NURS FPX 4050 Assessment 2 Ethical And Policy Factors In Care Coordination

Defining Care Coordination (McDonald et al., 2007)
Importance of Care Coordination
Factors that play a role in Care Coordination
Consequences of poor Care Coordination

• Care co-ordination is defined as the process in which the different participants involved in the care of a patient interact and correspond with one another to give better outcomes and quality of services (“Care Coordination,” 2014). This involves the cooperation of different healthcare professionals during instances of transit such as the transfer from hospital to home or vice versa.
• The importance of Care Coordination is unequivocal, since the absence of proper cooperation between different participants can lead to destructive results, leaving the patient mentally and physically marred. Smooth transitioning from being in the care of one professional to another is conducive to better recovery.
• When providing health care, there are many different ethical factors that come into play. When deciding on which course of action to take, the nurses can practice priority based on age, gender and previously underlying medical condition.
• Poor care coordination can lead to discrepancies in the treatment procedure, which can lead to unfavorable results. NURS FPX 4050 Assessment 2 Ethical And Policy Factors In Care Coordination
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Introduction

Example of ethical factors that play a role in healthcare – Choosing between two patients
Role of ethical Code of Conduct in making healthcare decisions

• An example that can be served to delineate this point is if two patients are to simultaneously enter a hospital, only to find one bed to be free, it would resolve to the administration to assess and evaluate the involved ethical factors to decide what course of action to take. These sorts of decisions and responses are governed by the Code of Conduct, which will be discussed in detail in this paper.
• The Code of Conduct enables the nurses to evaluate and realize the circumstances and the condition of the patients in order to prioritize the order in which the patients have to be tended. This is in relation to the example given before.NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination PS

Effect of Governmental Policies

The United States Department of Health and Human Services (Regis College Online, 2021)
Effect of Government policies on care coordination and healthcare
In the United States, the provision of healthcare and care coordination is vastly governed by the governmental policies. There are a number of different policies that are active in the United States as a result of the efforts of the Department of Health and Human Services (Regis College Online, 2021) NURS FPX 4050 Assessment 2 Ethical And Policy Factors In Care Coordination

• Government policies can lay out various guidelines and instructions for institutes and healthcare professionals to follow. The reason behind the enforcement of certain guidelines from the government can be to enhance the provision of healthcare, safeguarding the rights of the patients and so forth. Furthermore, policies can encourage professionals to adopt certain measures when dealing with patients. Similarly, policies can also act as a motivation for professionals to pursue a certain mode of treatment or interaction when dealing with patients
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Hospital Readmission Reduction Program

What is HRRP? – Defining what HRRP is
Purpose of HRRP – What is the aim of HRRP
Effect of HRRP – How does HRRP help care coordination? NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination PS

To further understand how government policies effect care coordination, the example of the Hospital Readmission Reduction Program can be taken. The main function of the HRRP is to reduce the number of readmissions. This is done by encouraging the healthcare service provides (nurses, doctors etc.) to efficiently and expertly discuss post-discharge plans with patients in order to help them recover better, in turn enabling them to avoid readmissions for problems that are manageable (CMS.gov, n.d.).
The way this policy affects care coordination is that it encourages the different healthcare service providers to actively and expertly communicate with one another, and the patients with the objective of delineating to them the various aspects necessary for the after-discharge recovery and treatment. By keeping the motivation of reduced readmissions, this policy serves to improve the quality of coordination and collaboration between patient and professional.

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Policy Provision in Scrutiny

Affordable Care Act (Regis College Online, 2021)
Hospital Readmission Reduction Program (CMS.gov, n.d)

( No notes for this slide. Simply the names of these two acts. ) NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination PS

Policy Provisions that raise ethical dilemmas

Affordable Care Act – The History of ACA (Regis College Online, 2021)
Purpose of ACA – why the ACA was introduced
What did the ACA entail – obligation and levying of fines
What ethical issues did the ACA raise?
There are a few policy provisions that can raise ethical dilemmas, and create implications for care coordination. The first policy provision that can be scrutinized is the Affordable Care Act of 2010. The essence of the Affordable Care Act was the obligation and enforcement of securing health insurance, the failing of which would culminate in the levying of fines (Regis College Online, 2021). From an unbiased perspective, it is quite apparent what ethical complications and dilemmas the ACA can bring about. The ethical corruption of the ACA can be attributed primarily to the aspect of religion. The concept of insurance is an aspect of prohibition in the fastest growing religion in the world viz. Islam. Since the concept of insurance is subjected to prohibition in the third largest religion in the USA, the ACA which is advocating and stressing upon insurance can be seen as an aspect causing ethical unrest and dilemmas. Coming to the effect this has on care coordination, since the lack of insurance will result in fines and penalties, a person who is not insured will not be able to get treated and medically aided. When such discrepancies can occur on the basis of insurance, it can lead to turbulence in the process of care coordination. It can get exceedingly hard for a person without insurance to get treated. If such a person can get partially treated, he can face complications going forward, based on the lack of insurance. NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination PS

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HRRP as an ethical complication

Chance of misdiagnosis
Chance of misunderstanding
Wrongful denial of readmission
Another policy that can be enumerated in this regard is the HRRP discussed previously. While the concept behind the HRRP was seen to be advantageous, as it encouraged doctors and nurses to better engage and communicate with the patients (CMS.gov, n.d.), there is the chance of ethical complications erupting from it. The complications that can rise from the HRRP can culminate from the possibility of a patient getting misunderstood, or the condition misdiagnosed, which can lead to denial of admission.
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Code Of Ethics of Nurses

Autonomy
Beneficence
Justice
Non-Maleficence
Autonomy means to hand over the decision making to the patients (as far as possible)
Beneficence means to do good. Which is conducive to good relationships.
Justice means to act with equality and without any trace of prejudice
Non-Maleficence means to ‘do no harm’

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NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination PS

Effect of Code of Ethics on Care Coordination

How Autonomy helps care coordination – Better understanding for patient
How beneficence helps care coordination – Creating good relationship
How justice helps care coordination – better relationships will be formed
How non-maleficence helps care coordination – formation of trust
Firstly comes the factor of Autonomy. The discretion and the decision-making is to be handed over to the patient as far as deciding between different treatments and medications etcetera is concerned. It is imperative for the nurse to present the viable options to let the patient choose on his or her discretion (Gaines, 2020). This impacts coordination and continuum of care as it helps the patient know all about how he is being treated. Since he is making the decisions, he will be able to properly portray and explain the treatment process to any future doctor.
Then, there is the beneficence factor which helps in creating good relationships between nurses and patients, which in itself is conducive to better cooperation (Gaines, 2020). NURS FPX 4050 Assessment 2 Ethical And Policy Factors In Care Coordination
Then follows the Justice factor. This aspect of the code of ethics demands that the nurses don’t act out of any degree or trace of racism or prejudice. Regardless of age, gender, race and ethnicity, the care given by the nurses must be the same (Gaines, 2020). This helps in care coordination and continuum as better bonds will be formed between the patient and nurse.
Finally, there is ‘Non-maleficence’ which means to cause no harm (Gaines, 2020). This point means that the nurses must opt for ways which are least deteriorative and harmful to the patient. This helps in the coordination of care as trust will be created between the patient and nurse.

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Conclusion

Summarizing the effect of government policies
Summarizing the effect of nurse’s code of ethics on care coordination
Governmental policies can affect care coordination vastly. In this paper, the purpose was to describe how exactly governmental policies effect coordination of care along with some examples. Policies like the ACA and HRRP were enumerated and elucidated.
Furthermore, the nurses’ code of ethics also features some points and aspects that has an impact on the care coordination. These points, along with the perceived effects, were enumerated.

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References

Care Coordination. (2014). Retrieved from https://www.ahrq.gov/ncepcr/care/coordination.html
CMS.gov. (n.d.). Hospital Readmissions Reduction Program (HRRP). Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program
Gaines, K. (2020). What is the Nursing Code of Ethics? Retrieved June 18, 2021, from https://nurse.org/education/nursing-code-of-ethics/
Regis College Online. (2021, April 22). 8 Important Regulations in United States Health Care. Retrieved June 18, 2021, from https://online.regiscollege.edu/blog/8-important-regulations-united-states-health-care/
McDonald, K. M., Sundaram, V., & Bravata, D. M. (2007). Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 7: Care Coordination). Agency for Healthcare Research and Quality (US).