CASE INTRODUCTION – Charlotte Greene, a registered nurse, is discharging a pediatric patient, Joey Slater, to home care under the supervision of his mother. The child returns to the hospital five weeks later with some concerning issues

Brief Summary of Case

SCENE 1: Joey Slater, an 8-year-old child who received blood transfusion for femur, is now ready for discharge. Stacey, a licensed practical nurse/licensed vocational nurse (LPN/LVN), offers to take care of discharge teaching about cast care, while Charlotte, an RN, calls home health care to arrange a home visit.

SCENE 2: Five weeks later, Joey is readmitted to the pediatric floor. On assessment by the RN, maggots were coming out of the cast, and perineal skin breakdown was noted. As Charlotte and the mother discuss the situation, it’s clear that there was a lack of education. The mother also states that home health nurses never contacted her. Later, Charlotte calls the agency and discovers that they tried repeatedly to contact the family without success.

SCENE 3: Charlotte tells Joey that the doctor says he can go home, but he seems worried and scared. Later, Charlotte calls social services to involve them in the patient’s care. Charlotte advocates for the patient by delaying his discharge and reporting subjective and objective findings to social services.

Instructions:

1. Read the case study above and then, answer the following questions for 
Scene 1:

a. What primary violation of the Code of Ethics in Nursing did you witness in this scene?

b. What evidence do you see for proper delegation, if any, by the RN in the video case?

· What improper delegation took place?

· What would you as the nurse have delegated in this scene?

2. Now, answer the following questions for 
Scene 2:

a. What evidence do we have of the potential for professional negligence and malpractice in the care delivery for this patient? 

b. Which of the nine Code of Ethics for Nursing provisions were upheld by the registered nurse in this scene?

3. Your paper should be:

. One (1) page

. Typed according to 

APA Writing StyleLinks to an external site.
 for margins, formatting and spacing standards.

To Prepare:

• Reflect on the four peer-reviewed articles you selected in the last assignment and the four systematic reviews you selected in previously.
• Reflect on the four peer-reviewed articles you selected and analyzed.
• Review and use the Critical Appraisal Tool Worksheet Template attached below.

The Assignment (Evidence-Based Project)

Part A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template attached below. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest. (please APA title page)

Part B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page APA format critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research. (please provide at least 4 references)

(Remember that part A is the appraisal matrix completed with your four articles.)

Part B is a 1-2 page p a p e r in which you suggest the best practices (an intervention recommendation) that you base on the findings within the four articles you are using.)

Week 4

Skin Comprehensive SOAP Note Template

Patient Initials: _______ Age: _______ Gender: _______

SUBJECTIVE DATA:

Chief Complaint (CC):

History of Present Illness (HPI):

Medications:

Allergies:

Past Medical History (PMH):

Past Surgical History (PSH):

Sexual/Reproductive History:

Personal/Social History:

Health Maintenance:

Immunization History:

Significant Family History:

Review of Systems:

General:

HEENT:

Respiratory:

Cardiovascular/Peripheral Vascular:

Gastrointestinal:

Genitourinary:

Musculoskeletal:

Neurological:

Psychiatric:

Skin/hair/nails:

OBJECTIVE DATA:

Physical Exam:

Vital signs:

General:

HEENT:

Neck:

Chest/Lungs:.

Heart/Peripheral Vascular:

Abdomen:

Genital/Rectal:

Musculoskeletal:

Neurological:

Skin:

Diagnostic results:

ASSESSMENT:

PLAN:
This section is not required for the assignments in this course (NURS 6512), but will be required for future courses.

© 2021 Walden University Page 2 of 3

  

Respond to this DB using APA and include at least 2 scholarly references.

. Competing Needs in Healthcare Policy Development: Addressing the National Healthcare Issue of Rising Costs

         The United States faces a critical challenge in the form of escalating healthcare costs, which have profound implications for care delivery and patient outcomes. Crafting effective healthcare policies to address these rising costs is a complex process influenced by various competing needs, including those of the workforce, available resources, and patients. 

                                                    Competing Needs in Healthcare Policy Development

         The development of healthcare policy is a multifaceted process that requires the careful consideration of various competing needs, primarily concerning three key stakeholders: the healthcare workforce, available resources, and patients.

The Workforce

         A primary concern in healthcare policy development is the well-being and satisfaction of the healthcare workforce. Nurses, physicians, and other healthcare professionals are essential for delivering quality care. Policies that fail to address the workforce’s needs can lead to burnout, decreased job satisfaction, and, ultimately, a shortage of healthcare providers (Milliken, 2018).

Resources

         Another critical factor in healthcare policy development is the allocation of resources. These resources encompass financial budgets, medical equipment, hospital facilities, and research funding. Competing needs emerge when policymakers must strike a balance in resource allocation between different healthcare sectors, such as primary care, specialty care, and mental health services.

Patients

        The ultimate goal of healthcare policy is to improve patient outcomes and ensure equitable access to care. Policies that do not prioritize patient needs can result in disparities in healthcare access and quality. Patients require affordable care, timely access to services, and assurance of their safety and well-being (American Nurses Association, 2015).

                                              Impacts of Competing Needs on Rising Healthcare Costs

         Rising healthcare costs pose a significant national healthcare issue that is profoundly influenced by the following competing needs discussed below.

Workforce Needs

         Healthcare professionals are indispensable for care delivery. However, addressing the workforce’s needs, such as fair compensation, manageable workloads, and a supportive work environment, often necessitates increased spending. This can directly contribute to rising healthcare costs as salaries and benefits for healthcare workers constitute a substantial portion of healthcare expenditures (Kelly & Porr, 2018). For example specialized settings like psychiatric hospitals, attracting and retaining mental health professionals is challenging due to the demanding nature of the work. To meet the workforce’s needs, policymakers may need to allocate additional funds for competitive salaries and mental health support programs.

Resource Allocation

         Effective resource allocation is crucial for managing rising healthcare costs. When resources are thinly spread across various healthcare sectors, inefficiencies, care delays, and increased costs can result. For instance, underinvestment in preventive care and community-based services can lead to higher costs associated with treating preventable chronic conditions for example, to address the escalating costs of psychiatric hospitals, policymakers may need to allocate resources for community mental health programs and early intervention services. This can help prevent hospitalizations and reduce the overall financial burden on the healthcare system.

Patient-Centered Care

         Policies that do not adequately prioritize patients’ needs can exacerbate healthcare costs. Patients who lack access to affordable care may delay seeking treatment, leading to more severe health issues and increased long-term costs. Furthermore, a lack of emphasis on preventive care can result in higher expenses associated with treating advanced illnesses for example, to address rising costs and ensure patient-centered care, policymakers may need to implement policies that expand access to affordable healthcare, including mental health services. This could involve subsidizing insurance premiums or increasing the availability of Medicaid programs.

                                                                   Addressing Competing Needs through Policy

         Effectively addressing the national healthcare issue of rising costs while considering the competing needs of the workforce, resources, and patients necessitates the implementation of several targeted strategies.

Workforce Support

         Policymakers should prioritize workforce needs by ensuring fair compensation, manageable workloads, and access to mental health support programs. This can help reduce turnover, enhance job satisfaction, and ultimately contribute to cost containment.

Resource Optimization

         Resource allocation should be evidence-based, maximizing efficiency and cost-effectiveness. This may involve investing in preventive care, telemedicine, and outpatient services to reduce the need for costly hospitalizations.

Patient-Centered Reforms

         Healthcare policies should prioritize patient needs, including affordability, accessibility, and safety. Expanding coverage options, implementing price transparency, and promoting preventive care can help reduce overall healthcare costs and enhance patient outcomes.

Interdisciplinary Collaboration

         Collaboration between healthcare professionals, policymakers, and healthcare administrators is essential. Interdisciplinary teams can develop and implement policies that effectively balance competing needs, drawing on diverse perspectives to find innovative solutions.

         Regular Review and Adjustment: Healthcare policies should remain dynamic and subject to regular review and adjustment. This allows policymakers to adapt to changing healthcare landscapes and emerging challenges while continuously optimizing resource allocation.

                                                                                                  Conclusion

         The development of healthcare policy is a multifaceted process influenced by competing needs, including those of the workforce, resources, and patients. Rising healthcare costs present a significant national healthcare issue, and addressing these competing needs is crucial to finding sustainable solutions. Ethical considerations, as outlined in the American Nurses Association’s Code of Ethics, play a pivotal role in ensuring that policies prioritize patient well-being, equitable access to care, and the support of healthcare professionals. By strategically balancing these competing needs and implementing targeted policy reforms, the healthcare system can work toward containing rising costs while delivering high-quality, patient-centered care.

                                                                                                   References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-Links to an external site. 

               view-only

Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. JAMA, 307(14), 1513-1516.     

              doi:10.1001/jama.2012.362

Cutler, D. M., & Sahni, N. R. (2013). If slow rate of health care spending growth persists, projections may be off by $770 billion.

               Health Affairs, 32(5), 841-850. doi:10.1377/hlthaff.2012.1258

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. Online   

               Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06.

Milliken, A. (2018). Ethical awareness: What it is and why it matters. Online Journal of Issues in Nursing, 23(1), Manuscript 1.

               doi:10.3912/OJIN.Vol23No01Man01.

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