History of Nursing for Emergency Medicine

History of Nursing for Emergency Medicine

Compose a scholarly paper (7th edition APA) that relates to one of the historical events presented in the History of Nursing PowerPoint that has influenced your personal, work or practice area. My personal work practice is emergency medicine if you could focus on events that has affected emergency medicine. The body of the paper should not be more than three (3) pages. See the grading rubric for details to successfully complete this assignment.History of Nursing for Emergency Medicine

Historical Events presented in the History of Nursing for emergency medicine


Nurses have an ethical obligation of taking part in efforts aimed at improving health and delivery of healthcare.  More importantly, nurses have been called upon to take key leadership roles in the reform of delivery of healthcare, entailing numerous components of the  Patient Protection and Affordable Care Act(PPACA). PPACA was signed into law in March 2010. The law was designed to reduce healthcare costs, increase  Americans’ access to care and elevate care quality. The paper discusses the ACA as a historical event in nursing ad healthcare finance.

A description of a historical event in nursing and healthcare finance

The  PPACA, commonly known as the Affordable Care Act (ACA) ACA or Obamacare is the most influential health care reform legislation enacted in the US since Medicaid and Medicare were created in  mid-1960. The law implemented reforms intended to improve the quality, affordability, and accessibility of health care.   According to French et al. (2016), on March 23, 2010, after a contentious and lengthy political and legislative process, President Obama signed the PPACA into law ushering in the most important reforms to the country’s health care system since the passage of Medicaid and Medicare in 1965.  The law was designed to address three major areas; health care costs, delivery of care, and access to health insurance.


The cost of health care affects the federal budget, the economy, and the financial wellbeing of almost every American family. Health insurance enables. Expanding coverage and ultimately increasing access to care is one of the major objectives of the ACA. According to French et al. (2016) have several strategies targeting different populations and increasing overall health insurance coverage. Under ACA’s dependent coverage provision, young adults are being covered by the insurance plans of their parents as dependents until they are twenty- six years. Larger employers are mandated to provide affordable, comprehensive insurance to employees who work on a full-time basis. People without employer-sponsored insurance are mandated to individually purchase insurance or be penalized.  Small businesses and these individuals can buy insurance plans via the federal marketplace or state Marketplace.  To help low-income earners, the ACA expands eligibility for Medicaid to the non-elderly (individual below 65 years) with a yearly income of up to 133% of the federal poverty level (FPL) but some states have not agreed to take part in Medicaid expansion. These expansions intend to expand insurance coverage and also make insurance plans more affordable.

How the event relates to my practice area (Emergency Medicine)

Emergency medicine is a specialty area concerned with the care of injuries or illnesses that require urgent treatment.  The emergency department has for a long time acted as a safety net for people without insurance along with people with limited access to routine healthcare. According to Probst et al.(2019 In the latest years, emergency department crowding has gotten worse as patients who are not able to access primary care on time primary care have utilized the emergency department for non-emergency care. Inappropriate  utilization of the emergency department can lead to needless procedures, testing, and admissions, which might contribute to escalating healthcare costs. The ACA aimed at improving people’s access to providers of primary care for non-emergency cases through the provision of expanded options for insurance coverage.History of Nursing for Emergency Medicine

Barakat et al. (2017) emphasize before Medicaid was fully expanded, yearly emergency department rates of visits in the US were rising at a faster rate partly due to a  rising fraction of patients without health insurance. One objective of the ACA was to enhance improved access to primary care through insurance coverage. Providing  Medicaid coverage to individuals without insurance was a significant part of the plan. The ACA insurance expansions were intended to augment access to care and possibly lessen hospital costs connected with undiagnosed and unattended health care problems that are usually lead to visits to the emergency department. Through an increase of access to primary care, it was expected that ACA insurance expansion, may lessen ambulatory care utilization.

How the outcome of the event has influenced my work

The ACA includes programs aiming to control healthcare costs and improve quality. Nurses are major players in healthcare delivery, nurses are in a unique position to contribute to and lead the transformative changes by fully partnering with other professionals as we move away from fee-for-service care to value-based care. According to Cleveland et al. (2019), the revolutionary ACA requires nurses to continue being transformational leaders, innovators, and care coordinators as key stakeholders in enhancing patient access, quality advances, and cost containment improvements.

The ACA supports new approaches such as value-based purchasing (VBP) and pays for performance(P4P)  IN P4P, health care providers are rewarded for attaining predetermined quality metrics. In VBP instead of providers being reimbursed for the number of tests, visits,  and procedures, reimbursement is made based on the value of care that is delivered- care that is patient-centered, equitable, effective, safe, efficient, and timely. According to Cleveland et al. (2019), for VBP to generate a reduction in healthcare cost, processes are essential to connect services, patients, and care coordination via the fragmented parts of healthcare. Nurses’ power is established as they use their disntictive position in the delivery system to measure, connect, and re-engineer processes within the system. Here, nurses take on leadership roles as informatics experts, care coordinators, and care managers by directing transformations in processes as well as evidence-based interventions essential to measure and report quality measures.


The ACA is a historic legislation that was signed into law in March 2010. The law was designed to address health care costs, delivery of care, and access to health insurance. The ACA is related to emergency medicine in that law aimed at improving access to providers of primary care for nom-emergent illnesses through the provision of expanded options for insurance coverage. The ACA compels nurses, including emergency department nurses to continue transformational leadership, innovation, and coordination of care as key stakeholders in enhancing patient access, quality advances, and cost containment improvements.History of Nursing for Emergency Medicine


Barakat, M. T., Mithal, A., Huang, R.J., Mithal, A., Sehgal, A., Banerjee, S., & Singh, G. (2027). Affordable Care Act and healthcare delivery: A comparison of California and Florida hospitals and emergency departments.  PLoS ONE 12(8):e0182346.https://doi.org/10.1371/journal.pone.0182346

Cleveland, K. A., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing the Power of Nurses. The Online Journal of Issues in Nursing, 24(2), Manuscript 2.

French, M. T.,   homer, J., Gumus, G., &  Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. Health Services Research, 51(5), 1735-1771. doi: 10.1111/1475-6773.12511

Probst B. D., Walls, L., Cirone, M., & Markossian, T. (2019). Examining the Effect of the Affordable Care Act on Two Illinois Emergency departments.  Western Journal of Emergency Medicine, 20(5), 710-716.  10.5811/westjem.2019.6.41943 History of Nursing for Emergency Medicine