ms-assignment reviosin Milestone one

Cardiac Failure

As a cardiothoracic surgeon, I operate in an area full of cardiac failure patients. As a surgeon, I have decided to come up with a team composed of a cardiothoracic surgeon, percussionist, anesthesiologist, physician assistant, and a scrub nurse to assist patients with cardiac failure. Our team, through evaluation of data collected in the operative period, has allowed us realization that many individuals suffer from heart failure. This enhanced our opportunity to use our contextual knowledge in filling the identified gap that is limited cardiac diagnosis services in this area. Engagement Microsystems with peer-reviewed literature provided an in-depth attempt to make an intelligent action. In the USA, more than 5 million people suffer from chronic heart failure. (Jastrzebska, et.al. 2018) Comment by Marquetta: Do you need to be in the operative area to realize that many people suffer from heart failure? Comment by Marquetta: I am not sure what you are trying to communicate here.

Pathophysiology of Cardiac Failure

This is a clinical disorder characterized by an insufficiency in blood flow due to myocardium injuries, leading to ineffective metabolism. Chronic heart failure is caused by diabetes, hypertension and ischemic heart disease. Furthermore, myocarditis, systemic toxins, cardiomyopathies and valvular diseases also cause mild cardiac failure. During heart failure, the heart develops pulmonary congestion hence dyspnea and impaired venous returns forming edema and ascites. Comment by Marquetta: And other etiologies

Cardiac failure is caused by a weakened condition of the heart or when the heart becomes too stiff. The ventricles may become stiff making an abnormal sensation of heartbeats. Heart muscles may be weakened and damaged dilating ventricles leading to inadequate blood pumping mechanism. See the figure below showing a healthy heart and an enlarged heart. Comment by Marquetta: What is the medical term? Comment by Marquetta: Incomplete sentence

(Jastrzebska, et.al. 2018) this will go at the end per APA formatting as an Appendix.

Signs and Symptoms of Cardiac Failure.

Cardiac failure may be acute or chronic. Its signs and symptoms include:

· Swelling of feet and legs (edema)

· Massive weaknesses and fatigue

· Irregular and rapid heartbeat

· Retention of fluids leading to high weight gain

· Nausea and lack of appetite

· Dyspnea when you lie down- Positional dyspnea and exertional dyspnea

· Increased need to urinate at night

· Chest pains

· Decreased alertness

Diagnostic Tests and Current Evidence-Based Treatment

Diagnosis of cardiac failure includes Frank-Starling mechanism of increasing cardiac output, ventricular remodeling for increasing increased wall thickness and ventricular volume and activating neurohormonal systems for maintenance of tissue perfusion. Diagnosis of the disease should be embraced during acute symptoms occurrences. There are rare cases where the determination is made during chronic heart failure state. Electrocardiography can help in diagnosing heart rhythm problems.; Video imaging of the heart is viewed via an echocardiogram and stress test done to detect the heart's response to exertion. Other diagnostic tests include X-ray, blood tests, and myocardial biopsy. The current treatment of cardiac failure is the use of medical therapy to augment contractility, suppressing overactive hormonal systems and diuresis. The surgical procedure for cardiac failure includes surgical ventricular remodeling, resynchronization of ventricles, heart transplant and ventricular service device implantation. Chronic heart failure is treated using heart transplant mechanisms since all the heart system would be malfunctioned. Not in all situation! People can have chronic heart failure with preserved ejection fractions and will not meet the criteria for heart transplantation. Comment by Marquetta: Incomplete sentence Comment by Marquetta: I no longer am going to be commenting on grammar. You will need to have someone review for your next assignment. I will provide you resources that maybe helpful.

Microsystems

In our cardiac diagnosis center, the patient meets with the scrub nurse. The nurse directs them to the relevant centers for their operation. A warm greeting is embraced for patient care and the general health awareness. Other team members in operation chamber include surgeons, anesthesiologists, and percussionists. The high interpersonal relationship between the clients and our operators is maintained to assure the clients of better health services. In surgery chamber, several surgical machines like a heart-lung machine for artery bypass graft surgery. The client receives treatment immediately after being directed to the operation chamber. This is done after diagnosis of the disease by the scrub nurse. Not the physician??

In our healthcare, management starts with the Executive officer to the floor nurses. The CEO is responsible for budgetary control and installation of diagnostic equipment. The CEO operates hand in hand with the departmental officers who in turn get reports from the nurses. In our Microsystem, effective communication is paramount for patients' justice. More so, proper leadership techniques are embraced. Theory Y leadership style is maintained where the patient care delivery is the order of the healthcare. Employee and client participation do the decision making. Information from the clients is collected via suggestion box regarding the effectiveness of the healthcare and areas that need improvement. This embraces proper decision making which is patient-centered. I think so too.

In respect of theory Y leadership technique, there is an interpersonal relationship among the employees (Yu et al. 2018). Each party is utilized in decision making embracing the element of inclusivity in the healthcare operation. Vertical and horizontal communication is useful in the delivery of information in the healthcare. The junior staff members freely interact with the seniors which eliminated biases in the delivery of patient care services. The interactive nature of the patients and the workers embrace proper distribution of information, which is sufficient for diagnosis and treatment of diseases. Decentralized service deliveries in our unit effect patient care services since tangible support are given to the patients by both the nurses and physicians. Comment by Marquetta: What happens if an employee is not motivated to achieve the organizational goals? Are patients aware of these goals?

There is an interaction between our healthcare and other health-related systems. To begin with, the healthcare works with the entire community in different ways. The health awareness programs are embraced by our health center to make the society aware of cardiac failure (Yu et al. 2018). Signs and symptoms of this disease are taught, and diagnosis is made to detect the infected lot for treatment. It also works with referral hospitals for further treatment. Information regarding heart failure is shared with the global community via social sites like Facebook and Google sites. With the federal office, the health center provides universal health care for the provision of comprehensive health facilities to different patients in the country. Furthermore, access to medication can be done using health funds derived from federal laws. Our facility ensures that patient census reports are delivered to central offices for the filing of patients with cardiac failures for national health awareness.

Federal regulations are vital for quality healthcare. Health regulation act suggests that each patient has an equal right to Medicare. This is vital for commensurate medication of the patients without favor. The patient outcome and recovery are paramount when giving medication. This law assures patients of proper medication. More so, the law provision embraces the use of health cards for payment of health services. This is a technique utilized by our health center for the cardiac patients with liquid cash. Such patients are entitled to proper medication like their counterparts with instant cash. The physicians should be entitled to relevant skills maintained in the federal laws. The physicians must be qualified in their areas of specialization with a minimum of a bachelor's degree. This ensures that proper medication is adhered to by both the nurses and physicians. Comment by Marquetta: There are many grammatical errors and slang that needs to be corrected in this paragraph.

Barriers

Clients are exerted?? to various common obstacles for their medication. These barriers include; Cost barriers. Diagnosis and treatment of cardiac failure are costly. Notably, the cardiac failure department maintains instant cost service delivery. What? As such, the most of the patients are unable to meet the medication cost of this disease. Insufficient equipment is limiting factors to the patients with cardiac failure. Notably, diagnosis tools like coronary angiogram and echocardiogram are costly. Treatment surgical tools like heart-lung machine are also expensive. This limits the clients with proper means to sustain the disease. I understand the barriers you describe but please reword for clarity.

Limited specialized personnel for related heart failures are a common barrier to the clients. The patients with cardiac failure are more than the surgeons in this field. As such, the patients give orders for them to be treated. The clients are limited from delivery of information regarding the work plan of the health center. This reduces the aspect of patient-centered service delivery hence decreasing the integrity of medical practitioners to the patients. Are the systems you describe in the United States??

Barriers Arising from Leadership Changes include;:

Communication barriers. When the management of a given Microsystems changes, there is an immense change in communication strategy. For instance, the new administration may concentrate on management centered decision making, which expels an element of inclusiveness.

Change in management increases biases in the health center. The patients will not be given a chance to give their ideas on how to improve health care operations. I don't understand this statement.

There exist operational barriers due to shifting in management. This is where the physicians operate within the strict orders from the administration. For instance, theory x managers give rules for health care to be given to a specific patient. This reduces the effectiveness of the health center.

Change in management shifts goal setting techniques. At this point, the old management will leave their set goals, aiming for proper health care and embrace the new objectives adopted by the new administration. Please reword for clarity. I am not sure what you are trying to convey here.

Leadership changes inhibit health awareness strategies embraced by the health unit. This reduces community awareness on specific measures to be taken on reducing chronic heart failure. I am sorry but I am not getting the connection here.

When rules and regulation of a given health center changes, several barriers occur (Koyani et al. 2017). They include improper use of organizational tools. For instance, change in strict rules of utilization of corporate equipment makes the staff members misuse the means for their gains. More so, patients will be entitled to poor healthcare services. Change in rules and regulations limits proper communication pathways. As such, the patients and junior staff will not be allowed for decision-making strategies. This eliminates the aspect of inclusivity on decision making. At this point, there will be a reduced quality delivery of healthcare services. Comment by Marquetta: Entitled?

References

Jastrzebska, E., & Brzozka, Z. (2018). Microfluidic Systems for Cardiac Cell Culture—Characterization. In Cardiac Cell Culture Technologies (pp. 155-167). Springer, Cham.

Koyani, C. N., Kolesnik, E., Wölkart, G., Shrestha, N., Scheruebel, S., Trummer, C., ... & Maechler, H. (2017). Dipeptidyl peptidase-4 independent cardiac dysfunction links saxagliptin to heart failure. Biochemical pharmacology, 145, 64-80.

Yu, Y., Yin, G., Bao, S., & Guo, Z. (2018). Kinetic alterations of collagen and elastic fibers and their association with cardiac function in acute myocardial infarction. Molecular medicine reports, 17(3), 3519-3526.

References are not APA formatted.

I think you have all the components necessary here but your communication has many grammatical errors that limit the understanding by the reader. I would suggest you let a friend review the writing prior to submission to help with grammar issues. Also, you have access to the writing lab, medical library, and can get assistance ideas from your advisor. Please review the APA Manual as this should help you with some techniques. If you want to re-write this paper for a higher score, please let me know.

To be change and deficits on this paper

Microsystems: Effectiveness: Evaluates the effectiveness of the leadership styles within the microsystem

Microsystems: Interrelates: Demonstrates how the facility interrelates with the meso- and microsystem

Microsystems: Regulations: Demonstrates how county, state, and federal regulations affect the facility and quality of patient outcomes

Barriers: Common Barriers: Discusses what barriers can and do arise from leadership changes or ineffective leadership within the microsystem

Barriers: Healthcare Regulation Changes: Discusses what barriers can and do arise from healthcare regulation changes

Articulation of Response: Submission has no major errors related to citations, grammar, spelling, syntax, or organization

Instructor comments

Microsystems: Typical Visit: Clarification required. Microsystems: Effectiveness: Theory Y concepts alluded to but not explained in detail. Microsystems: Interrelates: Initially federal regulations written but how these regulations directly impact the care and safety of the patient along with the impact on leadership is not fully discussed. Barriers: Leadership Changes: Comment made that new management would develop new goals and old goals would be left behind when management changes. This is not explained and limits details. Barriers: Healthcare Regulation Changes: Barriers identified but clear connection to leadership and what can be done to prevent these barriers were limited. Articulation of Response: Multiple grammatical errors. Refer to attached paper.