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You are the General Administrator at the Rainbow Skies Home Health Care Angels agency. In this assignment, you will be analyzing the situation that occurred and formulating evidence-based recommendations to prevent recurrence. After reading the case study and your grading rubric, please address the following questions about this scenario in recommendation memo to the agency’s Executive Director:

1. What is the organization’s legal reporting obligations in this scenario? Analyze the reporting requirements and legal considerations in the context of the case study and evidence base.

2. What ethical issues are present in this scenario? Identify at least two ethical issues. For each issue, identify at least one ethical principle or theory and analyze its application to each of these issues. Note: If you choose the same ethical principle or theory, be sure to provide a well-reasoned analysis for its applicability to each of the two issues.

3. State whether a tort(s) was committed and justify your response.

If yes, identify the tort(s) and each element which establishes that a tort(s)was committed.


If no, explain how you determined that the issues did not rise to the level of a tort.


4. What cultural, religious, or spiritual considerations do you need to consider, and how might they impact your decision making?

5. Identify those who may be impacted by your decisions as a healthcare administrator on this matter and provide a brief analysis on ways they be impacted.

6. Is there any information missing which would help you in your decision? If so, what?

7. Propose at least two high quality, evidence-based recommendations, using the analysis you have developed, plus supporting evidence from your course materials and as appropriate from credible external sources. Your recommendations should address the following at a minimum:

Should Nicole be allowed to continue to work at the agency? Why or why not?


What do you specifically recommend to address the issues presented in this scenario?

Purpose

To: David Executive Director

From: Mercy General Administrator

Date: August 30, 2018

Subject: specific codes of dealing with home health assistance misconduct.

The purpose of this memo is to address the issue of dishonesty and incompetence among home health care givers of this agency. The aim of representing this memo is to introduce specific codes in dealing with aides who practice the above unethical behavior.

Recently there has been occurrence of fraud and misconduct by one of the aides. This situation risked the life of one of our patient whose state of health has now worsened. According to my knowledge there exist laws against such kind of action. However we lack specific laws on actions to be taken ones an individual commits the delinquency. As such I have come up with specific regulations that outline the action to be taken in case of any misconduct

In this scenario Nicole was expected to report to the institution through her supervisor, who is in turn inform the authority.

 Ulrich,et.al (2010) affirms that there exists ethical concerns that home healthcare providers should follow. One of these principles provides that home care nurse, physician, or assistant should maintain professionalism standards, be honest in or their interactions not engage in fraud and report colleagues  who are dishonest to relevant authorities(Stuart2014). In our recent occurrence, Nicole violated this ethical concern since she regularly received a $20 tip from Steve’s wife. This was to keep her from reporting to the agency authorities about the condition of their house which contributed to Steve’s worsening condition.

Another principle for home health care givers is beneficence. Which calls upon practitioners to do what they can for the benefit of the patient ( Nieswiadom &Bailey 2008) . This involves undertaking recommended treatment, procedures and actions that proves to be best for the sake of the patient (Mitchell, P., & Golden, R. 2012). Nicole was aware that the house condition would lead to deterioration of the patient’s health state and required intervention but still remained silent about the matter. She ought to have educated the family on its impact and inform the doctor for them to look for a better solution for the patient’s best interest.

A tort can be committed to through an action and omission (Fuller 2010). Nicole committed torts by receiving a tip from Linda to keep her from taking relevant action of reporting to her agency about their condition. Her failure to report to the relevant authorities as it was required of her on its own is also a tort. Her actions lead to deterioration of her patient’s health and also put his life at risk which was contrary to her roles as a health aide.

Culture and religion are the major institutions in society which are considered to be of great importance in human existence (Matzo, et.al 2002) .This is because they usually offer common and essential values which guide all humanity in their interactions and influence their decisions(Wiener,et.al 2013). In all religions, transparency is a main and common value which is esteemed highly. These values are usually considered universally in all human endeavors. Some of these values are transparency, integrity, responsibility among others (Chanet.al 2010). By refraining to report the state of the patient’s environment, Nicole violated the value of transparency. By allowing the patient to continue staying around conditions that affected his health she did not portray responsibility. Again she portray lack of integrity because she received a tip from Linda which was against provided ethical values.

Summary

Any decision and remedy relating to this scenario would be aimed at ensuring improved healthcare service delivery. It affects patients under the agency and all healthcare aides’ assigned responsibility to offer home healthcare. The health practitioners and assistants will be directly affected by any decision concerning the occurrence. This is because they are the ones obligated with the responsibility of taking care of patients offering treatment and ensuring their wellbeing and welfare is promoted.

Patients will also be affected by any intervention linked to the occurrence. This is because an intervention on the practitioners performance, directly affects the quality of healthcare provided. Improved and quality service delivery by the agency through its aides’, means improvement on the health and welfare of our patients in turn.

In order to make an informed decision, it would be necessary to know if Nicole has been involved in fraud with any of her other patients that were assigned to her by the agency for any reason whatsoever. Secondly it would be important know if the health state of the patient’s exclusively be blamed on the house condition. Maybe Steve’s health condition could be deteriorating due to other factors other than the condition of his house.

I hereby recommend that all our home health aides be presenting feedback report state of their assigned patients after every three months to the agency. This report should entail details on whether the patient’s health condition is improving or deteriorating. In case it is worsening the practitioner should include detailed reasons for the same.

Secondly I would suppose the selection of agency representatives who will be conducting random field visits to our home patients to check on their state and environment and the conduct of our home practitioners. This will help improve the welfare of our patient.

Any home care giver who will be found guilty and whose actions are found to be major cause of deterioration of patient health will be dealt with in the following manner;

First time offenders should receive a warning letter for their misconduct. Offenders for the second time will receive a second warning letter and a three months’ suspension. If a practitioner is found guilty for the third time they will receive a letter of termination of their service as home health assistants for rainbow skies home health care angels agency.

References

Chan, M., Kazatchkine, M., Lob-Levyt, J., Obaid, T., Schweizer, J., Sidibe, M., ... & Yamada, T. (2010). Meeting the demand for results and accountability: a call for action on health data from eight global health agencies. PLoS Medicine, 7(1), e1000223.

Fuller, D. W. (2010). Intentional torts and other exceptions to the federal tort claims act. U. St. Thomas LJ, 8, 375.

Griffith, R., & Tengnah, C. (2017). Law and professional issues in nursing. Learning Matters.

Matzo, M. L., Sherman, D. W., Mazanec, P., Barber, M. A., Virani, R., & McLaughlin, M. M. (2002). Teaching cultural considerations at the end of life: End of life nursing education consortium program recommendations. The Journal of Continuing Education in Nursing, 33(6), 270-278.

Mitchell, P., & Golden, R. (2012). Core principles & values of effective team-based health care. National Academy of Sciences.

Nieswiadomy, R. M., & Bailey, C. (2008). Foundations of nursing research.

Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health Sciences.

Ulrich, C. M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal of advanced nursing, 66(11), 2510-2519.

Wiener, L., McConnell, D. G., Latella, L., & Ludi, E. (2013). Cultural and religious considerations in pediatric palliative care. Palliative & supportive care, 11(1), 47-67.

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