NRS 440 Topic 1 DQ 2: Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention
NRS 440 Topic 1 DQ 2
Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place.NRS 440 Topic 1 DQ 2
Greater coordination of care across providers and across settings will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department, utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions and adverse drug interactions (Salmond et al.,2017). Nurses who are well informed of health trends will be positioned to interpret their impact on health and better prepared to provide individual and systems level interventions to improve the health of communities. Nurse leaders will need to develop a multilevel approach that focuses on the nurse, the team and the organization to address trends to address disease-oriented health care goals.NRS 440 Topic 1 DQ 2
The Affordable Care Act recognized a principle by exempting a list of primary and secondary Nurse leaders preventive services from copays and deductibles (Dolan, 2018). Hopefully new trends in healthcare will continue to seek ways to prevent conditions that negatively impact patients. With the support of the health care reform, clinicians can treat more patients with poor lifestyle choices and provide better access to immunizations and medications. Interventions to reduce health disparities associated with social class in the future will likely result from policy efforts directed at the entire population to support wellness. Nurses will always support new trends for health promotion and disease prevention measures to engage patients to choose risk-reducing behaviors.
REPLY TO DISCUSSIONNRS 440 Topic 1 DQ 2
The Centers for Medicare and Medicaid Services (CMS) have shifted from traditional fee for service into value base purchasing with the enactment of Affordable Care Act (ACA) (Walker et al., 2022). Healthcare providers (hospitals, nursing homes, and home health agencies) are now part of this value-based purchasing contract where patients admitted should be kept out of the hospital for at least thirty days for them to get reimbursement.
If a patient gets readmitted for the same reason, especially with CHF diagnosis, the provider will not be paid for the patient’s readmission. Nurses play a huge role in keeping the patients out of the hospital. In the homehealth setting, nurses can provide education and health promotions such as medication compliance and front-loading visits to ensure the patient is closely monitored within the next two weeks of admission and ensure remains within baseline and out of the hospital.NRS 440 Topic 1 DQ 2
Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2022). The effect of the Affordable Care Act on Medicaid payments in long-term care facilities. International Journal of Healthcare Management, 15(1), 62–69. https://doi-org.lopes.idm.oclc.org/10.1080/20479700.2020.1843886
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Healthcare reform is often associated with the affordable care act(ACA). Although ACA may top the list of healthcare reforms, the list is much more extensive. Quality of care, health care cost, re-engineering insurance options, innovative technological advances, pharmaceutical cost, and improved approaches to treatment and overall healthcare sustainability.
Access to healthcare for every one is of the most critical reform that must be conquered. Until everyone can receive adequate, fair, care and disparities are minimized, will healthcare equity be obtained(Shi & Stevens, 2021). Healthcare cost is one of the largest expenditures of the GDP. Though cost has continued to increase year after, there are signs that the technology and medical advancements have improved. The question asked is just how much more will it cost? The cost has to be contained.NRS 440 Topic 1 DQ 2
It’s not the amount spent, but are we getting the worth of our spending? Quality of care must improve by investing in research that proves to be evidence-based in practice will allow health care providers to make better choices and practice with confidence and continuity.
How does nursing fit into this puzzle? Nurses are the largest percentage of the workforce providing care. The
government must invest in the profession and science of nursing. Nurses must be allowed to practice to the full extent of their knowledge and training. Advanced nurse practitioners are filling the shortage of physicians and should be allowed to practice with full autonomy and with the same respect as physicians including equal pay for the same care that is being provided according to the scope of practice(Brom, Salsberry & Graham, 2018).NRS 440 Topic 1 DQ 2
As for the professional baccalaureate-prepared nurse, care has been reformed from an illness to wellness continuum to a continuum of wellness to preventing illness and prevent further deterioration of the health status. How is this accomplished? Through the promotions of healthcare that address the three levels of prevention( primary, secondary, and tertiary). The primary focus is on preventing disease, the secondary focus is on screening and diagnosing, and the tertiary focus is on stabilizing and preventing further deterioration of the health status(Kisling & Das, 2021).NRS 440 Topic 1 DQ 2
Reference
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120.
Kisling, L. A., & Das, J. M. (2021). Prevention strategies. In StatPearls [Internet]. StatPearls Publishing.
Shi, L., & Stevens, G. D. (2021). Vulnerable populations in the United States. John Wiley & Sons.
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You make a valid point. Not only is there a shortage of nurses, but there is also a shortage of physicians. Studies show that patients living in rural areas are five times more likely to live in a county with a physician shortage than those living in urban or suburban areas. Studies also indicate a potential primary care physician shortage of between 14,800-49,300 physicians by 2030. With these shortages, there has to be health care providers to take care of patients in these areas. This is where nurse practitioners are filling the void. We have rural counties in our area where there is one primary care physician, and the rest of the health care needs are taken care of by nurse practitioners. They are able to provide the care the community members need and promote positive health promotion measures within the area.
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I like that you also tied in the three stages of prevention and health promotion, as prevention extends even beyond the diagnosis of the disease. One important part of prevention across all of the stages is education, which is a vital aspect of the nursing role. Health education plays a vital role in health promotion and preventing disease (Whitehead, 2018). We can educate people on modifying their risk factors and making lifestyle changes that will improve their health and prevent disease. For example, diet and exercise are major modifiable risk factors in so many diseases. If we can put more emphasis on educating the public about living an active lifestyle and eating a healthy diet, this could have a significant impact on their health and wellness, rather than waiting until after they already are faced with illness or disease.
Reference
Whitehead D. (2018). Exploring health promotion and health education in nursing. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 10.7748/ns.2018.e11220. Advance online publication. https://doi.org/10.7748/ns.2018.e11220
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The goal of health care reform is to allow all Americans to be and remain healthy by stopping diseases before they begin. The focus shifted from disease-oriented to wellness and prevention through community programs that assist patients in overcoming obstacles to preventive services such as childcare and transportation. Providing individuals with simple and affordable choices to healthy foods, exercise locations, nutrition information, and positive social interactions added to prevention and wellness. The affordable care act eliminated health disparities by providing education and employment to populations affected with heart disease, obesity, asthma, and HIV/AIDS. Education allows for well-informed decisions and employment provides access to health coverage, prevention care, and assists families to afford healthy foods.
Healthcare will continue the trend of wellness and prevention by continuing to achieve the goals of the IOM report. The role of nursing in supporting and facilitating wellness and prevention is an important one. One of the most critical roles for a nurse is that of an educator. Nurses spend the most time with patients delivering anticipatory guidance about medications, diet, nutrition, immunizations, and safety (Nurses Roles in Health Promotion | Colorado Technical University, n.d.). Nursing education prepares future nurses to work efficiently and collaboratively in many different scenarios. Nurses function as leaders and health professionals to deliver safe and quality patient care (Whitney, 2018).
Healthcare institutions are implementing efforts to shift focus from disease oriented to wellness and prevention. A disease oriented healthcare system focuses efforts and resources on disease management. The patients and the healthcare efforts are directed towards a disease. Wellness and prevention oriented healthcare system focus on promoting population health, preventing illness and complications and improving quality of life. The healthcare reform focuses on promoting this shift to wellness and prevention.
NRS 440 Topic 1 DQ 2 The healthcare reform increases access to healthcare insurance, which promotes health behavior. According to Grubber and Sommers (2019), the healthcare reform lowers the eligibility criteria to include individuals below 65 years based on income level. Individuals from low income families can now access insurance services. Gruber and Sommers (2019) note that increased insurance access increases health seeking behavior and access of healthcare resources. Healthcare reform also eliminated the previous discrimination of individuals based on their conditions. With the reform, individuals with chronic illnesses have increased access to resources because the barriers limiting their access to insurance services were eliminated.
Healthcare reform is a sustainable plan whose funding will be from state ad federal governments. These policies will be made into laws and related institutional policies and be intergrated into organizational culture(Gruber & Sommers, 2020).NRS 440 Topic 1 DQ 2 These steps will help retain the effects of the trend and enhance its continuity. They will also be continually assessed and improved to enhance the continuity of the trend. Nurses will play a role in supporting and facilitting the shift. Nurses will educate fellow nurses and patients on the trend, ewhich will help facilitate change. Nrses are also on the frontline of implementing care interventions. They will thus play a huge role in promoting the shift by incorporating change throught their daily activities and care planning (Fu et al., 2019).NRS 440 Topic 1 DQ 2
Reference
Fu, M. R., Kurnat-Thoma, E., Starkweather, A., Henderson, W. A., Cashion, A. K., William, J. K., & Coleman, B. (2020). Precision health: A nursing perspective. International journal of nursing sciences, 7(1), 5 – 12.
https://doi.org/10.1016/j.ijnss.201912.008
Gruber, J. & Sommers, B. D.(2019). The Affordable Care Act’s effects on patients, providers and the economy: what we have learned so far. Journal of Policy Analysis and Management, 38(4), 1028-1052
https://doi.org/10.1002/pam.22158
There are notable transformative changes occurring in the healthcare in which nursing personnel have a potential role for the shifting. Being a major role performer, nurses should know the common factors that are efficiently bring these changes in the society with regard to the skills and knowledge that is much essential for the plan wise success in the transition (Haas SA, 2010). AWV covered by Medicare since 2011 which provides a great opportunity to enhance efforts to identify risks and support healthy aging for growing numbers of Medicare beneficiaries. The visits are available without copays or deductibles. During the visit, the provider assesses health risks using a health risks appraisal, provides preventive screening, and lifestyle behavior changes, and at the same time develops a 5 to 10-year personalized prevention plan. (Simpson et al., 2021).NRS 440 Topic 1 DQ 2
The participation of nurses in the planning, implementation and evaluation of prevention and wellness initiatives funded by the Patient Protection and Affordable Care Act bodes well for patients, families, and organizations that provide care (Haas SA, 2010).NRS 440 Topic 1 DQ 2
Haas SA. (2010). Developing effective prevention and wellness programs. AAACN Viewpoint, 32(5), 12–13. NRS 440 Topic 1 DQ 2
Retrieved from:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?
Simpson, V., Edwards, N., & Kovich, M. (2021). Enhancing Annual Wellness Visit Outcomes: Patient Perceptions and Provider Practices. Journal for Nurse Practitioners, 17(5), 628–631. NRS 440 Topic 1 DQ 2https://doi-org.lopes.idm.oclc.org/10.1016/j.nurpra.2020.12.018
The need for health care transformation is one of the fundamental needs of the people of the U.S. However, some potential changes have been made in the past, which have promoted development in the sector in numerous ways. According to Salmond and Echevarria (2017), factors that necessitate healthcare transformation include unstainable costs, disparities, access problems, fragmentation, and suboptimal outcomes. Health care reform has been able to address most, if not all, of the fundamental problems in the sector to focus more on wellness and prevention rather than diseases only.
People have varying concerns regarding healthcare accessibility, quality, and affordability, which in turn affects the level of their wellness and prevention. The reform, through creation of affordable healthcare, has increased the health insurance coverage to include most of the middle- and low-class citizens of the U.S. (Chait & Glied, 2018). Today, many people in the U.S. can access healthcare services for their wellbeing and disease prevention through the newly created reform programs.
Notably, it is possible for the healthcare sector to continue with the trend of promoting and enabling wellness and prevention strategies. Some of the ways healthcare can continue the trend include addressing the newly emerging concerns in the healthcare sector, incorporating sustainability in decision-making process, and making necessary changes to promote effectiveness and efficiency in service delivery (Warner et al., 2020). Professionals in the nursing domain can conduct further research, abide by the newly set policies, and provide quality services to support the reforms.
The organization I work for has put some wellness and prevention initiatives in place to support the reform. For example, the facility, through experienced nursing and other medical professionals, educate the society through social media and physical engagements about selfcare. The enlightenment and sensitization include educating people about benefits of exercising, healthy eating, and generally recommended personal health routines.
In conclusion, the shift to wellness and prevention from sole focus on disease is becoming more effective over time. Nurses play a vital role in making the shift a reality that will bring positive change to the people in the short- and long-term effects. The reforms are bound to improve the experience of patients in healthcare facilities over time.
References
Chait, N., & Glied, S. (2018). Promoting prevention under the Affordable Care Act. Annual Review of Public Health, 39(1), 507-524. https://www.annualreviews.org/doi/pdf/10.1146/annurev-publhealth-040617-013534
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopaedic Nursing, 36(1), 12-25. https://doi.org/10.1097/nor.0000000000000308
Warner, J. J., Benjamin, I. J., Churchwell, K., Firestone, G., Gardner, T. J., Johnson, J. C., Ng-Osorio, J., Rodriguez, C. J., Todman, L., Yaffe, K., Yancy, C. W., & Harrington, R. A. (2020). Advancing healthcare reform: The American Heart Association’s 2020 statement of principles for adequate, accessible, and affordable health care: A presidential advisory from the American Heart Association. Circulation, 141(10). ahajournals.org/doi/10.1161/CIR.0000000000000759