Review the IOM and Kaiser Commission Report on the uninsured to develop the case report
DNP 825 Week 6 Nursing Case Report
DNP 825 Week 6 Nursing Case Report
Case Report: Application of Public Health Concepts for the Uninsured
Details:
In this assignment, learners are required to write a case report addressing the personal knowledge and skills gained in this course and potentially solving an identified practice problem.
DNP 825 Week 6 Nursing Case Report General Guidelines:
Use the following information to ensure successful completion of the assignment:
- This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
- Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
- This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
- You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
DNP 825 Week 6 Nursing Case Report Directions:
Construct a 2,500-3,000 word (approximately 10-12 pages) case report that includes a problem or situation consistent with a DNP area of practice.
- Review the IOM and Kaiser Commission Report on the uninsured to develop the case report.
- Apply public health concepts to describe understanding of the problem or situation of focus.
- Apply one or more public health concepts to the recommended intervention or solution being proposed.
- Develop the case report across the entire scenario from the identification of the clinical or health care problem through the proposal for an intervention, implementation, and evaluation using an appropriate research instrument.
- Describe the evaluation of the selected research instrument in the case report.
- Lastly, explain in full the tenets, rationale for selection (empirical evidence), and clear application using the language of public health concepts within the case report.
DNP 825 Week 6 Nursing Case Report Requirements:
In addition, your case report must include the following:
- Introduction with a problem statement.
- Brief literature review.
- Description of the case/situation/conditions explained from a theoretical perspective.
- Discussion that includes a detailed explanation of the synthesized literature findings.
- Summary of the case.
- Proposed solutions to remedy gaps, inefficiencies, or other issues from a theoretical approach.
- Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated.
- Conclusion.
Portfolio Practice Hours:
Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement that reminds you, the learner, to enter a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.
You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network.
To earn portfolio practice hours, enter the following after the references section of your paper:
Practice Hours Completion Statement DNP-825
I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.
Case Report Rubric: Application of Public Health Concepts for the Uninsured
1
Unsatisfactory
0.00% 2
Less than Satisfactory
74.00% 3
Satisfactory
79.00% 4
Good
87.00% 5
Excellent
100.00%
70.0 %Content
5.0 %Introduction and Problem Statement An introduction with problem statement is not present. An introduction with problem statement is present but incomplete. An introduction with problem statement is present but rendered at a perfunctory level. DNP 825 Week 6 Nursing Case Report An introduction with problem statement is present, clear, and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. An introduction with problem statement is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Brief Literature Review A brief literature review is not present. A brief literature review is present but incomplete. A brief literature review is present but rendered at a perfunctory level. A brief literature review is clearly present in full. Information presented is from scholarly though dated sources. A brief literature review is clearly present in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
10.0 %Description of the Case, Situation, or Conditions Explained from a Theoretical Perspective A description of the case, situation, or conditions from a theoretical perspective is not present. DNP 825 Week 6 Nursing Case Report A description of the case, situation, or conditions from a theoretical perspective is present but incomplete. A description of the case, situation, or conditions from a theoretical perspective is present but rendered at a perfunctory level. A description of the case, situation, or conditions from a theoretical perspective is convincing and defines specific elements. Information presented is from scholarly though dated sources. A description of the case, situation, or conditions from a theoretical perspective is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
10.0 %Discussion Includes a Detailed Explanation of the Synthesized Literature Findings A detailed explanation of the synthesized literature findings is not present. A detailed explanation of the synthesized literature findings is present but incomplete. A detailed explanation of the synthesized literature findings is present but incomplete. DNP 825 Week 6 Nursing Case Report A detailed explanation of the synthesized literature findings is convincing and defines specific elements. Information presented is from scholarly though dated sources. A detailed explanation of the synthesized literature findings is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
10.0 %Case Summary A case summary is not present. DNP 825 Week 6 Nursing Case Report A case summary is present but incomplete. A case summary is present but rendered at a perfunctory level. A case summary is convincing and defines specific elements. Information presented is from scholarly though dated sources. A case summary is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
10.0 %Proposed Solutions to Remedy Identified Gaps, Inefficiencies, or Other Issues from a Theoretical Approach Proposed solutions from a theoretical approach are not presented. Proposed solutions from a theoretical approach are presented but are incomplete. Proposed solutions from a theoretical approach are presented but are rendered at a perfunctory level. DNP 825 Week 6 Nursing Case Report Proposed solutions from a theoretical approach are clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. Proposed solutions from a theoretical approach are clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.
10.0 %Identification of a Research Instrument to Evaluate the Proposed Solution along with a Description of how the Instrument could be Evaluated Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated is not present. Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated is presented but is incomplete. Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated is presented but is rendered at a perfunctory level. Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated is clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. Identification of a research instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated is clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.
10.0 %Conclusion A conclusion is not presented. A conclusion is presented but is incomplete. A conclusion is presented but is rendered at a perfunctory level. A conclusion is clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. A conclusion is clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.
20.0 %Organization and Effectiveness DNP 825 Week 6 Nursing Case Report
7.0 %Thesis Development and Purpose Paper lacks any discernible overall purpose or organizing claim. Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear. Thesis and/or main claim are apparent and appropriate to purpose. Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.
8.0 %Argument Logic and Construction Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present. Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English. DNP 825 Week 6 Nursing Case Report
10.0 %Format
5.0 %Paper Format (Use of appropriate style for the major and assignment) Template is not used appropriately or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct.
5.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style) No reference page is included. No citations are used. DNP 825 Week 6 Nursing Case Report Reference page is present. Citations are inconsistently used. Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present. Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct. In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.
100 %Total Weightage
Review the IOM and Kaiser Commission Report on the uninsured to develop the case report
Introduction
The uninsured rate in the United States has increased to nearly 20 percent. While some of this increase is due to an aging population and increased longevity, it’s also clear that many Americans are not getting the preventive care they need because they cannot afford it. This situation puts them at risk for chronic diseases like heart disease and stroke that result from high blood pressure or diabetes.
Background of uninsured
The uninsured are a diverse group of people. They may not be poor, young or healthy but they do tend to have lower incomes and fewer health care needs than other Americans. The uninsured also tend to have less education than those with insurance coverage.
Describe the uninsured and what they report in terms of access to health care
The uninsured are a diverse group of people, who come from all walks of life. They include individuals who have never had insurance and those who were previously insured but lost their coverage due to job loss or other reasons. The uninsured may also be low-income individuals who qualify for Medicaid but choose not to enroll in the program because they do not want public assistance (the Kaiser Commission).
The Kaiser Commission notes that the uninsured are not necessarily limited access to health care; some may simply choose not go see doctors or hospitals if they think they won’t get treatment there. However, many people with chronic diseases such as diabetes or cancer do visit primary care providers regularly because these conditions require regular monitoring and management by medical professionals—especially when patients become symptomatic (IOM).
The likely impacts on public health of having so many uninsured persons
The report is up-to-date, but it does not go into enough detail about the likely impacts on public health.
The Kaiser Commission report [PDF] makes some recommendations for reducing the number of uninsured Americans:
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Increase eligibility for Medicaid and CHIP.
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Expand tax credits to help pay for insurance premiums and out-of-pocket costs (such as deductibles). This would likely benefit low-income people who don’t qualify for Medicaid or CHIP but nevertheless face high out-of-pocket expenses.
Solutions to reduce the number of uninsured through changes in federal policy and programs
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Increase the number of people eligible for Medicaid
The report recommends that states increase eligibility standards so that more individuals are covered by Medicaid, including those with low incomes, pregnant women and children. To do this effectively, states should increase enrollment in their Medicaid programs at a faster rate than they currently do. They should also consider ways to expand coverage beyond the traditional group of low-income adults who are ineligible under current rules because their income exceeds 133 percent of poverty level (about $16,000 per year for an individual or $32,000 per year for a family of four). The report notes that some states have already made significant strides toward this goal; for example:
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Arkansas expanded its program until it reached 138% FPL in 2015; Washington state has increased its Medicaid eligibility limit from 100% FPL up through 138% FPL since 2014; New York City increased its standard eligibility tier from 80% FPL up through 150% FPL since 2012.*
Solutions at the state level to reduce the number of uninsured.
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Increase the number of people who have insurance through Medicaid, SCHIP and other programs.
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Use state funds to provide health care to uninsured people.
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Provide subsidies to small businesses that provide coverage to their employees.
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Encourage employers to offer coverage to their employees
Conclusion
The IOM and Kaiser Commission report is a very important resource for understanding the challenges of providing health care to a large and uninsured population. Its findings are consistent with the literature on the uninsured and suggest that reducing the number of uninsured will have substantial public health benefits. The report also highlights several challenges that states face in addressing these issues, including gaps in federal funding for community-based programs or lack thereof at all levels of government. Although efforts to reduce poverty may be ineffective if not combined with strategies aimed at improving access to health care or expanding insurance coverage among low-income Americans, it appears that this would be an effective way forward if all parties work together towards a common goal.
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