This book is geared to nursing professionals who need to know about health care financing in non-CPA (certified public account) term. It is deductive, beginning with the big picture of health care financing and then applying a financial management perspective to nursing practice and general health care issues. The book is organized into four parts. Part I, The Big Picture of Health Care Finance, effectively covers the complexity inherent in reimbursement and insurance coverage. This section includes discussion of hospitals and health systems as businesses, the economics of health care, and insurance coverage and reimbursement in both acute and non acute settings. Part II, Budgeting for Acute and Ambulatory Care, lays the foundation for students to acquire budgeting skills and to prepare to make executive-type financial decisions at the macro and micro levels. Part III, Quality, Data Analysis, and Legal/Ethical Issues, emphasizes business skills such as project management and grant writing for Doctors of nursing practice (DNPs). It points out the fiscal and ethical responsibility of all providers of care to ensure that data are appropriately used to support the cost of care and the importance of data to providing quality. Part IV, Entrepreneurship and the Future, wraps focuses on what the hospital and health system of the future may look like as well as business skills for the DNP, including a sample business plan. This section includes being an entrepreneur, writing a business plan, financial management in academia, and issues behind global health care financing. Critical thinking exercises have been added to each chapter for use in the classroom. The book is designed to provide DNP students with the knowledge and skills needed to practice at a doctoral level.
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- Go to chapter: Professional Integrity in Interdisciplinary Simulation: Creating Workforce Relationships in Occupational Therapy and Nursing
Professional Integrity in Interdisciplinary Simulation: Creating Workforce Relationships in Occupational Therapy and Nursing
The Institute of Medicine identifies five core competencies for the delivery of quality health care. These core competencies serve as an overarching aim for quality health services. Interdisciplinary simulation exercises occur in the first semester of the program involving occupational therapy and nursing students. There are many advantages in using high-fidelity simulation. Through the use of standardized patients, occupational therapy students build on specific skills in a safe environment with a minimal safety risk. Simulation in occupational therapy education is gaining momentum and the International Nursing Association for Clinical Simulation and Learning (INACSL) standards provide guidance until the time that discipline-specific standards or expectations are established. INACSL best practice standards can offer design guidance to educators of many health care disciplines, particularly if they are new to simulation or curriculum design. These standards can provide a common language furthering the development of workforce relationships.
Cultural competency is considered an important skill for nurses and will aid in the elimination of health disparities, with the goal of increased quality of care and improved patient outcomes. Cultural competence is a contemporary issue in health care today and educators are seeking the best practice for teaching cultural competence in nursing education. This chapter discusses the problem and significance of cultural competence training for nursing students. Cultural immersion, or an experience of living among a culture different from one’s own, is a method of teaching cultural competence that appeal to the current generation of college students. To achieve patient-centered care, the chapter addresses the fact that American society, and the larger global society, is increasingly diverse in areas such as race, ethnicity, language, religion, gender, and sexual orientation. This diversity creates cultural gaps that must be bridged in order to provide quality health care.
This chapter focuses on providing a better understanding of the cost drivers in hospital operations. Priorities for tactical execution across the value-driven equation lie in the areas of leadership alignment, quality care delivery as a business strategy, data analytics, human capital management, and the integration of technology for clinical decision support. Strategic hospital leadership requires astute business and operational knowledge. This chapter makes the argument that the nurse executive is perhaps the single most qualified professional to address the care needs of the future. This leader holds the keys, wielding knowledge of hospital operations as well as an understanding of key data points to strategically identify and execute strategies against principal cost drivers. The chapter discusses four essentials that impact hospital efficiency: (1) organizational vision and cultural alignment; (2) quality care as a cost-effective strategy; (3) advanced analytics in the human capital equation; and (4) embrace technology.
Individuals with disability report poor communication, compromised care, negative attitudes on the part of health care professionals, lack of sensitivity, and fears related to quality of care all issues of universal concern to the nursing and medical professions. The inclusion of standardized patients with disabilities program (SPWD) in nursing education has the potential to improve the knowledge, attitudes and skills of students who will encounter individuals with disabilities in all health care environments, facilities, and home care settings throughout their professional careers. Simulations that incorporate SPWDs enable students to learn to communicate effectively, appropriately and sensitively with individuals with disabilities across the lifespan and with diverse types of disabilities. A well-planned strategy to integrate SPWDs in nursing education will enhance nursing students’ learning experiences and faculty members’ adoption of this innovative teaching approach with the goal of improving health care for persons with disabilities.
This chapter provides insight and examples of how health care is trying to determine what a positive outcome looks like to both the consumer and the institution. It explores the delicate relationship in health care between quality and costs and how understanding this relationship can be a critical piece in making a business case for funding initiatives, which can improve the outcomes of our patients. The chapter also discusses the relationships among health care financing, costs, and quality outcomes and the value of building a business case for quality that can ensure that monies are spent on the right initiatives. The Essentials of Doctoral Education for Advanced Nursing Practice describes various competencies for the doctor of nursing practice (DNP) nurse. The chapter addresses (i) Essential II—Organizational and Systems Leadership for Quality Improvement and Systems Thinking and (ii) Essential III—Clinical Scholarship and Analytical Methods for Evidence-Based Practice.
This chapter explains how chaos and confusion impacts staff as they move through the second phase of transition toward a new way of being. When departments or organizations merge, multiple policy and procedure manuals are supposed to merge as well, but this rarely happens fast enough. In the meantime when nurses are challenged by a practice issue and go looking for the correct policy or procedure to follow, they may find several or none. When this happens, staff can feel confused, anxious, frustrated, and fearful for patient safety. They may feel patients are being cheated of quality care and feel guilty about it, but not necessarily motivated enough to change. Mixed emotions, accommodating different practices, and mental and physical exhaustion can cause staff to more readily call in sick and feel less inclined to go the proverbial extra mile. The chapter provides tips for managing chaos and confusion.
Reinforcing reality is a principle learned in psychiatric and mental health nursing. It remains a useful tool for today’s nurse managers in helping staff understand the requirement for personal and professional change in order to thrive in today’s practice settings. In the past, changes in nursing practice resulted from internal requirements to improve patient care efficiencies, quality of care, and service delivery. Today, care provision is complex, being subjected to the influence of budgets, technology, acuity levels, changing demographics, intergenerational and culturally diverse workforces, dwindling human resources, and restructuring. This chapter explains the impact of transitioning from the “good ol’ days” to a new way of being. It discusses the key competencies that will positively influence nursing practice in a changing workplace. These competencies are already deeply embedded in nursing practice although not usually named as such. Rarely do nurses refer to themselves as innovators, risk takers, creative, or flexible.
This comprehensive manual contains essential elements aimed at improving the quality of healthcare provided to women across the life span. It provides an enhanced definition of the role and clinical skills of providers, including physician assistants (PAs), certified nurse midwives (CNMs), and nurse practitioners (NPs). The book offers an integrated and unique approach to the healthcare of women. It provides an excellent resource to link theory to clinical practice using critical thinking skills. The book is organized into 10 sections comprising 46 chapters. It begins with a comprehensive review of the basic anatomy and physiology of women. A complete understanding of the complexities of the menstrual cycle and normal vaginal flora, examined at the cellular level, is imperative for accurate understanding and diagnoses of conditions that affect women. The book discusses elements of a comprehensive, developmentally relevant health history with a unique approach to the physiological, psychological, and sociocultural components involved. The basic techniques of the physical examination—with a focus on the gynecologic examination—are outlined. The book provides a comprehensive guide to the assessment of obesity and body mass index. It discusses evaluation of special populations such as pregnant women, lesbian women, and transgenders. The book also describes evaluation of menopausal status, osteoporosis, vulvovaginal atrophy, pelvic pain, vulvodynia, polycystic ovarian syndrome, abnormal uterine bleeding, pelvic organ prolapse, and urinary incontinence. It contains critical information regarding women at risk for sexually transmitted infections. A nationally tested questionnaire is included to help identify the victims of violence and abuse. The book presents assessment of infertility and subfertility. It discusses contraception, cervical cancer prevention, vaginal microscopy, sonohysteroscopy, urinalysis, and other investigative procedures and workups. The book finally describes advanced techniques such as vulvar and endometrial biopsy, acrochordonectomy, cervical polypectomy, pessary insertion, intrauterine insemination, and percutaneous tibial nerve stimulation.
This chapter introduces the concept of attitude, discusses the power it can have on the quality of care, work life, and workplace relationships, and provides tips for influencing positive change. Negative attitudes may be a by-product of change in the workplace and reflect what is really happening at a deeper level with respect to staff’s feelings, perceptions, and behaviors. Most often, such attitudes emanate from feelings of low self-esteem, powerlessness, low level of trust, a sense of betrayal, disrespect, mental and physical exhaustion, and mismanagement. More recently, compassion fatigue has surfaced as potential cause for negativity at work. Change comes in the form of a staff attitude menu with choices that include the good to great, the okay and so-so, and the downright ugly. Nurse managers are ultimately responsible and accountable for ensuring that staff behaviors are consistent with professionalism in practice.