The Effectivenss of Nurse Navigation on Medication Compliance
explanatory Essay
963 words
In a rapidly changing healthcare environment wrought with financial pressures, government mandated performance incentives along with rising healthcare cost, hospitals have been challenged to meet the bottom line. Many hospitals have closed their doors while others have elected to cut staffing resources, programs and re-think their strategies (Barkell, Killinger, & Schultz, 2002). Under the Affordable Care Act, Medicaid recipients are now limited to six emergency room (ER) visits per year and nine primary care visits per year before they are forced to pay out of pocket or unable to pay. Many healthcare leaders now worry that emergency room reimbursement will be restricted and due to the growing number of uninsured, combined with a shortage of primary care doctors many patients will not be able to get into their doctors offices creating an overwhelming burden on already congested emergency rooms. Many patients return to the emergency room or seek primary care treatment in an ER due to factors related to medication noncompliance, whether it is lack of funds, transportation to their physician’s office or poor health literacy. This study will examine the effectiveness of utilizing a nurse navigator to improve medication compliance. The nurse navigator strategies will focus on education, primary intervention and collaboration with key stakeholders to reducing barriers to compliance. Navigators help patients make informed medical decisions and assist with setting up multiple doctors' appointments and tests. Navigators also provide tips on dealing with new diagnosis, complex medical problems and terminal conditions. They make sure patients stay on track with their treatment plan and offer emotional support. Depending on the hospital, navigators might be nurses, social workers or other staffers certified through programs that include training in care coordination, motivational interviewing skills, and cultural sensitivity. They have access to patient medical records and treating physicians. They can also run interference on insurance issues, help with translation for non-English speakers and even make sure patients have a ride to the doctor's office. Background This writer’s organization is a 100 bed acute care hospital located in a rural underserved area. This organization provides care to a large number of uninsured and underinsured patients. According to the Center for Disease Control (2011), 38% of the population lives below the federal poverty index level and 46% of the population live in housing units. The health and economic disparities pose a significant risk to the morbidity and mortality of the client population.
In this essay, the author
- Describes the writer's organization as a 100 bed acute care hospital in rural underserved areas.
- Explains that hospitals have been challenged to meet the bottom line in a rapidly changing healthcare environment wrought with financial pressures, government mandated performance incentives and rising healthcare cost.
- Explains that a qualitative study will focus on patient perceptions relative to barriers to medication compliance, and the effect of nurse navigators on reducing those barriers.
- Explains the relationship between nurse staffing models and patient outcomes: a descriptive study. linseth, a.
Related
- analytical
- comparative
- explanatory
- opinionated
- Health Care Reform in Unavoidableanalytical essayThe starting point of our healthcare system can be found to the beginning of the twentieth century. Medical technology was advancing rapidly, and opportunities grew with them. Training, performance, and skill all improved substantially. Hospitals became centers for specialized medicine, surgery, and research. With all of this, the cost of medical care began to ascend and would continue to rise above the cost of living for the rest of the century. By the end of the 1920’s, both the middle class and the poor found themselves struggling to deal with growing medical costs.
In this essay, the author
- Analyzes how john f. kennedy is unable to get a plan for the elderly passed through congress.
- Explains that president lyndon b. johnson's was able to get medicare for the elderly and medicaid for poor people.
- Narrates how nixon wanted to require employers to cover their workers and create federal subsidizations to help everyone else buy private insurance. the watergate scandal intervened and the campaign was dropped.
- Explains that president jimmy carter is unable to push a mandatory national health plan due to the economic recession.
- States president ronald reagan signed cobra, a mandate that states, employers must let former workers stay on the company health plan for 18 months after leaving.
- Narrates how congress expanded medicare by adding a prescription drug benefit and catastrophic care coverage. the expansion lasted one year due to protests from older americans upset about paying taxes.
- Analyzes how president bill clinton puts hillary rodham clinton in charge of developing a plan for universal coverage. the plan meets republican opposition, divides democratic party, and comes under firestorm of petitioning from businesses and the health care industry.
- States that clinton signs bipartisan legislation creating a state-federal program to provide coverage for millions of children in middle class families whose incomes are too high to qualify for medicaid.
- Describes how president george w. bush persuades congress to add prescription drug coverage to medicare for older people.
- Explains that obama and the democratic-controlled congress create legislation to mandate that everyone have coverage or pay a fine. this would require most companies cover their workers; require insurance companies to accept all comers, regardless of pre-existing conditions.
- Explains that the american medical association and other big groups of health professionals lend their weight to the effort to extend coverage to more than 30 million uninsured people.
- Explains that the supreme court upheld president barack obama's health care law following over a century of debate over whether or not the government should help people in the us afford medical care.
- Cites obama, b., the economic case for health care reform, white house.
- Explains that the battles for health care reform and the reasons for their failures make an interesting lesson in american history, philosophy and politics.
- Argues that healthcare reform is unavoidable due to the ever-growing profits of the health care corporations.
- Cites davidson, k. a., the world post, and hnn's history of healthcare reform.
1575 wordsRead More - Specialty Hospitals Finally Regulated by PPACAanalytical essayIn 2007, the House of Representatives passed the Children’s Health and Medicare Protection Act which included a provision that eliminated the whole hospital exception for all new or addition to existing physician-owned specialty hospitals (Perry, 2012). Next, in the same way, another similar provision was passed in 2008 (Perry, 2012). But, unfortunately, none of these bills were enacted (Perry, 2012) which attributed to a further growth of the threat to the ability of public hospitals to bring enough revenue to be able to afford their charitable community services.
In this essay, the author
- Explains that medical ethics have indirectly regulated the patient-doctor relationship for thousands of years. physician-owned specialty hospitals have ignited a controversial debate over the legitimacy of their entitlement to medicare and medicaid reimbursement.
- Argues that the growing competitiveness in the medical field coupled with a marked decline of specialty hospitals’ income can easily compromise patients’ care and lead to financially-conflicted decisions.
- Explains that specialty hospitals were excluded from the moratorium, but there were exceptions such as joining new physician ownerships, growing business requiring the addition of more beds, or changing specialties of care.
- Argues that a health policy proposal should set fixed reimbursement prices per diagnosis and services and vividly set the requirements for qualifications.
- Opines that specialty hospitals have always been a subject for controversial debate. the ppaca put an end to this controversy by strict legislation.
- Explains that the children's health and medicare protection act eliminated the whole hospital exception for all new or addition to existing physician-owned specialty hospitals.
- Cites burns, david, & helmchen, l. a. (2011). strategic response by providers to specialty hospitals.
1039 wordsRead More - Deliverance: A Study of Medicaid and Managed Careanalytical essayIn efforts to save money, states looked primarily at the benefits of managed care, which was becoming a successful delivery and financing system (Ruggie 1996). Medicaid patients had a history of using emergency rooms for problems such as colds, flues, and other minor illnesses. Medicaid paid $75 for an emergency room visit in 1995, but only $29 for a physician’s office visit (Lutz 1995). Medicaid officials hoped that placing the patient in contact with a primary care physician would encourage the use of preventative medicine, thereby holding down costs.
In this essay, the author
- Explains that the variables must be examined for collinearity. running a bivariate correlation will show which variables are essentially parallel measures.
- Explains that the lagged variable measuring the percent of the medicaid population enrolled in managed care in 1993 is significant at the.001 level.
- Explains that while party id and ideology have converged over the years, ideology has a greater effect on the dependent variable.
- Cites key, v.o., jr.'s southern politics in state and nation.
- Explains that medicaid's growth in expenditures and enrollment was the largest since the program began in 1965.
- Analyzes how states have enrolled medicaid recipients in managed care due to variations in state public policy. the first political variable is the ideology of the electorate.
- Explains the model yields an adjusted r square value of.599. this means that 59.9% of the variance in the dependent variable, percent of medicaid population enrolled in managed care, can be explained using the independent variables discussed above.
- Analyzes how the model explained the variation in medicaid managed care enrollment across the fifty states. per capita income was significant, confirming walker's hypothesis that wealthier states are more likely to adopt medicaid.
- Cites ruggie, mary, thompson, frank j., and diiulio jr.
2567 wordsRead More - Brooklyn Health Care Improvement Case Studycomparative essayAccording to the Centers for Disease Control and Prevention (CDC) in 2011 there were nearly 140 million emergency department visits within the United States, and 34 million of those visits were considered non-emergency. (Centers for Disease Control and Prevention , 2011). The article focused on the case study The Brooklyn Health Care Improvement program, the focus was to determine whether the use of the Emergency Department was being used based on preference, the lack of knowledge, or lack of access to a primary care provider (PCP). Within the Northern and Central area, there were 11,546 patients surveyed over the course of four weeks.
In this essay, the author
- Explains that the centers for disease control and prevention (cdc) reported nearly 140 million emergency department visits in 2011 and 34 million of those were considered non-emergency.
- Explains that americans base their health on finances or the capability to get their issue resolved quickly. a 30 year old has had unusual pain and hemorrhage while having a bowel movement for the last two weeks.
- Explains that with insurance rules and regulations changing, individuals don't know what they qualify for, nor are they aware of the different options to choose outside of going to the emergency department.
- Compares how people in the brooklyn area would go to their local urgent care facility, saving thousands of dollars. the majority of emergency departments report they are operating at or over capacity.
- Explains that there are ten solutions to solving the overcrowding of the emergency department.
528 wordsRead More - Hospital Case Analysisanalytical essayHospitals are a necessary part of every individual's life. When one thinks of hospitals, help comes to mind (Hospitals Struggle to Keep Their Promises). Neither a person's age, ethnicity, nor economic background should matter when it relates to access to healthcare. Everyone will need hospital care at one point in their lives, no matter how healthy one may think he or she is. That is the reality. Unfortunately, many of these organizations are in danger. "Hospitals are experiencing a period of financial duress unprecedented in recent history. The number of hospitals that have closed their doors is at an all-time high, and many more might close within the next few years" (Moore et al, 1999). It is ironic to think that the institutions such as Faith Community Hospital that provide healthcare and even save lives, face severe problems. Problems that must be addressed early to avoid jeopardizing an individual's access to healthcare should those same problems lead to the hospital's demise.
In this essay, the author
- Opines that hospitals struggle to keep their promises.
- Cites the university of phoenix's custom edition, making it work, and critical thinking: strategies in decision making.
- Argues that the mission statement at faith community hospital is too broad and the way it is written opens up the opportunity for a wide variety of interpretations.
- Recommends that faith community hospital adopt a more elaborate mission statement to resolve the wide variety of interpretations of the mission.
- Cites gomez, l.r. & balkin, d.b.
2200 wordsRead More - Waiting Time In The Ed Case Studyexplanatory essayAccording to the Centers for Disease Control and Prevention (CDC) (2012), the average time patients spend in the U.S. emergency department (ER) before they can see a doctor has increased to 25% between 2003-2009. The main cause of longer wait times (WT) in the ER is overcrowding. Overcrowding has been found to be closely related to both subjective and objective patient satisfaction (Miro’ et al, 2003). Longer wait times in the ED is such an important issue because its consequences are detrimental not only to the ER patients, but also to providers. As a health care provider, decreasing patients’ WT in the ED is essential, although challenging, to improve patient’s health outcomes and increase patients’ satisfaction. Although it is a very challenging issue to tackle, hospitals that have initiated some quality improvement (QI) strategies are experiencing some positive outcomes in that area of care. The outcomes are measured by decreased waiting times, improved patients’ clinical outcomes and increased patients’ satisfaction.
In this essay, the author
- Explains that waiting time has a negative impact on the work performance of emergency department nurses because it has forced staff to provide more complex and prolonged care than before.
- Explains that the focus of this paper was to investigate on the issue related to longer waiting time in the ed. overcrowding was found to be the main cause of longer wt.
- Explains that overcrowding is the main cause of longer wait times in the er, which is detrimental not only to patients, but also to providers.
- Explains that overcrowding is a serious threat to healthcare system that has reached the crisis proportions in the united states ed.
- Explains that long waiting times lead to patient's death. the incident is still under investigation by the state department of health.
- Explains how montefiore medical center developed a strategy called fast track in the ed to reduce the length of wait time.
1519 wordsRead More - Retail Clinicsopinionated essayWeinick, R. M., Burns, R. M. & Mehrotra, A. (Sept 2010). ‘Many emergency Department visits could be managed at urgent care centers and retail clinics’. Chevy Chase, 29(9), 1630-37.
In this essay, the author
- Explains that america spends more money on health care than any other nation in the world, and that physicians are getting a wage twice higher than those in europe. retail clinics are independently managed or in contract with hospitals and staff nursing practitioners.
- Opines that nurse practitioners see their patients twice as often as physicians and reduce emergency room use, hospital patient days, prescription costs, and medication noncompliance.
- Recommends a unified law pertaining to the functioning of retail clinics, making maximum use of nursing practitioners.
- Opines that the federal states vary greatly in their rules regarding the function of nurse practitioners and physician assistants.
- Explains that despite the huge amount of money the country spends on healthcare, it lags much behind other nations in the quality of healthcare it provides.
- Explains that the advance nurse model act, developed by the national council of state boards of nursing, allows nurse practitioners to function independently and decide cases to be referred to other healthcare providers.
- Explains that the state exchequer could save $ 6 billion if retail clinics were allowed to run using nurse practitioners and physician assistants.
- Analyzes the ethical aspects of retail clinics and nurse practitioners, stating that they are aiming at easy money, not social service.
- Argues that the federal and state governments, except the state of massachusetts, have not made a written regulatory tool for retail clinics.
- Asks what rules should be adopted to ensure proper incorporation of retail clinics and nurse practitioners into the primary health care system of the nation.
- Opines that the coming up of nurse practitioners and retail clinics will change the medical care field in the us from upside down.
- Explains the purpose of the nurse practitioners incorporation program to incorporate nurse practitioners, physician assistants, and retail clinics into the national health care facilities while ensuring safety, quality and convenience to the public.
- Opines that ensuring safety, quality and accessibility in health care facilities to all at a reasonable expenditure.
- Explains advance practice nurse model act: nurse practitioners are totally independent in their functioning and are responsible for deciding to refer patients to other health care providers as appropriate.
- Explains the californian physician oversight – nurse practitioners can diagnose, order tests and medicines but under supervision.
- Opines that a physician must review the charts in every fixed period of time. nurse practitioners should distinguish between the kinds of cases that can be addressed by nurse practitioners and the cases to be referred to doctors.
- Explains that nurse practitioners enjoy considerable freedom in their function and can practice independently and effectively in episodic care and in retail clinics.
- Opines that the level of safety and quality is not less than that from a physician, according to studies. however, some physicians and others protest regarding safety.
- Opines that the level of safety is as good as that from a qualified physician, but there is possibility of errors in taking independent decisions and conflict of interest in cases of referring patients to medical homes.
- Opines that lack of clear demarcation regarding cases nurse practitioners can attend and the cases to be referred to a physician can lead to problems taking decisions. retail clinics that employ nurses may try to exploit the patients.
- Explains that massachusetts can save a considerable amount of money by utilizing nurse practitioners.
- Describes fairman, rowe, hassmiller, and shalala's views on broadening the scope of nursing practice.
- Opines that for health care reform to survive, we must stick to the facts. nursing economics, 28(6), 401-403.
- Explains kaissi, a, and zucker, k. c. hospital-affiliated retail clinics: strategic opportunities and operational challenges.
- Explains the scope of practice and the nurse practitioner: regulation, competency, expansion, and evolution.
- Opines that a nurse-practitioner program must be made to work.
- Summarizes the national academy for state health policy's presentation on retail clinics: state regulatory issues.
- Describes the six state approaches to regulation and licensing for retail clinics.
- Explains schram, a. p., journal for nurse practitioners, 6(2), 132-139, elsevier science inc.
- Describes turton, h., 'have nurse practitioners reached a tipping point?' in nursing economics.
- Explains vandenbranden, s. l., 'the role of the nurse practitioner in the case of children with chronic respiratory disorders', pediatric annals, 39, 800-803.
- Opines that many emergency department visits could be managed at urgent care centers and retail clinics.
2531 wordsRead More - The Importance Of Health Careexplanatory essayHealth disparities, that exists among individuals who reside in rural communities, is significant to availability and access to health care. Access to affordable health care lacks in isolated areas. According to Francis, Scaife, Zahnd, Cook, and Scheeweiss (2009), rural residents “define their health as fair to poor” (Francis, Scaife, Zahnd, Cook, & Scheeweiss, 2009, p. 3555). This is due to healthcare professional shortage, low income status, and its geographic locations. Residents are faced to travel several miles to seek a health care provider for effective treatment. Although they may find a health care provider, cost without proper health insurance to cover medical bills becomes a burden. The increased rate of poverty within rural communities “forces residents to choose between basic human needs, such as shelter or food, and seeking healthcare” (Crosby, Wendel, Vanderpool, & Casey, 2012, p. 54). This causes non-compliance to receiving health care, which increases health complications. However, government assistance programs, such as Medicaid and Medicare,
In this essay, the author
- Explains that medicare is a critical source of insurance coverage for rural communities. poorly insured residents are reluctant to receive care due to the expensive cost of healthcare.
- Explains that medicaid health care coverage is beneficial to rural communities through its assistance with rural economic development.
- Explains that medicare and medicaid are beneficial to rural communities. they reduce health care disparities and upsurge health service resources.
- Explains that health disparities in rural communities are significant to availability and access to health care.
890 wordsRead More - How Have Stroke Patients Been Affected by Emergency Department Overcrowding in Hospitals?explanatory essayTrzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
In this essay, the author
- Explains that emergency departments of hospitals are fundamental in the treatment of time sensitive conditions such as acute stroke. overcrowding can be defined as the overabundance of patients requiring treatment.
- Explains that patient knowledge has been shown to influence outcomes for stroke patients — delays to emergency department presentation are the main reason for exclusion from treatment.
- Explains that overcrowding of emergency departments causes an increase in patient wait times. in-hospital delays impact negatively on the ability of stroke patients to be treated.
- Explains that emergency department overcrowding can have a detrimental impact in terms of patient safety.
- Explains that overcrowding of emergency departments has resulted in negative outcomes for patients and in particular stroke patients. identifying and understanding the causes of negative patient outcome can assist in the development of new procedures.
- Explains the effectiveness of stroke education in the emergency department waiting room. journal of stroke and cerebrovascular diseases, 19, 209215.
- Explains that patients' awareness of stroke signs, symptoms, and risk factors. stroke: journal of the american heart association.
- Explains kothari, jaunch, broderick, brott, sauerbeck, khoury, and liu. acute stroke: delays to presentation and emergency department evaluation.
- Explains panagos' approach to optimising stroke care. the american journal of emergency medicine, 26, 808816.
1024 wordsRead More - Importance Of Nursing Experience In Nursingexplanatory essayDuring this week at KLH my nursing skills were challenged as I began to administer medications. Although my experience was a rather positive one, I quickly realized how many factors play a role in ensuring the medication process runs smoothly and safely. By preparing my drug cards that pertained to my client ahead of time, I was able to have a general understanding of the drug and what assessments I would need to perform prior to administration. This made me more confident and comfortable while going through the process at my patient’s bedside.
In this essay, the author
- Describes how their nursing skills were challenged as they began to administer medications at klh. they quickly realized how many factors play a role in ensuring the medication process runs smoothly and safely.
- Narrates how they found time management challenging, as they did not anticipate how long it would take to complete a bedside safety check, obtain vitals, and perform morning care with their client.
- Explains that their assessments were relevant to their client's history of acute and chronic conditions and necessary for me to administer medications. they gained a substantial amount of information by going through their coming to know the client (ctktc).
- Describes how they used nursing theory to involve their client and her partner in their plan of care.
- Opines that their goal for next week is to become more fluent with documentation. they would like to increase their confidence in identifying relevant information and disregarding what is not.
- Opines that they enjoyed their days spent at the hospital this week. they feel that it was another huge learning experience for them and they were able to face the challenge and improve their nursing practice.
759 wordsRead More