What is the Health Care Quality Improvement Act (HCQIA) and how does this law affect a healthcare entity's peer review processes?  What was "the apprehension [that] prompted the creation of HCQIA's National Practitioner's Data Bank (NPDB)"? (Showalter, p 292) What types of reports are required to be made to the NPDB? Present your thoughts on why peer review, and maintaining confidentiality of this work are important activities. Provide references/citations to support your position.

How many calories in that fast-food meal? Ontario menu labelling legislation takes effect
Jan. 1
CBC News · Posted: Dec 29, 2016
Restaurant-goers in Ontario are going to notice a little extra something on some menus as of Jan.
1: calorie counts.
Legislation that comes into effect Sunday under the Healthy Menu Choices Act, 2015 requires
that all restaurants with 20 or more locations must clearly display the caloric information for any
food and drink items.
Not only will the information have to be on menus, but it will also need to be clearly displayed
on menu boards and even on restaurant apps. Hospitals, schools, daycares and correctional
institutions are exempt.
The Heart and Stroke Foundation supports the initiative, believing that providing people with
more information helps them make better choices.
"Menu labelling is one small thing that empowers parents and empowers Ontarians to take
control of the choices that they make when they're having lunch or dinner at a restaurant," said
Joe Belfontaine, executive director of the Ontario branch of the Heart and Stroke Foundation.
"Certainly it's not the end-all or be-all, but it's an important tool in the toolbox."
Although Ontario is the first province in the country to require nutritional labelling at restaurants,
Belfontaine said that he hopes other provinces will follow suit.
Will it make a difference?
Whether including caloric counts will have any lasting health benefits, however, is questionable.
New York City has had food labelling requirements at restaurants since 2008. Since then,
researchers have attempted to ascertain whether it's made a difference to the city's population.
Calories of each food item appear on a McDonald's drive-thru menu in New York City. The city
made it mandatory for restaurants to display nutritional information since 2008. (Associated
Press)
A 2012 study in the American Journal of Public Health concluded posting calories on foods had
no direct impact on what foods people chose to buy. Over time, it appeared that people simply
ignored the labelling altogether.
A more recent study from Tulane University suggested that the New York City mandate
"plausibly reduced the obesity rate by 2.5 percentage points."
Dr. Sean Wharton, an internal medicine specialist who also runs a weight management and
diabetes clinic in Toronto, believes that the move is a positive one by the government, 
particularly for those who are paying close attention to their nutrition. However, it's likely a
different story for the general population.
"From an overall population level, I'm not so sure it'll have the big impact that we're actually
looking for," Wharton said.
"I don't think it's going to decrease weight from a population basis, but I think an informed
consumer is better at making choices and making judgements."
Wharton also noted that data supporting the idea of health benefits from such labelling is weak.
As well, he said, no studies have found that nutrition intake is any better in a general population
when such measures are undertaken.
While the evidence may be slim for a smaller waistline associated with menu labelling, experts
believe that it's important that people make informed decisions.
"I think it's important for consumers to have choice," Belfontaine said. "I think it's important for
consumers to have the right information."

Requiring restaurants to put calorie counts on menus is an example of which mechanism of policy

•  A. Exhortation
•  B. Expenditure
•  C. Taxation
•  D. Regulation
•  E. Public Ownership

Dr Wharton suggests that “an informed consumer is better at making choices and making judgements.” What ethical principle does this represent?

•  A. Autonomy
•  B. Non-maleficence
•  C. Beneficence
•  D. Justice

Jennifer Williams is a 43-year-old recently divorced female who has two teenage daughters aged 18 and
16 years. Her 16-year old daughter is 7 months pregnant. Jennifer's ex-husband is an alcoholic and is
involved with her daughters but cannot be relied on for financial assistance. She lives in an older home
in a low-income neighborhood. Her aging and widowed mother, who lives a few blocks away, is in the
early stages of Alzheimer's disease and needs regular assistance. Ms. Williams is the main caregiver for
her mother. She is employed full-time as an office assistant and regularly has difficulty making ends
meet financially.

A number of recent events have been challenging for Jennifer. Her pregnant daughter recently broke up
with her boyfriend and Jennifer knows she will be largely supporting and raising her grandchild. She also
recently had an intense argument with her oldest daughter about attending college—something she
supports but can't afford. In addition to all of these issues, Jennifer's mother fell and broke her arm. She
is now trying to meet the increasing care her mother needs.

All these events have been weighing heavily on Jennifer's mind. She is feeling highly anxious and is
experiencing difficulty sleeping. She has had intermittent diarrhea and has become highly irritable,
leading to arguments at work with her coworkers. Jennifer also began experiencing headaches. Fearing
she had something seriously wrong with her, she went to an urgent care clinic. After a brief visit focusing
on her headache, she was told not to worry because she was “only experiencing a tension headache”
and was a little hypertensive, and she was advised to see her primary care physician. Jennifer was
relieved to learn she did not have a brain tumor, but she has no intention of seeing another physician for
the headaches. She does not want to spend any more money on herself.

        ZOOM         Case Analysis Template:
Select your case and use this format to analyze the important Concepts you identify.
Remember, there are likely more than 3, but use 3 as your maximum.
1.) Identify relevant data from the present problem/ situation:
- Summarize the current situation and factors
2.) Personal/ Social history:
- Summarize: familial, occupational, and recreational aspects of the patient's personal life
that have the potential to be clinically significant.
3.) What are the interrelated Concepts for this case that you have identified and choose to
focus your paper? Discuss the principles within the Concept/s selected, apply those
principles to the case.
Ex/ Adherence Case and Class Activity Example
1) Adherence
2) Health Promotion
3) Patient Education
4.) Bring in a research article to further support your case, how can the research support further
investigation of the concepts you are looking at, how as a nurse can the research help you
support (ie. Education, collaboration, communication) a patient/ family.
5.) Conclusion: What outcomes would be important to include for this patient/ case?
What is your conclusion (wrap -up) and key elements of the case?              

Include the following in your Day-in-the-Life Scenario:

In what setting are you located?

Who are your most regular patients?

What is the problem the client is presenting, e.g., weak heart due to perfusion/bypass, lack of range of motion due to knee injury, etc.?

What kind of very general activities would you prescribe?

What is the description of at least one tool from the list in the lesson, along with an interpretation of the data it produces? (You may need to do additional research, so be sure to include a list of Works Cited for your teacher.)

What is a situation in which there is a potential hazard for one of your clients, and how did you respond to that situation? This could be a heart attack, a fainting spell, dangerous equipment, etc.

What is a situation in which you had to work with another member of the health team in order to get the best outcome for your patient?

What is a situation in which you had to educate the patient on what kind of exercise you were providing and why?

What ethical situation came about in which you had to check out the ASEP Code of Ethics, or, base your reaction on your own understanding of past ethical discussions?

What situation occurred in which you had to explain certification and licensure to the client?

You can combine all of these sections into interaction with just one client or describe a whole day with various clients