Ijeoma Igbokwe   3 posts  Re:Topic 2 DQ 1   The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the American Nurses Association “Key Provisions Related to Nursing” summary at http://www.rnaction.org/site/DocServer/KeyProvisions_Nursing-PublicLaw.pdf?docID=1241&verID=1.

 Discuss how these two provisions have impacted, or will impact, your current practice of nursing. The Patient Protection and Affordable Care Act sometimes called “Affordable Care Act” or “Obamacare” is a law that provides numerous rights and protections making health coverages easier to understand and more accessible and affordable to people. 

This law provides a wider Medicaid coverage to people with low income (Health care.gov, n.d) According to the summary, nurses hold vital roles in health care system, in other to transform the health care services, the issues facing nursing profession must be addressed. The two key provisions related to nursing outlined in American Nurses Association summary are “Nursing Workforce” and “Nurse Home Visitation Services” Nursing Workforce Nursing like any other professions needs financial support to improve nursing training, education, and practice. T

he Nursing Workforce Development program helps in recruiting new nurses, encouraging nurses hired to advance in education by providing financial assistance in scholarships and grants to nurses, for advanced nursing education (American Nurses Association), so that nurses are better prepared to deliver high quality care to patients and to serve the community better.

 This program also helps to direct the registered nurses to areas of nursing needs to ensure nurses are adequately available to meet every need of the community members, whether in the hospitals, health centers, nursing homes or patients’ homes (American Nurses Association). This program will attract more people to nursing profession thereby solving the problem of nurses’ shortage and encourage nurses to go back to school for upgrade, without worrying about taking up more jobs to afford school fees, because they could qualify for grants or scholarships. Nurse Home Visitation Services.

 This program authorizes the federal and the states to provide financial supports to fund nurse home visitation coverages for maternal, infant, and early childhood interventions (American Nurses Association). This program would ensure continuity of patient’s care, follow-up, and more importantly provides opportunity for patients’ nursing needs to be met in the comfort of patient’s homes which is a familiar environment, and less stressful for the family members, who would have to commute to and from the hospital. This program not only benefits the patients, but also benefits nurses who have options of working outside healthcare facilities, where scheduling is more flexible. With the flexible of the schedule, nurses balance family, work, and

education.                                                                     

Reference 

American Nurses Association. “Key Provisions Related to Nursing”. Retrieved from http://www.rnaction.org/site/Docserver/KeyProvisions_Nursing-PublicLaw.pdf?doclD=1241&verID=

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ChristineTarbox 

1 posts

Re:Topic 1 DQ 1

A nursing shortage has been shown to decrease patients access to care, decrease job satisfaction, and increase nurse turnover (Huber, 2010).  “The current nursing shortage is anticipated to become twice as large as any nursing shortage experienced since the 1960s” (O’Neil, 2009, p. 180, para 7).  Nurse shortage has been a significant focus of study and debate because of the enormous effect it has on all of us at every possible level of healthcare. Numerous research studies have been conducted to determine the main factors driving the nursing shortage.  “This shortage is not solely nursing’s issue and requires a collaborative effort among nursing leaders in practice and education, health care executives, government, and the media” (Nevidjon & Erickson, 2001).  Factors contributing to the nursing shortage include the following:  Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services, nursing school faculty shortage is restricting nursing program enrollments, a significant percentage of the current nursing workforce is nearing retirement age, there is an increased need for nursing care because of our aging population, and  insufficient staffing is intensifying nurses’ stress level which impacts job satisfaction and drives many nurses to leave the profession.

Although there has been a 3.6% increase in baccalaureate nursing program enrollment in 2016 according to the AACN (2017), this increase is not even close to sufficient enough to meet the projected demand for nursing faculty, researchers and primary care providers.  The AACN also reports that nursing schools in the U.S. turned away 64,067 qualified applicants in 2016 due to an insufficient number of faculty, clinical sites, clinical preceptors and budget limitations. Nevidjon & Erickson discuss multiple collaborative recruitment efforts happening currently:  

In San Diego, six hospital systems have committed $1.3 million to support a program called, “Nurses Now”, which will add faculty and additional student slots to San Diego University.  The American Hospital Association News reports that in Laredo, Texas, a hospital CEO worked with Texas A&M University to develop a four-year bachelor’s program and is providing $425,000 in scholarships to local students over the next five years.  In Morris County, New Jersey, the Board of Freeholders offered scholarships to students who agreed to work in a long term care facility.  The Dallas-Fort Worth Hospital Council raised $600,000 to expand student enrollment at local schools.  These are examples of various successful collaborative efforts among healthcare organizations, government, nursing associations and nursing schools. Many more are happening at the local level (2011).

Ineffective leadership and management continue to foster suboptimal work environments minimizing the rate of improvement in the nurse shortage and turnover rates.  According to Kleinman (2004), results from a study conducted by Volk and Lucas in 1991 revealed that “management style was the only predictor of anticipated turnover” (p. 129, para 4). This correlation further substantiates the amount of influence that nurse leaders have on healthcare organizations in a variety of ways including: decreased quality of care, loss of patients, increased nurse turnover, increased turnover of medical support staff, increased staffing costs, and increased accident and absenteeism rates (Hunt, 2009).  Work environment has also been cited as a significant predictor of nurse turnover.  Nurse autonomy, interactions with managers, compensation and workload are all factors that have been reported to facilitate job satisfaction or lack-there-of, ultimately determining staff retention and turnover (Huber, 2010).  Leaders need to be aware of and understand the current healthcare challenges and develop expertise in the skills and approaches requisite for effective leadership (O’Neill, 2013).  “People’s time and effort, as well as organizations’ money, facilities, and supplies, need to be directed in a coordinated effort to achieve best results and meet objectives” (Huber, 2010).

Over time, study results have been consistently indicative of the direct impact managers and leaders have on the quality of healthcare at every level.  The importance of highly qualified and effective nurse leaders is evident now more than ever and by improving the methods used to manage nurses, positive changes will be put into motion (Hunt, 2009). While the direct benefit would be decreasing the nurse shortage, this change would also significantly benefit the availability and quality of healthcare for everyone. Implementing enhanced methods of managing nurses would successfully result in improved staffing.  In fact, effective leadership and management may be the key to overcoming the nurse shortage and finally optimizing the quality of healthcare for all.

References:

AACN. Nursing shortage fact sheet.  Retrieved from http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf 

Huber, D. (2010). Leadership and Nursing Care Management, 4th Edition. [Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781416059844/

Hunt, S. T. (2009). Nursing turnover: costs, causes, & solutions.  Retrieved from

https://www.nmlegis.gov/lcs/handouts/LHHS%20081312

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Faith Muchiri 

3 posts

Re:Topic 2 DQ 1

According to Healthypeople.gov, (2017), social determinants of health are situations which involve social connection such as religious places, mosques, temples, work places, learning institutions, places of play, people are born, and age. All these social determinants contribute to the development of illnesses. Health begins with our immediate contact social/physical environment; churches, schools, communities, hospitals, and at home. The quality, safety, and cleanliness of these places contribute to our being healthy alongside staying active, and eating healthy. Patients who have respiratory illnesses may say they worked in environment where there was air pollution/contamination which they were exposed for a long time, if quality of food that people are ingesting is not healthy, then development of heart diseases, or diabetes is inevitable. A community that is exposed to crime, violence, and insecurity creates social disorder, if the quality of education, and training is poor, then the community members are not able to secure well-paying jobs, resulting in poor housing, for example people that live in shelters due to not being able to secure a well- paying job, own, or rent a house, would be at risk to being exposed to various illnesses that other people have.

The communicable disease chain is described by Center of Disease Prevention, and Control, (2017), as a chain of infection which includes; host called reservoir (infected agent), port of exit (through which the pathogen leaves the infected host), mode of transmission (direct or indirect), and port of entry (is how pathogen enters the susceptible host). So steps that a nurse can take to break a link within the communicable disease chain as documented by Health Department, (2011), on antibiotic resistance task force assignment on how to break the chain of infection in your outpatient clinic include; hand-washing, keeping nails short, using gloves for one patient only, wearing personal protective equipment as necessary, and disinfecting contact areas thoroughly.

150 words no reference-NURSING RESPONSE POST

The ASAs campaign has been completely devoid of evidence, but they have gotten away with it because they have utilized the media to their advantage, as with this Facebook example.  These days people spend a lot of time on social media and tend to obtain a lot of their information that way, many getting duped by total nonsense.  Unfortunately very few people actually take the time to find real information from legitimate sources. Through out our last discussion, we saw that there is in fact sufficient evidence to prove that CRNAs are as safe as anesthesiologists, but there continues to be a disconnect between this information and the public. And so, I completely agree with that colleague’s statement; “I believe the CRNA associations need to start writing and circulating the research articles to prove otherwise.”  While it is important to continue new research endeavors to build more evidence to fight the VAs ruling and other decisions like it, I believe at this time it is imperative to focus on effectively disseminating the information already available in ways which will easily reach the lay public.  Perhaps utilizing things like videos posted on platforms such as Facebook, and YouTube, which people commonly use to look for information.  These videos could explain what CRNAs do, their safety, cost-effectiveness, while making emphasis on the training necessary to become a CRNA and the difference to a staff RN, as well as the fact that CRNAs are equivalent to anesthesiologists.  It can also make mention of the research already done to support these claims and post links to the articles for further reading.  There could also be videos of interviews done with patients that have been treated by CRNAs and what their experiences were.  

There is a lot of work left to be done and we as SRNAs can join the AANA in its mission “to advance the science of anesthesia through education and research” in many ways. The AANA supports and sometimes funds research conducted by SRNAs.  This research can be presented through the “State of Science” Oral or General Poster Presentations for which they could be $1000 award.  The research can also be presented through the AANA NewsBulletin in a designated section to research called Discoveries of Distinction.

Other ways that SRNAs can participate within the AANA can be through the Student Advocate program which was established in 2015.  The goal of the program is to have a student acting as a liaison between the AANA and the nurse anesthesia programs. The program is currently attempting to have one student advocate per state, but its ultimate goal is to have one student per anesthesia program. Aside from the Student Advocate position, the AANA also has a position for a student on the board of trustees.  This student keeps the flow of information open between the foundation’s board of trustees and SRNAs. Students can also showcase their non-anesthesia related talents like singing or playing a musical instrument, at fundraising events like that of 2014 “The Stars Come out Again”.  There are also multiple meetings and workshops through out the country SRNAs can be part of like the Nurse Anesthesia Annual Congress taking place in September or The Mid-Year Assembly which will take place in Washington D.C. in April 2018, where nurses go to “learn about the healthcare policies impacting nurse anesthesia, and develop the skills needed to effectively advocate for your profession during meetings with your federal legislators.” This will be a good time to learn how we can be most helpful in affecting change as with the current VA debate.