Resource Insert Sheet

Part One- Policy

Importance of Staying Updated on Health Policies

Health policies define the healthcare landscape of the United States (Mozafaripour, 2022). These policies shape the funding decisions, boundaries of patient and provider interactions, safety and privacy standards, the code of conduct among healthcare providers, and the competency requirements for different levels of practice. Staying up-to-date with health policies ensures that a nurse or any other healthcare practitioner understands the current policies and any policy changes. This ensures that they provide healthcare within the existing legal framework: Resource Insert Sheet.

Therefore, your practice is compliant with the existing legal framework. It also ensures practices within the healthcare setting are up to the required ethical standards while helping the practitioner avoid any legal and ethical issues and penalties. Staying updated on health policies also ensures that you keep your competencies as a healthcare practitioner compliant with the current legal and practice requirements. Additionally, being updated on health policies ensures that healthcare services are provided within the set and up-to-date guidelines, helping contribute to and achieve the large health systems’ goals as observed during the COVID-19 pandemic (Ashinyo et al., 2021).

Resources for staying updated on health policies:

• The U.S. Congress website available at https://www.congress.gov/
• Centers for Disease Control and Prevention (CDC) accessible via cdc.gov
• American Nurses Association (ANA) available via nursingworld.org
• The State Nursing Board specifically for your state

As a nurse, you can get involved in the policy process through:

• Taking an active role in advocating for policies, including getting in touch with your political representatives, including your senator
• Joining a policy advocacy nursing group such as the ANA (nursingworld.org), the Center for American Progress (https://www.americanprogress.org/), or the American Psychiatric Nurses Association (APNA) (https://www.apna.org/), among others.
• Actively engaging in research to develop evidence to guide policy development
• Actively participating in campaigns aimed at raising awareness of health policies and health policy changes and their impact on the health system.

Part Two- Economics

The economic principles in healthcare settings are focused on how resources are allocated within the health system and how the resources are utilized in the delivery of healthcare services (MacNeill et al., 2021). Resource allocation as a healthcare economic principle is a critical part of the decision-making process within healthcare systems.

It involves strategic analysis, selection, and assignment of available resources to the necessary tasks that ensure the right quality of sustainable healthcare services. The other concept guarantees that the healthcare services that are properly assigned provide high-quality treatment by utilizing resources to produce value-based care. The results are more important than the services provided.

Understanding the concepts of HCAHPS Scoring and CMS Payment

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a survey that focuses on developing data on patient satisfaction (Hospital CAHPS (HCAHPS) n.d). The HCAHPS data allows the comparison of hospitals and to guide decisions on Medicare reimbursements. The level of scores determines the financial allocations from the CMS.

The scores are focused on the patient-reported experiences during their interactions with nurses and other care providers within the hospital. High scores for hospitals lead to the hospital having fewer or no penalties, hence, higher CMS reimbursement rates. On the other hand, lower scores based on patient-centred measures, including reported patient satisfaction scores, increase the risk of penalties and may lead to lower CMS payments.

How Nurses can be Stewards of Resources

Nurses are a critical resource in healthcare that can be stewards of health resources management by focusing on the efficient use of available resources to reduce wastage, contributing to efforts that reduce the need for extra resources, including promoting and creating awareness on preventing healthcare to reduce the demand for health services or readmission rates. They can also promote collaborative teams for healthcare services delivery to further reduce wastage and promote efficiency in resource utilization.

Revenue sources and budgeting

The sources of revenue for healthcare facilities, including hospitals, include payments from insurance covers such as Medicare and Medicaid or any other privately funded insurance schemes, direct out-pocket-pocket patient payments, sale of equipment, and other funding mechanisms, including government grants.

Part Three- Legal

Principles of Malpractice

Malpractice occurs as a result of the failure of healthcare professionals to provide care services that meet expected care standards, risking or leading to harm to the patient. It is simply a failure of the care provider to do their job right. The key principles of malpractice include causation of the harm, duty to the patient and professional responsibility, negligence and breach of duty, and the damages.

Best Practices for Avoiding Malpractice

Malpractices are avoidable (Raveesh et al., 2016). The best practices to avoid malpractices and associated damages for nurses include ensuring that all documentation of any interactions with the patients is accurately captured, integrating the principles of effective communication when interacting with patients, other providers, and the family, adhering to specific patient care guidelines, taking care of oneself, and observing the State Board of Nursing Standards specific to the state of practice.

The State Board of Nursing Standards, accessible via https://www.ncsbn.org/, can help nurses understand the specific standards for nursing practices for different states, the requirements for nursing licensure and the authorized scope of practice as per the nurse’s level of education, and approaches to managing cases or instances of malpractice or other patient-related complaints.

References

Ashinyo, M. E., Dubik, S. D., Duti, V., Amegah, K. E., Ashinyo, A., Asare, B. A., Ackon, A. A., Akoriyea, S. K., & Kuma-Aboagye, P. (2021). Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study. PLOS ONE, 16(3), e0248282. https://doi.org/10.1371/JOURNAL.PONE.0248282

Hospital CAHPS (HCAHPS). CMS.gov. (n.d.). https://www.cms.gov/data-research/research/consumer-assessment-healthcare-providers-systems/hospital-cahps-hcahps#:~:text=About%20the%20survey%3A%20The%20HCAHPS,overall%20rating%20of%20the%20hospital.

MacNeill, A. J., McGain, F., & Sherman, J. D. (2021). Planetary health care: a framework for sustainable health systems. The Lancet Planetary Health, 5(2), e66–e68. https://doi.org/10.1016/S2542-5196(21)00005-X

Mozafaripour, S. (2022, March 22). Healthcare policy: What is it and why is it important?: USAHS. University of St. Augustine for Health Sciences. https://www.usa.edu/blog/healthcare-policy/#:~:text=Healthcare%20policy%20is%20an%20integral,%2C%20delivery%20methods%2C%20and%20privacy.

Raveesh, B., Nayak, R., & Kumbar, S. (2016). Preventing medico-legal issues in clinical practice. Annals of Indian Academy of Neurology, 19(5), 15. https://doi.org/10.4103/0972-2327.192886

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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.
  

  Resource Insert Sheet

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 APA citation, spelling, and grammar in the nursing orientation resource insert sheets