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Explain the health care policies that can affect emergency care.I NEED SOME CHANGES TO MY ASSESSMENT, HERE THE COMMENT OF MY TEACHER AND THE POINTS TO ADD.Overall Comments:HelloThank you for submitting this second assessment. I appreciate the effort that you have obviously put into this assignment. Please know this is a policy, law, and ethics course. This means that you need to include actual laws that related to the criteria. Also, please not that when looking for evidence-based systems – we need to include evidence-based triage systems that are used to assist with triage in the ED. . See the comments below and thank you for allowing me to evaluate the assignment.Faculty Comments:“I did not see where you explained the health care policies that can affect emergency care. What are the actual laws, regulations, and or policies in your facility? Additionally, you could include elaborate on the effects on the patient experience. This is required for a higher performance. Please incorporate the scoring guide criteria in the 2nd attempt revision. In addition, please remember to highlight any added information. Thanks!Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.Explain the health care policies that can affect emergency care.Recommend evidence-based decision-making strategies nurses can use during triage.SOME INFORMATION IN REGARD THIS ASSESSMENT DOWN BELOW…..Internet ResourcesAccess the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.American Nurses Association. (2015). Ethics and Human Rights. Retrieved from…American Nurses Association. (2016). Position statement: The nurse’s role in ethics and human rights: Protecting and promoting individual worth, dignity, and human rights in practice settings. Retrieved from…Vigil, J. M., Alcock, J., Coulombe, P., McPherson, L., Parshall, M., Murata, A., & Brislen, H. (2015). Ethnic disparities in emergency severity index scores among U.S. veteran’s affairs emergency department patients. PLoS One, 10(5). Retrieved from InstructionsYour supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

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Moral Dilemmas and Ethical Decisions
Capella University
March 2019
Moral Dilemmas and Ethical Decisions
In the healthcare industry healthcare providers usually, encounter many instances which
test their morals and decisions that they need to undertake. The healthcare providers usually
encounter moral dilemma and their ethical decision making are mostly tested in the emergency
care which is mostly the most sensitive area of health care due to factors such as urgency and
crowding. In triage care medics are usually required to sort and allocate treatment to patients
according to a system of priorities and urgency of need of care designed to maximize the number
of survivors. In the case study of the two patients, it provides a scenario which leads to moral and
ethical issues which occur when triaging patients and the best effective practices in managing
future occurrences. The presentation examines various moral and ethical issued which relate to
triaging patients in the emergency room.
The healthcare policies and protocols in place in many healthcare organizations that
direct triage care in an emergency is that all patients who come into the hospital and have various
cases of injuries should be assessed and triaged. This step ensures that those patients who are
need of immediate intervention ate determined and the appropriate location in which the patient
needs to be allocated in the emergency department are directed. The other protocol pertains to
the allocation of the patients to the defined clinical areas or being transferred to waiting rooms
where they would be offered treatment. The final transfer of patients is for the physicians to
allocate the patients to emergency department clinicians and this can be achieved through a
structured approach that includes IMIST between the paramedics and the patients.
In cases where there exist health care disparities, it usually impacts treatment decisions,
and this is where there are unequal burdens experienced by the minority groups and the dominant
group in disease morbidity. Most of the racial and ethnic disparities that exist in health care
pertain to poor outcomes even with the advances made in the diagnosis and treatment of
diseases. Many patients who are considered as ethnic and racial minorities like Brent Damascus
usually receive low-quality treatment leading to experiencing greater mortality. Health
disparities usually exist due to poor education, poverty, health behavior, and environmental
factors of the minority (Betancourt, J. R., & Maina, 2014). Solutions for these health disparities
is through promoting wellness and healthy lifestyles and ensuring that every individual can
access treatment at an affordable rate (Betancourt et al., 2016). There is also the need of having
disease control and immunization education programs to eliminate all the unequal burdens.
There are various health care policies that have been put in place to direct care for
uninsured individuals. Most of the uninsured individuals in the country their health care costs are
usually absorbed by the federal, local and state governments. There are also state programs
which usually help the uninsured individuals through offsetting all the cost of treatment that the
uninsured incur. Medicare also makes various payments to many hospitals after adjusting the
hospital payment rates which cater to the uninsured. Medicare also provides finances to various
hospitals which are mostly used to cater for the uncompensated care. The federal and state
governments also offer support to the providers and those who support the uninsured patients
through disproportionate share hospital Medicaid funding’s (Lipton & Coleman, 2015). These
information’s show the differences that usually occur in individuals of different social
background during triage care in an emergency.
There are various moral and ethical challenges that nurses usually encounter when they
are performing according to the hospital policies and protocols. The triage nurses usually
conduct quick assessment of patients who arrive in the emergency department and conduct their
actions according to the hospital protocols. Time constraints and actions conducted not like how
the patient prefers usually to lead to the nurses encountering ethical and moral problems. When
nurses are required to execute and offer intervention without being given consent by the patients
in such scenarios it usually leads to them conducting actions that may lead to moral and ethical
In many emergency situations, nurses usually have the mandate and ethical obligation to
conduct whats best for the patient even though the patient has the autonomy and the power of the
decisions regarding their lives. In many cases after a patient has received medical intervention,
they usually do not agree with some of the decisions which the nurses recommend or they
undertake. Many of these patients usually file a lawsuit against the hospitals which made the
health decision without considering their consent (Horwitz et al., 2015). In such situations, it
usually becomes difficult for nurses to save the life, deal and offer treatment to such patients. In
many emergency situations, there are usually no conflicts when a severely injured patient is
uninsured. The protocol in many hospitals is that patients who are placed in emergency
department need to receive medical care irrespective of whether they have insurance coverage.
All the hospitals have the responsibility of saving patients’ lives and providing quality care to the
patients. This provides the urge of providing care to every patient in an emergency to ensure that
they gain adequate health. In a case where the person is uninsured further treatments which the
patient is offered would be required to pay for the services. Scenarios, the hospital can decide to
offer uncompensated care to the patient if the hospital gets to receive funding’s from different
channels for different programs towards supporting healthcare activities.
Many patients in the country are uninsured mostly the low-income earning families. The
inevitable need for care for such families requires efficient strategies which will endure that they
receive adequate care at affordable prices. This provides the need for evidence-based strategies
that should be applied to manage the delivery of care of the uninsured and indigent individuals.
The government together with private organizations should come up with complex mosaic
initiatives which would help to defray the cost of care of such patients. Better organization in
various hospitals together with less fragmentation would play a major role towards effective care
delivery and offer treatment to the uninsured and indigent patients. Healthcare organizations
should also come together and lobby for the allocation of finances for the Medicaid and
Medicare programs. These initiatives would lead to a reduction of the cost of medical care and
make it affordable to every individual and the uninsured and indigent population would be able
to access care.
Offering adequate care to all patient especially those in an emergency department or
situations should always be made paramount irrespective of the social aspects or whether the
patient has health insurance or not. Towards providing the care nurses should also ensure that the
safety of the patient comes first without considering the moral and ethical issues that may arise
later. The uninsured and indigent patients are the responsibility of the government of ensuring
that they receive adequate care. Triaging patients in an emergency room should always be
conducted according to the hospital policies and protocol and without considering the financial
aspect of the patients.
Betancourt, J. R., & Maina, A. W. (2014). The Institute of Medicine report” Unequal
Treatment”: implications for academic health centers. The Mount Sinai Journal of
Medicine, New York, 71(5), 314-321.
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016).
Defining cultural competence: a practical framework for addressing racial/ethnic
disparities in health and health care. Public health reports.
Horwitz, S. M., Busch, S. H., Balestracci, K. M., Ellingson, K. D., & Rawlings, J. (2005).
Intensive intervention improves primary care follow‐up for uninsured emergency
department patients. Academic Emergency Medicine, 12(7), 647-652.
Lipton, H., & Coleman, M. (2015). Bereavement practice guidelines for health care professionals
in the emergency department. International journal of emergency mental health, 2(1), 1931.

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