NUR 4636 Nursing Course Reflection Paper 2

NUR 4636 Nursing Course Reflection Paper 2

Chapter 3: Health Policy, Politics, and Reform Chapter Highlights #1 ❖ Healthcare policy and the political process ❖ Healthcare finance and cost–benefit in relation to health policy ❖ Access to healthcare and insurance facts in the United States ❖ Healthcare workforce diversity and its effects on the quality of healthcare ❖ Nursing’s role in shaping healthcare policy Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter Highlights #2 ❖ Quality of care and evaluation ❖ Information management facts ❖ Equity in healthcare access ❖ Ethical consideration in health policy ❖ Political advocacy, how to be politically active and advocate Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter Highlights #3 ❖ Health advocacy and healthcare reform ❖ Affordable Care Act (ACA) overview and updates ❖ Community-based services and healthcare reform ❖ Health services research application to healthcare policy Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare Policy and Political Process ❖ Policies: set of principles that govern an action to achieve a given outcome, or guidelines that direct individuals’ behavior toward a specific goal ❖ Public health policy: decisions made in regard to the health of the individual and the community ❖ Health policies: impact on the health of an individual, a family, and a population or community Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #1 Is the following statement true or false? Health policies impact on the health of an individual, a family, and a population or community. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #1 True Rationale: Health policies impact on the health of an individual, a family, and a population or community. Copyright © 2020 Wolters Kluwer · All Rights Reserved Involving Politics ❖ Process of influencing the allocation of resources needed to enable policy and involves the strategies needed to achieve the desired goals. ❖ NUR 4636 Nursing Course Reflection Paper 2

Policy-making takes a great deal of effort, time, and commitment. o Setting an agenda o Policy formulation o Policy adoption o Policy implementation o Policy assessment o Policy modification Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare Finances and Cost-Benefit ❖ Economics is the study of how individuals, groups, organizations, and society allocate and utilize resources. ❖ When a policy is evaluated for its effectiveness, there is an interest in keeping the cost of a specific health program within reason, and it is critical to consider the overall costs and benefits of an existing program when a more efficient and effective service is identified and adopted. Copyright © 2020 Wolters Kluwer · All Rights Reserved Access to Care and Health Insurance ❖ The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments. Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #2 Is the following statement true or false? The U.S. healthcare system is a unique system of both independent power and action by the federal government. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #2 False Rationale: The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments. Copyright © 2020 Wolters Kluwer · All Rights Reserved Nursing’s Role in Shaping Healthcare Policy ❖ Nursing has a rich history as a unique profession, with its own values, ethics, respect, integrity, and responsibility. Nurses’ contributions to the policies are unlimited; there is a need for greater coordination of action to ensure that nursing is actively supported and involved in influencing and shaping health and healthcare policies. Copyright © 2020 Wolters Kluwer · All Rights Reserved Historical Highlights on Nursing Political Involvement ❖ Mid-‘70s and early ‘80s: Political involvement of nurses ❖ 1976: Important year of advocacy ❖ 1990s: Nurses included in healthcare policy formation Copyright © 2020 Wolters Kluwer · All Rights Reserved What Does It Mean to Be Politically Active? ❖ Personal and professional political involvement of nurses ❖ Nurses must be knowledgeable about issues, laws, and policy ❖ Why is nurse-informed political involvement? o Direct caregivers o Awareness of patient safety and satisfaction, access to services, clinical outcomes, and health disparities o Positioned to see impact of policy on individuals Copyright © 2020 Wolters Kluwer · All Rights Reserved Nursing Advocacy and Policy Participation ❖ Patient advocacy ❖ Political advocacy Copyright © 2020 Wolters Kluwer · All Rights Reserved How to Be Politically Involved? ❖ Evidence-based practice examples ❖ Nurses’ milestones in policy development have contributed to: o Quality outcomes o Decreases in cost o Expanded access o Major differences to the health of the nation Copyright © 2020 Wolters Kluwer · All Rights Reserved Advocacy Activities of Professional Nursing Organizations ❖ Role of professional nursing organizations o ANA o NLN o ICN Copyright © 2020 Wolters Kluwer · All Rights Reserved Current Situation of Nursing Involvement: Challenges and Barriers ❖ Not enough time to get involved ❖ Heavy workloads with understaffing ❖ Perception of powerlessness ❖ Gender issues ❖ Political action breaching family time ❖ Anxiety with public speaking ❖ Lack of knowledge in legislative process ❖ Fear of retaliation Copyright © 2020 Wolters Kluwer · All Rights Reserved Quality of Care ❖ Safety ❖ Effectiveness ❖ Patient centeredness ❖ Timeliness ❖ Equality ❖ Quality of care is defined by the Institute of Medicine (2001) as the degree to which health services for individuals and populations increase the likelihood of desired outcomes, and are consistent with current knowledge. ❖ It is extremely difficult to evaluate the complexities of the quality of care for the U.S. population. Copyright © 2020 Wolters Kluwer · All Rights Reserved Information Management ❖ U.S. policy-makers have made the adoption of health information technology a priority so that health records can be kept electronically, assisting patients, providers, and insurers. Copyright © 2020 Wolters Kluwer · All Rights Reserved Equity and Equality in Healthcare Access and Quality ❖ Because of the vast disparities in healthcare access and quality, President Obama has made healthcare his top priority, promising affordable and adequate healthcare insurance for all Americans. Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #3 Is the following statement true or false? Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #3 True Rationale: Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status. Copyright © 2020 Wolters Kluwer · All Rights Reserved Community-Based Services Association with Healthcare Reform ❖ Federally qualified health centers ❖ Patient-centered medical home ❖ Accountable care organizations ❖ Meaningful use Copyright © 2020 Wolters Kluwer · All Rights Reserved Ethical Considerations ❖ ANA Code of Ethics with Interpretive Statements ❖ NUR 4636 Nursing Course Reflection Paper 2

Code of Ethics for Nurses ❖ Social Policy Statement ❖ Scope and Standards of Practice in Nursing Copyright © 2020 Wolters Kluwer · All Rights Reserved Health Advocacy and Healthcare Reform ❖ Advocacy is collaborating with colleagues and engaging in conversations with decision-makers ❖ Healthcare systems are dynamic Copyright © 2020 Wolters Kluwer · All Rights Reserved Overview of the ACA Prior to the End of Obama Presidency ❖ Patient Protection and Affordable Care Act ❖ Health Care and Education Reconciliation Act Copyright © 2020 Wolters Kluwer · All Rights Reserved Health Services Research ❖ Research continues to be an influencing power by documenting the need for accelerated reform in order to achieve quality care, proper information management, insurance for all, and equity of access. Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter 15: Emerging Infectious Diseases Chapter Highlights ❖ Emerging versus reemerging infectious diseases ❖ Factors that influence the emergence/reemergence of infectious diseases ❖ Recent emerging/reemerging infectious diseases ❖ Prevention and control of emerging and reemerging infectious diseases ❖ Reemergence of vaccine‐preventable diseases Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #1 Is the following statement true or false? Factors that influence the emergence or reemergence of infectious diseases are multiple, complex, and interrelated. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #1 True Rationale: Factors that influence the emergence or reemergence of infectious diseases are multiple, complex, and interrelated. Copyright © 2020 Wolters Kluwer · All Rights Reserved Emerging Infectious Disease ❖ A newly identified clinically distinct infectious disease or the reappearance (or reemergence) of a known infectious disease after its decline with an incidence that is increasing in a certain geographic area or in a specific population Copyright © 2020 Wolters Kluwer · All Rights Reserved Factors That Influence Emerging Infectious Diseases ❖ Microbial adaptation and change ❖ Human susceptibility to infection ❖ Climate, changing ecosystems, and human behavior ❖ Travel, technology, and industry ❖ Lack of political will and breakdown of public health infrastructure Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #2 Is the following statement true or false? Epidemics and pandemics can place long‐term demands on healthcare systems. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #2 False Rationale: Epidemics and pandemics can place sudden and intense demands on healthcare systems. Copyright © 2020 Wolters Kluwer · All Rights Reserved Recent Emerging and Reemerging Infectious Diseases #1 ❖ Severe acute respiratory syndrome ❖ MERS‐CoV ❖ Avian influenza ❖ H1N1 Influenza ❖ Novel Avian influenza A ❖ West Nile virus Copyright © 2020 Wolters Kluwer · All Rights Reserved Recent Emerging and Reemerging Infectious Diseases #2 ❖ Lyme disease ❖ E. Coli 0157:H7 ❖ Tuberculosis ❖ Ebola virus disease ❖ Zika virus disease Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #3 Is the following statement true or false? Certain zoonotic diseases can be transmitted to humans through contact with zoo animals. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #3 False Rationale: Certain zoonotic diseases can be transmitted to humans through contact with animals and birds. Copyright © 2020 Wolters Kluwer · All Rights Reserved Reemerging Vaccine‐Preventable Diseases ❖NUR 4636 Nursing Course Reflection Paper 2

Measles ❖ Mumps ❖ Rubella ❖ Pertussis Copyright © 2020 Wolters Kluwer · All Rights Reserved Antibiotic‐Resistant Microorganisms #1 ❖ Urgent threats o Clostridium difficile o Carbapenem‐resistant Enterobacteriaceae o Neisseria gonorrhoeae ❖ Serious threats ❖ Concerning threats Copyright © 2020 Wolters Kluwer · All Rights Reserved Antibiotic‐Resistant Microorganisms #2 ❖ Urgent threats ❖ Serious threats ❖ Concerning threats Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #4 Is the following statement true or false? Outbreaks of emerging and reemerging infections can disrupt economic activity and development. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #4 True In addition to morbidity and mortality, outbreaks of emerging and reemerging infections can disrupt economic activity and development. Copyright © 2020 Wolters Kluwer · All Rights Reserved Chapter 1: Public Health Nursing: Present, Past, and Future Chapter Highlights ❖ Healthcare changes in the 21st century ❖ Characteristics of public health nursing ❖ Public health nursing roots ❖ Challenges for practice in the 21st century Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #1 Is the following statement true or false? Healthcare disparities are social conditions in which people live and work. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #1 False Rationale: Social determinants of health are social conditions in which people live and work. Healthcare disparities are gaps in healthcare experienced by one population compared with another. Copyright © 2020 Wolters Kluwer · All Rights Reserved Major Changes in Healthcare in the 21st Century ❖ Development of patient/client-centered care ❖ Increased use of technology ❖ Increased personal responsibility Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare Changes in the 21st Century #1 ❖ Social determinants of health are social conditions in which people live, their income, their social status, their education, their literacy level, their home and work environment, their support networks, their gender, their culture, and the availability of health services Copyright © 2020 Wolters Kluwer · All Rights Reserved Healthcare Changes in the 21st Century #2 ❖ Healthcare disparities—differences in healthcare and health outcomes experienced by one population compared with another Copyright © 2020 Wolters Kluwer · All Rights Reserved Role of Government in Healthcare ❖ Three core functions are as follows: o Assesses healthcare problems o Intervenes by developing relevant healthcare policy that provides access to services o Ensures that services are delivered and outcomes are achieved Copyright © 2020 Wolters Kluwer · All Rights Reserved Patient Protection and Affordable Care Act (PPACA) ❖ Provide affordable health insurance coverage to most Americans ❖ Lower costs ❖ Improve access to primary care ❖ Preventive care and prescription benefits ❖ Cover pre-existing conditions ❖ Extend young adults’ coverage Copyright © 2020 Wolters Kluwer · All Rights Reserved Question #2 ❖ What is one of the core functions of the role of government in healthcare? A. Provide affordable health insurance coverage B. Improve access to primary care C. Lower costs D. Assess healthcare problems Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #2 D. Assess healthcare problems Rationale: Three core functions are to assess healthcare problems, intervene by developing relevant healthcare policy that provides access to services, and ensure that services are delivered and outcomes are achieved. One of the goals of the Patient Protection and Affordable Care Act (PPACA) is to provide affordable health insurance coverage. Copyright © 2020 Wolters Kluwer ·NUR 4636 Nursing Course Reflection Paper 2

All Rights Reserved Patient/Client-Centered Care ❖ Cultural traditions ❖ Personal preferences ❖ Values ❖ Families ❖ Lifestyles Copyright © 2020 Wolters Kluwer · All Rights Reserved Technology ❖ Rapidly advancing forms of technology are dramatically improving lives. Copyright © 2020 Wolters Kluwer · All Rights Reserved Health Information Technology ❖ Health information technology (HIT)—comprehensive management of health information and its exchange between consumers, providers, government, and insurers in a secure manner ❖ Electronic health records Copyright © 2020 Wolters Kluwer · All Rights Reserved Telehealth ❖ Use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health-related education, public health, and health administration Copyright © 2020 Wolters Kluwer · All Rights Reserved Personal Responsibility for Health ❖ Active participation in one’s own health through education and lifestyle changes Copyright © 2020 Wolters Kluwer · All Rights Reserved Public Health Nursing ❖ Public health nursing—population-based practice, defined as a synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of Public Health Nursing #1 ❖ Client or unit of care is the population. ❖ Primary obligation is to achieve the greatest good for the greatest number of people or people as a whole. ❖ Public health nurses collaborate with the client as an equal partner. Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of Public Health Nursing #2 ❖ Primary prevention is the priority in selecting appropriate activities. ❖ Public health nursing focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive. Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of Public Health Nursing #3 ❖ A public health nurse is obligated to actively identify and reach out to all who might benefit from a specific activity or service. ❖ Optimal use of available resources and creation of new evidence-based strategies is necessary to assure the best overall improvement in the health of populations. Copyright © 2020 Wolters Kluwer · All Rights Reserved Principles of Public Health Nursing #4 ❖ Collaboration with other professions, populations, organizations, and stakeholder groups is the most effective way to promote and protect the health of people. Copyright © 2020 Wolters Kluwer · All Rights Reserved Scope and Standards of Practice ❖ The American Nurses Association sets the scope and standards for all professional nursing practice. ❖ The publication Public Health Nursing: Scope and Standards of Practice establishes the characteristics of competent public health nursing practice and is the legal standard of practice. Copyright © 2020 Wolters Kluwer · All Rights Reserved Competencies for Public Health Nursing Practice ❖ Three tiers of practice ❖ Competencies associated with that level of practice Copyright © NUR 4636 Nursing Course Reflection Paper 2