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28 Sep 2019

Evaluate one countryâs health system â

a. How does this country provides health care to their people?How do they finance the system? Does the way their finance thesystem corresponds with better service quality? Or better access toservices? Do they have enough resources: money, workforce, andfacilities?

b. What are the key problems/ challenges of this country interms of health? What are their current strategies to alleviate theproblems?

c. What are ways to propose to this country? Why?

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Lelia LubowitzLv2

28 Sep 2019

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I will like you do grammar check, and rewrite it in another form. This is to avoid plagirsm. Thank you.

The purpose of this research is to explain some advantages and disadvantages of the implementation of the electronic medical record in a general hospital and specific units such as Neonatal intensive care unit. Also, it will emphasize different challenges that physician face when using the eMR as well as some solutions they offered in order to help them to overcome the challenge of typing. Most importantly, it will focus on the beneficial use of the eMR such as reduced time when charting specially in nursing as they spend a lot of time when documenting, it will reduce the time in half when using electronic medical record. Also, the research will review how the electronic medical record can enhance the quality of care to the patient. The electronic medical record will provide all the information needed by the physicians or any health care provider when giving care especially the critical patient who needs a quick intervention. This reseach will provide some information on how the eMR can improve quality of care. On the other hand, it will be discussed how the use of eMR can affect the relationship between a health care provider and the patient. As we know, health care providers have to keep a professional but close relationship with their patients in order to provide care and give the best intervention. However, when a health care provider uses electronic medical record some information might be lost when typing from a paper-based system into the eMR. The journals discuss multiple solutions to overcome and to reduce the risk of losing important information of our patient when typing or scanning the information into the eMR. Ventura, M.L., Battan, A.M., Zorloni, C., Abbiati, L., Colombo, M. Farina, S., & Tagliabue, P. (2011). The electronic medical record: pros and cons. The journal of maternal- fetal and neonatal medicine, 24(1), 163-166. doi: 10.3109/14767058.2011.607582 In this journal, researchers want to implement an electronic medical record in a neonatal intensive care unit. This system will enhance critical patientâs treatment because it will implement bedside clinical observation with machine monitoring data, and results from the laboratory. The time of charting for nurses was reduced but medical staff complained about the lack of automation in the reports. Through this journal researchers demonstrate that even though electronic medical record is beneficial because it reduces the charting time, it also can increase the risk for system error which can be fatal for the patients. In conclusion, electronic medical record should be reviewed for any complication that can influence patientâs life. Fox, G. S. (2014). The people versus the electronic medical record, last Thursday. Acad Pshychiatry, 38, 368-372. doi: 10.1007/s40596-014-0042-x In this journal, physicians express their concern about the use of electronic medical record. Physicians believe that the use of technology interferes with the face to face discussion between patients and doctors. Physician stated that the essential and precious communication has been diminished for both care givers and patients. Indeed, I believe with the use of electronic medical record, the lack of interaction and eye contact between the care giver and patient is increasing. This journal is really relevant within the nursing profession because it raises awareness of how important it is to keep the essential of communication between patients and health care providers. In brief, health care providers should find other way to obtain and record patient information to support the doctors and patient relationship. Ossoff, R. H., Thomason, C. D., & Appleton, J. (2010). Challenges with the electronic medical record. Journal of Health Care Compliance, 12(6), 51-54. Retrieved from http://search.proquest.com/docview/822639350?accountid=3455 The authors in this article examine the different challenges that doctors are facing with the use of electronic medical record. Firstly, physicians have to take training to learn how to use the system. However, to overcome the challenge of typing, physicians proposed an idea of creating well detailed templates that list all organs systems. Indeed, templates should be used just as a baseline of information, to help the users to remember the key elements while adding the patientâs information. This is a good point in documentation because even though templates are easier to fill out, medical staff should keep in mind that documentation should be well detailed. Although the templates might be well detailed, it is better to write your own finding when assessing a client. As the authors mention, templates should be used only as a baseline information. The population of interest regarding this journal will be health care providers and people that might want to go into the health care profession. Perez, S., & Keijzers, G. (2012). Missing data in the electronic medical record. Emergency medicine Australasia, 24 (4), 465. doi: 10.1111/j.1742-6723.2012.01564.x The authors of this research explain the problems that caused the transition from paper-based system to electronic medical record. With the implementation of the eMR all paper-based data are scanned into the eMR using pdf files and then destroyed. This caused many missing information in the eMR because they were destroyed before being verified in the eMR. Some solutions were addressed in this journal including; depositing the data collection sheets and separating them from the medical charts and placing them in the data collection boxes. This might decrease the loss of a patientâs important information. In brief, this journal addresses a very important topic about the importance of completely transferring the patientâs information into the eMR. Also, it creates an awareness to keep paper documentation even though the eMR is present. Hoffman, M.A., & Williams, M.S. (2011). Electronic medical records and personalized medicine. Hum genet, 130, 33-39. doi: 10.1007/s00439-011-0992-y The authors emphasize two important aspects of a fully functional electronic medical record. Firstly, it is necessary to present patients or clinicians with a high quality context detailed information when providing care. Secondly, the users must combine clinical information from different sources in order to guide the clinician to improve intervention for a given patient. According to this journal, the use of electronic medical record can increase quality of providing care. As health care professionals our main goal is to provide the best intervention to our patient and this journal proved that the use of eMR can improve the intervention given to the patient. This is because it can give doctors a quick access to patientâs information in a critical scenario or even when just proving care.

plumplatypus115

Case Study

Skolnikland is in Eastern Africa, with a population of 30 million people. The country has a plains region, a hill region, and a region with high mountains. It has a number of ecosystems. The plains are dry for much of the year, there is some rainforest, and the rest of the country includes both hills and mountains. There are two seasons of heavy rainfall.

The citizens come from several ethnic groups that tend to live in their own regions and speak different languages. The ethnic groups largely follow one of three different religions. The large cities are mixed ethnically. One ethnic group is economically and socially very dominant. The people from this group live in the capital and most of the large cities. The national language is the language of this dominant ethnic group.

According to World Bank criteria, Skolnikland is among the poorest countries in the world. The economy has been growing at about 4% per year on average over the last decade, but the economy had very slow economic growth in the decades prior to that. The richest 10% of the population controls 80% of the national income.

About 80% of the people live in rural areas and 20% in urban areas. The number of people living in urban areas has been growing recently at an increasing pace. Most people earn their livelihood in agriculture but there is an increasing garment manufacturing industry in the two largest cities. There are also a number of mining industries. In addition, other export industries are beginning to grow, mostly focused on the export of commodities to China.

The total fertility rate is about 4.5 but it has been declining slowly over the last two decades, from over 6. There is an almost equal number of men and women in the population. Infant mortality is about 90 per 1,000 live births. Maternal mortality is about 500 per 100,000 live births. Thirty-five percent of the children are underweight for age.

The adult literacy rate is about 40%. The educational enrollment rate, especially for girls at the primary and secondary levels, has been growing slowly, but steadily. Most recently, this rate has been growing at an increasing pace and about 75% of the girls now attend school regularly, although many of them are of very low quality.

Only about 50% of citizens have access to safe water. Only about 30% have access to sanitary disposal of human waste.

HIV prevalence is 7% of the adult population. The number of new HIV cases annually has begun to plateau. About half of the people eligible for treatment for HIV are on treatment. Malaria is rampant in the plains.

Investments in the road system have been growing at a solid pace in the last decade and the use of private automobiles has begun recently to increase more rapidly.

Skolnikland has a pluralistic health system that is made up of public and private institutions, publicly financed providers, licensed private providers, unlicensed medical practitioners, and traditional healers. There is no health insurance, except for some free services for the poor in the few publicly financed hospitals, which the better off people do not attend. The health system is not very effective or efficient and is generally of low quality. The HIV, TB, and malaria programs are not effective or efficient and they are just beginning to adopt paradigms for services that follow global best practices.

QUESTION 11

If you were interested in investing in maternal and child health using a results-based financing scheme, which program is the most appropriate?

A. Invest in training more skilled birth attendants in a village.

B. A plan to give the local clinic in the village a grant after the clinic demonstrates that its efforts have led after two years to lower under-5 child mortality.

C.Provide all pregnant women in the village with a full course of antenatal vitamins.

QUESTION 12

In Skolnikland today, approximately what proportion of the burden of disease, measured in DALYs, is likely to be Group I-related?

A. 45%

B. 35%

C. 60%

QUESTION 13

In Skolnikland, life expectancy fell in the 1990s, which can be attributed to:

A. Malaria

B. HIV

C. Pneumonia

QUESTION 14

In Skolnikland, the cost for treating severe diarrhea in young children is $18 for community-based care and $20 for clinic-based care. The cure rate for community-based care is 60%. The cure rate for clinic-based care is 90%. Which approach is the most cost-effective?

A. Community-based care

B. Clinic-based care

C. They are equally cost-effective

QUESTION 15

In Skolnikland, what are likely to be three of the five leading causes of death of under-5 children, besides perinatal causes?

A. TB, diarrhea, pneumonia

B. Malaria, diarrhea, measles

C. Diarrhea, malaria, pneumonia

Q37 Research indicates more than 90 % of the deaths occur in older adult 65 and older due to lack of appropriate immunizations on which annual vaccination should the nurse first instruct the patient?

A Pneumonia

B Varicella

C TDAP

D influenza

Q38 which strategies of care would be least likely to enhance the physical function of older adult choose? Choose 2 answers

A weight control

B hearing and vision screening

C smoking cessation

D illness management

E forcing them to attend all activities

Q39 what are common risk factors that contribute to functional decline in the older adult population?

A physical inactivity

B tobacco use

C low sodium dietary intake

D having small families

Q40 what principle is least related to promoting health and preventing certain disabilities in older adults?

A continue activities of daily life (ADLs)

B Maintain as active a lifestyle as possible and desired

C Monitor illnesses through annual health screening ( AHS)

D keep up on assistive and information technology and other tools

Q41 Which focusing on the psychosocial needs of older adults, authorVirginia satir recommends that Healthcare providers get back to the basic communication. whatare the five basic principles satir describes?

A invite

B follow through

C respect personal space

D maximize understanding

E Arrange environment

F maximize attention levels

G trust

H maximize communication

Q42 how do electronic health records facilitate better care coordination? Choose 2 answers

A saving time typing rather than writing

B increasing the accuracy of diagnosis and health outcomes

C preventing an increase in the number of medical errors

D improving communication among health providers

Q43 Rick a 91 year old male, hasa history of chronic otitis media and is experiencing mild hearing loss in hisright ear,what type of assistive technology would Rick use to improve communicative function?

A icon communication board

B behind the ear ( BTE) hearing aid

C Augmentive and alternative communication ( AAC)

D completely in the canal ( CIC) hearing aid

Q 44 An elderly patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary diffulty after the stroke is dealing with dysarthria, whichhas limited the patient's ability to speak. whatcommunication technology would appropriately promote an optimal transition of care for the patient?

A an over the ear (OTE) hearing aid

B an augmentation and alternative communication ( AAC) device

C an assistive listening device ( ALD)

D an analog technology to amplify sound

Q45 what must the nurse inform the patient and family or caregivers about assistive devices? Choose 2 answers

A may lessen the importance of ongoing communication with healthcare providers.

B they may result in complete recovery from chronic illness

C they may limit complications of an illness or disability.

D they may enable independent performance and reduce risk of injury.

Q46 An 81 year old Patient has multiple chronic conditions including uncontrolled hypertension and peripheral artery disease and agrees to try assertive devices for monitoring blood pressure and improving circulation provided by a home health agency. Choose 2 answers

A allowing the patient enough time and opportunity for repetition

B only presenting the most relevant content to the patient.

C refraining from suggesting mnemonic devices to Aid the patients use of Technology

D having an outside educator provide several hours of detailed device instructions

Q47 A goal of the National Health Initiative healthy people 2010 is to increase the quality and extend the years of healthy life. What are two ways that this initiative can achieve its goal? Choose 2 answers

A by pressuring older adults who are lonely to move to nursing homes at younger ages

B By encouraging people to have more children so that the children can help their parents as they grow older

C by helping people overcome views of denial and foreboding as old age approaches

D by trying to spread the view that aging is natural and need not include illness and disease

Q48 match each government program with its description. Answer options may be used more than once or not at all

A provide health insurance for low-income families

B bases basic benefits on a workers average indexed monthly earnings in covered employment

C offers a payment system for long-term care ( LTC) foreligible older Americans and persons with disabilities

D is the health insurance program for those 65 or other people with disabilities

Q49 a senior is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work. On her lunch break, andafter she gets off work. thesenior expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself.which community resource should the nurse recommend looking into?

A a local Health Clinic

B Day Care Services for Seniors

C a medication assistance program

D Meals on Wheels.

Q50 the Independence at home demonstration was created by the Affordable Care Act. Which statement is true regarding Primary Care teams participating in this initiative?

A the teams are led by a licensed administrator

B the teams must serve at least 500 Medicare beneficiaries.

C the teams be led by a physician.

D the teams can be lead by a nurse practitioner.

Q51 which important facts about Medicare should nurses know? Choose 2 answers

A Medicare requires income assessment in order to qualify for coverage

B Medicare cover assisted living services for Americans in extreme poverty.

C Medicare recipients range from those simply needing Wellness services to those who are profoundly Frail.

D Medicare covers certain disabled Americans who have not reached age eligibility.

Q52 what is a common preventable error that can occur during the transition of care for older adults?

A unhelpful Hospital staff B inaccurate medication reconciliation.

C disorganized dosing schedule

D lost nursing equipment.

Q53 how is communication further facilitated? Choose 2 answers

A through communication to between and among the patients family caregivers and health care providers

B through active engagement of patients and family caregivers with a focus on meeting the patients goals

C through reliance on use of text messages that are less disruptive to the patient and family.

D through Healthcare Providers conversing with the patient and allowing the patient speak with the family.

Q54 what are appropriate evaluation measures related to successful transitions of care? Choose 2 answers

A emotional and social domains of quality of life.

B all clinical indicators related to Chronic conditions.

C functional status

D exclusion of nursing sensitive measures.

Q55 a critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults. What Broad caregiver competencies are included in this assessment?

A knowing the science behind the scenes of geriatrics

B allowing the active participation of the patient in all aspects of care.

C balancing the patient autonomy with safety

D knowing how to safely start an IV.

Q56 what Communications techniques promote safe transition of care in patients with aphasia?

A respond in the affirmative when a question is asked

B speak softer so as to never have a harsh tone

C give the patient time to speak

D use non-verbal gestures to communicate.

Q57 what roles of the nurse protect the patient from harm in a care transition?

A symptom manager,educator, collaborator, carecoordinator.

B medication manager screener educator listener

C liasson with Hospital decision maker collaborator coordinator

D decision maker Symptom Manager care coordinator.

Q58 which statements are true regarding health-related quality of life? Choose 2 answers

A cannot be measured in persons with chronic illness

B is measured by and object Observer, basedon the number of times an individual emits both verbal signs of happiness and well-being

C is measured by individuals perceived healthy days per month.

D can be measured by an instrument developed by the center of Disease Control (CDC)

Q59 several options are available as a care approaches to chronic illness care. Which method best describes palliative care?

A care that is only delivered by family or other personal caregivers

B end-of-life care that suspends active treatment

C a combination of active treatment and comfort measures

D a continued focus on here rather than comfort and quality of life.

Q60 A nurse caring for people at the end of their lives knows that Dysnea is relatively common and interferes with patients'comfort and rest. What is the evidence based intervention for shortness of breath?

A liquid morphine at starting dose of 10 mg every 4 hours and titrating dose upward until dyspnea is relieved.

B administer O2 at least 5 liters per minute

C 5 mg of liquid morphine every 4 hours,along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness.

D elevate the head of the bed no more than 20 degrees.

Q61 what do dying persons typically experience grief over?

A loss of bodily function and independence that occurs as illness becomes more prevalent

B loss ability to give and receive love

C loss of basic beliefs,values and faith.

D the feeling that nobody cares that the person is dying.

Q62 which of the following is often the biggest barrier to overcome in crucial conversations to death and dying?

A mistrust of healthcare providers

B lack of energy

C societal attitudes about death

D cost of care

Q63 The End of life Nursing Education consortium (ELNEC) is a resource targeted to nurse providing end of life care that supports evidence based care of dying patients and their families,as well as self care that lessens stress and anxiety and sustains nurse in providing excellent end of life care. Which of the following are self care principles? Choose 2 answers

A maintaining professional boundaries and relationships with patients and families, by tightly controlling feelings and empathy

B. Making good use of the expertise and support of the interprofessional care team

C. Diminishing attention on maintaining an active personal life since end-of-life care is a callings of sorts

D. Developing expertise in symptom management, which not only helps patients and their families, but increases satisfaction and lessens anxiety among professional caregivers

Q64. In addition to a living will, advanced directives may also include a durable power of attorney that encompasses health care related decision making. Which two of the following are accurate so statements regarding the legal instrument known as the durable power of attorney?

A. The alternative decision maker must be a close relative of a dying persons in order to understand his or her wishes.

B. It allows for an alternative decision maker in the event that the dying persons is incapacitated and no longer able to make health care decision

C. The living will remains a useful tool in providing direction to the alternate decision maker.

D. A durable power of attorney for health care decision also enables the alternative decision maker to also handle finances and other legal matters.

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