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Client Progress and Privileged Notes

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Client Progress and Privileged Notes

Create progress notes

  • Create privileged notes
  • Justify the inclusion or exclusion of information in progress and privileged notes
  • Evaluate preceptor notes

To prepare:

  • Reflect on the client family you selected for the Week 3 Practicum Assignment. verbiage from week three pt uploaded

The Assignment

Part 1: Progress Note

Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:

  • Treatment modality used and efficacy of approach
  • Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
  • Modification(s) of the treatment plan that were made based on progress/lack of progress
  • Clinical impressions regarding diagnosis and or symptoms
  • Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
  • Safety issues
  • Clinical emergencies/actions taken
  • Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
  • Treatment compliance/lack of compliance
  • Clinical consultations
  • Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
  • The therapist’s recommendations, including whether the client agreed to the recommendations
  • Referrals made/reasons for making referrals
  • Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
  • Issues related to consent and/or informed consent for treatment
  • Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
  • Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.

In your progress note, address the following:

  • Include items that you would not typically include in a note as part of the clinical record.
  • Explain why the items you included in the privileged note would not be included in the client family’s progress note.
  • Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

 

SAMPLE ANSWER

Client Progress and Privileged Notes

Part 1: Progress Note

Treatment Modality:   Matthew was involved in counseling sessions to understand that failure is normal. The approach applied Self-efficacy theory (Cohn, 2014).

Progress towards Client Goals: The client has been keen on engaging in the counseling sessions. He relates well with his mother and wife who are usually present during the family therapy session (Freedman, 2014).

Clinical Impressions: Physical assessment of Matthew reveals that his racing heart is slowing down. This shows that his condition is reducing progressively.

Psychosocial Changes: Matthew’s family has relocated to a suburban area. Moreover, their children have been admitted to boarding schools. Jennifer reveals that these actions are to ensure that she has more attention and support for her husband (Er, 2015).

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Safety issues: Matthew does not present any safety problems. He is friendly and social to people around him.

Clinical Emergencies Taken: No clinical emergencies have been taken as the client’s condition has not worsened.

Treatment compliance: The patient is compliant to the treatment procedure and follows the development rules.

Therapist’s Recommendations: It was recommended that the patient should increase the number of sessions in a week to enhance proper evaluation of the therapy’s effectiveness. The client showed willingness to follow the recommendation.

Referrals made/reasons for making referrals: The patient was referred to a cardiologist to have CT Scans for his heart to have an accurate understanding of its racing.

Termination Issues:The client does not have any termination-related issues. The counseling sessions continue without hindrances.

Informed Consent for Treatment: The patient was provided with suitable information to enable him make an informed consent. This act was in line with the ethical concerns of the facility.

Information concerning Abuse:Matthew does not present any form of child or dependent adult abuseat any place.

 

Part 2: Privileged Note

Data  
Client’s Name Matthew, A.
Record Number A2406D
DOB 7/6/1989
Organization’s Name Winther Hospital
Modality Family Therapy
Persons Present Provider and the Client
Progress of Report towards Goals The client shows a great improvement throughout the sessions.
Issues Presented 1.     Clinical Consultations: The practitioner has consulted the psychotherapist to get a clear picture of whether Matthew’s anxiety issues are gene-related or are caused by environmental conditioning. The practitioner found out that the problem emanates from environmental conditioning (Silva, Siegmund, &Bredemeier, 2015).

2.     Collaboration with other Professionals: The practitioner collaborated with the preceptor in analyzing the racing of the patient’s heart.

3.     Medications used: In private session, the patient admits to using Sertraline to control anxiety-related issues.

4.     Modification(s) of the Treatment Plan: Basing on the client’s confidential information, he was advised to stop using Setraline to enhance improvement of the therapy.

5.     Clinical Judgment Reflection: Reflection on the therapy shows that Matthew is at  low risk of persisting with anxiety problems. Observation of his physical body shows that he is normal. His cognition is also normal, indicating that he is progressing well.

 

 

Client Progress and Privileged Notes

Reasons for Exclusion of the Information from Progress Note

In healthcare law, privilege gives the patient the right to prohibit the therapist from disclosing the information. Therefore, the therapist has to create a protection of the patient’s confidential issues. In Matthew’s case, privileged information may refer to what he says in a private session. Since the family therapy also involves his mother and wife, the information he provides during a private session are not to be shared with anyone (Simon &Willick, 2016).

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Preceptor’s Perspective on Privilege Note Inclusion

The preceptor uses privilege notes. According to her, information that she would include in the notes are information that is based on her observation.  She also reveals that hypotheses are supposed to be kept confidential. Moreover, she also reveals that the questions that she is asked about the client or session need to be provided in the privilege note.  In addition, she advises that any thoughts that may be generated from the therapy should also be included in a privileged note.

 

References

Cohn, A. S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority

couples. Journal of Family Psychotherapy, 25(1), 73–77.

Er, I. (2015). Diagnosis and management of generalized anxiety disorder and panic

disorder in adults. Am Fam Physician, 91(9), 617-624.

Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and

couples. Australian & New Zealand Journal of Family Therapy, 35(1), 20–30.

Silva, J. A. M. D., Siegmund, G., & Bredemeier, J. (2015). Crisis interventions in online

psychological counseling. Trends in Psychiatry and Psychotherapy, 37(4), 171-182.

Simon, R. A., & Willick, D. H. (2016). Therapeutic privilege and custody evaluations: Discovery

of treatment records. Family Court Review, 54(1), 51-60.

 

 

 

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Qualitative Research Critique and Ethical Considerations

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Qualitative Research Critique and Ethical Considerations

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

SAMPLE ANSWER

Qualitative Research Critique and Ethical Considerations

Article 1

Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology, 39(1), 63. https://www.nature.com/articles/s41372-018-0231-7

Study Problem

Skin bacterial burden on the patients in the Neonatal Intensive Care Unit is a significant issue in the present world. The condition leads to high morbidity and mortality rates of patients in the ICU. Besides, the bacterial skin burden leads to extended stays in the hospital, which leads to increased healthcare costs for the patients. In the United States, more than 300 000 patients in the ICU are reported to have a bacterial skin burden (Johnson et al. 2019). Therefore, research needs to be done to solve the issues of Central-Line-Associated Stream Infection in the Neonatal Intensive Care Unit.

Qualitative Research Critique and Ethical Considerations

Significance of the study to the nursing practice

Antiseptic chlorhexidine gluconate is one of the primary measures that can be used to reduce bacterial infections in the central nervous and central line catheters. Chlorhexidine helps to prevent secondary and primary infections in patients because it has antibacterial activities which reduce pathogens in patient’s skin (Johnson et al. 2019). Therefore, nurses should consider the use of antiseptic chlorhexidine gluconate in the ICU since it is effective in preventing bacterial infections in patients as compared to regular soap and water bathing.

The objective of the study

The primary purpose of the study is to examine the effect of bathing with chlorhexidine gluconate on bacterial skin burden on patients admitted in the Neonatal Intensive Care Unit.

Research Question

Does bathing with chlorhexidine gluconate reduce bacterial skin burden in neonates admitted in the Neonatal Intensive Care Unit?

How does the article answer the PICOT question?

The PICOT question researches the comparison of the effects of bathing with Chlorhexidine and bathing with soap and water daily in decreasing the rate of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit for one year. Therefore, the article helps answer the question by assessing the effectiveness of daily Chlorhexidine baths in reducing central line-associated bloodstream infections. The utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Therefore, chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.

How the intervention and comparison groups in the article compare with that one identified in the PICOT question

The PICOT question compares the effects of daily chlorhexidine baths and soap and water baths on the reduction of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit. On the other hand, the article examines the effect of Chlorhexidine daily baths on central-line associated bloodstream infections by comparing the reduction level of central line-associated bloodstream infections between patients in the neonatal Intensive Care Unit who are exposed to Chlorhexidine and those who are not exposed.

 

Article 2

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access, 23(1), 30-41. Doi: 10.1016/j.java.2017.11.002

Study Problem

Central Line-Associated Blood Stream Infection (CLABSI) is a bloodstream infection that primarily leads to increased mortality and morbidity rates of patients in hospital. About 260,000 central line-associated bloodstream infections are reported in hospitals in the United States. Also, approximately 29,000 death cases related to the central line-associated bloodstream infections are reported every year. Nearly 29,000 US dollars are spent on treating each patient, which creates a burden of about 2.4 billion dollars on the US healthcare system every year.

Significance of the study to nursing

The suffering experienced by families and patients due to the central line-associated bloodstream infections acquired in the hospitals is immeasurable. Therefore, there is a need for nurses to focus on the prevention strategies for bloodstream infections in hospitals, especially in the Intensive Care Unit.

The objective of the study

Hospitals commit developing strategies to minimize the cases of central line-associated bloodstream infections which are the primary source of high costs of care by both patients and health institutions. Also, bloodstream infections are the leading causes of high mortality rates of patients admitted to hospitals. Therefore, the main objective of the study is to characterize the effectiveness and development of centralized Central Line-associated bloodstream infections prevention bundle in pediatric hospitals.

Qualitative Research Critique and Ethical Considerations

Research question

What is the effectiveness of centralized Central Line-Associated Bloodstream Infections prevention bundle in preventing CLABSI for patients in pediatric intensive care unit?

How does the article answer the PICOT question?

The PICOT question researches the comparison between the effects of daily baths with Chlorhexidine and with soap and water in reducing the rate of central line-associated bloodstream infections in patients in the Intensive Care Unit. The article answers the PICOT question by examining the effects of central line-associated bloodstream infections prevention bundle in reducing CLABSI in patients in the neonatal and Pediatric Intensive Care Unit. Therefore, the utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.

How the intervention and comparison group in the article compare to those identified in the PICOT question

The PICOT question compares the effectiveness of two interventions, that is, daily baths with Chlorhexidine and regular baths with soap and water in reducing the rate of Central Line-Associated Bloodstream Infections for patients in the Intensive Care Unit. On the other hand, the article compares different interventions, that is, central CLABSI prevention bundles in reducing the rate of Central Line-Associated Bloodstream Infections in patients in the neonatal and pediatric intensive care unit.

Study methods used in each of the two articles and how different they are

The article by Johnson et al. (2019) used an observational study to determine the relationship between Chlorhexidine baths and Central Line-Associated Bloodstream infection prevention. The groin and arm skin bacterial growth were observed in non exposed patients, and 40 Chlorhexidine exposed patients in the Neonatal Intensive Care Unit. The exposed patients were given 2 % Chlorhexidine baths for Central Line-Associated Bloodstream infection prevention.

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On the other hand, the study By Savage, et al. (2018) used a research method where the researchers applied a retrospective time series to examine the effectiveness of various prevention bundles that were developed by nurses in infection control in neonatal and pediatric intensive care unit in 2006-2014. The research was subdivided in to post, peri, pre, and second peri-intervention periods depending on each bundles implementation status.

Results of the studies and their implications to nursing

The study by Johnson et al. (2019) indicated that the bacterial burden reduced after the patients took the first bath. However, the bacterial load returned to baseline after 72 hours. The concentration of residual CHG on the skin reduced with time as the bacterial burden increased.

Bathing with Chlorhexidine decreases the bacterial burden on the skin. However, the burden’s baseline returns after 72 hours. Nurses should be aware that CHG bathing twice a week may not be adequate in reducing the growth of bacterial skin burden in patients admitted in the neonatal Intensive care unit. Targeted interventions in the ICU such chlorhexidine gluconate daily baths can reduce the risk of CLABSI associated with using central lines and central nervous catheters. Thus, the study has shown the efficacy of chlorhexidine gluconate in intensive care patients and support is increasing in caring for non-ICU patients.

On the other hand, the study by Savage et al. (2018) showed that there was a significant reduction in unit Central Line-Associated Bloodstream Infection rates where all units were less than the corresponding National Healthcare Safety Network Central Line-Associated Bloodstream Infection rates after the study.

Prevention bundle for centralized Central Line-Associated Bloodstream Infection can be useful in universalizing central line care, improve and control the quality of care to help maintain low CLABSI rates in the hospital. Thus, the study has shown the efficacy of chlorhexidine gluconate daily baths in reducing the risk of CLABSI associated with the use of central lines and central nervous catheters in intensive care patients.

Ethical Considerations

When conducting research, it is vital to maintain the confidentiality of patient information. Secondly, the study should be supported and approved by the Institutional Review Board.  The Institutional Review Board approved the two articles. Besides, participants of the studies were chosen voluntarily, and their health information was confidentially maintained.

References

Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology, 39(1), 63. https://www.nature.com/articles/s41372-018-0231-7

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access, 23(1), 30-41. Doi: 10.1016/j.java.2017.11.002

 

 

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Reviewing the Classical Argument

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Reviewing the Classical Argument

Please answer them thoroughly and in the order they are given. This type of journal should be at least 300 words or more.

 

FYI: Enclosed files might help to answer the assigment

 

How is the classical argument structure different from what you think of as a normal argument you might encounter in a conversation with somebody or an argument you might see on TV? Talk about the classical argument sections you feel you understand and do not understand.

 

SAMPLE ANSWER

Reviewing the Classical Argument

The classical argument differs from normal arguments as it strictly focuses on different sections. This type of argument aims at making inquiries, convictions, negotiations and persuasions. In normal conversations, these sections may not be present because there are no rules on how a person may approach a concept or subject. Therefore, there are different ways in which people argue or converse in a television setting. From another perspective, it can be seen that a classical argument does not involve more than one party (Winthrop, n.d.).

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In my understanding, all the different sections of a classical argument are necessary. In my view, the introductory section is easy to understand because it brings about the general information of the argument. I find the narration part to be tedious due to one’s involvement with various developments to create a position on an issue. In addition, it is difficult to understand because it restricts one from developing specific claims yet it requires one to state facts. The first reason and claim section is easy to develop because it involves developing one’s support of an argument basing on what they think to be strongest reasons (Winthrop, n.d.).

In addition, I find the second and third reason and claim sections to be well elaborated. They do not need much development a s long one brings about a suitable reason. Moreover, the rules involved in these sections are easy to follow. For instance, one needs to analyze a source and to support his or her position with suitable elaboration. The acknowledgement and refutation section is well-defined. However, it needs suitable techniques for writer to refute his position and come up with a better way to depict his position as the most relevant. In that regard, I find it to be difficult because it may make one to lose his direction when he acknowledges the opposing views without refuting it with the same rigor (Winthrop, n.d.).

 

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References

Winthrop (n.d.). The classical argument. Retrieved from

https://www.winthrop.edu › centerHandoutClassicalArgument

 

 

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Evidence Based Practice Guidelines for Otitis Media

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Evidence Based Practice Guidelines for Otitis Media

Assignment: Analysis of Current Evidence Based Practice Guidelines for the Treatment of OM

 

First, carefully review the case. Then, using the Internet, find a current (no older than 4 years old) relevant evidence based practice guideline for the treatment of otitis media for this particular pediatric patient.

Make sure to address the following in your paper:

  • Briefly explain your search strategy. For example, how did you find the correct guideline?
  • Who developed the guideline?
  • Is this a revision of a previous guideline or an original? What is the date of publication?
  • Explain the concept of “systematic review of current best evidence.”
  • How was conflict of interest managed in the development of these guidelines?
  • How is quality of evidence defined?
  • Explain differences among strong recommendation, recommendation, and option
  • What are “key Action statements?”
  • For this particular child, what are the specific treatment recommendations including any diagnostics, medications (include exact dosage, frequency, length of treatment), follow-up, referral, prevention, and pain control.

Case:

A 5-year-old male is brought to the primary care clinic by his mother with a chief complaint of bilateral ear pain for the last three days. The mother states that the child has been crying frequently due to the pain. Ibuprofen has provided minimal relief. This morning, the child refused breakfast and appeared to be “getting worse.”

Vital signs at the clinic reveal HR 110 bpm, 28 respiratory rate, and tympanic temperature of 103.2 degrees F. The mother reports no known allergies. The child has not been on antibiotics for the last year. The child does not have history of OM. The child is otherwise healthy without any other known health problems.

After your questioning and examination, you diagnose this child with bilateral Acute Otitis Media.

 

SAMPLE ANSWER

Evidence Based Practice Guidelines for Otitis Media

            The research strategy involved searching for content relevant to the subject in the various online journal databases. In the research, I used key words related to the condition, which yielded some results. Furthermore, I also added various filters when conducting the research to ensure that the guideline met a certain criterion. These filters included year of publication and needed to be peer reviewed.

Evidence Based Practice Guidelines for Otitis Media

The guideline is developed by the American Academy of Otolaryngology, The American Foundation of Pediatrics, Head, and Neck Surgery Foundation, and the American Academy of Family Physicians. Various researchers and medical practitioners are involved in the development of the guide. This involved include medical practitioners who may be involved in the treatment of Otitis media. Furthermore, the guideline is a revision of a guideline that was developed by the same organizations in 2004. The article was published on February 1, 2016, and it provides evidence-based recommendations for the management and treatment of otitis media (Rosenfeld et al., 2016).

The concept of systematic review of the current best practice applies in the context of the guideline. A systematic review includes a summarization of the results of carefully designed controlled trials or healthcare studies. Furthermore, they provide a high level of evidence regarding the effectiveness of the healthcare interventions that are used (Harmes et al., 2013). The researchers make judgments regarding the interventions and the outcomes, thus informing their recommendations. The changes that the researchers incorporated in the guideline included 20 new systematic reviews, evidence clinical practice guidelines, and 49 randomized control trials (Rosenfeld et al., 2016). Therefore, one can see the applicability of the concept of systematic review of current best practice, whereby the researchers combined the findings of various evidence based studies to recommend updated practices for addressing the problem.

Evidence Based Practice Guidelines for Otitis Media

To manage conflicts of interest, various strategies were employed. One of these was ensuring that the AAO-HNSF fully funded the entire research project. This ensured that no individual company or organization that may benefit from the research influenced it (Rosenfeld et al., 2016). Furthermore, the potential conflicts of interest for the various members who were involved in the research were compiled. After a review of the potential conflicts of interest, the panel set some conditions for the individuals who had conflicts of interest to remain in team. These included recusing themselves from discussions related to the areas that have conflict of interest, agreeing not discuss aspects related to the guideline to industry players before its publication, and ensuring that personal experiences of the panelists does not cause conflict of interest (Rosenfeld et al., 2016).

Quality of evidence may be described as the confidence that the estimates that are reported are sufficient to support specific recommendations. The quality of evidence can be described as high, moderate, low, or very low based on grading quality of evidence and strength of recommendations (GRADE) (Chonmaitree et al., 2016). High tends to have the best quality, while very low tends to have the least quality. Some of the key considerations when determining the quality of evidence include publication bias, imprecision, indirectness of evidence, risk of bias, inconsistency of results between different studies. In the guideline, these elements were considered to ensure that the quality of evidence was high.

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A strong recommendation implies that a review panel or committee believes that the benefits associated with the recommended approach exceed the harms of the same approach. Recommendation, on the other hand, means that the magnitude of the benefits is relatively small, or when benefits are there, by offset by other adverse consequences. Moreover, an option means that the evidence quality is suspicious, or the properly conducted studies have shown that there is little advantage of one approach over the other (Schilder et al., 2016).

For the particular child, one of the elements in the diagnosis is the symptoms. The child has been experiencing bilateral year pain during the last three days, which tends to be one of the symptoms for the condition. However, additional tests would be required to ascertain whether the child in indeed having the condition. One of these tests is otoscope, which involves looking into the child’s year and checking elements such as pus, redness, and swelling. A tympanometry test may also be conducted to determine the air pressure in the child’s eardrum. Furthermore, reflectometry may also be conducted to determine if the child has fluid in his years (Harmes et al., 2013). Treating the condition may include observation or antibiotic therapy. Studies have shown that two in every three children may heal without using antibiotics. Furthermore, the American Academy of Physicians suggests not prescribing antibiotics for treating the condition for children aged between 2 and 12 years particularly if their symptoms are not severe (Rosenfeld et al., 2016).

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If observation does not work within 48 to 72 hours, it is imperative for the patient to take antibiotics. The first antibiotic that needs to be used is Amoxicillin, but if it does not work, Cefdinir can be used as an alternative. Furthermore, analgesics are also recommended for addressing symptoms such as irritability, fever, and year pain. The analgesics are particularly important for addressing the symptoms that can make parents alarmed. The recommended analgesics include acetaminophen and ibuprofen. Benzocaine can also be used. However, ibuprofen needs to be the fast option considering it is less toxic in the event of overdose and it has a longer duration (Rosenfeld et al., 2016).

Therefore, the selected article is an update of a 2004 guideline related to the diagnosis, management, and treatment of otitis media. The guideline is developed by the American Academy of Otolaryngology, The American Foundation of Pediatrics, Head, and Neck Surgery Foundation, and the American Academy of Family Physicians. It was published in 2016. To find the guideline, I searched online journal databases using the appropriate keywords and using filters to ensure that the article is timely and relevant. In the development of the guideline, the issue of conflicts of interest is thoroughly addressed. Furthermore, the researchers ensure that the quality of evidence is high. For the 5-year-old male, the first in his treatment is analyzing his symptoms. Thereafter, various tests need to be conducted to ascertain whether he is suffering from acute otitis media. These tests may include otoscope, tympanometry, and reflectometry. If the results are positive, the observation may be one of the interventions. However, if there are no improvements, antibiotics therapy can be used. Some of the antibiotics that can be used include amoxicillin and Cefdinir. Furthermore, analgesics also need to be used to alleviate some of the symptoms associated with acute otitis media such as fever and pain.

 

References

Chonmaitree, T., Trujillo, R., Jennings, K., Alvarez-Fernandez, P., Patel, J. A., Loeffelholz, M. J., … & McCormick, D. P. (2016). Acute otitis media and other complications of viral respiratory infection. Pediatrics, 137(4), e20153555.

Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Van Harrison, R., & Passamani, P. P. (2013). Otitis media: diagnosis and treatment. Children, 100(8), 10.

Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., … Corrigan, M. D. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology–Head and Neck Surgery, 154(1_suppl), S1–S41. https://doi.org/10.1177/0194599815623467

Schilder, A. G., Chonmaitree, T., Cripps, A. W., Rosenfeld, R. M., Casselbrant, M. L., Haggard, M. P., & Venekamp, R. P. (2016). Otitis media. Nature Reviews Disease Primers, 2, 16063.

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Economic principles in Decision Making

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Economic principles in Decision Making

Unit outcomes addressed in this Assignment: •Utilize economic principles in decision making. •Use planning and prioritization to achieve organizational goals. Course outcomes addressed in this Assignment: • Apply economic principles to health care decision making. • Achieve goals through planning and prioritization. Instructions: In this scenario you have been hired by the World Health Organization. As a leader in the organization you have been assigned to assess a small developing nation and determine the most cost effective public health solutions to improve overall health in the country. You need to select public health options that will allow you to help the most people. You have a budget of $700 million, you cannot divide services in half as a means of cutting cost and you cannot go over budget. Review an overview of the country as well as the available public health services using this document: •Economic Health Decision Making Data Requirements: •Use the Unit 5 Assignment Submission Template to indicate your selections and write your narrative. •A 500-800 word narrative explaining how you used planning and prioritization to make your decisions and reach your goal as well as which of the Unit 4 trainings you found most prepared you for this Assignment and why.

SAMPLE ANSWER

 

Service Cost Reason for Selection:
Basic health education and empowerment $120 million Focusing on interactive group education on health factors such as nutrition and family planning, is critical in promoting health, especially in a developing nation.
vaccination $50 million Administering vaccines will mostly focus on children and pregnant women. This is necessary for the prevention infectious diseases.
basic sanitation and supply of clean water $130 million In such a developing nation, poor hygiene and inadequacy of clean water has a significant impact on the general health of the people, hence the need for supply of clean, purified water.
Access to antibiotics $50 million As a developing nation, the need for antibiotics is high and with this amount, it would be possible to provide adequate antibiotics to treat infections.
Disease detection $75 million Health promotion will be more natural if the country develops the necessary measures to monitor the outbreak and spread of infections.
Maternal and childcare $50 million As mothers and children are most affected in this country, setting aside such an amount is essential to provide necessary care to reduce morbidity and mortality rates
Control of communicable diseases $50  million This service will be beneficial in preventing the spread of infectious diseases such as measles and hepatitis, considering that such diseases significantly contribute to increased death rates.
Vector control $25 million Vector control will assist in the elimination of diseases causing insects.
Properly equipping the health centers $ 100 million Community health centers will be equipped with necessary tools and adequately staffed to provide quality care and improve general wellbeing of the citizens.
Training programs $50 million Training programs should be developed to efficiently train future health providers and equip them with necessary skills to provide quality care.

 

 

Service Cost Reason Not Selected:
Developing more health center $350 million As the country is still developing, there is still a need for advanced health facilities. However, this would be challenging to implement due to the costs involved.
Screening services $300 million For diseases that require advanced screening and tests, it might be challenging to achieve this due to the funds required as well as the equipment.
Development of infrastructure $100 million Timely access to health facilities is significantly affected by poorly developed roads. However, to develop better transport systems, the organization might be forced to work with the authorities. Road building is expensive and is not under the control of health sector policymakers.

 

Narrative

Planning and priority setting in healthcare are necessary since resources will always be limited, hence the need for prioritization. In the given case, a budget of $700million was provided to improve health provision in a small developing nation and the choices to invest in a particular service reflects the society’s values and visions for the health systems. Considering the setting of a developing nation, the principle decisions to focus on areas such as health education and maternal health care over other services were made after a situational analysis.

Economic principles in Decision Making

By incorporating planning and prioritization in the decision-making process, the aim was to select and address the most critical health issues among different options. However, essential issues of health in this case may not be viewed with the same weight as those of people in developed countries. In such countries health targets are achieved by emphasizing on healthy lifestyles and disease minimization through supportive environment. In this case, though, factors such as water purification and sanitation were prioritized as well as individual involvement in health provision. Further, other areas of focus like nutritional education and vaccination are prioritized over other health issues like cancer screening. Planning and priority-setting was used based on the most affected population and the most common health issues affecting the population in question. However, this was not just focused on prioritizing the health problems, but also the possible intervention

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Among the different options available for health investment, the priorities selected were influenced by various factors besides the limited financial resources. Such choices were influenced by the general distribution of resources as a response to population needs and demands. For instance, in such developing country, health promotion must  begin from the basics of general health education such as hygiene, before implementing more advanced care. As such, while other areas of health providers such as setting up of new health facilities might be regarded important, effectiveness can only be attained if the citizens are also trained on personal health. This would assist in preventing overcrowding in those health centers and unnecessary hospital visits. The priorities were also influenced by the need to reduce the high mortality rates that were attributed to lack of vaccination, antibiotics, and antenatal care. Further, the priority setting in selecting health interventions was based on the options that would achieve high health standards and maximization as required by WHO, reduce health inequalities, as well as financial protection.

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In the previous unit, financial management was identified as  a critical factor when it comes to health provision and proper budgeting. In this case, health provision must take into consideration all-round factors ranging from development of health facilities, provision of cost-effective medication, and holistic care. As cost is an essential factor of health provision, focusing on health improvement in such  developing nation would require effective planning and prioritizing essential services to the most affected groups. As such, issues such as immunization and vaccination to prevent communicable diseases as well as provision of health education to the general public must be addressed first.

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