Care Coordination for a Nursing Home

In nursing, the code of ethics guides the coordination of care, the decisions they make, and their impact on the patient and the general community. A nursing home requires a code of ethics because it influences care coordination in its facility. The selected group is a nursing home in California, United States. The group deals with caring for older people who are not safe to receive care in their homes. However, various government policies and provisions affect care coordination in the nursing home; the policies raise ethical questions. The paper explains the care coordination in a nursing home and how the code of ethics for nurses affects care coordination.

How Governmental Policies Related to the Health and Safety of the Community Affect the Coordination of Care

Communities operate in the context of the state and federal policies that the government develops to protect the people. Government policies related to the health and safety of a community affect the coordination of care by influencing the decisions made on people’s health. When healthcare providers in the community coordinate the care of the community, there are government policies that they consider essential in influencing their decisions. One of the specific policies affecting the nursing home involves the Affordable Care Act. The policy makes health insurance a legal expectation. According to the Act, most U.S. citizens can apply for health insurance coverage (Collins & Saylor, 2018). People who fail to secure insurance coverage from their employers can consider the minimum essential coverage, including Medicare or Medicaid. The policy affects the coordination of care in the nursing home by ensuring that people can get the necessary care services with or without insurance. The government uses this policy to protect the people in this nursing home from the high cost of medical care that they may incur while seeking the services.

The Health Insurance Portability and Accountability Act (HIPPA) is the other specific nursing home policy. The policy formed in 1996 protects the patients from discrimination brought by their health problems. In the nursing home, there might be a scenario where patients are denied healthcare services because of their health problems. However, HIPPA influences the coordination of care in the organization by ensuring that all the patients get an equal treatment that is safe regardless of their health problems.

National, State, and Local Policy Provisions that Raise Ethical Questions or Dilemmas for Care Coordination

The United States faces many ethical questions in its policy provisions related to care coordination. Some policy provisions are in the national and state government, while others are local. At the federal level, the Patient Protection and Affordable Care Act is a policy provision that raises ethical questions in care coordination. Despite the benefits of the policy provision for United States citizens, the policy is not clear for immigrants seeking medical help from different healthcare facilities (Townsend et al., 2017). For example, some immigrants need nursing home services; the Patient Protection and Affordable Care Act may fail to protect them, raising an ethical dilemma in care coordination.

The state policy provision requires the citizens to have health insurance. For example, in California, the state government provides Californians with health insurance when seeking medical help. The policy was referred to as an individual mandate because it required all people in the state to have insurance coverage. However, the provision raised ethical concerns because it did not address the issue of employers who deny employees insurance coverage. Local policy provisions also raise ethical questions for care coordination (Townsend et al., 2017). The local government provides U.S. citizens with quality healthcare from government health facilities. However, the issue of the increased cost of healthcare raises ethical concerns. An ethical dilemma may arise in care coordination as physicians handle poor patients without adequate financial support. Some services required by the patient may be expensive in a nursing home, thus raising the question of whether physicians should treat the patients or send them away. Despite the government spending a lot of revenue on drugs, the healthcare cost remains high in the United States for low-income families to afford.

Assess the Impact of the Code of Ethics for Nurses on the Coordination and Continuum of Care

The code of ethics for nurses set provisions that guide communication and interaction among interdisciplinary members during care coordination. The provisions enable nurses to uphold their role in developing strategies and aligning with family and patients at all points of the continuum of care. The code is essential for prioritizing policy options for advancing care coordination and proposing actionable strategies and leadership to advance the implementation of the continuum of care. Nurses rely on the code of ethics when undertaking their medical role in supporting patients while upholding morals in the health care practice (Bower, 2016). The code of ethics enables nurses to accord patients respect and offer the best services. Ethical codes that guide nursing practice may sometimes limit nurses’ creativity during care coordination. The situation might significantly affect care coordination which interferes with the quality of continuum of care implementation.

Factors contributing to health entail the situations and issues surrounding where a person is born, lives, works, and grows. Personal, environmental, social, and economic factors contribute to a person’s health. The factors involve medical care, genetics, environmental influences, behavior, and social factors. The health of any person largely depends on the factors surrounding work and lifestyle. Social determinants are responsible for health disparities that people experience when accessing health.

Health people 2020 explains issues that contribute to health disparities and how society can live healthily. Health people 2020 targets social determinants of health that contribute to health disparities. The determinants involve the factors that affect a person’s health and satisfaction. The framework categorizes social determinants of health into five groups: social context, economic stability, health, health care, environment, and education. Community organizations that focus on health require collaboration programs to address a society’s health needs.

Key Ethical and Policy Issues in a Presentation Affecting the Coordination and Continuum of Care for a Nursing Home

Nursing homes experience a significant effect of government policies and laws that focus on improving overall health provision to society. Policy issues like laws and government regulations significantly affect care coordination in nursing homes. For example, HIPAA provisions require nursing homes to offer the security of patient health information. The policies focus on expanding healthcare coverage admittance, advancing preventive consideration, and lower medical expenses. Policy issues that require nursing homes to increase the delivery of quality care affect the coordination of care in the facilities because of poor staffing (Lamb et al., 2015). Ethical issues affecting coordination and care continuum in nursing homes involve providing care during acuity. Policies requiring nursing homes to cater to excess patients requiring acute care contribute to ethical issues. Patient neglect is prevalent in such situations where poor staffing worsens that issue.

Nursing homes have little to contribute to the overall economy; hence, they have few benefits to gain from care continuum of care. Policy issues guiding care coordination in nursing homes enable the community to access care services that align with the nursing code of ethics. Ethical issues that guide nurses to offer the best medical care facilitate effective implementation of coordination and continuum of care in a nursing home. Community organizations play a vital role in helping people avoid health determinants and achieve well-being and personal satisfaction.

Conclusion

Coordination of care in nursing homes can be affected by the government policies and provisions provided. The policies influence the decisions made in health facilities; as a result, this affects care coordination. Nurses rely on the code of ethics to execute care coordination while upholding morals in the health care practice. Health people 2020 targets social determinants of health that contribute to health disparities. Policy issues that require nursing homes to increase the delivery of quality care affect the coordination of care in the facilities because of poor staffing.

 

 

References

Bower, K. A. (2016). Nursing leadership and care coordination: creating excellence in coordinating care across the continuum. Nursing administration quarterly, 40(2), 98-102.doi: 10.1097/NAQ.0000000000000162

Collins, B. L., & Saylor, J. (2018). The Affordable Care Act: 8 years later. Nursing Management, 49(8), 42-48. doi: 10.1097/01.NUMA.0000538917.37912.d4

Lamb, G., Newhouse, R., Beverly, C., Toney, D. A., Cropley, S., Weaver, C. A., … & Peterson, C. (2015). Policy agenda for nurse-led care coordination. Nursing outlook, 63(4), 521-530.http://dx.doi.org/10.1016/j.outlook.2015.06.003

Townsend, C. S., McNulty, M., & Grillo-Peck, A. (2017). Implementing huddles improves care coordination in an academic health center. Professional Case Management, 22(1), 29-35. https://doi.org/10.1097/NCM.0000000000000200

 

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