DALIA SALGADO
DALIA SALGADO
COLLAPSE
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Pilot studies represent a fundamental phase of the research process. The purpose of conducting a pilot study is to examine the feasibility of an approach that is intended to be used in a larger scale study (Lucas, et al., 2019). In addition, a pilot study can be used to evaluate the feasibility of recruitment, randomization, retention, assessment procedures, new methods, and implementation of the novel intervention. The fundamental purpose of conducting a pilot study is to examine the feasibility of an approach that is intended to ultimately be used in a larger scale study (Lucas, et al., 2019). This applies to all types of research studies. Despite the convention, pilot studies do not provide useful information regarding the population effect size because the estimates are quite crude owing to the small sample sizes. Basing a decision to proceed or terminate evaluation of a particular intervention on pilot data is risky because there is a very good chance that the decision will be derived from false positive or false negative results (Lucas, et al., 2019). By the very nature of pilot studies, there are critical limitations to their role and interpretation. For example, a pilot study is not a hypothesis testing study and therefore safety and efficacy are not evaluated. Further, a study can only examine feasibility of the patient type included in the study. The feasibility results do not necessarily generalize beyond the inclusion and exclusion criteria of the pilot. Several studies has concluded that pilot studies are still poorly reported, with inappropriate emphasis on hypothesis-testing (Lucas, et al., 2019).
According to Lucas, R., Zhang, Y., Walsh, S. J., Evans, H., Young, E., & Starkweather, A.(2019), Some authors suggest that analysis of pilot studies should mainly be descriptive, as hypothesis testing requires a powered sample size which is usually not available in pilot studies. In addition, inferential statistics and testing hypothesis for effectiveness require a control arm which may not be present in all pilot studies. However most of the pilot interventional studies in this review contained a control group and the authors performed and reported hypothesis testing for one or more variables. Some tested the effectiveness of an intervention and others just performed statistical testing to discover any important associations in the study variables(Lucas,
et al., 2019).
References
Kristin Markussen, Barriers to Research Utilization in Clinical Practice, Nordic Journal of Nursing Research, 27, 1, (47), (2007).
Lucas, R., Zhang, Y., Walsh, S. J., Evans, H., Young, E., & Starkweather, A. (2019). Efficacy of a Breastfeeding Pain Self-Management Intervention. Nursing Research, 68(2). doi:10.1097/nnr.0000000000000336
Pilot Study of an Instrument to Measure Attitudes to Palliative Care Practice in Neonatal Inte Development of a Nursing Competency Assessment Tool: A Pilot Study inside the Department of Pediatric Intensive Care. (2017). American Research Journal of Nursing. doi:10.21694/2379-2922.17001nsive Care Nursing. (Lucas, et al., 2019)
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magdaleine selondieu: week 14
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There have been significant changes in the Affordable Care Act (ACA) is critical legislation enacted under the leadership of the Obama administration. ACA is a state health insurance program which is nationally acceptable. Florida State leads in its adoption of the plan in the 2019 enrollment statistics compared to other federal governments despite the political forces arrayed against the legislation, which is still active nationally.
The current implementation of the policy includes the use of a federal exchange portal for online access for new members. The online platform makes the enrollment process fast and efficient. The federal government of Florida then oversees the acquisition and channeling of funds for the insurance programs.
Although the Trump administration dedicates itself to crushing ACA, the program continues to survive in spite of the changing laws allowing more Americans to choose more flexible insurance plans and to avoid a penalty for not enrolling for ACA. The people of Florida have since enrolled a little less than last year’s number despite the negative political pressure to end the program through the flexibility of insurance plans and the entry of many private company competitors (Chang, 2018).
The American Nurses Association (ANA) analyzed the implications of the proposed repeal of the ACA legislation. The organization was able to halt the process of repealing the act three times within the year 2017, arguing that the benefits of retaining the plan were very significant compared to the option of changing the health insurance plan. The process of defending ACA involved sending a letter to the president himself, with an outline of the principles the organization esteems for creating positive transformation in the healthcare system (“Health System Reform”, 2019).
References
Chang, D. (2018). As deadline looms for 2019 Obamacare coverage, Florida leads nation in sign-ups. Retrieved from https://www.miamiherald.com/news/health-care/article223118295.html
Health System Reform. (2019). Retrieved from https://www.nursingworld.org/practice-policy/health-policy/health-system-reform/
Rosie Jean louis: Discussion 8
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The Affordable Care Act as an Impactful Healthcare Policy
The healthcare policy chosen for this purpose is the Affordable Care Act (ACA) enacted in 2010 during the Obama Administration. The choice for the policy is based because it has received much political attention, opposition, and has had wide-reaching impacts on the healthcare industry. Famously known as Obamacare, ACA was initiated to make healthcare affordable for everybody, but it meant that the high-income individuals would contribute more to keep the program sustainable. The tools used to implement ACA include Medicare and Medicaid as well as integrated healthcare insurance where the private and the public insurance agencies come together to cater for needs of the public. Another tool used to expedite the healthcare policy is incentives in the form of tax credits advanced to employers who pay health insurance for their employees. Since the initiation of the program, several changes instituted by consensus from stakeholders have modified the policy to suit states and make the plan more efficient (Patient Protection and Affordable Health Care Act, 2010). For instance, in 2016, they introduced fines of a maximum of $695 or 2.5 percent of income, whichever is more significant for people who fail to enroll for health insurance program either in public or private sector. Also, these fines apply to employers with more than 50 employees who fail to provide their employees with affordable health insurance. For flexibility purposes, ACA allows states to establish their systems (health insurance exchanges) where its people can purchase health plans.
American Nurses Association (ANA) for the last couple of decades have been pushing for policy changes in the health sector. ACA comes to a fundamental policy change supported by ANA as the organization supports the affordable provision of primary health care for citizens. ANA’s quest for healthcare reforms first results came in during the enactment to ACA because nurses have witnessed families suffers because of unaffordable healthcare costs. ANA attributes that healthcare reform provides opportunities for nurses as it allows them to get more involved in educating the public about insurance health plans. Other nursing organizations that have informed the development of ACA include the Hospice and Palliative Nurses Association and the National Student Nurses Association. Obamacare has allowed every individual to access quality healthcare, but healthy individuals feel the pinch as they pay more than health services they receive. Also, ACA is a broad policy that has transformed the healthcare industry, and for that reason, it cannot gratify the needs of everyone. Also, most Americans underestimate the actual costs of running the healthcare industry.
References
Béland, D., Rocco, P., & Waddan, A. (2019). Policy Feedback and the Politics of the Affordable Care Act. Policy Studies Journal, 47(2), 395–422.
Kaiser Family Foundation. (2017, November 17). Kaiser Health Tracking Poll – November 2017: The Politics of Health Insurance Coverage, ACA Open Enrollment. Retrieved July 22, 2019, from The Henry J. Kaiser Family Foundation website: https://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-november-2017-the-politics-of-health-insurance-coverage-aca-open-enrollment/
Nadash, P., Miller, E. A., Jones, D. K., Gusmano, M. K., & Rosenbaum, S. (2018). A series of unfortunate events: Implications of Republican efforts to repeal and replace the Affordable Care Act For older adults. Journal of Aging & Social Policy, 30(3–4), 259–281.
Patient Protection and Affordable Health Care Act. (2010). Patient protection and affordable care act. Public Law, 111(48), 759–762.
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Laura Saldivar
State health policy
One important Florida policy is Title XXIX Chapter 381 Public Health provisions which discusses the law and components affecting who can administer the drug Naloxone Hydrochloride. This drug is an opiod antagonist and can be used acutely when a person is suffering from an opiod overdose. “Emergency opioid antagonist” means naloxone hydrochloride or any similarly acting drug that blocks the effects of opioids administered from outside the body and that is approved by the United States Food and Drug Administration for the treatment of an opioid overdose. Controversially, in some states emergency workers such as police officers did not have access to the drug, event though they are often the first to arrive to the scene.
According to the Florida Statue an authorized health care practitioner may prescribe and dispense an emergency opioid antagonist to a patient or caregiver for use in accordance with this section, and pharmacists may dispense an emergency opioid antagonist pursuant to such a prescription or pursuant to a non-patient-specific standing order for an autoinjection delivery system or intranasal application delivery system, which must be appropriately labeled with instructions for use. Such patient or caregiver is authorized to store and possess approved emergency opioid antagonists and, in an emergency situation when a physician is not immediately available, administer the emergency opioid antagonist to a person believed in good faith to be experiencing an opioid overdose, regardless of whether that person has a prescription for an emergency opioid antagonist. he following persons are authorized to possess, store, and administer emergency opioid antagonists as clinically indicated: Emergency responders, including, but not limited to, law enforcement officers, paramedics, and emergency medical technicians.
Nurses are included in this policy, by being able to administer the drug and withdraw it from the medical pixus. Nurses are obligated to be familar with this state policy in case we ever come across this scenario in the field or within the hospitals. This policy is fair and protective of those who take opiods by prescription or illegally. It protects them by giving the public access to the antidote which could potentially save their lives if they overdose in public.
References
Bill Citator. (2018). Retrieved from http://billinfo.leg.state.fl.us/
National Institute on Drug Abuse. (2019, May 22). Florida Opioid Summary. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/florida-opioid-summary
Marie Germain Discussion: 8
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The issues of health care policy have been one of the major topics in the political debates specially in the pasts years. It is a topic that everyone in the united of states and around the world have addressed, for it affects everyone one way or another. In the last few years the with Obama Care, health care policy has change considerably, which mandates insurance company to insure individuals with pre-exiting health problem and for individuals to be able to keep their health insurance regardless of serious health issues and not let go by their insurance providers. Under such policy many have become insured due to the affordability and also the requirements that Affordable Healthcare Act dictates and the penalty fee of not being insured. The health care policy has tremendously influenced how care is and has been delivered in the past decade from state to state.
The state of California develops various healthcare policies every year that most often oversee privately owned and public healthcare institutions as well as insurers. These healthcare policies address issues like managing individual health data, necessities acquiring operating licenses and several others. These healthcare policies affect how the residents of the state can easily access healthcare services as well as the service quality and have an overall influence on the health of the population. The rising cost of healthcare made California’s legislature come up with a policy to enhance access to healthcare. California’s affordable care policy also called the Affordable Care Act (ACA) is a policy aimed at ensuring the residents have healthcare insurance. Since its implementation in the year 2014, the percentage of the uninsured in the state dropped to less than 10 percent (McConville, 2019). The Medicaid program of the state called the Medi-Cal is accountable for most of the coverage gain. California insurance market referred to as Covered California maintains continuous membership registration of new members.
During the process of policy development, the choice of policy tools, and the behavioral assumptions by policymakers are influenced by the political climate at that particular time. The political contexts, including ideologies of the political leaders involved in the policy development, greatly influence the development of policies. Besides, the administrators and the healthcare workers in various healthcare organizations may use their authority in their daily activities such that the delivery of healthcare service may be affected either positively or negatively (Schneider, & Orgill, 2014). The political climate affects the policy choices as well as the policy enactment.
The American Nurse Association (ANA) collaborates with policy makers to develops health care policies that have and will promotes quality and safe delivery of care, protect and also that will advance the nursing profession. Professional nursing organizations have been involved in this policy issue in both its creation and employment. During the development of the policy, they provided advices and suggestions of how best the policy may be designed (Gore and Parker, 2019). During policy implementation, they are involved in offering healthcare services to the residents in different parts of the state.
References
Gilson, L., Schneider, H., & Orgill, M. (2014). Practice and power: a review and interpretive
synthesis focused on the exercise of discretionary power in policy implementation by front-line providers and managers: health policy and planning, 29(suppl_3), iii51-iii69.
Gore, R., & Parker, R. (2019). Analyzing power and politics in health policies and systems.
McConville, S. (2019). California’s Future: Health Care. Retrieved 29 July 2019, from https://www.ppic.org/wp-content/uploads/californias-future-health-care-january-2019.pdf
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Ariel Lopez
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State health policy
The state policy of New York is the program that is related to the insurance of the citizen. This program is named as New York Health Benefit Exchange. According to this plan, the restrictions have been imposed on each citizen that they should be having health coverage. This program is started following the health care Act, in which each state has to establish a health insurance exchange. The states of the USA had the option either to make their own, or they can let the federal government establish the health insurance exchange. The purpose of the health insurance exchange is to promote insurance among citizens. The citizens who would not be having the health insurance coverage, they are required to pay the penalty (nystateofhealth.ny.gov, 2019).
In exchange, the customers can have look at the different policies available, and they can have a comparison between others. This is the tool through which the government is imposing the conditions upon the citizens. This Act was imposed by the President Obama administration, which had experienced many critics from the Republican legislators. According to the critics, this kind of plan is like a liability on the people of America (Lovett, 2018).
The professional nursing organization has not been involved actively in the effort, as the nursing has very less concern about the health coverage plan. But the nursing organization should take part in it, like by contributing towards the customers through counseling of the best plan they have. The nursing organization can play a good role in providing good services.
References
Lovett, K. (2018, Dec 5). NYS Obamacare enrollment continues to rise. Retrieved from nydailynews.com: https://www.nydailynews.com/news/politics/ny-pol-obamacare-new-york-enrollment-increase-20181205-story.html
nystateofhealth.ny.gov. (2019, Jul 30). NY State of Health: The Official Health Plan Marketplace. Retrieved from nystateofhealth.ny.gov: https://info.nystateofhealth.ny.gov
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