Evolving practice of nursing and patient care delivery methods

nursing and patient care delivery methods
nursing and patient care delivery methods

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Nursing and patient care delivery methods


 The evolving practices in patient care delivery system indicate that the nursing profession need to transform in order to meet the healthcare’s demand.  The nursing practice is expected to change in its approach to leadership and education so that it can deliver its functions effectively (Nursing’s Social Policy Statement, 2010).  In this context, this paper aims at analysing how nursing practice is expected to change. The paper will also discuss the concepts of continuum of care, nurse-manage healthcare clinics (NMHCs) and accountable care organizations (ACO’s) (Perry & Hoffaman, 2010).

 The transformations are associated with the Patient Protection and Affordable Care Act of 2010 (PPACA) changes which focuses on provisions that will intertwine cost efficient care with high quality of care.   For a long time, the healthcare systems arrangements have been somewhat fragmented, lacking coordination and individual responsibility, which affected the quality of care.  The integrated care delivery models aims at improving coordination and quality of healthcare services by allocating resources in the underserved areas.

The law attempts to restore the healthcare system by rewarding quality of services rather than the volume of services delivered. Consequently, the nurses are expected to become adjusted to the reorganized structure as they are the focal point of patient care. They play a huge role in the attainment of objectives for the emerging healthcare delivery methods (Quad Council of Public Health Nursing Organizations, 2011).

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The continuity of care concepts refers to the interaction between a patient and practitioner that goes beyond the clinical encounters. It is defined by two core aspects; a) the focus on individual (patient) context and their health demands, and b) continuity of care i.e. patients care over time- present and future. The restructuring of the USA healthcare system aims at ensuring continuity of care, which entails developing a discharge care plan that will enable smooth transition from acute care to home self-care (Quad Council of Public Health Nursing Organizations, 2011).

This will call for extremely trained nurse practitioners, who are equipped with great nursing skills, competencies and knowledge. Therefore, looking forward to the challenging but exciting roles, nurse educators must ensure that the basic value of nursing is reemphasised. This is a profession that delivers care based on scientific knowledge. They must work in partnership with other disciplines to efficiently meet the healthcare goals (Nursing’s Social Policy Statement, 2010).  

 Arguably, various factors have converged to transform the healthcare system. Consequently, this affects the responsibilities of a nurse practitioner. The changes in the healthcare system are radical and occurring more rapidly than it used to be in the past.   Previously, health care facilities used to be the main avenue for nursing practice.  Today, the role has reversed. 

This is because patients are in the hospital for the shortest time possible. Only patients under critical conditions stay in the hospitals for the longest time. This calls for nurses who understand and value patient’s demands, and who have the capability to facilitate smooth transitions from healthcare settings to home (Quad Council of Public Health Nursing Organizations, 2011).

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 Accountable care organizations (ACO’s) were implemented to ensure that the various healthcare organizations focus on delivering comprehensive care to the patients. It comprises of an association of healthcare providers who join together to ensure a collective accountability to ensure delivery of quality and cost effective care. The ACO has developed pre-defined quality performance indicators to ensure that quality standards of care are maintained. 

The National Health Care Workforce commission (NHCWC) facilitates the analysis of the workforce to ensure that only qualified and determined people are permitted to practice. The processes of this commission are steered by nurse educators in conjunction with policy makers with the aim of identifying ways to improve delivery of care. This includes deploying resources in rural areas (Perry & Hoffaman, 2010).

 NMHC’s are primary healthcare services at community levels. It is under the leadership of the APN and is very important especially, with the new changed in the healthcare system that aims at providing medical cover to over 30 million people in rural areas. NMHC’s models are well established with the aim of providing health education, disease prevention and health promotion in the underserved areas (Quad Council of Public Health Nursing Organizations, 2011).

Currently, there are 200 NMHCs in 37 states. They currently attend about 2 million patients every year. Most of them are uninsured.  If the healthcare systems are restructured, it will facilitate the NMHC’s to operate at its full capacity.  If the healthcare reforms are made, the changes are expected to focus more on preventive care in the community. The advancement of technology will improve delivery services.  Therefore, nurse practitioners will be expected to be knowledgeable and competent on preventive health and in healthcare technological advancement (Nursing’s Social Policy Statement, 2010).  

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 Evidently, the restructuring of the healthcare systems will shape the nursing practice.  This implies that nurse educators should ensure that nurse student skills, abilities theoretical, practical and technological knowledge are improved. Additionally, the students must be equipped with leadership skills as they are intricate part of these healthcare changes.

This approach will ensure that the new professionals are adequately equipped with skills that will enable them to manage sensitive and ethical dilemmas in a healthcare that have uniform regulated systems. This will help in ensuring that the patient healthcare receives effective care and at a cost effective (Perry & Hoffaman, 2010).

Nurses feedback summaries:

 Feedback 1: Stephany is a RN with four years’ experience. She believes that nursing practice is a vocation. It requires one to be enthusiastic to deliver effective care. The practice is dynamic, which requires one to continue   researching to learning and understand the futuristic technological advancements that are emerging in this profession. She supports NMHC’s programme arguing that it will help reach many vulnerable population, and simultaneously offer new opportunities which will enable the nurses to cultivate their competencies.

 Feedback 2:

 Alfred has a 10 years’ experience in nursing profession. He has worked as an APN in both the traditional and current healthcare systems. His commitment to delivering effective care has made him become a nurse educator. He says that nursing practice is a sensitive field and only strong willed survive. He supports the concept of continuum of care arguing it is the only way one is assured that the patient healing is holistic.

He says that during teaching, he ensures that the students understand the benefits of establishing a good interaction with their clients.  He says that technological advancement   has improved the delivery of care as it helped reduce medical errors. The interoperability in healthcare practice has ensured that nurses can learn evidenced based practice. He states that he happy and confident that nurses are ready to face the future emerging trends in healthcare.

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Feedback 3:

 Aria is a passionate RN, who has worked in this field for the last five years. She began her nursing career as clinical assistant nurse and has consistently worked hard. The issue of Accountable Care Organization (ACO’s) is thrilling and has helped improve delivery of care in other healthcare institutions.  She says that she has analysed the ACO’s concepts and its intentions. She says that the model supports growth in healthcare system. She also supports NHMC’s arguing that their approaches of preventive care us strategic in ensuring that the community health is protected.

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Therefore, it is evident that nursing professionals act as the controllers of new healthcare system. This healthcare industry comprises of wide range of professionals with diverse knowledge and capabilities. Due to these increased changes in the healthcare industry, the nurses are ultimately responsible for the patient’s outcome. Therefore, the nurses are expected to be very knowledgeable in discussions of the proposed reforms.

The nursing professionals must participate in these policy making meetings. This evolution of collaborative approach is beneficial as it has enabled policy makers to address patient issues foreseen. This facilitates the uniformly regulated   healthcare systems to ensure that patients are well taken care of through the implementation of the care plans identified (Quad Council of Public Health Nursing Organizations, 2011).


Nursing’s Social Policy Statement (2010). The Essence of the Profession. 2010 Ed., 3rd ed. Silver Spring, Md.: American Nurses Association, 2010. Print.

Perry, C. & Hoffaman, B. (2010). Assessing tribal youth physical activity and programming using a community-based participatory research approach. Public Health Nursing, 27(2). 104-114.

Quad Council of Public Health Nursing Organizations. (2011). Core competencies for public health nurses. Washington, DC: Quad Council of Public Health Nursing Organizations

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