Ethical/Legal Discussion of Abuse
Child and elder abuse are disturbing, unfathomable issues due to the helpless nature of the victims; however, many people are affected daily by maltreatment. Healthcare providers often discover this abuse by assessment rather than self-disclosure. It can also be an issue family members bring up to a healthcare provider. Abuse can occur in many forms such as neglect, emotional, stealing their belongings, or sexual abuse. It is vital for health professionals to recognize maltreatment and know how to handle the situation properly for the sake of the patient’s safety. This post will cover four resources covering ethical and legal aspects of child and adult abuse and how they concern psychiatric mental health practitioners in their field.
Elder Abuse Ethics
Saghafi et al. (2019) studied the ethical dilemmas healthcare professionals face while trying to manage elder abuse. The ethical concerns they discuss cover the difficulties care team members face when the abused elder chooses to stay in an abusive situation, the legality of telling other team members secretive patient information for help with how to properly intervene, and the issue of how nurses should intervene for patients with neurocognitive disorders. They also discuss federal law mandating elder abuse reporting and the importance of protecting the autonomy of elders without forcing what another person believes is best for them. This can overlap when it comes to what the healthcare provider believes is best for a patient but it is not what the patient wants. Saghafi et al. (2019) pointed out the importance of clinical guidelines to help support care teams with making these ethical decisions.
Child Abuse Ethics
Glover and Justis (2015) discussed how many people believe taking care of child abuse when discovered is easy and should be taken care of immediately without realizing how many ethical dilemmas can make child abuse issues difficult to resolve. When people think of sexual or physical abuse, it seems understandable to know and report such abuse. However, when the abuse comes in the form of obese children, underweight children, verbal, or end of life care decisions, the ethics of what is right and wrong can become more difficult (Glover & Justis, 2015). Decisions that are difficult for all parties involved, including the health care provider that would be mandated to report it. Glover and Justis (2015) stated health care providers sometimes might find themselves having to intervene with parents and discuss decisions if not found to be in the child’s best interest, with a threshold of not reporting as mandated as long as their decisions do not cause harm.
Legal Considerations for the Elderly
Hess (2011) provided multiple types of elder abuse to assist health care providers to recognize what is legally mandated to be reported. Besides the more obvious physical or sexual abuse, she discusses psychological abuse that can present as being upset, withdrawn, agitated, or unusual behaviors such as biting, and also financial abuse, neglect, or abandonment. She provides the three R’s in detecting and reporting abuse of recognize, respond, and report. Health care teams should legally follow their reporting procedures for documentation, reporting abuse if needed, and following up to ensure patient safety. Hess (2011) points out a law in place to protect the elderly like the Older Americans Act of 1965. She also provides web sites like (http://www.apsnetwork.org/Abuse/index.htm that provide resources for reporting and http://www.ncea.aoa.gov/NCEAroot/Main_Site/Find_Help/State_Resources.aspx for numbers to call.
Legal Considerations for the Children
Fishe and Moffat (2016) discussed the Child Abuse Prevention and Treatment Act
(CAPTA) of 1974 that causes the Department of Human Services (DHS) to collect data and monitor the effectiveness of each state’s practices. By law, there are certain people required to report any type of child abuse. Fishe and Moffat (2016) provided those who are mandated to report child abuse which includes any medical or mental health professional and should be done quickly in most states (Fishe & Moffat, 2016). If abuse is discovered after a patient turns 18 or a while after the abuse happens, then the occurrences should still be reported (Fishe & Moffat, 2016). Another action required of healthcare professionals is collecting evidence by documenting findings, taking photos of evidence, and presenting lab results if ordered (Fishe & Moffat, 2016).
Personal Practice
Considering all medical or mental health professionals are mandated to report witnessed or suspected child or adult abuse, this directly affects my personal practice by providing an understanding of what, when, and who the information needs to be reported to. I was not aware that if patients report abuse from years ago, that I am mandated to report it so that changes my personal practice as well. According to Fishe and Moffat (2016), the state of Arkansas requires abuse to be reported immediately. Although it can be difficult to report suspected abuse, not knowing if more harm is being done than good, I would much rather live with that on my conscious than not reporting and having a terrible outcome for a patient.
References
Fishe, J. N., & Moffat, I. F. L. (2016). Child Abuse and the Law. Clinical Pediatric Emergency Medicine, 17(4), 302–311. https://doi.org/10.1016/j.cpem.2016.09.003
Glover, J., & Justis, L. (2015) Ethics and the Identification and Response to Child Abuse and Neglect. General Law. https://lawexplores.com/ethics-and-the-identification-and-response-to-child-abuse-and-neglect/
Hess, S. (2011). The Role of Health Care Providers in Recognizing and Reporting Elder Abuse: [1]. Journal of Gerontological Nursing, 37(11), 28–37. http://dx.doi.org/10.3928/00989134-20111012-50
Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and history of medicine, 12, 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642445/
Evidence-Based Clinical Intervention
/in Nursing /by adminYour Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:
The medical problem/diagnosis/disease.
Typical presenting signs and symptoms including:
Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course since onset, Usual age group affected
Concomitant disease states associated with the diagnosis
The pathophysiology of the problem.
Three differential diagnoses and the usual presenting signs and symptoms in priority sequence with rationales.
Reference to at least two current journal articles that show evidence-based practice as how to best treat this disorder related to the primary differential.
The expected outcomes of the intervention.
Algorithms if available.
A typical clinical note in SOAP format.
carcinogenesis
/in Nursing /by adminJ.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.
Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.
Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.
Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.
Case study questions:
Please name the potential most common sites for metastasis on J.C and why?
What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
Describe the carcinogenesis phase when a tumor metastasizes.
Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer.
Covid Colonoscopy
/in Nursing /by adminWhen seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, but body measurements can also provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process. Explore how you could effectively gather information and encourage parents and caregivers to be proactive about their health and weight.
For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.
Adult Assessment Tools or Diagnostic Tests.
The assigned Assessment Tool/Diagnostic Test is Colonoscopy
THE QUESTION:
Description how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is the purpose of Colonoscopy?
How is Covid Colonoscopy conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
nurse’s role in health promotion and disease prevention in older adults
/in Nursing /by admindescribe and discuss the nurse’s role in health promotion and disease prevention in older adults. Share an example from your personal experience as a RN.
Name and elaborate on at least three screening/preventive procedure that must be done in older adults.
Define and discuss three common End-of-life documents that you as nurse must be familiar with to be able to educate older adults.
Covid 19 and Mental Health ( Depression)
/in Nursing /by adminCompare your analysis of this issue in the media reports with your analysis of this issue in the professional nursing literature.
Identify the similarities and differences
Based on your findings in this comparative analyses identify the implications for nurses or nursing students, health care policy, and/or health care delivery systems
Use the following headings:
Introduction
Similarities
Differences
Implications for nurses, nursing students, health care policy, and/or health care delivery systems
Conclusion
name one financial aspect, one quality aspect, and one clinical aspect
/in Nursing /by adminAfter discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.
Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?
Evidenced-based Practice (EBP) and quality projects/initiatives
/in Nursing /by adminYou will explore Evidenced-based Practice (EBP) and quality projects/initiatives. A nurse leader’s role in these projects cannot be underestimated. It is important to understand the differences in research projects, quality improvement (QI) initiatives, and evidenced based practice (EBP) projects. This week students will explore and discuss those differences.
Learning Outcomes
Upon successful completion of this module, you will be able to:
Differentiate between evidenced-based practice and research.
Differentiate between quality improvement projects and research.
Explore how evidenced based practice, quality, and safety in health care are reflected in nursing theory, research, and science in meeting the mandate for quality and safety.
Be sure to complete all Introduction, Learn, and Apply items in Module 5: Week 5 – Evidenced Based Practice/Quality Improvement by 11:59 p.m. (ET) on the assigned due date. Use the Modules link on the left side of the screen at any time to view your progress in the course.
nurses in all settings need to strive to learn about existing or emerging mid-range theories
/in Nursing /by adminIn this module’s introduction, the following assertation is made: “Therefore, nurses in all settings need to strive to learn about existing or emerging mid-range theories, or seek to develop and describe theories that will explain phenomena they observe in practice?” APA, 150 words or more, two or more references.
Given the demands, we all face in our practices, how can we tangibly “seek to develop and describe theories that will explain phenomena they observe in practice?”
informed consent for Children and adolescents
/in Nursing /by adminThe legal implication of informed consent for Children and adolescents: Informed consent lays the foundation for the psychotherapy relationship and treatment to come in respecting the
client’s legal rights and offering them the opportunity to decide about participating in the treatment to be delivered. It enables the client’s autonomy and empowers them to play an active
role in their treatment. The potential benefits of an appropriately implemented informed consent process is a collaborative process that sets the tone for the psychotherapy relationship,
promoting an enhanced therapeutic alliance; it promotes shared decision-making. This information sharing and collaborative decision-making process minimize the risk of exploitation of
and harm to the client. (Coffman, C., Barnett, E., 2022). The legal implication of informed consent for adults: The process of informed consent occurs when communication between a patient
and physician results in the patient’s authorization or agreement to undergo a specific medical intervention. If the patient lacks decision-making capacity or declines to participate in making
decisions, the provider should: Assess the patient’s ability to understand relevant medical information and the implications of treatment alternatives and make an independent, voluntary
decision. Present relevant information accurately and sensitively, keeping with the patient’s preferences for receiving medical information. The physician should include information about
the diagnosis, the nature, and purpose of recommended interventions, the burdens, risks, and expected benefits of all options, including forgoing treatment. Document the informed
consent conversation. When the patient/surrogate has provided specific written consent, the consent form should be included in the record. In emergencies, when a decision must be made
urgently, the patient cannot participate in decision making, and the patient’s surrogate is not available, the provider may initiate treatment without prior informed consent. In such
situations, the physician should inform the patient/surrogate at the earliest opportunity and obtain permission for ongoing treatment in keeping with these guidelines.
(Informed consent.,2022).
Ethical implications of informed consent in adults: With informed consent, the patient and health care provider each play a role in formulating an acceptable treatment
plan. Essential aspects of informed consent include ethical obligations to promote autonomy, provide information, and avoid unethical forms of bias. Patients have the right to refuse
medical therapies, whether on religious or other grounds if they are competent to do so. Providers cannot subject patients to specific tests without informed consent. All patients should be
involved in decision-making to the degree their capacity allows, irrespective of age. (Van. Norman. G., 2008).
Ethical implications of informed consent for children and adolescents: The American Medical Association suggests that practitioners have a moral obligation to encourage
adolescents’ autonomy by involving them in the decision-making process of medical treatment. Although the American Academy of Pediatrics (2003) defers the regulation of consent rights of minors to
individual states, it takes the following position: “As children develop, they should gradually become the primary guardians of personal health and the primary partners in medical decision making,
assuming the responsibility of their parents” (Committee on Bioethics, 1995, p. 316). Even though the parent has a legal responsibility to ensure the child is receiving the appropriate medical care, there is
also, an ethical “need to respect the rights and autonomy of every individual, regardless of age” (Kunin, 1997, p. 44). Although practitioners are encouraged to respect adolescents’ autonomy, ethical
guidelines promote obtaining consent for treatment with the adolescent and the parent (Roberson, A.J., 2022)
References
Anthony James Roberson. Adolescent Informed Consent: Ethics, Law, and
Theory to Guide Policy and Nursing Research – ProQuest. (2022).
Retrieved 10 March 2022, from https://www.proquest.com/openview/
Caroline Coffman, Jeffrey E Barnett
Adolescents, I. (2022). Informed Consent with Children and Adolescents |
society for the Advancement of Psychotherapy. Retrieved 9 March 2022,
from https://societyforpsychotherapy.org/informed-consent-with-children-and-adolescents/
Informed Consent. (2022). Retrieved 9 March 2022, from https://www.ama-assn.org/delivering-care/ethics/informed-consent
Van Norman, G. (2008). Ethical Issues in Informed Consent. Perioperative Nursing Clinics, 3(3), 213-221. DOI: 10.1016/j.cpen.2008.04.004
Ethical/Legal Discussion of Abuse Child and elder abuse
/in Nursing /by adminEthical/Legal Discussion of Abuse
Child and elder abuse are disturbing, unfathomable issues due to the helpless nature of the victims; however, many people are affected daily by maltreatment. Healthcare providers often discover this abuse by assessment rather than self-disclosure. It can also be an issue family members bring up to a healthcare provider. Abuse can occur in many forms such as neglect, emotional, stealing their belongings, or sexual abuse. It is vital for health professionals to recognize maltreatment and know how to handle the situation properly for the sake of the patient’s safety. This post will cover four resources covering ethical and legal aspects of child and adult abuse and how they concern psychiatric mental health practitioners in their field.
Elder Abuse Ethics
Saghafi et al. (2019) studied the ethical dilemmas healthcare professionals face while trying to manage elder abuse. The ethical concerns they discuss cover the difficulties care team members face when the abused elder chooses to stay in an abusive situation, the legality of telling other team members secretive patient information for help with how to properly intervene, and the issue of how nurses should intervene for patients with neurocognitive disorders. They also discuss federal law mandating elder abuse reporting and the importance of protecting the autonomy of elders without forcing what another person believes is best for them. This can overlap when it comes to what the healthcare provider believes is best for a patient but it is not what the patient wants. Saghafi et al. (2019) pointed out the importance of clinical guidelines to help support care teams with making these ethical decisions.
Child Abuse Ethics
Glover and Justis (2015) discussed how many people believe taking care of child abuse when discovered is easy and should be taken care of immediately without realizing how many ethical dilemmas can make child abuse issues difficult to resolve. When people think of sexual or physical abuse, it seems understandable to know and report such abuse. However, when the abuse comes in the form of obese children, underweight children, verbal, or end of life care decisions, the ethics of what is right and wrong can become more difficult (Glover & Justis, 2015). Decisions that are difficult for all parties involved, including the health care provider that would be mandated to report it. Glover and Justis (2015) stated health care providers sometimes might find themselves having to intervene with parents and discuss decisions if not found to be in the child’s best interest, with a threshold of not reporting as mandated as long as their decisions do not cause harm.
Legal Considerations for the Elderly
Hess (2011) provided multiple types of elder abuse to assist health care providers to recognize what is legally mandated to be reported. Besides the more obvious physical or sexual abuse, she discusses psychological abuse that can present as being upset, withdrawn, agitated, or unusual behaviors such as biting, and also financial abuse, neglect, or abandonment. She provides the three R’s in detecting and reporting abuse of recognize, respond, and report. Health care teams should legally follow their reporting procedures for documentation, reporting abuse if needed, and following up to ensure patient safety. Hess (2011) points out a law in place to protect the elderly like the Older Americans Act of 1965. She also provides web sites like (http://www.apsnetwork.org/Abuse/index.htm that provide resources for reporting and http://www.ncea.aoa.gov/NCEAroot/Main_Site/Find_Help/State_Resources.aspx for numbers to call.
Legal Considerations for the Children
Fishe and Moffat (2016) discussed the Child Abuse Prevention and Treatment Act
(CAPTA) of 1974 that causes the Department of Human Services (DHS) to collect data and monitor the effectiveness of each state’s practices. By law, there are certain people required to report any type of child abuse. Fishe and Moffat (2016) provided those who are mandated to report child abuse which includes any medical or mental health professional and should be done quickly in most states (Fishe & Moffat, 2016). If abuse is discovered after a patient turns 18 or a while after the abuse happens, then the occurrences should still be reported (Fishe & Moffat, 2016). Another action required of healthcare professionals is collecting evidence by documenting findings, taking photos of evidence, and presenting lab results if ordered (Fishe & Moffat, 2016).
Personal Practice
Considering all medical or mental health professionals are mandated to report witnessed or suspected child or adult abuse, this directly affects my personal practice by providing an understanding of what, when, and who the information needs to be reported to. I was not aware that if patients report abuse from years ago, that I am mandated to report it so that changes my personal practice as well. According to Fishe and Moffat (2016), the state of Arkansas requires abuse to be reported immediately. Although it can be difficult to report suspected abuse, not knowing if more harm is being done than good, I would much rather live with that on my conscious than not reporting and having a terrible outcome for a patient.
References
Fishe, J. N., & Moffat, I. F. L. (2016). Child Abuse and the Law. Clinical Pediatric Emergency Medicine, 17(4), 302–311. https://doi.org/10.1016/j.cpem.2016.09.003
Glover, J., & Justis, L. (2015) Ethics and the Identification and Response to Child Abuse and Neglect. General Law. https://lawexplores.com/ethics-and-the-identification-and-response-to-child-abuse-and-neglect/
Hess, S. (2011). The Role of Health Care Providers in Recognizing and Reporting Elder Abuse: [1]. Journal of Gerontological Nursing, 37(11), 28–37. http://dx.doi.org/10.3928/00989134-20111012-50
Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and history of medicine, 12, 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642445/