Patient Protection and Affordable Care Act

rky note: am currently busy but sending this $100 first to account for braxton, will get to rest later tonight.

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

When the Patient Protection and Affordable Care Act was signed into law in 2010, it was so that everybody have some basic security when it comes to their healthcare. The legislation, including the reconciliation bill, the Health Care and Education Reconciliation Act is designed to reform healthcare insurance policies and practice, and expand coverage to the insured in the United States. The 2 bills together are known as the Affordable Care Act (ACA).

The two key provisions that have/will impact my current nursing practice are as follows:

  1. Nurse Loan Repayment and Scholarship Programs (NLRP): Section 5310

This provision provides loan repayment to students who serve two years as a faculty member at an accredited nursing school (AACN, 2010). This is a great incentive to encourage registered nurses to explore the educational side of the field. Most nurses are reluctant to become nursing educators due to the pay cut they acquire while doing so. This is another reason why nursing schools are so competitive- they do not have adequate staffing. This provision could close the gap between adequate staffing and the number of enrolled students.

  1. Comparative Effectiveness Research: Section 6301

The purpose of this section is to assist providers, patients, and policy makers in making health care decisions by performing research on comparative analysis (AACN, 2010). Ultimately this would ensure the most updated practice is being used in connection with prevention and treatment. I think this would also eventually work towards lowering health care costs due to mandated practice guidelines and cost coverage decisions as well.

Reference

American Association of College of Nursing (AACN). (2010). Nursing Education and Practicing Provisions. Retrieved from http://www.aacn.nche.edu/government-affairs/HCRrev…

 

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The scope of practice

Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question.

The scope of nursing practice differs based on each state. According to the GCU’s NRS 430V Lecture 3, “The scope of practice is developed in collaboration with nurses currently practicing, nursing education agencies, and regulatory bodies (2011, pg. 1).” It is about the actions, decisions, and boundaries nurses are learned to do based on their education. I currently work in New York. In New York, according to the New York State Law, Article 139, Section 6902, the nurse practice is defined as:

“The practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner’s regulations. A nursing regimen shall be consistent with and shall not vary any existing medical regimen” (pg. 1).

Under the scope of nursing practice, the RNs job is to use their education to do humanizing patient care. RNs do that with critical thinking, evidence-based practices, and supports from licensed physicians. Nurses are not allowed to give nursing services they are not competent to perform.

 

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What type of objective and subjective data can you collect with what you know?

Please read the following case study and complete the questions below.

Daniel is a 16 year old boy who is an identical twin. He and his brother Jeff are very close and do most things together. While Daniel excels at sports he believe his brother is much better at most everything. Daniel, his brother, and their two sisters live with their parents in the Midwest. Recently Daniel has been feeling more tired than usual. He thought it was because of his schedule and school work, which he is fairly good at. He gets mostly Bs, but his grades have been slipping of late. One day he fainted while getting ready for a game. His coach called his parents to let them know Daniel was taken to the Emergency Room. While there the doctor decided to admit Daniel to the hospital for observation. At the time he was running a slight fever, his breathing was shallow, and he was sweating. He was also very sleepy and his blood pressure was high. He did have some abnormal laboratory work, but his doctor was not too concerned at present. Daniel also stated that he felt achy.

You are assigned to take care of Daniel today and when you walk into his room, his mother and brother Jeff are there. Daniel appears to be sleeping. In your written assignment, respond to the following questions applying the nursing process:

Assessment: What type of objective and subjective data can you collect with what you know? How will you collect these data? What further evidence do you need?

Analysis and Identification of the Problem: What do you believe Daniel’s problem(s) are? What might be the nursing diagnoses? Use the following for identification.

Planning: Identify two goals and one nursing intervention for each, based on your nursing diagnoses.

While you will not be able to implement or evaluate, how well do you think your nursing interventions might help with Daniel’s care.

 

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Describe the mission, assumptions and objectives for the upcoming budget year for the departments involved.

1 Describe the mission, assumptions and objectives for the upcoming budget year for the departments involved. (Nursing, Laboratory, Pharmacy & Radiology) 2 Establish statistics volume projections for the budget year 2015 for all four (4) departments. 3 Establish a position control plan for the new Psychiatric Unit. (Part of Nursing) 4 Establish a position control plan for nursing and laboratory. 5 Complete expense item for laboratory & radiology for 2015. 6 Project the expected net revenue for all Medicare, HMO, and all Other Insurance patients. The percentage breakdown of patients by payor mix is as follows: Medicare 51% Blue Cross 16% Medical Asst 08% HMO 10% Commercial INS 07% Other 05% Self Pay 03% Total 100% In the new fiscal year, the hospital plans to: 1 Establish a separate distinct 15-bed inpatient psychiatric unit. 2 Install new equipment in the laboratory to enable the hospital to do 35% more tests in-house rather than send them to a reference lab. 3 Recruit a general surgeon and a Internist. 4 Purchase an additional CT scanner which is expected to increase current radiology volumes by 3.25%. THREE DEPARTMENTS ARE INVOLVED IN OUR BUDGET EXERCISE. THEY ARE NURSING, LABORATORY, PHARMACY AND OUTPATIENT/AMBULATORY SERVICES. STATISTICAL DATA 2012 – 2013 2013- 2014 2014- 2015 Admissions In Pt (Nursing) 7,395 7,400 7,370 Laboratory Test 399,330 411,810 421,564 Pharmacy Rx 99,832 100,011 99,642 Radiology Exams 68,222 69,124 68,950 LABORATORY EXPENSES 2012 2013 2014 Supplies $79,866 $86,480 $96,959 RADIOLOGY EXPENSES Supplies $395,205 $405,222 $410,100 PARIENT REVENUE Gross Revenue Projected for the 2014-2015 budget year is as follows: In Patient $30,675,000 Out Patient $36,878,000 Total $67,553,000 Current Reimbursement Formulas: In Patient Out Patient Medicare $5760/case 38% of Charge HMO $1215.00/pat day 31% of Charge Other Insurance $7655.00/discharge 42.5% of Charge

 

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If you agree with a classmate, explain why, give an example, share what you learned in the readings

Please do a paragraph about this post with this instruction .

post most have 4 or more sentences .

you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the readings

The nursing profession is one of the fast growing career fields and is looking like it is going to be unable to match the supply with the requisite demand in the near future. Three significant problems are contributing to the nursing shortage and they are:

  • Increasing age of Baby Boomers
  • 55% of current registered nurses are nearing retirement age
  • The need for more BSN nurses to appropriately care for more complex patients

Due to the shortage of nurses being able to adequately meet the needs of the current and future workplace, many nurses today are showing signs of workplace fatigue and facilities are having low retention of nurses (Rosseter, 2014). Many nurses are citing the increased stress related to staffing shortages as reasons for why they are leaving the field. Multiple strategies have been identified to help alleviate the nursing shortage. The article by Rosseter addresses the issue of nursing student shortages by highlights the changes currently being made to NursingCAS. NursingCAS is a centralized nursing school and APRN school application database. It streamlines the ability of students to apply to school as well as to help inform them of other potential school sites which they may be desirable locations to attend school. The idea behind the process being that if we can make it easier to get willing student into open programs, we can increase enrollment and therefore the workforce.

 

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What is the difference between a model and a theory?

Question # 1. Evaluate the application of models of practice to the advanced nurse roles.

What is the difference between a model and a theory?

A model demonstrates the researcher’s interpretation of how concepts are related to one another and is developed based on qualitative research. A theory is a hypothesis tested and measured to explain, predict, describe, and prescribe relationships between concepts and is developed through quantitative research.

In short, the difference between a model and a theory is the amount of proof that exists in demonstrating the outcomes they predict.

What do models and theories have in common?

Both models and theories show relationships between concepts. Models often are precursors to theory development.

Directions

Locate a model of practice that you could apply to nursing. It does not need to be a nursing model. Models of practice can be found in leadership, business, education, and technology. Explain how you will use the model you chose in your advanced practice role.

Use the table template to organize your thoughts and present them for this Assignment. In the first column, list the characteristics of the model of practice you chose. In the second column, list your application to your advanced nursing practice role upon graduation. In the first row, in the first column, write the name of your chosen model. An example has been provided in the first rows to guide you. Please remove the examples when entering your information.

Question # 2. Conceptual-Theory-Empirical

Writing in the voice of your chosen theorist from your Unit 5 Assignment, describe the Conceptual-Theory-Empirical (C-T-E) structure process you used in creating your theory?

Note that Unit 5 covers the Quality Caring Model.

Textbook Reading is

Philosophies and theories for advanced nursing practice

  • Chapter 21: “Theories Focused on Caring”
  • Chapter 22: “Models and Theories Focused on Culture”
  • Chapter 23: “The Praxis Theory of Suffering”
 

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National Quality Forum

Please do a paragraph about this post with this instruction .

post most have 4 or more sentences .

you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the readings, ask questions of each other, etc.

The National Quality Forum (NQF )defines Never Events as errors in medical care that are of concern to both the public and health care professionals and providers, clearly identifiable and measurable (and thus feasible to include in a reporting system), and of a nature such that the risk of occurrence is significantly influenced by the policies and procedures of the health care organization. The CMS denied Medicare reimbursement for eleven hospital-acquired conditions and ban hospitals from charging patients directly for these ‘never events’- or incidents that should never happen which affected reimbursement for hundreds of thousands of hospitals stays. This move has offered nurses an opportunity to take a leadership role in preventing these avoidable incidents through taking strategic approach for prevention in order to achieve a more effective and efficient outcome. Nursing effect on patient outcomes has become increasingly accepted with the CMS policy establishing an indelible link between Medicare reimbursement and quality nursing care. It was noted that when nursing staff increases, the quality of patient care improves and preventable incidents decrease which has made the ability of highly skilled nurses to reduce medical errors to be recognized, as more than half of all never events are nursing-sensitive, particularly pressure ulcers and patient falls. The nurses capability have therefore been engaged to prevent never events and also build a case for additional financial investment in nursing

 

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Summarize the four messages outlined in the IOM report and explain why these are significant to nursing practice.

Review the Institute of Medicine’s 2010 report “The Future of Nursing: Leading Change, Advancing Health.” Write a 750-1,000 word paper discussing the influence of the IOM report on nursing practice. Include the following:

  1. Summarize the four messages outlined in the IOM report and explain why these are significant to nursing practice.
  2. Discuss the direct influence the IOM report has on nursing education and nursing leadership. Describe the benefits and opportunities for BSN-prepared nurses.
  3. Explain why it is important that a nurse’s role and education evolve to meet the needs of an aging and increasingly diverse population.
  4. Discuss the significance of professional development, or lifelong learning, and its relevance in caring for diverse populations across the life span and within the health-illness continuum.
  5. Discuss how nurses can assist in effectively managing patient care within an evolving health care system.

Prepare this assignment according to the guidelines found in the APA

Style Guide,

 

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Transformational Nursing Leaders

Transformational Nursing Leaders
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This week’s graded discussion topic relates to the following Course Outcome (CO).

CO7 Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (POs 2 and 3)
Review Appendix A, Sections I–V in Finkelman (2016).

Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies. Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.
In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?
Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences.

 

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