NUR 514 DQs

Week 1 DQ 1 Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses. What major evolving trends in the health care delivery system will affect your practice in the next 3-5 years, and how do you think advanced registered nurses will continue to influence the direction of health care?

I completely agree that our healthcare system needs revamping, and the major problem that our current system has created with health inequality. Working at a large health care system in North Phoenix, we help serve nearby Native American Tribes such as the Navajo tribe. The Navajo Nation experiences a large number of health disparities due to isolation/remoteness of areas with a lack of transportation (no paved roads or public transportation), lack of government healthcare funding, lack of infrastructure (clean water, plumbing, electricity, and many lack telecommunications), and limited opportunities for education (Nez, 2020). When patients from the Navajo Nation require a higher level of care in an acute care setting, they are often flown to a hospital far from the reservation and become isolated from their families with limited communication capabilities. Being a leader in the acute care setting, we can look for opportunities to help provide resources to the Navajo nation. For example, being able to send a multi-disciplinary team composed of nurse practitioners, RN’s, providers, dietitians, pharmacists, and respiratory therapists to set up temporary clinics that focus on health education and prevention and help with the management of chronic diseases (i.e., diabetes, heart disease, etc.). While caring for Native American patients in the hospital, it is critical to provide the medical care team with the tools to communicate and with an understanding of their culture in order to provide information and support making informed decisions. The Office of Minority Health has provided a set of standards to adapt care to accommodate language and culture (DeNisco, 2021). The OHM has taken a step to help recognize cultural differences and the importance of providing culturally competent care. The Navajo Nation is an example of where the U.S. health system has failed and created health inequality by not eliminating poverty and not providing safe living environments, infrastructure, and access to health care.

Global perspectives and diversity issues in healthcare have helped create an understanding of health equity in areas of poverty like the Navajo Nation. The top 25 wealthiest nations, excluding the U.S, offer a form of universal healthcare coverage. Access to healthcare is considered a basic human right (DeNisco, 2021). A study by the RWJF shows the power of eliminating health disparities would significantly decrease healthcare costs (Braveman et al., 2019). These examples emphasize the importance of equal healthcare access for all communities in the US.

NUR 514 DQs References

Braveman, P., Gottlieb, L., Francis, D., Arkin, E., & Arcker, J. (2019, November 12). What can the health care sector do to advance health equity? Robert Wood Johnson Foundation. Retrieved September 24, 2022, from https://www.rwjf.org/en/library/research/2019/11/what-can-the-health-care-sector-do-to-advance-health-equity.html

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DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

Nez, J. (2020, July 17). The Navajo Nation – United States Commission on civil rights. U.S Commission of Civil Rights. Retrieved September 25, 2022, from https://www.usccr.gov/files/2020/2020-07-17-Jonathan-Nez-Testimony.pdf

Week 1 DQ 2 From your experience, how can developing strong interprofessional relationships increase collaboration and benefit patient outcomes or organizational initiatives? What are some ways you can form an interprofessional team and collaborate with other advanced registered nurse roles? Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response.

Week 2 DQ 1 Do you foresee any issues with implementation of your project? Identify stakeholders who could assist in supporting you, and any theoretical frameworks (organizational change, leadership, role-specific) or models that could help you adapt.

Week 2 DQ 2 What strategies will you use in your new practice as an advance registered nurse to review and critique literature pertinent to your practice?