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


NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination
Define care coordination
Demonstrate the influence of government policies on care coordination
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for Care coordination
Assess the impact of the code of ethics for nurses on the coordination and continuum of care

Community Organization to be Addressed
The focus of my presentation will be on nursing homes

What is Care Coordination?
According to Institute of Medicine,
Care coordination to mean the degree to which patient care services are coordinated across sites, people, activities, and functions progressively to maximize the value of healthcare services provided to patients (Okado et al., 2021)
This means that the needs and preferences of the patient are known in advance and communicated to the right people at the right time, and that this information is critical in providing effective, safe, and appropriate patient care
In nursing homes, care coordination can :
Reduce hospital admissions/readmissions
Improve patient satisfaction
Improve quality of chronic disease management
Improve patient outcomes

Influence of Government Policies on Care Coordination
Some of the policies that influence care coordination in the US are:
Medicare provide health insurance services to about million citizens with this number expected to rise (Andes et al., 2019).
It affect coordination in the sense that it works to improve access to care of the covered population
Since majority of beneficiaries are those burdened by chronic conditions, Medicare has significantly reduced the associated cost patient care by eliminating unnecessary tests and procedures.

Influence of Government Policies on Care Coordination

Medicaid serves more than 42 million Americans
This program primarily depends on community health centers, private providers of medical care, and different managed care plans to allow for effective care coordination
the US government ensures that the care delivered by different providers is not offered in silos
Because of this, challenges that adversely affect the care coordination, like the cost of medical care, is substantially reduced

Influence of Government Policies on Care Coordination
Patient’s private data in community organizations like nursing homes is protected under the Health Insurance and Accountability Act (HIPAA).
HIPAA affect care coordination in that it:
allows a healthcare professional to share important information about the patient with anyone who can help lessen or prevent the threatened harm in the event a patient poses a serious and imminent threat to his own or someone else’s health or safety (Qin, 2019)
This enhances patient-provider response
This applies to nursing homes where patient’s well-being majorly depends on the availability of data that eventually helps in decision implementation processes.

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

National, State, and Local Provisions that Raise Ethical Questions for Care Coordination
Patient Protection and Affordable Care Act (PPACA) has brought several ethical issues at the forefront in care coordination
The big question is who will be covered?
A major concern was that PPACA will offer free care to undocumented immigrants which are contrary to the true purpose of the law.
It was expected that by 2014, Obamacare will improve coverage for about 30 million of the 47 million people who were uninsured by then, none of whom were residents without legal documents.
The law neither is eligible for insurance through state exchanges nor provides free care for non-US citizens (Kerkhoff & Hanson, 2019).

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

National, State, and Local Provisions that Raise Ethical Questions for Care Coordination
What is the role of the government?
The Act requires that majority of legal residents and citizens have health insurance but this insurance can come from state-based insurance exchanges, Medicare, private companies, and employers.
Through the insurance exchanges, people who pay more than 8% of their household incomes for health insurance would get subsidized premiums (Kerkhoff & Hanson, 2019).
PPACA does not invite the government to intervene in the healthcare system but rather tries to improve both efficiency and access via mandates to be performed by private medical providers, states, and insurers

National, State, and Local Provisions that Raise Ethical Questions for Care Coordination
will this law hurt small businesses?
The present law requires all firms with 50+ employees to avail insurance to qualified employees.
The question is, is it right to leave the employees of small business to their own devices in securing medical care?
Even when the law does not provide for this, we know that small enterprises are morally obliged to do everything within their powers to cover for their workforce

The Impact of the Code of Ethics for Nurses on the Coordination and Continuum of Care
Code of ethics is important in nursing homes because it sets out rules for behavior and form the basis for preemptive warning
ANA’s code of ethics that apply to coordination are provisions 2, 4, & 8 (ANA, 2021):
Provision 2: Nurses commitment to the patient
Provision 4: Nurse have the responsibility, authority, and accountability for nursing practice and make decision to offer optimal patient care
Provision 8: Nurse collaboration with the public and other healthcare professionals
The provisions show that that enhancing care coordination is indeed an important section of ethical nursing practice.
It serves as a reminder for nurses commitment to the society


Government policies influence care coordination for individuals and community programs like nursing homes
Local and national policies like HIPAA, Medicaid, and Medicare influence care coordination
ANA’s codes of ethics which guide nurse-patient interaction also influence care coordination
All these factors may contribute to poor outcomes if not well handled


American Nurses Association. (2021). Code of ethics with interpretative statements. Silver Spring, MD: American Nurses Association; 2015.
Andes, L. J., Li, Y., Srinivasan, M., Benoit, S. R., Gregg, E., & Rolka, D. B. (2019). Diabetes prevalence and incidence among Medicare beneficiaries—United States, 2001–2015. Morbidity and Mortality Weekly Report, 68(43), 961.
Bower, K. A. (2016). Nursing leadership and care coordination: creating excellence in coordinating care across the continuum. Nursing administration quarterly, 40(2), 98-102.
Kerkhoff, T. R., & Hanson, S. L. (2019). Applied ethics.
Okado, I., Pagano, I., Su’esu’e, A., Cassel, K., Rhee, J., Berenberg, J. L., & Holcombe, R. F. (2021). Mixed-methods research to assess care coordination experiences among NCORP clinical trial participants.
Popejoy, L. L., Vogelsmeier, A. A., Wang, Y., Wakefield, B. J., Galambos, C. M., & Mehr, D. R. (2021). Testing Re-Engineered Discharge Program Implementation Strategies in SNFs. Clinical Nursing Research, 30(5), 644-653.

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