Research a health care organization or a network that spans several   states within the U.S. (Example: United Healthcare, Vanguard, Banner   Healthcare, etc.).

Harvard Business Review Online and Hoover’s Company Records, found   in the GCU Library, are useful sources. You may also find pertinent   information on your organization’s webpage.

Review “Singapore Airlines Case Study.”

Prepare a 1,000-1250-word paper that focuses on the organization or   network you have selected.

Your essay should assess the readiness of the health care   organization or network in addressing the health care needs of   citizens in the next decade, and include a strategic plan that   addresses issues pertaining to network growth, nurse staffing,   resource management, and patient satisfaction. Provide a comparison to   the health care organization or network and the Singapore Airlines.   Include any cultural issues that may influence the practices listed above.

Prepare this assignment according to the APA guidelines found in the   APA Style Guide, located in the Student Success Center. An abstract is   not required.

This assignment uses a rubric. Please review the rubric prior to   beginning the assignment to become familiar with the expectations for   successful completion.

You are required to submit this assignment to LopesWrite. Please refer   to the directions in the Student Success Center.

comment1

Prior to the passing of the Patient Protection and Affordable Care Act (PPACA) of 2010, the health care system was fragmented.  There was no one single entity responsible for the overall coordination and quality of a patient’s care.  The PPACA provides many provisions that seek to connect the quality of care with the cost of care.  It creates incentives for integrated care delivery models and pays for coordination and quality of care. One innovative care delivery model addressed in the PPACA is the accountable care organization (American Nurses Association [ANA], 2010).

                An Accountable Care Organization (ACO) is a collaboration of primary care providers, a hospital, specialists, and other health care professionals that accept joint responsibility for the quality and cost of patient care.  While ACOs are not new, the PPACA brought them to the forefront of new delivery models and provides the ACO with more leeway regarding who can lead them.  This permits greater nursing leadership and participation.  In fact, a key term in the PPACA is “ACO professional.” The law defines the ACO professional as a physician “and” a nurse practitioner, clinical nurse specialist, or a physician assistant (ANA, 2010).

comment2

In the PCMH, the team would know and care for the patient in their home. This would require a consistent and timely team work between team members. The use of electronic medical records increase the teams timely response and care. Also included with electronic care systems is the ability to request a consult from another team member. The progress, charting, labs and other pertinent information would be made available to each team member at all times. It is also imperative that nurses and physicians be able to contact a specialty physician. Getting to know who is on your team and being able to contact the specialty is important. Relationships need to be built or reinforced in order to provide quality care. In the PCMH, the care is focused on medical care given in the home (Haas, S., 2010). Patient-Centered Primary Care Collaborative (PCPCC) published an Annual Review of Evidence 2014-2015, in which it examined the cost measures and utilization of services. It was reported that PCMH care costs were lower and the health care quality had improved (Gross, A., 2016). The report continued to state that “The evidence continues to build that a high performing, patient-centered medical home – especially when supported by multiple, committed and aligned payers – is the foundation for a better performing health care system”. “…it [PCMH] can control costs and promote the right care” (Gross, A., 2016). The report continued to show evidence of improved health care, improved health for the client, decreased hospital admissions and emergency room visits. Overall, the quality of care was increased and costs decreased (Gross, A., 2016). Using  a telehealth with the RN as the point of contact increases the clients confidence at being heard. Some places call this form as a telehealth buddy, where the RN can triage, educate and counsel the patient (Haas, S., 2010). Telehealth systems are in place to compliment the home visits by the RN and helps the client to feel as though the health care team is always available to them without the traveling or long waits for doctor’s appointments.

Comment 1

The major difference between a Doctor of Nursing Practice (DNP) and a Doctor of Philosophy degree (PhD) is whether nurses translate research into practice to improve patient outcomes with a DNP or whether nurses want to advance the science of nursing, conducting research using a PhD (AACN, 2018). Most nurses who want to complete their DNP are oriented in the direction of improving outcomes, patient centered care and population health. Most nurses who want to complete their PhD are oriented in the direction of developing new nursing knowledge and scientific inquiry (AACN, 2018). Nurses who are committed to their practice will usually choose to purse a DNP when deciding on a doctoral program and nurses who want to commit their lives to research will most likely choose a PhD program of study. According to the American Association of Colleges of Nursing (2018), nurses who complete the DNP program or PhD program of study will be able to contribute to health care improvements through the development of practice and new knowledge from scholarly expertise in teaching and research.

Personally, if I had to choose between a DNP or a PhD in nursing I would go with a Doctor of Nursing Practice-Psychiatric Mental Health Nurse Practitioner (DNP-PMHNP), since that is where my passion and clinical expertise remains. After completing my BSN, I plan on becoming ANCC Psychiatric-Mental Health Nursing certified. There is so much more to discover when it comes to assessing, diagnosing, and treating patients who are seeking help with mental health disorders. I wish to acquire the advanced skills and abilities to integrate my knowledge, while making a positive contribution to the community and improving patient outcomes. I see myself as a leader in health care, taking initiatives to promote health, educating peers, patients and other health care providers.  I believe that a DNP would be in my best interest when it comes to my professional and personal goals as a professional nurse.

Comment 2

The Doctor of Nursing Practice (DNP) prepares BSN or MSN degreed nurses for the highest level of nursing leadership and practice within organizations with the ultimate goal of improving health care. The DNP will prepare nurses to become nurse leaders in interdisciplinary health care teams by providing the skills necessary to translate evidence gained through nursing research into their practice. The DNP program focuses on evidence-based practice and quality improvement and system leadership. They will have the skills to improve systems of care and measure outcomes of patient groups, populations and communities. (All Nursing Schools, n.d.)

The PhD in Nursing prepares nurse “scientist” to develop new knowledge for the science and practice of nursing.  They are prepared for an intellectual inquiry through scholarship and research. They pursue research interests; utilize external funding and creating well-designed methods to discover new knowledge related to nursing. PhD nurses will lead interdisciplinary research teams, design and conduct research studies and disseminate knowledge for nursing and related disciplines, particularly addressing trajectories of chronic illness and care systems. (All Nursing Schools, n.d.)

During my research of the DNP and PhD, I learned things about both degrees that I was not aware of. If I decided to continue my education to the doctoral level, I think I would go for the DNP. The DNP is more evidence based and hands on. I am more a hands on person and prefer to have the evidence there in front of me.

Comment 3

Difference between DNP AND PhD
 Based on Curriculum Content wise
The DNP is a practice doctorate that places greater emphasis on direct clinical practice. The curriculum focuses on organizational management, systems leadership, clinical-practice administration, quality improvement and program evaluation, in addition to other specialty areas, and less on statistics and research methodology.
 Ph.D. is more research-intensive and takes a scholarly approach to nursing. The curriculum for these degrees focuses on scientific inquiry and provides the evidence for nursing practice, as well as improving general nursing knowledge.
Based on Research Competencies
DNP-prepared nurses develop the skills necessary to implement the scientific findings conducted by nurse researchers with a Ph.D. or DNS (Doctor of Nursing Science). Graduates develop competencies in analytical methods, decision-making, enhanced knowledge and leadership skills to improve clinical practice and patient outcomes.
Ph.D. and DNS programs focus heavily on research methodology and scientific investigation. Graduates of these programs contribute to the improvement of healthcare by offering new information for practicing nurses.
Outcomes and Roles
 DNP programs have become the preferred preparation for advanced practice nurses, including nurse practitioners, clinical nurse specialists, nurse midwives or nurse anesthetists.  Meanwhile, graduates of DNS and Ph.D. programs pursue alternate paths within the field of nursing, commonly seeking roles as researchers, nurse scientists or scholars.
I would like to choose DNP if I decided to pursue my further study. We nurses frequently work alongside other health professionals with practice doctorates – physicians, pharmacists, physical therapists and more. The DNP provides nurses with a clinical option for nursing education that is more commensurate to the education of these disciplines.
According to the American Association of Colleges of Nursing, the DNP prepares nurses for the future tomorrow’s practice. If it is one’s interest in leading these changes, a DNP degree can help assume key executive positions as a nurse leader.

The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

• Complains of pain and heaviness in her leg.
• States she cannot bear weight on her leg and has been in bed for 3 days.
• Lives alone and has not had anyone to help her with meals.

Objective Data

• Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
• Left leg red from knee to ankle
• Calf measurement on left 3 in > than right
• Temperature: 38.9 degrees C
• Height: 160 cm; Weight: 83.7 kg

Laboratory Results

• WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
• Wound culture: Staphylococcus aureus

Critical Thinking Questions

1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

Discuss how professional nursing organizations support the field of nursing and how they advocate for nursing practice. Explain the value professional nursing organizations have in advocacy and activism related to patient care.

3 APA reference, 500 words, NO PLAGIARISM