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Remington, P. L., B. Pediatrics 144(6):e20183889. conducts daily patient visits, focused on optimizing patient health at discharge. For people who have difficulty accessing health care because of distance, lack of providers, lack of insurance, or other reasons, nurses are a lifeline to care that meets them where they are. County health rankings: Relationships between determinant factors and health outcomes. Improved telehealth technology and payment systems have the potential to increase access, allowing patients to obtain their care in their homes and neighborhoods. Castrucci, B., and J. Auerbach. Life expectancy, infant mortality, and maternal mortality are all worse in the United States than in most developed countries. NASN calls for 10,000 more school nurses. Henderson, K., T. C. Davis, M. Smith, and M. King. Future demand for long-term care workers will be influenced by demographic and utilization changes. The nurse has a key role in reducing health gaps, providing a wide range of treatments on the health-illness spectrum, active involvement in health education and promotion, developing treatment and assessment programs, participation in multi-professional teams, and standing at the forefront of technology with the evolvement of online services [ . The COVID-19 pandemic has highlighted the pivotal role of nurses in addressing health care equity. However, the ability of nurses to practice fully in these and other settings is limited by state and federal laws that prohibit them from working to the full extent of their education and training. 2017. Three randomized controlled trials found lower all-cause hospitalizations at 1 year postdischarge, resulting in cost savings as compared with a control group (Naylor et al., 1999, 2004, 2014). Although CDC has reported that COVID-19 poses a relatively low risk for children, research on natural disasters has shown that, compared with adults, children are more vulnerable to the emotional impact of traumatic events that disrupt their daily lives. Since the passage of the Patient Protection and Affordable Care Act, substantial changes have occurred in the organization and delivery of primary care, emphasizing greater team involvement in care and expansion of the roles of each team member, including RNs (Flinter et al., 2017). doi: 10.1542/peds.2008-0382. 2016; Shields 2012) and often positioned as vocationally driven to be caring, self-sacrificing, and compassionate. Storfjell, J., B. Winslow, and J. Saunders. Scherger, J. E. 2009. Healthy and ready to learn: School nurses improve equity and access. Foronda, C., D. L. Baptiste, M. M. Reinholdt, and K. Ousman. 2017. CMS. Pelzang, R. 2010. SBHCs often operate as a partnership between the school and a community health organization, such as a community health center, hospital, or local health department; more than half are supported by or are an extension of FQHCs (SBHA, n.d.). Historically, nursing has been at the forefront of advocacy, and there are many examples of how nurses have addressed, and are addressing, inequities in many aspects of our teaching, research, scholarship, and practice. The TCM nurse provides supplemental care if the person is hospitalized, and is responsible for care in the home (Hirschman et al., 2015). The evolution and rapid growth of these established retail clinics provide increased accessibility of basic care, health screenings, vaccines, and other services for some populations (Gaur et al., 2019). They often engage with and provide care to people in their homes, they work in a variety of clinics, they use telehealth to connect with people, and they establish partnerships and create relationships in schools and communities. Does race still matter in nursing? Increasingly, governments are looking to In addition to home health, nurse home visiting programs often include such services as health check-ups, screenings, referrals, and guidance in navigating other programs and services in the community (Child and Family Research Partnership, 2015). (Bodenheimer and Mason, 2016, pp. Yet, while there have been calls for every school to have access to a nurse (Council on School Health, 2016; NASN, 2020b), only 39.9 percent of schools employed a full-time nurse in 2017. Existing exemplars are also described, as well as implications of COVID-19 for health care access and quality. Policy agenda for nurse-led care coordination. The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. The person-centered care model embraces personal choice and autonomy and customizes care to an individuals abilities, needs, and preferences (Kogan et al., 2016; Van Haitsma et al., 2014). This positive impact has been found to continue into adolescence and early adulthood (NASEM, 2019). NASN. 2017. Health care equity focuses on ensuring that everyone has access to high-quality health care. In still another example, Banner Healths skilled nursing model delivers home care combined with telehealth services to people at home instead of their having to move to a nursing home facility (Roth, 2018). Care coordination is defined as the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patients care to facilitate the appropriate delivery of healthcare services. It is needed both to overcome obstacles of the health care system, such as fragmentation, communication, and billing/cost, and to increase access (McDonald et al., 2007, p. 4). These tasks in many cases have been performed in the absence of residents family members and friends, who have not been allowed to visit as part of efforts to prevent the spread of infection. Do you enjoy reading reports from the Academies online for free? The New England Journal of Medicine 383:274276. But the potential for nurses to help people and communities live healthier lives can be realized only if the barriers to their working to the full extent of their education and training are removed. Olds, D. L., H. Kitzman, E. Anson, J. Growth in retail-based clinics after nurse practitioner scope of practice reform. 3 ways telehealth tackles aging-related needs. Ways in which nurses can fulfill this potential to increase access to care for populations with complex health and social needs are discussed below. Uscher-Pines, L., J. Sousa, M. Jones, C. Whaley, C. Perrone, C. McCullough, and A. J. Ober. Yet, there remain too many examples of structural racism throughout nursing and we must be open to continuing to examine, identify, and change these within our own profession. Home healthcare market to expand in 2020. Care management for older adults: The roles of nurses, social workers, and physicians. Washington, DC: The National Academies Press. NASEM (National Academies of Sciences, Engineering, and Medicine). Both in the United States and globally, the rapid growth in the number of older people in the population will likely lead to increased demand for services and programs to meet their health and social care needs (Donelan et al., 2019; Spetz et al., 2015), including care for chronic conditions, which account for approximately 75 percent of all primary care visits (Zamosky, 2013). If health care equity is to be fully achieved, nursing schools will need to focus on ensuring that all nurses, regardless of their practice setting, can address the social factors that influence health and provide care that meets people where they are. Telemedicine and e-Health 26(2):184189. Virtually perfect? CPSTF (Community Preventive Services Task Force). 2009. IOM. Mutter, J. D. Berry, T. Yamanaka, D. T. Mohess, and T. Cornwell. School nurses are essential to expanding access to quality health care for students, especially in light of the increasing number of students with complex health and social needs. By contrast, the number of NPs providing home visits nearly doubled during that same period. Rockville, MD: Substance Abuse and Mental Health Services Administration. Nursing in a transformed health care system: New roles, new rules. Carthon, J., M. Brooks, T. Sammarco, D. Pancir, J. Chittams, and K. W. Nicely. School nurses work to assure that children have access to educational opportunities regardless of their state of health. Visiting people in their homes can advance equitable access to quality health care. But the role of nurses in these efforts is key, given their interactions with individuals and families in providing and coordinating person-centered care for preventive, acute, and chronic health needs within health settings, collaborating with social services to meet the social needs of individuals, and engaging in broader population and community health through roles in public health and community-based settings. 2011. performance of diagnostic tests within their scope of practice and state law, as they maintain required statutory relationships with supervising or collaborating physicians (CMS, 2020a). 2 Social Determinants of Health and Health Equity, 4 The Role of Nurses in Improving Health Care Access and Quality, 6 Paying for Equity in Health and Health Care, 8 Nurses in Disaster Preparedness and Public Health Emergency Response, 10 Supporting the Health and Professional Well-Being of Nurses, 11 The Future of Nursing: Recommendations and Research Priorities, Appendix A: Biographical Sketches of Committee Members and Project Staff, Appendix B: Data Collection and Information Sources, Appendix C: Data Sources, Definitions, and Methods. Catalysts for change: Harnessing the power of nurses to build population health in the 21st century. The RAND Corporation (2016) study found that while 21 percent of the U.S. population lived in medically underserved areas, only 12.5 percent of retail clinics were located in these areas. https://www.nursingworld.org/practice-policy/health-policy/care-coordination (accessed February 21, 2020). To improve health care access, nurses will need to be intentional about meeting patients where they are in the most literal sense, and to serve as advocates with and within public health, retail clinics, and health systems to ensure that patients can access the care they need in their homes and neighborhoods. According to Healthy People 2020, access to quality health care encompasses the ability to gain entry into the health care system through health insurance, geographic availability, and access to a health care provider. https://schoolnursenet.nasn.org/nasn/blogs/nasn-profile/2020/04/22/nasn-calls-for-10000-more-school-nurses (accessed March 26, 2021). Although much attention has been paid to the dire need for health care supplies and hospital beds to treat patients with severe cases of COVID-19, less attention has been directed at impacts of the pandemic on communities; their ability to weather the crisis; and individuals physical, mental, and social health. B. The nurse also accompanies the patient to her first physician visit following hospital discharge to ensure effective communication. This concern has been fueled by increases in the incidence of anxiety and depression, as well as a trend in which victims of suicide have been younger. https://www.aannet.org/initiatives/edge-runners/profiles/edge-runners--interprofessional-practice-vine-school (accessed June 19, 2019). Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. National trends in mental health care for US adolescents.

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