Discuss how the policy influences clinical practice and is used to promote best outcomes

Assignment 2: Course Project: Health Policy Paper
Health policy unfolds daily and drives clinical practice in the U.S. You will investigate current policies or legislation underway for a specific health-related issue and develop a scholarly, APA-
formatted paper supported by evidence. The policy paper rubric: you are writing on topic the affordable care act.
Topic: The Affordable Care ACT all the grading criteria must be covered in this topc.
• Introduction to population or problem (incidence, prevalence, epidemiology, cost burden, etc.)
• Description of how the policy is intended for a specific population, program, or organization
• Specific legislators involved in the policy development and dissemination
• Identify the role of the APRN in assisting with the policy or refuting the policy – this requires the evidence to support opinion, ideas, and/or concepts
• Discuss how the policy influences clinical practice and is used to promote best outcomes
• Examine how the policy can be used by the interprofessional team to ensure coordinated and comprehensive care for the specific population
• Conclusion – summarize findings
3 pages in APA format – use of primary peer-reviewed references as much as possible
Every topic must be centered in bold in the paper (a sample paper layout is provided below).
THE PAPER MUST BE WRITTEN ON THE GRADING CRITERIA,
All the grading criteria must be covered, in the topic The Affordable Care Act
Grading Criteria Maximum Points
Introduced population or problem (incidence, prevalence, epidemiology, cost burden, etc.). 20
Described how the policy is intended for a specific population, program, or organization. 20
Involved specific legislators in the policy development and dissemination. 20
Identified the role of the APRN in assisting with the policy or refuting the policy. 20
Discussed how the policy influences clinical practice and is used to promote best outcomes. 20
Examined how the policy can be used by the interprofessional team to ensure coordinated and comprehensive care for the specific population. 20
Provided conclusion and summarized findings. 10
Followed APA format and used primary peer-reviewed references as much as possible. 10
Total: 140
Every statistics and direct quotations must be reference with page numbers
EXAMPLE:
1. According to Palladino and Wade (2010), “a flexible mind is a healthy mind” (p. 147).
2. In 2010, Palladino and Wade noted that “a flexible mind is a healthy mind” (p. 147).
3. In fact, “a flexible mind is a healthy mind” (Palladino & Wade, 2010, p. 147).
4. “A flexible mind is a healthy mind,” according to Palladino and Wade’s (2010, p. 147) longitudinal study.
5. Palladino and Wade’s (2010) results indicate that “a flexible mind is a healthy mind” (p. 147).
6.
7. SAMPLE PAPER
8.
9. Ethical and Legal Issues
10. Jane Doe
11. Every University
12. SU_NSG4070_W1_A3_Doe_J.doc.
13. December 22, 2015
14. Ethical and Legal Issues
15. In this paper the writer will discuss a case study in which an ethical and legal decisions that will have to be made and the ethical and legal decisions the nurse would make for the
patient care. The paper will also discuss the ethical dilemma faced by the family in making decisions for the patient. During the process, the paper will also explain what advice the nurse would
give the patient’s concerning care family.
16. The Ethical Decisions you would make
17. According to data gathered by the nurse, the patient Ann was diagnosed with moderately advanced alzheimer’s disease. The nurse observed because of the disease, the patient is
exhibiting following symptoms obsessive thinking, confusion, inability to recall detail, frustration, and personality changes. The patient also has been diagnosed with pneumonia and has recently
unable to communicate and refuse to eat. As a nurse the ethical decision is to provide medically appropriate treatment using evidence-based medicine and assess the benefit and burdens involved. The
nurse would adhere to the healthcare institution’s policies and procedures for ethical decision making regarding artificial nutrition. According to Burkhardt & Nathaniel (2007), noted that “Nurses
are involved in patient care situations with moral implications and professionals in the health care system they make ethical decisions affecting life and death. (p. 81). The nurse is also aware
that the patient is the predominate stakeholder in this process, and the concern of family, physician, and other providers are what includes in the process of making the right choices and decisions
of nutrition therapy intervention in the patient’s healthcare delivery.
18. The nurse would discuss end-of-life healthcare issues with family while balancing the nurse obligation to the patient and implement strategy to eliminate conflict. The nurse would
also educate the family about the benefit of tube feeding vs the burden, inform the family that the purpose of feeding and hydration is the restoration of normal function for the patient. The nurse
would also educate the family that starvation and dehydration are rather uncomfortable and provision of food and fluids contribute to comfort. The nurse will also inform the family that it is very
difficult and time consuming to hand-feed the patient and a feeding tube may be the best option and an evaluation of patient progress will be done. According to Catlin (2012), “Ethical trained
nurse understands the decision to insert an enteral feeding tube can have crucial decision for patient family” (p.5). The nurse would also inform the family that this measure could be temporary
and they can refuse tube feeding for the patient. But the nurse also believe it is in this context that most of the controversy might occur.
19. The Legal Decisions you would make
20. The provision of adequate fluid and nutrients in most instances example drinking and eating is necessary and considered by the law as basic care. In adult it acceptable that
nutrition by artificial procedures is a medical treatment, involve professional determination and intervention, governed by the laws related to medical practice. in 2006, Korner et al, noted that
“When certain situation example persistent vegetative state or there is a conflict between professional decision and wishes of the family, the courts need to involve before any action taken” (p.
200). According to the law patients without capacity circumstances require the nurse to view legal and ethical challenges and make the decisions as the patient would if he or she could speak for
themselves. The mechanism to proceed with procedure is the existence of a prior statement about the issue in a Living Will or other advance care document advance directives. Appointment of a
healthcare `agent` identify on a healthcare proxy form, legally authorized to make decision based on reasonable evidence of the patient’s wishes.
21. The nurse stated use of other surrogate such as friends and family members which would require clear instruction of the patient wishes. The nurse would also explain to the family that a
request can be made for artificially provided nutrition can be withdrawn or withheld, if there is no reasonable hope of maintaining life or the artificially nutrition or hydration present extreme
burden. The nurse would also educate the family on the patient self-determination act (PSDA) of 1990, this federal law require hospitals, nursing homes, hospice, HMOs/PPOs and other healthcare
facilities who receive Medicare or Medicaid fund to advise patients of their legal rights to refuse treatment if they become unable to speak for themselves and to make advance directives. According
to Rouse (1991), “Written information required by the law must be given at the time of the individual’s admission as an inpatient” (p. s3). While the law does not answer every question, its
underlying assumption is that if informed, many patients might take advantage of their options.
22. The Nurse Advice to Frank and Sarah
23. Family members Frank and Sara are concern about Ann, they ask if a feeding tube is the same as a ventilator. The nurse would advise that a feeding tube can’t be remove unless
its deem necessary by the doctor, a request by the spouse or family, healthcare proxy form, legally authorized to make decision based on reasonable evidence of the patient’s wishes, or the patient
is near death and food and fluids become burdensome. The nurse would explain to Frank and Sara that pneumonia is an infection of the lungs and makes it difficult to breathe and cause pain,
confusion and progressive weakness and the use of a ventilator may be used for short period to treat pneumonia. Frank and Sara raise concern about Ann dying of starvation, but seems to also have
concern about feeding and seems reserve in allowing artificial feeding.
24. The nurse would explain to Frank and Sara that starvation is a long and usually painful process that can from 30 to 60 days in its course. The nurse informed them also that dying patient
who stop taking in food and fluid may not necessarily starve to death, but might be painful to see their love suffer. The nurse explained that patient who stop absorbing fluid and food drift into a
state of unconsciousness and usually between 5 to 8 days when food and fluid is stop. Patient will die several days after. According to Ganzini (2006), “Data suggest that stopping eating and
drinking in dying patients causes minimal suffering, though additional studies are needed” (p. 139). The nurse also informed the family that during dehydration the body can sustain itself for no
more than two weeks without fluid intake, unlike starvation, dehydration is not a painful experience and with comfort measure in place, less discomfort is experienced.
25. Frank and Sara are concern if starvation by dying is murder? The nurse would suggest to the family that while this issue raises lots of moral and religious questions, such as euthanasia or
word for murder, they the family should look at the patient’s will, the intention, and the condition of the patient. The nurse suggest the family should seek counselling about their feelings on the
issue and try to avoid the pain, anxiety and helplessness. The nurse suggests that because Ann didn’t have advance directive Frank as the husband as the legal right to make decisions for his wife.
Without an advance directive, the nurse suggest frank and Sara will be force to choose if nutrition and hydration should be stopped. Without advance directive the family is force to guess what
their family member would have wanted and then may face guilt over decision might they make. According to Silveira, Kim & Lang (2010), noted that “Patients who had written advance directives
received care that was associated with end of life preferences” (p.1211). The nurse noted that raising awareness of the purpose of advance directives is important, and raising professional
awareness for the need to respect them is key to improve care provided for the dying patient.
26. Frank and Sara continue to question themselves about the right thing to do about Ann. The nurse would encourage Frank and Sara to talk with sympathetic friends or family members, who have
weathered similar situations, embraced the comfort that you have made the right decision for your family member. The would encourage Frank and Sara to think of what Ann would have wanted and strive
to do it. Let the aim be for final days and moments of Ann’s life guided toward maintain comfort and reaching a natural death.
27. Conclusion
28. In this paper Frank and Sara struggles with the decisions about the appropriate care for Ann. They often question themselves about doing the right, without advance directives from Ann, the
primary course of action is to fulfill Ann’s wishes as she would want it to be. Healthcare professionals such as nurses can play an important role in guiding family to counselling support, privacy,
intimacy, comfort and emotional reassurance during terminal illness and possible death.
29.
30.
32. References
33. Burkhardt, M. A., & Nathaniel, A. K. (2007). Ethics and issues in contemporary nursing. [VitalSource Bookself Online]. Retrieved from
https://digitalbookshelf.southuniversity.edu/#1111440182/
34. Catlin, A. (2012). Feeding tube placement. American Journal of Nursing, 112(5), 12. http://dx.doi.org/doi:10.1097/01.NAJ.000414298.01556.b8
35. Ganzini, L. (2006). Artificial nutrition and hydration at the end of life: Ethics and evidence. Palliative and Supportive Care, 4(2), 135-143.
http://dx.doi.org/doi:10.1017/S1478951506060196
36. Korner, U., Bondolfi, A., Buhler, E., McaFie, J., Meguid, M. M., ., .., & Allison, S. P. (2006). Ethical and legal aspects of enteral nutrition. Clinical Nutrition, 25, 196-202.
http://dx.doi.org/doi:10.1016/jcinu.2006.01.024
37. Rouse, F. (1991). Patients, providers, and the PSDA. The Hasting Center Report, 21(5), S2-S3. Retrieved from http://search.proquest.com/ddocview/222366169?accountid=87314
38. Silveira, M. J., Kim, S. Y., & Langa, K. M. (2010). Advance directives and outcomes of surrogate decision making before death. The New England Journal of Medicine, 362(13), 1211-1218.
http://dx.doi.org/doi:10.1056/NEJMsa0907901
39.

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