Welcome, everyone. Thank you all for finding time to join me in presenting ethical and policy factors in care coordination. In this presentation, we will explore ethical and policy aspects in care coordination. We will also elaborate on ethics in nursing, government policies related to health or safety affect care coordination, national, state, and local policy that raises ethical questions for care coordination, the impact of the code of ethics for the nurse on the coordination and continuum of care, key ethical and policy issues in a presentation affecting the coordination of care in the homeless community.
What is care coordination? Swan & Conway-Phillips (2019) define care coordination as a proactive strategy to facilitating collaboration among health care professionals and care providers to satisfy the requirements of consumers to ascertain that they get incorporated, person-centered care in different healthcare environments. Care coordination can be as simple as verifying that patients can access their EHR data and share their medical information in an interdisciplinary setting. Moreover, care coordination can also be as complicated as handling multiple hospitalizations, requiring numerous sections of care, rehabilitation, insurance, and outpatient appointments. Coordinated care aims to improve the patient’s quality of life, reduce the length of stay in the hospital, minimize readmissions, and cut down the overall cost of care (McWilliams 2016).
Ethical and Policy Issues in Care Coordination
The nursing field utilizes regulatory mechanisms, ethical principles, and a Code of ethics in ensuring that care providers obey the standard practices. The aim is to ensure that healthcare experts carry out their core duties in the most accurate way without risking or endangering the patient’s life. The code of ethics serves as guidance during the decision-making processes. In America, nurses similar to their colleagues in other parts of the world work under the dogmas of the International Council of Nurses alongside national, state, and local policies.
In addition, the code of ethics facilitates adherence to wellness and life altruism of the patient as the primary concern. Hence, nurses have four fundamental roles: restoration of health, prevention of diseases, promotion of care, and alleviation of suffering every time they implement their duties (Wei et al., 2019). These duties include community-centered organizations like nursing homes. The primary fundamentals of car ethics are justice, autonomy, beneficence, and nonmaleficence. Nurses use these principles as the guideline when encountered detestable decisions in sophisticated studies. According to the American Public Health Association (APHA), public health entails massive beliefs in ethical activities of public health (Wei et al., 2019). The interdependence of people is a significant factor worth highlighting. APHA argues that public health is not limited to assuring the health of the communities but ensures that people’s healthcare is within their community.
Government Policies Related to Health or Safety Affect Care Coordination
The federal government’s primary role is to safeguard the patient’s wellbeing and wellness. It achieves this through enacted policies that significantly affect the coordination and continuum of care. The private data belonging to the patient in the U.S. is safeguarded by the Department of Health and Human Service under the Health Insurance and Accountability Act (HIAA). HIAA works with the policy for the Protection of Human Research Subjects (PHRS). The primary aim of federal guidelines is to enhance care coordination, especially when patients arc e shifting providers and insurance (Henson 2016). Furthermore, they enable the promotion of electronic exchange of data within the care facility. The government’s primary concerns regarding the patient’s data are to ensure confidentiality to protect the consumer against breach of disclosure of data accessed within the paradigm of professional data.
These policies affect care coordination in different ways. First and foremost, the guidelines permit the sharing of data among healthcare facilities as long as the aim is to improve the patient’s health. Through HIPAA, community-centered organizations and treating entities can disseminate data without separate authorizations. Consequently, HIPAA has led to improved health provisions and patient safety because nurses and doctors can easily access the patient’s data. This boosts the response between patients and practitioners. This is fundamental, more so for nursing homes where the wellbeing and wellness of a patient mainly rely on the availability of data which in turn helps in decision implementation processes (Henson 2016).
Furthermore, the policies permit the disclosure of data to the patients, clergy, friends, and family because they are on the same premise as the patient. This is crucial, especially when practitioners want to protect the patient’s data from their individual bad decisions, and authorized access to third parties such as family members or friend input would be meaningful. In community organizations like Life Care, particularly for elderly patients, HIPAA is beneficial in implementing decisions.
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National, State, and Local Policy That Raises Ethical Questions for Care Coordination
For any field to be accepted as a profession, it must satisfy specific standards of regulation and practice. This happens in nursing as rules are vital in ensuring safety and competency while carrying out nursing activities. These are actualized through established civil procedure and rules which direct the conduct and decision-making procedures in practice. In the United States, the U.S Department of Health and Human Services serves as the chief agent at the national level. Based on geographical location, various states and their counties have created their own regulations. Therefore, nurses must comprehend and adhere to these policies to avoid legal problems while upholding consistency when on duty.
As much as policies are designed to protect the patients and practitioners in decision-making practices, they create ethical concerns and dilemmas in the profession. For example, at the national level, the privacy regulations address confidentiality. In some scenarios, nurses find themselves in dilemmas between disclosing particular information or keeping the secrecy. Practitioners in nursing homes find themselves in such scenarios when patients ask them not to reveal their knowledge to their families. Additionally, the patient self-determination provision creates some ethical issues. This policy states that patients have a right to make decisions. Sometimes, the patient may fail to understand the practitioner’s concerns, thus making wrong decisions (Coldiron et al., 2017). In such scenarios, practitioners are left in a dilemma. In addition, at the local level, such as Volusia county, the alternative opioid rule, which asserts that patients with a history of opioid abuse should be treated using alternative medicines, can create an ethical challenge. The dilemma may occur when substitute medicine fails to work, and the practitioner is left wondering whether to administer opioids or leave the patient to suffer. Such dilemmas may happen in nursing homes, and nurses could be challenged about their patients.
Impact Of the Code of Ethics for The Nurse on The Coordination And Continuum of Care
Nurses work in a fast paced-and technical setting, which entails making crucial decisions that impact people’s lives; for that matter, the code of ethics is necessary because it helps in decision-making processes. The code of ethics dictates that nurse should carry out their roles irrespective of social determinants, including education, economic stability, health and healthcare, social and community context. Nurses act autonomously to determine patient welfare because of the code of ethics; even though the code of ethics brings so many benefits, adverse effects severely affect coordination and continuum of care (Jeong 2018). For instance, decrease in ethical uncertainty because of technological advancement concerning interventions. Moreover, there is a surge in stress levels and moral distress, especially when professional policies must be met alongside time pressures and complexities related to managing patients.
Key Ethical and Policy Issues in A Presentation Affecting The Coordination and Continuum of Care in Nursing Homes
Nursing homes experience a multitude of ethical and policy issues. Nevertheless, Healthy People 2020 is an appropriate policy that defines the advantages of tackling these social determinants, including constructing physical and social stings to enhance quality care for all (People 2020). Understanding how social determinants impact the consumers is core to offering better services in a nursing home. Despite the efforts to advance access to care, there are various concerns following the practicality of the Affordable Care Act (ACA). The patient confidentiality and privacy policies impact care coordination alongside addressing end-of-life problems policies.
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