Patient Advocacy 01.28.20
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\nCHSU COMPETENCY ASSIGNMENT
\nPatient Advocacy (Advocate)
\n_______________________________________________________________________________
\nCOMPETENCY ASSIGNMENT (CA)
\nCompetency assignments demonstrate competency in areas of performance aligned to PLOs. CAs are backwards designed to create evidence of competency for the targeted learning outcomes. CAs must be OBJECTIVE measures of INDIVIDUAL performance (typically by rubric or checklist) with reasonable inter-rater reliability. CAs should align to PLO rubrics and indicators (the rows within the PLO rubric) but may add additional context and focus relevant to the course. Each course typically has one to two competency assignments.
\nDescription Table:
\nCA
\nCA Description
\nDesign for PLO
\nEvaluation Instrument
\nPost-Mortem Case
\nEssay on Post-Mortem Case
\nPLO Patient Advocacy (Advocate)
\nModified AACU Inquiry and Analysis Rubric
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\nPLO KSM Table
\nPLO Patient Advocacy (Advocate)
\nCourses
\nList the courses here
\nPatient Self-Care (S1)
\nPatient Care I (S3)
\nPatient Care II (S4)
\nPatient Care III (S5)
\nList the courses here
\nAdvanced Patient Assessment (S3)
\nList the courses here
\nAdvanced Patient Assessment (S3)
\nP3 OSCEs (S6)
\nPharmacy Law (S6)
\nKSM
\nIntroduce\/Experience
\nPractice\/Movement
\nCompetency
\nKnowledge
\nPC I \u2013 III:
\nRATs\/Block Exams
\nADVANCED PATIENT ASSESSMENT:
\nAPPs on Recognition of Advocacy Challenge
\nADVANCED PATIENT ASSESSMENT:
\nFinal Simulation\/SOAP Note\/Rubric
\nP3 OSCEs:
\nSt 5: Vulnerable Patient Populations (ADVOCATE)
\nPHARMACY LAW:
\nEssay \u2013 Post-Mortem Case
\nSkills
\nPATIENT SELF-CARE:
\nCounseling Simulation
\nMotivational Interviewing Skill Set
\nPC I: Counseling
\nPC II: APPs
\nPC III: P&T Presentation on Formulary
\nADVANCED PATIENT ASSESSMENT:
\nPreliminary Simulation\/SOAP Note
\nMindset
\nFULL DESCRIPTION OF THE ASSIGNMENT AND EXPECTATIONS
\nYou specialize in forensic analysis and see yourself as the patient\u2019s advocate even in death. A law firm contacted you concerning the sudden death of a hospital patient. The firm is developing a case against Healing Arts Medical Center on behalf of the patient\u2019s family. You are serving as part of the claimant\u2019s side and you are tasked with providing a report of your professional assessment of the patient\u2019s care and recommendations for changes.
\nFULL CA INSTRUCTIONS FOR STUDENTS:
\nYou will evaluate the medical information obtained from the case narrative. Your report will describe the sequence of events during the hospital stay. Use the PICO Model to ensure you include all relevant information. The report will conclude with your professional recommendations to prevent this scenario from repeating, and strategies on disclosing errors to patients and death to their family members.
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\nThe PICO Model of Review
\nThe PICO Model will help you include all relevant information as you describe the sequence of events during the hospital stay.
\nP = Patient or Population
\n\u2022 Describe the patient.
\n\u2022 Why was the patient admitted?
\n\u2022 What was the treatment pathway for this case?
\nI = Intervention
\n\u2022 What was the team treating with each medication featured in the case?
\n\u2022 What types of medication and non-medication treatment options were given?
\n\u2022 What type of prognosis do patients have when admitted with similar conditions?
\nC = Comparison
\n\u2022 How does the intervention and treatment plan described here compare to the guidelines and evidence on treating this condition?
\n\u2022 What, if anything, could have been done differently?
\nO = Outcome
\n\u2022 What did the intervention hope to accomplish, measure, improve, or affect (i.e., the therapeutic goal)?
\n\u2022 How did the therapeutic goals change?
\nRecommendations
\nThe report will conclude with your professional recommendations to prevent this scenario from repeating and strategies on disclosing errors and deaths to patients and their family members.
\n\u2022 What information, not included in the case narrative, do you want and explain how you use this information?
\n\u2022 What could be improved, measured, or changed at Healing Arts Medical Center to help prevent this scenario from repeating in the future?
\n\u2022 What type of work environment and culture is essential for this incident to become a learning experience at Healing Arts Medical Center?
\n\u2022 What are the current \u201cbest practices\u201d for healthcare organizations disclosing medical errors to patients and death to their family members?
\nEVALUATION TOOL (RUBRIC(s) and INSTRUCTIONS:
\n\u2022 Each student must achieve 80% on this assignment to demonstrate competency.
\n\u2022 The paper needs to be greater than two pages and no more than four pages.
\n\u2022 You can use 1-inch margins on all four sides, standard portrait paper, double spaced, 12 pt. font, and use a sans-serif font (e.g., arial, caliibri, tahoma, but not comic sans).
\n\u2022 An assignment upload will be made available on BrightSpace a few weeks before the due date.
\n\u2022 Late papers will receive a reduced grade.
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\nModified AACU Inquiry and Analysis Rubric
\nCapstone
\n4
\nMilestones
\n3 2
\nBenchmark
\n1
\nScore
\nExplanation of central thesis, problem or issue
\nThe central thesis, issue, or problem is stated clearly and described comprehensively, delivering all relevant information necessary for full understanding.
\nThe central thesis, issue, or problem is stated, described, and clarified, so omissions do not seriously impede that understanding.
\nIssue\/problem\/thesis is stated, but description leaves some terms undefined, ambiguities unexplored, boundaries undetermined, and backgrounds unknown.
\nIssue\/ problem \/ thesis is stated without clarification or description.
\nMaximum score = 20
\nExisting Knowledge, Research, Views, and uses the PICO model.
\nSynthesizes in-depth information from relevant sources representing various points of view\/approaches.
\nPresents in-depth information from relevant sources representing various points of view\/approaches.
\nPresents information from relevant sources representing limited points of view\/approaches.
\nPresents information from irrelevant sources representing limited points of view\/approaches.
\nMaximum score = 20
\nAnalysis
\nOrganizes and synthesizes evidence to reveal insightful patterns, differences, or similarities related to focus.
\nOrganizes evidence to reveal important patterns, differences, or similarities related to focus.
\nOrganizes evidence, but the organization is not effective in revealing important patterns, differences, or similarities.
\nIt lists evidence, but it is not organized or is unrelated to focus.
\nMaximum score = 20
\nConclusions and Recommendations
\nStates a conclusion and recommendations that are a logical extrapolation from the inquiry findings.
\nStates a conclusion and recommendations focused solely on the inquiry findings. The conclusion arises specifically from and responds specifically to the inquiry findings.
\nStates a general conclusion and recommendations that, because it is so general, also applies beyond the scope of the inquiry findings.
\nStates an ambiguous, illogical, or unsupportable conclusion and recommendations from inquiry findings.
\nMaximum score = 20
\nControl of syntax and mechanics
\nUses elegant language that skillfully communicates meaning to readers with clarity and fluency and is virtually error-free. Proper use of citations.
\nUses straightforward language that generally conveys meaning to readers. The language has few errors \u2014 proper use of citations.
\nUses language that generally conveys meaning to readers with clarity, although writing includes some errors \u2014 lacking proper use of citations.
\nUses language and structure that impedes meaning because of errors in usage \u2014 lacking proper use of citations.
\nMaximum score = 20
\nMaximum score = 100<\/p>\n
Expert Witness\/Testimonial Dossier
\nBackground: You have been contacted by a legal firm to review the material related to sudden death in the hospital from 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online. The family of the individual has been working with their attorney to conduct a thorough review of all information related to the death of their family patriarch and leader. The family has obtained legal support and has developed a case against Healing Arts Medical Center. You are serving as part of the claimant\u2019s side and are tasked with reviewing all the medical information and providing your professional assessment and evaluation of the next steps in the case.
\nCase Homework help – Summary Dossier:
\nHealing Arts Medical Center is a community healthcare facility. The hospital can hold up to 200 inpatients and has multiple outpatient clinics. Medical services include; an emergency department, ICU, CICU, general surgery, labor and delivery, pediatrics, NICU, and a cancer center. The medical center has modern diagnostic equipment, and advanced technology supporting modern treatments. Also, the center has a state-of-the-art electronic health records (EHR) system that contains patient medical history, diagnoses, computerized provider order entry (CPOE), immunization dates, allergies, radiology images, and laboratory and test results. The CPOE system can warn clinicians ordering medications about potential allergic or adverse reactions, duplicate therapy, interactions with other medications, and a transaction log.
\nJF is a 62-year-old Caucasian male who was brought to the emergency department on October 8, 2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers, for shortness of breath. He was also suffering from severe leg pain causing a ground-level fall and various complications related to his physical wellness. The course of treatment in the emergency department included ordering a battery of investigational labs (CMP, CBC, CK, ABG, UA, UDS, D-dimer and US) and start oxygen treatment (nasal cannula), IV fluids, diuretics, and additional renal and cardiac monitoring. The course of the emergency department was uneventful and JF was admitted for more critical care in the CICU (Cardiac Intensive Care Unit) within hours of admission. The initial impression and diagnosis were consistent with pulmonary congestion and an overlapping deep vein thrombus. The individual will be treated for congestive heart failure exacerbation and venous thromboembolism in the intensive care unit. The plan will be to stabilize his condition and then transition his care back home to his family.
\nIn the CICU, JF spent 15 days in critical and acute care as his heart failure was being treated and as his circulation was being stabilized. He was placed on a ventilator and has periodic assessments for arterial blood gases and regular labs for body chemistry. He was also on cardiac monitoring using an EKG, and his urine output was collected and analyzed while in care. He was placed on furosemide therapy for his cardiac and pulmonary congestion and he was given both volume expansion with various crystalloid fluids and vasopressors (dobutamine and epinephrine) for cardiac stability, contractility, and chronotropy. During this time, he was placed on heparin to help him with the stability of the clot. To evaluate the safety of the medication regimen, renal function was assessed periodically, and the anticoagulation was monitored using aPTT, PT, and periodic INR checks.
\nDuring the care in the ICU, JF soon stopped producing urine 3 days into treatment, and his furosemide therapy was stopped. With a serum creatinine at 5.8 (up from 1.5 at admission), he was also carefully
\ntitrated on his IV fluids and pressor therapy. During this time, on day 5, he also developed an upper
\nrespiratory tract infection that had to be treated and started on a combination of antimicrobial agents
\n(ceftriaxone, levofloxacin, and vancomycin). Cultures and sensitivities on sputum were sought out and
\nhe was evaluated holistically for other signs and symptoms of infections. On day 7, his fever subsided
\nand was starting to get weaned off the ventilator and the drip rates of the IV fluids were modified
\naccordingly. JF was transferred to the general acute care ward early on day 8 and some of his home
\nmedications were continued. He was still on heparin therapy and was restarted on his home agents,
\nincluding enoxaparin. The medication was thought to have a significant DDI with heparin, so it was
\nstopped by pharmacy during rounds. On day 9, the home medications surfaced once more and were repopulated
\non the Medication Administration Record. Enoxaparin was on the list once again and no one
\nhalted the agent. Heparin was still being used during this time and was given concurrently with heparin
\nfor a total of 3 days. On day 12, the nurse called the pharmacist and physician rounding in the unit that
\nthe patient had blood in the urine and had been having an altered mental state. The patient was given
\nvitamin K and protamine to help reverse the condition to no avail. Packed red blood cells were
\nadministrated, as was FFP with no improvement. The patient died.
\nThe last physical exam and laboratory results reported in the medical chart.
\nPhysical examination:
\n1. Confused state up until death \u2013 confusion increased, and dementia-like symptoms and
\nirritability followed by extremely still behavior.
\n2. Petechiae of the eyes and oral mucosa
\n3. Bruising on the arms and legs in places of friction with the bed
\nLaboratory Results:
\n1. Bleeding time (BT) elevated
\n2. Platelet count reduced (< 75)
\n3. Activated partial thromboplastin time (aPTT) elevated
\n4. Prothrombin time (PT) elevated,
\n5. Thrombin time (TT)
\n6. LFT elevated > 150 for AST and ALT
\n7. INR: 2.4<\/p>\n","protected":false},"excerpt":{"rendered":"
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