Assignment 7063 1 2 The Advanced Nursing Professional As Policy Advocate
Assignment 7063 1 2 The Advanced Nursing Professional As Policy Advocate
Assignment 7063 1 2 The Advanced Nursing Professional As Policy Advocate
Milstead and Short (2019) share that boards of nursing write rules with criteria that applicants must meet to be eligible to sit for licensure examinations and for issuing licenses.“ Applicants for licensure must pass an initial licensing examination, then comply with continuing education requirements or undergo competency assessment by the regulatory body that provides oversight for that profession (Milstead & Short, 2019).
The College of Nurses of Ontario (CNO) is the regulatory board of nursing in the province I live, that provides licensure and establishes education requirements for Advanced Practice Registered Nurses (APRN). APRN’s bring a holistic as well as patient-centered and family-centered approaches to the prevention and management of complex health and behavioral issues addressed in various care settings across the life span (Bosse et al., 2017).
Within the category of APRN, are Nurse Practitioners (NP). NP’s provide primary, acute, and specialty health care across the lifespan through assessment, diagnosis, and treatment of illnesses and injuries (American Nurses Association).
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Within Ontario, CNO defines NP’s as “registered nurses who have met additional education, experience and exam requirements set by the College. They are authorized to diagnose, order and interpret diagnostic tests, and prescribe medication and other treatment” (College of Nurses of Ontario, 2020). CNO has outlined regulations for NP’s. One regulation the board has outlined for NP’s is in regards to medication administration. Only NP’s who have successfully completed approved additional education are authorized to prescribe controlled substances.
There are also prescription regulations for NP’s in the state of New York. The board of nursing in New York states the “law authorizes nurse practitioners (NPs) to order, prescribe or dispense medications (including controlled substances) for the treatment of their patients. After completing New York State Education Department approved pharmacology coursework and being certified by the New York State Education Department to prescribe, most nurse practitioners must obtain additional government approvals and meet other criteria in order to prescribe medications” (New York State Education Department, 2019).
Both the boards of nursing in Ontario and New York require additional education requirements prior to NP’s being able to prescribe medications. Ontario will allow NP’s after obtaining licensure to prescribe medications, but not controlled substances. To be able to prescribe controlled substances additional education will be needed.The New York State requires all NP’s to have an additional pharmacology coursework prior to having the ability to prescribe any medications.
The New York State board also allows nurses to practice independently and not under the supervision of Physicians (New York State Education Department, 2019). CNO also consider NP’s as independent Practitioners who also do not need to work under the supervision of a Physician (College of Nurses of Ontario, 2020).
The Texas Board of Nursing (2018) differs from New York and Ontario where NP’s must practice under the supervision of a Physician.
Bosse et al. (2017) share that APRNs who are able to work to the full extent of their education and training have greater potential to identify creative approaches for solving problems within these systems, which will benefit nursing as a discipline, the larger health care community, and most importantly the community they serve.
APRNs such as NP’s adhere to the regulations of their regulatory body by maintaining their educational requirements and license requirements. As Bosse et al. (2017) mentioned it is important that NP’s are able to work to the full extent of their education and training. As mentioned above some states still have not allowed NPs to work independently, such as Texas. It would benefit the community served if NP’s in all states and provinces had the ability to practice independently.
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References
American Nurses Association. (n.d.). ANA enterprse. Retrived December 29, 2020, from https://www.nursingworld.org/
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2017.10.002
College of Nurses of Ontario. (2020). Nurse Practitioners. https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/nurse-practitioners/
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning
New York State Education Department. (2019). Nursing Prescription Privileges. http://www.op.nysed.gov/prof/nurse/np-ppep.htm
Texas Board of Nursing. (2018). Advance Practice Registered Nurse.https://www.bon.texas.gov/applications_advanced_practice_registered_nurse.asp
Module 1: Agenda Setting (Weeks 1-2)
Laureate Education (Producer). (2018). Meet the Experts: Pioneers in Policy [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). The Policy Process [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Compare U.S. presidential agenda priorities
- Evaluate ways that administrative agencies help address healthcare issues
- Analyze how healthcare issues get on administrative agendas
- Identify champions or sponsors of healthcare issues
- Create fact sheets for communicating with policymakers or legislators
- Justify the role of the nurse in agenda setting for healthcare issues. Order Now
| Due By | Assignment |
| Week 1, Days 1–2 | Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post. |
| Week 1, Day 3 | Post your initial discussion post. |
| Week 1, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Begin to compose your Assignment. |
| Week 1, Day 6 | Post at least two peer Discussion responses on two different days (and not the same day as the initial post). Continue to compose your final draft of your Assignment. |
| Week 1, Day 7 | Wrap up Discussion. |
| Week 2, Day 1–6 | Continue to compose your Assignment. |
| Week 2, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11–13 only)
- Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17–36)
- Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171–180)
- Chapter 12, “An Insider’s Guide to Engaging in Policy Activities”
- “Creating a Fact Sheet” (pp. 217-221)
Kingdon, J.W. (2001). A model of agenda-setting with applications. Law Review M.S.U.-D.C.L., 2(331)
Document: Agenda Comparison Grid Template (Word document)
Required Media
Laureate Education (Producer). (2018). Setting the Agenda [Video file]. Baltimore, MD: Author.
Discussion: Presidential Agendas
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
To Prepare:
- Review the Resources and reflect on the importance of agenda setting.
- Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.
Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.
As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.
In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.
To Prepare:
- Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
- Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
- Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
- Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
- Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
- Describe the administrative agenda focus related to the issue you selected.
- Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
- Explain how each of the presidential administrations approached the issue.
- At least 3 resources must be used
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
- Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
- How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
- Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Part 3: Narrative
Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:
- Summarize why this healthcare issue is important and should be included in the agenda for legislation.
- Justify the role of the nurse in agenda setting for healthcare issues.
- The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.
Agenda Comparison Grid Sample Work
Part 1
| Identify the population health concern you
selected |
The Opioid Epidemic |
| Describe the Population Health concern you selected and the factors that contribute to it. | One of the top immediate worries for American healthcare officials over the past 20 years has been the growth in opioid abuse cases. Calls for a thorough analysis of the situation and potential solutions have been driven by an exponential rise in the number of people impacted by this growing crisis and the number of deaths related to it. Today, current estimates place the number of individuals who succumb to opioid overdose at 48,000 annually in the U.S. alone (Stein & Galea, 2020, p. 138). Several contributing factors have been linked to the current state of affairs. One of the main contributing factors in the availability of opioid prescription drugs due to an increase in its endorsement as an effective pain relief medication by healthcare practitioners. In most cases, physicians fail to educate patients appropriately regarding the potential for abuse when prescribing opioid medications. Patients, particularly those struggling with chronic pain, ultimately develop tolerance to opioid medications and are unable to cease its use due to a
combination of a high side-effect profile and serious withdrawal symptoms. Additionally, its |
| prevalence among drug users has also fueled its spread and surge among young adults in the
U.S. Opioid abuse is common among heroin users who seek to compound its effects. |
| Administration
(President Name) |
Donald Trump | Barrack Obama | George Bush |
| Describe the | President Trump’s primary | President Obama was well aware of the | President Bush viewed the opioid crisis as |
| administrative agenda | focus was on robust healthcare | challenges posed by opioid abuse. Yet, | a challenge that had snowballed over time |
| focus related to this issue | infrastructure to confront the | healthcare advisors remained undecided | due to a lack of commitment by the |
| for the current and two | opioid epidemic as a major | on the most appropriate measures to | country’s leadership and inadequate |
| previous presidents. | public health crisis. As a result, | implement (Tucker & Fraser, 2019). | funding. His solution to this problem was |
| the Trump administration | However, a widely accepted agenda | an increase in federal funding to | |
| focused exclusively on forming | involved raising awareness through the | initiatives which sought to address the | |
| public health commission to | Department of Health and Human | opioid epidemic and its ravaging effects in | |
| address the crisis. This | Services (HHS), government initiatives, | the U.S. The core of this campaign was a | |
| primarily involved creating | and awareness campaigns organized by | focus on identifying persons addicted to | |
| appropriate frameworks to | the Healthy People Consortium. | opioids and ensuring they receive | |
| reduce the number of opiate | Awareness, through patient education, | appropriate medical care. This approach | |
| prescriptions provided as a first- | was conducted mainly through | regarded addiction as a ‘disease’ requiring |
| line drug in pain management. In 2017, an President Trump signed an executive order which declared opioid addiction a national health crisis and subsequently formed a commission to address the
problem (Foreman, 2017). |
telemedicine to raise awareness about opioid abuse and addiction within the U.S. | the application of innovative medical management practices. Furthermore, the Bush administration also focused on stemming the illegal drug trade in a bid to implement systematic policies to manage drug addiction in the U.S. | |
| Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. | The Trump administration channeled approximately 6.2 billion U.S dollars to manage the opioid epidemic (Bryan et al., 2020). Initial efforts to manage the crisis were also coupled with efforts to introduce new drugs, chief
among them being fentanyl to |
The Obama administration provided 1 billion U.S dollars to initiatives geared towards raising awareness on the opioid epidemic and management opioid use disorder (Fraser & Levine, 2019,
p. 465). Management efforts also focused on regulating opioid prescriptions as a first-line pain relief medication in patients with chronic pain. |
The Bush administration allocated 1.6 billion dollars towards the management of the opioid crisis in the U.S (Knopf, 2015). As part of a two-pronged approach, the
U.S Drug Enforcement agency also focused on the illegal distribution of prescription drugs by proposing stiff penalties and minimum-mandatory jail time for offenders. |
| manage addiction. | |||
| Explain how each of the presidential administrations approached the issue. | President Trump administration viewed the opioid epidemic as a public health crisis. Using his executive powers, Trump formed a commission to develop the most suitable intervention while lobbying Congress to implement new measures to curb opioid abuse. | The Obama administration sought to manage the opioid epidemic through improved access to healthcare. This involved the implementation of new measures by the HHS to support alternative pain management options. One such effort was the inception of the Medication-Assisted Treatment (MAT) option and collaboration with China to stem the production and illegal distribution of fentanyl. | The Bush administration developed a stern approach towards the illegal trade and distribution of drugs. This strategy was implemented by policymakers who recommended an increase in funding towards this cause while targeting drug traffickers involved in the trade. |
Part 2: Agenda Comparison Grid Analysis
| Administration
(President’s Name) |
Donald Trump | Barrack Obama | George Bush |
| Which administrative
agency would most likely |
The National Institute of Health
(NIH) would play a central role in |
The Department of Health and Human
Services (HHS) would have played a |
The U.S Drug Enforcement Agency
(DEA) would have been suited best |
| be responsible for helping you address the healthcare issue you selected? | the subsequent management of the opioid epidemic in the U.S. Efforts to control and manage the crisis would focus primarily on treating the condition as a disease rather than a mere addiction while attempting to develop an actionable alternative.
Public health departments would also focus on retraining healthcare workers to manage frequent drug overdose cases associated with opioid abuse. |
central role in the management of the opioid crisis during the Obama era. Efforts implemented would be in tandem with the initial goal of educating the public on the dangers posed by opioid addiction and the management of opioid use disorder among individuals with the condition. The HHS is mandated to participate in public awareness initiatives and a primary reason why it is best suited to manage the condition (Nutt & Nestor,
2018, p. 189). |
in the management of opioid abuse during the Bush era. The DEA is primarily involved in pursing individuals involved in illegal drug trade and trafficking (Tucker & Fraser, 2019). Such efforts would have gone a long way in reducing the flow of prescription opioids to drug dealers, thus managing distribution among potential buyers. |
| How do you think your selected healthcare issue might get on the agenda for the current and two
previous presidents? |
Today, the opioid crisis is linked to a sharp increase in new cases of HIV/AIDS and hepatitis as a consequence of sharing needles
among addicts (Engel et al., 2019, |
The opioid crisis might have gotten on the agenda of the Obama administration by focusing exclusively on its effect on users through civic participation. Such
efforts are normally supported by lobby |
In the Bush administration, the opioid crisis would have become a major issue of concern after the subsequent implementation of collaborative
efforts between parties involved in |
| How does it stay there? | p. 265). Furthermore, it is also linked to an increase in mortality rate among infants linked to drug use during pregnancy. This would call for a serious focus on the opioid epidemic and implementation of a presidential administrative agenda focused solely on managing the opioid epidemic. | groups, advocacy groups, interest groups, and non-governmental organizations.
Public participation would strive to address issues of particular interest raised by the community in an attempt to develop some of the most appropriate care options based on healthcare priorities. |
efforts to manage the opioid epidemic. In particular, law enforcement officers would have benefitted from working with addicts in treatment centers and hospitals to stem to identify the flow of illegal drugs into the community and persons at the very center of this trade. Collaborative efforts are likely to prove beneficial in the initial management of illegal drug trade
within the U.S. |
| Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you
selected for the current |
The National Institute on Drug Abuse is an ideal choice to champion efforts to manage the opioid epidemic in the U. S. This is
mainly due to its involvement in |
Nurses play a central and invaluable role in managing adverse conditions such as substance abuse and drug addiction.
Their involvement within the Obama
administration would ensure the opioid |
The Department of Justice (DoJ) is an ideal choice in combating the trade in controlled substances within the United States. Efforts to prosecute
drug kingpins would be augmented |
| and two previous presidents? | substance abuse issues. NIDA’s involvement would go a long way in managing drug addiction by focusing on creating recovery and rehabilitation centers (Fleiz et al.,
2019). |
crisis is highlighted as a major public health issue requiring the meticulous application of practical management strategies to manage the issue. | by the DEA. Such efforts would go a long way in controlling the illegal trade in prescription drugs within the U.S. |
Part 3: Fact Sheet/Talking Point Brief
The opioid epidemic is one of the most serious public health issues in the U.S. today stemming from the misuse of prescription medications intended for pain management. Although pharmaceutical companies initially reassured concerned parties that opioid- based pain killers did not pose a threat to public health, a sharp increase in cases of drug misuse and overdose proved otherwise.
Today, experts unanimously agree that opioid pain medications have high likelihood for abuse and are highly addictive (Sharfstein, 2017, p. 27). This has resulted in an unprecedented rise in opioid abuse, misuse, and overdose, in addition to infants with withdrawal symptoms. Policymakers in successive administrations have steadily worked to ensure emerging alternatives are implemented to manage and control the misuse of prescription drugs. The Bush administrations regarded the opioid crisis as a serious threat to the overall wellbeing of Americans, therefore warranting concerted efforts to control its spread. President Bush responded to the crisis by increasing federal funding to the DEA to aid in identifying persons responsible for the overflow of illegal prescription drugs in the community (Dasgupta, 2020). Similarly, President Obama was also cognizant of concerns raised regarding a sharp increase in opioid use during his tenure in the White House. Efforts to manage the epidemic focused solely on raising public awareness through government agencies and initiatives by the Healthy People Consortium. President Trump responded to the opioid crisis by deeming it a major public health crisis. After signing an executive order declaring it a major public health crisis in 2017, the HHS responded by developing the inaugural 5-Point Strategy to Combat the Opioid Crisis (Campana, 2017). Today, nurses are at the center of efforts to manage the opioid crisis. They participate in efforts to curb misuse of prescription medication by implementing government policy, tracking patient’s drug use, participating in patient education, and preparing them for medication cessation.
References
Bryan, M. A., Hruschak, V., Dennis, C., Rosen, D., & Cochran, G. (2020). The opioid crisis. Encyclopedia of Social Work, 5(4), 285- 302. https://doi.org/10.1093/acrefore/9780199975839.013.1350
Campana, R. (2017). Opioid addiction treatment. MOJ Addiction Medicine & Therapy, 3(4), 285- 302. https://doi.org/10.15406/mojamt.2017.03.00044
Dasgupta, A. (2020). Genetic factors associated with opioid therapy and opioid addiction. Fighting the Opioid Epidemic, 5(3), 61- 88. https://doi.org/10.1016/b978-0-12-820075-9.00004-1
Engel, J. P., Goodson, V. N., Toe, M., & Landen, M. (2019). Public health surveillance and the opioid crisis. A Public Health Guide to Ending the Opioid Epidemic, 14(6), 253-264. https://doi.org/10.1093/oso/9780190056810.003.0021
Fleiz, C., Villatoro, J., Dominguez, M., Bustos, M., & Medina-Mora, M. E. (2019). Opioid crisis along Mexico’s northern border: Treatment needs Mexican opioid crisis. Archives of Medical Research, 50(8), 527-https://doi.org/10.1016/j.arcmed.2019.12.013
Foreman, J. (2017). The opioid mess in the United States. The Global Pain Crisis, 9(4), 449- 465. https://doi.org/10.1093/wentk/9780190259242.003.0004
Fraser, M. R., & Levine, M. (2019). A comprehensive approach to addressing the opioid crisis. A Public Health Guide to Ending the Opioid Epidemic, 6(4), 171-180. https://doi.org/10.1093/oso/9780190056810.003.0015
Knopf, A. (2015). N.H. battles opioid crisis, focusing on state, federal initiatives. Alcoholism & Drug Abuse Weekly, 27(46), 5- 6. https://doi.org/10.1002/adaw.30408
Nutt, D. J., & Nestor, L. J. (2018). The opioid system and addiction. Oxford Medicine Online, 14(4), 121- 189. https://doi.org/10.1093/med/9780198797746.003.0010
Olsen, Y., & Sharfstein, J. M. (2019). The basics of opioids and opioid addiction. The Opioid Epidemic, 9(6), 35- 57. https://doi.org/10.1093/wentk/9780190916039.003.0002
Sharfstein, J. M. (2017). The opioid crisis from research to practice. The Milbank Quarterly, 95(1), 24- 27. https://doi.org/10.1111/1468-0009.12241
Stein, M. D., & Galea, S. (2020). Three notes on the opioid crisis. Pained, 4(3), 135- 138. https://doi.org/10.1093/oso/9780197510384.003.0039
Taylor, D. R. (2015). Managing patients with chronic pain and opioid addiction. Managing Patients with Chronic Pain and Opioid Addiction, 4(2), 39-68. https://doi.org/10.1007/978-3-319-08111-3_4
Tucker, P., & Fraser, M. R. (2019). The role of public health agencies in convening partnerships and collaborations to respond to the opioid crisis. A Public Health Guide to Ending the Opioid Epidemic, 9(6), 137-https://doi.org/10.1093/oso/9780190056810.003.0013
By Day 7 of Week 2
Submit your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Narrative.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
- Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
To submit your Assignment:
Week 2 Assignment
Next Module
Laureate Education (Producer). (2018). Legislation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze how cost-benefit analysis affects legislative efforts
- Analyze legislative intent of bills
- Identify proponents and opponents of bills
- Analyze legislative process of bills
- Advocate policy position for bills
| Due By | Assignment |
| Week 3, Days 1-2 | Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post. |
| Week 3, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 3, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 3, Day 6 | Post at least two peer Discussion responses on two different days (and not the same day as the initial post). |
| Week 3, Day 7 | Wrap up Discussion. |
| Week 4, Days 1-6 | Continue to compose your Assignment. |
| Week 4, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 3, “Government Response: Legislation” (pp. 37–56)
- Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)
Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
United States Senate. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/
Document: Legislation Grid Template (Word document)
Required Media
Laureate Education (Producer). (2018). Working with Legislators [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Credit: Provided courtesy of the Laureate International Network of Universities.
Laureate Education (Producer). (2018). Contemporary Issues in Public Health Policy with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore, MD: Author.
Discussion: Politics and the Patient Protection and Affordable Care Act
Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.
Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.
To Prepare:
- Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
- Consider who benefits the most when policy is developed and in the context of policy implementation.
By Day 3 of Week 3
Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.
By Day 6 of Week 3
Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 3 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 3
To participate in this Discussion:
Week 3 Discussion
Assignment: Legislation Grid and Testimony/Advocacy Statement
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.
Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.
To Prepare:
- Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)
Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.
Part 1: Legislation Grid
Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:
- Determine the legislative intent of the bill you have reviewed.
- Identify the proponents/opponents of the bill.
- Identify the target populations addressed by the bill.
- Where in the process is the bill currently? Is it in hearings or committees?
Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:
- Advocate a position for the bill you selected and write testimony in support of your position.
- Describe how you would address the opponent to your position. Be specific and provide examples.
- At least 2 outside resources and 2-3 course specific resources are used.
By Day 7 of Week 4
Submit your completed legislation grid and testimony/advocacy statement.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
- Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 4 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 4 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 4
To submit your Assignment:
Week 4 Assignment
Next Module
NURS 6050 Policy and Advocacy for Improving Population Health Papers Module 3: Regulation (Weeks 5-6)
Laureate Education (Producer). (2018). Regulation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Compare state/regional board of nursing regulations
- Compare boards of nursing and professional nurse associations
- Analyze members of boards of nursing
- Analyze state regulations for healthcare
| Due By | Assignment |
| Week 5, Days 1–2 | Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post. |
| Week 5, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 5, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 5, Day 6 | Post at least two peer Discussion responses on two different days (and not the same day as the initial post). |
| Week 5, Day 7 | Wrap up Discussion. |
| Week 6, Days 1-6 | Continue to compose your Assignment. |
| Week 6, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 4, “Government Response: Regulation” (pp. 57–84)
Required Media
Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Healthcare economics and financing [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Quality improvement and safety [Video file]. Baltimore, MD: Author.
Discussion: Professional Nursing and State-Level Regulations
Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
- Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
- Consider how key regulations may impact nursing practice.
- Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..
By Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
By Day 6 of Week 5
Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 5 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 5
To participate in this Discussion:
Week 5 Discussion
Assignment: Regulation for Nursing Practice Staff Development Meeting
Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.
To Prepare:
- Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
- Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
- Describe the differences between a board of nursing and a professional nurse association.
- Describe the board for your specific region/area.
- Who is on the board?
- How does one become a member of the board?
- Describe at least one state regulation related to general nurse scope of practice.
- How does this regulation influence the nurse’s role?
- How does this regulation influence delivery, cost, and access to healthcare?
- Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
- How does this regulation influence the nurse’s role?
- How does this regulation influence delivery, cost, and access to healthcare?
- Include Speaker Notes on Each Slide (except on the title page and reference page)
By Day 7 of Week 6
Submit your Regulation for Nursing Practice Staff Development Meeting Presentation.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
- Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
- Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.
Grading Criteria
To access your rubric:
Week 6 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 6
To submit your Assignment:
Week 6 Assignment
Next Module
NURS 6050 Policy and Advocacy for Improving Population Health Papers Module 4: Healthcare Program Design and Implementation (Weeks 7-8)
Laureate Education (Producer). (2018). Design and Implementation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze health policies
- Analyze opportunities for RNs and APRNs to participate in policy-making
- Analyze strategies for overcoming challenges for participating in policy-making
- Recommend strategies to improve the advocacy and communication of policy-making opportunities
- Analyze healthcare programs
- Analyze the role of the nurse in healthcare program design
- Analyze the role of the nurse as advocates for target populations of healthcare programs
- Analyze the role of the nurse in healthcare program implementation
- Analyze healthcare teams necessary for implementing healthcare programs
| Due By | Assignment |
| Week 7, Days 1–2 | Read/Watch/Listen to the Learning Resources. Compose your initial Discussion 1 post. |
| Week 7, Day 3 | Post your initial Discussion 1 post. Begin to compose your Assignment. |
| Week 7, Days 4-5 | Review peer Discussion 1 posts. Compose your peer Discussion 1 responses. Continue to compose your Assignment. |
| Week 7, Day 6 | Post at least two peer Discussion 1 responses on two different days (and not the same day as the initial post). |
| Week 7, Day 7 | Wrap up Discussion 1. |
| Week 8, Days 1–2 | Compose your initial Discussion 2 post. Continue to compose your Assignment. |
| Week 8, Day 3 | Post your initial Discussion 2 post. Continue to compose your Assignment. |
| Week 8, Days 4-5 | Review peer Discussion 2 post.Compose your peer Discussion 2 post. Continue to compose your Assignment. |
| Week 8, Day 6 | Post at least two peer Discussion 2 responses on two different days (and not the same day as the initial post). |
| Week 8, Day 7 | Wrap up Discussion 2. Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 5, “Public Policy Design” (pp. 87–95 only)
- Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
- Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
- Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
Required Media
Laureate Education (Producer). (2018). Getting your Program Designed and Implemented [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Health policy and politics [Video file]. Baltimore, MD: Author.
Discussion 1: Evidence Base in Design
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.
To Prepare:
- Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
- Review the health policy you identified and reflect on the background and development of this health policy.
By Day 3 of Week 7
Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
By Day 6 of Week 7
Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 7
To participate in this Discussion:
Week 7 Discussion
Discussion 2: The Role of the RN/APRN in Policy-Making
Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.
What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?
Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.
To Prepare:
- Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
- Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.
By Day 3 of Week 8
Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.
By Day 6 of Week 8
Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 8
To participate in this Discussion:
Week 8 Discussion
Assignment: Advocating for the Nursing Role in Program Design and Implementation
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.
Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.
In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
To Prepare:
- Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
- Select a healthcare program within your practice and consider the design and implementation of this program.
- Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–4 pages)
In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:
- Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
- Who is your target population?
- What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
- What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
- What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
- Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Advocating for the Nursing Role in Program Design and Implementation Sample Work
Interviewer: Tell us about a healthcare program, within your practice.
April: I currently work for Grayson County Public Schools at Fries School as the nurse.
Schools are experiencing an increase in mental health concerns, partly as a result of the COVID-19 pandemic. Virtual learning has been taking place at home, which has had a big social influence on all students. However, because to a variety of underlying problems, like as neglect and physical and mental abuse, pupils of disparity have experienced more serious adverse effects. The healthcare program initiated through our county does not currently have a name; however, it should. Nurses, social workers, educators, counselors, and physicians are all working together to identify and refer students early with any signs of mental illness. At the beginning of the year, all Grayson County School Employees had to take additional mental health training, so we were able to identify early signs of mental illness. Staff are proactively educating students on self-identification of altered mental health and ways to cope and receive help. Children need to feel connected and have a sense of inclusion in the school; we foster this through individual time spent with children and offering themed days everyone can participate in to feel connected (Centers for Disease Control & Prevention, 2021). Our educational day has changed to include more time for “mind-breaks” by getting the children outside or promoting socializing times (Centers for Disease Control & Prevention, 2021).
Interviewer: What are the costs and projected outcomes of this program?
April: The costs are minimal because the school had already purchased the training program to provide all mandatory training. This training program had many additional trainings available that are not required, like the mental health training, but had to be purchased because they were part of the product. We expect outcomes to include decreased absences, increased academic success, and improved social skills, self-awareness, and connectedness to school and staff (Youth.gov, 2021).
Interviewer: Who is your target population?
April: The target population is school-aged children. Especially those children of disparity.
Interviewer: What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
April: The school nurse has a unique perspective to provide input to the design of this mental health program. We liaison between students, families, counselors, teachers, doctors, social workers, and psychologists. We have to be discretionary to triage student/patient needs (Tummers & Bekkers, 2014). For example, due to stigmatization, a student may feel more comfortable coming to the school nurse than to a behavioral health provider. This student will still receive appropriate treatment because the nurse can use her autonomy to decide what appropriate action needs to be taken to ensure proper care (Tummers & Bekkers, 2014).
Because the nurse has such an integral part in the mental health needs of the school, she is a crucial information provider to help facilitate appropriate action in scenarios like the one above. The relationship formed in the infancy of a mental health crisis is essential to building a trusting relationship between students and providers. Students often feel more comfortable coming to the school nurse than other staff members, putting the school nurse in the unparalleled position to be the center for the mental health needs of the students.
Interviewer: What is your role as an advocate for your target population for this healthcare program?
April: As the school nurse, I have many roles as an advocate for the students of my school. I may have to advocate on their behalf to social services due to neglect or abuse. If a student is being bullied or is the bully, it is my job to advocate to teachers, students, principal, parents, and counselors to find out why a student is being bullied or why they need to bully others. Many students come to the nurse with somatic issues caused by mental illness, and I must advocate on their behalf to providers to seek appropriate care.
Interviewer: Do you have input into design decisions?
April: I do have input into design decisions. Each principal formulates a team to implement procedures at their school. Along with the school counselor, Mt. Rogers counselor, and principal, I am on the team at Fries. As a team, we all vote on how we want to handle mental health issues at our school. My advice has been utilized and implemented into the current plan for mental health issues/crises.
Interviewer: How else do you impact design?
April: Another way I impact the design of our mental health plan is by researching and educating other staff. All staff must have a say in the way we run this program. Teachers are with students all day and have a wealth of knowledge to give if an incident arises. I impact design by having their voices heard as well.
Interviewer: What is the role of the nurse in healthcare program implementation?
April: The role I play in implementing our mental health program is evaluating completion compliance of the mental health training program. I am an administrator of the program, and as staff finishes their training, they print their certificate and give it to me. After Christmas break, we will have a follow-up training as a refresher course. Innovation is nothing without its implementation; this program can only be effective if all staff involved are staked in the students’ mental health and prove that through completion of training and continuous communication between team members (Klein & Sorra, 1996).
Interviewer: How does this role vary between design and implementation of healthcare programs? Can you provide examples?
April: My role as the nurse in designing the program compared to implementation has many differences. In designing, I communicate the needs I feel should be addressed to promote our students’ mental health. Those needs turn into goals for the program and are implemented by different members of the team. For example, I introduced the need for more outside time for the socialization of students this year, and it was incorporated into our plan. However, I am not over its implementation. I must depend on the teachers and principal to ensure this part of the plan is enacted. Working as a team and communication are the key factors to implementing the design of a plan.
Interviewer: Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
April: I don’t think there are any members of the team that are needed most. I feel our participation and duties are all important and necessary. Suppose all team members are not vested in the program’s goals, then it can never be effectively and completely implemented. For example, I could go around to every teacher and educate them on the mental health needs of their students and what they can do to help, along with ensuring they have completed their training. Still, if the teacher is not vested in their students’ well-being beyond ensuring their curriculum has been covered, they will not do their part to identify mental illness. Every member of the team is crucial to its effectiveness.
References
Centers for Disease Control & Prevention. (2021, August 18). Back to school. Centers for Disease Control & Prevention. https://www.cdc.gov/healthyyouth/back-to-school/feature.htm.
Youth.gov. (2021). School based mental health. https://youth.gov/youth-topics/youth-mental-health/school-based.
By Day 7 of Week 8
Submit your interview transcript.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
- Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 8 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 8 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 8 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 8
To submit your Assignment:
Week 8 Assignment
Next Module
NURS 6050 Policy and Advocacy for Improving Population Health Papers Module 5: Program/Policy Evaluation (Weeks 9-10)
Laureate Education (Producer). (2018). Program Policy and Evaluation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze opportunities for RNs and APRNs to participate in program/policy evaluations
- Analyze strategies for overcoming challenges for participating in program/policy evaluations
- Recommend strategies to improve the advocacy and communication of program/policy evaluations
- Describe healthcare program/policy outcomes
- Analyze healthcare program/policy evaluations
- Analyze the role of the nurse advocate in program/policy evaluation
| Due By | Assignment |
| Week 9, Days 1–2 | Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post. |
| Week 9, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 9, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 9, Day 6 | Post at least two peer Discussion responses on two different days (and not the same day as the initial post). |
| Week 9, Day 7 | Wrap up Discussion. |
| Week 10, Days 1-6 | Continue to compose your Assignment. |
| Week 10, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
Document: Healthcare Program/Policy Evaluation Template (Word document)
Required Media
Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Peter Beilenson: Ethics and advocacy [Video file]. Baltimore, MD: Author.
Discussion: The Role of the RN/APRN in Policy Evaluation
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
To Prepare:
- In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
- Review the Resources and reflect on the role of professional nurses in policy evaluation.
By Day 3 of Week 9
Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.
By Day 6 of Week 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 9 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 9
To participate in this Discussion:
Week 9 Discussion
Assignment: Assessing a Healthcare Program/Policy Evaluation
Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.
Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.
To Prepare:
- Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
- Select an existing healthcare program or policy evaluation or choose one of interest to you.
- Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
- Describe the healthcare program or policy outcomes.
- How was the success of the program or policy measured?
- How many people were reached by the program or policy selected?
- How much of an impact was realized with the program or policy selected?
- At what point in program implementation was the program or policy evaluation conducted?
- What data was used to conduct the program or policy evaluation?
- What specific information on unintended consequences was identified?
- What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
- Did the program or policy meet the original intent and objectives? Why or why not?
- Would you recommend implementing this program or policy in your place of work? Why or why not?
- Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
By Day 7 of Week 10
Submit your completed healthcare program/policy evaluation analysis.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
- Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
- Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.
Grading Criteria
To access your rubric:
Week 10 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 10 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 10
To submit your Assignment:
Week 10 Assignment
Module 5: Looking Ahead
Please Note: The Module 6, Week 11 Assignment, Global Healthcare Comparison Matrix and Narrative Statement, is due on Day 5 of Week 11.
Next Module
NURS 6050 Policy and Advocacy for Improving Population Health Papers Module 6: Global Healthcare Issues (Week 11)
Laureate Education (Producer). (2018). Global Healthcare Issues [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Compare healthcare policies related to global healthcare issues in the U.S. and abroad
- Analyze the impact of the social determinants of health on global healthcare issues
- Analyze how policy impacts the health of the global population
- Analyze how policy impacts the role of the nurse
- Compare how global health issues impact local healthcare organizations and policies in the U.S and abroad
- Recommend advocacy for the incorporation of a global perspective into local practice and the role of the nurse leader
- Analyze impacts of the incorporation of a global perspective into local practice and the role of the nurse leader
- Analyze how a global perspective represents and contributes to social change
| Due By | Assignment |
| Week 11, Days 1–2 | Read/Watch/Listen to the Learning Resources. |
| Week 11, Day 3-4 | Begin to compose your Assignment. |
| Week 11, Day 5 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 11, “The Impact of Globalization: Nurses Influencing Global Health Policy” (pp. 194–208)
Document: Global Health Comparison Matrix (Word document)
Required Media
Laureate Education (Producer). (2018). Global Healthcare Issues [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Final Thoughts [Video file]. Baltimore, MD: Author.
Assignment: Global Healthcare Comparison Matrix and Narrative Statement
Note: This Assignment is due on Day 5 of Week 11.
If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?
You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.
Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.
In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.
To Prepare:
- Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
- Select at least one additional country to compare to the U.S. for this Assignment.
- Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
- Review and download the Global Health Comparison Matrix provided in the Resources.
The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)
Part 1: Global Health Comparison Matrix
Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:
- Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
- Explain the strengths and weaknesses of each policy.
- Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
- Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
- Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
- Explain how the health policy you selected might impact the role of the nurse in each country.
- Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.
Part 2: A Plan for Social Change
Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.
In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.
- Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
- Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
- Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples
By Day 5 of Week 11
Submit Part 1 and Part 2 of your Assignment.
Submission and Grading Information
Global Health Comparison Grid Part 1 and 2 Sample Work
Global Healthcare Comparison Matrix and Narrative Statement
| Global Healthcare Issue | Social Determinates of Health (SDH)
In 2005, the World Health Organization (WHO) formed the Commission Social Determinates of Health. The Commission was tasked with identifying evidence based programs and strategies that promote health equity as well as garner global support to take action to achieve it. The report was delivered to WHO in 2008, after which the Commission was disbanded, since its’ directive had been fulfilled. The Commission delivered three recommendations for the global community to consider when addressing social determinates of health. They are, improve daily living conditions; tackle the inequitable distributions of power, money, and resources; and measure and understand the problem and assess the impact of action (WHO, 2021). |
|
| Description | To address inequity in health and healthcare delivery, countries worldwide are beginning to recognize and address the social determinates of health (SDH). Social determinates of health are conditions and environments in which people are born, live, work, play, worship, and age, that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Healthy People 2020, 2020). The World Health Organization (WHO) works to develop and align measures for a global approach to address SDH, along with countries like the United States and Canada. National leaders and policy makers are recognizing that inequity in social determinates directly impact the health and quality of health care its citizens receives. Some examples of SDH include, safe and affordable housing, accessible food markets, access to quality employment opportunities, access to emerging technologies, quality education, and quality health care. More examples include residential segregation, discrimination, racism, their exposure to crime, and violence. By
establishing policies that positively impact social and economic conditions, we can ensure improved health for large numbers people that will be sustained for longer periods of time. |
|
| Country | United States | Canada |
| Describe the policy
in each country |
The social determinates of health initiative is lead by
Healthy People 2020. The goal is to create social |
Canada is considered one the healthiest countries
worldwide. Its’ government was one of the first to |
| related to the identified healthcare issue | and physical environments that promote good health for all. The Healthy People 2020 has divided the SDH into 5 primary categories: economic stability, education, health and healthcare, neighborhood and built environment, and social and community context (Healthy People 2020, 2020). | adopt policies and develop strategies to address SDH when WHO launched the initiative in 2005; they recognize the root of health inequities are social.
Canada has committed to improving social causes of illness through the creation of the Canadian Reference Group on Social Determinates of Health. This group will focus on expanding the knowledge base related to Intersectoral action, work, and Aboriginal People’s health; increasing awareness and support of public decision makers; and contributing to systemic change (WHO, 2021). |
| What are the strengths of this policy? | This policy has strength in numbers; the widespread support from the CDC and other organizations within the federal government, like National Institute of Health, Health and Human Services, and Medicare and Medicaid, collaborate to programs to back the policy. One program the CDC has developed is the Health Impact in 5 years (HI-5) Initiative. HI-5 is composed of a short list of evidence-based community health programs and interventions aimed to assist states improve its health outcomes. Some interventions are expanding transportation system, expanding early childhood education programs, and making loans and grants available for home improvements. The CDC set up the SDH web portal,
which allows users to find SDH resources on one website (CDC, n.d.). |
Under the Rio Political Declaration on Social Determinates of Health, Canada has documented its’ actions to address SDH. They have formed numerous programs and dedicated multiple resources and tools to its’ cause. Canada has convened the Canadian Council on Social Determinates of Health, a collaborative, multi-sectoral group solely dedicated to addressing the social factors that impact health and wellbeing (Government of Canada, 2020). |
| What are the
weaknesses of this policy? |
Even though recognition and support to address
SDH is rapidly growing, organizations have failed to break from their individual action plans and partner |
Waldron, 2010 reports racialised, immigrant, and
refugee groups continue to be negatively impacted by social factors. Structural and institutional inequality is |
| with each other to make more progress. Currently the health care systems, public health departments, and social services departments all work toward improving the populations SDH, but they have done so with distinct and separate missions. These entities have to agree upon common principles and
strategies to guide their efforts toward addressing social determinate of health (Green & Zook, 2019). |
embedded in Canada’s processes and practices, these factors must be eliminated before Canadians can feel the effects of changes made to improve SDH. Failure to recognize and address the historically biased systems inhibits success of any steps taken to combat SDH. | |
| Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples) | The World Health Organization Global Commission on the Social Determinates of Health determined that social injustice is killing populations on a grand scale (Donkin et al., 2018). The SDH impacts the life expectancy of populations, for example in Baltimore City, MD and Washington, D.C., those living in poor areas have a life expectancy 20 years shorter than people who live in more affluent areas in the same city. | The social determinates of health is a major culprit in health globally. Research shows that SDH doesn’t only impact poor countries, it impacts wealthy countries as well. A country’s status is defined by how healthy its’ citizens are, unfortunately there are large numbers of Canadians are affected by social determinates of health. SDH is recognized as a top priority, nationally and globally, with each country
striving to reduce its impact on its people, ultimately increasing healthy populations worldwide. |
| How has each
country’s government addressed cost, quality, and access to the selected global health issue? |
According to the CMS Office of the
Actuary, national health spending is projected to grow rapidly and reach $6.2 trillion by 2028. For its part, in 1985, Medicaid spending consumed less than 10% of state budgets and totaled just over $33 billion dollars. In 2019 that number had grown to consume 29% of total state spending at a total cost of $604 billion dollars (CMS, 2021). CMS has changed its’ payment model from a fee- for-service to value-based, meaning clinicians will now be held accountable for their patients’ health |
In its’ 2021 budget, Canada allocated additional funds
for childcare, making it more affordable at $10/day, an unprecedented leap for Canada (McLaren, 2021). In 2016, the country dedicated $8.4 billion to addressing SDH of its’ Indigenous people, a long overdue commitment. Canada is working to increase the quality and access to improved SDH by engaging providers to participate in strategies, such as outreach to hard to reach patients or those who have been lost to follow-up; also integrating new positions like the Nurse Navigator who can follow the patient in the community working to help eliminate the barriers by offering resources and programs (Anderman, 2016). |
| outcomes. President Joe Biden has submitted a
$1.5 trillion budget to Congress for approval; $3.9 billion has been requested to address several factors of the social determinates of health. Including, housing, mental health, health equity, civil rights, and reducing the maternal death rate (Vaida, 2021). |
||
| How has the | According to a report submitted by the World Health | When the WHO Director-General identified a collective |
| identified health | Organization, the Director-General states that there | failure to address social determinates and the |
| policy impacted the | has been a collective failure, globally, when tackling | fundamental causes of health inequity, Canada was |
| health of the global | social determinates and underlying causes of | not excluded from the report. Canada is struggling to |
| population? (Be | inequities. This has resulted in many low-income | improve the health equity of its poorer population, it |
| specific and provide | people already negatively impacted by SDH, to have | recognizes middle income to wealthy live healthier, |
| examples) | sustained and continued low quality housing, food | longer, happier lives (Government of Canada, 2020). |
| insecurity, poor employment options, and poor | Implementing and sustaining programs and resources | |
| access to health services (WHO, 2021). This is most | have proven to more difficult than originally thought. | |
| evident by the state of poor people as we are in the | ||
| midst of the Covid-19 pandemic. | ||
| Describe the | Nurses have a unique and intimate role in | Canadian nurses are held to an ethical and |
| potential impact of | supporting SDH. The nurse can use a social | professional standard when addressing SDH. The |
| the identified health | determinate of health assessment to identify the | Canadian Nurses Association released a position |
| policy on the role of | social factors that impact patients’ lives. By asking | statement expressing they believe all facets of nursing |
| nurse in each | about patients’ access to: healthy foods, clean | should strive to reduce and ultimately eliminate health |
| country. | drinking water, physical and mental health care, | inequality. Nurses should include SDH in their health |
| safe, affordable housing, quality education and | assessments and interventions for patients (CNA, | |
| employment opportunities, safe and reliable | 2018). | |
| transportation, and social support. Nurses are also | ||
| able to collaborate with community, local, and state | ||
| programs to address these deficits. Nurses can | ||
| advocate for patients as healthcare workers and | ||
| community citizens (Cirigliano, 2021). Nurses in role | ||
| like Case Managers or Care Coordinators have | ||
| expertise knowledge in assessing patients’ needs |
| and identifying numerous resources in the
community that can help to eliminate deficits patients face. |
||
| Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples) | The health of the global community directly impacts the security and health of the United States. Early identification of global health threats help to mitigate its effects on the people living and traveling to the
U.S. Infectious diseases like Ebola Virus, H1N1 Flu, and SARS Virus, all global health issues, effects were efficiently mitigated, preventing an international pandemic. Unfortunately for the United States, we did not mitigate the effects of Covid-19, thus the entire country has suffered as a result. Countless Americans became infected and have died from the Covid-19 virus; as of May 13, 2021, 584,500 people lost their lives to the Corona virus (JHU, 2021 NURS 6050 Policy and Advocacy for Improving Population Health Papers). |
Canada is involved in several international initiatives to improve health worldwide. It offers its’ assistance to numerous countries helping to improve social factors. By collaborating with global organizations and its’ own Canadian civil society, Canada helps to provide life- saving resources to prevent and treat illnesses like HIV/AIDS, tuberculosis, malaria, malnutrition, and pneumonia. Canada has national security efforts in place to prevent the spread of communicable diseases (Government of Canada, 2021). The Canadian government has mitigated the effects of the Covid-19 virus, with 24,869 deaths as reported on May 14, 2021
(Government of Canada, 2021). |
| General Notes/Comments | Both countries have similar barriers to addressing social determinates of health. The United States is lacking a singular dedicated entity to tackle SDH. Many federal departments have a hand in the issue, funding has been provided, but it appears when the rubber meets the road, only a small fraction of resources are actually used to address the issues. In my research I found a plan to build 250 new homes for a Baltimore community impacted by SDH; this is
a meager attempt to address the overwhelming housing crisis the city faces. |
Overwhelming research affirms Canada as one of the healthiest countries in the world. I found this to be a macro-assessment of the country’s health status, when digging deeper, I noted Canada has relished in this accomplishment, even though statistics usually do not account for the social factors that impact health.
Canada has a long way to go to meet WHO’s guidelines for improving and ultimately eliminating social determinates of health. |
A Plan for Social Change
As a nurse leader, I am professionally and personally accountable for effecting positive change in the communities in which I live, work and serve. Social determinates of health is a global initiative that affects my local community; advocating for improving the SDH is necessary to improve the health and wellbeing of my community. Advocating for resources and programs that work to tackle social factors would be a top priority.
Using my expertise and knowledge base, I will partner with community agencies to influence local and state policy makers to develop legislation that targets and prioritizes the social determinates of health in my communities.
The social determinates of health directly and indirectly impacts me as the nurse leader. Caring for patients in Baltimore City, it is not uncommon to see poor communities, food deserts, cut-rates and sub shops on every corner, only to drive 5-8 minutes up the road to find magnificent homes, nestled in affluent neighborhoods, close to fresh organic food markets and restaurants, quality healthcare centers, and low crime rates. Working within these different “pockets”, as we Baltimoreans call them, the impact on the nurse leader is palpable and unforgiving; I cannot, in good faith, address the health of my patients without first addressing the social factors that negatively impact their health.
Addressing the social determinates of health as nurse leader is indeed contributing to social change in my community and globally. Social change involves the advancement and improvement of individuals, communities, and the population, with a special focus on people in the community effected by systemic policies designed to keep them from achieving optimal health and wellbeing. One way to contribute to social change is to work toward eliminating inequities in access to quality healthcare, discrimination, employment, education, nutrition, housing, and other social determinates of health.
References
Anderman, A. (2016). Taking action on the social determinates of health in clinical practice: a framework for health professionals. Canadian Medical Association Journal, 188(17-18), 474-483. https://doi:10.1503/cmaj.160177
Canadian Nurses Association (CAN). (2018). Position statement: Social determinates of health. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/social-determinants-of-health-position-statement_2018_e.pdf?la=en&hash=AE82392EB4843FBB1D43FAB26B8F85012D7AC636
CDC. (n.d.). Social determinates of health: Know what affects health. Retrieved May, 12, 2021, from https://www.cdc.gov/socialdeterminants/policy/index.htm
Centers for Medicare & Medicaid Services (CMS). (2021, January 7). CMS issues new roadmap for states to address the social determinates of health to improve outcomes, lower costs, support state value- base strategies. {Press release}. https://www.cms.gov/newsroom/press-releases/cms-issues-new-roadmap-states-address-social-determinants-health-improve-outcomes-lower-costs
Cirigliano, M. (2021, January 14). The vital role of nurses in supporting social determination of health. Healthify. https://www.healthify.us/healthify-insights/the-vital-role-of-nurses-in-supporting-social-
determinants-of-health
Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the social determinates of health. British Medical Journal: Global Health, 3(1), 1-7. https://doi:10.1136/bmjgh-2017-00603
Government of Canada. (2021). COVID-19 daily epidemiology update. https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
Government of Canada. (2020). Social determinates of health and health inequalities. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Green K., & Zook, M. (2019, October 29). When talking about social determinates, precision matters. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20191025.776011/full/
Healthy People 2020. (2020). Social determinates of health. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Johns Hopkins University & Medicine. (2021, May 13). Coronavirus resource center. https://coronavirus.jhu.edu/us-map
Waldron, I. (2010). The impact of inequality on health in Canada: a multi-dimensional framework. Diversity & Equality in Health Care. https://diversityhealthcare.imedpub.com/the-impact-of-inequality-on-health-in-canada-a-multidimensional-framework.php?aid=1943
McLaren, L. (2021, April 20). Does Canada’s federal budget address the social determinates of health? Think Upstream. https://www.thinkupstream.ca/post/does-canada-s-federal-budget-address-the-social-determinants-of-health
Sibbald, B., & Eggerston, L. (2016). Budget tackles social determinates of health. Canadian Medical Association Journal, 188(7), 493-https://doi:10.1503/cmaj.109-5258
Vaida, A. (2021, April 14). Public health, racial equality, climate action drive Biden’s budget request for healthcare. MedCity News. https://medcitynews.com/2021/04/public-health-racial-equity-climate-action-drive-bidens- budget-requests-for-healthcare/?rf=1
World Health Organization (WHO). (2021). Commission on social determinates of health, 2005- 2008. https://www.who.int/social_determinants/thecommission/en/
World Health Organization (WHO). (2021, January 6). Social determinates of health: Report by the Director-General. https://apps.who.int/gb/ebwha/pdf_files/EB148/B148_24-en.pdf
World Health Organization (WHO). (2021). Social determinates of health: Canada. https://www.who.int/social_determinants/thecommission/countrywork/within/canada/en/
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Nurse practitioners usually work in areas where health care is needed. Unlike physicians who follow the money, nurse practitioners establish their practice in areas with the greatest health care need (Davis et al., 2018). To perform optimally, nurses should work to the fullest of their training, education, and experience. However, state-level regulations affect how nurses work, including collaboration and the power to prescribe certain medications.
Advanced Practice Registered Nurses (APRNs) work under the reduced practice in Alabama. The defining element of the reduced practice is the state regulations reducing the nurses’ ability to engage in at least one element of practice (American Association of Nurse Practitioners, 2022). One of the board’s regulations is a career-long regulated collaborative agreement with a physician; the practice commences once all the requirements are met (Alabama Board of Nursing, n.d.). The other regulation is prescribing controlled substances with varying levels of restrictions. Nurse practitioners do not have full authority to prescribe some controlled substances (Schedule II-V). The situation is somewhat different in Texas, where nurse practitioners function under restricted practice. In Texas, APRNs work under career-long supervision from physicians to provide patient care (Wofford, 2019). They cannot prescribe Schedule II drugs.
The abovementioned regulations apply differently to APRNs who have the legal authority to practice within the full scope of their education and experience. Unlike APRNs under reduced or restricted practice, APRNs under the full practice authority do not need career-long supervision or collaboration. State practice and licensure laws allow them to diagnose, treat, and prescribe medications and controlled substances (American Association of Nurse Practitioners, 2022). To adhere to the required regulations, APRNs should fully understand standardized procedures and execute their mandates as authorized.
Patient care quality and access depend on the availability of health practitioners. Despite this critical need, some states limit nurses’ ability to practice according to their education and training. Alabama is among such states since nurses are required to work under reduced practice. This implies that nurse practitioners must collaborate with another health care provider, primarily a physician.
References
Alabama Board of Nursing. (n.d.). Advanced practice nursing. https://www.abn.alabama.gov/advanced-practice-nursing/
American Association of Nurse Practitioners. (2022). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
Davis, M. A., Anthopolos, R., Tootoo, J., Titler, M., Bynum, J., & Shipman, S. A. (2018). Supply of healthcare providers in relation to county socioeconomic and health status. Journal of General Internal Medicine, 33(4), 412–414. https://doi.org/10.1007/s11606-017-4287-4
Wofford, P. (2019). Texas nurse practitioners fight for full practice authority. nurse.org. https://nurse.org/articles/texas-nurse-practitioners-fight-for-practice/
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