NRS 440 Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention

NRS 440 Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention

NRS 440 Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention

Greater coordination of care across providers and across settings will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department, utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions and adverse drug interactions (Salmond et al.,2017). Nurses who are well informed of health trends will be positioned to interpret their impact on health and better prepared to provide individual and systems level interventions to improve the health of communities. Nurse leaders will need to develop a multilevel approach that focuses on the nurse, the team and the organization to address trends to address disease-oriented health care goals. The Affordable Care Act recognized a principle by exempting a list of primary and secondary preventive services from copays and deductibles (Dolan, 2018). Hopefully new trends in healthcare will continue to seek ways to prevent conditions that negatively impact patients. With the support of the health care reform, clinicians can treat more patients with poor lifestyle choices and provide better access to immunizations and medications. Interventions to reduce health disparities associated with social class in the future will likely result from policy efforts directed at the entire population to support wellness. Nurses will always support new trends for health promotion and disease prevention measures to engage patients to choose risk-reducing behaviors.


Dolan, E. (2018). The Role of Prevention in Health Care Reform. Commentary Health Care. Niskanen Center.

Salmond, S.,Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic Nursing. 36(1)

:p 12-25.

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The time spent interacting with patients on a personal level while treating their basic healthcare needs gives nurses a natural understanding of how healthcare professionals can best advocate for their patients

”Nursing is one of the most versatile occupations within the health care workforce.1 In the 150 years since Florence Nightingale developed and promoted the concept of an educated workforce of caregivers for the sick, modern nursing has reinvented itself a number of times as health care has advanced and changed (Lynaugh, 2008). As a result of the nursing profession’s versatility and adaptive capacity, new career pathways for nurses have evolved, attracting a larger and more broadly talented applicant pool and leading to expanded scopes of practice and responsibilities for nurses. Nurses have been an enabling force for change in health care along many dimensions (Aiken et al., 2009). Among the many innovations that a versatile, adaptive, and well-educated nursing profession have helped make possible are

  • the evolution of the high-technology hospital;
  • the possibility for physicians to combine office and hospital practice;
  • lengths of hospital stay that are among the shortest in the world;
  • reductions in the work hours of resident physicians to improve patient safety;
  • expansion of national primary care capacity;
  • improved access to care for the poor and for rural residents;
  • respite and palliative care, including hospice;
  • care coordination for chronically ill and elderly people; and
  • greater access to specialty care and focused consultation (e.g., incontinence consultation, home parenteral nutrition services, and sleep apnea evaluations) that complement the care of physicians and other providers.

With every passing decade, nursing has become an increasingly integral part of health care services, so that a future without large numbers of nurses is impossible to envision”.

Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011. 3, Transforming Practice. Available from:

I appreciate your discussion. It is true that the engagement of coordination of care and case managers in hospitals

NRS 440 Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention
NRS 440 Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention

has greatly reduced hospital stay marginally. I have been learning much from case managers in our hospital as they coordinate care for patients in my facility. For example, my unit admits a lot of dialysis patients in their acute phases of illness. The case managers work hard to ensure that as soon as they are stabilized they advocate for physical therapy towards rehabilitation and home health care. As soon as patients can tolerate a sitting position for at least four hours a day, they can be successfully placed in rehabilitation facilities or discharged home where they get support from health professionals and family. The practice of coordination of care by case managers is truly reducing hospital stays and health costs. As the health care system changes, inter-professional collaboration will allow providers to apply innovative and cost-effective approaches to care delivery that eliminate redundancy, reduce errors, and increase safety (IOM, 2011).


Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. (2011). Retrieved from

Health care reforms indicate the positive changes in the quality and easy access to medications. It is completely transformed from the early stages where disease-oriented medical care was used. Wellness and prevention system has taken advantage of the medical field presently. It is the most recommended system of medical approach by all healthcare providers (Freire et al., 2016).There are numerous advantages to wellness and prevention method compared to disease-oriented system. It has significantly reduced the unnecessary hospitalization, cost of treatments, repeated testings and improved the outcome and quality of meditation. The role of nurses had changed with the new healthcare system. Their knowledge, skills and educational qualifications are improved significantly from older times. A nursing practitioner has become the full partner in relentless efforts of the new system to achieve improved patient health care.


Freire, R. M. de A., Landeiro, M. J. L., Martins, M. M. F. P. da S., Martins, T., & Peres, H. H. C. (2016). Taking a look to promoting health and complications’ prevention: Differences by context. Revista Latino-Americana de Enfermagem24.

Healthcare institutions are implementing efforts to shift focus from disease oriented to wellness and prevention. A disease oriented healthcare system focuses efforts and resources on disease management. The patients and the healthcare efforts are directed towards a disease. Wellness and prevention oriented healthcare system focus on promoting population health, preventing illness and complications and improving quality of life. The healthcare reform focuses on promoting this shift to wellness and prevention. The healthcare reform increases access to healthcare insurance, which promotes health behavior. According to Grubber and Sommers (2019), the healthcare reform lowers the eligibility criteria to include individuals below 65 years based on income level. Individuals from low income families can now access insurance services. Gruber and Sommers (2019) note that increased insurance access increases health seeking behavior and access of healthcare resources. Healthcare reform also eliminated the previous discrimination of individuals based on their conditions. With the reform, individuals with chronic illnesses have increased access to resources because the barriers limiting their access to insurance services were eliminated.


Healthcare reform is a sustainable plan whose funding will be from state ad federal governments. These policies will be made into laws and related institutional policies and be intergrated into organizational culture(Gruber & Sommers, 2020). These steps will help retain the effects of the trend and enhance its continuity. They will also be continually assessed and improved to enhance the continuity of the trend. Nurses will play a role in supporting and facilitting the shift. Nurses will educate fellow nurses and patients on the trend, ewhich will help facilitate change. Nrses are also on the frontline of implementing care interventions. They will thus play a huge role in promoting the shift by incorporating change throught their daily activities and care planning (Fu et al., 2019).


Fu, M. R., Kurnat-Thoma, E., Starkweather, A., Henderson, W. A., Cashion, A. K., William, J. K., & Coleman, B. (2020). Precision health: A nursing perspective. International journal of nursing sciences, 7(1), 5 – 12.


Gruber, J. & Sommers, B. D.(2019). The Affordable Care Act’s effects on patients, providers and the economy: what we have learned so far. Journal of Policy Analysis and Management, 38(4), 1028-1052