Assignment: NURS 6050 Assessing a Healthcare Program/Policy Evaluation
Assignment: NURS 6050 Assessing a Healthcare Program/Policy Evaluation
Assignment NURS 6050 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.
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Healthcare Program/Policy Evaluation Analysis Template
Use this document to complete the Module 5 Assessment Assessing a Healthcare Program/Policy Evaluation
| Healthcare Program/Policy Evaluation |
Blood Pressure Management Initiative |
| Description |
The blood pressure management initiative implemented was intended to reduce the cases of heart attacks and strokes in the US by urging clinicians, healthcare settings, and patients to emphasize blood pressure control and ultimately enhance the quality performance metric using the guidelines of the American Heart Association (AHA). AHA recommends BP goal of 139/89 mm Hg or less (Arnett et al., 2019). This initiative entails providing new and existing patients a face-to-face education and lifestyle counseling coupled with clinical referral and follow-up, screening and lifestyle awareness through the help of educational resources such as informational letters, health fairs, videos, brochures, reminders, and newsletters, ensuring innovative pharmacy packaging such as calendar blister packaging (CBP) to improve medication adherence and persistence, and enhanced care coordination with collaborative primary care teams using various aspects such as electronic prescribing, self-monitoring of blood pressure through the help of clinical interventions, standardized protocol tools to manage high blood pressure, and medication therapy management programs.
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| How was the success of the program or policy measured?
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The best way to measure the success of the program is to conduct a comparative analysis of the blood pressures samples taken before and after the program. Consequently, the success of this program was determined by comparing the first resting blood pressures of the respondents taken when they enrolled in the program with the resting blood pressures obtained in the final session. In particular, the number of patients with a BP of 139/89 mm Hg or less was compared to the number of patients who recorded a BP of 139/89 mm Hg and above. Ultimately, the program proved a success since the number of patients with a 139/89 mm Hg or less significantly outweighed the patients with a BP of 139/89 mm Hg and above.
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| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?
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After reaching out to the potential participant, this program attracted 320 patients. However, 32 patients were excluded for failing to meet inclusion criteria. Besides, 12 patients also left before completing the program. Consequently, 276 patients participated in the program. The impact of this program was mostly successful with majority of the participants (242) recording outstanding positive improvement and outcomes on the blood pressure management.
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| What data was used to conduct the program or policy evaluation?
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The evaluation of program was conducted by program-based data such as client record, administrative records, observation, interviews with clients, and surveys. This data is vital in understanding the program’s performance include the type of output it achieve. Moreover, quantitative data was also used to evaluate the number of patients with both positive and negative outcomes after the execution of program.
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| What specific information on unintended consequences were identified?
| The program was rolled out as planned and no unintended consequences were experienced. |
| 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.
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The stakeholders identified in this program included the patients with high blood pressure, social workers, and hypertension quality improvement steering team that comprised of the nurses, clinical leaders, operational leaders, and clinical leaders. Of these stakeholders, patients with high blood pressure stand to benefit the most from the program because they are target population and so, if the program succeeds, they will undoubtedly reap the benefits of the program.
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| Did the program or policy meet the original intent and objectives? Why or why not?
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Essentially, the rationale of this program was to seek strategies to improve the blood pressures in hypertensive patients in the healthcare facility. Consequently, the outcome showed positive improvement in blood pressure management which ultimately reduces the risk of cardiovascular incidences. Therefore, the program met original intent and objective since it proved feasible to improve the management of high blood pressure among the hypertensive patients who enrolled for the program (Carey & Whelton, 2018). |
| Would you recommend implementing this program or policy in your place of work? Why or why not?
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Since this program has been tested in the healthcare facility and demonstrated to be effective in managing the blood pressure, it is highly recommended to be fully implemented in the organization to help in mitigating the rising cases of high blood pressure. Besides, the program should be implemented alongside cardiac rehabs to help enhancing the quality metric which are anchored on the guidelines of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). |
| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.
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A nurse advocate can evaluate this policy by using the program-based data such as client record, administrative records, observation, interviews with clients, and surveys to understanding the program’s performance include the type of output it achieve. Secondly, a nurse advocate can use quantitative data to evaluate the program after year by comparing number of patients with both positive and negative outcomes after the execution of program to help in determining whether or not the program is successful.
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| General Notes/Comments |
High blood pressure is a growing public health issue in the US. According to CDC (2020), almost 500, 000 deaths reported in the US in the year 2017 were attributed to hypertension as the primary or contributory cause. High blood pressure tends to make patients susceptible to risk heart diseases and stroke, which are also major causes of death in the US. Therefore, it is proper to utilize the blood pressure management initiative proposed in this program to avoid the risk of health issues in the future.
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References
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., … & Michos, E. D. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 74(10), e177-e232.
Carey, R. M., & Whelton, P. K. (2018). Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Annals of internal medicine, 168(5), 351-358.
Centers for Disease Control and Prevention (CDC). (2020). Facts about Hypertension | cdc.gov. Retrieved 5 April 2020, from https://www.cdc.gov/bloodpressure/facts.htm.
Evaluation of health policies and programs is critical as it assists in improving the outcomes and effectiveness of such initiatives on target population. Evaluation entails collections and analysis of information concerning policy features activities and results so that stakeholders can enhance the initiative. The purpose of this paper is to evaluate a program on HIV/AIDS aimed at reducing the spread of the disease by the International Association of Physicians in AIDS Care (AIPAC) to ascertain its effectiveness
| Healthcare Program/Policy Evaluation | International Association of Physicians in AIDS Care (IAPAC) Human immunodeficiency virus (HIV) as a health issue has different aspects that include social, political and economic impacts. IAPAC is an association of physicians established in 1995 with the aim of representing HIV-treating doctors and allied healthcare providers across the world. |
| Description | The IAPAC program focuses on a host of components on HIV, right from treatment and prevention to developing a heterogeneous response to HIV. The aim of the IAPAC program and institution is to development of normative guidance, carrying out capacity building activities and engagement in advocacy to support efforts to control the HIV epidemic at all levels. |
| How was the success of the program or policy measured? | IAPAC program utilizes its annual Adherence Conference to evaluate or assess the success of its initiatives. The objectives of the conference include assessing effectiveness of self-reports, evaluating the use of clinical trials in relation to objective adherence and use of other evidence-based interventions. Therefore, measuring the success of the program is critical to its overall effectiveness on the target population. |
| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? | The IAPAC program has reached millions of individuals in different parts of the world living with HIV/AIDS. According to the World Health Organization (WHO) close to 40 million people were living with HIV/AIDS. Further, about 1.7 million get infected each year. All these people are potential beneficiaries of the program (IAPAC, 2021). The IAPAC has services in five regions across the world. These include Africa, which is the most affected, Asia/Pacific, Latin America, North America, and Europe. The program’s impacts include reducing AIDS-related deaths by close to 35% between 2010 and 2017, and preventing new child infections by close to 1.5 million incidents (Brazier et al., 2019). The program has allowed countries to develop effective interventions to prevent further spread of the condition among vulnerable population through resource provision. |
| At what point in program implementation was the program or policy evaluation conducted? | Evaluation of the IAPAC program is done annually through its Adherence Conference where new objectives are set for the coming year. This implies that each year, the stakeholders review the program and seek better ways to enhance its effectiveness to the targeted population (IAPAC, 2021b). |
| What data was used to conduct the program or policy evaluation? | Program evaluation focuses on various aspects that include processes, resource allocation, feedback and overall impact on target population. Program implementers attain this data through surveys where they collect both qualitative and quantitative information. IAPAC program has used all these approaches to evaluate the impact of this initiative. For instance, it has conducted surveys by contracting firms to evaluate the effects of its interventions in five different regions around the world. These surveys were critical as they revealed significant information on various components like health status, adherence and tolerance to present regime and side effects of different HIV/AIDS medications, and resistance in HIV/AIDS medications. |
| What specific information on unintended consequences were identified? | The program’s unintended consequences included increased stigmatization and discrimination of individuals with HIV/AIDS that reduce the use of services rolled out through the initiative. IAPAC also observes that the program’s rollout also increased isolation and marginalization of individuals with the condition. The program’s rollout also affected the ability of HIV/AIDS patients to lead healthy lives. A core aspect of the unintended effects of the program was the passage of legislations in over 32 states and two territories in the U.S. that criminalize the failure to disclose an individual’s HIV status (HIV.GOV, n.d). Before the program, many states did not have these laws. |
| 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. | HIV/AIDS affects different types of stakeholders and it is essential to engage, coordinate with, and mobilize them to encounter the disease. Stakeholders in such programs play different roles. Therefore, it is essential to develop, maintain, and leverage both formal and informal interactions among the different stakeholders; right from government agencies to civil society (IAPAC, 2021). The program’s stakeholders include individuals living with HIV/AIDS, healthcare workers, governments and their agencies, local community leaders, medical associations, nursing association and faith-based organizations as well as nongovernmental bodies. Individuals living with HIV/AIDS and their families, healthcare workers, and government would benefit the most from effective outcomes of this program. People living with HIV/AIDS benefit through access to better treatment regimes, healthy living information, and increased evidence on the best way to manage the condition (Kaiser Family Foundation, 2019). Healthcare workers attain benefits as they understand new treatment trends and how to deal with patients. Healthcare workers benefit from more knowledge on attainment of safety measures to counter the problem. |
| Did the program or policy meet the original intent and objectives? Why or why not? | The program’s ambitious but achievable targets require more resources and involvement of more stakeholders. Basing on targets by the UNAIDS, the program hoped to reduce infections, increase access to antiretroviral therapy and more suppression of the virus. The program hoped to attain all these by close to 90% by 2020 (IAPAC, 2021). However, this has not happened since not close to 90% of individuals with HIV/AIDS across the world have access to quality antiretroviral treatment. For instance, the success in saving lives does not align with the overall goal of reducing new HIV infections. Further, stigma and discrimination are still a significant concern with women and girls being disproportionately impacted by the disease in different parts of the world, especially in developing countries. The program may have attained close to 75% of its original intent and requires more efforts to achieve the set objectives (IAPAC, 2021). |
| Would you recommend implementing this program or policy in your place of work? Why or why not? | The program continues to register success in different countries and regions across the world because of its benefits and efforts to reduce HIV/AIDS and its effects to populations. The IAPAC developed this program for an international perspective and not for institutional implementation. Therefore, while I would recommend the program for the workplace, it is not feasibility because of its overall scope. I would not recommend it because it requires more resources and involvement of different stakeholders, which the organization lacks the capacity to rollout. |
| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation. | Nurses can apply similar principles in assessing the impact and effectiveness of the program just like the evaluate clinical interventions, processes and procedures (Milstead & Short, 2019). Nurses are critical players in policy planning and evaluation with the aims of promoting and illustrating leadership among professional nurses and meeting the quadruple aims of healthcare. Nurses possess knowledge, experience and skills that allow them to participate in policy evaluation in different ways that include developing interventions to assess the effectiveness of the set policies (Milstead & Short, 2019). Nurses can also leverage their skills to develop better ways of engaging stakeholders like legislators to establish policies that align with the healthcare needs of their respective populations. |
| General Notes/Comments | The IAPAC program is an initiative whose mission is to enhance access to and improve the quality of life of individuals living with HIV/AIDS in different parts of the world. The program’s focus includes improving the quality of prevention, care, and intervention regimens offered to individuals living with and impacted by HIV and the associated comorbidities. The program is an initiative where the U.S. plays a critical role in providing resources from human expertise to material input to reduce the rate of infections and other components of HIV/AIDS around the world. |
Conclusion
Policy evaluation allows stakeholders to assess the effectiveness of a health care program to enhance quality and delivery of care. The evaluation of this policy shows that significant strides have been made and achieved in controlling the prevalence of HIV/AIDS across the world. The implication is that health care policies should focus on communities and individuals that require interventions to improve access to health services. The policy has played a critical role in reducing the effects of HIV/AIDS in the world, especially the worst hit areas in developing world.
References
Brazier, E., Maruri, F., Duda, S. N., Tymejczyk, O., Wester, C. W., Somi, G., … & Wools‐Kaloustian, K. (2019). Implementation of
“Treat‐all” at adult HIV care and treatment sites in the Global Ie DEA Consortium: results from the Site Assessment Survey. Journal of the International AIDS Society, 22(7), e25331. doi: 10.1002/jia2.25331
HIV.GOV (n.d). U.S. Government Global HIV/AIDS Activities.
International Association of Providers of AIDS Care (IAPAC) (2021). About: History.
International Association of Providers of AIDS Care (IAPAC) (2021b). Adherence 2021.
Kaiser Family Foundation (KFF) (2019). The U.S. Government and Global Health.
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed). A. Derouin (Ed.). Health policy and Social
program evaluation (pp. 116-1214). Burlington, MA: Jones & Bartlett Learning.
Name: NURS_6050_Module05_Week10_Assignment_Rubric
| Excellent | Good | Fair | Poor | ||
| Program/Policy Evaluation Based on the program or policy evaluation you seelcted, 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 time in program implementation was the program or policy evaluation conducted? | 32 (32%) – 35 (35%) Using sufficient evidence, response clearly and accurately describes the healthcare program or policy outcomes. Response accurately and clearly explains how the success of the program or policy was measured. Response accurately and clearly describes how many people were reached by the program or policy and accurately describes the impact of the program or policy. Response accurately and clearly indicates the point at which time the program or policy evaluation was conducted. | 28 (28%) – 31 (31%) Using sufficient evidence, response accurately describes the healthcare program or policy outcomes. Response accurately explains how the success of the program or policy was measured. Response accurately describes how many people were reached by the program or policy and accurately describes the impact of the program or policy. Response accurately indicates the point at which time the program or policy evaluation was conducted. | 25 (25%) – 27 (27%) Description of the healthcare program or policy outcomes is inaccurate or incomplete. Explanation of how the success of the program or policy was measured is inaccurate or incomplete. Description of how many people were reached by the program or policy and the impact is vague or inaccurate. Response vaguely describes the point at which the program or policy evaluation was conducted. | 0 (0%) – 24 (24%) Description of the healthcare program or policy outcomes is inaccurate and incomplete or is missing. Explanation of how the success of the program or policy was measured is inaccurate and incomplete or is missing. Description of how many people were reached by the program or policy and the associated impacts is vague and inaccurate or is missing. Response of the point at which time the program or policy was conducted is missing. | |
| Reporting of Program/Policy Evaluations · 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 the 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. | 45 (45%) – 50 (50%) Response clearly and thoroughly explains in detail: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program met the original intent and outcomes, including an accurate and detailed explanation of the reasons supporting why or why not. -whether the program should be implemented, including an accurate and detailed explanation of the reasons supporting why or why not. -at least two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation. | 40 (40%) – 44 (44%) Using sufficient evidence, response accurately identifies the data used to conduct the program or policy evaluation. Response explains in detail specific information on outcomes and unintended consequences identified through the program or policy evaluation. Response explains in detail the stakeholders involved in the program or policy evaluation. Response explains who would benefit most from the results and reporting of the program or policy evaluation. Response includes an accurate explanation of whether the program met the original intent and outcomes, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of whether the program should be implemented, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation. | 35 (35%) – 39 (39%) Response vaguely or inaccurately identifies the data used to conduct the program or policy evaluation. Explanation of specific information on outcomes and unintended consequences identified through the program or policy evaluation is vague or incomplete. Explanation of the stakeholders involved in the program or policy evaluation is vague or inaccurate. Explanation of who would benefit most from the results and reporting of the program or policy evaluation is vague or inaccurate. Explanation of whether the program/policy met the original intent and outcomes, and the reasons why or why not is incomplete or inaccurate. Explanation of whether the program or policy should be implemented, and the reasons why or why not, is incomplete or inaccurate. Explanation of ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation is incomplete or inaccurate. | 0 (0%) – 34 (34%) Identification of the data used to conduct the program or policy evaluation is vague and inaccurate or is missing. Response includes vague and incomplete or is missing explanation of: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program or policy met the original intent and outcomes, and the reasons why or why not. -whether the program or policy should be implemented, and the reasons why or why not. -ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation. | |
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas. Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. | 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. | 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. | 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. Purpose, introduction, and conclusion of the assignment is incomplete or missing. | |
| Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation | 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. | 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. | 3 (3%) – 3 (3%) Contains several (3-4) grammar, spelling, and punctuation errors. | 0 (0%) – 2 (2%) Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | |
| Written Expression and Formatting: The paper follows correct APA format for title page, font, spacing, parenthetical/in-text citations, and reference list). | 5 (5%) – 5 (5%) Uses correct APA format with no errors. | 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. | 3 (3%) – 3 (3%) Contains several (3-4) APA format errors. | 0 (0%) – 2 (2%) Contains many (≥5) APA format errors. | |
| Total Points: 100 | |||||
Name: NURS_6050_Module05_Week10_Assignment_Rubric
Evaluating Topic: California Affordable Drug Manufacturing Act.
In September 2020, Californian Governor Gavin Newsom signed the California Affordable Drug Manufacturing Act of 2020 (Bill Text – Sb-838 Health Care: Prescription Drugs., n.d.). This law allows the State to manufacture their own generic prescription drugs to help lower the cost of prescription drugs.
Outline of the Evaluation
California Affordable Drug Manufacturing Act required California Health and Human Services Agency to partner with drug manufacturers to produce prescription drugs under the label Cal RX (Bill Text – Sb-838 Health Care: Prescription Drugs., n.d.). The law aims to reduce the cost of medication, improve medication availability, and help address economic determinants for patients. The primary medicine addressed in the bill is Insulin. California is investing $50 million into developing three interchangeable biosimilar insulins, and an additional $50 million will be used to support the construction of an Insulin manufacturing facility based in California (Calrx Fact Sheet, 20232). Per the policy, 10mL vials of Insulin will be no more than $30, and a 5-pack of 3 mL pens will be no more than $55. Families have dramatically seen a reduction in cost compared to paying $90 and $300 per 10mL vials of Insulin and 500$ for 3mL insulin pens (Calrx Fact Sheet, 20232).
Social Determinants Impact
The social impact seen with implementing the Affordable Drug Manufacturing Act includes reducing medication costs. The act provides low medication costs by establishing an office of Drug Manufacturing with the Health and Human Services Agency; this lowers prices, increases competition, and addresses shortages in the prescription drug market (Bill Text – Sb-838 Health Care: Prescription Drugs., n.d.). The State can sell publicly-manufactured drugs at a fair price covering manufacturing costs while ensuring patients have access to medication. The primary individuals who will benefit most from this bill are those who use Insulin, naloxone, and antibiotics daily.
Reference
Bill text – sb-838 health care: Prescription drugs. (n.d.). California Legislative Information. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB838
Calrx fact sheet [PDF]. (20232, March 17). Calrx.ca.gov. https://calrx.ca.gov/uploads/2023/03/CalRx-Fact-Sheet.pdf
Ross, J. (2020, September 29). California governor signs bill allowing State to manufacturer generic drugs. https://www.jurist.org/news/2020/09/california-governor-signs-bill-allowing-state-to-manufacturer-generic-drugs/
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