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Patient Protection and Affordable Care Act
The health of a nation's population is the most important sector in the building of the nation's economy (Kovne, Knickman & Jonas, 2011). A sick nation cannot effectively produce anything substantial to keep it running. Thus, it is in this view that each government seeks to provide better quality and affordable health services. In so doing, the governments set up rules and laws that act to regulate the health sector.
The acts that the government has drafted and implemented have various initiatives that drive them. These initiatives include reducing costs and so as to make access to health affordable and protecting the consumers (Parks, 2012). In the previous times, the very industrious Americans had to live with having to pay the price for policies that let the insurance service companies exploit them. The act holds insurers accountable by allowing new tools for cracking down…
Kovner, A.R., Knickman, J., & Jonas, S. (2011). Jonas & Kovner's health care delivery in the United States. New York: Springer Pub.
Parks, D. (2012). Health care reform simplified: What professionals in medicine, government, insurance, and. S.l.: Apress.
Wolper, L.F. (2004). Health care administration: Planning, implementing, and managing organized delivery systems. Sudbury, MA: Jones and Bartlett Publishers.
The Act authorizes the Office of Personnel Management (OPM) to contract out with private health insurers to offer at a minimum of two multi-state qualified health plans (to include at least one non-profit) to provide individual or small group coverage through state-based exchanges. In the area of long-term care, this creates a voluntary and national long-term care insurance program to help purchase services. In addition, this provides support for people who have functional limitations. This is done in order to help them maintain their personal and financial independence (CLASS program). PPACA requires that this be financed through voluntary payroll deductions (ibid 3-4).
In the area of Medicaid and CHIP, PPACA expands Medicaid to all individuals under the age of 65 years of age to include incomes up to 133% of the federal poverty level. e will examine how this affects individual providers below. This will provides 100% federal funding to…
"Constitutionality of obamacare may be headed to supreme court." (2010) Retrieved from
Workers can opt out and as an alternative obtain coverage from their state's insurance exchange. The PPACA standards will considerably affect industries that employ part-time, provisional, seasonal and float-pool workers at length (Clarke, Keckley & Kraus, 2012). A hospital will have to look at whether hiring part time employees and float pool workers will still be beneficial for them or if they will need to go to only having full time employees.
The PPACA includes a grandfather clause for employer plans that are already in place as of the date the act goes into effect. With the exemption of some insurance reforms employer plans that already exist on the date of enactment will not have to be altered to meet the terms with other parts of the PPACA. This will be a vital issue for businesses as they consider the effects and costs of other requirements, because loss of grandfather…
Clarke, R.W., Keckley, P.H. & Kraus, S. (2012). Retrieved from http://www.deloitte.com/view/en_US/us/Insights/Browse-by-Content-Type/deloitte-review/deloitte-review-government/6411d6082dea9210VgnVCM100000ba42f00aRCRD.htm
Employer Health Care Reform: Moving Beyond Compliance. (2011). Retrieved from http://www.deloitte.com/view/en_US/us/Services/consulting/all-offerings/hot-topics/human-capital-trends -
Employers planning cutbacks in retiree coverage in response to health care reform. Shifting retirees to Medicare Part D and to the insurance exchanges are part of the strategy.
The Patient Protection and Affordable Care Act's Impact on Evidence-Based Practice in Nursing: The National Quality Strategy
The recently enacted Patient Protection and Affordable Care Act (PPACA), a landmark and controversial piece of legislation still years away from coming into full effect and currently being challenged (at least in part) in the nation's courts, is primarily seen by the public as impacting upon healthcare payment systems and insurance practices. These are certainly the areas of the legislation that have received the most significant amount of media attention, and they do represent the widest departure from current practices and institutions in the healthcare system, according to many perspectives. The PPACA is not solely concerned with improving access to healthcare and the affordability of care, however; the legislation contains directives and policy measures aimed at directly improving the overall quality of healthcare throughout the country through explicitly empirical means.
Berkman, B. (2011). Seizing Interdisciplinary Opportunities in the Changing Landscape of Health and Aging: A Social Work Perspective. Gerontologist 51(4): 433-40.
Dailey, M. (2011). Understanding the Measure Applications Partnership. Nursing Management 42(6): 16-8.
Groszkruger, D. (2011). Perspectives on healthcare reform: A year later, what more do we know? Journal of Healthcare Risk Management 31(1): 24-30.
HHS. (2011). National Quality Strategy will promote better health, quality care for Americans. Department of Health and Human Services. Accessed 5 October 2011. http://www.hhs.gov /news/press/2011pres/03/20110321a.html
students complete a policy analysis Patient Protection Affordable Care Act (ACA) . The paper include unbiased discussion sides issues, impact existing programs/agencies, costs implement, relevant statistics, role government (federal/state) influence special interest groups.ID
Patient Protection Affordable Care Act (ACA)
The Affordable Care Act (ACA) is one of the most controversial bills passed by the U.S. Congress in recent memory. Its provisions include an individual mandate that all Americans purchase some form of healthcare coverage, if financially able to do so. While it continues to be a source of political controversy, the systemic structural problems of U.S. healthcare, such as its spiraling costs, remain unaddressed. Universal coverage through publically-supported insurance is politically unpalatable and even moderate reforms like the ACA generate rage in many segments of the electorate, despite the popularity of many of the ACA's actual provisions.
The Affordable Care Act (ACA) was the result of many years…
Access to healthcare and the uninsured. (2012). NCSL. Retrieved:
Affordable Care Act (ACA). (2012). Times Topics. The New York Times. Retrieved:
Patient Protection and Affordable Care Act of 2010:
Supreme Court's recent upholding of the individual mandate of the Patient Protection and Affordable Care Act of 2010 was deemed to be an essential component of the enforcement of the Act. The individual mandate, and the ACA overall was designed to address the systemic problems within the American healthcare system related to the high costs of care and the lack of coverage for many Americans. 50 million Americans currently lack health insurance. "Before the legislation is fully phased in, Americans can be charged higher premiums when they are sick, and adults can be denied coverage because of a pre-existing condition... Illness or medical bills cause 62% of all personal bankruptcies (Tandem & Spiro 2012: 1). Without the individual mandate, the other provisions of the Act would have been unenforceable, even if provisions such as the prohibition of…
Klein, Ezra. (2010). How does the individual mandate work? The Washington Post. Retrieved:
Tanden, Neera & Topher Spiro. (2012). The case for the individual mandate in health care reform. American Progress. Retrieved:
The Patient Protection and Affordable Care Act of 2010 has become a contentious political issue, which I am sure your office is well aware of. As a future health care administrator and as an American citizen in your constituency, I would like to express my views on the Act. In particular, I am concerned about the impact of the Patient Protection and Affordable Care Act on service delivery in the community and public health care setting. Based on my extensive research using scholarly literature and reports issued by state and federal government agencies, I strongly urge you to continue to support the Patient Protection and Affordable Care Act. In fact, I suggest you to consider strengthening the act.
"Although the United States continues to overspend on health care compared to its peer countries, international studies of health care quality suggest that the United States health care system is underperforming,"…
"The Health Care Delivery System: A Blueprint for Reform." Center for American Progress. 31 Oct, 2008. Retrieved online: http://www.americanprogress.org/issues/healthcare/report/2008/10/31/5129/the-health-care-delivery-system-a-blueprint-for-reform/
Whitehouse, S. (2012). Health Care Delivery System Reform and the Patient Protection and Affordable Care Act. Retrieved online: http://www.whitehouse.senate.gov/imo/media/doc/Health%20Care%20Delivery%20System%20Reform%20and%20The%20Affordable%20Care%20Act%20FINAL2.pdf
PPACA on Nursing Practice:
The Patient Protection and Affordable Care Act is a legislation that was enacted in March 2010 as part of meaningful and comprehensive reform for America's healthcare system. Upon enactment, the legislation has had significant on the country's healthcare infrastructure. In order to accomplish its goals, the Patient Protection and Affordable Care Act focuses on registered nurses because of their role in the current healthcare system. egistered nurses are the largest single group of clinical healthcare practitioners in America's health system. They work in a holistic mechanism and interconnected system to provide care services to patients, families, and the community. The legislation seeks to transform the current sick care system into an actual healthcare system through various major provisions.
One of the major provisions with significant effects on current nursing practice is the changes in nursing workforce. The Patient Protection and Affordable Care Act has made considerable…
Brody, A. & Sullivan-Marx, E.M. (2012, November). The Patient Protection and Affordable
Care Act: Implications for Geriatric Nurses and Patients. Journal of Gerontological Nursing, 38(11), 3-5. Retrieved from http://www.healio.com/nursing/journals/jgn/%7B045952c2-c440-41b4-a1d7-ea791184c581%7D/the-patient-protection-and-affordable-care-act-implications-for-geriatric-nurses-and-patients
Joynt, J. & Kimball, B. (2008, January). Innovative Care Delivery Models: Identifying New
Models that Effectively Leverage Nurses. Retrieved October 30, 2013, from http://www.innovativecaremodels.com/docs/HWS-RWJF-CDM-White-Paper.pdf
new Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education econciliation Act (econciliation Act) will create a huge future demand for health care as millions of people who have been without health insurance will now have it, either through reduced rate plans and programs or public options. As the law reads there will be a sort of sliding scale system based on the poverty level and those who qualify based on income will be offered reduced premiums for coverage and those who do not but still choose not to get health insurance will be penalized with a fee. Currently there are an estimated 32 million people in the U.S. who have no health insurance coverage. Under the new law (PPACA) many of those individuals will have insurance coverage and therefore seek care more frequently. According to one source hospitals will be seeking to increase…
Carlson, J. (2010). Nurses in demand. Modern Healthcare, 40(20), 12
MBJ Staff. (May 30, 2011). River Oaks Hospital in Mississippi launches service to check ER wait times. Mississippi Business Journal.
Zolkos, R. (2011). More doctors, risks in the house under health care reform. Business Insurance, 45(25), 13.
Patient Protection and Affordable Care Act/Impact of ACA from the Organizational and the Patients view
Impact of the Affordable Care act (ACA) on the population that it affected
Impact of the economics of providing care to patients from the organization's point-of-view
How will patients be affected in relationship to cost of treatment, quality of treatment, and access to treatment?
Ethical implications of this act for both the organization and the patients
Impact of the Affordable Care act (ACA) on the population that it affected
The Affordable Care Act (ACA), as initially passed, mandated Medicaid expansion, for covering a majority of low-income, as-yet-uninsured American citizens and immigrants (with legal residency in the U.S. for a minimum duration of 5 years). The United States Supreme Court, however, in the historic National Federation of Independent Business v. Sebelius, 132 S. Ct. 2566 (2012), maintained that the obligatory Medicaid expansion proved to be unconstitutionally…
ACA. (2015). The Patient Protection and Affordable Care Act. Retrieved on 13th September, 2015 from http://www.dpc.senate.gov/healthreformbill/healthbill52.pdf
Howard, P. (2015). The Impact of the Affordable Care Act On the Economy, Employers, and the Workforce. edworkforce.house.gov. Retrieved on 13 th September, 2015 from http://edworkforce.house.gov/uploadedfiles/02.09.11_howard.pdf
Kengmana, R.T. (2015). An Ethical Perspective on the Affordable Care Act. MA: Psych Central. Retrieved on 13th September, 2015 from http://googleweblight.com/?lite_url=http://psychcentral.com/about/feedback&lc=en-IN&s=1&m=101&ts=1442202299&sig=APONPFlqjqQURNK5jFIewCvXRMJzyhz8zA
NCIOM. (2015a). Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina. Chapter 7: Quality. Retrieved on 13th September, 2015 from https://www.google.co.in/url?sa=t&source=web&rct=j&url=http://www.nciom.org/wp-content/uploads/2013/01/Final-Ch7-Quality-FINAL.pdf&ved=0CCYQFjABahUKEwjv_JDfr_XHAhVIB44KHfLKAPg&usg=AFQjCNEdTlwW2QuvqN5Rn6qM31poi4lBUA
Protection of Digital Health Information
With increase health information technology store access patient information, likelihood security breaches risen. In fact, Canadian Medical Association Journal (CMAJ): In United States, a whopping 97% increase number health records breached 2010-2011
Ensuring that patient information is protected at all times is vital for any health care institution. Patient information records contain sensitive information that can be used for malicious purposes like identity theft, credit card fraud, and leaking of information for malicious intent. The advancement and use of technology has made it easier for patient information to be accessed within the health care facility Shoniregun, Dube, & Mtenzi, 2010.
This increases the speed of service delivery to the patient and improves the care given to the patient. Technology has allowed for the use of portable electronic devices by the healthcare practitioners in entering and accessing patient records and information. Portable electronic devices are small…
Green, M.A., & Bowie, M.J. (2005). ESSENTIALS OF HEALTH INFORMATION Management: PRINCIPLES AND PRACTICES: Principles and Practices. Independence, KY: Thomson/Delmar Learning.
Harman, L.B., & Association, A.H.I.M. (2006). Ethical Challenges in the Management of Health Information. Burlington, MA: Jones and Bartlett Publishers.
Laurinda B. Harman, C.A.F., and Kesa Bond. (2012). Electronic Health Records: Privacy, Confidentiality, and Security. American Medical Association Journal of Ethics, 14(9), 712-719.
Shoniregun, C.A., Dube, K., & Mtenzi, F. (2010). Electronic Healthcare Information Security. New York / Heidelberg: Springer.
" (Morris & Woodcock, 2004)
V. Murakami et al. (2003)
In the work entitled: "Deep Venous Thrombosis Prophylaxis in Trauma: Improved Compliance With a Novel Miniaturized Pneumatic Compression Device" the authors state that: "Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue." (Murakami et al., 2003) the study conducted by Murakami et al. (2003) is stated to be a."..prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward." (Murakami et al., 2004) the study results state that: "Total compliance rate in the CECT group was significantly higher than in the SCD group…
Kehl-Preutt, Wendy (2006) Deep Vein Thrombosis in Hospitalized Patients: A Review of Evidence-based Guidelines for Prevention. Dimensions of Critical Care Nursing March/April 2006. Vol. 25 No.2. Online available at http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=636024 .
Chang, David et al. (2002) Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg. 2002 May;68:470-3 Online available at http://lib.bioinfo.pl/auid:1350109.
Practice Alert: Deep Vein Thrombosis Prevention" (2006 American Association of Critical-Care Nurses Journal " Vol. 23 No. 1 January 2006.
Morris, Rhys J. & Woodcock, John P. (2004) Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis. Ann. Surg. 2004 February 239(2): 162-171.
Among the most important aspects to the health promotion plan will be the benefits associated with a care manager, who can ensure that all six core elements of CCM are implemented fully. If this is accomplished, there should be a significant reduction in health disparities for patient and caregiver outcomes across generations.
AHQ. (2012). National Healthcare Disparities eport, 2011. No. 12-0006. ockville, MD: Agency for Healthcare esearch and Quality. etrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf.
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, . et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & uiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse…
AHRQ. (2012). National Healthcare Disparities Report, 2011. No. 12-0006. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf .
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, R. et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & Ruiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21(5), 278-86.
On March 23, 2010 the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. Along with the Health Care Reconciliation Act of 2010, the PPACA became part of the overall Health Care Reform concept of 2010. The health care reform process was promoted as a way to completely transform the health care industry and ensure that all Americans received affordable health care. hile supporters praise the legislation as a revolutionary law which will benefit ordinary Americans, critics claim that the Obama Administration used the health care reform process as a means of gaining control over the entire health care system. In an attempt to compare and contrast the provisions of this new law, this essay will discuss several provisions of the new health care legislation and compare the benefits as well as the criticisms of them.
Section 5501 of the PPACA provides for…
Appleby, Julie. (2011, Jan. 10). Effort To Reward Medicare Advantage Plans Draws Criticism. Kaiser Health News. Retrieved from http://www.kaiserhealthnews.org/Stories/2011/January/10/Medpac-on-Medicare-Advantage-bonuses.aspx
"Side Effects: Obamacare Could Punish Docs for Better Quality Care." (2010, July 16). The Heritage Foundation. Retrieved from http://fixhealthcarepolicy.com/health-care-news/side-effects-obamacare-could-punish-docs-for-better-quality-care/
Gold, Jenny. (2011, Jam. 18). "Accountable Care Organizations, Explained." NPR. Retrieved from http://www.npr.org/2011/04/01/132937232/accountable-care-organizations-explained
"Health Care Reform: Annual Fee on Prescription Drug Manufacturers and Excise Tax on Medical Devise Manufacturers." (2010, Apr.). Covington & Burling LLP Retrieved from http://www.cov.com
Examples of 'red flag' usage include logging in during odd hours (over the weekend and in the middle of the night) or unusual activity not typical of specific users. Cloud computing can also lessen the risks by making it more difficult to actively 'transport' data away from secure premises. "According to an HHS database, more than 40% of medical data breaches in the past two and a half years involved portable media devices such as laptops or hard drives" (Schultz 2012)
Q3. How can we minimize injury and harm after such incidents occur?
First and foremost, it is important to inform the affected patients of the nature and extent of the security breach. Patients can take action by putting a credit freeze on their accounts, if they are at risk for identity theft. Offering patients free credit protection might be one way to reduce anger and concern. Passwords must be…
Schultz, D. (2012). As patients' records go digital, theft and hacking problems grow
Kaiser Permanente Health News. Retrieved: http://www.kaiserhealthnews.org/Stories/2012/June/04/electronic-health-records-theft-hacking.aspx
This education program must include all levels of the institution from the highest level of management, physicians, nurses, technicians and support staff. As much as possible, it should also include all outside vendors and casual hires.
Although employee leaks remain the primary source for the loss of proprietary information attacks on information systems by hackers, viruses, worms and the occasional angry employee are becoming an increasingly more serious problem. The actual seriousness of this problem is skewed due to the fact that most institutions do not report such occurrences in order to avoid the negative publicity associated with such breaches.
Security breaches of this nature have traditionally been relegated to the exclusive province of it personnel. It was believed that such personnel were best able to handle such problems and, for the most part, that remains the case but due to the increase in such occurrences collateral damage must now…
3 Health Information Privacy. (n.d.). Retrieved November 29, 2010, from Department of Health and Human Services: http://www.hhs.gov /ocr/privacy
4 Nickels, William, McHugh, James, McHugh, Susan, (2008). Understanding Business, McGraw-Hill
5 Security Research in the Computer Science Department at Carnegie Mellon. (2010). Retrieved November 29, 2010, from Computer Science Department: http://www.csd.cs.cmu.edu/research.areas/security
Merrill, in the UK. Following his experience with heart surgery using innovating surgical techniques, the physician noted the problems he experienced in understanding all of his alternatives compared to a simpler earlier procedure, and finally trusted to the advice of his cardiologist to surgically intervene. In response to the experience, Dr. Merrill emphasized that, "As a physician talking to colleagues, I had the best information possible under the circumstances. But it wasn't the same as my hernia repair. The experience brought home to me the realization that the progress of medicine has made informed consent impossible -- even for me" (Merrill 1999: 190).
ationale of Study
Taken together, the foregoing issues indicate that there is an ongoing need for an assessment of knowledge levels of informed consent among perioperative nurses and operating department practitioners. Perioperative nurses and operating department practitioners, though, are frequently subjected to an enormous amount of stress…
Calloway, S.J. (2009) 'The Effect of Culture on Beliefs Related to Autonomy and Informed
Consent.' Journal of Cultural Diversity 16(2): 68-69.
Cobb, W.G. (2005) 'Defending the Informed Consent Case.' Defense Counsel Journal 72(4):
Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.
Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.
One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and…
Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.
Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328
Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.
Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.
Osteomyelitis in the Diabetic Patient
Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT
Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3
1. Stedman's Medical Dictionary. 27th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2000.
2. Butalia S, Palda V, Sargeant R, Detsky A, Mourad O. Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?. JAMA: Journal of The American Medical Association [serial online]. February 20, 2008; 299(7):806-813. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
3. Lavery L, Peters E, Armstrong D, Wendel C, Murdoch D, Lipsky B. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Research & Clinical Practice [serial online]. March 2009; 83(3):347-352. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
4. Turns M. The diabetic foot: an overview of assessment and complications. British Journal of Nursing [serial online]. August 12, 2011;:S19-S25. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
Equal Protection Clause of 14th Amendment
The equal protection clause of the Fourteenth Amendment extended to protections of the Bill of ights to all Americans, including pregnant women. Therefore, it is fundamentally unconstitutional under the equal protection clause of the Fourteenth Amendment to criminalize pregnant women who take illegal drugs for fetal abuse or neglect without applying the same conditions on pregnant women who endanger their unborn child by drinking alcohol, smoking, or otherwise failing to provide the best possible nurturing environment for the fetus. This paper reviews the relevant peer-reviewed and scholarly literature together with the precedential case law concerning these issues to support this view, followed by a summary of the research and important findings in the conclusion.
eview and Analysis
A growing body of research concerning fetal development together with innovations in modern healthcare technologies have provided researchers with new insights about what can harm or nurture…
Blank, R.H. (2002). Mother and fetus: Changing notions of maternal responsibility. New York:
Flavin, J. (2009). Our bodies, our crimes: The policing of women's reproduction in America.
New York: New York University Press.
Demographic Perception Survey of Patients with Atypical CP Who Present to Cardiac Care Doctors and Patient Outcomes
This study intends to examine gender differences in individuals who present to cardiac doctors with chest pain and specifically, atypical chest pain in women. The work of Debra L. Issac (2000) states that over the past ten years "there has been increasing awareness of both the importance of CAD in women and of the significant differences between men and women who have the disease. Potential gender biases, both within the medical community and within the general population of women themselves also have been identified. These gender differences and biases have the potential to influence investigation and management of suspected or confirmed CAD in women, and should be taken into consideration when faced with a woman with potential cardiovascular disease." (p.157)
Issac also states that chest pain in women is "common and often non-ischemic.…
Cayley, WE (2005) Diagnosing the Case of Chest Pain. American Family Physician. 15 Nob 2005. Retrieved from: http://www.aafp.org/afp/2005/1115/p2012.html
Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. (1):CD001877, 2011.
Issac, DL (2000) Women with Ischemic Heart Disease. Presented at the Canadian Cardiovascular Congress, Vancouver, British Columbia, October 2000. Retrieved from: http://www.stacommunications.com/journals/cme/images/cmepdf/oct01/womencv.pdf
Khan, JJ, Albarran, JW, Lopez, V, and Chair, SY (2010) Gender Differences on Chest Pain Perception associated with Acute Myocardial infarction in Chinese patients: A Questionnaire Survey. J Clin Nurs. 2010 Oct, 19 (19-20)2720-0. Retrieved from: http://www.ncbi.nlm.nih.gov /pubmed/20846222
Protection and Future Changes
It was moderately challenging to find sufficient sources. After receiving the assignment, I performed an initial search. There were only one or two sources from my original search that I ended up using in the final research essay. Research of any kind requires an above average level of persistence and diligence, so in that case, the research effort put forth was not out of the ordinary.
The only way to determine whether a resource will substantiate evidence is to read it. I read through many abstracts and the first few pages of many resources. I read through the tables of contents and the indexes of resources as well. I had to get a quick but in depth sense of the resources' content before choosing to include it in the final research essay. I had to read many resources to get a sense of the context within…
" (South Australia, p. 8)
This demonstrates the balance which is necessary in protecting the rights of the patient and simultaneously ensuring that physicians have the freedom necessary to perform to the best of their abilities. In a respect, this underscores the nature of the strategies used for the protection of patients' rights. The intention is primarily to provide a basic forum for the constructive interaction of patient and physician with legal recourse serving as a failsafe. So is this implied by the LSCSA, which indicates that the demands of existing Patients' Rights standards are designed to make the physician actively accountable to the patient's interests. Therefore, the LSCSA indicates a strategy for preserving the right to consent, reporting that "although the first step usually should be to speak to the doctor or other health care provider who has treated the patient, if any doubts remain, a patient should not…
Legal Services Commission of South Australia (LSCSA). (2010). Patients' Rights. Law Handbook.sa.gov.au.
South Australia (1995). Consent to Medical Treatment and Palliative Care Act 1995. Legislation Revision and Publication Act 2002.
South Australia1 (2009) Mental Health Act 2009. Legislation Revision and Publication Act 2002.
In health care, the protection of confidential patient information is an important key in to addressing critical issues and safeguarding the privacy of the individual. To provide more guidance are federal guidelines such as: the Health Care Insurance Affordability and Accountability Act (HIPPA). On the surface, all facilities are supposed to have procedures in place for discarding these kinds of materials. ("Summary of HIPPA Privacy ule," 2102)
In the case of St. John's Hospital, they have become known for establishing practices of innovation (which go above and beyond traditional safety standards). Yet, at the same time, there are no critical internal controls governing how this information is thrown away. What most executives are concentrating on: is meeting these objectives from an external stakeholder perspective.
This is creating problems inside the facility, as the custodial staff able to go through the garbage and read this information. The reason why,…
Summary of HIPPA Privacy Rule. (2012). HHS. Retrieved from: http://www.hhs.gov /ocr/privacy/hipaa/understanding/summary/index.html
Alguire, P. (2009). The International Medical Graduate's Guide. Philadelphia, PA: ACP Press.
Johnston, A. (2012). State Hospitals become more Transparent. Times Record News. Retrieved from: http://www.timesrecordnews.com/news/2012/jan/13/state-hospitals-become-more-transparent/
Kilipi, H. (2000). Patient's Autonomy. Amsterdam: ISO Press.
Where the hypotheses were well-followed throughout the text, the conclusion ignores the relevance of these factors to the delay experienced by patients in seeking treatment. Instead of developing a correlation between the identified behavior and the subject matter, importance of creating awareness among the general public was the highly emphasized. Furthermore, the responsibility of nurses and government authorities in this regard, was also discussed.
The study itself had a rather limited scope. Selection of convenience sample along with a particular racial background and non-inclusion of patients who died within hours of reporting AMI acted as major drawbacks. Secondly, a selection of considerably small sample also raised questions on the reliability of the sample.
The evaluation of this research does not lead to a confident and reliable conclusion. The limited scope of the sample, controlled questionnaires, neglect of other factors and the comparative analysis instead of individual examination of…
Lesneski, Lisa. (2010). Factors Influencing Tretment Delay for Patients with Acute Myocardial Infarction. Applied Nursing Research. 23, pg- 185-190.
If I found myself in a conversation with a citizen from a country where healthcare is socialized, I would be more than likely to speak with candor by expressing my disapproval for the nature of America's healthcare industry. As the same time, I would connect this to the more general nature of America's economy, political culture and socioeconomic hierarchy. The healthcare industry's monetarily-based exclusivity is consistent with most other aspects of public life in America such as the distribution public services, access to education and infrastructural maintenance. The way that Americans experience all of these things is highly subject to socioeconomic status. That said, I would explain quite simply that this constitutes one of the single greatest flaws in American public governance.
Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports…
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
Gawande, A. (2009). The Cost Conundrum. The New Yorker.
Hussey, P.S.; Vries, H.D.; Romley, J.; Wang, M.C.; Chen, S.S.; Shekelle, P.G. & McGlynn, E.A. (2009). A Systematic Review of Health Care Efficiency Measures. Health Services Research, 44(3), 784-805.
Waldman, J.D.; Kelly, F.; Arora, S. & Smith, H.L. (2010). The Shocking Cost of Turnover in Health Care. Health Care Management Review, 35(3), 206-211.
The modern nurse must then be willing to move beyond a simple catch-all of medical jargon and bureaucracy and become someone who is both supportive and critical of the system. This may seem dichotomous, but in reality is not. The system is designed with beneficence in mind -- to help the patient at all costs. It is thus up to the nurse advocate to ensure that that actually happens (Sheldon, 2009).
Undertake assessments which are sensitive to the needs of the patient- Assessment is one of the key factors in management of clinical medicine. The nurse is often at the forefront of that process simply due to the logistical nature of the situation -- taking vitals, preparing the patient for blood work, etc. However, it is in two particular areas that the nurse can be most effective when assessing the actual needs of the patient; culturally and when questions are…
Edwards, N., et.al. (2003). Aging, Heart Disease, and Its Management. Humana Press.
Lundy, K. And Janes, S. (2003). Essentials of Community-Based Nursing. Sudbury, MA:
Jones and Bartlett.
Miller, C. (2009). Nursing for Wellness in Older Adults. Philadelphia, PA:
Protection desired (Safety Factor)
Importance of Considering the level of Protection
In current decades, the industrial and process businesses have experienced fundamental changes with bringing in new types of safety protection when it comes to things such as electronics and microprocessor-based type of equipment in every feature of the industry. It is clear that these changes have introduced a new, very difficult class of gear with random failure design and a need for refined troubleshooting skills in regards to safety protection. As a result, when it comes to the importance of considering the level of protection desired it is important to develop management strategies in order to make sure that the required levels of plant uptime, cost and industry risk are met at the lowest likely cost.
When it comes to the importance of considering the level of Protection desired one of the first things that need to be addressed…
Charlton, J.A. (2002, April 4). Safer choices for older. Victoria: Monash University Accident Research Centre.
Federal Chamber of Automotive Industries. (2015, May 9). Retrieved from http://www.fcai.com.au/sales.php/2005/12/segmentation.html
Harris, L. (2010, April 7). The forth survey of attitudes of the american people on highway and auto safety. Retrieved from Prepared for the Advocates of Highway and Auto Safety: www.saferoads.org/press/press2001/
Hurnall, J. (2005, May 7). Benefits of consumer crash testing. Retrieved from http://www.officeofroadsafety.wa.gov.au / Facts/papers/benefits_of_consumer_crash_testing.html
Assessment 3: Professional Accountability and Patient Safety
Defining the Issue: Violence from Patients towards Nurses:
In this discussion, I concern myself with ‘violence from patients towards nurses.’ It is important to note, from the onset, that violence meted to nurses by patients is one of the least discussed contemporary nursing issues. In the words of Stevenson, Jack, O’Mara and LeGris (2015, p. 32), “registered nurses (RNs), compared to other healthcare providers are at a higher risk of experiencing violence in the workplace that is initiated by patients and families.” In essence, violence from patients towards nurses includes any act of aggression initiated by the patient and (or) their relatives and friends and directed at the nurse. Acts of aggression in this case could include, but they are not limited to, grabbing, scratching, hitting, and in some cases shouting down the nurse in a threating manner. It is important to note…
Nutritional Approach to Sun Protection by Niva Shapria
This article titled "Nutritional approach to sun protection: A suggested complement to external strategies' by Niva Shapria, is an extensive review of recent research evidence on the efficacy of a simple, natural, dietary model in protecting against harmful UVR exposure and related skin cancers. Through this article, the author clearly points out that a dietary or internal method of sun protection is a very effective complementary approach to preventing skin cancer due to solar radiation for the more susceptible light skinned population living in very sunny regions.
At the outset the author highlights that there is a growing incidence of melanoma around the globe with a significant number of new cases diagnosed among U.S. women. Projections indicate that the rates of melanoma will literally double over the next 2 decades with the increase in UVR exposure due to global warming as well…
1) Niva Shapria, (2010), 'Nutritional Approach to Sun Protection: a suggested complement to external strategies', Nutrition reviews, Vol 68(2) 75-86
Ethical Scenario: Skills as a Nurse Practioner
Nurses and other health care suppliers are the ones that are continuously confronted to make ethical choices in regards to things like life and death matters in giving out care to individuals, communities and families. To be pertinent and ethical, these choices need to be measured in the larger context of personal, societal, cultural and professional values and ethical ideologies. As scientific and medical technology advance, persons and society look at dilemmas and hard ethical choices. Nurses, as part of society and as frontline health care specialists, day-to-day face ethical dilemmas connected to life and death and fairness in health care. With that said, this paper examines the scenario of patient and nurse utilizing ethical principles.
As a nurse, the first thing to do is to understand that an unintended pregnancy further confuses the already confusing physical and mental changes of teens. Adolescents…
Begley A.M., 2. (2008). Truth-telling, honesty and compassion: a virtue-based exploration of a dilemma in practice. International Journal of Nursing Practice, 8, 336-341.
Lawlor, A. (2015, July 29). Morning-after pill poses moral dilemma for some MDs. Retrieved from http://www.consciencelaws.org/background/procedures/birth008.aspx
Marsh, B. (2015, July 29). Nurses' fear for morning-after pill. Retrieved from Daily Mail: http://www.dailymail.co.uk/health/article-179092/Nurses-fear-morning-pill.html
RN, M.S. (2013). The Ethical Component of Nursing Education: Integrating Ethics into Clinical Experiences. LWW; 1 edition.
Huntington's disease (HD) was the first autonomic dominant disorder for which genetic prediction became possible" (Harper, et al., 2000, Journal of Medical Genetics, p. 567). HD is a disease that occurs due to an inherited disorder leading to the death of brain cells. A diagnosis of HD is accomplished through genetic testing which can be implemented at any age regardless of whether the symptoms manifest or not. Although, the specific symptoms vary between people, nevertheless, symptoms can start with people between 35 and 45 years of age and can also start in some individuals at even anearlier age. The disease may affect successive generations if health interventions are not implemented (Mandel, 2016).
Additionally, "the cause of HD is due to a dominant mutation of autosomal form of the gene called Huntington. This shows that a child born by an affected person has a 50% chance of developing or inheriting the…
Causes and risk factors. (2016). Health Communities. Retrieved from http://www. healthcommunities.com/huntingtons-disease/cause.shtml.
Denbo, S. M. (2013, January 1). Balancing the rights of children, parents and the state: The legal, ethical and psychological implications of genetic testing in children. Southern Journal of Business and Ethics, 5, 188-190.
Domaradzki, J. (2015, January 1). Lay constructions of genetic risk. A case-study of the Polish Society of Huntington's Disease. Polish Sociological Review, 189, 107-111.
Draper, B. (2004). Dealing with dementia: A Guide to Alzheimer's Disease and other dementias. Crows Nest, NSW: Allen & Unwin.
Confab, howeve, is an achitectue that is able to bypass these limitations and combine both appoaches. It is limited, though, and a tue pevasive envionment calls fo complex pefeences that can be easily manipulated by the end use.
Moeove, all these appoaches ae not completely sufficient in meeting the challenges mentioned in section 3.2. Fo instance, PETs and pivacy models do not explicitly contibute in a eduction of data collection, no is that thei intent o pupose. Although anonymous data collection is based on the assumption that if data is collected anonymously then it cannot be linked with any individual, and if data cannot be elated to an individual then it poses no theats in tems of pivacy. Thus, detailed pivacy policies and safeguads fo data ae not seen as citical in this model. By collecting anonymous data, one may ague that a tue minimum amount of pesonal data is…
references that can be easily manipulated by the end user.
Moreover, all these approaches are not completely sufficient in meeting the challenges mentioned in section 3.2. For instance, PETs and privacy models do not explicitly contribute in a reduction of data collection, nor is that their intent or purpose. Although anonymous data collection is based on the assumption that if data is collected anonymously then it cannot be linked with any individual, and if data cannot be related to an individual then it poses no threats in terms of privacy. Thus, detailed privacy policies and safeguards for data are not seen as critical in this model. By collecting anonymous data, one may argue that a true minimum amount of personal data is being collected. However, ensuring complete anonymity remains both technically and practically difficult.
For example, mix zones and changing pseudonyms are used to maintain anonymity but it is also possible to break the anonymity and track a user in a mix zone. Pervasive computing, then, needs other, more robust means to minimize the amount of data collection. Moreover, there are usability and efficiency issues that arise with any of these approaches. Testing, for example, is typically done in a controlled environment under limited conditions. The effectiveness of many of these solutions, then, has not been adequately tested under typical, real-world, conditions. In a true pervasive computing environment, users will move extensively between different computing environments and will interact with various devices (e.g. starting from small portable hand held device to large wall sized displays), and applications. It is difficult to predict how privacy solutions will perform in a true user-environment under more typical conditions.
Thus, it will be necessary to find and incorporate a unique privacy model that accentuates both social and legal norms, while ensuring the technical ability to protect privacy.
Newman, a. 2008, Protectors of Privacy: Regulating Personal Data in the Global Economy, Cornell University Press.
Ethics in Healthcare Settings
Thinking as health care practitioners, in your opinion should Mr. Speaker's autonomy as a person had taken precedence over the CDC's desire to enforce public health law? Explain you answer.
It has not been prioritized over the desire of the CDC to implement public health law. There exist other good reasons for valuing the autonomy of patients. Patients that are aware of their condition and have an understanding of the reasons for a course of treatment are more probable of sticking to prescriptions. Even when a doctor ought to communicate information of a depressing prognosis, sincerely notifying the patients provides them with a chance of putting their issues in order, to think of their lives as a whole, and to adopt the spiritual or practical measures, which they may know to be essential. Furthermore, if doctors develop a practice of holding back bad news from patients,…
Struhkamp, R. M. (2005). Patient autonomy: A view from the kitchen. Medicine Health Care and Philosophy. doi:10.1007/s11019-004-1134-2
Traphagan, J. W. (2013). Rethinking autonomy: A critique of principlism in biomedical ethics. Albany: State University of New York Press.
PAKINSON'S & ASAGILINE
One of the drugs that has emerged as promising and at least somewhat effective in the treatment of Parkinson's disease is known as asagiline. This report will explore the neurobiological and psychological implications of the drug as it relates to Parkinson's and in general. The depth and breadth of some of the studies will be discussed as well as how that evidence was found, a general discussion of asagiline and its current/future status as a Parkinson's treatment and how all of the above should be taken with a grain of salt given the limitations that exist. There are some great opportunities for future research when it comes to Parkinson's in general and asagiline in particular.
Parkinson's is a very debilitating and difficult disorder to deal with and treat. Even with the prominence of several major celebrities (e.g. Muhammad Ali, Michael J. Fox, etc.) and increase public…
Badinter, F., Amit, T., Bar-Am, O., Youdim, M. B., & Weinreb, O. (2015). Beneficial behavioral, neurochemical and molecular effects of 1-(R)-aminoindan in aged mice. Neuropharmacology, 99264-272. doi:10.1016/j.neuropharm.2015.05.041
Giladi, N., Tal, J., Azulay, T., Rascol, O., Brooks, D., Melamed, E., & ... Tolosa, E. (2009). Validation of the freezing of gait questionnaire in patients with Parkinson's disease. Movement Disorders, 24(5), 655-661 7p. doi:10.1002/mds.21745
Hanagasi, H., Gurvit, H., Unsalan, P., Horozoglu, H., Tuncer, N., Feyzioglu, A., & Emre, M. (2011). The effects of rasagiline on cognitive deficits in Parkinson's disease patients without dementia: A randomized, double-blind, placebo-controlled, multicenter study. Movement Disorders, 26(10), 1851-1858 8p. doi:10.1002/mds.23738
Naoi, M., Maruyama, W., & Inaba-Hasegawa, K. (2013). Revelation in the neuroprotective functions of rasagiline and selegiline: the induction of distinct genes by different mechanisms. Expert Review Of Neurotherapeutics, 13(6), 671-684. doi:10.1586/ern.13.60
Diagnosis and Assessment in a Clinical Setting
Given the information provided in the subjective portion of the note, the clinician would want to find out if the patient has ever engaged in anal intercourse. If the patient has engaged in such intercourse, the clinician would want to know how many partners she’s had in this regard and when was the last incidence of anal intercourse. The clinician would also want to find out if the patient used protection when engaging this form of intercourse. Getting the total number of partners that this woman has had over the past year might shed some light on the situation as well. Additionally, it might be worth asking if the patient has made an obvious changes in personal hygiene or underwear. For example, the sudden usage of baby wipes in the vaginal or anal area has been found to cause irritation in some cases.…
Swinging the Pendulum: Shifting Views of Justice in Human Subjects esearch" By Ana Mastroianni And Jeffrey Kahn (542-547)
Compare the conception of justice in the Belmont era to the conception of justice in the 1990s? What is the significance of these shifting views of justice?
The conception of justice in the Belmont era pertains to realizing that vulnerable groups, such as prisoners, elderly populations or children, can be exploited by researchers, who do not gain informed consent -- and thus justice was viewed as something that could protect these groups or prevent their exploitation from occurring. An example of exploitation that occurred would be the Tuskegee experiments, where a minority group (blacks) were not told they had syphilis by researchers nor were they told they were part of a study. They were deliberately not treated even when treatment was available because they were the control of the experiment (to see…
Anna Mastroianni & Jeffrey Kahn, Swinging on the Pendulum: Shifting Views of Justice
in Human Subjects Research, HASTINGS CENTER REP., May-June 2001, at 21-28, reprinted in HARV. HEALTH POL'Y REV., Spring 2002, and inHEALTH CARE ETHICS IN CANADA 325-31 (Francoise Baylis et al. eds., 2d ed. Thomson Nelson 2004)
King, P. (1992). The Dangers of Difference. The Hastings Center Report, 22(6): 35-38.
Patient Protection and Affordable Care Act (PPACA)
One of the most significant recent U.S. Supreme Court decisions was the Court's validation of the PPACA's individual mandate, requiring virtually all Americans (with some exceptions) to purchase health insurance. The individual mandate was a critical component of the ability of the Act to function as it was designed by legislators. It was essential that people who were relatively healthy and young were insured to expand the risk pool of the insured given that preexisting conditions were no longer allowed to be grounds for denying people health insurance. This ensured that people would not simply wait until they were sick to seek out insurance. However, it is worth noting that there were numerous exceptions to this provision, including "undocumented immigrants, religious objectors, and people who are incarcerated" and those for whom paying the penalty for being non-insured would cause a financial hardship (Musumeci…
Cole, D. (2012). Obamacare upheld: How and why did Justice Roberts do it. The Nation.
Musumeci, M (2012). A guide to the Supreme Court's Affordable Care Act decision. Kaiser Family Foundation. Focus on Health Reform.
Over 100 law professors agree on Affordable Care Act's constitutionality. (2012).
Patient Protection and Affordable Care Act
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care
Act (PPACA). This is more commonly referred among United States Citizens as Health Care eform.
This revolutionary law offers three main guarantees: First, health insurance for all American's, not just those who can afford it; Second, cost reduction in the insurance premiums for individuals and businesses; Lastly, higher quality care. On the surface, the PPACA seems all around beneficial for all
American's, but there are some aspects that need to be further analyzed. There is no doubt, this law will give those who are uninsured or under-insured, better coverage and ensure better quality health care, but there is one factor that may have been overlooked; the PPACA comes at great financial cost for citizens, will take a decade to fully implement and will be not be sustainable for generations to…
Blumberg, L. (2010, July 6). How Will the PPACA Impact Individual and Small Group
Premiums in the Short- and Long-Term? Retrieved May 5, 2012, from Urban Institute: Health Policy Center: http://www.urban.org/health_policy/url.cfm?ID=412128
FLAHEC. (2007). Health Services Administrative and Clerical Staff . Retrieved May 6, 2012, from Florida Area Health Education Centers: http://www.flahec.org/hlthcareers/HCADMIN.htm
Owcharenko, N. (2005, June 21). A Road Map for Medicaid Reform. Retrieved May 6, 2012, from The Heritage Foundation: http://www.heritage.org/Research/Reports/2005/06/A-Road-Map-for-Medicaid-Reform
Healthcare eform PPACA
Determine how this Federal law will affect market-driven and non-market driven decisions.
One of the industries that has felt the effects of the Patient Protection Affordable Care Act most immediately and intensely was the insurance industry in the United States. One of the chief reasons that the Patient Protection Affordable Care Act was introduced and passed into American legislation was the effect of rising health care costs attributed to arbitrary and non-competitive costs exacted from healthcare consumers from the insurance industry. There was a general lack of regulation within the industry, which had been demonstrated to have had a negative impact on healthcare outcomes and trends. The United States, while the largest economy and a dominant world superpower, has an underperforming healthcare industry compared to other developed, industrialized nations.
One of the central conflicts associated with the Patient Protection Affordable Care Act is related to philosophical differences…
Gitlin, Saul. (2002) "Demystifying the Asian-American Market" Retrieved from: http://www.mrcc-online.com/presentations/Asian_American_Market_11-12-02.pdf
Greenfield, Lazar. (2010). "National Health Care Expenditures: Addressing the Cost of Health Care in the United States" Annals of Surgery. 251: 2.
Weiss, Joshua A., Medical Marketing in the United States: A Prescription for Reform. George Washington Law Review, Vol. 79, p. 260, 2010. Available at SSRN: http://ssrn.com/abstract=1748902
Boston Children's Hospital
This goal of this case is to demonstrate the importance of a community health nursing, or public health nursing strategy. The concepts addressed in the case study include forming strategic partnerships or alliances with related health care institutions, universities, and insurers. Concepts also include the ways non-profit organizations function and how strategic alliances are especially important to maintain. Also, the case study addresses the concept of community health nursing in general. Students should understand this case focuses on the multifaceted roles of the health care organization in the community. Students should also acknowledge the complex interaction between various external forces like economic constraint, legislation, and policy and the functioning of the organization. Students should also understand the complex interaction between internal forces like human resources management and cost accounting on the functioning of the organization. Students should recognize the key success factors for a non-profit health care…
Boston Children's Hospital Website: http://www.childrenshospital.org/
"The Health Care Law and You." Retrieved online: http://www.healthcare .gov/law/
US News and World Report (2013). U.S. News Best Children's Hospitals 2012-13
The topic of this research is "PPACA- Patient Protection an Affordable Care Act." PPACA has created a great impact in the healthcare industry of United States of America. The study is based on the critical analysis of the act by reviewing the performance since its inception.
Arguably the most prominent recent healthcare reform has been PPACA (Patient Protection and Affordable Care Act). PPACA is also known as the Affordable care act and Obamacare. It was signed by the President Obama in the year 2010 in collaboration with the Healthcare econciliation Act. This act is considered to be one of the most major reforms passed in the healthcare system of United States; the last such major reform was passed in the year 1965 in the form of Medicaid.
When this provision Act was passed in 2010, there were 50 million…
Barr, Donald A. Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. JHU Press. 2011
Blendon RJ, Benson."Public opinion at the time of the vote on health care reform." N. Engl. J. Med. 362 (16): e55. 2010
Elmendorf, Douglas. "CBO's Analysis of the Major Health Care Legislation Enacted in March 2010." Congressional Budget Office. 2011
Feldman, Arthur M. Understanding Health Care Reform: Bridging the Gap between Myth and Reality. CRC Press. 2011
Second Opinions for Tough & Smart Care
FLA, FECA, H2457
The federal government (under most current administrations) has tried to address the issue of the nation's need for better healthcare by focusing on improving what is already in place. Two of the regular efforts at this are the FLA (Family Leave Act) and the FECA, or Federal Employees' Compensation Act (DOL, b). The purpose of the first is to provide structured and economically efficient ways for people to be able to leave their positions, without risking their jobs, when they are dealing with either the birth of a child or a critically sick immediate relative. It is also seen as one effort to seek to protect men and women against the problems of gender injustice that can come about if women are challenged in keeping healthcare because of the choice to have children. FECA, on the other hand, seeks to…
DOL.gov. The Family and Medical Leave Act. United States Department of Labor, Wage and Hour Division. Department of Labor. Web < http://www.dol.gov./whd/regs/compliance/1421.htm >.
DOL.gov (b). The Federal Employees' Compensation Act. United States Department of Labor. Web. < http://www.dol.gov/compliance/laws/comp-feca.htm >.
GovTrack.us. H.R. 2457 (111th): Right to a Second Medical Opinion Act of 2009. < http://www.govtrack.us/congress/bills/111/hr2457 >.
R. Kuttner. Market-Based Failure -- A Second Opinion on U.S. Health Care Costs. New England Journal of Medicine, 2008; 358:549-551.
Employer Healthcare Benefit Plans
More than half of the American population is covered by a comprehensive health plan of one type or another. That's approximately 160 million people. The programs that come under the above mentioned coverage include the likes of employer sponsored plans and other government initiatives for instance Medicaid and Medicare, a small proportion of health insurance which is purchased on individual basis may also be included in this. If we proceed to explain employer sponsored health programs, government initiatives and individual healthcare benefits individually, then briefly we can say that the employer benefit plans mostly comprise of group plans and are called "the employee welfare benefit plans"
Table of Contents
The Estimated Effects of PPACA on Coverage
The Number of Uninsured Decreases by 53%
Four Million Children Will Gain Coverage
The Individual Mandate Contributes Most to educing the Number of Uninsured
Manning W. And Marquis S, "Health Insurance: The Tradeoff Between Risk Pooling and Moral Hazard," Journal of Health Economics, Vol. 15, No. 5, October 1996, pp. 609 -- 639.
Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A, and Marquis MS, "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment,"
American Economic Review, Vol. 77, No. 3, June 1987, pp. 251 -- 277.
Pauly MV and Herring BJ, "An Efficient Employer Strategy for Dealing with Adverse Selection in Multiple-Plan Offerings: An MSA Example," Journal of Health Economics, Vol. 19,
As Cuccinelli and Getchell point out that, "The police power is the antithesis of limited, enumerated powers. Given the breadth of that power, it cannot be exercised by the federal government without overwhelming the limitations intended by the Constitution's scheme of enumerated powers" (2011, p. 293).
The argument can be made that the individual mandate provisions of the Patient Protection and Affordable Care Act are for the greater good by making individual consumers accountable for their own healthcare. Even though the purpose of the PPACA may be laudable, the research was consistent in showing that many constitutional scholars believe that the individual mandate oversteps the authority of the U.S. Congress under the Commerce Clause. Although the PPACA is currently the law of the land, it is reasonable to conclude that it will continue to face legal challenges from the attorneys general of the several states due to its individual…
Cuccinelli, K.T. & Getchell, E.D. (2011, Spring). Why the debate over the constitutionality of the federal health care law is about much more than health care. Texas Review of Law & Politics, 15(2), 292-301.
Loyola, M. (2011, Fall). Trojan horse: Federal manipulation of state governments and the Supreme Court's emerging doctrine of federalism. Texas Review of Law & Politics, 16(1),
May, J.R. (2013, Spring). Healthcare, environmental law, and the Supreme Court: An analysis
The success of PPACA, and its provisions for people who are currently or chronically uninsured, will depend on reform of public programs as well as private insurance practices to create "new pathways to coverage (Gulley) and address the problematic link between employment and insurance coverage. In other words, employment should not be the only viable option for securing affordable insurance, nor should there be "significant work disincentives for people with disabilities" (Gulley). The law should help "reduce disparities in [healthcare] access (Gorin, 2010).
A number of provisions of PPACA have already taken effect. Beginning January 1, the law provided for a 50% discount on covered brand-name drugs. This provision was designed to close the coverage gap in Medicare Part D coverage, the so-called "Donut Hole." There is a 7% discount on generic drugs. The coverage gap will be completely eradicated by 2020, according to PPACA, making it even easier for…
Cobb, K., & Davis, C. (2007). The faces of the uninsured: One in four Texans has no medical coverage, posing dire physical risks for them and consequences for the state. Houston Chronicle 4/15/07.
Doheny, K. (1999). Filling a Health-Coverage Gap. WebMD. Retrieved from http://www.webmd.com/a-to-z-guides/features/filling-health-coverage-gap
Gorin, S.H., Gehlert, S.J., & Washington, T.A. (2010). Health care reform and health disparities: Implications for social workers. Health & Social Work 35(4), pp. 243-247.
Gulley, S.P., Rasch, E.K., Chan, L. (2011). Ongoing coverage for ongoing care: Access,
Individual Mandate in PPACA
On March 23, 2010 the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. Along with the Health Care Reconciliation Act of 2010, the PPACA became part of the overall Health Care Reform concept of 2010; a reform process that was promoted as a way to completely transform the health care industry and ensure that there is "more openness to the insurance marketplace…." ("Healthcare.gov") hile supporters praise the legislation as a revolutionary law which will benefit ordinary Americans, critics claim that the Obama Administration used the health care reform process as a means of gaining control over the entire health care system. In order to provide the necessary funding for this reform process, the PPACA contains a requirement that all American citizens either join a healthcare program, or pay a penalty. This has been identified as not only constitutional, but…
"PPACA: Detailed Summary." Responsible Reform for the Middle Class. Web. 25
Oct. 2012. http://dpc.senate.gov/healthreformbill/healthbill04.pdf
"PPACA: Executive Summary of the Government Expansions, Vast New Taxes,
Damaging Medicare Cuts, and Increased Health Costs and Premium."
Affordable Care Act
A current law that impacts the delivery of human services is the Patient Protection and Affordable Care Act, signed into law by President Barack Obama in March 2010. The legislation (most commonly known as the Affordable Care Act but also referred to as "Obamacare") basically overhauls the existing healthcare statutes and is aimed specifically at reducing the number of Americans who are not covered by health insurance.
Reliable Sources Available to Cover the Law's Implications
There are multiple reliable sources from which to gather information about this major change in the way the healthcare services are available in the United States. The law's implications are spelled out very clearly by the federal website www.ncbi.nlm.nih.gov (National Center for Biotechnology Information / National Library of Medicine / National Institutes of Health) (Rosenbaum, 2011).
The Act "…establishes the basic legal protections" that up until now have not be available to…
Department of Health and Human Services. (2012). Civil Rights -- Laws and Regulations
Enforced by Office of Civil Rights. Retrieved February 9, 2013, from http://www.hhs.gov .
Frank, John. (2013). Sen. Phil Berger spreading bad healthcare information, policy experts say.
Charlotte Observer. Retrieved February 9, 2013, from http://www.charlotteobserver.com.
Health Care eform:
In March 2010, after protracted public and political debate, the Patient Protection and Affordable Care Act (PPACA) was enacted into law by President Barack Obama. This legislation was one of the many health care reforms initiatives that have sought to rectify major features of the health care system in the United States such as service delivery, care coordination, and financing. Since its enactment, PPACA is considered as a milestone along the historical continuum of health care reform in America. Generally, health care reform in the United States is an issue that has continued to evolve based on the ever-growing health care needs of the population. However, this issue has been characterized with several challenges that are mainly influenced by the public's response to reform efforts.
Principal Features of U.S. Health Care System:
The Patient Protection and Affordable Care Act (PPACA), which is commonly known as the Affordable…
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: a clinical approach (6th ed.). New York, NY: McGraw-Hill Medical.
"Key Features of the Affordable Care Act by Year." (n.d.). Features of the Health Law.
Retrieved from U.S. Department of Health & Human Services website: http://www.hhs.gov /healthcare/facts/timeline/timeline-text.html
Leflar, R.B. (2013, July 12). Reform of the United States Health Care System: An Overview.
"What is the role of Congress in policy making process"?
Policy is a plan to identify goal or possible course of actions with administrative or management tools to accomplish these goals. n the other hand, policy is the authoritative decision made by the U.S. executive, legislative, judicial branch of government to influence the decision of others. Government is a key player in decision-making process and congress plays important roles in decision-making . In the United States, both House of Representatives and House of Senate fulfill the congressional policy responsibilities, and congress plays important role in health policy, which includes obesity prevention measures or health insurance program. Congress is an important arm of government that makes law. Important strategy that congress uses to make policy preference is by passing a bill into law. Typically, the congress could make a decision to pass or not to the policy of the…
Oregon Department of Human Services.(2008). The impact of federal policy on Oregon's health care reform efforts: Opportunities and barriers within Medicaid and the State Children's Health Insurance Program. Medical Assistance Programs.
Waller, M. (2005).Block Grants: Flexibility vs. Stability in Social Services. Brookings Institution Policy Brief.
Zuckert, M.P. (2002). Launching Liberalism: On Lockean Political Philosophy. Lawrence: University Press of Kansas.
The final legislation should have incorporated provisions to boost the IVD industry. On its entirety, the Patient Protection and Affordable Care Act must have benefited the IVD industry. This would have increased sales in a span of five years that it is otherwise seen in the absence of the law. Most significant IVD sales drivers will result from the legislation as an expansion of in the number of insured citizens and new coverage of prevention and wellness programs. If various key provisions are included in the PPACA, coupled with the population demographics, IVD product sales will be stimulated. This industry will die or live based on the number of the test procedures and hence increase in the number of persons with healthcare coverage will be appropriate for IVD. The Patient Protection and Affordable Care Act is a sophisticated legislature, virtually affecting all aspects of healthcare and the majority…
Law, J. (2009). Big pharma: How the world's biggest drug companies control illness. London: Constable.
Parks, D. (2012). Health care reform simplified: What professionals in medicine, government, insurance, and business need to know. United States: Apress.
Ross, B.M.C., & Ross, B.M.C. (2013). Beating Obamacare: Your handbook for surviving the new health care law. Washington, D.C: Regnery Pub.
Schweitzer, S.O. (2007). Pharmaceutical economics and policy. New York [u.a.: Oxford Univ. Press.
Internal & External Forces
The author of this report is asked to answer to a number of questions relating to the forces that exert themselves on a nursing or other medical organization, the source of the forces and what effect they can have on outcomes and decision-making in a medical organization. There will be total major internal forces, two major external sources and an overall assessment of the impacts these forces can and will have on things like strategic decisions, financial solvency and so on. While most external and internal forces are not terribly impactful on future outcomes and decisions relating to medical organizations, there are some major ones like the recent Affordable Care Act and recessions that can have a major and/or detrimental impact on the organization's outcomes and its people.
As suggested by the parameters of the assignment, one major external force relating to medical care and…
Abelson, R. (2011, November 16). The Smoker's Surcharge. The New York Times. Retrieved May 5, 2014, from http://www.nytimes.com/2011/11/17/health/policy/smokers-penalized-with-health-insurance-premiums.html?pagewanted=all&_r=0
Britt, R. (2014, May 5). Obamacare brings down uninsured rate to 13.4%, Gallup poll contends. Health Exchange RSS. Retrieved May 5, 2014, from http://blogs.marketwatch.com/health-exchange/2014/05/05/obamacare-brings-down-uninsured-rate-to-13-4-gallup-poll-contends/
Healthcare.gov. (2014, May 4). Health care law rights and protections; 10 benefits for you. HealthCare.gov. Retrieved May 4, 2014, from https://www.healthcare.gov/how-does-the-health-care-law-protect-me/
Healthcare Delivery System Challenges
The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…
Stolberg, S.G. & Pear, R. (March 24, 2010). Obama signs health care overhaul bill, with a flourish. The New York Times: p. A19. Retrieved March 1, 2013.
Woolhandler, S. & Himmelstein, D.U. (1997). Costs of care and administration at for-profit and other hospitals in the United States. The New England Journal of Medicine 336 (11): 769-774.
Swanson, E. (July 30, 2009). Health Care Plan: Favor / Oppose. Huffington Post.
Blumberg, L.J. & Holahan, J. (2009). The Individual Mandate: an Affordable and Fair Approach
Write about the culture and diversity. Describe the population/individuals in the VA hospital work environment. efer to at least four of the characteristics (such as cultural imposition, economically, cultural awareness, ethnocentric and acculturation). Then, discuss which ones have the most potential for conflict and why?
The VA serves veterans from various backgrounds. The most notable include: Caucasians, African-Americans, Asians, Latinos and American Indians. The four characteristics that will have an impact on the VA include: economically, cultural awareness, ethnocentric and cultural imposition. ("VA Mental Health," 2011)
Economically, the VA is facing challenges with the total number of patients increasing to 2.06 million last year. This is adding to their case loads and overwhelming the resources of many facilities. In the future, this can create conflict with veterans not receiving the quality of care they deserve. Cultural awareness is understanding, the needs of various demographics of patients and what…
VA Mental Health. (2011). GAO. Retrieved from: http://www.gao.gov/new.items/d1212.pdf
Farrell, C. (2008). The Abortion Debate. Edina, MN: ABDO.
Tate, N. (2012). Obama Care Survival Guide. West Palm Beach, FL: Huxman.
Medical Home Model and Health Disparity
Nursing esearch Proposal
The Impact of the Medical Home Model on Health Disparities
The Impact of the Medical Home Model on Healthcare Disparity
Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).
As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve…
AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home .
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf .
NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx .
Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.
In the recent years, trends have emerged in the healthcare management industry, which includes patient protection, social media in healthcare, and drug shortages. Patient protection has largely been influenced by laws and policies in different nations. In the United States, the enactment of the Patient Protection and Affordable Care Act (PPACA) has resulted in the lowering of overall healthcare costs, whereby millions of individuals have access to insurance, thereby guaranteeing free preventative care. Social media in healthcare has stemmed from the increased use and adoption of the technology for health-related reasons by patients as well as healthcare practitioners. Moreover, drug shortages have emerged as a challenge that hospital pharmacists encounter and manage in different measures on a daily basis. The paper explores the trends in the three aspects as they relate to the healthcare management industry. Furthermore, it focuses on drug shortages as the topmost priority.
Social Media in Healthcare…
Ethics to Practice: Analysis of 'end of life' decision making
The foregoing discussion is an incursion into nursing ethics. Implication(s) to 'omission' of information as a customary practice within our healthcare institution is reviewed in relation to best practices pertaining to 'informed consent,' and hospital policy is not definitive. Directed at the evolution of ethical decision making, the general query to the study focuses on the parameters of informed consent where individual practice is concerned.
In the nation of Canada where I am a nurse the number of situations where patient informed consent decisions might be subject to our national code of nursing ethics is many. e face critical ethical dilemmas every day, as emergency procedures and critical care interventions are standard practice. Complexity in decision making is furthered in the conduct and approaches made by international colleagues on contract in our institution by way of exchange.
The primacy of…
Bullough, B. ed. The Law and the expanding nursing role. New York, NY: Appleton-Century-Crofts, 1980.
Callahan, Joan, ed. Ethical Issues in Profesional Life. Oxford: Oxford University Press, 1988.
Canadian Medical Protection Association (CMPA), 2010. Web.
Finlay and Fernandez. Failure to report and provide commentary on research ethics board approval and informed consent in medical journals is discussed Journal of Medical Ethics, 34.10 (2008), 761-764. doi:10.1136/jme.2007.023325.
Restraining the Elderly
The Project Management path for this research proposal will follow the path of quantitative research in a 'quasi-experimental' environment. Adhering as closely as possible to quantitative experiments designed to establish the causal factors or interdependent links between grouped variables, the researcher will follow a natural course of progression in administering dependent and independent variables, designing the sampling set, determining the optimal time(s) and location(s) for conducting the research, developing the measures and instruments necessary for evaluation of non-empirical evidentiary conclusion (i.e., the thought processes and reasoning of medical staff), measuring the response to education and procedural methodology, documentation to include evaluation materials, response forms, and restraint logs, preparing the education program, delivering the lectures, and evaluating the results in change or lack of change in care providers attitudes toward patient restraint.
Any project that measures the process of learning, comprehension, acceptance or denial,…
Course competencies: APNs
The role and scope of practice of the advanced practice nurse (APN) in every field and sphere of healthcare has expanded in recent decades. There is "growing recognition that educational preparation must be adequate to meet the expectations that will be placed on the practitioner, coupled with increased regulatory oversight by state boards of nursing…Mandated education at the master's level is now the expected norm for advanced practice nursing" (Hanson & Harnric 2003: 203). With the increased professionalization of the role there has also been increased specialization, "specialties such as psychiatry and oncology leading the development of a cadre of master's-prepared APNs who moved the specialty forward. Current calls for master's level preparation in the specialty of wound/ostomy/continence nursing indicate that this specialty is moving into the third phase" (Hanson & Harnric 2003: 204). Other specialties once subsumed in the APN role have branched off…
Hanson, C. & Hamric, A.B. (2003) Reflections on the continuing evolution of advanced practice nursing. Nursing Outlook, 51:203-211. Retrieved from:
Patient Protection and Affordable Care Act; Program Integrity. (2013). ANA. Retrieved:
Effects on Current Position
With "The Patient Protection and Affordable Care Act," many healthcare professionals are affected (Democratic Policy Committee, n.d.). Nationwide, hospitals are scrambling to buy hospitals in an effort to control costs. Doctors are leaving small private practices. Large insurance companies are becoming more dominant as smaller ones disappear because they cannot stay competitive (New York Times, 2011). Furthermore, epublicans denounced the law as an intrusion by the government that would prompt employers to eliminate jobs, create an unsustainable entitlement program, saddle states and the federal government with unmanageable costs, and interfere with the doctor-patient relationship. As a result, the law would exacerbate the steep rise in the cost of medical services, thus affecting the elimination of many healthcare positions. Ironically, less healthcare professionals will ensue, but an increase in patient care will be needed, as a result in more people becoming insured.
Challenges & Opportunities
Democratic Policy Committee. (n.d.). The patient protection and affordable care act. Retrieved from http://dpc.senate.gov/healthreformbill/healthbill04.pdf
The New York Times. (21 Dec 2011). Healthcare reform. Retrieved from http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html