Category: Nursing

Legislation Comparison Grid and Testimony/Advocacy Statement

Health-related Bill Name

Lower Health Care Costs Act of 2019

Bill Number

S. 1895

Description

Introduced and sponsored by Senior Senator for Tennessee on 19
th
June 2019, the bill seeks to reduce health care costs through targeting health care coverage and services. It introduces cost-sharing approach for certain emergency and non-emergency services, and prohibits medical practitioners and facilities from billing above the recommended rates. In addition, it limits the pharmacy charges, establishes grant programs, and advocates for information dissemination. Besides that, it seeks to increase the minimum age of purchasing tobacco products from 18 years to 21 years (GovTrack, 2020).

Federal or State?

Federal…

Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy. Legislation Comparison Grid and Testimony/Advocacy Statement.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.

Identify the proponents/opponents of the bill.

Identify the target populations addressed by the bill.

Where in the process is the bill currently? Is it in hearings or committees?

Is it receiving press coverage? Legislation Comparison Grid and Testimony/Advocacy Statement

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.

Describe how you would address the opponent to your position. Be specific and provide examples.

Recommend at least one amendment to the bill in support of your position.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus Legislation Comparison Grid and Testimony/Advocacy Statement.

 

Required Readings

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

 

Chapter 3, “Government Response: Legislation” (pp. 37–56)

Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

 

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003

 

Note: You will access this article from the Walden Library databases.

 

United States House of Representatives. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

 

United States Senate. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/

 

United States Senate. (n.d.). Senate organization chart for the 115th Congress. Retrieved September 20, 2018, from https://www.senate.gov/reference/org_chart.htm Legislation Comparison Grid and Testimony/Advocacy Statement

 

Document: Legislation Comparison Grid Template (Word document)

 

 

Legislation Comparison Grid Template

Legislation Comparison Grid Template

 

Use this document to complete Part 1 of the Module 2 Assessment
Legislation Comparison Grid and Testimony/Advocacy Statement

 

 

Health-related Bill Name

 

 

Bill Number

 

Description

 

 

 

 

Federal or State?

 

Legislative Intent

 

 

Legislation Comparison Grid and Testimony/Advocacy Statement

 

Proponents/ Opponents

Proponents:

 

 

Opponents:

 

 

Target Population

 

 

Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)

 

 

 

 

General Notes/Comments

 

 

 

 

_Assignment_Rubric

Grid View

List View

 

Excellent

Good

Fair

Poor

Federal and State Legislation

Part 1: Legislation Comparison Grid

Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

• Determine the legislative intent of the bill you have reviewed.

• Identify the proponents/opponents of the bill.

• Identify the target populations addressed by the bill.

• Where in the process is the bill currently? Is it in hearings or committees?

• Is it receiving press coverage?

32 (32%) – 35 (35%)

The response clearly and accurately summarizes in detail the legislative intent of the health-related bill.

The response accurately identifies in detail the proponents and opponents of the health-related bill.

The response accurately identifies in detail the populations targeted by the health-related bill.

The response clearly and thoroughly describes in detail the current status of the health-related bill. Legislation Comparison Grid and Testimony/Advocacy Statement

28 (28%) – 31 (31%)

The response accurately summarizes the legislative intent of the health-related bill.

The response accurately identifies the proponents and opponents of the health-related bill.

The response accurately identifies the populations targeted by the health-related bill.

The response accurately describes the current status of the health-related bill.

25 (25%) – 27 (27%)

The response vaguely or inaccurately summarizes the legislative intent of the health-related bill.

The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill.

The response vaguely or inaccurately identifies the populations targeted by the health-related bill.

The response vaguely or inaccurately describes the current status of the health-related bill.

0 (0%) – 24 (24%)

Summary of the legislative intent of the health-related bill is vague and inaccurate or is missing.

Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing.

Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing.

The description of the current status of the health-related bill is vague and inaccurate or is missing.

Advocating for Legislation

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

• Advocate a position for the bill you selected and write testimony in support of your position.

• Describe how you would address the opponent to your position. Be specific and provide examples.

• Recommend at least one amendment to the bill in support of your position.

45 (45%) – 50 (50%)

Testimony clearly and thoroughly provides statements that fully justifies a position for a health-related bill.

Response provides a detailed, thorough, and logical explanation of how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples.

A complete, detailed, and specific synthesis of two outside resources is provided. The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the responses provided.

The response accurately and thoroughly recommends at least one amendment to the bill that fully supports the position.

40 (40%) – 44 (44%)

Testimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill.

Response provides an accurate explanation of how to address opponents to the position for the health-related bill and may include at least one supporting example.

An accurate synthesis of at least one outside resource is provided. The response integrates at least 1 outside resource and 2-3 course specific resources that may support the responses provided. Legislation Comparison Grid and Testimony/Advocacy Statement

The response accurately recommends at least one amendment to the bill that may support the position.

35 (35%) – 39 (39%)

Testimony used to justify a position for a health-related bill is vague or inaccurate.

Explanation of how to address the opponents to the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate.

A vague or inaccurate synthesis of outside resources is provided. The response minimally integrates resources that may support the responses provided.

The recommendation of an amendment to the bill in support of the position is inaccurate or incomplete.

0 (0%) – 34 (34%)

Testimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing.

Explanation of how to address the opponents to the position for the health-related bill is vague and inaccurate, or is missing.

A vague and inaccurate synthesis of no outside resources is provided, or is missing. The response fails to integrate any resources to support the responses provided.

The recommendation of an amendment to the bill in support of the position is inaccurate and incomplete, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors. 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Legislation Comparison Grid and Testimony/Advocacy Statement Name:  NURS_6050_Module02_Week04_Assignment_Rubric   Legislation Comparison Grid Template Legislation Comparison Grid Template   Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement     Health-related Bill Name Lower Health Care Costs Act of 2019 Bill Number S. 1895 Description Introduced and sponsored by Senior Senator for Tennessee on 19 th June 2019, the bill seeks to reduce health care costs through targeting health care coverage and services. It introduces cost-sharing approach for certain emergency and non-emergency services, and prohibits medical practitioners and facilities from billing above the recommended rates. In addition, it limits the pharmacy charges, establishes grant programs, and advocates for information dissemination Legislation Comparison Grid and Testimony/Advocacy Statement. Besides that, it seeks to increase the minimum age of purchasing tobacco products from 18 years to 21 years (GovTrack, 2020). Federal or State? Federal Legislative Intent The bill has the intention of reducing health care costs through targeting six specific cost containment measures. Firstly, it introduces a cost sharing requirements for in-network and out-of-networks with specified rates thus ensuring that medical services are accessible at affordable prices. Secondly, it expedites drug approvals, particularly generics and biosimilars thus ensuring that cheaper drugs are availed. Thirdly, it demands accountability at billing with all charges itemized. Fourthly, it limits pharmacy charges/prices. Fifthly, it establishes grant programs. Sixthly, it requires that insurers provide comprehensive information on their costs. In addition, the legislation seeks to raise the minimum age to purchase tobacco products from 18 years to 21 years (GovTrack, 2020). Proponents/ Opponents Proponents: Patients and health advocates who seek to make health care more accessible through reducing costs. Opponents: Health care providers, insurers and tobacco industry whose profit margins may be negatively impacted. Legislation Comparison Grid and Testimony/Advocacy Statement Target Population The target population is persons from low income households. The bill reduces health care costs thus making care more accessible. In addition, it targets adolescents and young adults through raising the minimum age for purchasing tobacco products thus reducing use of such products among the age group. Status of the bill (Is it in hearings or committees? Is it receiving press coverage?) The bill was introduced on 19 th June 2019 for discussion by the Senate Senate Health, Education, Labor, and Pensions committee. They were moved past the committee stage then sent to the House and Senate on 26 th June 2019 and are yet to be discussed and passed (GovTrack, 2020). General Notes/Comments     The bill takes a proactive approach in protecting patients against exploration. It ensures that the costs of medical services are controlled and that patients are aware of what they are paying for and can even conduct cost comparisons to identify where to get the lower costs. The issue of hidden costs is eliminated. In addition, the bill raises the minimum age of purchasing tobacco products thus improving the health of the targeted population (GovTrack, 2020). Legislation Comparison Grid and Testimony/Advocacy Statement   Part 2. Legislation testimony/advocacy statement The bill takes an important step is public health through addressing two agendas. The first agenda it addressing is reducing health care costs through eliminating the price controls that health care providers enjoy, and that allows them to exploit patients. It acknowledges that providers have enjoyed independence in setting prices (a hallmark of capitalism), but that this has allowed them to exploit patients. Through setting price caps and introducing cost sharing, the charges that patients incur can be minimized. It specifically targets medical facilities and practitioners through introducing cost sharing rates. In addition, it targets pharmacy services through limiting prices. Besides that, it targets health insurers through demanding transparency thus allowing patients to compare prices and get the best value for their money Legislation Comparison Grid and Testimony/Advocacy Statement. Also, it enables federal funds to be spent on grant programs to support data modernization and vaccination. These are all programs that have significant effects on lowering health care costs. Additionally, the bill helps to address population health concerns through raising the minimum age for purchasing tobacco products with the expectation that smoking incidences among the target group will be considerably reduced (Black, 2019). Opponents of the legislation could argue that the legislation exerts undue control over the health care industry by restraining market practice. Although business entities should be allowed to freely practice, the legislature has the responsibility of protecting the public against exploitation. The current practices allow the health care industry to reap high profits without concern for patients. Through the controls introduces by the legislation, the industry would still report modest profits while ensuring that persons from low income households can accessed lower priced medical services (Black, 2016) Legislation Comparison Grid and Testimony/Advocacy Statement. Also, opponents in the tobacco industry could argue that the legislation unfairly targets them since it only controls purchase behavior but does not control use age. Proponents could present the counterargument that although the legislation does not control use, it controls access so that teenagers and young adults find it harder to access tobacco products so that their use is minimized (Milstead & Short, 2019). There is a need to amend the legislation to include provisions that restrict tobacco products use among adolescents and young adults. It is not enough to restructure purchase access as the targeted age group could still access tobacco products through proxies. The control would be more effective by limiting the use age (Black, 2016). References Black, B. (2016). Professional nursing-e-book: concepts & challenges . New York, NY: Elsevier Health Sciences. GovTrack (2020). S. 1895 — 116th Congress: Lower Health Care Costs Act. Retrieved from https://www.govtrack.us/congress/bills/116/s1895 Milstead, J. A. & Short, N. M. (2019). Health policy and politics: a nurse’s guide (6 th ed.). Burlington, MA: Jones & Bartlett Learning. Legislation Comparison Grid and Testimony/Advocacy Statement.

Interprofessional practice for a professional nursing organization essay

As an Advanced nurse practitioners Interprofessional practice requires that health care practitioners recognize that patient outcomes are better when there is a collaborative team approach in addressing patient health issues. Also, there are barriers to interprofessional practice that must be addressed among health care practitioners. The Interprofessional Education Collaborative (IPEC) is an initiative including multiple professions designed to advance interprofessional education so that students entering health care professions are able to view collaboration as the norm and seek collaborative relationships with other providers (IPEC, 2011) Interprofessional practice for a professional nursing organization essay.

This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.

To prepare:

Identify a professional nursing organization and review their position on interprofessional practice

Review the following case study:

Case Study:

Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.

The patient returns and is seen by her internist Interprofessional practice for a professional nursing organization essay. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, ”I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.

By Day 3

Post an explanation of your understanding of interprofessional practice. Also, explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member. Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.

Please utilize the resource and information from the file I upload

 

Explain your understanding of inter-professional practice

Healthcare organizations across the world, the US included, aim at providing high-quality services to patients. Patient satisfaction is one of the driving factors that propel healthcare facilities to pursue` quality service provision (Batbaatar et al., 2017). Additionally, reducing or completely eliminating medical related errors as well as adverse events have seen facilities utilize all possible resources to ensure they do not occur. Further, practices that improve patient outcomes with minimal negative outcomes have been adopted. One such practice is the inclusion of interprofessional collaborative practices (Morgan, Pullon,& McKinlay, 2015) Interprofessional practice for a professional nursing organization essay. This practice is widely adopted in different healthcare facilities offering diverse services. No one professional is capable of attending to a patient solely; thus, a practitioner needs to collaborate with others in the field for the best possible patient outcomes. Further, besides the collaboration between practitioners, patient contribution and participation is necessary for comprehensive care to be provided. Patient involvement in has been shown to result in better outcomes. One such benefit is that it allows the patient to be informed on their illness, treatment options, and with this information, a patient can make autonomous decisions that would result in their improved health status (Sacchi et al., 2015). Hence, an interprofessional practice can be defined as the collaboration process where healthcare practitioners work together with other professionals who are not in the same field of practice as they are and also with the patients and their kin in improving the care quality offered to the patient (Morgan et al. 2015) Interprofessional practice for a professional nursing organization essay.

Explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member.

At my place of work (oncology clinic), a lot of importance is given to interprofessional practice. Cancer is one of the leading causes of death in the world with no known cure. The nature of the disease calls for research and experimental treatment regimens to be adopted in an attempt to improve patients’ lives. When treating cancer, the patient often wants to be given numerous alternatives in managing the illness. Some patients are willing to try out new treatment regimens while others seek for non-traditional methods of cancer management Interprofessional practice for a professional nursing organization essay. In some cases, some patients will willingly undergo surgery while some will opt for other alternatives that have a possibility of shrinking tumors such as radiotherapy, herbal options, and mind meditation, among others.

In line with respecting patient autonomy, the oncology clinic will often give the patient all the information they need as regards the different treatment options. With this information, a patient can make a decision which the oncologist embarks on implementing. It’s at this point that interprofessional collaboration comes into play depending on the choices made by the patient and their kin. The different professionals that make up the treatment management team rely on frequent, clear, and interactive communication. Interprofessional practice for a professional nursing organization essay This is because communication is key in ensuring that each team member is at par with regards to the patient’s progress, the current treatment plan, and the wishes of the patient. That said the team working collaboratively discusses a patient’s progress using diverse channels including real-time conferencing, shared patient electronic records, and face-to-face meetings. Additionally, all decisions made by the care team are run through the patient to ensure that the patient is always informed on the next steps to be taken as well as to give the patient a progress report on their health status.

Explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.

Regarding Ms. Tuckerno’s case, lack of communication on what makes for ideal care can cause negative effects on the patient. The internist used her expertise to prescribe the medication as she did. However, the NP was of a different opinion and discontinued some of the drugs effectively changing the patient’s treatment plan. In a fortnight, the patient was re-prescribed the prescriptions. The cessation of medication and subsequent reintroduction can result in the patient building resistance to the drugs thus rendering them ineffective once re-introduced. This will require alternative, stronger doses of the medication which could have adverse negative effects on the patient’s health outcomes (Shah, 2015) Interprofessional practice for a professional nursing organization essay.

A collaborative approach to caring for Ms. Tuckerno is critical if the healthcare professionals want to avoid lawsuits following adverse negative outcomes from their prescription choices. With collaboration, the NP and internist, as well as the patient, will come up with a care plan that will offer the best outcomes for the patient (Bareil et al., 2015). Further, a collaborative approach will ensure that the patient is not confused as regards how and when to take her medication. When the patient follows an agreed-upon treatment plan, she will be in a better position to report any side effects and the care team will have an easier time resolving the side effects issues. Finally, collaboration between the NP and internist will allow for the two to share information, skills, and knowledge. Doing so will improve on decision making, easier monitoring of the patient, as well as the opportunity to carry out farther focused research, all of which will improve patient outcomes Interprofessional practice for a professional nursing organization essay.

References

Bareil, C., Duhamel, F., Lalonde, L., Goudreau, J., Hudon, É., Lussier, M. T., … & Lalonde, G. (2015). Facilitating implementation of interprofessional collaborative practices into primary care: A trilogy of driving forces. 
Journal of Healthcare Management
, 
60
(4), 287-300.

Batbaatar, E., Dorjdagva, J., Luvsannyam, A., Savino, M. M., & Amenta, P. (2017). Determinants of patient satisfaction: a systematic review. 
Perspectives in public health
, 
137
(2), 89-101.

Morgan, S., Pullon, S., & McKinlay, E. (2015). Observation of interprofessional collaborative practice in primary care teams: an integrative literature review. 
International journal of nursing studies
, 
52
(7), 1217-1230.

Sacchi, L., Lanzola, G., Viani, N., & Quaglini, S. (2015). Personalization and patient involvement in decision support systems: current trends. 
Yearbook of medical informatics
, 
24
(01), 106-118.

Shah, P. (2015). Symptomatic management in multiple sclerosis. 
Annals of Indian Academy of Neurology
, 
18
(Suppl 1), S35. Interprofessional practice for a professional nursing organization essay.

The Relationship between healthcare reimbursement and Economics

Health care reimbursement and economics

Every day is a challenge for medical facilities to survive in the American health care climate, particularly with regards to financial. In fact, it is becoming increasingly difficult to find money to fund improvements such as quality care initiatives while being competitive and staying afloat. The top four of these challenges have been identified and discussed. The first challenge is meeting compliance and regulatory requirements that include outcomes from procedures to patient privacy.

ORDER A PLAGIARISM-FREE PAPER HERE

Failing to meet these requirements could have serious consequences so it is vital for the facility to invest funds in meeting the requirements The Relationship between healthcare reimbursement and Economics. The second challenge is how to adapt to the market forces that include competition, difficulty in recruiting and retaining top talent, and patients being heard as consumers. These act as financial pressures that increase expenses and cut into the profit margins. The third challenge is access to technological transformations and digital innovations with medical facilities finding it difficult to maximize their benefits due to outdate structures and cost constraints. There is increased pressure to use technology to improve patient outcomes, and yet implementing technology changes costs money (Mason et al., 2015). The fourth challenge is how to manage financial investments in a capital constrained environment. Between the growing demands of patients, expanding health care access, and frequently changing laws, medical facilities are forced to access more financial resources. This concern along with the pressure to boost outcomes in the face of cost cutting measures places restrictions on how much a medical facility can spend to improve care delivery (Northouse, 2016). There are four strategies that can be applied to respond to the four challenge. The first strategy is sharing resources with other medical facilities through cooperation agreements. The second strategy is bundling services to save total ownership costs, such as purchasing unified systems from the same vendor to include service, software and maintenance costs. The third strategy is to use alternative payment methods such as rentals and leases. The final strategy is to find alternative funding sources to improve capital (Curran, 2016) The Relationship between healthcare reimbursement and Economics.

 

References

Curran, C. (2016).
Nurse on board: planning your path to the boardroom
. Indianapolis, IN: Sigma Theta Tau International.

Mason, D., Gardner, D., Outlaw, F. & O’Grady, E. (2015).
Policy & politics in nursing and health care
(7
th
ed.). St. Louis, MO: Elsevier.

Northouse, P. (2016).
Leadership: theory and practice
(7
th
ed.). Thousand Oaks, CA: Sage Publications The Relationship between healthcare reimbursement and Economics.

Healthcare Balanced Card example

Balanced Card for Eisenhower Medical Center

Mission Statement and Goals

Eisenhower Health, a not-for-profit organization, exists to serve the changing healthcare needs of our region by providing excellence in patient care with supportive education and research. We ensure that measured outcomes meet/exceed agreed upon expectations. Evidence based clinical practice policies, procedures, and other standards are practiced 100% of the time. Tests, treatments and procedures are thoroughly explained to patients and are understood. Patients, visitors and donors are always safe from harm and prefer Eisenhower because of its high quality. We strive that our staff always practice good manners, are friendly, polite, and emotionally sensitive to each individual whether patient, family, visitor or fellow employee and we assure you our services are provided efficiently and effectively with a minimum of waste. Healthcare Balanced Card example

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Table 1

Analysis of Environment

Social

Technological

Economical

Environmental

Political

We count with live interpreters 24/7 to assist in our Emergency department and ICU

Cancer, Neuroscience, Cardiovascular, Orthopedics — these Centers of Excellence at Eisenhower Medical Center provide award-winning, comprehensive care for our patients requiring these specialized services

Our m
ain source comes as donations from our long standing benefactors. 

Improve our outsource of pollutants in our community by encouraging our employees and patients to recycle and dispose trash in adequate bins and containers.

Understand and support our local governors and entities in compliance with the state of CA and city of Rancho Mirage.

Our aging population has an average of 60-70% in ratio

New therapies for Non-invasive Procedures such as Vapotherm and E-Zpap

Understand and support our local needs.

Parking structure is large and ample for all our staff and patients

Healthcare Balanced Card example

Support and understand our schooling programs for our local academies and colleges

Provide safe and potable water

A new pulmonary Laboratory for inpatient services

Creation of a program where Non-insurance patients can opt for financial services in-house

Count with our own Cleaning and housekeeping team

Support our employees for adequate time for jury duty special Vote days.

Ensure a security team is always in and around perimeters.

First Robotic bronchoscopies were launched in May 2019

Cafe and restaurant 24/7 open for staff and patients

Continuing recycling education for patients, family members and employees.

Remain non political neutral parties

 

Table 2

S.W.O.T.

Strength

S

 

Weakness

 

W

 

 

Opportunities

 

O

 

Threat

 

T

 

Personalized care

New Ventilators/ RT equipment

Employ full time interpreters

 

2 more acute care hospitals

Happy and low turnout of employees

Healthcare Balanced Card example

 

Old medical equipment

In-House financial Services

Reject discrimination

Great management team effort

Unstable permanent positions

 

 

Housekeeping services

Zero tolerate to sexual harassment

 

In the table 2 above, the focus between customer and internal perspectives are combined. These highlights what the customer is looking for and how at Eisenhower is responding. There are three areas focused: The customer relationship, market leadership and operational excellence. Eisenhower also splits their “Learning and Growth” into perspective. Healthcare Balanced Card example

Table 3

Balanced Card

Financial

Objectives       Current     Target

Efficient Billing      7 days            5 days Reduc Op. Cost     $50,000         $45,000 Neg Price C           $80,000         $60,000

 

Learning and Growth

Objectives                  Current                Target

Organized Operations  Moderate            Mild Unresolved Issues       12,000                 5,000

 

Customer/Patient Satisfaction

Objectives                Current          Target

Dissatisfaction           25%              18% Law Suits                  5                   0

 

Internal Process

 

Objectives                  Current                Target

Innovations                 12                        20 Inventory Control        90%                    95% Employee Retention    30%                    50% Patients w/o Insurance  10%                   5% Healthcare Balanced Card example

 

 

These balanced card was created and based on information from previous data from Eisenhower Health internal database and some numbers may or may not reflect of current accuracy until this day.

References

How to improve our productivity and cost of care. (2017). Retrieved from https://eisenhowerhealth.org/employeeinternaldatabase Healthcare Balanced Card example

Leadership and management nursing Essay

Identify one specific contemporary issue or trend that you are interested in learning more about. Choose from the categories below. For example you might want to learn more about why it is more difficult for some groups to receive care than others, which would fall under Client Access to Care. Or, you might want to compare nursing practice in the U.S. with how nurses practice in Japan, which would fall under the category of Global Healthcare and Nursing.

Global Healthcare and NursingHealthcare ReformU.S. Healthcare FinancingNursing’s Role in the U.S. Healthcare SystemIntegrative HealthcareNursing Leadership and ManagementNursing EducationNursing PracticeNursing ProfessionalismAdvancing Nursing as a ProfessionClient Access to CareDelivering Client CareInterdisciplinary Teamwork and CollaborationEthical Practices in HealthcareQuality and Safety in Healthcare DeliveryHealth/Nursing Informatics

ORDER A PLAGIARISM-FREE PAPER HERE

Once the issue or trend is identified, find five important/significant facts about it, substantiated by an evidence-based article. Include the article in your submission. Leadership and management nursing Essay.

Create an 8-10 slide PowerPoint presentation with speaker notes, in-text citations and a reference page slide.

 

uLEADERSHIP AND MANAGEMENT: HEALTH CARE REFORM – ACA

unAme:

uInstitution:

u
INTRODUCTION

uACA remains highly debated in USA.

uOperational for close to a decade.

uRemains contentious with divisive opinions over costs and benefits.

uReducing the number of uninsured individuals. Leadership and management nursing Essay

uIncreasing quality of care.

uReducing costs

uExpand insurance coverage

uImproved health care delivery systems

Affordable Care Act (ACA) is perhaps one of the most debated health care reform topics in the USA. Close to a decade since was enacted, ACA remains at the forefront of public policy debates. Although representing a significant achievement in health care reforms, it remains persistently contentious with divisive opinions over the associated costs and benefits, and whether it should be repealed or replaced. It is undeniable that the legislation has had a profound effect on health care delivery in the country, through substantially reducing the number of uninsured individuals, increasing quality of care, and reducing costs. These benefits have been realized through efforts targeted at expanding insurance coverage and improving health care delivery systems. Despite the significant benefits, ACAs continued presence appears uncertain owing to the public policy debates on the legislation (McIntyre & Song, 2019) Leadership and management nursing Essay.

u
FACT #1: EXPANDED INSURANCE COVERAGE

uCreated marketplaces for health insurance.

uEncouraged choice and competition.

uSubsidized insurance plans.

uExpanded Medicaid program eligibility.

uTargeted persons living below poverty line.

ACA has expanded insurance coverage in two ways. Firstly, it has created marketplaces for health insurance through encouraging choice and competition. This allows the market to compare between many insurers and choose a plan that best fits the existing needs. Additionally, it has provided subsidized insurance plans for persons living below the poverty line. Secondly, it has expanded Medicaid program eligibility so that persons living below the poverty line can access insurance. Since it was enacted, insurance coverage has increased by approximately 20 million people (McIntyre & Song, 2019) Leadership and management nursing Essay.

u
FACT #2: RESHAPED PRIVATE INSURANCE

uEstablished new consumer protections.

uProtections against discriminations.

uProtected persons with pre-existing conditions.

uAbolished lifetime and annual limits.

uIntroduced dependent coverage provision.

ACA has improved private health insurance in three ways. It has established new consumer protections that have created a fairer market place. Under the legislation, private insurers are prohibited from discriminating against individuals on the basis of health status. Prior to the legislation, persons with preexisting conditions were required to pay higher premiums, and it was not uncommon for them to be denied insurance. In addition, the legislation abolished lifetime and annual limits on covered benefits Leadership and management nursing Essay. Besides that, the legislation introduced a dependent coverage provision that increased the age of children dependents up to 26 years of age thus allowing more young people to enjoy insurance coverage (McIntyre & Song, 2019).

u
FACT #3: LEGISLATIVE CHALLENGES

u50 million attempts to repel the legislation.

uContinued survival a testament to ACA’s durability.

uPolitical debate challenging owing to vote implications.

The Senate and Congress have presented numerous legislative challenges targeted at ACA. For one, they have advanced more than 50 billion attempts to repeal the legislation either in part of whole. Its continued survival, although with slim legislative advantages, is a testament to the legislation’s legislative durability Leadership and management nursing Essay. Besides that, the political challenge of withdrawing health benefits for a significant proportion of the population has made the possibility of removing the bill insurmountable despite being on tenuous grounds divided along partisan lines (McIntyre & Song, 2019).

u
FACT #4: CHALLENGES FROM TRUMP ADMINISTRATION

uUsed presidential veto power to terminate funding for cost reductions.

uReduced resource allocations towards public education and outreach activities.

uEliminated some consumer protections.

The Trump administration has repeatedly undertaken regulatory actions to undermine ACA, arguing that these actions promote state innovation and consumer choice. Firstly, the administration has used presidential veto power to unilaterally terminate funding for cost-reductions. This has negatively affected insurance enrollment through reducing supplemental subsidies so that some low income households are no longer able to afford health insurance. This action has also destabilized the insurance market Leadership and management nursing Essay. Secondly, it has reduced resources allocated to public education and outreach activities, resulting in low insurance enrolment. Thirdly, it has eliminated some of the consumer protections, such as allowing states modify Medicaid by requiring that nondisabled beneficiaries join the workforce before qualifying for insurance benefits (McIntyre & Song, 2019).

u
FACT #5: JUDICIAL CHALLENGES

uThreat to legislative sustainability.

uTurned Medicaid expansion into a state option.

uJudicial rollback of subsidies on ACA marketplaces.

uTexas ruling of 2018 zeroed-out mandate as unconstitutional.

Judicial actions have been a threat to the legislation, particularly its sustainability. In 2012, the Supreme Court determined that Medicaid expansion was not a nationwide mandate but a state option. This has enabled some states to refuse to expand Medicaid program to include more persons living below the poverty line. Yet another challenge is judicial rollback of subsidies on ACA marketplaces. Another challenge in the Texas ruling of 2018 that made a ruling against the zeroed-out mandate as being unconstitutional. Since the mandate is an integral part of the legislation, then the implication is that the rest of ACA could also be scrapped Leadership and management nursing Essay. The case is currently before an appeals court, and there is a possibility of the judicial processes proceeding to the Supreme Court (McIntyre & Song, 2019).

u
LOOKING FORWARD

uPossibility of repeal is dim.

uPossibility of stabilizing ACA also slim.

uVoter influence could have significant effects.

uDebate is an opportunity to rethink the role of government as represented by judiciary, legislature and executive.

Although the possibility of repealing ACA appears dim since the democrats control Congress, the possibility of stabilizing the legislation similarly appear slim. This is especially so in the face of Trump administration opposing the bill. Besides that, health care remains an important issue among voters, and politicians must consider the political repercussions of taking a stance. Leadership and management nursing Essay. Perhaps, the debate on ACA is an opportunity for the roles of the different arms of the government (judiciary, legislature and executive) in health care policy to be evolved.

u
RECAP

u
Reference

uMcIntyre, A. & Song, Z. (2019). The US Affordable Care Act: reflections and directions at the close of a decade.
PLoS
Med
, 16(2), e1002752. DOI: 10.1371/journal.pmed.1002752. Retrieved from https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002752 Leadership and management nursing Essay

u

Medical Organization Strategic Plan

Eisenhower Medical Centre | Strategic Plan for 2020-2022

Purpose

The main purpose of this strategic plan is to serve as a guide for the achievement of the organization’s goals that it envisions to accomplish in the next three years. Eisenhower Medical Centre recognizes the important role that all its stakeholders play to enable it achieve its aims and objectives over the years. This strategic plan takes into consideration the importance of this collaborative effort in the realisation of the goals set here in it.

Mission Statement

Eisenhower Medical Centre (EMC) is there to provide, without seeking profits, the best possible quality healthcare services in the state of California and beyond. It seeks to be the best in this respect and also provide the highest rated healthcare research and supportive patient education.

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Vision

To provide the most ideal patient care sought by our clientele.

To provide the most conducive working environment for all Eisenhower Medical Centre employees and volunteers. Medical Organization Strategic Plan

To partner with donors in generating resources towards the provision of affordable healthcare services.

To be the most attractive healthcare facility for physicians, nurses, nurse practitioners and other medical staff to work in.

To be the strongest and indispensable community resource in the entire state of California and beyond.

Integral Values

Excellence:
We practice only evidence-based interventions all the time to enable us achieve patient outcomes that are beyond set expectations. Our clinician-patient relationships are always the best and we place the highest premium on patient safety.

Courtesy:
Our employees are the most courteous and understanding to our patients, their relatives, and other visitors to the facility.

Efficiency:
We offer the most efficient and effective quality healthcare within the shortest time possible for our patients. Medical Organization Strategic Plan

Strategic Priorities

EMC must acquire new ventilators/ RT equipment and upgrade old medical equipment.

EMC has to do away with unstable permanent positions.

EMC must begin a policy of zero tolerance to discrimination of any sort and sexual harassment at the workplace.

EMC must recruit interpreters on a full-time basis. These have to work in the facility’s emergency department and the intensive care unit where quick intervention may be hampered by language barrier.

EMC to venture into housekeeping services for itself without outsourcing, and provide its own in-house financial services.

EMC to provide all-round security around the perimeter of its health facility to protect patient privacy and ensure their safety from outside intrusion.

EMC to make sure that all patients and their loved ones can at all times access clean, safe, and pure portable drinking water from multiple points within the facility.

The centers for Cancer, Orthopedics, Neuroscience, and Cardiovascular research and treatment at EMC to continue being equipped and supported to provide the latest state-of-the-art treatments. Medical Organization Strategic Plan

EMC to continue innovation concerning novel treatments with non-invasive procedures, for instance E-Zpap.

EMC to equip and staff a new lung laboratory that will cater for the facility’s inpatients.

EMC to continue its close relationship with its benefactors for continued provision of cheap not-for-profit healthcare services.

EMC to come up with a program that assists patients without healthcare insurance coverage to opt for in-house financial services.

EMC to drastically reduce its carbon footprint and encourage its employees and patients to dispose trash within the facility in designated recycling bins and containers.

EMC to remain apolitical and neutral in all political discourse. However, to continue compliance with the state of California and city of Rancho Mirage statutes, regulations, and by-laws. Medical Organization Strategic Plan

Strategic Objectives

Financial

Objective: Achieve better efficiency in the billing process

Lower the period of billing from seven to five days.

Objective: Reduce the cost of operations of the healthcare institution that is EMC

Target a reduction in operating costs from USD 50,000 to 45,000.

Patient Expectations

Objective: Reduce the rate of patient dissatisfaction with the healthcare services

Lower the rate from 25% percent to a target of 18%.

Objective: Do away with lawsuits related to malpractice and other claims

Cut down the number of cases from the current five to none at all.

Learning and Professional Development

Objective: Tackle any matters that still require resolution in the organization

Reduce unresolved issues from the current 12,000 to a target of just 5,000. Medical Organization Strategic Plan

Processes Internal to the Organization

Objective: Increase innovations within the organization’s employee ranks

Promote the emergence of more innovations within the organization from the current twelve to twenty.

Objective: Improve the control of inventory within the organization as a whole

Tighten the process of inventory control from the current 90% to a target of 95%.

Objective: Do better in preventing staff turnover that is preventable

Improve employee retention in their jobs from the current figure of thirty percent to a target figure of fifty percent.

Objective: Reduce the percentage of patient insurance

Lower the w/o insurance for patients from the current figure of 10% to five percent.

References

Eisenhower Health (2020).
Mission statement
. Retrieved 10 march 2020 from
https://eisenhowerhealth.org/about-us/mission-statement/

Healthgrades (2020).
Eisenhower Medical Center
. Retrieved 10 March 2020 from
https://www.healthgrades.com/hospital-directory/california-ca-southern/eisenhower-medical-center-hgste6618d46050573

ResearchGate (n.d.).
Eisenhower Medical Center
. Retrieved 10 March 2020 from
https://www.researchgate.net/institution/Eisenhower_Medical_Center 
 Medical Organization Strategic Plan

CASE STUDY ON MORAL STATUS

The sets of belief patterns, morals, ethics and behavior patterns expressed by people are different and develop over the years as shaped by personal experiences, relations with other people and worldviews.  The aforementioned aspects shape and guide personal decisions about right and wrong in everyday life.

Theories To Determine the Fetus Moral Status and How Each Theory Influences Recommendations for Actions

Maria’s Theory Based on Relationship and Sentient Properties

Maria’s moral decision is to save the life of the unborn child. Based on her actions, she appears to have a sentinel character and is emotionally dramatic. She inspires Maria to have…

ORDER A PLAGIARISM-FREE PAPER HERE

Based on ”Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity? Case study on moral status

Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?

How does the theory determine or influence each of their recommendations for action?

What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic study materials. NOTE: I AGREE WITH AUNT MARIAS DECISION AND IDEA

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center Case study on moral status.

This Case study on moral status assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

The sets of belief patterns, morals, ethics and behavior patterns expressed by people are different and develop over the years as shaped by personal experiences, relations with other people and worldviews.  The aforementioned aspects shape and guide personal decisions about right and wrong in everyday life.

Theories To Determine the Fetus Moral Status and How Each Theory Influences Recommendations for Actions

Maria’s Theory Based on Relationship and Sentient Properties

Maria’s moral decision is to save the life of the unborn child. Based on her actions, she appears to have a sentinel character and is emotionally dramatic. She inspires Maria to have faith by carrying the pregnancy to term and allowing Gods intention (Grand Canyon University, 2015). According to Beauchamp & Childress (2013), moral theory based on sentience involves a person’s ability to feel another person’s pleasure and pain as differentiated by perception and thughts. Maria also incorporates relationship properties in an attempt to influence Jessica’s moral decision by asking her to think about her motherly role. Case study on moral status.

The theory grounded on relationships emphasizes that the relationship between humans with those he/she values accounts for moral status (Beauchamp & Childress, 2013). More particularly, in this case, Jessica has a parent-child relationship with well-established roles and responsibilities to her unborn fetus. Applying the moral theory based on sentience and relationships, the best action is that Maria should carry the pregnancy to term and deliver.

Dr. Wilson’s Moral Theory As Supported by Cognitive Properties

Dr. Wilson is of the decision that Jessica should procure a medical abortion. His suggestion is scientism and ethical principles of western medicine. The theory grounded on cognitive properties holds that, for a competent human adult to have moral status, he/she should have cognition failure to which he/she is not valuable or have moral status (Beauchamp & Childress, 2013). He backs his suggestion using scientific facts by explaining how the fetus condition was rare and had an estimated 25% risk of Down’s syndrome (Grand Canyon University, 2015).  From an ethical perspective, he has the obligation to educate Jessica and recommend her the best action from a medical perspective. It is for this reason that the most recommended course of action as suggested by Dr. Wilson and backed by a medical and scientific background is to procure an abortion. Case study on moral status

Marco’s Moral Theory Based on Relationships

Marco is pro-choice on unwanted pregnancies. He requests that Jessica is not informed about the fetus devastating condition. However, after Jessica is informed, he is ready to support her on the water decision she makes. He strongly believes that in this case, there is no wrong or right path. However, Macro has racing thoughts about their financial freedom, which reveals his materialistic mindset (Grand Canyon University, 2015). Marco values material possessions more than spiritual values. Applying this theory, Jessica should procure an abortion. However, Marco is ready to support Jessica’s decision because of the relationship he has with her.

Jessica- theory Based on Moral Agency

Jessica is yet to determine her decision in this case. Her relationship with her physician, Maria, and Marco will have a great impact on her decision regarding the fetus moral status.  Jessica partially agrees with Marco that the fetus might be a hindrance to their independence and socio-economic progress. Case study on moral status. This materialistic perspective devalues spirituality, religion, and faith. On the other hand, Jessica also aligns herself to faith, God and religion and embraces life as sacred. These two views bring conflict, also known as dualism, within her. Dualism is a state where two entities that conflict each other (good vs. evil) separate. Aspects such as scientific values, truth-false, success-failure influence dualism. Moral agency defines Jessica’s moral status. According to this theory, a human is considered a moral agent if they can judge how right or wrong an action is (Beauchamp & Childress, 2013). This evidently illustrates that she is the only decision-maker of her course of action.

The theory I Agree With

The author agrees with Aunt Maria’s decision as influenced by the theory based on sentience and relationships. The latter holds that, the relations that exist between humans also determine moral status. More specifically, a person has moral status if he/she relates with other people who value him/her with well-established roles and responsibilities. A perfect example is a relationship between a parent and a child. Using this theory, it is evident that Jessica has a parent-child relationship with the fetus Case study on moral status. Therefore, as a mother, she has a role to fulfill to the unborn fetus. On the other hand, sentience retains that, a person’s moral status is determined by her conscious such as being able to feel pain and pleasure and differentiate the feelings from thoughts and perceptions (Beauchamp & Childress, 2013). It is for this reason that Maria understands Jessica’s pain and inspires her to have faith. Applying both theories, the recommended course of action is for Jessica to keep the pregnancy to term and deliver.

 

References

Beauchamp, T. & Childress, J. (2013). 
Principles of biomedical ethics.
(7
th
ed.) New York, NY:

Oxford University Press.

Grand Canyon University (2015).
HLT 310V Case Study: Fetal Abnormality.
Phoenix, AZ.

Kim, H., Callan, M. J., Gheorghiu, A. I., & Matthews, W. J. (2017). Social comparison, personal relative deprivation, and materialism. 
British Journal of Social Psychology
, 
56
(2), 373-392. Case study on moral status

Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Hospital acquired pneumonia

Competition has typically been encouraged within the health care industry as a strategy for increasing value for all stakeholders. To be more precise, competition ensures the provision of better services and products that satisfy the needs of all stakeholders through improving processes and quality while reducing costs. For instance, capital limitations can restrict hospital control approaches such as having overcrowded wards. In the present case (addressing hospital acquired pneumonia), every resource is considered as scarce and subject to competing needs from other health care agendas. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay. This makes efforts to prevent hospital acquired pneumonia in the midst of providing affordable and high-quality health care services an increasing challenge (Ruggiero, 2015). There is a conflict over whether to advocate for individual patients or equitable distribution of resources to larger populations. This conflict rests entirely on the role of social justice as it applies to the conflicting roles of non-maleficence (do no harm) and beneficence (do good) (Northouse, 2016). In addition, there are three resources of concern to the specific case owing to their scarcity. Firstly, the medical personnel who include nurses are limited in their capacities, skills, geography and time. Implementing strategies for preventing hospital acquired pneumonia are dependent on personnel awareness and their familiarity with the strategies. Having knowledgeable personnel is preferable since they are primed to understand and apply the prevention strategies. Secondly, facilities for delivering medical services are finite. It is not uncommon to have crowded facilities in the hospital. This situation is unlikely to change unless the facilities are expanded, a truly cost intensive endeavor. The facilities limitation can be addressed through making efficient use of the available resources so that high risk patients are isolated from the general populations. Thirdly, money for making changes to the facility is not unlimited. There are competing needs for money and there is a need to conduct a cost-benefit analysis to identify the agendas that have the least costs and most benefits (Joel, 2018). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

References

Joel, L. (2018).
Advanced practice nursing: essentials for role development
(4
th
ed.). Philadelphia, PA: F. A. Davis Company.

Northouse, P. (2016).
Leadership: theory and practice
(7
th
ed.). Thousand Oaks, CA: Sage Publications.

Ruggiero, V. (2015).
Thinking critically about ethical issues
(9
th
ed.). New York, NY: McGraw-Hill Education.

 

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

To Prepare:

• Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1. NOTE: The national healthcare issue/stressor I addressed in module 1 is “HOSPITAL ACQUIRED PNEUMONIA. So, you are going to use this topic to answer questions related to this discussion.

• Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

Required Readings

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only

Note: Review all, with special attention to “Provision 6” (pp. 23–26). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html

Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

 

Hospital-Acquired Pneumonia

Description of the National Healthcare Issue/Stressor

Hospital-acquired pneumonia (HAP) refers to pneumonia that a patient develops within a hospital setting after at least 48–72 hours after being admitted (Pássaro et al.; 2016). HAP is the second leading hospital-acquired infection and cause of death among critically sick patients. HAP is allied to an elevated rate of mortality and morbidity, as well as increased healthcare costs (Torres-García et al., 2019). According to Min et al. (2018), the incidence of HAP worldwide is 5–20 cases per 1000 admissions. The high prevalence of HAP indicates the need to address the issue.

In my healthcare organization, HAP is common among patients in the ICU, and notably patients who are mechanically ventilated. Similarly, the rate of HAP is also relatively high in patients within the medical-surgical ward and the general ward. In the organization, HAP in all units leads to an increased rate of morbidity and mortality, longer period of hospital stays, as well as increased costs for both the patient and the organization. This is consistent with other organizations where hospital-acquired infections like HAP are associated with a high mortality rate, a prolonged period of hospitalization, as well as higher healthcare costs (Pássaro et al., 2016). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

In the organization, the rate of HAP is particularly high among older adults, patients in the ICU, as well as patients with prolonged use of antibiotics and glucocorticoids. The high incidence of HAP among patients with lengthy use of glucocorticoids is allied to the reduced immunity that makes individuals susceptible to infections. Similarly, long-term use of antibiotics is a major risk factor for hospital-acquired pneumonia due to resistance to antibiotics. In my healthcare organization, HAP is associated with an increased rate of mortality, admission to the ICU, and an increased period of hospital stay. Besides, the organization, being a government agency, spends a lot of money on financing the treatment and care of HAP.

Summary of the Two Articles

According to Brett et al., (2019), HAP is allied to elevated morbidity and mortality rate and also increased medical costs. HAP is also a leading factor for transfer to the ICU and results in a prolonged hospital stay. Risk factors associated with HAP include advanced age, a longer period of hospital stay, being a male, dysphagia, numerous comorbidities, as well as chronic obstructive pulmonary disease (Brett et al., 2019). Brett et al. (2019) further indicate that poor oral hygiene causes a buildup of dental disease, which is a significant risk factor in HAP. Accordingly, Brett et al. (2019) explain that improved oral hygiene is effective in decreasing the rate of HAP. Other strategies that can reduce the rate of HAP include early mobilization, effective hand hygiene, proper management of dysphagia, and prevention of viral infections (Brett et al., 2019) Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay.

Again, Deng et al. (2019) explain that HAP is a very common hospital-acquired infection and a leading cause of death among hospitalized patients. Multi-drug-resistant organisms (MDROs) are attributed to the numerous cases of HAPs, and particularly within the ICU and emergency departments (Deng et al., 2019). Wide usage of broad-spectrum antibiotics is attributable to bacterial resistance, one of the risk factors for HAP.

Strategies used to Address HAP

The study by Brett et al. (2019) demonstrates that interventions such as improved oral care, increased movement, and mobility, as well as dysphagia management, are effective in preventing HAP. The study indicates that improved oral care is an important modifiable risk factor for HAP. Comprehensive oral care facilitated by nurses is effective in preventing HAP as it prevents the buildup of dental plaque, which is a significant risk factor in HAP.

Increased mobilization is also an intervention that can be used in preventing HAP, especially among patients with acute ischemic stroke. The intervention involves turning the patient from “supine position to right and left lateral resting position” after every two hours and passively mobilizing the four limbs. This intervention is effective in reducing the rate of HAP. The mobilization intervention also integrates pre-operative patient education, breathing exercises, as well as pre-operative physiotherapy (Brett et al.; 2019). Brett et al. (2019) further explain that proper management of dysphagia and particularly among post-stroke patients, is essential in reducing the rate of HAP. This intervention includes nurses screening patients for dysphagia and implementing the appropriate interventions. The reason is that dysphagia is the leading cause of aspiration pneumonia. After all, food or liquids can enter the airway when patients have difficulties in swallowing and hence introduce bacteria to the lungs. Therefore, effective management of dysphagia can prevent aspiration pneumonia. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay.

Preventing and treating infections caused by multi-drug-resistant organisms can go a long way in preventing HAP (Deng et al., 2019). Long-term use of antibiotics is a significant risk factor for HAP as a result of organisms’ resistance to antibiotic therapy. Interventions used to address the issue of multi-drug resistance include relieving the inflammatory reactions among patients, improving organisms’ clearance, reducing the period of mechanical ventilation, treating patients’ immunity, and increasing the success rate of ventilator weaning (Deng et al., 2019).

References

Brett M, Russo P, Cheng A, Andrew S, Rosebrock H, Curtis S, Robinsion S & Kiernan M. (2019). Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review.
Infection, Disease & Health
, 24(4), 229 – 239.

Deng, D., Chen, Z., Jia, L, Bu J, Ye M, Sun L, Gen Y, Wen Z, Chen G & Fang B. (2019)
.
Treatment of hospital-acquired pneumonia with multi-drug resistant organism by
Buzhong Yiqi
decoction based on
Fuzheng Quxie
classical prescription: study protocol for a randomized controlled trial.
Trials,
20(817).

Min, J. Y., Kim, H. J., Yoon, C., Lee, K., Yeo, M., & Min, K. B. (2018). Hospital-Acquired Pneumonia among Inpatients via the Emergency Department: A Propensity-Score Matched Analysis.
International journal of environmental research and public health
,
15
(6), 1178.
https://doi.org/10.3390/ijerph15061178
.

Pássaro, L., Harbarth, S. & Landelle, C. (2016). Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review.
Antimicrob Resist Infect Control
, 5(43 (20). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Torres-García, M., Pérez Méndez, B. B., Sánchez Huerta, J. L., Villa Guillén, M., Rementería Vazquez, V., Castro Diaz, A. D., López Martinez, B., Laris González, A., Jiménez-Juárez, R. N., & de la Rosa-Zamboni, D. (2019). Healthcare-Associated Pneumonia: Don’t Forget About Respiratory Viruses.
Frontiers in pediatrics
, 7(168).

Advanced Practice Legislation SAVE Act Essay

Advanced Practice Legislation Paper

Select a bill that is related to Advanced Practice nursing and is currently in congress and address the following:

1. Provide a thorough description of the bill including the sponsor of the bill, committees, latest action, amendments, the number co-sponsors (include the name of the congressman from your state if applicable) and the reason the bill was presented. 10points

2. Address how the bill relates to advanced practice nursing. For example, practice authority, reimbursement, collaborative practice, NP’s as primary care providers. What are the challenges to getting the bill passed? 15points

3. Address how this bill affects health care in general including cost savings, patient safety, quality, access to care. 20points

ORDER A PLAGIARISM-FREE PAPER HERE

4. Find an advanced practice professional organization and explain the purpose of the organization and the APN roles who participate in this organization. What are the benefits of joining this organization? Review their political advocacy portal to find out how they are involved political advocacy Advanced Practice Legislation SAVE Act Essay. Include the advocacy efforts they are currently engaged in. Are they involved in contacting legislators regarding current advanced practice legislation and specifically the bill you are discussing. What support or resources does the organization have for new members who want to be involved in legislation? How does the organization keep members abreast of upcoming legislation? For example: Sunset of the nurse practice act in your state. 30points

5. Contact your legislator through the “home” office (in your state, not Washington, D.C.) and convey to speak to someone about health-related legislation and tell them the name of the bill you want to discuss. Find out the legislator’s view point on the bill, whether or not they are in support of the bill and why or why not. 30 points

6. What is your viewpoint on the bill? Do you support passage of the bill? Advanced Practice Legislation SAVE Act Essay Why or why not? How can you as an advanced practice student participate in the passage of the bill? How will passage of the bill influence your practice? 10points

7. APA-10points

 

Advanced Practice Legislation

A description of the Bill (SAVE Act

The SAVE Act is a bipartisan bill (Senate Bill 143 and House Bill 185) that aims to remove requirements for APRNs in North Carolina to work in collaboration with a physician.   The key sponsors of the bill include Senator Ralph Hise and Representatives Donny Lambeth, Josh Dobson, Gale Adcock, and Sarah Stevens.  The bill is co-sponsored by over forty legislators including  Representatives  Ager John,  Jonh Autry, Rep  Lisa Barnes, Deb Butler,   Allison  Dahle, and  George Cleveland and Senators Jim Burgin,   Deanna Ballard, Senator  Danny Britt,  senator, Jim Burgin, and  Ben Clark.  The Bill is aimed at delivering Safe, Accessible, value Directed and Excellent (SAVE) health care by updating APRN regulations. Advanced Practice Legislation SAVE Act Essay. Senate bill 143 is currently before the senate rules committee and while the house bill 185 is before the House health committee.

The bill was presented to update laws regulating APRN practice. For the last four decades,  the laws regulating APRNs as one of health care providers with high training have not been changed. With the SAVE Act, lawmakers aim at modernizing healthcare in  North Carolina by eliminated unnecessary and outdated restrictions on APRNs (NCNA, 2019).  Everybody in the United States is looking at schemes that can be used to save the cost of healthcare while ensuring patients receive excellent care.   The bill proposes the removal of the requirements for clinical CNMs and NPs to be supervised and physicians.  By removing the requirements for APRNs to work under the supervision o physicians, APRNs in North Carolina will be able to deliver care independently and fully exploit their training, and education, which will provide North Carolina residents to have faster access to quality and less costly healthcare.

How the bill relates to advanced practice nursing

The bill relates to advanced practice nursing in that it seeks to eliminate state impediments that hinder APRNs from having independent practice.  The bill addresses outdated state laws and regulations on APRNs, including certified nurse midwives (CNMs), nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists (CNSs).   These advance practice roles have attained a certain level of education and become certified. Nevertheless,  restrictions imposed by state laws reduces the ability of APRN to deliver care independently which in turn less access to care and also raises costs of healthcare (Roberts, 2019) Advanced Practice Legislation SAVE Act Essay.

The SAVE aims at accomplishing two goals.  According to Roberts (2019), the first goal addresses the power of the North Carolina Board of Nursing to control the roles of advance practice nursing. Under the present law, certified midwives and nurse practitioners are regulated by the state Board of Nursing as well as the Medical Board.  The bill seeks to provide the Board of Nursing with the exclusive authority of regulating the practice of CNMs and NPs. The North Carolina Board of nursing exclusively supervises CRNAs and CNSs. Advanced Practice Legislation SAVE Act Essay  In addition, the legislation aims at codifying the services being performed by both CRNAs and CNSs and endows each profession with the APRN title.  The scope of practice of CNSDs and CRNAs will not change as a result of the passage of the bill into law, meaning that they will not be providing any novel services.

The other objective of the legislation is to eliminate the mandatory requisite for CNMs and NPs to collaborate with a physician to provide patient care. North Carolina is among the states that restrict CNMs and NPs to practice authority mandating them to have a written collaborative practice agreement supervising physician. The agreement delineates prescribing authorities, patient management, as well as the way the physician and the ARN will be communicating with one another. Roberts (2019) asserts that the problem with requiring APRNs to have practice agreements with Physicians is that the physician does not do much of the supervising. CNMs and NPs are not required to be in the same geographic area as the physician and they meet only biannually. The agreements between NPs and CNMs can be costly because nurses are required to pay collaborating fees to the physician, which increases health care costs. Advanced Practice Legislation SAVE Act Essay.

The challenges to getting the bill passes are opposition from physicians and physician organizations such as the North Carolina Medical Board.  Physicians have the perception that APRNs are not sufficiently trained to provide safe care  As Roberts,  (2019) indicates, antagonists of the bill maintain that the elimination of collaborative practice agreements will put patients at safety risks as nurses are not in a position to provide high-quality care compared to physicians.

How the bill affects health care

The bill will improve access to care by North Carolina residents.   When CNMs and NPs are authorized to practice independently, they will be able to deliver less costly care. When collaborating with a physician and the physician relocates to another state or retires, the nurse is forced to halt his or her practice until they get another physician to collaborate with. Roberts (2019)  claims that the removal of collaborative agreements will increase acre access in the state since nurses with the required education and certification will be able to deliver primary care services since their practice will not be constrained by accessibility or relocation of the collaborating physician. Advanced Practice Legislation SAVE Act Essay.

Apart from improving access to care, the independent practice of APRNs will lead to health cost savings because APRNs provide less costly care compared to physicians. It is approximated that with the passage of the bill, the state will be able to save up to four billion dollars healthcare costs.  According to Roberts (2019, the bill will also address the regional shortages of physicians in the state.  There is a shortage of physicians in remote regions and there is also an uneven distribution of physicians in the region Advanced Practice Legislation SAVE Act Essay.  Giving APRNs more flexibility to practice could alleviate the shortages of health care providers in rural regions of the State.

APN professional organization

The American Association of Nurse Practitioners (AANP) is a professional nursing organization for NPs of different specialties. The organization represents over twenty thousand NPs across the country.  The purpose of AANP is to offer lawmaking leadership at the national and state levels as well as the local level, promote research, education, and practice, and promote health policy. The organization also establishes standards that NPs must adhere to ensure that they serve patients that receive care from nurse practitioners as well as other consumers of health care. ANNP acts as the voice of nurse practitioners and represents NPs’ interests as providers of care that are less costly, of superior quality, comprehensive and centered on the patient.

Nurse practitioner participation in the AANP provides a variety of benefits.  Professional nursing organizations offer the opportunities to engage in advocacy efforts connected in areas like health, policy and regulators issues.  Being a member of the professional organization offers members the networking and training opportunities to advance their careers as well as knowledge in the profession.   Like any other professional organization, AANP   organizes conferences and meetings as networking events for members. Advocacy is another benefit that I can get from joining the AANP.  Goolsby and DuBois (2017) indicate that professional nursing organizations play an important role in advocating for their members’ interests and communities or patients served by nurse practitioners.

Participation in a professional organization enables members to have a say in identifying and developing health policy initiatives. These organizations publish policy agendas and policies related to regulation, reimbursement, safety, and practice. Additionally, professional organizations offer informative educational resources and position statements to inform their members on crucial pertinent policy and support both old and new members to voice their opinions at the institutional, state and federal levels. Resources are aimed at preparing members to have effective communications with policymakers (Goolsby & DuBois, 2017) Advanced Practice Legislation SAVE Act Essay.

AANP has involved in advocacy efforts at the state as well as the federal level.  Federal legislation directly influences the NP role and the patients served by NPs. AANP has a  legislative team that represents NPs along with their patients on significant matters connected with practice, reimbursement, healthcare reform, licensure and access to care. Apart from advocating on policies related to NP practice, AANP represents NPs’ health organizations and national committees, enabling NPs to take their perspectives to health care leaders. With the support of NPs, AANP works in partnership with federal legislators to ensure sufficient coverage of and access to NP services. At the state level, AANP supports NP policy initiatives (AANP, 2020).

The organization AANP is involved in contacting legislators regarding current advanced practice legislation. AANP contacts legislators via phone calls, emails or meetings in Capitol Hill. AANP is currently in numerous advocacy efforts.  The AANP pushes the 116
th
congress to eradicate feeder barriers that restrict the ability of patients to access less-costly, superior care and ensure that legislators do not enact laws that create additional barriers for NPs. Advanced Practice Legislation SAVE Act Essay. AANP is advocating for the passage of S. 296/H.R. 2150 to grant authority to NPs to sign eligibility of patients to receive home health care and S. 237/H.R. 808 to authorize NPs to certify patients’ requirement for therapeutic shoes. AANP is also Advocating for the passage of S. 2842/H.R. 3911 to allow NPs to order and oversee pulmonary and cardiac rehabilitation. The professional nursing organization keeps members up to date of upcoming legislation and healthcare issues through its advocacy center on its website.

Health-related legislation

The Home Health Care Planning Improvement Act of 2019 H.R. 2150/S. 296) is legislation to authorize physician assistants and APRNs to sign eligibility of patients for home healthcare services.  Under the present Medicare regulations, physicians are the only providers authorized to declare that patients are eligible to receive health care (Jaffe, 2019), after calling my legislator and discussing this bill, the legislator supports the legislation because when enacted into laws, the bill will enable patients to easily access home health services by expanding the scope of providers who can endorse the requirement for home health care under the rules set forth by Medicare. The legislator stated that the legislation is a pragmatic and practical approach of increasing access to him health care by elderly individuals who require it the most, entailing those who are provided care by clinicians who are not physicians.

My viewpoint of the bill

I view the Home Health Care Planning Improvement Act of 2019as a legislation that will be beneficial to patients, APRNs and physician assistants. If enacted,   physician assistants and advanced practice nurses would be able to provide certification for home healthcare, possibly cutting the requirement for a physician. I support the passage of the legislation because physician assistants and APRNs provide professional, personal and invaluable care to numerous individuals around United States. When enacted, the bill will enable Medicare patients to more easily and directly access home care and significantly cut the cost of health care services. It will be a win for providers, patients as well as Medicare Advanced Practice Legislation SAVE Act Essay.

As an advanced practice student, I can participate in the passage by asking my congressperson to speak with other lawmakers on how the bill will benefit their constituents and convince them to pass the bill.  As indicate by Edelman et al (2017), knowing local legislators, enlightening them about health care matters affecting their constituents and advising them on the needs of their constituents is a way in which nurses can be involved in policy-making.

The passage of the bill will influence my practice by enabling be provide home care services to my patients in a timely and consistent manner. When Medicare beneficiaries under the Care of APRNs need home care, (a physician, is often not the primary care provider for the patient) must be contacted to certify the requirement for home health care. This leads to incoherent care and the inclusion of a provider who might not know the care needs of the patient. The bill will ensure that as a clinician with a better knowledge of the patient, I will be able to order care that is clinically appropriate for the patient. Advanced Practice Legislation SAVE Act Essay

 

References

AANP. (2020). AANP Advocacy: Championing the NP Role and Amplifying the NP Voice. Retrieved from
https://www.aanp.org/advocacy

Edelman, C., Mandle C., & Kudzma, E.  (2017).
Health Promotion Through the Life Span
.  St. Louis, MO: Elsevier.

Goolsby, M., & DuBois, J.  (2017). Professional organizations membership: Advancing the nurse practitioner role.
Journal of the American Association of Nurse Practitioners, 29
(8), 434-440. Advanced Practice Legislation SAVE Act Essay.

Jaffe, S.  (2019). Home Health Care Providers Struggle With State Laws and Medicare Rules As Demand Rises.
Health Affairs, 38
(6), 981-986. 

North Carolina Nurses Association, (NCNA).   (Feb 26, 2019). NC Legislators Introduces Bipartisan SAVE Act to Increase Access to Quality Health Care.  Retrieved from
https://ncnurses.org/about-ncna/latest-news/nc-legislators-introduce-bipartisan-save-act/

Roberts, J.  (2019). SAVE Act: Increasing Freedom for N.C. Nurses. Retrieved from
https://www.johnlocke.org/update/save-act-increasing-freedom-for-n-c-nurses/ 
 Advanced Practice Legislation SAVE Act Essay

Practicum Journal Entry: Certification Plan

The practice environment for the PMHNP is regulated by the state scope of practice laws. PMHNPs in California practice under a restrictive environment where state law mandates that the PMHNPs collaborate with a physician for them to practice. The PMHNP and the collaborating physician must possess a written protocol that covers all major aspects of care. The protocol is jointly developed by the physician and nurse practitioner.  As indicated by Barton Associates (2020), nurse practitioners in California have the authority to prescribe medications, including schedule two to five controlled drugs but…

ORDER A PLAGIARISM-FREE PAPER HERE

Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Practicum Journal Entry: Certification Plan. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

In this Practicum Journal Assignment, you will develop a plan, which will serve as the road map for you to follow to attain your certification.

Learning Objectives

Students will:

• Analyze state restrictions or limitations for practice

• Compare PMHNP practice environments in various states

• Analyze clinical practice issues Practicum Journal Entry: Certification Plan

• Create plans for passing national certification exams

**Assigned in Week 1 but submitted in Week 4

To prepare for this Practicum Journal:

• Review the interactive nurse practitioner (NP) scope of practice law guide in your Learning Resources.

• Review your state regulations and a neighboring state or state in which you would like to practice.

• Reflect on how to approach relocating licensure from one state to another.

• Review certification exam requirements for PMHNPs.

Write a 2- to 3-page paper in which you do the following:

• Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.

• Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice.

• Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.

• Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc. Practicum Journal Entry: Certification Plan

 

Certification plan

PMHNP practice environment for California State

The practice environment for the PMHNP is regulated by the state scope of practice laws. PMHNPs in California practice under a restrictive environment where state law mandates that the PMHNPs collaborate with a physician for them to practice. The PMHNP and the collaborating physician must possess a written protocol that covers all major aspects of care. The protocol is jointly developed by the physician and nurse practitioner.  As indicated by Barton Associates (2020), nurse practitioners in California have the authority to prescribe medications, including schedule two to five controlled drugs but only under supervision by a physician.  A nurse practitioner in California can refer patients for physical therapy but only if it is outlined in the collaborative agreement. A PMHP is restricted from signing death certificates Practicum Journal Entry: Certification Plan.

Comparing the PMHNP practice environment in California State with the state in which I would like to practice (Maryland)

There are notable differences between the practice environment for PMHNP in California and those in Maryland State. Compared to California where state laws restrict the ability of PMHNPs to practice independently, Maryland state laws allow nurses PMHNPs to practice independently without the requirement for physician supervision. According to Barton Associates (2020), nurse practitioners in Maryland can diagnose, treat and prescribe without the involvement of a physician. Additionally, they are authorized to refer patients for physical therapy and to sign death certificates.

Professional and clinical practice issues a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process
.

There are several professional and clinical issues that a new PMHNP needs to put into consideration and tackle with the process of licensure, certification, credentialing and relocation. To offer patient care, a new PMHNP needs to get licensure as well as certification. Halter (2017) claims that licensure enables the nurse practitioner to practice in psychiatric mental nursing while certification is a demonstration that one is proficient in psychiatric nursing. PMHNP receives state licensure from the Board of Nursing.Practicum Journal Entry: Certification Plan.  Licensure requirements include the completion of a degree program from an accredited institution and completion of the NCLEX examination.  After getting state licensure, a PMHNP can receive certification.

National certification is the process by which the PMHNP demonstrates he or she has competencies in psychiatric mental health nursing.   To receive national certification   A PMHNP must sit and pass the ANCC PMHNP board certification examination. According to Halter (2017), for a PMHNP to certification offers nurse practitioners a sense of accomplishment and mastery, recognizes them as competent care providers. To take the ANCC examination, the PMHNP have complete a master’s program,  must have worked for two years as a full time registered nurse, attained two thousand hours in clinical hours within a psychiatric setting as well as thirty hours of continuing education in psychiatric mental health nursing. After a PMHNP takes the ANCC certification examination and passes, one is rewarded a board-certified credential and given the title PMHNP-Board Certified. Practicum Journal Entry: Certification Plan.

Credentialing is by the process by which healthcare agencies use to ensure that PMHNPs meet all the essential requirements and are properly qualified to provide safe and high-quality care to patients.  According to Stewart and DeNisco (2018), the process of credentialing involves authentication of education, licensure, along with reference checks. The process is utilized by numerous institutions, organizations and agencies to officially provide authority to selected healthcare professionals to practice as licensed providers in the health care delivery scheme.

When a PMHNP want to relocate to and practice in a different state, the first step in relocating licensure involves the PMHNP determining the licensure requirements in his current state and the state one wants to relocate, one should find out if his future home state is part of the nurse licensure compact Practicum Journal Entry: Certification Plan.  Roux and Halstead (2017) assert that the compact allows a licensed nurse who lives in a state that participates in the compact to practice in another state that participates in the compact without the requirement to obtain another practice license. If the PMHNP is relocating from the state that does not participate in the NLC, one should apply for licensure via endorsement from the new state’s board of nursing. Practicum Journal Entry: Certification Plan.

Checklist for passing the national certification exam,

Preparation for national examination includes financial and educational preparation. To be eligible to sit for the national certification examination, I must hold an active license, master’s degree and a minimum of five hundred supervised clinical hours. After confirming pricing and eligibility, I will apply for the ANCC examination online and pay the required examination fees. After receiving an eligibility notice, I will schedule a testing date at the Prometric center. Practicum Journal Entry: Certification Plan.

The next step will involve visiting the ACNN to check the test content outline that marks out areas that will be covered in the examination.  Apart from the test content outline, the ANCC also provides a test reference list as well as sample test questions accompanied by their answers. Around six months before I take the examination, I will develop a formal study plan. I will include study topics, resources, timetable and study methods. I will schedule regular study times, setting two hours a day, for five days a week.  I will also take a review course to evaluate my knowledge of the exam content. I will take a review course before the day of the exam so that I will have enough time to master areas I am weak and concentrate on these areas Practicum Journal Entry: Certification Plan.

 

References

Barton Associates. (2020). Nurse Practitioner Scope of Practice Laws. Retrieved from
https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws

Halter, M. (2017).  
Varcaroli’s Foundations of Psychiatric-Mental Health Nursing –E-Book: A Clinical Approach.
St. Louis, MO: Elsevier.

Stewart, J., & DeNisco, S. (2018).
Role Development for the Nurse Practitioner
. Burlington, MA: Jones & Bartlett Learning.

Roux, G., & Halstead, J. (2017).
Issues and Trends in Nursing
. Burlington, MA: Jones & Bartlett Learning. Practicum Journal Entry: Certification Plan