Question

PlEASE USED THE ANSWER ALL THE QUESTION

• articulately demonstrate (in 300-400 words for each) your understanding of how these topics are related when engaging in patient care.

1) How does a healthcare provider ensure the patient’s Rights and Responsibilities (including consent and Advance Directives) when providing interprofessional care?

2) From an ethical perspective; how do the various ethical perspectivesweigh into a provider’s decision regarding the patient’s case? How do ethical considerations impact and how are they impacted by interprofessional care?

3) What role does the legal system play in the patients’ care? Why is it important to understand legal considerations when practicing interprofessional care?

4) Finally, how are these topics impacted by and how do they impact costs of providing care, the patient’s access to care and ultimately the quality (positively or negatively) of care (can it be achieved or not)?

Answer 1

(1.) Answer:- A healthcare provider must ensure the patient’s Rights and Responsibilities , when providing interprofessional care.

(i.)patients rights while providing interprofessional care :-

Patient rights are those basic rule of conduct between patients and medical caregivers as well as the institutions and people that support them. A patient is anyone who has requested to be evaluated by or who is being evaluated by any healthcare professional. Medical caregivers include hospitals, healthcare personnel, as well as insurance agencies or any payors of medical-related costs. This is a broad definition, but there are other slightly more specific definitions. For example, a legal definition is as follows; patient rights is general statement adopted by most healthcare professionals, covering such matters as access to care, patient dignity, confidentiality, and consent to treatment.

(ii)Communication:-

Open and honest communication is an integral part of the doctor-patient relationship. The AMA's Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions. Situations occasionally occur in which a patient suffers significant medical complications that may have resulted from the physician's mistake or judgment. In these situations, the physician is ethically required to inform the patient of all the facts necessary to ensure understanding of what has occurred. Only through full disclosure is a patient able to make informed decisions regarding future medical care.

(iii.) Informed Consent:-

Part of communication in medicine involves informed consent for treatment and procedures. This is considered a basic patient right. Informed consent involves the patient's understanding of the following:

(a.)What the doctor is proposing to do

(b.)Whether the doctor's proposal is a minor procedure or major surgery

(c.)The nature and purpose of the treatment

(d.)Intended effects versus possible side effects

(e.)The risks and anticipated benefits involved

(f.)All reasonable alternatives including risks and possible benefits.

Closely associated with informed consent, voluntary consent means that the patient understands these concepts; the patient rights include the following:

(i)Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion

(ii) The right to refuse or withdraw without influencing the patient's future healthcare

(iii)The right to ask questions and to negotiate aspects of treatment.

(iv.)Confidentiality:-

Law and ethics state that the doctor-patient interaction should remain confidential. The physician should never reveal confidential information unless the patient wants this information disclosed to others, or unless required to do so by law. If the release of information is warranted, information should be released in the form of an official signed document.

(v.)The Right to Healthcare:-

Most people agree that everyone deserves the basic right to healthcare, but how far that right goes has been the center of America's healthcare debate; even with the Supreme Court upholding the current new federal healthcare laws, the debate continues, even to the point that the new laws may undergo repeal. Within the existing social structure, inequities in access to healthcare are widespread. Because of numerous inequities in healthcare that often involve such factors as race, socioeconomic status, and gender, politicians have tried for many years to change the healthcare system and are likely to continue to intervene and change these "patient rights."

(Vi.)Abandonment:-

The doctor has the duty to continue a patient's healthcare after consenting to provide medical care unless the patient no longer requires treatment for the illness. The doctor must notify the patient and transfer care to another acceptable doctor if planning to withdraw care. The doctors may be charged with negligent abandonment for ending the relationship with the patient without appropriate referral, transfer, or discharge. Although doctors are free to choose which patients they will treat, doctors should offer optimal care for patients who need emergency first-aid treatment.

(2.) Answer:- Nursing Ethical Considerations:- Ethics within healthcare are important because workers must recognize healthcare dilemmas, make good judgments and decisions based on their values while keeping within the laws that govern them. To practice competently with integrity, nurses, like all healthcare professionals, must have regulation and guidance within the profession.[3] The American Nurses Association (ANA) has developed the Code of Ethics for this purpose.

The Code of Ethics for Nurses is divided into nine provisions to guide the nurse. The following is a summary of the American Nurses Association Code of Ethics for Nurses:

Provision 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

The nurse must have a high level of respect for all individuals, and allow dignity in regards to dealings in care and communication. It's important that patient's families are also treated with respect for their relationship to the patient. Nurses must understand the professional guidelines in communications and work with colleagues and patient families. It's important to understand the proper professional relationship that should be maintained with families and patients.

Provision 2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.

The patient should always be a first and primary concern. The nurse must recognize the need for the patient to include their individual thought into care practices. Any conflict of interest, whether belonging to external organizations, or the nurse's habits or ideals that conflict with the act of being a nurse, should be shared and addressed to not impact patient care.

Provision 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

It is important for the nurse to understand all privacy guidelines with regards to patient care and patient identifiers. Nurses involved in research must understand all aspects of participation including informed consent and full disclosure to the patient of all aspects required to participate in the study. The nurse must understand any institutional standards set in place to review his/her performance; this includes measurements of progress and the need for further review or study to meet performance standards. To become a nurse, competence must be demonstrated in clinical and documentation prowess. Standards of competence will continue at institutions and academic organizations that employ the nurse. If there is witness or recognition of questionable healthcare practice, it is important that the patient is protected by reporting any misconduct or potential safety concern. And finally, the nurse will not provide patient care while under the influence of any substance that may impair thought or action, this includes prescription medication.

Provision 4. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.

As a nurse, it's inherent that accountability for all aspects of care aligns with responsible decision making. Use of authority must be professional and about all aspects of individualism and patient, ethical concerns. Nursing decisions must be well thought, planned, and purposefully implemented responsibly. Any delegation of nursing activities or functions must be done with respect for the action and the ultimate results to occur.

Provision 5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

Provision 6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.

Provision 7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

Provision 8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

Provision 9. The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

Nurses must continue to gather for committees and organize groups where they may share and evaluate values for accuracy and continuation of the profession. It is within these organizations that nurses may join in strength to voice for social justice. There is a need for continued political awareness to maintain the integrity of the nursing profession.

(3.) Answer:- the role of legal system in the patient care are as follows:-

The legal implications of nursing practice are tied to licensure, state and federal laws, scope of practice and a public expectation that nurses practice at a high professional standard. The nurse’s education, license and nursing standard provide the framework by which nurses are expected to practice. When a nurse’s practice falls below acceptable standards of care and competence, this exposes the nurse to litigation.

implementation of nursing laws can serve as strategic plan that guides nursing profession, whether in-patient nursing care or public health nursing. “Law governs how public health strategies are authorized and implemented” . Therefore, laws should guide and control nursing career practices to safeguard both employees and patients.Obviously, awareness of laws may protect nurses from legal issues while taking care of patient as evidence by tort law. Therefore, health care provider should be conscious of the consequences of breaching the law. One of the well-known laws in nursing field is tort law, which involves malpractice and negligence of patient care. “Basically a tort is a wrongful act which produces harm, whether it is unintentional or intentional” . Hence, nurses are responsible to be aware and practice specific tasks to avoid breaching of law.

legal knowledge is important for nurses:-

(a.) Nurses are expected to function within the legislation, legal policies, statutes relevant to the profession and practice setting, and professional standards.

(b.)The standard of practice of the College of Nurses of Ontario states that registered nurses must base their practice on an understanding and analysis of the legislation that influences nursing.

(c.)Nurses must know the rights and obligations of nurses in interactions with patients, families of patients, other nurses, and other health care practitioners.

(d.)Nurses are now being, and will continue to be given increased responsibility, thereby increasing their exposure to lawsuits.

(e.)Many of the actions traditionally performed by nurses are being delegated to non-professionals, under the supervision of nurses.

(4.) Answer:- the main aspects in providing improved patient oriented care are:-

Improving patient care has become a priority for all health care providers with the overall objective of achieving a high degree of patient satisfaction. Greater awareness among the public, increasing demand for better care, keener competition, more health care regulation, the rise in medical malpractice litigation, and concern about poor outcomes are factors that contribute to this change.

The quality of patient care is essentially determined by the quality of infrastructure, quality of training, competence of personnel and efficiency of operational systems. The fundamental requirement is the adoption of a system that is ‘patient orientated’. Existing problems in health care relate to both medical and non-medical factors and a comprehensive system that improves both aspects must be implemented. Health care systems in developing countries face an even greater challenge since quality and cost recovery must be balanced with equal opportunities in patient care.

(a.)Non-medical Aspects:-

The fact that the patient is the most important person in a medical care system must be recognised by all those who work in the system. This single factor makes a significant difference to the patient care in any hospital. In developing countries financial constraints often lead to compromised quality of care. This can be corrected by the introduction of management systems that emphasise cost recovery.

Some of the issues that need to be addressed to improve patient care are listed below.

(i)Access. Accessibility and availability of both the hospital and the physician should be assured to all those who require health care.

(ii)Waiting. Waiting times for all services should be minimised. In most developing countries, the high demand for services often makes this a huge problem. Nevertheless, it has to be addressed effectively through continual review of patient responses and other data and using this feedback to make the necessary changes in systems.

(III)Information. Patient information and instruction about all procedures, both medical and administrative, should be made very clear. Well trained patient counsellors form an effective link between the patient and the hospital staff and make the patient's experience better and the physicians' task much easier.

(iv)Administration. Check-in and check-out procedures should be ‘patient friendly’. For example, for in-patients, we have instituted a system of discharging patients in their rooms, eliminating the need for the patient or the family to go to another office or counter in the hospital and waiting there for a long time. This has been favourably received by patients.

(v) Communication. Communicating with the patient and the family about possible delays is a factor that can avoid a lot of frustration and anxiety. The creation of a special ‘Patient Care Department’ with a full time Administrator has helped our institution significantly and has enhanced our interactions with patients and their families.

(vi)Ancillary Services. Other services such as communication, food, etc. should be accessible both to patients and to attending families.

(b.)Medical Aspects

The medical aspects of patient care are much better understood by most health care providers. This is dependent on the quality of medical and technical expertise, and the equipment and quality assurance systems in practice. The following factors contribute to the improvement of patient care.

(i)Trained Personnel. A well-trained ‘Eye Care Team’ is critical to providing high quality care with desirable outcomes. Lack of adequate personnel and lack of adequate training facilities for the available personnel are major problems. The temptation to recruit untrained or poorly trained people should be resisted. The number of training programmes must be increased, and the existing programmes must be improved. Making a uniform basic curriculum available for all training institutions/programmes should help bring about standardisation.

(ii) Quality Eye Care. There is significant concern about the outcomes of cataract surgery, and other common surgical procedures. Incorporation of quality assurance systems in every aspect of patient care is critical. For example, adherence to asepsis in the operating rooms will help reduce post-operative morbidity and proper training of ophthalmologists in diagnostic techniques will help achieve better control of sight-threatening diseases.

(III) Equipment. All the necessary equipment must be in place and properly maintained. This is vital to the performance of the medical system and contributes significantly to better results. Eye-care equipment of acceptable standards is now available at reasonable prices, and this must be accompanied by appropriate maintenance systems.

(iV) Use of Proper Instruments. Good quality instruments are now available at lower costs. With the development of proper inventory control systems for a given operation, the costs can be lowered.

(v) Use of Appropriate Medications. Access to low cost medicines is an absolute necessity for appropriate care.

(vi) Use of Newer Technologies. It is important to continually employ newer technologies that improve the quality of care. Of course, this must be done with reference to cost-efficiencies.

Improvement of patient care is a dynamic process and should be uppermost in the minds of medical care personnel.