The Session Long Project for this course is to evaluate and critique a health care facility you are familiar with and compare it to the general principles and standards for quality assurance presented in this course.

In the earlier modules you identified a health care facility for the subject of the SLP and presented a description of the facility and it’s quality assurance program. You also critiqued the facility’s Continuous Quality Improvement program, Utilization Management Program, and Case management Program.

In this module you will discuss and critique the subject facility’s Risk Management program.

SLP Assignment Expectations

For this module you are to complete the following tasks in a 4- to 5-page paper:

• Describe and discuss the facility’s Risk Management program. Do you feel their Risk Management program is adequate?
• Compare and critique the subject facility’s Risk Management program to that of a model facility and whether the facility adheres to the recognized standard for risk management.
• Identify areas for improvement in the facility’s Risk Management program, if any, and any recommendations you think should be implemented to lower risks in the facility. Give valid reasons for your answer.

The final paper is intended for you to examine at least two specific theoretical concepts introduced in the reading or in lecture and “apply” or “use” them to understand a “real world” social issue. You will be expected to demonstrate: 1. an accurate understanding of your chosen issue and 2. an ability to use the theoretical concepts to understand/ critically analyze the social issue being presented.

These papers are to be 4-5 pages long. They must be typed (double-spaced, 1 inch margins, 11-12 point New Times Roman font).

Paper content and organization

(1) Please begin your analysis with a brief summary of the matter of concern and why you believe it is important to utilize theory to understand it.

(2) Once you have clearly introduced what you will be discussing… please introduce the theoretical concepts that will be utilized in analyzing your matter of concern.

(3) In the next part of the paper show how each theory/ concept gives us insight to the matter of concern. Explain the connection. What made you see this link and help me to see it like you did.

(4) Conclude the paper with a summary of your main points. What insights do you want the reader to take away from your paper? What should the reader really remember about what you’ve said in the paper?

DUE DATES: JUNE 17 TH @11:59 PM

Grading (see rubric below). Each application paper will be graded out of a possible 100 points.

• Introduction of Matter of Concern…………………………………………………………….…10
• Why do the theories that you chose give us insight to your matter of concern..…10
• Accurate definition/description of theories……………… …………………………………..10
• Application of theory to your matter of concern…………………………………………….40

– Clearly show how each concept is being applied to matter of concern

– Connections accurately/ thoroughly explained

5. Final summary paragraph highlighting main points……….……………………….….…15

– Key points accurate summarized

– Clearly explain what the reader should remember from your paper

6. Reference page included…………………………………………………………………………….. 5

– reference lecture notes/ readings

7. Basic Language Usage………………………………………………………………………………. 10

https://www.nursingworld.org/coe-view-only

• Outline and discuss a plan to promote the value of the APN model to the public.
• Using the latest statistics and evidence, provide a compelling argument and a brief background to the public about why APNP care is essential.
• Discuss how you would promote the value of utilizing an APN as a provider of services.
• Use data from sources that illustrate how efficient, and cost containing APNPs are versus other health care provider roles. This is not an exercise that diminishes our other colleagues, but one that promotes the value of the APNP role.

Students are expected to:

1. Post an initial substantive response of 250 words to each question
2. Please be sure to validate your opinions and ideas with citations and references in APA format.
3. References and citations should conform to the APA 6th edition.
4. Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
5. The peer postings should be at least one paragraph (approximately 100 words) and include references and in text citation

Helen’s post:

Define and describe legal, ethical and risk management (insurance):

Legal issues for NPs: Legal issues involve regulation and the law. Legislation and regulation are in place to ensure quality and to increase the value of healthcare (Buppert, 2018). Regulation is set up through policy and statute (Buppert, 2018).

Ethical issues are defined as doing what is right. Ethics encompasses acting in the interest of patient safety and performing duties only if one is competent to perform them. According to the ANA Code of Ethics, NPs should display moral courage, or stand up for one’s beliefs in the face of controversy (Dolan, 2017).

Risk management is the forecasting of financial risk by insurance companies that cover NPs with malpractice insurance. After the forecasting of risk, many companies create procedures to minimize the impact of the risk. Insurance companies may use a risk management forecast to generate the cost of malpractice insurance to the NP.

Describe how each of these is interrelated:

For NPs, following rules of regulation, policy and law is legal decision-making (Dolan, 2017). Ethical decision-making involves the synthesis of legal and moral influences, including social expectations and traditions (Dolan, 2017). Ethical decision-making is broad, involves the ponderance of right and wrong. In NP practice, there is a presumption that to practice ethically, one most practices legally (Dolan, 2017). Risk management comes into play if the NP makes an error, such as performing outside of the legal scope of practice. This is why it is important for NPs to know their scope of practice and to act in an ethical manner, abiding by the law.

Example of how ethics is interrelated in practice:

In one scenario a pregnant teenager presents to a gynecology office for an elective abortion with her mother who signs consent (Dolan, 2017). The teen decides she does not want the abortion but the mother insists that the minor have the abortion, telling the teen that it will not hurt. The procedure was performed by an NP, it did hurt and the teen protested during the entire procedure. In this example, patient autonomy is violated but no law is violated. Reasonable care suggests that the patient’s concerns should be prioritized (Dolan, 2017).

Journal Summary:

NPs in controversial situations in practice must meet patient care goals while maintaining moral integrity (Dolan, 2017). In this way, challenges are opportunities to benefit the common good (Dolan, 2017). The ANA Code of Ethics is a resource of professional guidelines that is applicable to advanced practice. The ANA Code of Ethics encourages APNs to stand up for core beliefs in the face of adversity (Dolan, 2017).

References:

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide. (6^th ed.). Burlington, MA: Jones & Bartlett Learning

Dolan, C. (2017). Moral, ethical, and legal decision-making in controversial NP practice situations. The Journal for Nurse Practitioners, 13(2), 57-67. Doi: 10.1016/j.nurpra.2016.10.007

Rebecca’s Post

Legalities, Risk Management, and Ethics

Legal issues, risk management, and ethical considerations go hand in hand when it comes to care provided by NPs. Legal standards are standards that are set forth in governmental laws. All the statutes and laws that lawyers point to are legal standards. Legal standards are useful because they help health care providers to know what they can and cannot do. With legal standards in place, authorities are allowed to enforce rules when providers do something illegal (Angela, 2016).

Ethical standards, on the other hand, don’t necessarily have a legal basis. Ethics is a branch of philosophy concerned with moral principles that guide decisions on how to live and how to behave. It is also defined as an evaluation of a moral choice based on ideas about what is morally right or wrong. Ethics provides an opportunity to describe and understand standards of conduct in nursing practice. The nursing profession has long held to high ethical standards with the most recent benchmark being the development of the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2018). The Principles of Medical Ethics and the Opinions of the AMA Council on Ethical & Judicial Affairs make up the AMA Code of Medical Ethics. This is a helpful tool NPs can use when faced with a difficult ethical decision or predicament. Using these standards, the provider will be able to help patients to participate meaningfully in decisions about their health care. Providers have a responsibility to provide information and help patients understand their medical condition and options for treatment (American Medical Association, 2018). Using these ethical standards, the best care is able to be provided to patients.

Risk management also plays a crucial role when it comes to NPs and the services they give to their patients. Risks to patients, staff, and organizations are common in healthcare. Therefore, it is necessary for an organization to have qualified healthcare risk managers to assess, develop, implement, and monitor risk management plans with the goal of minimizing exposure. There are many priorities to a healthcare organization, such as finance, safety and most importantly, patient care (The University of Scranton, 2015).

Ethical standards are based on human rights and wrongs while legal standards are based strictly on what it written within the law. It is possible that an action may be legal but not ethical. Unfortunately, sometimes making a difficult decision for a patient’s best health care plan, the provider is stuck and must decide between decisions where the correct legal route may not fall under the best ethical route. This is when risk management comes into play and can help the NP provide the best choice with the best outcomes. Together, legal, ethical, and risk management sections all must work together to provide the best patient care.

Medical malpractice has been defined in professional literature as ”any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient.” In the United States, the laws that govern medical malpractice come from the individual states. Each state has its own boards of professionals who create the licensing requirements and basic laws governing practice for the various practitioners. For example, the Nurse Practice Act in each state covers the definition of the nurse’s scope of practice, the educational requirements, and the grounds for disciplinary action for violations of the act. However, laws that govern medical practice are derived from common law. This means that they evolve from court rulings that have taken place over the years (Jankowski, 2017). The interrelationships between medical ethics and the law are perhaps nowhere as starkly apparent as in the realm of medical malpractice. Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict. Disclosure of errors; quality improvement activities; the practice of defensive medicine; dealing with patients who wish to leave against medical advice; provision of futile care at the insistence of patients or families, and the various protections of Good Samaritan laws are just a few of these (Solomon, 2016).

References

American Medical Association. (2018). Code of Medical Ethics: Consent, Communication & Decision Making. Retrieved October 14, 2018, from https://www.ama-assn.org/delivering-care/code-medi…

American Nurses Association. (2018). Ethics. Retrieved October 14, 2018, from https://www.nursingworld.org/practice-policy/nursi…

Angela. (2016). What is the Difference Between Legal & Ethical Standards? Retrieved October 14, 2018, from https://study.com/academy/lesson/what-is-the-diffe…

Jankowski. (2017). Legal Liability in Healthcare: Negligence & Malpractice. Retrieved October 14, 2018, from https://study.com/academy/lesson/legal-liability-i…

Solomon. (2006). Ethical issues in medical malpractice. US National Library of Medicine National Institutes of Health, 24(3), 733-735. Retrieved October 14, 2018.

The University of Scranton. (2015, February 02). The Purpose of Risk Management in Healthcare. Retrieved October 14, 2018, from https://elearning.scranton.edu/resource/business-l…

In Chapters 1-4 Krakauer lays the framework for his narrative. All writers must establish their credibility early on–this is know as ethos. We as readers are necessarily concerned with the truthfulness of Krakauer’s narrative, so Krakauer puts us at ease right away by using McCandless’ own words to begin. The book begins with a postcard McCandless sent to his friend Wayne Westerberg that includes an ominous phrase: “[t]his is the last you will hear from me” (3).

In your 350 word entry, discuss the strategies Krakauer uses in chapters 1-4 to establish the veracity (truthfulness) of his narrative. You will need to reference or quote the text (and do note that your quotations do not count towards your word count.) In an effort to establish our interest in McCandless, Krakauer is dealing with competing rhetorical issues: how to get the reader engaged, but also how to keep the narrative factual. How is this handled? I really want you to look at the construction of this text, and not only the plot of the text. For example, how and why are McCandless’ own writings used? How are eyewitness accounts incorporated? Why? What impact does this have on the reader?