02 Feb Compare the evidence that

Unit 4 discussion

Technology and Ethical Dilemmas in Evidence-Based Care

For this discussion, read the two case studies below. Choose one of the case studies and respond to all of the questions and points under that case study.

Case Study 1

M. J. is a 55-year-old Caucasian female who is presently recovering in an orthopedic unit of a large medical center following a total right hip replacement. She has had a Foley catheter in place since prior to surgery three days ago, and has now developed a catheter-associated urinary tract infection (CAUTI).Your institution has established a culture of safety and has protocols in place that have resulted in a significant decrease In CAUTIs in its post-operative population. As M. J. is the fourth patient to have a CAUTI in the last three months, this is especially disconcerting. A committee was established to look into the recent increases in CAUTI occurrences. Their research resulted in a recommendation to implement a trial of utilizing automatic computer technology prompts for the health care providers about discontinuing urinary catheters. The hope is this notification system will mitigate the sudden rise in CAUTIs and ensure patient safety.

If you have chosen to respond to this case study, please address the following in your response:

What might be potential ethical barriers to implementing automatic computerized reminders to remove Foley catheters on identified patients?

How do you integrate the ethics of caring into this practice environment?

Are there ethical considerations associated with using care bundle guidelines in practice? In monitoring and tracking data?

Discuss how the culture of patient safety is aligned with one of the ethical principles of beneficence or non-maleficence.

Be sure to cite at least two sources of evidence in your initial discussion post.

Case Study 2

Rachel is a registered nurse who works for a major insurance company in the diabetes wellness department. Her employer has identified potential high-cost utilizers, and those diabetics at risk for target organ damage, by utilizing data from the population health portal HEDIS benchmarks of those diabetic patients enrolled with their health plan. The data points being used are hemoglobin A1C levels less than 9% and LDL cholesterol levels below 100. All patients with high A1Cs and LDLs are being contacted by the insurance company to be enrolled in a telephonic nurse education program. The goal of the program is for the nursing staff to educate the patients on healthy lifestyle and self care to improve their diets, exercise, and medication adherence. During one of the calls, Rachel identifies that she is employed in Iowa, and her patient lives in Nebraska.

If you have chosen to respond to this case study, please address the following in your response:

Are there any legal or ethical issues with the RN and patient being in different geographical locations?

Does the nurse need to obtain a nursing license in every state where there might be electronic contact with the patient?

If the nurse gives the patient poor advice, and there is a case of substandard care or malpractice, where would the patient seek legal recourse?

How do you integrate the ethics of caring into this practice environment?

Be sure to cite at least two sources of evidence in your initial discussion post.

Response Guidelines

Review the posts of your peers and then select two to whom you wish to respond. If possible, these peers should have chosen to respond to the same case study as you. In your response be sure to address the following ( Note: Your responses should be substantive, 100-200 words):

Compare the evidence that you used to inform your response to that used by you peer.

How did the evidence lead you to similar conclusions as your peer?

How did the evidence lead you to different conclusions than your peer?

Briefly comment on what this indicates to you about the importance of considering multiple sources of evidence.

Briefly explain how additional evidence has changed your thoughts about what the appropriate actions are to take.

Resources

Discussion Participation Scoring Guide.