Tag: Clinical-Nursing

Perfect Memory, Imperfect Minds: The Hidden Costs of Never Forgetting – What if everyone had a perfect memory and no one ever forgot anything? What would everyday life be like?

 
Perfect Memory, Imperfect Minds: The Hidden Costs of Never Forgetting

Suppose that all humans had a perfect, infallible memory, every day of life would be completely transformed in cognitive, social, and institutional ways. Learning efficiency would grow exponentially on an individual level. The students would not have to study and re-study the same information, and professionals would have the ability to remember large amounts of information with extreme precision. Nevertheless, thinking does not only concern retention; forgetting is an important aspect of abstraction and prioritizing. In its absence, people may have a problem with filtering irrelevant information, which results in cognitive overload and dysfunctional decision-making (Ali, 2025).

Social relations would be re-modeled as well. Recollection of all the interactions, even minor conflicts or grievances of the past, may only serve to worsen interpersonal tensions. Forgiveness is often based on the weakening of the emotional intensity over time, without forgetting, people may struggle to overcome negative experiences. On the other hand, the trust might increase in situations where accurate recall prevents misunderstanding and deception.

Psychologically, the fact that traumatic events cannot be forgotten may have dire implications. The evidence gathered about such conditions as hyperthymesia, when a person remembers almost every event he/she had in his/her life, indicates that the constant recollection can be emotionally taxing and invasive (Hatoum, 2024). Forgetting, therefore, is a defense mechanism that aids in the control of emotions.

Systems like law, education, and governance would change to the value of interpretation and not memorization (Prendin et al., 2023). It is possible that legal systems may be more accurate with eyewitness testimony, yet biases in perception, but not memory, would still exist. Privacy issues would only get worse since one would be able to store information about other people in a way that they can access this information at any time.

Overall, whereas perfect memory would certainly have some evident benefits in terms of knowledge retention and accuracy, it would probably cause a lot of issues with emotional well-being, social harmony, and cognitive efficiency. Losing memory is not a weakness but rather an adaptive attribute that is crucial in the operations of human beings.

References

Ali, S. M. S. (2025). Cognitive biases in digital decision making: How consumers navigate information overload (Consumer Behavior). 
Advances in Consumer Research
, 
2
, 168-177.
https://acr-journal.com/article/cognitive-biases-in-digital-decision-making-how-consumers-navigate-information-overload-consumer-behavior–889/

Hatoum, K. (2024). 
Exploring the Psychological Mechanisms Underlying the Experience of Past-Life Memories
 (Doctoral dissertation, Selinus University of Sciences and Literature).
https://www.uniselinus.education/sites/default/files/2024-07/khattar%20chakib%20hatoum.pdf

Prendin, F., Pavan, J., Cappon, G., Del Favero, S., Sparacino, G., & Facchinetti, A. (2023). The importance of interpreting machine learning models for blood glucose prediction in diabetes: an analysis using SHAP. 
Scientific reports
, 
13
(1), 16865.
https://www.nature.com/articles/s41598-023-44155-x

Perfect Memory, Imperfect Minds: The Hidden Costs of Never Forgetting – What if everyone had a perfect memory and no one ever forgot anything? What would everyday life be like?

The Nurse’s Role in Promoting Quality Health Care Essay

 

The Nurse’s Role in Promoting Quality Health Care

Staff nurses play a crucial role in promoting quality and fostering a just culture within the health care organization. In that case, staff nurses can advocate for the patient’s safety, participate in root cause analyses, and work alongside the leadership of the health care organization to find solutions that can improve the health care delivery system. The discussion focuses on the role of the staff nurse and organizational culture and strategies for becoming a high-performing organization.

Role of the Staff Nurse and Organizational Culture

The health care organization that I work in fosters a culture of teamwork and finding ways to enhance healthcare quality within the organization. Staff nurses contribute to the quality of care by monitoring various aspects of patient health care. Additionally, the CEO and the chief nursing officer (CNO) use a transformational leadership style to inspire staff nurses to speak up with ideas and concerns regarding the health care of the patients (Yoder-Wise & Sportsman, 2022). That is because the leadership of the organization has invested in the staff nurses by providing a budget for various initiatives that will improve the safety of the patients and staff nurses. For instance, following a root cause analysis (RCA) of various medication administration issues, the organization purchased medication administration systems for the nurses and provided additional training for the staff nurses to use these systems (Bashaw & Lounsbury, 2012). Therefore, these investments by the leaders of the organization show their commitment to ensuring that staff nurses are protected from adverse health conditions that can result from the health care system.

Strategies for Becoming a High-Performing Organization

The different strategies that the organization uses to support patient safety include approving the budgets that will be used to provide education to staff nurses, purchasing new technology in the hospital, or funding safety programs for the hospital (Bashaw & Lounsbury, 2012). For example, after the root cause analysis of the causes of medication administration errors, the hospital administration purchased medication administration systems for the nurses and trained them in their use. Some of the strategies that can be used to improve the performance of the organization include increasing the participation of nurses in quality councils, utilizing resources from the Institute for Healthcare Improvement, and assessing the safety of patients in the hospital (Spath, 2018). Each of these strategies will work to improve communication between departments, hold individuals to account for their actions, and enhance the quality of care.

Conclusion

Staff nurses are vital to the improvement of the health care organization and the safety of the patients and staff nurses within that organization. Therefore, by adopting the strategies and the leadership styles that are currently used within the organization, the health care facility could continue to improve the patient’s health and that of staff nurses.

 

References

Bashaw, E. S., & Lounsbury, K. (2012). Forging a new culture: Blending Magnet® principles with just culture.
Nursing Management
, 43 (10), 49–53. http://doi.org/10.1097/01.NUMA.0000419492.49675.25

Spath, P. (2018).
Introduction to healthcare quality management
(3rd ed.). Health Administration Press.

Yoder-Wise, P. S., & Sportsman, S.  (2022).
Leading and managing in nursing
(8th ed.). Mosby Elsevier.

 

The Nurse’s Role in Promoting Quality Health Care Essay

A Root Cause Analysis (RCA) team is a cross-functional group. According to Patel, the Joint Commission requires RCAs after a sentinel event to look beyond individual mistakes and focus on system and process improvements to prevent future harm (Patel, 2026). This group typically comprises frontline staff, managers, and safety experts, designed to identify systemic flaws rather than blame individuals. By combining diverse perspectives, such as operational knowledge, process understanding, and analytical skills, the team moves from fixing symptoms to finding sustainable solutions. A Root Cause Analysis (RCA) team looking “beyond error” shifts the focus from blaming individuals for mistakes to identifying the underlying systemic, process, or environmental failures that enabled the error. In this approach, human error is treated as a symptom of a deeper issue rather than the final cause.

In this scenario, the root cause analysis team consists of the nurse who administered the medication, the pharmacy technician who approved the administration, and the risk manager. The RN will provide information on the administration process and on specific issues with equipment or technology. The pharmacy technician will be able to provide the information on how the medication is filled, as well as the technical aspects of the failure. Risk management serves as a facilitator, understanding regulatory standards, safety policies, and the methodology for conducting a structured, blame-free investigation.

The Pareto chart is the most effective tool to analyze this scenario because it visually prioritizes the most frequent causes of the medication error, allowing the team to move past blame and focus on the “vital few” issues. This tool helps identify which factors (e.g., pharmacy labeling, nurses, pharmacies) are having the greatest impact, driving effective root cause analysis.

Due to a drug allergy, a medication error was found. The RCA conducted reviews using a fishbone diagram, a Pareto chart, and a flowchart. The Pareto chart is the most effective tool to analyze this sentinel event because it visually prioritizes the most frequent causes of the medication error, allowing the team to move past blame and focus on the “vital few” issues. Thus, once the team identifies the issue as systemic, it can implement solutions such as different barcode scanning procedures. Personally, as a nurse, if the label did not say the right medication, a new medication should have been administered. The flow chart starts with the pharmacy, which makes it easy to put the blame on them and, in turn, does not look beyond individual mistakes, as Patel stated the RCA does.

According to Mutair, medication errors cause adverse effects on hospitalized patients and weaken the public’s confidence in the healthcare(Mutair et al. 2021) Per Mutair, encouraging reporting, monitoring, and open discussion of medication errors is key to preventing meds action errors (Mutair et al. 2021)

 

The Nurse’s Role in Promoting Quality Health Care Essay

As you have noted in this course and in your practice, nurses have an integral role in promoting a just culture focused on patient safety in their health care organizations. Determining resources to prevent error and improve patient safety can often be a battle, and this scenario illustrates how one organization makes strides to make sure resources are available in the interest of patient safety. As you review the scenario, consider the nurse’s role in promoting a just culture in your practice setting.

Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization.

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.

Chapter 10, “Managing the Use of Healthcare Resources” (pp. 249-280)

Yoder-Wise, P. S., & Sportsman, S. (2022). Leading and managing in nursing (8th ed.). Mosby Elsevier.

Chapter 1, “Leading, Managing, and Following” (pp. 1-16)

Chapter 7, “Gaining Personal Insight: Being an Effective Follower and Leader” (pp. 163-177)

Chapter 19, “Managing Costs and Budgets” (pp. 414-439)

Agency for Healthcare Research and Quality. (2016). Surveys on patient safety culture. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/index.html

Bashaw, E. S., & Lounsbury, K. (2012). Forging a new culture: Blending Magnet® principles with just culture. Nursing Management, 43 (10), 49–53. http://doi.org/10.1097/01.NUMA.0000419492.49675.25

—–Scenario—Build on RCA from Week 4 to encompass multiple departments, senior team, protects the staff nurse—Swiss cheese theory; IHI resources; Quality Council Meeting—RCA has budgetary implications that are approved by the senior teams to protect staff nurses against future errors The Nurse’s Role in Promoting Quality Health Care Essay

Formative 1 NSG 6210 Literature Search Summary

This formative assessment focuses on your understanding and application of evidence-based practice (EBP) in nursing. It builds towards the summative assessment by requiring you to apply EBP principles in a real-world scenario. This case study will prepare you by honing your skills in critical thinking, research application, and patient-centered care. Understanding and implementing EBP is crucial for providing high-quality, up-to-date care that improves patient outcomes and advances the nursing profession.

Instructions:

You are a registered nurse working in a medical-surgical unit. You’ve noticed that many patients are experiencing postoperative nausea and vomiting (PONV) despite receiving standard antiemetic medication. Your supervisor has asked you to research and propose an evidence-based intervention to address this issue.

Your task is to:

Conduct a brief literature search and identify at least two relevant, recent (within the last 5 years) research articles that address the clinical situation from the case study.

Critically appraise the evidence found in these articles, considering factors such as study design, sample size, and relevance to your patient population.

Based on the evidence and considering your clinical expertise, propose an intervention to reduce PONV in your unit.

In your response, be sure to:

Clearly define EBP and its core principles

Demonstrate how each step of your process aligns with these principles

Reflect on any challenges you encountered in applying EBP and how you overcame them

Your case study response should be approximately 400-600 words.

Use the following structure your response:

Literature Search Summary

Evidence Appraisal

Proposed Intervention

Remember to cite your sources using APA format and include a reference list at the end of your document.

 

Formative 1 NSG 6210 Literature Search Summary

Formative 1 NSG 6210

Literature Search Summary

Healthcare providers, including registered nurses (RN), incorporate evidence-based practice (EBP) into their daily nursing routine, thereby optimizing treatment outcomes through patient-centered care. According to Freeman et al. (2023), EBP involves integrating provider’s clinical expertise, the best current research evidence, and patient preferences to support patient-centered care and optimal treatment outcomes through real-time clinical decisions. EBP is a comprehensive process guided by core principles, including clinical enquiry, evidence search, critically appraising the evidence, incorporating findings into clinical practice, and evaluating outcomes to determine if the EB intervention was effective in addressing a specific clinical issue. However, EBP depends on patient safety concerns or gaps in the current practice that needs improvement. Clinical issue of concern in this case study is high rate of postoperative nausea and vomiting (PONV) among postoperative patients. This problem has persisted despite being managed using standard antiemetic medication. Thus, current literature should be reviewed to identify EB intervention for resolving PONV incidents in postoperative patients.

Peer-reviewed articles selected to resolve PONV incidents through recent and high-quality evidence are Albalawi et al. (2024) and Hu et al. (2025). In their narrative review, Albalawi (2024) and colleagues examined Enhanced Recovery After Surgery (ERAS) protocols for managing patients undergoing colorectal surgery. In particular, they explored significant elements of ERAS protocols and its benefits in patients undergoing colorectal procedures. The review focused on multimodal approaches for boosting treatment outcomes in colorectal surgery patients, including preoperative, perioperative, and postoperative measures. This narrative review examined use of ERAS protocols in patients undergoing colorectal surgery; making it relevant to targeted patient population, postoperative patients experiencing PONV incidents. On the other hand, Hu (2025) and the team presented updated clinical practice guidelines (CPG) using EB recommendations to prevent and manage PONV. This study is relevance to patient population in the case study since it targets postoperative patients experiencing PONV incidents. This process aligns with EBP principles since it involves systematic search for current evidence relevant to improvement of treatment outcomes in postoperative patients with high risk of PONV.

Evidence Appraisal

Albalawi et al. (2024) conducted a narrative review to assess efficacy of enhanced recovery after surgery (ERAS) protocols in improving treatment outcomes following colorectal surgery. Evidence from multiple studies focusing on perioperative care was included in this narrative review. This study has once significant strength since multimodal recovery interventions were used to prevent potential postoperative adverse treatment outcomes, including PONV incidents. Nonetheless, evidence from this study is considered low since narrative reviews lack standardized appraisal techniques, thereby increasing risk of bias.

On the other hand, CPG by Hu et al. (2025) presents high-quality evidence that would inform clinical decisions in this scenario. Authors used multiple EB approaches and the GRADE system to assess evidence quality and if it is recommended for application in a real-world scenario. Multimodal prophylaxis, including combining antiemetics was recommended as an EB treatment guideline for moderate- and high-risk patients following literature review involving multiple studies. Additionally, this multimodal approach is a credible and relevant EB treatment intervention for adult postoperative patients since it has been supported by other quality studies, including systematic reviews focusing on adults receiving postoperative care Formative 1 NSG 6210 Literature Search Summary.

One of the most significant challenge faced in the EBP process was identifying multiple recent and quality peer-reviewed articles focusing on postoperative patients with PONV incidents. Some studies presented strong evidence but focused on pediatrics makes them irrelevant to postoperative adult patients. To overcome this challenge, studies selected for the review presented perioperative evidence and CPGs targeting postoperative care settings for adults, thereby ensuring relevance of evidence to postoperative adult patients with high PONV risk.

Proposed Intervention

Proposed EB intervention involves implementing a standardized multimodal PONV prevention care protocol. This decision is based on strong evidence and CPGs from reviewed studies. This multimodal approach would lower PONV risk through preoperative, perioperative, and postoperative measures, including using validated screening tools to assess PONV risk and combined antiemetic prophylaxis therapy. Multimodal antiemetic therapy is supported by CPG of 2025 since its more effective in preventing nausea and vomiting in postoperative patients than a mono-medication regimen (Mieszczański et al., 2025). This approach further involves use of alternative pain management therapies to replace opioids, which increase nausea and vomiting risk in postoperative patients (Schlesinger et al., 2023). Additionally, ERAS measures, such as early mobilization, adequate hydration, and patient education can be incorporated into multimodal approach, thereby making this EB intervention more effective in preventing PONV.

Therefore, adopting this multimodal approach will prevent potential PONV incidence, lower risk of postoperative complications, and enhance comfort, resulting in positive patient experience Formative 1 NSG 6210 Literature Search Summary.

 

References

Albalawi, H. I. H., Alyoubi, R. K. A., Alsuhaymi, N. M. M., Aldossary, F. A. K., Albishi, F. M., Aljeddawi, J., … & Najm Jr, N. (2024). Beyond the operating room: a narrative review of enhanced recovery strategies in colorectal surgery. Cureus, 16(12).
https://assets.cureus.com/uploads/review_article/pdf/322294/20250121-2897226-ozrr5m.pdf

Freeman, N. L., Browder, S. E., & McGinigle, K. L. (2023). Balancing evidence-based care with patient-centered individualized care. 
Journal of Vascular Surgery: Venous and Lymphatic Disorders
, 
11
(6), 1089-1094.
https://www.sciencedirect.com/science/article/pii/S2213333X23003153

Hu, J., Wang, Z., Ma, B., Wang, T., Wang, E., & Yu, W. (2025). Clinical practice guidelines for the prevention and management of postoperative nausea and vomiting (2025 edition). 
Journal of Anesthesia and Translational Medicine
, 
4
(4), 286-302.
https://www.sciencedirect.com/science/article/pii/S2957391225000506

Mieszczański, P., Jurczak, M., Cylke, R., Ziemiański, P., & Trzebicki, J. (2025). Evidence-based perioperative prevention of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic bariatric surgery: a scoping review. 
Journal of Clinical Medicine
, 
14
(19), 6901.
https://www.mdpi.com/2077-0383/14/19/6901

Schlesinger, T., Meybohm, P., & Kranke, P. (2023). Postoperative nausea and vomiting: risk factors, prediction tools, and algorithms. 
Current Opinion in Anesthesiology
, 
36
(1), 117-123.
https://journals.lww.com/co-anesthesiology/abstract/2023/02000/postoperative_nausea_and_vomiting__risk_factors,.21.aspx
Formative 1 NSG 6210 Literature Search Summary

Columbus State University FNP Program NURS 6228 Health Promotion of the Elderly – Ethical Dilemmas of in long term placement of elderly men essay

Ethical Dilemmas in Long-Term Placement of Elderly Men

Placing elderly men in long-term residential care raises complex ethical issues in modern healthcare. As the adult male population ages, they face higher rates of functional disabilities, cognitive impairments, and chronic illnesses. This creates situations in which the elderly male patient wants to remain independent, which may conflict with healthcare providers’ concerns about quality of life, health outcomes, and safety. Among elderly men, these decisions can be especially difficult, as they may be strongly tied to personal, social, and cultural identities centered on control over decision-making, self-reliance, and independence. Family Nurse Practitioners (FNPs) and healthcare organizations are often tasked with balancing these competing ethical principles while ensuring compliance with professional standards and legal requirements. This paper explores the ethical dilemma of whether healthcare providers, including FNPs, should respect the autonomy of elderly male patients who refuse long-term residential care despite facing significant safety and health risks, or prioritize non-maleficence and beneficence by supporting institutional care placement. This ethical dilemma has significant implications for healthcare providers, organizations, patients, and families, affecting care outcomes, legal responsibilities, and clinical decisions.

Identification of the Ethical Dilemma

Elderly men aged 65 and older are most affected by this ethical dilemma because they often face increasing social isolation, functional dependence, physical frailty, multiple chronic conditions, or cognitive decline. They may include men diagnosed with advanced cardiovascular disease, stroke-related disabilities, Parkinson’s disease, dementia, or other conditions that impair their ability to live independently and safely. Many of these individuals live alone after the death of a spouse and may have limited social support, which increases their vulnerability to negative health outcomes. As their healthcare needs become more complex, healthcare professionals and family members may conclude that long-term placement in a nursing home or assisted living facility is necessary to ensure continuity of care and safety (Ouslander et al., 2022).

The ethical dilemma occurs when an elderly male patient with some decision-making ability refuses institutional placement despite clear evidence that staying at his current residence risks health issues such as medical decline, malnutrition, medication errors, neglect, or injury. Respecting the patient’s autonomy supports his right to choose his living situation. However, healthcare professionals also have an ethical obligation to prevent harm and promote health (Ouslander et al., 2022). Therefore, FNPs and other providers may face situations where honoring the patient’s wishes could significantly jeopardize his health, while pushing for placement might compromise his self-determination and personal autonomy. Neither option is fully ethically acceptable, creating a true ethical dilemma.

This dilemma impacts various stakeholders. The primary stakeholder is the elderly patient, whose quality of life, safety, dignity, and independence are directly affected. Family caregivers may experience moral conflicts, financial burdens, caregiver strain, and emotional stress as they try to balance safety concerns with respecting their loved one’s wishes. FNPs and interdisciplinary care teams must navigate ethical and legal issues while maintaining therapeutic relationships. Healthcare organizations also face challenges related to resource allocation, regulatory compliance, risk management, and liability. The conflicting interests of these stakeholders complicate decisions about long-term patient placement (Ouslander et al., 2022).

Scope of the Problem

The impact of long-term placement dilemmas on elderly male patients is significant. Many seniors see independence as tied to masculinity and personal identity, which makes moving into residential care facilities emotionally difficult. Research indicates that involuntary or highly pressured institutionalization can result in lower quality of life, feelings of abandonment, anxiety, and depression (Sun et al., 2021). Conversely, staying in unsafe environments may lead to hospitalization, self-neglect, medication errors, falls, and early death. Therefore, patients face substantial risks regardless of the decision ultimately made.

Family caregivers often face significant challenges when the placement decision becomes contentious. They frequently take on responsibilities such as managing emergencies, assisting with daily activities, coordinating healthcare appointments, and ensuring medication adherence. When the elderly patient refuses placement in a care facility, the caregiver may experience burnout, emotional exhaustion, and chronic stress. Recent studies show that prolonged caregiving duties are linked to higher rates of anxiety, depression, sleep disturbances, and a lower quality of life (Bongeli et al., 2024). Family conflict can arise when relatives cannot agree on the most appropriate course of action. Such disagreements can harm family relationships and complicate care planning efforts.

Furthermore, the ethical dilemma significantly impacts FNPs. They play a key role in advocating for patient-centered outcomes, facilitating family discussions, coordinating care, and evaluating cognitive capacity. They must carefully determine whether the patient has the ability to make informed decisions while respecting individual rights and professional responsibilities. Ethical distress may occur when the FNP believes a patient’s decision places them at serious risk but is ethically and legally obligated to honor it (Ahokas et al., 2025). According to Vinckers and Landeweer (2024), moral distress is a significant concern among healthcare professionals involved in complex geriatric care decisions, particularly when safety and autonomy are in conflict.

Healthcare organizations face financial and operational challenges related to placement dilemmas. They must ensure compliance with patient rights regulations while maintaining standards for quality and safety. Failing to properly assess decision-making capacity or document clinical recommendations can expose them to legal risks. Additionally, repeated hospital admissions due to unsafe living conditions can increase healthcare costs and resource utilization. Healthcare systems are increasingly recognizing that unresolved placement disputes lead to avoidable prolonged stays, emergency department visits, and hospitalizations among elderly patients (Rahemi et al., 2023; Sehatkarlangrodi et al., 2025). As a result, placement-related ethical dilemmas impact organizational performance and patient outcomes.

Discussion of Legality

Legal considerations affect how FNPs and healthcare organizations determine long-term placement options for elderly patients. A key legal principle is the presumption of decision-making ability. It is generally assumed that adults are capable of making decisions unless evidence shows otherwise. Capacity assessments focus on the individual’s ability to understand relevant information, appreciate the consequences of each decision, reason through available options, and communicate a choice. Decision-making capacity is not automatically compromised by cognitive decline, such as a dementia diagnosis (Ouslander et al., 2022). Therefore, FNPs must conduct careful capacity assessments and thoroughly document findings before recommending interventions that may restrict individual autonomy.

FNPs are legally required to respect a patient’s autonomy while ensuring their safety. When a cognitively intact older adult refuses placement in a nursing home, providers generally cannot force institutionalization merely because they, other clinicians, or family members disagree with the patient’s decision. The principle of informed refusal mandates that the patient is informed of and understands the potential risks of declining the recommended placement. Thorough documentation of patient preferences, assessments, and discussions is crucial in reducing legal risk and demonstrating compliance with professional standards (American Association of Nurse Practitioners, 2023).

When a patient’s capacity is impaired, legal mechanisms such as healthcare proxies, conservatorship, guardianship, and durable powers of attorney may become relevant. Guardianship proceedings allow courts to appoint individuals authorized to make decisions on behalf of the patient who lacks capacity. However, guardianship significantly restricts personal liberty and should only be pursued when less restrictive options are inadequate. Current legal and ethical frameworks prioritize supported decision-making whenever possible to preserve individual autonomy and rights (Largent et al., 2023).

Healthcare organizations also carry significant legal responsibilities. Federal regulations, including those under the Nursing Home Reform Act, require safeguarding patient rights, encouraging self-determination, and implementing personalized care plans. These organizations must establish policies and procedures that support ethical decision-making, proper documentation practices, capacity assessment, and informed consent. Failing to follow these standards and procedures can lead to reputational damage, accreditation issues, legal action, and regulatory penalties (Bodenheimer et al., 2023).

Legal requirements significantly influence clinical decision-making. FNPs must balance legal standards with ethical considerations by carefully distinguishing between situations that call for protective interventions and those where patients have a legal right to make decisions. Even when clinicians believe that institutional placement would ensure greater safety for the patient, legal obligations often require respect for the preferences of competent patients (Bodenheimer et al., 2023). As a result, legal frameworks emphasize the importance of evidence-based decision-making, patient-centered communication, and individualized assessment.

Intervention

An effective way to address the ethical dilemmas associated with the long-term placement of elderly patients is to adopt structured decision-making (SDM) alongside interdisciplinary geriatric ethics consultations. Shared decision-making provides a collaborative framework where FNPs, patients, family members, case managers, social workers, and other healthcare professionals work together to assess available options. Rather than framing each choice as either complete institutionalization or independence, SDM encourages exploring alternatives such as assisted living arrangements, remote monitoring technologies, community-based supports, adult day programs, and home health services (Guo et al., 2025).

Implementing SDM starts with a thorough geriatric assessment to review cognitive function, functional ability, environmental safety, psychosocial status, physical health, and available support systems. Then, the FNP guides structured decisions that clarify patient concerns, goals, preferences, and values. Ethics consultations may be requested when there are disagreements among stakeholders or significant uncertainty about appropriate actions. Ethics committees can provide objective guidance grounded in organizational policies, legal requirements, and ethical principles. Recent evidence suggests that ethics consultation services enhance satisfaction, reduce conflict, and improve communication among the stakeholders involved in the complex healthcare decisions (Bell et al., 2022) Columbus State University FNP Program NURS 6228 Health Promotion of the Elderly – Ethical Dilemmas of in long term placement of elderly men essay .

Decision aids are an important tool within the SDM framework. These are evidence-based resources that present information regarding benefits, risks, and alternatives in a way that supports informed choices. They help elderly patients and families understand the available options while promoting meaningful participation in care planning. In addition, they improve communication consistency and reduce misunderstandings about care needs and prognosis (Gans et al., 2023; Lognon et al., 2022).

Organizational commitment is essential for successful implementation. Healthcare organizations should develop policies and standards that promote routine SDM training for clinicians, ethics consultation services, interdisciplinary collaboration, and patient capacity assessments. FNPs should pursue continuing education in geriatric ethics, communication strategies, and legal aspects of decision-making. Standardized documentation templates can further enhance consistent documentation and assessment practices (Broom & Bhuyan, 2026).

Evaluation of intervention effectiveness should include both process and outcome measures. Process measures may include utilization of decision aids, rates of documented capacity assessments, and the number of ethics consultations completed. Outcome measures may assess quality-of-life indicators, placement outcomes, incidence of falls, emergency department utilization, hospitalization rates, caregiver satisfaction, and patient satisfaction. Reductions in provider moral distress and family conflict may provide additional evidence of intervention effectiveness. Continuous monitoring allows organizations to identify areas for improvement and strengthen ethical decision-making processes over time (Broom & Bhuyan, 2026).

Conclusion

The long-term placement of elderly male patients who refuse institutional care despite serious safety concerns presents a complex ethical dilemma involving conflicting principles of autonomy, non-maleficence, and beneficence. Elderly males with frailty, cognitive impairment, chronic illness, and limited support systems are especially vulnerable to this issue. The dilemma affects multiple stakeholders, including FNPs, patients, families, and healthcare organizations, resulting in operational, legal, ethical, and emotional challenges. Legal standards concerning patient rights, informed consent, and decision-making capacity strongly influence clinical decisions and highlight the need for individualized assessments. Combining interdisciplinary ethics consultation with shared decision-making provides an evidence-based, practical approach to addressing these conflicts, supporting informed choices and maintaining patient dignity. As healthcare systems care for an increasing number of elderly male patients, creating ethically sound and legally compliant approaches to long-term placement decisions will remain crucial for providing patient-centered, high-quality geriatric care Columbus State University FNP Program NURS 6228 Health Promotion of the Elderly – Ethical Dilemmas of in long term placement of elderly men essay .

 

References

Ahokas, F., Silén, M., Höglund, A. T., & Hemberg, J. (2025). Care leaders’ moral distress in older adult care: A scoping review. 
Nursing ethics
, 
32
(5), 1545–1563.
https://doi.org/10.1177/09697330251315939

American Association of Nurse Practitioners (2023).
Standards of Practice for Nurse Practitioners
. Author.

Bell, J. A. H., Salis, M., Tong, E., Nekolaichuk, E., Barned, C., Bianchi, A., Buchman, D. Z., Rodrigues, K., Shanker, R. R., & Heesters, A. M. (2022). Clinical ethics consultations: a scoping review of reported outcomes.
BMC medical ethics, 23
(1), 99.
https://doi.org/10.1186/s12910-022-00832-6

Bodenheimer, T. S., Grumbach, K., Willard-Grace, R. (2023). 
Understanding Health Policy: A Clinical Approach
(9th ed.). McGraw Hill LLC.

Bongelli, R., Busilacchi, G., Pacifico, A., Fabiani, M., Guarascio, C., Sofritti, F., Lamura, G., & Santini, S. (2024). Caregiving burden, social support, and psychological well-being among family caregivers of older Italians: a cross-sectional study. 
Frontiers in public health
, 
12
, 1474967.
https://doi.org/10.3389/fpubh.2024.1474967

Broom, K. D., & Bhuyan, S. S. (Eds.) (2026).
Fundamentals of Healthcare Management: Theory and Practice
. Springer Publishing Company.

Gans, E. A., van Mun, L. A. M., de Groot, J. F., van Munster, B. C., Rake, E. A., van Weert, J. C. M., Festen, S., & van den Bos, F. (2023). Supporting older patients in making healthcare decisions: The effectiveness of decision aids; A systematic review and meta-analysis. 
Patient education and counseling
, 
116
, 107981.
https://doi.org/10.1016/j.pec.2023.107981
c

Guo, J., Jiang, S., Dai, Y., Xu, X., Liu, C., & Chen, Y. (2025). Shared decision-making competency and its associated factors among palliative care nurses: a cross-sectional study in China. 
BMC nursing
, 
24
(1), 141.
https://doi.org/10.1186/s12912-025-02747-0

Largent, E. A., Peterson, A., & Karlawish, J. (2023). Supported decision making: Facilitating the self-determination of persons living with Alzheimer’s and related diseases. 
Journal of the American Geriatrics Society
, 
71
(11), 3566–3573.
https://doi.org/10.1111/jgs.18596

Lognon, T., Plourde, K. V., Aubin, E., Giguere, A. M. C., Archambault, P. M., Stacey, D., & Légaré, F. (2022). Decision aids for home and community care: a systematic review. 
BMJ open
, 
12
(8), e061215.
https://doi.org/10.1136/bmjopen-2022-061215

Ouslander, J. G., Studenski, S., High, K. P., Asthana, S., Supiano, M. A., Ritchie, C. S., & SchmadeR, K. (2022). 
Hazzard’s Geriatric Medicine and Gerontology
(8th ed.). McGraw Hill LLC.

Rahemi, Z., Malatyali, A., Bacsu, J. R., Sefcik, J. S., Petrovsky, D. V., Baker, Z. G., Ma, K. P. K., Smith, M. L., & Adams, S. A. (2023). Healthcare Utilization and Advance Care Planning among Older Adults Across Cognitive Levels. 
Journal of applied gerontology : the official journal of the Southern Gerontological Society
, 
42
(12), 2294–2303.
https://doi.org/10.1177/07334648231191667

Sehatkarlangrodi, S., Zargoush, M., Longo, C. J., & Ghazalbash, S. (2025). Shaping older adults’ care policy: a scoping review of key determinants in post-acute and community reintegration transitions. 
BMC health services research
, 
25
(1), 1236.
https://doi.org/10.1186/s12913-025-13433-x

Sun, C., Ding, Y., Cui, Y., Zhu, S., Li, X., Chen, S., Zhou, R., & Yu, Y. (2021). The adaptation of older adults’ transition to residential care facilities and cultural factors: a meta-synthesis. 
BMC geriatrics
, 
21
(1), 64.
https://doi.org/10.1186/s12877-020-01987-w

Vinckers, F., & Landeweer, E. (2025). Moral distress among healthcare professionals in long-term care settings: a scoping review. 
Philosophy, ethics, and humanities in medicine : PEHM
, 
20
(1), 8.
https://doi.org/10.1186/s13010-025-00171-5 
 Columbus State University FNP Program NURS 6228 Health Promotion of the Elderly – Ethical Dilemmas of in long term placement of elderly men essay

Developing the PICOT Question

This formative assessment will evaluate your ability to create a
well-structured PICOT question
that reflects the integration of evidence-based practice into clinical scenarios.

Instructions:

Read the Provided Scenario: Carefully review the clinical scenario below.

Identify Relevant Components: Use the PICOT framework to identify the components specific to the given scenario.

Create Your PICOT Question: Formulate a clear and concise
PICOT question
based on the identified components. Ensure each element of the PICOT is addressed.

Submit Your Assessment: Complete your PICOT question in the provided template and submit it by the designated deadline.

Clinical Scenario:

A hospital is seeing an increase in post-operative infections among diabetic patients who have undergone elective surgeries. The nursing staff is concerned about the effectiveness of current infection control measures and is exploring the possibility of implementing a new pre-operative glucose management protocol.

P (Population): Identify the specific patient population

I (Intervention): Define the intervention being considered

C (Comparison): Determine the comparison group

O (Outcome): Specify the desired outcome

T (Time): Indicate the time frame for measuring the outcomes

 

Developing the PICOT Question

Evidence-based practice (EBP) is incorporated into clinical activities to address a specific patient safety issue. Thus, EBP varies depending on current gap in clinical practice or a specific patient safety concern (Wafa’a et al., 2023). In the provided scenario, post-operative infections in persons with diabetes who have undergone elective surgeries are on the rise. Studies show that post-operative infections are common in diabetic patients receiving post-operative care in hospital’s med-surgical wards (Lee et al., 2024). Chen et al. (2025) reported a significantly high infection risk in diabetic patients receiving post-operative care compared to the general patient population. In diabetic patients, post-operative infections are attributed to adverse treatment outcomes, including prolonged stay (Osagwu et al., 2024). Post-operative infections further expose persons diagnosed with diabetes to huge economic burden, resulting in negative patient experience (Tomic et al., 2022). For these reasons, the upwards trend in post-operative infections should be addressed by implementing an EB intervention,
developed through a PICOT question
. This assessment focuses on the development of a well-structured PICOT question that would guide integration of an effective EB intervention into clinical care of persons with diabetes who have undergone elective surgeries.

Relevant PICOT Components

P (Population):
Adult diabetes patients receiving post-operative care in the hospital’s med-surgical ward following elective surgery.

I (Intervention):
Adopting a new pre-operative glucose management guideline

C (Comparison):
Standardized infection control measures

O (Outcome):
Decrease in post-operative infection rates.

T (Time):
Within 30 days.

PICOT Question

“In adult diabetic patients who have undergone elective surgeries (P), how does adopting a pre-operative glucose management guideline (I), compared to standardized infection control measures (C), influence post-operative infection rates (O) within the first 30 days of post-operative period (T)?”

References

Chen, K. Y., Chan, H. C., & Chan, C. M. (2025). Do
people
with diabetes have a higher risk of developing postoperative endophthalmitis after cataract surgery? A systematic review and meta-analysis. 
Journal of Ophthalmic Inflammation and Infection
, 
15
(1), 24 Developing the PICOT Question.
https://link.springer.com/article/10.1186/s12348-025-00483-9

Lee, B., Raftis, D., Shukla, D., Sarani, B., Sikka, N., & Hood, C. (2024). Investigating the Utility of Object Manipulation in Augmented Reality in Procedural Training. 
Telemedicine and e-Health
, 
30
(3).
https://par.nsf.gov/biblio/10535804

Osagwu, M., Okobi, E., & Ekor, E. (2024). Postoperative infections: risk factors, prevention, and management strategies. 
Int J Med Sci Dent Res
, 
7
, 52-76.
https://www.ijmsdr.org/published%20paper/1i1i35/Postoperative-Infections-Risk-Factors-Prevention-and-Management-Strategies.pdf

Tomic, D., Shaw, J. E., & Magliano, D. J. (2022). The burden and risks of emerging complications of diabetes mellitus. 
Nature Reviews Endocrinology
, 
18
(9), 525-539.
https://www.nature.com/articles/s41574-022-00690-7

Wafa’a, M. O., Ammouri, A. A., & Raddaha, A. H. A. (2023). Associations between barriers to implementing evidence-based practice and patient safety. 
Research and Theory for Nursing Practice
, 0(0); 1-15.
https://www.researchgate.net/profile/Ali-Ammouri/publication/370483638_Associations_Between_Barriers_to_Implementing_Evidence-Based_Practice_and_Patient_Safety/links/646f7a875fb30b716c51c1ff/Associations-Between-Barriers-to-Implementing-Evidence-Based-Practice-and-Patient-Safety.pdf 
 Developing the PICOT Question

A nurse working at a community health fair is administering intramuscular injections of influenza vaccine. Which injection technique will avoid leakage into subcutaneous tissue?

Massaging the injection site

Aspiration prior to injection

Injection at a 45-degree angle

Injection by the Z-track method

The Z-track injection method avoids leakage into subcutaneous tissue. Pull the client’s skin downward or upward, and inject the vaccination (or medication) at a 90-degree angle before releasing the skin. Aspiration is done to assure that the injection is not going into a vein or artery. Massaging the injection
site
can introduce the material into subcutaneous tissue. A 45-degree angle is incorrect.

Medical Terminology – Prefixes, Suffixes, and Root Words Essay

Why is it important for healthcare professionals to have a strong grasp of medical terminology, especially the basic word structures?

How do prefixes, suffixes, and root words help in deciphering complex medical terms?

Can you think of any examples where knowing the structure of a medical term could significantly impact patient care or communication among healthcare providers?

Instructions:

Initial Post:

Answer the provided questions about the origins of medical terminology.

Your initial post should be well-organized, thorough, and reflect your understanding of the topic.

Your response should be clear and at least 150 words.

Medical Terminology – Prefixes, Suffixes, and Root Words Essay

Medical and Terminology

Why is it important for healthcare professionals to have a strong grasp of medical terminology, especially the basic word structures?

Healthcare professionals must have a thorough understanding of
medical terminology
to ensure clear, efficient, and standardized communication. Medical terminology functions as a language that allows accurate, concise sharing of complex medical details, helping to minimize confusion in patient records, diagnoses, and treatment plans. Without a common language like medical terminology, misunderstandings can happen, leading to adverse effects such as medical errors and patient safety risks. Additionally, this language promotes teamwork across healthcare specialties by ensuring consistent interpretation of clinical data (Tassos et al., 2023). Mastering medical terminology improves accuracy in documentation and decision-making, both of which are vital for providing high-quality care.

How do prefixes, suffixes, and root words help in deciphering complex medical terms?

Prefixes, suffixes, and root words are essential parts of medical terminology, aiding healthcare professionals in systematically understanding unfamiliar terms. The root indicates the body system or part, the prefix modifies the meaning (such as quantity or location), and the suffix describes the procedure, disease, or condition. Recognizing these elements makes it easier to simplify complex terminology and minimizes the need for memorization. For instance, “hepatitis” is divided into “hepat,” meaning liver, and “itis,” meaning inflammation, which signifies liver inflammation (Tassos et al., 2023). Mastering these components and affixes greatly improves understanding and retention of medical vocabulary, helping medical personnel interpret new terms more efficiently (Elhaj & Abdalgane, 2025).

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Can you think of any examples where knowing the structure of a medical term could significantly impact patient care or communication among healthcare providers?

Understanding the structures of medical terms is essential for clear communication and effective patient care. For example, distinguishing between hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) is critical for selecting the appropriate treatment. Likewise, confusing tachycardia with bradycardia (slow heart rate) can result in mistakes. Correctly understanding the structure of medical terms ensures better communication, accurate medication administration, and proper diagnosis (Tassos et al., 2023). In the end, mastering medical terminology reduces errors, enhances patient safety, and improves healthcare outcomes.

References

Elhaj, M. G. Y., & Abdalgane, M. (2025). Investigating the effectiveness of affixes in learning medical terminology.
International Journal of Language and Literary Studies, 7
(1), 12–26.
https://doi.org/10.36892/ijlls.v7i1.1978

Tassos, M., Gjorgioski, B., & Barker, E. (2023). 
Mastering Medical Terminology
(4th ed.). Elsevier Medical Terminology – Prefixes, Suffixes, and Root Words Essay

After emptying a Jackson-Pratt drainage bulb, how does the nurse reestablish negative pressure in the system?

A. Fill the bulb with sterile saline solution.

B. Place the bulb lower than the client’s body.

C. Open the valve and fill the bulb with air.

D. Compress the bulb and close the valve.

A Jackson-Pratt drain creates negative pressure when the bulb is compressed and the valve is closed. This causes fluid around the surgical site to flow into the drain.

Body parts medical terminology

Welcome to our discussion forum on body systems!

In this forum, we will delve into the essential body systems that are fundamental to understanding medical terminology. Consider the following questions as you contribute to the discussion:

Choose one body system (e.g.,
cardiovascular
, respiratory, digestive) and discuss its key components and functions.

Include a brief overview of relevant medical terms associated with that body system.

Instructions:

Initial Post:

Answer the provided questions about the origins of medical terminology.

Your initial post should be well-organized, thorough, and reflect your understanding of the topic.

Your response should be clear and at least 150 words.I

 

Body parts medical terminology

Medical and Terminology

The respiratory system is vital to life as it helps in the exchange of gases, to supply the body with oxygen, and to remove carbon dioxide. The key components are the nose, pharynx, larynx, trachea, bronchi, and lungs. Air is inhaled through the nasal cavity, and here it is filtered, warmed, and humidified before traveling through the pharynx and the larynx to the trachea. The trachea further splits into the right and left bronchi, which further subdivide into smaller bronchioles in the lungs (Marchadier, 2025). These bronchioles end in tiny air sacs known as the alveoli, where the actual exchange of oxygen and carbon dioxide occurs through the bloodstream. The diaphragm is a dome-shaped muscle located under the lungs. It is an essential part of the respiratory system as it contracts and relaxes to enable the lungs to breathe in and out.

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The medical terminology of the respiratory system often contains suffixes, prefixes, and roots to describe structures and conditions. Examples include pulmo/pulmon/o, which means lungs, and pneum/o or pneumon/o, which means air or lung tissue. Some typical terms are dyspnea (difficulty breathing), apnea (absence of breathing), and bronchitis (inflammation of the bronchi) (Ernstmeyer & Christman, 2024). The suffix -itis denotes inflammation, and the suffix -ectomy denotes extraction, for example, lobectomy, the removal of a lobe of the lung. Knowledge of these terms assists healthcare providers in communicating and explaining respiratory diseases, diagnosis, and interventions effectively and accurately. The respiratory system plays a crucial role in keeping oxygen levels stable and contributing to the functioning of the body cells.

References

Ernstmeyer, K., & Christman, E. (2024).
Respiratory system terminology
. Nih.gov; Chippewa Valley Technical College.
https://www.ncbi.nlm.nih.gov/books/NBK607438/

Marchadier, D. (2025).
The respiratory system
. 21–33.
https://doi.org/10.1007/978-3-662-71489-8_3
  Body parts medical terminology

NURS 6041: Health Care Technology, Teaching & Evaluation in Health Care.

Final Project Guidelines

Introduction: This assignment will be an application of what is learned in the final modules, with application from the earlier modules (Theory and Electronic Health Record).  This work is intended to be a summation of information from this course with application of content.  The student should not cite sources directly (using quotes), but should assimilate and reference where material came from.  Except where noted, personal views and uncited information should not be used.  APA format is expected in all areas, start to finish.  Headers are required to guide the reader.  Appropriate grammar and sentence structure is expected.  Graduate level writing is expected.

You have been given the assignment of reviewing your clinic’s performance in addressing a major health disease/disorder.  In your clinic, the manager has reviewed some records and has asked that you devise a plan to improve how your clinic manages your selected disease process.  For this assignment, you may use a disease process identified as being ‘not being managed well’ or a disease process that could be managed better in the clinic you are currently involved in or from your current clinical practice if you are not in a clinical rotation this summer.

 

Title page (5 points)

Title should be a one sentence summation of the entire report

Review and Utilize APA format throughout title page and paper

 

Introduction (2 paragraphs) (10 points)

Introduction section should start with a broad introduction of the disease process

Next, a discussion on why it is important to address it at the clinic level

Must include a population that can be targeted (population can have a variable application). The population should be targeted based upon who is being seen in the clinic.  Examples below (One is pinpointed to a specific target and one is too broad. Please be specific)

GREAT EXAMPLE: Native American patients over the age of 65 with A1C levels greater than 8.0%.

POOR EXAMPLE: People with hypertension.

 

Abbreviated treatment guidelines from a nationally recognized professional organization (3-4 paragraphs) (15 points)

(Example: The American Diabetes Association for type two diabetes management).

 

This disease process must be one that is recognized as being managed by a family nurse practitioner in the clinic (Type 2 diabetes, Hypertension, Hyperlipidemia, Asthma, etc.)

Disease process is complex as to require both medical and nursing management

Medical management is
briefly
outlined (not the entire formulary of tiered medication, but a summary of drug classes is fine and for the first one or two tiers

Screenings and interventions associated with your selected disease discussed (example: annual flu shot, annual liver enzyme panels, etc.)

Nursing management (health behaviors) is briefly discussed to address long-term complications or disease progression (Smoking cessation, diet modification, exercise)

Discussion of selected benchmark goals of how clinics should address

Only need to address major ones and ones being addressed in the paper, or identified as being deficient in Review of Electronic Health Record.

Compare your clinic’s outcomes to those benchmark standards either in your area or local/state health departments, or national levels.
Hint
: you want to show you are not meeting a set standard and this is what you are wanting to improve in your clinic.

Review of Electronic Health Record of the office/clinical/unit (2 paragraphs) (10 points)

Population of focus is clearly identified (supported with statistical data)

Clinical outcomes are identified and discussed.

Area of Disease outcome measures are identified and supported with EHR data findings

Lacking management or health behaviors is identified with supported EHR data findings

Discussion of missing data unable to be retrieved from EHR.

How might the problem be alleviated?

 

Questions leading up to PLAN-DO-STUDY-ACT implementation (2-3 paragraphs) (15 points)

What specifically do you need to accomplish with your project? (consider where you are not meeting the benchmark standards. It may not be the same wording)

What specific change are you going to introduce [to help bring about a change] and why? [This will be a discussion on what changes you are going to make in the clinical structure or processes to make a difference]

How will you know the change is making an improvement? [What will you look at after you have made a difference to know if a positive change has been made?]

Answers to each question are to be supported by observation and plausible project implementation.

If research from another source, cite appropriately and address how it can be modified from the area of research to the clinic area.

 

PLAN (2 paragraphs) (10 points)

The basic plan is laid out

Assigned roles are briefly discussed (Review Roger’s diffusion of innovation)

How it will be implemented? What will be developed?

What specific strategies will you employ from the Roger’s Diffusion of Innovations model will you utilize to ensure success? (Strategies must be specific to the clinic) NURS 6041: Health Care Technology, Teaching & Evaluation in Health Care

 

DO (2 paragraphs) (10 points)

Discuss the education model or Theory you will be implementing in your clinic and using with patients to help them make a change. (There may be several, but choose one to discuss)

Provide a short paragraph to summarize and justify use of this particular model with the change you plan to make in the clinical setting to improve outcomes.

 

STUDY (2 paragraphs) (10 points)

Differentiate between process measures and outcome measures, and what you will look at for your project (may be repeated from above).

What EHR data will you be reviewing and analyzing to know if you made a difference?

What environmental data will you be reviewing?

What questions might you be asking of those working in the environment?

Address one possible unintended consequence that might occur.

 

Closing (1-2 paragraphs) (10 points)

Provide a brief, yet information dense, summary of content presented in paper.

Make a connection of concepts you learned from this course that you can apply in your future practice.

 

References (10 points)

Should be a substantial number of scholarly sources to address the required information.

All sources and in-text citations should be cited using APA format

Reference Page should be formatted using APA format

NURS 6041: Health Care Technology, Teaching & Evaluation in Health Care