In the memo (use the Memo Template), explain your decision and your reasoning for it. Include the following: 1. Who benefits from what you decided? Explain why.

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This assignment presents a difficult and painful medical dilemma, with you in an imagined professional role. Go through the You Decide scenario and make the decision it calls for. Then, compose an official memorandum that will be kept for the record and could potentially be read not only by your Peer Review Committee but also by those involved in charitable fundraising, which supports hospital development, as well as by others with financial interests in the decision.

In the memo (use the Memo Template), explain your decision and your reasoning for it. Include the following:

1. Who benefits from what you decided? Explain why.

2. Who gets denied a needed benefit? Explain why.

You will see notice that there is time pressure in the simulated situation, so remember that you would not have the luxury to dawdle in the decision-making process, and as the decision maker, you would not have the luxury of consulting a broad spectrum of advisors. It falls on you to decide!

Include in the memo the utilitarian ethical philosophy of John Stuart Mill (from the lesson last week) and one other ethical philosopher of your choosing that we have studied to date. Use both of those philosophies to bolster your decision.

You can use—- .Mill, J. S. (1991). Utilitarianism. Oxford: Oxford University  Press.

.Kant, I. (2008). Grounding for the metaphysics of morals. Brantford, Ont.: W. Ross MacDonald School Resource Services Library.

— Length: 2-3 pages (not including title page or references page)

SCENARIO

Okay, Lead Surgeon, it is time to do what you do best! There is a lot at stake. The decision must be made almost immediately. Like all actions, you will need to write your decision into medical documentation before you begin. Yes, that means YOU! In the limited time before you would begin surgery, you need to consider the cases; the technical issues involved also, and write a Memorandum for the Record to document what decision you made and what considerations you included in your process. This will be on the record, so it needs to be thorough in case it needs to justify your actions at a later date.

ROLE.

You are the Lead Surgeon in a major hospital, and by virtue of your seniority you are also the key decision maker for transplant cases. Right now you have three people who are waiting and hoping for a suitable heart to become available. Your cell phone rings suddenly, and you are notified that a heart has become available-meaning that you need to make a quick yet sound decision about which patient will receive the heart and then schedule surgery for today.

PLAYERS 

JERRY: (Male, 55 year old family man, mid-level manage)

Jerry, a father of 3 children and at the age of 55, is in the Ward awaiting a suitable heart for transplanting. His wife Joanie is a stay at home mother with no education beyond high school and no career. Jerry is the middle level manager at a carpet distributing business and 5 year short of his retirement eligibility. Jerry and Joanie have three teenage children aged 14, 16, and 19. The 19 year old is a sophomore at college; the 14 year old is mildly autistic, and the 16 year old is an astronaut wannabe. If Jerry gets the heart, his chances of living another 10-15 years are very high. His heart is damaged due to the use of steroids in his early 20s when he was involved with bodybuilding before the dangers of steroid use were fully known.

LISA: (Female, 12 year old lifelong health issues)

Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a teenager. She reads voraciously and yet likes the activities of a younger girl playing with her Barbie Doll. She has suffered health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart was damaged during a nasty bout with pneumonia last year and actually stopped for a brief period. Her mother knew to begin CPR on her or she would have died there. Even with a transplant, her chances of surviving into her 20s are not good. She is the only child in the family, and they cannot bear more children. Her parents will do anything for her, and they have offered to donate $2 million to the hospital’s construction of specialized facilities if she can get a heart soon enough. Her father is also a noted oncologist working in the same hospital but in a different department.

OZZY:  (Male, 38 year old homeless drug abuser)

Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a teenager. She reads voraciously and yet likes the activities of a younger girl playing with her Barbie Doll. She has suffered health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart was damaged during a nasty bout with pneumonia last year and actually stopped for a brief period. Her mother knew to begin CPR on her or she would have died there. Even with a transplant, her chances of surviving into her 20s are not good. She is the only child in the family, and they cannot bear more children. Her parents will do anything for her, and they have offered to donate $2 million to the hospital’s construction of specialized facilities if she can get a heart soon enough. Her father is also a noted oncologist working in the same hospital but in a different department.

Dr Doe: ( Male, 35 year old Lisa’s Dad, the oncologist)

Dr. Jonathan Doe is Lisa’s father. He has offered the hospital $2 Million Dollars in exchange that his daughter gets the heart transplant. He is an up-and-coming oncologist in the same hospital. He is loyal and totally committed to Lisa; while not obnoxious and pushy, his presence is keenly felt around the professional community in the Hospital and there is a need for his $2 Million.

 

One of the great ongoing situations that calls for ethical decision making is the reality that there is almost always a greater need for something than there is a supply to meet the need.

For this assignment and scenario, the demand is the life-and-death situation of the need for transplantable organs and the rather small and transitory supply. Hard decisions need to be made, and there is little time to think things through. These are emergency situations.

Transplantable organs become available on short notice–usually because a donor has died for reasons unrelated to the organ. They need to be removed and transplanted very quickly because they only remain fresh for a limited period. Then there is the whole complicated issue of tissue type matching. There is also an ongoing concern about how long recipients can wait.

Describe the research question for this experiment.  What were the null and alternative hypotheses?

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Focus of the Final Exam

The purpose of the Final Exam is to assess your understanding of the main statistical concepts covered in this course and to evaluate your ability to critically review a quantitative research article.  The exam will consist of two parts: Part I includes three essay questions and Part II includes a research critique.  All of your responses should be included in a single Word document for submission.

Please include the following general headings for each section of the written exam within your Word document:
Part I: Essay Questions

  1. Essay 1
  2. Essay 2
  3. Essay 3

Part II: Research Study Critique

  1.  Introduction
  2.  Methods
  3.  Results
  4.  Discussion

Your complete Word document must include a title page with the following:

  1. Student’s name
  2. Course name and number
  3. Instructor’s name
  4. Date submitted

Part I: Essay Questions
There are three essay questions in this section.  You must answer all three questions.  The length of each essay should be one to two double-spaced pages (excluding title and reference pages).  Use 12-point font and format your paper with regular 1-inch margins.  Do not include the essay prompt in your document.  It will not count toward the length requirement for your essays.

Essay 1
A group of researchers conducted an experiment to determine which vaccine is more effective for preventing getting the flu. They tested two different types of vaccines: a shot and a nasal spray. To test the effectiveness, 1000 participants were randomly selected with 500 people getting the shot and 500 the nasal spray. Of the 500 people were treated with the shot, 80 developed the flu and 420 did not. Of the people who were treated with the nasal spray, 120 people developed the flu and 380 did not. The level of significance was set at .05. The proportion of people who were treated with the shot who developed the flu = .16, and the proportion of the people who were treated with the nasal spray was .24. The calculated p value = .0008.
For this essay, describe the statistical approaches (e.g., identify the hypotheses and research methods) used in this excerpt from a research study.  Interpret the statistical results and examine the limitations of the statistical methods.  Finally, evaluate the research study as a whole and apply what you have learned about hypothesis testing and inferential statistics by discussing how you might conduct a follow-up study.

Your essay must address the following points:

  • Describe the research question for this experiment.
    • What were the null and alternative hypotheses?
    • Were the results of this test statistically significant?
    • If so, why were they significant?
  • Would the researchers reject or fail to reject the null hypothesis?
  • Do the results provide sufficient evidence to support the alternative hypothesis?
  • Was the sample appropriate for this study?  Explain your answer.
  • What are some possible limitations to this study?
  • Discuss how you would conduct a follow up study to this one. Explain your answer.
  • Describe the difference between practical and statistical significance.

Essay 2
A researcher has investigated the relationship between IQ and grade point average (GPA) and found the correlation to be .75.

For this essay, critique the results and interpretation of a correlational study.

  • Evaluate the correlational result and identify the strength of the correlation.
  • Examine the assumptions and limitations of the possible connection between the researcher’s chosen variables.
  • Identify and describe other statistical tests that could be used to study this relationship.

Your essay response must address the following questions:

  • How strong is this correlation?
    • Is this a positive or negative correlation?
    • What does this correlation mean?
  • Does this correlation imply that individuals with high Intelligence Quotients (IQ) have high Grade Point Averages (GPA)?
  • Does this correlation provide evidence that high IQ causes GPA to go higher?
    • What other variables might be influencing this relationship?
  • What is the connection between correlation and causation?
  • What are some of the factors that affect the size of this correlation?
  • Is correlation a good test for predicting GPA?
    • If not, what statistical tests should a researcher use, and why?

Essay 3
A researcher has recorded the reaction times of 20 individuals on a memory assessment. The following table indicates the individual times:

2.2

4.7

7.3

4.1

 

9.5

15.2

4.3

9.5

 

2.7

3.1

9.2

2.9

 

8.2

7.6

3.5

2.5

 

9.3

4.8

8.5

8.1

In this essay, demonstrate your ability to organize data into meaningful sets, calculate basic descriptive statistics, interpret the results, and evaluate the effects of outliers and changes in the variables.  You may use Excel, one of the many free online descriptive statistics calculators, or calculate the values by hand and/or with a calculator.

Next, separate the data into two groups of 10; one group will be the lower reaction times, and the second group will be the higher reaction times.  Then, address the following points in your essay response:

  • Calculate the sum, mean, mode, median, standard deviation, range, skew, and kurtosis for each group.
  • How do the two groups differ?
  • Are there any outliers in either data group?
  • What effect does an outlier have on a sample?

Lastly, double each sample by repeating the same 10 data points in each group.  You will have a total of 20 data points for each group. After completing this, address the following in your essay response:

  • Calculate the following for the new data groups: sum, mean, mode, median, standard deviation, range, skew, and kurtosis.
  • Did any of the values change?
  • How does sample size affect those values?

Part B: Research Study Critique
In this second portion of the Final Exam, you will identify and critically evaluate a quantitative research article based on a social science topic.  Your selected article must include a research question(s) and/or hypothesis(es) and utilize statistical analyses covered in the course. The article must be peer-reviewed and published within the last 10 years.

In the body of your critique, describe the statistical approaches used, the variables included, the hypothesis(es) proposed, and the interpretation of the results.   In your conclusion, suggest other statistical approaches that could have been used and, if appropriate, suggest alternative interpretations of the results.  This process will allow you to apply the concepts learned throughout the course in the interpretation of actual scientific research. Your critique must include the following sections:

  1. Introduction: This section will include a general introduction of the quantitative study from a peer-reviewed source published within the last 10 years.  The research questions and/or hypothesis(es) as well as the purpose of the study should be clearly defined.
  2. Methods: Describe and evaluate the procedures and methods of data collection, measures/instruments used, the participants and how they were selected, and the statistical techniques used.
  3. Results: In this section describe and critique the results presented in the study.
  4. Discussion: Discuss and evaluate the efficacy of the results presented in the study.  Address, the strengths, weaknesses, and limitations of the study, and suggest future research directions.  Include additional forms of statistical analyses as part of the suggestions for future research.

The Research Study Critique:

  1. Must be three to four double-spaced pages in length (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.  Use 12-point font, with 1-inch margins.
  2. Must use the sections and headings described above.
  3. Must address the article with critical thought by examining, reflecting, and evaluating the article from an objective viewpoint and by using facts to support your argument. Refer to the Critical Thinking Community (Links to an external site.) website for further assistance.
  4. Must end with a conclusion that summarizes your critical evaluation.
  5. Must use one quantitative research study from a peer-reviewed source that was published within the last 10 years.
  6. Must properly cite the source article in APA style as outlined in the Ashford Writing Center.
  7. Must include a separate reference page, formatted according to APA style as outlined in the Ashford Writing Center.

Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment.

Internet use within childhood

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1.As the world conforms to newer technology, we have to be able to adapt in an environment that is advanced and scary.  As a teacher, I can see both benefits and disadvantages in what technology and the Internet have to offer.  Children can learn so much by just clicking a mouse. As a parent, I am terrified of the Internet and technology because it is not monitored and used appropriately by many people.  I have figured out that too much technology over stimulates children and it restricts children to a screen there fore they are not engaged in lots of things that affect their development such as, social, fine, and gross motor skills. The Internet and technology hinder children in general because they are not involved in conversations with other children and adults.  They become consumed by these devices and it influences them in a negatively rather than positively. “15Do not love the world or anything in the world. If anyone loves the world, love for the Father is notin them. 16For everything in the world-the lust of the flesh, the lust of the eyes, and thepride oflife-comes not from the Father but from the world. 17Theworldand its desires pass away, but whoever does the will of God lives forever.” (1 John 2 15-17, NIV) Children should be monitored at all times and restricted on the time spent using it.   Monitoring and restrictions will cut back on so many negative aspects on technology and the Internet but parents have to be willing to enforce those rules.  Unfortunately, I have realized that it is much easier for a busy parent to sit their child down with a tablet so they can have time to themselves.  Another way that parents, churches, and even schools can help is to teach the dangers of the Internet to their children and to other adults.  If we stand back and not talk about the issues at hand then we are doing nothing to stop the problems that can come from the Internet.

2.  Internet use within childhood is an important matter of discussion. As someone working to become a school guidance counselor, the topic is applicable; especially to safety.

Internet communication (email, chat rooms, messaging, etc.) affects adolescents specifically. It’s changed the way they communicate (Martorell et at., 2014). Studies indicate that teens who spend a lot of Internet time spend less time with friends, have fewer friends, and reduce social connectedness and well-being (Martorell et at., 2014). This goes to show how Internet communication affects relationships with others.

Internet predators is another important topic pertaining to online communication. The internet grants much freedom. Teens are essentially free to communicate with whomever they want on the Internet (Louge, 2006). This poses a danger since others may mask their identity while communicating with children, adolescents, etc.

Fake identities are easy to produce and to sell on the Internet. Teens will often create personal pages where they can make up or post their real identities, personal profiles, and pictures on websites such as Myspace and the Facebook. This poses a safety risk since it is difficult to discern someone’s “real” identity over the Internet (Louge, 2006, p.3).

However, there are ways to safeguard youth on the Internet. First, parents and churches can pray for safety and the making of good Internet-use choices. “…The prayer of a righteous person has great power as it is working” (James 5:16, ESV). Finally, being aware of the child/adolescent’s life/being present is an important means of safeguarding. In this, measures can be taken to restrict, monitor, etc. if needed. It additionally shows the child you care for them and their safety. “You are a hiding place for me; you preserve me from trouble; you surround me with shouts of deliverance. Selah” (Psalm 32:7, ESV).

Describe and support the use of monitoring in evaluating an organization or the status of a condition as an evaluation tool. What is the value of collecting and documenting monitoring data over time?

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Answer one of two questions below:

  1. Describe and support the use of monitoring in evaluating an organization or the status of a condition as an evaluation tool. What is the value of collecting and documenting monitoring data over time? Discuss how the lack of monitoring impacts the evaluation of a market based decision? Cite and reference your resources.
  2. Explain how health care organizations use quality improvement techniques to guide decision making? Discuss the challenges organizations encounter in applying quality improvement techniques to guide decision making. Cite and reference your resources.

Also in two separate paragraph give your personal opinion to  Nikki Thompson and    Samantha Taylor

Nikki Thompson

Quality improvement techniques are used in healthcare setting to determine and prioritize potential areas of improvements and establish a culture of quality in healthcare practices. With quality improvement technique the managers can be able to make informed decisions about a given problem hence effective service provision. Through quality improvement practices management and employee will collect more information about a given problem hence facilitating development of an evidence-based intervention (Cockerham et al, 2016). A high-functioning practice will strive to continually improve performance, revisit the effectiveness of interventions, and regularly solicit patient and staff feedback. This is all attributed to quality improvement strategies within the healthcare organizations. Some of the challenges that may face quality improvement process include lack of effective leadership, sustainability, and poor data collection techniques among others. Any discrepancy on the above stated issue may affect the effectiveness of the given quality improvement method.

References

Cockerham, J. R., Lowe, G. R., Willis, R., Stecks, R. M., & Berlinski, A. (2016). Quality improvement project to improve timeliness between bronchodilator treatments from emergency department to medical wards. Respiratory care, 61(12), 1573-1579.

Samantha Taylor

Explain how health care organizations use quality improvement techniques to guide decision making? Discuss the challenges organizations encounter in applying quality improvement techniques to guide decision making. Cite and reference your resources.

“Measuring the quality of health care by observing its structure, processes, and outcomes. Structure measures assess the accessibility, availability, and quality of resources, such as health insurance, bed capacity of a hospital, and number of nurses with advanced training,” (Hughes, para. 7)There is multiple way how health care organizations use quality techniques to help any decision making. There are a lot of steps that must be taken with any decision and must be discussed with others. It is important for any business and health care organization to have on site training for that position. By having health care job training for all employees will help ensure that everyone is on the same page on how everything operates on a daily basis. Ensuring that employees understand the decision-making process help the practice run smoother and more efficiently. Leadership is important to have for each and every employee that to encourage the decision-making process so that everyone feels like their participation in the process counts. Making each employee feel like their voice matters will help the organization and improves communication. In any organization it is vital to remove barriers that may be between departments. By removing the barriers will not only improve the entire decision-making process, but creates harmony in the operations that go on in the organization. In order to create perfect harmony, the data must be accurate, collected correctly, and used with monitoring tools. For the best quality assurance, the decisions must be made correctly and the information must be understood. Quality improvement techniques are important to incorporate in a health care organization in order for success to occur.  Bench marking health care means collaborative discipline of measuring and comparing the key to the process. Putting a huge emphasis on the management staff to have faith in the projects, communicate the purpose, and encourage the staff. Bench marking is important because it helps slow down the process and become careful in the preparation in the process. “Future, with processes and tools n place supporting Continuous Quality Improvement with research and bench marking as critical contributing elements in QI implementation in health organization becomes less challenging (Burs et al, 2011). The Six Sigma strategy ties together the improved metrics and uses a different management philosophy to help decrease errors, which reinforces the organization’s market status while improving the profit margin.

Every day in health care, by measuring the performance, using careful analysis to new approaches, incorporating new approaches to the process, and reassessing the performance to determine if the changes that were made are successful or not. Without a true and efficient leader, and poor data collection techniques, the organization will not be successful.

Discuss the challenges organizations encounter in applying quality improvement techniques to guide decision making. Cite and reference your resources.

There are many different challenges that may occur when applying quality improvement techniques to guide the decision-making process. Discrimination in the workplace and not having enough staff who getsengaged causes many issues. Disagreements could involve the ones who are involved in the problem-solving process and the overall final decision. Poor leadership that does not cover what problems that may be faced or not having enough information to guide the process may occur. Without having the proper leadership, there will be multiple issues that will come about and the environment will not be such a great place. Leadership is the key to success within an organization. Inefficiency in data collection hence quality improvement is hampered due to the most critical areas not being prioritized. Quality improvement will not happen if the data is not organized and the tasks that should be on top of the list, aren’t. Over- Ambitiousness by the management in the quality Quality improvement techniques are used to help healthcare setting be able to prioritize certain tasks which may need more attention too and helps establish a culture. Managers and employees will be able to communication decisions and that helps with the efficiency. Quality improvement process may lead to the staff feeling as if change is impossible or disregard it all together. Culture change is one of the major challenges that can hold an organization back when they are trying to improve the quality and reduce medical errors.

Burns, L., Bradley, E., & Weiner, B. (2011). Shortell and Kaluzny’s Healthcare Management: Organization Design and Behavior, 6th Edition. [VitalSource Bookshelf version]. Retrieved from http://online.nitalsource.com/books/9781435463950/id/P4-95.

Donabedian A. Evaluating quality of medical care. Milbank Q. 1966;44:166–206.

Hughes, R. G. (n.d.). Tools and Strategies for Quality Improvement and Patient Safety. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2682/.