Comment 1

The PPACA was aimed to improve the health care system, offering affordable health insurance to more Americans, expand the Medicaid program to cover all adults that live below the poverty level, and to support innovative medical care delivery methods designed to lower the costs of health care generally (Lampert, 2009). The PPACA mandates that everyone that is legal will have health coverage in the United States or a penalty will have to be paid at the end of the year. With the influx of people now receiving healthcare, they will be seeking medical attention where in the past they would not. The increase in people seeking medical attention will result in a needed increase in nurses to take care of these patients and more training to gain more expertise and skills to be able to manage the emerging needs and diseases.

A key nursing provision is the health care workforce loan repayment program (Section 5203). This section focuses more on children. It has a focus on pediatric medical or surgical and children mental and behavioral health care. The repayment program will offer psychiatric nurses, social workers, and professional/school counselors up $35,000 a year in loan repayments for their participation in an accredited pediatric specialty residency program.  A second key provision is public health workforce recruitment and retention programs (Section 5204).  This provision is aimed at eliminating the shortage of public health agencies. This provision has offered a one third repayment of loans for an exchange of a contract of employment acceptance with a public health agency for three years. This program is offered to eligible public health or health professions.

I know my nursing career will be affected by the provisions that were listed above along with all the other provisions listed in the PPACA. Offering loan repayments will give nurses the incentive to obtain higher degrees. Recruitment and retention would likely decrease the nurse shortage by new nurses coming in and showing loyalty to the season nurses.

Comment 2

The effect of the Patient Protection and Affordable Care Act (PPACA) resonates profoundly in the U.S. healthcare environment and among the public. Two key provisions of the act include: 1) Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions; 2) Section 5204 Public health workforce recruitment and retention programs.

           With the first requirement, health care setting experienced a rise in the number of new patients, as expected. Many of these patients were probably afraid or restricted from going to the hospital or seeking medical care due to the lack of healthcare coverage. The impact is that more people are seeking medical care. From my nursing practice, I observe some of these patients have chronic illnesses that have been neglected and thus require more care. Also, more patients come for medical services; emergency rooms fill with more patients. This increases patients’ population. In return, this affects nurse to patient ratios. Nurses have to care for more patients. They have to work extra time due to shortage of staff. The downsides is that nurse morale is low and the risks for medical errors are high.  

                The second nursing provision (Section 5204) retained refers to the established “Public Health Workforce Loan Repayment Program.” This provision gird to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. The positive impact of this provision is that government will repay up to “1/3 of loans incurred by a health professions student in exchange for an agreement to accept employment with a public health agency for at least three years” (CDC). Ultimately, this provision makes it easier to attract young people to the field of nursing. This will have a positive impact on the nursing shortage. It is an attract incentive for many current nurses to pursue their studies and opt for advanced degree in nursing. This is exactly what I am intended to do.

Comment 3

Nice post! Some important aspects of the ACA, include the consumer assistance program, which is a program that helps people enroll in coverage as well as file complaints if a person is denied payment for any type of healthcare service. There are also preventative healthcare services if eligible, paid by insurance. Seniors that are on Medicare who are struggling with prescription costs, can find assistance with discounts and rebates as well. The ACA also offers more options when choosing insurance coverage. There is also a pre-existing condition insurance plan for people who may have a disability or chronic condition, that were previously denied coverage under regular insurance options. In addition, parents are able to cover their children under the age of twenty-six if they are unable to get insurance. The ACA has given people the ability to choose any doctor they wish to see, whether or not they are affiliated with a network or not. Additionally, the Children’s Health Insurance Program (CHIP) will be extended from 2015 through 2019, providing coverage to children in low-income families (KHN, 2018).

dentify what issues may arise with the prescriptive authority of controlled substances and how you may avoid these situations?

Whenever there is a prescriptive authority of controlled substances, there is likely to be an abuse of the same by drug administrators. This has been demonstrated by the case of Heather Alonso, who was an advanced practice registered nurse (APRN) and used her position to prescribe controlled substances under the Medicare drug program. Nurse practitioners are not supposed to prescribe schedule 2 drugs since there is a high potential that they will be abused. Such issues mainly arise when medical practitioners compromise their practice and administer highly controlled substances contrary to rules and regulations, mainly because they receive hefty payments for the same.

To control the administration of controlled substances, the first step that must be taken is to ensure that a diagnostic workup is conducted (Young, 2018). The diagnostic workup will enable physicians to properly diagnose a patient before administering any drug. In the case of Heather Alonso, many of the patients were not being reviewed hence leading to prescriptions being administered wrongly. The second step that must be taken is to utilize prescription databases and obtain a medical history of the patient. The database will give information on whether the patient has received medication from multiple doctors. Screening for drug seeking is also necessary as it will enable one to establish if the patient is genuine or they are just abusing drugs.  Also, states can revamp their prescription drug monitoring programs (PDMP) which will have better standards for monitoring the administrati0n of controlled drugs (Perrone & Nelson, 2012). All the drugs which fall under schedule 2-5 are monitored. This will enable the states to understand whether stricter control and surveillance is needed. Through the PDMP, surprise audits can be done at the premises of drug administrators to check whether the necessary guidelines are being followed.This will lead to better monitoring and control when it comes to administration of controlled substances.

References

Young, J. (2018).Best Practices When Prescribing Controlled Substances. Retrieved from https://www.psychologytoday.com/us/blog/when-your-adult-child-breaks-your-heart/201806/best-practices-when-prescribing-controlled

Perrone, J., & Nelson, L. S. (2012). Medication reconciliation for controlled substances—an “ideal” prescription-drug monitoring program. New England Journal of Medicine, 366(25), 2341-2343.

APA format

4-5 pages, including references

no plagiarism

Must answer the following questions (not necessarily in that order)

– What is polypharmacy?

– What risks does polypharmacy bring to older adults

– What concerns do medical professionals (nurses in particular) have with polypharmacy in elderly patients?

– Problems caused by polypharmacy

– Possible solutions for problems caused by polypharmacy

– As a nurse, what tips can be given to elderly patient to monitor polypharmacy. 

Discussion board questions:

500 word APA FORMAT 

1.  Think about the ethical theories and approaches in this Chapter 4 and the moral conflicts you have experienced in the past.  Have you used one of these approaches to resolve a conflict?  Which theory or approach have you used?

2. Has there ever been a time when you have experienced the dilemma of having to make a choice that you know will affect the well-being of another individual? Have you ever experienced moral suffering?