RESPOND TO THE 2 POST .  AT LEAST 3 CITATIONS

Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

 Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples. 

Respond to this post. Post 1 JI

Nurses are considered the largest group of health professionals. Per the American Nurses Association, there will be far more registered nurse jobs available than any other professional healthcare by 2022 (Nursing Workforce, n.d.). Because of this shortage, there is a competing need for needing nurses due to nursing shortage and the high volume of patients requiring care. One of the causes of the nursing shortage is the result of the aging population. Currently, there are about 40.3 million people in the United States that are age 65 or older (Older Population and Aging, n.d.).  As these babyboomers age, they are requiring higher acuity/patient needs in the hospitals (Haddad et al., 2020).

This high acuity of patients and nursing shortage causes organizations to develop policies that ensure a safe patient to nurse ratio. These policies ensure there is safe staffing of nurses and patient safety. An appropriate nurse-patient ratio allows the best and safer care of patients and prevents nursing burnout (The Importance of the Optimal Nurse-to-patient Ration, 2016). 

The Healthcare issue selected is nursing burnout which is greatly impacted by patient acuity level and not having appropriate staff to take care of patients. This sometimes results in nurses taking care of more patients than the recommended safe nurse to patient ratio. Nurses having to work in a high-stress environment also impacts patient safety (Nursing Workforce, n.d.).

The way policies would be able to address this current issue would be to have organizations be fined if nurses are given an assignment that requires taking care of patients more than the nurse-patient ratio allows. Currently, California is the only state that legally has a defined nurse to patient ratio (The Importance of the Optimal Nurse-to-patient Ration, 2016).

References

Haddad, L. M., Annamaraju, P., & Toney-Butler., T. J. (2020, July 25). Nursing shortage. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK493175/

Nursing Workforce. (n.d.). American Nurses Association. Retrieved September 14, 2020, from https://www.nursingworld.org/practice-policy/workforce/

Older population and aging. (n.d.). The United States Census Bureau. Retrieved September 14, 2020, from https://www.census.gov/topics/population/older-aging.html

The importance of the optimal nurse-to-patient ratio. (2016, November 11). Wolters Kluwer. https://www.wolterskluwer.com/en/expert-insights/the-importance-of-the-optimal-nursetopatient-ratio

POST 2 SC

A competing need, when it comes to having a 2020-BSN prepared workforce, would be hiring non-BSNs or making exceptions for staff not to achieve a BSN degree.  This goal allows for some wiggle room by being 80% and not 100% of the nurses having a BSN.  Making exceptions is ok, but too many exceptions and the hospital may not meet this goal on time.  The policy impacted would be policies that mandate hiring BSN nurses and the requirement of non-BSN nurses getting their BSN.  The policy should remain, but the exceptions should be vetted through higher management to allow for exceptions.

The problem this goal imposes is balance.  Patient safety remains the top concern.  Immediately firing all nurses without BSNs and replacing them with BSN nurses can leave a hospital stripped of experience in nursing and policy, leaving patient safety compromised.  This problem is why this goal must be measured, and fortunately, it allows for an extended time frame (Gerardi et al., 2018). 

Not achieving this goal is the compromise that may be needed to ensure a safe balance of nurses that are familiar with the hospital and have adequate experience.  This compromise would be the impact of relaxing policies on hiring BSN nurses.  The nurses with experience with ADNs feel like the BSN nurses are no better than they are at bedside nursing (Matthias & Kim-Godwin, 2016).  Although they think they are the same, the higher ratio of BSN nurses in the workforce has many benefits (Straka et al., 2019).  Regardless, this goal has been set, and the competing needs are manageable.

In the hospital where I work, we have not achieved this goal but have been trying to.  I have seen days in the ICU where the most experienced nurse, including the charge and ANM, has three years of nursing experience.  This situation is where this goal, and other factors, has compromised patient safety.  We did not meet the goal by 2020 but are still trying to safely.  I have seen new hires come in with plenty of ICU experience that do not have BSNs, but they plan on getting it.

References

Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared 

workforce goal. AJN, American Journal of Nursing, 118(2), 43–45. 

https://doi.org/10.1097/01.naj.0000530244.15217.aa

Matthias, A. D., & Kim-Godwin, Y. (2016). RN-BSN students’ perceptions of the differences in 

practice of the ADN- and BSN-prepared RN. Nurse Educator, 41(4), 208–211. 

https://doi.org/10.1097/nne.0000000000000244

Straka, K. L., Hupp, D. S., Ambrose, H. L., & Christy, L. (2019). Reaching beyond 80% 

BSN-prepared nurses. Nursing Management (Springhouse), 50(5), 52–54. 

https://doi.org/10.1097/01.numa.0000557624.27437.25

One page with two reference 

 Would your problem identified in the Week 2 discussion question lend itself to a qualitative or quantitative design? What level of evidence (research design) would best address the problem? Explain your answer. 

 post was this please refer to answer the above question

To achieve a high-quality person-centered system of healthcare, there is a need to ensure that there is an active engagement of patients and their families in making decisions about their care. Family is any person who offers support to the patient and who is defined by the patient as such including relatives and friends among others. This effort has been ongoing for a long time as parents are allowed to be with their children at the hospital and patients under end-of-life care are allowed to have family around. However, this is different during a pandemic as healthcare workers have to balance between family support and limiting virus exposure (Frampton et al, 2020).

To discuss my topic, I will use an article by Hart et al that was published in 2020 and is titled ‘Family-centered care during the covid_19 era’. This article discusses how family-centered care can be achieved during a pandemic. In the case of a pandemic like Covd_19, the best way to ensure public safety is by restricting the physical of people, especially those that are not sick, in hospitals. This means that family-centered care, which requires the family to be there to communicate with the caregivers on important matters regarding the patient, will be affected. The article provides strategies on how we can support family-centered care while at the same time maintaining physical distancing (Hart et al, 2020).

This article will be beneficial to my topic because it will help me understand how we can maintain patient and family engagement in healthcare even during a pandemic. Both family-centered care and safety during a pandemic are things that we cannot compromise. It is however a bit difficult to achieve both during a pandemic. However, with information from this article, we can be sure to keep the patient and their family safe while at the same time achieving family-centered care. These strategies will lead to long-term progress in delivering care that engages both the patient and their family.

References

Frampton, S., Agrawal, S., & Guastello, S. (2020, July). Guidelines for Family Presence Policies During the COVID-19 Pandemic. In JAMA Health Forum (Vol. 1, No. 7, pp. e200807-e200807). American Medical Association.

Hart, J. L., Turnbull, A. E., Oppenheim, I. M., & Courtright, K. R. (2020). Family-Centered Care During the COVID-19 Era. Journal of Pain and Symptom Management.

For this assignment, you create a Power Point Presentation discussion ACA and health insurance. Address the following questions in the presentation

• Title slide
• Discuss in your own words at least 2 advantages and 2 disadvantages to MCO’s (2-3 slides)
• Discuss the specific characteristics of HMO’s (how are HMO’s different from other plans?) (2-3 slides)
• Discuss the specific characteristics of  PPO’s (2 to 3 slides)
• In your own words, explain how Obamacare/Affordable Care Act has changed healthcare in America. (3-4 slides) 
• Show the case scenarios (below) (4-6 slides)

 In each case scenario that follows, calculate the financial responsibility of the patient and/or carrier and the discounted amount that the physician must write off. Show calculations and identify amounts. Student should complete each case on a separate slide. Students can place the questions on the slide, then provide the answers with calculations.

1. Felix Grossman was seen today for an upper respiratory infection. Total charges for today’s services are $140. The allowed amount is $90. What is the discount amount and the amount the carrier pays to the provider?
2. Emma Mastrangelo had a CT scan of the brain today because of recurrent migraines. Total charges are $720.50. Her benefits pay 90 percent of this procedure. The allowed amount is $462.60. What is the patient responsibility, discount amount, and the amount the carrier pays provider?
3. Mabel Smith was seen in the office today for a checkup on her rheumatoid arthritis. Total charges are $85. The allowed amount is $52. She has a copay of $10. What is the discount amount, and the amount the carrier pays provider?
4. Rufus Durst had a cholecystectomy performed today. Total charges are $2995.70. His benefits pay 60 percent of this procedure. The allowed amount is $1745.32. What is the patient responsibility amount, discount amount, and the amount the carrier pays? What amount will the physician write off?

For this section, insure information is referenced and cited in your slides. The presentation should start with a title slide and end with a reference slides. If you include pictures, you pictures should also be referenced and cited.

Assignment Expectations:

• Length:
  • 15 – 21 slides
  • Use the tips at http://www.garrreynolds.com/preso-tips/design/ to create the slideshow.  
  • Because good PowerPoints have very few words, submit a script that describes the content of each slide – about 50 words per slide.  Place this script in a separate Word document that shows each slide number and the text for each slide as shown in the provided PowerPoint Slide Notes.docx.
• Structure:
  • Include a title page and reference page in APA style
• References:
  • References are not required; however, you should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions

MODULE 6

TOPIC: Public Health Laws and Ethical Implications

Public health laws and regulations are often passed in response to human-caused or natural disasters or the spread of an infectious disease or other health epidemic. Select a law or regulation that was passed after a significant public health event or in response to an epidemic. In a 1,250-1,500 word paper, discuss the public health law or regulation and describe its impact on a community, including its ethical implications. Examples could include laws/regulations targeting smoking, obesity, healthy mothers and babies, vaccinations, etc. Include the following:

Introduction with an overview of the law/regulation, why it was passed, and how it was or is being implemented on the local, state, and/or federal level.

1. A discussion of who the law/regulation targets and how they are being impacted.
2. An evaluation of the efficacy of the law/regulation. Include evidence demonstrating whether it is or is not working.
3. A discussion of the law/regulation’s ethical implications-Do you think this law is fair and ethical in natural? It is being applied ethically/fairly? Were/are there any unforeseen/unintended      consequences to be considered?

Prepare this assignment according to the guidelines found in the APA Style Guide.

You are required to submit this assignment to LopesWrite. 

STUDY MATERIALS

Read Chapters 9 and 10 in Public Health Nursing: Practicing Population-Based Care. URL:https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/public-health-nursing_practicing-population-based-care_3e.php

Read “Fostering Nurses’ Moral Agency and Moral Identity: The Importance of Moral Community,” by Liaschenko and Peter, from Hastings Center Report (2016). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118225080&site=ehost-live&scope=site

Read “Safeguarding the Public’s Health: Ethical Nursing,” by Rushton and Broome, from Hastings Center Report (2015). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103880265&site=ehost-live&scope=site

Read “Laws & Regulations,” from U.S. Department of Health and Human Services (2010). URL: https://www.hhs.gov/regulations/index.html

Read ” Explore Legislation, Regulations & Policies,” from Centers for Disease Control and Prevention (2015).URL: https://www.cdc.gov/stltpublichealth/policy/legislation-regulation-policies.html

Read “Specific Laws and Regulations Governing the Control of Communicable Diseases,” from Centers for Disease Control and Prevention (2017).URL: https://www.cdc.gov/quarantine/specificlawsregulations.html

Explore the Public Health Law Center at Mitchell Hamline School of Law website.URL: http://www.publichealthlawcenter.org

Within your community, there has been a large increase in teenage smoking, and community leaders are developing a plan to decrease the incidence of smoking. To help them, you will:

A) Develop a research question to address the problem.
B) Determine what kind of study should be undertaken.
C) Design a study to decrease the incidence of smoking in teenagers.