Nursing Care Plans: Guidelines for individualizing Client Care Across the Life Span 8th edition eBook

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  • Download: Nursing Care Plans Guidelines for individualizing Client Care Across the Life Span 8th edition eBook
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  • Published: 2010
  • ISBN-10: 0803622104
  • ISBN-13: 978-0803622104

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Nursing Care Plans, Guidelines for individualizing Client Care Across the Life Span 8th edition eBook

Issues and Trends in Nursing

and Healthcare Delivery

CHAPTER 1

In order for nurses to be actively involved in restructuring

and maximizing healthcare delivery systems, they must possess

current knowledge of trends in the healthcare environment

and issues in nursing practice that relate to overall

healthcare practice.

The Ever-Changing Healthcare

Environment

The Center for American Nurses cites the American Nurses

Association’s (ANA) Code of Ethics for Nurses (2001) and

Nursing: Scope and Standards of Practice (2004) as proof

that nurses have a professional responsibility to be involved

in the planning and delivery of nursing practice.

According to Rivera and Halvorson (2008), “the fundamental

focus of healthcare reform must be on quality of

care.” This is not new to nurses. Quality of care has always

been a major focus of the profession. And we agree that it is

a critical issue in healthcare reform, but it is by no means the

only issue.

Healthcare is impacted by many other factors, including

poverty, the escalating cost of healthcare, the everincreasing

numbers of uninsured or underinsured healthcare

consumers, and the need for allocation of limited healthcare

dollars and resources. According to The World Health

Organization, the United States is 37th in their ranking of

health among nations worldwide, even though the United

States spends a larger percentage of its wealth on healthcare

than any other industrialized nation (Rivera & Halvorson,

2008). While left to ponder the possible reasons for that ranking,

healthcare providers realize that issues about socioeconomic

status, ethnicity, and culture impact the disparity in

healthcare and will continue to have an effect on nursing

practice and job satisfaction.

In addition, technological advances, as well as the

ethical and liability issues associated with living in a technological

age, will continue to affect nursing practice now

and in the future.

Nurses must be aware of these varied influences

and take an active role in the formulation of policies and

legislation affecting their practice. The Center for

American Nurses (2007) strongly supports nurses’ active

participation in the assessment, restructuring, and redesign

of their work to ensure that nursing practice is evidencebased

and positively impacts healthcare consumers’ and

providers’ safety and satisfaction. Furthermore, as nurses

define their practice, they must set the standards of practice

to provide quality nursing care with a high degree of

client satisfaction and within the constraints of available

resources, such as shortages and changing roles for healthcare

providers.

Healthcare Costs

and the Allocation

of Resources

Nurses have a responsibility to be aware of how the cost of

healthcare impacts clients’ choices and well-being.

Healthcare-funding issues are constantly in the news, and

cuts threaten the health of our nation. As healthcare expenditures

continue to rise, both government and private payers

of healthcare costs are pursuing various methods of cost

containment.

Modern reforms began in the 1980s when the

Medicare payment system for inpatient healthcare services

changed from a cost-based retrospective payment system to

a prospective payment system based on diagnosis-related

groups (DRGs). This change meant that reimbursement for

services followed specific guidelines and restrictions,

including the requirement of prior approval for treatment.

Since then, many changes and upgrades have been made in

this payment system, such as all-patient refined DRGs (or

APR-DRGs) and severity DRGs, to better reflect the complexity

of a client’s condition or care needs; however, reimbursement

still remains below billed costs. Now, as a result

of budgetary concerns, most states are considering or have

already developed options to similarly curb Medicaid reimbursement.

These changes have widely affected both access

to healthcare and healthcare delivery systems.

One of the most far-reaching solutions for cost containment

has been the implementation of managed care services

and the building of health maintenance organizations

(SMALL SAMPLE OF CHAPTER 1)

 

 

 

Nursing Care Plans Guidelines for individualizing Client Care Across the Life Span 8th edition eBook

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