Health-Care Reform in the United States

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According to Scholtz, King, and Kolb (2014), nurses’ contributions should be maximized, and federal, and state policies should be updated to ensure that American patients have access to appropriate health care services. The restructuring of the health-care delivery system in the United States resulted in scope-of-practice rules that took advantage of APRNs’ education while also appreciating their potential. Insurance companies and states must improve financial changes and individual policies that allow patients to choose from various providers, including APRNs, freely. To come up with a foundation for building reformed health care, the removal of financial barriers and policies is necessary for promoting patient-centered care and patient choice (Aponte, 2012).

Al-Mazrooa (2011) asserts that the enhancement of health care services will mean that there will be high demand for nurses and at the same time there will be growth and changes in their practice. The implementation of recommendations by the Institute of Medicine (IOM) will lead to changes in most policies that have an impact on nursing. Aponte (2012) adds that the modification of the professional nurses’ practice is enhanced by the concept of continuum or continuity. The concept of Continuum or Continuity focuses on the episodic care in providing proper ways of treatments to the users of the services which the nurse has to be educated. The concept of Continuum or Continuity aims at providing health care services that are integrated with the users of the services accompanied by affordable, high-quality treatments and proper care to those suffering from health issues that are severe (Scholtz et al.,2014). There are various types of Continuum or Continuity such as;

Informational Continuity

This refers to a transaction that is efficient and has accumulated knowledge together with accurate information meant to create a gap between different care events for emphasizing the treatment ways (Aponte, 2012).

Relational Continuity

This type of continuity bridges the bridge between the service users and the providers of health service in gathering the existence of vital information related to the current and future setting of health care. It mainly refers to the therapeutic relationship that exists within the setting of concurrent healthcare (Scholtz et al., 2014).

Management Continuity

This is cohesive as well as the spontaneous approach for enhancing the provision of services to the users. Aponte (2012) explains that this type of continuity includes the critical approaches meant to increase the services’ quality, planning related to the shared management and the care protocols.

As a result of the increment in the funding from federal and state, there has been a positive implication of NMHC (Nurse Managed Health Clinics).It has impacted thousands of patients positively throughout the country. This has been achieved by accessing the entire environment when treating patients as opposed to focusing only on the medication and disease (Al-Mazrooa, 2011).NMHC deals more with person-centered care and cares mostly for patients who are uninsured. However, lack of funding has resulted in this service being at risk with current reports indicating that the UK utilizes the NMHC and the primary care nurse practitioners in a better way (Aponte, 2012).

Accountable Care Organizations (ACOs) is very vital in the current American Nurses Association. It is composed of the nurses, physicians, and other professionals. In the recent times, it is vital for nurses to be educated on how certified nurse midwives who are not part of ACO deliver high quality and seamless care for beneficiaries of Medicare. There was an included shift in the focus of providers of health care to value-based health care and accountable care after Patient Protection, and Affordable Act of 2013 (PPACA) was implemented (Scholtz et al.,2014).Also, there is the growth of medical homes that enhance delivery of primary care through the approach of patient –centered.

Impressions of the Nurse Colleagues on the Anticipated Changes to Delivery of Health Care

The feedback I got from my colleagues was very positive and inspiring since they were very supportive with what I presented. They indicated that there should be the maintenance of the established government legislations due to the improvement in the simultaneous conditions of the US healthcare sector. Moreover, as Aponte (2012) explains, there is a discussion of Actions Coalitions in diversifying the stakeholders’ groups as well as improvising the concept related to the future of the practice of nurses. It is worth noting that the concept of sustainable development in the sector of healthcare can be affected by these diverse groups. Actions Coalitions entails coming up with proper goals meant to improve the health sector through the potential of professional nurses. This entails the involvement of stakeholders in representing a variety of areas used in the building of proper blueprint action (Al-Mazrooa, 2011). Aponte (2012) observes that currently, there is the launch of at least 36 Action Coalitions into different nations such as Hawaii, Georgia, Texas, Ohio, Virginia and other places.

On the other hand, the facilitation of each Action Coalitions is through desired goals that are as a result of the entire outcome related to the campaigns of the healthcare in influencing the professional nurses (Scholtz et al., 2014). Additionally, the feedback from the nurse colleagues, nurses has innovative strategies and the potential to mitigate different severe health issues together with enhancing the current system of health care. However, they may experience a variety of challenges that can be about aging workforce, fragmentation of related healthcare setting, demographic challenges as well as other significant barriers that can affect the nurses’ potential. Nurses have expectations that the problem of long shift hours, as well as the patient to a low nurse ratio, will be resolved.

It is crucial to note that, Accountable Care Organizations aim at giving the issues that are faced by nurses a priority. Additionally, life and death decisions among the health professions act as the primary challenge from both practical and ethical view. Through the expansion of highly significant opportunities for the professional nurses, the Nursing advocates in the United States can overcome the barriers. This will be of great aid to them since it assists nurses in the enhancement of the practical skills and knowledge in providing better services to the clients.

The lack of potential of the professional nurses acts as the primary barrier in advancing the Action Coalitions (Aponte, 2012).Most of the healthcare companies are faced with the challenge of finding the adequate and efficient number of the professionals meant to offer enhanced services. Also, there is the existence of the inappropriate partnership between various organizations in the healthcare which has created barriers in the US. However, the feedback provided by the nurses, nurses can get help from the concept of Continuum or Continuity has aided them when faced with the difficulties related to demand for enhanced healthcare services, service users, and the complexity of the healthcare settings that are in existence. By the discussion provided by the nurses, there are a minimal number of integrated mechanisms that are used growth enhancement and the change of nursing professions practice as discussed below.

Information Systems for Health

The professional nurses can achieve the issue of providing high-quality services at low costs by using the integrated system to fetch information of the clients. This is achieved through the collection of service users’ integrated information depending on the various lifestyle aspects such as cultural, financial, and environmental as well as the behavioral barriers (Al-Mazrooa, 2011).

Program Events for Managing Diseases

Basing on the feedback provided by the professional colleagues, it is very vital to place the program events for managing the diseases. This is because they enhance the measurement of the limit of severe issues of health such as diabetic issues, cardiovascular diseases as well as other severe health issues faced by the users of the services. In this case, the mitigation of such health problems will be improved for the nursing professions.

Services that are Community-based

By applying the Continuum or Continuity concept, the professional nurses who have home health care experience can aid the service users through the expansion of the Continuum and visitations to the service users’ residence as well as providing efficient services by assessing their health (Aponte, 2012).


Al-Mazrooa, A. (2011). Evolving Nurses into Home Health Care Practice. Home Health Care Management & Practice, 23(2), 118-124.

Aponte, J. (2012). Cultural Competency in Baccalaureate US Nursing Education. Holistic Nursing Practice, 26(5), 243-258.

Scholtz, A., King, K., & Kolb, S. (2014). The Care Model of the Future: Supporting APRNs Through an Innovative Transition to Practice Program. Journal Of Pediatric Health Care, 28(3), 276-279.

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