At MGH the decline was 87.6% in 1988 to 78.4% in 1993 as well. Because of their high medical cost and lack of primary care physicians, 30% of the hospitals revenues were at risk, giving the opportunity to other hospitals to provide these services and create price competition based on Chapter 495. The reduction of gross patient service revenue at MGH and BWH were affected by the changes in government programs such as Medicare, Medicaid and the enactment of chapter 495. These programs along with many insurance companies adopted the Prospective Payment System (PPS) which began monitoring hospital charges and refusing payment for unnecessary services. The hospitals were receiving a standardized payment for each service
The level of safety of hospitalized patients and the degree of quality care that they receive has more to do than fixed nurse-to-patient ratios. It has been well established in the literature that when nursing workload increase to unmanageable levels; whether it be from the addition of patients, increases in acuity, or from high levels of fluctuation in patient turnover, that nurses ability to perform patient surveillance is disordered, putting patients in undue risk (Needleman, et. al, 2011). Increasingly, studies continue to show links in patient deaths and adverse events to inadequate nurse staffing levels in acute care hospitals (Needleman, et. al., 2002; Aiken et.
Prescriptive Authority and Nurse Practitioners Kaymie Chandler Johnston Austin Peay State University Healthcare Policy NURS 5001 February 7, 2013 Prescriptive Authority and Nurse Practitioners There are many healthcare policy issues that affect nurse practitioners today and in the future. The Affordable Care Act is to add approximately 32 million Americans to the roles of the insured at a time when there is a shortage of primary care providers. (Fairman, Rowe, Hassmiller, Shalala 2011). Nurse practitioners will be part of the solution for this shortage, but with ever tightening restrictions on the care that they can provide, it will prove more and more difficult to ease the strain on an already over-burdened system. One policy that is especially concerning and confusing to many advanced practice nurses and future advanced practice nurses is prescriptive authority.
Nurse to patient staffing ratios I read an article published in the Online Journal of Issues in Nursing about staffing ratio’s. The article pointed out that the nurse to patient ratios are high because the hospital doesn’t get additional reimbursement based on the individual acuity of the patient. Since the hospitals already have to keep a set standard of nurses they have lowered the number of unlicensed personnel and housekeeping staff to offset the cost (Welton, 2007). This practice doesn’t solve the real issue that the ratios present such as safety, it simply reduces the cost to the hospital while putting a greater workload on the nurse. The article explained that the nursing needs are even higher because of the shorter hospital stays.
Betty Neuman’s theory of wellness has a holistic approach to the patient. The patient’s energy, any potential patient defenses, resistances, and reactions are included in the assessment process. She suggests the patient care and caregiver approach to it by comparing perceptual differences. The nurse makes a diagnosis from information collected during the assessment and sets the goals to match the desired outcomes based on the assessment and the perceived patient need. According to Betty Neuman, the goals have to be stable and suitable.
The nursing process is beneficial to the patient, the nurse, and the nursing profession. It ensures that a high quality of care is provided to patients and enhances the patient’s participation in all stages of the process. It provides personal and professional growth to nurses and leads to job satisfaction. For the nursing profession, the nursing process contributes to the autonomy of the profession and defines the scope of the nursing practice. The nursing process includes four phases: assessment, planning, implementation, and evaluation of care (Habermann and Uys, 2005).
Running Head: A CENTRAL THEME OF NURSING: THE NURSE –PATIENT RELATIONSHIP A Central Theme of Nursing: The Nurse-Patient Relationship Melia B. Maketo Fall 2009 Melia B. Maketo, Clayton State School of Nursing, Nursing Student A Central Theme of Nursing: The Nurse-Patient Relationship The American Nurses’ Association defines nursing as the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, communities, and populations. It is a dynamic and flexible career; centered on the holistic well-being of the individual. With this in mind, nurses must have the ability to use their knowledge and skills to think critically in order to provide the best care possible. Perhaps the most important factor of providing quality care is fostering a cohesive nurse-patient relationship. While nurses strive to nurture this relationship, the foundation and concepts from which it is derived are evident in the CCSU Conceptual Model.
I note that their knowledge and experience from multiples years of nursing prepare them for position that they are now in. The staff nurse provided more direct involvement in her role on the team by educating her patients during care. The nurse educator, on the other hand, was involved with her team indirectly by educating the staff on patient care issues. The interviewees’ position on promoting quality care outcomes requires them both to be directly engaged in the plan of care for the patient’s on their respective units. Although national evidence based research effects nursing as a whole, the staff nurse believes that nursing research has greatly improved her area.
Typically nurses have always taught their patients how to manage their daily lives with an illness, but now the purpose is more on how the patient can remain healthy and what preventative measures the nurse needs to implement for their patients. Nursing roles and responsibilities have changed within the last ten years or so. The role of a nurse now is typically seen as being an advocates, educators, researchers, collaborators, partners, and policy-makers with a continued focus on community health. Nursing has become increasingly more involved in the process of health promotion. With budget cuts at facilities and high physician to patient scenarios, nurses implement
This scholarly nursing journal called 'Constructing nurses' profession identity through social identity theory'(Dec,2012) by Georgina Willetts and David Clarke is a reliable peer-reviewed article because of the writer's credentials ,the number of references they have used, the structure and the relevance of the content. In between 1960s and 1980s, transition phase to recognize nursing as a profession was initiated by shifting nursing studies from hospital training environment to educational institutions in North America, UK, New Zealand and Australia. Thirty years since nursing profession has been recognized as a profession but still nurses are facing difficulties while describing their professional identity and there is a doubt regarding whether it is really a profession. So the article has put forward the social identity theory (SIT) as a important framework for research, to shed light and define nurses' professional identity. Since SIT was first introduced, it has set a long-standing research framework with its verified facts from different contexts to support its thesis.