Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.

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Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.

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Assessment 2 Instructions: Ethical and Policy Factors in Care Coordination

● Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the

● coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation, with audio, intended for that audience. Create a detailed narrative script or speakers notes for your presentation, 4-5 pages in length.

● ***Provide a prompt to read from for presentation****

Preparation

Your nurse manager at the community care center is well connected and frequently speaks to a variety of community organizations and groups. She has noticed the good work you are doing in your new care coordination role and respects your speaking and presentation skills. Consequently, she thought that an opportunity to speak publicly about contemporary issues in care coordination would be beneficial for your career and has suggested reaching out to a community organization or support group to gauge their interest in hearing from you, as a care center representative, on a topic of interest to both you and your prospective audience.

You have agreed that this is a good idea and have decided to research a community organization or support group that might be interested in learning about ethical and policy issues related to the coordination of care. Your manager has suggested the following

community organizations and support groups, but acknowledges that the choice is yours.

● Homeless shelters. ● Local religious groups. ● Nursing homes. ● Local community organizations (Rotary Club or Kiwanis Club).

To prepare for this assessment, you may wish to:

● Research your selected community organization or support group.

● Review the Code of Ethics for Nurses With Interpretive Statements and associated health policy issues, specifically, the ACA.

● Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.

● Allocate sufficient time to rehearse your presentation before recording the final version for submission.

Instructions

For this assessment:

● Choose the community organization or support group that you plan to address.

● Develop a PowerPoint with typed speaker notes (the script for your voice recording) and audio voice-over recording, intended for that audience. Video is not required.

Note: PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature or you may choose to submit a separate document. See Microsoft Office Software for technical support about the use of PowerPoint, including voice recording and speaker notes.

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For this assessment, develop your presentation slides and speaker notes, then record your presentation. You are not required to deliver your presentation to an actual audience.

Presentation Format and Length

You may use PowerPoint (recommended) or other suitable presentation software to create your slides and add your voice over. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.

Be sure that your slide deck includes the following slides:

● Title slide. ○ Presentation title. ○ Your name. ○ Date. ○ Course number and title.

● References (at the end of your presentation).

Your slide deck should consist of 10-12 slides, not including a title and references slide with typed speaker notes and audio voice over. Your presentation should not exceed 20 minutes.

Create a detailed narrative script for your presentation, approximately 4-5 pages in length.

Supporting Evidence

Cite 3-5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.

Grading Requirements

The requirements outlined below correspond to the grading criteria in the Ethical and Policy Factors in Care Coordination Scoring Guide, so

be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

● Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.

○ Provide examples of a specific policy affecting the organization or group.

○ Refer to the assessment resources for help in locating relevant policies.

○ Be sure influential policies include the Health Insurance Portability and Accountability Act (HIPPA).

● Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination.

○ What are the implications and consequences of specific policy provisions?

○ What evidence do you have to support your conclusions? ● Assess the impact of the code of ethics for nurses on the

coordination and continuum of care. ○ Consider the factors that contribute to health, health

disparities, and access to services. ○ Consider the social determinants of health identified in

Healthy People 2020 as a framework for your assessment. ○ Provide evidence to support your conclusions.

● Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included for a proficient score; both speaker notes and the audio voice over are included for a distinguished score.

○ Present a concise overview. ○ Support your main points and conclusions with relevant

and credible evidence.

Additional Requirements

Before submitting your assessment, proofread your presentation slides and speaker notes to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your presentation.

RESOURCES:

Policy and Ethics

As you read the following, consider how policy and ethics relate to your current role and the role of the care coordinator.

● Bower, K. A. (2016). Nursing leadership and care coordination: Creating excellence in coordinating care across the continuum. Nursing Administration Quarterly, 40(2), 98-102.

● Collins, B. L. Saylor, J. (2018). The Affordable Care Act: 8 years later. Nursing Management, 49(8), 42-48.

● Connor, J. A., Antonelli, R. C., O’Connell, C. A., Bishop Kuzdeba, H., Porter, C., & Hickey, P. A. (2018). Measuring care coordination in the pediatric cardiology ambulatory setting. Journal of Nursing Administration, 48(2), 107-113.

● Lamb, G., Newhouse, R., Beverly, C., Toney, D. A., Cropley, S., Weaver, C. A., Kurtzman, E., Zazworsky, D., Rantz, M., Zierler, B., Naylor, M., Reinhard, S., Sullivan, C., Czubaruk, K., Weston, M., Dailey, M., Peterson, C., & Task Force Members. (2015). Policy agenda for nurse-led care coordination. Nursing Outlook, 63(4), 521-530.

● Townsend, C. S., McNulty, M., & Grillo-Peck, A. (2017). Implementing huddles improves care coordination in an academic health center. Professional Case Management, 22(1), 29-35.

● Zolotorofe, I., Fortini, R., Hash, P., Daniels, A., Orsolini, L., Mazzoccoli, A., & Gerardi, T. (2018). Return on investment for

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https://www-sciencedirect-com.library.capella.edu/science/article/pii/S0029655415001839?_rdoc=1&_fmt=high%20_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y
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the baccalaureate-prepared RN in ambulatory care. JONA: The Journal of Nursing Administration, 48(3), 123-126.

Ethics and Community Care

As you read the following documents, focus on how ethics impacts community care, and consider the cultural implications.

● American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. ********* Review this one

● Magelssen, M., Gjerberg, E., Lillemoen, L., Førde, R., Pedersen, R. (2018). Ethics support in community care makes a difference for practice. Nursing Ethics, 25(2), 165-173.

Activity: Vila Health: Ethical Decision Making**** PLZ READ AND REVIEW

Content

● Vila Health: Ethical Decision Making

Ethics is essential to the care provided by nurses. As has been stated, nursing is the most trusted profession. Nurses have a responsibility to the Florence Nightingale Pledge, the International Code of Ethics for Nurses, and the American Nurses Association (ANA) Code of Ethics for Nurses to provide care in a manner that is ethical and promotes public trust.

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Because care coordination is such an involved and personal process, wherein the nurse is integral to the patient’s unique background and health needs, the nurse must act in an ethical manner that supports patient care.

A Tale of Two Babies ● At St. Anthony Medical Center, a large hospital in Minneapolis,

Minnesota, two women have been in labor for most of the day in the Labor and Delivery unit. Anna Jiang and Brittany Clinton, two nurses who are involved in both patients’ care, talk outside the birthing center after both births are complete.

● Two nurses talk outside the birthing center after their patients’ births are complete.

● Anna Jiang: How’s Crystal doing? ● Brittany Clinton: Okay, I guess. I mean, medically, just fine. But

this is her eighth child! And she already can’t afford the other seven. She works at Walmart and her husband is a police officer, and they are just pushed to the limit. How about Elizabeth?

● Jiang: [Sighs] She’s fine, but the baby isn’t. She lived for about 14 minutes. She was in respiratory distress right from the beginning and they just couldn’t get her stabilized.

● Clinton: Oh, that’s so sad. This was her first, wasn’t it? ● Jiang: It was. She’s sleeping now but she’s got a hard road

ahead of her. She wanted that baby so much, and it’s going to take awhile to get used to the fact that she’s not going home with her.

● Clinton: It’s such a shame. Meanwhile, Crystal is going home with a baby she’s just not excited about. I saw the crowd waiting for Elizabeth. But Crystal was alone—not even her husband came in with her! It’s a really awful thing to say, but I’ll bet Crystal would change places with Elizabeth in a heartbeat.

● Jiang: Wait a minute! What if she could? If she’s really not that invested, what if Elizabeth adopted Crystal’s baby?

● Clinton: Whoa. I didn’t even think of that! ● Jiang: I’ll bet it wouldn’t be hard to get all the paperwork

coordinated for them. If they agree, I mean. Wouldn’t that be amazing if it worked out? It’s such a win-win!

The proposal is made to both mothers, and the adoption proceeds. But a week after the adoption is initiated, the hospital’s Ethics Committee meets to discuss what happened. While the two mothers both seem satisfied and no questions about their medical treatment have been raised, the committee wants to consider whether proposing the adoption was ethical.

She looked so relieved when we suggested this to her. I have to say, when I saw that, I felt like we’d really taken a bad situation and turned it into a good one.—Nurse Manager

But this woman was vulnerable in more than one way. We know she’s living near the poverty line, but what do we know about her husband? The other children? What’s going to be the effect on them, and what might happen to her as a result?—– Pt Advocate

I know this will sound strange coming from me, but what about the hospital’s liability if the mother who adopted changes her mind? This won’t be an easy situation to unravel if either mother decides that (a) she made the wrong decision and (b) the hospital put her in a position of making that decision when she wasn’t able to.——Chaplin

I’m equally concerned about the mother whose baby died. She may be in better shape economically, with a better support system, but she had such a serious loss that she may or not be able to grieve appropriately. She may feel guilty about replacing her own baby with another one, or resent the baby she adopted, or both. And she was in

an emotional state too, following the loss. Are we sure that she was in a mental state that would enable her to make an informed decision—Social Worker

The first thing that troubles me about this is the woman who gave up her baby. Was there an effort made to assess her emotional state? Her ability to make such a significant decision while recovering from delivery?—VP

Who Gets Dialysis?

In a dialysis unit at St. Anthony Medical Center, all slots for treatment are taken for the day except one. Two patients come to the hospital through the ER, and it’s determined that each would benefit from dialysis. But there’s only one spot for dialysis left.

Two health care professionals discuss who to prioritize for dialysis.

Emilio Boggio: Denise, we’ve got a problem.

Denise McGladrey: Okay, tell me about it.

Boggio: I’ve got two patients here that the ER sent up for dialysis. Margaret Fitzgerald is 65, she had a kidney transplant 20 years ago, and she’s in acute kidney failure secondary to transplant failure. I’ve also got Bob Karnow, also 65. He contracted rhabdomyolysis after he ran a marathon, and developed acute kidney failure.

McGladrey: What’s our time frame?

Boggio: They’re similarly acute.

McGladrey: Nearby hospitals?

Boggio: I’ve been calling around. Nope.

McGladrey: I’d be inclined to go with the one who has children…

Boggio: …but they both have children.

McGladrey: Any chance one of them is a career criminal?

Boggio: Funny. Fitzgerald is a philanthropist and serves on a couple of nonprofit boards. Karnow is a grocery store manager. But we wouldn’t really make the choice based on their profession, would we?

McGladrey: Well, let’s get back to medical matters. Which of them is most likely to survive if they get dialysis?

Boggio: Karnow probably is in better overall health, what with the marathon running, but Fitzgerald isn’t in poor health. I guess on the whole I’d say Karnow has the better prognosis.

McGladrey: Based on what?

Boggio: Uh, we don’t know why Fitzgerald’s transplant kidney failed. But it may be an underlying pathology that would undercut the effectiveness of the dialysis. On the other hand, rhabdomyolysis is reversible, so I think he’s got a better shot at stabilization and recovery.

McGladrey: Wait. Do they both want dialysis? What do the patients say?

Boggio: Hm. They both want to live, of course. But I’d say Karnow was a bit less enthusiastic. It’s hard to tell, because he might just be somewhat depressed from his diagnosis. But I got the feeling he was reserving judgment on what he’d do if he had to stick with the dialysis long term. He said, “That’s not much of a life for a marathon runner.”

McGladrey: They both have other family, I’m assuming?

Boggio: Yep. Fitzgerald is married, two children, three grandchildren. Same number of children and grandchildren for Karnow, but he’s divorced.

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