This week, you complete and submit your first journal entry. Your journal draws from evidence, concepts, and/or theories you have examined in this program, especially those related to your specialization. What have you observed during your Practicum Experience that you would like to analyze through your journal writing?
To prepare:
- Reflect on your Practicum Experiences in Weeks 1–3.
- Think about the evidence, concepts, and/or theories (evidence) learned throughout this program and your specialization.
- Analyze a problem, issue, or situation that you have observed during your Practicum Experience.
- Using a minimum of three peer-reviewed sources of evidence, consider what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from the scholarly literature.
- Determine how the problem, situation, or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory, concepts, and principles detailed in the evidence.
- Given the various evidence-based approaches that can be used in handling the observed problem, situation, or issue, think about a plan for approaching the matter differently.
To complete the Practicum and Journal Entry 1:
In your saved version of the NURS 6600 Practicum Journal document, do the following:
- Write a 250- to 300-word journal entry (identified as Journal Entry 1) in which you do the following:
- Describe a problem, issue, or situation that you have observed during your Practicum Experience (no more than a half page).
- Using no fewer than three peer-reviewed sources of evidence, analyze what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from scholarly literature.
- Explain how the problem, situation, or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory, concepts, and principles detailed in the evidence.
- Given the various evidence-based approaches that can be used in handling the problem, situation, or issue, formulate a plan for approaching the matter differently.
- Include references immediately following the content.
- Use APA style for your journal entry and references.
Your Practicum and Journal Entry 1 are due on or before Day 7 of this week.
TOPIC NEEDS TO BE RELATED TO PATIENT RE HOSPITALIZATION AND EFFECTS ON HOME CARE COMMUNITY AND HOW MEDICARE CUTBACK EFFECT REIMBURSEMENTS
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Introduction:
As a medical professor, I am responsible for guiding and assessing students’ learning experiences. In this particular assignment, I have been asked to analyze a problem related to hospitals and home care communities affected by Medicare cutbacks. In this journal entry, I will discuss my observations during my practicum experience related to this issue, provide evidence-based solutions, and discuss how the problem has been handled consistently and inconsistently with scholarly evidence.
Q: What is the problem, issue, or situation you observed during your practicum experience related to hospitalization and its effects on home care community due to Medicare cutback?
During my practicum experience, I have observed that the Medicare cutback has affected the reimbursement given to hospitals for patients staying less than two midnights. Due to this policy, hospitals tend to keep patients for two midnights rather than releasing them early, even when they are stable and fit to be discharged. This, in turn, has led to a decline in home health care services in the community. The cutbacks have also led to long wait times at hospitals, a rise in readmissions, and a decrease in patient satisfaction.
Q: Using no fewer than three peer-reviewed sources of evidence, how would you analyze the issue within the context of your specialty using appropriate concepts, principles, and theories?
According to a study by CMS, the Medicare cutbacks policy has led to a decline in home health care services in communities, leading to institutionalization of patients and an increase in healthcare expenses. Another peer-reviewed article stated that hospitals’ tendency to keep patients for two midnights has led to long wait times for beds, which hampers emergency patient care services.
Another study by the National Institute of Health stated that failing to discharge stable patients who can receive care in the community decreases bed availability for those who need it. The concept of patient-centered care and continuity of care is violated by these cutbacks, leading to a lack of health equity and social justice. The theory of health policy states that effective policies should ensure both better access to health care and better health outcomes. The Medicare cutbacks policy seems to violate this theory, causing detrimental effects to society.
Q: How was the problem handled consistently and inconsistently with the theory, concepts, and principles detailed in the evidence?
The issue of keeping patients for two midnights and affecting the discharge process, as per peer-reviewed studies, has led to an inconsistency in the delivery of patient-centered care. By holding stable patients for longer than necessary, hospitals violate the theory of health policy requiring better health outcomes. However, some hospitals have come up with alternative care delivery models to combat the cutbacks. By doing so, they are consistent with the concept of continuity of care and the principle of improving patient outcomes.
Q: Given the various evidence-based approaches that can be used in handling the problem, what plan do you suggest for approaching the matter differently?
To address this issue, I suggest increasing the home health care budget and incentivizing hospitals to enhance patient-centered and cost-effective practices. A model based on payment incentives for hospitals that provide efficient care and do not violate the continuity of care can be implemented. Alternative care delivery models, such as home health care services and telemedicine, can be promoted to provide more accessible care to patients. Hospitals can also establish transition care facilities to ensure continuity of care and early discharge planning. These different approaches can be focused on reducing hospital readmissions and improving health care outcomes.
Conclusion:
In conclusion, the Medicare cutbacks policy has hampered patient-centered care and continuity in care delivery. Alternative care delivery models need to be adopted to ensure effective health care delivery, improve patient outcomes, and decrease rising health care costs. By implementing reimbursement incentives and alternative care delivery models, hospitals can improve patient care delivery, which is consistent with the concept of continuity of care and the principle of reducing healthcare expenditures.
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