Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

Ongoing evaluation is crucial for changing approaches to meeting individual needs and staying abreast of all the regulatory changes in the healthcare field. Nurses engage in a continuous and active process of evaluating various facets of patient care, including the examination of diverse scenarios, assessment of healthcare policies, and the integration of evidence-based practices (Milstead and Short, 2019). As a Nurse Practitioner student, I am realizing the benefit of advocating for policy at the state and national level. In this discussion post, I explore the Supplemental Nutrition Assistance Program (SNAP), a USDA initiative focusing on nutrition-related programs.

The SNAP program focuses on all nutrition related programs such as Women, Infants, and Children (WIC) at federal level (Bleich et al., 2020). The assessment of this program aims at impacting various programs related to nutritional outcomes, food security, and general health at federal levels. The evaluation criteria for this program includes dietary quality improvements, food security reduction rates, and health outcomes. The evaluation further considers the program delivery’s efficiency, the strength of policies towards changing the socioeconomic conditions and the outreach efforts.

Various social determinants including employment stability, income inequality, cultural beliefs, and accessibility to healthcare services have a great influence on federal nutrition assistance programs (Bleich et al., 2020). Considering these factors is crucial for a comprehensive evaluation and program success. Ganacias and Rethy (2023) found that gaps in provider knowledge for referral criteria resulted in suboptimal enrollment for children ages 1 to 4 years old. Acknowledging and addressing the multifaceted impact of social determinants is imperative for achieving comprehensive evaluations and ensuring the success of federal nutrition assistance programs.

Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

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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.

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.

References

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.

Nurses and APRNs can actively participate in policy review in different ways. A nurse’s influence on policy evaluation protects patient safety, increases the quality of care, and gives access to resources (Arabi et. al, 2014). There are many steps that a nurse and APRN need to take to be involved in the policy review stage. This includes finding a concept of analysis and determining its purpose, reviewing the literature, and understanding the concept of influence (Arabi et. al, 2014). Another opportunity for a nurse and APRN to partake in policy review would be by advocating for their patients and becoming educated by joining organizations that help evaluate policies. These organizations like the Nursing Community Coalition, American Nurses Association’s Organizational Affiliates, and more can help nurses get their voices heard when advocating for their patients (AACN, n.d.).

The following are some of the difficulties that nurses and APRNs face when attempting to participate in policy evaluation. Nurses feel excluded and that their numbers are insufficient to be heard (Shariff, 2014). Nurses and APRNs frequently perceive a lack of policy and political development skills, a lack of policymaking education, and a lack of organizational support (Shariff, 2014). I would advise nurses to continue advocating for their patients and to educate themselves on policymaking. I would recommend joining an organization where a nurse’s voice is heard and discussing and reviewing the policy advocacy process, as the nurse is the backbone of patient advocacy (Jurns, 2019). Nurses and APRNs can continue to educate themselves and advocate for what they believe in, giving them a voice in policy evaluation and review.

 References

American Association of Critical Care Nurses (AACN). (n.d.). Policy and advocacy. Received

from https://www.aacn.org/policy-and-advocacy

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A

concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315–322.

Jurns, C. (2019). Policy advocacy motivators and barriers: Research results and applications.

OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 3.

Shariff N. (2014). Factors that act as facilitators and barriers to nurse leaders’ participation in

health policy development. BMC nursing, 13, 20. https://doi.org/10.1186/1472-6955-13-20

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050  

RE: Discussion – Week 9

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                 Nurses are at the forefront of reviewing health policies that policymakers have developed and put into law. Nurses are more equipped with the knowledge to help drive policymaking to be functional, sustainable, and successful due to the care they provide they can see how policy works for patients. Evaluating nursing policies is invaluable to the sustainability and success of the program. The importance of policy review helps congress and the executive branch to know what impact the program is having and is it achieving the goals that it was designed to do (Laureate Education, 2018). Being able to measure the outcome through effectiveness and efficiency is key to see if the program is successful (Laureate Education, 2018).

One strategy for nurses to engage in health and nursing policy review is through accessing a nation professional nursing organization-often through the first point of entry- the organization’s website (Catallo et al, 2014). Nurses have also joined forces with other professional organizations to create a movement that allows them to express their knowledge and feed it to policy makers through internships and working with the very people that develop health care policy. The American Nurses Association (ANA) has an entire section dedicated to advocating for health care policy making and review. One of ANA’s primary ways to achieve improved health care reform is by advocating on behalf of registered nurses at the top levels of the government as policies are conceived, debated, and implemented (ANA, n.d.). ANA is also responsible for monitoring federal agencies as they issue regulations and implementation of federal laws (ANA, n.d.).

Health care and public health systems around the world operate within frameworks of health policies. These health policies vitally and directly affect the delivery and availability of care for populations, health outcomes, health disparities, health equity, and the environmental, socio-cultural and industrial contexts of health workers (Turale & Kunaviktikul, 2019). Nurses can no longer afford to be blind to health care reform and policymaking. For so long nurses were content with doing their job and not becoming an active participant in health care policy design, implementation, and review and to prosper for the greater good nurses can no longer stay quiet.

While nurses are key in policy review, they have also encountered many barriers along the way. Barriers to nursing involvement in health policy have included a lack of political awareness and understanding of the importance of being involved in nursing organizations, time to engage in policy development outside of nursing work, and resources to develop skills in policy participation (Catallo et al, 2014). Nurses are the largest group of health care providers but in some countries they are not encouraged to engage in health policy, participation and reform, thankfully the United States encourages nurses to get involved through their profession nursing organization. Another challenge nurses encounter are bureaucratic walls which act as barriers to nurses being denied opportunities to openly voice their policy concerns (Turale & Kunaviktikul, 2019). Education is key to getting nurses to have the knowledge and comprehension to become actively involved in policy review. According to Turale and Kunaviktikul (2019) at the heart of nurses not being involved enough in policy, politics and advocacy is the gap in their education about these important matters. Nurses need access to well-thought-out policy training programs to effectively advocate for policy review and reform.

Nurses and APRNs can overcome these barriers by taking additional educational courses on policy making and review and getting involved. Nurses will never know how to impact change if they are not willing to learn. Education courses on health policy and politics is such as this one is a great way to get a foundation to improve knowledge and be able to actively participate in policy review and reform. Becoming an advanced educated nurse such as a APRN in education or leadership are great ways to strengthen knowledge and speak in a clear and professional means when advocating policymaking. When nurse leaders do not make it into the settings where decisions are made that have profound effects on health and health care-for example in parliament, in government, and in boardrooms of major organizations- they are often neither heard nor headed (Salvage & White, 2019). Nurses can impact change in policy review and reform if they get involved. Become a member of your local, state, and federal professional nursing organization. They offer support and offer toolkits to members on how to advance nursing and advocate for positive and effective change.

Resources

American Nurses Association. (n.d.). Practice and Advocacy. Retrieved from Federal Issues | Advocacy | American Nurses Association (nursingworld.org)

Catallo, C., Spalding. K., & Haghiri-Vijeh, R. (2014). Nursing Professional Organizations: What Are They Doing to Engage Nurses in Health Policy? Sage journals. https://doi.org/10.1177%2F2158244014560534

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

Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. International Nursing Review. https://doi.org/10.1111/inr.12523

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

 

RE: Discussion – Week 9

 

            Just like in policy development, RN’s and APRN’s have the opportunity to participate in policy review. When programs and policies are implemented it is not a given that they will be effective, will work out as intended, or not have unforeseen impact (Laureate Education, 2018). Policy review is just as important, if not more so, than policy development. The evaluation component is something that needs to be considered from the beginning because it is important to see if a bill needs to be reshaped and written in a way to reach the legislators or public in a better way (Laureate Education, 2018).

APRN’s have a direct line into program evaluation in their line of work. Programs funded by governments, nonprofit organizations, and most private foundations require that these programs be evaluated regularly to meet a variety of criteria, including ensuring that the program is being conducted as developed, that there is fiscal responsibility, that goals and objectives are being met, and increasingly, that the outcomes are examined (Milstead & Short, 2019). Most APRN’s are directly involved in these types of programs. Especially in small, community-based programs, an APRN could be selected to study the needs of different social groups, plan program interventions, help to write proposals, as well as work to develop the evaluation process (Milstead & Short, 2019). This is one example of how a professional nurse can actively participate in policy review.

Another way a professional nurse can directly participate in policy review would be for the RN or APRN to develop a relationship with local legislators who are the ones supporting whatever legislation you are trying to get passed. You can be the one to provide the evaluation data to them to demonstrate that the program you are suggesting is or will work. They can then provide you with questions or feedback of things that need to be revised in the program, and you can take that information back to recraft the program if needed (Laureate Education, 2018).

Nurses policy influence is the nurse’s ability in influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurse’s job environment and increases patient outcomes (Arabi, Rafii, Cheraghi, & Ghiyasvandian, 2014). We can see the importance of nurse’s influence of policy development and evaluation, but there are struggles to accomplish these tasks. If an APRN works in a place where government funded program design isn’t happening, it may be hard for them to become involved in policy review and evaluation. They may have to look at how their policies are developed and figure out how they can use where they are at to become an active participant in this area. Another foreseen barrier would be the struggle to develop relationships with legislators. This may take many years. You may have to work your way up the ladder by researching their view on topics, who works beneath them and start to develop those relationships lower down the ladder until you can work your way up.

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014, May). Nurses’ policy

influence: A concept analysis. Retrieved April 20, 2020, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/

Laureate Education (Producer). (2018). Program Policy and Evaluation[Video file]. Baltimore,

MD: Author.

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 (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

Hi K..,

I enjoyed reading your post. You listed some great ideas on how nurses can get involved in policy evaluation. Here are a few suggestions to consider as well. Many nurses think they must get involved in a major nursing association or contact their congress members to be involved in this evaluation step of health policy. However, we are involved daily with evaluation. The patient evaluation we document daily is compiled to be used in reports that are forwarded on to people who use this information at the state and federal levels to make policy changes and improvements. This information becomes evidence-based to justify or improve efficiency (Laureate Education (Producer), 2018). As nurses, we must be mindful of this every time we chart patient outcomes. Everyone involved in the policy procedure of design, implementation, and evaluation can view documentation provided by nurses to see the effect their policies and programs have and whether they are efficient and productive or not (Milstead, J. A., & Short, N. M.,2019). It takes all of us to design, implement, and evaluate health policies and programs for the best patient outcomes possible.

References

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 (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Response 2

Week 9

Kayla, I enjoyed reading your post as you made good points regarding policy review. In one of your challenges you posted you said that it may be hard to develop a relationship with legislators. I have also wandered how a nurse or anyone for that matter can start to develop a relationship with a legislator to be able to get there voice out there. I feel that without having a means of a relationship will greatly increase the difficulty of trying to participate in political matters. I am sure that representatives are also overwhelmed at times by lobbyist, and without proper planning, time, and research in whatever you are trying to change your actions may just be thrown to the side. This is why I feel it necessary to develop relationships and spend time with your local representatives and lobbyist. An introduction from the American College of Clinical Pharmacy states “An effective and sustained relationship with a Member of Congress and staff members in the Congressional office is built upon a foundation of personal communications and face-to-face exchanges. These  must  occur  consistently  over  time  so  that  the  other communications that you will invariably need to use – letters, e-mails, phone calls, — will have  the  kind  of  personal  impact  and  value  that  can  result  in  real  action  from  the office in support of the issues of importance to you” (Webb, E. n.d.).

There are also some ways you can start building these relationships. These tips I found from the American Academy of Ambulatory Care Nursing seem to be a good starting point for nurses to take to get to the initial development of knowing and having your representatives know you. “face-to-face meetings, telephone calls, letters, or e-mails. Generally, the more personal the contact, the more effective. If you cannot meet with a legislator, a meeting with his/her legislative assistant is almost as good” (Phillips. R. 2003). Generally, this is what lobbyist do. So, you can technically call yourself a nursing lobbyist by performing these tasks.

References

Phillips, R. (2003). The ABC’s of Lobbying. American Academy of Ambulatory Care Nursing.

Retrieved from: https://www.aaacn.org/volunteer/teams/legislative/abcs-lobbying

Webb, E. (n.d.). Building Relationships with Elected Officials. American College of Clinical

Pharmacy. Retrieved from: https://www.accp.com/docs/govt/advocacy/ga_build.pdf

RE: Discussion – Week 9

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            Just like in policy development, RN’s and APRN’s have the opportunity to participate in policy review. When programs and policies are implemented it is not a given that they will be effective, will work out as intended, or not have unforeseen impact (Laureate Education, 2018). Policy review is just as important, if not more so, than policy development. The evaluation component is something that needs to be considered from the beginning because it is important to see if a bill needs to be reshaped and written in a way to reach the legislators or public in a better way (Laureate Education, 2018).

APRN’s have a direct line into program evaluation in their line of work. Programs funded by governments, nonprofit organizations, and most private foundations require that these programs be evaluated regularly to meet a variety of criteria, including ensuring that the program is being conducted as developed, that there is fiscal responsibility, that goals and objectives are being met, and increasingly, that the outcomes are examined (Milstead & Short, 2019). Most APRN’s are directly involved in these types of programs. Especially in small, community-based programs, an APRN could be selected to study the needs of different social groups, plan program interventions, help to write proposals, as well as work to develop the evaluation process (Milstead & Short, 2019). This is one example of how a professional nurse can actively participate in policy review.

Another way a professional nurse can directly participate in policy review would be for the RN or APRN to develop a relationship with local legislators who are the ones supporting whatever legislation you are trying to get passed. You can be the one to provide the evaluation data to them to demonstrate that the program you are suggesting is or will work. They can then provide you with questions or feedback of things that need to be revised in the program, and you can take that information back to recraft the program if needed (Laureate Education, 2018).

Nurses policy influence is the nurse’s ability in influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurse’s job environment and increases patient outcomes (Arabi, Rafii, Cheraghi, & Ghiyasvandian, 2014). We can see the importance of nurse’s influence of policy development and evaluation, but there are struggles to accomplish these tasks. If an APRN works in a place where government funded program design isn’t happening, it may be hard for them to become involved in policy review and evaluation. They may have to look at how their policies are developed and figure out how they can use where they are at to become an active participant in this area. Another foreseen barrier would be the struggle to develop relationships with legislators. This may take many years. You may have to work your way up the ladder by researching their view on topics, who works beneath them and start to develop those relationships lower down the ladder until you can work your way up.

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014, May). Nurses’ policy

influence: A concept analysis. Retrieved April 20, 2020, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/

Laureate Education (Producer). (2018). Program Policy and Evaluation[Video file]. Baltimore,

MD: Author.

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 (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

RE: Discussion – Week 9 Initial Post

Promoting Evaluation

Nurses’ influence on health policy remains a newer concept in nursing. There are many opportunities for nurses to become involved in policymaking and policy enhancement. S.1602 was established to increase the availability of school nurses in school districts, that 20% of students were granted reduced or free lunches. There were many supporting findings, such as in 2017, the National Association of School Nurses reported 39.3% of schools employed a full-time school nurse (Davidson, 2014). Furthermore, national data indicates that between 15-20% of school children have a chronic health condition. Since S.1602 has been introduced, if passed, it will be imperative to evaluate its success in measurable units.

Many times, nurses also have difficulty evaluating evidence-based health care policy. In this particular S.1602- Nurse Act Bill, nurses have the opportunity to show effectiveness by evidence. The success can be measured by the increase of nurses hired and the enhanced health of the students. Items that should be computed are students’ attendance, classroom time, academic achievement, and health (Congress, 2021). APRNS and nurses can assist with this by being active participants. Practice change occurs when there is an active engagement of nurse leaders (Davidson, 2014). Active engagement is challenging because there is limited time and resources for APRNs to research and practice. A way to increase participation is funding, and S.1602 has allotted a sufficient amount to hire nurses to practice. One additional step would be to fund nurses to gather the data and research the items that should be computed.

Although nurses form the most significant profession of the United States’ healthcare workforce, we lack involvement in health care making and enhancement. Every day is an opportunity to become involved. Search topics that are important to you and take your stance as a health care leader to ignite the implementation and evaluation of policies for the wellness of our communities.

 References:

Congress. (2021). S.1602 Nurse Act. 117th Congress. https://www.congress.gov/bill/117th-congress/senate-bill/1602/text?q=%7B%22search%22%3A%5B%22nurse%22%2C%22nurse%22%5D%7D&r=2&s=1

Davidson, J. (January 1, 2014). Evaluation of nurse engagement in evidence-based practice. AACN Advanced Critical Care, 25(1):43-55. https://doi.org/10.4037/NCI.0000000000000006

Glasgow, R.E., Lichtenstein, E. & Marcus, A.C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261-1267. https://eds-p-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=0&sid=034020d0-0a73-4bfa-b6f1-ab78c877d060%40redis&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=10595993&db=bth

 

I chose the Affordable Health Care Act Policy as this is well-known and has been a big part of the legislation. The Affordable Care Act (ACA) makes affordable health insurance available to more people. The law provides consumers with subsidies and tax credits that lower costs for households with incomes between 100% and 400% of the federal poverty level (Affordable Care Act, 2020). Politics plays heavily into policy making and evaluation. A video from Walden University (2018) featuring Joel Teitelbaum shares, “It is clear that politics is playing a vital role in the design of the outset and now the implementation and evaluation of the ACA.” A program could not be successful after many years if it were not being evaluated and adjusted.          

            There have been several ways the ACA has been evaluated over time. After evaluation, the ACA has changed from 2011-2022. The policy will always change as the population grows, presidents change, and the cost rises or falls over time. One of the first ways the policy has been evaluated is by the number of individuals enrolled from 2010 to 2022. The government calls this administrative data and has looked at how many people have enrolled through new health insurance marketplaces or the number of people who have enrolled in Medicaid. As numbers have increased over time, policymakers have assumed success. So, if fewer Americans lack health insurance, it will be a crucial indicator of how well the ACA is working.

            Administrative data can be limited, so A lot of the policies evaluation has come from surveys over time. In 2014 before federal surveys were allowed, they launched, the Health Reform Survey, this is a quarterly survey of the nonelderly designed to provide timely information on implementation issues under the Affordable Care Act (ACA) and changes in health insurance coverage and related health outcomes (Long,2014).  This looked at data, affordability, participation, and healthcare access. It helped give a good visual of implementation success. After that rolled out so did other surveys that had been given to private entities, which ask about health insurance by type of coverage and track changes over time.

Another survey that is often a source of health coverage evaluation is the Annual Social and Economic Supplement (ASEC) to the Current Population Survey, which provides socioeconomic and demographic information, including health coverage status, for the non-institutionalized U.S. population (Montero,2022). The surveys look at insurance utilization and insurance status. The survey data received from the U.S. Department of Human Services and Medicare has been used for the evaluation and success of the policy.  

Social determinants weigh heavily in the health world, especially regarding the ACA. The World Health Organization defines social determinants of health as the conditions in which people are born, grow, live, work, and age (Abrams,2017). Racism, poverty, unsafe neighborhoods, and lack of education are some of the many social determinants that create health inequity in our country (Leong & Roberts,2013). Not everyone had access to healthcare in 2010 due to the high costs of plans. Poverty greatly affected this over time as money was required to deliver efficient care safely. The Affordable Care Act expansion did lessen the consequences of socioeconomic status and healthcare access by assisting disadvantaged persons in receiving health services. The ACA has been a tremendous help to those falling at or under the poverty level.

References

Abrams, M. (2017). Chapter 7 – Social Determinants of Health. Alliance for Health Policy. Retrieved October 19, 2022, from https://www.allhealthpolicy.org/sourcebook/social-determinants-of-health/

Centers for Medicare & Medicaid Services. (2020). Affordable Care Act (ACA). Federal Poverty Level (FPL) – Glossary | HealthCare.gov. Retrieved October 19, 2022, from https://www.healthcare.gov/glossary/federal-poverty-level-fpl/ 

Leong, D., & Roberts, E. (2013). Social determinants of health and the Affordable Care

 Act. Rhode Island medical journal (2013)96(7), 20–22.

Long , S. (2014). What do we know about ACA implementation? introducing the Health Reform Monitoring Survey. Introducing the Health Reform Monitoring Survey. Retrieved October 20, 2022, from https://www.urban.org/urban-wire/what-do-we-know-about-aca-implementation-introducing-health-reform-monitoring-survey 

Montero,A. (2022). Measuring Changes in Insurance Coverage Under the Affordable Care Act. 

KFF. Retrieved October 19, 2022, from https://www.kff.org/health-reform/poll-finding/5-charts-about-public-opinion-on-the-affordable-care-act-and-the-supreme-court/

Walden University, LLC. (Producer). (2018). Introduction to Health Policy and Law with Joel

Teitelbaum [Video file]. Baltimore, MD: Author.

            I like your choice of program for this discussion. The ACA has undergone quite a bit of change as it has changed hands throughout different presidencies. I agree that it has had many positive impacts on people below the poverty line and has led to many becoming insured that could previously not afford to be. I believe that evaluating this program in future years is key as the times change. What was the solution when the program was signed into law may not be the solution in future years. As the program changes hands and different presidents and congress staff changes, hopefully beneficial changes are made to allow this to continue to be a beneficial program. I do not think there is a perfect solution to healthcare, however those in charge must strive to continue to evaluate and amend this program.

References

Centers for Medicare & Medicaid Services. (2020). Affordable Care Act (ACA). Federal Poverty   Level (FPL) – Glossary | HealthCare.gov.                   Retrieved October 27, 2022, from https://www.healthcare.gov/glossary/federal-poverty-level-fpl/

Effect of the Affordable Care Act in Maryland. (n.d.). ballotpedia.org/ Retrieved on 10/27/2022 from                                                                                    https://ballotpedia.org/Effect_of_the_Affordable_Care_Act_in_Maryland_(2009- 2017)

I concur with your post that nurse use their voices to advocate for policies that they believe will improve health outcomes for low-income populations. This can include contacting policymakers, participating in lobbying efforts, and working with patient advocacy groups. Nurse anesthesiologists have effectively manipulated a legislative revolution to comprise comprehensive practice power throughout the US. These legislative variations straight influence the extent of the practice, patient care, and the progression of the nursing occupation. Though, nurse anesthesiologists continue uncertain to comprise health policy support as professional accountability.

To perform as an advocate, attentiveness must occur about professional responsibility to involve in political advocacy, and how to participate in this position. Effective statewide policies connecting participants of a professional state society for nurse anesthesiologists. Managers from the state groups combined proven location visits to generate a common dream and notify legislators about their part and its effect on stipulating harmless, eminence, lucrative protection to patients. These strengths were efficient in affecting the policy program advancement. Also, this progression of instructing legislators in the hospital has authorized a different invention of nurse anesthesiology supporters.

References

Newell, S. M. (2022). An Analysis and Review of the Use of State Legislator Clinical Site Visits to Increase Advocacy for Nurse Anesthesiologists. AANA journal90(6).

Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerationsLinks to an external site.Links to an external site.Nursing Outlook, 66(4), 386–393.

Nurses Need to Be More Involved in Creating Health Policy 

  

Given that there are more nurses than any other profession in healthcare, it is only natural that nurses should play a larger role in creating healthcare policy. Key organizations are articulating the need for nurses to become more involved in leadership, advocacy and policymaking. Consequently, the need for nurses to receive more training about leadership in connection to their role for influencing health policies is emphasized. There also needs to be a greater effort to grow a cadre of health policy nurses and help everyone in the nursing profession understand how nurses can effectively impact health policy. 

  

According to Sigma Theta Tau International Honor Society of Nursing, more than ever, nurses are present in every healthcare setting and possess a unique role in formulating policy. The Institute of Medicine’s 2010 report, The Future of Nursing: Leading Change, Advancing Health, recognized the importance of involving nurses in healthcare policy creation and called for nurses to take leadership in improving the quality of healthcare. Being actively involved in policy formulation is something that most leading nursing organizations advocate. Sigma also provides the examples of how the American Association of Colleges of Nursing emphasizes the role of nursing in policy and identifies, in its “Essentials” documents, the expected policy involvement that should be addressed in educational programs at the baccalaureate, master’s, and doctoral levels of professional nursing, including advanced practice. 

That being said, nurses nevertheless play an important role in health policy making. Nurses can use their local and state resources or national nursing advocacy groups to gain an understanding of current issues and learn how they can become involved. Many specialty nursing organizations have policy experts available as resources to beginning nurse advocates. They can help with preparing written or oral statements for hearings and may accompany nurses to hearings at the local state house or even on Capitol Hill. 

Nurses are encouraged to participate in health policy for three reasons. First, nurses closely deal with patients and their families in a variety of settings; therefore, their comments can be considered as valuable sources for policy development. Second, different health policies have direct effects on nurses. Thus, policies should ensure a supportive work setting. Third, nurses play key role in professional development and can highly contributed to the formation of appropriate and efficient health policies. 

  

References 

Boschma G. International nursing history: the International Council of Nurses history collective and beyond. Nurs Hist Rev. 2014;22(1):114–8. https://doi.org/10.1891/1062-8061.22.114

Robinson J. Nursing and health policy perspectives: is it time for nurses to write from their anger? Int Nurs Rev. 2013;60(2):147. https://doi.org/10.1111/inr.12030

Benner P. Educating nurses: a call for radical transformation—how far have we come? J Nurs Educ. 2012;51(4):183–4. https://doi.org/10.3928/01484834-20120402-01

Sample Answer for Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

VANNA 

RE: Discussion – Week 9  

Just as is true with policy and program making, nurses are a great resource for policy review.  One way to get involved in policy review is to become part of a team or group within your organization whose purpose is to review policies and programs that are in place.  Often these groups are composed of the same individuals that are involved in policy making; this can be both positive and negative.  The positive aspect comes from the individuals being able to see and interpret the results of their implemented policies.  This can be extremely rewarding when the outcomes are positive.  The negative aspect of the same people being a part of both the development and review of programs and policies is the inability to view the situation objectively.  When a great deal of time, thought, and effort is put into something, it can be difficult to accept that there are imperfections and needed changes.  Another common practice for policy review is for administrators and directors to be responsible for gathering suggestions for policy revision and to determine which suggestions have merit.  In this case it is important for nurses who notice a policy or procedure falls short of the standards of patient care make those shortcomings known to the people responsible for policy review.  It is not enough to simply state there is a problem; one must also make suggestions for how to fix the problem.  The “gap between research and practice is the result of several interacting factors, including limited time and resources of practitioners, insufficient training, lack of feedback and incentives for use of evidence-based practices, and inadequate infrastructure and systems organization to support translation.” (Glascow et al., 2003).  This article also tells us that the demands on staff’s time is a huge contributing factor to lack of involvement in measurement of effectiveness of implemented policy (2003).  It would be beneficial to include a designated amount of time during the regular shift to review what staff is experiencing with the current policies and collect suggestions for improvement.   

            Another way for nurses to be involved in policy review is on a wider scale and is something that has been discussed since beginning a career as a professional nurse.  That is to become a member of a professional nursing organization (PNO).  These professional nursing organizations typically have members that are lobbyist who are experienced at presenting the issues to their state representatives or even to capitol hill when issues rise to a national level.  “Professional nursing organizations (PNOs) play a critical role in maximizing the influence of our nursing profession on health systems and policy, through support of patient safety, the socioeconomic welfare of nurses, and professional practice.” (Crumley, 2020).  This concept has been presented repeatedly.  While people join professional nursing organizations for a variety of reasons, the fact that joining is invaluable is indisputable.  The challenges for being involved in policy review are like the challenges for being involved in policy making.  “Most nurses say they just want to get on with their job, and not worry about the macro‐level concerns of policy and politics.” (Salvage & White, 2019).  Good nurses spend every minute of a shift providing patient care, education, reviewing charts, catching mistakes, and being advocates for their patients.  By the end of the day, there is often little time or energy left to discuss and review policy.  When an individual is involved in a PNO, they feel more empowered to offer suggestions for improvement and are not required to do so after or during an already busy shift.   

            Communicating the existence of the opportunity for policy review can be done by encouraging peers at work to verbalize their grievances to the individuals responsible for changing the policy.  It would even be beneficial for a nurse and her peers to write out what they feel is not working and a few strategies they believe would work better.  An APRN such as an educator has a unique opportunity to advocate for the prospects for policy review by expressing the importance of and outlining the steps that can be taken to improve existing policies.  An educator may even be able to point out flaws of policies within an organization where there are participating in clinicals and make it an assignment to review the policy.  This can make the student passionate about being involved and set the groundwork for being involved in policy.   

  

References: 

Crumley, Carolyn. (2020). The Benefits of Active Engagement in Nursing Professional Organizations: A View From Here. Journal of Wound, Ostomy & Continence Nursing, 47, 547. https://doi.org/10.1097/WON.0000000000000700 

Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267. 

Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. https://doi.org/10.1111/inr.12523

  Sample Answer for Discussion: The Role of the RN/APRN in Policy Evaluation NURS 6050

ERIN 

RE: Discussion – Week 9  

Nurses are at the forefront of reviewing health policies that policymakers have developed and put into law. Nurses are more equipped with the knowledge to help drive policymaking to be functional, sustainable, and successful due to the care they provide they can see how policy works for patients. Evaluating nursing policies is invaluable to the sustainability and success of the program. The importance of policy review helps congress and the executive branch to know what impact the program is having and is it achieving the goals that it was designed to do (Laureate Education, 2018). Being able to measure the outcome through effectiveness and efficiency is key to see if the program is successful (Laureate Education, 2018). 

                 One strategy for nurses to engage in health and nursing policy review is through accessing a nation professional nursing organization-often through the first point of entry- the organization’s website (Catallo et al, 2014). Nurses have also joined forces with other professional organizations to create a movement that allows them to express their knowledge and feed it to policy makers through internships and working with the very people that develop health care policy. The American Nurses Association (ANA) has an entire section dedicated to advocating for health care policy making and review. One of ANA’s primary ways to achieve improved health care reform is by advocating on behalf of registered nurses at the top levels of the government as policies are conceived, debated, and implemented (ANA, n.d.). ANA is also responsible for monitoring federal agencies as they issue regulations and implementation of federal laws (ANA, n.d.). 

                Health care and public health systems around the world operate within frameworks of health policies. These health policies vitally and directly affect the delivery and availability of care for populations, health outcomes, health disparities, health equity, and the environmental, socio-cultural and industrial contexts of health workers (Turale & Kunaviktikul, 2019). Nurses can no longer afford to be blind to health care reform and policymaking. For so long nurses were content with doing their job and not becoming an active participant in health care policy design, implementation, and review and to prosper for the greater good nurses can no longer stay quiet. 

                While nurses are key in policy review, they have also encountered many barriers along the way. Barriers to nursing involvement in health policy have included a lack of political awareness and understanding of the importance of being involved in nursing organizations, time to engage in policy development outside of nursing work, and resources to develop skills in policy participation (Catallo et al, 2014). Nurses are the largest group of health care providers but in some countries they are not encouraged to engage in health policy, participation and reform, thankfully the United States encourages nurses to get involved through their profession nursing organization. Another challenge nurses encounter are bureaucratic walls which act as barriers to nurses being denied opportunities to openly voice their policy concerns (Turale & Kunaviktikul, 2019). Education is key to getting nurses to have the knowledge and comprehension to become actively involved in policy review. According to Turale and Kunaviktikul (2019) at the heart of nurses not being involved enough in policy, politics and advocacy is the gap in their education about these important matters. Nurses need access to well-thought-out policy training programs to effectively advocate for policy review and reform. 

                Nurses and APRNs can overcome these barriers by taking additional educational courses on policy making and review and getting involved. Nurses will never know how to impact change if they are not willing to learn. Education courses on health policy and politics is such as this one is a great way to get a foundation to improve knowledge and be able to actively participate in policy review and reform. Becoming an advanced educated nurse such as a APRN in education or leadership are great ways to strengthen knowledge and speak in a clear and professional means when advocating policymaking. When nurse leaders do not make it into the settings where decisions are made that have profound effects on health and health care-for example in parliament, in government, and in boardrooms of major organizations- they are often neither heard nor headed (Salvage & White, 2019). Nurses can impact change in policy review and reform if they get involved. Become a member of your local, state, and federal professional nursing organization. They offer support and offer toolkits to members on how to advance nursing and advocate for positive and effective change. 

  

Resources 

American Nurses Association. (n.d.). Practice and Advocacy. Retrieved from Federal Issues | Advocacy | American Nurses Association (nursingworld.org) 

Catallo, C., Spalding. K., & Haghiri-Vijeh, R. (2014). Nursing Professional Organizations: What Are They Doing to Engage Nurses in Health Policy? Sage journals. https://doi.org/10.1177%2F2158244014560534 

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

Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. International Nursing Review. https://doi.org/10.1111/inr.12523 

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

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