Tag: Clinical-Nursing

  • Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

    Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

    Agenda Comparison Grid Assignment Template for Part 1 and Part 2

     
    Part 1: Agenda Comparison Grid

    Use this Agenda Comparison Grid to document information about the population health/healthcare issue you selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

    You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

    Identify the Population Health concern you selected.

    People residing in America regardless of social status, race, ethnicity and age

    Opioid epidemic

     

    Describe the Population Health concern you selected.

    The opioid epidemic has been experienced in most parts of the world, including the United States. According to the National Institute on Drug Abuse (2022), the opioid crisis is currently characterized by a high prevalence of mortality related to the use of illicit synthetic opioids like fentanyl. For instance, approximately 108,000 individuals in America succumbed to drug-related overdose from both prescription and illicit drugs with 73 838 deaths were associated with fentanyl (National Institute on Drug Abuse, 2022). Some of the opioid use long-term side effects include sleep-disordered breathing, chronic constipation, and increased bone fracture risks al Institute on Drug Abuse, 2022). Hence, as the opioid epidemic continues to rise, all stakeholders must incorporate an evidence-based and pragmatic approach to save lives, reduce risks, and remove barriers that hinder effective interventions Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet.

     

    Administration (President Name)

    President Joe Biden Administration

    President Donald Trump Administration

    Explain how each of the two presidential administrations approached the issue.

    President Joe Biden’s administration has taken the opioid epidemic issue seriously and has incorporated it into the Unity Agenda. The reason why the president decided to tackle the issue is because of the effects that opioid trafficking and use have on families, particularly in blue and red communities and other communities as well (The White House, 2022). As a result, under President Biden’s leadership, the rate of opioid poisoning and deaths have reduced even though these deaths continue to be unaccepted since most are due to fentanyl. The President’s efforts include his administration trying to sign the Consolidated Appropriations Act into law since the law aimed at classifying fentanyl and its related substances to fit in the Controlled Substances Act as Schedule I substances.

     

    During Donald Trump’s administration, the first step to curbing the opioid epidemic was declaring the epidemic as a public health emergency. The administration also proposed strategies to enhance and enforce the crisis by ensuring the affected individuals can access treatment, recovery, and prevention services (Grogan et al., 2020). The strategies also focused on ensuring that overdose-reversing drugs were available, including ways they would be distributed. The President also launched efforts to educate the community on the dangers of overdosing, which was one factor that led to an opioid prescription decrease of 31 percent in 2017 (Grogan et al., 2020). The reason was that the administration was targeting the opioid distributors to prevent them from fueling the opioid harm and epidemic in the American communities.

     

    Identify the allocations of resources that the current and previous presidents dedicated to this issue.

    For President Joe Biden in 2022, the administration awarded the Territories and States $1.5 billion in 2023 to address the opioid and addiction crisis. Also, the Substance Abuse and Mental Health Services Administration (SAMHSA) enabled the awarding of $1.5 billion to the U.S Department of Health and Human Services (HHS) that would increase support of territories, tribal lands, and State’s efforts in addressing the opioid crisis and support recovering individuals (SAMHSA, 2024). Also, in 2024, the administration has set aside about $1.48 billion for the District of Columbia, territories, and states, and $63 million for Tribes to address the opioid crisis.

     

    Also, President Trump’s administration provided $1.8 billion in grants that would help in addressing the public health emergency crisis to prevent losing more Americans to overdose. Also, in 2018, the President Trump administration set 12.1 billion for opioid prevention and treatment efforts, with $15.6 billion for interdiction, law enforcement, and international initiatives (CMS, 2019). Other considerations in 2018 were the $500 million used for state grants under the CURES Act authorization to enhance access to treatment, recovery, and prevention services and minimize opioid misuse.

     

     

     

     

    ORDER YOUR ASSIGNMENT HERE

    Part 2: Agenda Comparison Grid Analysis

     

    Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue you selected

    Administration

     

    Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency the most helpful?

     

    The administrative agency that would be crucial in addressing the opioid epidemic is the Food and Drug Administration (FDA). According to the Food and Drug Administration (2024), the FDA is still committed to addressing the opioid crisis in all measures, particularly in medical product innovation, since it will limit new opioid addiction and abuse cases and in treating people living with an addiction. For instance, in 2018, the FDA started an innovation challenge that aimed at enhancing medical device development, including mobile medical applications and diagnostic tests to combat the crisis while enhancing opioid use disorder treatment and prevention (Food and Drug Administration, 2024). Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

    Also, the FDA approved new drugs through rigorous product reviews that highlighted their specific risks and benefits. Such considerations are necessary during opioid cases since the drugs must be assessed on the risks they pose to the patient, such as addiction and dependency.

    How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there?

    President Joe Biden has incorporated the opioid epidemic in his Unity Agenda, thus showing the emergency state of the health issue. Hence, the only factor remaining is ensuring that the health issue remains part of the presidential agenda. Some of the strategies to boost the opioid epidemic in the Unity Agenda is by reaching out to the legislative through the nursing professional organization to present evidence-based research on why the opioid crisis fight should continue (The White House, 2022). That is evident in the statistics conducted in 2022 by the CDC, which shows that the rate of synthetic opioid deaths between 2021 and 2022 increased by 4.1 percent despite other rates like semisynthetic, heroin, and methadone being reduced (The White House, 2022). Also, it would be crucial to mobilize the communities with high mortality and morbidity rates to air their grievances to enable the federal, local, and state governments to formulate better means to intervene on the issue, especially in creating awareness.

     

    Who would you choose to be the entrepreneur/ champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected? An example is Michael J. Fox a champion for Parkinson’s disease.

    The champion that would be crucial in the fight against the opioid epidemic is Andrea Joy Campbell, who is the Attorney General of Massachusetts. That is because she started a fight against the opioid epidemic after Massachusetts witnessed over 2,000 individuals succumbing due to opioid overdose (Zang et al., 2021). Therefore, she can help in reaching out to other leaders to embrace policies and laws that might help the country fight the opioid epidemic entirely.

     

     

    Fact Sheet

    The fact sheet will address why the opioid crisis serves as a vital legislation agenda and the nurses’ role in its agenda-setting.

    Why Opioid Crisis Serves as a Vital Legislation Agenda

    The opioid crisis affects the well-being of all individuals regardless of their gender, race, or ethnicity particularly those that rely on opioids to minimize chronic illness.

    In 2022, there were approximately 108,000 individual deaths in America due to prescription and illicit drug overdose, with about 73,838 deaths associated with synthetic opioids, specifically fentanyl (National Institute on Drug Abuse, 2022).

    Reasons for Addressing the Opioid Crisis

    In 2024, the President Biden administration set aside about $1.48 billion to help the District of Columbia, territories, and states address the opioid crisis, while Tribes were awarded $63 million proving the cost the health issue has imposed to the country (The White House, 2022)

     Since mortality continues to increase, it is necessary to formulate appropriate strategies that incorporate all stakeholders, including the federal, state, and local governments and community members.

    Managing Opioid Crisis

    President Joe Biden’s administration has incorporated the opioid crisis into the Unity Agenda.

     

    The Nurses’ Role in Its Agenda Setting

    The primary role that nurses have towards agenda setting include;

    Opioid Use Disorder Identification and Prevention

    Nurses spend most of their time in practice interacting with the patient, thus they can use the Opioid Risk Tool (ORT) for evidence purposes and then utilize patient education to educate the patient and formulate effective treatment and condition management process (Grogan et al., 2020).

    Prescription Monitoring

    The best way that nurses can monitor patient prescriptions is by regularly assessing the symptoms to prevent instances where patients with chronic conditions like cancer become addicted to opioids.

    Advocacy

    Nurses’ major role is advocacy to fight for patient rights. According to Van-Cleave et al. (2021), nurses can participate in the policy-making process, provide evidence-based research to back the proposed policies and laws to curb the opioid crisis and identify better standards for opioid prescription.

     
    References

    CMS. (2019).
    Trump Administration takes Steps to Expand Access to Treatment for Opioid Use Disorder | CMS
    . Www.cms.gov. https://www.cms.gov/newsroom/press-releases/trump-administration-takes-steps-expand-access-treatment-opioid-use-disorder

    Food and Drug Administration. (2024).
    Overdose Prevention Activities Timeline
    . U.S. Food and Drug Administration. https://www.fda.gov/drugs/food-and-drug-administration-overdose-prevention-framework/timeline-selected-fda-activities-and-significant-events-addressing-substance-use-and-overdose#:~:text=On%20March%2022%2C%20FDA%20announced

    Grogan, C. M., Bersamira, C. S., Singer, P. M., Smith, B. T., Pollack, H. A., Andrews, C. M., & Abraham, A. J. (2020). Are Policy Strategies for Addressing the Opioid Epidemic Partisan? A View from the States.
    Journal of Health Politics, Policy and Law
    ,
    45
    (2), 277–309. https://doi.org/10.1215/03616878-8004886

    National Institute on Drug Abuse. (2022, January 20).
    Overdose Death Rates
    . National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=Overall%2C%20drug%20overdose%20deaths%20rose

    SAMHSA. (2024, May 2).
    Biden-Harris Administration Announces Critical More Than $1.5 Billion State and Tribal Opioid Response Funding Opportunities
    . Www.hhs.gov. https://www.hhs.gov/about/news/2024/05/02/biden-harris-administration-announces-critical-more-than-1.5-billion-state-tribal-opioid-response-funding-opportunities.html

    The White House. (2022, September 23).
    Biden-Harris administration announces new actions and funding to address the overdose epidemic and support recovery
    . The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/23/fact-sheet-biden-harris-administration-announces-new-actions-and-funding-to-address-the-overdose-epidemic-and-support-recovery/

    Van-Cleave, J. H., Booker, S. Q., Powell-Roach, K., Liang, E., & Kawi, J. (2021). A Scoping Review of Nursing’s Contribution to the Management of Patients with Pain and Opioid Misuse.
    Pain Management Nursing
    ,
    22
    (1), 58–68. https://doi.org/10.1016/j.pmn.2020.11.007

    Zang, X., Macmadu, A., Krieger, M. S., Behrends, C. N., Green, T. C., Morgan, J. R., Murphy, S. M., Nolen, S., Walley, A. Y., Schackman, B. R., & Marshall, B. D. (2021). Targeting community-based naloxone distribution using opioid overdose death rates: A descriptive analysis of naloxone rescue kits and opioid overdose deaths in Massachusetts and Rhode Island.
    The International Journal on Drug Policy
    ,
    98
    , 103435. https://doi.org/10.1016/j.drugpo.2021.103435 Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

     

    Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

    Agenda Comparison Grid and Fact Sheet

    It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

    Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

    As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

    In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

    Resources

     

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    To Prepare:

    Review the agenda priorities of the current/sitting U.S. president and at least one previous presidential administration.

    Tip: 
    You can locate presidential agenda information by searching Google for your health topic and the president. For example,
     mental health Obama presidential agenda
    .

    Select an issue related to healthcare that was addressed by two U.S. presidential administrations (current and previous).

    Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

    Use your Week 1 Discussion post to help with this assignment
    .

    The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources.

    Part 1: Agenda Comparison Grid

    Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the previous president, and their agendas related to the population health concern you selected. Be sure to address the following:

    Identify and provide a brief description of the population health concern you selected.

    Explain how each of the presidential administrations approached the issue.

    Identify the allocation of resources that the presidents dedicated to this issue.

    Part 2: Agenda Comparison Grid Analysis

    Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

    Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected and why is this agency the most helpful for the issue?

    How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there?

    An entrepreneur/champion/sponsor helps to move the issue forward. Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected and why would this person be a good entrepreneur/ champion/sponsor? An example is Michael J. Fox is champion for Parkinson’s disease.

    Part 3: Fact Sheet

    Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

    Summarize why this healthcare issue is important and should be included in the agenda for legislation.

    Justify the role of the nurse in agenda setting for healthcare issues.

    Assignment document should include:

    Title page

    Introductory paragraph

    Agenda comparison grid and analysis

    Fact sheet

    Summary/conclusions

    References

    By Day 7 of Week 2

    Submit
     your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Narrative.

    submission information

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
    Turnitin Drafts
     from the 
    Start Here
     area.

    To submit your completed assignment, save your Assignment as 
    WK2Assgn+LastName+Firstinitial

    Then, click on 
    Start Assignment
     near the top of the page.

    Next, click on 
    Upload File
     and select 
    Submit Assignment
     for review.

    Rubric

    NURS_6050_Module01_Week02_Assignment_Rubric

    NURS_6050_Module01_Week02_Assignment_Rubric

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning Outcome
    Part 1: Agenda Comparison GridExplain how each of the presidential administrations approached the issue. Identify the allocations of resources that the two presidents dedicated to this issue.

    20
     
    to >
    17.0
     pts
    Excellent
    The response clearly and accurately explains how the presidential administrations approached the issue and identifies the resource allocations dedicated to the issue.

    17
     
    to >
    15.0
     pts
    Good
    The response accurately explains how the presidential administrations approached the issue and identifies the resource allocations dedicated to the issue.

    15
     
    to >
    13.0
     pts
    Fair
    The response is vague or partially inaccurate in its explanation of how the presidential administrations approached the issue, and/or in the identification of the resources allocated to the issue.

    13
     
    to >
    0
     pts
    Poor
    The response is missing or inaccurate in its explanation of how the presidential administrations approached the issue, and/or in the identification of the resources allocated to the issue.

    20
     pts

    This criterion is linked to a Learning Outcome
    Part 2: Agenda Comparison Grid Analysis- Address the following:Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency most helpful?How do you think your selected healthcare issue might get on the agenda? How does it stay there?Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected and justify your selection.

    25
     
    to >
    22.0
     pts
    Excellent
    The response clearly and accurately identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue and why that agency is most helpful. …Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there. …The response clearly and accurately identifies and justifies the entrepreneur/champion/sponsor of the healthcare issue selected.

    22
     
    to >
    19.0
     pts
    Good
    The response identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue and why that agency is most helpful. …Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there. …Identification and justification of the entrepreneur/champion/sponsor of the healthcare issue is included.

    19
     
    to >
    17.0
     pts
    Fair
    The identification of an administrative agency responsible for addressing the selected healthcare issue is vague or inaccurate and justification is inaccurate or misaligned for why that agency is most helpful. …Explanation of how the healthcare issue gets on the agenda and remains there is vague or inaccurate. …Identification and/or justification of the entrepreneur/champion/sponsor of the healthcare issue selected is inaccurate or does not align with the healthcare issue.

    17
     
    to >
    0
     pts
    Poor
    Identification of an administrative agency responsible for addressing the selected healthcare issue is missing. …Explanation of how the healthcare issue gets on the agenda and remains there is inaccurate or missing. …Identification and/or justification of the entrepreneur/champion/sponsor of the healthcare issue selected is inaccurate or missing.

    25
     pts

    This criterion is linked to a Learning Outcome
    Part 3: Fact SheetBased on your Agenda Comparison Grid for the healthcare issue you selected, develop a 1-2-page narrative that you could use to communicate with a policy- maker/legislator or a member of their staff for this healthcare issue.Summarize why this healthcare issue is important and should be included in the agenda for legislation.Justify the role of the nurse in agenda setting for healthcare issues

    30
     
    to >
    26.0
     pts
    Excellent
    Creates an accurate and thorough fact sheet. …Using sufficient evidence, the response provides an accurate synthesis of evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response accurately justifies the role of the nurse in agenda setting for healthcare issues.

    26
     
    to >
    23.0
     pts
    Good
    Creates an accurate fact sheet. …Using sufficient evidence, the response provides an accurate summary evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response accurately justifies the role of the nurse in agenda setting for healthcare issues.

    23
     
    to >
    20.0
     pts
    Fair
    Creates a fact sheet that is partially accurate or incomplete. …Response provides an incomplete or inaccurate summary of evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response partially or inaccurately justifies the role of the nurse in agenda setting for healthcare issues.

    20
     
    to >
    0
     pts
    Poor
    Creates a fact sheet that is inaccurate or incomplete. …Response provides an inaccurate summary of evidence or evidence is missing on why this healthcare issue is important and should be included in the agenda for legislation. …Response justifying the role of the nurse in agenda setting for healthcare issues is inaccurate and incomplete or missing.

    30
     pts

    This criterion is linked to a Learning Outcome
    Resources

    10
     
    to >
    8.0
     pts
    Excellent
    Response includes 3 or more course resources and 2 or more outside sources.

    8
     
    to >
    7.0
     pts
    Good
    Response includes 2-3 course resources and 2 outside sources.

    7
     
    to >
    6.0
     pts
    Fair
    Response includes fewer than 2 course resources and/or fewer than 2 outside resources.

    6
     
    to >
    0
     pts
    Poor
    Response includes 2 or fewer resources.

    10
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting: ParagraphParagraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

    5
     
    to >
    4.0
     pts
    Excellent
    Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

    4
     
    to >
    3.0
     pts
    Good
    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

    3
     
    to >
    2.0
     pts
    Fair
    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time.

    2
     
    to >
    0
     pts
    Poor
    Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. 5  pts This criterion is linked to a Learning Outcome Written Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation. 5   to >
    4.0
     pts
    Excellent
    Uses correct grammar, spelling, and punctuation with no errors.

    4
     
    to >
    3.0
     pts
    Good
    Contains a few (1-2) grammar, spelling, and punctuation errors.

    3
     
    to >
    2.0
     pts
    Fair
    Contains several (3-4) grammar, spelling, and punctuation errors.

    2
     
    to >
    0
     pts
    Poor
    Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

    5
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, indentations, parenthetical/in- text citations, and reference list. Walden University NURS-6050 Week 2: Assignment Agenda Comparison Grid and Fact Sheet

    5
     
    to >
    4.0
     pts
    Excellent
    Uses correct APA format with no errors.

    4
     
    to >
    3.0
     pts
    Good
    Contains a few (1-2) APA format errors.

    3
     
    to >
    2.0
     pts
    Fair
    Contains several (3-4) APA format errors.

    2
     
    to >
    0
     pts
    Poor
    Contains many (≥5) APA format errors.

    5
     pts

  • Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

    Walden University Nurs 6050 week 1 Presidential Agendas discussion post and responses

    Presidential Agendas

    Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)  

    Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

    Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?

    Reference:

    New York State Department of Health. (n.d.). 
    Making New York the healthiest state: Achieving the triple aim
    . Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf

    Resources

     

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources. 

    WEEKLY RESOURCES

    To Prepare:

    Review the Resources and reflect on the importance of agenda setting.

    Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

    By Day 3 of Week 1

    Post
     your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?

    By Day 6 of Week 1

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
     by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

     

    Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

    COVID-19- Health Issue 

    A great deal of different health issues has risen to the presidential agenda level for decades.  Various cases of health issues rise to the presidential level because of  high significance and need for immediate resolution. The health topic of Covid-19 greatly rose to the presidential agenda level due to significant illness and death, which led to widespread lockdowns, and disruptions to global supply chains; severely impacting the economy (Anselm et al., 2021). This pandemic led to a combination of economic, public health, and political crisis. The covid-19 pandemic crisis dominated news cycles, putting pressure on the government to address the situation (Anselm et al., 2021). These factors combined to elevate COVID-19 to the level of a presidential agenda item, requiring direct leadership, policy development, and public communication.

     

     I
    mpact of Social Determinants of Health

    The social determinant of health that mostly affected Covid-19 pandemic was socioeconomic status. Social economic status intersects with many other factors, including access to healthcare, living conditions, and occupation. For instance, people with lower income levels often have limited access to healthcare, and during the pandemic it made it extremely difficult to get tested or receive timely treatment for COVID-19 (Garrett, 2023).  During these times, economic pressure forced people to work even when sick, which was further spreading the viruses. Individuals in lower socioeconomic brackets were mostly living in crowded housing conditions, where social distancing was difficult (Garrett, 2023). This then increased the risk of transmission within households and communities. In addition, most citizens had jobs that required close physical proximity to others, increasing exposure to the virus (Garrett, 2023). Overall, lower socioeconomic status had less access to reliable information about the virus, prevention measures, and vaccines, leading to higher rates of infection and vaccine hesitancy (Garrett, 2023)

    GET WRITING HELP HERE

    Past President’s Approaches

    Presidents Joe Biden and Donald Trump approached the COVID-19 pandemic differently, in respect to their distinct leadership styles and policy priorities. President Trump’s initial approach to the covid 19 pandemic was  inconsistent while downplaying the virus. It was treated like a flu with the prediction that it would disappear. Citizens were disappointed with the inadequate distribution of testing kits and personal protective equipment (Park, Haynes, & Gasper, 201). In March 2020, Trump initiated and signed the CARES Act which provided $2.2 trillion in economic relief. This  included direct payments to individuals, expanded unemployment benefits, and support for small businesses (Park, Haynes, & Gasper, 2021). In addition, Trump emphasized on state autonomy in handling the pandemic, which led to disorganized enforcement of policies across the country (Park, Haynes, & Gasper, 2021). Federal mandates on issues like mask-wearing were not strongly imposed. Overall, Trump was a strong advocate for reopening the economy, which clashed with public health officials who recommended more cautious approaches.

     

    President Biden’s initial approach was consistent and emphasized on the seriousness of the pandemic. He encouraged mask-wearing, social distancing, and vaccination, and was modeling these behaviors in public appearances. Biden implemented a national strategy to combat COVID-19, focusing on vaccine distribution, testing, and public health measures. His administration placed a strong emphasis on following scientific guidance. Biden’s administration prioritized the mass distribution of vaccines. By March 2021, vaccines were widely available, and were administered (Park, Haynes, & Gasper, 2021). Initiatives like mobile vaccination units were widely available while partnerships with pharmacies to increase access (Park, Haynes, & Gasper, 2021). Biden implemented several federal mandates, including a mask mandate on federal property and for interstate travel. His administration also pursued vaccine mandates for federal workers and contractors, as well as for large employers, though some of these mandates faced legal challenges. Overall, Biden’s administration took a more centralized, federal approach to managing the pandemic, whereas Trump emphasized state autonomy and limited federal intervention.

               

     What I would do differently

    What I would do differently as an individual at the presidential level who will be handling COVID-19 case will initially be to establish a dedicated pandemic response team early on to monitor global health threats. I will implement comprehensive Lockdowns and travel restrictions in the early stages to prevent widespread transmission (Anselm et al., 2021). My early on approaches will be to prioritize mass production and distribution of testing kits, ensuring widespread and easy access to testing from the outset. I will provide clear, consistent, and science-based communication to the public. I will be regularly updating citizens through briefings, ensuring that the information is accessible and transparent. I will develop a response plan that specifically addresses the needs of vulnerable populations. This will include racial and ethnic minorities, low-income communities, and frontline workers (Garrett, 2023). Also, I will work closely with community leaders and organizations to reach underserved populations with specific public health messages and support. I will ensure equal distribution of vaccines, treatments, and healthcare resources to all. In addition, I will implement economic relief measures that support both individuals and businesses. These could include direct payments, expanded unemployment benefits, and small business grants.  Overall, I will rely mainly on the advice of public health experts and scientists in my decision-making processes, ensuring that policies are informed by the best available evidence. By focusing on these areas, as a presidential-level leader I could potentially manage a pandemic more effectively,  and maintain public trust.

     

     

    Reference
     

    Anselm J.M. Hennis, Anna Coates, Sandra del Pino, Massimo Ghidinelli, Rodolfo Gomez Ponce de Leon, Edwin Bolastig, Luis Castellanos, Renato Oliveira e Souza, & Silvana Luciani. (2021). COVID-19 and inequities in the Americas: lessons learned and implications for essential health services. Revista Panamericana de Salud Pública, 45(130), 1–5. https://doi.org/10.26633/RPSP.2021.130

     

     
    Garrett, T. M. (2023). Border securocracy: Global expansion of the U.S. Department of homeland security bureaucratic apparatus before, during and beyond covid-19. Administrative Theory & Praxis (Taylor & Francis Ltd), 45(3), 230–246. https://doi.org/10.1080/10841806.2022.2112454

     

     
    Park, H. J., Hu, D., Haynes, E., & Gasper, K. (2021). When a lack of passion intertwines with thought and action: Neutral feelings about COVID-19 are associated with US presidential candidate attitudes and voting behavior. Emotion, 21(8), 1796–1800. https://doi.org/10.1037/emo0001051

     

    Reply from Tamika Cheatham

    The topic that I will be considering is mental health.  As such, mental health becomes a priority concern of the presidency due to the fact of its broad ramifications affecting not only the individual but social levels as well. Socioeconomic status is one of the most common socio-ecological contributors to mental disorders that affect care availability, accessibility, adequacy, and, hence, overall outcome (Horn et al., 2021). Low income and a lack of education are some typical aggravating factors in mental health decreases, which ultimately lead to an increased risk for significant disorders such as depression and anxiety. Addressing these disparities remains important if improvement in mental health outcomes at the population level is to be realized.

    During his term, Former President Donald Trump passed the Mental Health Parity and Addiction Equity Act so that similar coverage could be provided to mental health and substance use disorder services as would be provided for services of physical health (Presskreischer et al., 2022). His administration increased funding for programs in mental health and augmented access through the Affordable Care Act. Former President Donald Trump continued to keep mental health in the forefront, calling for programs such as the National Suicide Prevention Lifeline. However, he gave most of his attention to mental health regarding substance abuse. By contrast, some of the programs dealing with mental health received reduced funding during the presidency of Trump.

    Presently, Joe Biden has made mental health part of his broader health agenda. His administration has sought to expand access to mental health services through initiatives like the American Rescue Plan, which, among many other things, allocated significant funding to mental health and substance use disorder services. Biden has also tried to underscore that an approach will be necessary to help ease the mental health crisis worsened by the COVID-19 pandemic to create access to more care, particularly in under-resourced communities.

    If I had to approach mental health from the presidential level, I would increase the funding of mental health services and integrate mental health care into the primary setting. Because stigma plays such a huge role, the expansion of mental health education and awareness campaigns is imperative in reducing stigma and increasing access. Finally, socioeconomic determinants would be addressed through policy changes promoting access to education, jobs, and affordable housing (Adabre & Chan, 2019). If we address these social determinants, it would lead to the construction of a holistic approach toward mental health and support all individuals, especially those coming from a disadvantaged background. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

     

    References

    Adabre, M. A., & Chan, A. P. C. (2019). Critical success factors (CSFs) for sustainable affordable housing. Building and Environment, 156, 203–214. https://doi.org/10.1016/j.buildenv.2019.04.030

    Horn, R., Arakelyan, S., Wurie, H., & Ager, A. (2021). Factors contributing to emotional distress in Sierra Leone: a socio-ecological analysis. International Journal of Mental Health Systems, 15(1). https://doi.org/10.1186/s13033-021-00474-y

    Presskreischer, R., Barry, C. L., Lawrence, A. K., McCourt, A., Mojtabai, R., & McGinty, E. E. (2022). Factors Affecting State-Level Enforcement of the Federal Mental Health Parity and Addiction Equity Act: A Cross-Case Analysis of Four States. Journal of Health Politics, Policy and Law, 48(1). 
    https://doi.org/10.1215/03616878-10171062
    Links to an external site.

    Short, N. M. (2022). 
    Milstead’s health policy and politics: A nurse’s guide
     (7th ed.). Jones & Bartlett Learning.

    The White House. (2023, May 18). 
    Fact sheet: Biden-Harris administration announces new actions to tackle nation’s mental health crisis
    . The White House. Retrieved August 28, 2024, from https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/18/fact-sheet-biden-harris-administration-announces-new-actions-to-tackle-nations-mental-health-crisis/

    The White House. (2020, October 5). President Donald J. Trump is safeguarding Americans’ mental health and preventing the tragedy of suicide. The White House. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/

     

    Initial Post on the Opioid Crisis in America

    The opioid crisis in the United States has emerged as a significant public health emergency, rising to the level of a presidential agenda due to its widespread impact. Over 80,000 people succumbed to opioids in 2022.
    (CDC, 2023)
      The epidemic, characterized by the over-prescription and misuse of opioid medications, such as, Hydrocodone and Oxycodone, has resulted in a dramatic increase in opioid-related overdoses and deaths. The opioid crisis has disproportionately affected rural areas just as much as urban areas. In some rural communities, the overdose death rate is nearly twice that of urban areas. A critical social determinant of health that significantly affects this issue is socioeconomic status, and access to healthcare. Individuals in lower-income brackets are more likely to experience chronic pain, have limited access to healthcare, and consequently are more susceptible to opioid misuse. Communities with high unemployment rates and limited economic opportunities are disproportionately affected by the opioid crisis as well.

    Current President Biden

    The Biden Administration has prioritized addressing the opioid crisis, recognizing it as a significant public health issue that demands immediate action. A critical social determinant affecting this crisis is access to healthcare. Many individuals, particularly those in underserved communities, lack adequate access to comprehensive healthcare services, including mental health and addiction treatment. This lack of access exacerbates the misuse of opioids as individuals may turn to these substances for unmanaged pain or untreated mental health issues.

    President Joe Biden’s approach to the opioid crisis involves a multi-faceted strategy focusing on prevention, treatment, and harm reduction. His administration has allocated significant resources to expand access to evidence-based treatment, including medication-assisted treatment, and has emphasized the importance of reducing the stigma associated with addiction. The administration is working to increase access to naloxone, a life-saving medication that can reverse opioid overdoses, and to improve support systems for individuals in recovery.

    Past Presidents

    Two past U.S. Presidents have taken different approaches to addressing the opioid crisis. President Barack Obama, during his tenure, focused on expanding access to treatment and recovery services. The Comprehensive Addiction and Recovery Act (CARA), signed into law in 2016, was one of his administration’s key legislative efforts. This act aimed to expand prevention and education efforts while also improving access to treatment for those struggling with addiction. Obama’s approach recognized the need for a multi-faceted response that included both public health and criminal justice components.

    President Donald Trump, on the other hand, declared the opioid crisis a public health emergency in 2017 and focused on stricter law enforcement as well as expanding access to treatment. The SUPPORT for Patients and Communities Act, signed into law in 2018, was a comprehensive package that included measures to increase access to addiction treatment, support prevention efforts, and reduce the supply of opioids. Trump’s administration also emphasized the importance of securing the U.S. borders to prevent the flow of illegal drugs into the country.

    What could be done differently

    While all approaches made strides in addressing the opioid crisis, there are areas where improvements could be made. If given the opportunity to tackle this issue, I would advocate for a more vigorous emphasis on prevention through education and community-based interventions. By addressing the root causes of opioid misuse, such as poverty, mental health issues, and lack of economic opportunities, a more sustainable solution could be developed. I would also focus on expanding access to non-opioid pain management alternatives such as massage and acupuncture. And increasing funding for research into new treatments for chronic pain that do not involve addictive substances. These efforts would help reduce the demand for opioids and provide long-term relief for those affected by this crisis.

    References

    https://www.cdc.gov/drugoverdose/deaths/index.html
    Links to an external site.

    Jones, C. M., et al. (2018). Trends and key correlates of prescription opioid injection misuse in the United States. Addictive Behaviors, 76, 53-61.

    Kolodny, A., et al. (2015). The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559-574.

    Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263.

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    Tracy M Chaves

    Aug 28, 2024 9:01pm
    | Last reply Sep 1, 2024 2:16pm

    Reply from Tracy M Chaves

    Per the Health Policy and Politics Nurse’s Guide, there are four categories that influence what issues would make it to a presidential agenda level. Actors refer to people or groups that draw attention to problems; ideas refer to the power or value an issue has with polls or surveys; interests are related to the benefits such as reelection addressing an issue has; and lastly institutes are the “organizational structure” or the setting where the agenda is discussed (Short, 2022).
     

    There has been models developed to address explain how a policy rises to the presidential agenda level and change occurs, these models are the Iron Triangle Model, The Punctuated Equilibrium Model, The Advocacy Coalition Model, The Path Dependent Model, and the most popular Kingdom Model as described in the text (Short, 2022). When a problem coupled with the right timing and the right interest group leading the way an agenda gets on a presidential level.
     

    A popular health topic that rises to presidential agenda level is the topic of health insurance. Social determinants most affected by this health issue are economical stability and healthcare access and quality. There has been numerous presidential administrations that have tried reform with difficulty. The difficulty comes on the political views and goals of each political party. A good example of this is the Affordable Care Act. Implemented by democrats in 2010, later changed by republicans, and now currently going through different change again by democrats. For the 2024 elections, health policy issues will continue to be a main debate (Emory Rollins, n.d.).

    It is hard to say what I would do as no one has been successful in addressing the affordable healthcare issue. However, I would start with implementing health care professionals, such as nurses into the discussion as members. Unfortunately the decisions about our health is being made by those with little knowledge about it. “Nurses and IPHCWs bring a unique and trusted perspective to policy deliberation and development because of their training, values, ethics, and experience”(Short, 2022).
     

    A policy briefing would also be beneficial. Due to politicians usually not coming from a healthcare background, it would be important to assess their level of understanding, give clear explanations of the significance of the policy, give the actions that are needed, and the research evidence to back it all up (DeMarco, 2014).

    I know I would also would like to incorporate more preventative coverage research. On a personal level I have seen changes being made to CMS related to home health that I feel is not preventative but reactive. Insurance type also plays a factor on what services are covered or not, both with private insurance coverage and Medicare coverage.

     

    References

    DeMarco, R., & Tufts, K.A. (2014). The mechanics of writing a policy brief. 
    Nursing Outlook,
     62(3), 219-224.

    Emory’s Rollins School of Public Health. (n.d.) Health policy and the 2024 elections. Retrieved Aug 28 2024, from https://sph.emory.edu/features/2024/presidential-election/health-policy/
     

     
    Short, N.M. (2022). 
    Milstead’s health policy and politics: as nurse’s guide.
     Seventh edition, 57-71. Burlington, MA, Jones and Bartlett Learning.
     

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    Mihret Ghebreamlak

    Aug 28, 2024 9pm
    | Last reply Sep 1, 2024 4:17am

    Reply from Mihret Ghebreamlak

    COVID-19 and the Impact of Social Determinants of Health

    Main Post

    The COVID-19 pandemic has underlined the profound influences that social determinants of health, broadly socio-economic status, have on population health. SES, measured by income, education, and employment, is important in determining health outcomes. The pandemic has made the low-income population face higher risks from limited access to healthcare, living in overcrowded environments, and employment in essential but high-exposure jobs (Abrams & Szefler, 2020). Each of these factors has contributed to higher COVID-19 infection rates, hospitalizations, and mortalities in marginalized communities. The disparities in health outcomes underline the need for more significant investments in public health infrastructure, notably in underserved communities, to mitigate the effects of such social determinants during future health crises (Maani & Galea, 2020).

    Past President’s Approaches

    President Donald Trump had earlier focused on economic measures and vaccine development. The administration initiated Operation Warp Speed to accelerate vaccine development, production, and distribution (Kellogg & Overton, 2021). His administration had been criticized for minimizing the severity of the virus and issuing confusing guidance on public health (Parker & Stern, 2022). Trump’s policies were generally directed toward opening up the economy, which made lower-income individuals particularly vulnerable as they could not work from home.

    President Joe Biden came into office with a pledge for a coordinated federal approach. His administration has emphasized widespread vaccination, public health guidance, and direct financial support to individuals and businesses. Biden also moved to address health inequity, targeting vaccination efforts in underserved communities, increasing funding for public health infrastructure, and extending unemployment benefits and stimulus payments to help those facing economic hardship due to the pandemic (The White House, 2021).

    What Could Be Done Differently

    While both administrations took necessary steps, addressing SES as a determinant of health would have led to improved outcomes. Such policy measures would include enhancing healthcare access for the uninsured or underinsured segments of society, supporting essential workers, and investing in public health infrastructure in low-income communities. Public health messaging must remain consistent and ensure that all communities receive accurate and proper information and resources to manage future health crises.

    References:

    Abrams, E. M., & Szefler, S. J. (2020). COVID-19 and the impact of social determinants of health. 
    The Lancet Respiratory Medicine
    , 
    8
    (7), 659–661. https://doi.org/10.1016/s2213-2600(20)30234-4

    Kellogg, K., & Overton, H. (2021, June 4). 
    Operation Warp Speed: Innovating Vaccine Development While Addressing a National Crisis
    . Americafirstpolicy.com. https://americafirstpolicy.com/issues/operation-warp-speed-innovating-vaccine-development-while-addressing-a-national-crisis

    Maani, N., & Galea, S. (2020). COVID-19 and Underinvestment in the Public Health Infrastructure of the United States. 
    The Milbank Quarterly
    , 
    98
    (2). https://doi.org/10.1111/1468-0009.12463

    Parker, C. F., & Stern, E. K. (2022). The Trump Administration and the COVID-19 crisis: Exploring the warning-response problems and missed opportunities of a public health emergency. 
    Public Administration
    , 
    100
    (3). https://doi.org/10.1111/padm.12843

    The White House. (2021, January 20). 
    President Biden Announces American Rescue Plan
    . The White House. https://www.whitehouse.gov/briefing-room/legislation/2021/01/20/president-biden-announces-american-rescue-plan/

     

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    Kayla Rena Davis

    Aug 28, 2024 8:52pm
    | Last reply Sep 1, 2024 4:50am

    Reply from Kayla Rena Davis

    A widely discussed health topic that will be discussed in this post is the cost of prescription drugs and what Presidents Biden and Trump have done to assist Americans in lowering this cost. Biden and Trump aimed to bring down prescription drug prices and end surprise billing, even agreeing on some interventions to help this initiative.

     

    President Joe Biden’s Inflation Reduction Act (IRA) grants Medicare the authority to negotiate the prices of specific prescription drugs, thereby introducing a significant shift in federal healthcare policy. Initially, the negotiations encompass ten selected drugs, with a maximum of 20 drugs per year; however, President Biden aims to expand this number to 50 drugs annually (The White House, 2024). The newly negotiated prices are slated to take effect in 2026, with projected savings estimated at $1.5 billion in prescription drug costs (Centers for Medicare & Medicaid Services [CMS], 2024). In addition to drug price negotiations, the IRA imposes a cap on out-of-pocket expenses for Medicare beneficiaries, expected to yield an average savings of $400 per year (The White House, 2024). The Act also extends the insulin price cap introduced under the Trump administration, transitioning it from voluntary to mandatory and establishing a $35 monthly cap on insulin costs.

     

    President Donald J. Trump implemented several executive orders to reduce the cost of prescription medications and enhance access for Americans. One executive order extended the drug rebates that manufacturers offer to private insurers, making them available to Medicare beneficiaries (Robertson, 2023). Another order focused on making insulin and epinephrine more affordable for low-income individuals, reducing their cost to $35 or less. Initially voluntary, President Biden codified this measure into law (The White House, 2020). Additionally, President Trump signed an order permitting the importation of drugs from other states or countries to foster competitive pricing and abolished gag clauses, which had previously prevented pharmacists from discussing the most cost-effective options with consumers (The White House, 2020).

     

    To build upon the efforts of the current and previous administrations in reducing prescription drug costs for Americans, I propose extending negotiated drug prices to individuals without Medicare or Medicaid coverage. Additionally, to prevent price gouging, a pricing benchmark should be established based on the prices negotiated by Medicare and the prices paid by other countries for the same medications. This approach would ensure that negotiated prices are accessible to all, enhancing affordability and equity in healthcare.

     

     

     

     

    Reference:

     

    Centers for Medicare & Medicaid Services (CMS). (2024, August). 
    Medicare prescription drug inflation rebate program part …
     https://www.cms.gov/files/document/fact-sheet-part-b-rebatable-drug-coinsurance-reduction.pdf

     

    Robertson, L. (2023, September 19). 
    Trump’s executive orders on prescription drugs
    . FactCheck.org. https://www.factcheck.org/2020/07/trumps-executive-orders-on-prescription-drugs/

     

    The White House. (2020, July). 
    FACT SHEETS  President Donald J. Trump Is Taking Action to Lower Drug Costs and Ensure That Americans Have Access to Life-saving Medications
    . https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-taking-action-lower-drug-costs-ensure-americans-access-life-saving-medications/

     

    The White House. (2024, March 8). 
    Fact sheet: President Biden takes new steps to lower prescription drug and health care costs, expand access to health care, and protect consumers
    . https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/06/fact-sheet-president-biden-takes-new-steps-to-lower-prescription-drug-and-health-care-costs-expand-access-to-health-care-and-protect-consumers/

     

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    Hiedi Wurster

    Aug 28, 2024 8:37pm
    | Last reply Aug 31, 2024 6:07pm

    Reply from Hiedi Wurster

    The Opioid Crisis

    The opioid epidemic is one of the most devastating crises of our time.  Since opioids became widely prescribed in the 1990s, at least 500,000 people in the U.S. have died from an opiate overdose (Uncovering the Opioid Epidemic, n.d.). An estimated 2.5 million Americans have opioid use disorder (Abuse, 2023), and approximately 10 million Americans twelve years  old and older have misused opioids in the past year (Association, 2023). This crisis has manifested in three waves (Feldscher, 2022). Oxycontin, which has a high risk for dependency, was the first legally prescribed opioid that brought on the first wave of deaths that were linked to opioids (Feldscher, 2022).  The second wave came from heroin, which appealed to people who were already addicted (Feldscher, 2022). We are currently in the third wave, which is attributed to illegally obtained opioids such as fentanyl (Feldscher, 2022). In 2021 alone, close to $1.5 trillion was spent in combatting the crisis (Beyer, 2022). Opioid abuse not only takes a toll on its victims and their families, it costs society as well. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

     

    Trump Administration Response

    Trump’s strategy appeared to take a reactive approach. He allocated $1.8 billion in grants to be given to states to fight opioid abuse (Trump Whitehouse Archives, n.d.) He has contacted countries, such as China, to appeal to them to stop the flow of drugs to the U.S. (Trump Whitehouse Archives, n.d.). He has even been able to quell the distribution of drugs over the internet by getting rid of one of the biggest online distributors (Trump Whitehouse Archives, n.d.). He also expanded access to treatment for opioid use disorder by creating the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act in October 2018 (CMS, 2019).

     

    Biden Administration Response

    The Biden administration appears to be taking a more proactive approach. They have certainly allocated money to the states to combat this epidemic. But they have also taken some specific action. They enacted legislation that has allowed nearly two million more medical professionals to be able to prescribe medication to treat opioid use disorder (Whitehouse, 2024).  He has prioritized keeping drugs out of the country by providing the latest drug detection technology to our federal agents who protect our ports of entry (Whitehouse, 2024). Although the Trump administration contacted China concerning their illicit exports, the Biden administration was able to convince them to close down the sources of drug manufacturing and to share information with the U.S (Whitehouse, 2024).  This administration also went global by bringing over 140 countries together to fight this epidemic (Whitehouse, 2024).

     

    Social Determinants of Opioid Abuse

    Social determinants play a large role in our health and well-being. There are five main categories of determinants that are known as upstream factors (Nicholson, 2023).  These five categories refer to our environment. They are economic stability, education access and quality, health access and quality, neighborhood and build environment, and social and community context (HHS, n.d.). People with lower education, lower incomes and are participating in some manner in a government program, are more likely to use opioids (Nicholson, 2023).

     

    What Would I Do Different

    I would have acknowledged the problem much earlier. But as of now, I would start locally by educating students about opioids.  This would include all levels of school using age-appropriate materials. I would also contact many of the employers in this area to offer information sessions on it. I would like to allocate more resources to our local law enforcement so they can be more pro-active in getting dealers off the streets. At a state level, I would like to have more education as well as treatment available at colleges as well as in prisons. It would be great to have more affordable housing options for people with SUD who are struggling with homelessness. As Maslow has reminded us, shelter is one of our basic needs, and we cannot achieve anything unless we have the safety of housing.

     

    References

    Abuse, N. I. (2023, August 7). 
    Only 1 in 5 U.S. Adults with opioid use disorder receive medications to treat it in 2021
    . Retrieved from nida.nih.gov: https://nida.nih.gov/news-events/news-releases/2023/08/only-1-in-5-us-adults-with-opioid-use-disorder-received-medications-to-treat-it-in-2021#:~:text=News%20Release-,Only%201%20in%205%20U.S.%20adults%20with%20opioid%20use%20disorder,to%20treat%20it%20in%

    Association, A. P. (2023, August 28). 
    The Opioid Crisis: Impact, Challenges, and Paths to Recovery.
     Retrieved from Psychiatry.org: https://www.psychiatry.org/news-room/apa-blogs/opioid-crisis-impact-challenges-recovery

    Beyer, D. (2022, September 28). 
    JEC Analysis Finds Opioid Epidemic Cost U.S. Nearly $1.5 Trillion in 2020.
     Retrieved from beyer.house.gov: https://beyer.house.gov/news/documentsingle.aspx?DocumentID=5684#

    CMS. (2019, November 1). 
    Trump Administration takes Steps to Expand Access to Treatment for Opioid Use Didorder.
     Retrieved from cms.gov: https://www.cms.gov/newsroom/press-releases/trump-administration-takes-steps-expand-access-treatment-opioid-use-disorder

    Feldscher, K. (2022, February 9). 
    What led to the opioid crisis-and how to fix it.
     Retrieved from Harvard T.H. Chan School of Public Health: https://www.hsph.harvard.edu/news/features/what-led-to-the-opioid-crisis-and-how-to-fix-it/#:~:text=It%20started%20in%20the%20mid,use%20of%20legal%20prescription%20opioids.

    HHS. (n.d.). 
    Healthy People 2030
    . Retrieved from healthy.gov: https://health.gov/healthypeople/priority-areas/social-determinants-health

    Nicholson, H. L. (2023). Social determinanats of opioid use behaviors among adults in the United States. 
    Journal of Substance Use
    , 371-378.

    Only 1 in 5 US Adults With Opioid Use Disorder.
     (n.d.). Retrieved from National Institute on Drug Abuse.

    Trump Whitehouse Archives.
     (n.d.). Retrieved from Trump Whitehouse Archives: https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-dedicated-administration-fighting-back-opioid-crisis/

    Uncovering the Opioid Epidemic.
     (n.d.). Retrieved from CDC: https://www.cdc.gov/museum/pdf/cdcm-pha-stem-uncovering-the-opioid-epidemic-lesson.pdf

    Whitehouse. (2024, march 8). 
    Fact Sheet: President Biden’s Unity Agenda for the Nation
    . Retrieved from whitehouse.gov: https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/08/fact-sheet-president-bidens-unity-agenda-for-the-nation/

     

     

     

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    Hiedi Wurster

    Aug 28, 2024 8:21pm

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    WU_6050_Discussion_Draft2-2.docx

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    Hiedi Wurster

    Aug 28, 2024 8:19pm

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    Mehal Patel

    Aug 28, 2024 7:16pm
    | Last reply Aug 31, 2024 10:13pm

    Reply from Mehal Patel

    Social determinants of health

    According to Healthy People 2030, there are five determinants of social health, among them, neighborhood and safe environment are critical for a person’s wellbeing and quality of life. Due to the rise in gun violence, one of the five social determinants is in jeopardy. According to NICHM (National Institute of Healthcare Management), “Gun violence is a major public health problem, and a leading cause of premature death”.

    Gun violence issue

    On average, 118 people a day were killed from gun-related incidents in 2023. Gun violence, on average costs $557 billion annually, and among that $2.8 billion is spent on medical care, mental health services, and emergency services. For taxpayers in the United States of America, each non-fatal gun costs over $25000 and each gun death injury costs approximately $ 274,000. Its average cost is $1700 per taxpayer.

    How President Trump and Biden addressed this issue

    Former President Donald Trump offered one of the steps to prevent gun violence. He provided police protection to minorities. As per Donald Trump, minorities need police protection because of the hate crime. He understands what going into inner cities and need of police protection for minorities.

    On the other hand, President Biden stated that he will do everything he can, to prevent such crisis after mass shooting at Texas Elementary school in May 2022. According to a Washington D.C post released by Rhode Island senator Jack Reed, President Biden needs to take long overdue steps toward keeping firearms out of the hands of dangerous people, crack down on gun trafficking, and invest significant funding in mental health and school safety measures.

    How Gun Violence can be prevented

    In May 2022, a horrific incident happened in Texas Elementary School which suggests that gun violence issue needs to be taken seriously and politicians and leaders across the country need to make strict laws when it comes to gun access. Addressing mental health issues in the communities and removing stigma related to mental health issues is a critical component. Nurses can play an important role by joining professional organizations to address this issue.

    Nurses can join ANA and the American Academy of Nursing as it supports nurses’ engagement with family and community health screening, counseling work, and prevention training. In June 2023, ANA built upon its long-lasting advocacy with a resolution recommending heightened support and legislation, improved mental health services, and research specific to the healthcare arena. ANA has a large campaign related to violence against nurses in the workplace thus joining ANA will also help create more awareness about this issue and build networking to fight against this issue.

    References

    Sheehan, A. (2024). Nursing Power through Advocacy. Advocacy 101: Staying Connected with Your Legislators. 
    Pediatric Nursing
    , 
    50
    (3), 143–146. 
    https://doi.org/10.62116/PNJ.2024.50.3.143
    Links to an external site.

    Office of Disease Prevention and Health Promotion. (n.d.). 
    Social determinants of health
    . Healthy People 2030; Office of Disease Prevention and Health Promotion. https://health.gov/healthypeople/priority-areas/social-determinants-health
    https://nihcm.org/publications/gun-violence-the-impact-on-society
    Links to an external site.

    Gartley, C. E. (2023, November 4). 
    The role of nurses in firearm safety
    . American Nurse. https://www.myamericannurse.com/the-role-of-nurses-in-firearm-safety/

    Black Americans want new gun laws to curb gun violence. Trump offers more police. (2017, October 12). 
    Washingtonpost.com
    . 
    https://link.gale.com/apps/doc/A509302219/OVIC?u=minn4020&sid=ebsco&xid=da661830
    Links to an external site.

    BIDEN SIGNS SWEEPING GUN VIOLENCE PREVENTION BILL INTO LAW. (2022, June 25). 
    States News Service 
    NA. https://link.gale.com/apps/doc/A708422887/EAIM?u=minn4020&sid=ebsco&xid=647ab7a1

     

     

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    Amy Simmons

    Aug 28, 2024 6:54pm
    | Last reply Aug 31, 2024 11:10am

    Reply from Amy Simmons

    Main Post 

     

          Prescription Drug Prices

                Prescription drug costs have emerged as a significant concern in presidential discussions, mirroring the public’s growing anxiety about the increasing price of medications in the U.S. The debate centers on ways to lower drug costs for consumers while allowing pharmaceutical companies to continue investing in research and development. Although this issue has received support from both political parties, their proposed solutions can differ widely. It remains a key focus in healthcare reform debates, with many voters considering it a critical priority. 
    According to Vincent Rajkumar (2020), about 25% of American citizens struggle to pay for their medications, which, in turn, causes those Americans to be non-compliant, increasing their healthcare needs and costs due to the worsening of their health conditions.

                  
    Present Presidents Approach

                 Our current President, Joe Biden, views health care as a fundamental right rather than a luxury, which I completely agree with. From the outset, he has expanded access to health care for millions of Americans and worked to reduce costs. He remains committed to enhancing and safeguarding Medicare, Medicaid, and the Affordable Care Act. Due to the President’s initiatives, more Americans have health insurance compared to any previous administration. This commitment is reflected in his support for legislation like the American Rescue Plan Act and the Inflation Reduction Act, aimed to decrease prescription drug prices and lower monthly health insurance costs (The White House, 2022).

    Past President’s Approach

                Trump consistently spoke out about the high costs of prescription drugs, aiming at pharmaceutical companies and pharmacy benefit managers. Although he made the issue a focal point in political discourse, his administration made limited strides in reducing drug prices. The Trump administration tried to get the co-pays lowered to $35 for Americans with Medicare and Medicaid, but even that was ultimately denied. The Trump administration has faced many challenges meeting major campaign promises, especially those requiring legislative or administrative changes (Levitt, 2024).

    What could be Done Differently? 

                
    As an advanced practice provider, I will advocate for legislative and policy changes to lower drug prices and express support for bills allowing Medicare to negotiate drug prices, increase transparency, or promote generics and biosimilars. I will educate patients on the importance of preventative care, medication compliance, and healthy lifestyles to keep healthcare costs to a minimum Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

     

    References

    Levitt, L. (2024, February 15). 
    What would another Trump presidency 
    mean for health care?
     JAMA Health Forum. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815369

    The White House. (2022, October 14). 
    Executive order on lowering prescription drug costs for Americans
    . The White House. 
    https://www.whitehouse.gov/briefing-room/presidential-
    Links to an external site.
     actions/2022/10/14/executive-order-on-lowering-prescription-drug-costs-for-americans
    /

    Vincent Rajkumar, S. (2020). The high cost of prescription drugs: Causes and solutions. 
    Blood Cancer Journal
    , 
    10
    (6). https://doi.org/10.1038/s41408-020-0338-x

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    John Dulko
     (He/Him)

    Aug 28, 2024 6:35pm

    Reply from John Dulko

    The topic considered that rises to the presidential agenda is mental health. Kirkbride et al. (2024) assert that the social determinants of mental health are socioeconomic disadvantage, early life adversity, childhood adversity, migration, ethnoracial discrimination, inequalities experienced by the LGBTQ+ community, sex-based inequalities, loneliness and social isolation, neighborhood socioeconomic disadvantage and inequality, social capital, fragmentation, and ethnic density, and physical environment.

    A limiting factor for any project is money. The Biden administration funded several projects to expand access to mental health services. Some of these services include the 988 Suicide and Crisis Lifeline, FindSupport.Gov, the Mental Health at Work Initiative launched by the Department of Labor, the Workplace Stress Toolkit rolled out by the Occupational Safety and Health Administration (OSHA), the TodayIAm Campaign for veterans’ mental health, and the 24/7 hotline, 1-833-TLC-MAMA (The White House, 2023). All these efforts aimed to increase access to care and offer resources, which was made possible by the Biden administration’s funding and support.

    The Trump administration also offered funding for mental health improvement in the United States. “The President allocated approximately $425 million in emergency funds to address mental and substance abuse disorders” (The White House 2020). The Trump administration also repealed the individual mandate of the Affordable Care Act, declared the opioid crisis a public health emergency, signed the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act, and released emergency grants to states to improve access to treatment for substance use disorders and other mental illnesses during the COVID-19 pandemic (The White House 2020).

    Walden University (2020) recommends strengthening system capacity, connecting more Americans to care, and supporting Americans by creating healthy environments to improve the mental health crisis in the United States. In addition to what has already been done to improve access to care during the Trump and Biden administrations, all health plans could cover behavioral health services, and some could offer three visits per year without a copay. Another suggestion is to embed these professionals within the community, such as libraries, community centers, and homeless shelters. Telehealth services also must be invested in to improve access to care. To create healthy environments, the effect of social media should be studied, and the number of early childhood and school-based interventions should be increased (Walden University 2020).

     

     

    References

    Kirkbride, JB., Anglin, D.M., Colman, I., Dykxhoorn, J., Jones, P.B., Patalay, P., Pitman, A., Soneson, E., Steare, T., Wright, T., Griffiths, S.L. (2024) The social determinants of mental health and disorder: evidence, prevention and recommendations. 
    World Psychiatry
    , 23(1):58-90. 10.1002/wps.21160.

    Walden University. (2022). America’s agenda for addressing the mental health crisis. Walden University. https://www.waldenu.edu/online-doctoral-programs/phd-in-clinical-psychology/resource/americas-agenda-for-addressing-the-mental-health-crisis

    The White House. (2023, May 18). 
    Fact sheet: Biden-Harris administration announces new actions to tackle nation’s mental health crisis
    . The White House. Retrieved August 28, 2024, from https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/18/fact-sheet-biden-harris-administration-announces-new-actions-to-tackle-nations-mental-health-crisis/

    The White House. (2020, October 5). President Donald J. Trump is safeguarding Americans’ mental health and preventing the tragedy of suicide. The White House. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/ Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

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    QF

    Qiana Felder

    Aug 28, 2024 3:58pm
    | Last reply Aug 30, 2024 9:21pm

    Reply from Qiana Felder

    Topic

    The healthcare issue I chose is mental health, a pressing concern in the United States. Shockingly, nearly 50 million Americans are currently dealing with mental health issues, with over half of them not receiving any treatment (Mental Health America, 2022). This alarming trend persists due to various barriers, including limited coverage and socioeconomic status, making mental health a significant problem within our communities.

    Current President’s Approaches

    Current: The Biden administration has taken some necessary steps to prioritize mental health. In 2022, the administration launched the nationwide 988 hotline to ensure people could access support for mental health crises and suicide prevention more easily. President Biden also made more funding available for school-based mental health services and proposed a rule to make it easier for schools to bill Medicaid by reforming the billing processes (Affairs, 2023). Lastly, he intends that all insurance plans cover behavioral health services, including at least three visits yearly (The White House, 2022).

    Past President’s Approaches

    An emphasis was placed on improving mental health and the opioid crisis during the Trump administration. Legislation was signed to address mental health and substance abuse disorders, which allocated emergency funds to improve access to treatment (The White House, 2020). An executive order was also signed to make suicide prevention a priority for veterans. In addition, he signed the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT). This law increases access to treatment for citizens with mental health and substance abuse disorders.

    What Could Be Done Differently

    I see the impact of mental health far too often working as a nurse. Both Presidents have accomplished a great deal of change to improve the crisis. However, the need for more comprehensive mental health services is urgent. Mental health services would benefit from being integrated into primary care practices to make it easier for a behavioral health and primary care team to collaborate on the patient’s needs. Integrating care would also eliminate the need for the patient to find a provider, which can be stressful. With the available funding, the focus should be on prevention and awareness. More public health campaigns should be utilized to educate and reduce the stigma around mental health to encourage people to get treatment and the support they need.

     

    References

    Affairs (ASPA), A. S. for P. (2023, September 25). 
    Biden-Harris Administration Announces More Than $200 Million To Support Youth Mental Health
    . HHS.gov. https://www.hhs.gov/about/news/2023/09/25/biden-harris-administration-announces-more-than-200-million-support-youth-mental-health.html

    Mental Health America. (2022). 
    Quick Facts and Statistics About Mental Health
    . Mental Health America. https://mhanational.org/mentalhealthfacts

    The White House. (2020, October 5). 
    President Donald J. Trump Is Safeguarding Americans’ Mental Health and Preventing The Tragedy of Suicide – The White House
    . Trumpwhitehouse.archives.gov. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/

    The White House. (2022, March 1). 
    FACT SHEET: President Biden to Announce Strategy to Address Our National Mental Health Crisis, As Part of Unity Agenda in his First State of the Union
    . The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/

     

     

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    LA

    Lailat Andu

    Aug 28, 2024 9:11am
    | Last reply Aug 31, 2024 3:44pm

    Reply from Lailat Andu

    Opioid Epidemic

    Opioid abuse presents a significant challenge to the public, requiring a multifaceted response that includes education, direct patient care, and public health interventions. It is a crisis that has been described as a public health emergency, with more than 70,000 overdose deaths recorded in 2019 alone, largely driven by synthetic opioids like fentanyl (Scholl et al., 2020). I believe the opioid epidemic underscores the need for a comprehensive approach to population health strategies to address the root causes of the opioid epidemic. Numerous socioeconomic factors, such as economic instability and access to healthcare, have been identified to have a major impact on the opioid epidemic. Implementing comprehensive healthcare reforms that ensure coverage for addiction treatment services is also vital to curbing opioid epidemics (Bachhuber et al., 2023).

     

    Social Determinant

    Economic Instability plays a crucial role in the opioid epidemic by exacerbating vulnerabilities that lead to substance misuse. Patients facing unemployment, low wages, and poverty often experience chronic stress, anxiety, and feelings of hopelessness, which can increase the likelihood of turning to opioids as a coping mechanism. Economic hardships also limit access to education and job opportunities, creating a cycle where patients are trapped in environments with fewer prospects for upward mobility. In economically distressed communities, the lack of resources and support systems further contributes to the spread of opioid misuse, as people have fewer avenues for seeking help and more exposure to drug use.

    Access to Healthcare is another key factor influencing the opioid epidemic. Patients in economically unstable situations often lack health insurance or have limited access to healthcare services, including mental health and substance abuse treatment. This barrier prevents early intervention, leading to the progression of addiction and increasing the risk of overdose. Even when healthcare is available, stigma, cost, and transportation issues can prevent patients from seeking or maintaining treatment. The lack of accessible, affordable, and integrated healthcare services exacerbates the opioid crisis by leaving many without the necessary support to recover and manage their addiction.

    Presidential Response to Opioid Epidemic

    Both President Joe Biden and former President Donald Trump have addressed the opioid epidemic as a significant public health issue, but they have taken different approaches based on their administrations’ priorities, strategies, and political contexts.

    PLACE YOUR ORDER NOW

    President Trump’s approach to the opioid crisis focused heavily on law enforcement, border security, and public health emergency declarations. Here are some key aspects; In October 2017, Trump declared the opioid crisis a public health emergency. This declaration allowed for the mobilization of resources and directed federal agencies to prioritize the crisis, though it did not unlock significant new funding. President Trump emphasized the need to strengthen law enforcement and border security to combat the influx of illegal opioids, particularly fentanyl, from other countries like Mexico and China. His administration increased funding for the Drug Enforcement Administration (DEA) and other agencies to crack down on drug trafficking. His administration also focused on prosecuting opioid manufacturers and distributors that were believed to be contributing to the crisis. He Also launched multiple public awareness campaigns to educate Americans about the dangers of opioid abuse, often framing it within the context of law and order. The campaigns emphasized the importance of prevention, and the risks associated with opioid misuse.

    President Biden’s administration’s approach to the opioid crisis has been more focused on public health, treatment, and harm reduction, while also maintaining an emphasis on law enforcement and border security. Under President Biden’s administration, the American Rescue Plan allocated significant funding to address the opioid crisis, including $4 billion for behavioral health and substance use disorder services. This funding aimed to expand access to treatment, recovery services, and harm reduction programs. The administration has also emphasized harm reduction strategies, such as supporting syringe service programs, expanding access to naloxone, and advocating for medication-assisted treatment (MAT) for opioid use disorder. Biden’s approach is more public health-oriented, focusing on reducing the stigma associated with addiction and ensuring that those affected have access to the care they need. President Biden’s administration also focused on reducing overdose deaths by promoting overdose prevention sites, supporting community-based interventions, and ensuring that emergency medical services are equipped to respond to overdoses.

    I believe both of the last two presidential approaches to the opioid pandemic are very good. However, I would have combined the two approaches with more funding allocated to prevention and treatment for opioid abuse. A study by Volkow and Blanco (2021) highlights that improving physician training on pain management and the risks of opioid addiction can significantly reduce the number of new cases of opioid misuse. I believe curbing the opioid pandemic requires a holistic approach that combines prevention, treatment, harm reduction, and policy reform. By addressing the issue from multiple angles, society can reduce the incidence of opioid misuse and provide support to those affected by addiction.

    References

    Bachhuber, M. A., et al. (2023). Healthcare reform and opioid use disorder: A review of evidence. Journal of Substance Abuse Treatment, 146, 108-115. https://doi.org/10.1016/j.jsat.2023.01.012

     

    Centers for Disease Control and Prevention. (2022). Prescription drug monitoring programs (PDMPs). Retrieved from https://www.cdc.gov/drugoverdose/pdmp/index.html

     

    Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2020). Drug and opioid-involved overdose deaths—United States, 2013–2019. Morbidity and Mortality Weekly Report, 69(11), 290–297. https://doi.org/10.15585/mmwr.mm6911a4

     

    Volkow, N. D., & Blanco, C. (2021). The changing opioid crisis: Development, challenges, and opportunities. Molecular Psychiatry, 26(1), 218-233. https://doi.org/10.1038/s41380-020-00841-6

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    Julia N Taylor

    Aug 28, 2024 7:57am
    | Last reply Aug 30, 2024 2:04pm

    Reply from Julia N Taylor

    More than 1.8 million new cancer cases are expected to be diagnosed. About 607,000 Americans are expected to die of cancer in 2024, which translates to about 1,660 deaths per day, of which lung cancer makes up almost 25% of all cancer deaths (American Cancer Society [ACS], 2020a; ACS, 2020b). The estimated national expenditures for cancer care in 2017 were $147.3 billion (National Cancer Institute [NCI], 2018). The cost of treatment significantly impacts patients when deciding which treatment to use. The question is proposed which is safer and more cost-effective, alternative medication and/or conventional treatment for lung cancer, with the intent of comparing their effectiveness. Both cancer treatment approaches are beneficial and available; therefore, exploring treatment options using evidence-based sources and provider recommendations is critical. The clinical issue is the existence of competing options in treating lung cancer. People with cancer are interested in trying anything that may help them. Some people prefer alternative medication and others conventional treatment because each approach has benefits and limitations that suit the preferences or perceptions of an individual (Johnson, Park, Gross, & Yu, 2018a).

    Biden-Harris Administration’s goal is to reduce the cancer death Rate by at least 50 % over the next 25 years and improve the experience of living with and Surviving Cancer. This administration is said to put up $150 million in new federal funding to develop technology to help surgeons successfully remove cancerous tumors (white house). The issue is important in healthcare because a more practical option needs to be identified and recommended. Lung cancer has ravaged the population in terms of deaths and illnesses. Therefore, there is a need to identify effective evidence-based solutions to help the patients (ACS, 2020).

    While President Biden tried to reduce the cancer death rate, Former President Trump stated, “We’re going to get to the cure for cancer and Alzheimer’s and so many other things.” (med page today). I feel if finding the cure for cancer was that easy, then it would have been done a long time ago. Looking back on this administration, Trump talked a good game when he spoke about finding the cure for cancer, but it doesn’t seem as though he took it seriously. I say this because Trump is a money guy, and there is no money in the cure, but it is in the treatment. So the question remains: was his statement from the heart, or was it something his team put together for him to say? Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

    As cancer is a terrifying disease, and patients would be interested in anything that may help, the existence of competing options for curing the disease or achieving good palliation increases the dilemma and anxiety when deciding the treatment approach that needs to be used. I personally would explore different treatment options, such as alternative medication versus other conventional treatments, which are widely used and likable treatment approaches, with the intent of comparing their effectiveness on lung cancer. Evidence supports the use of AM compared to CCT, but more research with more excellent quality and evidence supports CCT over AM. The unintended finding on this topic is that using CCT combined with AM is the most effective approach for treating lung cancer because CCT is more effective in reducing tumors. At the same time, AM is more appropriate for enhancing general wellness during treatment.

     

    American Cancer Society. (2020a). Cancer facts & figures 2020. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

    American Cancer Society (2020b). Key statistics for lung cancer. 
    https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html
    Links to an external site.

    Johnson, S. B., Park, H. S., Gross, C. P., & Yu, J. B. (2018a). Use of alternative medicine for cancer and its impact on survival. JNCI: Journal of the National Cancer Institute, 110(1), 121-124. 
    https://doi.org/10.1093/jnci/djx145
    Links to an external site.

    https://www.medpagetoday.com/washington-watch/electioncoverage/111158

    National Cancer Institute. (2018, April 27). Cancer Statistics. 
    https://www.cancer.gov/about-cancer/understanding/statistics
    Links to an external site.

    https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/02/fact-sheet-president-biden-reignites-cancer-moonshot-to-end-cancer-as-we-know-it/

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    MM

    Miriane Meigueu

    Aug 28, 2024 7:46am
    | Last reply Sep 1, 2024 1:22am

    Reply from Miriane Meigueu

    The rising cost of healthcare has been a persistent and significant issue in the United States, frequently reaching the presidential agenda due to its profound impact on the nation’s overall well-being (Galvani et al., 2020). Among the various social determinants of health, economic stability stands out as the most critical factor influencing this issue. The ability of individuals and families to afford healthcare services directly affects their access to necessary medical care, preventive services, and overall health outcomes. When healthcare costs are prohibitively high, it exacerbates health disparities, particularly among low-income populations, leading to worse health outcomes and increased mortality rates. Economic stability, or the lack thereof, plays a pivotal role in determining whether individuals can afford insurance, pay for out-of-pocket expenses, or access necessary treatments without facing financial ruin (Rahman et al., 2022). This determinant directly impacts the overall health of the population, making it a crucial focus area in addressing the cost of healthcare.

    In addressing the cost of healthcare, two recent U.S. presidents, Barack Obama and Donald Trump, approached the issue with differing policies and strategies. President Obama’s approach was primarily centered around the Affordable Care Act (ACA), which aimed to increase access to healthcare while attempting to control costs. The ACA expanded Medicaid eligibility, established health insurance marketplaces, and provided subsidies to make health insurance more affordable for low- and middle-income individuals (Terrizzi et al., 2022). One of the ACA’s significant achievements was its provision preventing insurance companies from denying coverage based on pre-existing conditions, thereby improving access to care for many Americans. However, while the ACA made strides in increasing coverage, it did not fully address the rising costs of healthcare services and prescription drugs, which continued to burden many Americans.

    On the other hand, President Donald Trump’s administration sought to dismantle many aspects of the ACA, arguing that it imposed excessive government regulation and led to increased premiums for many consumers. Trump’s approach included efforts to repeal the ACA, which ultimately failed in Congress, and the promotion of short-term health plans and association health plans as more affordable alternatives (Levitt, 2024). These plans, however, often provided less comprehensive coverage, leaving consumers vulnerable to high out-of-pocket costs. Additionally, Trump signed executive orders aimed at increasing price transparency in healthcare and reducing prescription drug costs, but these measures had limited impact on the overall cost trajectory of healthcare in the United States.

    While both presidents addressed the issue of healthcare costs, their approaches highlight the complexity of the problem and the challenge of finding a comprehensive solution. The ACA’s expansion of coverage was a significant step forward, but it fell short in controlling the underlying factors driving healthcare costs, such as high prices for services, administrative expenses, and prescription drug prices. Conversely, Trump’s emphasis on deregulation and market-driven solutions failed to provide meaningful relief for those struggling with high healthcare costs, as these measures did not address the systemic issues contributing to the problem (Vogenberg & Marcoux, 2018).

    If I were to approach the issue of healthcare costs differently, I would advocate for a multi-faceted strategy that addresses both the affordability and the underlying cost drivers of healthcare. First, I would prioritize the implementation of a public option within the existing healthcare framework. A public option would provide consumers with a government-run insurance plan that competes with private insurers, potentially driving down premiums and out-of-pocket costs through increased competition (Geruso & Layton, 2020). This approach would maintain the consumer choice inherent in the current system while providing a more affordable alternative for those struggling to afford private insurance.

    Additionally, I would focus on addressing the underlying cost drivers in the healthcare system. This would include efforts to negotiate lower prices for prescription drugs, as well as implementing payment reforms that incentivize value-based care rather than fee-for-service models. By shifting the focus from the volume of services provided to the quality and outcomes of care, healthcare providers would be encouraged to deliver more efficient and effective care, ultimately reducing costs. Finally, I would invest in preventive care and public health initiatives aimed at addressing the social determinants of health that contribute to high healthcare costs. By improving access to preventive services, promoting healthy behaviors, and addressing factors such as housing, education, and food security, we can reduce the incidence of chronic diseases and other costly health conditions, ultimately lowering the overall demand for healthcare services and reducing costs. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

    References

    Galvani, A. P., Parpia, A. S., Foster, E. M., Singer, B. H., & Fitzpatrick, M. C. (2020). Improving the prognosis of health care in the USA. 
    The Lancet
    , 
    395
    (10223), 524–533. 
    https://doi.org/10.1016/s0140-6736(19)33019-3
    Links to an external site.
    .

    Geruso, M., & Layton, T. J. (2020). Selection in health insurance markets and its policy remedies. 
    The Journal of Economic Perspectives
    , 
    31
    (4), 23–50. 
    https://doi.org/10.1257/jep.31.4.23
    Links to an external site.
    .

    Levitt, L. (2024). What would another Trump presidency mean for health care? 
    JAMA Health Forum
    , 
    5
    (2), e240262. 
    https://doi.org/10.1001/jamahealthforum.2024.0262
    Links to an external site.
    .

    Rahman, T., Gasbarro, D., & Alam, K. (2022). Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature. 
    Health Research Policy and Systems
    , 
    20
    (1). 
    https://doi.org/10.1186/s12961-022-00886-3
    Links to an external site.
    .

    Terrizzi, S., Mathews-Schultz, A. L., & Deegan, M. M. (2022). State versus federal health insurance marketplaces: A bigger deal for Medicaid and a smaller deal for the individual mandate. 
    Health Policy OPEN
    , 
    3
    , 100059. 
    https://doi.org/10.1016/j.hpopen.2021.100059
    Links to an external site.
    .

    Vogenberg, F. R., & Marcoux, R. (2018, September 1). 
    Challenges to the U.S. health care system from legal and regulatory changes in the Donald Trump era
    . PubMed Central (PMC). 
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110638/
    Links to an external site.
    .

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    Chhinderpal Kaur

    Aug 28, 2024 5:54am
    | Last reply Aug 29, 2024 3:36pm

    Reply from Chhinderpal Kaur

    Presidential Issue

    One of the topics of presidential concern is mental health. Mental health is a subject that has grown over the decades and gained much awareness among populations. In the USA, mental health is an important part of everyday life and therefore must be given the attention it deserves. According to a study by the Centers for Disease Control and Prevention (CDC), about 51 million US adults 18 years and above were suffering from a mental illness in 2019 (McKnight-Eily, 2021). According to the same report, the COVID-19 pandemic contributed to an increase in mental disorders, with 40.9% of people aged 18 and above reporting having mental issues during the pandemic (McKnight-Eily, 2021).

    Related Social Determinants of Health

    According to Santamaria-Garcia et al. (2020), there are negative and positive factors that influence mental health. In the research, adverse factors include different forms of violence, inadequate access to resources, and discrimination (Santamaria-Garcia et al., 2020). Positive aspects include social and family support (Santamaria-Garcia et al., 2020). Another study by Anglin et al. (2021) identifies broader factors including neighborhood, trauma, racial disparities in antenatal and postnatal care, and discrimination. The study further discusses these in broader detail as social determinants of health that are related to psychosis in the USA.

    Actions of USA presidents

    President Donald Trump

    During his presidency, Donald Trump implemented several initiatives and policies related to mental health in the United States. First, he signed into law the SUPPORT Act, which stands for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities. This Act addressed mental health by targeting opioid use which usually is a cause for mental health disorders. Second, he signed an executive order creating  PREVENTS (President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide). This service was targeted to help veterans cope by improving their access to mental health services to reduce suicide rates among them. Lastly, he improved mental healthcare in schools to help in diagnosing and treating mental health issues in school-going students after the Parkland shooting of 2018 (Yan et al., 2021).

    President Joe Biden

    In 2021, The American Rescue Plan (ARP) was signed as an initiative to improve American health care by increasing funding for mental health due to the increase in mental illnesses posed by the Covid 19 pandemic. This initiative was meant to benefit especially the underserved communities as they were the most affected by the pandemic.  The ARP also addressed funding for mental health care accessibility in schools. A second initiative by Biden was that he supported the full implementation of the 988 Suicide & Crisis Lifeline, which launched in July 2022. The hotline is toll-free and meant to help people 24/7 get access when they are in a mental crisis or are suicidal. President Biden also addressed the Surgeon General Advisory on Mental Health by directing funds toward mitigating issues such as bullying and social media that cause mental illnesses among the youth (Mezuk et al., 2022).

    What I Would Do Differently

    Mental health according to my understanding, begins at the basic unit of society, which is a family. I would focus my interventions on the community level. I would increase access to mental health services in the community and make them affordable. I would increase community mental health workers to improve mental health service delivery. This will help to address other factors that lead to mental illnesses at the community level which will generally improve health outcomes.

    References

    Anglin, D. M., Ereshefsky, S., Klaunig, M. J., Bridgwater, M. A., Niendam, T. A., Ellman, L. M., … & van der Ven, E. (2021). From womb to neighborhood: a racial analysis of social determinants of psychosis in the United States. American Journal of Psychiatry, 178(7), 599-610. https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2020.20071091

    Mezuk, B., Maust, D., & Zivin, K. (2022). A Response to the President’s Call to Support Public Mental Health. American journal of preventive medicine, 63(4), 660-663.

    McKnight-Eily, L. R. (2021). Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 pandemic—United States, April and May 2020. MMWR. Morbidity and mortality weekly report, 70. https://www.cdc.gov/mmwr/volumes/70/wr/mm7005a3.htm?ACSTrackingID=USCDC_921-DM48285&ACSTrackingLabel=This%20Week%20in%20MMWR%20-%20Vol.%2070,%20February%205,%202021&deliveryName=USCDC_921-DM48285

    Santamaría-García, H., Baez, S., Gómez, C., Rodríguez-Villagra, O., Huepe, D., Portela, M., … & Ibanez, A. (2020). The role of social cognition skills and social determinants of health in predicting symptoms of mental illness. Translational psychiatry, 10(1), 165. https://www.nature.com/articles/s41398-020-0852-4 Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

    Yan, B. W., Hsia, R. Y., Yeung, V., & Sloan, F. A. (2021). Changes in mental health following the 2016 presidential election. Journal of general internal medicine, 36, 170-177. https://link.springer.com/article/10.1007/s11606-020-06328-6

    Expand discussion thread from Chhinderpal Kaur

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    Romel Suason

    Aug 27, 2024 11:45pm
    | Last reply Sep 1, 2024 9am

    Reply from Romel Suason

    Covid 19 Pandemic

     

    I will be discussing Covid 19 Pandemic. This is the topic I chose because Covid19 started when President Trump was still in office and ended in the President Biden Administration. Covid 19 crippled the whole world. Crashed economies of multiple countries. People resorted to using social media platforms to get their opinions across to family, friends, government agencies and the whole world.

     

    President Donald Trump initial Approach

    President Trumps saved millions of lives because of his decisive response to Corona Virus Pandemic. Even with all the negative and positive feedback from a lot of people he stopped unnecessary travel to foreign countries. A Corona Virus task force was immediately created to guide the country and everyone to prevent the spread of the virus. President Trump made sure that front line workers have all the necessary equipment (PPE, Gloves, Mask and Face shield) to protect frontline workers and their families and everyone. At first very little was known about Corona Virus.

     

    President Joseph Biden

    President Biden followed through with what President Donald Trump started. Testing sites were doubled. He made sure that social distancing was Implemented, vaccines, test kits were made available to everybody. Families, Schools, Small Businesses were guided properly on how to combat Corona Virus. The Biden Administration invested $25 billion dollars in vaccine manufacturing and distribution plan that it will get to all the states, cities and families. Elderly and immune compromised people were protected to reduce the mortality rate. Prepared for any pandemic threats that may or may not happen.

    Reflections

    I respect and believe both President Trump and President Biden did what they think was necessary to prevent the Spread of this deadly disease. They have succeeded in preventing this disease from getting worst.

    Being a Front Liner during the said pandemic. I will always be biased in the protection of health care workers. I have read in the Nursing, Health, & the Environment electronic book that was given to us as one of the references that really struck me.

     

    Among health care providers, registered nurses occupy a unique position. In both rural and urban settings, nurses are often the initial, and sometimes the only, point of contact for people seeking medical care. They are also the largest group of professional health care providers in the United States: an estimated 2.2 million. In occupational health practice, nurses outnumber physicians by six to one. Yet the vast majority of nurses have had no formal training in occupational or environmental health.

    If environmental health hazards and health effects are to be recognized and dealt with effectively, it is of fundamental importance that all health care providers have a clear understanding of the association between the environment and health. Toward that end the committee makes a series of recommendations for the integration and enhancement of environmental health in nursing education, practice, and research.

     

    What I would do differently if I was in the position to make a change is educate people first on how to prevent the spread of an infectious disease. Social media is being utilized for sports, news, music, people’s daily lives and all you can think of. It is part of people’s daily lives now a days. I would urge people from Centers for Disease Control and Prevention to post on every page in Facebook, twitter, Instagram ways to prevent spread of diseases. Rather than report about how many people have been infected. Communities and Schools should have periodic exercises about disease prevention. So, in the in the future if something like this pandemic happens again people will be equipped with the knowledge of prevention. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

     

    Reference

    Institute of Medicine (US) Committee on Enhancing Environmental Health Content in Nursing Practice, Pope, A. M., Snyder, M. A., & Mood, L. H. (Eds.). (n.d.). 
    Nursing health, & environment
    Links to an external site.
    Links to an external site.
    :
    Strengthening the relationship to improve the public’s health.

    https://trumpwhitehouse.archives.gov/issues/coronavirus/
    Links to an external site.

    https://www.whitehouse.gov/priorities/covid-19/
    Links to an external site. 
     Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

  • Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post

    Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post

    Artificial intelligence tools and technologies can enhance the competency of patient assessment by AI-driven algorithms can identify subtle patterns, support different diagnosis, which can improve diagnostic accuracy and effectiveness, especially in complex or high-volume settings.  For example, the new stethoscopes Nurses and Dr.’s use are digital they give a heart rate and rhythm, which in turn sends the reading to a cell phone in which can prevent early signs of deterioration or disease.

    The potential benefits of integrating AI into patient assessment include improved diagnostic accuracy, early detection of diseases, and reduced clinical cognitive overload in high-stress environments. Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post

    Challenges include a lack of transparency and ethical issues, such as patient autonomy. Patient Data must be shared with AI systems. This raises issues of HIPAA compliance, data breach, and confidentiality.

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    In summary, AI can help clinicians perform at a higher level by augmenting core competencies, improving patient outcomes, and reducing disparities; however, ongoing education and intentional design to ensure safe outcomes.  It could have the potential to equip you with advanced digital literacy as a APRN, enhancing clinical fluency.

     

    References

    Khosravi, M., Zare, Z., Mojtabaeian, S. M., & Izadi, R. (2024). Artificial intelligence and decision-making in healthcare: a thematic analysis of a systematic review of reviews.
    Health services research and managerial epidemiology
    , 
    11
    , 23333928241234863

    Li, Y. H., Li, Y. L., Wei, M. Y., & Li, G. Y. (2024). Innovation and challenges of artificial intelligence technology in personalized healthcare. 
    Scientific reports
    , 
    14
    (1), 18994.

    Olawade, D. B., David-Olawade, A. C., Wada, O. Z., Asaolu, A. J., Adereni, T., & Ling, J. (2024). Artificial intelligence in healthcare delivery: Prospects and pitfalls. 
    Journal of Medicine, Surgery, and Public Health
    , 
    3
    , 100108.

     

    Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post response instructions 

    Post to colleague’s main post that is reflective and justified with credible sources. 9 to >8.0 ptsExcellent Point range: 90–100Response exhibits critical thinking and application to practice settings. … Responds to questions posed by faculty. … The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

    8 to >7.0 ptsGood Point range: 80–89Response has some depth and may exhibit critical thinking or application to practice setting.

    7 to >6.0 ptsFair Point range: 70–79Response is on topic, may have some depth.

    6 to >0 ptsPoor Point range: 0–69Response may not be on topic, lacks depth
    Reflection on AI Integration in
    Advanced Practice Nursing week 1 Discussion Post

     

    Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post response

    Reflection on AI Integration in Advanced Practice Nursing

    A superb discussion, Lewis! Your exploration of the application of artificial intelligence (AI) tools and technologies in the healthcare setting is perfectly evaluated. You have highlighted the importance of AI and related technologies in enhancing patient assessment in helping identify major diagnoses accurately, even in settings with huge amounts of data (Bajwa et al., 2021). Through the discussion, you have provided important examples the way AI helps in supporting effectiveness in care provision. For instance, the emerging stethoscopes Nurses and Doctors are digitally linked such that they are able to give heart rate and rhythm, which directly sends these messages to the cellphones, hence helping identify early signs and address them before the disease deteriorates. You have also provided the benefits of linking the AI into patient assessments since it helps in accurate diagnosis, early illnesses detection, and reducing clinical cognitive overload (Maleki, 2024). Additionally, there are evident challenges that arise due to the continued use of AI in healthcare facilities. For instance, AI might lead to a lack of transparency since only a few experts in IT and nurse informatics are able to access these systems. In addition, ethical issues including patient autonomy are at risk since the systems shares patient information with other are providers, hence data breach is possible. Such incidences might harm the continued use of AI systems in care facilities due to issues with HIPPA regulations that ensured patient data of protected (Alhejaily, 2024). Additionally, the AI systems might be hacked and leading to mass losses of essential data for patients and care facilities, which can lead to huge losses and safety issues. The discussion is perfectly written and clearly brings out the importance of AI in clinical settings and its challenges. The most important practice is to ensure there is digital literacy among the APRNs towards improving their clinical fluency. Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post

     

    References

    Alhejaily A. G. (2024). Artificial intelligence in healthcare (Review). Biomedical reports, 22(1), 11. https://doi.org/10.3892/br.2024.1889

    Bajwa, J., Munir, U., Nori, A., & Williams, B. (2021). Artificial intelligence in healthcare: transforming the practice of medicine. Future healthcare journal, 8(2), e188–e194.
    https://doi.org/10.7861/fhj.2021-0095

    Maleki Varnosfaderani, S., & Forouzanfar, M. (2024). The Role of AI in Hospitals and Clinics: Transforming Healthcare in the 21st Century. Bioengineering (Basel, Switzerland), 11(4), 337.
    https://doi.org/10.3390/bioengineering11040337 
     Reflection on AI Integration in Advanced Practice Nursing week 1 Discussion Post

  • Reflection on AI Integration in Advanced Practice Nursing Essay

    Reflection on AI Integration in Advanced Practice Nursing Essay

    Week 1 Discussion Post

    The integration of artificial intelligence (AI) in healthcare offers several potential benefits that can significantly enhance clinical practice. One key advantage is the increased efficiency and precision that AI brings to patient care. By reducing human error, AI facilitates quicker, evidence-based decision-making, which is vital for improving patient outcomes (Li, 2025). Furthermore, advancements such as telemedicine and AI-powered triage platforms have notably improved access to care, particularly for individuals in remote or underserved areas. This is crucial for patients who might otherwise encounter obstacles due to limited healthcare resources (Balakrishnan et al., 2025).

    However, alongside these benefits, there are significant challenges to consider. One of the most critical hurdles is the demand for robust infrastructure; high-quality data and reliable digital systems are essential for AI to function effectively. Unfortunately, these resources are not always available, especially in rural or resource-limited settings (Dankwa-Mullan, 2024). Additionally, trust and transparency are pivotal issues, as many AI systems operate as “black boxes.” This lack of transparency can lead to hesitance among providers who are keen to understand the rationale behind AI-driven decisions (Weiner et al., 2025).

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    Ethical considerations also loom large in the conversation about AI in healthcare. For example, there is a risk of bias and inequity, as algorithms trained on non-diverse datasets may reinforce existing health disparities rather than alleviate them (Gurevich, 2022). Concerns about privacy further complicate the landscape, as the processing of patient information by AI systems raises important questions regarding confidentiality and informed consent. Moreover, accountability remains a pressing issue; when AI recommendations lead to poor outcomes, it becomes unclear who should bear the responsibility—the healthcare provider, the AI system’s developer, or the system itself (Weiner et al., 2025). Hence, addressing these ethical complexities is crucial for ensuring that AI supports safe and equitable care. Reflection on AI Integration in Advanced Practice Nursing Essay

    In summary, while AI holds great promise for improving patient outcomes through early detection and personalized care, it is vital to thoughtfully consider the implications of its integration within the healthcare system.

     

    References

    Balakrishnan, K., et al. (2025). Artificial intelligence in rural healthcare delivery: Bridging gaps and enhancing equity through innovation. 
    ArXiv.
     https://arxiv.org/abs/2508.11738

    Dankwa-Mullan, I. (2024). Health equity and ethical considerations in using artificial intelligence in public health and medicine. 
    Preventing Chronic Disease, 21
    (245). 
    https://www.cdc.gov/pcd/issues/2024/24_0245.htmLinks to an external site.

    Gurevich, E. (2022). Equity within AI systems: What can health leaders expect? 
    Journal of Medical Systems, 46
    (8), 1–9. https://doi.org/10.1007/s10916-022-01787-3

    Li, D. M. (2025). A critical look into artificial intelligence and healthcare. 
    Frontiers in Artificial Intelligence, 8
    , 1545869. https://doi.org/10.3389/frai.2025.1545869

    Weiner, E. B., et al. (2025). Ethical challenges and evolving strategies in the integration of artificial intelligence into clinical practice. 
    ArXiv.
     
    https://arxiv.org/abs/2412.03576Links to an external site.

     

    This criterion is linked to a Learning OutcomeFirst Response:Post to colleague’s main post that is reflective and justified with credible sources. 9 to >8.0 ptsExcellent Point range: 90–100Response exhibits critical thinking and application to practice settings. … Responds to questions posed by faculty. … The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

    8 to >7.0 ptsGood Point range: 80–89Response has some depth and may exhibit critical thinking or application to practice setting.

    7 to >6.0 ptsFair Point range: 70–79Response is on topic, may have some depth.

    6 to >0 ptsPoor Point range: 0–69Response may not be on topic, lacks depth

     

    Discussion Response: Reflection on AI Integration in Advanced Practice Nursing

    Your discussion post offers an insightful and well-balanced overview of the promises and pitfalls of artificial intelligence (AI) integration in healthcare in general, and advanced practice nursing (APN) in particular. While well presented, I would like to further explore that issues identified, particularly the philosophical and systemic dimensions underpinning the technological shift towards AI as it related to equity, epistemology, and the evolving role of clinical judgment.

    First, the discussion post notes that AI-powered tools like triage and telemedicine platforms have expanded care access and improved equity, especially in underserved regions. While this is demonstrated, it is important to interrogate the inclusivity and sustainability of the AI-powered tools. The digital divide has exacerbated health inequities as seen digital literacy, device availability, and internet access disparities. For instance, populations in rural regions may benefit from the use of AI-powered tools, such as AI-driven diagnostics, only of they possess the infrastructure to support such technologies. This then raises concerns regarding whether the AI-powered tools and system are designed with contextual adaptability, or if they are perpetuating a one-size-fits-all model that simply privileges technologically advanced settings (Carroll, 2024). Additionally, the algorithmic bias noted in the discussion is a good point, but can be advanced to indicate that it is not mere a technical flaw, but a reflection of the broader societal inequities. Gurevich (2022) supports these sentiments, highlighting that training datasets may lack representation from marginalized communities, resulting in skewed risk assessments and diagnostic inaccuracies. There is a need to address this through a paradigm shift in data governance towards informed data collection, with a focus on prioritizing participatory design and community.

    Second, the discussion post explores the need to reframe clinical judgement and epistemic authority. Many AI systems have a “black box” nature that introduces a profound epistemological tension in clinical practice. Traditionally, decision-making in the healthcare environment is grounded in the combination of patient narratives, clinical experience, and empirical evidence. By contrast, AI operates using opaque algorithms that may not be aligned with human reasoning. This creates a disconnect that may erode the confidence of clinicians, and compromise shared decision-making (Kudyba, 2022). Weirner et al. (2025) underscore the need to have explainable AI systems, but acknowledge that this is difficult to achieve since it extends beyond a technical challenge to become a philosophical challenge. There is a need for AI to reconcile the machine-generated insights with nuanced, context-dependent nature of human health. A promising solution to this challenge is to develop “human-in-the-loop” models, in which clinical judgement is augmented by, rather than replaced with, AI. This presents a hybrid mode that helps to preserve the epistemic authority of healthcare providers while leveraging the computational strengths of AI (Carroll, 2024).

    Third, the discussion post is salient on ethics and accountability. AI-mediated care diffuses responsibility between institutions, clinicians, and developers. This poses a significant ethical dilemma. There is a need to establish a clear framework for oversight and accountability, and cultivate a culture of ethical reflexivity. This may involve providing ongoing education to clinicians about AI ethics, having transparent communication with patients about AI being involved in their care, and interdisciplinary collaboration between healthcare professionals, ethicists, and technologists (McGonigle & Mastrian, 2024).

    In conclusion, the discussion post makes it evident that AI offers transformative potential for healthcare. However, AI integration must be guided by principles of equity, transparency, and ethics. The goal should not be for AI to replace human care. Rather, the goal should be for AI to be fused in technological innovation, while remaining anchored in justice, context, and compassion. Overall, your discussion post is well presented, but can be improved by including the above mentioned points.

    References

    Carroll, W. (2024).
    Nursing Informatics: Truths, Talent, and Transforming the Future
    . Taylor & Francis.

    Gurevich, E. (2022). Equity within AI systems: What can health leaders expect?
    Journal of Medical Systems, 46
    (8), 1–9.
    https://doi.org/10.1007/s10916-022-01787-3

    Kudyba, S. P. (2022). 
    Healthcare Informatics: Improving Efficiency Through Technology, Analytics, and Management
    . Taylor & Francis Group.

    McGonigle, D., & Mastrian, K. (2024).
    Nursing Informatics and the Foundation of Knowledge
    (6th ed.). Jones & Bartlett Learning.

    Weiner, E. B., et al. (2025). Ethical challenges and evolving strategies in the integration of artificial intelligence into clinical practice.
    ArXiv
    .
    https://arxiv.org/abs/2412.03576

    Reflection on AI Integration in Advanced Practice Nursing Essay

  • NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

    NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

     
    Case Scenario Description and Problem Identification

    A hospital located in an urban area has an emergency room where the reason behind the huge time wastage in recording the patient information was the lack of interconnectivity between the triage entries, vital signs, and the physician’s prescriptions. Such disorder will extend patient wait times and enhance the rate of error in the process of offering care, which infuriates staff and encourages fatigue. Poor record keeping prevents collaboration between nurses and doctors, resulting in overlaps and time wastage (Ibrahim et al., 2022). In order to overcome such barriers, it is crucial to implement technology that assists in flow control of records, fewer repetitive operations, and additional financial outcomes as per the results in the emergency room.

    Technology Identification and Relevance

    Two crucial tools that can be used to solve the problems of processing data and keeping records in a simple way are enhanced EHR systems that are enhanced to facilitate smooth data transfer between platforms or mobile apps that will allow the nurses to make data on the move using voice command. One will enhance precision in medical records and also instill consistency in the understanding of records of care; the other will expedite the flow of patients in the clinics, as it will help the clinics make faster decisions at the point of care. NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

    Advanced EHR Integration with Interoperability Enhancements

    The current networked health records can carry out the automatic synchronization of patient information in the check-in, testing, and treatment areas. Once one team has entered information like temperature, drugs given, or blood test results, then that is shown in the places where it is needed without including the same data. That will decrease the frequency of repetitions and help the doctors, nurses, and specialists keep pace.

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    Accurate Documentation:

    Electronic health records involve better use with automatic upgrading rather than typing some information manually, reducing errors. As an example, as soon as a nurse fills in the background details of a patient, the figures will autofill every place the numbers are required. Physicians access correct information immediately (Murray, 2022). The system also has alerts that identify discrepancies, such as drugs incompatible with others or a lack of allergy records, enabling patient records to be more trustworthy in general.

    Use of Standardized Nursing Data:

    Electronic health records use set nursing terms such as SNOMED CT or LOINC to maintain consistency in notes and increase the compatibility of the system across clinics. At the same time, unified data input improves the cooperation of teams and gives them a chance to analyze big data and achieve better outcomes and insights (Gade, 2021). In EDs, making the data format consistent implies that nurses record the assessment or actions in a similar manner, which does not contribute to confusion, and that can facilitate the reporting of inaccurate rules.

    Improved Individual Patient Outcomes:

    Clinicians can make smarter decisions in real time when they are aware of the entire, updated patient information immediately. Since care is initiated sooner due to instant access that enables them to see the triage records and test results simultaneously, there is no waiting time. This will mean that there will be an increased number of people being seen within a shorter period of time, and the lines in the ER will be reduced, and the more important cases, such as heart attacks or some severe injuries, will be treated, for which time is everything.

    Mobile Nursing Documentation Tools with Voice Recognition

    Mobile documentation solutions enable nurses to record and access patient information in the field of care using a tablet or a handheld device. A voice recognition technology allows even further simplification of this process since nurses can dictate notes directly into the EHR system, preventing the need to lose focus on the patient.

     

    Accurate Documentation:

    Voice-assisted mobile technologies enhance promptness and fulfillment of record-keeping through instantaneity in charting in situ or as soon as the patient is encountered. This reduces the use of memory and post-shift note-taking, eliminating the chance of omissions or lack of accuracy. The research demonstrates that the area of mobile documentation minimizes the average time of documentation, and it also enhances the quality of nursing records (Morgan, 2023).

    Improved Individual Patient Outcomes:

    This will enable nurses to make more time to attend to patients since they are able to save time that would have been spent on keying in data by hand. Live documentation is applied in order to ensure that vital signs and assessments are instantly provided to the entire care team, which enhances the immediate response in cases of emergency. Indicatively, the inappropriate readings that would be typed in the mobile tools would trigger automatic signals to the providers, prompting immediate remedies.

    Population Health Planning:

    Mobile documentation tools make it possible to combine the data and find patterns in patient demographics, conditions, and treatment outcomes to assist in managing population health. They can help us in the allocation of resources and preventive health practices by monitoring the trends of respiratory diseases in the season or the local cases of trauma. These tools are incorporated together with electronic health records (EHR), which increases the data interoperability and precision to enhance the efficiency and safety of emergency departments.

    Technology Analysis and Application

    The identified technology is addressing the slow decision of documents, and the other technology is the correction of broken messages in the ERs. The EHR of the modernized version helps in the smooth flow of the entire patient data, yet the mobile applications speed up the task of treatment where it is provided.

    Documentation Improvement:

    The information between the check-in and release is made easier with the help of the handheld device and its respective health records. As an example, with the assistance of nursing notes, when the workers give the information about the gadgets used around, the information will automatically be transferred to the main server, so there will be no need to repeat the work, though the information about the latest changes will be ready at once for all individuals.

    Data Use and Outcome Enhancement:

    The tracking of live data embedded in EHRs can determine the slow parts of work, including the busiest time during check-in, and base workflow changes on it. The speech-to-text system helps cut down on paperwork and boosts the morale of the staff, which decreases stress and turnover of employees.

    Population Health Impact:

    This data has been consistent and can assist the hospital managers in monitoring the health of the masses, such as the rates of illness or injury, as they attempt to respond promptly. That can be aligned with larger objectives in the healthcare industry: the use of digital data to inform community health-related decisions.

    Ethical and Safe Use Proposal

    Moral guidelines, compliance with rules, and the protection of information are connected with the rollout of these tools, which are aimed at protecting patient rights and ensuring that technologies are used correctly.

    Data Privacy and Confidentiality:

    The two systems are to adhere to the HIPAA regulations as well as the data safety policies of individual organizations. Any data sent or stored must be encrypted to prevent unauthorized persons from viewing it. Role-based entry builds in only allow authorized employees to access private health records.

     

    Risk Mitigation and Security Strategies:

    Staff practice and cybersafety checks should be regularly updated; otherwise, an opportunity to commit fraud, attempts at hacks, or poor management of equipment increases. Rather than using passwords, fingerprints should be used with timed, induced word locks on handheld record systems; in case one is lost, the information is always secured.

    Ethical Standards and Professional Accountability:

    By documenting the data at the appropriate time and place, the nurses would have to do what is good and avoid what is harmful. Training must not be concentrated on the teaching of skills only, but also on the necessity of proper records and the repercussions of wrong or delayed information. And in that regard, hospitals should also have clear policies regarding the applications of voice technology to correct mistakes even before they are even stored in the account of a single patient.

    Legal and Regulatory Considerations:

    The groups are to make sure that their technology suppliers take into account the local demands concerning the communication between the equipment and its safety. These updates of the electronic health record should be in line with the existing laws and the ONC laws on system compatibility. It is necessary to have regulations for phone or tablet applications in patient care; they help maintain concentration and prevent poor etiquette. NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

    Workplace Policy and Ethical Oversight:

    The hospitals ought to have digital oversight solutions, such as recording technology malfunctions and developing ethical boards to screen novel applications. Honesty with the patient regarding data collection creates trust, and it is necessary to focus on the value of the individual choice and consent. Prudent use of digital records and mobile applications can make health groups safer and effective if they are empowered with good values and principles, and avoid the traps of being unable.

     

    Conclusion

    Information management in the emergency rooms is important to provide quality care with improved efficiency and safety. Voice technology combined with connected medical records will increase the accuracy of the records, improve the speed of team communication, and improve patient outcomes (Elhadad et al., 2024). Ethical implementation of the new tools is possible by adhering to regulations and protecting confidential information. With the innovative digital approach and proper management, clinics will modernize emergency treatment and support the health improvement of communities.

    References

    Elhadad, A., Hamad, S., Elfiky, N., Alanazi, F., Taloba, A. I., & El-Aziz, R. M. A. (2024). Advancing Healthcare: Intelligent Speech Technology for Transcription, Disease Diagnosis, and Interactive Control of Medical Equipment in Smart Hospitals. 
    AI
    , 
    5
    (4), 2497-2517.https://www.mdpi.com/2673-2688/5/4/121

    Gade, K. R. (2021). Data-driven decision making in a complex world. 
    Journal of Computational Innovation
    , 
    1
    (1).https://researchworkx.com/index.php/jci/article/view/2

    Ibrahim, I., Sultan, M., Yassine, O. G., Zaki, A., Elamir, H., & Guirguis, W. (2022). Using Lean Six Sigma to improve timeliness of clinical laboratory test results in a university hospital in Egypt. 
    International Journal of Lean Six Sigma
    , 
    13
    (5), 1159-1183.https://www.emerald.com/insight/content/doi/10.1108/IJLSS-08-2021-0138

    Morgan, A. S. (2023). Improving Timeliness of Nursing Documentation.https://arch.astate.edu/dnp-projects/39/

    Murray, L. (2022). 
    Unified Documentation and Information Retrieval for Electronic Health Records
    (Doctoral dissertation, Massachusetts Institute of Technology).https://dspace.mit.edu/handle/1721.1/143410 NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

     

     

    In this assignment, students will create a comprehensive Healthcare Technology Innovation Proposal designed to enhance patient care delivery, data management, and ethical use of technology in healthcare.

    For this assignment, please complete the following steps:

    Step 1: Choose one of the Case Scenarios provided

    Scenario 1: Telehealth Delivery in a Rural Community Health ClinicDownload Telehealth Delivery in a Rural Community Health Clinic

    Scenario 2: Emergency Department Patient Flow and EHRDownload Emergency Department Patient Flow and EHR

    Scenario 3: Social Media Boundaries and Patient PrivacyDownload Social Media Boundaries and Patient Privacy

    *Clearly describe the scenario, in your own words. Identify and describe current challenges related to patient data management, documentation accuracy, population health considerations, and care delivery efficiency.

    Step 2: Technology Identification and Analysis

    Identify two (2) current technologies (e.g., EHR, mobile health apps, telehealth platforms, multimedia communication tools, etc.) relevant to your scenario.

    For each of the two (2) technologies you select, explain how it contributes to at least two (2) of the following:

    Accurate Documentation – Describe how the technology supports clear, timely, and precise clinical documentation (e.g., auto-populated fields, decision-support prompts, error reduction).

    Use of Standardized Nursing Data – Explain how it helps nurses collect or use standardized terminology and classifications to improve consistency and interoperability.

    Improved Individual Patient Outcomes – Discuss how the technology improves patient care at the individual level, such as through better tracking, early detection, personalized care, or clinical decision support.

    Population Health Planning – Describe how data collected from this technology can be used to identify trends, allocate resources, or inform health policy for broader populations.

    Step 3: Ethical and Safe Use Proposal

    Outline a detailed proposal addressing the ethical, responsible, and safe use of your chosen technologies.

    Include specific strategies to mitigate common risks, adhere to professional nursing standards, legal/regulatory requirements, workplace policies, and promote patient rights concerning personal data and medical records. NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

    Guidelines

    Please include a properly formatted APA 7th Edition STUDENT Title PageLinks to an external site. (includes page numbers; NO running head).

    Your submission should be 3-5 pages in length, double-spaced,

    Please include 2-3 scholarly references to support your paper; only 1 reference can be a website (must be credible).

    APA 7th Edition documents should be double-spaced, including the reference page.

    Please use Times New Roman, Arial, or Calibri 12-pt font with 1-inch margins

    Do NOT write in first-person.

    Please use!

    Scenario 2:

    Focus: Data Management

    In a busy urban emergency department, nurses are experiencing delays in documenting care due to poor integration between triage notes, vital signs, and provider orders in the electronic health record (EHR). These delays lead to communication errors, repeated tests, and extended patient wait times, affecting both patient outcomes and staff burnout.

    Challenge: How can improved EHR functions and supporting technologies (e.g., voice

    recognition, mobile documentation tools) streamline documentation and improve patient flow and safety?

    NRSE 4545 – Informatics and Safety Essentials – Healthcare Technology Innovation Project

  • Rising Healthcare Costs and Financial Barriers to Access National Healthcare Issue/ stressor essay

    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Rising Healthcare Costs and Financial Barriers to Access National Healthcare Issue/ stressor essay

     Rising Healthcare Costs

    Rising healthcare costs in the United States represent a significant national issue, impacting healthcare delivery, access, and financial sustainability. In 2023, national health expenditures reached $4.9 trillion, reflecting a 7.5% increase from the previous year and accounting for 17.6% of the U.S. gross domestic product (Centers for Medicare & Medicaid Services [CMS], 2023). Several factors contribute to this escalation, including increased utilization of medical services, higher prescription drug prices, advanced medical technologies, and administrative costs. These rising expenses place financial strain on healthcare systems, patients, and providers, leading to disparities in access and quality of care (Martin et al., 2025). Healthcare organizations face growing pressure to balance cost containment with the delivery of high-quality, patient-centered services.

                                                                                        How It May Impact My Workplace Setting

    Rising healthcare costs directly affect my workplace setting by increasing operational expenses, creating resource limitations, and intensifying staff workload. According to Kiss et al. (2023), budget constraints can lead to staff reductions, limited access to advanced medical technologies, and the postponement of non-urgent services. I have observed increased patient-to-nurse ratios, which compromise the quality of care and elevate the risk of errors. For example, nurses in my unit are often assigned more patients than the recommended ratio, reducing the time available for individualized care. Additionally, financial pressures have resulted in the postponement of equipment upgrades, forcing staff to rely on outdated technology that may hinder efficiency. Rising costs also impact patient access, as many individuals delay care due to high out-of-pocket expenses, leading to worsened health outcomes and increased reliance on emergency services.

    GET A HUMAN-WRITTEN, PLAGIARISM-FREE PAPER 

                                                                                  Social Determinant Most Affecting Healthcare Costs

    Income and socioeconomic status are the social determinants most significantly affecting the impact of rising healthcare costs. Individuals with lower incomes often struggle to afford healthcare services, medications, and insurance premiums, leading to delayed or foregone care. According to the Kaiser Family Foundation (2023), nearly one in four adults in the U.S. reported skipping or delaying medical care in the past year due to cost concerns. This financial barrier disproportionately affects vulnerable populations, exacerbating health disparities and increasing the demand for safety-net services. Geographic location also influences healthcare access, particularly in rural areas where medical facilities may be scarce, and travel expenses further complicate access to care. These social determinants contribute to a cycle of poor health outcomes and increased healthcare utilization, placing additional strain on the healthcare system.

                                                                  How My Healthcare System Has Responded to the Healthcare Issue and Changes

    My healthcare system has implemented several strategies to address rising healthcare costs while maintaining quality care. One significant initiative includes the adoption of value-based care models, which focus on improving patient outcomes while controlling costs (Leao et al., 2023). This approach incentivizes providers to deliver evidence-based, efficient care, reducing unnecessary procedures and hospital readmissions. In my workplace, multidisciplinary care teams have been established to coordinate treatment plans, improving communication and reducing duplication of services. Telehealth services have also been expanded, allowing patients to access care remotely, which reduces operational costs and improves patient convenience. For instance, the implementation of virtual follow-up appointments for chronic disease management has decreased hospital readmissions by 15% over the past year.

    Additionally, my healthcare system has prioritized staff training on cost-effective care delivery, emphasizing evidence-based practices and resource optimization. Cost-saving measures, such as bulk purchasing of medical supplies and streamlining administrative processes, have been implemented to reduce overhead expenses (Hinrichs-Krapels et al., 2022). Despite these efforts, the facility still faces challenges in balancing cost containment with staff satisfaction and patient-centered care. Continued investment in technology, staff support, and community outreach programs are essential to address the long-term impact of rising healthcare costs on both patients and healthcare providers.

     

                                                                                                                             
    References

    Centers for Medicare & Medicaid Services. (2023). 
    National Health Expenditures 2023 Highlights.
     Health Affairs. 
    https://www.cms.gov/files/document/highlights.pdf
    Links to an external site.

    Hinrichs-Krapels, S., Ditewig, B., Boulding, H., Chalkidou, A., Erskine, J., & Shokraneh, F. (2022). Purchasing high-cost medical devices and equipment in hospitals: a systematic review. 
    BMJ open
    , 
    12
    (9), e057516. 
    https://doi.org/10.1136/bmjopen-2021-057516
    Links to an external site.

    Kaiser Family Foundation. (2024, May 28). 
    Health care affordability: Key facts.
     
    https://www.kff.org/health-costs/issue-brief/health-care-affordability-key-facts/
    Links to an external site.

    Kiss, A., Kiss, N., & Váradi, B. (2023). Do budget constraints limit access to health care? Evidence from PCI treatments in Hungary. 
    International Journal of Health Economics and Management
    , 
    23
    (2), 281-302.  
    https://doi.org/10.1007/s10754-023-09349-w
    Links to an external site.

    Leao, D. L., Cremers, H. P., van Veghel, D., Pavlova, M., & Groot, W. (2023). The impact of value-based payment models for networks of care and transmural care: a systematic literature review. 
    Applied Health Economics and Health Policy
    , 
    21
    (3), 441-466. 
    https://doi.org/10.1007/s40258-023-00790-z
    Links to an external site.

    Martin, A. B., Hartman, M., Washington, B., Catlin, A., & National Health Expenditure Accounts Team. (2025). National Health Expenditures In 2023: Faster Growth As Insurance Coverage And Utilization Increased: Article examines National Health Expenditures in

     

    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Rising Healthcare Costs and Financial Barriers to Access National Healthcare Issue/ stressor essay

    National Healthcare Issue: Rising Healthcare Costs and Financial Barriers to Access

    One of the most pressing national healthcare issues today is the rising cost of healthcare and the financial barriers that prevent patients from accessing necessary medical services. Healthcare costs continue to increase due to factors such as expensive medical technologies, administrative inefficiencies, and the high prices of prescription drugs (Slonim, 2023). These financial burdens disproportionately affect low-income individuals, leading to disparities in health outcomes.

    Impact on Work Setting

    In my healthcare setting, rising costs have led to increased financial strain on patients, resulting in delayed care, medication non-adherence, and higher rates of preventable hospitalizations. Many patients struggle with out-of-pocket expenses, making it difficult to follow through with recommended treatments. Additionally, healthcare providers face administrative challenges related to insurance processing and billing, further complicating patient access to timely care (Carter & Busby, 2023).

    Social Determinants of Health (SDOH) Affecting Healthcare Costs

    Economic stability, insurance coverage, and education play significant roles in patients’ ability to afford healthcare. Uninsured and underinsured individuals are more likely to forego necessary medical care, worsening health conditions over time. Additionally, individuals with lower health literacy may not fully understand their healthcare options or how to navigate insurance systems effectively (Amalberti et al., 2019).

    Health System Response and Implemented Changes

    My healthcare institution has implemented several strategies to address financial barriers to care. One initiative includes expanding financial assistance programs and offering sliding-scale payment options for low-income patients. Additionally, efforts have been made to improve price transparency, ensuring that patients understand the costs associated with their treatments before receiving care.

    Another key initiative has been the integration of value-based care models, which focus on improving patient outcomes while reducing unnecessary healthcare expenditures. By emphasizing preventive care and chronic disease management, the healthcare system aims to lower overall costs and minimize the need for expensive emergency interventions (Slonim, 2023). Furthermore, legislative efforts such as the Affordable Care Act (ACA) have played a critical role in increasing insurance coverage and reducing the number of uninsured individuals (Kominski, Nonzee, & Sorensen, 2017).

    Conclusion

    Rising healthcare costs present a significant challenge to patient access and overall public health. While my healthcare setting has taken steps to mitigate financial barriers, continued policy reforms, investment in preventive care, and efforts to control prescription drug pricing are essential for long-term improvement. Addressing these financial challenges is crucial to ensuring equitable healthcare access for all individuals.

     

    References

    Amalberti, R., Vincent, C., Nicklin, W., & Braithwaite, J. (2019). Coping with more people with more illness Part 1: The nature of the challenge and the implications for safety and quality. 
    International Journal for Quality in Health Care, 31
    (2), 154–158.

    Carter, M. W., & Busby, C. R. (2023). How can operational research make a real difference in healthcare? Challenges of implementation. 
    European Journal of Operational Research, 306
    (3), 1059–1068.

    Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. 
    Annual Review of Public Health, 38
    , 489-505.

    Slonim, A. (2023). Top challenges facing healthcare: Back to basics. 
    Physician Leadership Journal, 10
    (2), 12–14. 
    https://doi.org/10.55834/plj.2064149664
    .

    Xu, T., & Wickizer, T. (2020). The impact of Medicaid expansion on healthcare access, affordability, and financial security for low-income families. 
    Journal of Health Politics, Policy and Law, 45
    (1), 5-27.

     

     

    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Rising Healthcare Costs and Financial Barriers to Access National Healthcare Issue/ stressor essay

    Healthcare issue: The High Cost of Healthcare
     

    For many decades, one of the greatest obstacles facing the US healthcare system has been the exorbitant expense of medical care. It is a major national problem that impacts the economy, families, and individuals (Steinreich, 2022).

    Social determinants of health
     

    The high cost of healthcare has led to significant problems in terms of socioeconomic determinants. Social variables like socioeconomic level, education, insurance coverage, cultural views, and accessibility to medical services are contributing factors to the rising expense of healthcare (KFF, 2025). People in rural areas with little to no access to healthcare facilities, as well as individuals from lower-income families, frequently struggle to get the healthcare they need, which causes delays in treatment and, eventually, higher expenses. The high costs and high percentage of underinsured or uninsured individuals put many people at risk of becoming bankrupt in the event of a catastrophic illness, according to Harvard professor Dr. Shmerling, MD. He also emphasized that the United States does poorly on several key health measures, including life expectancy, preventable hospital admissions, suicide, and maternal mortality, while spending significantly more on healthcare than other high-income nations. In other words, the US healthcare system is not the greatest, despite its high cost. In addition, Americans are dissatisfied with the current state of the healthcare system despite all that investment (Shmerling, 2021).

    How your health system work setting has responded to the healthcare issue
     

    The Division of Public Health in Delaware offers services to uninsured adults and children, as well as those on Medicaid, at minimal or no cost, contingent upon income. We offer cost-effective immunizations for children and treatments for infectious disease control, including tuberculosis for immigrants or anyone at risk of exposure, as well as sexual and reproductive health services. For individuals who lack access to healthcare due to prohibitive costs and limited availability of healthcare facilities, we offer a community mobile unit that operates from Monday to Saturday, providing services such as blood pressure and cholesterol monitoring, HIV and other sexually transmitted disease testing, lead screening, and immunizations.

     
    Conclusion,
     

    Debates on how to address the high cost of
    healthcare issues
    such as insurance reform, government-provided health coverage, drug price regulation, and the sustainability of the healthcare system have been ongoing for decades. Although the Affordable Care Act was introduced, it has had little to no effect on these issues. To guarantee that everyone has access to competent and reasonably priced healthcare without experiencing financial hardship, these issues necessitate comprehensive policy adjustments.

    Telesford, I.
     
    Links to an external site.
    Winger
    Links to an external site.
    , A. & Rae, M. (2024). Beyond cost, what barriers do health care consumers 
     

    face? (Peterson-KFF)
     
    https://www.healthsystemtracker.org/chart-collection/beyond-cost-what-barriers-to
    Links to an external site.
    . (February 24, 2025).
     

     

    Steinreich, D. (2022). Big Med: Megaproviders and the High Cost of Health Care in
     

    America. Quarterly Journal of Austrian Economics, 25(2), 501–528.
     

    https://doi.org/10.35297/qjae.010135
     

     

    Shmerling, R. (2021). Is our healthcare system broken? Harvard Health publishing 
     

    https://www.health.harvard.edu/blog/is-our-healthcare-system-broken-202107132542
    Links to an external site.
     
     (February 24, 2025).
    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Rising Healthcare Costs and Financial Barriers to Access National Healthcare Issue/ stressor essay

  • Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations

    Professional Nursing and State-Level Regulations

    Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

    It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.

    Resources

     

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    To Prepare:

    Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

    Consider how key regulations may impact nursing practice.

    Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.

    By Day 3 of Week 5

    Post
     a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

    By Day 6 of Week 5

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
     and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

     

    Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations

    Main Post

    State and regional boards of nursing (BON) focus on public protection by regulating nursing practice and setting licensing, education, and disciplinary standards. Advanced Practice Registered Nurses (APRNs), who are pivotal in addressing healthcare shortages, face a variety of regulatory environments across states. Due to vested interests and ongoing career involvement in the following three states, this essay compares APRN regulations in California, Oregon, and New York, evaluating differences in their scope of practice. This analysis also examines how these regulations impact APRNs’ ability to practice within their full scope of education and experience.

    Comparison of California and Oregon APRN Regulations

    In California, APRNs operate under restricted practice authority, requiring them to collaborate with physicians for certain tasks, such as prescribing medications. The California Board of Registered Nursing (BRN) mandates that nurse practitioners (NPs) follow standardized procedures under physician oversight when making medical decisions and prescribing controlled substances (California Board of Registered

    Nursing, 2023). For example, NPs in California must have a collaborative agreement with a physician to prescribe medication, which limits their autonomy in clinical decision-making.

    In contrast, Oregon is among the states that grant full practice authority to APRNs. This means APRNs in Oregon can practice independently without needing physician supervision. The Oregon State Board of Nursing (OSBN) allows APRNs to diagnose, treat, and prescribe medications, including controlled substances, without physician oversight, provided they meet licensure requirements (Oregon State Board of Nursing, 2023). The full practice authority enables APRNs to fully use their skills and education, making them more effective in addressing primary care needs, especially in rural areas where physician availability is limited.

    The difference between the two states lies in the extent of APRN autonomy. While California’s regulations are restrictive, requiring physician involvement in key clinical decisions, Oregon’s regulations empower APRNs to provide comprehensive care independently. According to Neff et al. (2018), such regulatory variations have significant implications for patient access to care, particularly in underserved regions. In states like Oregon, with full practice authority, APRNs can fill critical gaps in primary care, while in restrictive states like California, access may be limited by the availability of collaborating physicians.

    Comparison of California and New York APRN Regulations

    New York’s regulations for APRNs are similar to those in California but with some distinctions. In New York, APRNs must collaborate with

    physicians to practice and prescribe medications. However, after completing 3,600 hours of clinical practice, APRNs may apply for a collaborative practice exemption, which allows them to practice more independently but still requires some limitations on prescribing controlled substances (New York State Education Department, 2023). This step towards autonomy significantly differs from California’s more consistently restrictive approach.

    Like California, New York’s semi-restrictive environment challenges APRNs who aim to use their education and training fully. However, the collaborative practice exemption offers more flexibility for experienced APRNs compared to California, where physician oversight is required throughout the APRN’s career. Bosse et al. (2017) argue that full practice authority for APRNs is essential for transforming primary care, as it allows APRNs to practice at the top of their license and meet the growing demand for healthcare services. The semi-restricted environment in New York reflects a step towards this goal, but it still falls short of full practice authority.

    Application of Regulations to Full Scope Practice

    APRNs in states with full practice authority, such as Oregon, can fully utilize their education and training to provide direct patient care. For example, an APRN in Oregon may run an independent primary care practice, diagnosing and managing conditions without needing physician approval. This ability to provide autonomous care is crucial in rural areas where healthcare providers are scarce (Bosse et al., 2017).

    In contrast, APRNs in California must adhere to physician oversight for tasks such as prescribing controlled substances. For example, an APRN in California working in a family practice setting must consult a physician for approval before prescribing certain medications. This supervisory requirement can delay care and limit the APRN’s ability to provide timely treatment (California Board of Registered Nursing, 2023). According to Neff et al. (2018), such restrictions can reduce APRN effectiveness in meeting the population’s healthcare needs, particularly in underserved communities.

    Similarly, APRNs in New York must collaborate with physicians during the initial years of practice. An example would be an NP in New York who, after completing the required 3,600 hours, applies for the collaborative practice exemption, gaining more independence but still facing limitations in prescribing controlled substances (New York State Education Department, 2023). While this provides more autonomy than California’s model, it still restricts the full utilization of APRNs’ education and training.

    Conclusion

    APRNs’ ability to practice within the full scope of their education and training depends heavily on state regulations. While Oregon offers full practice authority, allowing APRNs to practice independently, California and New York impose restrictive and semi-restrictive environments, respectively. These regulations significantly affect patient care and access, particularly in underserved areas. As seen in Oregon, full practice authority enables APRNs to maximize their role in primary care, a model that California and New York may benefit from considering as they evaluate their regulatory frameworks. With autonomy and the maximization of services being the goal, it is in my best interest as a clinician to leave California and practice as an APRN in Oregon after completing the advanced degree program.

    References

    Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765.

    California Board of Registered Nursing. (2023). Advanced practice registered nurse: Nurse practitioner practice. https://www.rn.ca.gov/

    Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385.

    New York State Education Department. (2023). Nurse practitioner. https://www.op.nysed.gov/registered-professional-nursing

    Oregon State Board of Nursing. (2023). Advanced practice registered nurse (APRN) licensure. https://www.oregon.gov/osbn/pages/index.aspx

    Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning.

    Expand discussion thread from Brandon Grundy

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    SS

    Stephania A Senter

    Sep 24, 2024 8:52pm
    | Last reply Sep 29, 2024 2:43am

    Reply from Stephania A Senter

     APRN Board of Nursing Regulations: Ohio vs. Alabama

    Advanced Practice Registered Nurses (APRNs) play a pivotal role in healthcare, providing advanced-level care. The regulations governing their practice vary significantly from state to state, particularly in terms of practice authority, prescriptive rights, and supervision requirements. I will focus on comparing the APRN regulations in Ohio and Alabama, outlining key differences and discussing their implications for APRNs practicing within the full scope of their education and experience.

    Comparison of APRN Regulations in Ohio and Alabama

    Practice Authority

    Ohio requires APRNs to have a Standard Care Arrangement (SCA) with a collaborating physician to diagnose, treat, and prescribe. The SCA must outline the scope of the APRN’s practice, including prescriptive authority, and the physician must review patient records at regular intervals. An example includes, An APRN working in primary care in Ohio must have a formal agreement with a physician, which limits their autonomy and mandates regular consultations for certain care decisions.

    Alabama has one of the most restrictive environments for APRNs. APRNs in Alabama are required to have a supervisory agreement with a physician. They cannot practice independently, and all prescribing and patient management decisions must be reviewed by the supervising physician. There are also limitations on how many APRNs one physician can supervise. An example includes, an APRN in Alabama working in a rural area still requires direct oversight from a physician to manage patient care, which can be challenging when physicians are scarce.

    Prescriptive Authority

    In Ohio, APRNs can prescribe medications, including controlled substances, but only under a Standard Care Arrangement. They may prescribe Schedule II controlled substances under specific conditions, such as within the first 72 hours of care in a hospital or similar setting, or after consultation with the collaborating physician. An example includes, an Ohio APRN working in a hospital can prescribe a Schedule II opioid for a patient post-surgery, but only after following strict guidelines or consulting with their collaborating physician.

    In Alabama, APRNs face tighter restrictions on prescriptive authority. They can prescribe non-controlled substances, but to prescribe controlled substances, they must have a Qualified Alabama Controlled Substances Certificate (QACSC). Even with this certification, there are limits on the type and quantity of controlled substances that can be prescribed.  Prescribing Schedule II controlled substances requires additional supervision and certification. An APRN in Alabama who wants to prescribe a Schedule II narcotic for chronic pain management must go through an additional certification process and is still subject to the oversight of a supervising physician.

     

    Differences in APRN Regulations and Impact on Practice

    The primary difference between Ohio and Alabama lies in the level of autonomy granted to APRNs. In Ohio, while APRNs are required to collaborate with a physician, they still have some degree of autonomy in managing patient care and prescribing medications. The Standard Care Arrangement allows for some flexibility in care delivery. Alabama imposes a more restrictive oversight, limiting the ability of APRNs to practice independently or to manage patient care without direct supervision.

    Ohio allows APRNs to prescribe a broader range of medications with a collaborating physician’s approval, Alabama has more stringent controls, particularly on prescribing controlled substances. This can significantly limit an APRN’s ability to treat patients in Alabama, especially in rural areas where physicians may not be as accessible.

    Application of Regulations for APRNs Practicing Within Their Full Scope

    APRNs who are trained to provide comprehensive care, including diagnosis, treatment, and prescription of medications, may face barriers in fully utilizing their skills due to state regulations.

    Ohio APRNs are restricted by the Standard Care Arrangement, but they can practice within their full scope if the collaboration with a physician is well-structured. For instance, an APRN in a hospital or primary care setting can provide patient care with some independence, though regular physician collaboration is required for certain decisions like prescribing Schedule II medications.

    Alabama APRNs, on the other hand, have a more limited scope. They are required to work under a physician’s direct supervision and cannot make autonomous decisions regarding controlled substances, which may hinder their ability to provide comprehensive care, particularly in underserved areas.

    Conclusion

    The regulatory environments in Ohio and Alabama present distinct challenges and opportunities for APRNs. While Ohio’s regulations allow for some degree of autonomy through collaboration agreements, Alabama’s restrictive practices severely limit APRN independence, particularly in prescribing controlled substances. These differences in regulations highlight the ongoing need for states to review APRN practice authority and adopt regulations that empower APRNs to practice to the full extent of their education and experience. As healthcare systems evolve, enabling APRNs to provide more autonomous care could be a crucial step in addressing healthcare provider shortages, especially in rural and underserved communities.

     

    References

    Alabama Board of Nursing. (2023). APRN scope of practice and prescriptive authority regulations. Retrieved from [Alabama Board of Nursing Website].

    American Association of Nurse Practitioners (AANP). (2023). State practice environment for NPs. Retrieved from [AANP website].

    Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). 
    Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care.Links to an external site
    Links to an external site.
    . 
    Nursing Outlook, 65
    (6), 761–765.

    Ohio Board of Nursing. (2023). APRN practice and prescriptive authority guidelines. Retrieved from [Ohio Board of Nursing Website].

    Expand discussion thread from Stephania A Senter

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    Ukamaka Okpalanwobi

    Sep 24, 2024 8:26pm
    | Last reply Sep 27, 2024 8:55pm

    Reply from Ukamaka Okpalanwobi

    Initial Post

    Advanced Practice Registered Nurses (APRNs) are highly trained nurses with advanced degrees (Master’s or Doctorate) who can diagnose and treat illnesses, prescribe medications, and manage patient care across specialties like primary care, mental health, and anesthesia. They include 
    Nurse Practitioners (NPs)
    , 
    Clinical Nurse Specialists (CNSs)
    , 
    Certified Nurse-Midwives (CNMs)
    , and 
    Certified Registered Nurse Anesthetists (CRNAs)
    . The scope of practice for APRNs varies by state, particularly when it comes to how much autonomy they have.

     California Regulations, 
    In 
    California
    , APRNs initially need to practice under physician supervision, but thanks to 
    AB 890
    , they can transition to 
    full practice authority
     after completing 
    4,600 hours
     or 
    3 years
     of supervised practice. Full practice authority means they can independently diagnose, treat, and prescribe without needing a physician. This has significantly improved healthcare access, especially in rural and underserved communities. For instance, a 
    PMHNP
     in California, after meeting the supervised practice requirement, can independently manage mental health patients, including prescribing medications, without physician oversight.

     Texas Regulations
    , In 
    Texas
    , APRNs are required to maintain a 
    collaborative practice agreement
     with a physician throughout their career. There is no pathway to full practice authority, meaning APRNs in Texas cannot practice independently. They need physician oversight for diagnosing, treating, and especially prescribing controlled substances. This collaboration requirement can cause delays in care, especially in rural settings where finding a physician to collaborate with is challenging. For example, in Texas, a 
    Family Nurse Practitioner (FNP)
     must get physician approval to prescribe certain medications, which can slow down care for patients with chronic conditions like diabetes or hypertension.

     Differences and Impact on APRNs

    I’ve also noticed that interdisciplinary collaboration is more prominent in California. APRNs often work with pharmacists, social workers, and mental health professionals in comprehensive care teams. This integrated model, while less common in Texas, could be hugely beneficial for mental health care and other specialized areas (AACN, 2023). During the COVID-19 pandemic, both states issued waivers to grant APRNs more autonomy. California made some of these temporary changes permanent through 
    AB 890
    , but Texas has largely reverted to its pre-pandemic rules. This demonstrates how emergencies can lead to long-term improvements in some places but not others (AANP, 2023; NCSBN, 2023).

    Cultural and socioeconomic factors also play a role. California’s APRNs are often more involved in providing 
    culturally competent care
     for diverse populations like immigrants and Native Americans. In Texas, the medical landscape tends to reflect more conservative practices, with physician-led care models limiting the flexibility APRNs must meet the needs of diverse groups (California BRN, 2023The most significant difference is that California offers APRNs a path to 
    full practice authority
    , allowing them to work autonomously without physician oversight after meeting the requirements. In 
    Texas
    , APRNs are always dependent on a physician for certain aspects of their care, which limits their autonomy and can delay patient care in regions where physician access is limited.

    An example of how this plays out is that in 
    California
    , an APRN working in primary care can independently manage a patient’s chronic illness, adjust medications, and provide follow-up care without needing physician collaboration. In 
    Texas
    , that same APRN consults a physician, which could slow treatment and reduce efficiency, especially in remote areas. 
    Impact on Practice
     in 
    California
    , APRNs with full practice authority can offer faster, more comprehensive care, especially in underserved areas, by leveraging their full training and expertise. In 
    Texas
    , APRNs are more restricted by collaborative agreements, which may delay patient care and limit their ability to practice independently, particularly in rural settings where physicians are scarce.

                                                                 References

    American Association of Nurse Practitioners (AANP). (2023). 
    State Practice Environment
    . Retrieved from 
    https://www.aanp.org
    Links to an external site.

    California Board of Registered Nursing (BRN). (2023). 
    AB 890 Implementation and Full Practice Authority
    . Retrieved from                          
    https://www.rn.ca.gov
    Links to an external site.

    National Council of State Boards of Nursing (NCSBN). (2023). 
    Nurse Licensure Compact and APRN Practice Regulations
    . Retrieved from                
    https://www.ncsbn.org
    Links to an external site.

    Texas Board of Nursing (BON). (2023). 
    APRN Practice and Collaborative Agreements
    . Retrieved from https://www.bon.texas.gov

     

    Comparing APRN Board of Nursing Regulations

    Scope of Practice

    Every nursing regulatory body has specific instructions as to the scope of practice of the nurses based on education, experience, and the state. In Florida, APRNs normally have a supervisory agreement with a physician as they practice. They are not allowed to practice autonomously. The need for a physician to supervise has however been removed when APRNs meet certain criteria such as completing 3000 physician-supervised clinical hours in five years, and not having been in any disciplinary action in five years, among others. This shows that Florida still limits how APRNs practice and certain areas of their scope are limited to working under a physician (Brooks, 2024).

    In New York, APRNs can practice to the full extent of their scope. They are only required to complete the 3600 physician-supervised hours of practice after which they are free to practice independently. New York has allowed APRNs full autonomy meaning they can be more independent and resourceful, especially in underserved  (Poghosyan, 2021).

    Authority to Prescribe

    In Florida, APRNs are allowed to prescribe certain medications. The authority to prescribe controlled substances is based on certain criteria. The major criteria is that the APRN must be a Master’s or Doctoral degree graduate in a specialized nursing area and trained in specialized skills. Also, for certain schedule II drugs, APRNs can only prescribe for up to 7 days unless the condition demands prolonged use. This shows that there are limits to prescribing medication in Florida, especially in controlled substances to prevent abuse and misuse (Brooks, 2024).

    In New York, APRNs can prescribe all drugs including controlled substances with fewer regulations. This is because in New York APRNs must register with the New York State Prescription Monitoring Program and the Drug Enforcement Administration. This is to monitor and control the prescription of regulated drugs to prevent misuse. This autonomy allows them to fully practice total patient care without authority challenges limiting their scope (Poghosyan et al., 2021) Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations.

    Differences Between the two States

    As noted above, Florida is still restricting the autonomy of APRNs while New York has honored it. Nurses in Florida must practice under physician supervision for at least five years and fulfill other criteria for autonomy, while those in New York can fully practice autonomously after fulfilling the hours requirement (Phillips, 2021). In Florida, there are strict regulations for prescribing while in New York, the regulations are quite friendly. Also, in Florida APRNs do not register with any other body to regulate prescription while in New York, they register with the DEA and prescription monitoring program for prescription registration (Phillips, 2021).

    Examples

    A nurse working in a rural area clinic in Florida can handle patients independently with a physician agreement and if the patient needs regulated medication, the APRN must consult with a physician for prescribing long-term use. On the other hand, a nurse working in similar conditions in New York can practice unsupervised and prescribe medication independently with regular check-ups with the prescription monitoring program for safety in controlled substances prescription.

    References

    Brooks, J. (2024). Advanced Practice Registered Nurse Autonomy in Florida: A Policy Analysis (Doctoral dissertation, Jacksonville University). https://search.proquest.com/openview/e4752108934cffe873c2bdfa1235072f/1?pq-origsite=gscholar&cbl=18750&diss=y

    Phillips, S. J. (2021). 33rd annual APRN legislative update: unprecedented changes to APRN practice authority in unprecedented times. The Nurse Practitioner, 46(1), 27-55. https://journals.lww.com/tnpj/fulltext/2021/01000/33rd_Annual_APRN_Legislative_Update__Unprecedented.6.aspx

    Poghosyan, L., Ghaffari, A., Liu, J., Jin, H., & Martsolf, G. (2021). State policy change and organizational response: Expansion of nurse practitioner scope of practice regulations in New York State. Nursing Outlook, 69(1), 74-83. https://www.sciencedirect.com/science/article/pii/S0029655420306217

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    Nicole Greco Carl

    Sep 24, 2024 6:22pm
    | Last reply Sep 26, 2024 9:22pm

    Reply from Nicole Greco Carl

    My state of California (CA) is a full practice state, meaning, “nurse practitioners can perform the full scope of practice without a supervising or collaborating physician. They can diagnose a patient, order tests, prescribe medication, and operate their own independent practices” (Feeney, 2024).

     

    This type of independence for Nurse practitioners (NPs) in California is fairly new, with Assembly Bill 890 (AB 890) only being passed last year on January 1, 2023 (Miec, 2023). So, as of last year, NPs have the option to apply to be a 104 NP, they can “work independently outside of a group setting, including owning their own practice, and practices without standardized procedures within the population focus of their National Certification” after working “in a group setting (a clinic, hospital, or medical group) with at least one physician for at least three years” (Miec, 2023).

     

    However, in a state like South Carolina (SC), for nurse practitioners, it is considered a restricted practice state, in this type of state, “nurse practitioners must work under the supervision of a physician for all of their scope of practice. While they may have extensive autonomy in some nurse practitioner functions, they are not acting as independent practitioners” (Feeney, 2024). This means at this time, NPs in the state of SC are unable to open their practice compared to ones in CA.

     

    In a state like CA many NPs I know are opening their own Med spas, in SC a NP can also do this but would need a medical doctor to oversee the practice. What NPs can still do in both these states is prescribe medications. In CA, “a registered nurse may dispense drugs or devices upon

    an order by a licensed physician and surgeon if the nurse is functioning within a licensed clinic” (State of California Director of consumer affairs, 2013). As well in SC, “administration of medications means the acts of preparing and giving drugs in accordance with the orders of a licensed, authorized nurse practitioner” (South Carolina code of laws unannotated, 2006).

     

     

    References

     

    Feeney, A. (2024, May 23). 
    Nurse practitioner practice authority: A state-by-state guide
    . NurseJournal.org. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/

    Nurse practitioner expanded scope of practice in California
    . MIEC. (2023, February 16). https://www.miec.com/knowledge-library/nurse-practitioner-expanded-scope-of-practice-in-california/

    Nurse practitioners: Laws & regulations
    . State of California Director of Consumer Affairs. (2013, November 11). https://www.rn.ca.gov/pdfs/regulations/bp2834-r.pdf

    South Carolina Code of Laws Unannotated
    . Code of laws – title 40 – chapter 33 – nurses. (2006, September 30). https://www.scstatehouse.gov/code/t40c033.php

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    Selina Villanueva

    Sep 24, 2024 4:16pm

    Reply from Selina Villanueva

    Application to Advanced Practice Registered Nurses
     

    Advanced Practice Registered Nurses (APRNs) are subject to varying regulations across states, particularly concerning their scope of practice, prescriptive authority, and collaboration requirements. A comparison between two APRN boards of nursing regulations in California and Texas provides a fundamental point of analysis. The first regulation is on collaborative practice where NPs in California, are required to collaborate with a supervising physician. As part of this partnership, written protocols and standardized processes outlining the NP’s practice area, including their prescription authority, are collaboratively developed. Collaboration with a licensed physician is also a requirement in the state of Texas. APRNs must establish and maintain a formal agreement to practice and prescribe medications.

    Another significant APRN Board of Nursing regulation involves prescriptive authority. In California, unlike in most other states across the country, NPS have the prerogative of writing prescriptions and this is inclusive of the Controlled Substances, as soon as they meet the conditions laid down under the collaborative agreement. On the other hand, in Texas, where the NPs have gotten Full Practice status, they still need a supervisory agreement for prescribing controlled substances. This is a significant difference because it might limit the patient’s access to the drugs as he or she may not be able to consult the physician in charge every time he or she needs a drug. Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations This is especially so in the rural areas where the R.Ph. might be the only professional health facility available. For example, if a patient in Texas is required to have immediate access to pain management that involves a prescription of substances controlled under VITA, the NP may be confined to physician supervision. Nevertheless, the article by Bosse et al. (2017), “Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care,” strongly supports the case for full practice authority (FPA) for APRNs.

    In essence, APRNs need to have a collaborative partnership with a physician in order to work effectively. For the APRNS privileged to practice within the statutes of their education and experience, this regulation is both a strength and a weakness. Although the collaborative model provides APRNs with a support structure where they may turn to physicians for advice, this structure poses challenges to autonomous practice. This is because it may also delay care if an NP needs immediate prescribing authority to address a patient’s urgent needs, potentially impacting the overall quality of care. Prescriptive authority remains one of the APRN practice essentials that define the scope of their practice in terms of effective care delivery. Whereas, California’s independence framework for NP practice allows NPs to have more authority, limitations inherent in the Texas model hinder practice as it may lead to delayed treatments. “Allowing NPs full autonomy to practice may be a relatively simple policy mechanism for states to improve access to primary care” (Neff et al., 2018).

    APRNs in California or Texas might focus on improving their practical knowledge of the emerging trends in new treatment and continuing their education requirements. “In the fast-moving world of health care, it is vital that nurses are able to practice to the full extent of their education and abilities, in order to deliver the most efficient, quality care to patients” (American Nurses Association, n.d.)  By realizing these regulations, APRNs are well equipped to maneuver within their practice environments while observing the legalities in providing some of the best quality patient care.

     

     

    References

    American Nurses Association. (n.d.). 
    ANA enterprise
    Links to an external site.
    Links to an external site.
    .

    Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary careLinks to an external site.. Nursing Outlook, 65(6), 761–765.

    Neff, D. F., Yoon, S. H., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman, J. S. (2018). The impact of nurse practitioner regulations on population access to care. 
    Nursing Outlook
    , 
    66
    (4), 379-385.

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    Deco Tanjong

    Sep 24, 2024 12:09pm
    | Last reply Sep 25, 2024 10:57pm

    Reply from Deco Tanjong

          Advanced practiced registered nurse(APRN), or NP, means a Registered nurse who has completed an advanced formal graduate education program at the master’s level or Doctoral level acceptable to the board and who demonstrates advanced knowledge and skill in the assessment and management of physical and psychosocial health, illness status persons, families, and group. (Ohio Board of Nursing). Because the United States does not have a National APRN licensing board, states have different methods for evaluating credentials and qualifications.

    Differences between Ohio APRN and South Carolina APRN

    In terms of certification, Ohio APRNs must complete an application, pay fees, pass a criminal background check, and complete a master’s or Doctoral program in a nursing specialty, while in South Carolina, APRNs must have a doctorate, post-nursing master’s certificate or master’s degree in advanced Education in a specific area.

    In Ohio, APRNs must enter into collaborative agreements with physicians and other healthcare professionals for the duration of their careers. While in South Carolina, the APRN must practice in collaboration with the physician.

    For example, in the State of South Carolina, APRNs can only practice independently with direct collaboration with a physician(South Carolina Board of Nursing). However, in Ohio, APRNs can practice independently once a collaborative agreement is signed with a physician for the period of his or her career. (Ohio Board of Nursing).

    Reference:

    National Council of State Boards of Nursing (NCSBN)Links to an external site.
    Links to an external site.
    . (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm

    APRN scope of practice
    . Ohio Board of nursing. (n.d.).

    APRN scope of practice
    . South Carolina board of nursing. (n.d.).

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    Doreen Pokuaa Yebuah

    Sep 24, 2024 11:47am
    | Last reply Sep 27, 2024 10:31pm

    Reply from Doreen Pokuaa Yebuah

    Initial post

    Comparing the APRN nursing regulation between the states of Texas, California, and Oregon

    Firstly, looking at the scope of practice between the three states:

    According to the American Association of Nurse Practitioners, Texas is a “restricted practice state.” In Texas, APRNs have a supervisory or collaborative agreement with physicians to be able to provide diagnosing activities for patients, prescribe medicines, and monitor treatments (A State-by-State Breakdown of Nurse Practitioner Practice Authority Laws, n.d.). These supervisory arrangements usually need to be in writing, detailing the physician’s role as supervisor, with a notation of the frequency in which the physician will review the charts. This type of arrangement limits APRN autonomy because physicians are required to be involved in most aspects of patient care. This can make practicing difficult, especially in rural or underserved areas with a doctor shortage. California has a mixed model; it gradually moves toward full practice authority over time. Currently, some settings require NPs to have standardized protocol agreements for some aspects of their practice. NPs can apply to work without physician supervision if they have completed 4,600 hours or three years of full-time clinical work. Still, the facility must have a doctor on site
     (A State-by-State Breakdown of Nurse Practitioner Practice Authority Laws
    , n.d.). After three additional years, they can apply for full practice authority.

    There is also a written code of conduct or guidelines for APRNs in their line of duty. APRNs in California may diagnose and treat patients. Still, they cannot practice independently due to these collaborative agreements that restrict their clinical decision-making and prescription powers in the first couple of years after graduation. This, therefore, renders it impossible for APRNs to utilize their full scope, especially in clinical decision-making independent of direct physician supervision. Oregon, in contrast, is a full-practice state (ORS 678.375, Nurse Practitioners, n.d.). APRNs can evaluate patients, determine diagnoses, interpret diagnostic tests, and develop treatment plans, including ordering medications, independently of physician oversight. APRNs are educated and competent to provide this level of care; therefore, they may practice independently and provide complete care. Full practice authority in Oregon allows APRNs to utilize their complete skill and knowledge, adding accessibility and quality to healthcare, particularly in rural and impoverished communities.

    The second comparison will be based on prescriptive authority.

    In Texas, APRNs can only prescribe under the delegating authority of a physician. APRNs may prescribe drugs, including Schedule III-V controlled substances, but not Schedule II drugs unless they are in a hospital or hospice setting (NursingLicensure.org, 2021). Because of this provision, APRNs have no choice but to rely on physicians if they are to enjoy full prescribing privileges. This may delay patient care and reduce efficiency, especially in busy areas such as emergency rooms or rural clinics where doctors may be unavailable. In California, Advanced Practice Registered Nurses (APRNs) can prescribe medications if they adhere to the agreed-upon standards and procedures with a supervising physician (A
     State-by-state Breakdown of Nurse Practitioner Practice Authority Laws
    , n.d.). However, like Texas, California restricts the prescribing of controlled substances, particularly Schedule II drugs, unless under specific rules or direct physician authorization. For instance, an APRN can prescribe medicines for chronic conditions. However, they must adhere to strict protocols and frequently undergo periodic evaluations by a physician. This prevents the APRN from autonomously adjusting patient care according to their evolving needs. In Oregon, however, APRNs have full prescribing practice authority. They can prescribe any medication at any time for patients, including controlled substances. Having no restrictions on their scope of practice puts APRNs in a position to use all their education and training to provide timely and effective care without physician intervention. Full prescribing authority is beneficial in primary care, where APRNs can monitor patient responses and alter treatment plans independently of physicians while managing complex medication regimens Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations.

    Comparing the three states and their regulations, Texas and California restrict the autonomy of APRNs by requiring them to collaborate with physicians or follow standardized procedures. This regulatory framework often creates barriers to achieving important goals, such as coordinating care across multiple providers, managing supervisory constraints, and processing additional paperwork. These criteria pose significant challenges to implementing APRN-led care models in healthcare facilities, even when their services are required to substitute unavailable doctors, particularly in rural areas. However, in Oregon, APRNs can practice independently in the whole practice model, making major clinical decisions without physician oversight (
    ORS 678.375, Nurse Practitioners
    , n.d.). This autonomy complements the APRN’s role as a primary care provider and provides latitude in taking responsibility for patient care, reducing healthcare expenditure, and improving accessibility to services when needed.

    Regarding healthcare access, Texas and California, for example, have strict rules that make getting care challenging, particularly in underserved areas of the states. The limited scope of practice in these states, which often burdens APRNs, impacts the entire healthcare service. This can be a disadvantage; for example, in remote regions where the need for doctors to cooperate may delay care, particularly in situations where APRNs must communicate with doctors who are not present or accessible. Oregon’s plan addresses doctor shortages by allowing APRNs to practice independently. It also facilitates the establishment of APRN-led clinics and provides direct care to patients without awaiting physicians’ consent. The plan enables access to health care, thus improving health outcomes in urban and rural areas.

    In the cases of states where APRN practice is restricted, like Texas and California, APRNs may still find ways around the rules and perform at their best. For instance, in a rural health clinic in Texas, an APRN can independently treat chronic conditions like diabetes or hypertension by conducting assessments, prescribing medications with approval, and providing patient education. The APRN adheres to the regulatory requirements through a collaborative agreement with a physician who reviews the charts monthly. As limited as this arrangement may be, it still gives the APRN tremendous authority to change the level of care provided for patients and fill substantial gaps within the local healthcare personnel.

    When applying APRN rules to work in California, An APRN practicing in California can, with the help of a supervising physician, establish a standardized procedure when working in primary care. The APRN can independently perform regular examinations, provide follow-up care for chronic conditions, and order prescription medications for noncontrolled substances under these circumstances. For instance, an APRN may have a protocol that enables them to provide asthma management for pediatric patients by adjusting inhaler prescriptions per the established guidelines without direct and immediate consultation with a physician, provided the physician periodically reviews the treatment plan. These examples show how APRNs can work around strict rules to provide excellent care within the law in their states. They also show the importance of thoughtful, collaborative agreements and standard processes.

    In conclusion, the biggest problem is considerable discrepancies in the rules, making it challenging for APRNs to practice independently and utilize their entire education and training. States such as Texas and California have rigid regulations that pose a severe barrier to allowing APRNs to practice as they wish, which may reduce access to care, particularly in underserved areas. On the other hand, states like Oregon grant full practice authority to APRNs, providing examples of how giving such professionals discretion in handling all concerns pertinent to patient care can be effective. Thus, less restrictive models would make the professional role of APRNs more substantial by improving the quality of healthcare and catering to the needs of more people.

     

    Reference

    A state-by-state breakdown of nurse practitioner practice authority laws
    . (n.d.). The Intake. 
    https://www.tebra.com/theintake/checklists-and-guides/legal-and-compliance/nurse-practitioner-laws-by-state
    Links to an external site.

    NursingLicensure.org. (2021, September 21). 
    APRN license requirements in Texas | How to become a nurse practitioner in TX—NursingLicensure.org
    . NursingLicensure.org: A More Efficient Way to Find Nursing License Requirements in Your State. 
    https://www.nursinglicensure.org/np-state/texas-nurse-practitioner/
    Links to an external site.

    ORS 678.375: Nurse practitioners
    . (n.d.). Retrieved on September 22, 2024, from https://oregon.public.law/statutes/ors_678.375

     

     

     

     

     

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    Romel Suason

    Sep 24, 2024 11:33am
    | Last reply Sep 27, 2024 8:16pm

    Reply from Romel Suason

    Comparing APRN Regulations in State Boards of Nursing

    Nursing practice in different states is guided by policies, standards, and regulations that allow professionals to deliver various services to meet the needs and preferences of patients and populations. In the state of California, the Board of Registered Nursing (BRN) defines the specific regulations and standards by which Advanced Nurse Practitioners (APRNs) must maintain the targeted levels of healthcare services that meet the needs and preferences of patients (California Board of Registered Nursing, 2024). These standards require that an individual seeking licensure to practice as an APRN must have a minimum of a master’s degree and a national certification in the specialty of interest. The Board of Nursing in Texas requires additional requirements, such as prescriptive authority, that include supervisory requirements in the form of collaborative agreements with a physician. The distinction outlines the level of practice, particularly the autonomy and independence of advanced nurse practitioners in prescribing medications to patients.

    In California, APRNs can prescribe treatments independently after obtaining a Nurse Practitioner Furnishing Number, which the provider attains upon meeting the full educational and certification requirements. On the other hand, Texas nurse practitioners must have a formal agreement with the supervising physician as a collaborative agreement (Texas Board of Nursing, 2021). These agreements may limit the nurse practitioners’ ability to respond quickly to the patient’s needs. These issues contribute to barriers that can delay the nurse practitioner’s ability to offer timely interventions or respond to emergencies Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations.

    Concerning the scope of practice, the nurse practitioners in California have a full practice model, allowing them to evaluate patient needs, diagnose conditions, order and interpret diagnostic tests, and initiate treatments independently. On the other hand, nurse practitioners in Texas have a restricted practice that requires them to work under the full supervision of a qualified physician (California Board of Registered Nursing, 2024). The practice status in Texas implies that nurse practitioners have limited practice, which does not allow them to practice to the fullest of their training and education. Nurse practitioners have to collaborate with the supervising physician and have limited independence in ordering and interpreting tests initiating treatments, as well as diagnosing various conditions that impact public health. In this case, although the nurse practitioner may have the necessary skills and abilities for managing patient needs, the limited practice authority by the state board requires them to collaborate with other professionals, impacting their professional autonomy.

    The state board practice authorities significantly impact the level of practice and population health outcomes. For instance, in California, where nurse practitioners have full practice, they can independently assess patient needs, order and interpret tests, and develop treatment plans to manage underlying patient needs. The practice authority contributes to the expansive access to healthcare resources among vulnerable populations (McGilton et al., 2023). On the other hand, in Texas, where the state board has limitations, access to primary care services may be limited, resulting in growing health disparities. The collaborative agreements may complicate the decision-making processes, limiting the nurse practitioner’s ability to respond effectively to patient needs (Short, 2022). The process can limit the effectiveness of patient needs, compromise responsiveness to patient needs, and result in high dissatisfaction levels among patients and populations.

    Adhering to the state board regulations requires the nurse practitioner to maintain key strategies and mechanisms that attain the desired safety and ethical code of practice and promote professional growth and ability to serve diverse populations (Short, 2022). Nurse practitioners in both state boards must maintain continuing education and adhere to the certification requirements. These strategies are necessary to promote adherence to the recommended standards and maintain the guidelines outlined by the collaborative agreements.

     

     

    References

    California Board of Registered Nursing. (2024). 
    Advanced Practice and Certification
    . Www.rn.ca.gov. 
    https://www.rn.ca.gov/applicants/ad-pract.shtml
    Links to an external site.

    McGilton, K. S., Haslam-Larmer, L., Wills, A., Krassikova, A., Babineau, J., Robert, B., Heer, C., McAiney, C., Dobell, G., Bethell, J., Kay, K., Keatings, M., Kaasalainen, S., Feldman, S., Sidani, S., & Martin-Misener, R. (2023). Nurse practitioner/physician collaborative models of care: A scoping review protocol. 
    BMC Geriatrics
    , 
    23
    (1). 
    https://doi.org/10.1186/s12877-023-03798-1
    Links to an external site.

    Short, N. M. (2022). 
    Milstead’s health policy and politics: A nurse’s guide
     (7th ed.). Jones & Bartlett Learning.

    Texas Board of Nursing. (2021). 
    Texas Board of Nursing – Practice – APRN Scope of Practice
    . Texas.gov. 
    https://www.bon.texas.gov/practice_scope_of_practice_aprn.asp.html#:~:text=in%20Disaster%20Areas-
    Links to an external site.

     

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    Reylynn M Dunn

    Sep 23, 2024 11:23pm
    | Last reply Sep 28, 2024 12:36pm

    Reply from Reylynn M Dunn

       When applying for an Advanced Registered Nurse Practitioner (ARNP) license in the state of Idaho the individual must have an active Registered Nurse (RN) license, have completed an accredited advanced nurse practice graduate or post-graduate program, and be nationally certified by the desired specialty (IBON, 2023). Washington state requirements are the same as the State of Idaho as they require a copy of the individual’s national certification, official transcripts from the completed ARNP program, and an active RN license.  

       The State of Idaho requires that an APRN renewal applicant undergo a peer-review process to display competency to the regulatory board (DOPL, 2023). According to the policy, an applicant must have a peer review that includes evidence of competence according to the national standards of care by 
    either
     another ARNP, physician, or Physician’s Assistant. Competence can be displayed through clinical rounds, record reviews, and on-site peer collaboration (DOPL, 2023). The State of Washington does not require any peer-review process for ARNP renewal. Instead, the Washington State Board of Nursing (WABON) requires the applicant to provide an attestation that the applicant completed at least a minimum of thirty hours of continuing education per renewal period (WABON, n.d.). Both states, however, require an active license in addition to the peer-review process or continuing education. 

       The Washington State Scope of Practice states that the ARNP is able to “assume primary responsibility and accountability for the care of patients within their roles” (DOH, 2023, para. 1) Primary responsibility includes diagnostic testing, management of health conditions, education, and prevention (DOH, 2023, para. 2). According to the Idaho Board of Nursing, the ARNP’s scope of practice includes “assume primary responsibility for the care of their patients in diverse settings. This practice incorporates the use of professional judgment in the assessment and management of wellness and conditions appropriate to the advanced practice registered nurse’s role” (2023, p.3). Both regulations on the ARNP’s scope of practice state that the ARNP will take primary responsibility for care. Also, both Washington and Idaho state that the ARNP can manage an individual’s health & wellness.  Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations

    References
     

    ARNP License
    . Washington State Board of Nursing. (n.d.). 
    https://nursing.wa.gov/licensing/apply-license/arnp-license
    Links to an external site.
     

    Department of Health, WAC 246-840-300 ARNP Scope of Practice. Retrieved February 20, 2023, from 
    https://apps.leg.wa.gov/wac/default.aspx?cite=246-840-300
    Links to an external site.
    . 

    Idaho Board of Nursing. (2023, March 28). IDAPA 24 – Division of Occupational and Professional Licenses. Boise, ID. 

    Renew or Reactivate a License
    . Washington State Board of Nursing. (n.d.-b). 
    https://nursing.wa.gov/licensing/renew-or-reactivate-license
    Links to an external site.
     

    State of Idaho Division Of Occupational and Professional Licenses. (2023, October 12). Idaho Board of Nursing ADVANCED PRACTICE REGISTERED NURSES POLICIES: Boise, ID. 

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    Erin Roecker

    Sep 23, 2024 9:35pm
    | Last reply Sep 25, 2024 5:07am

    Reply from Erin Roecker

    I currently have two nursing licenses, one in South Carolina which is a compact state and one in Alaska which is not. I hold two licenses because I am a military spouse and had to get an Alaskan nursing license when we moved up here last year. It would be so helpful if all 50 states were compact states, especially for military spouses who are forced to move at a moment’s notice. I will become an APRN while living in the state of Alaska. So, I have chosen to compare the board of nursing regulations to Alaska compared to South Carolina. According to the NCSBN website, “More than 100 years ago, state and territorial governments established NRBs to protect the public’s health and welfare by overseeing and ensuring the safe practice of nursing. NRBs achieve this mission by outlining the standards for safe nursing care and issuing licenses to practice nursing (National Council of State Boards of Nursing, n.d.).” According to the state of Alaska board of nursing website, to practice as an APRN in Alaska you must first be licensed as an RN in Alaska. (Alaska Department of Commerce, Community, and Economic Development, n.d.) Alternatively, according to the state of South Carolina board of nursing website, any nurse from a compact state with a current RN license can be licensed in the state of South Carolina as an APRN. With that said, you must have a South Carolina APRN license to work in South Carolina. The NLC requirements that apply to RN licenses are different than an APRN.  (South Carolina Department of Labor, Licensing and Regulation, n.d.) The other difference between the two is scope of practice. Alaska allows APRNs to work a little more independently, with full prescriptive authority. Whereas South Carolina tends to have tighter guidelines and requires collaboration with a physician before prescribing medications.

    References:

    Alaska Department of Commerce, Community, and Economic Development. (n.d.). 
    Advanced practice registered nurses (APRN)
    .
     
    https://www.commerce.alaska.gov/

    National Council of State Boards of Nursing. (n.d.). 
    About nursing regulatory bodies
    . 
    https://www.ncsbn.org/nursing-regulation/about-nursing-regulatory-bodies.page
    Links to an external site.

    South Carolina Department of Labor, Licensing and Regulation. (n.d.). 
    APRN update lead
    . 
    https://llr.sc.gov/nurse/Online/APRNUPDATELEAD.aspx
    Links to an external site.

    Expand discussion thread from Erin Roecker

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    KW

    Kailey Wooton

    Sep 23, 2024 5:04pm
    | Last reply Sep 26, 2024 9:04pm

    Reply from Kailey Wooton

    Kentucky:

    Before prescribing controlled substances the APRN must consult with a KY physician, report that to the KBN, and have been an APRN for 1 year. All prescribed meds must be sent to the KBN (Kentucky Boards of Nursing, n.d).

    Meet with a physician with whom you’ve entered into a collaborative agreement quarterly to review the KASPER report or prescription drug monitoring report used in KY and this meeting must be sent to the KBN (Kentucky Board of Nursing, n.d).

    Tennessee:

    APRN’s can prescribe controlled substances once receiving a certificate of fitness by the State Board of Nursing (NCSL, n.d).

    APRN’s do not have to have the constant presence of a physician but one must be available to them if needed. A written protocol must be jointly developed that outlines standards of care and reviewed biennially. I was unable to find if any of this information of the prescriptions of controlled substances must be reported to the Tennessee Board of Nursing (NCSL, n.d)

     

    The difference I’m seeing between Kentucky and Tennessee is that Tennessee’s regulations on prescribing controlled substances are laxer. Kentucky Is required to meet with a physician before being able to prescribe controlled substances. The APRN then must turn this information in to the KBN. The APRN and physician must enter a “collaborative agreement” upon hiring the APRN. The physician and APRN meet quarterly to review and discuss KASPER records. This information also must be turned into the KBN (Kentucky Board of Nursing, n.d). Tennessee allows APRNs to prescribe controlled substances if they receive a certification of fitness from the Tennessee Board of Nursing. Physicians do not have to be consulted before prescribing; one must be available if needed. I did not find any information that indicated the record of controlled substances had to be turned in to their board of nursing (NCSL, n.d). One example of how APRNs must adhere to the regulations listed is ensuring that they’re meeting with a physician before prescribing controlled substances and reporting this information to the board of nursing Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations.

    APRNs who have the full legal authority to practice within the full scope of their education and experience can perform a wider range of medical services without the need for content physician supervision in most cases. I feel like this is important in rural areas where there are not a lot of physicians or APRNs. The regulations in Kentucky are stricter on prescribing controlled substances than those in Tennessee. However, I do not feel that either state’s regulations hinder the APRN from performing to their full scope of education and experience.   Following these regulations in my state ensures that your nursing license is safe and will not be revoked due to not following rules. I feel like consulting with a physician is the safest and most patient-centered approach to prescribing controlled substances.

    References:

    Aprn Prescriptive Authority
    . Kentucky Board of Nursing. (n.d.). https://kbn.ky.gov/advanced-practice-registered-nurse/Pages/aprn-prescriptive-authority.aspx

    Tennessee Scope of Practice Policy – State Profile
    . NCSL-Scope of Practice Policy. (n.d.). https://scopeofpracticepolicy.org/states/tn/ Walden University NURS-6050 Week 5: Discussion Professional nursing and state level regulations

  • Work-related stress in healthcare workers Current Healthcare Issues/ stressor essay

    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Work-related stress in healthcare workers Current Healthcare Issues/ stressor essay

    Post a description of the national healthcare issue/stressor you selected for analysis.

    The national healthcare issue I selected to analyze is work-related stress in healthcare workers. This stress affects healthcare workers’ physical and mental well-being and interferes with the quality of care provided to patients. Healthcare workers often encounter significant stressors that lead to burnout and job dissatisfaction (Bangani et al., 2021).

    Explain how the healthcare issue/stressor may impact your work setting.

    Work-related stress impacts my work setting regarding delivering adequate and efficient nursing care when treating patients. I often hear amongst my colleague the feeling of burnout and inability to take vacation due to nursing staff shortage and emotional exhaustion, which may affect their ability to provide high-quality care. Sometimes, some of my co-workers can be impaired with decision-making interventions and not focus on attention to detail because of being overworked and fatigued. This can compromise patient safety and well-being, resulting in increased medical errors, longer patient recovery times, and potentially adverse health outcomes due to delay or oversight in care (Greco et al., 2022). Additionally, we have many calls off because of the overwhelming exhaustion that my co-workers may experience from an overwhelming workload they experienced during their previous shifts; this can result in staff shortage, causing more stress and pressure on my colleague’s workload. Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Work-related stress in healthcare workers Current Healthcare Issues/ stressor essay

    Which social determinant(s) most affects this health issue?

    Socioeconomic status is the social determinant affecting work-related stress in nursing healthcare staff (Senanayake et al., 2019). Nursing staff with lower social and socioeconomic status experience financial insecurity and have access to fewer resources, leading to higher stress and anxiety both at work and in their personal lives. In the workplace, these individuals may feel a loss of control over their jobs, leading to feelings of being overworked, having fewer benefits, and receiving less support from management (Senanayake et al., 2019). This emotional and physical toll on their work ethics creates a stressful work environment, making it more challenging to manage patient workload. This stress also significantly impacts the job performance of nursing staff, as well as their mental and physical health and overall well-being.

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    Describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

    My healthcare facility has implemented different strategies in my work setting to reduce the workload stress amongst nursing staff. For example, to help reduce the call-offs, my health system has introduced flexible scheduling that allows for better work-life balance and the introduction of new nursing staff positions. These changes help ensure that
    nursing
    staff reduce the pressure to meet high demands and improve the quality of care they can provide. There are also serenity rooms where nursing staff can take breaks and engage in mindfulness and stress-reduction relaxation time. My facility has implemented these steps in my work setting to address work-related stress and improve staff retention and patient care outcomes.

    REFERENCES

    Bangani, R. G., Menon, V., & Jovanov, E. (2021). Personalized Stress Monitoring AI System For Healthcare Workers. 
    2021 IEEE International Conference on Bioinformatics and Biomedicine (BIBM)
    , 2992–2997. 
    https://doi.org/10.1109/bibm52615.2021.9669321
    Links to an external site.

    Greco, E., Graziano, E. A., Stella, G. P., Mastrodascio, M., & Cedrone, F. (2022). The impact of leadership on perceived work-related stress in healthcare facilities organisations. 
    Journal of Organizational Change Management
    , 
    35
    (4/5), 734–748. 
    https://doi.org/10.1108/jocm-07-2021-0201
    Links to an external site.

    Links to an external site.
    Senanayake, B., Wickramasinghe, S. I., Edirippulige, S., & Arambepola, C. (2019). Stress and its Social Determinants – A Qualitative Study Reflecting the Perceptions of a Select Small Group of the Public in Sri Lanka. 
    Indian Journal of Ps Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Work-related stress in healthcare workers Current Healthcare Issues/ stressor essay

  • New Jersey and New York Board of Nursing APRN regulations

    New Jersey and New York Board of Nursing APRN regulations

    Two APRNs Board of Nursing regulations in New Jersey and New York.

    New Jersey and New York have several similarities in their APRN regulations. Both states require APRNs to possess a valid registered nurse (RN) license before they can obtain advanced practice certification, ensuring a solid nursing foundation. Additionally, APRNs must achieve certification in their specific advanced practice roles from accredited certifying bodies, promoting a consistent level of competency. Continuing education is mandatory in both states for APRNs to maintain their certification, helping them stay updated on healthcare practices and regulations. Furthermore, APRNs in both states are permitted to perform various services, including patient assessments, diagnoses, and prescribing medications, although the specifics may differ. These shared regulations support safe and effective APRN practice in both states.

    Difference between regulations in NJ and NY with examples.

    New Jersey, APRNs must have a collaborative practice agreement with a licensed physician or dentist that outlines their scope of practice and patient care protocols. Conversely, New York requires a written practice agreement with a collaborating physician, emphasizing the collaborative aspects of care without needing a detailed scope outline.

    The scope of practice for Nurse Practitioners (NPs) differs significantly between New York and New Jersey, affecting their roles and responsibilities. In New York, NPs enjoy greater autonomy, allowing them to assess patients, diagnose conditions, interpret diagnostic tests, and initiate treatment plans independently, following the 2021 law that grants full practice authority. For example, an NP in New York can manage a patient’s diabetes, including prescribing and adjusting insulin as needed New Jersey and New York Board of Nursing APRN regulations.

    Conversely, NPs in New Jersey must establish a collaborative practice agreement with a physician, which dictates their scope of practice and patient care protocols. This means that an NP in New Jersey must consult with their collaborating physician when determining treatment plans, such as in the case of managing a patient with hypertension. These distinctions underscore New York’s focus on NP autonomy compared to New Jersey’s collaborative approach, both aiming to provide high-quality patient care tailored to their respective healthcare systems.

    How regulations I selected may apply to APRNs in NJ and NY.

    Prescriptive authority and collaboration with a physician are crucial aspects of the APRN role. In New Jersey, APRNs can prescribe medications, including controlled substances, but must do so under the protocols outlined in their collaborative practice agreements. This regulation allows APRNs to operate with a degree of independence while ensuring that they have the necessary support from a physician, especially as they navigate the early stages of their careers. Collaboration is particularly beneficial for new APRNs, as it provides a valuable learning opportunity. Working closely with a physician not only enhances their clinical knowledge and skills but also reinforces safe practices in patient care. Given that new APRNs may face risks associated with their limited experience, this partnership can help mitigate potential safety concerns. Overall, the regulatory framework in New Jersey fosters both the professional growth of APRNs and the delivery of safe, effective healthcare.

    Nurse Practitioners (NPs) in New York complete specialized pharmacology certification, allowing them to practice independently without needing a collaborative agreement with a physician. Additionally, NPs in New York must obtain national certification, which sets their educational requirements apart from those in New Jersey, further empowering them in their roles. The 2021 law enables NPs to manage conditions like diabetes on their own, including prescribing insulin and adjusting dosages. This increased autonomy not only enhances the role of NPs within the healthcare system but also alleviates some of the burdens on physicians, promoting a more collaborative approach to patient care.

    Example of how APRNs adhere to two regulations I selected.

    In the healthcare institution where I work as a nurse, I’ve observed that APRNs actively collaborate with physicians. While they conduct patient assessments, prescribe medications, and order diagnostic tests, there is always a physician to whom they report. This relationship is essential, as physicians provide guidance when any issues arise New Jersey and New York Board of Nursing APRN regulations.

    For example, if a patient is being treated for an infection and has an abnormal heart rhythm, APRNs will collaborate with a cardiologist to develop an appropriate plan of care. Before discharging the patient, APRNs ensure that follow-up appointments are scheduled with both the cardiologist and the infectious disease physician. This approach exemplifies a multidisciplinary team effort where each member works independently but remains equally accountable for the patient’s care. Such collaboration not only enhances the quality of care but also supports the ongoing learning and professional development of APRNs.

    References:

    New York State Education Department. (n.d.). 
    Advanced practice registered nursing
    . Retrieved from http://www.op.nysed.gov/

    New Jersey Division of Consumer Affairs. (n.d.). 
    Advanced Practice Nursing
    . Retrieved from 
    https://www.njconsumeraffairs.gov/
    Links to an external site.
     New Jersey and New York Board of Nursing APRN regulations

  • Nurse Staffing Shortages National Healthcare Issue/ Stressor

    Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Nurse Staffing Shortages National Healthcare Issue/ Stressor

    National healthcare issue/stressor

    There are many issues and stressors that impact healthcare, one is the lack of adequate healthcare providers. The healthcare industry is facing a shortage of multiple disciplines, impacting the number of patients receiving treatment. By the year 2033 there is an expected shortage of 124,000 physicians, and hospitals are having to replace 200,000 nurses each year to keep up with care demands (American Hospital Association, 2021).  The population is increasing due to people living longer, however the number of providers to render treatment is diminishing. The population expectancy is 2 billion people by the year 2050 with most of the population having at least one chronic health condition (Amalberti et al., 2019). The number of healthcare providers needs to increase to meet the demands of the growing population.

    Impact on work setting

    The shortage of healthcare providers impacts on the work environment by not allowing patients to receive adequate treatment for illnesses. Patients are forced to go without treatment or receive less than treatment because there are not enough providers to render care. Patients are having to wait long periods of time to visit with providers and are having the least informed healthcare works decide on whether the patient should see a physician (Slonim, 2023). The number of patients a healthcare worker is having to care for is increasing, adding stress to providers and decreasing the quality-of-care patients are receiving. Healthcare providers are having to render treatment as tasks, such as needing to give medications and drawing labs, rather than being able to listen to patients, spend time with them, while still performing tasks. Physicians often spend very little time with patients due to their workload, leaving patients feeling unheard and uncared for (Slonim, 2023).

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    Social determinants affected  

    Healthcare and quality are the social determinants that are affected by the lack of health care providers. People already do not seek healthcare treatment for many reasons, one being the lack proximity to provider, some people do not seek specialized screenings because the provider who do the screens are not nearby (Healthy People 2030, 2018). If people are currently finding it difficult to find providers in close proximity with a even greater shortage of providers expected, then the number of people not choosing to seek treatment could increase. This leaves people at a disadvantage and an increased risk for many illnesses.

    Responded to the healthcare issue/stressor

    The changes I have witnessed in healthcare facilities are hiring providers that are from outside of the country to help with the staffing shortages. For example, one facility I worked with employed nurses that were from the Philippines and Africa, to help with nursing shortages. This phenomenon is not new and help physicians and nurses alike from other countries receive an expedited Visa authorization process in order to have these healthcare workers help with staff shortages (American Hospital Association, 2021).  While it may not be a new concept it seems that with healthcare provider shortages more facilities are using this method to help with increasing staff needs.

     

    References

    Amalberti, R., Vincent, C., Nicklin, W., & Braithwaite, J. (2019). Coping with more people with more illness. Part 1: The nature of the challenge and the implications for safety and quality. 
    International Journal for Quality in Health Care
    , 
    31
    (2), 154–158. 
    https://doi.org/10.1093/intqhc/mzy235
    Links to an external site.

    American Hospital Association. (2021). 
    Fact Sheet: Strengthening the Health Care Workforce | AHA
    . Www.aha.org; American Hospital Association. 
    https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce
    Links to an external site.

    Healthy People 2030. (2018). 
    Health Care Access and Quality – Healthy People 2030 | health.gov
    . Health.gov. 
    https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality
    Links to an external site.

    Slonim, Anthony (2023). Top Challenges Facing Healthcare: Back to Basics.
     Physician Leadership Journal, 10
    (2), 12-14. 
    https://www.proquest.com/scholarly-journals/top-challenges-facing-healthcare-back-basics/docview/2788462727/se-2
    Links to an external site.

     

    Nurse Staffing Shortages National Healthcare Issue/ Stressor

    National Healthcare Issue: Nurse Staffing Shortages

    One of the most pressing healthcare stressors in the U.S. is nurse staffing shortages. The increasing demand for healthcare services, the aging nursing workforce, and high burnout rates contribute to this ongoing issue. The COVID-19 pandemic further exacerbated shortages, leading to increased workloads, stress, and job dissatisfaction among nurses.

    Impact on My Work Setting

    As a Charge Nurse in the PACU at Mary Washington Healthcare, staffing shortages directly impact patient care and nurse well-being by increasing workloads, leading to fatigue and burnout. Inadequate staffing also results in longer patient wait times, affecting post-anesthesia recovery and overall satisfaction, while higher turnover rates create a continuous need for training new staff. Additionally, limited nurse availability reduces the time for crucial patient education on post-operative care. For instance, when fewer nurses are available to manage the 20-bed PACU, patient assessments and discharges are delayed, placing added pressure on the team to maintain safe, high-quality care under stressful conditions.

     
    Social Determinants Affecting Nurse Staffing Shortages

    Nurse staffing shortages are influenced by several social determinants, including economic stability, working conditions, and education access. Budget constraints in hospitals limit the ability to hire and retain nurses, while long hours, mandatory overtime, and high patient loads contribute to burnout. Additionally, a shortage of nursing faculty and training programs restricts the pipeline of new nurses entering the workforce, further exacerbating the issue. “Nursing shortages, especially in emergency medicine (EM), where nurses face significant burnout rates, are predicted to worsen.”
     (
    Hodgson et al., 2024)

     
    Response of My Health System

    To address these challenges, Mary Washington Healthcare has implemented several strategies to improve staffing and support nurse retention. Competitive salaries, sign-on bonuses, and retention incentives encourage nurses to stay, while flexible scheduling options, including self-scheduling and PRN shifts, help maintain work-life balance. Cross-training PACU nurses in multiple areas ensures adequate coverage during staffing shortages. Additionally, the integration of electronic health records (EHRs) and remote monitoring tools streamlines documentation and reduces nurse workload. To support mental health and well-being, the hospital also offers wellness programs, counseling services, and resilience training to help staff manage stress and prevent burnout. Companies have also begun using social media to promote job openings and share valuable information to increase visibility. “Hospital and health system recruiters use social media to connect with top talent locally, regionally, and nationally.”  (Hale, 2021)

    Example of Change Implemented

    One specific change is the float pool expansion, where nurses from different units are cross trained to work in PACU when needed. This has helped fill staffing gaps during peak hours and high-acuity cases. Additionally, leadership has worked on improving communication and collaboration by implementing daily staff huddles to assess needs and reallocate resources effectively.

    Conclusion

    While staffing shortages remain a challenge, proactive strategies such as retention incentives, cross-training, and mental health support help mitigate the impact on both nurses and patients. “National work to improve nurse staffing offers specific recommendations and actions for short-term and long-term change, including recommendations to build healthy work environments and test new approaches to care delivery.” (Delgado, 2024) Continued efforts in recruitment and workforce well-being will be crucial in sustaining quality patient care.

     

    References:

    Delgado, S. D. (2024). Evidence-Based Approach to Appropriate Staffing. 
    Critical Care Nurse
    , 
    44
    (6), 69–72. https://doi.org/10.4037/ccn2024614

    Hale, K. (2021). 
    Benefits and challenges of social media in health careLinks to an external site.
    Links to an external site.
    . 
    Critical Care Nursing Quarterly
    , 
    44
    (3), 309–315.

    Hodgson, N. R., Kwun, R., Gorbatkin, C., Davies, J., & Fisher, J. (2024). Emergency department responses to nursing shortages. 
    International Journal of Emergency Medicine
    , 
    17
    (1), 1–5. https://doi.org/10.1186/s12245-024-00628-y

     

     

    Nurse Staffing Shortages National Healthcare Issue/ Stressor

    The United States has been battling Nursing Staff Shortage for many decades. Being in the healthcare field for almost 10 years, I believe that it has gotten worse each year after the pandemic.  This healthcare issue has significant implications for the quality, accessibility, and cost of healthcare services. The nursing shortage impacts not only inpatient services but outpatient as well. According to the World Health Organization (WHO) report, it was estimated that there will be a shortage of 7.2 million health workers to deliver healthcare services worldwide, and by 2035, the demand of nursing will reach 12.9 million.

    The impact of nursing staff shortage in a work setting is nurses’ experiencing burnout. Burnout syndrome has been characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is typically observed to be the result of chronic workplace stress (Li et al,2024). Nurses can also experience significant physical, emotional, and mental stress due to the nature of their work. Nurses work long shifts with high patient to nurse ratios and physical demands that can contribute to burnout. I currently work in an outpatient service and the staff is overworked with the influx of patients. With the inadequate supply of nurses has notably created many negative impacts on the patient’s health-related outcome as well as challenges to fight diseases and improving health, which causes increased workload and stress levels on nurses and later results in decreasing the quality of nursing care (Tamata and Mohammed, 2022).

    Social determinants that affect the nursing staff shortage is income and financial stability, often nurses are underpaid in comparison to the level of responsibility they bear. Another social determinant is lack of cultural competence and support in a healthcare environment can lead to discrimination or unequal treatment of nurses from diverse backgrounds. Work- life balance has become big in healthcare. Nurses, especially women may face pressure to balance professional demands with family responsibilities. The lack of flexible working hours, paid family leave, and affordable childcare can discourage nurses. Multiple national medical professional associations recommend social risk screening and documentation in healthcare settings because of the compelling evidence that social risks are associated with poorer adherence to treatment plans, worse health outcomes, and increased costs of care (Tiase et al, 2022).

    The
    healthcare system
    that I work for has implemented mental health days and recruitment programs. I work in Outpatient so there is some flexibility for nurses that are mothers and have children to work 5×8 hour days or 4–10-hour days. The manager is very big on work life balance and takes the extra step by gifting us with treat, food, and celebratory parties to show her appreciation for our hard work.

    Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. 
    https://bookshelf.vitalsource.com/books/9780826135056
    Links to an external site.

    Li, L. Z., Yang, P., Singer, S.J., Mathur, M. B., & Shanafelt, T. (2024). Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systemic Review and Meta-Analysis. JAMA network open, 7 (11), e2443059. https://doi.org/10.1001/jamanetworkopen.2024.43059

    Tiase, V., Crookston, C. D., Schoenbaum, A., & Valu, M. (2022). Nurses’ role in addressing social determinants of health. 
    Nursing
    , 
    52
    (4), 32–37. 
    https://doi.org/10.1097/01.nurse.0000823284.16666.96
    Links to an external site.

    Tamata, A. T., & Mohammadnezhad, M. (2022). A systematic review study on the factors affecting the shortage of nursing workforce in the hospitals. 
    Nursing Open
    , 
    10
    (3), 1247–1257. 
    https://doi.org/10.1002/nop2.1434
    Links to an external site.

     

    Nurse Staffing Shortages: National Healthcare Issue/ Stressor

    Nursing and Clinician Shortage: A National Healthcare Issue
     
     

    Nursing is a highly demanding and stressful profession. Many nurses are experiencing burnout, fatigue, and dissatisfaction with their working conditions at the bedside. According to a study by Petterson et al. (2015), cited in Broome and Marshall (2020), by the year 2035, there is expected to be a shortage of 33,000 primary care physicians. Additionally, it is estimated that 20% of nurses leave their jobs within the first year of employment. 
     

    Impact on the Work Setting
     

    Due to nursing shortages, hospitalized patients are at an increased risk of unsafe events, such as falls, reduced quality of care, poor health outcomes, and decreased patient satisfaction ratings (Quaranta, 2024). According to Lasater et al. (2021, cited in Quaranta, 2024), “The lack of nurses in hospital settings increases errors, morbidity, and mortality, and decreases patient satisfaction.” As healthcare evolves and patient demographics change, with patients living longer, there is a strong push to enhance the quality of care. Hospital reimbursement models are increasingly focusing on quality of care rather than volume of services. Furthermore, there is a growing demand for patient care outside of hospital settings, leading to a shift towards more home care and telemedicine. However, the shortage of nurses and clinicians can negatively impact the quality of care delivered through these alternatives as well.
     

    Social Determinants Affecting Shortage
     

    Some argue that the COVID-19 pandemic significantly contributed to the trend of nurses leaving the profession, while I contend that COVID may have merely been the last straw. Nurses are facing burnout, fatigue, and dissatisfaction with their working conditions at the bedside. Sixty percent of the 3.2 million nurses in the United States are employed in hospital settings (Quaranta, 2024). In 2021, over 100,000 nurses exited the profession (Auerbach et al., 2022, as cited in Quaranta, 2024). According to Quaranta (2024), nurses leave bedside positions due to unfavorable working conditions, including unsafe patient ratios, low pay, long shifts, and poor management Nurse Staffing Shortages National Healthcare Issue/ Stressor.
     

    Furthermore, financial concerns contribute to the shortages of nursing staff. Hospitals spend substantial amounts of money on hiring, training, paying salaries, covering insurance, and providing benefits such as retirement plans. These expenses may hinder hospitals from hiring additional nurses. 
    Hospital CEOs, policymakers, and legislators may not fully grasp the importance of adequate nurse staffing for ensuring the safety of both patients and nurses, improving patient outcomes, and reducing nurse burnout. Additionally, the personal experiences of those in positions of power can significantly influence these decisions, making them less empathetic to the actual needs of nurses and patients.
     

    Healthcare System Response 
     

    There is a growing population of aging individuals with health problems. In brief, people are living longer due to advancements in medicine and technology. According to Amalberti et al. (2019), “By the 2050s, over 50% of the global population will be living with a chronic illness.”
     

    In response to the shortage of clinicians, some states are granting Advanced Practice Registered Nurses (APRNs) greater autonomy and flexibility. While this may help alleviate the shortage of clinicians, it does not address the ongoing shortage of nurses or the trend of nurses leaving the bedside profession. Many states in the United States do not have mandated nurse-to-patient ratios. There are currently bills pending that aim to address nursing ratios, but they have not made progress or received approval.
     

    Conclusion 
     

    The nursing and clinician shortage remains a pressing national healthcare issue with far-reaching consequences for patient care and safety. The challenges faced by nurses, including burnout, inadequate working conditions, and insufficient staffing ratios, contribute to high turnover rates and diminished quality of care. As the healthcare landscape evolves, it is crucial to address these underlying issues to cultivate a sustainable workforce. While initiatives to enhance the autonomy of Advanced Practice Registered Nurses (APRNs) may provide some relief, a comprehensive strategy that also focuses on improving the workplace environment for all nurses is necessary. This includes advocating for mandated nurse-to-patient ratios, addressing financial constraints for hospitals, and fostering supportive management practices. By prioritizing these changes, we can ensure a healthier future for both healthcare professionals and the patients they serve Nurse Staffing Shortages National Healthcare Issue/ Stressor.
     

     

    References 
     

    Amalberti, R., Vincent, C., Nicklin, W., Braithwaite, J. (2019).  Coping with more people with more illness part 1: The nature of the challenge and the implications for safety and quality. 
    International Journal for Quality in Health Care
    , vol 31 (2), pages 154–158.
     
    https://doi.org/10.1093/intqhc/mzy235
    Links to an external site.
     

    Broome, M., & Marshall, E. (2020). 
    Transformational Leadership in Nursing (3rd ed.). Springer Publishing LLC.
     
    https://mbsdirect.vitalsource.com/books/9780826135056
    Links to an external site.
     

    Quaranta, N. (2024). Team nursing: An innovative approach to address the nursing shortage. 
    MEDSURG Nursing
    , 
    33
    (2), 79–84. 
    https://doi.org/10.62116/MSJ.2024.33.2.79
    Links to an external site.
    Nurse Staffing Shortages National Healthcare Issue/ Stressor