Font: Arial size 12, double spaced NO HEADER AND FOOTER

****20 paragraphs total****

Link to access the Ebook below:

http://library.lol/main/85B4FA22F988376D9F5DA30583736714 

NOTE: HIT GET AT THE TOP OF THE PAGE & THE BOOK WILL DOWNLOAD

Chapter Exercises:

On Page 1:

• 14.1—Please write 4 paragraphs with each paragraph containing 45-55 words.

On Page 2:

• 14.2—Please write 4 paragraphs with each paragraph containing 45-55 words.

On Page 3:

• 14.3—Please write 4 paragraphs with each paragraph containing 45-55 words.

On Page 4:

• 14.4:  1st question in the problem—Please write 4 paragraphs with each paragraph containing 45-55 words.

On Page 5:

• 14.4:  2nd question in the problem—Please write 4 paragraphs with each paragraph containing 45-55 words.

Instructions: Doctorate level work. 2 pages, APA format, at least 2 references (must be within 5 yrs ). Absolutely plagiarism free

Due date/time: 18 Nov, 2020 @8:00am. 

Ethical Decision-Making

Let’s return to the ethical scenario presented within Page 2 of the Explore section of Week 4 to consider it further. Upon learning that a medication error occurred resulting in a child’s death, the Chief Nursing Officer (CNO) of a regional acute care facility held a press conference to announce the mistake. The conference centered on reporter questions about why the nurse was not fired. The CNO explained that the nurse was highly regarded and that the problem was a “system” problem, not simply a problem of an incompetent nurse. The CNO also explained that an examination of the medication administration procedures was ordered and that an electronic medication error avoidance system would be implemented to ensure that such an error would not happen again. Consider this scenario to address the following.

· As the CNO in the scenario, defend your decision to disclose the incident to the media. How does this decision influence value-based healthcare? What risks might you encounter? What impact might this decision have on you personally and professionally?

·  At a regional health consortium, fellow CNOs remark that they would not disclose such an incident to the media. Provide two justifications for withholding disclosure of the error to the public. How does this decision influence value-based healthcare?

·  Imagine you are the patient’s family. How would you want the issue to be handled by the CNO? Explain your rationale

Reading/references:

1.  Chism, L. A. (2019). The Doctor of Nursing Practice: A guidebook for role development and professional issues (4 th ed.). Jones & Bartlett Publishers.

·  Chapter 7: The DNP Graduate as Ethical Consultant, pp. 177-197

·  
https://online.vitalsource.com/#/books/9781284155259/epubcfi/6/164%5B%3Bvnd.vst.idref%3Di17_Chapter07%5D!/4/2%5Bch07%5D/8/6%400:0

2.  Marshall, E. S. & Broome, M.E. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.).  Springer Publishing Company.

·  Chapter 4: Economics and Finance

o”The Present State of Health Care Finance,” p. 88

o”Emerging Models of Care Delivery: A Glimpse into The Future of Financing,” -p. 114

·  https://online.vitalsource.com/#/books/9780826193995/epubcfi/6/32%5B%3Bvnd.vst.idref%3DChapter_4%5D!/4/2/366/2%400:61.2

3.Nelson, E. C., Batalden, P. B., & Godfrey, M. M. (2007). Quality by design: A clinical microsystems approach. Jossey-Bass.

·  Chapter 7: Planning Patient-Centered Care, pp. 148-164

4.Sorbello, B. (2008). The nurse administrator as caring person: A synoptic analysis applying caring philosophy, Ray’s ethical theory of existential authenticity, the ethic of justice, and the ethic of care (Links to an external site.). International Journal for Human Caring, 12(1), 44-49. Permalink

Maternal Morbidity and Mortality

The U.S. has unacceptable rates of maternal morbidity and mortality, especially when compared to other developed nations. Women in America continue to experience sickness and death throughout the perinatal period – during pregnancy, birth, and in the postpartum period. 

This activity provides resources and educational stories from National Public Radio (NPR), USA Today, the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN), the March of Dimes, and the Illinois Department of Public Health. Please work through the activities and respond to the prompts after each section directly on this document.  Place your responses on this document in a different color ink or font. Submit this assignment to clinical Absences Assignment Dropbox.

Student Name: _________________________________________

1. NPR maternal mortality series (2017): https://www.npr.org/series/543928389/lost-mothers

o Watch To Keep Women from Dying in Childbirth, Look to California (14:07)

o Watch Focus on Infants During Childbirth Leaves U.S. Moms in Danger (12:11)

o Watch Black mothers keep dying after giving birth: Shalon Irving’s story explains why (12:11)

o Watch For every woman who dies in childbirth in the U.S., 70 more come close (10:42)

o Read Redesigning Maternal Care: OB-GYNs Are Urged to See New Mothers Sooner and More Often (4/23/2018)

o Read Nearly Dying in Childbirth: Why Preventable Complications Are Growing in the U.S. (12/22/2017)

o Watch Many Nurses Lack Knowledge of Health Risks to Mothers After Childbirth (6:54)

o Read If You Hemorrhage, Don’t Clean Up: Advice From Mothers Who Almost Died (8/3/2017)

o Read U.S. has the worst rate of maternal deaths in the developed world (5/12/2017)

Prompt #1: Choose two of the video stories and two of the article stories that captured your attention the most. Provide a brief summary for each of the four pieces. Include your reaction, and if anything surprised you. Each commentary should be a separate paragraph, 4-5 sentences for each.

2. USA Today videos and stories (2018)

Deadly Deliveries: (9 minutes)

https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/09/19/maternal-death-rate-state-medical-deadly-deliveries/547050002/

Prompt #2: Briefly summarize Antoinette Pratsinakis, Ali Lowry and YoLanda Mention’s stories. What were their complications? What did the health care team do right? What did they do wrong?

How Hospitals Are Failing New Moms, in Graphics:

https://www.usatoday.com/deadly-deliveries/interactive/how-hospitals-are-failing-new-moms-in-graphics/

Prompt #3: Define maternal mortality. Rank the maternal mortality rate from lowest to highest for the following developed nations: U.S., Canada, Germany, Japan, France, England. Approximately how many women die in childbirth in America every year? How many suffer severe complications? 

3. AWHONN: Read the article “Saving Women’s Lives” https://awhonnconnections.org/category/post-pregnancy/postpartum-care/ 

Prompt #4: What does the acronym POSTBIRTH stand for? How can we use this to better educate our new mothers on postpartum risks? 

4. March of Dimes – Read position statement:

https://www.marchofdimes.org/materials/March-of-Dimes-Maternal-Mortality-and-SMM-Position-Statement-FINAL-June-2018.pdf

Prompt #5: According to the CDC, what are “pregnancy-related deaths”? What are the top causes of maternal deaths? What is the role of the March of Dimes in efforts to reduce maternal mortality?

5. Read about House Resolution (HR) 1318: 

https://www.congress.gov/bill/115th-congress/house-bill/1318

Prompt #6: What is the name of HR 1318? In your own words, summarize HR 1318. What and when was the outcome of HR 1318? Do you think this will help to reduce the problem of maternal M&M? Why?

6. March of Dimes – Take this 6-question quiz to test your knowledge: https://quiz.marchofdimes.org/quiz/maternal-health-quiz/?utm_medium=email&utm_source=marchdimes&utm_content=2%20-%20Take%20this%20quiz%20You%20may%20be%20surprised%20by%20s&utm_campaign=20180913_MaternalMortality_quiz_SenderA&source=20180913_MaternalMortality_quiz_SenderA

Take a screen shot of your results and submit with this document.

7. Read article: Illinois Releases First Maternal Morbidity and Mortality Report

http://www.dph.illinois.gov/news/illinois-releases-first-maternal-morbidity-and-mortality-report

Prompt #7: What were the highlights of what the committee found? Summarize the 6 key recommendations from the report.

8. Final reflection

Prompt #8: 

o What reaction did you have to these resources? What was the most impactful story, article, or new information you learned? Why? 

o What solutions have been suggested to address the growing problem of preventable complications? What is our responsibility, as health care professionals? 

o What do you think are the barriers that nurses face which prevent the delivery of quality care and education?

Discuss the principles of research and evidence-based practice and how to effectively implement them for advanced practice nurses.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

CASE STUDY #2 

Chief Complaint: “I have pain in my belly”

History of Present Illness (HPI): A 25-year-old female presents to the emergency room (ER) with complaints of severe abdominal pain for 2 weeks . The pain is sharp and crampy It hurts if I run, sit down hard, or if I have sex

PMH: Patient denies

Drug Hx: Birth control

Allergies: NKA

Subjective: Nausea and vomiting, Last menstrual period 5 days ago, New sexual partner about 2 months ago, No condoms, he hates them No pain, blood or difficulty with urination

Objective Data:

PE: B/P 138/90; temperature 99°F;  (RR) 20; (HR) 110, regular; oxygen saturation (PO2) 96%; pain 5/10 

General: acute distress and severe pain

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.

Lungs: CTA AP&L

Card:S1S2 without rub or gallop

Abd: INSPECTION: no masses or thrills noted; no discoloration and skin is warm to; no tattoos or piercings; abdomen is nondistended and round
• AUSCULTATION: bowel sounds (BS) are normal in all four quadrants, no bruits noted
• PALPATION: on palpation, abdomen is tender to touch in four quadrants; tenderness noted on light palpation, deep palpation reveals no masses, spleen and liver unremarkable
• PERCUSSION: tympany heard in all quadrants, no dullness noted in abdominal area

GU: • EXTERNAL: mature hair distribution; no external lesions on labia
• INTROITUS: slight green-gray discharge, no lesions
• VAGINAL: normal rugae; moderate amount of green discharge on vaginal walls
• CERVIX: nulliparous os with small amount of purulent discharge from os with positive cervical motion tenderness (CMT)
• UTERUS: ante-flexed, normal size, shape, and position
• ADNEXA: bilateral tenderness with fullness; both ovaries without masses
• RECTAL: deferred
• VAGINAL DISCHARGE: green in color

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes

Neuro: No obvious deficits and CN grossly intact II-XII

Then answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.

–Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.