Assignment Topic: Evolving Practice of Nursing and Patient Care Delivery Models
The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline and their local communities.
As the country focuses on the restructure of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and less will be available in acute care hospitals.
Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and changes. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics and medical homes.
In 800-1,000 words summarize the responses shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
A minimum of three scholarly references are required for this assignment.
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
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Nursing: Benchmark Assignment: Evolving Practice of Nursing and Patient Care Delivery Models
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Introduction
The healthcare and public healthcare system in the US has undergone major reforms. It is prudent that the nursing workforce is able to meet the changing and increasing healthcare reforms. There have been many reports that have focused their attentions on “what should be” rather than “what is”. All these reports have studied the capacity of the workforce in the healthcare to meet future demands in the sector. The healthcare system in the US has evolved greatly and there is need to educate nurses on the need for continuum in order to meet these changes.
Evolving Practice of Nursing and Patient Care Delivery
A thorough examination of the capacity of RN to meet the ever-changing healthcare system in the US is justified by many reasons. The administration of Obama, for instance, introduced many changes in the healthcare system, (Nap.edu, 2014). These changes include the legislation reform in the healthcare signed by the president in 2010 and the American Recovery and Reinvestment Act of 2009. All these changes are designed to change the way the healthcare is financed and how the services are delivered. The RN nurses should be acquainted with these changes in order to ensure that they are most competent and able to meet future changes and challenges.
Most of the organizations under the new programs introduced by the Obama administration, for example, the Accountable Care Organizations (ACOs) and the Primary Care Medical Homes rely entirely on the services of the RNs. The RN are tasked with the responsibilities of coordination and transition care. This points the importance of RNs in the success of the reforms in the healthcare both currently and in the future. Furthermore, the investments in interoperable health information technology (HIT) form critical core area in the implementation of major reforms in the healthcare system. In addition, interoperable health information technology (HIT) has an effect of influencing the growth of the information exchange in the community, potential of changing the skill mix, distribution and the scope of the RNs in many ways.
Therefore, the questions to be answered are whether the demand for the services provided by RNs will change as suggested by the healthcare reforms. Furthermore, has nursing workforce been positioned effectively? Moreover, what does the future ask of the nursing workforce? The policies put forth by the Obama administration, in addition to other healthcare reforms, calls for the reorganization of the healthcare system and the healthcare providers, (‘Obama announces radical healthcare reforms’, 2009). The implementation of these reforms and related policy frameworks has a significant impact on the roles of the RNs and their requirements.
Advancing the Care Management Models
Care Management are a collection of strategies meant primarily for individuals under critical illness and whose services require intervention of a number of healthcare providers with long-term and continuous management. The most dominant care management in the past 15 years in the country has been disease management and this has been responsible for huge spending in the healthcare. The program heavily relies on the good coordination and interdisciplinary clinical management for it to be a success.
Medicare Prescription Drug Improvement Modernization Act of 2003 made a number of provisions in population based care programs to assess whether cost saving could be achieved in its pilot programs. Although cost savings were elusive, a number of quality outcomes were achieved through this program.
However, some care programmes have been able to achieve best care outcomes and cost savings by avoiding unnecessary hospital admissions for patients. The pronounced features for the successful care programmes includes a good coordination from RNs and the interdisciplinary team serving such patients. Such RNs have been able to coordinated successfully care management strategies through directed the care to such patients by maintaining personal attention to such patients through such means as direct telephone calls and other electronic methods. These provide benchmark for RNs in their future roles in the healthcare systems. Healthcare reforms include several programmes and healthcare initiatives that require care management services, cross-care setting and interdisciplinary coordination by the RNs.
Patient-Centered Medical Homes
Taking into consideration the huge amount of dollars spent in the healthcare, the healthcare reform placed more emphasis on strategies that are indented to reduce costs, fragmentation and poor quality outcomes in the sector. A report published by Institute of Medicine’s Roundtable on Evidence-Based Medicine in 2009, shows that over $271 billion can be saved annually by coordinating healthcare and consequent elimination of discontinuity. One strategy that is consistent with the reform policies is the patient centered care. In this strategy, the RNs are required to attend to the varied needs of the patients and thus provide comprehensive care that is patient centered.
The healthcare reforms draws more from the innovations in the structural and care delivery over the decades, in developing its own version of patient centered medical homes, (Keepnews, 2010). The patient centered home models are indented to address existing gaps in healthcare, where patients are required to be the center of care and redesigning the nursing practice so that it is centered on caregivers and the patients. The other major component the model addresses is the management of the chronic illnesses in the primary care settings and provision of necessary resources for the effective operations of the patient centered homes.
The demand for advanced practice nurses and RNs will keep growing since there will be increased accessibility, coverage and service setting as well as services. A good example of this scenario is the increased demand in Massachusetts due to the passage of the healthcare reform in 2006. Many of the expansion will likely fall largely on the shoulders of the practicing nurses since the number of nurses rivals those of the family physicians who offer primary care services. This increased demand shows the need for the readiness of the nurses and nursing profession to the future developments in the healthcare sector. (Evolving Practice of Nursing and Patient Care Delivery Models)
Summary of the Responses Shared by Nursing Colleagues
The responses provided by the nurses were consistent with the research this paper did. The nurses asserted that there have been major changes and that majority of the services and focus is bound to change in the healthcare system. The nurses acknowledged the impact the policies as entailed in the healthcare reforms has affected the roles of the RNs and other healthcare professionals at large. Similarly, the RNs observed that there has been an increase in the number of individuals seeking healthcare services in the US. An example was given on the statistical changes in the number of patients from 2000- 2006, where an estimated growth of 67% in patients served by the healthcare system in the US was recorded. The nurses, in reference to this growth and the new policy directions provided by the Obama administration admitted that there are many changes in the sector and that the healthcare professionals need to be aware and acquaint themselves with the new roles that they would be required to play.
The other major issue that arose was that the change in demographics and diversity are the major trends observed in the healthcare system in the United States. This response is consistent with the research findings in this paper in that the healthcare reforms were formulated specifically to address the changes in the population. There is increasing life expectancy in the US, which is estimated to be more than 65 years by 2020 with over 20% of the population living beyond the age of 65. With this in mind, it is worth noting that the healthcare system should expect many challenges in the future and this mostly rests with the RNs’ shoulders. The student demographics as well as ethnic diversity is rapidly changing in the US and these are some of the responses that were put forth as the major changes that would be observed in the future. Although this response appears inconsistent with the research findings in this paper, it is indeed a challenge for the healthcare system in the US. Modern nurses are tasked with the responsibility of learning their culture and understanding the culture of the population it serves. However, culture is dynamic and the competence of any RNs is based in his/her cultural competence. The diversity of the culture in the US colleges has created even a rich source of students with diverse backgrounds. The other aspect in this opinion rested on the fact that there is growing demand for more nurses and many students continue to enroll in baccalaureate in order to be able to response well to the ever changing diversity and cultural backgrounds of the US…………………………………………………………………………………………Evolving Practice of Nursing and Patient Care Delivery Models……………………………….
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