I need help to create 10-12-slide, 20-minute presentation for my NURSING course

NHS-FPX4050_Renfro.Amanda_Assessment2-1.pptx

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Ethical and policy factors in care coordination Amanda Renfro Capella University NHS-FPX 4050: Coordinating Patient-Centered Care Prof. Gina Causey

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Agenda Care Coordination Government Policies - Nursing Homes - Affordable Care Act (ACA) - Health Insurance and Portability and Accountability Act (HIPAA) Policy Provisions and Ethical Questioning Impact of the Code of Ethics for Nurses and Care Continuum Sample Footer Text 20XX 2

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Care Coordination What is care coordination? Why is it important? Sample Footer Text 20XX 3 “the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services” (Karem et al., 2021).

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Government policies - Nursing Home Reform Act (NHRA) - Affordable Care Act (ACA) - Health Insurance Portability Accountability Act (HIPAA) Sample Footer Text 20XX 4

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Nursing home reform act (nhra) Ethical and sufficient medical care Government bodies that will advocate for them Freedom from abuse and the right to be treated with respect Patients’ protections in institutional settings Liberation from chemical and physical restraints Sample Footer Text 20XX 5

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Affordable care act (aca) Low-income individuals are eligible for health coverage. Expansion of Medicaid Cost-cutting medical care delivery methods Ultimate goal to lower healthcare costs so everyone can afford the care they need. Sample Footer Text 20XX 6

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Health insurance portability and accountability act ( hipaa ) Discretion Policy Criteria for the privacy of medical records at the national level Grants people the freedom to make decisions about their own health records Protects your privacy from unauthorized use of disclosure Privacy regulations must be adhered to by all personnel in the healthcare industry. Sample Footer Text 20XX 7

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Policy Revisions raising ethical dilemmas Sample Footer Text 20XX 8

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Nursing code of ethics Sample Footer Text 20XX 9

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Healthy People 2030 Goals Eradicate health inequities Promote health literacy Sample Footer Text 20XX 10

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Conclusion Questions? Comments? Concerns? Sample Footer Text

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References Please see speaker notes for references Sample Footer Text 20XX 12

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Good morning. My name is Amanda Renfro, and I am a nurse care coordinator. Today's talk will focus on how to organize care around the patient. In this presentation, I'll discuss how federal guidelines for nursing home safety and resident health affect team-based care planning and delivery. I plan to identify ethical concerns with current federal, state, and local policies through policy revision. In this presentation, I will assess the impact of the code of ethics on nurses and the method of providing care as a whole. Following that, I'll review moral and legal concerns that impact care coordination. 2

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Care coordination is "the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services" (Karem et al., 2021). This definition is taken from a study published in 2021 in the International Journal of Integrated Care. Multidisciplinary care teams, coordinating all services at the correct time and location, are crucial to successfully implementing this concept of organized patient care. According to the research done by Karem et al. (2021), social and medical specialists develop each patient's treatment plan using their expertise and available resources. The patient's experience in the healthcare system will improve with the application of this method. As a result of having so many medical professionals involved, the likelihood of polypharmacy and therapy gaps because of misdiagnosis is decreased. Care coordination aims to lessen the possibility of unfavorable patient outcomes while increasing the quality of care provided. 3

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The government has created many policies and laws to protect patients receiving medical treatment. Additionally, the government has utilized these laws and policies to ensure patients receive fair and adequate medical treatment, including primary preventative care. In the following slides, I will discuss these laws and policies and how they directly impact our facility. While many of these laws might seem to create extra work or be cumbersome, they were designed to make healthcare more affordable, accessible, and equal for people. Upholding them is not only a legal requirement but also allows nurses to promote patient involvement and rights related to their care. 4

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According to Werner et al. (2022), the Nursing Home Reform Act of 1987 was passed to mandate specific care plans and resident rights for those residing in nursing homes. Nursing home residents are guaranteed protection from abuse and respect under this statute. Nursing home abuse, neglect, and a lack of regulation and control were significant factors in the creation of OBRA, passed to better the lives of nursing home patients. Quality of life and health were mandated to increase thanks to OBRA. Patients have the right to use banks, to be free from unwarranted physical and chemical constraints, and to have councils speak on their behalf, according to Werner et al. (2022). These modifications were an effort to alter institutional culture such that residents would be treated with respect and allowed to retain their rights. The law has resulted in better care for residents, more caregivers, less reliance on constraints, and more seniors remaining in their homes as they age. A person can transition from a transient to a permanent facility resident by choosing to age in place. This allows them to feel more at ease, establish a more regular pattern, and stay at the facility rather than risk being sent home without the needed support. 5

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The Patient Protection and Affordable Care Act (ACA) was passed in March of 2010 in the United States to expand health insurance options for its citizens. Improving coverage is a top priority, and one way to get there is by increasing collaboration between businesses, individuals, and government. The law also aims to reduce costs and increase the availability of medical care for Americans. As the Affordable Care Act requires, more healthy people enrolling in health plans will help keep premiums low. The process was designed to increase access to Medicaid for people who might not have it otherwise, including by lowering the likelihood of being denied coverage due to a preexisting condition. Readmission rates are down, preventative care is getting more attention, and more hospitals are using electronic medical record systems thanks to this law. Specifically, since the ACA was enacted, payment methods based on patient outcomes have been used. To maximize the potential for reimbursement for services rendered, healthcare systems need to employ a care coordinator to ensure patients receive adequate follow-up care. 6

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The Privacy Rule (Standards for Privacy of Individually Identifiable Health Information) establishes minimum requirements for protecting certain types of health information at the federal level. It ensures that people can access and control their health records. The Privacy Rule aims to ensure the confidentiality of patient's medical records while allowing for essential data uses that improve access to and the quality of health care and safeguard the safety and well-being of the public. Every healthcare provider must adhere to the Privacy Rule when transmitting electronic patient health information concerning particular transactions, including claims, benefit eligibility inquiries, referral authorization requests, and so on. So why is this so important, exactly? This means that any doctor, hospital, or affiliate representative must respect your right to confidentiality and avoid disclosing your personal information without your consent. (HHS, 2020) 7

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When this presentation's study was being done, there was no clear policy about how many nurses are needed to run a nursing home safely. Patients' safety may be compromised since no regulations exist to prevent facilities from employing just the bare minimum of employees. According to Harrington et al. (2020, p. 1), “Higher RN staffing levels are associated with better resident care quality in terms of fewer pressure ulcers; lower restraint use; decreased infections; lower pain; and improved activities of daily living (ADLs)” (p. 1). Employees have reported feeling more stressed and dissatisfied with their jobs due to this issue, and leadership turnover has also increased. Nursing home patients suffer from substandard care and a greater mortality rate due to a shortage of staff and supplies. Residents of nursing homes can only get top-notch treatment through collaborative efforts among specialists in various fields. Most states do not have regulations in place that address acceptable nurse-to-patient ratios. ( Rajamohan et al., 2019). 8

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Safe staffing ratios Ethical challenges Lack of resources in the nursing homes Many different disciplines needed Lack of state regulations regarding nurse-to-patient ratios

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Safe staffing ratios Ethical challenges Lack of resources in the nursing homes Many different disciplines needed Lack of state regulations regarding nurse-to-patient ratios

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Nurses vow to uphold the four pillars of ethics in patient care: autonomy, beneficence, justice, and non-maleficence. Moral standards and individual convictions sometimes mesh, leading to friction. Difficult decisions concerning patient care are a common focus for ethics committees. The nursing profession benefits from having a code of ethics to guide their actions. According to the article (Gaines, 2022), these four guiding principles are the basis for the code of ethics. Nursing entails advocating for the patient, whose autonomy includes the right to make care decisions. The nurse will make sure the patient has all the facts so they can make the best decision for themselves. When necessary, the nurse must also enforce the patient's chosen course of medical treatment. Providing treatment in the patient's best interest is commonly known as the ethical principle of beneficence. Patients are guaranteed equal treatment under the law, regardless of age, gender, sexual orientation, religion, or inability to pay. Similarly, nonmaleficence necessitates that no harm be brought upon the patient. This is picking the treatment that causes the patient the least harm while producing desirable outcomes. With these rules in place, nurses can provide treatment that is both effective and moral. Nursing ethics will be affected by the policies of the organization. Despite being understaffed and caring for more patients than is safe, nurses will always do their best to treat their patients. This results in exhaustion and stress on the job, which increases the likelihood of mistakes being made while caring for the patient. 9

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Autonomy – recognizing the right of each individual patient to self-determination and decision-making. Naturally, as nurses, it is our duty to equip patients with all the information they need to make educated decisions. Beneficence – exhibiting traits like kindness and charity while acting in the best interests and welfare of others. This is similar to what is meant by "compassionate care." Justice -integrity in all aspects of healthcare provision. Nurses have a duty to treat all patients with dignity and respect, regardless of their socioeconomic status, race, religion, gender, or sexual orientation. Nonmaleficence- to avoid causing harm. This is the cornerstone of nursing ethics; everyone knows and understands it. Choosing treatments and procedures will have the fewest adverse side effects while producing the desired result.

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The goal of Healthy People 2030 is to promote the health and well-being of all people worldwide by reducing health disparities and raising health literacy levels. One of the most critical aspects of health literacy is people's ability to read, analyze, and understand health-related information. To make well-informed decisions about your health, you need access to essential health information and services. Care coordination facilitates communication with healthcare providers, access to community resources, and understanding of electronic health data, all of which contribute to achieving health literacy goals and objectives. (HHS, 2020) Access, quality, user satisfaction, and efficiency are all enhanced when resources, service delivery, management, and organizational factors are coordinated. It is also described as an organized set of methods and models for promoting coordination, harmony, and interdependence. (Ruggiero et al., 2019) 10

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Nursing homes serve a crucial part in caring for America's aging population, who will continue to need the assistance of skilled nursing facilities. Regulations and policies exist to aid nursing homes and guarantee the safety of their patients. The people who need the care provided by nursing homes may be abused or neglected if this monitoring is not in place. Nurses must follow the Code of Ethics and the law to ensure that their patients get the care they deserve. I value your patience and interest in this lecture. Feel free to voice any complaints, questions, or thoughts below. I am grateful for your attention. 11

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Harrington, C., Dellefield , M. E., Halifax, E., Fleming, M. L., & Bakerjian , D. (2020). Appropriate Nurse Staffing Levels for U.S. Nursing Homes. Health Services Insights , 13 , 1–14. https://doi.org/10.1177/1178632920934785 Gaines, K. (2022, November 4). What is the Nursing Code of Ethics . Nurse.org. Retrieved February 4, 2023, from https://nurse.org/education/nursing-code-of-ethics/ HHS. (2020). HIPPA privacy rule . United states department of health & human services. http://www.hhs.gov/ocr/hipaa Karam, M., Chouinard, M. C., Poitras, M. E., Couturier, Y., Vedel, I., Grgurevic , N., & Hudon , C. (2021). Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review. International Journal of Integrated Care , 21 (1), 16. https://doi.org/10.5334/ijic.5518 Rajamohan , S., Porock , D., & Chang, Y. (2019). Understanding the relationship between staff and job satisfaction, stress, turnover, and staff outcomes in the person‐centered care nursing home arena. Journal of Nursing Scholarship , 51 (5), 560–568. https://doi.org/10.1111/jnu.12488 Ruggiero, K., Pratt, P., & Antonelli, R. (2019). Improving outcomes through care coordination: Measuring care coordination of nurse practitioners. Journal of the American Association of Nurse Practitioners , 31 (8), 476–481. https://doi.org/10.1097/jxx.0000000000000276 Werner, R. M., Konetzka , R. T., Grabowski, D. C., & Stevenson, D. G. (2022). Reforming Nursing Home Financing, Payment, and Oversight. New England Journal of Medicine , 386 (20), 1869–1871. https://doi.org/10.1056/nejmp2203429 12

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Presentation title Amanda Renfro Amanda Renfro 1 2023-08-18T13:46:16Z 2023-08-29T18:17:11Z

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