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

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

Ethical and Policy Factors in Care Coordination

Care coordination is an integrated health care provider practice regulated by the health care professionals at the health care settings (Swan et al., 2019). It is a multidisciplinary concept that holds immense importance in the health care setup. Nurses are the main stakeholders of the care ordination according to the American Nursing Association Nursing Code of Ethics (ANA, 2001). The care coordination requires multiple sectors involvement of the community health care and national policymakers. 

This paper analyzes the ethical considerations and implications in terms of the policies of the governments related to coordinated care. Several factors contribute to the care coordination plan including the nurses’ ethical conduct and the service provision limitations. The organization addressed for the policy regulatory analysis and ethical implications is the American Lung Association (ALA). This organization works with the Federal and local governments to provide optimal lung health under different community and national laws. 

The use of ethical consideration in the health care practice can be experienced in several events. For example, in COPD the post-discharge monitoring is researched to provide a better outcome of the respiratory events. The issue of the confidentiality of the patient’s information in the electronic records cannot be accessed without the patient’s consent. The preservation of private information hinders the proper post-discharge monitoring and care.

Governmental Policies for Health Care and Community 

The government also have set up coordination care strategies and policies to enhance the patient-centred outcomes at the health care centre and community level. The Affordable Care Act provides the necessary financial support to the patients to obtain optimal care. The Affordable Care Act was started in 2011 providing socio-economic benefits in the form of health insurance to chronic disease patients. The patients with COPD having frequent readmissions can be managed by the Affordable care act (Hanlon, 2017).

  The coordination of care enhances communication across the health care department. It also enhances the coordination among professionals that will reduce medication errors and provide the timely diagnosis of intra professional communication. The care coordination plan also improves the quality of care. The Center for Medicare & Medicaid Services (CMS) issues some community-based care transition programs that enhance the coordination in post-discharge patients and reduce the rehospitalization rate. This program uses meaningful technologies for monitoring and investigation of the improvement of the patient (Gov. U.S.).

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

The American Lung Association (ALA) working with the U.S. Health Department has the triple aim of providing Care Coordination oriented health care. The policies include the involvement of the multiple sectors of society and health care units. The policies originated by the U.S. health care department and regulated by the ALA are centred to improve the patient experience of care at the health care units. Improve the health of the overall population with efficient care and reduce the costs of the health measures and treatment measures (U.S. Health Department, 2018). The Federal Action Plan undergoes the multisectoral management of the policy. The 2021 action plan agenda emphasizes the policy implementation in the research arenas and the environmental pollution reduction (Gov.Us.). 

Patients with COPD have triggered respiratory distress attacks because of the several toxic pollutants and dirt particles (Gayle et al., 2021). The Federal National Action plan, 2021 provides the National Ambient Air Quality Standards (NAAQS) and transitions to cleaner cars, SUVs and Light Trucks to reduce environmental pollution. The transition to non-combustion sources of energy is also aimed to reduce a considerable amount of pollutants (U.S. Gov.).

National, State and Local policies

The U.S. implemented National and State policies of the cessation of smoking and funded programs for the people who wants to quit smoking are provided (ALA, 2021). The local laws and regulations of preventing indoor smoking, cessation of the smoking campaigns, high taxes on tobacco and general community campaigns of the awareness of smoking and its health effects create a reasonable impact on the policy measures (Thrul et al., 2021). The American Lung Association is an organization that works with the Federal government in implementing and regulating lung health-related policies and laws. It is working in multiple domains to ensure safe air, lung health and preventing tobacco. ALA is mainly concerned with uplifting lung health. Its main purpose is to advocate and educate the events related to lung health (ALA, 2021). 

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

ALA advocates the national laws and policies that support lung health. The main advocacy policies of ALA are clean air that means free of toxins, pollutants and dirt, as people with lung diseases often have respiratory triggers related to the environmental pollutants. Lung health policy includes medical, health care and community policies of improving the health of lungs. Tobacco, the most common irritant of COPD, policies of quiet smoking is necessary for COPD patients. ALA introduces tobacco and cigarette prevention measures to prevent the exacerbation of COPD (ALA, 2021). 

The community-based National program for the prevention of tobacco, cigarette smoking is being implemented that provides support for smoking cessation (ALA, 2021). The government have laved high taxes on the purchase of the cigarette and tobacco (Congress, 2011).

Ethical Dilemmas of Care Coordination

The purpose of care coordination is to work collectively with the patient-centred approach. The nursing practice often reports certain ethical and moral dilemmas that address the nurses to review the code of conduct. Nurses being the stakeholders of the health care department are responsible for keeping the confidentiality of the patient’s information to themselves (Gutierrez et al., 2020). The negligence in the workplace can cause the patient’s long recovery time and poor health outcomes. The malpractice can be identified by the nurses and addressed to the authorities. The whistleblower at the organization requires to build a trustworthy relationship with the organization to address the negligence practised at the organization (Aydan and Kaya, 2018). The nurse code of conduct for the provision of efficient care with coordinated and continuously improving efforts of care requires the nurses to address the negligence in the care at once. The Nurses has reported the negligence of the patient care in the primary health care setting and addressing the negligence of the fellow nurse was faced by the moral and ethical concern of the whistleblower (Rainer et al., 2018). However, the ANA code of conduct allows the nurses to address penitent centred care. The ethical dilemmas of care coordination are also observed in the autonomy and dignity of the physicians to work in coordination (Shenoy and Appel, 2017). The balance between responsibility and accountability must be maintained which become an ethical dilemma (Tonnessen et al., 2017).

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

Ethical Implications, Nurse Code of Conduct, Coordination and Continuum of Care

The ethical implications and the code of conduct of nurses provide the continuum of care in the community and medical care. The working ethics of the hospital provide interprofessional communication and timely, safe, quality and efficient health care. The code of conduct addresses the basic care coordination practices that ensure the practice of the regulatory conduct at the health care organization. 

The nurse’s code of ethics is based on the care coordination ‘triple aim’ enables them to provide quality, access and reliable care to the patients with continuous efforts to improve coordinated care and efficient health care practices (ANA, 2001). Nurses have the role of care coordinators (IHI, 2011). It implicates the nurses to provide coordinated care by communicating with the other health care professionals. The American Association for College of Nursing (AACN) also enables Nurses to practice holistic care measures. The continuum of health and illness must be regulated by enhancing the communication with the patient and with other health care providers (ANA, 2001). The caring practices require multiple resources in the form of financial, medication and manpower to provide better-coordinated care. 

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

Impact of the Nurses’ Code of Conduct on Care Coordination

The impact of the Nurses code of conduct of care coordination., continuous improvement, patient centred safe and efficient care provisions provide patient satisfactory care (Baker et al., 2018). The addressing of the malpractice and medication negligence will increase the number of reported medication errors (Alomari et al., 2018). The costs for the medication and the organizational expense son the readmission will decrease after the efficient care practices along with better post-discharge care and monitoring (Werner et al., 2019).

Key Ethicaland Policy Issues In Apresentation Affecting The coordination And Continuumof Care

The main issues identified in the ethical practice is the dilemma of malpractice by the nurses and personal autonomy for the professional to work together (Podgorica et al., 2021). It enables the nurses to depend on their decision-making abilities to competently handle the situation. The autonomy of the patient and the confidentiality issue of the patient’s electronic health records give jeopardy of the post-discharge monitoring. However, patients’ consent and electronic telehealth technology can policies the right benefit (Gutierrez et al., 2020). The policies of the health care and community resources require costs analysis and financial support. However, there is also a need for research in identifying the low costs and highly energy-efficient sources of the energy

Conclusion

The Nursing code of conduct and organizational working ethics implicate the nurses to provide safe and efficient care provisions under the umbrella of a coordinated care plan. The ethical dilemmas pose certain implications in the proper care coordination measures. It also affects the autonomy, dignity and freedom of work of fellow professionals. The policies of smoking cessation programs and high taxes have improved the non-smoking rates in the younger generation because of the low affordability of the products (Thrul et al., 2021)

References 

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Aydan, S. and Kaya, S. (2018). Ethical climate as a moderator between organizational trust and whistle-blowing among nurses and secretaries. Pakistan journal of medical sciences34(2), p.429.

Podgorica, N., Flatscher-Thoeni, M., Deufert, D., Siebert, U. and Ganner, M. (2021). A systematic review of ethical and legal issues in elder care. Nursing ethics28(6), pp.895-910.

Werner, R.M., Coe, N.B., Qi, M. and Konetzka, R.T. (2019). Patient outcomes after hospital discharge to home with home health care vs to a skilled nursing facility. JAMA internal medicine179(5), pp.617-623.

Gutierrez, A.M., Hofstetter, J.D., Dishner, E.L., Chiao, E., Rai, D. and McGuire, A.L. (2020). A Right to Privacy and Confidentiality: Ethical Medical Care for Patients in United States Immigration Detention. Journal of Law, Medicine & Ethics48(1), pp.161-168.

Rainer, J., Schneider, J.K. and Lorenz, R.A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing27(19-20), pp.3446-3461.

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

American Lung Association. (2021). Public Policies. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/copd-advocacy

Swan, B.A., Haas, S. and Jessie, A.T. (2019). Care coordination: roles of registered nurses across the care continuum. Nursing Economics, 37(6), pp.317-323.

Hanlon, P. (2017). Reducing COPD readmissions with or without the Affordable Care Act. RT for Decision Makers in Respiratory Care, pp.12-15.

Baker, J., Travers, J.L., Buschman, P. and Merrill, J.A. (2018). An efficient nurse practitioner–led community-based service model for delivering coordinated care to persons with serious mental illness at risk for homelessness. Journal of the American Psychiatric Nurses Association24(2), pp.101-108.

U.S. department of Health . (2021). Priorities in Focus-Care Coordination. https://www.ahrq.gov/workingforquality/reports/priorities-in-focus/care-coordination.html

Alomari, A., Wilson, V., Solman, A., Bajorek, B. and Tinsley, P. (2018). Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study. Comprehensive child and adolescent nursing41(2), pp.94-110.

U.S. Health Department. (2018). Care Coordination Brief. https://www.ahrq.gov/ncepcr/care/coordination/mgmt.html#care

Anderson, E., Wiener, R.S., Resnick, K., Elwy, A.R. and Rinne, S.T. (2020). Care coordination for veterans with COPD: a positive deviance study. The American journal of managed care, 26(2), p.63.

Vanfleteren, L.E., van‘t Hul, A.J., Kulbacka-Ortiz, K., Andersson, A., Ullman, A. and Ingvar, M. (2020). Challenges to the application of integrated, personalized care for patients with COPD—a vision for the role of clinical information. Journal of clinical medicine, 9(5), p.1311.

Gaveikaite, V., Grundstrom, C., Winter, S., Schonenberg, H., Isomursu, M., Chouvarda, I. and Maglaveras, N. (2020). Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece. BMC medical informatics and decision making, 20(1), pp.1-12.

Shenoy, A. and Appel, J.M. (2017). Safeguarding confidentiality in electronic health records. Cambridge Quarterly of Healthcare Ethics, 26(2), pp.337-341.

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

Tonnessen, S., Ursin, G. and Brinchmann, B.S. (2017). Care-managers’ professional choices: ethical dilemmas and conflicting expectations. BMC health services research, 17(1), pp.1-10.

Hendryx, M., Luo, J., Chojenta, C. and Byles, J.E. (2019). Air pollution exposures from multiple point sources and risk of incident chronic obstructive pulmonary disease (COPD) and asthma. Environmental research, 179, p.108783.

Riesco, J.A., Alcázar, B., Trigueros, J.A., Campuzano, A., Pérez, J. and Lorenzo, J.L. (2017). Active smoking and COPD phenotype: distribution and impact on prognostic factors. International journal of chronic obstructive pulmonary disease, 12, p.1989.

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Thrul, J., Riehm, K.E., Cohen, J.E., Alexander, G.C., Vernick, J.S. and Mojtabai, R. (2021). Tobacco control policies and smoking cessation treatment utilization: A moderated mediation analysis. PloS one16(8), p.e0241512.

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