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The Patient Protection and Affordable Care Act enacted in 2010 identified nurses as drivers of health care reforms. However, in order to effectively and efficiently execute this mandate, nurses need solid representation among the policy makers to sustain their interests. One such legislator, who is also a nurse and has immensely contributed towards the advancement of the nursing profession and care delivery, is a Congresswoman Lois Capps from California (Abood, 2007). Before gaining a position of a congresswoman in 1998, Representative Capps had served as a nurse for over 20 years (RWJF, 2014) and had played a crucial role in improving health care delivery. She was a vocal advocate of Medicare reforms, cancer, and mental health. Representative Capps chairs and sits in the host of committees and caucuses including the House Nursing Caucus, which she founded in 2003, and the House Cancer Caucus. She is also a committee member of the Sustainable Energy and Environment Coalition (RWJF, 2014). She has leveraged her position and influence in these settings to improve health care delivery, especially through the increased funding for hospitals and subsidies for nursing educational programs.
Having served as a nurse, Representative Capps has particularly advocated for the increased eforts to solve the problem of nursing shortage in the US (Abood, 2007). For instance, Representative Capps authored the Nurse Reinvestment Act, which seeks to enhance the quality of nursing care. The Act enabled programs such as Title VIII Nursing at the workplace that, in turn, increased the number of qualified nurses, especially APNs and nurse researchers (RWJF, 2014). She also sponsored the Registered Nurse Safe Staffing Act, which among other things related to the responsibility of staffing decisions in hospitals to nurses (RWJF, 2014). The quality of care is consequently enhanced through adequate staffing. Representative Capps has therefore been vital in improving health care delivery. Thus, the nursing profession is privileged to have her in a policy-making position.
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The CMS reimbursement rules for never events altered the patient care delivery model making it increasingly nurse-led and patient-centered. It brought a volume-to-value shift (Traynor, 2015). The rules denied hospitals Medicare reimbursements for the costs incurred due to the occurrence of incidents that should never happen. The CMS reimbursement rules prohibit hospitals from charging their inpatients for these conditions that were acquired in the hospital, because they should not have occurred in the first place (Leard, 2014).
The major implication of inpatient delivery model is that it shifted the responsibility of leading care delivery to the nurses (Traynor, 2015). The majority of the CMS reimbursement rules for never events are nurse-sensitive. They identify nurses as leaders of health care delivery who should assume the responsibility for ensuring that preventable or avoidable incidents do not occur. Unlike the previous models, the rules crucially recognize the nurses’ ability and extensive skill sets to promote patient safety by reducing medical errors. It represents a shift in patient care delivery that was physician-led and cost-centered (Leard, 2014). The physician-led model merely considered nurses as physician assistants. They were to follow orders and only deliver patient care. The situation was compounded by the cost-centered approach that demanded that patients first pay a percentage of the cost of services they require before any interventions are devised. With the current rules, nurses now lead the health care delivery first by ensuring that pre-hospital documentation is meticulously done to avoid any preventable patient safety concerns (Traynor, 2015). It is an additional incentive to hospitals and the other health care institutions to improve the quality of care delivery. Now, the shift is on the value of patient care and not on the volume or costs incurred (Traynor, 2015).
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