BSN410 Healthcare Delivery and Quality Outcomes
Module 1 Discussion
DQ1 Much of the current debate in the U.S. and individual state governments centers on the inclusion and expansion of health insurance coverage for all Americans under the Patient Protection and Affordable Health Care Act of 2010 (ACA). In addition, the scope of the uninsured and the underinsured population in the U.S. is great relative to other countries.
Describe the purpose and importance of the Medicare and Medicaid programs. Support your stance (position) by describing how you agree with or disagree with the purpose and intent of these plans. Provide evidence for your stance (position).
Answer the following question: Will having universal health insurance coverage for all citizens in the U.S. substantially change the health status of individuals and populations? If yes, how so. If no, why not. Support and provide evidence for your discussion.
DQ2 One of the critical issues facing health reform is dealing with escalating costs of healthcare, which drives up premiums, co-pays, and the amount of out-of-pocket costs.
Describe two or more ideas on controlling health costs and at what level (insurance companies, healthcare organizations, general public/community).
Explain how these ideas would not impact quality and safety.
BSN410 Healthcare Delivery and Quality Outcomes
Module 2 Discussion
Landmark studies To Err is Human (1999) and Crossing the Quality Chasm (2001) from the Institute of Medicine (IOM) identified medical errors are causing harm and death to almost 45,000 Americans and costing over $29 billion every year. Other studies, have indicated preventable healthcare associated conditions (HACs) such as infections, sepsis, and pneumonia are main contributors for increasing the length of patient stays, the cost of care, and the likelihood of mortality (death).
Consider the below case study:
Margret Spinner-Ramirez is a 66yr is a Hispanic-American. She speaks both Spanish and English fluently. She was scratched by a stray cat that she feeds on her back porch daily. She went into her local ER two days after the incident for pain, and swelling in her left lower leg where she was scratched by the stray cat. Ms. Spinner-Ramirez also complained of difficulty with baring weight on that extremity. Vital signs stable, and Ms. Spinner-Ramirez was sent home on oral Keflex for her skin infection. Five days later Ms. Spinner-Ramirez was taken back to the same ER via ambulance. She was lethargic and had difficulty being able to move. Cat scan and blood work revealed that Ms. Spinner-Ramirez’s knee replacement in her left leg was infected secondary to the cat scratch. Ms. Spinner-Ramirez was admitted for sepsis. She needed to have her old knee replacement removed, six weeks of IV antibiotics, new knee replacement placed, and rehab.
If you were in charge of a healthcare insurance company:
Explain why insurance companies (which are considered payers) should or should not pay (reimburse) for injuries, extended costs, readmissions, or death (mortality) from a hospital-acquired infection or medical error. Support your why or why not?
Describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.
Discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursements (payments) for services/care.
BSN410 Healthcare Delivery and Quality Outcomes
Module 3 Discussion
After reviewing the websites and completing the readings for this week, locate and read the Healthy People 2010 goals and the process that has been started to develop the Healthy People 2020 goals.
Describe the Healthy People 2010/2020 process.
Discuss the purpose for the development of the national health plan (Healthy People) for U.S. citizens. Explain how your local health department, community, or your employer is helping to achieve one of the Healthy People goals.
Discuss at least one other country which has a national health plan for their citizens and explain how the plan is similar and different from the U.S. plan.
BSN410 Healthcare Delivery and Quality Outcomes
Module 4 Discussion
DQ1 Start by selecting one of the eight Millennium Developmental Goals (MDGs) from the World Health Organization (WHO). After choosing one of the MDGs, explore a specific outcome measurement (indicator) for a country of your choosing to determine the progress towards achieving the MDG. In addition, you will explore nursing roles that would be helpful in achieving the MDG.
Choose one ranked country from the list below not chosen by another student. For this discussion you will need to check the discussion board before posting so that the country you choose has not already been chosen by someone else.
Start a new thread with the name of your country in subject line so that we all can quickly see the country you have chosen. This will not count as one of your postings/responses; it is informational posting only.
DQ2 From your discussion and your chosen country from question one, discuss each of the following indicators.
Please do not post a table or figure to answer this question. Discuss your findings.
Average life expectancy
Cause-specific mortality
Neonatal (infant) mortality rate
Maternal mortality rate
Morbidity-diseases with greatest prevalence
Then answer:
If you were in charge of a mission trip to your country and were asked to choose one of the below indicators as an area to provide free nursing care services, which indicator would you choose to focus your nursing care to help reduce? Explain why?
Average life expectancy
Cause-specific mortality
Neonatal (infant) mortality rate
Maternal mortality rate
Morbidity-diseases with greatest prevalence.
BSN410 Healthcare Delivery and Quality Outcomes
Module 5 Discussion
After watching the Sick Around the World video (found in the required readings for this module), you have been assigned the task of creating an universal healthcare system design for your population/citizens, how would you answer the following:
Describe what type of model you would choose to design your system and explain rationale (why).
Explain how your system you have created would cover two underserved population groups such as an ethnic or cultural minority, women, children, elderly, or disabled.
Choose one country that has a universal healthcare model (from the list of models in the assignment overview or from the Sick Around the World video) and describe how it works. Discuss one positive and one negative.
BSN410 Healthcare Delivery and Quality Outcomes
Module 6 Discussion
DQ1 Describe two nurse sensitive indicators.
Discuss what these specific indicators tell us about bedside nursing practice.
Explain how nurses should be accountable for their patients’ health outcomes.
DQ2 The Leapfrog Group was one of the first groups to offer hospital ratings and demand transparency so that companies and individuals could choose quality care facilities.
Describe the pros and cons of this level of transparency.
Discuss what data about nursing care should be available to the public. Support whether or not you believe facilities should collect individualized nursing care data and use the results to evaluate your nursing care (similar to the report care process used for physicians).
BSN410 Healthcare Delivery and Quality Outcomes
Module 7 Discussion
As the course is coming to a close, it is important for you to examine what you have learned. As you journey forward with pursuing knowledge to improve your work as a nurse, keep this in mind:
Reflect on your learning during this course and explain what was the most important area or something that modified your thinking about an issue. Think back to your introductory post. Discuss if what you posted is similar or different to what you think now. Discuss how you will use what you learned in this course to make improvements in your current practice area. Describe how you intend to share what you have learned in this course with others.
BSN410 Healthcare Delivery and Quality Outcomes
Module 8 Discussion
DQ1 Chronic diseases such as “coronary heart disease, cancer, diabetes, and asthma are the nation’s leading cause of illness and death” (Jonas & Kovner, 2018, p. 152). These diseases pose serious burdens on the health systems and on society. Changing these figures will require that we engage patients, families, communities, and providers in order to impact behavior and health. According to Jonas & Kovner (2018) changing health-related behavior and provider-related behavior represents a prime target for improving national health goals and healthcare” (p. 157). Nursing needs to be engaged in helping to reduce the incidence of chronic diseases and illnesses.
If you were designing a mix of interventions to improve national health goals, what one behavior-related intervention and one provider-related intervention (described in the text-book) would you choose and explain your rationale(s) for choosing each. Describe what the impact or outcome of these interventions would be.
DQ2 Each community bears the burden of disease on its fiscal resources.
Choose ONE of the behavioral risk factors (chapter 7 table 7.1) and discuss the following:
Describe the behavioral risk factor.
Identify and discuss two determinants of health (social, economic, or physical).
Explain how educational status, economic status (poverty or wealth), and health status are related.
BSN410 Healthcare Delivery and Quality Outcomes
Module 3 Assignment
National Health Coverage Plans, Reimbursements, and Quality
For this assignment, you will examine the importance of healthcare coverage (insurance). You will also examine how reimbursements (payments) from health plans are impacted by quality of care. Start by selecting two major national (U.S.) insurance health plans. You may choose Medicaid, Medicare, HMO, PPO, or private insurance plans. You can choose your own personal insurance plan if you prefer. You will review coverage options offered by both plans that benefit and hinder patient’s access to care. Examples of coverage options that facilitate or limit access include medication coverage, primary care physicians, specialists, emergency care, lab or blood work and diagnostics, wellness care, prevention services, surgery (these are just a few examples). You will also explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities and how charity care impacts the vulnerable or uninsured population.
**We will not discuss deductibles and costs of the plans as this will not be the focus of this this assignment.
This assignment requires a minimum of four current (no more than 10 years old), relevant, peer-reviewed, references. Prepare a 3-5 page (does not include title page and references page) APA formatted paper (no more than 5 pages)
OR
6-7 slide power point presentation (does not include title or reference slides) following the rule of 7 (no more than 7 bullet points per slide, no more than 7 words per line) using the presenters notes section in proper APA format
addressing the following:
Introduction
Write an introductory paragraph that describes the importance of healthcare coverage (insurance). End with a clearly worded purpose statement.
Healthcare Coverage and Vulnerable Populations
Discuss two ways healthcare coverage would be beneficial (helpful) for the vulnerable/ uninsured populations.
Select a Major Healthcare Plan - (Label heading with the name of the plan Ex: Preferred Provider Option Plan)
Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient.
Select a Second Major Healthcare Plan - (Label heading with the name of the plan)
Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient.
Diagnosis Related Groups
Describe the purpose of Diagnosis Related Groups (DRGs). Explain the impact of DRGs on length of stay and payment of services. Discuss how payments for DRGs are now impacted by quality of care.
Charity Care
Describe the role of charity care within an acute care health facility (hospital). Discuss how vulnerable populations and the uninsured are helped (impacted) from the charity care provided by healthcare facilities (hospitals). Explain how charity care can benefit the facility.
BSN410 Healthcare Delivery and Quality Outcomes
Module 5 Assignment
Global Health Goals and Health Disparities
This assignment is designed for you to examine global health goals and health disparities. You will select one Millennium Developmental Goal (MDG) and explore a specific outcome measurement (indicator) for a country of your choice to determine the progress towards achieving the MDG. In addition, you will explore nursing roles that would be helpful in achieving the MDG.
We use the term “health disparities” to describe the phenomenon of different health outcomes of varied groups within a particular community. Access the Virtual Library and search in the CINAHL full text database the term “health disparity.” Choose at least two articles that describe health disparities of a particular population or group of people (gender, ethnic, or cultural minority).
This assignment requires a minimum of two current (no more than 10 years old), relevant, peer-reviewed, references.
Prepare a 3-5 page (does not include title page and references page) APA formatted paper (no more than 5 pages)
Or
6-7 slide power point presentation (does not include title or reference slides) following the rule of 7 (no more than 7 bullet points per slide, no more than 7 words per line) using the presenters notes section in proper APA format
addressing the following:
Introduction
Include an introductory paragraph that explains the importance of the World Health Organization and the Millennium Developmental Goals (MDGs). Provides details. End with a clearly worded purpose statement.
Global Health Goals
Select one MDG and include a description of that goal and discuss how the MDG is important to global health.
Country and Goal Progress
Select any country (from module four list). Explain the country’s current status in relation to the outcome measurement being used to represent progress of the chosen MDG. Describe how the country is on track to meet this MDG or not. Include data and details.
Nursing Roles
Select two nursing roles and explain how each role can help the country achieve the chosen MDG. Provides details.
Health Disparity and Findings
Explain the term health disparity and discuss how health disparities can impact vulnerable or underserved populations. Choose one population or particular group (ethnic or cultural, underserved, vulnerable group) and describe a health disparity occurring among this group. Includes evidence, facts, and details.
Nursing Strategies
Discuss how nursing can help to eliminate this disparity or health inequality. Discuss two nursing strategies for improving the health disparity or health inequality (such as access to care, health education, health promotion and prevention, earlier screenings).
.
BSN410 Healthcare Delivery and Quality Outcomes
Module 7 Assignment
Final Project
Health Care Priority Issue
For our final project, we will examine how priority healthcare issues should be examined by nursing. We will select a key healthcare priority issue and a population. You will find articles that describe nursing interventions designed to improve patient outcomes for your population and healthcare priority issue. Finally, you will discuss why Quality Improvement is important for patients and then you will describe how nursing values can be used to help improve patient care. Write a 5-7 page APA style paper (excluding title page and reference page). No more than seven pages of content will be accepted. A minimum of five scholarly references will be required.
Access the Priority Areas for National Action: Transforming Health Quality and read Chapter 3: Priority Areas for Quality Improvement, pages 41-45.
Select ONE priority area (priority healthcare issue) and identify a population you would like to explore. Conduct research to locate information to write about the following:
Specifically, the paper should include the following components:
Health Care Priority Issue
Identifies a healthcare priority issue. Describes the healthcare priority issue, the population it involves, and significance of the healthcare issue by using specific facts and details. Ends with a clearly worded purpose statement.
Rationale and Importance to Nursing
Discuss the rationale for choosing the priority healthcare issue and describe why this issue is important to nursing. Provides details.
Nursing Interventions and Outcomes
Clearly identify two nursing actions or interventions designed to improve care that is measured in patient outcomes. From two nursing articles, select a total of two (no more or less than two) key nursing interventions that improved patient outcomes and explain how the nursing interventions improved each of the two patient outcomes. Provide details.
Quality Improvement Initiative and Patient Care
Using the interventions from the articles/studies, describe how you would recommend a Quality Initiative (QI) to improve patient care within a healthcare facility (hospital) and explain why this QI would be important to implement for patients. Provides details.
Nursing, Quality, and Outcomes
Discuss why it is important for nursing to be involved in quality initiatives and explain how two professional nursing values can help to improve patient care. Provides details
