Presentation Script-Ethical and Policy Factors in Coordination Care

Presentation Script-Ethical and Policy Factors in Coordination Care

Hello and welcome to this presentation on the ethical and policy factors involved in the coordination of care among individuals in a nursing home. In this presentation, I will explain how the governmental policies linked to the health and safety of the community affect the coordination of care; identify the national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination; and assess the impact of the code of ethics for nurses on the coordination and continuum of care. Our assignment writing help is at affordable prices to students of all academic levels and academic disciplines.

Governmental Policies

Governmental policies are highly important in determining the success of the healthcare system. Various policy and ethical issues affect healthcare organizations. In recent years, there are various reforms that have been implemented to boost coordination of care. One of the governmental policies that commonly affect the coordination of care in nursing homes is the Affordable Care Act. The objectives of the ACA are to improve access to healthcare for patients, improve the quality of care and lessen expenditures in healthcare (Collins & Saylor, 2018; Luther & Hart, 2014). Under the ACA, consumers currently have easier access to more information regarding nursing homes to aid in the selection of a facility and also monitor the care that is being provided. For instance, consumers are able to gain access to information regarding who owns the nursing home, how much the facility spends on resident care in comparison to administrative costs, the number of violations and complaints as well as the hours of nursing care that residents receive (AARP, Health Reform for Seniors, 2015).

HIPAA

Health Insurance Portability and Accountability Act is another governmental policy that affects the coordination of care in nursing homes. HIPAA emphasizes the need for covered entities to protect sensitive health and personal information. For several years in most nursing homes, employees tend to violate the privacy of patients. In one nursing home in San Francisco, staff members are said to have physically and verbally abused patients and sent photos of such incidents to other employees (Davidson, 2021). Complying with HIPAA regulations can help to avoid such incidents. HIPAA emphasizes the protection of patient privacy, which increases the trust of patients in healthcare and helps improve the quality of care received. Through the sharing of important information with only covered individuals or essential people, there can be better coordination of care as well as patient-centered care. However, this restriction could also prevent coordinated care.

Medicare

Medicare is among the most notable government policies that affect the coordination of care. Medicare provides health insurance services to millions of individuals (particularly elderly persons) in the US. Medicare boosts coordination of care since it strives to improve access to care for the covered individuals. However, some researchers claim that individuals covered by Medicare record an increase in readmission and hospitalization rates (Khullar & Chokshi, 2018). Given that a wide population of people with chronic diseases covered under Medicare are also poor, there is the possibility of high numbers of patients, which could hamper the coordination of care due to issues like staff shortages, medical errors, and burnout.

National, State, and Local Policy Provisions That Raise Ethical Questions For Care Coordination

Medicare and Medicaid patients are normally more likely than privately insured patients to receive delayed treatment. Research shows that Medicaid has greatly lessened the cost of care for patients, but at the same, it has also lowered the quality of care that patients receive (Allen et al., 2021; Hsiang et al., 2019). One of the most significant ethical dilemmas in healthcare today is how to provide quality healthcare at a lower cost. Physicians have often cited low payment rates for Medicaid and Medicare (Holgash & Heberlein, 2019). This often affects the quality of care offered as well as the acceptance of these services among healthcare practitioners. With lower payment rates, care coordination can be impacted as the willingness to provide care also tends to lessen.

Healthcare reforms have brought about major positive changes in the US society. As stated earlier, creating a balance between quality and low-cost care is a major ethical issue. Affordable Care Act and patient protection as stipulated by HIPAA are some of the government policies that bring about major ethical questions. For instance, ACA tends to leave out the majority of people who are covered, and this would prevent access to care. Furthermore, ACA is likely to increase the national debt, given the number of people covered under it (Mauldin, 2016). Consequently, the health budget is also likely to be affected in the long run, and this is likely to impact the coordination of care. For instance, with increased number of people covered and fewer healthcare practitioners who suffer from problems like burnout and stress, there is a likelihood that care coordination will be highly negatively impacted. Physician burnout is linked with increased medical and medication errors and is also likely to negatively affect communication between healthcare practitioners, thereby preventing better quality and coordinated care from being offered to patients.

The Impact of the Code of Ethics For Nurses on the Coordination and Continuum of Care

Ethical codes are the instructions that shape ethical behaviour and also determine which beliefs and values should be accepted (Bijani et al., 2017). These codes are the practical guidelines in the nursing field. The various codes of ethics in nursing tend to bring about ethical conflicts. These codes could have both positive and negative effects. Whereas the codes provide moral standards for nurses, which are considered non-negotiable, they are not all-inclusive of all situations, and this tends to limit moral decisions for nurses. These codes of ethics enable nurses to provide quality care as they facilitate increased evidence-based care through consultation and communication with other interdisciplinary teams, hence increasing care coordination.

Factors That Contribute to Health, Health Disparities, and Access to Services

There are various factors that contribute to health disparities, such as poor quality of care, access to care, genetics, community factors like poverty, inadequate access to healthy foods, violence and limited personal support systems, and environmental conditions such as poor air quality, and unpolluted and uncongested environment. Health behaviours and language barriers also play an integral role in health disparities. According to Healthy People 2020, some of the major influences on health for most Americans include the availability of as well as access to nutritious food; safe and decent housing; health insurance; non-polluted air and clean water; reliable and affordable public transportation as well as culturally sensitive health care providers.

Social Determinants by Healthy People 2020

Healthy People 2020 has made various provisions for the social determinants of health in an attempt to create an environment that is safe and healthy for the general population. A range of environmental, economic, social, and personal factors majorly contribute to population and individual’ health. For instance, individuals with quality education, safe neighbourhoods and homes, stable employment, and access to preventive services tend to be healthier in their lifetime. On the other hand, poor health outcomes are made worse by the association between individuals and their physical and social environment. Social determinants are partly responsible for the avoidable unequal differences in health status between and within communities. Some of the social determinants include the availability of resources to meet daily needs like job opportunities, healthful foods, and living wages; exposure to social disorder, violence and crime; socioeconomic problems like poverty, public safety, transportation options, quality schools, exposure to mass media and emerging technologies like cell phones and internet, residential segregation, social attitudes and norms like discrimination and also social interactions and social support (Healthy People, 2020).

Ethical Issues in Nursing Homes

Some of the commonly encountered ethical issues in nursing homes include advance directives, the use of restraints, psychotropic medication, competence and capacity of decision-making, resident abuse, and decisions regarding life-sustaining treatment (Bollig et al., 2015). There are also issues with informed consent, autonomy, and refusal of food or medication. Everyday ethical issues majorly include issues with informed consent, autonomy, the use of restraints, offensive behaviour, and refusal of food or medication. On the other hand, end-of-life care and decision-making are considered big ethical issues. For instance, decisions to withdraw or withhold life-sustaining treatments and questions regarding whether to hospitalize or not are common in nursing homes. The nurse’s code of ethics can provide relevant information, but nurses tend to face major challenges, particularly in relation to big ethical issues.

Conclusion

In conclusion, there are various government policies that affect the health and safety of care in nursing homes, especially in relation to the coordination of care. Affordable Care Act, Medicare, and the Health Insurance Portability and Accountability Act are some of these policies. Some of these policies also raise major ethical questions for care coordination. The major dilemma is how to ensure quality and well-coordinated care at a low cost. The code of ethics can help guide nurses in the manner in which they provide care. These codes help in decision-making and in making informed and well-coordinated care. However, they also limit creativity in decision-making in complex situations. In nursing homes, the major ethical dilemmas involve issues of autonomy and informed consent. Some other factors like poor housing, education, and lack of proper nutrition, sanitation and nutrition are among the major social determinants that cause inequalities in healthcare.

References

AARP, Health Reform for Seniors. (2015). How the Affordable Care Act is Impacting Nursing Homes. https://www.caitlin-morgan.com/nursing-homes-aca/

Allen, H., Gordon, S. H., Lee, D., Bhanja, A., & Sommers, B. D. (2021). Comparison of utilization, costs, and quality of Medicaid vs subsidized private health insurance for low-income adults. JAMA Network Open, 4(1), e2032669-e2032669.

Bijani, M., Ghodsbin, F., Fard, S. J., Shirazi, F., Sharif, F., & Tehranineshat, B. (2017). An evaluation of adherence to ethical codes among nurses and nursing students. Journal of medical ethics and history of medicine, 10.

Bollig, G., Schmidt, G., Rosland, J. H., & Heller, A. (2015). Ethical challenges in nursing homes–staff’s opinions and experiences with systematic ethics meetings with participation of residents’ relatives. Scandinavian Journal of Caring Sciences, 29(4), 810-823.

Collins, B. L. & Saylor, J. (2018). The Affordable Care Act: 8 years later. Nursing Management, 49(8), 42–48.

Davidson, G. (2021). HIPAA regulations for nursing homes. https://www.jotform.com/blog/hipaa-regulations-for-nursing-homes/

Healthy People 2020. Determinants of Health. https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

Healthy People 2020. Disparities. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities

Holgash, K.,& Heberlein, M. (2019). Physician Acceptance Of New Medicaid Patients: What Matters And What Doesn’t. Health Affairs. https://www.healthaffairs.org/do/10.1377/hblog20190401.678690/full/

Hsiang, W. R., Lukasiewicz, A., Gentry, M., Kim, C. Y., Leslie, M. P., Pelker, R., … & Wiznia, D. H. (2019). Medicaid patients have greater difficulty scheduling health care appointments compared with private insurance patients: a meta-analysis. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56, 0046958019838118.

Khullar, D., & Chokshi, D. A. (2018). Can Better Care Coordination Lower Health Care Costs?. JAMA network open, 1(7), e184295-e184295.

Luther, B., & Hart, S. (2014). What does the Affordable Care Act mean for nursing? Orthopaedic Nursing, 33(6), 305–309.

Mauldin, J. (2016). Thanks To Obamacare, Government Debt Is Worse Than You Think. Forbes. https://www.forbes.com/sites/johnmauldin/2016/11/02/thanks-to-obamacare-government-debt-is-worse-than-you-think/?sh=11ce371e15f9

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Presentation Script-Ethical and Policy Factors in Coordination Care

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.
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 health care 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. with speaker notes