The purpose of this paper is to conduct a cultural self-assessment. You will read each of the boxes in Chapter 2 of your textbook (one for each domain of the Purnell Model for Cultural Competence), answer these questions as they relate to you. Remember to answer these questions from your personal perspective. At all times, explain why you do or do not adhere to the dominant cultural practices and beliefs of the ethnic group(s) with which you primarily identify. If you do not wish to self-disclose a specific area from the Organizing Framework, indicate so instead of just not addressing it; of course, this should not happen very often. Your paper should be formatted per APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions)

SIM410 act 4 2 to 3-page paper. Include title and reference pages. Consider the below case study: Margret Spinner-Ramirez is a 66 y/o female Hispanic-American who speaks both Spanish and English fluently. She is retired, lives alone, and has Medicaid as her primary insurance. Ms. Spinner-Ramirez was scratched by a stray cat that she feeds on her back porch daily. She has been cleaning the wound daily; however, after 2 days she went to her local ER for increased pain, redness, and swelling in her left lower leg wound where she was scratched by the stray cat. Ms. Spinner-Ramirez explained she recently had her left knee replaced about 6 months ago and verbalized new difficulty with baring weight on that extremity to the point that she was having to use her cane again. Her vital signs at the ER visit were stable. Her left leg wound was cleaned and redressed. After 5 hours in the ER, Ms. Spinner-Ramirez was discharged to home on oral Keflex for her left lower leg infection and was instructed to call her primary care physician for a follow-up appointment. Five days later Ms. Spinner-Ramirez was taken back to the same ER via ambulance. Her neighbor found her lethargic, short of breath, and was experiencing difficulty being able to move. A CT scan and blood work revealed that Ms. Spinner-Ramirez’s knee replacement in her left leg was infected secondary to the cat scratch. She was admitted as an inpatient for sepsis. She needed to have a second left knee replacement surgery with wound irrigation and debridement, which extended her inpatient stay to 3 weeks. Once she was discharged to home, she required six weeks of IV antibiotics, extensive rehab, and home health. If you were in charge of a healthcare insurance company: Explain why insurance companies (which are considered payers) should or should not pay (reimburse) for injuries, extended costs, readmissions, or death (mortality) from a hospital-acquired infection or medical error. Support your why or why not? Describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety. Discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursements (payments) for services/care.

Read Chapter 14, Complementary and Alternative Strategies.You will post this response to the online Journal using the text submission tool. Create a journal entry of 200-250 words reflecting on your personal experiences or thoughts regarding alternative therapies, integrating content from the reading into your entry.