Assignment Instructions
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced within the last 5 years to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse's role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years in response to upcoming trends or predicted issues in health care.
Sample Answer
Introduction
Healthcare systems are usually large and complex systems and are in all countries in the world. They are meant to steer the provision of care services in the right direction. Healthcare reforms are meant to impose purposeful, sustained, and fundamental changes in care provision. Reforms are a process of change that involves who, what, and how of the health sector action. The healthcare reforms can be classified into global and partial reforms. Partial reforms define the developmental incremental issues and day-to-day operation and they focus on changing one aspect of the healthcare system. On the other hand, global structural reforms aim at reshaping the entire healthcare system. This paper discusses the current or emerging care laws, quality measures for Pay for Performance, emerging professional nurse and management roles, and emerging trends in nursing.
Current or Emerging Health Care Law or Federal Regulation and Effect on Nursing Practice, Role and Responsibility
One of the most recent healthcare reforms in the United States is the Inflation Reduction Act which improves affordable and quality healthcare. The act extended the premium tax credits up to 2025 and this allowed low and middle-income families to afford the health insurance previously purchased through the Affordable Care Act. This law limited the out-of-pocket costs of prescriptions for all the seniors in Medicare Part D. A lot of patients living with lung diseases cannot afford the necessary medication and 3 out of 10 patients have to skip their medication. Under this law, patients under Medicare will pay less than $2000 for their drugs and they can choose a flexible Medicare Prescription payment plan (American Lung Association, 2023). The Inflation Reduction Act covers bills that are related to vaccine coverage and the Protecting Seniors Act. The Vaccine Coverage Act ensures that all the patients under Medicaid have access to all the CDC-recommended vaccines at no cost. On the other hand, the Protecting Seniors Act removed all the copayments for the vaccine and as of January 1, 2023, more than 50 million seniors under Medicare no longer incur any out-of-pocket costs for the vaccinations. The Act affects the roles and responsibilities of nurses and nursing practice as nurses are now relieved of the burden of care as more people can access vaccines and thus are protected from diseases.
Quality Measures for Pay for Performance, Patient Outcomes and, Effect on Nursing Practice
The pay for performance plays a crucial role in improving patient outcomes. The model improves healthcare by reducing the amount of healthcare services that may result in to undersupply or oversupply and this results in to direct effect on the use of resources. This payment model improves patient outcomes by incentivizing the implementation of quality measures such as allocating more money for healthcare facilities. Though it can be argued that the pay-for-performance model enhances the quality of care, it yields a negative reaction from the hospitals (Mathes et al., 2019). Sometimes, hospitals avoid taking in very sick patients or patients suffering from various diseases to achieve the best performance. By doing so, the hospitals can receive more payment without necessarily increasing the quality of care provided. Also, sometimes, hospitals can focus more on improving the neglect procedures that previously were not incentivized. The pay for performance affects nursing practice as they have to always adhere to principles of beneficence and non-maleficence. This ensures that the care provided is beneficial to the patients and it limits the harmful effects of the care provided. By applying these principles, nurses encourage healthcare providers to admit patients suffering from complex health issues. Nurses also remind other healthcare providers to adhere to the Hippocratic Oath that requires them to participate in life-saving activities and avoid patient dumping.
Professional Nursing Leadership and Management Roles
There has been a lot of technological advancement in healthcare and the emerging technology has led to new roles such as the nursing informatics and perioperative informatics nursing roles. Nurse informaticist oversees huge sets of health data and this is crucial in advancing population health and nursing practice in general. One of the top concerns in healthcare is security and nurse informaticists enhance compliance with standards such as the Food and Drug Administration (FDA) and Health Insurance Portability and Accountability Act (HIPAA) (Duquesne University School of Nursing, 2022). Nurse informaticists promote patient safety and provide high-quality care by determining the needs of healthcare organizations and using technology to meet these needs. They are in charge of designing and delivering training on the use of various technologies by patients and healthcare providers. Additionally, nurse informaticists communicate key data findings to the stakeholders and this promotes data-driven care plans and decision-making processes. Another emerging role among the nurses is the perioperative informatics nurse. A perioperative informatics nurse specializes in taking care of the patients before, during, and after surgery while utilizing the most recent technologies (Duquesne University School of Nursing, 2022). Nurses in this role also introduce and expand the models of care and this improves the perioperative process and they conduct research on Health Information Technology (HIT).
Predict Change in Nursing Roles and Nursing Practice
There are various trends in healthcare that have led to the emergence of new nursing roles and nursing practice and they are the increased use of telehealth technology and the need for self-care in nursing. Telehealth technology became more popular during the COVID-19 pandemic as it became almost impossible for every patient to visit a healthcare facility (Doraiswamy et al., 2020). The technology has transformed nursing practice as now; nurses can now attend to the patients and make follow-ups without the patient visiting the facility. The role of nurse informaticists has emerged as there is a need for the security and privacy of protected health information. Nurse informaticists ensure that the nurses are using telehealth in a manner that is secure to communicate any sensitive data. There is a need for self-care for nurses as they experience trauma and stress daily. The pressure at work affects the nurses’ satisfaction with the work environment, their mental health, and their overall quality of life. This has led to the emerging role of nurse counselors who help nurses deal with the emotions of fear and frustration. Additionally, nurses should support each other to deal the mental health toil in the workplace.
Conclusion
Healthcare reforms are crucial in introducing effective changes in healthcare. One reform in the United States currently is the Inflation Reduction Act covers bills that are related to vaccine coverage and the Protecting Seniors Act. Different pay models derive different effects in healthcare and the pay-for-performance model enhances the provision of high-quality care while adhering to the principles of non-maleficence and beneficence. The new technologies and emerging trends in healthcare have led to the emergence of new roles such as nursing informaticists and perioperative nursing informaticists roles.
References
American Lung Association. (2023). Part Two: Reviewing the Inflation Reduction Act, One Year Later. https://www.lung.org/blog/ira-healthcare-policy-review#:~:text=The%20Inflation%20Reduction%20Act%20has,the%20Affordable%20Care%20Act%20marketplaces
Doraiswamy, S., Abraham, A., Mamtani, R., & Cheema, S. (2020). Use of telehealth during the COVID-19 pandemic: a scoping review. Journal of medical Internet research, 22(12), e24087. https://www.jmir.org/2020/12/e24087/doi:10.2196/24087
Duquesne University School of Nursing. (2022). Five trends in nursing. https://onlinenursing.duq.edu/blog/trends-in-nursing/
Mathes, T., Pieper, D., Morche, J., Polus, S., Jaschinski, T., & Eikermann, M. (2019). Pay for performance for hospitals. Cochrane Database of Systematic Reviews, (7). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611555/