1.Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
2.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.
1. To make sure that all the patients of America have access to required health care services, the nurses’ unique contributions are maximized, federal and state actions are updated. It also standardized the scope-of-practice regulations to take advantage of the potential and education of APRNs. States and insurance companies must follow specific policies, and financial changes that give patients the freedom to choose from a range of providers, including APRNs. Removing policies and financial barriers to promote patient choice and patient-centered care should be a foundation for the building of a reformed health care system (Center for Nursing – Foundation of NY State Nurses, 2016).
The health sector in the United Kingdom is getting a face lift, by providing the clients with long-awaited top notch service delivery. With the shift in the health care services, there is high demand for nurses and their practice is going to grow and change. Most of the policies related to nursing are bound to change once the recommendations by the “Institute of Medicine (IOM)” are implemented.
The concept of Continuum or Continuity is highly important for growing and modifies the practice of the professional nurses (Jenkins et al., 2015). As opined by Uijen et al., (2012), the entire concept of Continuum or Continuity is focused on the episodic care to provide enhanced ways of treatments to the service users. The nurses must be educated about such services. The primary objectives of the concept of Continuum or Continuity are to provide integrated healthcare services to the service users along with high quality of treatments, low cost as well as efficient care to the entire service user who are suffering from the severe health issues (Uijen et al., 2012). Apart from that, as commented by Digel Vandyk et al., (2013), few types of Continuum or Continuity are there. Those are:
Management Continuity refers to the spontaneous as well as the cohesive approach for providing enhanced services to the service users. As stated by Woods et al., (2013), management continuity includes the care protocols, planning related to the shared management and the critical approaches that can increase the quality of the services.
Informational Continuity: refers to the effective transaction related to the accumulated knowledge as well as the significant information for efficiently creating a bridge between various care events for emphasizing the ways of the treatments (Jenkins et al., 2015).
Interpersonal or Relational Continuity: refers to the existing therapeutic relationship within the concurrent healthcare setting. As revealed by Uijen et al., (2012), interpersonal or relational continuity can bridge the gap between the healthcare service providers and the service users to gather the significant information related to the existing as well as future health care setting.
There is a positive implication of “nurse-managed health clinics (NMHC)” with the increase in federal and state funding. It has the positive impact on thousands of patients across the nation. It includes treating the patients assessing the whole environment in which they live instead of merely focusing on the disease and medication. It includes more of person-centered care (Jenkins et al., 2015). NMHC is well known for the caring majority of uninsured patients. However, this service is greatly at risk due to lack of funding. Recent reports show that in UK, there is a greater utilization of NMHC and the nurse practitioners in primary care (Pittman et al., 2014). It is already on the ground, and it seems promising for patients in critical care.
Currently, the area of particular importance to American Nurses Association is the “accountable care organizations or ACOs” (Sheingold & Hahn, 2014). It includes the group of service providers (physicians, nurses, and other professionals). However, certified nurse-midwives are not listed as a part of ACO. Presently, nurses should be educated about how these people collaborate to deliver seamless and high quality care for the “Medicare beneficiaries”. After the implementation of the “Patient Protection and Affordable Care Act of 2010 (PPACA)”, the focus of health care providers shifted to “accountable care and value-based health care” (Redman et al., 2015). Additionally, “medical homes” are growing popular. These deliver primary care with the patient-centered approach. It aims to provide care and also respect patient’s dignity and decisions. These MH provide comprehensive and coordinated care (specialty care, community services, and home health care). It helps patients to enable services with minimum waiting time and 24 hours telephone access (Woods et al., 2013).
2. As per the feedback from the nurse colleagues, they seem supportive with my presentation as well as they revealed that the establishment of the appropriate government legislations has to be maintained for improving the concurrent situations of the healthcare sector of United Kingdom. Also, as stated by Pittman et al., (2015), Action Coalitions are discussed for improvising the concept of the future of the nursing as well as to diverse the groups that are related to the stakeholders. It is necessary to mention that, these diverse groups can affect the concept of sustainable development related to the healthcare sector. Action Coalitions includes setting clear goals of improving the health sector by the potentiality of the professional nurses. It requires involving the stakeholders to represent the various areas for building up an appropriate blueprint action (IOM Future of Nursing Report 2016). As opined by Pittman et al., (2015), presently, near around 36 Action Coalitions are launched into two significant phases in various nations such as Virginia, Georgia, Hawaii, Texas, Ohio, and the other places.
On the other hand, each of the Action Coalitions is facilitating with the desired goals that can be a part of the overall outcomes that are related to the healthcare campaigns to influence the professional nurses (Redman et al., 2015). Moreover, as per the feedback of the nurse colleagues, the nurses have the potential as well as innovative strategies for mitigating various highly serious health issues as well as to improve the existing situation of the healthcare system. However, various difficulties may come to them, which can be related to the demographic challenges, aging workforce, fragmentation of the related healthcare setting and the other relevant barriers that can hinder the potentiality of the nurses. Nurses expect the problem of a low nurse is to patient ratio to be resolved as well as the issue of long shift hours.
It is necessary to mention that, Accountable Care Organizations (ACO) is always prioritizing the issues that are faced by the nurses. Also, decision-related to the life and death in the health professions is the foremost challenge from the ethical as well as the practical viewpoint. Nursing advocates in the United States can overcome the barriers through expanding the highly significant opportunities for the professional nurses. It will help leading them towards enhancing their practical knowledge and skills to provide better services to the clients.
The existing barrier to the advancement of Action Coalitions is the lack of potential of the professional nurses (Uijen et al., 2012). Most of the healthcare organizations have insufficient numbers of professional for providing enhanced services. On the other hand, lack of better partnerships between the health care organizations is also creating barriers in the United States. However, as per the feedback of the professional nurses the concept of Continuum or Continuity can help the professional nurses for facing the challenges related to service users, demand for the enhanced healthcare services and existing complexity of the healthcare settings. As per the discussion of the professional nurses, few integrated mechanisms are particularly used for enhancing the growth and change of the professional nursing practices. Those are discussed blow.
Community-based services: According to the concept of Continuum or Continuity, the professional nurses who are related to the home health care, can help the service users by expanding the continuum by visiting the residence of the service users and assessing their health to provide effective services (Uijen et al., 2012).
Health information Systems: The professional nurses can use the integrated system of fetching information of clients to provide the high quality of services with low costing. This is to collect integrated information (biased data) of the service users as per their various lifestyle aspects such as financial, cultural, behavioral as well as environmental barriers (Woods et al., 2013).
Disease Management Program Events: As per the feedback from the professional nursing colleagues, placing the disease management program events are highly essential to measure the limit of the serious health issues such as cardiovascular diseases, diabetic issues and other highly serious health issues of the service users. Therefore, the way to mitigate those health problems will be easier for the nursing personnel.
Reference List
Center for Nursing – Foundation of NY State Nurses. (2016). Foundationnysnurses.org. Retrieved 10 June 2016, from https://foundationnysnurses.org/foundation/future-of-nursing.
Digel Vandyk, A., Graham, I. D., VanDenKerkhof, E. G., Rossâ€ÂWhite, A., & Harrison, M. B. (2013). Towards a conceptual consensus of continuity in mental healthcare: the focused literature search and theory analysis.International Journal of Evidenceâ€ÂBased Healthcare, 11(2), 94-109.
IOM Future of Nursing Report. (2016). Nursingworld.org. Retrieved 10 June 2016, from https://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/IOM-Future-of-Nursing-Report-1.
Jenkins, M. G., Ford, J. B., Todd, A. L., Forsyth, R., Morris, J. M., & Roberts, C. L. (2015). Women׳ s views about maternity care: How do women conceptualise the process of continuity?. Midwifery, 31(1), 25-30.
Pittman, P., Bass, E., Hargraves, J., Herrera, C., & Thompson, P. (2015). The future of nursing: monitoring the progress of recommended change in hospitals, nurse-led clinics, and home health and hospice agencies. Journal of Nursing Administration, 45(2), 93-99.
Pittman, P., Horton, K., Terry, M., & Bass, E. (2014). Residency Programs for Home Health and Hospice Nurses Prevalence, Barriers, and Potential Policy Responses. Home Health Care Management & Practice, 26(2), 86-91.
Redman, R. W., Pressler, S. J., Furspan, P., & Potempa, K. (2015). Nurses in the United States with a practice doctorate: Implications for leading in the current context of health care. Nursing outlook, 63(2), 124-129.
Sheingold, B. H., & Hahn, J. A. (2014). Medical Homes and Accountable Care Organizations: Innovation for the Delivery System of the Future. Policy and Politics for Nurses and Other Health Professionals, 223.
Uijen, A. A., Schers, H. J., Schellevis, F. G., & van den Bosch, W. J. (2012). How unique is continuity of care? A review of continuity and related concepts. Family Practice, 29(3), 264-271.
Woods, L. N., Lanza, A. S., Dyson, W., & Gordon, D. M. (2013). The role of prevention in promoting continuity of health care in prisoner reentry initiatives. American journal of public health, 103(5), 830-838.
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