NUR 4327 – Deliverable 7 – Nursing Orientation – Resource Insert Sheets
Part One- Policy Section
Why Stay up to Date on Policies
- Nurses work in dynamic environments and must stay current on relevant information and policies for current practice to provide quality patient care based on evidence and improve time and cost-effectiveness.
- Nurses need information that is accessible, good quality, up-to-date, manageable, and relevant, as well as information services to provide quality care.
- Access to reliable, evidence-based information sources allows for professional judgment in the best interest of patients and the best available evidence for clinical decision-making when providing care (Ricks et al., 2015).
Resources for Staying up to date on Policies
- American Nurses Association (ANA)
- GovTrack
- Kaiser Family Foundation State Health Facts
- National Council of State Boards of Nursing
- ANA Journals
- National League for Nursing
How to Get Involved in Policy Decisions
- Join professional nursing organizations
- These organizations have lobbyists who bring nursing issues to Capitol Hill.
- Using evidence-based practice
- Local and State resources or national nursing advocacy groups
- Networking with other nurses within a specialty
- Participate in policy meetings or related activities
- Learn how policy is developed and seek out areas of policy you want to influence (Arabi et al., 2014).
Part Two- Economics Section
Economic Principles for Nursing
- Payer Mix
- Percentage of patients with government health plans, Medicare and Medicaid, versus private insurance. The payer mix is the key driver of a hospital’s financial health, influencing quality care and patient outcomes (Manary et al., 2015)
- Finding a Balance
- Cost-conscious care by trimming expenditures in strategic ways to not worsen the quality of care patients receive
- EMRs
- Departments remain on budget
- Avoid overtime hours
- Lower cost employee benefits (Vanbook, 2007).
- Cost-conscious care by trimming expenditures in strategic ways to not worsen the quality of care patients receive
HCAHPS Scoring and CMS Payment
HCAHPS is a national, standardized, publicly reported survey of patient’s perspectives of hospital care. This allows comparisons to be made across hospitals locally, regionally, and nationally. HCAHPS scores play a role in hospital payment through the Hospital Value-Based Purchasing program.
Survey includes:
- Experience in communication with doctors and nurses
- Responsiveness of hospital staff
- Communication about medicines
- Cleanliness and quietness of the hospital
- Discharge information
- Transition to post-hospital care
- Overall rating of the hospital
Centers for Medicare and Medicaid Services (CMS) publishes updated HCAHPS results quarterly on its Hospital Compare website (“Hospital CAHPS,” 2020).
Stewards of Resources
- Communicate
- Empower patients by keeping them informed and speaking in a way they can understand
- Educate
- Involve patient in their care. Educate in a way that is best for learning for each specific patient.
- Respect
- Create a quiet, healing environment. Take the time to listen to the patient and their family’s concerns (Berkowitz, 2016)
NUR 4327 – Deliverable 7 – Nursing Orientation – Resource Insert Sheets
Part Three- Legal Section
Principles of Malpractice
The injured patient must show that the physician negligently rendered care and that such negligence resulted in injury.
Four legal elements must be proven:
- A professional duty owed to the patient
- Breach of such duty
- Injury caused by the breach
- Resulting damages (Bal, 2008)
Avoiding Malpractice
Nurses must follow these guidelines within their course of care:
- Practice within your scope
- Ensure communication
- Record all activities, chart communication
- Report suspected errors
- Stay up to date on best practices and engage in continuing education (Brous, 2019)
State Board of Nursing Disciplinary Process
The Board of Nursing (BON), through its statutory authority specified in the Nurse Practice Act, is responsible for reviewing and acting on complaints in order to fulfill its responsibility to protect the public. After a thorough investigation, if the BON determines there is sufficient basis that the nurse violated the act or regulations, the BON may take disciplinary action on the nurse’s license (NCSBN, 2020).
Nurse practice standards and scope of practice can be found through professional nursing organizations such as the American Nursing Association (ANA). Additional information specific to each state can be found through the board of nursing. Understanding hospital organizations’ mission and values can also give more information on their standard of care.
References
Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315–322.
Bal B. S. (2009). An introduction to medical malpractice in the United States. Clinical orthopedics and related research, 467(2), 339–347. https://doi.org/10.1007/s11999-008-0636-2
Berkowitz, B. (January 31, 2016) “The Patient Experience and Patient Satisfaction: Measurement of a Complex Dynamic” OJIN: The Online Journal of Issues in Nursing Vol. 21, No. 1, Manuscript 1.
Brous, E. (2019, July). The Elements of a Nursing Malpractice Case, Part 1: Duty: AJN The American Journal of Nursing. Retrieved December 16, 2020, from https://journals.lww.com/ajnonline/Abstract/2019/07000/The_Elements_of_a_Nursing_Ma lpractice_Case,_Part.37.aspx
Discipline. (2020). Retrieved December 16, 2020, from https://www.ncsbn.org/discipline.htm
Hospital CAHPS (HCAHPS). (2020, November 19). Retrieved December 16, 2020, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/HCAHPS1
Manary, M., Staelin, R., Boulding, W., Glickman, S. (2015). Payer Mix and Financial Health Drive Hospital Quality: Implications for Value-Based Reimbursement Policies [PDF]. https://behavioralpolicy.org/wp-content/uploads/2017/02/BSP_vol1is1_Manary.pdf
Ricks, E., & ten Ham, W. (2015). Health information needs of professional nurses are required at the point of care. Curationis, 38(1), 1432. https://doi.org/10.4102/curationis.v38i1.1432
Vanhook PM. (2007). Cost-utility analysis: a method of quantifying the value of registered nurses. Online Journal of Issues in Nursing, 12(3), 3p.
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Question 
NUR 4327 – Deliverable 7 – Nursing Orientation – Resource Insert Sheets
Competency
- Analyze the components of political action in nursing.
- Explain the process of policy-making in healthcare delivery.
- Apply the principles of economics as they relate to nursing and healthcare.
- Appraise economic aspects that influence healthcare delivery systems.
- Analyze legal components related to nursing practice.
- Determine strategies that minimize legal risks related to negligence and malpractice in nursing practice.
NUR 4327 – Deliverable 7 – Nursing Orientation – Resource Insert Sheets
Student Success Criteria
View the grading rubric for this deliverable by selecting the “This item is graded with a rubric” link, which is located in the Details & Information pane.
Scenario
Your nurse manager has asked you to partner with the nurse educator to coordinate orientation for new nursing hires. The nurse educator suggests that the following areas (policy, economics, and legal) are not well-represented in nursing orientation materials and that your input would be welcome. You are told that the orientation materials should be brief, as they are part of each nurse’s notebook, and they should include hospital and nursing policies and procedures and tips for best practice.
Instructions
Prepare resource insert sheets for the nursing orientation manual that contains the following:
Part One – Policy Section
- Examines the importance of staying up to date with federal and state health policy.
- Provides resources for staying up to date.
- Illustrates ways nurses can get involved in the policy process.
Part Two – Economics Section
- Identifies key economic principles for nursing.
- Explains the concept of HCACPS Scoring and CMS payment.
- Summarizes ways nurses can be stewards of resources.
- Discusses the revenue sources and budgeting.
Part Three – Legal Section
- Identifies the basic principles of malpractice.
- Assesses best practices for avoiding nursing malpractice.
- Summarizes the State Board of Nursing Disciplinary Process and resources to find Nursing Practice Standards.
- Provides stated ideas with professional language and attribution for credible sources with correct citation, spelling, and grammar in the nursing orientation resource insert sheets.
- Include in-text citations and references.
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