Ethical And Policy Issues about Care Coordination

Welcome, everyone. Thank you all for finding time to join me in presenting ethical and policy factors in care coordination. In this presentation, we will explore ethical and policy aspects in care coordination. We will also elaborate on ethics in nursing, government policies related to health or safety affect care coordination, national, state, and local policy that raises ethical questions for care coordination, the impact of the code of ethics for the nurse on the coordination and continuum of care, key ethical and policy issues in a presentation affecting the coordination of care in the homeless community.

Care Coordination

            What is care coordination? Swan & Conway-Phillips (2019) define care coordination as a proactive strategy to facilitating collaboration among health care professionals and care providers to satisfy the requirements of consumers to ascertain that they get incorporated, person-centered care in different healthcare environments. Care coordination can be as simple as verifying that patients can access their EHR data and share their medical information in an interdisciplinary setting. Moreover, care coordination can also be as complicated as handling multiple hospitalizations, requiring numerous sections of care, rehabilitation, insurance, and outpatient appointments. Coordinated care aims to improve the patient’s quality of life, reduce the length of stay in the hospital, minimize readmissions, and cut down the overall cost of care (McWilliams 2016).

Ethical and Policy Issues in Care Coordination

            The nursing field utilizes regulatory mechanisms, ethical principles, and a Code of ethics in ensuring that care providers obey the standard practices. The aim is to ensure that healthcare experts carry out their core duties in the most accurate way without risking or endangering the patient’s life. The code of ethics serves as guidance during the decision-making processes. In America, nurses similar to their colleagues in other parts of the world work under the dogmas of the International Council of Nurses alongside national, state, and local policies.

            In addition, the code of ethics facilitates adherence to wellness and life altruism of the patient as the primary concern. Hence, nurses have four fundamental roles: restoration of health, prevention of diseases, promotion of care, and alleviation of suffering every time they implement their duties (Wei et al., 2019). These duties include community-centered organizations like nursing homes. The primary fundamentals of car ethics are justice, autonomy, beneficence, and nonmaleficence. Nurses use these principles as the guideline when encountered detestable decisions in sophisticated studies. According to the American Public Health Association (APHA), public health entails massive beliefs in ethical activities of public health (Wei et al., 2019). The interdependence of people is a significant factor worth highlighting. APHA argues that public health is not limited to assuring the health of the communities but ensures that people’s healthcare is within their community.  

Government Policies Related to Health or Safety Affect Care Coordination

            The federal government’s primary role is to safeguard the patient’s wellbeing and wellness. It achieves this through enacted policies that significantly affect the coordination and continuum of care. The private data belonging to the patient in the U.S. is safeguarded by the Department of Health and Human Service under the Health Insurance and Accountability Act (HIAA). HIAA works with the policy for the Protection of Human Research Subjects (PHRS). The primary aim of federal guidelines is to enhance care coordination, especially when patients arc e shifting providers and insurance (Henson 2016). Furthermore, they enable the promotion of electronic exchange of data within the care facility. The government’s primary concerns regarding the patient’s data are to ensure confidentiality to protect the consumer against breach of disclosure of data accessed within the paradigm of professional data.

            These policies affect care coordination in different ways. First and foremost, the guidelines permit the sharing of data among healthcare facilities as long as the aim is to improve the patient’s health. Through HIPAA, community-centered organizations and treating entities can disseminate data without separate authorizations. Consequently, HIPAA has led to improved health provisions and patient safety because nurses and doctors can easily access the patient’s data. This boosts the response between patients and practitioners. This is fundamental, more so for nursing homes where the wellbeing and wellness of a patient mainly rely on the availability of data which in turn helps in decision implementation processes (Henson 2016).

            Furthermore, the policies permit the disclosure of data to the patients, clergy, friends, and family because they are on the same premise as the patient.  This is crucial, especially when practitioners want to protect the patient’s data from their individual bad decisions, and authorized access to third parties such as family members or friend input would be meaningful. In community organizations like Life Care, particularly for elderly patients, HIPAA is beneficial in implementing decisions.

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National, State, and Local Policy That Raises Ethical Questions for Care Coordination

            For any field to be accepted as a profession, it must satisfy specific standards of regulation and practice. This happens in nursing as rules are vital in ensuring safety and competency while carrying out nursing activities. These are actualized through established civil procedure and rules which direct the conduct and decision-making procedures in practice. In the United States, the U.S Department of Health and Human Services serves as the chief agent at the national level. Based on geographical location, various states and their counties have created their own regulations. Therefore, nurses must comprehend and adhere to these policies to avoid legal problems while upholding consistency when on duty.

            As much as policies are designed to protect the patients and practitioners in decision-making practices, they create ethical concerns and dilemmas in the profession. For example, at the national level, the privacy regulations address confidentiality. In some scenarios, nurses find themselves in dilemmas between disclosing particular information or keeping the secrecy. Practitioners in nursing homes find themselves in such scenarios when patients ask them not to reveal their knowledge to their families. Additionally, the patient self-determination provision creates some ethical issues. This policy states that patients have a right to make decisions. Sometimes, the patient may fail to understand the practitioner’s concerns, thus making wrong decisions (Coldiron et al., 2017). In such scenarios, practitioners are left in a dilemma. In addition, at the local level, such as Volusia county, the alternative opioid rule, which asserts that patients with a history of opioid abuse should be treated using alternative medicines, can create an ethical challenge. The dilemma may occur when substitute medicine fails to work, and the practitioner is left wondering whether to administer opioids or leave the patient to suffer. Such dilemmas may happen in nursing homes, and nurses could be challenged about their patients.

Impact Of the Code of Ethics for The Nurse on The Coordination And Continuum of Care

            Nurses work in a fast paced-and technical setting, which entails making crucial decisions that impact people’s lives; for that matter, the code of ethics is necessary because it helps in decision-making processes. The code of ethics dictates that nurse should carry out their roles irrespective of social determinants, including education, economic stability, health and healthcare, social and community context. Nurses act autonomously to determine patient welfare because of the code of ethics; even though the code of ethics brings so many benefits, adverse effects severely affect coordination and continuum of care (Jeong 2018). For instance, decrease in ethical uncertainty because of technological advancement concerning interventions. Moreover, there is a surge in stress levels and moral distress, especially when professional policies must be met alongside time pressures and complexities related to managing patients.

Key Ethical and Policy Issues in A Presentation Affecting The Coordination and Continuum of Care in Nursing Homes

Nursing homes experience a multitude of ethical and policy issues. Nevertheless, Healthy People 2020 is an appropriate policy that defines the advantages of tackling these social determinants, including constructing physical and social stings to enhance quality care for all (People 2020). Understanding how social determinants impact the consumers is core to offering better services in a nursing home. Despite the efforts to advance access to care, there are various concerns following the practicality of the Affordable Care Act (ACA). The patient confidentiality and privacy policies impact care coordination alongside addressing end-of-life problems policies.

Tuberous Sclerosis Complex – PowerPoint Presentation

  • Tuberous sclerosis complex (TSC) is rare genetic disorder mainly characterized by the progressive development of internal growths and tumors in body organs.
  • Although a majority of reported TSC cases begin in the brain, growths may also manifest on the skin, eyes, kidneys and vital organs such as the heart and lungs.
  • Today, the Centers for Disease Control and Prevention (CDC) reports that empirical statistical data on the exact number of individuals with TSC in the United States alone still remains unknown due to its rarity. However, current estimates of confirmed cases stand at 40,000 (National Organization for Rare Disorders, 2020).

Tuberous sclerosis complex is a debilitating disorder affecting cellular differentiation and migration during the formative stages of development. As a consequence, numerous hamartomatopus lesions develop across different sites in the body and are now characteristically known to affect every organ system (Kirollos et al., 2019). Adomasabaceum is the best-known display of the condition and usually remains dormant; only becoming apparent between late child hood and early adolescence (Ehninger & Silva, 2013). Furthermore, TSC causes the development of scarlet muscular lesions as a common early sign among patients, and often mistaken for acne or freckles.

Pathophysiology Of Tuberous Sclerosis Complex

  • Tuberous sclerosis complex is primarily caused by a genetic defect of the TSC1 or TSC2 genes (National Organization for Rare Disorders, 2020).
  • As an autosomal dominant disorder, TSC first affects the brain and commonly associated with the development epileptic seizures.
  • TSC is also concomitant with focal developmental malformations within the cerebral cortex region of the brain among persons with the condition.
  • The development of tubers then follows, and normally recognized by a sudden permeation of giant cells, astrocytes, and dysmorphic neurons (Kwiatkowski et al., 2017).
  • Understated neuropathologic variations within the brain may also be present.

Tuberous sclerosis complex is an autosomal dominant disorder primarily caused by prominent inherited defects within the TSC1 or TSC2 genes (Lhatoo et al., 2019). It initially starts in the brain, but later spreads to all organ systems; affecting the eyes, skin, lungs, kidneys, and heart. Developmental malformations, in the form of tubers, then advance in the cerebral cortex, and are commonly discernable by the proliferation giant cells, astrocytes, and dysmorphic neurons. The resulting unregulated cell growth causes spontaneous seizures as a direct consequence of changes in cortical lamination.

Major Defining Features

  • Periungual fibroma.
  • Hypomelanotic macules.
  • Connective tissue nevus.
  • Multiple retinal nodular hamartoma.
  • Cortical tuber.
  • Subependymal nodule.
  • Subependymal giant cell astrocytoma.
  • Lymphangioleiomyomatosis.
  • Renal AML.

A primary defining feature of Tuberous sclerosis complex is the presence of forehead plaque typically accompanied by Periungual fibroma. Furthermore, the presence of a nontraumatic ungula and shagreen patch also signify the preliminary development of multiple retinal nodular hamartoma, common in most TSC cases. Cerebellar cortical dysplasia, punctuated by the migration of white matter is also one of the early signs of TSC (Ehninger & Silva, 2013). Additionally, the presence of renal AMLs and lymphangioleiomyomatosis (LAM) also signify tuberous sclerosis.

Clinical Presentations

  • Abnormal neurological findings.
  • Cutaneous manifestations, chief among them being adoma sabaceum.
  • Cardiac involvement in the development of rhabdomyomas.
  • Ocular abnormalities.
  • Cystic pulmonary abnormalities.
  • Autosomal dominant polycystic lesions as a consequence of kidney disease.
  • Pitting of the dental enamel.
  • Hamartomas and polyposis in gastrointestinal area.
  • Sclerotic and hypertrophic lesions.

Several clinical manifestations are also associated with the initial advance of TSC. Since the condition is known to originate in the brain, preliminary neurological results usually reveal the proliferation of subependymal giant cell astrocytomas (SEGAs) and subependymal nodules (SENs) (Jones, 2016). Adomasabaceumbegins developing, and becomes apparent during late childhood. TSCs impact during early infancy also results in the development of rhabdomyomas as the most common indication of cardiac disease. The pitting of the teeth is rare in children, but common among TSC patients.  Evidence of pitting of the enamel in primary teeth and Sclerotic and hypertrophic lesions on the bones further signify TSC.


  • Laboratory studies: Computed Tomography Scanning (CT scans), Renal Ultrasonography, and a routine Echocardiography.
  • Assessment tests: Electroencephalography and Electrocardiography.

Tuberous sclerosis complex diagnoses are typically guided by laboratory studies conducted to detect the presence of common genetic alterations associated with the condition. CT scans are performed to detect SEGAs prior to the development of obstructive hydrocephalus play a major role in diagnosis (Learning, 2019). Renal ultrasonography, on the other hand, evaluates variations in cysts, paving the way for operative intervention while a routine echocardiography serves as a major baseline diagnosis test (Kwiatkowski et al., 2017). An electroencephalography is typically conducted as a follow on clinical indications of TSC, while a baseline electrocardiography identifies cardiac arrhythmias in suspected cases.

Treatment And Management

  • TSC is a complex medical condition, often requiring specialized care and treatment. The following are some of the most common TSC management practices in use today:
  • Pharmacologic treatment:  By prescribing antiepileptic medications (AEDs) and medication to manage kidney tumors.
  • Surgery: Thermal ablation, stimulation of the vagus nerve, and Corpus callosotomy.

Both surgery and pharmacologic treatment options are recommended in managing TSC.  However, the latter is more commonly used today. Antiepileptic medications (AEDs) pharmacologic treatment options for TSC target patient’s epileptic syndrome as a major clinical manifestation of the condition (Jones, 2016, p. 32). Furthermore, kidney medications such as Everolimus (Afinitor) are commonly prescribed to manage lesions and tumors which emerge shortly after affecting the urinary system. Surgical option such as thermal ablation, stimulation of the vagus nerve, and Corpus callosotomy may also be employed.


  • Treatment for TSC starts with AEDs to manage epileptic seizures evident among patients.
  • The worsening of seizures normally results in inpatient care for TSC patients.
  • Inpatient care may also be recommended for patients presenting with retroperitoneal hemorrhage, and pneumothorax or dyspnea as a consequence of TSC-related LAM.

The initial treatment for Tuberous sclerosis complex does not typically require hospitalization and only involves prescribing AEDs to manage epileptic features. However, a further worsening of the condition may result in inpatient care to allow the patient to adjust to AEDs. Cases of hematurias may also cause embolization and a primary reason why evidence of AML and LAM normally results in hospitalization for supportive care.

Impact of Motivation on Employee Performance – Annotated Bibliography


Today’s business world is characterized by stiff competition in almost all industries. As a result, organizations have to find ways to maintain a competitive advantage in their respective industries. Considering that employees are the most important asset of any organization, it is imperative that employers hone their ability to get the best out of their workforce. One of the ways that they can achieve this is through employee motivation. The current research seeks to assess the impact of motivation on employee performance. Notably, an effective inquiry must be based on a rich body of literature related to the topic under consideration. Hence, the below identified six articles will be instrumental to completing the current research as they are rich in knowledge relating to the topic under consideration and provides different perspectives of evaluating the relationships between the research variables.

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Quantitative Research Articles

Sandhu, M. A., Iqbal, J., Ali, W., & Tufail, M. S. (2017). Effect of employee motivation on employee performance. Journal of Business and Social Review in Emerging Economies3(1), 85-100.

The study seeks to evaluate the relationship between employee motivation and workplace performance. Specifically, the researchers seek to understand the influence of employee motivation on job performance. The research uses a sample consisting of 120 college and university lecturers from Sahiwal city, Punjab. The research results indicate that employee motivation has a positive impact on job performance.

The researchers base the study on Maslow’s Need Hierarchy theory. Thus, a plausible theory informs the conceptual framework of the research. Moreover, the research findings concur with the existing body of research on the topic. Existing literature on organizational productivity elucidates that employee motivation positively influences job performance leading to optimal productivity.

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The article will prove significantly resourceful to the completion of my research as it provides empirical evidence regarding the relationship between employee motivation and job performance. It not only confirms the existence of a correlation between the two variables but also goes further to break down various types of employee motivation strategies and their effectiveness. The article will, therefore, help me establish a strong basis for a well-informed inquiry.

Diamantidis, A. D., & Chatzoglou, P. (2019). Factors affecting employee performance: an empirical approach. International Journal of Productivity and Performance Management.

The study seeks to identify factors that influence employee performance in the workplace. The research participants entail 79 human resource managers and 392 employees from various organizations.  Among the factors identified as having a strong impact on work performance is employee performance. The research results show that both extrinsic and intrinsic motivators significantly influence employee performance.

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The theoretical framework of the study entails a rich foundation of literature regarding employee-related factors and employee performance. The research findings also contribute to the developing body of knowledge in employee performance. Additionally, the findings align with the existing research body regarding the relationship between employee motivation and job performance. Thus, the research is reliable to inform the current research.

This study takes a different angle in evaluating the correlation between employee motivation and work performance. Unlike most studies, which directly assess the link between the two variables, it indirectly identifies employee motivation as a significant factor affecting employee performance. The research will, therefore, provide a different perspective on looking at the relationship between the two variables; thus, it will be instrumental to the completion of the current research.

Read also Article Analysis – Global Trends in Employee Motivation

Qualitative Research Articles

Jain, A., Gupta, B., & Bindal, M. (2019). A study of employee motivation in organization. International Journal of Engineering and Management Research (IJEMR)9(6), 65-68.

            The study seeks to evaluate the effects of motivation on employee performance and identify approaches that employers can use to motivate employees. The research collects qualitative data from Mind Science India Pvt. Limited whereby it incorporates 100 participants. Analysis of data collected demonstrates that motivation is a significant aspect within any workplace as it leads to increased job performance.

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            The research is founded on a robust conceptual framework incorporating three research theories, including Maslow’s Hierarchy of Needs model, Expectancy theory, and Herzberg two Factor theory. The research findings align with these theories as well as existing literature on the topic. Moreover, it identifies forms of motivation and their effectiveness based on analysis of collected data.

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            The article will be instrumental to the completion of the current research. The article’s contents align with the current research topic. Besides identifying a correlation between motivation and employee performance, it also explores different approaches that organizations can use to effectively their workers. Thus, the article promises to be significantly resourceful to the current inquiry.

Setiawan, D. A. (2020). A qualitative study of employees’ motivation factors on organization: a case study from a company in Indonesia. Hasanuddin Economics and Business Review3(3), 112-121.

The study by Setiawan evaluates employee motivation factors and their impact on work performance. The research focuses on one (unidentified) of Indonesia’s state-owned organizations. The research findings identify salary, work-life balance, reward/recognition, and growth opportunity as motivational factors influencing employee performance. Hence, the researcher concludes that both extrinsic and intrinsic factors have a positive influence on employee performance.

Read also Annotated Bibliography Example – Employee Motivation And Retention

McGregor’s X and Y theories inform the conceptual framework of this study. The research is also based on a rich foundation of existing literature on the topic. The research findings align with the research literature and also confirms the study hypotheses. The article is, therefore, reliable to inform the current research focusing on the relationship between employee motivation and job performance.

The article will be useful to the completion of the current research as it provides rich information regarding the research topic. It also incorporates recommendations regarding how employees enhance employee motivation outcomes. Hence it will prove to be significantly important to the literature review part of the current study.

Mixed-Methods Research Articles

Kuswati, Y. (2019). Motivation Role in Improving Work Effectiveness. Budapest International Research and Critics Institute-Journal (BIRCI-Journal), 281-288.

The study seeks to assess the motivation role in improving work effectiveness of the employees of an Irrigation Network at Talaga, Majalengka. The researcher utilizes both qualitative and quantitative data. The research findings show that motivation improves employee’s morale and engagement level leading to increased work effectiveness. The researcher, therefore, concludes that employee motivation positively influences work performance.

The researcher assesses the relationship between employee motivation and job performance using various indicators, including the principles of performance, communication, authority, and mutual attention. The research is, as such, founded on an extensive literature review of the topic. Additionally, the research findings concur with existing literature on the topic under consideration.

The article will prove useful to the current literature by introducing a different perspective on the relationship between employee motivation and work performance. Rather than directly examining the said relationship, the researcher bases his analysis on how motivation impacts work environment and how this translates to improved employee performance. Therefore, the source will be significantly useful to the completion of the current research.

Deressa, A. T., & Zeru, G. (2019). Work motivation and its effects on organizational performance: the case of nurses in Hawassa public and private hospitals: Mixed method study approach. BMC research notes12(1), 1-6.

The primary objective of this research was to evaluate the level of motivation in a workplace and how it reflects in organizational performance. The research focuses on public and private hospitals located in Hawassa, Ethiopia. The research findings demonstrated that the level of employee motivation can predict organizational performance. The article, therefore, concludes that there exists a positive correlation between employee motivation and work performance.

Numerous credible sources inform the literature review section of this study. Hence, the research’s conceptual framework is founded on a rich body of literature on the topic under consideration. The research results also concur with existing literature focusing on the topic. Most importantly, the study introduces new aspects of the relationship between employee motivation and organizational performance by incorporating aspects such as job satisfaction, team spirit, job attachments, and others.

A solid body informs the research literature of the study of credible sources and theories on the topic. Additionally, the research uses a reliable instrument of measuring employee motivation whereby it utilizes the multidimensional work motivation scale (MWMS). The information presented by the article is, therefore, reliable and can be used in the completion of the current research.

The article will be useful to the research since it arrives at a conclusion that supports my research hypotheses. Additionally, it introduces a unique perspective of analyzing the relationship between employee motivation and work performance. Thus, it will prove significantly resourceful.


            Organizations must strive to establish and maintain a competitive advantage in their respective industries. One of the ways that they can do this is through enhancing organizational performance. Achieving this objective requires optimal performance from individual employees and the organization as a collective. Given the importance of employee performance, knowledge regarding how organizations can influence their workers to perform optimally is essential to employers. The current research proposes that motivation can help organizations improve employee performance. The six identified articles will prove significantly resourceful in the completion of the paper. Although they all support the current research’s hypothesis, they provide different perspectives of analyzing the relationship between motivation and employee performance.

Mitigating COVID-19 Crisis in America’s Emergency Rooms

America’s emergency departments need to adopt a holistic approach that encompasses mitigation, preparation, response, and recovery. Mitigation refers to efforts geared towards minimizing the impact of an outbreak before the event (Cao et al., 2020). For instance, in case of COVID-19, there was a considerable lag time between the first reported case and its spread throughout the US. Early mitigation strategies would have proved useful in reducing the spread of the virus. The second element, preparation, refers to preparedness activities necessary when mitigation measures have not or cannot prevent a disaster (Quah et al. 2020).

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For COVID-19, this entails stockpiling of resources such as PPE, ventilators, testing equipment, and other necessary supplies. It also entails gathering information to inform best practices for ensuring safety and desired patient outcomes. The third aspect, response, seeks to assist victims and reduce secondary damage. COVID-19 is an ER disease. Hence the US health care system needs to establish systems and approaches for responding to the disease in emergency rooms and find ways to expand oversight by critical care in ERs. Services such as telemedicine are crucial to improving the survival chances of the infected. The response phase also requires close monitoring for unintended outcomes and appropriate modification. The last but equally essential element is recovery. Preparation for recovery should begin as soon as the incident occurs. The goal should be to facilitate successful recovery with minimal health impacts (Cao et al. 2020).

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The US health care system should be regularly evaluating the capacity and availability of trained practitioners to assess contacts, manage new cases, and determine whether they return to ER is warranted. Notably, while ER attention mainly focuses on the response phase, effective emergency management requires a precisely balanced approach. Health care facilities need to provide care for all patients in the safest way possible. The use of this holistic approach in ERs can help America’s ERs mitigate the COVID-19 crisis.

Advice to A 17 Year-old Sexually Active Female Interested in Starting Birth Control

A 17 year-old sexually active female presents to your clinic and reports that she is interested in starting birth control. Briefly discuss at least THREE birth control options and be sure to mention the pros/cons/indications/contraindications for each method.

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            Contraception for adolescents is a fundamental tenet of sexual health promotion meant to promote best practices among young adults. Considering both “typical use” and “perfect use” of various available methods of contraception ensures a suitable choice is made solely based on the efficiency. In this case scenario, selecting and reviewing the most suitable method of contraception for our 17-year old sexually active client is crucial in preventing unplanned pregnancies and contracting sexually transmitted infections (STDs). Combined Oral Contraception (COC) pills, Progestin implants, and intrauterine contraception (IUDs) are among leading methods of contraception in use today. COCs have been available for the past five decades and now considered one of the most effective methods in preventing unwanted pregnancies. They are the most preferred method of hormonal contraception among young adults and typically designed to taken orally.

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Combined Oral Contraceptions contain a combination of progestin and estrogen as prototype contraception for other methods of birth control (Shah & Agrawal, 2017, p. 413). COCs are favored because they do not interrupt sex, are easy to take, and have a higher likelihood of success when taken consistently. However, it does not protect users from STIs and associated with adverse side effects which may include nausea, headaches, and an irregular monthly period. Combined Oral Contraceptions are also associated with reduced chances of developing pelvic inflammatory disease and also lessen symptoms of premenstrual syndrome in young women (Guillebaud, 2016). The contraindications for Combined Oral Contraceptions include diabetes, a history of renal disease, smoking, and hypertension.

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On the other hand, progestin implants are in a class of contraceptives which periodically etonegestrel to block the release of oocytes from the ovaries (Phill, 2019, p. 321). Progestin implants are highly effective and may remain in place for up to 3 years. Advantages include its cost-effectiveness as a long-term method of contraception, is safe, and can be used for an extended period. Yet, common disadvantages include mood swings, high prevalence of developing acne, and breast tenderness. Indications for progestin implants include cigarette smoking, obesity, and a current history of STIs or PID.

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Intrauterine device or coil is a long-acting method of birth control which involves placing a copper-coated T-shaped device in the uterus to prevent fertilization (Guillebaud, 2016, p. 136). Major advantages include its small size, effectiveness in preventing pregnancies and low maintenance. Nonetheless, it must be inserted by a specialist, does not protect against STIs, and may occasionally slip out of place. Indications include persons living with HIV and those with nulliparous while contraindications include pregnancy, current pelvic infection, and a distorted uterine anatomy (Trussell, 2017).

Social Media, A Societal Trend Affecting Patient Education

Over the past five decades, numerous rapid technological changes have been recorded globally and currently impact nearly all spheres of modern life. In particular, the introduction of the internet and related services is among one of the most notable changes witnessed today. According to Carroll, Bruno & Vontschudi (2015), the internet has greatly transformed the process of communication, sharing of important messages, and peer-to-peer interaction within a relatively short period (p. 95). Today, it is more prevalent than ever; especially as a constant presence in our homes and within the workplace environment.  As a communication medium, the internet has also morphed from simple messaging and chatting services to sophisticated social media applications such as Instagram, Facebook, and Twitter. The widespread use of social media today has revolutionized remote interactions and resulted in the “online community” phenomenon where likeminded persons or individuals with similar interests associate on a continual basis. Yet, it remains imperative to consider the implications of such technological changes in nursing. Perhaps one of the most striking aspects of the Information Age is the ever-increasing population of individuals relying on the wide range of services on offer. A future consequence of this current state of affairs is an overall increase in the number of patients and nurses interacting in social media signifying an elevation in basic engagement capabilities. Millennials in the nursing profession grapple with the idea of promoting such changes in a profession with a sizeable older generation which is generally conservative.  Nursing in the Information Age, therefore, represents a yardstick with far reaching consequences for the medical professions the provision of care, and mainly in patient education.

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Fundamentals of Social Media    

            The initial introduction of social media as a major element of the Information Age prompted pundits versed in society’s transformation to posit a future focused on interactions, communication, and education.  Initial speculations were subsequently realized when social media emerged as a key tool in learning and communication owing to the relative ease of access and overall affordability. Today, the permeation of the Telehealth portent, as a product of social media, has seen a considerable improvement in nursing frameworks on patient education (Moorhea, Hazlett, Harrison, Irwin, & Hoving, 2017). Messages transmitted through social media platforms reach the intended target within a relatively shorter period and serves as the epitome of speedy communication. Web platforms and e-mails provide a unique opportunity to relay important information within a relatively short period, allowing nurses to communicate with patients intending to share crucial information regarding their wellbeing. If any of the questions posed remain unanswered, patients are often referred to a specialist versed in the medical field specified to guarantee access to accurately specified information.

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 Furthermore, the internet is seemingly bottomless repository of information and data which can be harnessed to improve individual’s overall wellbeing. Patient education today may also involve actively searching for healthcare information from credible peer-reviewed journal articles and online textbooks. The emergence of this trend is part of a new wave of ideas which underscore the significance of individuals being cognizant of information relevant to their health any given period (Ventola, 2018). For instance, patients today supplement instructions offered during the initial assessment with useful instructional material from government agencies such as the United States Food and Drugs Administration (FDA) and the Centers for Disease Control (CDC).  This relative ease of access to information through social media ensures a greater population, ranging from health science students, nurse practitioners, and educators, gain succinct comprehension of best practices applied today within the healthcare sector (Sinclair, Mcloughlin, & Warne, 2015).

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The internet, through social media platforms and applications, has recently enabled healthcare practitioners to offer consultations, evaluations, therapy, and patient education remotely through innovative technology. Efforts to increase the number of platforms offering such services are informed by the essential nature of health promotion today. The initial discharge of patients and subsequent expectations placed on them represents some of the most precarious phases in healthcare. Patients are known to experience a great deal of difficulty sticking to a treatment plan which would otherwise improve their wellbeing (Ventola, 2018). Failure to adhere to available treatment options may be a sign of patient’s reservations to a particular treatment option due to insufficient information regarding its actual significance. Social media offers a unique opportunity for patients to ask pertinent questions about medication management in a bid to improve healthcare outcomes. Additionally, innovative technologies such as video conferencing promote direct correspondence between patients and healthcare providers for the purpose of clarification or further directions on a treatment plan.

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The introduction of this new subset of healthcare has significantly improved its quality by now allowing primary care providers to liaise with specialists who provide crucial care information to promote care delivery. Proponents of using social media in care provision view current trends as a major revolution in the definition of the most appropriate conduits of pertinent healthcare information while particularly aspiring to foster health promotion. Such efforts are likely to address healthcare disparities recorded in the United States today by guaranteeing unlimited access to information capable of promoting care-seeking behavior, ultimately reducing major emergency room cases. The presence of support groups in social media platform has played an invaluable role in offering a sense of community in a manner bound to improve patient outcomes by sticking to the treatment plans provided and in reducing stigma. Innovations such as telepsychiatry apply social media to engage directly with patients. Pertinent questions posed during the course of routine consultations are explored extensively in a manner that explores the behavioral and primary care aspects to guarantee comprehensive coverage.

Read also Patient Safety and Quality Improvement Act of 2005

Professional Standards

While social media is commonly hailed as a positive development today, it remains crucial to acknowledge its drawbacks. The prevalence of social media use within the workplace environment for the purpose of patient education today is also associated with misuse. Evidence of blatant misuse of social media within professional settings is prohibited, with offenders risking stern legal and disciplinary action (Grajales , Sheps, Ho, Novak-Lauscher, & Eysenbach, 2016).  The aforementioned standard is also applicable within a clinical setting and may result in lawsuits for periodic offenders.  Healthcare facilities are, therefore, advised to develop and maintain an elaborate code to ensure ethical considerations are upheld and cases of malpractice accorded the appropriate punitive action.

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Recent technological advances, such as the internet and social media, have by far transformed healthcare and patient education today. The Information Age provides patients with a wide range of options, ranging from online consultations, telemedicine and even to Telepsychiatry. The common thread among these transformations is the application of social media to eventually improve patient outcomes. With the application of professional standards, patients are bound to expect the highest standards of care within a new dispensation.

Niagara Health System : An Innovative Communications Strategy – Case Analysis Report

Issues Facing the Organization

The key issues facing the Niagara Health System (NHS) is poor communication and public relation. Notably, the hospital’s strategic plans do not entail any public relations metrics. Thus, when it attracted negative public opinion due to the C. difficile outbreak, the NHS was not well equipped or prepared to effectively manage the crisis that stemmed from negative public opinion. Johnston and Sheehan (2020) elucidate that how a healthcare institution responds to a crisis and bad press is crucial to its trust and reputation. The communication and public relations struggles adversely impacted NHS’s reputation as both internal and external stakeholders lost trust with the hospital.

Possible Solutions

            A possible solution to the communication and public relation issues is the formulation and implementation of an innovative communications strategy. The strategy must incorporate both short and long-term provisions. The short-term communications framework will serve as a crisis management and damage control strategy. On the other hand, the long-term aspect of the communications strategy will be geared towards ensuring that the NHS maintains an authentic relationship with all the stakeholders by making them feel they are part of the hospital. According to Pursiainen (2017), an effective communication strategy is one that builds strong relationships with the stakeholders by facilitating regular flow of purposeful information.

Recommended Solutions

            The central aspect of the communications strategy should be the hospital’s message to the public emphasizing what it stands for. For the short-term communications strategy, NHS should ensure to communicate as much information as possible to the public, press, and other stakeholders. The public knowledge of what is going on minimizes room for speculation (Bundy, Pfarrer, Short, & Coombs, 2017). Secondly, the hospital should take responsibility for the situation to pre-empt the blame. Taking ownership demonstrates a sense of responsibility, hence, trustworthiness. Lastly, the organization should ensure to react as fast as possible to avoid further deterioration of its reputation (Johnston & Sheehan, 2020). An effective communications strategy emphasizes character and competence.

            Regarding long-term solution, NHS should integrate the formulated communications strategy into its organizational culture. The key underpinnings of the communications strategy should be integrity, character, and competence. By emphasizing integrity, an organization demonstrates care for others, transparency, and courage to stand by what is right. On the other hand, stressing competence and character cultivates three key values namely honesty, fairness, and authenticity (Bundy, Pfarrer, Short, & Coombs, 2017). Notably, the communications strategy should also incorporate a two-way communications framework so that the community is involved in the decision-making process of the hospital, where applicable. NHS should also leverage technology such as social media to improve its relationship with the public.

Expected Outcomes           

If well implemented, the short-term solution will manage the existing crisis and repair the damage that is already done. NHS has already attracted negative press and public opinion which have adversely impacted its reputation. The short-term communications strategy will repair the reputation and help rebuild trust with the stakeholders. As for the long-term communications strategy, it will ensure that the hospital builds robust relationships with the stakeholders based on trust and mutual respect. The strategy emphasizes two-way communication and transparency, which is what has been missing in NHS’s communications with the stakeholders. The strategy will also allow NHS to be better prepared in case of a future crisis. Bottom line, the expected outcomes include effective crisis management, damage control, repaired trust and reputation, and strong relationships with all stakeholders.

Transformational Leadership Vs Servant Leadership

Over the past century, leadership styles have emerged as some of the most effective approaches to apply when aspiring to provide a clear sense of direction, motivating a group of likeminded individuals, and the execution of strategies. Leadership styles are currently applied in a wide array of fields with the primary intention of fostering the conceptualization of solutions to aid organizations in making considerable headway. Transformational leadership and servant leadership are two of the most common leadership styles currently in application today.

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            Although transformational leadership and servant leadership both endeavor to realize similar goals, they remain unique in their own right as inimitable styles and manner of application. Transformational leadership is essentially a structured system where leaders liaise with their employees and other subordinates to develop a deeper connection among those involved in this exchange (Bass, 2016). As a consequence, higher levels of motivation, ethics, and morality among leaders and followers are then recorded; ultimately resulting in a general rise in trust and productivity. On the other hand, servant leadership is based on an altruistic model where the wellbeing of followers always takes precedence as opposed to focusing solely on self-interest (Dierendonck & Patterson, 2018). From this foundation, it is possible to deduce the fact that transformational leaders work steadily to ensure individual employees are always motivated while servant leaders will focus more on helping employees as one of the main moral obligations.

Read also Great Man Theory versus Transformational Leadership Theory

Striking similarities are also present in both transformational leadership and servant leadership in relation to their application and mode of operation. As a rule of thumb, both seek to promote an aspect of continuity within an organization by working towards the creation of likeminded leaders within the organization. In both styles, leaders are acutely aware of the significance of human resource and, therefore, ensure that concerted efforts aim to raise the consciousness of staff members. This guarantees their comprehension of their role as an important cog in the organizational wheel and their role in ensuring that set organizational goals are ultimately realized. Leaders eventually avoid self-interest and acknowledge the actual importance of members of staff, which then fosters their drive to nurture, buttress, and empower them in any given situation (Gardenia, 2019).

Read also Concept of Servant Leadership and The Difference Between Servant Leadership and Transformational Leadership

Nevertheless, it is worth acknowledging transformational leadership lacks an ethical element to its overall application. Ethics serve an important role in servant leadership where followers are placed above leaders and regarded as equal partners in controlling various aspects of their organization (Northhouse, 2016, p.240). This ultimately impacts the actual manner in which employees are treated during management.

Masterpiece Cake Shop v. Colorado Civil Rights Commission (2018) – Case Summary

 The core of this case was individual’s right to exercise free speech and worship as enshrined in the First Amendment, especially with regard to non-discrimination in public accommodation.  Masterpiece Cakeshop declined a request by a gay couple seeking to have their custom wedding cake made based on the proprietor’s religious belief (Gilkis, 2018). The case was later forwarded to the Colorado Civil Rights Commission which later determined that the owner’s actions were discriminatory. Furthermore, the bakery was issued with fresh orders relating to the couple’s request which prompted the bakery’s owner to lodge an appeal against the decision in the US Supreme Court. The commission’s decision was subsequently reversed since the commission failed to apply religious neutrality.

The main question in this particular case was whether the Colorado Public Accommodations law was applied constitutionally by issuing fresh orders requiring the defendant to design a cake violating his religious beliefs. The bakery’s owner, Jack Phillips, was unequivocal in asserting his position as a staunch Christian whose religious beliefs were in direct opposition to his faith. In essence, this violated his First Amendment rights by obstructing the Free Exercise Clause.

The 7-2 ruling by the Supreme Court determined that the Colorado Civil Rights Commission had failed to act constitutionally by ignoring Jack Phillip’s First Amendments. It also failed to implement religious neutrality during the initial appraisal and the autonomy enjoyed by persons in relation to free exercise (Levy, 2017). The court reversed the initial ruling and highlighted the need for an in-depth evaluation of anti-discrimination laws to address challenges bound to emerge during adjudication.

 The Supreme Court’s decision was to reverse a previous ruling made by the Colorado Civil Rights Commission on Jack Phillips’ failure to design a wedding cake for a gay couple. Justices Elena Kagan, Anthony Kennedy, John Roberts, Stephen Brever, and Neil Gorsuch were unanimously agreed on Phillip’s right to freely exercise his religion and the religious neutrality clause subsequently violated (Masterpiece Cakeshop, Ltd. v. Colorado Civil Rights Commission, 2018). The commission had, therefore, openly displayed belligerence towards Phillips religious disposition. Dissenting voices, primarily by Sonia Sotomayor and Ruth Bader Ginsburg, asserted that the Commission was justified in its ruling and had acted well within stipulated legal bounds. However, both justices were keep on stating that legal precedents were of the utmost importance in such cases since they provided a workable framework to inform commissions when confronted with a constitutional debacle. In this case, the business owner’s decision to deny an essential service to a member of the public did not go against their statutorily protected traits.

Obergefell v. Hodges (2015) – Case Summary

The main issue of contention in this particular case was the fundamental right to marry as enshrined in the Equal Protection Clauses of the Fourteenth Amendment and the Due Protection Clause. This liberty extends to same-sex couples that were particularly lobbying against state legislation-based restrictions upheld by states such as Tennessee, Michigan, Ohio, and Kentucky which only recognize unions between a man and a woman. This prompted the subsequent filing of lawsuits challenging laws in the aforementioned jurisdictions, ultimately culminating in the Obergefell v. Hodges Supreme Court decision that resulted in the formal legalization of same-sex marriages on a federal level.

            The Obergefell v. Hodges presented a number of key legal questions for evaluation solely based on the actual constitutionality of outlawing same-sex marriages in a number of jurisdictions in the United States. Chief among these questions was whether the definition of marriage only recognizing union between a man and a woman was constitutional or in direct violation of the Fourth Amendment. The choice to uphold this perspective was informed by the 1971 Baker v. Nelson Supreme Court case which acknowledged marriage as a union between a  man and a woman; subsequently invalidating the legitimacy of same-sex marriages.

            The 5-4 decision in the Obergefell v. Hodges was that legal restrictions in Tennessee, Michigan, Ohio, and Kentucky were unconstitutional and an affront on the Fourteenth Amendment. This resulted in the formal legalization of same-sex marriages on a federal level as a guarantee based on legal provisions within the Fourteenth Amendment and the Equal Protection Clause.  All states with the United States and its insular territories were now required to acknowledge same-sex marriages and their protection under provisions outlined in the US Constitution,

            The rationale of the court’s decision was based on the rationale that it was prudent for the United States to reject legal provisions that only recognized marriage as a union between a man and a woman since it was unconstitutional.  In particular, the majority opinion by Justices Elena Kagan, Ruth Bader, Stephen Brever, and Sonia Sotomayor underscored that outlawing same-sex marriages was unconstitutional since it does not uphold the provision of liberty to all. The decision to marry was, therefore, a personal choice that had to be protected since it was deeply steeped in individual autonomy.

            Dissenting opinions were expressed by Justices Antonin Scalia, John Roberts, Clarence Thomas, and Samuel Alito. The rationale behind this dissent was the idea that the verdict would set a dangerous precedent where the substantive due process clause would be misused. Furthermore, dissenting voices also argued that the ban on same-sex marriages did not infringe upon the right privacy while further arguing that its main objective was promoting successful child rearing.