Discussion: Role of the RN APRN in Policy Evaluation Essay

Sample Answer for Discussion: Role of the RN APRN in Policy Evaluation Essay Included After Question

Discussion: Role of the RN APRN in Policy Evaluation Essay

Discussion: Role of the RN APRN in Policy Evaluation Essay

Numerous healthcare programs are in place in the US, each tasked with addressing specific issues in healthcare. The Children’s Health Insurance Program (CHIP) is a good example of such a program. The program’s primary purpose, as explained by Alker et al. (2020), is to provide health coverage to children from low-income families and communities who fail to qualify for Medicaid. Established back in 1997, CHIP ensures that eligible children from deprived communities have access to basic healthcare services. Arguably, this program fills the gap for those who do not qualify for Medicaid and, at the same time, cannot pay for private insurance. With this in mind, the policy goes a long way in reducing healthcare disparities and promoting equity in healthcare.

An appropriate evaluation topic for this program is its level of accessibility and utilization patterns. The rationale for this topic is that many children in deprived and less endowed communities face diverse financial and social challenges causing them to place relatively less priority on healthcare. The main focus of such an evaluation would be factors such as awareness, enrollment processes, and healthcare-seeking behavior. Arguably, the social determinants of health that would come into play are income disparities and educational levels. According to Brooks-LaSure and Tsai (2021), these social determinants would influence awareness and utilization of CHIP. Therefore, these determinants must be addressed to help ensure equitable access.

Healthcare policies are a collection of decisions, goals, and actions created to positively impact the health and wellbeing of the community. The scope of policies can be as small as teams within a healthcare institution to as broad as the entire nation. Nurses learn policies to enable them to increase positive outcomes during the process of care. For instance, they may reduce the risk of contracting a particular disease. Nurses can also use their knowledge and expertise to improve the efficiency of existing policies and propose future policies (Lee et al., 2018). Tobacco tax is an example of state healthcare policies. Tobacco smoking increases the risk of lung cancer and chronic obstructive pulmonary disease (COPD). Upward adjustment of tobacco taxes aims to discourage the use of the product, hence improving health and wellbeing of the community. This discussion reviews the tobacco tax policy.

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Tobacco taxes are considered among the most effective policies in discouraging the use of tobacco use especially among younger people (world Health Organization, 2021). Increasing the taxes increases the prices of the products, hence making them expensive. As such, it reduces the number of habitual smokers. The policy also helps to increase revenues for the government. The funds are used to finance other tobacco policies, such as community education. Each state of the United States determines the amount to tax to impose on tobacco products depending on its unique goals and objectives. The most effective criteria for measuring the effectiveness of the policy is determining the decrease in tobacco use after the implementation of the policy. A significant decline implies that the policy was highly successful. No change, on the contrary, implies that the policy was not successful, thus requiring some modifications.

Social determinants such as the impact of the policies on employment affect the policy. The Tobacco industry is a multibillion industry that provides employment for millions of Americans. A drop in revenues caused by the impacts of the tobacco taxes results in loss of employment (Sheikh et al., 2021). However, there is a need to balance between the economic and health benefits of the product. If it costs the country much more to treat tobacco related illnesses than the economic benefits of the product, it is justifiable to impose much higher taxes to discourage the cultivation and consumption of tobacco.


Lee, H.-F., Chiang, H.-Y., & Kuo, H.-T. (2018). Relationship between authentic leadership and nurses’ intent to leave: The mediating role of work environment and Burnout. Journal of Nursing Management, 27(1), 52–65. https://doi.org/10.1111/jonm.12648

Sheikh, Z. D., Branston, J. R., & Gilmore, A. B. (2021). Tobacco industry pricing strategies in response to Excise Tax Policies: A systematic review. Tobacco Control, 1–12. https://doi.org/10.1136/tobaccocontrol-2021-056630

World Health Organization. (2021). WHO technical manual on tobacco tax policy and administration. Geneva: World Health Organization.

I enjoyed reading your post. Nurses must participate in the establishment of health policies, according to nursing organizations and healthcare professionals. Policy evaluation would provide a better understanding of a policy’s value, efficacy, and worth (Ellenbecker, et al., 2017). RNs and APRNS could take part in various chances to influence and change the health policy agenda during the policy review process.

Beginning with an analysis and assessment of the literature on health policy study, APRNS could start their evaluation process. According to Williams and Anderson (2018), APRNS could use their expertise to contribute intelligently to policy debates that seek to develop efficient and patient-centered health policies.

Both registered nurses (RNs) and advanced practice registered nurses (APRNs) make up a sizeable portion of the healthcare profession, giving the nursing workforce the unique ability to influence healthcare reforms by offering support and direction to elected officials in order to impact legislation. A number of nurses lack sufficient political knowledge. As a result, nurses should be permitted to attend some legislative proceedings to increase their expertise in formulating public policy.

Consequently, throughout the policy review process, RNs may provide expert evidence, serve as subject matter experts, and win over legislators. All policy assessments have difficulties, although some of these are unique to the evaluation procedure. These include a lack of resources or a hazy evaluation position. There may not be enough data to back up the position taken by nurses who are pushing for a policy change.

The presentation of developing data and feedback channels might be considerably improved through advocacy through regional nurse associations. Nurses can get the necessary expertise to assist the review of health policy by attending professional conferences and health meetings sponsored by nursing organizations.

The presentation of developing data and feedback channels might be considerably improved through advocacy through regional nurse associations. Nurses cam get the necessary expertise to assist the review of health policy by attending professional conferences and health meetings sponsored by nursing organizations (Williams & Anderson, 2018).

Through national organizations that are affiliated with the worldwide council of nurses, nurses might participate in politics. Research studies, governmental organizations, and nursing organizations might all provide extra knowledge to nurses. Additionally, organizations like the AN may provide written information on how to participate in politics and advocate effectively.

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  • Ellenbecker, C. H., Fawcett, J., Jones, E. J., Mahoney, D., Rowlands, B., & Waddell, A. (2017). A Staged Approach to Educating Nurses in Health Policy. Policy, Politics, & Nursing Practice, 18(1), 44-56. https://doi.org/10.1177/152715441770925
  • Williams, Janet K., and Cindy M. Anderson. “Omics Research Ethics Considerations.” Nursing Outlook, vol. 66, no. 4, July 2018 386-393, 10.1016/j.outlook. 2011

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.

Evaluation Topic: The Affordable Care Act (ACA) and its impact on healthcare access and equity.

The Affordable Care Act, also known as Obamacare, was signed into law in 2010 with the intention of improving access to healthcare, lowering healthcare costs, and protecting consumers from unfair insurance practices (U.S. Department of Health and Human Services [HHS], 2021). The ACA’s key provisions include Medicaid expansion, the establishment of health insurance marketplaces, and the provision of subsidies for individuals and families to purchase health insurance. This evaluation examines the ACA’s effectiveness in meeting its objectives and assesses its impact on various social determinants.

Criteria Used for Evaluation:

Insurance Coverage: The evaluation assesses how successful the ACA has been in expanding health insurance coverage to previously uninsured people and lowering the overall uninsured rate (Sommers, Gunja, Finegold, & Musco, 2015).

Affordability: The evaluation assesses individuals’ and families’ ability to afford ACA-mandated health insurance premiums, deductibles, and out-of-pocket costs (HHS, 2021).

Social Determinants Impact:

By expanding access to healthcare and providing financial assistance to vulnerable populations, the ACA has made significant strides in addressing social determinants of health. According to research, states that expanded Medicaid under the ACA saw significant reductions in uninsured people and improvements in healthcare access for low-income people (Sommers et al., 2015). Furthermore, the ACA has aided in the reduction of racial and ethnic disparities in healthcare coverage (Artiga, Orgera, & Damico, 2019).

However, many people continue to struggle with affordability, particularly those in states that did not expand Medicaid and those with high out-of-pocket costs (HHS, 2021). Social determinants such as income, race, and geographic location continue to have an impact on people’s ability to access affordable, high-quality healthcare, and these factors should be considered in future evaluations and policy changes.

The role of professional nurses in this policy evaluation.

Professional nurses are critical in assessing the Affordable Care Act (ACA) policy, ensuring that it meets the needs of patients and contributes to improved healthcare access, affordability, and quality (American Nurses Association [ANA], 2021). Their unique perspective and understanding of patient needs, health disparities, and healthcare systems can significantly inform the ACA’s effectiveness evaluation.

Assess the ACA’s impact on patient care: Nurses can monitor and evaluate how the ACA affects patient care, such as access to healthcare services, preventive care, and chronic condition management (Coffman, 2021).

Examine how the ACA has influenced nursing practice, such as changes in nurse-to-patient ratios, scope of practice, and interdisciplinary collaboration (Mason, Gardner, Outlaw, & O’Grady, 2016).

Conduct ACA outcomes research: Nurses can participate in research to assess the ACA’s effectiveness in improving healthcare coverage, reducing disparities, and promoting health equity (Artiga, Orgera, & Damico, 2019).

Advocate for ACA policy changes: Based on their experiences and evaluation findings, professional nurses can advocate for ACA policy changes to address gaps in coverage, affordability, and quality of care (ANA, 2021).

Professional nurses can help ensure that the ACA policy meets its objectives, addresses health disparities, and supports the provision of quality care to all individuals by actively participating in policy evaluation.


American Nurses Association. (2021). Policy & Advocacy. https://www.nursingworld.org/practice-policy/advocacy/Links to an external site.

Artiga, S., Orgera, K., & Damico, A. (2019). Changes in Health Coverage by Race and Ethnicity since the ACA, 2010-2018. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/changes-in-health-coverage-by-race-and-ethnicity-since-the-aca-2010-2018/Links to an external site.

Coffman, S. (2021). The Role of Nurses in Health Policy and Advocacy. NurseJournal.org. https://nursejournal.org/community/the-role-of-nurses-in-health-policy-and-advocacy/Links to an external site.

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy and Politics in Nursing and Health Care (7th ed.). Elsevier.

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.

The Projects For Assistance In Transition From Homelessness Program (PATH)

The Projects for Assistance in Transition from Homelessness Program (PATH) is a healthcare policy that aims to improve health outcomes and patient satisfaction among homeless individuals. The program funds states to support outreach, engagement, case management, and other necessary services for homeless individuals with serious mental illness, substance use disorders, or co-occurring disorders. PATH also aims to help homeless individuals access mainstream healthcare services and other supportive services such as housing, employment, education, and transportation (SAMHSA, 2021).

Evaluation Topic

After reviewing the criteria used to measure the effectiveness of the PATH program, the program’s impact on reducing healthcare disparities among homeless individuals was considered. The accessibility and quality of the program’s healthcare services and its ability to improve health outcomes and patient satisfaction among homeless individuals with demonstrated outreach to the homeless communities.

Lowe (2021) states that PATH provides accessible and high-quality healthcare services to address the healthcare disparities among homeless individuals. In 2020, the triennial evaluation of the program was conducted by the Center for Behavioral Health Services and Quality’s Office of Evaluation and found the services provided by PATH to be appropriate and well administered, with outcome and process goals demonstrating successes (Substance Abuse and Mental Health Services Administration [SAMHSA]).

Social Determinants

Social Determinants


It is important to note that social determinants, such as poverty, lack of access to affordable housing, and limited access to healthcare services, can significantly impact the effectiveness of healthcare policies addressing homelessness. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) website, homeless individuals are likelier to experience mental health and substance abuse disorders. Additionally, they may need help accessing and utilizing healthcare services due to a lack of insurance, transportation, or trust in the healthcare system. This highlights the need for healthcare policies such as PATH to address physical health needs and mental health and substance abuse disorders among homeless individuals. 


Overall, PATH has improved health outcomes and patient satisfaction among homeless individuals. It is essential to continue to support and strengthen PATH and similar funding programs to ensure that homeless individuals receive the healthcare services and support they need to improve their health outcomes and overall well-being. 


Lowe, J. (2021). Health care for homeless people: The role of the PATH program. Journal of Social Distress and the Homeless, 30(1), 1-12

Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). Homelessness and Behavioral Health. Retrieved from https://www.samhsa.gov/homelessness-programs-resources/homelessness-behavioral-health

Substance Abuse and Mental Health Services Administration. (2020). 2020 triennial process evaluation report of the projects for assistance in transition from homelessness program (path) [PDF]. Retrieved July 25, 2023, from https://www.samhsa.gov/data/sites/default/files/reports/rpt37930/PATH-2020-Evaluation.pdf

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RE: Discussion – Week 9



Evaluation is a familiar term to the nursing profession. One of the first things that a nurse is taught is the nursing process which includes assessment, planning, implementation, and evaluation. Program or policy evaluation is no different, the same theory applies to assess the effectiveness of a specific program or policy (Milstead & Short, 2019). This evaluation is a vital part of policy development to determine the long-term effects of policy on populations, however it is sometimes overlooked (Laureate Education, 2018).

RN’s and APRN’s have a responsibility to their profession to advocate for health policy (Laureate Education, 2018). One way for them to become involved in evaluation of health policy is to form relationships with and educate political leaders so they understand the wealth of knowledge that an RN or APRN holds related to health policy.

“The challenging work of the NP political advocate is to educate and demonstrate to powerful policy makers that supporting and advancing policies that promote better health and health care is in the best interest of the larger community” (Kostas-Polston, Thanavaro, Arvidson, & Taub, 2015).Gaining the trust of a political leader can help one gain access to become involved in policy evaluation.

As the relationship grows between the nursing advocate and the political leader, the nurse will be recognized as a trusted source of impartial information and evaluation (Kostas-Polston et al., 2015). Another avenue for participating in policy evaluation is to become part of a professional organization, such as the American Nurses Association (ANA).

Many professional organizations, like the ANA, are involved in providing data to lawmakers during policy evaluation processes (Milstead & Short, 2019). Nurse advocates oftentimes become the voice of these healthcare changes. Keeping abreast of current health care policies and issues will allow for the nurse to step in and advocate for the nursing profession as well as patient safety and access to care.

Nurses must be prepared for challenges that exist with policy evaluation. One challenge could be gaining access to political leaders, as they have busy schedules. When requesting to meet with a legislator, it is possible that the nurse would be meeting with the legislative staff member. However, the legislative staff member is still influential and their job is to advise the legislator on research and issues (Kostas-Polston et al., 2015).

The nurse should present her evaluation of the health policy to the legislative staff member and have a written evaluation to leave with them. An additional challenge to policy evaluation is sparking community comment on the results of the evaluation. Sometimes evaluations can bring to light other issues that will need to be addressed, changing the direction of the political agenda.

One strategy that I would recommend is incorporating health policy into all nursing education. Currently health policy is not part of the ADN curricula, however I believe that the foundation should be started here. Another strategy to enlighten nurses on involvement in health policy would be for nursing leaders to take initiative with their employees and teach them about health policy and advocacy.

Health care organizations could make it part of a clinical ladder program or a yearly education requirement. Knowledgeable nurses need to promote the existence of political advocacy. Nurses should be involved in all stages of health care policy and are urged to use their expertise and their critical thinking to evaluate health policy for the betterment of society.


  • Kostas-Polston, E. A., Thanavaro, J., Arvidson, C., & Taub, L.-F. M. (2015). Advanced practice nursing:      shaping health through policy. Journal of the American Association of Nurse Practitioners27(1), 11–20. https://doi-org.ezp.waldenulibrary.org/10.1002/2327-6924.12192
  • Laureate Education (Producer). (2018). The Importance of Program Evaluation[Video file]. Baltimore, MD: Author. Milstead, J. A. & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6thed.). Burlington, MA: Jones & Bartlett Learning.

The American Association of Colleges of Nursing (AACN) mandates that policy is part of baccalaureate, masters, and doctoral nursing programs. Baccalaureate nursing programs usually focus on a basic understanding of how policy affects health care (Staebler, Campbell, Cornelius, Fallin-Bennet, Fry-Bowers, Kung, LaFevers, & Miller, 2017).  My undergraduate program incorporated policy into its curriculum, but it was not a separate class.

The class combined ethics, law, economics, and health policy, so you can imagine how much focus was on health policy. Nursing education is vital to develop a nurse’s political understanding and to promote political advocacy (Pery & Emory, 2017). I agree with you that health policy should start at the ADN level. Perhaps if a solid foundation was built in my lower-level courses, then some assignments in this class wouldn’t have seemed so overwhelming.


  • Perry, C., & Emory, J. (2017). Advocacy through education. Policy, Politics, & Nursing Practice, 18(3), 158-165. doi: 10.1177/1527154417734382
  • Staebler, S., Campbell, J., Cornelius, P., Fallin-Bennet, A., Fry-Bowers, E., Kung, Y., LaFevers, D., & Miller, J. (2017). Policy and political advocacy: Comparison study of nursing faculty to determine current practices, perceptions, and barriers to teaching health policy. Journal of Professional Nursing, (33)5, 350-355. doi: 10.1016/j.profnurs.2017.04.001

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RE: Discussion – Week 9


Primary opportunities for RNs and APRNs to effectively participate in policy review are through professional associations and the work place. RNs and APRNs belong to a variety of professional organizations such as the American Nurses Association (ANA), Emergency Nurses Association and the American Academy of Nursing. These organizations work as a support system for nurses and they make sure that the policies enforced are beneficial for the nurses.

Secondly, through the workplace RNs and APRNs as professionals have the responsibility and opportunity to influence policies that would enable them promote quality patient care. RNs and APRNs are professionals who can influence policies that would be effective in their work environments.They can provide a written request for a policy to be reevaluated if a policy does not promote quality patient care.

Some challenges that these opportunities may present are RNs and APRNs not being knowledgeable and updated about implemented policies, not being part of any professional organization due to the complexity of registration and lack of unity, initiative and leadership (American Nurses Association, 2010).

A strategy to better advocate for or communicate the existence of these opportunities are informing RNs and APRNS in a timely manner about policy changes, nurses need to work together, be united in order for their voices to be heard. Nurses should be provided adequate training to understand their roles, responsibilities and work environment in order to be effective professionals.

Opportunities should be provided for all RNs and APRNs to develop their leadership skills and involving them in the policy review process and professional organizations having a well-defined, simple registration system for nurses to follow when joining professional organizations.


  • American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Nursesbooks. org.
  • Milstead, J.A & Short, N.M. (2019). Health policy and politics: A nurse’s guide. (6th ed.). Burlington, MA: Jones & Barlett learning

RE: Discussion – Week 9



Good job on your post. Being a member of a professional organization is a great place to have a voice in policy making and evaluation since there is strength in number. This means that from now on, we must strive to be voices that will be counted in and join as dues paying members of these organizations. The evaluation process begins as the policy is been crafted as the efficiency and effectiveness of the policy must be measured (Laureate education, 2018).

Challenges are part of any task that we embark on in real life. It is not different on a professional platform. Apart from challenges with political leaders, we may also face challenges with other professionals as noted with some states restricting APRNs’. To overcome such challenges, nurses must always remember that we are all fighting for a common purpose and remain focused on the goal.

Charity they say begins at home. Not many nurses advance to graduate program and not many nursing programs  either at associate or bachelor degree level lay strong emphasis on advocacy thereby loosing a significant number of nurses who desire to but do not have the educational background and insight as to what to do. Nursing advocacy I believe starts with us and our nursing schools. Not surprisingly, literature is scanty on teaching advocacy in nursing school.


  • Abood, S. (2007, Jan. 31). “Influencing Health Care in the Legislative Arena”. OJIN: The Online Journal of Issues in Nursing. 12(1), Manuscript 2. https://doi.org/10.3912/OJIN.Vol12No01Man02
  • Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.

*Note: Throughout this program, your fellow students are referred to as colleagues.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.


Nurses are the backbones of the medical system.  The nursing profession is the largest in the U.S. healthcare industry.  For seventeen consecutive years, nursing ranked the most trusted job in Gallop’s ethic survey (For the 17th Year in a Row, Nurses Top Gallup’s Poll of Most Trusted Profession | AHA News, 2019).

With so many responsibilities in nursing, it is an obligation that nurses actively participate in the policy review. By involving in policy review, nurses draft and analyze policies to be in a better position to advocate for their patients. This post will discuss the opportunities that currently exist for RNs and APRNs to actively participate in policymaking.

One opportunity for RNs and APRNs to actively participate in policymaking is policy draft.  Through policy drafts, nurses will be able to identify topics that will be critical for the next few years in healthcare. For example, Covid-19 pandemic really took a toll in U.S. healthcare industry.  As of date, over 700,000 people have died from Covid-19 infection in America (CDC, 2020).

Nurses played a significant role in the fight against Covid-19 and continue in the path to defeat this deadly virus.  Professional experiences of the nurses who worked with Covid-19 infected patients speak volumes about how exhausted the healthcare system is.  During the rollout of the Covid-19 vaccines, professional nurses were argued to engage in the vaccine advocacy campaign.

Advocacy is a skill that nurses often use in their career; therefore, pairing that skill with a policy draft will enable nurses to organize the policy document with operational benefits properly. A well-drafted document will be easier to administer, maintain and enforce.  Likewise, Rasheed et al. (2020, P 447, Para 2) stress the importance that “due to their close interactions with individuals and communities across the healthcare system, nurses can offer greater direct insights concerning the effect of healthcare policies on individuals and communities.”

So, nurses need to be the drafters of the policies because it will reduce the overall amount of time an organization needs to spend on those activities, for example, vaccine advocacy programs. Appropriate content and specific knowledge and skills are essential in the policy document to avoid valuable time being wasted editing, discussing, and rewording statements that do not belong in the policy in the first place.

After completing a well-drafted policy document, nurses can participate in policy analysis and evaluate the current policy.  They can make a judgment about what went well and what did not, “whom to involve in future efforts, whom to trust, what the most effective timing is, how to create more powerful coalitions, and so forth” (Yoder‐Wise, 2019, p 52).

The evaluation step is crucial because it allows the group to determine how to protect the current success and strategies needed to succeed.  However, there are challenges to these opportunities. Policy drafting and analysis opportunities may present challenges because of poor technical knowledge and clinical skills and a lack of exposure to federal and state government involvement (Scott and Scott, 2020).

These current opportunities present challenges that can be overcome by proper training regarding policy draft and analysis during undergraduate nursing level and, of course, at the graduate level, encouraging students and faculty to participate in politics for policymaking and visiting the state and federal policy places. Scott and Scott (2020) argue that establishing relationships with policymakers is one of the best methods to get your issue on their agenda; it is about who you know and how you can influence them to listen to you.

Therefore, nurses must visit their local representatives to understand their stand on specific issues.  For example, if the nurse advocates for Covid-19 vaccines, they need to know how their local representative feels about the mass vaccination because if the representative does not fully support the vaccines, then the nurses will lose the support for publicizing the importance of the vaccines.

The representative can lobby against it because it is not profitable for them, challenging the nurses to prove their support and decisions.  If that becomes the case, nurses can use irrefutable evidence and knowledge more clearly and justifiably to publicize their support for the policy.

The strategies for better advocating are training and education programs for the nurses. Nurses already understand that they are the largest number of healthcare professionals in the healthcare industry, and therefore, their voices and suggestions are essential.  Advocating for patients at the bedside is as important as advocating for them at the state or federal government.  Nurses must understand that what they want for their patients, only they can deliver, and so, therefore, no one else can provide that on their behalf (Scott and Scott 2020). Suggestions from nurses will ensure safe and quality care through policymaking.


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            Tax-payer dollars are a conundrum of sorts but not to mention always a hot topic of debates at the capital, city halls, and local towns. After all, the publics’ voting is reflective of what each candidate will be doing with taxpayers’ dollars. Program and policy in nursing are no different. For example, money, in the form of tax-payer dollars, is being requested to be allocated to either reshape, support a bill, or research and not personal monies Laureate Education (2018b). A great majority of decisions and programs at the federal, state, and local levels, involve the health status of the population Milstead and Short (2019). One must be engaged in continuous evaluation at every level of program planning related to the economic impact as tax-payer dollars Milstead and Short (2019). Nurses impact policy through evaluation are poised to measure what the impact is likely to be and the effectiveness of the implemented program, outcomes, or policy Laureate Education (2018b). Furthermore, nurses can review current policy, like at their place of employment or within their practicing state, and engage in evaluation to see why a process did not work Milstead and Short (2019).  According to Milstead and Short (2019), nurses must be in the hierarchy of those in attendance having a pivotal voice at meetings for the redesign of healthcare systems. This includes being engaged from the beginning of policy planning with key participants, to program evaluation of healthcare policies within facilities Milstead and Short (2019). Also, the bill could also come from congress that a nurse may evaluate Laureate Education (2018b). Nurses should utilize the “five-step” framework from the Center for Disease Control and Prevention (CDC) for the evaluation in public health CDC (n.d.).  Nurses must promote cost clarity, patient education, and assist with the dispersion of accurate evaluation results Milstead and Short (2019). Leadership roles, like that of nurses, at times are met with adversity.

Discussion: Role of the RN APRN in Policy Evaluation Essay Challenges

There can be several challenges during program planning more so if the program is not completed in a tried format. This can be burdensome on program planning; however, most can be alleviated. Some of these challenges are out of the hands of the researcher and others are more apparent. For example, at times, the new policy may go through congress quickly or too slow with the respective audience, either the branch of government or the public, requesting the evaluation results quicker than anticipated Milstead and Short (2019).  Also, when comparing the context of other policies, deficiency of suitable data results may exhibit making it difficult to determine the effect Milstead and Short (2019). Some evaluation results can be unexpected and can divide communities creating a new focus regarding social or health policies Milstead and Short (2019).  Take COVID-19 for example, where some regions were being hit much harder than others and that required refocus and replanning for the safety of everyone. Limited resources or not having the appropriate person to complete the evaluation could also jeopardize program evaluations Milstead and Short (2019). According to Laureate Education (2018b), while measuring the efficiency or effectiveness of a program that did not yield expected results can result in inaccurate results. Fortunately, there are available steps nursing and other vital personal can integrate to decrease or alleviate the above-listed challenges.

How to Overcome Challenges

For program planning, one can be proactive to prevent problems that occur during the program evaluation from a nursing standpoint. Assigning a “point person” to the program is instrumental for the success of a program for they are a professional analyst who is accountable for compiling and creating the evaluation (Milstead & Short, 2019, p. 122). Other strategies available to nurses to guide effective evaluation and overcome challenges include the following. Implementing and applying a series of predetermined questions to the research program will address some challenges before they occur Agency for Healthcare Research and Quality (AHRQ, 2021). For example, is the bill or program doing what it is intended to do? How was the data collected and analyzed? Was the data reviewed by a trustworthy research team? Is it unbiased and complete Laureate Education (2018b)? Furthermore, AHRQ (2021) has compiled several questions to answer during the development of the plan. Some of these include “Who needs to act on the results and who will make decisions based on the results?” (AHRQ, 2021). Ethical issues need to be addressed and governed during the program building to ensure reliability and effectiveness.

Laureate Education (2018a) discusses ethics and advocacy and a point addressed is when a program is implemented, the creation of another implication can be created to address the ethics component of it.  For example, it could have been argued that when the needle exchange program went into effect that there would be more drug users. Instead, to address the ethics component, this program had a triple purpose with two ultimately addressing the risk of increased drug users. These included addressing the overdose with drug treatment options, needle exchange, and training addicts to revive those that have overdoses Laureate Education (2018a). In addition, available to nurses is the “Five-step framework” to guide policies and programs with guidelines regarding public health actions (Centers for Disease Control and Prevention, n.d.).

Strategies to Advocate or Communicate the Existence of these Opportunities

            To any plan, or project created or altered, strategies are available to communicate the existence of the prior discussed opportunities. To address ethical issues, there is professional organizations that provide ethical guidelines for evaluation CDC (n.d.).  For example, American Counseling Association, the American Psychological Association, and other professional organizations have available a series of ethical principles questions and principles that nurses should utilize while implementing and creating their planning Milstead and Short (2019). Milstead and Short (2019) have a list of strategies that can be used during the project planning that are directly related to communication approaches. These include using the most suitable methods during the evaluation, such as the CDC framework for program evaluation. Also, to identify key participants and multiple other vital members with the overall aim, and address conflicts rapidly. Lastly, habitually connecting with members throughout the execution and evaluation cycle of the project is critical Milstead and Short (2019). These strategies when combined with other beneficial theories and guidelines can have a positive effect on the entire process of project planning from beginning to end Milstead and Short (2019).


Agency for Healthcare Research and Quality. (2021). Elements of an Evaluation Plan. Retrieved from ahrq.gov

Centers for Disease Control and Prevention. (n.d.). Program Performance and Evaluation Office (PPEO). Retrieved from cdc.gov

Laureate Education (Producer). (2018a). Peter Beilenson: Ethics and advocacy [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018b). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

The healthcare program I decided to look at was the Affordable Care Act (ACA). The ACA was signed into law by President Barack Obama back in 2010 with the goal of lowering the number of uninsured persons in the country. The evaluation I looked at was done in the state of Maryland and presented statistics regarding the number of uninsured, cost to the consumer, and government spending regarding the ACA. According to the Effect of the Affordable Care Act in Maryland, between 2013 and 2016 the number of uninsured persons in Maryland dropped 38.8 percent, with the cost of insurance increasing 24 percent and the tax relief for insurance increasing 152 percent (n.d.). The ACA is estimated to increase spending from the federal government by 1.4 trillion dollars between 2017 and 2026 (n.d.). Overall, this program was very expensive to the federal government and in turn to the taxpayer. Those who were already insured ended up paying more for their insurance while not necessarily benefitting from the tax breaks provided. The ACA did however cut the amount of uninsured people by a significant amount. This program is subject to constant change due to the main two parties differing on opinions of it.

The social determinants affected by this program are lower socioeconomic level citizens and the elderly. The ACA did allow for people who could not necessarily afford health insurance to have greater access. As well as expanding Medicare and Medicaid to greater impact the elderly and those with long term disabilities.

Evaluation Topic: Affordable Care Act

In 2010, the United States government passed a law called the Patient Protection and Affordable Care Act (eHealth Insurance, 2022). Its goals included expanding access to health insurance, ensure that every American could afford health insurance and bettering the quality of healthcare for all Americans (eHealth Insurance, 2022). Several parts of the Affordable Care Act facilitate increased access to insurance, a broader selection of therapies for patients, and stronger healthcare delivery systems. The reform has resulted in vast improvements to health insurance in the United States.

Outline of the Evaluation

Considering the ACA’s stated aims of increasing access, decreasing costs, improving quality, and addressing social and economic determinants of health. The success of the ACA was evaluated using both numerical and qualitative metrics. Quantitative criteria included the overall cost of health care in the United States, the percentage of the population without health insurance, the availability and cost of specific medical procedures and treatments, and so on (Kenton, 2022). The quality of care provided to patients since the adoption of the Affordable Care Act was evaluated based on survey data collected from patients, feedback from stakeholders, and healthcare providers’ responses to surveys about the quality of care they have been able to provide.

Sign-up rates, coverage retention rates, premium prices, and the availability of doctors and hospitals that accept the Affordable Care Act were only few of the measures used to evaluate the success of the program. The success of the program was measured in a number of ways (Center on Budget and Policy Priorities, 2019): by the number of people who signed up, by how many of them kept their coverage, by how much it cost to maintain, and by how many medical professionals were willing to take ACA patients.

 Social Determinants

Examples of social determinants of health include a person’s living conditions, working conditions, and social environment. The Affordable Care Act (ACA) has made some efforts to address the socioeconomic determinants of health, such as poverty, education, access to healthy food and transportation, and exposure to violence.Urban neighborhoods have benefited greatly from a method of gauging a project’s success that compares the access to healthcare experienced by people of varying racial and ethnic backgrounds who live in urban and rural settings.


Any evaluation of the Affordable Care Act’s success should focus on improving health outcomes and expanding access to health care for vulnerable populations. The goal is to give a balanced assessment of the ACA so that policymakers in Washington may make well-informed decisions about the future of health care in the United States.

I like your post and your views regarding policy evaluation of Affordable Care Act. According to ASPE (office of the Assistant Secretary For planning and Evaluation), “the briefing book features key findings from two dozen reports published” in 2021-2022 to find out the outcomes of ACA success. Also, ASPE further illustrated that mostly reports published by Department of Health and Human Services which collaboratively works with CMS (Centers for Medicare & Medicaid Services) who not only analyze the strategies but also implement those strategies nationwide. They analyze that people after implementation of ACA coverage of the insurance increased from 2016-2019, improving access to preventive services for millions of Americans, interest of population has also increased (ASPE, 2021 March 18). I think comparisons of pre and post implementation of Datas is an effective way to analyze the effectiveness of new policies.

I agree with you that because of excessive costs people were not able to get coverage and with ACA it makes easier for people under poverty line to get coverage. Another act of Medicare for All Act of 2022, will also overcome the discriminations in which “No person shall, on the basis of race, color, national origin, age, disability, marital status, citizenship status, primary language use, genetic conditions, previous or existing medical conditions, religion, or sex, including sex stereotyping, gender identity, sexual orientation, and pregnancy and related medical conditions (including termination of pregnancy), be excluded from participation in or be denied the benefits of the program established under this Act (except as expressly authorized by this Act” (Congress. Gov). If this act becomes law, then this health policy will also bring health equity among US residents.

There are many different opportunities that RNs and APRNs can actively participate in the policy review. One option for nurses to actively participate in policy review is by joining a leadership position within health care and join an internship that provides formal training in politics, become involved in city councils and committees, or even run for local office (Welliver, 2021c). However, nursing education does not adequately prepare nurses to participate in policy review and politics. One strategy to overcome this hurdle would be for the nurse to find a mentor with policy review and join professional organizations that education policy and policy reviews. Nurses that get involved can successfully influence policy.

Another example of how nurses can actively participate in policy review is by participating in studies or research. For instance, studies targeted at helping understand how populations can get better access to health care will provide beneficial information to policymakers, health leaders, and the nursing profession (Turale & Kunaviktikul, 2019). In addition, nursing research can provide nurses with the understanding and skills of policies and how they can improve our profession. However, a challenge to this is there is not a lot of nursing participation in research. Nurses’ involvement in clinical research is associated with their perception of the benefit of research to practice and their understanding of time as a factor for them engaging in reading scientific articles (Nkrumah et al., 2018). This challenge can be overcome by nurses participating more in research and incorporating policies and politics in nursing schools.


Nkrumah, I., Atuhaire, C., Priebe, G., & Nambile Cumber, S. (2018). Barriers for nurses’ participation in and utilisation of clinical research in three hospitals within the Kumasi Metropolis, Ghana. Pan African Medical Journal, 30. https://doi.org/10.11604/pamj.2018.30.24.15230

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International Nursing Review, 66(3), 302–304. https://doi.org/10.1111/inr.12550

Welliver, M. (2021c, March 10). The nursing profession’s potential impact on policy and politics. American Nurse. https://www.myamericannurse.com/nursing-professions-potential-impact-policy-politics/

Opportunities for Policy Making 

A Sample Answer for The Assignment: Discussion: Role of the RN APRN in Policy Evaluation Essay

Title: Discussion: Role of the RN APRN in Policy Evaluation Essay

Good Evening Colleagues, 

When it comes to nursing, many people previously associated us with solely patient care and keeping patients safe. Although this is still true our role has evolved quite a bit. Not only do we hold the public’s trust on many levels, we are now being considered important in policy making. With new roles come opportunities. Although many would run from politics (much like myself before) this is becoming our new reality and norm. One opportunity as Milstead & Short, (2019, BigData, p. 138) explained is healthcare professionals along with researchers in health services have the ability to manipulate as well as analyze big data so that policymakers may be provided with information that is vital to medicine. Milstead & Short, (2019, Background, p. 138) further explain special expertise lies with nurse informaticists as well as with other specialists that facilitate knowledge that is collected from big data. Along with collecting data they are also able to analyze as well as apply the collected data. The nurse informaticist specializes in the integration of nursing and other sciences so that data and information may be communicated as ANA’s work states. This in turn supports the stakeholders in the medical field to make decisions. Another opportunity for nurses is being a member of an nursing association such as ANA, (n.d., ANAFAQs) whom states that they are an organization that represent registered nurses in the U.S. They advance nursing by fostering, promoting, advocating, and boosting not only nursing practice but the work environment, and the wellness of nurses themselves. ANA considers themselves advocates for nurses, the public, and health care issues. ANAs further states that their mission is to, “Lead the profession to shape the future of nursing and health care.” According to ANA, (n.d., AboutANA) they are a representative of registered nurse’s interest, along with providing resources related to career development and lobbying Congress. 

Challenges and Opportunities 

Anders, (2021, Abstract) stated that nurses are rarely involved when it comes to being informed on policy, while also mentioning different barriers such as lacking political sophistication, confidence, work demands, and family when it comes nurses’ absence in politics. Anders also stated that nurses have consistently outperformed in comparison to other professions in the last ten years to be the most trusted profession. As a wife and mother to two young children, I know exactly what Anders is talking about when it comes to being present regarding policy. The way I would attempt to overcome these challenges is by having my children by my side. I am an extremely family oriented person and although I love and am passionate about nursing Faith and family come first for me. That is the only way I am able to function and be productive in society and that trusted professional many patients depend on. I think it would be a great idea if more places would have child care or somehow integrate our children, that way nurses would be much more available to discuss policy while not being as stressed without their families. Time management is something I would have to concur as well before stepping into the political arena. Never did I think I would be considering politics in nursing, but I have come to realizing that just may be part of my destiny. 

Strategies for Advocacy 

Strategies that would make me a better advocate would be time management, availability, becoming a part of ANA, and begin documenting trends, changes we need to see, as well as practicing the policy process. Keeping myself readily available to what Congress is doing and closely following updates posted by ANA would help me be able to strengthen my political position. Another strategy would also be speaking to the public and my patients. Doing windshield surveys of my surrounding areas along with asking my patients what would help them with compliance and further restore faith in health and humanity. Having this information, I could start the process to find the proper avenues to advocate for the community. 


American Nurses Association. (n.d.). retrieved October 17, 2022 from        https://www.nursingworld.org/ana/ 

American Nurses Association. (n.d.). retrieved October 17, 2022 from About ANA | American    Nurses Association | ANA Enterprise (nursingworld.org) 

Anders R. L. (2021). Engaging nurses in health policy in the era of COVID-19. Nursing   forum, 56(1), 89–94. https://doi.org/10.1111/nuf.12514 

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).         Jones & Bartlett Learning.

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