The Need for Classification of Nursing Data in EHRs In the healthcare industry, nursing is underrepresented in the development of healthcare policies. Current nursing practice depends on the use of standardized nursing terminology and documentation to accurately communicate and identify nursing diagnoses, nursing care provided, and interventions that were performed within healthcare disciplines process (Mennella & Caple, 2016). The essential solution to making nursing more visible is having necessary data to adequately measure the direct effects and retrieve associated nursing care costs to attach nursing care services with each patient. Minimum data sets for nursing are vital classification systems necessary to categorize the practice of nursing, and they allow consistent collection of essential nursing data that provide accurate descriptions of the complete nursing process (Dolezel & Moczygemba, 2015). The primary goal for the development of nursing minimum data sets involve the establishment of comparability nursing data among various populations, settings, and periods of time. Nursing minimum data sets allow trends of nursing care and resources to be followed, motivate nursing research, gather data to encourage policies in nursing and healthcare, and determine nursing practice as a recognizable and comprehensible record of care. Classification of nursing data in electronic health records (EHRs) is essential for the support of financing, nursing education,
Nursing informatics really gained momentum in the 1980’s. The first national conference on computer technology and nursing was held (Ozbolt, J.G., Saba, V.K. 2008). Scholarships and the first educational courses on Nursing Informatics were introduced into the nursing programs at Boston College, University of New York and University of Utah (Ozbolt, J.G., Saba, V.K. 2008). The growing record of accomplishment allowed nurses to move into managerial roles (Edwards, H. 2011). By the mid ‘80’s, nearly three decades after Nurse Werley pushed for minimum data sets, was the idea finally embraced by nurse professionals (Ozbolt, J.G., Saba, V.K. 2008). Four specific elements of the minimum data set became a standard for nursing care: nursing diagnosis, nursing intervention, nursing outcome and the
The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing
Over the last five years, the United States has implemented a new policy in which Americans will receive their health care benefits. This policy is known as the Patient Protection and Affordable Health Care Act which was implemented in 2010 through United States federal statue and signed into law by President Barack Obama. The intentions of the reform is to insure that all Americans have affordable access to health care benefits without struggling to afford the cost associated. The reform is broken down into nine title sections that affect all aspects of health care and changes that will be associated. In this paper, I will be discussing each of the title sections and how the changes will affect the field of nursing.
The Affordable Care Act of 2010 was a transformative piece of legislature aimed at putting health insurance back in the hands of the public. This comprehensive healthcare plan outlines several key provisions that apply to nursing. "The Affordable Care Act is working to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike. The Patient Protection and Affordable Care Act clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation’s healthcare system (About, 2014).
Affordable Care Act (ACA), and the aging of the population are the three major factors driving healthcare costs at this time (CMS, 2014). The nursing profession has the ability to contribute to refining the cost-effectiveness and efficiency of care through the delivery of evidenced-based treatment strategies to known populations with communal needs, and by advocating for polices that address the fundamental aspects that influence health and healthcare (Curley & Vitale, 2016, p. 5). The NE must be well-informed of laws entrenched in policy, as well as those central to both healthcare delivery systems and payment structures. Having knowledge of policy and law will enable the nurse leader to provide financial stability and sustain quality
Drafted by congress under the recommendation of president Barack Obama, signed into law on March 23, 2010 by President after long legislative debates, the Affordable Care Act 's main purpose is to provide access to affordable and comprehensive health coverage to millions uninsured Americans who do not have coverage or adequate coverage, those who would be denied coverage under the previous insurance practice either base on pre-existing condition, gender or age, while controlling the cost of health care. (New York Time, October 26, 2014) The purpose of this paper is to provide a comprehensive overview of the Affordable Care Act, examine the nine titles of the law, their effectiveness as well as their impact on the nursing practice today
One common theme that has resurfaced throughout the entire Obama administration and has created a great deal of focus and debate is health care reform. The Patient Protection and Affordable Care Act (PPACA) which was introduced by Obama in 2010 creates a new structure of health care. It transforms health care from “late-stage, high intensity, illness focused, tertiary, interventional health service to a much stronger value driven focus on achieving the highest levels of health” (Porter-O’Grady, 2014, p. 65). Through this act, legislation has been created that regulates the way hospitals and physicians are reimbursed, which is built on evidenced-based, quality health care outcomes that are cost effective without infringing upon patient satisfaction. At the heart of this debate is the impact on nursing care, for nursing is the largest health care professional as well as the largest component of health care costs. Any change in the health care reimbursement will greatly affect the nursing practice (Buerhaus, 2010). In order to fully understand the impact of this health care reform, one must understand that health care reform is not a new concept. Health care reform has been transforming since the 1800s.
There are over three million nursing professional in United States and they make the largest segment of nation’s health care workforce. Nurses can play a vital role in helping to realize the objectives set forth in the 2010 affordable act, legislation that represents the broadest health care overhaul since the 1965 creation of Medicare and Medicaid program (IOM 2010). Due to the restricting barriers nurses were not able to respond effectively to the changing health care systems. In 2008, The
It’s crucial that nurses document care using a standardized language and the reasons for this is countless. Standardized nursing terminologies offer many benefits to the patient and nurses that are in direct care of patients (Rutherford, 2008). Patients are able to receive continuity of care due to the ability for nurses to represent and communicate their practice through standard nursing terminology (Tastan et al., 2014). Due to advancements and standardizations in technology, the electronic health records make it easier for hospitals and health care providers to communicate better. Having standard nursing language or terminology provides uniformity and effectiveness of being able to share information among healthcare providers (Tastan et
The authors conclude that in order to collect data for meaningful use, one must get back to nursing basics to satisfy regulatory requirements. Under direction of a nurse informaticist, utilizing electronic health records helps facilitate this.
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In November of 2010, the Institute of Medicine (IOM) released “The Future of Nursing: Leading Change, Advancing Health”. This special report examined the current state of nursing and changing landscape of the American healthcare system and offered recommendations for the future role nurses should play. The committee that released the report, Committee on the Robert Wood Johnson Foundation, divided it into three parts. Part II of the study, focused on transforming the nursing profession in order to improve America’s healthcare system. In order to achieve this transformation, the committee recommended that nurses attain higher levels of education and training, practice to the full extent of that education and training, and assume more
Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011}
According to Dr. Ken Majowski (Laureate, 2011) health care informatics has been in existence for at least the past two to three decades. Ozbolt & Saba (2008) state that “in the second half of the 20th century” the focus of nursing informatics was on the development of “a standardized language” (p. 199). In the 1970’s, informatics included “nursing care planning and documentation” (Ozbolt & Saba, 2008, p. 200). In the 1980’s, nursing informatics research and education led to the “establishment of data standards … unleashing the potential of nursing informatics to improve practice” thus giving nursing the opportunity to “translate knowledge to practice via decision support, and to create new knowledge from the data generated in nursing practice” (Ozbolt & Saba, 2008, p 201). In the 1990’s the “Nursing Terminology Summit Conferences” met “to develop concept-oriented reference terminology models for nursing” (Ozbolt & Saba, 2008, p. 203). The 2000’s proved to be a decade of additional progress with the call for “an electronic health record” for every
For all of mankind, the cost of health care is a major daily stressor. This article stated an interesting fact that, “A concern of businesses and governments for at least 30 years, the cost of health care in the United States has approached 15 percent of the total gross national product (Barbara R. Heller, Marla T. Oros, and Jane Durney-Crowley, 2013, para. 19).” Even with that fact, there are over 40 million individuals living in the United States that do not have health care coverage. The total health care spending in America surpasses that of any other developed country. This is due to technological advances that are readily available and breakthroughs in medicine. Still, there are present concerns in nursing practices, such as: the affects on the nursing profession, treatment options for their patients, and the patients participation in their own care. This article stated, “Nursing professionals, who have historically taken the lead in health education and health promotion, are disappointed by the lack of financing and reimbursement available through managed care organizations for