for creative instructor dqs due tonight

hi 3 of these I need tonight and the other 2 i need tomorrow ok



      • posted by ERMA  


Ludwick (1999) speaks commonly, professions use external measures for assuring competence.  Qualification for practice is assured by licensing laws and by professional standards.  Familiar examples in nursing for assuring competency include:  licensing exams for practice entry, continuing education (CE) for renewal of practice license, work-based orientation programs, and graduation from an accredited program of study.


Laws and rules are generally considered to uphold the lowest minimum standard for practice.  Licensing laws for example, protect patients from harm, but do not hold professionals accountable to a skill level that promotes quality.  Hall (1996) writes:  “Law is the minimum ethic and, therefore, legal behavior is not necessarily the highest ethic” (p. 49).  As a profession, nursing does not want to rely on self-reflection on competence as the sole method to assure the public and ourselves that nurses are competent.  Nor should we be satisfied that external measures such as licensing laws, CE, or competency-based evaluations will provide the absolute assurance of competency.  Competency is a complex construct that requires numerous measures.  To practice competently requires us to comply with external competence measures and to reflect ethically about competence.






Ludwick, Ruth (December 10, 1999).  Ethical Thoughtfulness and Nursing Competency. Online Journal of Issues in Nursing Vol. 5 No. 1.


Contemporary Issues in Healthcare Law and Ethics, Chapt 14


    • posted by gustavo  


One of the most current issues in the health system of the country  is the recruitment of doctors for the payers health  insurance companies. With the desire to control health care costs and stay profitable, the insurance companies hire certain physicians. Those doctors take care of the money from those companies. This has limited the choice of patients who in the past used to chose  the physician. I recently  had a bad experience  with  one of those HMO. A patient in ED  refused to  be admitted under certain physician. This patient just  left another hospital  in the area because he was under the care of that doctor. This patient never realized that  in the new hospital the same doctor cover the same HMO. I  had a conversation with  the HMO  and it was not way to get the approval  for admit the patient under a different doctor. This patient asked his family to  bring to  a hospital  in a different county. Something is wrong in the system. In  my  opinion this is a case where patient lost the autonomy, this patient was not able to  decide for himself. There are many  space for discussion about the legal and ethics implications of those contracts. Hospital  is tied. Patient satisfaction and patient and family experience are seriously injured. This hospital  received many  complaints from patients because of the particular physician. What to  do? The hospital  needs  patients and also the hospital  needs those patients happy.




Harris, D. (2008). Contemporary issues in healthcare law and ethics (3rd ed.). Chicago: Health Administration Press.






posted by Gustavo      



    Conflict of interest is one of the most important aspects to take into consideration when contracts are made with health service organizations. “Conflicts of interest arise when those who owe conscientious duties to others appear to have personal interests that might tempt them to subordinate those duties to their self-interest” (Dickens and Cook, 2006). A conflict of interest exists when, for example a doctor or organization refers a patient to another specialist or health service in exchange for a payment, or when a laboratory gives a physician bonuses for using their services. Conflicts often involve monetary or material interests, such as in advising patients to take more expensive over less expensive but equally suitable treatment when the former promotes practitioners’ incomes. The risk of committing legal errors in contracts for health services is very high under the current conditions. Hospitals have increased their relationship with physician groups and the state monitors any possibility of non-ethical actions, so hospitals should develop compliance procedures for establishing new compensated physician relationships. To reduce these errors the hospital compliance officer should carefully review any contract that the hospital perform with a group of doctors, and this person can not be involved in the negotiation. Every physician financial agreement must satisfy a core exception under the Stark self-referral prohibition law. It is inadequate for example, that emergency physicians refer patients to the physical therapy department of the hospital.


    Dickens, B., & Cook, R. (2006). Conflict of interest: Legal and ethical aspects. International Journal of Gynecology & Obstetrics, 92(2), 192-197. Retrieved September 6, 2014, from


    • posted by gustavo  




The Affordable Care Act brings justice to the health system of the United States. The Healthy People 2020 project would have no success if there is no health coverage to the vast majority of the population. The reform to the health system attempts to curb the exaggerated costs of the health service. This is social justice. Justice is a basic principle of ethics of the health system. The new reform does not exclude from its program the legal immigrants. However, immigrants do not understand the new concept of reform. To obtain a health insurance is mandatory and that comes in contradiction with their beliefs. How much the social  justice can interfere the autonomy  of people?




Evans, M., & Kaiser Health News is an editorially independent program of the Kaiser Family Foundation. (2014, September 4). Enrolling people in Obamacare who have no ‘concept of insurance’ Retrieved September 5, 2014.


    • posted ANGELA


Marketing practices and priorities of pharmaceutical industries have been under scrutiny.  There has been an increase emphasis on drugs that over medicalize problems.  Accusations about short cuts, pressure for favorable results, conducting test on people with proper approval, and using drugs for unapproved uses (Shah, 2010).




Many drug companies prefer less government involvement.  Which in my opinion, should not be allowed, because disease and illness affects some of the poorest people that cannot afford medication and treatment.  And the government is the only source for funding for these people.  So, they should be included in whatever decisions made concerning providing medication to the poor.






Shah, A. (2010). Global Issues. Retrieved from







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