Much of the current debate in the U.S. and individual state governments centers on the inclusion and expansion of health insurance coverage for all Americans under the Patient Protection and Affordable Health Care
DQ1 Much of the current debate in the U.S. and individual state governments centers on the inclusion and expansion of health insurance coverage for all Americans under the Patient Protection and Affordable Health Care Act of 2010 (ACA). In addition, the scope of the uninsured and the underinsured population in the U.S. is great relative to other countries.
Describe the purpose and importance of the Medicare and Medicaid programs. Support your stance (position) by describing how you agree with or disagree with the purpose and intent of these plans. Provide evidence for your stance (position).
Answer the following question: Will having universal health insurance coverage for all citizens in the U.S. substantially change the health status of individuals and populations? If yes, how so. If no, why not. Support and provide evidence for your discussion.
DQ2 One of the critical issues facing health reform is dealing with escalating costs of healthcare, which drives up premiums, co-pays, and the amount of out-of-pocket costs.
Describe two or more ideas on controlling health costs and at what level (insurance companies, healthcare organizations, general public/community).
Explain how these ideas would not impact quality and safety.
BSN410 Healthcare Delivery and Quality Outcomes
Module 2 Discussion
Landmark studies To Err is Human (1999) and Crossing the Quality Chasm (2001) from the Institute of Medicine (IOM) identified medical errors are causing harm and death to almost 45,000 Americans and costing over $29 billion every year. Other studies, have indicated preventable healthcare associated conditions (HACs) such as infections, sepsis, and pneumonia are main contributors for increasing the length of patient stays, the cost of care, and the likelihood of mortality (death).
Consider the below case study:
Margret Spinner-Ramirez is a 66yr is a Hispanic-American. She speaks both Spanish and English fluently. She was scratched by a stray cat that she feeds on her back porch daily. She went into her local ER two days after the incident for pain, and swelling in her left lower leg where she was scratched by the stray cat. Ms. Spinner-Ramirez also complained of difficulty with baring weight on that extremity. Vital signs stable, and Ms. Spinner-Ramirez was sent home on oral Keflex for her skin infection. Five days later Ms. Spinner-Ramirez was taken back to the same ER via ambulance. She was lethargic and had difficulty being able to move. Cat scan and blood work revealed that Ms. Spinner-Ramirez’s knee replacement in her left leg was infected secondary to the cat scratch. Ms. Spinner-Ramirez was admitted for sepsis. She needed to have her old knee replacement removed, six weeks of IV antibiotics, new knee replacement placed, and rehab.
If you were in charge of a healthcare insurance company:
Explain why insurance companies (which are considered payers) should or should not pay (reimburse) for injuries, extended costs, readmissions, or death (mortality) from a hospital-acquired infection or medical error. Support your why or why not?
Describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.
Discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursements (payments) for services/care.
BSN410 Healthcare Delivery and Quality Outcomes
Module 3 Discussion
After reviewing the websites and completing the readings for this week, locate and read the Healthy People 2010 goals and the process that has been started to develop the Healthy People 2020 goals.
Describe the Healthy People 2010/2020 process.
Discuss the purpose for the development of the national health plan (Healthy People) for U.S. citizens. Explain how your local health department, community, or your employer is helping to achieve one of the Healthy People goals.
Discuss at least one other country which has a national health plan for their citizens and explain how the plan is similar and different from the U.S. plan.
BSN410 Healthcare Delivery and Quality Outcomes
Module 4 Discussion
DQ1 Start by selecting one of the eight Millennium Developmental Goals (MDGs) from the World Health Organization (WHO). After choosing one of the MDGs, explore a specific outcome measurement (indicator) for a country of your choosing to determine the progress towards achieving the MDG. In addition, you will explore nursing roles that would be helpful in achieving the MDG.
Choose one ranked country from the list below not chosen by another student. For this discussion you will need to check the discussion board before posting so that the country you choose has not already been chosen by someone else.
Start a new thread with the name of your country in subject line so that we all can quickly see the country you have chosen. This will not count as one of your postings/responses; it is informational posting only.
DQ2 From your discussion and your chosen country from question one, discuss each of the following indicators.
Please do not post a table or figure to answer this question. Discuss your findings.
Average life expectancy
Cause-specific mortality
Neonatal (infant) mortality rate
Maternal mortality rate
Morbidity-diseases with greatest prevalence
Then answer:
If you were in charge of a mission trip to your country and were asked to choose one of the below indicators as an area to provide free nursing care services, which indicator would you choose to focus your nursing care to help reduce? Explain why?
Average life expectancy
Cause-specific mortality
Neonatal (infant) mortality rate
Maternal mortality rate
Morbidity-diseases with greatest prevalence.
BSN410 Healthcare Delivery and Quality Outcomes
Module 5 Discussion
After watching the Sick Around the World video (found in the required readings for this module), you have been assigned the task of creating an universal healthcare system design for your population/citizens, how would you answer the following:
Describe what type of model you would choose to design your system and explain rationale (why).
Explain how your system you have created would cover two underserved population groups such as an ethnic or cultural minority, women, children, elderly, or disabled.
Choose one country that has a universal healthcare model (from the list of models in the assignment overview or from the Sick Around the World video) and describe how it works. Discuss one positive and one negative.
BSN410 Healthcare Delivery and Quality Outcomes
Module 6 Discussion
DQ1 Describe two nurse sensitive indicators.
Discuss what these specific indicators tell us about bedside nursing practice.
Explain how nurses should be accountable for their patients’ health outcomes.
DQ2 The Leapfrog Group was one of the first groups to offer hospital ratings and demand transparency so that companies and individuals could choose quality care facilities.
Describe the pros and cons of this level of transparency.
Discuss what data about nursing care should be available to the public. Support whether or not you believe facilities should collect individualized nursing care data and use the results to evaluate your nursing care (similar to the report care process used for physicians).
BSN410 Healthcare Delivery and Quality Outcomes
Module 7 Discussion
As the course is coming to a close, it is important for you to examine what you have learned. As you journey forward with pursuing knowledge to improve your work as a nurse, keep this in mind:
Reflect on your learning during this course and explain what was the most important area or something that modified your thinking about an issue. Think back to your introductory post. Discuss if what you posted is similar or different to what you think now. Discuss how you will use what you learned in this course to make improvements in your current practice area. Describe how you intend to share what you have learned in this course with others.
BSN410 Healthcare Delivery and Quality Outcomes
Module 8 Discussion
DQ1 Chronic diseases such as “coronary heart disease, cancer, diabetes, and asthma are the nation’s leading cause of illness and death” (Jonas & Kovner, 2018, p. 152). These diseases pose serious burdens on the health systems and on society. Changing these figures will require that we engage patients, families, communities, and providers in order to impact behavior and health. According to Jonas & Kovner (2018) changing health-related behavior and provider-related behavior represents a prime target for improving national health goals and healthcare” (p. 157). Nursing needs to be engaged in helping to reduce the incidence of chronic diseases and illnesses.
If you were designing a mix of interventions to improve national health goals, what one behavior-related intervention and one provider-related intervention (described in the text-book) would you choose and explain your rationale(s) for choosing each. Describe what the impact or outcome of these interventions would be.
DQ2 Each community bears the burden of disease on its fiscal resources.
Choose ONE of the behavioral risk factors (chapter 7 table 7.1) and discuss the following:
Describe the behavioral risk factor.
Identify and discuss two determinants of health (social, economic, or physical).
Explain how educational status, economic status (poverty or wealth), and health status are related.
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