future of nursing discussion 2

Question Description

Please respond to the discussion questions. Please also respond to the peers discussion.


The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” Discuss how these two provisions have impacted, or will impact, your current practice of nursing.


Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. How is this advantageous to patient outcomes?

Peer discussions

Peer 1

In 2010, the Patient Protection and Affordable Care Act (PPACA) was passed into law and the reformation of health care ensued (Hertel, 2011). This act was predicted to empower citizens, censor socialized medicine, and change the operations of health care insurance companies throughout America (Hertel, 2011). The act has resulted in national debt and funding is a major issue, but this act has profoundly impacted the practice of medical-surgical nursing (Hertel,2011).

Two articles discussed in the article, Health Care Reform & Issues in Nursing. The PPACA and its impact on Medical-Surgical nursing, serves as an alarm to the future of medical-surgical nursing (Hertel,2011).

First,” reauthorization of Title VIII Workforce Development Programs ensures there are grants for workforce diversity providing stipends for racial and ethnic minorities with diplomas or associate degrees in nursing to enter bridge or degree completion programs” (Hertel,2011, p.1). Grants allow nurses to advance to the role of nurse practitioner and provides additional access to health care for the public in nurse driven clinics, medical centers and physician offices. However, funding is expected to decrease, and this will result in a significant loss of grants available to nurses. Loss of grants means fewer nurse driven clinics. Fewer clinics means medical-surgical nurses will see an increase in chronic illnesses, high readmission rates and a decline in the number of nurses seeking advanced training.

Secondly, provisions for Graduate Nursing Education has positively affected medical-surgical nursing. Increased funding has enabled hospitals to implement nurse residency programs that allow new graduates to gain on-the-job experience and enhance their knowledge through patient and nurse interactions, evidence-based research and leadership development. The presence of new graduates increases staffing ratios, combats turnover, and helps to increase morale. Residency programs fulfil the need for mentorship and allow for a smooth transition from student to professional nursing practice.

Hertel, R. (2011). Health Care Reform & Issues in Nursing. The PPACA and its impact on Medical-Surgical nursing. MEDSURG MATTERS, Sep/Oct2011; 20(5): 14-16. (3p).

Peer 2

The first nursing provision that has affected me directly would be the Nursing Workforce Diversity Grants. It states that section 5404 will expand the workforce diversity grant programs by allowing them to be used for diploma and associate degree nurses to enter a bridge program, or a program for degree completion (Federal Grants Wire, n.d.). There has been a huge push at the hospitals in my area, including the one I worked for before, to attain an 80% of their nursing staff to be BSN prepared. With this provision, the hospital has sought out donations to help increase the scholarship money available for those seeking a BSN or higher level of education, essentially making the cost of obtaining a BSN not the biggest barrier for progressing in one’s education.

The Independence at Home program can have a large impact on acute care hospitals. It states, “Creates the independence at home demonstration program for chronically ill Medicare beneficiaries to test a payment incentive and service delivery system that utilizes physicians and nurse practitioner directed home-based primary care teams aimed at reducing expenditures and improving health outcomes” (Independence at Home Demonstration Program, n.d). By creating more at home visits from doctors or NPs, the low acuity patients can now be seen outside the hospital at home. This could mean that the overall acuity of patients in the hospital can go up. This would impact the home health field as well by increasing demand.


Independence at Home Demonstration Program. (n.d.) Retrieved August 20, 2018 from https://primaryimmune.org/wp-content/uploads/2011/…

Federal Grants Wire. (n.d.). Nursing Workforce Diversity. Retrieved August 20, 2018 from https://www.federalgrantswire.com/nursing-workforc…

American Nurses Association (ANA), (n.d). Nursing Workforce Development. Retrieved August 20, 2018 from https://ana.aristotle.com/SitePages/nursingworkfor…

American Nurses Association. (2014). Health Care Transformation: the Affordable Care Act and More. Retrieved August 20, 2018 from https://www.nursingworld.org/~4afc9b/globalassets/…

Peer 3

“Nurse driven clinics provide comprehensive care and wellness services to our underserved and vulnerable populations” (ANA,2010, p.1) My community recently opened two nurse driven clinics that are run by nurse practitioners: a COPD clinic and a CHF clinic. Our goal is to provide further access to the public and prevent readmissions through knowledge, follow-up care, medication assistance and easy access to resources.

Nurse Managed Health Clinics are organized and led by APRN’s and redefines the delivery of primary care (ANA,2010). “Primary care, wellness education, management of chronic diseases and conditions, coordination and integration of care are all building blocks to a “reinvented” health care system that attempts to contain costs, while optimizing patient outcomes” (ANA,2010, p.1). Care provided by nurse practitioners is cost effective, efficient, increases compliance, and enhances the overall outcome for patients suffering from chronic health issues (ANA, 2010).

Since our clinics opened the hospital has seen a decrease in readmissions related to CHF and COPD. Our patients visit the clinic and if the patient is unable to physically be at the clinic a nurse will visit them at their home. We teach oxygen safety, breathing techniques, warning signs of exacerbations and prevention to name a few. Patients are more compliant with medication and treatment regimens and we have seen fewer missed appointments since the clinics were implemented. The clinic decreases patient costs and the lessens the cost of unpaid hospital fees. Together we are fighting COPD and CHF. The nurse driven clinic model has profoundly benefited my facility and the community. Together, with education, we are saving lives!

American Nurses Association (ANA). (2010). New Care Delivery Models in Health System Reform: Opportunities for Nurses & their Patient. Retrieved from:https://www.nursingworld.org/~4af0e8/globalassets/…

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