Pay for performance (P4P) has been introduced in several health care systems. P4P is a model that offers financial incentives to health professionals and medical groups to meet specific performance measures(Kyeremanteng et al., 2019). This compensation approach is performance-based and aims at improving the delivery and quality of health services to patients. Failing to meet a particular result implies that a health practitioner does not receive the incentives associated with meeting the set target. Some penalty-based P4P incentivesprovide financial penalties to hospitals when medical complications arise following failure to institute the appropriate preventative measures(Kyeremanteng et al., 2019). The P4P model motivates nurses, physicians, and other health care professionals to offer high-quality services to their clients to meet specific performance criteria to receive the tied financial benefits. However, Kyeremanteng et al. (2019) observe there is a risk for poor patient outcomes associated with this model when it encourages patient dumping. This means that health professionals may concentrate more on patients with less complex health issues and with a higher likelihood of faster recovery while relegating patients with complex health issues to the periphery. This would lead to poor health outcomes for the neglected patients as they would lack timely and sufficient medical attention and services.
When such situations confront a nurse, they should apply the ethical principles in their practice. These include non-maleficence (to not harm), beneficence (to do good), justice, and autonomy (Varkey, 2020). The nurse should also encourage other health professionals and practitioners of the Hippocratic Oath, which binds them to the duty of saving patient lives. By adhering to the ethical principles, nurses would give all patients the necessary medical attention they require, irrespective of the complexity of their situations, and not based solely on motivation to attain specific set performance standards to achieve the financial incentives tied to them.
Professional Nursing Leadership and Management Roles
The emerging trends and diverse health care needs of the population have necessitated nursing roles to continue arising and evolving to continue responding to the trends. One of the emerging roles is the use of nursing informatics and technology in nursing. In health care settings, the use of technology has become ubiquitous. This has increasingly necessitated nurses to equip themselves with the knowledge and skills in technological advancements. For instance, the use of surgical robots in surgeries is a trend observed in some advanced health care settings. For the nurses to have fulfilling experiences and roles in such operations, they must be conversant with the use and operation of such robots.
Another advancement in technology is the use of bedside alert systems which alert nurses when patients leave their beds unattended. The patients also use them to notify nurses that the former needs urgent attention. Therefore, these bedside alert systems improve timely medical interventions and reduce the incidence of falls. The nurse leaders and managers are responsible for ensuring their nursing staff are technologically well-informed as part of their nursing roles. Additionally, nurses must also be aware of using electrical medical records, which have revolutionized clinical documentation. They must use the EMRs appropriately and comply with the provisions and regulations of the HIPAA.
Emerging Trends
One of the emerging trends is the use of robots in surgeries. Robot-assisted surgeries have been driven by robotic proliferation, machine and AI learning growth, and the rollout of 5G connectivity.Medical practitioners must know how these robots are set up and recognize situations where they malfunction. Therefore, nurses will be required to learn how these robots work, how they affect nursing roles and duties, and how to respond in an emergency, which can be life-saving.
Another trend observed in the health care settings is the increased use of telemedicine. Hyder and Razzak (2020) define telemedicine as the use of information technology and telecommunications to provide health services in a situation where a considerable physical distance exists between patients and health providers. Telemedicine will continue to enhance the nurses’ roles as communicators, reaching out to clients upon request through different telehealth systems. Nurses should communicate timely with patients, within the shortest time possible, and use simple messages. Therefore, nurses will be required to enhance their knowledge and skills on technology and the use of various platforms to communicate with patients. It is vital that nurses appropriately use devices used in telemedicine to avoid mistakes that could have
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