Table of contentsIntroductionHealth care issues and trendsConclusionIntroductionThe health care profession is in constant demand from health care providers health ; Fortunately, mid-level practitioners are ready to step in and fill this void. The number of nurse practitioner (NP) programs has increased significantly in recent years. The problem does not lie in finding a program to pursue or even finding a job after completing a master's program, it lies in the restrictions one faces daily in practice due to the limitations set by the nursing council itself. no to plagiarism. Get a custom essay on “Why Violent Video Games Should Not Be Banned”?Get the original essayThis article will address two current issues in health care delivery and health care policy, it will outline two strategies that can be implemented to improve these problems. , in addition to presenting the current state of health costs, discussing the implications related to access to care and the quality of care, and highlighting a legal aspect and an ethical aspect to take into account in the provision of health care. Finally, it will describe how the adult gerontological acute care nurse practitioner can use five specific professional nursing qualities to influence evidence-based practice. Health Care Issues and Trends The first topic to address concerns the lack of a defined role that can be associated with the adult gerontological acute care nurse practitioner (AG-ACNP). The role of nurse practitioner has its origins in a pediatric and family practice context. The emergence of an acute care nurse practitioner is a newer role that is becoming increasingly popular. Although there is no clear, universal interpretation of what AG-ACNP's scope of practice consists of, there are rules and regulations that vary from state to state and are designed to define NP practice (Lugo, O’Grady, Hodnicki, & Hanson, 2007). ; Pearson, 2007). The rules and regulations of advanced practice nurse (APN) practice are determined by the nursing licensure one holds, but many states go further by setting specific requirements and limiting who can use an advanced practice nurse credential under state protection. (Hamric, Spross and Hanson, 2005, p.407). The problem is that many states do not distinguish between various NP practice specialties such as (family, pediatric, adult, geriatric, acute care) (Hamric, Spross, & Hanson, 2005, p. 407). They also don't provide services. a list of skills, a list of tasks, or a list of acceptable procedures that the NP can perform within their specialized scope of practice (Hamric, Spross, & Hanson, 2005, p. 407). This is why there is such ambiguity about the actual nature of an AG-ACNP's role. It has been reported by other AG-ACNP practitioners that hospital administrators and even physicians do not know what differentiates an AG-ACNP from a family nurse practitioner (FNP), because to them, they do not than one (Hamric, Spross and Hanson, 2005). , p. 430). This becomes problematic because it will significantly limit the scope of practice of the AG-ACNP. Therefore, it is extremely important to educate all personnel on the purpose of their role, the training required to perform that role, the training that followed the training, and how the AG-ACNP can be used safely and efficient. When wedescribes the role, you must describe what your practice consists of, in particular: the nursing paradigm; interview and investigation skills; physical examination to create a plan of care that addresses the patient's holistic issues as well as a medical diagnosis; interventions that manage disease processes and promote health; create a discharge plan that will address medical care as well as nursing care; and perform all AG-ACNP role capabilities applicable to one's practice (Hamric, Spross, & Hanson, 2005, p. 430-31). Through education and role promotion, great progress can be made in developing powerful collaborative agreements with physicians and other members of the care team to achieve exceptional patient outcomes (Hamric, Spross and Hanson, 2005, p. 431). The second problem concerns the restricted prescriptive power. In the state of Oklahoma, NPs are authorized to prescribe Schedule III through V controlled dangerous substances (CDS) and may only prescribe a thirty-day supply without a refill (Oklahoma Board of Nursing [OBN], 2012 ). In a setting where patients need to be seen for acute injuries, there will be instances where short-term narcotic prescriptions are necessary. Since NPs do not have full prescriptive authority, this requires that a physician be nearby for the patient to receive the appropriate medication. Another medication-related issue is that NPs are not permitted to order and promote rapid-sequence intubation medications in a respiratory emergency. This limitation is not only detrimental to the patient but also to the profession itself. A device is less marketable if it cannot perform basic emergency room tasks such as rapid sequence intubations. The bias that NPs are not competent in this skill but then grant privilege to physician assistants to do so is absurd when both are mid-level practitioners. Again, this comes down to the governing body, the nursing council will need to be more open to change and advocate for more autonomy to secure the future of the profession. The only way for change to happen is to take it directly to the Capitol and push for what we want to change. The Tulsa, Oklahoma-based Emergency Physicians (EMP) group visited the state Capitol this year and declared the importance of the role of NPs in intubation and the need to administer rapid-sequence medications to be able to do their job effectively. Although not all medications are permitted for use, as with paralytics, they have allowed etomidate and versed to be added to the list of medications NPs can administer in an acute care setting. In order to achieve more autonomy, such as full prescriptive authority, to come, groups of NPs and health care advocates will need to lobby to demonstrate the significant impact the change can have on the community. Overall, allowing NPs to have full practice authority as well as prescriptive authority could open the door to greater access to health care in rural areas, with the overall hope of improving health and the well-being of Oklahoma (Langley, 2015). The second topic of discussion concerns the evaluation of complex issues regarding health care delivery. In 2014, health care spending in the United States increased by 5.3%, reaching $3 trillion, or $9,523 per person (Centers for Medicare and Medicaid Services [CMS], 2014). It is not surprising that there has been an influx of health care spending since adoption and entry into force.force of the Affordable Care Act (ACA) in recent years. As more and more people obtain insurance and seek medical services, health care costs are out of control. Consequently, the reimbursement system, formerly based on quantity, will now promote purchases and the quality of care. The implications related to accessibility of care are to improve comprehensive care and promote quality health services (Office of Disease Prevention and Health Promotion [ODPH], 2016). Access to care includes four components: coverage, services, timeliness, and workforce (ODPH, 2016). All four factors are necessary to ensure that people reach their full potential for optimal health and quality of life (ODPH, 2016). An important aspect related to the quality of care one receives is that it is now based on the value and coordination of care rather than the quantity and reproduction of care compared to the past (CMS, 2014). The objective of system reform is to emphasize the quality of care. system-wide health care with the goal of simultaneously reducing health care costs (CMS, 2014). The shift in healthcare reimbursement has opened the door to legal and ethical dilemmas. Due to the value-based modifiers coming into effect, facilities that have high rates of hospital-acquired infections as well as high readmission rates will be penalized through payment (Page & Fields, 2011). This payment penalty could be painful for an establishment and lead to the falsification of information. documentation, to avoid paying these fines. If documents are falsified, this could raise a legal issue of fraud. This is also an ethical dilemma that staff may face or feel pressured to do by supervisors or administration. The ethical principle of fidelity would be violated. As nurses, it is our duty to advocate for patients and be honest in everything we do. We must remain faithful in everything we do, from patient care to documentation, all of which relates to our core virtue of care. The final topic of discussion is how the adult gerontology acute care nurse practitioner can utilize five nursing qualities including: caring, competent. , communication, leadership and professionalism to influence evidence-based practice. First of all, kindness is at the heart of our profession and it is why we do what we do. The adult gerontological acute care nurse practitioner differs from other healthcare practitioners in that they use theoretical frameworks to shape evidence-based practice, such as Jean Watson's theory of caring, which always incorporates benevolence but also evaluates the results. Ultimately, what is most important is providing patients with optimal outcomes, which can be achieved by building a pragmatic framework based on core nursing values ​​(American Nurse Association [ANA], 2010, p. 4). Second, just as a nurse (RN) is expected to demonstrate competence throughout their practice, the same is expected of an NP. Throughout their graduate studies, they are expected to complete tasks and think critically within their scope of practice. As a new NP, certain skills will need to be assessed before you can perform these tasks independently, such as a certain number of intubations or central lines, to be performed under physician supervision to ensure that the NP execute the.