Discussion: Review of Current Healthcare Issues

The national healthcare issue I have chosen to discuss the health provider shortage in the United States. The lack of nurses has been warned for many years, and lately, during a pandemic, hospitals, clinics, and other companies are feeling the strain. It is predicted that by 2025, the shortage of nurses could reach 500,000. (Kiel, 2020) This is only taking into account retirement and turnover, not a pandemic. These statistics will be much worse as the stress of COVID-19 continues to affect all healthcare providers. Having nurses that are not educated at the baccalaureate level affects the quality of healthcare. Extensive studies indicate that patients have a better chance of survival when care for by BSN level nurses. (Rosseter, 2020)

Unfortunately, the Iowa Department of Corrections hasn’t taken the initiative to retain nurses or connect with agencies to recruit. We have had many nurses retire earlier just because of the workload, the health department’s management, and the recent reverse of premium pay for holidays and overtime. It’s a technicality working for the state that is not fair. The state union lost most bargaining rights a few years ago, and that was when the revolving door for nurses began. Since then, the department can’t seem to get high-quality nurses or retain them. Correctional nursing takes extra training; not everyone would like to work at a prison. Some hospitals offer up to $20,000 as a sign-up bonus to recruit nurses; others have an education incentive where facilities will help with nurses’ student loans. (Brusie, 2019) Even though $20,000 may be much for Iowa, the idea needs to be considered to fix the Iowa Department of Corrections’ health care issues.

References

Brusie, C. (2019, October 1). 10 Hospitals Offering 20K Sign-On Bonuses to RNs. nurse.org. http://nurse.org

Kiel, J. M. (2020). An analysis of restructuring orientation to enhance nurse retention. The Health Care Manager, 39(4), 162–167. https://doi.org/10.1097/hcm.0000000000000303

Rosseter, R. (2020). Fact Sheet: Nursing Shortage (American Association of Colleges of Nursing) [Fact Sheet]. https://doi.org/http://aacnnursing.org

NURS_6053_Module01_Week01_Discussion_Rubric

Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6053_Module01_Week01_Discussion_Rubric
Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.
Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

You chose a topic that is affecting patient outcomes on national and global levels. According to Rao et al., (2017), a low cost efficiency of psychiatric medications was

responsible for an increase in patient noncompliance. Medications that are affordable to the patient with the least amount of adverse effects promote patient compliance. Relapse

and rehospitalization are common clinical outcomes related to noncompliance (George et al., 2017). The Prescription Drug Pricing Act (PDPA) was a proposed bipartisan bill

that Senator Grassley and Senator Ron Wyden introduced in July of 2019 (Kaplan, 2019). The PDPA would promote pricing transparency, creative incentives for lower priced

medications, and simplified the Medicare Part D program. In September of 2019, the Lower Costs Now Drug Act (LCNDA) was introduced, building on the PDPA. One of the the

additional aspects of the LCNDA was that the Department of Health and Human Services would be required to negotiate prices on certain medications. The LCNDA

passed the House on December 12, 2019 (Congress.gov, 2020). The LCNDA is under review for a second time in Senate and has been placed on the Senate

Legislation Calendar as of September 8, 2020.

Compliance and a patient’s ability to afford their prescriptions is a concern for all clinical practitioners. Hospital readmission is the leading cost associated with

noncompliance (Rao et al., 2017). Prescribing medications that a patient is unable to afford is a disservice to that patient, as the patient may be unwilling or unable to fill

those medications, which result in noncompliance. When I worked on the Behavioral Health Unit at a regional hospital, we kept a list of common medications prescribed on our

unit and their prices at local pharmacies. It never made sense to me why one medication would have a low price at one pharmacy, yet was hundreds of dollars at another local

pharmacy. The pricing seemed so inconsistent. Costco often was the least expensive option for patients and many did not know that a person does not have to have a

Costco membership to purchase medications from their pharmacy. Prescribers have a duty to educate themselves on ways to ensure their patients have access to affordable

medications when possible.

References

Congress.gov. (2020). H.R.3 – Elijah E. Cummings Lower Drug Costs Now Act. https://www.congress.gov/bill/116th-congress/house-bill/3/actions

George, J., Rao, K. N., Sudarshan, C. Y., & Begum, S. (2017). Treatment compliance and noncompliance in psychoses. Indian journal of

    psychiatry, 59(1), 69–76. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_24_17

Kaplan, L. (2019). Lowering the cost of prescription drugs. The Nurse Practitioner. 44(11),14-15. doi: 10.1097/01.NPR.0000586028.61540.6a

Rao, T., Manohar, J. S., Raman, R., Darshan, M. S., Tandon, A., Karthik, K. N., Saraswathi, N., Das, K., Harsha, G. T., Kunkeri, S. P., &

Andrade, C. (2017). The prospective, 24-week assessment of cost-efficacy of and compliance to antidepressant medications in a rural setting

(PACECAR) study. Indian journal of psychiatry, 59(2), 157–163. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_202_17

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