After studying the course materials located on Module 7: Lecture Materials & Resources page, answer the following:

1. Cure / care: compare and contrast.
2. Basic care: Nutrition, hydration, shelter, human interaction.
   • Are we morally obliged to this? Why? Example
3. Swallow test, describe; when is it indicated?
4. When is medically assisted N/H indicated?
   • Briefly describe Enteral Nutrition (EN), including:
     • NJ tube
     • NG tube
     • PEG
   • Briefly describe Parenteral Nutrition (PN), including:
     • a. Total parenteral nutrition
     • b. Partial parenteral nutrition
5. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
6. Case Study: Terry Schiavo (EXCEL FILE on Module 7: Lecture Materials & Resources page). Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not?
7. Read and summarize ERD paragraphs #:  32, 33, 34, 56, 57, 58.

Submission Instructions:

•  is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
• If references are used, please cite properly according to the current APA style. 

Using the DMAIC model of Six Sigma, discuss a recent process improvement model in which you were involved with in your role as an assistant director of nursing at your long-term care facility. Define the project, explain how data was measured and analyzed. Discuss improvement methods employed and if the process improvement was controlled or hardwired.

 Due 9/24/23    4 pm EST 

• For this assignment, you must complete a matrix table for three research articles (see template provided below).
• You will be identifying the following to complete the table:
  • Articles/reference (in APA format)
  • Purpose of the article/Study question
  • Variables (i.e. independent vs dependent)
  • Study design: Quantitative/Qualitative/Mixed
  • Sampling
  • Methods
  • Instruments
  • Findings/Result
• You will be identifying the concepts being explored in the study: the “what” of the study, the methods or the “how” of the study, participants in the study or the “who,” along with the instruments/tools used in the study to collect data, i.e., surveys, interviews, etc.
• Lastly, you will state the findings of the study.
• Remember, the studies should support your ideas and should be less than five (5) years old.
• They should not be from the Web, but from the library databases. Use the resources found in the library.
• In addition, you must follow APA 7th edition guidelines when documenting the reference in the first column.
• Please use, at minimum three scholarly references for this assignment.

USE THIS TOPIC AND ARTICLES

Topic and 3 articles that were used previously TOPIC:  Healthcare Equity among the Elderly in Europe · Article 1: “ Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. “The article evaluates the various interventions on health equity, impact on health outcomes, healthcare access, and reductions in health disparities.· Article 2: “Evaluating Policy Reforms for Healthcare Equity Among the Elderly in Europe”It investigates the impact of policy reforms on health disparities and access to healthcare services.· Article 3: “Socioeconomic Factors and Health Outcomes Among European Elderly: A Critical Analysis of Healthcare Equity Policies”It critically examines the role of socioeconomic factors in healthcare equity and disparities. 

Maria Hernandez

Main Post:

H.R. 977- Patient Access to Higher Quality Health Care Act of 2023.

 

Description: When a patient has health insurance, depending on which premium, they are made to use providers or hospitals that are “in-network” to avoid higher costs of services. This can often be an issue for patients because some providers are not in network with their health insurance, specifically Medicare recipients. The Patient Access to Higher Quality Health Care Act would “repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals” (Congress.gov, 2023).

Background: According to the American Hospital Association, “For decades, the Ethics in Patient Referrals Act (“Stark Law”) has protected the Medicare program from the inherent conflict of interest created when physicians self-refer their patients to facilities and services in which they have a financial stake” (AHA, n.d.). At one point, physicians were allowed to make referrals to hospitals with ownership within the entire facility; this gap was closed in 2010 when the Affordable Care Act was passed.  

Social Determinant: One social determinant is access to health care and quality care. Patients, regardless of their socioeconomic status, should receive high-quality care. The American Hospital Association states, “The Government Accountability Office (GAO), the Centers for Medicare & Medicaid Services and MedPAC all found that physician-owned hospitals’ patients tend to be healthier than patients with the same diagnoses at general hospitals” (AHA, n.d.). This would lead those with serious illnesses to rely on general hospitals for healthcare services.

Evidence: The growth of Physician-owned hospitals was prohibited in 2010 after the passing of the Affordable Care Act. According to Ehrenfeld, “a systematic review of 30 years of research demonstrating that physician-owned specialty hospitals or so-called “focused factories” offer higher-quality care at comparable or lower cost, while physician-owned community hospitals are no worse than their counterparts” (Ehrenfeld, 2023). If H.R. 977 is passed into law, it would allow physicians of physician-owned hospitals to extend their services to the community by opening new hospitals that would provide high-quality, efficient care and be affordable to patients. This would place competition against general hospitals at risk of losing market share, leading them to reform their services to stay in competition. This would benefit patients in being able to seek assistance in a variety of hospital or hospital-owned facilities. 

 

References:

American Hospital Association. (n.d.). Fact sheet: Physician self-referral to physician-owned hospitals. https://www.aha.org/fact-sheets/2023-02-27-fact-sheet-physician-self-referral-physician-owned-hospitals

Congress.gov. (n.d.). H.R.977 – 118th Congress (2023-2024): Patient Access to Higher Quality Health Care Act of 2023. https://www.congress.gov/bill/118th-congress/house-bill/977?q=%7B%22search%22%3A%5B%22HR+977%22%5D%7D&s=1&r=1

Ehrenfeld, J. M. (2023, August 10). End restrictions on physician-owned hospitals to expand Quality Care. American Medical Association. https://www.ama-assn.org/about/leadership/end-restrictions-physician-owned-hospitals-expand-quality-care