NURS 8100 Week 5 Discussion Technology and Cost Containment

Walden University NURS 8100 Week 5 Discussion Technology and Cost Containment– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8100 Week 5 Discussion Technology and Cost Containment assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8100 Week 5 Discussion Technology and Cost Containment

Whether one passes or fails an academic assignment such as the Walden University NURS 8100 Week 5 Discussion Technology and Cost Containment depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8100 Week 5 Discussion Technology and Cost Containment

The introduction for the Walden University NURS 8100 Week 5 Discussion Technology and Cost Containment is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8100 Week 5 Discussion Technology and Cost Containment

After the introduction, move into the main part of the NURS 8100 Week 5 Discussion Technology and Cost Containment assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8100 Week 5 Discussion Technology and Cost Containment

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8100 Week 5 Discussion Technology and Cost Containment

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8100 Week 5 Discussion Technology and Cost Containment

A significant challenge to containing health care costs is the price of the equipment and medications needed to diagnose and treat patients and the lack of adequate reimbursement. Bodenheimer and Grumbach (2020), speculate that “the price of prescription drugs in the United States is 50% higher than that in other countries” (p. 94). IN my world the charge for delivering a baby is around $7,500.00. Private insurance companies pay approximately 2/3 of the delivery fee compared to Medicaid covering on average about 20%. This is not sustainable if a hospital operates in a community with high Medicaid rates. Additionally, the quality of health care is directly tied to reimbursement.  A hospital that operates with a low-profit margin makes cuts in staffing, replaces needed equipment, and struggles to attract physicians and care providers that provide high-quality care.  

One way that Bodenheimer and Grumbach (2020), describe technology being utilized to decrease costs is a broader use of robotic surgeries. Gall bladder surgery, specifically described in the reading from this week can be performed in less time if robotics is used, is less invasive for the patient which decreases the length of stay, and requires less payout to providers who perform the surgery related to the decrease in time.  

It is hard to say if I agree or disagree with the policymakers on reducing health care costs. I would say that it depends on how collaborative policymakers are with the individuals who provide healthcare. A few years ago Colorado tried to pass a bill  (www.coloradoindependent.com) that was well-intended in the effort to provide broader coverage for the public but wanted to introduce the idea that all hospitals would be reimbursed at Medicare and Medicaid rates to accomplish this. The governor was convinced that hospitals were price gouging and so in his mind reimbursing hospitals at a lower rate made sense. Fortunately, the bill lost momentum with the Covid-19 pandemic and has not resurfaced. 

The concept of patient-centered medical homes (PCMHs) according to Rosenthal et al. (2010), continues to be a popular idea. The notion of a PCMH is to provide care to patients in a more coordinated fashion to reduce inefficiencies.  One provider guides all of the care of the patients. Although specialists, subspecialties, and acute and long-term care may be needed, the overseeing provider organizes all of this.  

References: 

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach. McGraw Hill.  

The Colorado Independent. (March, 2020), Update: Colorado’s public/private healthcare option clears first hurdle. Retrieved at https://www.coloradoindependent.com/2020/03/12/colorado-public-option-healthcare/ 

Rosenthal, M., Beckman, H., Forrest, D., Huang, E., Landon, B., & Lewis, S. (2010). Will the patient-centered medical home improve efficiency and reduce costs for care? A measurement and research agenda. Medical Care Research & Review, 67(4), 476-484. 

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Sample Answer 2 for NURS 8100 Week 5 Discussion Technology and Cost Containment

In the healthcare industry, nurses’ turnover is a significant challenge to contain health costs. It was ranked third of the top three industries with high turnover, with the nurses’ turnover becoming a rapidly growing human resource problem that affects the healthcare sector worldwide (Cohen, 2019). Its world rate is considered very high, ranging from 15 to 44%, resulting in a significant impact on a hospital’s profit margin, with the average cost of turnover for a nurse ranging from $37,700 to $58,400, and hospitals losing $5.2 million to $8.1 million annually (Lockhart, 2020).  

According to the 2019 National Healthcare Retention & RN Staffing Report, it costs between $40,300 and $64,000 to replace one clinical nurse, with the average hospital losing $4.4 million to $6.9 million each year (Lockhart, 2020). The turnover rate for RNs continues to rise, 43 percent of new nurses working in hospitals leave their jobs within three years, and additionally, 33.5 percent resign after two years, and 17.5 percent work only one year (Lockhart, 2020). Nursing turnover is extremely costly for healthcare organizations, which struggle to keep experienced and novice nurses alike, but 18% percent of new nurses change jobs or even professions, within the first year after graduation, and an additional one-third leave within 2 years (Lockhart, 2020). Nationally, the nursing turnover rate averages 19.1% and rising, leaving a nursing vacancy rate of 8%, and the average period it takes to fill a nursing position is 85 days, with more than three months, for a specialized nursing position (Lockhart, 2020). 

The hospital managers state that nurse turnover disrupts hospital service operations, staffing processes, managerial processes, hospital revenue, loss of experienced and trained nurses, nurse shortages, and an imbalanced composition of new and remaining nurses, which increases the costs for recruitment and training cost for new hires (Dewanto & Wardhani, 2018). The turnover negatively affects hospital services, revenue is disrupted, due to the decreased work productivity of the new nurses, increased expenses related to new hires’ recruitment, mentoring training to placement, and, because the new nurses require an orientation process, as their skills do not meet the expected standards (Dewanto & Wardhani, 2018). These staffing problems cause issues in setting schedules, necessitating increased overtime, low morale of existing nurses, the less-than-optimal service provided, because of communication, and, barriers between the senior and the new nurses (Dewanto & Wardhani, 2018). The services are heavily impacted, leaving the patients frustrated with frequent replacements, mediocre treatment by a less competent new nurse leading to the patient’s decreased trust, satisfaction, and increased complaints about nursing service (Dewanto & Wardhani, 2018). 

The advancements in technology and their implementation can alleviate some of the turnovers by improving workflows and making patient care easier. Technology use can reduce medical care costs. reduce the burden on nurses, motivate more clinicians into the workforce to mitigate the shortage, and improve the transparency of medical records between healthcare organizations (Cohen, 2019). The development of innovative nursing practice models with increased computer technology, to be used for all documentation of patient care, and generation of the electronic medical records (EMRs) is an example (Moore, 2000). There are several other technologies which include including telehealth, artificial intelligence, texting, blockchain credentialing, mobile staffing apps staff augmentation, and artificial Intelligence being some of the tools, which make daily workflows easier for nurses and nurse practitioners amid a shortage of clinicians (Agbo et al., 2019). These tools can help to alleviate the shortage’s effects on nurses and NPs, by improving efficiencies in their daily workflows and how they provide care for patients. Many providers and patients were initially uncomfortable with telehealth, however, the pandemic not only increased adoption but also led to a rise in comfort levels, for those using the technology, allowing nurses and NPs to see more patients in a day (Rojahn, et al., 2016). Blockchain credentialing is an app that allows for a nurse’s credential data to be stored on multiple servers, rather than just a single server, allowing organizations to see entries in real-time, which creates a public electronic ledger, making it easier for healthcare organizations to look up a nurse’s credentials and speed up approvals (Agbo et al., 2019). The mobile staffing apps and staff augmentation, modulate the staffing based on patient volume and acuity, allowing nurses and NPs to see the hospital’s schedule, sign in, swap a shift, or pick up holidays (Mayer et al., 2019). It also allows healthcare organizations to supplement their support staff, through third-party staffing to ensure operations run smoothly, with the clinicians being to able to focus better on patient care and complete their day-to-day tasks efficiently (Mayer et al., 2019). Artificial Intelligence is often applied within healthcare to make sense of clinical data by identifying trends, that can lead to better patient outcomes, and can be used to assess fall risk, or detect tuberculosis in x-rays (Mayer et al., 2019). 

I agree with policymakers that technology needs to be more introduced as mainstream in health care because healthcare policies and insights, need to be revolved around a multifaceted approach to address nurses’ shortage and turnover. One insight is the introduction of the electronic medical record (EMR) and other technological advances, which can also affect nurses staying in or leaving the organization (Haddad et al., 2022). Another insight is the electronic scheduling tool, which allows nurses to sign up for individual shifts they are qualified to cover, as well as trade shifts with other nurses with the same skill set when needed, this has the ability not only helps with work-life balance, flexibility but also makes scheduling easier for both nurses and management (Haddad et al., 2022). Social media on job recruitment platforms have become major sources of information for nurses looking for jobs as they provide an opportunity for the organization to communicate, introduce and explain the kind of environment they have, through the reviews provided by both workers and patients (Haddad et al., 2022). 

References: 

Agbo, C. C., Mahmoud, Q. H., & Eklund, J. M. (2019). Blockchain Technology in Healthcare: A Systematic Review. Healthcare (Basel, Switzerland), 7(2), 56. https://doi.org/10.3390/healthcare7020056  

Cohen, J. K. (2019). Tech helping to alleviate nurse shortage, experience gaps. Modern Healthcare, 49(32), 14. 

Dewanto, A., Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nurs 17, 5. https://doi.org/10.1186/s12912-018-0317-8 

Haddad, L. M., Annamaraju, P., &Toney-Butler, T. J. (2022). Nursing Shortage. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/ 

Lockhart, Lisa. (2020). Strategies to reduce nursing turnover, Nursing Made Incredibly Easy: March/April Volume 18 – Issue 2 – p 56 Doi: 10.1097/01.NME.0000653196.16629.2e 

Mayer, M. A., Rodríguez Blanco, O., & Torrejon, A. (2019). Use of Health Apps by Nurses for Professional Purposes: Web-Based Survey Study. JMIR MHealth and UHealth, 7(11), e15195. https://doi.org/10.2196/15195 

Moore P. (2000). Perspectives. How can we help to alleviate the nursing shortage? ONS News, 15(5), 14. 

Sample Answer 3 for NURS 8100 Week 5 Discussion Technology and Cost Containment

In the world today technology is inevitable in all industry sectors. Health care is not an exception. There is an added cost in trying to make technology secure. There are however other costs that are challenging to the health care system and one such cost will be addressed in this discussion.

Significant Challenge to Containing Health Care Costs.

The cost of health care in the United States can be attributed to many reasons. A glimpse of the cost is mentioned as a summation of over four million dollars in the year 2020 alone (Centers for Medicare and Medicaid Services, 2021). Unnecessary emergency room (ER) visits in United States is one of the challenges that make containing health care costs a hard task. According to Rubin, (2021), in the year 2017 alone there were over one hundred and forty-four million ER visits that costed over seventy-six billion. This statistic is alarming.

 Health care cost reduction can be achieved by eliminating of unnecessary ER visits (Walden University, Producer (2011).  The root cause of these visits can be attributed to numerous factors including underpaying health care providers who opt to send their patients to ER instead of taking care of them in an outpatient clinic.

Cost containment is therefore easier said than done because to reduce ER visits means to have an effective system of health care delivery. One way this would be achievable would be to manage chronic conditions like hypoglycemia without involving ER visit.  Knowing how expensive going to the ER can be has led to different interventions being put in place to reduce these visits.

According to Lyons, Olson, Palmer, Horwitz, Mandl & Fine  (2017), those who frequent the ER can be identified but unfortunately there are those who use multiple ERs. These patients who visit different ERs may lead to duplicative and unnecessary care.

Policy Makers Envision of Technology

Technology has made it possible for clinicians to access health information from different sources. In the ERs clinicians sometimes have to make quick decisions and with technology it would be possible to have knowledge regarding previous care. Simple information like allergies would be accessible to clinicians. Having history and physical information in a data base that would be accessed at the ER would make the visit less time consuming. According to Ojetti, Covino, Brigida, Petruzziello, Saviano, Migneco, Candelli & Franceschi (2020), sometimes the ER is is viewed by patients as a place to have solutions to health care problems. With technology, the ER clinicians can determine after having access of health care information if a patient needs to be triaged to the next level of care or needs to be discharged.

One Example

One example of use of technology is one that is required in the state of Maryland. Chesapeake Regional Information System for our Patients (CRISP). This is the state of Maryland designated health information exchange. As a provider especially in the ER one has to log in to CRISP and is able to see all the scheduled medications that the patient is taking, the last refill, the provider who wrote the prescription and the pharmacy that the medications were filled. This information is critical because there are some patients who visit the ER expecting to be given narcotics when they already have current supply for a month.

Agree or Disagree with the Policy Makers.

The long term effect of using technology remains positive from the point of view of the provider. It is therefore fair to be agreeable with the stakeholders. According to Fereydon, Roghayeh, Ahmad & Mohsen (2020), technology has the ability of having a positive impact in health care improvement in regards to quality, safety, and efficiency. It is however important to acknowledge there would be a cost related to training and implementing and sustaining technology. However, in the ER technology offers critical information for patients that is urgently needed to aid in treatment modalities. This information sharing saves time which in turn saves the cost of treatment.

References

Centers for Medicare & Medicaid Services. (December, 2021). National Expenditure Data https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical

Fereydon ,E., Roghayeh, S., Ahmad, J., & Mohsen, S. (2020). The Use of Health Information Technology by Nurses in Healthcare. Preventive Care in Nursing and Midwifery Journal, 9(1), 36–39.

Lyons, T. W., Olson, K. L., Palmer, N. P., Horwitz, R., Mandl, K. D., & Fine, A. M. (2017). Patients Visiting Multiple Emergency Departments: Patterns, Costs, and Risk Factors. Academic Emergency Medicine, 24(11), 1349–1357. https://doi.org/10.1111/acem.13304

Ojetti, V., Covino, M., Brigida, M.,  Petruzziello, C., Saviano, A.,Migneco, A., Candelli, M & Franceschi, F. (2020). Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Medicina, 56(512), 512. https://doi.org/10.3390/medicina56100512

Rubin, R. (2021). The Costs of US Emergency Department Visits. JAMA, 325(4), 333. https://doi.org/10.1001/jama.2020.26936

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Cost containment. Baltimore: Author.

NURS 8100 Week 6 Discussion Individual Right Versus the Collective Good

The Vaccines Health Policy 

Vaccines are responsible for various global public health successes, such as the eradication of smallpox and significant reductions in other serious infections like polio and measles. Even so, vaccinations have also long been the subject of various ethical controversies. In the United States, state policies mandate certain immunizations, including school entry requirements, which cover significant numbers of children (Salmon & Omer, 2006). The first vaccination requirements were enacted in the 1850s to prevent smallpox, and Federal and state efforts to eradicate measles in the 1960s and 1970s motivated several modern mandates policies (Toebes, 2020). By the 1990s, all 50 states required immunizations, and vaccines were licensed and added to the immunization schedule, after research, testing, and monitoring, coordinated and reviewed by The National Vaccine Program and other key vaccine committees (Salmon & Omer, 2006). 

Explain the Tension between Individual Rights and the Collective Good. 

 People decline vaccines for various reasons, like inadequate access to vaccines, fears of iatrogenic diseases, preferences for natural lifestyles, and religious opposition to vaccines (Van Hooste&Bekaert, 2019). The other reasons are the increased sense of responsibility for the small risks of vaccines, as opposed to the responsibility for the risks of exposing one’s children to infectious diseases, and the rest being, simply vaccine-hesitant, not rejecting vaccination tout court in principle, but their skepticism and concerns, cause them to delay vaccination (Van Hooste&Bekaert, 2019). Tension results when individuals want to exercise their right to protect themselves, and their children by refusing vaccination, by not accepting existing medical or safety evidence, or if their ideological beliefs do not support vaccination (Toebes, 2020). The vaccination decisions and policies present tensions between individual rights and the moral duty to contribute to harm prevention, as the government to protect the public from infectious diseases, imposes health vaccine regulations and compulsory immunization requirements (Toebes, 2020). These requirements can infringe upon individual liberty, with laws that curtail their autonomy, with some aspects of these health requirements, being viewed as paternalistic, and the objection to vaccines therefore arises, because these individuals, communities disagree with the mandates, and/or have religious or philosophical beliefs that conflict with vaccination (Van Hooste&Bekaert, 2019). The clinical and public health perspective frameworks also contributed to the arguments for, and against making vaccination mandatory, because neither of them could solve the question of mandatory vaccination policies completely.  One side supports mandatory immunization, based on the duty of health professionals to improve the well-being of the public, while the other one, supported the violation of the employee’s autonomy, which is mentioned as a primary objection to the requirement of immunization (Toebes, 2020). 

Analyze the Ethical and Legal Considerations of the Policy. 

The ethics of vaccination clearly exemplifies the interdependence of individual responsibilities to be vaccinated, the collective responsibilities, realizing herd immunity against infectious diseases, with institutional responsibilities, enact policies that guarantee herd immunity, and its fair realization (Toebes, 2020). Mandatory vaccination is the leading factor in the new ethics point of view, and the government has a legal responsibility, to protect the public, from the dangers of highly communicable, and deadly diseases. The responsibilities, however, were not clear as to whether to mandate vaccination or assessment of a recalcitrant person with a serious communicable disease and their execution in a non-discriminating and fair manner, as per the US Constitution (Krasser, 2021). This was to protect an individual’s rights and help to ensure a balance between the ethical requirements of government, ensure society’s welfare, and support individual autonomy in the context of justice. The public health ethics frameworks justify mandatory programs by supporting the claim that the protection of the community through immunization is fundamental to public health. The same ethics also support the claim that there is no direct evidence, that mandatory vaccination programs prevent diseases, and should therefore not be implemented (Van Hooste&Bekaert, 2019). The anti-vaccines argue that non-coercive measures are ethically preferable unless in emergency cases, while the pro-vaccines state that the measures should be ethically justified even in absence of emergencies, with the fundamental moral principle being, the protection of the vulnerable, with the implementation of a comprehensive approach to ensure that these patients are protected (Grohskopf et al., 2020). The healthcare provider is ethically bound by the four ethical Hippocratic principles, to care, to prevent harm or infection to the patient. and the new ethics model tried to substitute the clinical Hippocratic model with a public health model, with the emphasis on prevention and optimizing public health, not on individual outcomes (Van Hooste&Bekaert, 2019). An expert committee replaced the individual patient, as a decision-maker, and the mandatory influenza vaccination was, therefore, based on authority, and not on facts (Grohskopf et al., 2020). The policy of requiring a vaccine, like the flu vaccine as a condition to work in healthcare, demonstrates the dogmatism of the public health model, and how it transcends individual autonomy, while the Hippocratic ethics, and evidence-based medicine, argue that the strength of the evidence, is inversely proportional to the moral zeal of the mandatory proponents of vaccination (Giubilini, 2021). 

References: 

 Giubilini, A. (2021). Vaccination ethics, British Medical Bulletin, Volume 137, Issue 1, March 2021, Pages 4–12, https://doi.org/10.1093/bmb/ldaa036 

Grohskopf, L. A., Liburd, L. C., & Redfield, R. R. (2020). Addressing Influenza Vaccination Disparities During the COVID-19 Pandemic. JAMA.;324(11):1029–1030. doi:10.1001/jama.2020.1584 

Krasser, A (2021). Compulsory Vaccination in a Fundamental Rights Perspective: Lessons from the ECtHR” ICL Journal, vol. 15, no. 2, pp. 207-233. https://doi.org/10.1515/icl-2021-0010 

Salmon, D. A., & Omer, S. B. (2006). Individual freedoms versus collective responsibility: immunization decision-making in the face of occasionally competing for values. Emerging themes in epidemiology, 3, 13. https://doi.org/10.1186/1742-7622-3-13 

Toebes, B., (2020). Mediating tensions between public health and individual rights, European Journal of Public Health, Volume 30, Issue Supplement_5, September 2020, ckaa165.044, https://doi.org/10.1093/eurpub/ckaa165.044 

Van Hooste, W., &Bekaert, M. (2019). To Be or Not to Be Vaccinated? The Ethical Aspects of Influenza Vaccination among Healthcare Workers. International journal of environmental research and public health, 16(20), 3981. https://doi.org/10.3390/ijerph16203981