Poor Patient Outcome

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Question description
Poor Patient Outcome
Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.
Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.
This case portrays a poor patient outcome after a misdiagnosis.
Case scenario
A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.
On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.
The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.
Written Assignment:
Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning.

  1. As an NP in primary care what would you have done differently?
  2. Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?

If a serious diagnosis comes to mind based on a patient’s symptoms:

  • Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral?
  • Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario?
  • Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis?
  • What other diagnosis could it be? How might the treatment to date have altered the patient outcome?
  • What other diagnostic and laboratory or imaging was needed in order to make a complete differential list? What support tools would you consider using in helping to create a differential diagnosis list?
  • Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.
Assignment Requirements:
Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
  • Utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition format as outlined in the APA Progression Ladder.

Introduction, Thesis Statement, and Annotated Bibliography

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Introduction, Thesis Statement, and Annotated Bibliography

Question descriptionPrepare: To help with the preparation of your annotated bibliography, review the following tutorials and resources from the Ashford Writing Center: •Introduction Paragraph Guide (Links to an external site.)Links to an external site. •Thesis Statement tutorial (Links to an external site.)Links to an external site. •Annotated Bibliography tutorial (Links to an external site.)Links to an external site. •Sample Annotated Bibliography (Links to an external site.)Links to an external site. •Evaluating Sources (Links to an external site.)Links to an external site. Reflect: Reflect back on the Week Two Discussion in which you shared with the class the global societal issue that you would like to further address. Explore critical insights that were shared by your peers and/or your instructor on the topic chosen and begin your search for scholarly sources with those insights in mind. Write: For this assignment, review the Annotated Bibliography Formatting GuidelinesPreview the documentView in a new window and address the following prompts: •Introductory Paragraph to Topic: Refer to the Final Argumentative Essay guidelines for your topic selection. Write an introductory paragraph with at least 150 words, which clearly explains the topic, the importance of further research, and ethical implications. •Thesis statement: Write a direct and concise thesis statement, which will become the solution to the problem that you will argue or prove in the Week Five Final Argumentative Essay. A thesis statement should be a declarative statement that makes one point in 25 words or less. The thesis statement must appear at the end of the introductory paragraph. •Annotated Bibliography: Develop an annotated bibliography to indicate the quality of the sources you have read. For each annotation, you need to summarize in your own words how the source contributes to the solution of the global societal issue. Your annotation should be one to two paragraphs long (150 words or more) and fully address the purpose, content, evidence, and relation to other sources you found on this topic. The annotated bibliography must include no less than five scholarly sources that will be used to support the major points of the Final Argumentative Essay. Critical thinking skills need to be demonstrated by accurately interpreting evidence used to support various positions of the topic. The Introduction, Thesis Statement, and Annotated Bibliography Assignment •Must be 1,000 – 1,250 words in length

self-assessment essay on technical competencies

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self-assessment essay on technical competencies

Question descriptionMore and more there is an expectation by employers and others that upon completion of a Master’s Degree in the field of Health Administration you will show knowledge and skills – competencies – that demonstrate your readiness for professional work in these fields.
In these assigned essays, you are asked to REFLECT and then DISCUSS, your own competencies, and DEMONSTRATE AN AWARENESS of your own strengths and areas for further growth. No matter where you are in your career, you should be able to assess you education, and prior life experience has prepared you to move ahead as a professional.
Prepare an essay on specific competencies [knowledge and technical skills [not just technology skills, unless they are relevant to your future career] that you have (or you expect to have) upon completion of this master’s program. Support your essay with evidence or examples from your prior or current work settings, volunteer roles, and course work, as well as any self-assessment questionnaires you may have previously completed. [at this time do not discuss the competing values questionnaire]
Compare your current competencies with those required for a specific position of the type for which you desire to qualify and discuss where you are well-prepared and where you anticipate needing further on-the-job experience to reach the desired competencies. You may also compare your own competencies to those of a leader or mentor in the type of position you are seeking. For this essay, please include a description of a real relevant position [with the full job description and a posting, if available], focusing on the required and desired qualifications.
This essay should be at least 5 pages long, double-spaced. The position description is not part of the page count, and should be submitted simultaneously, if possible.
P.S: please write an essay based on hospital project administrator position

Ethics Position Paper

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Ethics Position Paper

Question descriptionPhil 1112 Ethics Final Paper The final paper. The paper will be 8 pages in length, 12 pt font (New Times Roman is a standard font), and double-spaced.
Topics Choose one of the two topics for your final paper.
1. Contemporary Moral Problem. The paper should be a position paper focused on your chosen topic from Part 3 Moral Problems of our text (the table of contents gives you an idea of the variety of topics available). You will need to choose a topic (e.g. Abortion, World Hunger, Capital Punishment, etc), set out and explain at least two of the positions argued for from that section by the authors in the text. Explain and evaluate their arguments. Additionally, argue for (i.e. explain and defend) your own position on the topic.
2. Carl Elliott’s White Coat Black Hat. Set out and explain Carl Elliott’s argument in White Coat Black Hat in detail. Provide textual evidence/citation in setting out and explaining his argument. Present, explain, and discuss at least 2 types of “players” (e.g. guinea pigs, ghost writers, etc.) in the medical world that he discusses in order to illustrate his argument. Evaluate Elliott’s argument you have presented.
Discuss whether you think the argument is a good one. Incorporate at least two of the following moral theories into your discussion: Utilitarianism, Kantianism, and/or Virtue Theory. Remember to explain and defend your own points in regard to your evaluation of his argument. Note: Imagine that the reader of your essay is not entirely familiar with the views you are presenting. This means you might want to explain any specific or technical concepts/language you use. Make sure you answer all of the above parts of the topic. Try to be clear and to the point in your essay. Use examples to make your points, but remember that you will need to explain how your example actually illustrates the point you are trying to make, i.e. don’t rely on the example to do your explaining for you. Also, avoid excessive quotations and a reliance on them to do the explaining for you.
Evaluation Criteria
The primary criteria for evaluating papers will involve a demonstrated understanding of the arguments/positions relevant to the paper topic, the soundness of arguments for one’s own position regarding the topic and general clarity of expression. That is to say, papers will be graded for philosophical content and writing style. If you have difficulty in expressing your points clearly through writing, I suggest you plan on writing many drafts of your essay and that you seriously consider working with the writing center/tutors in order to strengthen your essays.
I use the following scale in distributing grades for assignments. I have also provided explanations for what each level of paper will be like. A Superior achievement of assignment/course requirements.
An A paper will be well organized and extremely clear such that the author’s flow of thought is very easy to follow. One key for this is that there are very few typos and grammatical errors. The thesis, if there is one for the assignment, should be very clear and the essay should be focused on it. There should be no irrelevant digressions or tangents, and the thesis should be well-supported and explained. The views discussed should be captured correctly, and there should be no inconsistencies in the paper’s argument/discussion. An A paper will also show originality/insight and independent thought. It should be an excellent essay that goes well beyond merely satisfying the questions.
B Better than satisfactory achievement of assignment/course requirements While an A paper is an excellent one, a B paper is a good one. It does a bit more than just satisfying the assignment. It shows that effort has been put into the essay with a clear thesis and generally solid argumentation and explanation of the key issues/points involved in the assignment. However, there could be improvement in content and writing. There may be grammatical errors, though not many, which detract from the flow of the essay. There may be confusion in argumentation or some small point at issue, but the errors will not generally be very substantial.

C Satisfactory achievement of assignment/course requirements a C paper is satisfactory and covers the material of the assignment. It is generally correct and deals with at least one of the relevant issues well enough to be understood and to make its point. Various deficits of a C paper include mistaken arguments and key points as well as unexplained concepts/terms that should be explained. Other deficits may be an unclear thesis, a glaring inconsistency in reasoning, other elements that detract from clarity, or an essay consisting of just description/narrative without any analysis of the material. Often times these essays just mention key points without explaining and evaluating them, or they do so in very brief fashion.

D Less than satisfactory achievement of assignment/course requirements but acceptable for credit A D paper seems to have a thesis and point, though it is hard to see what, exactly, it is. The essay mentions relevant material, but it is organized and written such that it is a list of unrelated points and thoughts. Key subject matter is omitted or not explained at all. F Failure to achieve assignment/course requirements An F paper shows little to no comprehension of the material or the assignment directions. These papers usually display an incompetence in grammar and reasoning skills.