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NRS 440VN Week 1 DQ 2
Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place.
answer
This course addresses how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. It discusses ways in which health care will continue this trend and explains the role of nursing in supporting and facilitating this shift.
Health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Health care will continue this trend with improved coverage for preventive screenings, immunizations, and routine checkups. Nursing has an integral role to play in supporting and facilitating this shift. One important area for nursing is to provide education about wellness, prevention strategies, and healthy lifestyle choices to patients, families, employees, faith organizations, community groups, and others. In my specialty area of cardiology we educate patients about the benefits of smoking cessation as well as annual influenza vaccinations which are important strategy for preventing heart attacks.
Health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention in many different ways. The biggest way is health care costs. Now, people don’t have to pay as much for preventative care and their insurance is required to cover it. It is cheaper in the long run to maintain wellness than trying to deal with myriad of issues that can arise if we are unhealthy. Nurses are instrumental in this transition by continuing to educate the public on how important maintaining one’s health is, including practicing self-care on our own time.
Our paradigm in the United States has shifted from a disease-oriented health care system. Health Care reform has allowed for this shift to occur. I feel that the focus of health care has become more focused with prevention and wellness measures. Additionally, I feel that many organizations and specialty areas have adopted new protocols to assist in these preventive measures. I am currently working on a medical floor and my Specialty area has taken is approach to patient care to be encompassed by the patient as a whole rather than just viewing the illness or disease that landed them in the hospital. For example; as an RN, I conduct care round and each day I assess patients for any skin breakdowns or wounds, their nutritional status and ability to eat, ensure they are moving around the hallways and exercising their arms/legs whenever possible especially if they are on isolation precautions (I do not want anyone developing contractures or skin breakdowns while they wait for discharge). In addtion, if they are diabetic, I make sure my CNA checks blood sugars before meals, when arriving, and before bedtime as well as making sure we carry diabetic shoes to ensure our patients do not suffer from foot ulcers (which can turn into amputations or worse) knowing diabetes is
Healthcare reform has helped shift the focus from a disease-oriented healthcare system to one of wellness and prevention. The Affordable Care Act is helping to promote wellness and prevention by providing funding for things like workplace wellness programs, school-based health centers and community based health care providers who serve low-income rural areas. Additionally, hospitals are being encouraged to move away from a fee-for-service payment model, which only values acute episodic care, to a value-based model that requires ongoing care, collaboration, risk sharing and coordination of care. A fee-for-service healthcare system incentivizes hospitalizations while a value-based health care system encourages outpatient services. By making the switch to such a system, it is expected that the emphasis on hospitalizations will change so that there is more emphasis put on infection control, outbreak prevention and healthy behaviors (Gerstenberger, M., 2017).
The focus of health care has been shifting from a disease oriented health care system to one of wellness and prevention. (Lerner et al., 2018) This concept is now being utilized in organizations across the country. As nurses, we are vital to the implementation of these new approaches. A good example of an organization that is supportive of healthy lifestyles is Kaiser Permanente. They have a program called “Thrive” which is used as a wellness program for their employees. In my workplace, we also have a wellness committee that focuses on healthy eating and exercise.
Health care reform strengthened the emphasis on wellness and prevention. This includes programs to improve disease management, expand safety nets for underserved populations, increase access to preventive services, and strengthen public health systems. Nurses can educate patients on preventative measures they can implement to decrease their risk of disease. Nurses can also educate communities via outreach programs about the importance of wellness and prevention. The role of the nurse in supporting this trend is fundamental to a return to health from illness.
The Institute of Medicine’s 2011 report, The Future of Nursing: Leading Change, Advancing Health, and the 2015 National Academy of Medicine report, National Health Care Quality Strategy and National Quality Strategy Progress Report 2015–2016: Charting a Course for Quality Together: Action Toward a Realigned U.S. Health System and a Culture of Health discuss the need to redefine “health”. These recommendations support the need for a greater emphasis focused on prevention rather than treatment alone (IOM, 2011; IOM/NAM, 2016). The U.S. healthcare system has steadily become more disease-oriented rather than focusing on maintaining individual health and wellness status (IOM/NAM, 2016). Improved access to care from the Affordable Care Act makes it possible to reach patients who have historically been underserved by healthcare providers and insurance coverage. This expanded access will provide more people with an opportunity to lead healthier lives supported by qualified and effective health service providers. Nurses provide the primary means by which the majority of patients interact with healthcare services (IOM/NAM, 2016). As such, nurses play an important role in supporting and facilitating a shift toward a greater focus on wellness and prevention in healthcare services through outreach
According to the United States Health Care Reform bill, “The Affordable Care Act is designed to support a new approach to health care delivery that will improve the quality of care while reducing costs. One way it’s doing this is by shifting the focus from sick care—a disease-oriented approach to health care—to wellness and prevention. The goal is to deliver services in different settings to keep people as healthy as possible and improve their quality of life.”
Historically, our healthcare system focused on treating disease when it occurred. Today, the focus is shifting from treating disease to promoting health and wellness and preventing illness. Many preventative care screenings such as mammograms, prostate checks, and colonoscopies are now covered by insurance companies without copay or out-of-pocket expense. This has enhanced awareness among the general population of their own health status and encouraged many more people to seek preventative care. In order to be effective with this paradigm shift, nurses must continue to keep up-to-date with current research and educate ourselves as well as our patients about new treatment strategies.
The word wellness incorporates many aspects of life. The term has been used commonly to describe a holistic approach to health care (Bercuson, 2004). A prime example of a holistic approach is the following statement by the Centers for Disease Control and Prevention (CDC): Wellness is an active, dynamic process of change and growth. Wellness involves all aspects of life, including physical, emotional, spiritual, mental, intellectual, and social well-being. Ideally, each person pursues all aspects of wellness contributing to his or her own optimal health — feeling well and functioning well in all dimensions. Positive health can be promoted through various programs that support wellness initiatives. Examples include walking programs, lifestyle changes such as weight loss programs and smoking cessation programs.
Provide a summary of the topic of the thread that includes an explanation of the main ideas, findings, or conclusions that have been presented in the discussion.