Category: Nursing

NURS-6501 week 1 Discussion: Alterations in Cellular Processes

Discussion: Alterations in Cellular Processes

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At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

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Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans. NURS-6501 week 1 Discussion: Alterations in Cellular Processes.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

The role genetics plays in the disease. NURS-6501 week 1 Discussion: Alterations in Cellular Processes.

Why the patient is presenting with the specific symptoms described.

The physiologic response to the stimulus presented in the scenario and why you think this response occurred.

The cells that are involved in this process.

How another characteristic (e.g., gender, genetics) would change your response. NURS-6501 week 1 Discussion: Alterations in Cellular Processes.

NURS 6050 Agenda Comparison Grid Template

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

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In Part 1 of this module’s Assignment, you were asked to begin work on an Agenda Comparison Grid to compare the impact of the current/sitting U.S. president and the two previous presidents’ agendas on the healthcare item you selected for study. In this NURS 6050 Agenda Comparison Grid Template Discussion, you will share your first draft with your colleagues to receive feedback to be applied to your final version.

To Prepare:

Review the Resources and reflect on the importance of agenda setting.

Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

Review Part 1 of the Module 1 Assignment and complete the requirements for this NURS 6050 Agenda Comparison Grid Template Discussion.

Agenda Comparison Grid Template

Agenda Comparison Grid and Fact Sheet
or Talking Points Brief Assignment Template for Part 1 and Part 2

 

Part 1: Agenda Comparison Grid

 

Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

 

You will use the information in the Part 1:
Agenda Comparison Grid
to complete the remaining Part 2 and Part 3 of your Assignment. NURS 6050 Agenda Comparison Grid Template.

 

 

Identify the Population Health concern you selected.

 

 

Describe the Population Health concern you selected and the factors that contribute to it.

 

NURS 6050 Agenda Comparison Grid Template

 

Administration (President Name)

(Current President)

(Previous President)

(Previous President)

Describe the administrative agenda focus related to this issue for the current and two previous presidents.

 

 

 

 

 

 

 

 

 

 

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

 

 

 

 

 

 

 

 

 

Explain how each of the presidential administrations approached the issue.

 

 

 

 

 

 

 

 

 

 

 

Part 2: Agenda Comparison Grid Analysis

 

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

 

Administration (President Name)

(Current President)

(Previous President)

(Previous President)

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

 

 

 

 

 

 

 

How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

 

Note: Part 3: of the Module 1: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or Talking Points Brief the you will create in a separate document.

 

 

 

Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2

 

Part 1: Agenda Comparison Grid

 

Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

 

You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

 

 

Identify the Population Health concern you selected.

Abortion

Describe the Population Health concern you selected and the factors that contribute to it.

Abortions has been a debate in healthcare for many year, but most recently, it has become a huge topic of discussion and debate in politics. Abortion laws affect many different populations and there are many factors that contribute to the debate. Factors that contribute to abortion are the effects abortion has on birthrates, the economic impact of abortion, changes of sexual behavior among teens. A recent study was performed to determine the factors affecting the mental well-being of a woman after abortion. Implications of the study included; Source of stress experienced by women after abortion and the effects abortion has in regards to religious beliefs (Annas, G. n.d.). According to a 2011 study of the British Journal of psychiatry 81 percent were likely to experience a mental health disorder such as anxiety disorder, depression, alcohol abuse, marijuana abuse, and suicide (Laguna Treatment Center, 2019). Other studies, found that women were more emotionally stressed if they were denied an abortion (Laguna Treatment Center, 2019). The reason for this was they were not prepared to have children, rape, the child had birth complications, and parents of the child were unable to care for the baby, or shame.

 

Administration (President Name)

(Current President)

Donald Trump

(Previous President)

Barack Obama

(Previous President)

George W. Bush

Describe the administrative agenda focus related to this issue for the current and two previous presidents.

On January 19, 2018, while speaking to participants at the annual March for Life, a rally for activists who opposed abortion, President Donald Trump said that his administration “will always defend the very first right in the Declaration of Independence, and that is the right to life. We are protecting the sanctity of life and the family as the foundation of our society (whitehouse.gov, n.d.). President Trump is % against abortion. He has always maintained that is and will always be the case for him as long as he is president.

 

 

 

 

 

 

 

 

 

Obama strongly supported a women’s right to choose to terminate her pregnancy for any reason through legal and safe abortion procedures as defined by Roe. Obama wound do just about anything and everything he could to preserve a women’s right to affordable and unfettered abortion on demand as promoted by tax subsidized abortion providers like Planned Parenthood. (
www.nrlc.org
, April, 201). He believed it was a moral issue and did not feel the government should be involved. Obama enacted the freedom of choice Act in 2008, which would codify the right to abortion by eliminating all federal and state-level restrictions on the procedure (The federalist, 2019 para.9).

President Bush is likely the president that was the most sensitive on the subject than the other two presidents.

Bush supported a constitutional amendment making the procedure illegal – except in cases of rape, incest and when the woman’s life was in jeopardy. But he also added that Americans didn’t support the measure, so there was no need to pursue it. He also added that he not require his Supreme Court nominees to pass an anti-abortion litmus test (Abortion without the rhetoric, 2012). He did not believe in intentional death of babies, but he  believed women should have some rights initially, but then he took away funding, and settled for Partial abortion.

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

Trump signed an executive order reinstating the ban known as the Mexico City Policy. This policy prohibits the U, S. giving federal family planning funding to international health groups that provide abortion care” (Freiburger, C., 2019).This would include organizations such as Planned Parenthood.

Shortly afterwards, the President’s press secretary Sean Spicer made a bold statement that stated, “ Mr. Trump was/is standing up for all Americans – including the unborn” (Freiburger, C., 2019).

 

 

 

 

 

 

 

The Obama administration finalized a rule to stop states from withdrawing federal money from Planned Parenthood and other health clinics that provide abortions.

The protections were in effect two days before Donald Trump took office.

Under the rule, states are legally required to distribute federal funds for services related to contraception, fertility, pregnancy, sexually transmitted infections and breast and cervical cancer screening, regardless of whether they also perform abortions (Annas, G. n.d.).

Upon taking office, President Bush reinstated the “Mexico City Policy,” also known by critics as the “Global Gag Rule.” This rule required that all non-governmental organizations (NGOs) that receive federal funding must refrain from performing or promoting abortion services (prolifeprofiles.com, n.d.).

Explain how each of the presidential administrations approached the issue.

Trump’s major actions on abortion during his first two years in office were: Signing a resolution that allowed states to withhold federal funding for health care providers that perform abortions into law; Reinstating the Mexico City Policy, which prohibited foreign aid and federal funding for international NGOs that performed abortions or offered related services; and issuing a proposal to modify the Title X family planning program that proposed making family planning clinics that refer patients for abortions and share finances or facilities with abortion providers ineligible to receive funding from the program. Additionally, healthcare providers would not be required to provide abortion counseling if it violated their moral or religious beliefs (Israel, M., 2018).

 

 

 

 

 

 

 

 

As president, Obama dedicated himself to promoting abortion, rather than reduce them as he promised. He has done this by; expanding abortions through Obamacare, appointing a bevy of pro-abortion judges and officials, moving to strip medical professionals of conscience rights, and forcing taxpayers to fund groups who provide abortions in other countries (Annas, G. (n.d.).

NURS 6050 Agenda Comparison Grid Template

On November 5, 2003, Bush signed into law the “Partial Birth Abortion Ban Act,” which prohibited a form of late term abortions dubbed “partial birth abortions” by pro-life groups and referred to in medical literature as “intact dilation and extraction.”  Under this law, “Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both.” In 2007 its constitutionality was upheld by the U.S. Supreme Court, in the case of Gonzales v. Carhart; Bush supported the Texas Parental Notification Law which required doctors to notify a parent or guardian by phone or certified mail at least 48 hours before performing an abortion on a minor girl.  It also allowed a judicial bypass where extenuating circumstances existed, provided a $10,000 fine for failing to notify and waived notification in cases of medical emergency.

 

In his own words he stated, “I will lead our nation toward a culture that values life — the life of the elderly and the sick, the life of the young, and the life of the unborn. I know good people disagree on this issue, but surely we can agree on ways to value life by promoting adoption and parental notification, and when Congress sends me a bill against partial-birth abortion, I will sign it into law” NURS 6050 Agenda Comparison Grid Template

(On the issues.org, n.d.).

 

 

 

 

 

 

Part 2: Agenda Comparison Grid Analysis

 

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

 

Administration (President Name)

(Current President)

(Previous President)

(Previous President)

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

 

The Centers for Disease Control and Prevention (CDC), the government agency currently responsible for compiling U.S. abortion data.

 

In 1996, as well, the Food and Drug Administration (FDA) took significant steps toward approving the use of medical (nonsurgical) abortion in the United States, essentially by “preapproving” the use of mifepristone, popularly known as RU 486, as an abortifacient.

 

The Department of Health and Human Services play a huge role in addressing administrative policies for abortions.

 

 

 

NURS 6050 Agenda Comparison Grid Template

How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

President Trump addressed abortion often in his run for president. He has already addressed the issue as the president. President Trump’s first day in the Oval Office on Monday, he signed a ban on federal money going to international groups that perform or provide information on abortions.

NURS 6050 Agenda Comparison Grid Template

During his first week in office, Obama made it clear that he would support abortion when he made it a priority to overturn the Mexico City Policy. Republican President Ronald Reagan first created the Mexico City Policy in 1984, stopping funding for international groups which perform or provide information on abortions. It was reinstated by George W. Bush and then it was overturned again by President Barack Obama in 2009 (Bilger, 2018).

The Mexico City Policy created by President Reagan was reinstated when President George W Bush took over in 2001. Also in 2001, President Bush declared that federal funds could not be used for embryonic stem cell research, which requires the destruction of human embryos. Instead, Bush promoted adult stem cell research, which does not destroy embryos. In 2002, Bush signed the Born-Alive Infants Protection Act, which extends legal protection to infants who survive induced abortions by providing them with identical legal protections as babies who are born prematurely.

 

In 2003, President Bush signed into law the Partial-Birth Abortion Ban Act, which prohibits late-term abortions.

 

In 2004, Bush signed the Unborn Victims of Violence Act, which defines a child “in utero” at any stage of development as human, and accords the child the legal rights of the victim if subject to certain crimes that involve death or injury.

 

In 2005 and 2006, Bush appointed two pro-life justices, Justice John Roberts and Justice Samuel Alito, respectively, to the U.S. Supreme Court.

 

In 2007, both justices voted to uphold the federal Partial-Birth Abortion Ban Act of 2003, which was challenged in a lawsuit.

 

In 2007, Bush also sent congressional Democratic leaders a letter threatening to veto any bill that weakened existing pro-life policy.

 

In 2008, Health and Human Services Secretary Mike Leavitt issued a regulation to protect the rights of federally funded health care providers to decline to participate in services to which they morally object, including abortion.

(Ryan, 2009).

Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

I personally would choose President George W. Bush. His stand on abortion laws were more from a sympathetic and personal approach. He was very much a Christian President and this played a big role into his views and his acts on the subject, while the others are very much opposite. President Trump does not seem to view the sides of abortion that in fact may warrant it, such as a rape victim. President Obama is very much an advocate for abortion and is adamant that abortions should be a choice for women regardless of the reason. He does not seem to have regard for anyone’s ethical or religious beliefs on the matter.

References:

Abortion without the rhetoric. (2012, April 04). Retrieved from https://abortion.info/politics/presidents-and-abortion/george-w-bush-2001-2009/

Annas, G. (n.d.). Abortion Politics and Health Insurance Reform | NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp0911513.

Bilger, M. (2018, December 13). Barack Obama, The Abortion President, Receives Human Rights Award. Retrieved from

Barack Obama, The Abortion President, Receives Human Rights Award

Freiburger, C. (2019, February 22). Trump admin cuts $60 million from Planned Parenthood. Retrieved from
https://www.ontheissues.org/Celeb/Donald_Trump_Abortion.htm

George W. Bush Former President of the U.S. (R) Tier 4 – Personhood Never. (n.d.). Retrieved from http://prolifeprofiles.com/george-w-bush-abortion

Ryan, J. (2009, January 16). Bush Had Best Pro-Life Record of Any President, Say Pro-Life Groups. Retrieved from
https://www.cnsnews.com/news/article/bush-had-best-pro-life-record-any-president-say-pro-life-groups
.

The Federalist. (2019). How The Obama Presidency Normalized Abortion Extremism. Retrieved from https://thefederalist.com/2019/03/04/how-the-obama-presidency-normalized-abortion-extrimism/ NURS 6050 Agenda Comparison Grid Template

 

 

Note: Part 3: of the Module 1: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or Talking Points Brief the you will create in a separate document. NURS 6050 Agenda Comparison Grid Template

Importance of validity and reliability in diagnostic testing or research essay

Topic 2 DQ 2

According to Gleason, Harris, Sheean, Boushey and Bruenner (2010), reliability and validity allow us to answer the question of whether the measurement process used in a study produces consistent and accurate information. If a measure is reliable, that means its value would have been approximately the same even if some aspect of the measurement had been different, such as being completed at a different time or by a different observer or rater (Gleason, et al, 2010). With a reliable measure, one can feel confident that its value is not unduly influenced by some idiosyncratic aspect of the measurement process. It is not sufficient for a measure to just be reliable. A measurement process that yields a consistent value when repeated is not useful if that value does not accurately reflect the underlying characteristic or outcome it is intended to measure. importance of validity and reliability in diagnostic testing or research essay. Thus, variables or measures used in research must be valid as well as reliable. A valid measure reflects what it is intended to reflect, and one can feel confident that there is no systematic error in this measure (Gleason, et al, 2010). Validity is the extent to which a test measures what it is supposed to measure; in other words, it is the accuracy of the test. Validity is measured by sensitivity and specificity (Parikh, Mathai and Thomas, 2008). Parikh, et al (2008) describe sensitivity as the ability of a test to correctly classify an individual as ′diseased′. The ability of a test to correctly classify an individual as
disease- free
is called the test′s specificity (Parikh, et al, 2008). The basic idea of performing a diagnostic test is to increase (or decrease) the suspicion that a patient has a particular disease, to the extent that a management decision can be appropriated. importance of validity and reliability in diagnostic testing or research essay.

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ECG analysis requires a systematic approach that includes knowledge of the patient’s age, sex, and race and presenting complaint/symptom. The abnormalities observed must be correlated with the data collected from the individual’s medical history and physical examination and from other tests performed. The interest in using computer programs to analyze ECGs has risen rapidly over the past decade. Although the programs used for computerized ECG analysis have been recognized to be imperfect, their use has become accepted as providing the less experienced physicians with an almost immediate, reasonably accurate analysis to assist them in achieving more accurate analyses (Oweis, and Hijazi, 2006). This proposed computer-aided ECG diagnostic tool in this work has made a contribution to reducing the load of analysis of the many ECGs recorded routinely. Its use actually increases physician’s accuracy in ECG analysis, saves physician time, and improves quality of patient care and leads to a reduction in the costs associated with ECG analysis (Oweis and Hijazi, 2006). The results of applying the tool on randomly selected representative sample show 99% matching with those results obtained at specialized medical facilities. The inexperienced physicians in their routine practice may benefit from the proposed diagnostic tool to get reasonably accurate diagnosis and informative backup to improve the accuracy of their analyses. importance of validity and reliability in diagnostic testing or research essay.

The gold standard is the best single test (or a combination of tests) that is considered the current preferred method of diagnosing a particular disease (Parikh, et al, 2008). All other methods of diagnosing a condition, including any new test, need to be compared against this ′gold′ standard. The gold standard is different for different diseases. The gold standard for one condition may be considered outdated or inadequate, but any new test designed to replace the gold standard 
has
 to be initially validated against the gold standard (Parikh, et al, 2008). If the new test is indeed better, there are ways to prove that; following which the new test may become the gold standard.

Gleason, P. M., Harris, J., Sheean, P. M., Boushey, C. J., & Bruemmer, B. (2010). Publishing nutrition research: validity, reliability and diagnostic test assessment in nutrition-related research. Journal of the American Dietetic Association, 110(3), 409-420. importance of validity and reliability in diagnostic testing or research essay.

Parikh, R., Mathai, A., & Thomas, R. (2008). Understanding and using sensitivity, specificity and predictive values. Indian Journal of Ophthalmology, 56(1), 45-50.

Oweis, R., & Hijazi, L. (2006). A computer-aid ECG diagnostic tool. Computer Methods and Programs in Biomedicine, 81, 279-285.

 

Explain the importance of validity and reliability in diagnostic testing or research. Describe how validity relates to sensitivity and specificity in diagnostic testing. Identify a health screen specific to a diagnostic test that is currently being debated regarding its use, recommended ages, or frequency, and discuss how validity and reliability play into this debate. What other factors should you consider when you assess the recommendations for a diagnostic test or screen? importance of validity and reliability in diagnostic testing or research essay.

 

Topic 2 DQ 2

When using a test to distinguish between individuals with normal and abnormal results, it is imperative to understand how characteristics of the disease are distributed in varying populations (Celentano & Szlko, 2019). This is why validity and reliability are so important to the success of diagnostic testing. The validity of a test is the ability to differentiate between those that have a disease and those who do not (Celentano & Szlko, 2019). The reliability of a test indicates the extent to which it is without bias and ensures dependable measurement across time and the various items of the tools given in the research (Bajpai & Bajpai, 2013).There are two key factors to validity: (1) sensitivity of the test and (2) specificity of the test (Celentano & Szlko, 2019). The sensitivity of the test is the ability to determine who has the disease. The specificity of the test is the ability to determine who does not have the disease (Celentano & Szlko, 2019).A health screen that is currently being debated is a breast exam for women, specifically a mammogram to screen for breast cancer. Young women experience a breast exam at routine women appointments, but the mammogram is not performed until the age of 45 (Pratt, 2018). New research suggests that women with specific risk factors should begin breast screenings at the age of 30, but some experts say it may not be effective for women of this age group (Pratt, 2018) importance of validity and reliability in diagnostic testing or research essay.Validity and reliability play into this debate because it is important to know what age group of women are affected are which are not. Only then will experts be able to determine whether or not mammograms will prove to be beneficial at a younger age.

Other factors that should be considered are the health risks and drawbacks associated with the test itself. One large drawback in mammography screening is breast cancer overdiagnosis and overtreatment (Kresser, 2017). For this example, it is critical for research experts to take this factor into consideration before determining whether or not to lower the age for mammograms. importance of validity and reliability in diagnostic testing or research essay.

References

Bajpai, S. & Bajpai, R. (2013). Goodness of Measurement: Reliability and Validity. Retrieved from https://www.ejmanager.com/mnstemps/67/67-1380953319.pdf

Celentano, D.D. & Szklo, M. (2019). 
Gordis Epidemiology 
(6
th
 Ed). Philadelphia, PA: Elsevier Inc.

Kresser, C. (2017). The Downside of Mammograms. Retrieved from https://kresserinstitute.com/the-downside-of-mammograms/

Pratt, E. (2018). Should Some Women Get Mammograms at 30? Retrieved from https://www.healthline.com/health-news/some-women-should-have-mammograms-starting-at-age-30 importance of validity and reliability in diagnostic testing or research essay

Financial Management in Healthcare Organizations Essay

As a health care manager, daily management tasks include financial management. Financial management includes items such as labor cost, equipment cost, and a budget that controls the operations. Operations requires management planning and control. The budget is created using the basic financial information and accounting principles information that an organization reports in its monthly, quarterly, and annual financial reports.

After learning the basics of financial statements, it is very important for a health care manager to understand the basic five areas of performance that set the financial plan for the organization Financial Management in Healthcare Organizations Essay. Define and provide an example of what the following mean:

Short-term solvency

Activity

Financial leverage

Profitability

Value

Define the following terms, and explain why they are important in a health care organization:

Current ratio

Total asset turnover

Debt ratio

Profit margins

Include a minimum of 2 reference

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Financial Management in Healthcare Organizations

Introduction

Financial management in a healthcare organization is an important aspect that determines the success of the operational activities of the facility. Any healthcare organization must thrive on sound financial management to ensure that it can finance all its administrative and operational costs. For sustainability of these facilities, a health care manager will be required to perform certain tasks on a daily basis to keep the institution operating efficiently. Financial Management in Healthcare Organizations Essay.

The key management tasks that a healthcare manager must deliver promptly include management of the financial resources of the healthcare facility. Financial management in a healthcare facility entails ascertaining all the items relating to the labor cost, equipment cost, and the operational budget. It is, however, important to note that effective operation of healthcare facilities require proper management planning and control. Financial Management in Healthcare Organizations Essay. Besides, the operational budget is created in conformity to the basic financial information and accounting principle just like other entities in different sectors of the economy

The basic areas of performance that define the performance of a healthcare facility are the profitability and efficiency ratios that must be incorporated into the organization’s financial plan. Below are the definitions and explanation of the significance of various profitability and efficiency ratios that the management of a healthcare organization must acquaint them with to achieve efficient and healthy performance.

Financial Performance Areas in a Healthcare Organization

Short-term solvency

Short-Term Solvency

This refers to a metric ratio which is utilized in the measurement of the ability of a healthcare institution to meet its debts with the inclusion of other obligations to achieve the short-term financial goals (Berger, 2008). Short-term Solvency ratio is a good indication as to whether the cash flow of a healthcare organization is self-sufficient to ensure that it meets its liabilities in both the long terms and short-term aspects. Therefore, with reference to a healthcare organization, the lower the solvency ratio it is likely to have, and the increased the probability that, the healthcare institution will default in its obligations to meet the long-term and short debts. There exist various types of short-term solvency ratios within a healthcare organization.

These include but not limited to; ratios of interest coverage, debt to equity ratios and total debt to total assets ratio. A healthcare facility operating under short-term solvency can easily finance its administrative and operational expenses with the revenue collected from the service offered without relying on insurance reimbursements and donations from other charitable entities Financial Management in Healthcare Organizations Essay. To obtain this ratio, the current assets and liabilities are key requirements. For instance, if a healthcare organization has assets amounting approximately to $20,000,000 whereas its liabilities amount to $10,000,000, the short-term solvency ratio results to 1.2.

Activity

This refers to the day to day actions which take into consideration production, distribution, and utilization of services in a healthcare setting. Therefore, the actions that will be taken to ensure that medical services are provided to meet the healthcare needs of patients will largely form the activity (McLean, 2003). The efficiency with which a healthcare organization runs its activities can be ascertained through calculation of activity ratios Financial Management in Healthcare Organizations Essay.

This involves estimation of the ability of a healthcare facility to turn its liabilities, capital and assets into either sales or cash. For the sake of efficiency and sustainability, a healthcare facility is required to increase the values of its activity ratios. Examples of activity ratios that a healthcare facility management needs to understand include accounts receivable turnover, inventory turnover, and total assets turn over. All these activity ratios are measures against the sales of the healthcare facility in terms of revenue earned from the provisions of healthcare services.

The significance of activity ratios is that they help the management of the healthcare facility to identify the best way of managing the operations of the facility for sustainability. Once the management of a healthcare facility has identified the areas that register fewer activity ratios, it takes the necessary measures to improve the values, thus increasing its sustainability. Examples of these activities include performing diagnostic tests, performing surgery, providing medication to patients’ in both inpatient and outpatient care setting among others. Financial Management in Healthcare Organizations Essay.

Financial leverage

Financial leverage in the context of a healthcare facility may also refer to the difference between the assets and liabilities of the healthcare facility (Berger, 2008).  A healthcare facility with more assets than its liabilities is said to be highly leveraged as compared to a healthcare facility that has more liabilities than assets. In this regard, a healthcare facility will require the knowledge of financial leverage to effectively manage its assets and liabilities to avoid cases of collapsing in the process of offering its services.  It is also referred to as trading on equity.

The significance of financial leverage to a healthcare facility is that it gives the entities an opportunity to monitor its assets alongside its liabilities for effective performance. Financial Management in Healthcare Organizations Essay. A perfect example is an instance whereby, a hospital utilizes cash amounting to $1,500,000 and goes ahead to borrow $ 3,500,000 for the purchase of medical equipment and supplies, amounting to a total cost of $5,000,000. Therefore, for such an instance, what is being used as financial leverage control by the hospital is $ 5,000,000 of medical supplies and equipment with its money of $1,500,000.

Profitability

Profitability in a healthcare setting refers to a measure which determines the range of the profits made by a healthcare organization relative to its size. Moreover, profitability can be well-defined as the possibility of a healthcare organization to achieve a return on investment as grounded on its resources and activities (McLean, 2003).The significance of profitability of a healthcare facility is basically the difference between the revenue earned from the healthcare services offered and the expense incurred in financing the operational and administrative overheads. Financial Management in Healthcare Organizations Essay.

A healthcare facility is obliged to operate within its limits to ensure that it remains sustainable. None the less, it has to spend less than it charges for the service so as to earn a substantial income that will be used to finance its sustainable operations in future. More profitable healthcare facilities tend to be more stable and sustainable, unlike healthcare facilities that record less profitability in their operations. For instance, when the margin of net profit of a healthcare organization is more than one, then the healthcare organization can be considered to have profitability.

Value

The financial worth of a healthcare organization, liabilities, assets and services that it provides is referred to as value (Berger, 2008). The value of a healthcare facility also refers to the total net worth of its equipment, facilities premises and other research and development projects it has initiated. It is a significant aspect of the healthcare organization because it distinguishes it from other competitors, thus allowing patients to make decisions on whether to seek medical services from it or its competitors. Values of healthcare facility depend on professional estimates done by professional with vast knowledge and experience in the healthcare environment Financial Management in Healthcare Organizations Essay.

The significance of value to a healthcare facility in promoting sustainability cannot, therefore, be ignored in any way. Majority of the healthcare facilities with high-end health equipment and facility and highly trained specialist healthcare professionals is regarded as a very valuable healthcare institution in the society. This improves the reputation of the facility; leading to more patients attended to thus more revenue earned which in turn leads to sustainable growth. As an example, the value of a healthcare organization is defined by expenses it suffers, worth of its properties and the loss or profits made in the daily provision of services.

Economic terms frequently used in finance management in a healthcare organization

Current ratio

The current ratio is defined an efficiency liquidity ratio which is used a measure in the determination of a healthcare organization to pay short-term requirements. Just as the definition depicts, the ratio only considers current assets and current liabilities as possessed by a healthcare organization (McLean, 2003) Financial Management in Healthcare Organizations Essay. The importance of a current ratio to a healthcare organization cannot be underestimated since it is the determinant of the liquidity of a healthcare organization to pay liabilities in the short term.

A healthcare facility with the high current ratio is more liquid since it can easily pay all its current liabilities with the help of its current assets. On the other hand, a healthcare facility with a lower current ratio is less liquid because its liabilities are more than its current assets and thus the facility has to rely on other sources of finance to fully settle its current liabilities. Financial Management in Healthcare Organizations Essay The significance of current ratio to a healthcare facility is that it enables the healthcare facility to effectively plan how to offset its liabilities and assents without operating out of its budget. Therefore, by the use of the current ration, a healthcare organization is in a position to estimate its ability to settle its liabilities with attention to critical financial issues that may be faced at a particular given time.

Total asset turnover

This is a financial ratio which is the determinant of the proficiency of a healthcare organization to utilize its assets in terms of generating revenue (McLean, 2003). A healthcare organization which maximizes on its available assets to ensure that more revenue is generated for the organization to facilitate its efficient performance is financially healthier in comparison to that healthcare organization which does not maximize full use of its assets to generate revenue. Financial Management in Healthcare Organizations Essay.

Total asset turnover is an indicator ratio which can be used to determine the efficiency of a healthcare organization in the deployment of its assets so as to generate revenue. A higher total asset turnover ratio is a performance indicator that a healthcare organization generates more revenue per asset. Since profit margins in a healthcare organization can also be determined by the total asset turnover, it is, therefore, possible for to determine mechanisms in which performance and general operations can be improved.

Debt ratio

Healthcare organizations incur debts just as any other well-established business organization. Therefore, debt ratio refers to a financial ratio which measures the extent of leverage of a healthcare organization. It can also refer to the total ratio of the total debts in both the short term and the long term to total assets conveyed in form of a percentage (Berger, 2008).  A high debt ratio for a healthcare organization is an indication of its high leverage which implies a great financial risk for such an organization. Alternatively, this can be denoted as the proportion of the assets of a healthcare organization which are financed by debts Financial Management in Healthcare Organizations Essay. In this manner, debt ratio can be used by a healthcare organization management to estimate its debts and plan for payment accordingly.

Profit margins

Profit margin is associated with the gains made by a healthcare organization from day to day operations in relation to expenses and revenues. It is defined as a degree of the amount by which returns made from sales exceed incurred costs irrespective of a minimum limit on the excess made (McLean, 2003). Financial Management in Healthcare Organizations Essay A healthcare with high-profit margin is more stable sustainable. It is in a position to earn more income from its operation, which can be used to improve the quality of healthcare provided.

More profitability also indicates that a healthcare facility is in apposition to finance research on chronic disease without relying on donors. The significance of profitability to healthcare facilities is, therefore, to help the organization remain afloat throughout their operations. For instance, one of the activities that take place in a hospital is dispensing of medicine at different prices. In consideration of the dispensing of a drug at a cost of $30 whose purchase price was $25, the total amount of revenue that is made from the sale of each unit of such a medicine amounts to $5. Expressing this revenue amount in terms of profit margin is equivalent to 25%. Financial Management in Healthcare Organizations Essay.

References

Berger, S. (2008). 
Fundamentals of healthcare financial management: A practical guide to fiscal issues and activities
. San Francisco: Jossey-Bass.

McLean, R. A. (2003). 
Financial management in healthcare organizations.
Clifton Park, NY:       Delmar Learning. Financial Management in Healthcare Organizations Essay

Disease surveillance DQ Essay

Topic 2 DQ 1

The CDC Division of Health Informatics and Surveillance (DHIS) supports NNDSS by receiving, securing, processing, and providing nationally notifiable infectious diseases data to disease-specific CDC programs. DHIS also supports local, state, and territorial public health departments in helping them collect, manage, and submit case notification data to CDC for NNDSS. DHIS provides this support through funding, health information exchange standards and frameworks, electronic health information systems, and technical support through the NNDSS web site, tools, and training. DHIS and the CDC programs publish statistical data based on NNDSS to support recognition of outbreaks, monitoring of shifts in disease patterns, and evaluation of disease control activities.(Centers for Disease Control and Prevention, 2019) Disease surveillance DQ Essay.

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What is monitored is done very well. The issues with gaps in information is that they ranking issues according to priority and government moneys that are used to hold up programs like this. Often government operations have strings attached that may do with trade or money we are sending over to support a country. Disease surveillance DQ Essay. Gaps in information can be as easily as this is a new priority and the resources were not available to track that information as those resources were used to track what they already are tracking.- for example – In the United States, there are data systems for specific diseases, such as the National Program of Cancer Registries; however, there is no similar system for SCD, which could determine the actual or true number of people living with SCD and how SCD affects their health. (SCD summit 2019)

The global challenge is that the rest of the world may lack seeing this tracking as a real issue or even needed at all. Many countries don’t even track the people living there, let alone keeping medical records in a national database. Often it is not a lack of wanting to it is the lack of resources and the ability to upkeep them. For example India: Although India is expected to meet the United Nations’ Sustainable Development Goals on extreme poverty in due time, a very large share of its population lives on less than $3.2 a day, putting India’s economy safely into the category of lower middle income economies. (World Economic Forum) Disease surveillance DQ Essay.

I see the world as a garden that grows wild. Some areas love the heat and others love the shade. Often you may want the benefits of one plant in one area but if you move them the conditions are not right and it down not grow. I would think that if teams were allowed to set up systems and structures of information in those areas they could gather the information they would like to have and would like to share. Issues will arise such as India has 1.6 billion people and many are not kept track of. In time it may be possible but the need will grow as the concern for the health of those countries grow.

Celentano, D. D., & Szklo, M. (2019). 
Gordis epidemiology
 (6th ed.). Retrieved from https://www.gcumedia.com/digital-resources/elsevier/2019/gordis-epidemiology_6e.php

Centers for Disease Control and Prevention. (2019). National Notifiable Diseases Surveillance System (NNDSS). Retrieved from 
https://wwwn.cdc.gov/nndss/

Goldsteen, R.L., Goldsteen, K., & Dwelle, T.L. (2015) 
Introduction to Public Health Promises and Practices
(2nd ed.). New York, NY: Springer Publishing Company. Disease surveillance DQ Essay.

 

 

Topic 2 DQ 1

The CDC’s National Notifiable Disease Surveillance System (NNDSS) was implemented in order to track cases and spread of diseases through voluntary reporting by governmental agencies (Richards, Iademarco, & Anderson, 2014). The strengths of this system are the foundation and high standards it provides, specifically by incentivizing its users to report timely and accurate information (Richards, Iademarco, & Anderson, 2014). It also aims to improve the interchange, handling, and dissemination of data used for disease surveillance (Richards, Iademarco, & Anderson, 2014). However, standardized systems such as the NNDSS also have their share of weaknesses. For example, there are numerous systems being used in addition to the NNDSS that are not robust nor integrated with one another (Richards, Iademarco, & Anderson, 2014). This can often create redundancy, reporting difficulties, and functionality concerns on the behalf of the reporting agencies using the varied systems (Richards, Iademarco, & Anderson, 2014). This calls for the need of enhanced coordination not only globally but nationally so that public health authorities worldwide can receive actionable disease data (Richards, Iademarco, & Anderson, 2014) Disease surveillance DQ Essay.

The challenges of global disease surveillance are primarily how cases are reported in developing countries and how disease is defined (Celentano & Szklo, 2019). In developing countries where certain diseases may be prevalent, it can be difficult to reach targeted areas or uphold communication with authorities positioned away from these areas (Celentano & Szklo, 2019) Disease surveillance DQ Essay. Similarly, countries may define disease differently, depending on laboratory access and the ability to obtain proper resources for disease diagnosis (Celentano & Szklo, 2019). An example of these global surveillance issues relates to the Ebola virus outbreak where some response systems in Africa were inadequate due to underqualified health care workers and mistrust for modern health care practices (Adokiya & Awoonor-Williams, 2016).

Constant efforts to improve disease surveillance has been a high priority goal for governmental bodies like the Centers for Disease Control and Prevention (CDC). In 2014, the CDC created its own Surveillance Strategy that aims to promote progress and trust amongst surveillance partners (Richards, Iademarco, & Anderson, 2014). The NNDSS was one of the outcomes of this initiative and ongoing improvement tactics for this data system are in place as an overarching part of the Surveillance Strategy (Richards, Iademarco, & Anderson, 2014) Disease surveillance DQ Essay.

References

Adokiya, M. N., & Awoonor-Williams, J. K. (2016). Ebola virus disease surveillance and response preparedness in northern Ghana. 
Global health action
, 
9
(1), 29763.

Celentano, D. D., & Szklo, M. (2019). 
Gordis epidemiology 
(6th ed.). Philadelphia, PA: Elsevier. ISBN-13: 9780323552295

Richards, C. L., Iademarco, M. F., & Anderson, T. C. (2014). A new strategy for public health surveillance at CDC: improving national surveillance activities and outcomes. 
Public Health Reports
, 
129
(6), 472-476 Disease surveillance DQ Essay.

Cost accounting for healthcare organizations Essay

Understanding basic accounting principles is imperative to the health care manager role. Reading a balance sheet and recognizing the importance of cash flow are skills that are compulsory to this function. With this in mind, discuss the following:

Discuss the most important headings in a balance sheet and what the summary numbers mean.

Explain 4-5 reasons why cash flow is important to a health care organization.

Use 2 references to validate your response. 
Validation
means that references have been used to prove your assertions and statements. Academic work is not what is thought to be true, but is what is researched to be true. Cost accounting for healthcare organizations Essay.

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The Most Significant Titles in a Balance Sheet and What the Summary Indicate

As a manager of a healthcare facility, it is important to poses the knowledge of accounting and the basic accounting principles so as to effectively discharge the functions of a healthcare manager. The understanding of the balance sheet is imperative to ensure that the assets and liabilities of the healthcare organization are properly managed and maintained in good condition. This calls for the healthcare manager to properly read and comprehend a balance sheet and recognize the significance of cash flow.

The name of the organization details the type of entity the balance sheet refers to. The title heading illustrates the type of financial statement and its significance (Finkler & Ward, 2015). The date heading illustrates the financial period the statement refers to while the unit measure illustrates the currency which the values in the balance sheet have been valued. The asset heading shows the value of all what the health care organization own while the liabilities heading shows the amount the organization owes its creditors. The stockholder’s equity heading illustrates what capital was invested into the healthcare facility by the equity owners. Cost accounting for healthcare organizations Essay.

The significance of Cash Flow To a Health Care Organization.

Cash flow statement is a statement that revelers the source of revenue of a health care facilities and the nature of expenses the cash was used to offset. Being an important document for a healthcare facility, cash flow statement will help the healthcare managers identify the exact locations where money is spent in delivering services, thus channeling funds to the areas that need more services.

Also, the statements help the healthcare organizations to cost for health care services to justify their claim for reimbursements from payers and funders (Finkler, Ward & Calabrese, 2012). This way, the healthcare managers will identify the equipment needed and lease them depending on their demand Cost accounting for healthcare organizations Essay.

Cash flow statement also helps in accelerating the mode of cash collection to finance their operating activities. It helps the health care facilities set the correct bills to identify areas that consume a huge amount of funds but face delay in payments for the services provided (Finkler & Ward, 2015). As a result, the healthcare facilities will timely bill and collect all revenue due to the organization to ensure a steady flow of cash and income. It also enables the healthcare managers to effectively negotiate contracts so that only the procedures that are beneficial to the patient and cost-effective to the organization are ordered.

Cash flow statement also helps the managers of health care facilities to deploy and distribute their healthcare equipment in departments that generate high margin. This will prevent cases of organizations holding idle equipment that, thus increasing costs of maintenance, repair and holding or storage (Young, 2013).  It is only through higher margins that a health care facility will be in a position to have a positive cash inflow to finance its daily operations and administrative expenses Cost accounting for healthcare organizations Essay.

Healthcare organization also need a cash flow statement to restructure the costs they incur in provisions of procedures that are very expensive. This allows the facilities to identify the best formula that can be used to apportion costs and claim reimbursements Finkler, Ward & Calabrese, 2012). It also allows the managers of the healthcare facilities to identify the best way of cost-sharing the expensive procedures so as to avoid locking out many patients out of the procedures. As a result, the healthcare facilities will avoid incurring losses after offering the expensive procedures since they will convince the suppliers to reduce the costs of supply.

 

References.

Young, D. W. (2013).
Management accounting in healthcare organizations
. San Francisco, CA:

Jossey-Bass.

Finkler, S. A., Ward, D. M., & Calabrese, T. D. (2012).
Accounting fundamentals for healthcare

management
. Sudbury, Mass: Jones & Bartlett Learning.

Finkler, S. A., & Ward, D. M. (2015).
Cost accounting for healthcare organizations: Concepts

and applications
. Gaithersburg, Md: Aspen Publishers. Cost accounting for healthcare organizations Essay

Endemic, epidemic, and pandemic definition essay

Topic 1 DQ 1

An epidemic is defined as the occurrence in a community or region of a group of illnesses of similar nature, clearly in excess of normal expectancy and derived from a common or a propagated source. An epidemic occurs when an infectious disease spreads rapidly to many people. (Celentano, & Szklo 2019). For example, in 2003, the severe acute respiratory syndrome (SARS) epidemic took the lives of nearly 800 people worldwide.

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Pandemic refers to a worldwide epidemic. A pandemic is a global disease outbreak. HIV/AIDS is an example of one of the most destructive global pandemics in history. Influenza pandemics have occurred more than once. A preventive measure for a pandemic is vaccinations. In addition to vaccinations, you can take other prevention steps like these: Wash your hands often with soap and water. If these are not available, use an alcohol-based hand cleaner or gel sanitizer. If using a gel, rub your hands until they become dry. (DerSarkissian, 2019) Endemic, epidemic, and pandemic definition essay.

Endemic is defined as the habitual presence of a disease within a given geographic area. It may also refer to the usual occurrence of a given disease within such an area (sometimes referred to as the “background rate of disease. Examples of endemic diseases include chickenpox that occurs at a predictable rate among young school children in the United States and malaria in some areas of Africa.

Epidemic-Dengue is an ongoing risk in many parts of Africa and the Middle East. Dengue virus disease became a nationally notifiable condition in 2010. Cases are reported to CDC by state, territorial, and local health departments. (CDC, 2019). Travelers to areas of risk should protect themselves by preventing mosquito bites. Dengue is a disease caused by a virus spread through mosquito bites. The disease can take up to 2 weeks to develop with illness generally lasting less than a week Endemic, epidemic, and pandemic definition essay.

Primary Prevention: Using Repellents to Protection against Mosquitoes bites such as EPA-registered insect repellents are proven safe and effective e. g DEET. Risk increases with the duration of travel and disease incidence in the travel destination (such as during the rainy season and during epidemics).

Secondary- A vaccine to prevent dengue (Dengvaxia®) is licensed and available in some countries for people ages 9-45 years old. The World Health Organization recommends that the vaccine only be given to persons with confirmed prior dengue virus infection. (CDC, 2019). Endemic, epidemic, and pandemic definition essay.

Tertiary prevention: There is no specific medication to treat dengue. Treat the symptoms of dengue and see your healthcare provider. Take acetaminophen (also known as paracetamol outside of the United States) to control fever and relieve pain. Do not take aspirin or ibuprofen! Fever should be controlled with acetaminophen and tepid sponge baths. Febrile patients should avoid mosquito bites to reduce the risk of further transmission.

References:

DerSarkissian, Carol. (2019). Epidemics, Pandemics, and Outbreaks. Retrieved from. 
https://www.webmd.com/cold-and-flu/what-are-epidemics-pandemics-outbreaks#1-1

Celentano, D. D., & Szklo, M. (2019). Gordis epidemiology (6th ed.). Philadelphia, PA: Elsevier. ISBN-13: 9780323552295

Centers for Disease Control and Prevention, (CDC, 2019). Dengue. Retrieved from. https://www.cdc.gov/dengue/about/index.html Endemic, epidemic, and pandemic definition essay

 

Topic 1 DQ 1

Endemic is an outbreak that occurs at a predictable rate in a certain area or among a set population. It usually remains at a steady-state, but do not disappear from a population. Chickenpox is classed as an endemic as it occurs at a high but predictable rate amongst youngsters (CDC, 2012).

An epidemic is the rapid spread of disease amongst a large number of people in a given population. During an epidemic, the disease will normally spread in two weeks or less.

There have been more 14 epidemics since 2010, including the Ebola epidemic in West Africa, which killed 11,300 people between 2013 and 2016. There are some non-infectious diseases that are presumed epidemic such as diabetes and obesity (CDC, 2012). Endemic, epidemic, and pandemic definition essay.

Pandemic is the worldwide spread of a new infectious disease that stretches over a larger area, infects more people and causes more deaths than an epidemic. There have been a number of devastating pandemics including smallpox, and tuberculosis; in 2009 a pandemic of swine flu killed 14,286 people worldwide (Steward, 2019).

Prevention, as it relates to health, is really about avoiding disease before it starts. It has been defined as the plans for, and the measures taken, to prevent the onset of a disease or other health problems before the occurrence of the undesirable health event. The three levels of prevention are:

Primary Prevention is intervening before health effects occur, through measures such as vaccinations, altering risky behaviors (poor eating habits, tobacco use), and banning substances known to be associated with a disease or health condition(CDC, 2014). Endemic, epidemic, and pandemic definition essay.

Secondary Prevention is screening to identify diseases in the earliest stages, before the onset of signs and symptoms, through measures such as mammography and regular blood pressure testing (CDC, 2014).

Tertiary Prevention is managing disease post-diagnosis to slow or stop disease progression through measures such as chemotherapy, rehabilitation, and screening for complications (CDC, 2014). Endemic, epidemic, and pandemic definition essay.

References:

Center for Disease Control and Prevention. (2012). Introduction to Epidemiology. Retrieved from

https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html

 

Steward, K. (2019). Epidemic vs Pandemic. Retrieved from

https://www.technologynetworks.com/immunology/articles/epidemic-vs-pandemic-323471

 

Center for Disease Control and Prevention. (2014). What Is Prevention? Retrieved from

https://www.cdc.gov/pictureofamerica/pdfs/picture_of_america_prevention.pdf

 

Topic 1 DQ 1

When an endemic occurs, it refers to a continuous or typical existence of a disease or infection within a certain population (Principles of Epidemiology, 2012). An example of this would be the expected spread of chickenpox amongst school-aged children before the Varicella vaccine was created. Epidemic is the opposite situation, where an often sudden increase in disease appears in a select population (Principles of Epidemiology, 2012). An epidemic example started with the Ebola outbreak in West Africa where many communities suddenly fell ill with this virus after the initial transmission that is believed to have occurred from bats. Endemic, epidemic, and pandemic definition essay One current epidemic happening in the United States is the outbreak of Escherichia coli infections in relation to Romaine lettuce. While this contamination has been reported multiple times, another recent eruption has transpired, effecting 25 states with 138 reported cases and 72 hospitalizations (Outbreak of E. coli Infections, 2019). Finally, a pandemic is an extension of an epidemic, in which the sudden spread of disease occurs over multiple countries or continents around the world (Principles of Epidemiology, 2012). Using the same Ebola outbreak as an example, a pandemic occurred when this disease was spread to multiple other continents through travel outside of the initially infected West African countries Endemic, epidemic, and pandemic definition essay.

Public health professionals have established three types of prevention for these disease outbreak classes and they are primary, secondary, and tertiary prevention. When preventing or controlling an epidemic, primary prevention can be achieved by taking action before an event occurs, such as using the Varicella vaccine to avoid chickenpox in school children. Secondary prevention involves early screening and intervention like utilizing mandatory physicals for school eligibility that take a thorough family history and vaccine records. This would identify any unvaccinated children that may be susceptible to a chickenpox incident in school. Finally, tertiary prevention is implemented to slow or stop a disease that has already begun. If a chickenpox epidemic would occur in a particular school, public health officials could utilize quarantine and treatment methods to prevent further spread to other unvaccinated children. Endemic, epidemic, and pandemic definition essay.

References

Outbreak of E. coli Infections Linked to Romaine Lettuce. (2019, December 19). Retrieved from https://www.cdc.gov/ecoli/2019/o157h7-11-19/index.html.

Principles of Epidemiology. (2012, May 18). Retrieved from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html. Endemic, epidemic, and pandemic definition essay.

HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay

Background Statement

Last Chance Hospital has been well-received by the community it serves with many patients in older age groups as compared to other hospitals within the region. The hospital is located outside San Diego, California in a densely populated area with other health facilities facing operational and financial challenges. Although Last Chance Hospital has had a financially sound history that has seen it remain independent financially over the years, recently, the hospital has started experiencing financial challenges HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay. This has prompted the management to utilize their cash reserves above what the board of trustees recommends.

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There exist numerous gaps within the human resource in the…

Last Chance Hospital—Case for Chapters 5 and 6

Last Chance Hospital (LCH) is a 254-bed, community hospital located in a small, affluent suburb just outside of San Diego, California. The hospital has historically been well-received by the local community, which demographically has a higher concentration of older age groups than most other local areas. The greater San Diego area is densely populated, and over 25 hospitals operate in the larger geographic area. Historically, LCH had always been financially sound, and had managed to remain independent as their local competitors joined larger systems. But that was then, and this is now. HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay About a year ago, Last Chance Hospital undertook a strategic planning process to encompass the next five years. At the time, the hospital was doing okay financially, but was starting to dip into their cash reserves more often than the Board of Trustees liked; LCH was in need of an ideal strategy to bring them ahead of the market before things got out of hand.

As the strategic planner for LCH, Russ Newmarket reported indirectly to the CEO, Marvelous Marvin, but his immediate boss was Courtney Graveyard—and she had a lot on her plate. LCH did not have a chief nursing officer, and as COO, Graveyard was responsible for all of the nursing departments as well as surgical services, facilities, and information technology. A nurse by background, Graveyard spent the majority of her time trying to find different ways to recruit much-needed nursing staff HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

During the development of the strategic plan, Russ called together the usual group of senior executives, Board members, and key physician leaders. He diligently developed the SWOT using their input and applying their assumptions. During his market research, Russ became aware of some patient-centric trends emerging across the country, but he was also aware that LCH had always strategically catered more to physicians due to the notion that physicians were the ones who ultimately referred patients to the hospital. Through the strategy development process, it became clear that senior management was stuck on this physician-centric mindset. Russ, ambitious and eager to make a name for himself, found and presented valid information that concurred with management’s mindset. At the end of the planning process, Marvelous Marvin felt confident that their physician-focused strategy would give them a market lead—the plan was to attract more surgeons—and increase OR volumes. Graveyard was under intense pressure from Marvelous Marvin to make sure the operating rooms were as efficient as possible to handle the planned increase in volume, as OR efficiency would be a key recruitment issue for surgeons. The LCH physician recruiter was under the gun as well. The remainder of the executive staff breathed a collective sigh of relief that their areas were not part of the strategic initiative. Russ suspected LCH needed more of a strategy than attracting new surgeons, but he convinced himself that senior management knew best HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

After the Board approved the strategic plan, Graveyard immediately met with her OR Director and charged him with increasing the efficiency of the ORs. She then turned her focus back to her first love, nursing. The physician recruiter hit the ground running, developing an elaborate plan to increase surgeon recruitment. From all appearances, LCH was on a roll. HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

Over the next several months, the OR Director was able to reduce the OR’s operating budget by 13%, a result that made Marvelous Marvin very happy. At the same time, Graveyard made great strides in increasing LCH’s exposure to and status in the nursing community, and was able to decrease the nursing vacancies by over 6%. In a time of nursing shortages, the Board was impressed with Graveyard’s results. The physician recruiter was having only moderate success at recruiting surgeons, however, and her targeted volume projections were noticeably under budget. Marvelous Marvin approved her request to increase her staff, adding approximately $250,000 to her budget line. Overall, patient volumes were steadily decreasing at what was becoming an alarming rate, and thus the financial picture for LCH was in critical condition. Marvelous Marvin couldn’t help but wonder aloud, “Why isn’t the LCH strategic plan working?”

 

CASE STUDY WRITE-UP

Prepare a written report of the case using the following format.

Background Statement

What is going on in this case
as it relates to the identified major problem
? What are (only) the key points the reader needs to know in order to understand how you will “solve” the case? Summarize the scenario in your own words—do not simply regurgitate the case. Briefly describe the organization, setting, situation, who is involved, who decides what, and so on. HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

Major Problems and Secondary Issues

Specifically identify the major and secondary problems. What are the real issues? What are the differences? Can secondary issues become major problems? Present analysis of the causes and effects. Fully explain your reasoning.

Your Role

In a sentence or short paragraph, declare from which role you will address the major problem, whether you are a senior manager, departmental manager, or an outside consultant called in to advise. Regardless of your choice, you
must
justify in writing
why
you chose that role. What are the advantages and disadvantages of your selected role? Be specific.

Organizational Strengths and Weaknesses

Identify the strengths and weaknesses that exist
in relation to the major problem
. Again, your focus here should be in describing what the organization is capable of doing (and not capable of doing) with respect to addressing the major problem. Thus, the identified strengths and weaknesses should include those at the managerial level of the problem. For example, if you have chosen to address the problem from the departmental perspective and the department is understaffed, that is a weakness worthy of mentioning. Be sure to remember to include any strengths/weaknesses that may be related to diversity issues.

Alternatives and Recommended Solutions

Describe the two to three alternative solutions you came up with. What feasible strategies would you recommend? What are the pros and cons? State what should be done—why, how, and by whom. Be specific.

Evaluation

How will you know when you’ve gotten there? There must be measurable goals put in place with the recommendations. Money is easiest to measure; what else can be measured? What evaluation plan would you put in place to assess whether you are reaching your goals?

TIP:
Write this section as if you were trying to “sell” your proposed solution to the organization. Convince the reader that your proposed solution is the best available and that it will work as planned. Make sure the goals you identify are worth the effort required to achieve them! HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

 

 

 
 

 

 

 

CASE STUDY: Report on LCH hospital Strategic Planning Process.

 

Background Statement

Last Chance Hospital has been well-received by the community it serves with many patients in older age groups as compared to other hospitals within the region. The hospital is located outside San Diego, California in a densely populated area with other health facilities facing operational and financial challenges. Although Last Chance Hospital has had a financially sound history that has seen it remain independent financially over the years, recently, the hospital has started experiencing financial challenges. This has prompted the management to utilize their cash reserves above what the board of trustees recommends.

There exist numerous gaps within the human resource in the hospital management such as the lack of a Chief Nursing Officer that is a setback to how day to day operations are held. The Chief Operating Officer; Courtney Graveyard faces challenges in overseeing nursing departments, surgical facilities, services, information technology and recruitment of nursing staff.

As the strategic planner for Last Chance Hospital, Russ Newmarket had the task of ensuring that the financial and human resource challenges starting to be experienced by Last Chance Hospital are done away with. The strategic planning team of Board members, senior executives, and key physician leaders made a decision that was physician-focused after a SWOT analysis, in an aim to attract more surgeons since majority referred patients to the health facility. However, this strategy was not the best for the meantime since market research conducted by Russ established patient-centric trends across the country.

Although the hospital was able to record reduction in OR operating budgets and vacancies in nursing, overtime, patient volumes started to decrease rapidly at a rate that was not only alarming but also had serious implications to the financial status of Last Chance Hospital. Evidently, this is a revelation that the strategic plan developed by the select committee failed to work with serious reasons thus leading to the failure of the whole system of Last Chance Hospital.

Major Problems and Secondary Issues

The major issue, in this case, is that Last Chance Hospital has begun digging into its cash reserves to finance its 5-year strategic plan. As opposed to the previous years, the hospital has stopped being financially stable and is currently operating on a financial instability that threatens its sustainability and future operations (Buchbinder & Shanks, 2013). There is also no division of labor and Graveyard, who is a nurse by profession has to discharge the duties of the Chief Operating Officer for the hospital. Instead of working as the chief unstring officer for the hospital, she is forced to spend the majority of her time thinking of how to recruit extra nurse staff for the hospital.

The hospital, through Russ also used a wrong approach in developing a strategic plan that ignored other critical areas touching on the hospital operations.  The usual group comprising of executives and physician are the ones who were actively involved in the strategic planning process, leaving out the nurses (Moseley, 2015). The physician-centric mindset took over the patient-centric trend made Russ over ambitious and more focused to make a name for himself. So instead of focusing on how best to come up with a valuable strategic plan, he worked on an idea that could capture the mindset of the management.

Lack of organization is also a major issue in this case. LCH hospital is planning on how to increase OR volumes by increasing the number of operations, the efficiency of operations and the number of surgeons, yet it goes ahead to cut the OR budget by 13%. It is clear that such a move will not work in favor of the strategic plan approved by the directors but instead hamper its implementation. All the goals of this strategic plans require additional funding for them to be achieved (Zuckerman, 2014). Thus, it is expected that once the hospital has settled on such a goal in its strategic plan, then the OR budget should be increased.

The secondary problem, in this case, is the understaffing and diversity in the hospital. It is also a secondary issue concern that the patient volumes were decreasing constantly despite the strategic planning envisaging an increase in their number due to the improved OR department.  The financial state of LCH deteriorated because the hospital lacked the revenue to fund its operations after the expansion in its strategic plan was implemented. This clearly explains the key issue in the case which is a strategic plan that is not working as planned.

The gaps noted within the human resource in the hospital management plays a critical role in ensuring efficiency in service delivery. Lack of a Chief Nursing Officer in Last Chance Hospital is not only a setback to how day to day operations are held but also a challenge to the Chief Operating Officer; Courtney Graveyard,  in overseeing nursing departments, surgical facilities, services, information technology and recruitment of nursing staff.

The difference between the major problem and the secondary problem is that the secondary problems arise from the inconveniences caused by the major problems. For instance, when the hospital fails to incorporate all key stakeholders in its strategic planning, SWOT analysis, and other decision-making processes, it basically gives room for the emergence of the secondary problems such as decreasing patients numbers and reduced revenue.

The secondary problems, in this case, have the potential of turning out to be the major problems in case they are not solved in time (Zuckerman, 2014). The staff deficiency at the hospital has the potential of causing a strained workforce that cannot deliver as per the expectation of the management. Besides, it has the potential of hindering the effective delivery of services, which will, in turn, affect the number of patients attended to and visiting the hospital. As a result, this secondary problem will lead to reduced revenue, thus putting the hospital in a finical crisis. That way, the secondary problem shall have turned out to be a major problem.

An analysis of the causes of the major and secondary problems shows that relying on assumptions and the urge to satisfy self-assertion and the top management is to blame for the problems (Zuckerman, 2014). All along, Russ did not focus on solving the real issues affecting the hospital. Instead, he focused on satisfying the mindset of the executive by recommending what was only good in their imagination. The effects of this move is that the strategic plan did not work as expected since it was impractical in totality

My Role

I would address the current problem in Last Chance Hospital as a departmental manager. I choose this role since it provides the opportunity to talk to some of the patients who seek health care services at Last Chance hospital from the Department of Clinical services hence know some of the factors that largely contribute to the decrease in patients from their shared experiences and reasons (Moseley, 2015). Advantages of my role are that I have the opportunity to interact one on one with the client hence provision of firsthand information from those affected.

The disadvantage is that, even though direct contact with the clients is facilitated, it is hard to convince a client to continue getting services at the facility when he/she has made the decision not to. In addition, since the hospital has many departments, I am not in a position to influence much change due to client dissatisfaction in another department. In this case, the protocol has to be followed, which time is consuming.

Organizational Strengths and Weaknesses

The strength of the organization is that it is strategically located in a suburb and the good reputation it has been getting from the locality. It has the diversified workforce and different department within its operations. The dense population also provides a good market for the hospital. It is therefore capable of handling any number of patients and all kinds of patient’s needs (Zuckerman, 2014). However, the organization faces weaken in understaffing, lack of sufficiency trained physicians and nurses, working on budgetary constraints and facing financial instability. This means that the hospital cannot work outside its budget nor can it operate sustainably to provide efficient services to its patients.

Alternatives and Recommended Solutions

An alternative that LCH would have considered implementing is involving all stakeholders in the SWOT analysis, strategic planning. It should also consider various market segments in its market research so as not to focus on only one market of operations but rather have a diversified market that brings on board patients with different needs. Other alternatives are the goals of increasing nurse staff, increasing the budgetary allocation for OR and the nursing staff and giving more attention to the nurse demand (Shi, 2014). Also, patient-centric needs and physician-centric demands are better alternatives that LCH can implement for success in its operations

The feasible strategy recommendation that would help improve the situation at LCH is to have a chief nursing officer take charge of the recruitment process. It is also recommended that during strategic planning, the focus must be put to the interest of the hospital with preference given to the future of the hospital. This means that personal interest, assumptions, and egos must be left out of the strategic planning process and conduct the recruitment and budgeting on a need basis. These recommendations are good because they will help seal all the gaps that made the strategic plan fail. The pros of this strategy are that it will be focused towards solving the major and secondary problems and the key issues outlined in the case of LCH. However, its cons is that will attract extra costs in terms of implementation, thus increasing the overall operational cost and budgetary allocations (Shi, 2014).

Evaluation

Performance indicators are the best way of knowing that the objective and missions of LCH have been achieved. Thus, looking at the performance indicators against the strategic plan is a good way of knowing that the hospital has indeed gotten where it had planned to be. The outcomes of the implementation undertaken by the LCH must also be compared with the initial targets and plans to measure how effective the goals have been meeting (Hillestad & Berkowitz, 2013). This will help the management to make recommendations in areas where improvement is needed. By identifying the areas that showed poor performance, a recommendation on how to correct the mistakes noticed is made. On the other hand, the areas that showed outstanding performance against the targets and goals are improved to maintain such performance.

Apart from measuring the money spent and collected from the Operation Room in the hospital, customer satisfaction, efficiency of service delivery and the number of patients served are also goals that are measurable in this case. An evaluation plan that can be put in place is a constant review, monitoring the performance and implementation of the goals and making a recommendation (In Austin, In Bentkover & In Chait, 2016).  This evaluation plan will help identify the best means of reaching the goals of the hospital as well as providing recommendations on how to overcome any challenge faced in the course of implementing the recommendations.

This proposed solution provides the best available evaluation plan that it will help the management of LCH to work as planned and achieve the goals outlined in its strategic plan. For instance, the goals of increasing nurse staff, increasing the budgetary allocation for OR and the nursing staff and giving more attention to the nurse demand, patient-centric needs, and physician-centric demands are worth the effort required to achieve them. HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

References

Buchbinder, S. B., & Shanks, N. H. (2013).
Fundamentals of Strategic Planning for Healthcare

Organizations

Hillestad, S. G., & Berkowitz, E. N. (2013).
Healthcare market strategy: From planning to

action
. Burlington, Mass: Jones & Bartlett Learning.

In Austin, J., In Bentkover, J., & In Chait, L. (2016).
Leading strategic change in an era of

healthcare transformation
.

Moseley, G. B. (2015).
Managing healthcare business strategy
. Sudbury, Mass: Jones and

Bartlett.

Shi, L. (2014).
Managing human resources in healthcare organizations
. Sudbury, Mass: Jones

and Bartlett Publishers.

Zuckerman, A. M. (2014).
Healthcare strategic planning
. Chicago IL: Health Administration

Press. HCM_3305 Last Chance Hospital (LCH) Strategic Planning Process Essay.

CDC’s Morbidity and Mortality Weekly Report (MMWR) Essay

The Morbidity and Mortality Weekly Report is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention (CDC). It is the main vehicle for publishing public health information and recommendations that have been received by the CDC from state health departments.

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CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders continue to investigate a nationwide outbreak of e-cigarette, or vaping, product use–associated lung injury. Characterizing EVALI patients who experience rehospitalization or death after hospital discharge might identify risk factors for higher morbidity and mortality. CDC analyzed national data on EVALI patients to determine the prevalence of rehospitalization and death after discharge and to identify characteristics associated with EVALI patients who require rehospitalization and those who die after discharge, compared with other EVALI patients. As of December 10, 2019, a total of 2,409 EVALI cases requiring hospitalization have been reported to CDC, as have 52 deaths CDC’s Morbidity and Mortality Weekly Report (MMWR) Essay. Among the 1,139 EVALI patients discharged on or before October 31, 2019, 31 (2.7%) were re-hospitalized after discharge, with a median of 4 days (interquartile range between discharge and rehospitalization; seven deaths occurred after discharge, with a median of 3 days, between discharge and death. Characteristics of EVALI patients who were re-hospitalized or died after hospital discharge suggest that chronic medical conditions, including cardiac disease, chronic pulmonary disease (e.g., chronic obstructive pulmonary disease [COPD] and obstructive sleep apnea), and diabetes, are risk factors leading to higher morbidity and mortality among some EVALI patients. (MMWR 2019) CDC’s Morbidity and Mortality Weekly Report (MMWR) Essay

 

These reports are both discrtiptive and analitlcal by using description and numbers. Descriptive epidemiology describes the what, where, and whys of a disease. The analitlical portion breaks down the issues into further sub catigories of existing conditions and conditions that were in addition to the current medial issues. The evaluation of the systems are needed because medicine often works backwards with information. Systems allow the medical staff to seek a direction of how the body is reacting to a specific issue and also rule out possible issues as well. Many times by having this information the medical staff can inform or rule out issues that often might be treated but in fact are wasting time on what is the real issue that needs to be treated. CDC’s Morbidity and Mortality Weekly Report (MMWR) Essay.

 

Center for Disease Control and Prevention. (2019). About the morbidity and mortality weekly report (MMWR) series. Retrieved from 
https://www.cdc.gov/mmwr/about.html 
 CDC’s Morbidity and Mortality Weekly Report (MMWR) Essay

Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study

Case Study 2:

A 36 year old woman is seen for easy fatigue for many months. She is now 24 weeks pregnant with her 3rd child in 3 years. She does not see any obstetrician and does not take any prenatal vitamins. Lately, she has developed a taste for eating ice shavings. She has no other complaint. Family and past history are negative. She does not smoke or drink. Physical examination is positive for pale conjunctiva, mild spooning of nails, and a II/VI systolic murmur at left lower sternal border. Stools are negative for occult blood. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

Labs: Complete blood count (CBC) – Hg 7.1 gm/dl, Hct 23%, WBC 5,400/mm3 (differential is normal), platelets 450,000/mm3; Mean Corpuscular volume (MCV) is 74 fl (normal 85-95 fl); Red cell Distribution Width (RDW) is 17.1% (normal 13-15).

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Please answer the following:

–       Explain the significance “tasting for eating ice” and spooning of nails.

–       What are you differential diagnoses for this patient and why?

–       What further tests would you like to do in this patient to confirm your diagnosis?

–       Based on your diagnosis, what is your therapeutic strategy for treatment of this woman’s condition?

 

Explanation of the Importance of “Tasting For Eating Ice” And “Spooning Of Nails”

The phrase “tasting for eating ice” has been used to describe the client’s craving for substances which have no nutritive value, a condition medically referred to as pica. From a medical perspective, the “taste for eating ice” is also known as pagophagia and is a symptom of iron deficiency anemia which commonly occurs among pregnant women and children Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study. In this case, iron deficiency anemia tends to develop gradually as blood is slowly lost. A person can, therefore, fail to show any signs until the stores of iron are totally depleted and the production of red blood cells is compromised (Wu, Lesperance & Bernstein, 2016).  It is at this point that patients develop fatigue and other symptoms. It is worth knowing that fatigue usually occurs due to lack of circulating hemoglobin and proteins depletion which need iron in their structural formulation. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study. However, the severity is usually dependent on the degree of anemia. Research suggests that it is the dysfunctional nature of non-hemoglobin proteins that have deleterious effects such as ice tasting (Wu, Lesperance & Bernstein, 2016).

Pica was initially renowned in the 6
th
century in a woman who was pregnant. Since this period, there are many cases related to Pica that have been reported where most patients have acknowledged behaviors such as pagophagia (ingesting ice cubes), geophagia (clay) and amylophagia (dry pasta). It should be noted that, despite the fact that pica has been noted to commonly occur among children with disabilities in development and pregnant women, it has also been observed among women and men of all ethnicities and ages. However, it is more prevalent among persons with a lower socio-economic status. According to the World Health Organization, globally, between 25-35% of cases in pica involve children, 30% are gravid women and 10-20% are persons with disabilities in learning (Auerbach & Adamson, 2016) Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

“Spooning of nails” medically known as koilonychia, is a primary characteristic of chronic iron deficiency anemia where the nails appear to have a spoon shape: thinner than usual with outer edges that have turned up. In other cases, the nail can even crack and the outer part comes out of the nail bed. In such cases, iron deficiency may be as a result of inadequate intake of dietary iron, malnutrition, intestinal bleeding or inability to efficiently absorb enough iron from the diet (Auerbach & Adamson, 2016). As in this case, it is more likely that it was as a result of multiple pregnancies within a very short period of time.  This presentation should, therefore, prompt for an immediate diagnosis of chronic iron deficiency anemia.

Differential Diagnoses for This Patient

Chronic Iron Deficiency Anemia:
the patient presented with complaints of easy fatigue which had sustained for many months and reported not to take any vitamins despite being pregnant. This patient experienced fatigue since she lacked enough red blood cells to transport essential nutrients and oxygen to vital organs of the body. Therefore, the organs worked much harder to produce the energy needed by the body (Abu-Ouf & Jan 2015). This generally translated to less energy leading to feelings of exhaustion. In pregnancy, the risk for iron deficiency anemia increases since there is an increase in the maternal requirements and demands from the developing placenta and fetus (Breymann, 2015). There is also an increase in the mass of the erythrocytes and an expansion in maternal blood volume to support the developing fetus. This is the reason pregnant mothers are highly recommended to take additional 0.9-1.0 grams of iron, which the client never did. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

The clients also acknowledged having an ice eating taste and a physical examination revealed that she was pale, had spoon-shaped nails and a systolic murmur that could be heard at the left lower sternal border. An ice-eating taste revealed the clients craving for non-nutritional substances, a condition known as pica which is a characteristic symptom of iron deficiency anemia (Auerbach & Adamson, 2016). The client’s paleness could relate to the laboratory findings of: a hemoglobin level of 7.1 gm/dl, which is way below the standard value of 11g/dl, a mean corpuscular volume of 74fl which was below the normal range of 85-95 fl and the red cell distribution width of 17.1% that had exceeded the normal range of 13-15(Auerbach & Adamson, 2016).

A low MCV and a high RDW have been associated with iron deficiency anemia. While the MCV divides the client’s anemia into micro, normal and macro whose classifications have different differential diagnoses, the RDW tends to measure anisocytosis. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study. Therefore, an MCV of 74 fl is indicative of microcytic anemia (Wu, Lesperance & Bernstein, 2016).  Since the patient had been anemic for several months and in a pregnancy state, her heart is forced to pump more blood in order to compensate for the oxygen that lacked in blood. While this is a risk for anemic heart failure, it was the reason the patient had a systolic murmur which could be heard at the left lower sternal border (Anand & Gupta, 2018).  This makes Iron deficiency anemia the most probable diagnosis for this patient.

Thalassemia
: The clinical signs and symptoms that the patient presented with were characteristic of thalassemia syndrome. However, her RDW was elevated and the MCV was low. Patients with thalassemia usually have a normal RDW and a low MCV (Wu, Lesperance & Bernstein, 2016).  Based on this explanation, a diagnosis of thalassemia is less likely.

Anemia of Chronic Disease (Renal Failure, Rheumatoid Arthritis):
The client’s clinical presentation of prolonged fatigue, ice eating taste, spoon-shaped nails, paleness, and a systolic murmur can similarly be found in anemic patients with chronic diseases. However, this patient has apparently not reported having any chronic disorders. Although her MCV was low as seen in anemia of chronic disorder, the RDW was high. In chronic disease, the RDW is always normal (Auerbach & Adamson, 2016). This excludes anemia of Chronic Disease as a possible diagnosis.

Additional Tests to Do In This Patient to Confirm the Diagnosis

To confirm the diagnosis of Chronic Iron Deficiency Anemia, further tests that I would do are as follows:

Serum Iron and Ferritin:
the serum iron test will measure the ferric ion associated with Transferrin. Under normal circumstances, the values usually range from 12.7-35.9mol (60-90g/dl). In case the serum iron levels turn out to be reduced, it may precede alterations in the morphology and indices of red blood cells (Wu, Lesperance & Bernstein, 2016). It is worth noting that, all iron transported in the body is usually bound in the ferrous form to transferrin, the corresponding iron-binding protein. Therefore, serum iron is the iron bound in transferrin. In some patients with thalassemia and Sideroblastic anemia, the concentration level of serum is always increased (Auerbach & Adamson, 2016) Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

Saturation and Total Iron-binding capacity:
iron concentration is important for the saturation of the transferring sites where iron binds. Therefore, it can be used to measure the concentration of transferrin.  The normal range is 45.2-77.7mol/L (250-410g/dl). It is worth knowing that transferring is usually 30% bound to iron, it carries 2 atoms of iron in each molecule and is a reflection of the measure of serum transferrin. Therefore, it can be measured through the saturation of all binding sites available (Wu, Lesperance & Bernstein, 2016).  The normal values for transferrin are 170-370mg/dl. The level of serum iron is usually low in patients with iron deficiency anemia, the serum iron is always low, the TIBC is high and transferrin saturation is decreased to less than 16%. In anemia of chronic disease and Thalassemias, the serum iron is always normal, the TIBC may be normal or decreased and transferrin saturation decreased to less than 16 % (Auerbach & Adamson, 2016). Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

Therapeutic Strategy for the Management of This Client

I will prescribe the client Ferrous Sulfate 325mg PO TID which is an iron supplement. She will also be prescribed vitamin supplements for the entire duration of her pregnancy and an additional 6-8months after delivery (Auerbach & Adamson, 2016). After the first 2 weeks following the initiation of these supplements, the client will have to return for a follow-up to find the reticulocyte response which will be expected to be less than 10%. Within 8 weeks, her hemoglobin will be expected to be within normal range. Even after the levels return normal, iron replacement therapy will be prolonged for the purposes of restoring iron stores in the bone marrow. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study.

 

References

Auerbach, M., & Adamson, J. W. (2016). How we diagnose and treat iron deficiency anemia. 
American journal of hematology
, 
91
(1), 31-38.

Abu-Ouf, N. M., & Jan, M. M. (2015). The impact of maternal iron deficiency and iron deficiency anemia on a child’s health.
Saudi medical journal
, 
36
(2), 146. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study

Anand, I. S., & Gupta, P. (2018). Anemia and iron deficiency in heart failure: current concepts and emerging therapies. 
Circulation
, 
138
(1), 80-98.

Breymann, C. (2015, October). Iron deficiency anemia in pregnancy. In 
Seminars in hematology
 (Vol. 52, No. 4, pp. 339-347). WB Saunders.

Wu, A. C., Lesperance, L., & Bernstein, H. (2016). Screening for iron deficiency. 
Policy Statement
, 
23
, 171-177. Iron Deficiency Anemia Essay – “Tasting For Eating Ice” and “Spooning Of Nails” case study