Discussion Week 3: Initial Post 

As registered nurses, our job is to provide holistic, patient-centered care, which is often accompanied by long hours and extremely challenging patient situations. On top of this, we must maintain a balance between competing needs and limited resources. Kelly and Porr note that in recent decades, many hospitals have switched from a treat-heal-care model to a more corporate business prototype that focuses on efficiency and profit, rather than patient outcomes (2018). With this model, it seems that more resources and staff are geared towards areas of the hospital that will profit the hospitals. At CoxHealth, the hospital revenue primarily comes from surgeries and primary care clinics (Haefner, 2018). Both Medicare and private insurers tend to pay more for such procedures and preventative care (Abelson, 2020). 

With this model, there are fewer incentives to provide high-quality, affordable, and convenient healthcare to individuals who do not have private insurance or are uninsured. For example, CoxHealth refers patients who do not have insurance to their Family Medical Care Center (FMCC), which is primarily run by resident physicians. As these resident physicians have recently graduated medical school, they are still learning, and sometimes do not always provide the highest quality of medical care. They also lack resources and staff that the family practice clinics only serving private and Medicare-insured individuals have access to. This creates an ethical dilemma as these patients still deserve high-quality patient-centered care even though they may lack financial resources. 

For this reason, there are policies in place to protect this vulnerable patient population and address these competing needs. Individuals who do not have health insurance are primarily in a lower socioeconomic class, which is linked to poor health outcomes and increases the risk of behavioral health issues and substance abuse (Pampe et al., 2010).  CoxHealth partners with Jordan Valley and Burrell Behavioral Health, which are community health centers that aim to serve uninsured individuals by offering high-quality, patient-centered care. According to the Springfield Business Journal, Jordan Valley Community Health Center obtained a federal government-issued grant of $2 million to improve access, resources, and adequate staffing needs to care for uninsured individuals seeking primary care. Also, Burrell Behavioral Center received $4 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) to expand access to mental health and substance abuse treatment for uninsured individuals living in southwest Missouri (2020). 

It is clear that lower socioeconomic classes may not always receive the highest quality care from hospitals biased towards allocating resources to the areas that create high-profit margins. As nursing leaders, we must balance the organization’s needs and ensure quality, effective, and safe patient care.  

References

Abelson, R. (2020). Hospitals Struggle to Restart Lucrative Elective Care After Coronavirus

Shutdowns. Retrieved September 12, 2020, from https://www.nytimes.com/2020/05/09/health/hospitals-coronavirus-reopening.html

Burrell Behavioral Health. (2020). Burrell Behavioral Health awarded $4 million CCBHC

Expansion Grant. Retrieved September 12, 2020, from https://www.burrellcenter.com/media/burrell-behavioral-health-awarded-4-million-ccbhc-expansion-grant/

Haefner, M. (2018). CoxHealth’s net income falls 40% in FY18: Springfield, Mo.-based

CoxHealth saw its net income fall in the fiscal year ended Sept. 30, 2018, according to recent financial documents. Retrieved September 12, 2020, from https://www.beckershospitalreview.com/finance/coxhealth-net-income-falls-40-in-fy18.html

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to

enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. Doi:10.3912/OJIN.Vol23No01Man06. Retrieved September 12, 2020 from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert

clinician to influential leader (2nd ed.). New York, NY: Springer. 

Pampel, F., Krueger, P., & Denney, J. (2010). Socioeconomic disparities in health

behaviors. Retrieved September 12, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169799/

Springfield Business Journal. (2020). Federal government issues $2M grant to Jordan Valley.

Retrieved September 12, 2020, from https://sbj.net/stories/federal-government-issues-2m-grant-to-jordan-valley,68434

Create a professional evidence based poster about about nursing and hospital Strategies to prevent VAP (Ventilator-associated Pneumonia ).  Be sure to include the significance of each strategy.  include recent references.  Allow space to add name on poster. Send me printable version of poster.

 Assignment 1.1   Health and disease concepts Instructions 

• Write a paper in APA style – 3 pages – cover and reference pages not included. Defining the concepts of health and disease using references from different authors.
• Add examples of preventive health programs, representing the different levels of prevention, explain their application today.
• Use the APA style and send it via Blackboard for evaluation. Your essay must use at least three bibliographic references. Avoid plagiarism by submitting your work to Safeassign.

complete the document attached below 

This is a discussion post that I will need completed by tomorrow 09/25/2020 at 5:00 pm EST. Please see attached word document with instructions and attached grading rubric. Must follow requested references and grading rubric accurately.

Read the instructions on the word document and answer the assignment. 

Assignment: Assessing a Healthcare Program/Policy Evaluation

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

• Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
• Select an existing healthcare program or policy evaluation or choose one of interest to you.
• Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

• Describe the healthcare program or policy outcomes.
• How was the success of the program or policy measured?
• How many people were reached by the program or policy selected?
• How much of an impact was realized with the program or policy selected?
• At what point in program implementation was the program or policy evaluation conducted?
• What data was used to conduct the program or policy evaluation?
• What specific information on unintended consequences was identified?
• What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
• Did the program or policy meet the original intent and objectives? Why or why not?
• Would you recommend implementing this program or policy in your place of work? Why or why not?
• Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

By Day 7 of Week 10

Submit your completed healthcare program/policy evaluation analysis.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
• Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
• Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

You have a total of three assignments. You will need to answer the assignment questions with 1-2 paragraphs. Instructions are attached bellow. APA format

Change. See attached

Select a research article (peer-reviewed) that pertains to Oregon’s Death with Dignity Act. In a 2-page paper provide a synopsis of an article that pertains to any of the five states in the U.S. where physician- assisted suicide is legal: Oregon, Washington,Vermont, California, or Montana, and provide an argument for or against the law. Your critique is in relation to the law itself (was it followed as written). APA format wirh Headings are required. Please include the research article.