Please also respond to the peers discussion APA with referenceDQ4After reviewing the “Nursing and Health Reform” document I have noticed at least two standouts that have impacted me in some way whether it be indirect or directly. These two provisions being: Section 5202 Nursing student loan program—Updates the loan amounts for the Nursing Student Loan program and after 2012 the Secretary (of the Department of Health and Human Services) has discretion to adjust this amount based on cost of attendance increases. Section 5302 Training opportunities for direct care workers—Establishes a 3-year grant program under which an institution of higher education can subsidize training of individuals at that institution who are willing to serve as direct care workers in a long-term or chronic care setting for at least two years after completion of their training. Both provisions have played a roll in how my place of employment has changed some of it’s business strategies. Now with that said first and foremost I am a new graduate nurse, have not been working for longer than a month, and I truly still have no idea how the PPACA works of influences healthcare corporations such as Banner Health. What I can say that since the passing of this bill with it’s provisions I have just noticed a couple changes within Banner. When it comes to the first provision Section 5202. Banner Health has changed their school loan policies. Now to enroll it is a first come first serve waiting basis and it is dependent upon how many classes you are taking. Before at Banner you could just apply and receive aide I believe their may have been stipulations before but now everyone gets access but not everyone who applies will receive it. The second provision I mentioned Section 5302 I believe is a great way to help new graduates become employed however, I know Banner Health no longer does these contracts. At least not at my facility. Now Banner has a whole new program one that is aimed at retention and still allows new nurses to receive training. I believe the issue with this provision that led to Banner changing their methods was this could lead to nurse burn out. While yes there is a contract to work for two years. These nurses may not have truly like their place of employment and by the time their two years were up they were just done with the nursing profession. Thus, I believe this is what lead Banner Health to create a new hire program that is aimed at helping train and retain nursing staff. I feel as thought the PPACA has done a lot of good and has many provisions that I believe can help many. However, I believe there is a lot of wiggle room for corporations to continue to do what they want to either meet the provisions or amend them and make them better. Reference: https://c.ymcdn.com/sites/www.wocn.org/resource/re...DQ5The Affordable Care Act affects the field of nursing in various ways as it includes a number of ambitious reforms that are based on the employer-sponsored insurance system and establishes new requirements for employers, healthcare providers, insurance companies as well as the individual patients. It is anticipated to address three key areas of access to health insurance, delivery of care and healthcare costs. According to Blumenthal, Abrams, and Nuzum (2015), the introduction and adoption of the Patient Protection and Affordable Care Act was aimed at increasing access to nurses, improving the nursing workforce, providing financial assistance to health institution workers and education advancements and the underserved areas. Among the provisions, increasing the number of nurses within healthcare is a key provision which has had grant programs established for the health institutions as well as the training programs to address the various health care concerns. The grant health organizations and the training programs for physicians focus on providing personalized training to the nurses in order to enhance the delivery of health care to patients. Further, to ensure that the number of nurses is sufficient, the federal loans have been increased whose target is the nursing students to aid them manage the education costs and successfully complete their nursing course without financial constraints. Another key provision is the expansion of public programs in that the ACA provides for the extension of Medicaid to all individuals with incomes that go up to 138% of the federal poverty-level as dictated by the regulated gross income (Frean, Gruber, & Sommers, 2017). This expansion establishes a new minimum Medicaid eligibility-criteria level for adults and gets rid of the program’s limitation that prohibits adults without dependent children from registering in the program. These provisions impact the nursing practice in a positive approach in that it enables for nurses to advance their education which subsequently results to decreased mortality rates and enhanced quality of care delivery. References Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years. Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of Health Economics, 53, 72-86.DQ6With the passage of the patient protection and affordable care act (PPACA) in 2010 by president Obama, a lot of transformation have been initiated into the healthcare system. The transformation brought by this new law will have an impact on providers, consumers, insurers, payment policy etc. The affordable care act created an influx of patients who where previously uninsured into the healthcare. The boom in patient activity has left many hospitals short staffed, forcing longer wait times for patients in need of care – a potentially dangerous problem, especially in the emergency departments where time is of essence.With the estimated 30 million Americans that are expected to gain health insurance through the affordable care act (Anderson, 2014), there will be an imbalance between demand and supply. Bradley university (2016) estimated the supply and demand of physicians to patients around 46,100 to 90,400. With the increase demand of physicians and an already existing workforce shortage within the nursing community, the policy makers recognized the need for an increased workforce. This led to the development of provisions aimed at increasing the number of nurses in few years. According the article “Nursing and Health Reform”, Some of the provisions that have impacted or will impact my nursing practice are sections 5404 – student workforce diversity grant and 5310 – Loan repayment and scholarship program. SECTION 5404 – STUDENT WORKFORCE DIVERSITY GRANT: This section approves the award of grant to eligible entities to meet the costs of special projects to increase nursing education opportunities for individuals who are from disadvantaged background by providing student scholarship or stipends; stipends for diploma or associate degree nurses to enter a bridge or degree completion program. This provision has impacted my nursing practice as I have received some grants for this RN-BSN program. SECTION 5310 – LOAN REPAYMENT AND SCHOLARSHIP PROGRAM: This program offers registered nurses substantial assistance to repay educational loans in exchange for services in eligible facilities located in areas experiencing a shortage of nurses. Through this program, 60% of the participant’s total qualifying loan balance are paid for in two years and additional 25% of the original balance for an optional third year (Benefits.gov, 2017). It helps in recruitment and retention of professional nurses that are dedicated to providing healthcare to underserved populations. This provision will impact my nursing practice in the future.Anderson, A. (2014). The Impact of the Affordable Care Act on the Health Care Workforce. Retrieved from https://www.heritage.orgBenefit.gov (2017). Nursing Education Loan Repayment Program. Retrieved from https://www.benefits.govBradley University (2016). How the Affordable Care Act Affected Nursing retrieved from https://www.onlinedegrees.bradley.eduWound Ostomy and Incontinence Nurses Society. (2013). Nursing and Health Reform. Retrieved from https://c.ymcdn.com/sites/www.wocn.org/resource/re...

Overview Your Clinical Practice Project required you to become a change agent. You selected a problem that was professionally or personally important to you, researched the problem, and developed a plan of action that included strategies for success, stakeholders and resources by linking a QSEN competency. Now it is time to put it all together.  You may use the information from your weeks 1-3 templates - but do not just copy and paste - synthesize all of your information. For this assignment you will write a minimum of a 4-5 page paper (no more than 5 pages, not including the title page, abstract, or reference page) connecting all of your links. Your paper should be in strict APA format including citations and references, and an abstract is required for this paper. You may use first person, but limited use. The Second Solution: The paper includes a discussion of a hypothetical second solution, implementation, and evaluation. (numbers 5 and 6 above).  A good nurse always has a back-up plan - or what are your next steps now that you implemented your CPP. This is where your second solution comes into play. Also, are there stakeholders or resources that might be available if there were a different solution? Is there a short term solution and a long term solution? Do you need to adjust your plan due to time or money constraints? Objectives This assessment is aligned with the the course objectives. Extend academic experience into areas of nursing practice interest, working with new ideas, issues, organizations, and individuals. Demonstrate the ability to think and act critically and creatively about nursing practice issues. Develop analytical and ethical leadership skills necessary to address and help solve these issues. Utilize evidence based research and demonstrate proficiency in written and communication skills. Clinical Practice Project Final Paper- Must be submitted via the Safe Assign link. Must be in APA format. You must use page headers and section headings as part of an APA paper: **Use the rubric for your headings and important assignment content: Abstract-format per APA - please note, the abstract is on a separate page and not indented. An abstract is a self-contained, short, and powerful statement that describes a larger work. Components vary according to discipline. An abstract of a social science or scientific work may contain the scope, purpose, results, and contents of the work. Paper title-use the title of your paper for your introduction heading The Problem-frame the problem; discuss the scope, duration, and history with supporting evidence Supportive Organization-the organization you selected that supports your project Second Solution-your back-up plan. What if you could not implement the solution you chose? How else could you address the problem? You are not expected to have actually done this, just describe how it might be Implementation-implementing and evaluating your second solution (the plan of how you would implement and evaluate) Overall Project Evaluation- this overall evaluation should briefly describe the implementation of your actual project. Were there any barriers? Surprises? Include what the overall experience of the project was like; how did you learn and grow, has your professional practice been impacted by this experience, will you use this experience as a change agent moving forward? Include examples of your statements. Preceptor Experience-explain your work together Conclusion-the conclusion should provide a brief synopsis of the paper, but does not require a heading *Please note-APA points will be deducted for missing headings.

Please see attached Case study, Will upload additional information per assignment. Please let me know if you have any question. Thank you