Evolving Practice of Nursing and Patient Care Delivery Models

EvolvingPractice of Nursing and Patient Care Delivery Models

EvolvingPractice of Nursing and Patient Care Delivery Models

Writean informal presentation (500-700 words) to educate nurses about howthe practice of nursing is expected to grow and change. Include theconcepts of continuity or continuum of care, accountable careorganizations (ACO), medical homes, and nurse-managed health clinics.

Thenursing practice is anticipated to grow and change. It is thereforeanticipated to change regarding practice and also leadership andeducation to attain its function in the provision of the healthcarein the United States of America. The continuity of care concept is animportant element used for the primary care including the integrationof care concepts, patient, concentrated care, and care coordinationamong all the health practitioners (Hamric et al., 2013). Thecontinuity of care, in this case, refers to the relations that existbetween the patients’ and the practitioner which in the end will gopast particular disease episodes. In general, this concept ofcontinuity of care is precisely defined by the two most importantconstituents. One is being the concentration on the individualperspective, the requirements of the customer and the care over thetime which it can be present parts or future.

Afterthe restructuring of the United States health care system, thecontinuity of care will in most cases involve discharge planning thatfollows acute care which is the case with the hospitals to thecommunity or the self-care which is based in the home. The mainobjective of the program is to sustain an approach that is reliablewhich takes care of the nurse`s practitioners and to personalize careto the dynamic requirements of the ill health during attack bydiseases. The type of the continuum is the relational continuitywhich is a persistent drug relationship involving the patient and theprovider. The management continuity is a continuous connection usedto the management of particular disease which is changing accordingto the ever changing desire of the ill health person.

Anotherone (third) is the continuity of the information that involvesutilizing info relating to the previous happenings including thecircumstance that surround the patient in the process of makingrelevant the present care for all the customers being attended in thehealth facility (Kitson et al., 2013). Therefore, the paramount wayswhere the Obama care or the affordable care act is attempting toreduce the health cost is by encouraging sanitary centers, thephysicians, and the other healthcare practitioners to uphold theproper record keeping and professionalism to ensure that reliableinformation is available in all the facilities. The information, inthis case, are kept in an accessible manner that will assist thefuture practitioners to utilize them in making judgments on theaccruing patient`s conditions. The information thus needs to be keptin safe custody of professionals.

Thenurse managed clinics are the well-established models that help toserve the areas that are underserved. They are the communityhealthcare services under the practitioner nurse leadership. Thenurse, in this case, concentrates on the promotion of health,prevention of diseases where they mainly target the underservedcommunity. The nurse managed clinics are not for profit institutions,unlike the minute clinics that are profit oriented. In some case,they are federally health centers that are qualified. The consortiumof the national nursing centers is among the members of thenurse-managed clinics. About seventy-four of the participants areinvolved in the academic nursing programs, on top of meeting theneeds of the healthcare and the population that is underserved withthe health services. They also act as the training schools for thenursing students. There exist about two hundred facilities in aboutthirty-seven states serving an estimated two million patients peryear (Potter et al., 2016). More than half of the patients are notinsured or under the Medicaid. The research also indicates that thesefacilities perform to their full capacity and are less expensive.Nevertheless, they have the highest rate of the generic medicationsand provide lower hospitalization rates as compared to the otherhealthcare provider such as the community health centers. However,there is a challenge experienced by the nurse managed clinics as itis hard to accredit some of the nurse practitioners as the primarycare providers. This, therefore, affects the facilities from gettingthe necessary reimbursements from the charity institutions or theinsurers that can help carry some of the cost relating to careprovision of the patent.

Homeclinics are a wide variety of services offered to the people thatrequire treatment of the nurses and education on the self-caremanagement. few of the services that are provided by theseinstitutions to the persons include the care for wound, management ofthe chronic diseases and management of the medication. For one toqualify for this service, they must meet the eligibility requirementsto receive the home care. Referrals or appointments can access theservice. therefore nurses need to understand the needs of every kindof nursing practice that help them reach as many people as possiblein extending their care services. The government also needs to loosenthe regulations that can ensure accreditation of the nurses that canmake them shun away from establishing facilities such as thenurse-managed clinics that extend its services to the underservedcommunities. This will help to enhance the performance of the nurseshence they will develop professionally and provide quality care tothe patients.

In800-1,000 words summarize the feedback shared by three nursecolleagues and discuss whether their impressions are consistent withwhat you have researched about health reform

Theword ‘nursing practitioners’, ‘nursing’ has frequently beenused in the PPACA document. In as much as not all the implicationsregarding nurses and the practice of nurses are indicated in thelegislation, it is apparent that the thirty-two million insuredpeople will have an impact on the health care system where nurses areat the epicenter of this scheme. Due to this, I spoke to three nursesX, Y and Z who are nationally known nurses leaders concerning theimplications of the reforms. Here is their feedback concerning thetopic of discussion.

NurseX- whatdo the health care reforms mean to nurses?

Inseveral ways, the changes in the HealthCare are an excellent thing tothe nurses. For the newcomers, the bill ensures the provision offunds for the advanced practice and the general education of nurses.However, one of the most stimulating things about the nurses is thedemonstration of interests. In this case, the law provides a massiveprogram for the innovative safety net programs which include thenurse-managed health clinics.

Sincethere is a shortage of the family physicians, the impact willincreasingly affect us. Therefore, the nurse practitioner programsare going to get better and better since here will be funds availablefor the United States to support the clinics that we manage whereinitially had to go through hoops to obtain funding from the privateinstitutions and some sorts of maneuvers to stay afloat. Hence, now,that we are in a position to get real money, and we can give care, wewill begin showing the results hence making it a day of the nursepractitioner. This is in line with the researched health reforms asit explains how the program has helped in the training of the nursesand the availing of the funds to the healthcare facilities.

NurseY- Howare nurse-managed clinics received by the medical community?

Thepractice has always been in the rural areas where they are consideredas the primary caregivers which have never been disputed. Accordingto me, I think this issue will come down to pocketbook war. In asmuch as the nurse practice is are taking care of the people whocannot pay, while the nurse practitioners are still willing and ableto work in the rural areas where the physicians are not prepared towork, there will be no objection to their service. Now that thenurses are setting up their facilities in the urban centers, thephysicians may feel pinched for they will lose some customer base tothese clinics where they will not be paying. Therefore, they willarguably raise the issue of safety terming the move by the nursesbogus which is not the case as no study has proved that the servicesprovided by the nurses are inferior as compared to that provided bythe physicians.

Thisis therefore in line with the reforms studies initially where it wasrealized that nurses face a lot of resistance to obtain accreditationto offer their service freely in various parts of the United States.The issue, in this case, is the competition for the patients wherethe physicians have their selfish gains, and they feel they will bedeprived of their customers if nurses are allowed to operate freely.This has therefore undermined the efforts of the nurses to offertheir services to the needy people.

NurseZ- Howthe HealthCare reform impacts the hospital-based nurses?

Theycan expect many patients. However, many nurses are afraid that thehospitals will add more workers even if they have more ill healthpersons. One of the ways the reforms was able to get attention fromthe hospitals was to convince them that what they are losing in ratereduction in the payments would be the component of the volume. Thebigger concern is the influx of the people seeking healthcare thatthey have been putting off since they did not have the insurance butthe hospitals will not do employment of the nurses. The respondentwas not sure of how the cycle will pay out.

Somepart of the healthcare reform law is quality but not quantity. Smarthospitals will indicate that they need enough staff to preventcomplications and concentrate on improving care to preventreadmissions. If they do not, they will be getting small paymentslater on. It is either pay now or pay later. This is in line with theresearched health reforms where the improvements will offer cheaphealth care service hence many people who are unable to pay highexpenses will seek healthcare services from the hospital at a cheaperrate hence accessibility of medical services and facilities isimproved. On the other hand, a number of complicated diseases will behighly eradicated since medical reforms would have been put intoplace thereby giving nurses a better chance to offer the practice.

Conclusivelythis reforms offer a varied opinion hence each individual perceivethem differently as it is seen that they can either be positive ornegative depending on what matter is put into consideration.


Hamric,A. B., Hanson, C. M., Tracy, M. F., &amp O`Grady, E. T.(2013).Advancedpractice nursing: An integrative approach.Elsevier Health Sciences.

Kitson,A., Marshall, A., Bassett, K., &amp Zeitz, K. (2013). What are thecore elements of patient‐centredcare? A narrative review and synthesis of the literature from healthpolicy, medicine and nursing.&nbspJournalof advanced nursing,&nbsp69(1),4-15.

Potter,P. A., Perry, A. G., Stockert, P., &amp Hall, A.(2016).&nbspFundamentalsof nursing.Elsevier Health Sciences.