in a

clear, succinct, and scholarly manner. (CO#3) Course Outcomes This assignment enables the student to meet the following course outcomes: (CO #2) Employ strategies to

affect the development, implementation, and consequences of policies at the institutional, local, national, and international levels. (PO 4, 8, 10) (CO #3) Communicate

with policymakers to advocate for effective policies that affect nurses and nursing, consumers, or the health care system. (PO 2,3,10) (CO #4) Analyze the historical,

ethical, and political contexts of health care policy and the consequences of policy implementation. (PO 6, 10) (CO #5) Advocate for institutional, local, national,

and international policies that influence health care and its consumers and nurses and their nursing practice. (PO2,10) Due Date: Sunday 11:59 p.m. MT at the end of

Week 5 Total Points: 100points Requirements Assignment Criteria for Presentation 1. Introduce your chosen policy issue, the current status, and an overview of your

plan for a legislative visit. 2. Articulate key communication strategies involved in your approach to the legislator including plan, message, and recommendations; see

Worksheet 2 and again, the focus is on evidence-based communication techniques for effective healthcare policy visit to the legislator. 3. Provide an analysis of

empirical evidence of effective communication strategies and techniques to support an effective visit and follow-up to the legislator. 4. Provide specific examples of

the impact and/or importance of a successful visit/presentation to nursing. 5. Provide concluding statements summarizingthe content. 6. Paper will be 2-3 pages,

excluding title and reference pages, and in APA format 6th edition. 7. Five non-text book references are required as minimum. Preparing the Paper Following completion

of Planning Your Visit Ungraded Worksheet 2, target communication strategies that support an effective policymaking visit. Include a minimum of five (5) classic

references or current references (published within the past 5 years) that support your policy plan, the message, recommendations, and follow-up. Part B Planning Your

Visit–Public Talk Video (Part B) Guidelines and Grading Rubric Purpose The purpose of this assignment is to: (a) identify communication strategies that support an

effective policy making-presentation/visit(CO #2);(b) deliver a message andmake recommendations (CO #2,3), and (c) communicate ideas in a clear, succinct, and

scholarly manner. (CO#3) Course Outcomes This assignment enables the student to meet the following course outcomes: (CO #2) Employ strategies to affect the

development, implementation, and consequences of policies at the institutional, local, national, and international levels. (PO 4, 8, 10) (CO #3) Communicate with

policymakers to advocate for effective policies that affect nurses and nursing, consumers, or the health care system. (PO 2,3,10) (CO #5) Advocate for institutional,

local, national, and international policies that influence health care and its consumers and nurses and their nursing practice. (PO2,10) Due Date: Sunday 11:59 p.m. MT

at the end of Week 5 Total Points: 75points Requirements Assignment Criteria for Presentation 1. Articulate your policy priority message in 3 minutes or less by video.

2. Video is to be of clear image and audible sound. Preparing the Video Fol

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3. Identify three ways that a Family Nurse Practitioner would use the AACN Essentials skills in nursing practice.

4. Provide empirical evidence to support three (3) ways a master’s-prepared nurse would use the AACN Essentials in practice. A minimum of two (2) current scholarly articles no older than 5 years old are required in this section of the presentation.

1. This is a PowerPoint presentation

2. Demonstrate how the skills outlined in the nine (9) AACN Essentials are applicable to Family nurse practitioner.

3. Identify three ways that a Family Nurse Practitioner would use the AACN Essentials skills in nursing practice.

4. Provide empirical evidence to support three (3) ways a master’s-prepared nurse would use the AACN Essentials in practice. A minimum of two (2) current scholarly articles no older than 5 years old are required in this section of the presentation.

5. Concluding statements summarize content.

6. 15-slide presentation with speaker notes in APA format, not counting title and reference slides.

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The post 3. Identify three ways that a Family Nurse Practitioner would use the AACN Essentials skills in nursing practice. 4. Provide empirical evidence to support three (3) ways a master’s-prepared nurse would use the AACN Essentials in practice. A minimum of two (2) current scholarly articles no older than 5 years old are required in this section of the presentation. appeared first on best homeworkhelp.

Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER.

Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.
The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.
Preparation

Search the Capella library and the Internet for scholarly and professional peer-reviewed articles on best practices in triage nursing. You will need at least three articles to use as support for your work on this assessment.

Directions

Create a 15-minute presentation (3–4 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.

Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.
Explain how health care disparities impact treatment decisions.
Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?
Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?
Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.
Additional Requirements

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The starting point for an organization to prevent and, if necessary, solve ethical problems is its philosophy. The statement of philosophy identifies values and principles reflecting the moral right and wrong for the organization, thus distinguishing the acceptable from the unacceptable. It is helpful if the philosophy statement is sufficiently precise that performance in achieving it can be measured. At minimum, the statement of philosophy must be consistent with the law.

The statement of philosophy is different from the mission statement and should be developed separately. The philosophy statement provides a context for the mission statement; the mission statement is subordinate to it. Some organizations include references to values in their mission statements. A mission statement that “the corporation owns and operates hospitals to provide care for the sick and injured” provides no information about the moral context of care. A mission statement that “the hospital provides care for the sick and injured in the context of humanitarian principles” is imprecise but provides a clearer values or moral context than the first.
Health services organizations with no specific, written philosophy nonetheless have an identifiable de facto or operational philosophy. The aggregate decisions and actions taken by the governing body and management reflect implicit, if ill-defined, philosophical bases. Management actions may be contradictory or inconsistent, and this suggests another negative aspect of not determining prospectively a comprehensive organizational philosophy. This lack of continuity and consistency will lead to incompatible, even contradictory, policies, procedures, and rules. The effect is diminished efficiency. Equally important is that the mixed, even contradictory messages that staff members receive will confuse and frustrate them, with a resulting decline in patient focus and quality.
The importance of identified and shared values in organizations is now widely understood, if less frequently operationalized. In the early 1980s, however, it was a new concept, one that was synthesized by Peters and Waterman in their study of successful American corporations.1 The quote attributed to IBM’s former president Thomas J. Watson, Jr., is instructive: “The basic philosophy of an organization has far more to do with its achievements than do technological or economic resources, organizational structure, innovation, and timing.” That statement’s context was the focus on customer service so important to IBM’s reputation and financial success at the time. If consumers and service are important to IBM, which has many characteristics of a products-based organization, consider the importance of customers and service in healthcare. The centrality of shared values is shown in Figure 5, the 7-S Framework, developed by McKinsey & Company.
Deal and Kennedy2 also identified the characteristics of successful companies:
• They stand for something—that is, they have a clear and explicit philosophy about how they aim to conduct their business.
• Management pays a great deal of attention to shaping and fine-tuning these values to conform to the economic and business environment of the company and to communicating them to the organization.
• These values are known and shared by all the people who work for the company—from the production worker right through to the ranks of senior management.
Building on the importance of shared values or philosophy that make up a culture, Deal and Kennedy3 identified the essential elements of a culture: 1) understanding and fitting into the business environment—the single greatest influence in shaping a corporate culture, 2) values—the basic concepts and beliefs of an organization, 3) heroes who personify the culture’s values and are role models for employees, 4) rites and rituals that show employees the kind of behavior expected of them, 5) ceremonies that provide visible and potent examples of what the company stands for, and 6) the cultural network—the primary (but informal) means of communication within an organization that is the “carrier” of the corporate values and heroic mythology.
In further explaining corporate cultures, Kennedy4 noted the following:
Culture isn’t a single thing. It’s not a budget; it’s not a plan; it’s not the shape of a building. It is an integrated pattern of all the things that go on in an organization on a day-to-day basis. Each company has its own unique culture, values, and standards communicated internally by style, dress, expectations, and assumptions.
New people in the workplace find out what is expected of them because their peers take them aside and say, “Look, don’t wear jeans here. Come in to work on time, or you do this or that.” They lay out some of the unwritten rules of behavior that are required for entrance into your workplace. That’s how culture transmits itself to each new generation of persons. They don’t come in and invent a whole new style of organization. They come in and learn from those around them what’s going on in the organization and how they are expected to behave.
An organization’s values are inextricably linked to its culture. To transform the organization so that its culture is a living reflection of values that facilitate the mission and vision, management must know which values are present in the culture. This presents somewhat of a chicken-and-egg situation. Regardless, management must biopsy the culture. This can be compared to a financial audit, except it is the organization’s values that are being audited. Direct measures such as observation, staff surveys, exit interviews of departing staff members, and focus groups can be used. Proxy measures of culture include patient satisfaction surveys and service area surveys. Regardless of how it is done, however, management cannot effectively transform the organization’s culture until its present content and course are known.

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The post The starting point for an organization to prevent and, if necessary, solve ethical problems is its philosophy. The statement of philosophy identifies values and principles reflecting the moral right and wrong for the organization, thus distinguishing the acceptable from the unacceptable. It is helpful if the philosophy statement is sufficiently precise that performance in achieving it can be measured. At minimum, the statement of philosophy must be consistent with the law. appeared first on best homeworkhelp.

In January 2015, a surgeon at Brigham and Women’s Hospital in Boston was shot and killed at work by the son of a deceased patient. Even though the event received substantial media coverage, reporters did not highlight the fact that although the murder of a health care worker is rare, episodes of workplace violence against medical providers happen daily across the country.

Although the majority of these incidents of workplace violence are verbal, many others constitute assault, battery, domestic violence, stalking, or sexual harassment.1
This review focuses on our current knowledge about workplace violence in various health care settings, including the prevalence across professions, potential risk factors, and the use of metal detectors in preventing violence. It also highlights the difficulty researchers have encountered in developing experimental models and the need for further evidence-based research.
Health care workplace violence is an underreported, ubiquitous, and persistent problem that has been tolerated and largely ignored. According to the Joint Commission, a major accrediting body for health care organizations, institutions that were once considered to be safe havens are now confronting “steadily increasing rates of crime, including violent crimes such as assault, rape, and homicide.”2 Even though the health care sector is statistically among the industries most subject to violence in the United States (aside from law enforcement),3 researchers have yet to discover statistically significant, universally applicable methods of risk reduction. To date, most research has been directed at quantifying the problem and attempting to profile perpetrators and their victims. The few studies that have focused on interventions to reduce violence have highlighted the unlikelihood of finding a simple, one-size-fits-all solution to prevent this violence.
RESEARCH AND STATISTICS
Experts have classified workplace violence into four types on the basis of the relationship between the perpetrator and the workplace itself (Table 1TABLE 1Types of Workplace Violence.). Most common to the health care setting is a situation in which the perpetrator has a legitimate relationship with the business and becomes violent while being served by the business (categorized as a type II assault).4,5 The highest number of such assaults in U.S. workplaces each year are directed against health care workers.1 These episodes are characterized by either verbal or physical assaults perpetrated by patients and visitors against providers. Although other types of workplace violence certainly deserve attention, in a 2014 survey on hospital crime, type II workplace violence accounted for 75% of aggravated assaults and 93% of all assaults against employees.6
Among episodes of fatal violence against employed adults, nearly 25% occur at their place of employment.3 Between 2011 and 2013, the number of workplace assaults averaged approximately 24,000 annually, with nearly 75% occurring in health care settings.7 Data from the Bureau of Labor Statistics show that health care workers are nearly four times as likely to require time away from work as a result of violence as they are because of other types of injury.8
However, inconsistencies in the existing data can make interpretation of the findings quite difficult. The Bureau of Labor Statistics and the National Institute for Occupational Safety and Health are among several federal agencies devoted to the collection of statistics on workplace violence, and their results are disparate. The results of academic studies also vary considerably. In addition, inconsistency in defining categories of violence (e.g., verbal assault, threats, physical assault, and battery) compromise reliability among studies.9-13 One review showed that no two studies have used the same instrument to measure workplace violence in the emergency department,13 and nearly every study method was based on voluntary retrospective surveys, an approach that risks both selection bias and recall bias. Furthermore, data from the federal Bureau of Labor Statistics may be grossly inaccurate,14,15 as shown by one study in which investigators found that the actual number of reportable injuries was as much as three times the number in the federal survey.16 Since the Bureau of Labor Statistics does not record verbal incidents, the prevalence of workplace violence cannot be reliably gauged on the basis of data from the agency.17 Despite these limitations, the statistics on the prevalence of workplace violence in the health care setting remain alarming.
Most studies on workplace violence have been designed to quantify the problem, and few have described research on experimental methods to prevent such violence. The most recent critical review of the literature in 2000 identified 137 studies that described strategies to reduce workplace violence. Of these studies, 41 suggested specific interventions, but none provided empirical data showing whether or how such strategies worked. Only 9 studies, all of which were health care–related, reported data on interventions. Even so, the conclusion of the 9-study review was that each of the studies used weak methods, had inconclusive results, and used flawed experimental designs.18 A review of nursing literature had similar conclusions: all the studies showed that after training, nurses had increased confidence and knowledge about risk factors, but no change was seen in the incidence of violence perpetrated by patients. There is a lack of high-quality research, and existing training does not appear to reduce rates of workplace violence.19

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The post In January 2015, a surgeon at Brigham and Women’s Hospital in Boston was shot and killed at work by the son of a deceased patient. Even though the event received substantial media coverage, reporters did not highlight the fact that although the murder of a health care worker is rare, episodes of workplace violence against medical providers happen daily across the country. appeared first on best homeworkhelp.

Create a 6-8-slide PowerPoint presentation that describes communication barriers within an interdisciplinary team and how those barriers affect patient safety and health care outcomes. Offer a solution in which you recommend evidence-based strategies to improve communication within the team and explain how the strategies benefit the team and patients.

The ability to effectively communicate as part of interdisciplinary collaboration is essential for patient safety and successful health care delivery.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Explain the principles and practices of highly effective interdisciplinary collaboration.

Describe communication barriers that can occur within an interdisciplinary team.

Recommend evidence-based strategies to improve communication within an interdisciplinary team.

Explain how specific communication strategies benefit both team members and patients.

Competency 3: Explain the internal and external factors that can affect the health of individuals, families, communities, and populations.

Explain how communication barriers between members of an interdisciplinary team can affect patient safety and health care outcomes.

Competency 4: Communicate in a manner that is scholarly, professional, and consistent with the expectations of a nursing professional.

Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

Correctly format citations and references using current APA style.

Context

Effective communication is important in all organizations and is especially important in the area of health care. Communication can come in many forms, but the crucial factor is whether the communication is effective.

Collaboration among teams is important for the delivery of appropriate medical care and for providing the specialized skills necessary to meet the needs of patients and the public. Assessing the needs of a community may involve communication across several public service providers and private entities.

Maintaining open communication and collaboration among teams is essential to assess the needs of a community or those of patients and their families within a health care system. The same communication skills must be evident within the interdisciplinary health care team, or across the public and private sectors in a community, in order to promote collaboration and understanding and to provide the utmost quality service.

Questions to Consider

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

How might communication styles and perceptions influence clinical-practice decisions?

What types of patient issues might require interdisciplinary collaboration, both within a health care delivery domain and within a community setting?

Suggested Resources
Library Resources

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Analyzed and provided relevant
information pertaining to all parts of the project. Failed to analyze and
provide relevant information pertaining to all parts of the project, giving a clear understanding. Analyzed and provided
Some relevant information pertaining to parts of the project but information was incomplete.

Accurately analyzed
and provided relevant information pertaining to most parts of the
project but needs more detail. Thoroughly analyzed and
provided relevant information pertaining to all parts of the project in detail. __x 10= 40
Described key findings and identified four issues related to the chosen
population. Vaguely described 1 key finding and lack cohesion of relating issue for chosen
population. Described 2 key findings and identified 2 issues
related to the chosen population but information
was vague. Described key findings and identified 3
issues related to the chosen population but
needs more detail. Thoroughly described key findings and accurately
identified four issues related to the chosen
population. __x 5= 20
Analyzed and suggested implications
(4 risk factors) for community health nursing related to local, national, and global settings. Vaguely discussed implications for community health nursing related to

local, national, and global settings. Discussed
implications for
community health nursing related to local, national,
and global settings but information was
vague. Analyzed and
suggested implications for community health nursing related to
local, national, and global settings but needs more detail. Analyzed and suggested
Implications (4 risk factors) for community health nursing related to local, national, and global settings throughly. __x 5= 20
Analyzed and suggested two areas of research based on weekly readings
and lectures. Provided a vague suggestion about areas
of research not based on weekly readings and
lectures. Provided a suggestion about one area of
research based on weekly readings and lectures; however lacked
detailed information. Examined and suggested two areas
of research based on weekly readings and
lectures but needs
more detail. Thoroughly analyzed and suggested two areas of
research based on weekly readings and lectures in
detail. __ x 5= 20

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Age: 84 Race: Caucasian Sex: Male MS: Divorced Chronic or Previous Health Problems (include date of onset if known):
-Arthritis
-COPD
-Lung dz
-Hypercholesterolemia
-HTN
-Cancer
-Multiple myeloma
-Muscle Cramps
-Thyroid

___________________________________________________
History of current symptoms: Denied any other pain or complications besides his arm Diet: Healthy Heart,
Height: 172.72 cm Weight: 86.18kg Code Status: Full Resuscitation Activity Ordered: Activity as tolerated
Religion: No preference Economic Status: Medicare Activity Possible: Bed rest. Activity as tolerated
Perception of Health/Reason for Admission (pt’s own words): Nutrition: ? PEG Tube PO
“I broke my arm”
Elimination: ? Foley ? Ostomy—Type: Void
I & O schedule:
Admitting Medical Diagnosis:
Syncope, Hypotension, ARI
Wounds/ Wound Care:
No wound care
Previous Surgeries (include date):
-Left heart cardiac 8/11/15
-Coronary arteriography using two caths 8/11/15
-Biopsy of bone marrow 4/16/15
-Eye
-Hernia
-HIp replacement,
-Knee
-Shoulder replacement
-Thyroid
Respiratory: No supplemental O2
? O2 @ ______ L/min via _________________________
? Incentive Spirometer every ___________
? Respiratory Treatments:
-Documented: Albuterol (Albuterol 90 mcg/inh inhalation) – 2 puffs, INH, BID, PRN SOB or wheezing
-Documented: Fluticasone-salmeterol – 1 puff, INH, BID # 60 EA
-Fluticasone-salmeterol (Advair Diskus 250 mcg-50 mg inhalation powder) – 1 puff, Inh-oral disk, INH, BID, Routine
? Ventilator Settings_________________________
Date of Admission: 2/12/17
Surgical Procedures: No surgeries since admission
Date:
Home Medications:
-Aspirin (Aspirin EC 81 mg) = 1 tab(s), oral daily
-Prochlorperazine (Compazine) = 1 tab, oral q 6hr
-Multivitamin with mineralys (PreserVision oral capsule) = 1 cap, oral, BID, presersivion with Lutein
-Fluticasone – Salmeterol – 1 puff, INH, BID, #60 EA
-Calcium-Vitamin D (Calcium 500 + D oral tablet, chewable) – 1 tab chewed BID
-Multivitamin – 1 tab, oral, daily
-Acetaminophen-hydrocodone (Norco 5mg/325mg) – 1 tab, oral, q4hr, PRN for pain
-Omega-3 polyunsaturated fatty acids (omega – 3 polyunsaturated fatty acids 1000 mg oral capsule) – 1,000 mg = 1 cap, oral, once a day (bedtime) #60 cap
-Potassium chloride – 10 mEq, oral daily
-Memantine (Namenda) – 10mg = 1 tab, oral, BID #60 tabs
-Cetirizine (Cetirizine 10 mg oral tab) = 10 mg = 1 tab, oral daily #30 tabs
-Cyanocobalamin (Vita B12 100 mcg oral tablet) – 100 mcg = 1 tab, oral, daily #30 tab
-Levothyroxine (levothyroxine 112 mcg (0.112 mcg) oral tablet) – 112 mcg = 1 tab, oral daily # tab
-Polyethylene glycol 3350 (MiraLax) – 17 gm 1 packet, oral, daily

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Before you enter this discussion, please complete your unit reading assignment. Please read the Case 5 “Wound Care at Mountainview Nursing Center” on pages 535-537 in

your text. Then respond to the following questions from your text in your original post:

Evaluate the legal implications of the nursing care that Mr. Harris received while a patient at Mountainview Nursing Center.
Would a physical restraint be appropriate to prevent falls in this situation?
Discuss the care of Mr. Harris from the standpoint of his rights as a patient.
In this situation, how would you ensure that the patient’s own wishes are carried out?
Why do you think that the nursing home corporation settled this case out of court? Would you have let the litigation proceed through the court system? Why? Do you

think the facility would be held liable? Why?
It was assumed that the patient’s agitation caused the dressing to dislocate. Could the facility have done anything to prevent that?
What actions would you take to assess and improve infection control practices in the nursing following Mr. Harris’s discharge?

Case study

Wound Care at Mountainview Nursing Center THE ASSISTANCE OF PATRICK CLAUDIUS, MD, IN DEVELOPING THIS CASE IS GRATEFULLY ACKNOWLEDGED. Subsequent to his discharge

from a local acute care hospital where he had received treatment for pneumonia, Jim Harris was admitted to Mountainview Nursing Center five years ago. Mr. Harris was

83 years old. According to the minimum data set (MDS) assessment, the patient had various chronic comorbid conditions. These conditions persisted over a period of two

years while Mr. Harris was a patient at Mountainview. The patient was eventually discharged to an acute care hospital and never returned to Mountainview. Mountainview

is a 112-bed dually certified nursing care facility affiliated with a for-profit multifacility chain. The nursing home is located in a rural county with a population

of 27,000. The median household income in the county is $32,900. Approximately 64% of the adults over the age of 25 have completed a high school education; 10% of the

adult population have finished a bachelor’s degree or higher. Mr. Harris’s daughter, Nancy, had the power of attorney for the patient’s medical treatment. Nancy

visited the facility regularly and did not express any notable concerns with her father’s care at Mountainview.

Medical and Nursing Evaluations and Treatments Diagnoses at the Time of Admission • Diabetic gangrene of the foot (heightens the risk for septicemia).

• Peripheral vascular disease (causes poor healing of wounds). • Congestive heart failure (poses high surgical risk).

• Depression.

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