Asvance Care Planning

I believe that patients have the right to decide what they intend to do for their future health care. Patients are not just people we give a bed to so they can die. They have plans that they intend to have laid out for themselves. As healthcare professionals, we must respect the patient’s

when the child or young person may become seriously ill or a family member or close friend

The process of this forward thinking and planning is called advance care planning. The most common reason this happens is if a person develops

The Federal Patient Self-Determination Act (PSDA) of 1991 first brought attention to the importance of advance directives (GAPNA, n.d.). Although regulatory bodies continue to promote advance directives, little has been done to encourage and enforce this initiative, highlighting the need for directed efforts to improve AD completion rates. The overall prevalence of completed advance directives in the United has been estimated that 5-15% (Tung & North, 2009). This indicates a need for programs to educate and empower patients and providers to ensure that dialogue about advanced care planning is initiated early on, and that advance directives are completed. Studies have shown that patients prefer that their primary care doctor initiate such planning while they are in good health and that such planning should occur earlier than it did in terms of age, natural history of disease, and patient-physician relationship. The barriers to advance care planning that have been identified include availability of trained staff, organizational commitment and policy to support advance care planning, and understanding/support of providers (Ramsaroop, Reid, & Adelman, 2007).

While uncertainty about the role of an Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) persists, what research has found about the role is that AG-ACNP’s provide advanced nursing care to those who are acutely, critically or chronically ill in both traditional and nontraditional healthcare settings (Kleinpell et al., 2012). Standard of scope differs between all types of scopes and nurse practitioners alike. The scope of practice (SOP) for an Acute Care Nurse Practitioner (ACNP) is not based on practice setting, but rather what type of care the patient will need, for example, someone who needs ventilator management in either the home or hospital environment (Kleinpell et al., 2012).

circumstances can be taken into account when planning care that will empower individuals. I will use a variety of examples from health and social care. I will also extend these examples by assessing the potential difficulties in taking individual circumstances into account when planning care that will empower an individual, and make suggestions for improvement.

Write one nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility.

If the individuals’ wishes conflict with their care plan in relation to health & safety and their risk assessment, you would need to ensure that the individuals’ wishes were listened to and respected and that their, your own and others health and safety was not put at risk. Include the individual in the risk assessment to help prevent conflict from arising, help them feel empowered, the reasons why it is necessary, that it in place for them as well as the people that are helping them. Ask the individual why it is that they object/disagree and give them time to explain. Give reassurance and try to reach a compromise that is safe and protects the individual, yourself and other’s well being. Explain the consequences for

Currently, the Affordable Care Act establishes nurse practitioners as providers whom are eligible providers in ACOs; however, the current Medicare Shared Savings program statute prevents beneficiaries of Medicare, who are receiving primary care service from a nurse practitioner, from being assigned to Accountable Care Organizations inside the program (AANP, 2015). The American Association of Nurse Practitioners (2015) also claim the exclusion of nurse practitioners must be repealed if ACOs want to develop further as models of practice, which improve cost effectiveness, patient access and quality.

In this paper, I will discuss advance directives, what it is, and the reason for it. I will talk about the issues that are currently facing advance directives care and talk about whether it has failed, or not. Finally, I will prove my stand on the issues with evidence.

AAPA also strive to create progressive work environments for physician assistants. Developing and pursuing legal strategies to expand and protect the PA scope of practice thus achieving a more autonomous work environment. Also developing plans and solution to remove any workplace-imposed barriers to PA practice thus creating a positive working environment for PAs across the country.

The term, Accountable-Care Organization (ACO) is a model that consists of a “group of healthcare providers, including primary care physicians, specialists, and hospitals who agree to take on a shared responsibility/partnership for the care of a defined population of patients while assuring active management of both the quality and cost of that care” (Foster, et. al, 2012). The overall goal of the ACO is to “reduce costs through preventative care and disease management, improve quality of care through multidisciplinary medical professionals, and develop the necessary skills and resources to meet the costs and quality of healthcare goals in the present and future of patient care” (Accountable Care Facts, 2012). Not to mention, patient care

Advance Practice Nurses exhibit holistic healthcare when they treat a patient as a whole and not just based on physical findings. For example, the APN is referring a patient without transportation for dialysis treatment three times per week; in addition, the APN will also find transportation resources for the patient or refer them to social services for further assistance.

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

As individuals age changes occur physiologically that are part of normal aging. These changes occur in all organ systems and can impact an individual’s quality of life. The changes related to aging can be attributed to an individual’s genetic make up, lifestyle, physical activity, and dietary lifestyle. Being able to differentiate between normal changes in aging against disease process is important because it can help clinicians develop a plan of care (Boltz, Capezuti, Fulmer, & Zwicker, 2012). Creating an accurate plan of care for older adults will greatly impact their quality of life.