The Affordable Care Act (ACA) is the most significant piece of healthcare legislation signed into law within the last decade; it is highly controversial but addresses critical issues related to access, cost, education, insurance, prevention and quality. The role and competencies of the Clinical Nurse Specialist (CNS) can help to shape and propel the initiatives set forth by the ACA. Armed with the ACA roadmap the CNS can be an influential change agent for patients, nursing practice and the healthcare system. In 2010, the ACA became policy but the major reforms started in 2014 and will continue to build its infrastructure until completion in 2019 (Mason, Leavitt, & Chaffee, 2014). The ACA calls for new models of care that will decrease health cost but not decrease the quality of care. Easier access to community based care providers, which include the CNS and other Advance Practice Registered Nurses (APRN). Increased focus on health promotion, disease prevention, life style change and health education. There is a need for innovational work that will intensify patient safety and improve clinical care outcomes. The ACA encourages healthcare systems to develop care continuity from hospital to home; a care plan continuum (Mason et al., 2014).
Over the next six years, Advance Practice Nurses cannot sit idly by believing the aforementioned aspects of ACA will just take shape. Nursing history has vibrant narratives of advocacy, activism and political influence thorough the diligent work of Florence Nightingale, Lillian Wald, and American Nursing Association. Today, maintaining status quo will continue to leave the United States ranking below other developed countries (Mason et al., 2014).
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...o make a difference for those in need. The CNSs and other APRNs can collaborate with American Nursing Association or the National Association for Clinical Nurse Specialist (NACNS) in one powerful voice. With one voice, one common goal, the political reach can turn the tide and that is empowerment (Mason et al., 2014).
Even though there are individual spheres of influence, they work in tandem or as a lattice to accomplish their work. The Affordable Care Act provides an opportunity to over-haul the healthcare system granting greater access to healthcare services. In order to sustain infrastructures like the community health centers and other components of the ACA, Clinical Nurse Specialists and nursing leaders need to be advocates for better healthcare delivery and activist in all three spheres of influence to guarantee better healthcare outcomes.
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