The impact of the Centers for Medicare and Medicaid Services (CMS) payment denial on the provision of healthcare services can be discussed from two perspectives. On the one hand, the quality of care can be affected if the payment for required services is denied because they can belong to the conditions listed by the CMS (Bae, 2017). On the other hand, this policy promotes the outcome-based approach to funding that can be followed in order to improve patient care.
The use of standardized terminology for nursing documentation contributes to improving communication between members of interdisciplinary teams, as well as data collection, exchange, and analysis, leading to the required interoperability and uniformity of data. Evidence-based practice guidelines usually improve patient outcomes and provided care because of referring to the best evidence in diagnosing and treatment (Hebda, Hunter, & Czar, 2018; Mackey & Bassendowski, 2017). As a result, clinical decisions become effectively supported by study findings and practice to improve the delivered care significantly.
The use of patient portals has many advantages because persons receive constant access to their health data, laboratory results, and healthcare providers to contact among other information. However, there are also disadvantages associated with availability of certain data provided by several organizations because of differences in their information systems and privacy concerns (Hebda et al., 2018).
To ensure patient safety and guarantee confidentiality and protection of personal data, there are certain safeguards in patient portals that include the use of encrypted data, keywords, and passwords to access reports. As a result, unauthorized access can be successfully prevented with the help of these tools (Greysen, Garcia, Sudore, Cenzer, & Covinsky, 2014; Kruse, Bolton, & Freriks, 2015). It is possible to agree with using patient portals and applying procedures to guarantee security of data even when not all information is available because this process generally simplifies access to required medical records.
Challenges associated with accessing only portions of data by patients are observed when they need to continue treatment in other healthcare organizations and provide data on previous diagnoses, prescriptions, and procedures.
Telehealth is the recent trend in providing healthcare services using electronic media and different types of digital devices. Thus, telehealth guarantees the provision of care to remote territories without the necessity of face-to-face real life contacts (Hebda et al., 2018). This trend will positively impact nursing practice because of the possibility to address the needs of many patients and offer on-going care for individuals with chronic or severe conditions and limited mobility (Carroll, 2018).
Legal issues associated with telehealth include problems with determining healthcare providers’ legal responsibility if patients are injured or harmed following recommendations given distantly. Ethical considerations are associated with the aspect of beneficence because not all patients requiring distant care can access it due to limited resources and the lack of technologies (Phillips & Vetter, 2016). Finally, there is also a privacy concern associated with guaranteeing confidentiality and protection of patients’ records used by telehealth nurses.
If a nurse is distracted from providing the care for a patient because of false alarms, it is possible to speak about ethical issues and potential negative outcomes for patients. For example, a nurse provides a patient prepared for being discharged with instructions and recommendations regarding the care at home. Suddenly, she is interrupted by alarms, and she is the only nurse to check the state of the patient to whom these alarms are related.
When she returns to the discharged patient, she does not provide this individual with the list of written recommendations and does not end her education with important notes on hygiene in a particular case. As a result, during follow-ups, it is found that the patient does not follow extremely important routines that can affect his state. Alarm fatigue and distractions can have a negative impact on patient safety if they are not addressed (Hebda et al., 2018). The reason is in problems with nurses’ concentration, the quality of care, and the absence of appropriate management policies in facilities (Winters et al., 2018).
If nurses use personal communication devices like smartphones and tablets for communicating with colleagues, reviewing medical records, and accessing health data, effects of using technologies are positive because of improving the quality of care. However, such devices can be used by nurses for other purposes, including personal ones, and they can significantly distract them from providing care.
Ethical implications are observed when the overall quality of provided care is decreased because nurses are distracted by their devices. Still, legal implications are associated with situations when such distractions lead to patient safety issues and negatively affect care and treatment because of nurses’ attention deficits. However, recent studies are inclined to support the idea that personal communication devices can be used to contribute to safe nursing practice if nurses are trained to use them (McBride & LeVasseur, 2017). It is important to educate nurses regarding benefits of using devices for improving care and monitor use of smartphones and tablets as a means of distraction (Hebda et al., 2018; McBride, LeVasseur, & Li, 2015).
References
Bae, S. H. (2017). CMS nonpayment policy, quality improvement, and hospital-acquired conditions: An integrative review. Journal of Nursing Care Quality, 32(1), 55-61.
Carroll, K. (2018). Transforming the art of nursing: Telehealth technologies. Nursing Science Quarterly, 31(3), 230-232.
Greysen, S. R., Garcia, C. C., Sudore, R. L., Cenzer, I. S., & Covinsky, K. E. (2014). Functional impairment and Internet use among older adults: Implications for meaningful use of patient portals. JAMA Internal Medicine, 174(7), 1188-1190.
Hebda, T., L., Hunter, K., & Czar, P. (2018). Handbook of informatics for nurses and healthcare professionals (6th ed.). New York, NY: Pearson.
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The effect of patient portals on quality outcomes and its implications to meaningful use: A systematic review. Journal of Medical Internet Research, 17(2), 1-12.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55.
McBride, D. L., & LeVasseur, S. A. (2017). Personal communication device use by nurses providing in-patient care: Survey of prevalence, patterns, and distraction potential. JMIR Human Factors, 4(2), 10-15.
McBride, D. L., LeVasseur, S. A., & Li, D. (2015). Non-work-related use of personal mobile phones by hospital registered nurses. JMIR mHealth and uHealth, 3(1), 1-12.
Phillips, M., & Vetter, M. J. (2016). Looking at the issues impacting telehealth nurses. AAACN Viewpoint, 38(6), 1-10.
Winters, B. D., Cvach, M. M., Bonafide, C. P., Hu, X., Konkani, A., O’Connor, M. F.,… Kane-Gill, S. L. (2018). Technological distractions (Part 2): A summary of approaches to manage clinical alarms with intent to reduce alarm fatigue. Critical Care Medicine, 46(1), 130-137.