Response 2 19477435

 Respond to at least two of your colleagues* by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

  

Introduction

The demand for healthcare and the shortage of providers to offer this care, especially in geographically and economically challenged populations, has put a strain on healthcare availability. The Creating Opportunities Now for Necessary and Effective Care Technologies for Health (CONNECT) Act of 2019 looks to promote access through increased use of telehealth. 

What It Means

Currently, telehealth is limited by geography, billing and reimbursement, and provider restrictions. The CONNECT bill HR 4932, proposes removal of some or all of these stipulations to expand access to care. Specifically, the bill targets Medicare restrictions and lack of coverage to improve access to the elderly and disabled (Wicklund, 2019). 

The Evidence

The evidence to support telehealth expansion has been proven. As discussed by Totten et al., (2016) numerous studies have shown an increase in positive outcomes regarding patient/provider communication, education, and the management of chronic health conditions. Passing of this bill could provide a multitude of benefits to involved parties. 

First and foremost, it would improve access to care for those limited by age, disability, geography, or finances. Improved access to care promotes health prevention and decreases more costly care due to complications associated with delay of treatment. The expansion of telehealth could also reduce the strain placed on providers by the shortage. The bill looks to permit telehealth use by more providers and remove some of the travel and point of origin restrictions. Greater use of telehealth would also encourage better insurance coverage and reimbursement (H.R. 4932, 2019).

Conclusion

With all the changes in healthcare and the concerns over cost and accessibility, the need for legislation to address these issues cannot be ignored. The promotion of telehealth and removal of current restrictions could solve many of these dilemmas. As healthcare providers, we can continue to conduct the research and provide the evidence needed to advocate for legislative change to improve healthcare. 

 
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Response 2 19434783

I need a response for these 2 peers

Peer 1 

Societal justice and critical reflection are the fundamental concepts underlying community activism. The former refers to the unbiased distribution of resources for a prolific and fulfilling lifestyle (Reichlin et al., 2019). For instance, through campaigns and demonstrations, nurses, practitioners and the general community would be able to advocate the cause of providing adequate medical amenities.  

Critical reflection boosts one’s understanding of the resident community’s issues (such as inadequate staffing) as well as those of others across the globe. Through this approach, the management and staff members would be able to devise long-term resolutions that ensure adequate staffing in the present and future (Reichlin et al., 2019). For example, pursuing suitable programs at academic institutions can steer students in the direction of the healthcare industry.  

Paying attention and keeping up with the trends in the tobacco industry is vital. This effort helps the advanced practice nurses to engage in community activism for preventing the negative health impacts associated with Big Tobacco in their respective societies (Salmond & Echevarria, 2017). As a result, the nurses would be in a position to enlighten the community members on addictiveness and diseases (such as lung cancer) associated with the increased consumption of tobacco products.  

Organizing programs to campaign against smoking is an essential stratagem that would aid nurses in educating the public on why tobacco control policy measures such as higher taxes are needed to ensure reduced consumption. With this tactic, nurses could participate in community activism to curb any further ill effects arising from the use of Big Tobacco (Salmond & Echevarria, 2017). Moreover, holding seminars that counsel smokers and non-smokers, especially the youth, to remain vigilant against industry-instigated efforts would be essential in discouraging the consumption of tobacco products. 

Peer 2 

Through schooling, training, and knowledge learned along the way, Advanced Registered Nurse Practitioners (ARNPs) are equipped with the necessary skillset and tools to assist members of the community have improvement in their health outcomes. As key players in patient, ARNPs play a vital role in community activism to bridge the gap in healthcare disparities across different population groups and to improve the community. Maryland & Gonzalez (2012) asserts that the vast “amount of interactions that nurses have with patients leads to them personally witnessing the positives and negatives of the current healthcare system and consequently enable them to identify the needs of their patients by the care or the lack of it they receive.” Due to their first-hand interaction, nurses can advocate for their patients and their families and convey their experiences to the public and policymakers to bring about change in current health care policies (Maryland & Gonzalez, 2012).  

According to Messias (2019), community activism entails the key concepts of “community, social justice, raising consciousness, critical reflection, praxis, and empowerment of members of the community.” With each key concept comes certain actions on the part of the activist and subsequent delineations of certain orders of events. Nurse Practitioners can embody all the characteristics of community activism Messias asserts to promote the overall health status of the community. According to Messias (2019), community activism starts with an understanding of the community, in which individuals must realize that they are part of a larger group and share common interests in order to catalyze change. Praxis entails the process of ideas and theories being made and actualized, which consequently brings about unification—or division—of members of the community. Praxis affects the practices and customs of members of the community and affect the interaction of these individuals. With social justice, the way individuals perceive justice and what is right or wrong, affects the justice system and what behaviors are viewed as deviant in the community.  

Raising consciousness and empowerment of members of the community are vital to altering the status quo hopefully for the better but negative impacts can ensue. Teaching members of the community that they have rights can empower them to develop or defend them against lawmakers. Shining light on certain issues, such as through protest and petition with local or federal elected officials can bring about necessary changes in the management of certain disease plaguing the community (Mason, Gardner, Outlaw, & O’Grady, 2016). Empowerment is the ultimate goal (Mason et al., 2016) as by doing so individuals in the community will do what is necessary to improve their health on a holistic level.  

Maryland & Gonzalez (2012) argues that nurses can make significant influence in community activism on a multilevel approach. Maryland & Gonzalez (2012) asserts that school nurses can attend school board meetings to voice their personal viewpoint of the ramifications of inadequate staffing to monitor the health of school children. They are only equipped with the knowledge to voice this opinion because of their personal experience with performing their duties of providing basic healthcare to their patients (in this case, school children). My daughter is a third grader at a local elementary school. In a school of more than 800 students, there is only one nurse. Imagine how difficult it is to provide care to these students during the cold and flu season or any ordinary day for that matter. This stresses the importance of community activism by nurses and advanced practice nurses. The level of care they provide to their patient population is affected by factors in the community so who is best to make the issues known and advocate for and against them but nurses? Nurses, through their inimitable experience with their patients, can bring to the forefront issues that affect their patient and the community. Policymakers should hold the voice of nurses in high-esteem prior to making any changes that will affect individuals of a community.  

From a community activism approach, ARNPS can mitigate further negative health impacts from Big Tobacco by bringing social awareness and consciousness to the issue. Letting members of the community become aware or reminded of the ramifications of smoking cigarettes or consuming other tobacco products will greatly decrease the number of individuals in the community that smoke or will smoke. Health fairs broadcasting posters of individuals with lung cancer or tracheostomies from cigarette smoking or oral cancers from chewing tobacco are one of the ways that ARNPS can use community activism to help manage the negative impact of Big Tobacco. On each healthcare visits, ARNPs need to assess if their patients smoke and make them aware of the ramifications in addition to offer smoking cessation counseling and education. Empowerment is necessary to help individuals in the community to stop because many of them have been smoking since childhood. Smoking is also a way that many of these individuals cope and manage stress. Offering them alternative coping measures is crucial to getting them to stop smoking. Educating the community of the long-term risk of smoking, the consumption, and second-hand smoking, is vital to deterring the use of tobacco and promoting the overall health of the community. Mason et al. (2016) states that tobacco usage and exposure is the foremost cause of preventable death in the nation. This statement alone will serve to remind individuals of the negative consequences of smoking and will lead to many of them quitting. 

To conclude, advanced practice nurses play a rather significant role in patient advocacy to improve the health outcomes of their patients. Nurses can employ various teaching methodologies to assist their patients improve their overall health. Tackling issues at the community level can help nurses being awareness to issues that directly and indirectly affect patients. Bringing awareness to certain issues, such as the negative influence of Big Tobacco on the overall health of individuals in a community, are one of the many ways that ARNPS can help ameliorate the health status of the community. The ARNP can collaborate with other members of the interdisciplinary team and elected officials to maximize the impact of decreasing negative health issues in the community. 

Response posts must be minimum 100 words each. Word document, double space. APA (6th) 

This the original work if you needed 

Describe the key concepts underlying community activism and give examples of how each of these concepts applies to a specific context. Examine how advanced practice nurses can engage in community activism to limit further negative health impacts from Big Tobacco in their respective health communities. 

Attached below is an additional resource, an article, that details various ways by which nursing professionals can engage in community activism. 

Patient Advocacy and in the Community and Legislative Arena: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocacy-in-Community-and-Legislative-Arena.html?css=print 

 
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Response 2 19339909

In your responses to your 2 peers, what additional resources can you share that will help you and your fellow classmates be successful? What commonalities do you share with your classmates? What opportunities can you explore for collaboration and peer support?

Please respond to both peers individually.

Both peers reponse is attached below.

 
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Responses Discussion

  

The responses should be 100 words and should add to the understanding and learning of the topic and should include at least one peer-reviewed journal article reference. Asking and addressing questions is also highly encouraged.

 
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Response To D 4 4667

 Please, respond to following discussion with one paragraph using one reference from peer-reviewed Nursing Journal not older than 5 years. APA format required.

McCamy Claude

Alternative Health Modalities

Complementary health modalities are the use of natural therapies and healing cultures for medicinal purposes. Examples of the alternative of conventional medicines are:

Traditional Alternative Medicine

 In ancient years, traditional medicine was used as a source of health care and also in a spiritual and cultural belief system through the use of herbal medicine to improve health standards. In the contemporary world, traditional medicine has been integrated into health systems (Aveni et al., 2017). Examples of alternative medicine are Ayurveda, homeopathy, naturopathy, and Chinese oriental medicine.

Body Therapy

Body therapy is a form of healing through touch used by the ancient man as a powerful healing force. It is believed that to achieve optimum body functionalities, one has to maintain equilibrium in the life energies. Thus, today, hand techniques are used to restore a balance in the flow of this energy in a human’s body. The healing touch theory is based on physical, mental, and emotional health aspects which results cannot be effectively measured (Isidoro, Huang, & Sheen, 2016). Some of the body touch therapies include chiropractic and osteopathic medicine, massages, tai chi, and body movement therapies.

Diet and Herbs

 Nutrition is an important factor in leading a healthy lifestyle. A good diet helps in the maintenance of a healthy weight and reduces the risks of contracting chronic diseases which promotes health. A nutrient deficiency is a major problem in today’s society; this is caused by poor feeding habits that have led to obesity and the development of chronic diseases such as heart diseases, diabetics, and cancer.  The health issues have instigated the development of dietary and herbal approaches such as dietary supplements in an attempt to achieve a balanced diet (Isidoro, Huang, & Sheen, 2016).

 
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Response2 19472585

Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

Nursing boards were created to establish guidelines for the scope of nursing practice. Each state has established its own board; thus regulations can vary by state. Advanced practice registered nurses must be familiar with their own state board’s regulations as it pertains to their practice, and advocate for the expansion of the nurse practitioner’s ability to practice and provide best care. 

Regulation 1

A main topic of conversation among nursing boards is the ability of advanced practice registered nurses (APRN’s) to practice independently of a collaborating physician. As discussed by Bosse et al., (2017), the ability of APRN’s to practice independently would help fill the gap in access to care associated with physician shortages and remote locations. Greater access to care has the potential to improve outcomes and reduce healthcare costs and complications. Currently, Missouri and Illinois both require APRN’s to maintain a collaborative practice agreement with a physician within a certain geographic range (Nurse Practice Act, 2018; Nursing & Collaborative Practice, 1996). The National Council of State Boards of Nursing (NCSBN) encourages APRN’s to advocate for independent practice in their states (Bosse et al., 2017). 

Regulation 2 

As technology plays an increasingly central role in the provision of healthcare, the use of technology must be addressed by regulatory boards. Telehealth is another solution to improving access to healthcare, especially in rural areas. Missouri permits APRN’s to practice virtually if the care is being provided to patients in remote areas (Utilization of telehealth, 2014). Illinois permits APRN’s to treat residents of the state via telehealth without geographical stipulations (Telehealth Act, 2018). 

Conclusion

As nurse practitioners, we can adhere to these regulations while also advocating for the advancement of the advanced practice registered nurse’s role in healthcare. Another opportunity for advocacy lies in the use of telehealth to improve access to care in rural areas. By providing exceptional care and demonstrating the knowledge and skills needed to practice independently, we can emulate the need to expand the scope of practice for nurse practitioners.  

 
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Response To Below Discussion

MSN degree, APA format 1 page 3 references 1 from walden university library,

Due 3/2/2019 at 7pm EST

 

Wars and Nightingale

New Fields and Technology

Research and Respect

Past

     Earliest nurses were often a response to wars and the need for medical care for injured soldiers.  These women were patriotic but not truly educated as nurses and often caused more damage than good related to their lack of basic healthcare knowledge (Keating & DeBoor, 2018).  Florence Nightingale was a proponent of nursing education from her own experiences during the Crimean War (Davida, 2012).  She influenced some of the first nursing schools with her idea that the education should stand alone and not be associated with an apprenticeship with the teaching hospital (Keating & DeBoor, 2018).

Present

     Nurses of today specialize in all sorts of fields from the operating room to pediatrics to hospice to just name a few.  This specialization has made the nurse workforce incredibly diverse and nursing educators and programs have had to respond accordingly.  Economically, nursing schools have become expensive programs and often difficult to staff as experienced nurse educators retire (Keating & DeBoor, 2018).  Immense changes in technology from how a nurse charts to how IVFs are given have dramatically changed how nurses do their work and how they are educated.

Future

     Higher education for nurses will continue to evolve with an emphasis on nursing research as well as life-long learning (Laureate, 2012c).  The need for evidence-based nursing research will influence healthcare to the extent that the solutions garnered from nursing investigation will be on the same par as medical studies done by providers.  This increased respect for nursing could lead to increased interest in nursing as a career and in nursing education overall.

References

Davida, M. (2012).  History of nursing education:  In our past, lies our future.  Retrieved from

 http://nursingeducationhistory.org/

Keating, S.B. & DeBoor, S.S. (Ed.). (2018).  Curriculum Development and Evaluation in

     Nursing (4th Ed.).  New York, NY:  Springer.

Laureate Education, Inc. (Executive Producer). (2012c).  Requirements through the years. 

     Baltimore, MD:  Author.

 
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Response2 19472583

Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

Nursing boards were created to establish guidelines for the scope of nursing practice. Each state has established its own board; thus regulations can vary by state. Advanced practice registered nurses must be familiar with their own state board’s regulations as it pertains to their practice, and advocate for the expansion of the nurse practitioner’s ability to practice and provide best care. 

Regulation 1

A main topic of conversation among nursing boards is the ability of advanced practice registered nurses (APRN’s) to practice independently of a collaborating physician. As discussed by Bosse et al., (2017), the ability of APRN’s to practice independently would help fill the gap in access to care associated with physician shortages and remote locations. Greater access to care has the potential to improve outcomes and reduce healthcare costs and complications. Currently, Missouri and Illinois both require APRN’s to maintain a collaborative practice agreement with a physician within a certain geographic range (Nurse Practice Act, 2018; Nursing & Collaborative Practice, 1996). The National Council of State Boards of Nursing (NCSBN) encourages APRN’s to advocate for independent practice in their states (Bosse et al., 2017). 

Regulation 2 

As technology plays an increasingly central role in the provision of healthcare, the use of technology must be addressed by regulatory boards. Telehealth is another solution to improving access to healthcare, especially in rural areas. Missouri permits APRN’s to practice virtually if the care is being provided to patients in remote areas (Utilization of telehealth, 2014). Illinois permits APRN’s to treat residents of the state via telehealth without geographical stipulations (Telehealth Act, 2018). 

Conclusion

As nurse practitioners, we can adhere to these regulations while also advocating for the advancement of the advanced practice registered nurse’s role in healthcare. Another opportunity for advocacy lies in the use of telehealth to improve access to care in rural areas. By providing exceptional care and demonstrating the knowledge and skills needed to practice independently, we can emulate the need to expand the scope of practice for nurse practitioners.  

 
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Response2 19472581

Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

Nursing boards were created to establish guidelines for the scope of nursing practice. Each state has established its own board; thus regulations can vary by state. Advanced practice registered nurses must be familiar with their own state board’s regulations as it pertains to their practice, and advocate for the expansion of the nurse practitioner’s ability to practice and provide best care. 

Regulation 1

A main topic of conversation among nursing boards is the ability of advanced practice registered nurses (APRN’s) to practice independently of a collaborating physician. As discussed by Bosse et al., (2017), the ability of APRN’s to practice independently would help fill the gap in access to care associated with physician shortages and remote locations. Greater access to care has the potential to improve outcomes and reduce healthcare costs and complications. Currently, Missouri and Illinois both require APRN’s to maintain a collaborative practice agreement with a physician within a certain geographic range (Nurse Practice Act, 2018; Nursing & Collaborative Practice, 1996). The National Council of State Boards of Nursing (NCSBN) encourages APRN’s to advocate for independent practice in their states (Bosse et al., 2017). 

Regulation 2 

As technology plays an increasingly central role in the provision of healthcare, the use of technology must be addressed by regulatory boards. Telehealth is another solution to improving access to healthcare, especially in rural areas. Missouri permits APRN’s to practice virtually if the care is being provided to patients in remote areas (Utilization of telehealth, 2014). Illinois permits APRN’s to treat residents of the state via telehealth without geographical stipulations (Telehealth Act, 2018). 

Conclusion

As nurse practitioners, we can adhere to these regulations while also advocating for the advancement of the advanced practice registered nurse’s role in healthcare. Another opportunity for advocacy lies in the use of telehealth to improve access to care in rural areas. By providing exceptional care and demonstrating the knowledge and skills needed to practice independently, we can emulate the need to expand the scope of practice for nurse practitioners.  

 
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Response2 19297547

The cross posts provide new or supplemental information to the original posting or raise additional areas for discussion. New or additional peer reviewed references should be cited in both cross posts.

Discussion cross posts should elaborate upon the ideas of others or content found in the readings/keynotes by adding details, examples, a different viewpoint, or other relevant information. The cross posts should provide original insights or responses which integrates multiple views. (Just saying ditto, I agree, or restating the original post is not considered elaboration.) There should be evaluation and feedback which assesses the accuracy, reasonableness, or quality of idea, and provides constructive feedback to classmates.

Be sure to use at least one reference. APA formatting, References should be timely, published within the previous 5 years.

Listed below is the discussion post you must respond to in 250-350 words max:

Background

The topic chosen that is related to nursing informatics is the role of the electronic health records on quality and safety in providing patient care. The Electronic Health Records (EHR) is an electrically version that is used to store the medical history (progress, problems, and medication among others) of the patient and it is being maintained by the provider at the given time (Cowie, 2017). Previously in the year 1950s, all the medical accounts in the hospitals were being kept together with papers in a filling system which was manual. By the middle of the 1960s, Lockheed come up with an electronic program by the name clinical information system that was used to store the medical records electronically. From his invention, the engineering and the technology firms started to develop the electronic medical records systems that were being used both by the universities and the hospitals. In 1970s, the government started to use the EHR as more of the medical facilities started to use it and is still being use up to date (Goldstein, 2017).  

Significance

This system plays an important role in the production of the documentations and exchanging information in the different disciplinary which are found under the patient care (Cowie, 2017). Besides, it also plays an important role in providing the opportunity for educating, teaching and learning under the medical environment. The EHR allows for medical facilities to have a decrease in the amount of paper work dealt with, and the amount of storage spaced required is decreasing. Also, it plays a major role in managing the results and the decision making as the quality of the patients care is highly improved. The nurses has the ability to review lab work with the click of a button. This enhances the quality of the medical records as the man-made errors from the manual system have been dealt away with. 

Challenges and benefits in healthcare

The information within the medical records of the patient is very safe and secure. This is because it is not easily accessed by unauthorized person hence security. Also, it is very hard to lose such data as compared to the manual system where the information could easily be misplaced. Despite the benefits of EHRs, these systems are faced with many challenges. Among the challenges we have the security and privacy issues as all the computers are networked currently have, which makes them vulnerable to hacking of a patient’s data. This is dangerous as the information of the patient might land to the hands of the wrong person (Goldstein, 2017). Another challenge is that some people using the system might be stuck in their ways making it impossible for the system to be accessed with efficiency. This is challenging as much time and resources have to be taken to train them on how to use the system. Another challenge comes on the side of the power disruption where all the activities will have to be stopped until a backup for power is available. 

^^PLEASE REMEMBER THAT THIS WILL BE A RESPONSE TO THE DISCUSSION ABOVE^^

 
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