COMMUNITY NURSING: WEEK 2 DISCUSSION

Chapter 3: Health Policy, Politics, and Reform
1. You Have learned about health information technology (HIT) in this chapter. Give a few examples for the application of HIT in the clinical practice. Explain the main barriers of using HIT in the healthcare system.

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Chapter 2: Public Health Systems

Chapter Highlights #1
Public health and healthcare systems as a complex organization of institutions and structures
National and international perspectives on public health structure, function, and outcomes differ by fiscal support and philosophical attitudes concerning health

Chapter Highlights #2
Public health administration as a reflection of health, politics, economics, and social structures
Influences of history, resources, financing mechanisms, interest groups, and environmental conditions on public health
Governmental and nongovernmental organizations and public health

Question #1
Is the following statement true or false?
Nongovernmental organizations use endowed funds or private fund-raising to address the needs of individuals, families, and populations.

Answer to Question #1
True
Rationale: A nongovernmental organization (NGO) is an agency that acquires resources from private (vs. public) sources to help others. A philanthropic organization is one that uses endowed funds or private fund-raising to address the needs of individuals, families, and populations.

Importance of Understanding How Public Health Systems Are Organized
Public health involves organized efforts to improve the health of communities rather than individual people.
The central goal of public health is the reduction of disease through prevention and the improvement of health in the community, both nationally and internationally.

Structure of Public Healthcare in the United States
Governmental Agencies and Public Health
U.S. Department of Health and Human Services
State and local health departments

Functions of Public Health in the United States
Healthy People 2020
Funding for the healthcare system in the United States comes primarily from privately owned health insurance companies.

Trends in Public Health in the United States
Health status and its determinants
Utilization of healthcare resources
Expenditures and health
Vulnerable populations and healthcare

Question #2
Is the following statement true or false?
The United States has found the most efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.

Answer to Question #2
False
Rationale: Despite the economic strength of the United States and other industrialized nations, many countries have found more efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.

Healthcare Systems in Selected Developed Nations
Identifying indicators of health
Being committed to providing healthcare professionals and the public with a system that works
Generating policy that allows for the production of positive outcomes

Question #3
The International Council of Nurses is a federation of more than how many national nurses associations?
100
110
120
130

Answer to Question #3
D. 130
Rationale: The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations, representing more than 13 million nurses worldwide.

National and International Public Health Systems
The United States healthcare system includes structures and functions to support assessment, assurance, and health policy related to the health of populations.
Other industrialized nations have found more efficient and effective ways to care for all by decreasing health disparities and giving equal access to care.

Public Health Commitments to the World: International Public Health and Developing Countries
World Health Organization
Refugee and disaster-relief assistance
Multilateral, bilateral, and nongovernmental organizations as international organizations of health
International Council of Nurses

Question #4
Is the following statement true or false?
Bilateral agencies and organizations conduct their services in two specific countries.

Answer to Question #4
False
Rationale: Bilateral agencies and organizations conduct their services within one specific country.

Chapter 3: Health Policy, Politics, and Reform

Chapter Highlights #1
Healthcare policy and the political process
Healthcare finance and cost–benefit in relation to health policy
Access to healthcare and insurance facts in the United States
Healthcare workforce diversity and its effects on the quality of healthcare
Nursing’s role in shaping healthcare policy

Chapter Highlights #2
Quality of care and evaluation
Information management facts
Equity in healthcare access
Ethical consideration in health policy
Political advocacy, how to be politically active and advocate

Chapter Highlights #3
Health advocacy and healthcare reform
Affordable Care Act (ACA) overview and updates
Community-based services and healthcare reform
Health services research application to healthcare policy

Healthcare Policy and Political Process
Policies: set of principles that govern an action to achieve a given outcome, or guidelines that direct individuals’ behavior toward a specific goal
Public health policy: decisions made in regard to the health of the individual and the community
Health policies: impact on the health of an individual, a family, and a population or community

Question #1
Is the following statement true or false?
Health policies impact on the health of an individual, a family, and a population or community.

Answer to Question #1
True
Rationale: Health policies impact on the health of an individual, a family, and a population or community.

Involving Politics
Process of influencing the allocation of resources needed to enable policy and involves the strategies needed to achieve the desired goals.
Policy-making takes a great deal of effort, time, and commitment.
Setting an agenda
Policy formulation
Policy adoption
Policy implementation
Policy assessment
Policy modification

Healthcare Finances and Cost-Benefit
Economics is the study of how individuals, groups, organizations, and society allocate and utilize resources.
When a policy is evaluated for its effectiveness, there is an interest in keeping the cost of a specific health program within reason, and it is critical to consider the overall costs and benefits of an existing program when a more efficient and effective service is identified and adopted.

Access to Care and Health Insurance
The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

Question #2
Is the following statement true or false?
The U.S. healthcare system is a unique system of both independent power and action by the federal government.

Answer to Question #2
False
Rationale: The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

Nursing’s Role in Shaping Healthcare Policy
Nursing has a rich history as a unique profession, with its own values, ethics, respect, integrity, and responsibility. Nurses’ contributions to the policies are unlimited; there is a need for greater coordination of action to ensure that nursing is actively supported and involved in influencing and shaping health and healthcare policies.

Historical Highlights on Nursing Political Involvement
Mid-‘70s and early ‘80s: Political involvement of nurses
1976: Important year of advocacy
1990s: Nurses included in healthcare policy formation

What Does It Mean to Be Politically Active?
Personal and professional political involvement of nurses
Nurses must be knowledgeable about issues, laws, and policy
Why is nurse-informed political involvement?
Direct caregivers
Awareness of patient safety and satisfaction, access to services, clinical outcomes, and health disparities
Positioned to see impact of policy on individuals

Nursing Advocacy and Policy Participation
Patient advocacy
Political advocacy

How to Be Politically Involved?
Evidence-based practice examples
Nurses’ milestones in policy development have contributed to:
Quality outcomes
Decreases in cost
Expanded access
Major differences to the health of the nation

Advocacy Activities of Professional Nursing Organizations
Role of professional nursing organizations
ANA
NLN
ICN

Current Situation of Nursing Involvement: Challenges and Barriers
Not enough time to get involved
Heavy workloads with understaffing
Perception of powerlessness
Gender issues
Political action breaching family time
Anxiety with public speaking
Lack of knowledge in legislative process
Fear of retaliation

Quality of Care
Safety
Effectiveness
Patient centeredness
Timeliness
Equality
Quality of care is defined by the Institute of Medicine (2001) as the degree to which health services for individuals and populations increase the likelihood of desired outcomes, and are consistent with current knowledge.
It is extremely difficult to evaluate the complexities of the quality of care for the U.S. population.

Information Management
U.S. policy-makers have made the adoption of health information technology a priority so that health records can be kept electronically, assisting patients, providers, and insurers.

Equity and Equality in Healthcare Access and Quality
Because of the vast disparities in healthcare access and quality, President Obama has made healthcare his top priority, promising affordable and adequate healthcare insurance for all Americans.

Question #3
Is the following statement true or false?
Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

Answer to Question #3
True
Rationale: Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

Community-Based Services Association with Healthcare Reform
Federally qualified health centers
Patient-centered medical home
Accountable care organizations
Meaningful use

Ethical Considerations
ANA Code of Ethics with Interpretive Statements
Code of Ethics for Nurses
Social Policy Statement
Scope and Standards of Practice in Nursing

Health Advocacy and Healthcare Reform
Advocacy is collaborating with colleagues and engaging in conversations with decision-makers
Healthcare systems are dynamic

Overview of the ACA Prior to the End of Obama Presidency
Patient Protection and Affordable Care Act
Health Care and Education Reconciliation Act

Health Services Research
Research continues to be an influencing power by documenting the need for accelerated reform in order to achieve quality care, proper information management, insurance for all, and equity of access.

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