In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment

In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment

Reform of Federal Healthcare Law

The Sustaining Excellence in Medicaid Act of 2019 is a recent federal law that reforms the American healthcare system (HR 3253). This bill was presented to Congress on June 13, 2020, and it was signed into law on August 6, 2020. Debbie Dingell, a representative from Michigan, introduced and sponsored this legislation. The legislation seeks to restructure the Medicaid program by extending some of its provisions (KDP LLP, 2019). One of the modifications allowed Medicaid funding to continue through the fiscal year 2024. This bill also authorizes state Medicaid fraud units to review and investigate complaints from non-institutionalized patients. This reform is significant because it eliminates some of the disparities that result from ignoring the complaints of such patients, even though they are legally eligible for Medicaid coverage.

PURCHASE A PAPER FREE OF COPYPASTE HERE

We write everything from scratch, so place your order now.

This bill also includes an expansion of Medicaid eligibility to protect individuals from their spouses’ poverty or impoverishment. Medicaid coverage is sometimes denied to spouses from lower socioeconomic backgrounds because it is not available to them. This legislation expands coverage to such populations, including those who receive home- and community-based medical services. In addition to these reforms, this bill eliminates the requirement that drug manufacturers include the prices of generic drugs in their price calculations. In addition, it excludes drug manufacturers from the definition of drug wholesalers in order to facilitate rebate calculations.

This bill affects nursing practice by modifying the nurse’s responsibilities and roles. For example, since the bill extends Medicaid coverage to spouses and protects them from poverty, the nurse should ensure that all patients are informed of the new provisions of this bill. A patient’s spouse’s poverty may restrict their access to high-quality medical care. The nurse should be able to recognize these patients and educate them on the new changes to facilitate their access to high-quality medical care. This bill also affects the nurse’s role and responsibility by expanding the advocate’s role in nursing. The nurse should advocate for non-institutionalized patients whenever they have complaints and assist them with Medicaid appeals if services are denied. The new legislation protects patients and allows them to have their complaints reviewed, thereby increasing their likelihood of obtaining social justice. The nurse should advocate for patients’ access to social justice by assisting them in filing complaints.

How Pay for Performance and Quality Measures Influence Patient Outcomes

Pay for performance is a system that financially rewards practitioners for their performance in medical practice based on certain criteria. It is a method of compensation based on performance that aims to enhance the quality and delivery of healthcare services to patients. Consequently, this model also penalizes practitioners for poor performance. For instance, a psychologist whose patient fails to quit smoking at the conclusion of their sessions is not compensated for her services. In some ways, this model improves patient outcomes because it incentivizes physicians and nurses to provide high-quality care to their patients in order to receive the financial rewards associated with their roles and performance evaluation criteria. This reward system, however, poses a risk for poor patient outcomes because it encourages patient dumping. This concept implies that patients with more complex and high-risk healthcare issues tend to be relegated to the periphery, as physicians prefer to concentrate on cases that are likely to be successful in order to receive their rewards and bonuses (Kyeremateng et al., 2019). This practice results in negative patient outcomes because those on the periphery do not receive adequate or timely medical care.

In such situations, a nurse should consider applying ethical principles such as nonmaleficence, which means to cause the least amount of harm. By applying this principle, the nurse would encourage physicians to admit patients with complex medical conditions and provide care for them. In addition, the nurse should remind the other practitioners of the Hippocratic Oath, which obligates them to save lives. Patient dumping is a serious breach of this oath, and it is the nurses’ duty to remind their colleagues of these ethical applications.

Professional leadership and management functions in nursing

Knowledge of nursing informatics and the use of technology in nursing would be required for a new leadership role in nursing that addresses new trends (Harris et al., 2019). An emerging trend in healthcare is the use of technology in clinical settings, which is increasing the need for nurses to acquire technological skills. For instance, surgical robots are utilized in surgery, and surgical nurses must be familiar with these machines to fulfill their role in the operating room. The use of bedside alert systems that notify practitioners when a patient leaves their bed unattended, thereby reducing patient falls, is another example. As a result, nurse leaders are tasked with ensuring that nursing teams are technologically savvy as part of their nursing responsibilities. The nurse leader and manager will ensure the availability of technological trainings to improve the professionalism of the nursing staff. The nurses promote patient health and safety in this manner. For instance, bedside alert systems reduce the occurrence of patient falls, and learning how to manage electronic health records promotes patient health and raises the level of professionalism among healthcare professionals because they comply with HIPAA regulations.

Emerging Trends

Emerging in the field of healthcare is the use of medical robots in surgical procedures. This practice necessitates that the medical professionals learn how to operate the robots in the event that the surgeon cannot continue the operation due to an emergency. Additionally, the nurse must learn how to set up the machine and identify malfunctioning situations. Consequently, given this change, the nurses’ roles in the healthcare setting will expand to include technological operations. The nurses will be tasked with learning how technological devices in a hospital function, as they may save a life in certain emergency situations.

Telemedicine is an additional emerging trend in the healthcare industry. Given the technological advancements of today, telemedicine is on the rise. The incorporation of telemedicine practices into nursing will alter the roles of nurses. Telemedicine will enhance the role of the nurse as a communicator, as the nurse will be accessible to the client via telehealth systems upon request. Since the interaction with the patient is no longer in person, the nurse should enhance their role as a communicator by using clear language, providing timely communication to their patient, and communicating in the shortest time possible, so they can attend to other patients.

The use of technology to provide nursing care to patients is an additional nursing function influenced by telemedicine. Similar to medical and surgical robots, nurses will be required to increase their knowledge of technology and internet-based communication platforms with patients. It is crucial that the nurse avoids complications when using telemedicine devices, which could have severe negative effects on patient health. Consequently, the nurse’s responsibilities now include those that require extensive technological use.

Assessment Description