Transitional Times In Nursing

This is an opportunity for hospitals to work more closely with skilled nursing facilities and other post-acute providers to improve care transitions, and experience fewer readmissions. The ACA impacted hospitals by holding back a one percent reimbursement rate. Hospitals will actually need to perform and deliver high-quality evidenced based care to recover the one percent withheld reimbursement rate while hospitals that exceed the benchmark, will received a higher reimbursement rate over the one percent. The Act is intended to help spur the trend of more integrated care throughout the continuum. The Affordable care act (ACA) of 2010 designed programs for improvements and innovation in the quality of hospital care by instituting the Medicare’s hospital readmission reduction program. Through this program, CMS reduces Medicare payment bt one percent for hospitals for hospitals that demonstrated high rate of avoidable readmissions for patients with a diagnosis of heart failure, heart attack

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

In Australia Registered nurses are primarily obtained from recently graduated university who has successfully finished a three years of education in the bachelor of nursing. New graduates student nurse are very significant to the healthcare sector. The transition from new graduate to registered nurse is challenging which requires support from the entire medical team. The aim of this paper is to explore the transition from student nurse to registered nurse. The paper will focus on the theme skills transition into practice and other issues during the transition.

Job retention rates amongst newly graduate nurses tend to fluctuate widely. These fluctuations have many possible and combined explanations including orientation quality, level of confidence, residency programs, pay rates, mentoring programs, management support, and countless views of job satisfaction. My concept will focus on transition to practice success of new graduate nurses in relationship to their organization’s orientation process, job satisfaction, and the effects of job retention rates.

Transitioning from an licensed practical nurse to a registered nurse is of the hardest things I have ever done. Twelve years ago I took my boards and became a licensed practical nurse. Going to school to become an LPN was difficult, but I was not a mother and I did not work full time as I do now. Getting to know the students I attend school with has made me realize that each student’s role transition is different, with unique outlooks and emotional roller coasters. In the following paragraphs I will preview licensed practical nurse to registered nurse role comparisons, my change in

A number of emotions were felt during this experience, in regards to transitioning from a student nurse to the registered nurse role. Primarily, the transition in role from student nurse to registered nurse was similar to any clinical experience I have had at Midlands Technical College. I was placed in a medical-surgical rotation. I felt slighted that not only were we required to complete a data tool but we also participated in the teamwork model demonstrated in prior semesters. Personally, I did not feel a transition during this particular clinical experience.

The new graduate nurses (NGN) are faced with various issues and challenges especially in their first year of nursing practice. The period of transition from a student to a graduate nurse is a demanding period that is filled with new experiences and there are several concerns and factors that can affect the transition process. The research into the issues has recommended some strategies that can be utilised to ease the transition process from being a student to a professional practicing nurse. Exhaustion, reality shock and time management are some of the factors and issues that the new graduate might encounter during their first year in their career.

An underlining principle that forms all nursing practice is respect for the inherent dignity, worth, unique attributes, and human rights of all individuals. (Jimenez-Lopez, Roales-Nieto, Seco, Preciado, 2016) Nurses are to always treat all patients with dignity. For example, closing doors before you start providing patient care. It’s also essential as a nurse to respect patients regardless of their background, race, culture, value system, or spiritual belief. (Jimenez-Lopez, et al., 2016)

Studies have found that improvements in hospital discharge planning can dramatically improve the outcome for patients as they move to the next level of care (Alliance, 2016). Moreover, Patients, family caregivers and healthcare providers all play roles in maintaining a patient's health after discharge. And although it's a significant part of the overall care plan, conversely there is a surprising lack of consistency in both the process and quality of discharge planning across the healthcare system (S. Shapperd,

The monitoring of critical factors affecting positive transition of health care will lead to a decrease in re-hospitalization of patients in this population.

Partnership for Patients (PfP) has made significant progress in decreasing the number of preventable hospital acquired conditions (HACs), hospital readmissions, hospital patient deaths, and health care expenditures. Nonetheless, much work remains to be done so that PfP is more effective in their mission to make and improve care safety and care transitions. The progress made is part of a program that has been in effect since April of 2011, soon after sections 3011 and 3026 of the Patient Protection and Affordable Care Act (PPACA) were signed into law. These sections allowed then Department of Health and Human Services (DHHS) Secretary, Kathleen Sebelius, and Center for Medicaid and Medicare Services (CMS) Administrator, Donald Burwick, to create and provide funding through Medicare for a dual program to reduce hospital readmissions and transition care services.

The Bridge's model of transition is made up of three stages known as the ending phase, the neutral phase and the new beginnings phase. The ending phase is characterized by the ability of an individual to let go of the old responsibilities. It consists of components such as disengagement, misidentification, disenchantment, and disorientation. In the second phase, the nurse begins to accept the new position and its responsibilities, accepting that most probably their relationships with former peers will change. The nurse works to proceed in the new job while at the new beginnings phase of transition through the maximum resistance of the temptation to go back to former position. In my

Interventions to Reduce Acute Care Transfers is a quality improvement program that has been used throughout health care settings worldwide. Its main goals are to decrease hospitalizations and readmissions, with an overall aim of improving quality of care (Ouslander et al., 2014). Interact’s website provides health care facilities with affordable and easy to use “tool kits” that are based on five fundamental strategies including; principles of quality improvement, early identification and evaluation of changes in condition, management of common changes in condition, improved advance care planning, and improved communication and documentation (Ouslander et al., 2014). By using the tools health care providers can help prevent unnecessary hospitalizations and related complications, at the same time receive financial

For years, healthcare costs have continued to increase in the United States and policymakers are constantly trying to find ways to reduce spending. According to reports, in 2011, about $900 billion out of the $2.6 trillion annual health care spending was wasteful spending. In the following year, there was a reported $690 billion wasted annually on healthcare. This wasteful spending is attributed to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody et al., 2016). Policymakers on the federal and state level have developed and implemented several programs, some varying state to state, to help reduce wasteful spending while improving quality of care.

In nursing practice, it is important to always remember the importance of seeing each person as a unique individual. Recognizing the uniqueness of each individual allows for patient-centered and holistic care. In order to be objective and provide quality care a nurse needs to be able to recognize the needs of each patient and adapt to their needs.