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  1. Dysfunctional healthcare delivery system    



    After reading Chapters 3 through 6 of Rosenthal (2018) and Chapter 15 of Mason and colleagues (2021), describe two strategies you would employ to address two issues Rosenthal brings up in the readings. You must identify the specific issues; be sure to give the page numbers from the text. You can provide it as a direct quote. You must support your strategy with current, professional references.
    Rubric for this assignment:
    Rubric: (strongly follow)
    1.Outline is well organized and provides a very clear big picture of the ideas. Main concepts are easily identifiable, and the outline contains an appropriate number of concepts. Follows standard conventions. Concepts are concise.



Subject Nursing Pages 5 Style APA


Dysfunctional Healthcare Delivery


Issue 1: Poor Health Status of the United States

Although the United States is the only country that spends millions of dollars in increasing affordability of healthcare, the system is so fragmented that it ranks poorly on various health indicators (Mason et al. 2020, pg. 125). According to a report by Healthy People 2020, the United States is characterized primarily by limited access to quality healthcare especially among underserved populations, limited clinical preventative services, increased incidents of injury and violence, poor environmental quality due to high pollution incidents, mental health, child and maternal health, among several other components. It also has the highest maternal mortality ratios with low life expectancy at birth (Mason et al. 2020, pg. 125). Among the factors causing these disparities is the provision of incompetent care quality due to the high level of racism in the systems. The disparity cuts across all levels of education and persists depending on the socioeconomic status (Mason et al. 2020, pg. 125). 

These trends require adjustments in the existing health reforms by strengthening the capacity of the Affordable Care Act (ACA). Healthcare reforms should be driven by the two principles of the right to healthcare and the cost of health care (Mason et al. 2020, pg. 127). By imposing the ACA more, the United States government will ensure that every person has access to insurance coverage and can meet the growing medical costs depending on their care demands. The ACA policy should also expand the provisions of Medicaid and allow low-income populations to purchase health coverage with available subsidies based on income levels (Mason et al. 2020, pg. 126). Improving this policy could ensure that patients can afford quality care, and both physicians and care providers are compensated well. The goal is to improve access, quality, and cost of available care services to all population irrespective of their ethnic dynamics. 

Another effective approach is advancing care provision through technology to ensure accessibility to a diverse population within a short time frame, which can be achieved through enabling telehealth and health information technology (health IT or HIT) (Mason et al. 2020 pg. 125). Telehealth is a strategic measure of providing clinical healthcare, public health, and health education to remote and other long-distance regions using telecommunications technology. Health IT will enhance the electronic transfer of critical health data across departments to streamline operations, increase accuracy, privacy, and to reduce the workloads of nurses (Mason et al. 125). The systems are collectively meant to enhance the quality of care provided, improve efficiency, reduce likely costs on patients, payers’ ad care providers. 

Issue 2: Practice Restrictions among Advanced Practice Registered Nurses (APRNs)

From the analysis, nurses are subject to barriers that inhibit them from adequately enhancing their training, continuous education, and perspective to these underlying efforts (Rosenthal 2018, pg. 332). They face various barriers that inhibit them from practicing the full extent of their practitioner license. Several states are presented with gaps between the quality of health services that assigned nurse practitioners can adequately address, utilizing their responsibility and level of training and the existing laws and regulations that allow nurses to fulfil these roles (Mason et al. 2020, 128). Substantive evidence suggests that advanced practice registered nurses (APRNs) are eligible, safe, and can work independently to offer various health services within the scope of their licensure and practice certification, several states restrict their ability to practice. Some institutions require the nurses to carry out their tasks according to a written agreement with a certified physician. Thus, most nurses cannot practice independently as they require supervision from physicians, thus, denying the healthcare consumers the benefits of broader competition and growth in practice. Several states have imposed restrictions on the scope of APRN’s scope of practice, and 80% of them are not based on safety concerns but weak political restrictions (Rosenthal 2018, pg. 330). 

The best approach to managing this significant issue is through restricting the meaningless APRN scope of practice to ensure improve the delivery of effective health care (Mason et al. 2020, pg. 129). Political influencers must recognize and appreciate nurses as an essential group in meeting the growing health demands of patients across diverse populations. They comprise the largest share of the entire workforce in primary care, especially in care provider shortage regions. Healthcare institutions should also embrace effective leadership that can mould incoming nurse workers into effective practitioners, create a platform for advancing their scope of care, and delivering patient care on the evidence-based basis (Mason et al. 2020, pg. 129). Nurses should be represented adequately, especially in areas where social, economic, policy, professional, and political decision concerning the healthcare system in the United States and established and amended. The major significant sign of the underrepresentation curve is the low visibility of nurses in the media. Media should take up the challenge and recognize the significant contributions of nurses to the medical profession, shed light on pressing issues affecting the workforce, and allow the public understand the significant role that nurses play in their lives, and why their interests should be met and their concerns addressed promptly (Mason et al. 2020, pg. 128). 



Mason et al. (2020), Chapters 15

Rosenthal (2018), Chapters 3, 4, 5, 6, pp. 328-337



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