Policy and State Boards of Nursing

Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing.

To prepare:

• Review      the Thomas, Benbow, and Ayars article and the Watson and Hillman article      focusing on how states regulate advanced nursing practice and how      legislative changes are impacting scope of practice.
• Visit      your state board of nursing website and/or contact the board to determine      how the state board controls advanced practice through regulations (google mbon.org for my state board      of nursing)
• Determine      if your state board has created any new policies or regulations that      address changes to scope of practice in response to legislative changes.

By tomorrow 04/25/2018 10am, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) What are the most recent regulations promulgated through your state board of nursing for advanced practice?

2) How are the state regulations supported within your place of employment? (google mbon.org for my state board of nursing)

3) How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?

Required Readings

Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the political development of health care reform in the States. Journal of Health Politics, Policy & Law, 34(5), 679–716.

The authors provide an analysis of varying state health care policies, with a basic premise that health care risk is either “pooled”—shared, or “actuarial”—segmented by risk level. Most states have taken a segmented approach to health care, and therefore, have not solved health care issues such as rising costs and access to care. The authors maintain that federal action is needed to create a uniformed approach to health care.

Junghee, L. (2009). Cultural, social, and political influences on state-level indigent health care policy formation. Journal of Policy Practice, 8(2), 129–146.

This article provides details on a 50-state study of Medicaid spending. The authors concluded that political and economic factors can positively predict individual state Medicaid spending, and that actual need has a negative impact on spending. In conclusion, a uniform, federal structure may be the only method to ensure equal access to Medicaid.

Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and consequences—Insurance-premium rate regulation and the ACA. New England Journal of Medicine 363(10), 899–901.

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. Journal of Law, Medicine & Ethics, 36(2), 403– 412.

Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research update. Health Affairs, 29(7), 1350.

The enrollment and retention of eligible children in Medicaid and Children’s Health Insurance Program (CHIP) is a health care concern. The article concludes that some state processes have mitigated this issue but other requirements, such as providing citizenship documentation, may have a detrimental effect. Therefore, these concerns should be incorporated into the implementation on PPACA of 2010.

Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and board regulation: One state expands options. Journal of Continuing Education in Nursing, 41(11), 524-528.

The authors use the changes instituted by the state of Texas in regard to the licensing of nurses to illustrate the need to adapt state licensing requirements to the changing diversity and scopes of practice among nurses.

Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education, scope of practice, and liability issues. Journal of Legal Nurse Consulting, 21(3), 25–29.

The expanded role of the advanced practice nurse has led to changes in licensure, education, certification, and scope of practice definitions. The author points out that this expanded role has led to increased liability and accountability concerns as well.

Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory enforcement and nursing home termination from the Medicare and Medicaid programs. Health Services Research, 45(6p1), 1796-1814. doi:10.1111/j.1475-6773.2010.01164.x

Those nursing homes receiving Medicare and Medicaid funding are subject to strict quality and safety regulations. This article examines the consequences of enforcing those federal quality standards.

Optional Resources

Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. Nursing Education Perspectives, 31(3), 160-166.

Investigating Pandemics and Epidemics

Some of the most notable epidemics include the bubonic plague in the 14th century, smallpox in the 18th century, and influenza in the 20th century. Reportedly, the bubonic plague caused over 137 million deaths, whereas the death toll associated with influenza was 25 million (Ernst, 2001). These are dramatic examples of the kinds of acute outbreaks that led to the practice of epidemiology.

Many epidemiologists and health care professionals are concerned about the next potential pandemic or epidemic. With the increased mobility of society, the spread of infectious diseases continues to pose a serious threat. For this Discussion, you will investigate pandemics and epidemics using epidemiological tools, and you will consider strategies for mitigating disease outbreaks.

To prepare:

• Using      the Learning Resources, consider examples of emerging or reemerging      infectious diseases that are occurring locally, nationally, or abroad.      Then, select one example on which to focus.
• Explore      the epidemiological investigative process used to identify the emerging or      reemerging infectious disease or outbreak.
• Examine      your selected infectious disease using the epidemiologic triangle and      vector theory.
• Consider      how health care interventions may reduce the emergence or reemergence of      infectious diseases.

By tomorrow 04/25/2018 12pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) Identify the emerging or reemerging infectious disease you selected.

2) Discuss the investigative process used to identify the outbreak, and describe its effect using descriptive epidemiology (person, place, and time).

3) Apply the epidemiologic triangle and vector theory to your selected outbreak.

4) Evaluate how prior health care interventions, or lack thereof, created the conditions that allowed this infectious disease to emerge.

5) Discuss how the disease outbreak might have been avoided or mitigated. Include agencies, organizations, and resources that could have supported these efforts. If appropriate, consider ongoing efforts to control the outbreak.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 12, “Epidemiology of Infectious Diseases”

In this chapter, the authors examine the epidemiology of infectious diseases, one of the most familiar applications of epidemiology.

Martin, T. W., Stevens, L., & Miller, J. W. (2011). Rare germ drives outbreak. The Wall Street Journal. Retrieved from http://online.wsj.com/news/articles/SB10001424052702303745304576360780812512492?mod=djemHL_t&mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303745304576360780812512492.html%3Fmod%3DdjemHL_t

In news coverage of a deadly outbreak, the authors note unusual aspects of the situation, as well as the economic, political, and personal ramifications.

Centers for Disease Control and Prevention. (2011). CDC says “Take 3” actions to fight the flu. Retrieved from http://www.cdc.gov/flu/protect/preventing.htm

This page contains the CDC’s most up-to-date recommendations regarding the prevention of seasonal flu. In addition to this page, you may wish to explore the CDC’s Seasonal Influenza home page, http://www.cdc.gov/flu/

World Health Organization. (2012). Disease outbreak news. Retrieved from http://www.who.int/csr/don/en/

The World Health Organization (WHO) provides information on the most recent disease outbreaks around the world. Stay up to date by visiting this site.

HealthMap. (2007). Retrieved from http://www.healthmap.org/en

Explore this interactive map that lists disease outbreaks around the world.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report: Summary of notifiable diseases. Retrieved from http://www.cdc.gov/mmwr/mmwr_nd/index.html

Review the most current report on infectious diseases as reported by health care providers to state or local authorities. According to the CDC, “A disease is designated as notifiable if timely information about individual cases is considered necessary for prevention and control of the disease.” This report highlights infectious diseases reported in 2009.

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Infectious disease: Two case studies [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 8 minutes.

In this week’s program, the presenters discuss HIV and AIDS

Discussion: Diversity in the Workplace

Creating and managing a diverse workforce is a process, not a destination.  —R. Roosevelt Thomas, Jr.  What concepts come to mind when you think of diversity? What kinds of diversity exist in your workplace? How does diversity impact communication, working relationships, productivity, and patient care?  In the workplace, focusing on differences can create divisiveness. Nurse managers should approach diversity as a way to highlight, communicate, and build on the commonalities of their workforce. Modeling this behavior can encourage appreciation for diversity and create a more positive workplace environment. When managing a diverse workforce, nurse managers should never make assumptions about an individual’s motivations, goals, or work ethic based upon personal traits such as age, gender, race, or culture. Nurse managers should strive to facilitate an inclusive environment for all.  To prepare •Review the article, “Diversity within Nursing: Effects on Nurse-Nurse Interaction, Job Satisfaction, and Turnover.” Examine Figure 1 on p. 218. Determine how these and other diversity issues might impact the interaction of nurses in the workplace. •Consider situations in your current organization or one with which you are familiar in which obvious diversity exists. How do these types of diversity issues affect the daily work environment? •Examine this week’s Learning Resources to identify strategies for finding commonalities among workers. How might these strategies also help to increase appreciation of diversity within the workplace?  By Day 3  Post an explanation of how diversity-related issues impact your current organization or one with which you are familiar. If you do not believe there are any issues related to diversity, explain how this workplace instills a culture of acceptance and positivity. Conclude your posting by describing at least two commonalties everyone in this workplace shares and at least one new strategy you could implement to increase appreciation of both differences and similarities.

Required Readings  Beheri, W. H. (2009). Diversity within nursing: Effects on nurse-nurse interaction, job satisfaction, and turnover. Nursing Administration Quarterly, 33(3), 216–226.  Retrieved from the Walden Library databases.     Beheri’s article examines the effects of diversity in nursing. The study found that nurses who are satisfied with their jobs and have a higher level of education are more likely to tap into the potential offered by cultural diversity.   Collins-McNeil, J., Sharpe, D., & Benbow, D. (2012). Performance potential. Aging workforce: Retaining valuable nurses. Nursing Management, 43(3), 50–51.  Retrieved from the Walden Library databases.     Due to the increasing connectivity between patient safety and government-sponsored financial incentives, it is important for nurse managers to understand the specific language used by finance. This article examines the importance of this topic.   Harton, B. B., Marshburn, D., Kuykendall, J., Poston, C., & Mears, D. A. (2012). Self-scheduling: Help or hindrance? Nursing Management, 43(1), 10–12.  Retrieved from the Walden Library databases.     This article discusses the possibility of allowing nurses to create their own schedules to boost retention.

APA format 6 peer review references 3 from Walden Library.  Please pick the topic Congestive Heart Failure or COPD from below list and follow instructions

Assignment: Application: The Pathophysiology of Disorders

In previous weeks, you explored various body systems: cardiovascular, respiratory, nervous, endocrine, musculoskeletal, gastrointestinal, and hematological. These seven systems work together, along with other body systems, to complete a myriad of functions. For this reason, when disorders occur within one body system, they can create potentially devastating effects throughout the entire body. For instance, Parkinson’s disease is a disorder of the central nervous system, yet its alterations actually affect multiple body systems, from the cardiovascular system to the gastrointestinal system. In this Assignment, you examine alterations associated with disorders, as well as the impact of the alterations on multiple body systems.

To prepare:

• From the list below, select a disorder of interest to you:
  • Alzheimer’s disease
  • Asthma in children
  • Chronic obstructive pulmonary disease (COPD)
  • Congestive heart failure
  • Hepatic disease (liver disease)
  • Hypertension
  • Hyperthyroidism and hypothyroidism
  • Seizures
  • Sepsis
• Reflect on alterations associated with the disorder you selected. Consider the pathophysiology of the alterations. Think about how these alterations produce pathophysiological changes in at least two body systems.
• Think about the types of drugs that would be used to treat alterations associated with the disorder you selected.
• Reflect on how patient factors, such as genetics, gender, ethnicity, age, and behavior might impact the pathophysiology of the alterations you identified. Then, consider how these factors might impact the effects of prescribed drugs, as well as measures you might take to help reduce any negative side effects.
• Locate an agency that provides patient education on your selected disorder and review the available materials and curriculum. Consider how you might be able to use those materials to educate a patient on the disorder, treatment options, management, and self-care.

By Day 7

Develop a 5- to 10-slide PowerPoint Presentation that addresses the following:;

• Describe the disorder you selected, as well as associated alterations. Explain the pathophysiology of the alterations, including changes that occur in at least two body systems.
• Describe the types of drugs that would be prescribed to treat alterations associated with the disorder.
• Explain how genetics, gender, ethnicity, age, and behavior might impact the pathophysiology of the alterations you identified and the effects of prescribed drugs.  Then, describe measures you might take to help reduce any negative side effects.
• Explain how you would use materials from a supporting agency to educate patients on the disorder, treatment options, management, and self-care.

This assignment is due.