The paper aims to exhaustively examine the changes that were put in place to restructure the health care delivery system in the U.S and consider the role that nurses play in the process. The paper will include a current health care law introduced to restructure some parts of the health care system and its influence on nursing practice putting in mind the nurses’ roles and responsibilities. Pay per performance and quality measures affecting patients and how nurses should handle the situation will also be discussed in this paper. Emerging professional nursing management roles and leadership in connection to quality care and patient safety in diverse health care settings will also be covered in the paper. Lastly, the paper will cover research on emerging nursing trends and give two predictions of the growth in nursing roles in five years.
American Health Care Act (AHCA) and its effects on Nursing Practice, Responsibilities and Roles
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The American Health Care Act (AHCA) was introduced in 2017 as a reconciliation bill aimed at modifying fiscal and budgetary provisions of the Patient Protection and Affordable Care Act (ACA) ( Willison & Singer, 2017). The bill, however, did not propose the total repeal of the initial ACA but introduced penalties given to individuals upon failure to maintain health coverage. The penalties also applied to employers when they fail to offer coverage to their employees. Additionally, the bill proposed a tax credit system basing on age through high premiums for individuals who fails to maintain a continuous coverage. According to Willison & Singer (2017), the bill moreover reduced government funds directed that were channeled to public health initiatives as it opposes a larger part of the Medicaid Act.
The introduction of the AHCA resulted in lower coverage on fundamental aspects of the initial ACA policy and this has limited Medicaid funding. As a result, nurses have strongly come out to oppose the new law since it is projected that close to 14 million Americans will lose coverage over the next decade (Willison & Singer, 2017). Consequently, nurses will be directly impacted by this shift making it impossible for a significant number of them to render their services in a decade.
Quality Measures and Pay for Performance and their effect on Patient Outcomes and Nursing Practice
Quality measures have been put in place to ensure that patient care delivery is done to the required standards and to every patient’s satisfaction. For instance, structural measures have been put in place to ensure each health facility has enough physicians and the ration of patients and providers is balanced appropriately. Process measures have also been put in place to regulate the immunization process and ensure effective control of chronic diseases like diabetes. Pay for performance involves a payment model that attaches financial incentives to the performance of the providers (Kondo et al., 2016). Providers are more inclined towards value-based health care system hence achieving quality and a higher patient satisfaction.
Both quality measures and pay for performance policies have had significant improvements on patient outcomes as patients can access quality treatments from respective health care providers. Nurses, on the other hand, have a central role in ensuring that both policies are running effectively. They become part the hospital’s decision- making process since they fully understand the hospital system including its strengths and weaknesses. Kondo et al (2016), nurses’ responsibilities should also include a commitment to their patients to realize better outcomes for the pay for performance policy to be fully operational.
Professional Nursing Leadership and Management Roles
Professional nursing leadership and management roles require nurses to have a combination of the required skills, leadership qualities and clinical expertise (Cherry & Jacob, 2016). For the vision of a transformed health care system to be achieved, strong management and leadership are expected from the nurses for them to cope up with the emerging trends in health care. For instance, new management roles like nurse informatics have arisen to plan, design and implement the EHR system in collaboration with the hospital staff. Patient safety and quality care are increased when strong management and leadership are used to implement the emerging trends in healthcare like the EHR others.
Some of the emerging trends in healthcare include the “medical home” where the doctors have extensive interactions with their patients hence establishing a closer link. As a result, patient outcomes are expected to be higher. Individualized medicine is also another emerging trend in nursing where individuals are segmented into smaller groups which require specific treatment administered by health professions. Basing on DNA tests, patients can closely monitor their health with the aid of a nurse or physician. Electronic Health Record system (EHR) is also an emerging trend in health care and nurses can use it to effectively record and monitor patient diagnosis and treatment ( Koppel & Lehmann, 2014). According to Cherry and Jacob (2016), strong leadership and management are vital in realizing a positive shift of the emerging trends. The nurses should therefore be empowered to embrace these qualities since they play a central role in implementing the policies.
Change in Nursing Roles and Practices over the next five years
In the next five years, nursing roles and practices are expected to change as technology advances. According to Taylor et.al (2015), emerging trends like Telehealth where a mobile app is used to provide health care to patients at any location will most likely increase healthcare outcomes as patients will have improved access to medication a the convenience of their phones. Nursing roles and practices are likely to increase over the next five years as nurses will be required to match the growing number of telehealth users. The use of the EHR system is expected to be in place in most healthcare institutions and in next five years, it is expected to fully replace the use of cumbersome manila folders which are often used in keeping the client’s data.
Conclusion
The American Health Care Act (AHCA) was put in place by the Trump administration as an alternative to the previous ACA. However, nurses tend to oppose the bill due to fact it limits the government’s funding to the nation’s health care. Notably, emerging trends in health care such as Telehealth and the use of the EHR system are more likely to enhance nursing practice over the next five years. This is because the technology is more likely improve health care outcomes by enhancing service delivery.
References
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Kondo, K. K., Damberg, C. L., Mendelson, A., Motu’apuaka, M., Freeman, M., O’Neil, M., ... & Kansagara, D. (2016). Implementation processes and pay for performance in healthcare: a systematic review. Journal of general internal medicine, 31(1), 61-69.
Koppel, R., & Lehmann, C. U. (2014). Implications of an emerging EHR monoculture for hospitals and healthcare systems. Journal of the American Medical Informatics Association, 22(2), 465-471.
Taylor, J., Coates, E., Brewster, L., Mountain, G., Wessels, B., & Hawley, M. S. (2015). Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption. Journal of advanced nursing, 71(2), 326-337.
Willison, C. E., & Singer, P. M. (2017). Repealing the affordable care act essential health benefits: Threats and obstacles. American journal of public health, 107(8), 1225.
