NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Introduction

Care coordination is an essential intervention in nursing practice. Care coordination entails organizing patient care services and activities with other healthcare providers to achieve optimum care outcomes. It also entails the sharing of patient information among multiple healthcare providers to ensure safety, efficiency, and quality in the care process. The implication of care coordination in nursing practice is that the care given addresses the actual and potential needs of the patients. Care coordination also entails the utilization of the existing community resources to achieve the desired patient outcomes. For example, resources such as social support from patients’ significant others is explored to enhance the care outcomes (Gray et al., 2020). Therefore, nurses should play a proactive role in exploring the ways in which care coordination can be used to achieve the set patient outcomes.

Selected Organization

Nursing homes are the selected organizations for focus in this presentation. Nursing homes are institutions that are established to provide general and specialized care to diverse groups of patients. The institutions have specialists and general healthcare providers that collaborate to address the care needs of their patients. Care coordination is an important component of patient care in nursing homes. They use it to provide patient-centered care that meets the care needs of their patients. Care coordination enables nursing homes to achieve care outcomes such as enhanced safety, quality, and efficiency in the patient care process. Nurses play crucial roles as care coordinators in these settings. They collaborate with other healthcare providers in ensuring care that addresses the patients’ needs is provided.

Effect of Government Policies on Care Coordination

Government policies have a significant effect on care coordination. One of the effects is that it influences the financing for care coordination. The government develops schemes and guidelines used in reimbursing healthcare providers involved in the care coordination process. An example of the ways in which the government regulates financing for care coordination is seen in policies such as the Affordable Care Act that establishes the models used in reimbursing healthcare providers. Government policies also affect care coordination by regulating resources utilized in the process. The government develops policies that strengthen equity in access to and utilization of resources in the patient care process. Healthcare providers have to abide with the developed guidelines for utilizing resources in the care process. The government also develops policies for care coordination. For example, it implemented HIPAA act to ensure the safe and efficient utilization of healthcare technologies in the care coordination process. Through the above roles, government contributes to quality, safety, and efficiency in care coordination by setting standards for use by healthcare providers. The standards assure optimum health to the patients involved in the care model (Gray et al., 2020).

Policies Affecting Nursing Homes

Several policies affect care coordination in nursing homes. One of them is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a policy that was implemented in the USA to ensure the safe use of health information technologies. The policy ensures organizational accountability in the promotion of data integrity. The policy holds nursing homes accountable for integrity of their patients’ data. As a result, they have to ensure privacy and confidentiality of the data of their patients. The Affordable Care Act is the other policy that affect care coordination in nursing homes. The Affordable Care Act was adopted in the USA with the aim of enhancing patient access to high quality, affordability, and availability of care. The act aims at ensuring equity in the access and utilization of healthcare services by the majority of the Americans. The act expanded the American population with health insurance coverage. The adoption of the ACA has enhanced care coordination in nursing homes by eliminating barriers to care such as cost and availability of healthcare providers to offer patients high quality care. Medicaid and Medicare are the other policies that affect care coordination in nursing homes. The policies influence the financing of healthcare organizations involved in the coordination of care. Medicare is one of the largest insurance provider to most than 40 million people in America. Medicare an Medicaid improve coordination of care by enhancing the affordability and access to care by the population irrespective of their backgrounds. They also minimize disease burden and eliminate barriers to access to healthcare due to influence of aspects such as cost and availability of care. Therefore, Medicare and Medicaid enhance care coordination by increasing the affordability of care given by the multidisciplinary teams (Dang & Dearholt, 2018).

National, State, and Local Policies Raising Ethical Questions for Care Coordination

Some national, state, and local policies raise ethical questions for care coordination. One of them is HIPAA provisions. As noted initially, HIPAA was established to ensure data integrity in healthcare. It safeguards the confidentiality and privacy of patient data. HIPAA provisions however raise ethical questions related to data integrity in the care coordination process. Healthcare providers involved in care coordination share patient data to make sound decisions on the care needed. The sharing of patient data raises concerns about its privacy and confidentiality. Patients should be assured that the sharing of private and confidential data will not be accessed by unauthorized parties in the care process. The other policy that raises ethical questions for care coordination is the Affordable Care Act. The Affordable Care Act was adopted with the main aim of increasing the proportion of the American population with medical insurance coverage. The increase in the population with medical insurance was anticipated to result in enhanced access to healthcare, including care coordination. Through it, the act could have address barriers to healthcare attributed to affordability and availability of healthcare services. The act has however undergone changes that have increased the requirements to be met by the majority of the poor population in America. The revisions in the act continually make it difficult for the poor to benefit from its provisions. The other issue that raises ethical questions for care coordination is healthcare access by ethnic minority populations in the USA. Accordingly, significant disparities in access to healthcare services exist in the USA due to effect of race/ethnicity. Ethnic minority groups such as African Americans experience challenges in accessing their needed care due to socioeconomic factors. Inequalities in healthcare access by ethnic minorities raises ethical concerns related to the population’s right to accessing and utilizing healthcare services. The American population has the right to access coordinated care. However, effect of factors such as ethnicity and socioeconomic status raises concerns about the role of government in enhancing equity in access to healthcare services.

Impact of Nurses’ Code of Ethics on Care Coordination

The nurses’ code of ethics affects care coordination and continuum of care. One of the ways in which it affects care coordination and continuum of care is that they promote ethical decision making. The code of ethics inform nurses to make decisions that align with their professional roles and obligations. They ensure the adopted decisions minimize patient harm and optimize outcomes. The code of ethics also strengthens patient-centeredness in care coordination and continuum of care. Accordingly, it raises the level of awareness among nurses on their roles in ensuring holism in the patient care process. The ethics enable nurses to prioritize both the actual and potential health needs of their patients. They also enhance the adoption of interventions that empower patients take responsibility for their health, hence, patient-centeredness in the care process. Nurses’ code of ethics also influence care coordination by ensuring that the adopted decisions protect the patients’ rights. Nurses involved in care coordination ensure that the rights of patients to safe, efficient, and high quality care are protected in the care process. The code of ethics also strengthen professionalism, responsibility and accountability in care coordination and continuum. Nurses involved in care coordination ensure that the care given to the patients align with the professional standards and regulations in nursing, hence, the realization of the desired goals of care in care coordination.