NRS 440 TOPIC 1 DQ 2  

Sample Answer for NRS 440 TOPIC 1 DQ 2   Included After Question

Topic 1 DQ 2 

Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place. 

A Sample Answer For the Assignment: NRS 440 TOPIC 1 DQ 2  

Title: NRS 440 TOPIC 1 DQ 2  

The Centers for Medicare and Medicaid Services (CMS) have shifted from traditional fee for service into value base purchasing with the enactment of Affordable Care Act (ACA) (Walker et al., 2022). Healthcare providers (hospitals, nursing homes, and home health agencies) are now part of this value-based purchasing contract where patients admitted should be kept out of the hospital for at least thirty days for them to get reimbursement. If a patient gets readmitted for the same reason, especially with CHF diagnosis, the provider will not be paid for the patient’s readmission. Nurses play a huge role in keeping the patients out of the hospital. In the homehealth setting, nurses can provide education and health promotions such as medication compliance and front-loading visits to ensure the patient is closely monitored within the next two weeks of admission and ensure remains within baseline and out of the hospital. 

Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2022). The effect of the Affordable Care Act on Medicaid payments in long-term care facilities. International Journal of Healthcare Management, 15(1), 62–69. 

A Sample Answer 2 For the Assignment: NRS 440 TOPIC 1 DQ 2  

Title: NRS 440 TOPIC 1 DQ 2  

Healthcare reform is often associated with the affordable care act(ACA). Although ACA may top the list of healthcare reforms, the list is much more extensive. Quality of care, health care cost, re-engineering insurance options, innovative technological advances, pharmaceutical cost, and improved approaches to treatment and overall healthcare sustainability.  

 Access to healthcare for every one is of the most critical reform that must be conquered. Until everyone can receive adequate, fair, care and disparities are minimized, will healthcare equity be obtained(Shi & Stevens, 2021). Healthcare cost is one of the largest expenditures of the GDP. Though cost has continued to increase year after, there are signs that the technology and medical advancements have improved. The question asked is just how much more will it cost? The cost has to be contained. It’s not the amount spent, but are we getting the worth of our spending? Quality of care must improve by investing in research that proves to be evidence-based in practice will allow health care providers to make better choices and practice with confidence and continuity. 

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 How does nursing fit into this puzzle? Nurses are the largest percentage of the workforce providing care. The government must invest in the profession and science of nursing. Nurses must be allowed to practice to the full extent of their knowledge and training. Advanced nurse practitioners are filling the shortage of physicians and should be allowed to practice with full autonomy and with the same respect as physicians including equal pay for the same care that is being provided according to the scope of practice(Brom, Salsberry & Graham, 2018). 

 As for the professional baccalaureate-prepared nurse, care has been reformed from an illness to wellness continuum to a continuum of wellness to preventing illness and prevent further deterioration of the health status. How is this accomplished? Through the promotions of healthcare that address the three levels of prevention( primary, secondary, and tertiary). The primary focus is on preventing disease, the secondary focus is on screening and diagnosing, and the tertiary focus is on stabilizing and preventing further deterioration of the health status(Kisling & Das, 2021). 


 Brom, H. M., Salsberry, P. J

NRS 440 TOPIC 1 DQ 2
NRS 440 TOPIC 1 DQ 2

A Sample Answer 3 For the Assignment: NRS 440 TOPIC 1 DQ 2  

Title: NRS 440 TOPIC 1 DQ 2  

How has health care reform contributed to making health care more about wellness and prevention as opposed to treating disease? The Affordable Care Act (ACA) mandates that patients pay nothing out of pocket for preventive care that their doctors recommend. Preventive interventions backed by scientific evidence have been found to save health care costs and enhance patient outcomes. It can save a lot of money if illnesses are caught early, managed well, and treated before they progress to more serious, life-threatening stages, which is what some programs are designed to do. However, for other people, the price of preventative care is a barrier to access. Payment for primary care prevention, care coordination, and care management is triggered by office visits and procedures for patients with established conditions (Salmond, Echevarria, & Mercedes, 2017).

Poverty, homelessness, food insecurity, violence, and a dearth of education are all factors that negatively affect people’s health in our area. All healthcare delivery systems suffer from these problems, and it shows in people’s poor health. Ninety percent of the variance in population health is attributable to factors in the surrounding environment. We can’t expect the communities we’re caring for to be in the state of health we envision for them unless we actively participate in improving their lives. What if we approached stress management, weight control, smoking cessation, and addiction treatment with a fresh perspective? Communities will be healthier if we can provide information on which treatments and supplements are most effective.

“Nurses are in a prime position to shape the future of healthcare and make significant contributions to the ongoing transformations in the industry. Nurses who want to play a significant role in creating these shifts should familiarize themselves with the forces pushing for change, the requirements for implementing shifts in practice, and the requisite abilities (knowledge, skills, and attitudes) for both individual and systemic success  ( Salmond, Echevarria, & Mercedes, 2017). 

According to the IOM, the current health care system could most benefit from the efforts of its around 3 million registered nurses. The Institute of Medicine agreed that nurses are the backbone of the American healthcare system. The ACA promotes multidisciplinary teams in the medical field, and nurses may play a key role in ensuring that all patients receive the highest quality treatment possible according to Whitney (2018). 


Salmond, Susan W.; Echevarria, Mercedes (2017) Healthcare transformation and changing roles for nursing, orthopedic nursing: Volume 36 – Issue 1 – p 12-25 doi: 10.1097/NOR.0000000000000308 

Whitney, S. (2018) The future of nursing in an evolving health care system. 

A Sample Answer 4 For the Assignment: NRS 440 TOPIC 1 DQ 2  

Title: NRS 440 TOPIC 1 DQ 2  

The health care reform plays important role in shifting the focus from a diseases-oriented health care system to one of wellness and prevention by striving to prevent the diseases before the outbreak and to ensure that all United States citizens are healthy and fit (Salmond & Echevarria, 2017). The health of the people is imperative in ensuring productivity and innovativeness for the benefit of the future of the nation. The Affordable Care Act and Patient Protection Act formulated the National Prevention Strategy to help in transforming the health care system by ensuring it shifts focus to prevention and health. This shift to disease prevention and ensuring wellness of citizens is essential in saving and improving lives and also reducing health care costs.  

The health care will continue this trend of adopting the idea and ensuring that it is implemented in the health care organizations. On the other hand, nurses can play significant role in supporting and facilitating this shift (Salmond & Echevarria, 2017). One of the nursing roles includes provision of patient education and supporting of the wellness and preventive health care. Since health care system is increasingly shifting to evidence-based practice (EBP), nurses will base their education on EBP recommendations to educate and inspire patients to get preventive services. Moreover, public health nurses can support and facilitate this shift by educating the mass and inspiring them to get involved in healthy lifestyles to lead healthy and long lives. In their effort to support and facilitate this shift, nurses can randomly apply the three types of prevention strategies depending on the circumstances and working environment. The three types of prevention include primary, secondary, and tertiary prevention.  


Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12. doi: 10.1097/NOR.0000000000000308 

A Sample Answer 5 For the Assignment: NRS 440 TOPIC 1 DQ 2  

Title: NRS 440 TOPIC 1 DQ 2  

The Affordable Care Act (ACA) impacts all professionals working in health care, including public health professionals, health care administrators, and nurses (Salmond & Mercedes,2017). It has further shifted the health care system focus from financially rewarding high-cost medical care to one where promoting health and preventing disease results in financial gain. Public health professionals have always had the goal of helping the community stay well, but the ACA moves this goal to the policy forefront (Levine,2019). Public health professionals are called upon to lead initiatives that remove barriers to screenings and early disease detection and promote health-related behaviors such as physical activity and good nutrition. To be effective in this new age of healthcare, healthcare administrators must be visionary. Levine (2019) adds that leaders need to understand how the radical shift in health policy impacts available resources and the need to rethink strategic direction. Administrators need to explore ways to reduce healthcare costs while improving quality and operational efficiency. For example, the need to share financial risk and drive better outcomes across the spectrum of healthcare services means administrators must partner, collaborate and negotiate with each other (Levine,2019). The ACA is creating new opportunities for nurses, including in care management and as advanced practice primary care providers. In addition, nurses are being employed in large numbers by payers such as insurance companies to help reduce costs and increase quality outcomes.


Levine S., Malone E., Lekiachvili A., Briss P. (2019). Health Care Industry Insights: Why the use of preventive services is still low. Preventing Chronic Disease. Retrieved from

Salmond S. & Mercedes E. (2017). Healthcare Transforming and changing roles for nursing. Orthopedic Nursing.