Ethical Dilemma at Emergency Department

Assessment 2 Instructions: Applying Research Skills • PRINT • Create a 3-5-page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you. Introduction In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the everchanging health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research a current health care problem or issue faced by a health care organization that is of interest to you. Demonstration of Proficiency By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria: • • • Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care. • Identify academic peerreviewed journal articles relevant to a health care problem or issue and describe the criteria used for the literature search. Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care. • Assess the credibility and relevance of information sources. • Summarize what was learned from developing an annotated bibliography. • Analyze academic peerreviewed journal articles using the annotated bibliography organizational format. Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards. • Summarize a health care problem or issue and describe a personal interest in it and experience with it. • • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics. Write following APA style for in-text citations, quotes, and references. Instructions Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed. For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking. 4. View the Assessment Topic Areas media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview: • Summarize the health care problem or issue. • Describe your interest in the topic. • Describe any professional experience you have with this topic. 5. Identify peer-reviewed articles relevant to health care issue or problem. • Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic. You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search. Use keywords related to the health care problem or issue you are researching to select relevant articles. ▪ o 6. Assess the credibility and explain relevance of the information sources you find. o Determine if the source is from an academic peerreviewed journal. o Determine if the publication is current. o Determine if information in the academic peerreviewed journal article is still relevant. 7. Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography: o Identify the purpose of the article. o Summarize the information. o Provide rationale for inclusion of each article. o Include the conclusions and findings of the article. o Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length. o List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography. o Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents. 8. Summarize what you have learned from developing an annotated bibliography. o Summarize what you learned from your research in a separate paragraph or two at the end of the paper. o List the main points you learned from your research. o Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic. Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: • Assessment 2 Example [PDF]. Additional Requirements Your assessment should also meet the following requirements: • Length: 3–5 typed, doublespaced pages, not including the title page and reference page. Font and font size: Times New Roman, 12 point. • APA template: Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOCX] for guidance. • Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics. • Content: Provide a title page and reference page following APA style. • References: Use at least four scholarly or academic peerreviewed journal articles. • APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page. If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, please do not hesitate to ask faculty or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions. • Resources: Research and Annotated Bibliographies • PRINT • How do you approach a problem or issue within your organization? How often do you need credible information to solve a personal or professional problem? Credible information is information that is trustworthy. One of the best sources for credible information is the professional literature of the field you are studying; in your case, health care. Professional literature is research that has been written and reviewed by other people in your field. The following resources can help you as you complete your research and seek out professional literature on a health care topic. Gennaro, S. (2016). Why write? Journal of Nursing Scholarship, 48(2), 117. • U.S. National Library of Medicine, National Institutes of Health. (n.d.). Evidence-based practice and health technology assessment. Retrieved from https://hsric.nlm.nih.gov/hsric _public/topic/evidence_based_ practice/ • Rollins, J. A. (2017). Healthcare: It’s “So complicated.” Pediatric Nursing, 43(2), 58, 102. Each of the following research guides is written with a specific program in mind. The one for your program can • provide insights about researching topics related to your field. BSN Program Library Research Guide. • Public Health Undergraduate Library Research Guide. • Health Care Administration Undergraduate Library Research Guide. The following resources provide specific information about annotated bibliographies. • • • What Not to Do: Source Material for the Annotated Bibliography. Sample Annotated Bibliography [PDF]. Ethical Case Studies Consider the ethical dilemma the health care professional is faced with in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior). Ethical Dilemma at Emergency Department

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make. View All Incident 2: Emergency Department Repeat Admissions — A Question of Resource Use Matt Losinski finished reading an article that provided grim details of a study of the overuse of emergency services in hospitals in central Texas. He smiled that sardonic half smile that meant there was a strong possibility that County General Hospital (CGH) might have the same problem. As chief executive office (CEO), Losinski always saw the problems of other hospitals as potential problems at CGH, a 300–bed, acute care hospital in a mixed urban and suburban service area in the south central United States. CGH was established as a county–owned hospital; however, 10 years ago the county wanted to get out of the hospital business and the assets were donated to a not–for– profit hospital system. The new owner has continued a strong public service orientation, even though CGH no longer receives the tax subsidy it did when it was county owned; it must look to itself for fiscal health. The study data showed that nine residents of a central Texas community had been seen in emergency departments (EDs) a total of 2,678 times over 6 years. One resident had been seen in an ED 100 times each year for the past 4 years. Given that an ED visit can cost $1,000 or more, the nine residents had consumed $2.7 million in resources. These high users of ED services were middle age, spoke English, and were split between male and female. To Losinski, the problem seemed like a manifestation of Wilfredo Pareto’s classic 80/20 rule. Losinski forwarded the article on a priority basis to Mary Scott, his chief financial officer (CFO), and asked her to see him after she read it. Scott stopped by Losinski’s office late the next day and began the conversation by asking him why he thought the article was a priority. Scott reminded Losinski that Medicaid paid 75% of costs for eligible ED users and that the cross subsidy from privately insured and self–pay ED admissions covered most of the unpaid additional costs. Losinski had a good working relationship with Scott, but he was a bit annoyed by her rather indifferent response. Losinksi wanted details on use of the ED at CGH. Ethical Dilemma at Emergency Department

He asked the administrative resident, Aniysha Patel, to gather data to identify use rates for persons repeatedly admitted to the ED. The findings that Patel gave to Losinski two weeks later were not as extreme as those reported from central Texas; however, they did show that a few persons were repeatedly admitted to the ED and accounted for hundreds of visits in the past year. The clinical details were not immediately available, but a superficial review of the admitting diagnoses suggested that most admissions involved persons with minor, nonspecific medical problems—persons commonly known as the “worried well.” Although Scott was correct that Medicaid covered the majority of costs, the fact remained that over $200,000 each year was not reimbursed to CGH. Were that money available, it could go directly to the bottom line and could be used for enhancements to health initiatives for the community. In addition, repeated admissions to the ED contributed to crowding, treatment delays, and general dissatisfaction for other patients. Losinski presented the data to his executive committee, which includes all vice presidents, the director of development, and the elected president of the medical staff. The responses ran the gamut from “So what?” to “Wow, this is worse than I imagined.” Losinski was bemused by the disparity of views. He had thought there would have been an almost immediate consensus that this was a problem needing a solution. The financial margins for CGH were already very thin, and the future for higher reimbursement was not bright. A concern echoed by several at the meeting was the requirement of the federal Emergency Medical Treatment and Active Labor Act (EMTALA) that all persons who present at an ED that receives federal reimbursement for services must be treated and stabilized. Losinski asked his senior management team for recommendations to address the problem of ED overuse. Running head: APPLYING RESEARCH SKILLS Applying Research Skills Learner’s Name Capella University Developing a Health Care Perspective Applying Research Skills February, 2018 Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. 1 Comment [A1]: You effectively used the APA Template paper format. APPLYING RESEARCH SKILLS 2 Applying Research Skills With the advent of new technologies and treatment methods, health care organizations are facing many challenges. Patient safety is one such challenge that needs to be addressed not only by health care professionals but also by other stakeholders in the business. Ensuring patient safety is essential for providing quality health care. As a medical transcriptionist, I am responsible for converting voice-recorded reports of health care professionals into text. Although I am not directly involved in treating patients, any errors that occur during the transcription process could result in inaccurate documentation of medical data. For example, one of my colleagues documented the dosage of Lasix as 400 mg instead of 40 mg in a discharge summary. When the health care professional who had dictated the report reviewed it, he was able to spot the error in the dosage and correct it, which helped prevent the patient from having a dangerous reaction to the incorrect dosage. This incident helped me realize the importance of preparing accurate documents for ensuring patient safety and delivering quality care. I developed a keen interest in issues relating to patient safety ever since. Ethical Dilemma at Emergency Department

Identifying Academic Peer-Reviewed Journal Articles Using Summon, Capella University Library’s search engine, I accessed databases relating to health care, such as ProQuest Central and PubMed Central. I used keywords such as health care issues, patient safety, and quality of care to search for peer-reviewed literature relevant to patient safety. Using the advanced search option, I limited my search to scholarly and peerreviewed journals, choosing journal article as the publication type, medicine and nursing as the subjects, and articles published within the last five years as the publication date range. Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. Comment [A2]: You effectively summarized a health care problem and described an interest in the topic, and provided an informative example. APPLYING RESEARCH SKILLS 3 Assessing Credibility and Relevance of Information Sources Comment [A3]: Sub-headers are a helpful resource to use to organize your writing! To ensure credibility, I selected peer-reviewed journal articles that were published within the past five years. I made sure that the selected sources were published by authors who were well-known in the field of health care and had extensive professional experience. Comment [A4]: As you noted, it is best to select current peer-reviewed academic journal articles to ensure current practices. To ensure that the chosen sources of information were relevant to the topic, I confirmed that they contained accepted facts and opinions on issues relating to patient safety and quality care. I also checked whether each information source had a clearly defined purpose and contained pertinent information about patient safety and quality care. Annotated Bibliography Kronick, R., Arnold, S., & Brady, J. (2016, August 2). Improving safety for hospitalized patients: Much progress but many challenges remain. The JAMA Network, 316(5), 489–490. Retrieved from https://jamanetworkcom.library.capella.edu/journals/jama/fullarticle/2528945 This article provides a viewpoint on the progress that hospitals have made toward reducing patient harm and understand the factors that have led to this progress. The authors cite reports released by the Agency for Healthcare Research and Quality (AHRQ) and the National Healthcare Safety Network (NHSN) to analyze the occurrence of issues relating to patient safety in hospitals. The authors hypothesize that improvement in health care safety for hospitalized patients may have been possible because of reasons such as an awareness of the importance of improving safety culture with evidence-based suggestions. The authors conclude by expressing the need for finding ways to maintain or accelerate the rate of decline in adverse events relating to patient harm. They believe that Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. Comment [A5]: In your annotation, you effectively identified the purpose of the article. APPLYING RESEARCH SKILLS 4 investing in patient safety research programs and ensuring that patient safety remains a high priority for hospital leadership teams can help reduce the number of adverse events. This article is relevant to patient safety because it examines evidence of reduction in patient harms in hospitals and offers approaches to reduce such harms. Morris, S., Otto, N. C., & Golemboski, K. (2013) Ethical Dilemma at Emergency Department

. Improving patient safety and healthcare quality in the 21st century—Competencies required of future medical laboratory science practitioners. Clinical Laboratory Science, 26(4), 200–204. Retrieved from https://searchproquestcom.library.capella.edu/docview/1530677721/fulltextPDF/CF6F9C5B900402CPQ/1?acc ountid=27965 In this article, the authors express their concern about health care professionals, particularly medical laboratory science (MLS) practitioners, being insufficiently trained to achieve the five core competencies that the Institute of Medicine (IOM) identified in 2002. The authors discuss ways to incorporate patient safety practices and concepts in the MLS curricula to ensure that future MLS practitioners are well-versed in the abovementioned competencies identified by the IOM. The authors conclude that by focusing on the aims and competencies identified by the IOM, future practitioners will be better equipped to deal with patient safety concerns while practicing MLS. This article was chosen because it offers a solution for dealing with patient safety issues and explains how patient safety concepts can be incorporated in the curricula for courses pertaining to Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. Comment [A6]: In your annotation, you clearly summarized the main argument and the topics covered. APPLYING RESEARCH SKILLS 5 health care, such as MLS, to enable future health care practitioners to provide effective health care. Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality and patient safety: A systematic review. BMJ Open, 4(9). http://dx.doi.org/ 10.1136/bmjopen-2014-005055 This article provides a systematic review of available empirical literature to understand how health care managers are involved in delivering quality health care and ensuring patient safety. Based on the literature review, th … Ethical Dilemma at Emergency Department