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Currently Skimming:

4 The Role of Nurses in Improving Health Care Access and Quality
Pages 99-126

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From page 99...
... Health care equity focuses on ensuring that everyone has access to high-quality health care. As shown in the Social Determinants of Health and Social Needs Model of Castrucci and Auerbach (2019)
From page 100...
... Changing health outcomes will require action at all levels -- upstream, midstream, and downstream -- and nurses have a major role at all levels in reducing gaps in clinical outcomes and improving health care equity. Nurses can strengthen their commitment to diversity, equity, and inclusion by leading large-scale efforts to dismantle systemic contributors to inequality and create new norms and competencies within health care.
From page 101...
... 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. 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)
From page 102...
... Access to quality health care services is an important SDOH, and equitable access to care is needed for "promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, and achieving health equity" (ODPHP, 2020)
From page 103...
... , retail clinics, home health and home visiting, telehealth, school nursing, and school-based health centers, as well as nurse-managed health centers. Across all of these settings, nurses are present and facilitate access to health services for individuals and families, often serving as a bridge to social services as well.
From page 104...
... RAND concluded that "overall, retail clinics are not improving access to care for the medically underserved." Thus, while these new models of care have the potential to advance health care equity and population-level health, the available data do not indicate that this potential has been realized (RAND
From page 105...
... . With the expansion in the home health care industry driven by an aging population, home visiting nurses are essential to providing care and enhancing health care equity (Walker, 2019)
From page 106...
... Box 4-1 describes several innovative nurse-led, in-home care programs. 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)
From page 107...
... It is a multidisciplinary, nurse-led home visiting intervention with the goal of helping older adults age in place. CAPABLE has been studied in randomized controlled trials (RCTs)
From page 108...
... 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. Access to school nurses helps increase health care equity for students.
From page 109...
... . Accordingly, schools and, by extension, school nurses are being incorporated into strategies for improving health care access, serving as hubs of health promotion and providers of population-based care (Maughan, 2018)
From page 110...
... SOURCE: Data from Willgerodt, 2018. Health-e-Schools, in which onsite school nurses connect sick students with health care providers.
From page 111...
... Care management, care coordination, and transitional care are activities that nurses perform as members of a health care team to decrease fragmentation, bolster communication, and improve care quality and safety. A care management approach is particularly important for people with complex health and social needs, who may require care from multiple providers, medical follow-up, medication management, and help in addressing their social needs.
From page 112...
... . The components of care management include care coordination, transitional care, and social care.
From page 113...
... . TCM relies on a master's-level "transitional care nurse" who is trained in the care of people with chronic conditions.
From page 114...
... 375) Nurses may contribute to structural inequities in how they facilitate or hamper access to quality health care services since they are frequently the first point of contact for many individuals who need care.
From page 115...
... These services should be extended to ensure that community health clinics, outpatient facilities, and public health partners also focus on CLAS in goals, policies, and management. Importantly, a community needs assessment would appropriately account for the community's demographics, changes in population, collaboration with stakeholders and constituencies, and the community's linguistic diversity to ensure services for equitable care (HHS, n.d.)
From page 116...
... . Maintaining these broadened scopes of practice for nurses after the pandemic has ended would increase NPs' opportunities to increase access to quality health care for individuals with complex health and social needs.
From page 117...
... Demand for home health nursing services, inclusive of following strict public health measures (masks, handwashing, quarantining) , has increased during the pandemic.
From page 118...
... It is important to note that the barriers discussed earlier due to restrictive scope-of-practice regulations may include limitations on providing telehealth services across state lines. Recognition of clinical licenses across states, such as through interstate agreements, could ease these barriers (NQF, 2020)
From page 119...
... As noted earlier, programs such as Nurse-Family Partnership (see Box 4-1) , as well as school nurses and school-based health centers, represent channels through which nurses can assist children and families with health care access to address mental health needs.
From page 120...
... 2016. Retail clinics drive new health care utilization and that is a good thing.
From page 121...
... 2020. Mississippi diabetes telehealth network: A collaborative approach to chronic care management.
From page 122...
... 2009. Care management of patients with complex health care needs.
From page 123...
... 2017. Healthy and ready to learn: School nurses improve equity and access.
From page 124...
... 2020b. NASN calls for 10,000 more school nurses.
From page 125...
... 2016. The evolving role of retail clinics.
From page 126...
... 2019. Home healthcare market to expand in 2020. Managed Healthcare Executive.


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