Collaborative Practice in Health Care Essay

Collaborative practice in health care occurs when a member of the health care team consults with another member to provide patient care. Collaboration most often occurs between doctors and nurses. â€Å"Collaboration is defined as a relationship of interdependence; the ability to work together involves trust and respect not only of each other but of the work and perspectives each contributes to the care of the patient† (Phipps and Schaag, 1995, p. 19). Effective collaborative practice amongst all health care team members leads to continuity of care, professional interdependence, quality care and patient satisfaction and decreased costs. Ongoing collaboration between health care members results in mutual respect, trust and an appreciation of what each individual brings to the overall goal in rendering care to the client. The following vignette will provide the foundation for the discussion of collaborative care, differentiating between nursing diagnosis and collaborative proble ms, and potential barriers to successful collaboration. JG is a 74 year old married Hispanic male diagnosed with colon cancer. He had a history of prosthesis placement of his left lower leg; he is ambulatory. He is a diabetic on oral medications. He worked as a farm laborer. He lives with his wife she does not speak English she is a homemaker. He has a son who lives nearby and a nephew who periodically visits him. JG can understand some English. He does have some difficulty expressing his health concerns to the staff because of his limited vocabulary. His son or nephew brings JG to his clinic appointments. He receives weekly chemotherapy at the outpatient oncology clinic. The day I cared for JG he arrived at the clinic accompanied by his nephew. This was week seven of his treatment. His clothing was dirty, he smelled of stool, his fingernails were dirty, hair uncombed, he appeared to be dehydrated. He reported bowel movements of eight stools per day with complaints of occasional abdominal cramping. He denied nausea or loss of appetite. He stated that he was very tired and was not able to do much at home. His main concern was the frequency of his bowel movements. He reports having to go to the bathroom two to three times during the night and has episodes of soiling the bed. He reports that sometimes he does not feel the  urge to go. JG was wearing adult diapers. He expressed concern that it was getting expensive for him to purchase. The nephew confirmed that JG toileting has created a problem in the home. His nephew verbalized that JG had medication for diarrhea but ran out of it and he did not have the money to purchase the medication. When questioned why he was using a wheelchair he stated that his foot hurt to walk the distance from the lobby to the treatment room. He mentioned that it was probably due to an ingrown toe nail. He also asked how he could obtain a wheel chair for his personal use at home. Physical assessment revealed that he had a necrotic area on the ball of his left foot with surrounding redness, lost 12 pounds in six weeks, poor skin turgor, hyperactive bowel sou nds, and his blood pressure was slightly lower than baseline. In the ambulatory chemotherapy setting, the clients do not always see their physician every time they receive treatment. The nurse must ascertain when to collaborate with the physician on issues regarding the patients status, response to treatment, or toxicities that may be life threatening. It is essential that the nurse is capable to communicate effectively her-(Be careful with gender bias, nurses come in both genders.) observations to the physician. Collaborative problems are detected from the nurse’s assessment of the patient. The nurse’s monitoring of the patient status is to evaluate physiological complications that may threaten the patient’s integrity. Management of collaborative problems will include implementing physician prescribed and nurse prescribed actions to curtail escalation of the problem and preventing patient harm. From the nurse’s assessment, she also formulates a nursing diagnosis. The nursing diagnoses are stated in the form of the problem, the etiology and the symptoms that the nurse observes. Nursing diagnosis can include a current or potential problem, an at risk problem, or a wellness diagnosis. Nursing diagnosis provides the framework from which the nurse begins to devise a plan of care and nursing interventions. In the case of JG, there were two collaborative problems identified. Two  problems I collaborated with physician, these were: 1. JG is experiencing toxicity from the chemotherapy. There is potential for electrolyte imbalance, circulatory collapse. 2. The necrotic area on his foot was a new development in his condition. There is potential complication for infection The collaborative problems discussed with JG physician and nurse quickly resolved. JG did not receive his chemotherapy. He was given an injection of sandostatin LR to help minimize his diarrhea; a stat basic metabolic panel was obtained; and he was given intravenous hydration with potassium. The doctor made a referral to JG podiatrist for the next day to assess the integrity of his left foot. Listed are four, but not all, possible nursing diagnosis obtained from my assessment. 1. Diarrhea related to chemotherapy manifested by hyperactive bowel sounds and eight loose stools. 2. Bowel incontinence related to loss of rectal sphincter control and chemotherapy manifested by fecal odor, fecal staining of clothing, urgency. 3. Altered Nutrition related to colon cancer manifested by diarrhea, abdominal cramping. 4.Ineffective management of therapeutic regimen related to JG lack of knowledge of his disease manifested by his inability and unwillingness to manage his symptoms. Considering JG comments regarding his finances, his overall physical appearance and the comments from his nephew, I decided to consult with the social worker. I felt that a home visit or a thorough investigation of JG home situation was warranted. The social worker was able to arrange for in home support, and helping the patient with insurance issues so he could obtain the needed supplies. I did not think to enlist the participation of the dietician. In retrospect, the dietician would have been a valuable resource to assess JG caloric intake and recommendations for optimal nutrition. I felt that the above incident demonstrated collaboration amongst health care providers. The physician in this case was receptive to the nurse’s observations with respect to her capabilities of accurate assessment of the patient’s condition and potential complications. This is not always the case, barriers to collaboration are also inherent in the health care industry. Barriers occur in patient situations where the physician is not sympathetic or does not trust the nurse’s evaluation of patient condition. The nurse may have feelings of inferiority, lack of confidence and does not appropriately collaborate with the physician correct information. Conflicts in the goals desired for the patient is often cited as a barrier to collaboration. I recall an incident of a male patient diagnosed with metastatic breast cancer. His appearance was that of an individual who had been in a Nazi concentration camp. The nurse wondered why the physician was treating this man aggressively. In her mind, this patient was not an appropriate candidate to receive the particular treatment that was ordered. She feared the patient would not tolerate such an aggressive schedule and that it was pointless to put this poor man through treatment. The patient was diagnosed two years ago. He is still receiving treatments, he has gained weight and in October of last year he hiked to the summit of Mt. Whitney. Role conflict is another major barrier to collaboration. To deliver cost effective care, many institutions utilize nurse practitioners and physician assistants. Role conflict arises when practitioners have opposing views or expectations (Blais, Hayes, Kozier, & Erb, 2002). Role conflict and can lead to litigation. According to Resnick, physicians hesitate to collaborate informally with Nurse Practitioners for fear of being held liable for the actions of the Nurse Practitioner (Resnick, 2004). Clear definition of roles  for practitioners is essential to prevent misunderstanding. In conclusion, collaborative practice is the gold standard that health care practioners should strive towards. The nurse is central in determining the patient issues that warrant collaboration and she must be able to effectively communicate her observations. Collaborative practice minimizes complications that could lead to tragic outcomes. The ultimate goal of collaborative practice is to provide the quality service that each patient under our care deserves. References Blais, K.K., Hayes, J. S., Kozier, B. & Erb, G. (2002). Professional nursing practice: Concepts and perspectives (4th ed.). New Jersey: Prentice Hall. Phillps, W.J., & Schaag, H.A. (1995). Persepctives for health and illness. In Phipps, W.J, Cassmeyer, V.L., Sands, J. E., Lehman, M.K(Eds.), Medical surgical nursing concepts and clinical practice, p. 19. St. Luis, MO: Mosby. Resnick, B. (2004). Limiting litigation risk through collaborative practice. Geriatric Times, 5(4), 33. Retrieved March 21, 2004 from EBSCOhost database.

Does Marketing create or satisfy needs

Marketing is an ongoing activity that does not stop, continuously obtaining needs that define a state of felt deprivation and wants that defines what Is need. It Involves transaction In terms price, place, product and promotion. At the end of this exchange, the most important result most desired is customer satisfaction. The discovering and satisfying of consumers' needs and wants is the prime marketing activity. Thus, the marketing function is to search needs and then satisfy it.According to Philip Kotler, he mission of marketing is to create products that satisfy the unmet needs of target markets. The marketers do not create needs: Needs preexist marketers. Marketers, along with other societal factors Influence wants. Marketers might promote the Idea that a Mercedes would satisfy a person's need for social status. They do not, however, create the need for social status. We all need to eat, drink and sleep and reproduce, this is all part of who we are as human beings.Therefore at th e basic level ompanies will strive to satisfy these functions and keep doing so by once in a while showing advertisements that tells the public that they are around and can provide the products they need. The other aspect Is that needs vary depending on what country and society you live In. â€Å"For example a consumer In the United States may need food but may want a hamburger, french fries and a soft drink and a person that lives in Mauritius that needs food may want a mango, rice, lentils and beans. Wants are shaped by our society.Marketers must therefore continually be creating and developing attractive products and then in turn devising a brilliant marketing strategy to win the consumer over to buy their product over other competing products. Companies strive to retain their customer base by delivering value and satisfaction from their products and this Is formulated in consumers' minds as a combination of service, quality and price. Some consumers would not mind paying a high er price for an item or service if they received very good service.

BERTOS MANUFACTURING CORPORATION Case Study Example | Topics and Well Written Essays - 1000 words

BERTOS MANUFACTURING CORPORATION - Case Study Example BFSI consists of three foreign subsidiaries in Mexico, Canada, and UK. There are ten nations selected to establish which ones form most suitable for the instantaneous institution of a new BFSI subsidiary. Therefore, Victoria being in charge of the project has to recognize the key criteria and reflection that necessitate evaluating BFSI embryonic in the projected foreign markets. In order to establish the best nations, Victoria must make a financial system assessment for every nation. The strategy includes a historical synopsis of the nations’ financial classifications, present financial laws and policy and financial institutions available in the nation. The analysis should constitute of a list and an explanation of all the banks (financial institutions). Whether domestic or foreign the analysis must present in the state comprising assets, total liabilities, deposits, capital, preserved earnings, net income and the diverse services provided by institutions. In addition, Victoria must include the banking modes and regulations, customer profile and in her analysis (Roussakis 2). Moreover, imperative elements like the country’s balance of trade, imports, balance of payment, investments, and principal sources of experts, fund transfer and foreign treasury considered. Subsequently, she must describe in the country’s assessment the current exi sting country’s currency. Certainly, she should consider the exhibition of the country’s FDI to political jeopardy in the various countries proposed (Roussakis 8). Some political proceedings can dent the economic feasibility and production of the firm, like expropriation, governance threat, and blocked finances. Furthermore, the analysis must discuss the ultimate risk of terrorist financing and money laundering, and highlight imperative financial corporation’s failures and indignities in the state. As a result, the board has recognized the necessity for an extra of finance companies of chosen foreign

Adapting to ChangesSituational Leadership Assignment

Adapting to ChangesSituational Leadership - Assignment Example The situational model comes with a number of strengths and limitations as described below. The situational leadership engages supple approach to meeting the distinct demands of every situation and individual. This model offers a prescription of understanding the capabilities and the nature of subordinates to enable the provision of exact requirements for better performance of a task. For instance, pushing an individual forward on to a task may work if the concerned party is low on confidence other than the employee who lacks the necessary skills (Carew, Carew & Blanchard, 2008). Putting in mind that employees often present their strengths and weaknesses at work, situational leadership approach enables a leader to personalize his approach towards the employees. This model mainly dwells on the need for leaders to constantly understand the needs of their subordinates. To assess and develop a better understanding of an employee’s abilities and lead him/ her towards performing tasks effectively, it is paramount that communication is used. Thus, the situational leadership model enhances the levels of communication between the leader and the subjects hence increasing the levels of efficiency and productivity in the organization (Fernandez, Cho & Perry, 2010). Most leaders under the situational leadership model are often under constant pressure to analyze their situations prior to making decisions on any action. Other leadership styles emphasizing on leaders following their strengths and innate traits often present more instinctive reactions to problems. Other prominent situational leadership models propose that leaders ought to constantly establish the manner in which their actions offer immediate and long-term motivation to the employees. The major challenge to this question is that each response varies depending on the follower and the situation. Despite the effectiveness of the situational theories, they are always criticized for their rigidity. The

The Business Strategies of Google Inc and Its Effects on the Business Essay - 2

The Business Strategies of Google Inc and Its Effects on the Business and the Industry - Essay Example This paper illustrates that a research study conducted by Morgan Stanley pegs the total number of internet users at about 1.8 billion as of the year 2009. The number is expected to grow by about 13 percent annually on a year on year basis. The report also states that approximately 18.8 thousand minutes was spent on internet browsing by ‘netizens’ across the world. Geographically China followed by USA and India have the largest number of active internet users with the numbers growing geometrically over the years. The analysis of the strategic framework of an organization can be done by using the framework of the Generic model proposed by Michael Porter. The model states that a firm can pursue four strategies that include overall cost leadership, focus, differentiation, and differentiation focus strategies. Depending on the business and the market environment a firm can either chose one strategy or a combination of these strategies. Overall cost leadership strategy involve s a strategic framework in which a business organization lowers its cost of operations and uses the cost benefits to sell products at lower prices than their competitors. Business organizations using a differentiation strategy provide a unique product or service offering that is unmatched by the competitors in the industry segment. Firms using such a strategy normally charge a premium for their uniqueness in the product or service offering and generate their core competence based on their innovations. Focus strategy involves targeting a very core and niche consumer segment and providing services that tend to cater to the very specific needs of the customers.

Distill information about culture and cultural diferences from three Assignment

Distill information about culture and cultural diferences from three interiors - Assignment Example A close examination of the photographs reveals that the interior number 1 belongs to an elderly British couple living in the country side, interior number 2 is inhabited by a few families of different ethnicities and interior 3 is a guest house with no permanent residents. Let us now examine the interiors in more detail. Interior 1: The living room exudes a sense of deep and profound calmness. The heavy wooden furniture, the thick mat on the floor and the heavy scenery convey an idea of stability and eternity. The glass windows, most of them open, give the impression of a friendly host. The books in the study are arranged neatly and maintained clean. The inhabitants are clearly very fond of books. The ladder seems to be used quite often indicating that the inhabitants are in the habit of reading regularly. The bedroom and the bedside table again show a conservative style, typical of old British homes. The kitchen and dining area are also spick and span and tastefully decorated. Nature, birds and dogs are the favorite themes in the paintings on the walls. The paintings in the office room and the latest finished painting on the easel indicate that the person living in the house is a professional painter. The house is surrounded by lush greenery and it is obvious that the house is located in the countr yside. The elderly couple seem to be alone, but happy and contented. To maintain such a big house, they must have many servants and so it can be deduced that they are very rich. The overall impression that we get is that of an elderly couple belonging to the elite class, with lots of money and time to spare, living a peaceful life away from the hustle and bustle of modern life. It is noteworthy that there are no signs of modern technology like telephone, mobile or TV; may be they are purposely hidden from view. It may be noted that the kitchen is having modern facilities like cooking range etc. Interior 2: The first picture

MECHANISMS FOR EVALUATING FINANCIAL HEALTH OF HEALTH CARE Essay - 1

MECHANISMS FOR EVALUATING FINANCIAL HEALTH OF HEALTH CARE ORGANIZATIONS CS - Essay Example The total revenue for Pearland Medical Center reduced by $250,000,000 in the year 2013, compared to the revenue the firm had generated in the year 2012. At the same time, the operating expenses reduced by $200,000,000, which means that the net income of Pearland Medical Center reduced by $50,000,000 between the two years. The net revenue for 2012 and 2013 was $915,000,000 and $865,000,000 respectively. On the other hand, the total profit for the same period was $965,000,000 and $915,000,000 for 2012 and 2013 respectively. The cash flow of the Medical Center was equal to the total profit of the company since the inflow of the business was only through revenue and the cash outflow was through marketing, operating, research and education expenses. However, sinceBut depreciation is a non-cash flow item in this scenario, it should be used to establish the total profit and the net cash flow of Pearland Medical Center (Fridson & Alvarez, 2011). The profit margin measures how much every dollar revenue a firm keeps in its earnings (Albrecht & Albrecht, 2008). The total profit margin of the firm stood at 69% and 61% in 2013 and 2012 respectively. This means that the firm realized a net percentage of $0.69 and $0.61 for every dollar of sales. This showed that Pearland Medical Center’s ability to control its expenses, improved in 2013 as compared to 2012, and it is attributed to a reduction in operating expenses by $200,000,000. On the other hand, the total profit margin, excluding grants and investments, stood at 59% and 48% in 2013 and 2012 respectively. This implied that the firm’s earnings from every dollar it had invested reduced to 0.59 and 0.48 per dollar as a result of the exclusion of grants and investment in its revenue. Based on the income statement report, the firms financial health is not badly off because Pearland medical center made some positive returns from its investments. But if they are