Ethical and Policy Factors in Care Coordination-Nursing Home

Ethical and Policy Factors in Care Coordination-Nursing Home

Hello, and welcome to today’s presentation. This presentation explores ethical and legal factors that affect care coordination in nursing homes. Also, it evaluates how the code of ethics impacts care coordination.

Presentation Outline

We will begin by explaining how government policies related to nursing homes impact care coordination. We will then identify policy provisions that elicit ethical questions. Thereafter, we will explain how care coordination is affected by the code of ethics. Finally, we will provide a summary of our presentation.

Government Policies

Nursing homes provide holistic care to their residents. Most of the residents are the elderly population who may have multiple comorbidities. The majority of the population comprises permanent residents that require continuous monitoring. Various government policies impact care coordination for nursing homes. Firstly, the Nursing Home Reform Act establishes quality standards to guide the day-to-day operations in nursing homes (NursingHomeAbuseGuide.org, n.d.). According to the Act, residents have the right to access services such as proper nutrition, appropriate medication, right to privacy, mental health services, and services involving activities of daily living (NursingHomeAbuseGuide.org, n.d.). In addition, the residents should not be mistreated. Also, the Act directs healthcare providers to create an individualized plan of care for all residents (NursingHomeAbuseGuide.org, n.d.). To accomplish this, the Act directs nursing homes to have optimized ratios of healthcare providers to patients. As such, the Nursing Home Reform Act impacts care coordination by advocating adequate staffing to ensure that all residents access quality healthcare services.

Secondly, the Older Americans Act aims to optimize the general well-being of older adults by providing various services. To accomplish this, it established a department to provide Federal grants. These grants facilitate various activities such as funding nursing homes, making social services available, training personnel about aging, and planning community resources (NursingHomeAbuseGuide.org, n.d.). Furthermore, the grants provide nutritional services to the elderly population. This Act impacts care coordination by training more personnel and funding nursing homes to address the unique needs of the elderly population (NursingHomeAbuseGuide.org, n.d.). Thirdly, the Health Insurance Portability and Accountability Act impacts care coordination. This Act requires covered entities to uphold patient information privacy, confidentiality, and security (Theodos & Sittig, 2021). Nurses and other healthcare providers working in covered nursing homes should uphold HIPAA to improve the quality of care.

The Nursing Home Reform Act is an example of a policy aiming to improve the quality of care in nursing homes. Nursing homes that fail to adhere to this Act risk penalizations and lower reimbursement rates from Medicare and Medicaid (NursingHomeAbuseGuide.org, n.d.). The Act directs nursing homes to have an adequate number of nurses to avert the risk of fatigue and errors caused by nursing shortages (NursingHomeAbuseGuide.org, n.d.). An adequate number of nurses will allow the delegation of duties and promote care coordination in nursing homes. Also, nurses are required to formulate individualized care plans that fulfil patients’ holistic needs (NursingHomeAbuseGuide.org, n.d.). For instance, incapacitated patients should be assisted in accomplishing their daily activities. Furthermore, nursing homes should maintain proper documentation and adequate supervision and monitor patients closely.

Policy Provisions

Various policy provisions impact care coordination and raise ethical questions for nursing home residents. Medicare is a federal policy that mainly targets people aged 65 years and above (HHS.gov, 2022). Also, it provides coverage for people with specific conditions, such as end-stage kidney failure (HHS.gov, 2022). Medicare has standardized costs and is similar in all states. Medicaid provides coverage for low-income individuals and those with limited resources (HHS.gov, 2022). Secondly, Medicaid coverage varies from one state to another. Lastly, the Affordable Care Act was enacted to expand healthcare coverage and promote innovativeness in healthcare (McIntyre & Song, 2019). Therefore, Medicare, Medicaid, and the Affordable Care Act aimed to improve access to healthcare services.

Medicaid, Medicare, and the Affordable Care Act raise some ethical concerns. Firstly, Medicaid and Medicare present the dilemma of improving access to healthcare services versus cost and quality care. Medicaid and Medicare have provided health coverage to approximately forty-two million and 40 million people, respectively. Increased coverage and access to care are likely to compromise the quality of care because primary care physicians and other providers will be required to serve more patients. Also, increased coverage may lead to increased billing charge rates, hence higher treatment costs. The Affordable Care Act limits immigrants’ access to marketplace healthcare coverage. By so doing, undocumented immigrants and other ineligible individuals are likely to have limited access to cost-effective healthcare services. These ethical concerns impede the delivery of healthcare services and care coordination.

Code of Ethics

The social determinants of health account for health disparities among various populations. Firstly, quality education is associated with good health outcomes because individuals have pertinent information concerning healthy life practices (Health.gov, n.d.). Secondly, access to quality healthcare services allows individuals to receive timely services. By so doing, their needs are addressed promptly, hence a better outcome. Thirdly, economically stable individuals are likely to afford healthcare costs and receive timely quality healthcare services (Health.gov, n.d.). Fourthly, safe environments such as adequate housing, access to clean water, and unpolluted air are associated with a healthy population (Health.gov, n.d.). Lastly, positive social relationships impact health positively. Positive social relationships enable people to get appropriate social support at their residences and places of work (Health.gov, n.d.). By so doing, the overall well-being of this population is improved.

The code of ethics guides the practice of nurses. Nurses should uphold these ethics during patient care and when interacting with other stakeholders (ICN.ch, 2021). Nurses are required to maintain professional competency by advancing their education levels and participating in continuous professional development (ICN.ch, 2021). Also, nurses should promote patient safety by offering quality healthcare services. The code of ethics directs nurses to advocate for the patient’s rights and overall well-being (ICN.ch, 2021). Furthermore, nurses should embrace evidence-based practice by collaborating with other healthcare providers and researching.

Nurses should embrace the code of ethics to assess determinants of care and promote a continuum of care for patients. They should engage in the advocacy for safe environments and communities to improve the well-being of individuals. Also, they should advocate access to quality healthcare by participating in policy formulation. Increased access to healthcare is achieved when more people are allowed to access healthcare coverage. Professional competency will enable them to provide pertinent patient education and exchange information with other interdisciplinary team members to promote quality healthcare services.

Summary

Nursing homes provide holistic care to their residents. Most of the residents are the elderly population who may have multiple comorbidities. Various government policies impact the delivery of care for patients found in nursing homes. Examples of these policies include the Older Americans Act, the Health Insurance Portability and Accountability Act, and the Nursing Home Reform Act. The provisions of Medicare, Medicaid, and the Affordable Care Act raise some ethical questions related to access to healthcare, quality of healthcare, and healthcare costs. The code of ethics enables nurses to provide quality healthcare services.

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Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation with audio intended for that audience. Create a detailed narrative script or speaker notes for your presentation, 4-5 pages in length.

Ethical and Policy Factors in Care Coordination-Nursing Home

Introduction
As coordinators of care, nurses must be aware of the code of ethics for nurses and health policy issues that affect the coordination of care within the context of the community. To help patients navigate the continuum of care, nurses must be proficient at interpreting and applying the code of ethics for nurses and health policy, specifically, the Affordable Care Act (ACA). Being knowledgeable about ethical and policy issues helps ensure that care coordinators are upholding ethical standards and navigating policy issues that affect patient care.

This assessment provides an opportunity for you to develop a presentation for a local community organization of your choice, which provides an overview of ethical standards and relevant policy issues that affect the coordination of care. Completing this assessment will strengthen your understanding of ethical issues and policies related to the coordination and continuum of care and will empower you to be a stronger advocate and nursing professional.

It would be an excellent choice to complete the Vila Health: Ethical Decision-Making activity prior to developing the presentation. The activity provides a helpful update on the ethical principles that will help with the success in this assessment.

Preparation
Your nurse manager at the community care centre is well-connected and frequently speaks to a variety of community organizations and groups. She has noticed the good work you are doing in your new care coordination role and respects your speaking and presentation skills. Consequently, she thought that an opportunity to speak publicly about contemporary issues in care coordination would be beneficial for your career and has suggested reaching out to a community organization or support group to gauge their interest in hearing from you as a care centre representative on a topic of interest to both you and your prospective audience.

You have agreed that this is a good idea and have decided to research a community organization or support group that might be interested in learning about ethical and policy issues related to the coordination of care. Your manager has suggested the following community organizations and support groups but acknowledges that the choice is yours.

Homeless shelters.
Local religious groups.
Nursing homes.
Local community organizations (Rotary Club or Kiwanis Club).
To prepare for this assessment, you may wish to:

Research your selected community organization or support group.
Review the Code of Ethics for Nurses With Interpretive Statements and associated health policy issues, specifically the ACA.
Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.
Allocate sufficient time to rehearse your presentation before recording the final version for submission.
Recording Equipment Setup and Testing
Check that your audio speaker and PowerPoint software are working properly. You can record audio directly to your slides using PowerPoint or other presentation software.

Note: Technical support about the use of PowerPoint, including voice recording and speaker notes, can be found on Campus’s Microsoft Office Software page.

If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your presentation in the courtroom.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.

Instructions
For this assessment:

Choose the community organization or support group that you plan to address.
Develop a PowerPoint with typed speaker notes (the script for your voice recording) and an audio voice-over recording intended for that audience. Video is not required.
Note: PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature, or you may choose to submit a separate document. See Microsoft Office Software for technical support about the use of PowerPoint, including voice recording and speaker notes.

For this assessment, develop your presentation slides and speaker notes, then record your presentation. You are not required to deliver your presentation to an actual audience.

Presentation Format and Length
You may use PowerPoint (recommended) or other suitable presentation software to create your slides and add your voice-over. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.

Be sure that your slide deck includes the following slides:

Title slide.
Presentation title.
Your name.
Date.
Course number and title.
References (at the end of your presentation).
Your slide deck should consist of 10–12 slides, not including a title and references slide with typed speaker notes and audio voice-over. Your presentation should not exceed 20 minutes.

Create a detailed narrative script for your presentation, approximately 4–5 pages in length.

Supporting Evidence
Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.

Grading Requirements
The requirements outlined below correspond to the grading criteria in the Ethical and Policy Factors in Care Coordination Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.
Provide examples of a specific policy affecting the organization or group.
Refer to the assessment resources for help in locating relevant policies.
Be sure influential policies include the Health Insurance Portability and Accountability Act (HIPPA).
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination.
What are the implications and consequences of specific policy provisions?
What evidence do you have to support your conclusions?
Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
Consider the factors that contribute to health, health disparities, and access to services.
Consider the social determinants of health identified in Healthy People 2020 as a framework for your assessment.
Provide evidence to support your conclusions.
Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included for a proficient score; both speaker notes and the audio voice-over are included for a distinguished score.
Present a concise overview.
Support your main points and conclusions with relevant and credible evidence.
Additional Requirements
Before submitting your assessment, proofread your presentation slides and speaker notes to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your presentation.

Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 4: Defend decisions based on the code of ethics for nursing.
Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
Competency 5: Explain how healthcare policies affect patient-centered care.
Explain how governmental policies related to the health and/or safety of a community affect the coordination of care.
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination.
Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over is included.