The movie “Escape Fire: The Fight to Rescue American Healthcare,” identified seven issues affecting our current healthcare system: Paying more, getting lessTreating the whole personPreventing DiseaseO

The movie “Escape Fire: The Fight to Rescue American Healthcare,” identified seven issues affecting our current healthcare system: Paying more, getting lessTreating the whole personPreventing DiseaseO
Discussion: Unit 2 Week 3, Due Wednesday by 11:59 pm CT Instructions: The movie “Escape Fire: The Fight to Rescue American Healthcare,” identified seven issues affecting our current healthcare system: Paying more, getting less Treating the whole person Preventing Disease Overmedication Overtreatment An entrenched system Reimbursement Please create a thoughtful and supported post addressing the points below. Let us all do our best to create thoughtful discussions and an open forum for all opinions. Pick 4 of the issues listed above and answer the following questions: How are these issues affecting our current system (spending/debt, Medicare, ACA, population health)? Who is responsible for these issues and correcting them? How can these issues be improved whether at a local/state (community health department), national (USDHHS), or global level (WHO)? Which of these issues fall under the Strategic Goals of the USDHHS and Healthy People 2020? What can we do as nurses? Your post should be at least 400 words. Use chapters 3 and 5 in your text and at least one scholarly article (not Wikipedia or a website). Please be sure to validate your opinions and ideas with citations and references in APA format. The post and responses are valued at 75 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria. Peer Response: Unit 2 Week 3, Due Sunday by 11:59 pm CT Instructions: Respond to at least 2 of your peers, agreeing or disagreeing with their post. Each response should be a minimum of 150 words. Use scholarly supporting evidence. Please be sure to validate your opinions and ideas with citations and references in APA format.
The movie “Escape Fire: The Fight to Rescue American Healthcare,” identified seven issues affecting our current healthcare system: Paying more, getting lessTreating the whole personPreventing DiseaseO
Case Study Postoperative Delirium Patient Profile M.C. is a 74 year old male who has been in the intensive care unit (ICU) for 3 days after unexpected major abdominal surgery. He is becoming increasingly confused and agitated. Before surgery, he was alert and oriented. Subjective Data States he needs to “get out of here” Angry at family members for not “taking me home” Family members are very upset about M.C.’s confusion Objective Data Blood pressure 110/70, pulse 98, respirations 20, temperature 97.3 F Oxygen saturation 97% on nasal cannula oxygen at 2L Abdominal incision healing, no redness or drainage Difficulty speaking with decreased short-term memory and recall Trying to climb out of bed Oriented to person only Difficulty focusing attention, and disorganized thinking Answer the following questions thoroughly and cite resources appropriately in APA format. What type of cognitive impairment does M.C. likely have? How can this diagnosis be confirmed? Are there any other issues that you need to consider as possible causes for his mental state? What is the nurse’s priority regarding M.C.’s mental status? What is the next priority for the nurse caring for M.C.? What diagnostic tests may be ordered and what would each contribute? How will you support M.C.’s family at this time? Complete the attached CAM worksheet for this patient and discuss the results here
The movie “Escape Fire: The Fight to Rescue American Healthcare,” identified seven issues affecting our current healthcare system: Paying more, getting lessTreating the whole personPreventing DiseaseO
Confusion Assessment Method (CAM) (Adapted from Inouye et al., 1990) Patient’s Name: Date: Instructions: Assess the following factors. Acute Onset 1. Is there evidence of an acute change in mental status from the patient’s baseline? YES, NO UNCERTAIN NOT APPLICABLE Inattention (The questions listed under this topic are repeated for each topic where applicable.) 2A. Did the patient have difficulty focusing attention (for example, being easily distractible or having difficulty keeping track of what was being said)? Not present at any time during interview Present at some time during interview, but in mild form Present at some time during interview, in marked form Uncertain 2B. (If present or abnormal) Did this behavior fluctuate during the interview (that is, tend to come and go or increase and decrease in severity)? YES, NO UNCERTAIN NOT APPLICABLE 2C. (If present or abnormal) Please describe this behavior. Disorganized Thinking 3. Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable, switching from subject to subject? YES, NO UNCERTAIN NOT APPLICABLE Altered Level of Consciousness 4. Overall, how would you rate this patient’s level of consciousness? Alert (normal) Vigilant (hyper alert, overly sensitive to environmental stimuli, startled very easily) Lethargic (drowsy, easily aroused) Stupor (difficult to arouse) Coma (unarousable) Uncertain Disorientation 5. Was the patient disoriented at any time during the interview, such as thinking that he or she was somewhere other than the hospital, using the wrong bed, or misjudging the time of day? YES NO UNCERTAIN NOT APPLICABLE Memory Impairment 6. Did the patient demonstrate any memory problems during the interview, such as inability to remember events in the hospital or difficulty remembering instructions? YES NO UNCERTAIN NOT APPLICABLE Perceptual Disturbances 7. Did the patient have any evidence of perceptual disturbances, such as hallucinations, illusions, or misinterpretations (for example, thinking something was moving when it was not)? YES NO UNCERTAIN NOT APPLICABLE Psychomotor Agitation 8A. At any time during the interview, did the patient have an unusually increased level of motor activity, such as restlessness, picking at bedclothes, tapping fingers, or making frequent, sudden changes in position? YES NO UNCERTAIN NOT APPLICABLE Psychomotor Retardation 8B. At any time during the interview, did the patient have an unusually decreased level of motor activity, such as sluggishness, staring into space, staying in one position for a long time, or moving very slowly? YES NO UNCERTAIN NOT APPLICABLE Altered Sleep-Wake Cycle 9. Did the patient have evidence of disturbance of the sleep-wake cycle, such as excessive daytime sleepiness with insomnia at night? YES NO UNCERTAIN NOT APPLICABLE Scoring: For a diagnosis of delirium by CAM, the patient must display: 1. Presence of acute onset and fluctuating discourse AND 2. Inattention AND EITHER 3. Disorganized thinking OR 4. Altered level of consciousness Source: Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941-948. Confusion Assessment Method (CAM) Diagnostic Algorithm Feature 1: Acute Onset and Fluctuating Course This feature is usually obtained from a family member or nurse and is shown by positive responses to the following questions: Is there evidence of an acute change in mental status from the patient’s baseline? Did the (abnormal) behavior fluctuate during the day; that is, did it tend to come and go, or increase and decrease in severity? Feature 2: Inattention This feature is shown by a positive response to the following question: Did the patient have difficulty focusing attention; for example, being easily distractible, or having difficulty keeping track of what was being said? Feature 3: Disorganized Thinking This feature is shown by a positive response to the following question: Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject? Feature 4: Altered Level of Consciousness This feature is shown by any answer other than “alert” to the following question: Overall, how would you rate this patient’s level of consciousness? (alert [normal], vigilant [hyperalert], lethargic [drowsy, easily aroused], stupor [difficult to arouse], or coma [unarousable]) Source: Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941-948.