Introduction
Nursing homes, also known as residential nursing homes or care home with nursing, are facilities that provide health care for people with distinct conditions or various types of disabilities. A Nursing home focuses on providing such care for individuals who may have struggled with daily life and may need attention. Such people may be older persons, children, and the disabled, among others. In a nursing home, there should be a qualified nurse who oversees the provision of medical services to these groups. The specialists in nursing homes are trained to care for patients with unique medical conditions, such as dementia and severe learning disabilities. This paper explores ethics in practicing health care in nursing homes and policy issues that affect the coordination of care in these facilities.
Code of Ethics in Nursing Homes
Nurses in a nursing home must demonstrate fairness when delivering clinical duties. The care should be justly, equitably, and fairly distributed to the group being hosted in such facilities. Beneficence means doing what is right for the patient without favoring other aspects that do not lead to the well-being of a patient. Nonmaleficence calls for nurses not to harm either intentionally or unintentionally (Bruvik et al., 2017). For a nurse to be termed accountable, they should be liable for their actions in a nursing home. Fidelity calls for nurses to keep their promises and to be true to their duties without conspiracy. Since the patients in a nursing home have unique conditions, autonomy calls for nurses to provide safe care and quality services in a competent manner (Frankova, 2018). Nurses must withhold any truth that is relevant for patients to know even when it may cause some levels of distress.
Policy Factors in Care Coordination in Nursing Homes
When it comes to the provision of quality healthcare to patients with special attention demands, nurses may find some difficulties when doing their job. Care coordination may be challenged depending on the level of solution needed to treat the patient (Bruvik et al., 2017). For instance, the US government’s Medicaid caters for cost in medical expenses for patients under the program only when the facility has a quality certificate. These policies have been offered in accordance to HIPPA standards and requirements. The need here is to have the best health care services accessible to every individual in the country.
Medicaid Program in Nursing Homes
The government of the US imposed Medicaid programs that were meant to take care of people with lower incomes. A nursing home is regulated by a Certificate of Need (CON), which is a cost-containment program to control expenditures on the supply of nursing home equipment. Similarly, nursing homes must provide high-quality services, which may be costly. Medicaid reimbursement for caring for Medicaid patients is done by consideration of price and quality. Thus, if a nursing home has challenges with the cost of getting supplies and ends up charging higher prices, the program may not cover all expenses. Therefore, it becomes an issue to leverage the cost of medicine and clinical procedures for the middle class
Medicare Policy for the Older People
The US government policy on Medicare Restructuring on Nutritional Care for the Elderly has had an impact on the coordination of care in nursing homes. The 1998 changes led to the elimination of standards that comprised staffing requirements for a qualified dietitian. The move was to make sure that any care facility is accountable for the nutritional health of older patients. However, since the elimination of the nutritionist, there has been low follow-up on the appropriate approach to the issue (Frankova, 2018). Therefore, it becomes a challenge for nursing homes to keep up with the shift of chronic care for older persons who at times may have malnutrition. The policy affected the coordination of care since there is a lack of expertise in a nursing home that can prevent nutrition inadequacies.
Financial Policies
For a nursing home to operate simultaneously, money is required to buy medical equipment, buy drugs, and pay workers, among other expenditures. Only 60% of the funds are catered to by the governments in most cases (Frankova, 2018, p.172). Nursing homes care is a demanding area, and therefore, any aspect that requires money must be considered seriously (Kosari, 2018). For example, when taking care of older people, there is a need to have equipment such as respirators and ventilators to assist the group when they develop challenges in breathing and heart function. Therefore, there is a need to have functional equipment for this. It requires other interventions such as private developers or charity organizations to assist in running nursing home facilities.
9-5 Policy
Nurses are required by the government policy on labor to work from 9 am to 5 pm. Nursing homes have significantly engaging activities that may lead to extended shifts for the nurses. With the challenge of high staff turnover being witnessed in many working homes, it can be difficult to cover a wide area in a workstation. For example, a nurse can be in charge of up to ten patients who require special attention (Frankova, 2018). The workload is hefty in scenarios where patients develop other clinical conditions which were not anticipated. Any nurse must withstand the challenge and commit to working in such busy environments.
Adherence to Technology
In the healthcare context, technology is fairly important in delivering healthcare duties. Through modern systems backed by cloud software, reimbursement, appointments, laboratory work, and diagnosing activities have been boosted (Kosari, 2018). However, when a nursing home faces challenges of poor network connection, some tasks may be hard to undertake. Additionally, having in place experts who are competent with microservices architecture in medical services is also a challenge. Most students are learning cloud computing about retail industries, whereby healthcare is neglected (Frankova, 2018). Therefore, it can be a problem to have a stable computerized institution without technology experts. Other technology barriers include breaches of patient data and system failure in nursing home departments.
Future of Care Coordination
Nursing homes need to have various initiatives to leverage the issues analyzed by the paper. First, there is a high emphasis on training nurses more about ethical practices in such facilities. Staff in these areas should be guided by special programs that will enable them to adapt to the challenging nature of their work. Additionally, the community must participate by contributing funds that can be used to run some operations. Society needs to embrace health education by taking young people to study medicine. The challenge of technology can be prevented by having in place experts who have specialized in healthcare programmed software to enable run the technology-centric functions in these facilities. Lastly, nursing homes must provide a work environment that must discourage staff turnover. For example, staff can be paid well, given enough time to prepare for work, and get a manageable workload. In that way, coordination of care would be an easy task in nursing homes.
All national, state, and local policies seem to have adhered to the required ethical standards. This has helped in minimizing cases of dilemma in the care offered.
Conclusion
Nursing homes are medical facilities that take care of patients with special medical attention, such as the disabled and older group
For one to work in a nursing home, they should practice ethics such as accountability, beneficence, and autonomy, among others
Some of the issues that are rampant in the coordination of care in a nursing home include heavy workloads, availability of community resources, and financial issues, among others. Coordination of care in nursing homes is highly affected by the government through policies and programs instituted to regulate their functioning. The kind of policies and programs instituted in nursing homes are helping in enhancing the quality of care offered.
References
Bruvik, F., Drageset, J., & Abrahamsen, J. (2017). From hospitals to nursing homes – The consequences of the Care Coordination Reform. Sykepleien Forskning, 6(60613), e-60613.
Frankova, H. (2018). Issues with the financial model of care homes. Nursing And Residential Care, 20(4), 171-173.
Kosari, S. (2018). Medication errors in nursing homes: The role of pharmacological knowledge. Journal Of Intensive and Critical Care Nursing, 01(01), 23-27.