A nurse is assisting with discharge planning for a client who has a sacral pressure injury and has a prescription for daily dressing changes. Which of the following resource referrals should the nurse anticipate from the provider for this client?

Choice A reason: If client is uninsured the ED can decline to render services is not an information that the nurse should include in the teaching. This is a false statement that contradicts the purpose and the provision of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who requests it, regardless of their insurance status or ability to pay.
Choice B reason: The ED has the right to refuse to provide client services is not an information that the nurse should include in the teaching. This is a false statement that violates the principle and the requirement of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department has a duty to provide stabilizing treatment to any individual who has an emergency medical condition or is in active labor, unless an appropriate transfer is arranged.

Choice C reason: The ED can transfer medically unstable clients to other facilities is not an information that the nurse should include in the teaching. This is a false statement that breaches the rule and the regulation of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must not transfer an individual who has an emergency medical condition or is in active labor, unless the transfer is requested by the individual or their representative, or the transfer meets certain criteria, such as the benefits outweigh the risks, the receiving facility has agreed to accept the transfer, and the transfer is effected by qualified personnel and equipment.
Choice D reason: Clients must receive a medical screening evaluation (MSE) is an information that the nurse should include in the teaching. This is a true statement that reflects the essence and the standard of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who comes to the emergency department and requests examination or treatment for a medical condition, to determine whether or not an emergency medical condition exists

Choice A reason: This statement is true and should be included in the educational session. SDOH are the nonmedical factors that influence health outcomes, such as income, education, housing, food security, social inclusion, and access to health services. SDOH can affect a person's physical, mental, and social wellbeing, as well as their risk of developing certain diseases.

Choice B reason: This statement is false and should not be included in the educational session. SDOH are not determined by an individual’s ethnic background, but rather by the broader social, economic, and political context in which they live. However, ethnic background can influence how a person experiences SDOH, as some ethnic groups may face discrimination, racism, and marginalization that affect their access to resources and opportunities.

Choice C reason: This statement is false and should not be included in the educational session. Identifying SDOH does not increase disparities in health care, but rather helps to address them. Disparities in health care are the differences in the quality and accessibility of health services among different populations⁵. Identifying SDOH can help to understand the root causes of these disparities, and to design interventions that target the most vulnerable and disadvantaged groups.

Choice D reason: This statement is false and should not be included in the educational session. SDOH do not include psychological factors, but rather affect them. Psychological factors are the individual characteristics and behaviors that influence a person's mental health and wellbeing, such as personality, coping skills, self-esteem, and stress management. SDOH can influence psychological factors by creating stressful or supportive environments, and by facilitating or hindering access to mental health services.