I interviewed a nurse
manager to explore the external factors influencing decision-making. Some of
the factors that had the greatest influence on the course taken for
decision-making in the clinical setting included the nature of health policies,
external regulatory requirements, accreditation, and healthcare financing. This
submission highlights the major points that unfolded in the interview. Besides,
an analysis of the interview supported by literature is given.
Roles of the Interviewed Nurse Manager
All
nurse managers play leadership roles in one way or another. Therefore, they
have an influential role that aims at the creation of a safe working
environment for healthcare workers engaging with patients. Consequently, nurse
managers facilitate professional growth for the workers under their leadership
as they help in maintaining or improving factors that promote positive
healthcare outcomes for patients within hospitals and other healthcare
organizations. Some of the defined duties for nurse managers include managing
staff, case management, planning treatment, recruiting nurse practitioners, conducting
departmental budgeting, scheduling for sensitization workshops, mentoring younger
professionals such as those on internship, contributing to educational plans,
and managing patient or workforce records. Additionally, the effective
performance of the mentioned roles needs professional communication and
leadership skills. Nurse managers are often faced with challenging decision-making
responsibilities either on the treatment of patients or on the overall management
of the institutions in which they offer their leadership services. As a result,
nurse managers imperatively need advocacy skills in conjunction with professional
maturity to actively participate in making decisions for the common good of
everyone in the healthcare sector.
Impacts of Health Policies on Decision-Making
Health
policies may influence shared decision-making (SDM) hence impacting the extent
to which nurse managers may act. For example, the Patient Protection and
Affordable Care Act (ACA) recommends shared decision making especially for
patients who present preference-sensitive situations (Reis & Spencer, 2019).
Besides, the ACA also ensures that patients are given the necessary support to
make informed decisions concerning the nature of care that they wish to
receive. The ACA established the Center for Medicare and Medicaid Innovation
(CMMI) with the power to analyze the cost-benefit ratios associated with the
use of various service delivery methods while emphasizing the enablers for
informed decision-making. In certain circumstances, the use of decision-support
tools becomes inevitable. For instance, nurse managers working in a variety of
departments may select from a pool of video-recorded clinical situations that
take a certain direction of decision-making. Therefore, institutional or
federal policies may make it imperative for reference to particular
evidence-based and quality-assessed decision-making video aids. The policies
improve the functionality of SDM not only in the emergency departments but also
in the provision of acute or unscheduled care.
Payment
policies significantly impact shared decision-making. For example, the use of
Medicare payment incentives may improve the participation of physicians in SDM
even though there is a challenge that may arise from a lack of precise billing
codes. However, the American Medical Association can develop new procedural
terminology codes and recommend them for consideration by the Centers for
Medicare and Medicaid Services. Pre-existing codes could also be used (Reis & Spencer, 2019).
Perceptions Related to
the Impacts of Regulatory Agencies on Decision-Making
The
major regulatory agencies that govern decision-making in nursing are federal.
Besides, they exert their influence on the scope of nursing decisions through
established acts and state laws. For instance, the Board of Nursing defines and
governs the roles played by nurse managers and advanced practice registered
nurse practitioners serving in various capacities. Additionally, the Nurse
Practice Act may serve the same role with slight differences from one state to
another. Regulatory bodies set in to help in the interpretation of complex acts
which becomes pivotal in facilitating quality patient-centered decision making.
An example of regulatory agency opinion would be suggesting whether or not
advanced registered nurses may administer intravenous anesthetics for
intractable pain. The regulatory bodies in nursing prioritize safe patient
care. Therefore, apart from licensing practicing nurses, they determine the
required standards of providing care.
Nurse managers have the responsibility of applying their full expertise in making decisions that conform to the medico-legal requirements because regulatory bodies conduct regular appraisal assessments. Besides, nurse managers must always adhere to jurisdictional laws failure to which unsafe nursing practices may lead to the loss of licenses. References are made to the Nurse Practice Act that outlines license qualifications, the scope of practice, and the consequences of acting against nursing laws. Notably, the American Nurses Association (ANA) advocates for nursing decisions at a federal level hence championing legal solutions to some of the problems that face nurses and their managers not only in the nation but also globally. Therefore, agencies like ANA impact decision-making directly by providing suggestive opinions or indirectly by participating in policy legislation.
Impact of Healthcare Financing on Decision Making
When
healthcare institutions offer financial assistance to support policy-related decisions, nurse managers find it easier to perform their duties
than when such financial aid is lacking. External sources of funding may also be
relied upon based on the benefits associated with quality improvement
decisions. These benefits are usually felt by patients economically or
socially. From research, funding decisions are objective with emphasis on
certain criteria that must be satisfied before any funds are released. Funding
decision-making balances evidence needs, criteria weightings, organization
staff, and finite financial resources (Meadmore
et al., 2020). Peer reviews further help in augmenting the
decision-making process.
Analysis of the
Interview
The
interview with the nurse manager was well conducted regardless of the time
limit because he had emergency occupational duties to perform before the time formally
elapsed. Consequently, more data would have been collected even though the
succinct conversation still generated adequate information regarding the active
role of nurse managers in decision-making under the influence of several
external factors. Besides, the use of a modified personal interview gave an
added advantage to the data collection method because the traditional panel
method was avoided (Pieris, 2019).
Conclusion
Nurse managers are among the healthcare workers who are actively involved in running daily patient care in a myriad of institutions. However, their decisions range from being independent to relying on interprofessional expertise. Besides, external factors such as health policy regulatory requirements, accreditation, and healthcare financing may either impact nurse managers’ decisions positively or negatively.
References
Meadmore, K., Fackrell, K.,
Recio-Saucedo, A., Bull, A., Fraser, S., & Blatch-Jones, A. (2020).
Decision-making approaches used by UK and international health funding
organizations for allocating research funds: A survey of current
practice. PloS one, 15(11), e0239757. https://doi.org/10.1371/journal.pone.0239757
Pieris D. (2019). A critical perspective on the modified personal
interview. Perspectives on medical education, 8(1),
33–37. https://doi.org/10.1007/s40037-018-0477-y
Reis, J., & Spencer, P. S. (2019). Decision-making under uncertainty
in environmental health policy: new approaches. Environmental health
and preventive medicine, 24(1), 57. https://doi.org/10.1186/s12199-019-0813-9
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