Current Trends in Nursing Practice

Classroom Policies Per Instructor for Peer Responses
Responses to peers are a minimum of 100 words (with citations and references per APA Format). All assignments must have citations and references for credit. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
I expect conversation, rather than drop a quote and leave. It is best to add references and personal experiences or current events. Again, just as if you were in a ground classroom, the goal is to share and stimulate a conversation, not simply agree with everything. On that note, it is ok to agree, just support your answer and why. If I suspect copy and pasting, you will receive a zero.
Classroom Resource Materials

Ask support for logins
Chapter 2 in Trends in Health Care: A Nursing Perspective
URL: https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/trends-in-health-care_a-nursing-perspective_1e.php

The Future of Nursing: Leading Change, Advancing Health
URL: http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

Nursing and Health Reform
URL:https://c.ymcdn.com/sites/www.wocn.org/resource/resmgr/AdvocacyPolicy/PPACA_and_Nursing_-_Nursing_.pdf

Health Reform Act: New Models of Care and Delivery Systems
URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104846661&site=eds-live&scope=site

Summary of the Affordable Care Act
URL: http://files.kff.org/attachment/Summary-of-the-Affordable-Care-Act

The Health Care and Education Reconciliation Act
URL: https://www.dpc.senate.gov/healthreformbill/healthbill61.pdf

What Is Pay for Performance in Healthcare?
URL: https://catalyst.nejm.org/pay-for-performance-in-healthcare/

Nurse and Health Care Worker Protection Act
URL: https://www.nursingworld.org/~4af9f9/globalassets/practiceandpolicy/work-environment/health–safety/nursehealthcareworkerprotectionact-factsheet.pdf

Promoting Prevention Under the Affordable Care Act
URL: https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-040617-013534

Implementation of the Provision of the Comprehensive Addiction and Recovery Act of 2016 Relating to the Dispensing of Narcotic Drugs for Opioid Use Disorder
URL: https://www.deadiversion.usdoj.gov/fed_regs/rules/2018/fr0123_2.htm

What Is the U.S. Opioid Epidemic?
URL: https://www.hhs.gov/opioids/about-the-epidemic/

HCAHPS: Patients’ Perspectives of Care Survey
URL: https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalhcahps.html

Discussion Question:
Explain how interprofessional collaboration will help reduce errors, provide higher-quality care, and increase safety. Provide an example of a current or emerging trend that will require more, or change the nature of, interprofessional collaboration.

Peer’s Answer:
Andrea Rocha
Interprofessional collaboration is an effective tool for creating better patient care through better communication between healthcare team members. Better communication is more effective when team members from all of the disciplines understand each member’s education, scope of practice, and areas of expertise (Jakubowski & Perron, 2018). For example, a new doctor may not know that hospice nurses can pronounce patients when they die. In 2009. The Interprofessional Education Collaborative was created with sic healthcare organizations. These organizations established four competencies: 1) values and ethics for interprofessional practice, 2) roles and responsibilities for collaborative practice, 3) interprofessional communication practices, and 4) interprofessional teamwork (Jakubowski & Perron, 2018). These four competencies helps all healthcare members better understand each other’s role in providing optimal patient care. Interprofessional collaboration also helps reduce preventable errors and reduce healthcare costs (Jakubowski & Perron, 2018).

Reference
Jakubowski, T. & Perron, T. (2018). Interprofessional Collaboration Improves Healthcare. Retrieved from https://www.reflectionsonnursingleadership.org/features/more-features/interprofessional-collaboration-improves-healthcare

Peer’s Answer:
Cathy Wills
Collaboration between doctors, nurses and other health care providers has not always been the norm in health care. Interprofessional collaboration holds promise for reducing medical errors, improving the quality of care and meeting the needs of diverse populations. Per the Robert Wood Johnson Foundation, when providing patient care, health care professionals must interact with providers from other professions to share information, execute quality and safety checks and help patients understand and comply with treatment plans. Research has long suggested that collaboration across health care professions improves coordination, communication and, ultimately, the quality and safety of patient care. It utilizes both the individual and collective skills and experience of team members, allowing them to function more effectively and deliver a higher level of services than each would working alone. There is increasing evidence that coordinating care by assigning teams of providers can help reduce medical errors and improve quality, as well as help providers provide patient-centered, higher quality care to an increasingly diverse patient population (Robert Wood Johnson Foundation, 2011). Increase interprofessional collaboration can be accomplished by educating doctors, nurses and other health professionals together, and by retraining providers to work together.
Interprofessional collaboration in healthcare helps to prevent medication errors, improve the patient experience (and thus HCAHPS), and deliver better patient outcomes — all of which can reduce healthcare costs (TigerConnect, 2020). It also helps hospitals save money by shoring up workflow redundancies and operational inefficiencies. By improving the interprofessional collaboration model between its nurses and physicians, one hospital cut its fall rate in half, decreased average length-of-stay by 0.6 days, increased annualized bed turn by 20 percent, and increased discharges before noon by 20 percent — according to a Robert Wood Johnson Foundation study of 20 hospitals. At another hospital in the study, interprofessional collaboration significantly improved surgical start times and prevented delays that led to 700 wasted hours over the previous four years (TigerConnect, 2020).
An example of a current trend that has changed the way interprofessionals collaborate is tigertext. TigerConnect’s secure messaging tool boosts teamwork and communication amongst healthcare professionals, saving time, money, and most importantly, lives. We used this method of communication to send EKG’s to cardiologist when I worked on the Critical Care Cornary floor. I thought it was helpful to keep the team on the same page.

Reference
Robert Wood Johnson Foundation. (2011). What Can Be Done to Encourage More Interprofessional Collaboration in Healthcare? Retrieved from https://www.rwjf.org/en/library/research/2011/09/what-can-be-done-to-encourage-more-interprofessional-collaborati.html

TigerConnect. (2020). 5 Benefits of Interprofessional Collaboration in Healthcare. Retrieved from https://tigerconnect.com/blog/5-benefits-of-interprofessional-collaboration-in-healthcare/

Peer’s Answer:
Marie Marc
Hi professor and class,
Inter-professional collaboration is an approach that provides a means for health care professionals and institutions to achieve various objectives. The approach has significant contributions in the cost-sharing, reduction of supply chain uncertainty, and spreading of risks in various fields. The provision of healthcare is faced with multiple disparities, and inter-professional collaboration is one of the most effective strategies that promote efficiency and effectiveness of innovative approaches. According to Green and Johnson (2015), the inter-professional strategy has been widely used in science and knowledge, which are the key elements in healthcare research. The healthcare problems in the modern era are complicated due to the increased incidences of chronic diseases. As such, collaboration in research has significantly helped in the reduction of medical errors, as most health care professionals are involved in building informational networks and stimulate new insights.
The provision of safe and proper patient outcomes requires active collaboration between health care professionals in various disciplines. Inter-professional collaboration requires different competencies that impact safety and patient outcomes. These core competencies include inter-professional communication practices, value and ethics for interprofessional practice, roles and responsibilities for collaborative practice, and inter-professional teamwork. One of the most effective initiatives that impacts on inter-professional collaboration are the adoption of interprofessional education that emphasizes on the global strengthening of student learning on the need to collaborate with other health care professionals within and outside the health care system. According to Bosch and Mansell (2015), inter-professional collaboration leads to the development of team trust where health care professionals become confident in their abilities. As such, patients are satisfied with the level of services offered through a collaboration of different health care professionals.
References
Bosch, B., & Mansell, H. (2015). Inter-professional collaboration in health care: Lessons to be learned from competitive sports. Canadian Pharmacists Journal: RPC, 148(4), 176–179. doi: 10.1177/1715163515588106

Green, B. N., & Johnson, C. D. (2015). Inter-professional collaboration in research, education, and clinical practice: working together for a better future. The Journal of Chiropractic Education, 29(1), 1–10. doi; 10.7899/JCE-14-36

Discussion Question:
Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. Explain how this model is advantageous to patient outcomes.

Peer’s Answer:
Andrea Rocha
Affordable Care Act made us think hard on our care delivery models. Greater emphasis was given to holistic approach that incorporated different discipline to achieve better patient outcome. Aim was to reduce healthcare cost and improve people’s life. Various models are floated to achieve the goal. Some of the models are Accountable Care Organizations (ACO), Medical/Health Homes, and Nurse- managed Health Clinics (NMHC), Chronic Care Delivery Model, Mobile Integrated Healthcare, Longitudinal High Risk Care, etc. (American Nurses Association, 2010).
ACO is gaining popularity. It is a basic team or collaboration between doctors, hospitals, specialist, other health care professional who take the responsibility of caring for their patients in a cost effective manner and providing quality care. Financial gains/bonuses are given if the ACO meets it target of quality (standards are set by HHS) and savings. “The ACO is a group of providers of services and suppliers that promotes accountability for a patient population and coordinates items and services under [Medicare] parts A and B, and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery” (American Nurses Association, 2010, para 7). Now it is expanding beyond Medicare. This type of model is a unique ability to adjust to any type of payment method. They are able to take care of their patients across life span in various settings across continuum of care, figure out the budget beforehand and plan accordingly, help with resources, use evidence based treatment plans and cares, and have a detailed and reliable ways to measure performances. This model reduces hospital admission by stressing and implementing better preventive and wellness measures/primary care, reduces readmission via well-coordinated care approach, reduces costly hospital and ED admissions, and emphasis on total care (Haas, 2011, p.11). This model promises a better managed life for the patients and opens up a lot scope of practices for the nurses. Advanced practice nurses and the ambulatory nurses play a major role in providing for primary care of the patient and working towards the wellness and preventive care as emphasized in the ACA. A better coordinated care and triage is possible due to the electronic medical records and nurses reach out to the patient via telehealth.

Reference
American Nurses Association. (2010). New Care Delivery Models in Health System Reform: Opportunities for Nurses & their Patients. Nursing world. Retrieved from https://www.nursingworld.org/~4af0e8/globalassets/docs/ana/ethics/new-delivery-models—final—haney—6-9-10-1532.pdf

Haas, S. A. (2011). Health Reform Act: New Models of Care and Delivery Systems. ViewPoint: American Academy of Ambulatory Care Nursing (AAACN). Retrieved from https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=1&sid=d3b0da99-0ad5-4d7f-be7d-c2336008de51%40sdc-v-sessmgr01

Peer’s Answer:
Cathy Wills
The Patient Protection and Affordable Care Act of 2010 (PPACA) contains many provisions that seek to intertwine the quality of care with the cost of care. Three emerging care delivery models, in particular, are addressed in PPACA. These are the accountable care organization, the medical or health home, and the nurse-managed health center. Under the terms of PPACA, the health team is required to collaborate with local primary care providers and existing state and community based resources to coordinate disease prevention, chronic disease management, transitions between health care providers and settings and case management for patients (Haney, 2010). Within these collaborations, the health team is also required to develop and implement interdisciplinary, inter-professional care plans that integrate clinical and community preventive and health promotion services. Such care planning is a basic element of skilled nursing practice and nurses can guide such development and implementation with the voice of authority and experience (Haney, 2010).
In general, the “medical home” (or “health home” ) can be understood as a mechanism to provide patients with a central primary care practice or provider who coordinates the patients’ care across settings and providers. This might be promoted through a capitated payment or other financial incentive to providers to encourage preventive care and chronic care management, as well as reduce reliance on specialist and emergency care (Haney, 2010). PPACA authorizes HHS to provide grants to or contract directly with states or state-designated entities to establish community-based interdisciplinary, interprofessional teams to support primary care practices, including obstetrics and gynecology practices. The teams also must agree to provide services to eligible individuals with chronic conditions. The interdisciplinary, inter-professional providers comprising a health team may include medical specialists, nurses, pharmacists, nutritionists, dieticians, social workers, behavioral and mental health providers (including substance use disorder prevention and treatment providers), doctors ofchiropractic, licensed complementary and alternative medicine practitioners, and physicians’ assistants.
As Medicaid spending continues to overwhelm state budgets, the medical home model of care offers one method of transforming the health care delivery system. Per the National Conference of State Legislature, medical homes can reduce costs while improving quality and efficiency through an innovative approach to delivering comprehensive patient-centered preventive and primary care. Also known as the patient-centered medical home (PCMH), this model is designed around patient needs and aims to improve access to care (e.g. through extended office hours and increased communication between providers and patients via email and telephone), increase care coordination and enhance overall quality, while simultaneously reducing costs. The medical home relies on a team of providers—such as physicians, nurses, nutritionists, pharmacists, and social workers—to meet a patient’s health care needs. Studies have shown that the medical home model’s attention to the whole-person and integration of all aspects of health care offer potential to improve physical health, behavioral health, access to community-based social services and management of chronic conditions (National Conference of State Legislature, 2012).

Reference
Haney, C. (2010). ANA Issue Brief. New Care Delivery Models in Health System Reform: Oppurtunities for Nurses and their Patients. Retrieved from https://www.nursingworld.org/~4af0e8/globalassets/docs/ana/ethics/new-delivery-models—final—haney—6-9-10-1532.pdf

National Conference of State Legislature. (2012). The Medical Home Model of Care. Retrieved from https://www.ncsl.org/research/health/the-medical-home-model-of-care.aspx

Peer’s Answer:
Marie Marc
Hi professor and class,
Given the ongoing evolution in the healthcare digital world, the use of electronic health visits has been identified as one of the most effective models that promote quality and safe healthcare services. The advances in the electronic provision of healthcare services have resulted in the effective accommodation of the increased preferences of patients, especially for convenience as a result of the growing patient population. Notably, virtual visits can be attended by the patient’s primary care physician instead of the other physicians at the emergency level (Clarke et al. 2017). The increased prevalence in multiple chronic conditions is also another potential factor that calls the coordination of both patient and healthcare providers across various clinical sites of care. As such electronic patient portals serve as an effective medium that incorporates different interdisciplinary personnel in offering crucial medical information. The approach plays a critical role in ensuring effective communication between healthcare providers and patients without traveling for clinical and medical facilities.
The approach helps in strategically mobilizing appropriate resources for healthcare professionals to provide well-coordinated, safe, and affordable healthcare. One of the important roles of virtual visits is the mitigation of challenges that result from continued barriers in accessing insurance coverage. According to Alotaibi and Federico (2017), patients in rural areas face a lot of difficulties in accessing healthcare services due to the inadequate supply of healthcare providers. As such. Communication becomes a significant problem in typical inpatient and outpatient care delivery. Additionally, patients suffering from critical chronic conditions effectively access valuable lab tests, diagnoses, and medications from various healthcare providers. Consequently, the model enhances remote monitoring of patients, especially those suffering from chronic conditions such as hypertension, heart failure, and Stroke.

References
Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. doi:10.15537/smj.2017.12.20631

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population Health Management, 20(1), 23–30. doi:10.1089/pop.2016.0076