From the continuing debate over changes to the Affordable Care Act (ACA) to the expansion of the Internet of Things (IoT) in healthcare, 2017 has shaped up to be a transformational year for healthcare providers, lawmakers, and patients. For nurses, the changes have implications for the future of the profession.
The healthcare trends underscore the rapid advances in patient care at a time when the nursing profession is also rapidly changing. As lawmakers continue to evaluate changes to the ACA, nurses are being asked to take prominent roles in decision making and leading roles in improvements. The American Association of Colleges of Nursing (AACN) said it is vital for advanced practice registered nurses (APRNs) to have a voice in policy making, not only as patient advocates but also for the healthcare community as a whole.
“Health care policy – whether it is created through governmental actions, institutional decision making, or organizational standards – creates a framework that can facilitate or impede the delivery of health care services or the ability of the provider to engage in practice to address health care needs,” the AACN said. “Thus, engagement in the process of policy development is central to creating a health care system that meets the needs of its constituents.”
APRNs are working toward influencing positive changes. The policy trends include the following:
For months, lawmakers have been wrangling with changes to the ACA, including cuts to Medicare and Medicaid, the government-sponsored programs that cover healthcare costs. While the two programs are just part of the ACA, changes to them will impact millions of Americans. Medicare, a federal program, provides health coverage to some 55 million Americans age 65 and older and some people with disabilities. Medicaid, a joint state-federal program, helps nearly 70 million low-income individuals and families pay for medical costs.
Some of the current proposals would be to reduce federal payments for Medicare expansion. The Congressional Budget Office said such changes could prevent millions of people from getting insurance, but would reduce the national debt by billions of dollars. Proposed cuts to Medicaid could impact millions of low-income Americans but will give states greater flexibility in administering the program.
Nursing organizations nationwide have raised their voices in the debate over changes to Medicare and Medicaid. The American Nurses Association urged lawmakers to consider alternatives to the cuts and offered to help in the decision-making.
“Any legislation that would fundamentally alter health-care delivery and deeply impact patients and providers deserves thoughtful, deliberate and transparent consideration,” ANA President Pamela F. Cipriano said. “ANA stands ready to work with Congress as a constructive voice and positive force for improving health care delivery, coverage, and affordability for the American people.”
Electronic Health Records (EHR), wireless connectivity in hospitals, interconnected medical devices, and remote medical care has changed how medical professionals care for patients. Internet of Things (IoT), or the networking of electronic devices, has allowed nurses to work more efficiently by using predictive analytics and preventive maintenance for lifesaving interventions.
At the same time, there are concerns that IoT-connected devices open the door to violations of HIPAA (the Health Insurance Portability and Accountability Act), which protects patient privacy. IoT technology may also provide easier access for hackers to invade healthcare systems. A May 2017 ransomware attack crippled healthcare computer systems in 150 European countries, locking doctors and nurses out of critical health records. The so-called Wannacry attack utilized software stolen from the U.S. National Security Agency.
Researchers, however, have found IoT technology has widespread applications. A 2017 study found remote contact, using two-way video chats, between healthcare practitioners and injured student athletes reduced the diagnosis and treatment time of sports-related concussions. For the study, researchers found that nurse practitioners (NPs) who used telemedical interactions to assess and diagnose student athletes provided faster, more convenient, and less costly interventions when compared to conventional treatment practices, such as visits to the emergency room.
Nursing-advocacy groups worldwide are calling for nurses to attain higher levels of education and training. The Institute of Medicine (IoM), in its Future of Nursing report, said APRNs could fill the need across the spectrum of healthcare to “contribute to primary care and help respond to shortages, especially for those populations who are most underserved.” Supporters say DNP degrees, in particular, can shape the system of healthcare, influence trends, and lead improvements.
Nursing-advocacy groups say a DNP is not a role, but instead is a degree program that enhances a nurse’s ability to improve healthcare outcomes. Healthcare leaders say the DNP is an important component to the future of nursing because it provides advanced preparation for the increasingly complex and changing healthcare landscape.
DNP programs are designed to prepare APRNs for clinical practice and leadership, including in the areas of policy, decision-making, and advocacy. By comparison, the Ph.D. in nursing degree focuses on research and scientific inquiry. The AACN endorsed the DNP as a terminal degree, or the highest practice, in nursing.
DNP graduates can assume roles that are clearly defined, such as clinician or nurse administrator. A DNP education also provides useful skills – such as information technology, integration and implementation of evidenced-based practice, evaluation and implementation of policy, and leadership – that can be used across the spectrum of clinical settings, researchers for the healthcare journal Advance said.
Duquesne University’s innovative DNP program provides skills, training, and education for future nurse leaders. The 100 percent online curriculum allows experienced healthcare professionals to work from anywhere at anytime. The university’s DNP program builds on existing skills in preparation for roles in public policy, education, and leadership. For more information, visit DU’s online DNP program website.