NSG 4029 Week 3 Project

People diagnosed with SUD are 2.2 times more likely to be hospitalized than those without substance abuse. In particular, there is an increase in the use of acute medical care and, accordingly, high healthcare costs in the years before and after an overdose. In addition, SUD can lead to an indirect burden on the health care system because of the long-term effects of substance use. (Jessica & Rosa, 2020) IV drug use could lead to endocarditis, an ongoing issue in our hospitals because these patients require 6 weeks of IV antibiotics and long-term IV access. Most of these patients do not have health insurance, which costs the hospital in write-offs and taxpayers’ money.

Analysis of the Role of the Nurse Leader

 This issue of patient care significantly impacts the budget as a matter of managing finances in the department. The patient is stuck in the hospital at a high cost and may or may not be stable enough to be transferred to a lower level of care. This leads to a significant financial burden on the hospital and falls onto the shoulders of the nurse leader. The nurse leader’s role is to keep things within budget; one of those items is patients’ length of stay. A patient without insurance is on 6 weeks of IV antibiotics and cannot be transferred due to the risk of possibly shooting drugs into their IV access or going septic. Sometimes, hospital floors such as med surg, for instance, may have multiple IVDAs taking up space, leaving no room for insured patients needing a bed. Hospitals may need to reevaluate their budget to account for the additional costs associated with these patients. Hospitals may also need to find a way to cover the cost of caring for an uninsured patient who requires a lengthy hospital stay. One possible solution that the nurse leader has to face may be to consider whether a patient’s condition affects the hospital’s ability to care for other patients and whether the hospital can afford to have that patient’s condition affect other patients. Nursing leaders make decisions to move patients who may be independent to lower acuity floors. However, that also depends on whether those other floors have adequate staffing to care for those patients. Every nurse manager’s job is to assure fiscal accountability for their unit or department. Every nurse should manage their department as if it were their own business, regardless of whether they work in a not-for-profit or for-profit health system. (Rundio, 2023)

Regulatory Agencies and Policies

The bodies that regulate hospitals and hospital stays are Medicare and Medicaid and the Joint Commission, which has policies and procedures to follow. Hospitals also have guidelines for the length of patient stays and treatment of patients with SUD. Our facilities treat the patient with respect and dignity, not with a stigma. It is hard not to be prejudiced or biased towards these patients, but with better education and research on withdrawal and addiction, I hope to gravitate away from the stigma. Our facilities have a policy that if we suspect a patient is using inside the hospital, we can have a 2-person check. This involves two people, security and a nurse leader, going through the patient’s belongings to ensure that the patient isn’t using or possessing illicit drugs while inpatient. This protects the patients as well as the staff and other patients as well. If we give medications to keep them from having withdrawal, and they are taking other drugs, it could result in serious harm or even death.