NSG6002-Health Policy and Health Promotion

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Hi, I RECEIVED THIS QUESTION FROM THE PROFESSOR. Please answer. Have in mind my state is florida. SHE WROTE THIS. An adverse drug event (ADE) is defined as harm experienced by a patient as a result of exposure to a medication, and ADEs account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year (Agency for Healthcare Research and Quality [AHRQ], 2018). Nearly 5% of hospitalized patients experience an ADE, making them one of the most common types of inpatient errors (AHRQ). Ambulatory patients may experience ADEs at even higher rates—the dramatic increase in deaths due to opioid medications has largely taken place outside the hospital (AHRQ). Transitions in care are also a well-documented source of preventable harm related to medications. What strategies can the Advance Practice Nurse use to ensure patients do not experience harm related to medications? Reference Agency for Healthcare Research and Quality (2018). Medication Errors. Retrieved from https://psnet.ahrq.gov/primers/primer/23/medication-errors besides I need: Review and answer about the same topic each discussion from my peers and answer with a long positive paragraph and references in each one.  Discussion 1  Identify the role of patient safety and the influence on the Federal initiatives that are used to prevent unintentional death as a result of medical mistakes. This is a very interesting topic given the global pandemic that is currently happening. It has been over a year into the two-week flatten the curve and get back to normal plan. Well, that didn’t work. Back in 1999, the Institute of Medicine (IOM) published To Err is Human: Building a safer health system. This report stated that nearly 100k people die every year in hospital settings due to human error. An error is defined as “an act involving an unintentional deviation from truth or accuracy” or “an act that through ignorance, deficiency, or accident departs from or fails to achieve what should be done” (Merriam-Webster, 2021). The IOM report stood to do serious harm in the public eye to the U.S. Healthcare system. It also shined a light on an ugly truth that needed to be brought to light so that a safer health system could be built. The title of the article both sheds light and while it places the blame squarely on the healthcare professionals it somewhat absolves them of the guilt of intentional harm. In doing so, this allows everyone involved to take a serious look at a serious problem and collaborate on how this can be fixed.             There have been many mistakes with COVID-19. Mistakes like, knowingly placing COVID-positive patients into nursing homes via direct orders as did the Governors of Michigan, California, New York, New Jersey, and Pennsylvania. Intentional or not, these orders were mistakes. To date, only Gov. Cuomo’s office chose to differ from the IOM’s effort expose and correct errors. Instead they “knowingly undercounted fatalities to preserve its reputation” as revealed via telephone with Melissa DeRosa, an aide to Gov. Cuomo (Husebo, 2021, para 9). The enforcers and authors of said orders often removed their elderly family members from the very nursing homes they were filling with COVID-positive patients. Then Health Secretary for Pennsylvania, and current Biden nominee for assistant secretary of the Department of Health and Human Services, did just that, removing his mother from a nursing facility (Husebo, 2021).             Laws such as the Whistleblower laws protect “employees from retaliation for reporting violations of various workplace safety and health” and other various activities (U.S. Department of Labor, 2021, para 1). Employers or employees who knowingly violate standards of care or policy need to be held accountable and the whistleblower laws provide security and incentive to report wrongdoing. If Men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and the next place, oblige it to control itself.     -James Madison Rules and regulations, federal initiatives, and other guidelines are necessary to determine a minimum standard of patient care. These rules are necessary to keep everyone honest and on the same page. Every year the Joint Commission releases its National patient Safety Goals (NPSG) to improve patient safety, enhance the quality of care and limit medical errors. NPSG 2021 outlines ways to improve staff communication, identify patients correctly, use alarms and medicines safely, prevent infection, identify patient safety risks, and prevent mistakes in surgery. These goals are developed in collaboration with “industry experts and stakeholders to gather information about emergent issues in patient safety and care” (Clarkson, 2020, para 1). NPSG and state, local, and federal initiatives all work in cooperation to improve the safety and quality of patient care.   References Clarkson, K. (2020, December). Joint Commission releases 2021 national patient safety goals. Pulsara.com. https://www.pulsara.com/blog/joint-commission-releases-2021-national-patient-safety-goals Husebo, W. (2021, March 1). Four Democrat governors issued similar nursing home policies to Cuomo’s. Breitbart.com. https://www.breitbart.com/health/2021/03/01/four-democrat-governors-issued-similar-nursing-home-polices-andrew-cuomo/ Madison, J. (2021). Quote by James Madison. Goodreads.com. https://www.goodreads.com/quotes/7196640-if-men-were-angels-no-government-would-be-necessary-if Merriam-Webster. (2021). Error. Merriam-webster.com. https://www.merriam-webster.com/dictionary/errors U.S. Department of Labor. (2021). The whistleblower protection programs. Whistleblowers.gov. https://www.whistleblowers.gov/   Discussion 2  The Role of Patient Safety on Federal Initiatives Patient safety is one of the most challenging issues in healthcare. The Agency for Healthcare Research and Quality (AHRQ) in the US continually develops frameworks to address patient safety challenges in healthcare. One of the documents by the agency that attempts to address the issue is the Institute of Medicine’s (IOM) sentinel report, and especially the 1999 report titled, To Err is Human: Building a Safer Health System. Overall, patient safety is a critical issue that attracts the attention of legislative chambers. More so, a significant interest in patient safety and which has resulted in federal initiatives is the need to prevent unintentional deaths. The following discussion evaluates the impact of patient safety on federal initiatives. According to Nash (2016), the focus on population health and safety has resulted in the creation of quality interventions. Pertinently, population health depends on the existence of coordinated care interventions, including prevention, health promotion, and screening. Essentially, an emergent issue that has resulted in the need for quality interventional measures is medical errors. Rodziewicz and Hipskind (2020) described two types of medical errors. The first is the error or omission that results from actions that have not been taken. The second is an error or commission from wrongly taken actions. In both cases, the health of the patients is compromised. The Institute of Medicine (IOM) defined a medical error “as the failure to complete a planned action as intended or the use of a wrong plan to achieve the aim” (Nickitaset al. 2016, p. 126). From this definition, medical errors can be described as resulting from negligence from the persons put in charge of population health. Further, Nickitas et al. gave different types of medical errors. They include diagnostic errors, equipment failures, infections, blood transfusion injuries, and misinterpretation of medical orders. Marsack and Hollier (2017) emphasized the seriousness of medical errors, who noted that they are the third-leading causes of death in the US.  As Nash (2016) discussed, the focus on patient safety is on the creation of quality interventions. Some of these are legal interventions created in the legislative chambers. Several policies have been developed to enhance patient safety, especially pertaining to deaths related to medical errors. Two of these federal initiatives are the Patient Safety Improvement Act (2020) and the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (2019). The Patient Safety Improvement Act (2020) is a bill sponsored by Senator Whitehouse, whose intention is to improve patient safety by creating state-based quality improvement efforts and enhancing reporting and data collection. A critical outcome of the bill is that it establishes initiatives meant to reduce infections associated with healthcare. Also, the bill is quality because it demands improved communication during care transitions, which is critical in reducing medical errors, such as infections. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (2019) is a bill sponsored by Janice Schakowsky, the State Representative for Illinois. It intends to amend the Public Health Service Act to improve the staffing of registered nurses for patient safety. The bill is one of the legislative actions that have been described as geared towards enhancing patient care, especially through the employment of highly qualified and registered nurses. It is a way of ensuring that there is a reduction in medical errors in healthcare. s References Marsack, K. P., & Hollier, L. H. (2017). Review of “Medical error—the third leading cause of death in the US” by Makary MA and Daniel M in BMJ 353. Journal of Craniofacial Surgery, 28(5), 1390. http://doi:10.1097/scs.0000000000003673 Nash, D. B. (2016). Population health: Creating a culture of wellness. Jones and Bartlett Learning Nickitas, D. M., Middaugh, D. J., & Aries, N. (2016). Policy and politics for nurses and other health professionals: Advocacy and action. Jones & Bartlett Learning. Rodziewicz, T.L. & Hipskind, J.E. (2020). Medical error prevention. StatPearls, 1-18.

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