During the course, you have done a thorough analysis of a company and the health care subsector in which the company operates now is the time to look at all your findings and insights and frame the situation of the company in terms of cost, access, and quality. Specifically:

1. Are there any major cost-containment policies or practices from private insurers or the government that affect your company? Are there any internal/ competitive forces that are trying to do the same?
2. How does your company (and industry) is assessed in terms of its ability to offer access to all populations?
3. What kind of quality assessment and assurance is done? Are there any positive or negative stories about the quality of health care services of the organization?

SOAP note Heart Failure

View the TEDTalk “Why I live in Mortal Dread of Public Speaking”Links to an external site. by Megan Washington (TEDx, 2014). Then, view the Sources of Communication Apprehension presentation (adapted from Engleberg & Wynn, 2015). In light of the TEDTalk, the presentation, and your own experiences respond to the following questions:

• What strikes you as most interesting about Ms. Washington’s talk?
• Do you relate in any way to her talk or to the Sources of Communication Apprehension presentation?
• If you had to pick one or two sources of communication apprehension that you feel relate to you, which ones would they be and how do you manage them?

Be sure to respond to your peers as well. As a note, aim for full credit and connect to a scholarly source beyond the TED Talk to show how the discussion ties to your studies in the course. For this post, an integration of a scholarly course should go beyond a mention of the apprehensions from the text above. 

References 

Engleberg, I. N. & Wynn, D. R. (2015). Think communication. Boston, MA: Pearson 

TEDx. (2014). Megan Washington: Why I live in mortal dread of public speaking. http://www.ted.com/talks/megan_washington_why_i_live_in_mortal_dread_of_public_speaking 

Week 2 Ethical Frameworks Essay

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below).  Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way?  Does this seem like a valid process for you to apply in your practice? 

Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

· What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

· What are the goals of treatment?

· In what circumstances are medical treatments not indicated?

· What are the probabilities of success of various treatment options?

· In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

Patient Preferences: The Principle of Respect for Autonomy

· Has the patient been informed of benefits and risks, understood this information, and given consent?

· Is the patient mentally capable and legally competent, and is there evidence of incapacity?

· If mentally capable, what preferences about treatment is the patient stating?

· If incapacitated, has the patient expressed prior preferences?

· Who is the appropriate surrogate to make decisions for the incapacitated patient?

· Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

· What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

· On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

· Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

· What ethical issues arise concerning improving or enhancing a patient’s quality of life?

· Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

· What are plans and rationale to forgo life-sustaining treatment?

· What is the legal and ethical status of suicide?

Contextual Features: The Principles of Justice and Fairness

· Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

· Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

· What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

· Are there financial factors that create conflicts of interest in clinical decisions?

· Are there problems of allocation of scarce health resources that might affect clinical decisions?

· Are there religious issues that might influence clinical decisions?

· What are the legal issues that might affect clinical decisions?

· Are there considerations of clinical research and education that might affect clinical decisions?

· Are there issues of public health and safety that affect clinical decisions?

· Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeContent	20 to >17.2 pts Proficient The writer clearly and effectively responds to the assignment. 17.2 to >15.0 pts Approaches Proficiency The response to the assignment is generally adequate, but may not be thorough. 15 to >0 pts Does Not Meet Expectations The writer does not respond to the assignment.	20 pts
This criterion is linked to a Learning OutcomeFocus and Detail	18 to >15.48 pts Proficient There is one clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information. 15.48 to >13.5 pts Approaches Proficiency There is one clear, well-focused topic. Main ideas are clear but are not well supported by detailed information. 13.5 to >0 pts Does Not Meet Expectations The topic and main ideas are not clear.	18 pts
This criterion is linked to a Learning OutcomeOrganization	14 to >12.04 pts Proficient The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong. 12.04 to >10.5 pts Approaches Proficiency The introduction states the main topic and provides an overview of the paper. A conclusion is included. 10.5 to >0 pts Does Not Meet Expectations There is no clear introduction, structure, or conclusion.	14 pts
This criterion is linked to a Learning OutcomeMechanics and APA	8 to >6.88 pts Proficient The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly. 6.88 to >6.0 pts Approaches Proficiency The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly. 6 to >0 pts Does Not Meet Expectations The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are cited and referenced incorrectly, or citations and references are missing.	8 pts
Total Points: 60

 

  

Soap Note 1 is based on the Case Study # 1

1.Templates used from another classes will not be accepted. Student must use the template provided in this class which must clearly contain the progress note (in the Assessment section) of the encounter with the patient ( this section is clearly mark in bold, highlighted  and underlined). No passing grade will be granted if this section is not completed properly. 
2.Follow the MRU Soap Note Rubric as a guide
3.Use APA format and must include minimum of 2 Scholarly Citations.

4.Check for plagiarism,Turn it in Score must be less than 25% or will not be accepted for credit, must be your own work and in your own words. Copy-paste from websites or textbooks will not be accepted or tolerated.
5.The use of tempates is ok with regards to Turn it in, but the Patient History, CC, HPI, The Assessment and Plan should be of your own work and individualized to your made up patient.  

6.The case study does not contain all the information related to the patient, so you must complete each step of the template according to the symptoms, signs, treatment, diagnostic methods, plan, education, etc. according to the patient’s diagnosis.

7. Attached you can find the rubric and SOAP note template. Also you can find one example.