Health_Carereform

Abstract A number of barriers prevent nurses from being able to respond effectively to rapidly changing healthcare settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are well-positioned to lead change and advance health ("The IOM Issues Recommendations’ for Transforming Nursing Practice," 2010, p. 1). Given the increasing complexity and overwhelming challenges that exist within the healthcare systems in which one practice nursing, it is no longer possible for nursing practice and nursing education to function in isolated silos. It is not easy to describe one’s attitude towards other healthcare professionals because it is an integrated multidisciplinary problem. So, one should adjust their attitude towards the way nursing administer care, to be more cost effective by concentrating on prevention of chronic illnesses through patient education and collaborating with other disciplines to reduce duplication of services. Having negative attitudes and blaming top executives of the insurance companies, pharmaceutical firms, hospital executives, family-practice physicians, medical specialists, powerful interest groups and our government for this country’s expensive and inefficient healthcare delivery system will not benefit anyone. The objective of this paper is how the nursing practice affects nursing practice and how nurses can lead the innovative strategies to improve the changing health system. There are a multitude of problems in healthcare availability, access and affordability, our aging population, faulty prenatal care, overall poor health status, increases in chronic diseases, abuse and diversion of drugs, large numbers of uninsured and underinsured, improper patient use of hospital emergency room facilities and lack of adequate attention to long-term care and end-of life initiatives. The 2010 healthcare reform act (Patient Protection and Affordable Care Act, or PPACA) gives nurses new opportunities to deliver care and play an integral role in leading change. Nurses need to know how one can be part of the solution to achieve better patient outcome at a more reasonable cost. Nurses need to do more on prevent diseases; provide chronic care management to an aging, sicker, and more diverse population; and often end of life care that emphasizes comfort and compassion. Different Nursing Roles-Innovation is not a new concept to the nursing profession. Nurses worldwide are engaged in innovative activities on a daily basis; activities motivated by the need to improve care outcomes and reduce costs to the health system. Many of these developments by nurses have resulted in significant improvements in the health of patients, populations and health systems. In most health systems, nurses are the main professional component of ‘frontline’ staff providing up to 80% of primary health care. As such, they are critically positioned to provide the creative and innovative solutions for current and future global health challenges –challenges such as ageing populations, HIV/AIDs, an increase in non-communicable diseases, poverty, inadequate resources and workforce shortages. The need for innovative solutions has never been greater as health care environments globally struggle to provide equitable, safe and effective health services, while at the same time contain costs (Hughes, 2006). Innovative care models include nurse-managed health clinics, and home visiting programs for low-income mothers. This helped in reducing re hospitalizations of elderly patients with multiple chronic conditions. Using Transitional Care Model (TCM) helps patients to achieve better long term health outcomes. Evidence based practice- Nurses play important roles as innovators who help shape quality and safety. Successful models were implemented, or sustained with solid effective data. It is up to all nurse to collect and tract data to improve care. Collection of data about nursing practice is important for patient safety and care because nurses are at the bedside, so they are the ones that are most aware of patient needs and concerns; whether it is medical, personal, cultural, spiritual, or psychosocial. Therefore, collecting data about nursing practice allows for the development of nurse driven protocols and a better awareness of national standards for patient care and safety, which is derived from evidence based practice. Nursing research helps build the scientific foundation for clinical practice, prevention, and improved patient outcomes. Nursing education- All nurses need to possess basic competencies to meet the demands of an aging and diverse society, with an emphasis on clinical training in multiple settings across the lifespan. The emphasis should be on quality and safety, evidence-based practice, research, and leadership. Several programs are working to incorporate these concepts into nursing education, including Quality and Safety in Nursing Education and the Nurse Faculty Scholars program. Therefore, one need to remove barriers to attaining baccalaureate and other advanced degrees, such as by strengthening partnership links between community colleges and upper-division degree-granting institutions and all academic institutions and practice organizations. A standardized residency program would give nurses on-the-job learning and would better prepare them for clinical practice. Certification and continuous learning opportunities are essential to a profession that’s responsible for others’ lives. As lifelong learners, nurses seek to continue their learning beyond the initial preparation for licensure. In the initial period post-licensure, we often seek to gain more knowledge about the basic skills and concepts needed to practice nursing. This may come in the form of in-service programs, on-the-job training, or personal inquiry. These activities are important for day-to-day functioning of nursing. Institutions may require specific activities to maintain employment. The education provided by an institution may or may not have associated continuing nursing education contact hours. In a recent Med/Surgical Nursing editorial, Roberts (2011) noted lifelong learning goes beyond attainment of basic knowledge and skills. The lifelong learner commits to moving to new levels of knowledge and development. After initial orientation and first years of practice, the lifelong learner seeks more specific knowledge related to his or her practice setting. Increasing knowledge regarding the practice setting helps the nurse to become more competent in practice. Thus, the nurse furthers his or her development, moving along the path (Fights, 2011). Scope of practice- Advanced practice nurses (APNs) must be permitted to practice to the full degree of their education and licensure. Working with physicians, they can provide cost-effective care and help address the primary care shortage. It’s essential that APNs be permitted to provide the primary care they’re trained to give. Diversify the workforce- Approximately 33% of our population belongs to a racial or ethnic minority group, and by 2042 minorities will account for a majority of the U.S. population. To reduce health disparities, greater efforts must be made to ensure that the nursing workforce reflects patients’ diverse backgrounds and cultural values. Furthermore, all nurses should be educated to provide culturally competent care (Shipman & Hooter, 2009). Using Advanced Technology- Nurses must learn to use the new¬est medical technology and electronic documentation systems to improve quality. Nursing schools should use simulation labs and take advantage of online classes to educate more students. Nurses are frequent technology users; some nurses need to be at the table to help make decisions about designing and purchasing the technologies that help patients the most. Teamwork- Inter professional collaboration is critical to flawless high quality care. Collaborative teamwork occurs when health professionals focus on patient-centered care, problem solving, coordinated care, learning together, and networking across communities, in order to optimize quality care to patient and families. Develop leadership at every level- Nurses should have the opportunity to take on leadership activities whether they practice at the bedside or sit in the higher level. They must believe they are capable and fully empowered to provide excellent care and make the changes necessary to improve inadequate systems. Physicians and administrators must support nurses in their efforts. Most of all, nurses need to help each other through mentoring, educational and skills development opportunities, and support networks. As healthcare professionals actively engaged in direct patient care, nurses are placed to provide leadership in all healthcare areas, including developing systems to reduce medical errors, improving quality, providing better care coordination, increasing access to care, and preventing workforce shortages (Hassmiller, 2010). If the President’s healthcare plan is placed into effect, there would be more work opportunities for those in the healthcare profession. If more healthcare insurance were available, the number regular doctor visits would increase. Therefore allowing chronic, curable disease to be detected sooner, leading to a healthier America. References Fights, S. D. (2011, June 20). AMSN President’s Message What Have You Learned Today' [Journal Article] CINAHL with full text Retrieved from http://web.ebscohost.com/ehost/detail Hassmiller, S. (2010) Nursing’s role in healthcare reform [American Nurse Today]. Practice Matters, 5(9). Retrieved from http://www.americannursetoday.com Hughes (2006), Nurses at the forefront of innovation [Journal article]. CINAHL with Full Text Retrieved from http://search.ebscohost.com/login.aspx' Shipman, D. & Hooter, J. (2009), Eliminating Ethnic and Racial Disparities in Health Care [Practitioner Form]. Federal Practitioner 34 Retrieved from http://americansentinel.mrooms3.net/file.php/2682/EthnicRacialDisparities The Future of Nursing: Leading Change, Advancing Health. (2010). Retrieved from http://www.nap.edu/catalog.php'record_id=12956