The government of the United States of America is devoted to promoting the level of health care in all states and making health care affordable and accessible to all. In the efforts to promote health care, the government has introduced new policies and regulations in health care delivery. The nursing practice has been impacted by federal regulation making it change in various ways in the effort to improve and adhere to quality care provision and enhancing patient safety. Nursing leadership and management has been modified to accommodate more roles such as human resource management. With the current emerging trends, the practice of nursing is likely to transform completely in the next five years.
The Affordable Care Act of 2010 is one of the comprehensive reforms introduced by former president Barrack Obama. It entails policies that strive to expand access to health insurance to all uninsured Americans (Griffith et al., 2017). Affordable Care Act aimed to serve three core functions in the health care system. First, it was objectively formulated to reform the private insurance sector. It changed rules to ensure private insurers offered comparable policies at appropriate rates.
The Act laid policies to improve Medicaid to include the initially uninsured. Medicaid was capacitated to incorporate low-wage earners of up to 133 percent of the federal poverty level (Griffith et al., 2017). The Act was implemented to direct how significant health decisions were made. The decisions on ensuring family members were settled upon that all children remained under their parents’ insurance plan.
The Affordable Care Act has impacted nursing practice in the United States of America. Following the implications, most Americans could access health care services, resulting in an increased number of hospital entries. More admissions created a gap in the nurse-patient ratio reflecting nurses’ shortage. The demand for nurses significantly increased with not adequate nurses aspiring to work. The roles and responsibilities of already employed nurses were adversely affected. This is because, despite their shortage, they had to work to meet the demand. Nurses, therefore, are overworked, performing many duties for long hours. The quality of care delivered by the nurse deteriorated due to fatigue from overworking. Some nurses who could not sustain the amount of work resolved to resign, leading to more shortages.
Impact of Quality Measure and Pay for Performance of Patient Outcomes
Quality measures serve as assessment tools to determine the quality and efficiency of care delivered to patients. They measure health care processes, health outcomes, and patient opinions on the care received. The main measures are structural, process, and outcome measures. These measures play a critical role in care delivery and patient outcomes. Structural measures, for instance, determine the patient-to-nurse ratio (Kaufman et al., 2019). This ratio is used to define if the number of nurses available meets the demands. As such, decisions of hiring more nurses will be made depending on the information. This, therefore, will lead to timely and efficient health care delivery.
Process measures assess the care delivery process to patients in health care facilities. These measures will aid in the detection of errors and areas requiring improvement. The measures are also used in public reporting on matters of public interest. These measures, therefore, play a role in improving patient care delivery by improving various aspects of care and correcting errors. Outcome measures reflect on the results of care interventions, including the cure rates and death rates. They measure quality and determine how best to improve it in favor of patient outcomes.
Pay for performance is an introduction in health care that stipulated a payment model where any medical staff offered financial offers for meeting a specific set level of performance. Nurses, physicians, and health facilities were financed per the quality and number of services provided (Kaufman et al., 2019). Services rewarded include blood pressure monitoring management, and counseling of patients with various challenges, such as smoking addiction.
The model also impends penalties on medical personnel for any errors committed when delivering health care services that result in poor outcomes or increased costs. This initiative servers as a motivator as caregivers strive to earn more. It also plays a role in ensuring efficiency in care delivery by reducing errors in care provision. This has positively impacted care delivery and therefore has improved patient outcomes.
Quality measures and pay for performance have impacted nursing practice in different ways. Quality measures have aided in identifying errors during care delivery and rectifying them. The measures also assess the area where nursing training is insufficient and provide an opportunity to learn and improve nursing practice. The improved patient outcomes provide a sense of satisfaction for nurses and improve their morale for practicing nursing. Pay for performance and quality measures have raised the expectations of the role and responsibilities of nurses. Nurses should work harder to ensure efficient care delivery to ensure a positive outcome, earn more, and avoid penalties for errors.
New Roles in Nursing Leadership and Management
The health care sector universally is experiencing rapid changes to meet the increased demand for health care. The nursing fraternity forms a significant section of the health care sector. In the efforts to ensure improved health care and patient outcomes, nursing has also changed, and its leadership and management have also evolved (Quinn, 2017). The new roles that have arisen include human resource management, policy formulation and implementation, and organizational productivity.
Nurses’ leaders and managers have been mandated with the role of managing human resources in health facilities. This involves proper allocation and utilisations of resources, such as finances and equipment. Nurses are required to be responsive, accountable, and responsible in using these resources to promote efficiency in care delivery (Quinn, 2017). Leadership in nursing has been empowered to make significant decisions in the health sector, unlike in the past. Nurse managers at any level, be it in a medical ward, have the role of deciding how best care can be delivered without any outside interruption.
These duties play a crucial role in enhancing the new nursing practice trends that aim to improve care delivery. The roles empower the nurse to manage the available resources and make independent choices concerning patients care. The Elimination of the power tussles that initially downgraded nurses motivates the nurse who strives to improve their productivity. As a result, patients receive timely and accurate care that promotes patient safety and quality care.
Future Reforms in Nursing
Among the new trends being faced in the present day is the increased rate of specialization. Nursing has been categorized into more specific fields that include intensive care nursing, oncology nursing, and anesthetic nursing (Rafferty, 2018). Specialization and certification facilitate competence and assurance in care delivery. The nursing care setting is also changing from the hospital setup to the community setup. This aims to deliver care to the large population in the community rather than the few in the hospital.
In the future, nursing practice and roles are likely to transform to ensure adequate care provision. In about five years, the enrolment of nursing staff will improve to larger numbers. This is due to the changes in nursing practice and training that have enabled more students to join the nursing school. The focus of nursing care is also likely to change to population health more than patient health. This is related to the desire to prevent the disease from occurring at the population level.
References
Griffith, K., Evans, L., & Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in health care access. Health Affairs, 36(8), 1503-1510. Web.
Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & O’Brien, E. C. (2019). Impact of accountable care organizations on utilization, care, and outcomes: A systematic review. Medical Care Research and Review, 76(3), 255-290. Web.
Quinn, B. (2017). Role of nursing leadership in providing compassionate care. Nursing Standard (2014+), 32(16-19), 53.
Rafferty, A. M. (2018). Nurses as change agents for a better future in health care: The politics of drift and dilution. Health Economics, Policy and Law, 13(3-4), 475-491. Web.