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DNP- 840A Leadership For Advanced Nursing Practice

DNP- 840A Leadership For Advanced Nursing Practice

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DNP- 840A Leadership For Advanced Nursing Practice


Module 1


A healthcare delivery system comprises four main parts: finance, delivery, access to care, and quality of care.
The financing and quality of care features of a healthcare delivery system are two factors that could impact how my project site is carried out.

The financing component deals with how medical services are paid and includes funding sources like insurance, government programs, and out-of-pocket expenses (DeNisco, 2019).
This could affect how well my project site is run by making it harder to get the money and resources needed for tools, supplies, and people.
The project’s progress can be slowed down or stopped without adequate funding.

Another critical factor is the quality of care, because it directly affects how well the treatment works.
If patients get bad care, they might not get the best results, which could hurt how the project site is run.
This is a very important factor because it could affect patient satisfaction, which is an important part of providing healthcare (Stimpfel et al., 2019).

In conclusion, the elements of financing and care quality are crucial to the creation of a healthcare delivery system.
These factors must be appropriately assessed and managed to ensure the project’s successful completion.


S. DeNisco (2019).
The profession of advanced practice nursing requires a thorough understanding of this subject.
4th edn.
Learning from Jones & Bartlett.

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Common determinants of nurse-reported quality of care and patient safety, Stimpfel, A. et al. (2019), Health Care Management Review, 44(1), pp. 57-66.
DOI: 10.1097/hmr.0000000000000155 is a resource.


Understanding the organizational structure of a healthcare organization requires knowledge of an organizational chart.
My research will use this chart to understand better how individuals interact at different organizational levels.
This will help me figure out the important stakeholders, their roles and responsibilities, and how to work with people at different levels of the organization to get the project’s measurable patient results.

The success of a project can be severely impacted by bureaucracy since it can hinder communication between different organizational levels and slow down decision-making (Vohnsen, 2017).
I will keep lines of communication open with the right people and build partnerships based on trust and cooperation to lessen the impact of this and get around any administrative roadblocks that might come up.

Bureaucracy and organizational influence both have a significant impact on patient quality and safety results.
Strong organizational influence can lead to better practices, more resources, and better patient outcomes. On the other hand, bureaucracy can slow down the implementation of initiatives and cause delays.

To get patient results that can be checked, you must get through the bureaucracy and find the resources and help you need.
Contrarily, two benefits are

The project plan must be modified to account for changes in the project’s budget, scope, and timeframe.
To keep the project on track and reach its goals, monitoring these variables and making changes to the budget and schedule is vital.


S. DeNisco (2019).
The profession of advanced practice nursing requires a thorough understanding of this subject.
4th edn.
Learning from Jones & Bartlett.

Gruber, J.; Sommers, B. D. (2017).
State budgets were protected by federal financing from rising costs associated with Medicaid expansion. Health Affairs, 36(5), 938–944.

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DQ 3

PICOT: To examine how socioeconomic and political factors impact patient outcomes and the ability of healthcare providers to make a profit in low-income rural areas.

Low-income residents of rural areas were the demographic group selected for this study.
These people have trouble getting good care because they do not have enough money, the healthcare system is not perfect, and there are more people with long-term illnesses. (Balcazar & George, 2018)
These people frequently belong to racial and ethnic minority groups, are unemployed or work in low-paying jobs, and struggle with language barriers while attempting to access healthcare.
These social and economic factors greatly affect their health, making chronic diseases more common and lowering their life expectancy.

The financial stability of healthcare organizations in low-income rural areas and patient outcomes are substantially impacted by socioeconomic and political challenges.
insufficient access to

Balcazar and George (2018) say that not having access to healthcare services makes chronic diseases more common, hurts health, and shortens life expectancy.
When community healthcare centers try to give high-quality care to people who do not have much money, these factors also affect their ability to stay financially stable.

The American healthcare system tries to ensure that everyone has access to high-quality care, no matter how much money they have. However, this is only sometimes the case.
Addressing healthcare disparities and expanding access to high-quality healthcare services are essential to enhancing patient outcomes and ensuring the financial viability of healthcare facilities (Sommers & Gruber, 2017).


Balcazar, H., M. S., & George, S. (2018). Community health workers: Bringing a new era of
systems change to stimulate investments in health care for vulnerable US
populations. American Journal of Public Health, 108(6), 720-721.

Sommers, B. D., & Gruber, J. (2017). Federal funding insulated state budgets from increased
spending related to Medicaid expansion. Health Affairs, 36(5), 938-944.
Institute for Healthcare Improvement. (2018). Providing better care for less.

Module 3

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Barasa, E. W., Molyneux, S., English, M., & Cleary, S. (2015). Setting healthcare priorities
at the macro and meso levels: A framework for evaluation. International Journal of Health
Policy and Management, 4(11), 719-732. https//

Casselman, J., Onopa, N., & Khansa, L. (2017). Wearable healthcare: Lessons from the past
and a peek into the future. Telematics and Informatics, 34(7), 1011-

Mitchell, J. D., Haag, J. D., Klavetter, E., Beldo, R., Shah, N. D., Baumbach, L. J., Sobolik, G.
J., Rutten, L. J., & Stroebel, R. J. (2019). Development and implementation of a team-
based, Primary Care Delivery Model: Challenges and opportunities. Mayo Clinic
Proceedings, 94(7), 1298–1303. doi/10.1016/j.mayocp.2019.01.


The regulatory organizations that are mandated to offer oversight within the healthcare delivery
system in the United States include the following:

  1. Center for Medicaid and Medical Services: This is a federal agency that oversees and
    regulates the Medicare and Medicaid programs in the United States.
  2. The Joint Commission: Accreditation and certification for healthcare facilities in the
    The nonprofit Joint Commission handles United States. The organization is a non-
    profit entity.

Somalia is an example of a country where there is no government body responsible for
monitoring the quality of medical treatment provided to its citizens (Devi, 2015). There is a
severe lack of both medical facilities and trained medical personnel in Somalia. Due to this,
patients may receive inferior care and be put in danger.

Regulatory bodies exert considerable sway over DPI projects and patient outcomes by establishing norms and criteria for healthcare delivery and enforcing compliance with those

norms and guidelines. If a healthcare provider or facility is found to be in violation of CMS rules, the agency
may issue a fine. Trust in the quality of healthcare can be boosted when The Joint Commission has awarded a facility accreditation. Improvements to both the DPI project and
patient results are possible with strict adherence to the requirements of the relevant regulatory
bodies (Baker & Berman, 2017).


Baker, D. W., & Berman, S. (2017). Continuity and change at the Joint Commission Journal on
Quality and Patient Safety. The Joint Commission Journal on Quality and Patient Safety,
43 (1), 1–2. doi/10.1016/j.jcjq.2016.11.

Devi, S. (2015). Slowly and steadily, Somaliland builds its health system. The Lancet,
385 (9983), 2139–2140. doi/10.1016/s0140-6736 (15)61009-
Module 4


Two bills or laws that influence nursing practice are:

Federal level: Obamacare, or the Affordable Care Act: This legislation from 2010 has had wide-
ranging effects on the healthcare system, including the work of nurses. The Affordable Care Act
was created to expand medical coverage and enhance medical services (Cleveland et al., 2019).
In addition, it instituted a number of initiatives to encourage the implementation of technological
solutions in healthcare provision and the adoption of electronic health records (EHRs).

Indicators such as patient satisfaction and readmission rates from hospitals to encourage
improvement in these areas (Cleveland et al., 2019). As a result of the ACA’s focus on quality,
safety, experience, and financial indicators, healthcare organizations are held to higher standards
and given financial incentives to continually enhance the quality of care they provide to their

The ACA also aligns with experience metrics, such as patient satisfaction and experience. The
ACA requires hospitals to report on patient experience measures, such as the Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) survey, and it provides incentives
for improving patient experience.

As a doctorally-prepared nurse, I am in a unique position to influence change within the ACA by
pushing for evidence-based policies and practices that boost patient outcomes and promote the
use of technology to streamline and enhance care. New, more efficient, and patient-centered
models of treatment can be developed with my help through research and quality improvement
programs in which I can take part.


Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of Nurses.
OJIN: The Online Journal of Issues in Nursing, 24 (2).

DNP- 840A Leadership For Advanced Nursing Practice

Module 5


Prior authorization is one policy or law at the state and federal levels that impedes health care delivery. During the prior authorization process, a healthcare provider contacts the patient’s
insurance company to gain permission to offer a specific service or procedure (Huot et al., 2019).
The time and effort required for this procedure might delay treatment, lowering both the quality
and availability of care. To overcome this hurdle, I propose reforms to policy or legislation that
would expedite the prior authorization procedure while reducing its negative effects on patient
care. Providers and payers could work together more effectively if steps were taken to streamline
the process of obtaining approval for medical services and procedures. Patients would benefit
from increased access to care and fewer wait times as a result of these reforms. This would lead
to higher standards of care, better outcomes for patients, and greater satisfaction on the part of
those receiving treatment. On the other side, these alterations may lead to higher healthcare
expenditures for patients, their insurers, and healthcare providers (Huot et al., 2019).
I believe modifications to prior authorization regulations should be complemented by
steps to enhance the efficacy and cost-effectiveness of the healthcare delivery system to lessen
the severity of these negative effects. This may involve a variety of measures, including as
advocating for the uptake of telehealth services, enhancing care coordination, and recommending
the implementation of evidence-based procedures.


Huot, S., Ho, H., Ko, A., Lam, S., Tactay, P., MacLachlan, J., & Raanaas, R. K. (2019).
Identifying barriers to healthcare delivery and access in the circumpolar north: Important
insights for health professionals. International Journal of Circumpolar Health, 78 (1),


TOPIC: Patient Care Delivery

Assessment Description

Sometimes, the doctorally prepared advanced practice nurse must suggest a change in patient care delivery. It will be important for the doctorally prepared advanced practice nurse to understand how to deliver information and what information should be shared with an audience.

This assignment will give you practice with presentation software and prepare you to provide specific information for your proposed changes. This two-part assignment will also give you practice in presenting to administrators.

General Requirements:

Use the following information to ensure successful completion of the assignment.

  • Doctoral learners are required to use APA style for their writing assignments.
  • This assignment requires at least two scholarly research sources related to this topic and at least one in-text citation from each source.
  • You are not required to submit this assignment to LopesWrite for similarity scores.


Part 1:

Create a 12-15 slide presentation (PowerPoint or voice-over; Prezi, include voice-over) that presents a proposed change in patient care delivery related to your DPI Project. The presentation must demonstrate finance, quality, patient safety, and patient experience considerations.

If you are completing a PowerPoint presentation: The speaker notes must contain a detailed script of your presentation, as if you were verbally presenting. The speaker notes must include embedded citations supporting your presentation.

If you complete a Prezi, Citations supporting your presentation must be embedded.

Include the following:

  • Background of issue
  • SWOT analysis
  • The proposed solution
  • How the solution meets the need of the population (stakeholders, cost, and payer to proposed change)
  • Proposed change process
  • Expected outcomes
  • Implications that are realistic and aligned with current and future health care financing

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Part 2:

  1. Present your presentation to at least one administrator. Inform the administrator on the purpose of the assignment and that you will seek feedback on content and delivery. This is an      opportunity to practice presenting to the executive team.
  2. Write a brief summary (100-250 words) of the feedback given to you by the administrator(s).


Read Chapters 8, 9 and 11 in Advanced Practice Nursing: Essential Knowledge for the Profession.

Robbins, K. C. (2020). The year of the nurse: Nurse-led initiatives. Nephrology Nursing Journal, 47(2), 167-171. https//

Barasa, E. W., Molyneux, S., English, M., & Cleary, S. (2015). Setting healthcare priorities at the macro and meso levels: A framework for evaluation. International Journal of Health Policy and Management, 4(11), 719-732. https//

Mitchell, J. D., Haag, J. D., Klavetter, E., Beldo, R., Shah, N. D., Baumbach, L. J., Sobolik, G. J., Rutten, L. J., & Stroebel, R. J. (2019). Development and implementation of a team-based, primary care delivery model: Challenges and opportunities. Mayo Clinic Proceedings, 94(7), 1298-1303). https//

Casselman, J., Onopa, N., & Khansa, L. (2017). Wearable healthcare: Lessons from the past and a peek into the future. Telematics and Informatics, 34(7), 1011-1023. https//

Center for Community Health and Development/University of Kansas. (n.d.). Chapter 3 – Section 14. SWOT analysis: Strengths, weaknesses, opportunities, and threats. Community Tool Box.

Lim, R. (2021, June 22). Drive Better Decision Making with SWOT Analysis. Project Management.

Aloqail, A., & Dahanayake, A. (2015). A framework for quality improvement in healthcare information systems. International Journal of Computer Science and Electronics Engineering 3(2), 166-172.

View: Institute for Healthcare Improvement. (2016, October 7). IHI quality improvement games: The red bead experiment [Video]. YouTube.

Institute for Healthcare Improvement. (2017, August 24). Seven challenges facing today’s health care leaders [Video]. YouTube.



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