1 day ago Jessica Dunne  RE: Discussion - Week 10 COLLAPSE Top of Form NURS 6050C: Policy and Advocacy for Improving Population Health INITIAL POST Resource Allocation for an Aging Population             Technological advances in medicine and preventative care means that Americans are living longer lives than ever before. Hayutin, Deitz, and Mitchell (2010) assert that by the year 2030 Americans over the age of 65 will account for 20% of the population. There will soon be more elderly Americans than children, and the number of working adults is expected to decrease concurrently. This shift in the population will yield significant economic, political and social challenges. Healthcare needs are also changing. Death and disability rates are declining, yet the incidence of chronic illness within the elderly population continues to rise (Hayutin, Deitz, & Mitchell, 2010).  Crippen and Barnato (2011) contend that 20% of the population assume 80% of all healthcare-related costs. As much as 75% of these costs are attributable to chronic diseases (Crippen & Barnato, 2011). Revenues for healthcare are projected to decrease while expenditures are expected to increase. Healthcare providers, policymakers, and industry experts need to work towards solutions that will optimize healthcare dollars and create sustainability for future generations. Ethical Considerations The dynamics of healthcare are complicated; financial resources seem insignificant when making life and death decisions. Nonetheless, resources are finite, and therefore, distribution and allocation of funds must be ethical. According to Craig (2010), the theory of distributive justice requires that people with the same health needs have equitable access to all available resources. However, distributive justice also requires that the associated costs also be shared equitably. Fairness is another ethical principle that should be applied in the allocation of healthcare resources. Policies that are fair must be transparent, understandable, and there must be regulatory process to address complaints and resolve conflicts. The idea that healthcare is a human right is outlined in the declaration of independence which guarantees citizens the right to life, liberty, and the pursuit of happiness. The need of the patient should also be considered. A burn patient needs plastic surgery more than a patient that wants rhinoplasty (Craig, 2010). Nurses provide the best possible care to every single patient regardless of gender, ethnicity, sexual orientation, ability to pay, or age. The American Nurses Association (2012) provides ethical guidelines for nurses to employ in their practice. Provisions one, two, and three promote the principle of beneficence, and the obligation nurses have to advocate for the best interests of their patients. Provisions seven, eight, and nine focus on providing social justice for clients through practice and policy (American Nurses Association, 2012). Nurses should also promote aut.

1. 1 day ago
Jessica Dunne
RE: Discussion - Week 10
COLLAPSE
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population
Health
INITIAL POST
Resource Allocation for an Aging Population
Technological advances in medicine and preventative
care means that Americans are living longer lives than ever
before. Hayutin, Deitz, and Mitchell (2010) assert that by the
year 2030 Americans over the age of 65 will account for 20% of
the population. There will soon be more elderly Americans than
children, and the number of working adults is expected to
decrease concurrently. This shift in the population will yield
significant economic, political and social challenges. Healthcare
needs are also changing. Death and disability rates are
declining, yet the incidence of chronic illness within the elderly
population continues to rise (Hayutin, Deitz, & Mitchell,
2010). Crippen and Barnato (2011) contend that 20% of the
population assume 80% of all healthcare-related costs. As much
as 75% of these costs are attributable to chronic diseases
(Crippen & Barnato, 2011). Revenues for healthcare are
projected to decrease while expenditures are expected to
increase. Healthcare providers, policymakers, and industry
experts need to work towards solutions that will optimize
healthcare dollars and create sustainability for future
generations.
Ethical Considerations
The dynamics of healthcare are complicated; financial resources
seem insignificant when making life and death decisions.
Nonetheless, resources are finite, and therefore, distribution and

2. allocation of funds must be ethical. According to Craig (2010),
the theory of distributive justice requires that people with the
same health needs have equitable access to all available
resources. However, distributive justice also requires that the
associated costs also be shared equitably. Fairness is another
ethical principle that should be applied in the allocation of
healthcare resources. Policies that are fair must be transparent,
understandable, and there must be regulatory process to address
complaints and resolve conflicts. The idea that healthcare is a
human right is outlined in the declaration of independence
which guarantees citizens the right to life, liberty, and the
pursuit of happiness. The need of the patient should also be
considered. A burn patient needs plastic surgery more than a
patient that wants rhinoplasty (Craig, 2010).
Nurses provide the best possible care to every single patient
regardless of gender, ethnicity, sexual orientation, ability to
pay, or age. The American Nurses Association (2012) provides
ethical guidelines for nurses to employ in their practice.
Provisions one, two, and three promote the principle of
beneficence, and the obligation nurses have to advocate for the
best interests of their patients. Provisions seven, eight, and nine
focus on providing social justice for clients through practice
and policy (American Nurses Association, 2012). Nurses should
also promote autonomy, an ethical principle that focuses on the
patients right to make their own decisions regarding their care.
Finally, the principle of non-maleficence means that the nurse
must not harm.
Ethical Dilemma
Healthcare resources are often viewed as an investment.
The sicker the patient, the more risk is associated with
allocating recourses for their care. Systematic health care
rationing is effective for resource conservation and allocation.
In Great Brittan, an elderly patient would not be an unlikely
candidate for an organ transplant because the rate of
complication and death are significantly increased for this
population. Healthcare dollars are reserved for patients that will

3. have the most benefit and are likely to have the best outcomes
(Craig, 2010).
However, this type of resource allocation is unethical. The
ethical principles of distributive justice, autonomy, beneficence,
non-maleficence, fairness, need, and healthcare as a human
right must be upheld for each patient. Even though it is
necessary to provide ethical care, our current path is financially
unsustainable. We are consuming healthcare resources more
quickly than we are earning revenue. The cost of chronic
disease is our biggest expenditure. Our children will be paying
not only for us but for the care consumed by their grandparents
and great-grandparents. It is not unethical for young workers to
finance care for the elderly, but rather, is implicative of the
high costs associated with healthcare (Crippen & Barnato,
2016).
Solution
s
Healthcare costs must be controlled, or revenues must be
increased to provide all patients with equitable care. I believe
the most logical strategy is to control costs through health
promotion. Healthcare policies should incentivize healthy
choices and preventative care. Research indicates that patients
with mental illness have the highest rates of chronic disease. It
seems counterintuitive to spend money to save money.
Nonetheless, financial investments in mental healthcare will
decrease the amount of money spent on chronic illness (Crippen

4. & Barnato, 2016).
Policy changes are necessary to ensure fair and ethical
distribution of healthcare resources. Making changes that focus
on prevention and health promotion will help younger
generations. However, we must also make adjustments that will
control costs for those who are already chronically ill. Karnik &
Kanekar (2016) assert that healthcare providers should
encourage patients and their families to engage in end of life
planning strategies. It is essential to do this before a patient is
too ill to make decisions for themselves. Healthcare
organizations should institute standards for end of life and
palliative care. Polices should also promote a regulatory process
to resolve conflicts such as an ethics board (Karnik & Kanekar,
2016).
People do not like to talk about end of life care; it is unpleasant.
There are also a lot of misconceptions about what can
realistically be done to save a person who is dying. Providers
need to do a better job at explaining what heroic measures
constitute – broken ribs, sedation, ventilation, pain,
complications, infections, and the significant emotional and
financial cost associated with such. Additionally, advanced
directives are frequently limited to the state in which a person
resides. Should a person become medically incapacitated in a
different state there is a very small chance that anyone will
know about an advanced directive until it is too late. I would

5. propose a policy that list basic advanced directive information
on state issued identification. Organ donation status is already
identified on state issued identification, so adding advanced
directive information seems like a logical measure. Moreover, a
national database that lists advanced directives would be
extremely helpful. If such a service were voluntary, and
required consent, it would theoretically comply with HIPPA
regulations. Moreover, these measures would ensure patient
autonomy and would alleviate the next of kin from making
extremely difficult life and death decisions for the people that
they love.
References
American Nurses Association. (2012). Code of Ethics for
Nurses. Retrieved from https://www.nursingworld.org/practice-
policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
Crippen, D., & Barnato, A. E. (2011). The ethical implications
of health spending: Death and other expensive conditions. The
Journal of Law, Medicine & Ethics,39(2), 121-129.
doi:10.1111/j.1748-720x.2011.00582.x
Hayutin, A. M., Deitz, M., & Mitchell, L. (2010). New realities
of an older America. Retrieved from
http://www.nasuad.org/sites.nasuad/files/hcbs/files.199/9941/Ne
w_Realitites_of_an_Older_America.pdf
Karnik, S., & Kanekar, A. (2016). Ethical issues surrounding
end-of-life care: A narrative review. Healthcare,4(2), 24.

6. doi:10.3390/healthcare4020024
Bottom of Form
Reflection research week 6
February 5
Reading Reflection
Please submit a few sentences regarding this week
chapter reading, explain what are some of the important aspects
of this week's reading, provide examples when possible.
Topic 1- Sampling involves decisions about who or what will be
tested, observed, or interviewed in your study (Morse, 2007)
•Key questions to address:
–Who should and should not be included?
–How many should be included?
Topic 2-Reliability is concerned with questions of consistency
•Other terms for reliability are:
–Repeatability
–Reproducibility
–Stability

7. –Consistency
–Predictability
–Agreement
–Homogeneity
The initial post will be regarding the topic of the week and will
be a minimum of 250 words. Make sure you provide appropriate
references and utilize APA style. Peer posts will be a minimum
of 75-100 words, otherwise will be counted as 0. There will be a
total of 8 discussion posts worth 1.25 points each or 10 points
of your grade. In order to obtain full credit students must follow
the above requirements. Each discussion will be allocated to a
specific Master's Essential.
Criteria
1.25 Point
1 Point
0.75 Point
0
Participation
Weight 25.00%
100 %
3 Posts
80 %
2 Posts

8. 60 %
1 Posts
0 %
0 Posts
Quality of informtaion
Weight 25.00%
100 %
Information is clear and relates to topic
80 %
Information is somewhat clear and might relate to topic
60 %
Information has little relation to topic and is not clearly
displayed
0 %
Information is not clear and it does not relate to topic
Resources
Weight 25.00%
100 %
Provides relevant resources using APA guidelines
80 %
Provides relevant resources without APA guidelines
60 %
Limited on the resources provided with major errors in APA
0 %
Does not provide any resources

9. Critical Thinking
Weight 25.00%
100 %
Enhances the critical thinking process through premise
reflection
80 %
Enhances the critical thinking process without premise
reflection
60 %
Does enhance the critical thinking process in a very limited
manner
0 %
Does not enhance the critical thinking process