Ethical Considerations in Care Coordination in Nursing Homes

Topic: Medical Ethics
Words: 1301 Pages: 5

Introduction

Nursing homes are essential to the healthcare sector because they offer specialized nursing care to chronically sick patients. Most people living in nursing homes are in their elderly years, and the level of care that is given to each individual varies significantly both in breadth and in the manner in which it is delivered. As a result of the variety of care needs and patients, many ethical dilemmas might arise from observable variances. A nursing home is conducive to care coordination since the caregivers constantly access the patients. Mastering the ethics of care coordination in nursing homes would enhance clients’ quality of life and promote professionalism in the health sector.

Impacts of Code of Ethics for Nurses on the Coordination of Care

Access to health care and health inequalities are influenced by the client’s geographical location, patient age, social and economic position, disability, sexual identity, and ethnicity. Social determinants are settings that engage in their community and are affected by the distribution of supplies such as money and power. Managing social determinants of health is essential for enhancing health and decreasing persistent inequities in health care (Donkin et al., 2017). For instance, when a society has limited access to healthcare, its health declines. A potential effect of health policy might be affordable healthcare. The government offers cost-sharing subsidies and enacts new legislation to encourage health insurance firms to provide residents with more cost-effective treatment (Santana et al., 2018). Many people can access quality care services, and the nation’s health condition would improve due to the implementation of an affordable care policy.

A code of ethics serves as a guide for nurses, and its purpose guarantees that the actions of caregivers always result in the most favorable health outcomes for the patients in their care. The American Code of Nursing lays forth the requirements for nurses. Caregivers are responsible for treating patients with the highest respect in all aspects of their care, including preserving the patients’ dignity and protecting their privacy. The nurses must advocate for patients’ rights and adhere to rules and patient rights while providing care. Since policies and privileges are enacted by the government, the laws and regulations affect the capacity to observe and conform to the code of ethics, which may lead to ethical difficulties. Residents in nursing homes express self-determination as one of their primary concerns. However, the client has the legal right to be educated and to have an active role in making choices on the course of treatment. Many patients in nursing homes are not in the correct state of mind to make decisions. Self-determination in healthcare is essential for the right to engage in care as a patient (Bevilacqua et al., 2020). The patient needs to have a say in the evaluation, treatment planning, and timing of their departure from the hospital. Clients in nursing homes have the legal right to reject medicine and physical constraints, as well as the right to access and examine their medical information.

The federal nursing home legislation stipulates that residents of nursing homes have certain rights. In the case that nursing homes violate the legislation, they risk losing their license to practice and being withdrawn from the Medicare and Medicaid Services. The government subsidizes nursing homes by enabling patients to cover their nursing home fees through Medicaid and Medicare (Yang et al., 2021). The resident is entitled to be advised of all services offered and related fees. As a result of the number of caregivers involved in coordinated care, the details may not be communicated to the patient since each caregiver expects that the other health professional has discussed the costs and resulting consequences with the patient.

How Governmental Policies Affect the Coordination of Care

Various government regulations and legislation influence the coordination of care in nursing homes. Health Insurance Portability and Accountability Act (HIPAA) is one example of such a statute. This federal regulation is meant to prevent the delivery of sensitive health information without patient consent in an unprofessional manner (Centers for Disease Control and Prevention, 2022). The term sensitive health data refers to information the public authority considers sensitive. This patient data might be given in numerous formats, including diagnosis, medication, and personal information. The development of HIPAA centered on privacy regulations, which provide a set of rules governing how patient health information may be disclosed to individuals or organizations within the privacy rule’s jurisdiction.

Electronic clinical records (EMR) are technical devices vulnerable to cyber-attacks, and unauthorized people may easily access this data since they are housed inside the software. As a result, the protection of patient data has become more challenging. Facilities provide a variety of insurance to safeguard patients’ health information. Patient health information (PHI) can only be accessed with certain devices, and these devices are equipped with code to thwart hackers. When professionals violate HIPAA regulations, they may face sanctions of varying severity based on the extent of patient data exposure (Centers for Disease Control and Prevention, 2022). These experts may be subject to severe penalties, including license revocation, hefty fines, and even criminal charges.

National, State, and Local Policy Provisions That Raise Ethical Dilemmas

National, Local, and state policy measures may pose ethical issues and concerns about care coordination. Such policy elements include insurance coverage and the cost of health services in the American Healthcare system, where care coordination and ethical concerns pose the greatest challenges for health professionals. Accessing health care for the poor is one of the ethical challenges and conundrums. Even with the introduction of generic pharmaceuticals, the issue persists due to the high cost of medicines. The Affordable Care Act (ACA) offers low-income individuals insurance options accompanied by complexity and yearly adjustments, making it difficult to appreciate them. There is an issue with medical and worker insurance in the United States which raises ethical difficulties when corporations refuse to provide better health care.

Key Ethical and Policy Issues Affecting the Coordination of Care

After the nurses have provided a patient with all of the necessary information, they must preserve the patient’s autonomy and enable them to make the decision they believe appropriate. Unless the patient is rendered unconscious or insane, they will not lose the capacity to make choices throughout their treatment. Patients need to be treated as individuals and allowed to keep their thoughts, ideas, and values. These needs should be maintained even if they are impeding the rehabilitation process. Patients should never be pressured into making choices by personnel who are responsible for care coordination.

In addition to providing care in line with standards, the caregiver owes the patient kindness and compassion. With the existing staffing rules, it may be difficult to do acts of kindness. Spending quality time with a terminally ill patient is one of the activities that might be deemed beneficial (Muldrew et al., 2018). A physician must refrain from causing damage to patients. Medical professionals must assess the related risks when implementing a care coordination strategy. People requiring long-term healthcare are often plagued with comorbid conditions that raise the danger of certain medical operations. Therefore, significant care must be taken to guarantee that nursing care choices are in the patient’s best interests.

Conclusion

In addition to providing care in line with standards, the caregiver owes the patient kindness and compassion. With the existing staffing rules, it may be difficult to do acts of kindness. Spending quality time with a terminally ill patient is one of the activities that might be deemed beneficial. A physician must refrain from causing damage to patients. Medical professionals must assess the related risks when implementing a care coordination strategy. People requiring long-term healthcare are often plagued with comorbid conditions that raise the danger of certain medical operations. Therefore, significant care must be taken to guarantee that nursing care choices are in the patient’s best interests.

References

Bevilacqua, G., Bolcato, M., Rodriguez, D., & Aprile, A. (2021). Shared care plan: An extraordinary tool for the personalization of medicine and respect for self-determination. Acta Bio Medica: Atenei Parmensis, 92(1).

Centers for Disease Control and Prevention (2022). HIPAA Privacy Rule.

Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the social determinants of health. British Medical Journal Global Health, 3(Suppl 1), e000603.

Muldrew, D. H., McLaughlin, D., & Brazil, K. (2019). Ethical issues experienced during palliative care provision in nursing homes. Nursing Ethics, 26(6), 1848-1860.

Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), 429-440.

Yang, O., Yong, J., & Scott, A. (2022). Nursing home competition, prices, and quality: A scoping review and policy lessons. The Gerontologist, 62(7), e384–e401.

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