NURS 4050 – Assessment 2: Ethical and Policy Factors in Care Coordination narrative scripts Essay

NURS 4050 – Assessment 2: Ethical and Policy Factors in Care Coordination narrative scripts Essay

Nursing Home Presentation Narrative Script

Slide 1

Hello and welcome to my presentation on ethics and policies of care coordination in nursing home care. My name is …. Welcome!

Slide 2

In this presentation, I will address government policies and ethical principles that affect care coordination in nursing homes. Firstly, I will explain how government policies affect nursing care and coordination. Thereafter, I will identify relevant government policies that affect nursing home care coordination. These will include national, state-based, and local policies. I will also explain the impact of the code of ethics for nurses on the coordination and continuum of care in a nursing home. Finally, I will recap the key ethical and policy issues that affect care coordination in nursing homes.

What is Care Coordination? Slide 3

Before discussing ethics and policies of care coordination, it is prudent to define care coordination and understand the coordination process in nursing homes. The agency for healthcare research and quality defined care coordination as a systematic process of collecting pertinent patient information and sharing it with relevant stakeholders for care continuum, continuity, and seamless transition. This process is deliberate and is initiated by a care coordinator, who in most cases is a nurse or a care administrator. Care coordination is required in a nursing home to safeguard patient safety, cut care costs, reduce turnaround time for care, ensure the effectiveness of the care interventions, bridge health disparities, and focus care on the patient’s characteristics and needs.

Who and When? Slide 4

Care coordination is needed in a nursing home during shift reporting, discharge, admission, referral, ethical and policy decision-making, and patient education. During discharge, admission, and referral, the responsibility of care for the resident changes from one nurse to other nurses or care specialists. Some of the care specialists include geriatricians, physicians, surgeons, therapists, and psychiatrists. Sharing of patient information can also involve other stakeholders of residents’ care, such as insurance, family, caregivers, and policymakers. Community resource managers are also important stakeholders and must be included in the care coordination loop.

Role of Government Policies in Nursing Care Coordination: Slide 5

Government policies impacts care coordination in various ways. Government policies create guidelines through which care coordination is delivered. This ensures that coordination activities that are deemed illegal, unprofessional, or inappropriate by the governing body are avoided by care practitioners. Government policies also ensure patient safety. Policies that guide safety protocols during care coordination ensure the safety of patient information and physical safety. Local and national government health policies can improve the reduction in medication errors and intentional injuries in nursing homes. Government policies also affect payment or care, the scope of nursing care, nursing education, and access to patient information. Therefore, government policies have important roles in the continuum of care and care coordination.

Specific Policies Affecting Nursing Home Care Coordination: Slide 6

Influential policies that impact nursing home care coordination include but are not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Affordable Care Act (ACA), Medicaid and Medicare Policies, and Nursing Home Reform Act (NHRA).

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Cont’d: Slide 7

HIPAA is influential because it regulates how patient information is shared for care coordination purposes. HIPAA, therefore, safeguards sensitive patient information from privacy and security attacks. ACA improved transparency in nursing home care by implementing the Nursing Home Transparency and Improvement Act of 2009. This allowed consumers and care regulators to possess access to nursing home ownership and additional disclosable party information. This information access affects the process of information sharing by making resident and their caregivers aware of the facility information that will encourage participation.

Specific Policies cont’d: Slide 8

The Medicare and Medicaid policies provide insurance to adults aged above 65 years and this receiving dialysis. Most nursing home residents qualify for this program; thus, its policies will affect how care coordinators perform care coordination concerning the patient payment. Medicaid, on the other hand, assists low-income patients with paying for medical expenses. The Nursing Home Reform Act enacted in 1987 set federal standards for nursing homes to regulate their operation, according to an article by Miller & Hamler in 2019. These operations included communication and care coordination. This policy aimed at ensuring the protection of residents and improvement in the quality of their care at the nursing homes. Recently, the Nursing Home Reform Modernization Act of 2021 was introduced into congress. The Nursing Home Reform Modernization Act of 2021 act seeks to improve nursing home care by including centers for Medicaid and Medicare in the care quality improvement program and oversight.

Policies That Raise Ethical Dilemma: Slide 9

Some policies that regulate care coordination of care in a nursing home can impact ethical decision-making by creating ethical challenges and dilemmas. Ethical dilemmas represent situations where two or more principles of ethical decision-making and care delivery conflict with each other and may require higher-level decision-making. In ethical decision-making, the right choices are difficult to come up with, while ethical challenges arise when broad social and policy issues present the alternative decision is not morally right. Currently, the Nursing Home Reform Act of 1987 is still in use. One of the provisions of this policy is to deter nursing homes from using any form of physical restraints among residents. Physical restraints are sometimes used in emergencies when patients pose safety threats to themselves and others. Nursing homes are not devoid of these emergencies. When physical restraints are used, nonintentional harm is caused to the patients. Therefore, the principles of non-maleficence and beneficence conflict in these situations.

Slide 10: The 1987 Nursing Home Reform Act dilemma

This policy also grants residents the right to spend time with relatives, volunteers, and friends of their choosing. However, this provision becomes dilemmatic when the safety of these relatives is at risk, say, when the patient has an infectious illness. A good example is the case of COVID-19, which necessitated the centers for Medicaid and Medicare services to order through a press release to restrict visitors to residents. According to an article by Kusmaul (2020), this step would infringe on the 1987 Nursing Home Reform Act provisions that granted residents this freedom. In their decision, the principle of non-maleficence and beneficence.

Impact of Code of Ethics:  Slide 11

The Code of Ethics provides a framework for nurses for clinical decision-making where decisions of right and wrong are required. This code explains decision-making issues and determines which principles would be considered in certain situations. The code of ethics encourages nurses to communicate and collaborate with other nurses, healthcare professionals, and care stakeholders to ensure an interdisciplinary approach to decision-making. As explained earlier in the initial discussions in my presentation, care coordination in a nursing home involves various stakeholders with whom nurses will require to collaborate with. The code of ethics will be useful in these situations.

Slide 12: Code of Ethics and Social Determinants of Health

Residents in nursing homes come to seek care from various social and economic backgrounds. Factors such as race, access, environment, and genetic predisposition affect the planning and treatment of these residents. Planning and care coordination involves referral and utilization of facility and community resources. The code of ethics assists the care coordinator in decision-making revolving distribution of these resources to uphold the justice and fairness principles of ethics. Reducing the impact of these health disparities will thus be achieved by ethical decision-making based on the code of ethics.

Key Policy and Ethical Issues: Slide 13

This final part of my presentation recaps the key ethical and policy issues in care coordination and the continuum of care for residents in nursing homes. Critical ethical issues discussed include patient safety, fair resource distribution, and social justice in resource utilization. Policy issues include the use of restraints, freedom of interaction and association, payment systems, access to information, and sharing of personal health information. A care coordinator must incorporate these issues when clinical making decisions during care coordination. For quality care, the decisions made must aim at achieving patient safety, timeliness in action execution, health equity, coordination efficiency, coordination effectiveness, and patient-centeredness. Thank you for your time and attention.

References

Agency for Healthcare Research and Quality. (2018, August). Care Coordination. Ahrq.gov. https://www.ahrq.gov/ncepcr/care/coordination.html

Kusmaul, N. (2020). COVID-19 and nursing home residents’ rights. Journal of the American Medical Directors Association, 21(10), 1389–1390. https://doi.org/10.1016/j.jamda.2020.07.035

Miller, V. J., & Hamler, T. (2019). A value-critical policy analysis of the nursing home reform act: a focus on the care of African American and Latino residents. Social Work in Health Care, 58(5), 471–493. https://doi.org/10.1080/00981389.2019.1587660

Nursing Home Reform Modernization Act of 2021, (2021) (testimony of Pascrell, Bill, & Jr). http://www.congress.gov/

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Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation, with audio, intended for that audience. Create a detailed narrative script or speakers notes for your presentation, 4-5 pages in length.
Introduction
As coordinators of care, nurses must be aware of the code of ethics for nurses and health policy issues that affect the coordination of care within the context of the community. To help patients navigate the continuum of care, nurses must be proficient at interpreting and applying the code of ethics for nurses and health policy, specifically, the Affordable Care Act (ACA). Being knowledgeable about ethical and policy issues helps ensure that care coordinators are upholding ethical standards and navigating policy issues that affect patient care.
This assessment provides an opportunity for you to develop a presentation for a local community organization of your choice, which provides an overview of ethical standards and relevant policy issues that affect the coordination of care. Completing this assessment will strengthen your understanding of ethical issues and policies related to the coordination and continuum of care, and will empower you to be a stronger advocate and nursing professional.
It would be an excellent choice to complete the Vila Health: Ethical Decision Making activity prior to developing the presentation. The activity provides a helpful update on the ethical principles that will help with success in this assessment.
Preparation
Your nurse manager at the community care center is well connected and frequently speaks to a variety of community organizations and groups. She has noticed the good work you are doing in your new care coordination role and respects your speaking and presentation skills. Consequently, she thought that an opportunity to speak publicly about contemporary issues in care coordination would be beneficial for your career and has suggested reaching out to a community organization or support group to gauge their interest in hearing from you, as a care center representative, on a topic of interest to both you and your prospective audience.
You have agreed that this is a good idea and have decided to research a community organization or support group that might be interested in learning about ethical and policy issues related to the coordination of care. Your manager has suggested the following community organizations and support groups, but acknowledges that the choice is yours.
Homeless shelters.
Local religious groups.
Nursing homes.
Local community organizations (Rotary Club or Kiwanis Club).
To prepare for this assessment, you may wish to:
Research your selected community organization or support group.
Review the Code of Ethics for Nurses With Interpretive Statements and associated health policy issues, specifically, the ACA. Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete. Allocate sufficient time to rehearse your presentation before recording the final version for submission.
Recording Equipment Setup and Testing
Check that your audio speaker and PowerPoint software are working properly. You can record audio directly to your slides, using PowerPoint or other presentation software.
Note: Technical support about the use of PowerPoint, including voice recording and speaker notes, can be found on Campus\’s Microsoft Office Software page.
If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your presentation in the courseroom.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.
Instructions
For this assessment:
Choose the community organization or support group that you plan to address.
Develop a PowerPoint with typed speaker notes (the script for your voice recording) and audio voice-over recording, intended for that audience. Video is not required.
Note: PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature or you may choose to submit a separate document. See Microsoft Office Software for technical support about the use of PowerPoint, including voice recording and speaker notes.
For this assessment, develop your presentation slides and speaker notes, then record your presentation. You are not required to deliver your presentation to an actual audience.
Presentation Format and Length
You may use PowerPoint (recommended) or other suitable presentation software to create your slides and add your voice over. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.
Be sure that your slide deck includes the following slides:
Title slide.
Presentation title.
Your name.
Date.
Course number and title.
References (at the end of your presentation).
Your slide deck should consist of 10–12 slides, not including a title and references slide with typed speaker notes and audio voice over. Your presentation should not exceed 20 minutes.
Create a detailed narrative script for your presentation, approximately 4–5 pages in length.
Supporting Evidence
Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.
Grading Requirements
The requirements outlined below correspond to the grading criteria in the Ethical and Policy Factors in Care Coordination Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Explain how governmental policies related to the health and/or safety of the community affect the coordination of care. Provide examples of a specific policy affecting the organization or group.
Refer to the assessment resources for help in locating relevant policies.
Be sure influential policies include the Health Insurance Portability and Accountability Act (HIPPA).
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination. What are the implications and consequences of specific policy provisions?
What evidence do you have to support your conclusions?
Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
Consider the factors that contribute to health, health disparities, and access to services.
Consider the social determinants of health identified in Healthy People 2020 as a framework for your assessment. Provide evidence to support your conclusions.
Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included for a proficient score; both speaker notes and the audio voice over are included for a distinguished score.
Present a concise overview.
Support your main points and conclusions with relevant and credible evidence.
Additional Requirements
Before submitting your assessment, proofread your presentation slides and speaker notes to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your presentation.
Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 4: Defend decisions based on the code of ethics for nursing.
Assess the impact of the code of ethics for nurses on the coordination and continuum of care. Competency 5: Explain how health care policies affect patient-centered care.
Explain how governmental policies related to the health and/or safety of a community affect the coordination of care.
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination. Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included.