Evolution of Nursing Roles: Impact on Healthcare Services in the US

This essay examines the evolving landscape of nursing practice in the United States, driven by demographic shifts, emerging diseases, rising medical costs, and patient dissatisfaction. It highlights the transformation of healthcare services, emphasizing efficiency and improved patient outcomes through various nursing roles. The discussion covers continuity of care, the function of Accountable Care Organizations (ACOs), the role of nurses in medical homes, nurse-managed health clinics, community health nursing, and new nursing roles in both hospital and community settings. The essay also emphasizes patient-centered care, care coordination, and the impact of advanced practice nurses in reducing healthcare costs, referencing key studies to support its points. The essay concludes that nurses are integral to coordinate and deliver quality care meeting all potential needs of patients in all settings.

Change in Nursing Practice

Emerging nursing roles
• Transformation of health care services in United States occur
due to demographic changes and new emerging diseases,
increasing medical costs and patient dissatisfaction
• Health care delivery in US aims to improve efficiency of care
providers to improve patient outcomes
• Nursing practice evolves in various ways to provide efficient
and quality health care to improve health status on a
population scale

Continuity of care
• It is a procedure to provide quality care to the patients
• Patients and their families are involved by nurses in the care delivery
process
• Nurses act as patient advocate to identify potential patient needs
• Nurses communicate with the health care team and ensure that
patients’ needs are met properly

Accountable Care Organisations (ACO)
• A group of health care professionals working in collaboration to
manage patient health across clinical settings
• ACO concept relies on prevention of medication errors and
complications, duplication of services, reduction of medical costs
• In United States, health care payments are tied through care models
where nurses play a collaborative role to ensure proper access to
health services among patients
• Nurses form an integral member in health care team to coordinate
and deliver quality care meeting all potential needs of patients in all
settings (Scholl et al., 2014)

Nurses in medical homes
• Nursing practice evolves to promote patient-centred care in medical
homes
• Nurses have expertise in providing health education; practice-based
management of care is required to provide coordinated care to
patients in transitional settings (Oliver et al., 2014)
• Nurses assist physicians in transitional care settings
• In US health care system nurses involve patients and their families in
decision making process about their care plan.

Nurse-managed health clinics
• Nurse-led clinics provide health services in underserved areas
• Nurses intervene and provide comprehensive health care to patients
• Health services include health promotion, disease prevention, health disparity
reduction, preventive care therapy (Pittman & Forrest, 2015)
• Nurses provide care under minimal costs or even free treatments

Nursing in community health
• Nurses involve in evidence based care approach to provide quality care in
communities
• Nurses perform theoretical approach and develop research based care plan to
promote wellness
• Community nurses attend to the cultural and socioeconomic needs of community,
thereby adjusting care program for community individuals

New nursing roles in hospital settings
• US health care system focusses on care coordination and navigation of nurses within
multiple health sectors
• Patient education on their illness and management of care
• Focusses on patient safety through educating and assisting health care practitioners
(Oliver et al., 2014)
• In US, nurses perform as boundary spanners to manage patient care in transitional
settings

New nursing roles in medical homes
• Nurses perform patient centred care in medical homes through expanding their nursing
skills and abilities
• Various care models are implemented by nurses to promote patient centred care
• In US, nurse-led intervention approach considers primary care models, transitional care
models to improve health condition
• Advanced practice nurses are integral to perform care model-based nursing practice,
thereby reducing health services and health costs (Auerbach et al., 2013)

New nursing roles in nurse-led clinics
• Nurses evolve to educate patients and provide plan of care management
• Nurses reach to undeserved and poor patients in remote region
• Nurses involve in self-designed care models to provide quality care, which reduces
health care costs for poor patients in US health care system (Auerbach et al., 2013)

References
Auerbach, D. I., Chen, P. G., Friedberg, M. W., Reid, R., Lau, C., Buerhaus, P. I., & Mehrotra, A. (2013). Nurse-
managed health centers and patient-centered medical homes could mitigate expected primary care physician
shortage. Health Affairs, 32(11), 1933-1941.
Oliver, G. M., Pennington, L., Revelle, S., & Rantz, M. (2014). Impact of nurse practitioners on health outcomes of
Medicare and Medicaid patients. Nursing Outlook, 62(6), 440-447.
Pittman, P., & Forrest, E. (2015). The changing roles of registered nurses in Pioneer Accountable Care
Organizations. Nursing outlook, 63(5), 554-565.
Scholl, I., Zill, J. M., Härter, M., & Dirmaier, J. (2014). An integrative model of patient-centeredness–a systematic
review and concept analysis. PloS one, 9(9), e107828.