MSN 6011DQ Technology and Ethical Dilemmas in Evidence-Based Care

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MSN 6011DQ Technology and Ethical Dilemmas in Evidence-Based Care

MSN 6011DQ Technology and Ethical Dilemmas in Evidence-Based Care

 

For this discussion, read the two case studies below. Choose
one of the case studies and respond to all of the questions and points under
that case study.

Case Study 1

M. J. is a 55-year-old Caucasian female who is presently
recovering in an orthopedic unit of a large medical center following a total
right hip replacement. She has had a Foley catheter in place since prior to
surgery three days ago, and has now developed a catheter-associated urinary tract
infection (CAUTI).Your institution has established a culture of safety and has
protocols in place that have resulted in a significant decrease In CAUTIs in
its post-operative population. As M. J. is the fourth patient to have a CAUTI
in the last three months, this is especially disconcerting. A committee was
established to look into the recent increases in CAUTI occurrences. Their
research resulted in a recommendation to implement a trial of utilizing
automatic computer technology prompts for the health care providers about
discontinuing urinary catheters. The hope is this notification system will
mitigate the sudden rise in CAUTIs and ensure patient safety.

If you have chosen to respond to this case study, please
address the following in your response:

What might be potential ethical barriers to implementing
automatic computerized reminders to remove Foley catheters on identified
patients?

How do you integrate the ethics of caring into this practice
environment?

Are there ethical considerations associated with using care
bundle guidelines in practice? In monitoring and tracking data?

Discuss how the culture of patient safety is aligned with
one of the ethical principles of beneficence or non-maleficence.

Be sure to cite at least two sources of evidence in your
initial discussion post.

Case Study 2

Rachel is a registered nurse who works for a major insurance
company in the diabetes wellness department. Her employer has identified
potential high-cost utilizers, and those diabetics at risk for target organ damage,
by utilizing data from the population health portal HEDIS benchmarks of those
diabetic patients enrolled with their health plan. The data points being used
are hemoglobin A1C levels less than 9% and LDL cholesterol levels below 100.
All patients with high A1Cs and LDLs are being contacted by the insurance
company to be enrolled in a telephonic nurse education program. The goal of the
program is for the nursing staff to educate the patients on healthy lifestyle
and self care to improve their diets, exercise, and medication adherence.

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During one of the calls, Rachel identifies that she is employed in Iowa, and
her patient lives in Nebraska.

If you have chosen to respond to this case study, please
address the following in your response:

Are there any legal or ethical issues with the RN and
patient being in different geographical locations?

Does the nurse need to obtain a nursing license in every
state where there might be electronic contact with the patient?

If the nurse gives the patient poor advice, and there is a
case of substandard care or malpractice, where would the patient seek legal
recourse?

How do you integrate the ethics of caring into this practice
environment?

Be sure to cite at least two sources of evidence in your
initial discussion post.

Response Guidelines

Review the posts of your peers and then select two to whom
you wish to respond. If possible, these peers should have chosen to respond to
the same case study as you. In your response be sure to address the following (
Note: Your responses should be substantive, 100-200 words):

Compare the evidence that you used to inform your response
to that used by you peer.

How did the evidence lead you to similar conclusions as your
peer?

How did the evidence lead you to different conclusions than
your peer?

Briefly comment on what this indicates to you about the
importance of considering multiple sources of evidence.

Briefly explain how additional evidence has changed your
thoughts about what the appropriate actions are to take.

Resources

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