Author: chris

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has mandated that organizations have policies in place by January 2009 for codes of conduct for employees.
Evaluate the Sentinel Event Alert article above and write a word paper describing the policy. Include:
Sentinel Event description.
Purpose for event reporting.
What authority does The Joint Commission have to make such a mandate?
What happens to a facility that does not comply?
If you work for an organization, even it is not health care, is there a code of conduct policy in place?
Do you know about it?
Have you been oriented on the policy? If so, has anyone had to report an incident?
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located on the Student Success Center. An abstract is not required.
LECTURE:
Behaviors and Attitudes
Introduction
Most health care professionals have chosen their careers from a genuine interest in caring for others. Health care is a fulfilling, yet challenging field in which positive outcomes are not always possible when dealing with disease and illness. The entire health care system is a demanding industry from the long-standing history of hierarchical structure of professions, the increasing demand on the workforce, and the constant threat of legal retaliation from the public. Adverse work behaviors have been studied for years, as have policy decisions made to make the profession safer and more attractive for the future generation.
Workplace Behaviors
Every industry has problems with poor workplace behaviors since they all involve working with people. Human nature is described as “fundamental dispositions and traits of humans” (Britannica Concise Encyclopedia, 2006). Every industry has its own stress levels and intrinsic characteristics that can contribute to poor workplace behaviors, but the health care industry has unique situations that can increase the stress levels that can be overwhelming for any professional. Most decision or treatment options made by health care professionals have an impact on patient care or outcomes. Unlike the manufacturing industry that deals with an inanimate object, health care demands accurate results all the time.
Verbal abuse, physical threats, and violence have been ongoing issues in the health care profession for years. Many reports and research studies have attempted to make the profession and the public aware of this unsafe work environment and find ways in which to correct the situation. Recently, The National Institute for Occupational Safety and Health, a division of the Centers for Disease Control and Prevention (CDC) granted the University of Cincinnati College of Nursing an award to study violence by the public and patients against care workers in the emergency department (Koenig, 2008). Although this is not a new occurrence, the study will assess intervention effectiveness.
In 1995, 384 assaults and eight homicides occurred in hospitals. The largest number occurred in the emergency department (American College of Emergency Physicians, 2008). A recent Emergency Nurses Association (ENA) survey found that 86% of emergency room nurses were a victim of violence by patients or families of patients (Emergency Nurses Association, 2007). Often physical or verbal attacks are not reported, so accurate statistics are not possible to monitor the seriousness of the problem. Violence in the emergency department is so common that policies, instruction manuals, and entire conferences address the issue of protecting the workforce.
Assaults in the health care workplace have been accepted as just “part of the job” (Montana Nurses’ Association, 2007) and can contribute to added stress and high burn-out rates. The Massachusetts Nursing Association reports 200,000 assaults on health care workers in a 4-year span. It lists physical, emotional, cognitive, and behavioral symptoms after either witnessing an assault or being assaulted (Massachusetts Nursing Association, 2005). Reactions to the event can be so significant that the Critical Incident Stress Debriefing was developed to avoid post-traumatic stress reactions in the health care worker.
Assaults, violence, or verbal abuse can be a result of multiple reasons that impact health professionals, no matter where they are employed. Patients have long waits for care because of staff shortages or insurance coverage issues. This can cause disruptive behavior from the patient or the patient’s family. Substance abuse among emergency nurses was found to be 3.5 times higher than general practice nurses. This can be contributed to by the stress of working with trauma (AdditionSearch.com, 2007). With the addition of having to deal with disruptive behaviors, many professionals seek ineffective ways to handle the stress. This issue is not isolated to the emergency department; it affects all health care professionals.
Drug or alcohol use can also affect patient outcomes and put the entire health care profession in jeopardy. The U.S. Department of Labor, Office of the Assistant Secretary reports that 5% of the hospital and other health services drink heavily and the 4% of nursing home employees drink heavily. The use of illicit drugs is even higher (U.S. Department of Labor, 2008). The positive aspect is that most organizations and the federal government have recognized the problem and have programs in place to set drug-free workplace policies. Most nursing associations have drug assistance programs to help with addiction problems.
The Institute for Safe Medication Practices (2004) lists intimidation as a form of abuse that negatively affects patient care and the possibility of forming effective collaborative work teams. The intimidation comes from other health care workers in the form of verbal abuse or threatening body language. Those that feel intimidated hesitate to question an order or action taken by others, often at the expense of patient care. Male and female employees felt equally intimidated by behaviors from all health care professionals. Few reported their issues even though their organization had a written policy to deal with the problem (Institute for Safe Medication Practices, 2004).

Make one paragraph for each unit for a total of three paragrags. reinstate the questions in the beginning of each paragraph.
Unit 6.1-Conflict Perspective
If a client system characterizes his or her community as featuring only conflict, should the counselor attempt to adjust the client’s perspective? If so, how might this be done? If not, why not?
Unit 6.2 : Theory of Social Organization
Which theory of social organization (Structural Functionalism or Postmodernism) best approximates your own perspectives on social life? What are the benefits and limitations of each perspective?
Unit 6.3-Community Perspective Assessment Tool-Develop list of at least three questions that might be part of an assessment tool to determine a client’s perspective on his or her community. Discuss why these three questions are important.

Watch “Global warming swindle” movie and write a 1 page response

1. Define tariffs, summarize its history, discuss 7 types of tariffs and, analyze the impacts of tariffs on international trade.
2. Explain non-tariffs barriers to trade and discuss 6 most common non-tariffs barriers
3. Evaluate the arguments for and against protection and state which one (free market or protectionism) is more beneficial to a country.
4. State and discuss six forms of imperfect competition and seven distinct trade fairness principles.

Read the Starbucks case and answer the questions.
Is Starbucks effectively leveraging its resources and capabilities in a way that will allow it to meet company goals of growth?

Use a separate table to list Starbucks’ resources/capabilities along its value chain, and summarize with a comment on how well Starbucks is leveraging its capabilities to meet its growth strategy. A one-page comment will be sufficient for this write-up.

according to the senario , there are 6 questions should be answer in accurate scientific knowledge based on particular assigned paper and articles on the document , if any question need more detailed answer from external scientific references don’t hesitate to cite outer references

the list of recommended references for each questions are included in the document that I will upload, add references page , answer each question separately in a separate page

For this conference exercise, please download the article, “Using Problem-Based Scenarios to Teach Writing.” http://wikisend.com/download/478204/document.pdf
Actually, the scenario with Todd and Loren is in this article. The scenario begins on page 74 of the article. The letter you read is on page 75. The authors of the article—Smart, Hicks, and Melton—critique the response by Loren, as you did. They then provide a second possible response to Todd on pages 76-77. They then critique this second response.They then provide a third possible response to Todd on page 78. They then critique this third response. Please examine pages 74-79 of the article. Then answer the following questions.

1. After you read the analysis by Smart, Hicks, and Melton of the letter by Loren Lackluster, did your initial critique of the letter change at all? Did they point out issues that you had not thought of? If so, what issues did they point out that might cause you to revise your critique. Or perhaps your critique still stands. If so, why does is still stand?
2. After you took a look at the second response and the third response, how did the first response letter compare? Did the first response letter seem less effective to you after you saw the second and third ones? Why or why not?
3. Smart, Hicks, and Melton mention on page 75, “Too great a focus on an organizational strategy or predefined format results in this type of response.” Do you feel that Smart, Hicks, and Melton have a point? Explain in a sentence or two.
4. Does this scenario of Todd’s applying for a credit card represent a bad-news scenario? Examine the points made by Smart, Hicks, and Melton as you answer this question.
5. Examine the visual layout of the information in response 1, response 2, and response 3. Comment on them, compare them, and write a sentence or two on the importance of bullets, short paragraphs, or other visual elements in business writing of this nature.
6. Examine page 73 and the section, “Academic Writing Assignments: What is Lacking?” In this section, Smart, Hicks, and Melton note that some business communication books might emphasis a “‘fill-in-the-blank’ approach for a generic audience.” Describe a situation in your life, either at work or in another context, in which you had to respond to someone but that was not entirely either a bad-news or a good-news scenario. The authors of this article maintain that rhetorical context is important rather than a one-size-fits-all approach. They use the situation with Todd to demonstrate that a formulaic positive message strategy or a formulaic negative message strategy might not feature the best approach in some situations. Consider their discussion and analyze whether your writing situation “fit” a bad-news situation.

The main assignment here is a multi-modal composition that uses various rhetorical positions and different types of evidence to make arguments. This one, however, is a bit different from the first in that over the course of these next few weeks, as you research and evaluate various sources, and as you draft, craft and organize your thoughts and evidence, you will at some point have to make a decision to become an advocate for solutions to your central problem. you need to advocate for one or more specific solutions to the significant and current political/social/cultural problem that sits at the center of your focus; (the solutions you advocate should be limited in three and it is better that the solutions you advocate are related to each other).
When we think of the act of advocating and when we imagine a person or an organization who is an advocate for a cause, we think of strongly held opinions delivered with intensity from a rhetorical position that appears unshakable, deeply confident in the ethical rightness of its arguments and the accuracy of its knowledge. If we look at advocacy in such ways, we can understand why it takes time to become a convincing advocate, and that advocacy, even when it is delivered in the form of a thesis-driven composition, is a form of argumentation that can be quite different from the balanced arguments we often think of as academic writing even if it is as rigorous its presentation of evidence.
This is not to say that academic writers are not advocates. They are, and over the course of this project, you will become such an advocate�one who uses academic research and methods to deliver persuasive arguments convincingly to a public of one�s peers. Academic writers in many disciplines often write with the purpose of advocating for solutions to political/social/cultural/environmental problems. When they do so, they are expected to consider and present positions that run against theirs in various ways � call them counter arguments � in order to meet the expectations of their academic audience. They must demonstrate their mastery of established arguments and knowledge in areas of discourse and recognize the legitimacy of other perspectives, even if the author seeks ultimately to dismiss them.
In the realm of public advocacy, arguments and persuasion can look, feel, and sound quite different. Public advocates deliver strong and impassioned arguments by undermining counter arguments. They do so by choice and with knowledge about the various perspectives and pieces of evidence that may potentially undermine their case. When putting forth arguments in academic or public settings, the most convincing advocates do not simply put forward solutions without first comprehending the informed debates in which these solutions are situated. Rather, successful advocates draw from a deep well of knowledge when carefully selecting the evidence and rhetorical appeals that will make their case about how to address the profound social problems they put before their audiences.
This assignment challenges you to become that strong advocate, one who delivers convincing solutions to a current and pressing political/social/cultural problem. You cannot, in all likelihood, be this advocate at the beginning of the project. You will need to spend time researching and evaluating sources; you will need to explore various arguments and perspectives as you write proposals and drafts. At some point, however, after deepening your knowledge and maybe even after writing a full draft or two, you will need to choose a position to advocate.
for this assignment, you need to include at least 2 muti-modal elements (such as graphs, statistics graph, or image) to support your arguments. the thesis statement of this paper should focus on the reason why your policy is the best solution to this paper

Write an essay on the following: Irving’s “Rip Van Winkle.”
You are asked to examine how a literary work expresses the culture of the time that it was written. At the same time, you must demonstrate an understanding of the work as literature. For example, you might tell about how a story’s setting symbolizes a struggle to define American self-identity.

Details:
Working in the health care industry often puts health care professionals in the line of danger from ill patients, stressed families, overburdened health care facilities, and the many situations and locations in which each individual works. The Critical Incident Stress Debriefing (CIS) Management Tool has been designed to decrease the stress levels of those that experienced or witnessed violence or trauma.
Write a 500-750-word paper describing the CIS. Be sure to specifically address:
What is the purpose of using the tool?
The process of using the tool.
The expected outcome from utilizing this stress management tool.
Name at least three professions that are at risk and have utilized the tool.
Do you believe the tool to be useful in decreasing stress and coping with violence in the workplace? Why or why not?
List several physical, cognitive, emotional, and behavioral reactions to stress.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located on the Student Success Center. An abstract is required
Week 5
The National Center for Health Statistics has established the Healthy People 2020 for tracking the nation’s health. Locate the 42 topic areas discussed in Healthy People 2020.

Write a 750-1,000-word paper identifying the top 10 areas that you would consider the most important to address if budgetary restraints limited the study.What are the areas?
Why did you choose these areas?
How would you develop a program and present it to an individual and a community?
Discuss the impact of failure to achieve the goals of the chosen focus areas.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located on the Student Success Center. An abstract is not required.
Trends and Issues for the 21st Century

Introduction
Health care trends and issues are well documented by multiple governmental and private organizations to study changes in the demographics of the populations, to discover disparities in health care, and to develop consistent solutions to any problems exposed. Changing population age, ethnic minority shifts, and economic swings do not alter the basic need for adequate health care and developing sustainable programs to adjust to future needs. The health of the nation is at risk without solutions in place.
Factors in Disparities

Disparities in health care quality and access have been extensively studied by The National Center for Health Statistics for the purpose of discovering trends and directing policy to improve the health of the nation (Centers for Disease Control and Prevention, 2008). The U.S. Department of Health and Human Services, through the Agency for Healthcare Research and Quality (AHRQ) has as its mission to improve the quality of health care for all Americans by identifying inequalities in care (Agency for Healthcare Research and Quality, 2004). A research search finds other agencies address the same basic disparity issues in health care.
The aging population of the United States creates new problems with an increased need for more access to health care. The Centers for Medicare and Medicaid Service (CMS), report that in 2006 there were 35.5 million people over the age of 65 in the United States. This is expected to rise to 55 million by 2020 (The Centers for Medicare and Medicaid Service, 2006) As people are living longer, the incidence of chronic diseases increase the need to utilize the health care system, increase the cost of and usage of medications, and an overall increase in the size of the health care budget (Lecca, Valentine, & Lyons, 2003, p.176). Utilizing the budget for the elderly takes money from other programs needed to be financed. The governmental Medicare and Medicaid systems provide coverage for the elderly and disabled, but struggle to keep access to adequate care available.
The Centers for Medicare and Medicaid Service (CMS) report states that in 2006 the expenditures for Medicare and Medicaid were estimated to be 3.2% of the gross domestic budget (GDB). The government realizes that costs need to be controlled and pass the Medicare Modernization Act to identify and put in place cost-cutting solutions to help the Medicare system survive (The Centers for Medicare and Medicaid Service, 2006). Without the programs many more elderly Americans would have no insurance coverage and only increase the disparity to adequate health care.
Changing minority and ethnic populations in the United States presents unique challenges to health care delivery. The demographics in the United States have changed to a more ethnically diverse population, which has forced health care providers to reevaluate the health care delivery system and those that deliver the care. Lecca et al. (2003) suggest that more cross-cultural programs be developed to meet the needs of minorities.
The Institute of Medicine commissioned a study on health disparities in minority populations. In its 2002 report Unequal Treatment: What Healthcare Providers Need toKnow About Racial and Ethic Disparities in Healthcare, The Institute of Medicine suggested that health professionals should be educated on attitudes, knowledge base, and skills to better understand another culture in order to deliver effective health care. Only through education and understanding will the racial and ethnic barriers be eliminated to decrease disparities in care.
The U.S. Census Bureau reports that in 2007 the minority population numbered over 100 million. This translates to one in three people living in the United States being classified as a minority (U.S. Census Bureau, 2007). Blacks, Hispanics, Asians, American Indian, Alaska Native, and Native Hawaiian are all listed as minority groups, with non-Hispanic, single race representing 66% of the population. With such large numbers of the population listed as minorities, health care concerns must be addressed.

Disparities in health care often include a lack of insurance or financial means to pay for care. Those that qualify can enroll in governmental programs to pay for their care, but others find it difficult to afford even basic health needs. Disparities in health care can also include locations where access is limited, as rural areas that have either no health care providers available or lack of transportation to get to where the care is provided. Persons with diseases that require specialized treatments may need to access health systems that are far from their homes and have few care options to consider (Shi & Singh, 2003).
Quality of Care
Access to health care providers is just one aspect of receiving adequate health care. One of the requisites of good health care is delivering it in an equable manner, no matter which racial background, location of care, or economic status of the patient (Mead, Cartwright-Smith, Jones, Ramos, Woods, & Siegel, 2008). Quality of care issues includes practicing in a facility that has been properly licensed, staffed with knowledgeable professionals, and has achieved good outcomes, no matter which patient population is being served (Shi & Singh, 2003).

Quality of care issues result from behaviors displayed by both the providers of care and the receivers of care. It has been shown that there is an inequity in treatment plans for both disease management and routine care from the providers. Many providers are not aware of the cultural issues and plan their treatments on biased information. Many times language is a barrier to effective treatments that can delay care and result in a worsening condition (Mead et al., 2008, pp. 61-65).
Providers can be more effective in their care of minorities by following the recommendations of the American Medical Association (AMA) and other organizations to increase knowledge regarding the minority populations and not rely on past experiences (American Medical Association, 2008). The Center for Health Equity Research and Promotion recommended that providers increase cultural competency to decrease health care disparities for their patients, whatever their cultural or economic situation (Thompson, 2007). As the population of minorities grows, the importance of effective communication with patients is key to healthy outcomes.

Minorities also affect their quality of health care. Cultural and socioeconomic beliefs can delay seeking medical care until conditions worsen and options are limited. Language barriers limit receiving both health care information and the correct information to make informed decisions. Minorities may distrust providers and either fail to seek treatment or reject the treatment options given. Quality of care can also be affected by the location care is received. Minorities often go to community clinics or emergency departments for treatment of acute episodes of illness and never establish care with a primary provider for a more consistent treatment plan, which can provide wellness programs (Mead et al., 2008).
Qualities of care issues are often hard to measure. The financial systems that pay the bills for patient care are always researching ways to keep the quality care, but limiting the costs of delivering that care. Outcomes of disease management or routine care can vary depending on the provider of that care. Over the years several methods have been put in place to establish treatment plans and best practice guidelines to achieve the best patient outcomes in the most cost-efficient way.
Clinical Guidelines are evidence-based treatments that have been established to be the best options to care. Clinical Pathways are designed for a multidisciplinary collaboration for patient treatments. They specify the outcomes for “…guidance for each stage in the management of a patient…” (Open Clinical, 2003). Each gives details on how patient care should be directed. In the health care industry, which is comprised of multiple levels of professionals that come from different educational backgrounds, each can improve quality of care by decreasing the disparity of care and work from the same plan of action.

Health Care for the Future

Health care in the future, as in the present, must first concentrate on the financial or payer source in order to make changes. Governmental and private insurance payers must find ways in which to cut costs while delivering care. Insurance coverage and payment options have shifted the cost of insurance to the covered person from the employer or insurance companies. Consumer-directed health plans (CDHPs) allow employees to choose coverage options according to their needs. CDHPs allow more of the decision making control concerning health care costs, lifestyle choices, and treatment decisions to the individual, who can choose to participate in wellness programs or disease management training for a reduction in premiums. CDHPs include health reimbursement accounts or health saving accounts that have been slow to be offered by employee groups, but they are the trend of the future (Tynan & Christianson, 2008). Many employers consider a long education retraining necessary in order for employees to be knowledgeable with the multiple new choices of coverage available and have chosen to go slowly with the conversion to a CDHP program.
Medicare has attempted to decrease overall costs and improve service to the elderly by passing the Medicare Modernization Act in 2003 to expand medication coverage with Medicare Plan D. The medications are included in a deduction program with cost limitations and costs shared by the policy holder (Centers for Medicare and Medicaid Services, 2005). Medicare has also implemented the means testing provision so those persons that have a higher income pay more for their Medicare coverage starting in 2007 (Pauly, 2004). Medicare and Medicaid agencies understand that unless costs are controlled, the United States will no longer be able to finance the fast growing programs as they are administered today.
Health status in the future will greatly depend on the wellness programs in place in the present. The population is living longer, more chronic conditions are being better managed, and new technology has developed vaccines to control diseases. Wellness programs focus on screening for health issues, providing education on self-help resources, and prevention methods to remain healthy. Education can include weight reduction, smoking cessation, or the dangers of illegal drug use. The focus of future health will be to remain healthy instead of struggling to regain health.
The Department of Health and Human Services (HHS) recognizes the importance of getting the population more involved in their own health care and remaining healthy for the future. In 2000, HHS initiated Healthy People 2010 that established 467 objectives designed to improve the health of the nation for the future. The program includes 28 focus areas representing different health areas (Centers for Disease Control and Prevention, 2007). The focus of Healthy People 2010 is to eliminate health disparities and identify areas that need improvement. The National Center for Health Statistics is responsible for monitoring the data and making recommendations for future programs and changes.