Discussion: Review of Current Healthcare Issues NURS 6053

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Discussion: Review of Current Healthcare Issues NURS 6053

Discussion: Review of Current Healthcare Issues NURS 6053

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

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To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.
Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, 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.

RE: Discussion – Week 1

The national healthcare issue/stressor that I selected for analysis in the discussion board this week involves the need for more primary care providers. Data provided by Auerbach, Staiger, and Buerhaus (2018) indicates that while physicians have historically provided most medical care, there is currently a shortage of providers due, in large part, to issues related to the ability of post-secondary institutions to increase capacity to educate and train new physicians. This is occurring at a time when the number of non-physician medical providers including physician assistants and advanced practice registered nurses (APRNs) are being educated in record numbers (Yang et al., 2017). Jacobs, McGovern, Heinmiller, and Drenkard (2018) argue that part of the Triple Aim in healthcare is to increase patient experience while reducing costs. This can be achieved by ensuring that patients have access to needed care such that actions such as health promotion and disease prevention can be achieved.

Based on this assessment, it is helpful to consider how my healthcare system has responded to this problem. In recent months, the organization has hired more physician assistants and advanced practice registered nurses. Additionally, the organization has pledged political support for making APRNs independent practitioners. Collectively, efforts to promote independent practice for advanced practice nurses have focused on initiatives undertaken at the state level (Yang et al., 2017). State boards of nursing are responsible for setting the scope and standards of practice for the profession and, ultimately, have the final word regarding independent practice for this group (Yang et al., 2017). At the present time, my organization is working with state policymakers to prompt a change in how advanced practice nurses provide care for patients. It is hoped that this will increase patient access to care providers, alleviating the current strain faced by patients and physicians alike.

Expanding the healthcare workforce to enable APRNs to provide services including primary care and mental health has consistently been supported in the literature as a means to improve the quality of patient care while increasing access to health services and lowering costs (Woo, Lee, & Wilson, 2017). The relevance of the policy to nursing is quite substantial and should have a significant impact on the expansion of the role of the advanced nurse practitioner. Current evidence indicates that following the passage of the Affordable Care Act, demand for primary care and mental health services has increased dramatically (Bodenheimer & Smith, 2013). As the healthcare system attempts to accommodate increased demand for healthcare services, providers have struggled to ensure that all patients seeking these services are able to provide high quality supports for patients (Bodenheimer & Smith, 2013). This situation is juxtaposed against a backdrop of a changing landscape for nursing education and training. More specifically, research indicates that nursing education has become more rigorous, creating an environment in which care provided by APRNs is commensurate with that delivered by physicians (Swan, Ferguson, Chang, Larson, & Smaldone, 2015). Further, this care is typically less expensive and more accessible (Swan et al., 2015).

What this suggests is that by supporting APRN independent practice, my healthcare facility will, at some point in the future, be part of a transformational change for nursing. This change should facilitate the ability of the organization to accomplish the Triple Aim in healthcare, leading to improved outcomes for patients while also reducing costs. Clearly, there are a multitude of benefits that can be achieved from this change, warranting consideration to ensure that efforts are being made by organizations to improve the nation’s healthcare system.

References

Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869

Bodenheimer, T. S., & Smith, M. D. (2013). Primary care: Proposed solutions to the physician shortage without training more physicians. Health Affairs, 32(11), 1881-1886. doi: 10.1377/hlthaff.2013.0234

Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa

Swn, M., Ferguson, S., Chang, A., Larson, E., & Smaldone, A. (2015). Quality of primary care by advanced practice nurses: A systematic review. International Journal for Quality in Health Care, 27(5), 396-404. doi: 10.1093/intqhc/mzv054

Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15, 1-22. doi: 10.1186/s12960-017-0237-9

Yang, B. K., Trinkoff, A. M., Storr, C. L., Johantgen, M. E., Idzik, S., Zito, J. M.,…Safer, D. J. (2017). Nurse practitioner independent practice authority and mental health service delivery in US community health centers. Psychiatric Services, 68(10), 1032-1038. doi: 10.1176/appi.ps.201600495

RE: Discussion – Week 1

I agree we need more NP’s and what a valuable asset they are. My inpatient psych unit had one that worked four days a week and had full privileges and in Iowa, an ARNP can practice independently complete with prescription privileges, or partner with a physician (Advanced Registered Nurse Practitioner – Role & Scope, 2020). For some unknow reason, the healthcare system I am part of decided not to use mid-levels on the psych un it but will use them as hospitalist and in the emergency department. I believe it was in relation to the fact that our medical director is only there on weekends and the remainder of the doctors are tele-medicine ones. Our medical director was required to sign off most of the NP’s charts per hospital policy. Some doctors find this a burden putting their signature to a patient chart they had not seen that day, but for the unit it was nice having someone on hand to help communicate with and ease the rounding responsibilities for the doctor (Poghosyan et al., 2018). I agree that we are going to be in even worse shape if we don’t ease the requirements of what APRN’s can do, especially with so many provider shortages already. While I can’t change what my health system decides to do, it would help if they adhered to the state laws, and if they were equal in all states.

References

Advanced registered nurse practitioner – Role & scope. (2020). Iowa Board of Nursing. Retrieved September 1, 2020, from https://nursing.iowa.gov

Poghosyan, L., Norful, A. A., & Laugesen, M. J. (2018). Removing restrictions on nurse practitionersʼ scope of practice in new york state. Journal of the American Association of Nurse Practitioners30(6), 354–360. https://doi.org/10.1097/jxx.0000000000000040

RE: Discussion – Week 1

The healthcare stressor you have chosen is something I can relate to right now because the hospital I work at is transitioning to another facility, and we are short of nursing staff every day.  The shortage of nurses has been going on for quite some time, and there is no relief in sight.  This issue makes it hard for the nurses working to maintain a clear mind and not become burned out.  My place of work offers double-time as an incentive to bring nurses in but, many have stopped working extra shifts due to them feeling burned out. It is a sad situation because it is the patients who suffer from a lack of time that nurses have to spend with them.  Often, the nurses have six to seven patients at any given time with new admits coming in all night long.  I am just hoping that when this move is over, the nurses and patients will have some relief.

According to the Bureau of Labor Statistics (BLS), there will be 1.2 million registered nurse job openings between 2014-2022 and will increase by 2025.  Because people are living longer, and the high population of seasoned nurses retiring, plays a role in the shortage (Haddad et al., 2020).  One major issue that causes nursing shortages is because of nursing schools.  Nursing schools are not keeping up with the demand for nurses.  Many individuals who pursue nursing as a career are turned away because of a lack of space. Also, nursing schools are having a rough time finding sufficient faculty to teach the nursing program. Many times, financial issues are the basis of the lack of educators.  To help in this problem, individuals can turn to specialize in areas of need in healthcare, such as gerontology (Mewshaw et al., 2017).

Reference

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing Shortage. In StatPearls. StatPearls Publishing.

Mewshaw, J., Bailey, D. E., Jr, Porter, K. A., Anderson, A. L., Anderson, R. A., Burd, A. L., Colón-Emeric, C., & Corazzini, K. N. (2017). A novel program for ABSN students to generate interest in geriatrics and geriatric nursing research. Journal of nursing education and practice7(6), 95–99. https://doi.org/10.5430/jnep.v7n6p95

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 1

To participate in this Discussion:

Week 1 Discussion

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6053_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6053_Module01_Week01_Discussion_Rubric

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