Week 3 Discussion Questions: Patient Self-Determination Act (PSDA) and healthcare-acquired conditions (HACs)
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Response to each question is approximately 250-500 words with 1 or 2 references
Reference Week 3 Lecture & References
Week 3 Discussion Question 1:
The Patient Self-Determination Act (PSDA) was implemented to allow patients to state “Do Not Resuscitate” (DNS), or to assign a surrogate decision-maker in the event the individual is unable to make the decision. What relationship does an ethics committee have in enforcing the advance directives of the patients in their care? Support your analysis with one peer-reviewed article.
Week 3 Discussion Question 2:
In 2011, the Center for Medicine and Medicaid Services (CMS) published a list of healthcare-acquired conditions (HACs). What actions has your health care organization (or health care organizations in general) implemented to manage or prevent these “never events” from happening within their health care facilities? Support your response with two peer-reviewed articles.
Preventing Healthcare-Acquired Conditions (HACs)
The implementation of effective risk management programs in healthcare organizations serves a significant role in the reduction of HACs. Different organizations implement programs that include specific strategies such as hand washing, use of efficient and necessary equipment, using critical paraphernalia such as goggles, gloves, and gowns among others. Of greater importance, however, organizations implement adherence to evidence-based medicine, effective data and information systems, and use surveillance systems for the identification of the HACs and possibility of patient harm. The implementation of these measures assists in the reduction or elimination of preventable HACs. Implementing the effective systems for health records and patient information reduces cases of HACs by centralizing data and preventing avoidable infections. Moreover, evidence-based healthcare practices ensure limited infection of patients. While this is the case, the integration of an active surveillance system in the delivery of care ensures that organizations learn from mistakes and develop efficient and safer intervention measures (Murni, Duke, Kinney, Daley, & Soenarto, 2015).
According to Krein, Kowalski, Hofer and Saint (2012), for the effective prevention of HACs, any healthcare organization should focus on the implementation of an effective program that measures, evaluates, and optimizes critical care. Such a program works towards the assurance of quality health care services and the reduction of any cases of HACs within an organization. Most organizations continue to implement this strategy to reduce HACs and tackle them effectively upon their occurrence. In the process of implementation, healthcare organizations ensure that patients receiving critical care in ICU or ED are transferred as soon as possible after receiving the necessary medical attention. This process ensures that such patients do not contract preventable infections. Moreover, they continue to receive quality care using processes that are constantly monitored, measured, and evaluated to ensure effectiveness and minimize HACs (Murni, Duke, Kinney, Daley, & Soenarto, 2015). The implementation of these measures has decreased cases of HACs in healthcare organizations significantly.
The Patient Self-Determination Act (PSDA)
The PSDA was implemented to ensure the protection and communication of the patient’s right to self-determination in making health care decisions. For example, the Act allows patients to decide whether or not they need resuscitation in cases where their heart or breathing stops. It permits the application of the DNR order when the resuscitation will not benefit the individual, will not restart the breathing or heart, and where the burden outweighs the benefits. In the implementation of the DNR order, the healthcare organization’s ethics committee plays a key role. Before the implementation of the directive, the committee must make note of it in the medical records and discuss the directive with the patient or when that is impossible the engage the immediate family. Moreover, the ethics committee should consider the possibility of restarting the heart or breathing of the patient upon resuscitation and the possibility of quality life after the procedure. Upon determination, there is a need to communicate efficiently with the patient (C & Broderick, 2011).
Most importantly, the ethics committee must ensure that the DNR order is not abused and does not lead to unethical healthcare practices. The committee must make sure that the order is not violated where it is applied without the patient or relatives’ knowledge. Additionally, it must make sure that the relatives do not violate the order by allowing it against the patient’s wish. For instance, the committee should ensure that DNR is not applied against the will of the elderly. Moreover, according to the PSDA, the advance directive of a DNR should not influence the process of health care delivery whereby health care providers may discriminately treat or admit patients based on their advance directive (C & Broderick, 2011).
C, K. L., & Broderick, A. (2011). Developing a policy for do not resuscitate orders within a framework of goals of care. Joint Commission Journal on Quality and Patient Safety/ Joint Commission Resources 37 (1), 11-19.
Krein, S. L., Kowalski, C. P., Hofer, T. P., & Saint, S. (2012). Preventing hospital-acquired infections: a national survey of practices reported by U.S. hospitals in 2005 and 2009. Journal of General Internal Medicine 27 (7), 773-779.
Murni, I. K., Duke, T., Kinney, S., Daley, A. J., & Soenarto, Y. (2015). Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country : an effectiveness study. Archives of Disease in Childhood 100 (5) , 454-459.