Acct10001 Accounting Reports | Alcohol Assessment Answers

Description:

Students are to select a non-hospital based specialised health program of their choice such as treatment for drug, alcohol and other substance abuse, immunisation, hearing, oral health, reproductive health, etc. Students will evaluate the system that underpins that specialised health program regarding ethics, risk, quality, and safety. select one.

The evaluation should include:

Description of the Program

Program descriptions convey the mission and objectives of the program being evaluated. Descriptions should be sufficiently detailed to ensure understanding of program goals and strategies. The description should discuss the program's capacity to effect change and its stage of development. Program descriptions set the frame of reference for all subsequent decisions in an evaluation. Areas for consideration are:

Need - a statement of need describes the problem or opportunity that the program addresses and implies how the program will respond.

Activities - describing program activities - what the program does to effect change.

Resources - resources include the time, talent, technology, equipment, information, money, and other assets available to conduct program activities.

Ethical Considerations

Most health programs and professionals operate under ethical guidelines that are based on four overarching principles.

1. Help or benefit to others – promoting others’ interests, by helping individuals, organisations, or society as a whole.
   
   
2. Do no harm – bringing no harm, such as physical injury and psychological harm (such as damage to reputation, self-esteem, or emotional well-being).
   
   
3. Act fairly – treating people fairly and without regard to race, gender, socioeconomic status, and other characteristics
   
   
4. Respect others – respecting individuals’ rights to act freely and to make their own choices, while protecting the rights of those who may be unable to fully protect themselves.

How well does the chosen program address these and other program-specific ethical considerations (e.g. patient confidentiality)?

Risk Identification and Management

The definition of risk has changed from ‘the chance of something happening that will have an impact on objectives’ to ‘the effect of uncertainty on objectives’.

Each health organisation and program faces unique challenges, there is not a one-model-fits-all risk management solution. Consider the chosen program and its capacity to manage risk regarding issues such as:

Patient safety

Mandatory Federal and State regulations

Potential medical error

Existing and future policy

Legislation impacting the field of healthcare

Quality and Safety

The primary aims of the National Safety and Quality Health Service Standards introduced in Australia in 2011 were very specific. They focused on protecting the public from harm and to improve the quality of health service provision. They provided “a quality assurance mechanism that tests whether relevant systems are in place to ensure minimum standards of safety and quality are met, and a quality improvement mechanism that allows health services to realise aspirational or developmental goals”.

The Standards were designed to be used by all health services and programs as part of their internal quality assurance mechanisms or as part of an external accreditation process.

Using the NSQHS Standards as a guide, evaluate the quality and safety activities and initiatives for the selected program. 

Introduction and Description

The alcohol and substance abuse program work under the principle of several activities to effect change in the addicted population which are mostly affected by the alcohol usage and substance abuse. It affects an individual's behavior and brain functioning and causes problems like rise in crime and addiction. Some of the activities strategized in the program to effect change includes; medication long-term follow-up to avoid relapse, behavioral counseling, treatment and evaluation of the co-occurring mental disorders like anxiety and depression, and applications of medical devices for treating withdrawals symptoms or for delivering training skills. The devices and medications can be useful to suppress the withdrawal symptoms at the time of detoxification. The program ensures the use of medication to prevent relapse, establish the normal brain functioning and reduce cravings. The behavioral therapies can be used in treating the alcohol and drug abuse. The behavioral rehabilitations assist the clients to modify their behaviors and attitudes that are related to drug usage. Through behavioral therapies, a drug addict can increase healthy lifestyles skills (Zschucke, Heinz and Ströhle, 2012). The program will involve both the group and individual drug counseling. The need for program is to evaluate the medication to treat the likely mental health issues that may be contributing to an individual's engagement to the drug abuse and reduce the effect of alcohol, drug and substance abuse. The drug counseling approaches have to be conducted at different periods of time according to the person's level of addiction. For the outpatient behavioral therapy, the client is supposed to visit the counselor on a regular schedule of several sessions every week. For the residential or inpatient treatment, the patient has to remain at a residence for about six to twelve months. The program psychiatrist specialist with counseling talents and those who are highly informed in technological information that could be helpful to the influenced population. Some of the equipment resources that can be useful in the implementation of the program include certified laboratories, specimen collection, and qualified medical officers. The program also has to involve special training and education programs for drug-testing. The program has to be connected to the government healthcare financing facilities like Substance Abuse and Mental Health Service Administration (SAMHSA) that works to ensure behavioral therapies are delivered to the public at an affordable cost (Emanuel et al, 2012). The goals and objectives of the program include; identifying the environmental, biological, social and behavioral consequences and causes of alcohol, drug, and substance abuse, developing improved and new strategies to prevent the abuse, and developing newly improved and new treatments to assist people with abuse alcohol, drug, and substance.

Stages for treatment of alcohol, drugs and substance abuse

Stage 1: Identification

For a person with alcohol and substances abuse to receive the treatment, he or she must be first identified, this will enable one to develop a path towards recovery. Some people may self-identify themselves but others are identified by parents, teachers, employers or spouses. Brief intervention, referral, and screening are the models of identification that occur in settings including occupational health clinics, hospitals, children's services, and emergency departments.

Stage 2: Assessment

A comprehensive assessment of the individual's conditions and how it affects his health working is essential in determining the effective treatment for the individual. For effective assessment, one has to consider some factors like; the severity of the problem, the influence of the substance to the individual and the individual attitude and perceptions towards the treatment. When an individual is effectively assessed one is able to administer appropriate treatment immediately that will address the individual strengths and needs. 

Stage 3: Treatment

Treatment is essential to help the patient decrease his or her dependence on alcohol, drugs and substances abuse and achieve an advanced level of social, psychological and physical functioning (Bogenschutz et al, 2015). For successful outcomes of the treatment program, one has to maintain the patient in treatment programs for an adequate time period. The patient stay in the treatment program depend on individual factors like motivation and support from friends or families.

Stage 4: Ongoing Recovery Treatment

Treatment for alcohol, drug and substance abuse takes a long time for the results to be observed. The patient needs to self-regulate their memory, judgment, thinking, feeling and behavior increase. In order for patients to self-regulate their need to stabilize this may include detoxification from alcohol, drugs and substance abuse (Connors et al, 2013).

Ethical considerations

Ethical principles give an alert on significant conditions and issues like informed consent, independent ethical evaluation, maximization of program benefits, protection of confidentiality and privacy, and protection of vulnerable in the society (Carroll and Buchholtz, 2014). Some ethical issues for considerations include; beneficence, non-maleficence, respect for autonomy, protection of confidentiality and privacy, and distributive justice. 

Respect for autonomy

When treating people with substance abuse their actions should not be interfered with and should be respected at all time. Since mostly the people who abuse drugs are adults they are able to decide on their own actions without being forced or coerced. The person offering the treatment must ensure that he or she respect and protect the individuals who are not able to fully protect themselves. When the nurse wants to test an individual for substance disorder he or she must inform the patients of the test and if a patient is very sensitive that the information received from him or her might be shared the physician should respect the client decision. The people who receive the treatment should give voluntary and informed consent to participate and the person who is offering the treatment should always tell the patient the truth regarding the treatment (Greaney, O'Mathúna and Scott, 2012).

Non-maleficence

The non-maleficence principle means no harm to the patient. One is required not to cause any injury and harm or placing others in danger of injury and harm. In the treatment of drug abuse, one should ensure that the program does not cause any psychological injury and physical harm like destruction to self-esteem reputation or emotional well-being of the participants. The Medicare need to be fully aware of the substance the patient is abusing this will help to prevent dangerous and unexpected medication or missed diagnosis. Individuals may be harmed once substance abuse has been viewed as moral failing instead of the medical issue. In the treatment of alcohol, drug, and other substance abuse requires one to minimize the danger of participation. Telling the truth is related to the principle of non-maleficence. One is required to give full information to the patient about the danger of participation (Shahian and Normand, 2012).

Beneficence

The principle of beneficence requires the person who is offering the treatment have a chance of generating benefits and the benefits must outweigh any risks and burden of participation. In the treatment of substance abuse not only requires the benefits to society outweigh the risks but also the danger to individual participants must be outweighed by benefits. The program should ensure that it promotes other people interests by helping the organizations, individuals and society as a whole.

 Distributive justice

The principle of distributive justice requires equitable and fair distributions of the benefits and burdens of participation. The routine screening for alcohol, substance and drug abuse should be carried out to all regardless of socioeconomic status, race, gender, age or sex (Törnblom and Vermunt, 2016). A just and fair treatment for substance abuse program aims at ensuring that the dangers of participation are not unequally distributed, for example not confined among the indigent and poor leaving out the rich. Also, the benefits should be concentrated equally on all individuals and all individuals should be treated fairly and without regard to socioeconomic status, race, gender, and other characteristics. For example, access to new treatments is equally shared among all beneficiaries (Mayser and von Wangenheim, 2013).

Protection of confidentiality and privacy

 The confidentiality and privacy of the individuals participating in the treatment must be maintained, respected and protected at all time. Personal information concerning clients should not be shared with anybody without the consent of the individuals who are participating. The identity of the program should not be discernable from the published results of the treatment. Violation of protection of confidentiality and privacy might occur when the individual is in a stigmatized condition like drug dependency or mental illness but they should be guarded against (Terry, 2012).

Risk identification and management

Patient safety

When dealing with an individual who abuses a substance, one is required to understand the risks and impact of the program towards the individual safety. The risks of patient safety can be identified by being inclusive and transparent through communication and interviewing of the participants (Reuben and Tinetti, 2012). Open communication with the patient is helpful because their culture and personality will not be interfered with. Consultation and communication are essential in analyzing, monitoring and identifying risks related to patient safety. The risk of harming the patient safety can be managed through not starting or continuing with activities that distrust the safety of patients (Middleton et al 2013).

Mandatory State regulations

State regulations are rule, law or principle designed to govern or control conduct. One is required to maintain state regulations (Jones et al, 2015). The risk can be identified through the use of techniques for gathering information. Techniques that can be utilized for gathering information about program expectations include; Delphi technique and brainstorming. Through gathering information one is able to understand the requirements of government in the treatment of alcohol, drug and substance abuse and hence managing the likelihood of not conforming to the state requirements.

Medical error

During the treatment of individuals who abuse substances one might cause a medical error in prescribing and storing medicines. Poor communication is the main source of medical error that causes adverse effects on the health of the patient. The risk of medical error can be identified through the continual checking, reviewing or observing the performance level of the medicines administered to the patient. The risk of medical error can be managed by removing the medicine that has a negative effect on the person who abuses alcohol, drug, and substance (Collins and Varmus, 2015).

Existing and future policy

The treatment of alcohol, drug and substance abuse has an obligation to ensure that it conforms to the existing policy. The activities carried out during the treatment should adhere to the existing treatment strategies and provide care to the patients. Information gathering techniques can be utilized in ensuring that the program addresses the risk of maintaining existing and future policies. The program of treatment of alcohol, drug and substance abuse should be tested through research in order to ensure that it conforms to existing period throughout the entire period of delivery. Sharing and changing the consequences of the program can help in minimizing the risk of non-adherence to existing and future policies of drug abuse (Becker and Kleinman, 2013).

Legislation affecting healthcare 

The providers of the treatment for alcohol, drug, and substance must ensure that they conform to legislative acts when people access their services. They are required to conform to key legislation that includes; Mental Health Act 2014 and Severe Substance Dependence Treatment Act 2010. Retaining risk by informed decision can be helpful in case a person does not adhere to the requirements of legislation acts (Sobell, Sobell and Ward, 2013). Sharing with the stakeholders can also help in managing risk associated with legislation acts it helps in acquiring ideas and information required for conformity with legislation acts.

Quality and Safety

According to the National Safety and Quality Health Service Standards (NSQHSS) partnering with clients is essential. During the treatment of people who abuse alcohol, drug and substance partnership with consumers is enhanced through improving their health conditions and patient experience (Doyle, Lennox and Bell, 2013). A partnership is also enhanced during the monitoring and maintenance of ongoing treatment. Partnering with clients helps in improving the observance of treatment regimens.

The NSQHSS standard of medication is enhanced through correct medication. Prescribing the correct medication to address the treatment of alcohol, drug and substance abuse is important. In the program management for medication error is addressed this will ensure there is correct prescribing, supplying, storing, manufacturing, and dispensing medicines.

The NSQHSS standard of Governance for Safety and Quality in Health Service organizations is enhanced through effective risk management strategies. Risk management ensures that the risks that are likely to be encountered are fully addressed this is an important component of Governance. During the treatment of alcohol, drug, and substance the standard of Governance is enhanced through respecting patient's right like the right to autonomy (Shekelle et al, 2013).

The NSQHSS standard of patient identification and procedure matching is enhanced in the stage of identification. The treatment of substance abuse requires correct identification of the patient it ensures correct care and treatment is administered to the right patient. Correct identification helps in reducing the chances of mistakes during progress and cause harm (Giguère et al, 2012). This help in reducing the risk to patient safety because there is a match between patient and care given to him or her, the components care may include therapeutic, diagnostic or supportive.

The NSQHSS standard of Preventing and Controlling Healthcare-Associated Infections is important when associating with patients who abuse alcohol, drug, and substance. During the program the standard has been enhanced through correct medication. During the stage of treatment, the program is required to address the issue of timely and correct medication to ensure no further complications arise from the use of the treatment. Correct medication help in reducing the chances of infections associated with the treatment of alcohol, drug and substance abuse (Australian Commission on Safety and Quality in Health Care, 2012).

Conclusion

It is evident from the program that alcohol, drug and substance abuse has some negative effects on the wellbeing of the individual and society at large. To address the issues brought about by substance abuse, one has to consider the ethical issues. Ethical considerations ensures that the program works as expected and also ensures that the program avoids errors. Risk identification is essential in every program because it enables one to identify potential risk early, hence providing strategies that can be used to manage the risks identified. Every program should consider the National Safety and Quality Health Service Standards during operations in order to ensure that safety and quality necessities are met during implementation of the program.

References

Australian Commission on Safety and Quality in Health Care, 2012. National safety and quality health service standards. Australian Commission on Safety and Quality in Health Care.

Becker, A.E. and Kleinman, A., 2013. Mental health and the global agenda. New England Journal of Medicine, 369(1), pp.66-73.

Bogenschutz, M.P., Forcehimes, A.A., Pommy, J.A., Wilcox, C.E., Barbosa, P.C.R. and Strassman, R.J., 2015. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. Journal of psychopharmacology, 29(3), pp.289-299.

Carroll, A. and Buchholtz, A., 2014. Business and society: Ethics, sustainability, and stakeholder management. Nelson Education.

Collins, F.S. and Varmus, H., 2015. A new initiative on precision medicine. New England Journal of Medicine, 372(9), pp.793-795.

Connors, G.J., DiClemente, C.C., Velasquez, M.M. and Donovan, D.M., 2013. Substance abuse treatment and the stages of change: Selecting and planning interventions. Guilford Press.

Doyle, C., Lennox, L. and Bell, D., 2013. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open, 3(1), p.e001570.

Emanuel, E., Tanden, N., Altman, S., Armstrong, S., Berwick, D., de Brantes, F., Calsyn, M., Chernew, M., Colmers, J., Cutler, D. and Daschle, T., 2012. A systemic approach to containing health care spending.

Giguère, A., Légaré, F., Grimshaw, J., Turcotte, S., Fiander, M., Grudniewicz, A., Makosso?Kallyth, S., Wolf, F.M., Farmer, A.P. and Gagnon, M.P., 2012. Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (10).

Greaney, A.M., O'Mathúna, D.P. and Scott, P.A., 2012. Patient autonomy and choice in healthcare: self-testing devices as a case in point. Medicine, Health Care and Philosophy, 15(4), pp.383-395.

Jones, C.M., Campopiano, M., Baldwin, G. and McCance-Katz, E., 2015. National and state treatment need and capacity for opioid agonist medication-assisted treatment. American journal of public health, 105(8), pp.e55-e63.

Mayser, S. and von Wangenheim, F., 2013. Perceived fairness of differential customer treatment: Consumers' understanding of distributive justice really matters. Journal of Service Research, 16(1), pp.99-113.

Middleton, B., Bloomrosen, M., Dente, M.A., Hashmat, B., Koppel, R., Overhage, J.M., Payne, T.H., Rosenbloom, S.T., Weaver, C. and Zhang, J., 2013. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. Journal of the American Medical Informatics Association, 20(e1), pp.e2-e8.

Terry, N.P., 2012. Protecting patient privacy in the age of big data. UMKC L. Rev., 81, p.385.

Reuben, D.B. and Tinetti, M.E., 2012. Goal-oriented patient care—an alternative health outcomes paradigm. New England Journal of Medicine, 366(9), pp.777-779.

Shahian, D.M. and Normand, S.L.T., 2012. Autonomy, beneficence, justice, and the limits of provider profiling. Journal of the American College of Cardiology, 59(25), pp.2383-2386.

Shekelle, P.G., Pronovost, P.J., Wachter, R.M., McDonald, K.M., Schoelles, K., Dy, S.M., Shojania, K., Reston, J.T., Adams, A.S., Angood, P.B. and Bates, D.W., 2013. The top patient safety strategies that can be encouraged for adoption now. Annals of Internal Medicine, 158(5_Part_2), pp.365-368.

Sobell, L.C., Sobell, M.B. and Ward, E. eds., 2013. Evaluating alcohol and drug abuse treatment effectiveness: Recent advances. Elsevier.

Törnblom, K. and Vermunt, R., 2016. Distributive and procedural justice: Research and social applications. Routledge.

Zschucke, E., Heinz, A. and Ströhle, A., 2012. Exercise and physical activity in the therapy of substance use disorders. The Scientific World Journal, 2012.