...The Affordable Care Act: Nursing’s Practical Solution Desmond Mueller California State University, Fullerton School of Nursing Concepts of Professional Nursing Practice BSN 306, Section 05 Anne Johnston-Silverberg, MS, FNPc September 14, 2012 The Affordable Care Act: The Role of the Nurse Practitioner The recent implementation of the Affordable Care Act (ACA) has had a significant impact on the American health care delivery systems. The passage of this bill mandates that all Americans must have health care coverage and that insurance companies cannot disqualify applicants due to preexisting conditions (National Council of State Boards of Nursing, 2014). These changes will undoubtedly lead to an increase in the number of people seeking medical care, particularly those with chronic diseases. It is estimated that this influx in the number of patients will result in a primary care provider shortage of 20% by the year 2025 (Poghosyan, Boyd & Knutson, 2014). With many new physicians choosing to pursue specialties due to the promise of a larger salary, hospitals and clinics will need to start looking to other health care providers, such as nurse practitioners, to fill this role. The purpose of this paper is to discuss the role nurse practitioners play with regards to the Affordable Care Act by examining the history and qualifications of nurse practitioners, the current practice of nurse practitioners, the basics of the Affordable Care Act legislation, and potential nursing...
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...Running head: INDEPENDENT PRACTICE FOR NURSE PRACTITIONERS Analysis of independent practice for Nurse Practitioners in Pennsylvania Jamie Novitski Misericordia University Analysis of the policies of independent practice for Nurse practitioners in Pennsylvania This paper will analyze the policies throughout the United States of independent nurse practitioners. The paper will include the following topics: proposed solutions, background information, political setting and structures involved, stakeholders, value assessment, resources needed to reach intended goals, and power bases involved. Identification and Analysis of the policy Currently in the state of Pennsylvania, nurse practitioners...
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...ompassion: A Concept Analysis Joseph E. Vincent Florida International University June 24, 2011 Abstract Our world is still dominated by all kinds of social conflicts, despite our outstanding material, scientific and technological advancements. Human beings, too often lack in their conduct the essential attributes that separate us from other animals. A sense of decency, moral, logic, the feelings of love and compassion for others in our various forms of interaction with one another. Too often these noble expressions of our common humanity are not respected, even in areas where they are deemed to be essential. Nursing, from its foundation and elevation by pioneers such as Florence Nightingale has always relied upon the idea of compassion as its core essence. Later on, other nursing theorists like Sister Simone Roach made it a key component of the development of her own version of caring as a theory on which nursing is based. The concept analysis developed by Avant and Walker (2011). Concept analysis in strategies for theory construction in nursing pp.157-176 provides tools that can be used to demonstrate the importance of compassion when it comes to its application for relevant and competent nursing practice. Compassion: A Concept Analysis From its inception to today’s practice the essence of nursing has not changed, despite its ever growing scope and field of action. According the international council of nurses(ICN) ‘’Nursing” encompass...
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...Running head: ANALYSIS OF AN ETHICAL DILEMMA Analysis of an Ethical Dilemma NRS 437V December 11, 2011 Analysis of an Ethical Dilemma Euthanasia, sometimes referred to as mercy killing, is an act by a third party that causes a patient’s death. Such acts include administering a lethal dose of medication by way of injection or mask, usually to a seriously ill patient. This analysis will discuss the ethics of euthanasia as it relates to nursing, laws, society, and the stakeholders involved in the scenario. The American Nurses Association (ANA) believes that the nurse should not participate in Active euthanasia because such an act is in direct violation of the Code for Nurses with Interpretive Statements, the ethical traditions and goals of the profession, and its covenant with society. (Task Force on the Nurse's Role in End-of-Life Decisions, 2011) While patient advocates should be vigilant for providing diligent care, they should perform their tasks with respect, support and due commitment towards their care. In healthcare practice, in order to relieve pain and suffering, there is an obligation to promote dignity and autonomy of patients. Euthanasia is a complex issue in which nurses are uncomfortable determining the life and death of a patient. Nurses have to practice ethical principles of beneficence, which maximize benefit and reduce potential risk and harm to the patient. Non-malfeasance is another ethical issue in which a nurse should do no harm. A competent...
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...When outlining the process for developing standards of practice the American Nurses Association relies on members as the first link in developing an official resource. Members are nominated to a working group that researches the issue at hand and writes a statement before going to the ANA for final approval. This bottom-up approach ensures the standards are current and accurately represent nurses across the nation (ANA 2014). The Department of Health Scope of Practice Tree asks us, Is the act permitted or prohibited by the nurse practice act, Is it consistent with standards? Do you have current clinical skills to perform the act safely? Is the act with in in standard of care? Are you prepared to accept the consequences of your action? The six main categories of practice are assessment, Analysis, Outcome Identification, Planning, Implementation, and Evaluation. By implementing standards of care we are able to provide excellent care to out patients. Different entities that might be involved in developing a standard of practice are The American nurses Association and the Joint Commission on Accreditation of Healthcare Organization (JACHO) have established and recognized standards of care. Standards of care are found at the national and state level. State boards of nursing develop standards of care at the state level and enforce those standards. The American Nurse Credentialing Center (ANCC) work on the national level. Professional specialty nursing organizations...
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...Legitimizing basic research by evaluating quality.Abstract:The aim of this study was to use ethical arguments to strengthen the relationship between the concepts of legitimacy and evaluation. The analysis is based on the ethics of Levinas and Buber and is motivated by a sense of responsibility using dialogical ideology as a mediator. The main questions in this study consider the following: Does caring science as an independent academic discipline have the moral responsibility to develop a theory for evaluating the quality of basic research? and Will such a quality evaluation theory have a reasonable probability of introducing legitimization into caring science? On an ethical level, this study introduces a meaningful interaction inspired by social demands and is linked to the concept of research justification. Legitimization turns from an abstract idea to an achievable entity by an act. The act of evaluation has the likelihood of delegating legitimacy and empowers the foundation of caring science, which in turn will become a cornerstone of nursing. At this stage there is no intention to develop an evaluation theory, rather to create a meaningful discussion for the future development of an ethics-based theory.2. Watson's caring science as a framework for exploring the experience of the act of praying... 30th Annual International Association for Human Caring Conference, Chapel Hill, North Carolina~The Carolina Inn~April 6-9, 2008.(1992) attributes of caring, the survey’s questions...
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...Identify the different entities that might be involved in developing a standard of practice. Outline the Process for Developing Nursing Standards of Practice and Identify the Different Entities That Might Be Involved in Developing a Standard of Practice. When outlining the process for developing standards of practice the American Nurses Association relies on members as the first link in developing an official resource. Members are nominated to a working group that researches the issue at hand and writes a statement before going to the ANA for final approval. This bottom-up approach ensures the standards are current and accurately represent nurses across the nation (ANA 2014). The Department of Health Scope of Practice Tree asks us, Is the act permitted or prohibited by the nurse practice act, Is it consistent with standards? Do you have current clinical skills to perform the act safely? Is the act with in in standard of care? Are you prepared to accept the consequences of your action? The six main categories of practice are assessment, Analysis, Outcome Identification, Planning, Implementation, and Evaluation. By implementing standards of care we are able to provide excellent care to out patients. Different entities that might be involved in developing a standard of practice are The American nurses Association and the Joint Commission on Accreditation of Healthcare Organization (JACHO) have established and recognized standards of care. Standards of care...
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...Nurse Practice Act Comparison of Illinois and Indiana Toccara Kelly NU 100 ITT Technical Institute Nurse Practice Act Comparison of Illinois and Indiana Most people are aware that there is a governing body over hospitals, but many do not know that each of these are separate. Each state has its own Board of Nursing to define and govern all practice of professional nurses. These state boards promote safety and help to ensure that all employed nurses obtain quality education and practice with proper licensure. This essay compares Illinois’ Nurse Practice Acts to those of Indiana’s. The data included has been procured from both state’s government website, which entails the Nurse Practice Acts. In the state of Illinois, the Board of Nurses consist of 11 members who are appointed by the governor. Each member of the board serves a four-year term that is subject to their death, resignation, or being removed by the governor. Of the 11 members on the board 6 are nurse representatives of various specialties and the remaining 5 members may include representatives of associations, health care providers, nursing educators, and consumers. In the state of Indiana, the Board...
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...Resistance of Nurses in Use of Electronic Documentation The field of health information technology for nursing is rapidly growing. Advancements in electronic documentation for health care, such as the electronic medical record (EMR), can be an overwhelming addition to the workload of nurses. There is resistance by nurses in use of electronic documentation (Sharifian, Askarian, Nematolahi, & Farhadi, 2014). It is this writer’s opinion that nurses are under informed regarding the rationale for changes taking place in documentation and the implications. The purpose of this paper is to provide nurses with the basics of the Federal regulations outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) that require electronic documentation to be compliant and receive reimbursement. It also reviews how data are collected to determine the reimbursement for care (meaningful-use) and its role in evidence-based practice (Wright, Feblowitz, Samal, McCoy, & Sittig, 2014). Included is a review of the negative impact resistance generates on health organization reimbursement and the relevance it has on nurse staffing, jobs, wages, and satisfaction, along with, evidence reinforcing the training and support of nurses as a means to promote proper use of electronic documentation and increase user satisfaction. Federal Laws and Requirements for Compliance Health care...
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...Running head: Accountability of Nursing Professionals Accountability of Nursing Professionals for Patient Safety Practices Related to Informed Consent Lavonia Deanne Bishop Grand Canyon University NURS-430V Professional Dynamics 23-Aug-2010 (0106) September 19, 2010 Accountability of Nursing Professionals for Patient Safety Practices Related to Informed Consent Accountability in nursing can be defined as the state in which the nurse is responsible for upholding a professional agreement with the patient to provide services and be held answerable for the outcomes of behaviors related to these services (Hood, 2010). One of the main areas we are held accountable for as professional nurses is the safety of our patients. After an evidence-based review of patient safety practices, the Agency for Healthcare Research and Quality has identified numerous opportunities for quality improvement. The practices identified were rated by strength of evidence, with the highest rated being listed first. This paper will examine practice number five, asking patients to recall and restate what they have been told during the informed consent and the responsibility of the professional nurse in this process. The Informed Consent Process According to Terry (2007) informed medical consent occurs when a patient autonomously and expressly permits a professional to perform a medical act on that patient or include the patient in a research project. Patients are now encouraged to be more informed consumers...
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...Analysis of an Ethical Dilemma Part 1 Grand Canyon University April 26, 2013 Analysis of an Ethical Dilemma Part 1 Voluntary and assisted euthanasia have been and will continue to be one of the most controversial ethical debates in the medical field. Euthanasia stems from the Greek language: eu meaning good and thanatos meaning death. The practice of voluntary euthanasia is when the patient requests to die but someone else has to perform the act, for example removing the patient from all life-sustaining equipment or giving a lethal injection. Where as the definition of assisted suicide is a physician prescribes a lethal dose of medication and the patient on his or her own will have to perform the act of consuming the medication to cause death. There are many ethical implications that arise from either option. “In the balance are crucial issues: personal autonomy, dignity, compassion, ending suffering, protection of the vulnerable, promotion of good palliative care, and redefinition of the role of the physician in death and dying” (Van Norman, (2012). It is imperative for nurses to be conscious of their obligations professionally, educated on the laws surrounding the issue, who the stakeholders involved are, the impact on social values/morals, and the ethical theories and principals involved. Nursing Obligation According to the American Nurses Association nurses are never allowed to have any part in euthanasia, such actions would be a direct violation of the...
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...Advanced practice nurse’s are reimbursed at a lower rate for the same services than physicians by Medicare, Medicaid and other private insurance companies. American medical association sets our scope of practice and regulations and legislation is often influenced by these recommendations. Advanced practice nurses should be consider as equal members of the healthcare provider community and receive equal reimbursement. To make these changes one must develop a plan and advocate for the profession. Advanced practice nurses are reimbursed at a lower rate, for the same services, than physicians. Medicare reimburses nurse practitioners at 85%, certified nurse midwives at 65 %, and physician assistants at 85% or less of the physician fee. The exception to the reimbursement rate is called the “incident to”. Medicare will reimburse at 100% if billed under a physician provider number. Medicaid pays 75-100% of the physician fee with the exception of some rural areas. Private insurance companies reimbursement to advanced practice nurses policies vary state to state. In an attempt to find ways to decrease cost, private insurance companies are beginning to follow Medicare’s reimbursement policies. For advanced practice nurses the reimbursement policies vary according to state, company, and licensure, and are not equitable to physician reimbursement. CRITICAL ANALYSIS OF OFFICIALS VIEW ON ISSUE This issue is being buried by the American Medical Association. The...
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...CONCEPT ANALYSIS Safeguarding Vulnerable Adults: Concept Analysis Abstract Aim. This study is to analyse the concept of safeguarding the vulnerable adults and the role of registered nurse. Background. Registered nurse has major responsibilities in caring and safeguarding the vulnerable adult population. Reduction of health inequalities among vulnerable adults are top international healthcare priorities. Vulnerable adults are among most vulnerable of the populations, many people associate vulnerability with old age only, resulting in negative stereotypical views. Understanding the concepts of vulnerability as relates to adults population, examines how and why adults could be vulnerable will help nurse to educates the vulnerable adults about the rights and choices available to them, enabling nurse to safeguarding the vulnerable adults and empower the vulnerable adults to participate fully in the society. Data Sources. Data source include the Nursing Standard, The PubMed, Health & Social Care information Centre (hscic), Department of Health, Action on Elder Abuse, Offices of National Statistics (ONS), electronic databases were used to search for research papers, articles published between 2000-2013. The searching keywords used are ‘Vulnerable’, ‘Abuse’, ‘vulnerability’, ‘safeguarding’. Seventeen papers from variety of disciplines, including nursing, public health, social-care and medicine were reviewed. Method. The concept analysis was done using Rodgers’ evolutionary...
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...An Ethical Analysis of Negligence In this paper, the author will describe the main differences among negligence, gross negligence, and malpractice in the medical field. In addition, the author will explain his opinion about this article and the facts described in it as well as the rationale used to form this opinion. Furthermore, the author will describe the importance of documentation in the medical field as well as how nurses should document when providing care while complying with legal and ethical requirements. Unintentional torts are the most common torts in the medical field. Torts are acts occurred without the tortfeasor intention to cause harm; however, some type of harm results from it. Torts are also actions committed unreasonably or disregarding the consequences, in legal terms this represents negligence (Judson & Harrison, 2010). According to Judson and Harrison (2010), negligence is an unintentional tort and a person is negligent when in similar circumstances he or she did not performed as expected from a reasonable person (Judson & Harrison, 2010). Defining gross negligence is a more complicated issue. According to Thornton (2006) the Texas Civil Practice and Remedies Code defines gross negligence as an act of omission that when viewed from the position of the actor at the time the omission occurred it shows a significant degree of risk and possible harm to others (Thornton, 2006). In addition, the actor is aware of the risks but proceeds disregarding the rights...
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...Individual Analysis Standards of Nursing Nursing is a multi-faceted and evolving profession defined by the American Nurses Association (ANA) as, “The protection, promotion, and optimization of suffering through the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, communities and population” (ANA, 2010, p.1). Standards of nursing care set by the ANA include standards of care, code of ethics, and professional standards. The standards set forth by the ANA help to define the scope of nursing practice. For the purpose of this paper, I will further detail how these standards affect my professional nursing care. Nursing professionals are obligated and expected to practice within the scope and standards of nursing care. Within my own scope of practice, I follow the standards of care on a daily basis. I am assessing patients, planning patient care, implementing, and evaluating the outcomes of patient care. My facility has outlined standards of care. By following these policies and procedures, I can commit to safe nursing practice. Nursing professionals are also obligated and expected to adhere to the standards of professional performance. Within my own nursing practice, I am expected to provide nonjudgmental care, therefore I must disrequard my own prejudices and be an advocate for the patient no matter the patient’s race, economic status, disease process, or chosen lifestyle. The nursing professional is also responsible to...
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