NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

Sample Answer for NRSE 6050 Week 7 Discussion 1: Evidence Base in Design Included

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

A Sample Answer for The Assignment: NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

Title: NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

I am glad that you are discussing this topic and policy. I have experienced this issue firsthand while working in a critical care environment. There were many times that I felt unsafe as did my patients. You stated from another source, “If the determined ratios listed in the bill are not met and or there is a safety concern related to the expertise of nurse and patient care, a nurse is allowed to refuse an assignment without any repercussions” This is very important in the safety of patients and the safety and license of health care provider and worker. Every nurse’s ability to provide safe, high-quality care in all practice settings is impacted by staffing. We can improve healthcare for all by doing away with risky nurse staffing practices and policies. (nurse staffing, 2022) There is broad agreement that nurses are an essential part of the health care delivery system and that nurse staffing affects safety, but there is very little agreement regarding the specifics of what research data have and have not established, and there is active disagreement regarding the best course of action to ensure public safety. Nurse staffing is a crucial health policy issue. (Clarke & Donaldson, 2008)

Resources:

 https://www.nursingworld.org/practice-policy/nurse-staffing/. (2022). Nurse Staffing.

 Clarke, S. P., & Donaldson, N. E. (2008, April 1). Nurse Staffing and Patient Care Quality and Safety – Patient Safety and Quality – NCBI Bookshelf. Nurse Staffing and Patient Care Quality and Safety – Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2676/

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

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H.R.2907 – Let Doctors Provide Reproductive Health Care Act 

The Let Doctors Provide Reproductive Health Care Act was introduced to the 118th Congress on April 26th, 2023 (H.R.2907, 118th Congress, 2023). The purpose of this bill is to address the regulations on reproductive health care services. Additionally, this bill is asking the government to outlaw the ability to make regulations against providing reproductive health care services by healthcare providers. The main intention of this bill is to protect healthcare providers who provide reproductive healthcare services.  

The Let Doctors Provide Reproductive Health Care Act is introduced during a time when reproductive rights are being threatened. In 2022 Roe vs. Wade was overturned by the Supreme Court (Center for Reproductive Rights, 2023). Roe vs. Wade was a lawsuit made in 1973 that ended with the Supreme Court ruling to protect abortion rights (Center for Reproductive Rights, 2023). Since Roe vs. Wade was overturned, many states have since changed their restrictions on reproductive rights. Currently there are 14 states that have made it illegal to get an abortion, many of which have criminal penalties if this law is broken (Center for Reproductive Rights, 2023).   

This Act affects the social determinant of healthcare access and quality by attempting to improve access to reproductive healthcare. The Let Doctors Provide Reproductive Health Care Act is fighting for protection for providers when trying to provide reproductive healthcare services. I believe there is enough evidence to pass this bill. The restriction on reproductive rights in many states has threatened healthcare providers’ duty to do no harm. Bridget Balch of the Association of American Medical Colleges (2023) discussed how each states rules vary and has made it very confusing to providers. Balch (2023) specifically discussed the rules in Idaho which are abortions are only legal if a provider believes that without the abortion it would lead to the death of their patient. This bill has enough evidence to pass through Congress and unfortunately will keep on gaining more evidence as these restrictions against reproductive care grow.  

Main Post

Nursing is a profession where the care that is provided should be evidence base, and as we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became the culture of care. As our profession is and should be practiced based from evidence we must venture away from those practices and adhere with the evidence base practices. The health policy that I selected is Bill H.R.4647, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act. This bill sponsors are Rep. Schneider, Bradley Scott [D-IL-10], was introduced

on 10/15/2019. The background for this proposed bill/problem goes way back before the Affordable Care Act (ACA), whereas people that had pre-existing health conditions were denied health insurance or their prices were way higher to the point where they could not affordable to pay and went uninsured for decades (Giled & Jackson, 2017). President Franklin D Roosevelt introduced the Social Security Act, President Lyndon Johnson made an amendment to the Social Security Act with the passage of Title1X where the Medicare Act was introduced under Title V111.

Prior to the ACA, health insurance was obtained medically, meaning insurance companies were privy to an individual health record and other risks factors which they use to determined eligibility and applicants had to fill out a lengthy form with their medical history (Claxton et al., 2016).  Medicare Act was introduced at the federal state level to provide coverage to the poorest citizens (Auerbach, 2019). The Patient Protection Affordable Care Act (PPACA) was passed in to law 2010 which protects people with pre-existing health condition against insurance companies that would deny them health insurance coverage (Auerbach, 2019).

There is enough evidence to support the fact that people with pre-existing conditions were denied health insurance because before the passage of the PPACA insurance companies were not held accountable.  According to Claxton et al. (2016) more than 18% of applicants were denied health insurance before the ACA act and many more people that had pre-existing condition did not apply because they were already informed that they would be denied. PPACA has extended coverage and hold insurance accountable, no preexisting inclusion and now more than 32 million more people have gain access to insurance coverage including people with pre-existing conditions such as patients with cancer (Plaxe & Nagle, 2014).

References

  • Auerbach, M. P. (2019). Patient Protection and Affordable Care Act: Overview. Salem Press Encyclopedia.
  • Claxton, G., Cox, C., Damico, A., Levitt, L., Pollitz, K & Kaiser Family Foundation. (2016).
  • Pre-existing conditions and medical underwriting in the individual insurance market prior to the ACA. Montana, 25, 152-000.
  • Glied, S., & Jackson, A. (2017). Access to Coverage and Care for People with Preexisting Conditions: How Has it Changed Under the ACA? Issue Brief (Commonwealth Fund)18, 1–12.
  • Plaxe, S., & Nagle, V. L. J. (2014). Patient Protection and Affordable Care Act (“Obama Care”). Journal of Gynecologic Oncology Nursing24(1), 25–26.

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy. 

Access to mental health services as well as an overall shortage in Mental Health providers is an ongoing issue throughout the United States. Due to these shortages, patients are left in limbo when attempting to receive either mental health or addiction treatment. Patients seeking treatment become housed in emergency departments where they begin detox or are isolated due to mental illness. These prolonged stays are costing Arizona alone over $20 million dollars every year (Waiting for Care Causes, Impacts and Solutions to Psychiatric Boarding in Arizona, 2015).  With the lack of services available, patients are then deterred from seeking treatment or seeing treatment options through completely. The idea of the 2024 policy priorities is to ensure that the deficit in available resources begins to close and the wait times for care decrease.

Along with the shortage of facilities and providers comes challenges in funding and insurance coverage or reimbursement. With a large number of the patients seeking mental health and addiction services being uninsured here in Arizona, services become limited with reimbursement opportunities for private treatment facilities (Policy Objectives, n.d.). By adjusting healthcare financial allocations in the state to include more mental health options, it would also contribute to closing the gap of those seeking treatment and treatment options and availabilities.  

References:

Guide to Community Preventive Services. (2012). Mental Health: Mental Health Benefits Legislation. https://www.thecommunityguide.org/findings/mental-health-mental-health-benefits-legislation

Links to an external site.

Policy Objectives. (n.d). https://assets.nationbuilder.com/azhha/pages/107/attachments/original/1704232059/2024_Public_Policy_Priorities.pdf?1704232059

Links to an external site.

Policy Priorities. (n.d). Arizona Hospital and Healthcare Association. https://www.azhha.org/issue_papers

Links to an external site.

Waiting for Care Causes, Impacts and Solutions to Psychiatric Boarding in Arizona. (2015). https://d3n8a8pro7vhmx.cloudfront.net/azhha/pages/107/attachments/original/1596350998/Psychiatric-Boarding-Full-Report.pdf?1596350998

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

RE: Discussion – Week 7

 

The recent law to ban abortion in Texas sent shock waves across the state and outside, bringing fear of the repo effect as policymakers interfered with a human right. The right to women’s health services. The law put forth restrictions on abortion as early as six weeks and even gave the power for ordinary citizens to sue health care providers found to break this law in the state (Najmabadi, 2021).

To prevent the passing of the outrageous law in California, Rep. Chu, Judy (D-CA-27) introduced the bill H.R.3755- Women’s Health Protection Act of 2021. The bill persuaded Congress to protect the right of individuals, in this case, women, when it is time to make an informed decision to terminate the unwanted pregnancy and the protection of providers involved in performing abortion procedures under standardized protocols (Congress.gov, 2021).

The Women’s Health Protection Act bill is currently under the Senate review, and it has been used to bring public awareness and to the legislatures on the impact of anti-abortion rules, which through informed evidence, its consequences have been found to perpetuate decreased access to safe abortions, as evidenced by a review of the literature completed by Espinoza et al. (2020), which showed an increased rate of infection and mortality amongst 22 million adolescent girls globally.

Also, increased service cost has hindered women from participating in economic and social developments, leaving women vulnerable to socio-economic exploitations from the opposite sex. Last, the sharp increase in mental health disorders and health disparities in minority ethnics have been associated with limited access to women health services and has continued to affect other preventative vital health services that include screenings, contraceptive services, sexually transmitted disease services, prenatal care, and adaptation services (Congress.gov).

The fourteenth amendment of the U.S. Constitution gives rights to all American citizens, thus protecting a woman’s right to make adequately informed and educated health decisions and abortion being part of them.

References

  • Congress.gov. (2021). H.R.3755 – Women’s Health Protection Act of 2021 . Retrieved from CONGRESS.GOV: https://www.congress.gov/bill/117th-congress/house-bill/3755/text
  • Espinoza, C., Samandari, G., & Andersen, K. (2020, April). Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature. Sexual and Reproductive Health Matters, 28(1); PMC7888105. doi: 10.1080/26410397.2020.1744225.
  • Najmabadi, S. (2021). Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy. THE TEXAS TRIBUNE.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

Description of the Health Policy

H.R.6637, or the Health Fairness and Accountability Act of 2020, seeks to do two things: decrease health inequalities and increase healthcare fairness. Increased access to culturally and linguistically appropriate healthcare, a higher reporting of demographic and health disparities data, and adjustments to eligibility and conditions for Medicaid, Medicare, private medical coverage, and various other initiatives are all included in the bill’s suite of solutions (Congress.gov, 2020). Some forms of cancer, HIV/AIDS, renal disease, and diabetes disproportionately impact people of color, and this legislation seeks to address these issues. It also stresses the need to ensure environmental and social justice.

Background of the Problem or Issue

The United States has long struggled with health disparities or systematic variations in health outcomes across various groups. Racial and ethnic minorities, the economically disadvantaged, and foreign nationals are among the groups most likely to have poor health outcomes and the most difficult time gaining access to adequate medical treatment (Schwartz et al., 2019). Unequal distribution of resources, prejudice, socioeconomic position, educational gaps, and cultural differences are all possible causes of such gaps.

Social Determinant Most Affecting the Policy

The suggested approach is heavily influenced by socioeconomic status, one of the social determinants of health. A person’s access to medical care, health outcomes, and quality of life are heavily influenced by socioeconomic status (Tzenios, 2019). Lower-income people sometimes encounter monetary hurdles to healthcare services, insufficient health awareness, and fewer preventative care options. This factor may exacerbate existing health inequalities.

Evidence Base to Support the Proposed Policy

The Health Equity and Accountability Act of 2020’s suggested policy has strong empirical backing. The presence of health inequalities and the need for tailored treatments to overcome them have been repeatedly shown by research. For instance, studies have shown that those from impoverished backgrounds, including racial and ethnic minorities, and those with shorter life expectancies and inferior health outcomes overall (Razai et al., 2021).

Moreover, efforts aimed at reducing health inequalities have had encouraging outcomes. According to Tzenios (2019), health outcomes and inequalities have improved thanks to efforts to expand access to primary care, increase healthcare practitioners’ cultural competence, and spread health awareness.

Aligning with the current research base and addressing the deficiencies discovered in healthcare equity and quality, the Act incorporates evidence-based measures like workforce diversity support, improved data collection, and targeted interventions for particular illnesses.

Conclusion

The Health Equity and Accountability Act of 2020 implements research-based policies to lessen healthcare access and outcome gaps. The strategy seeks to address the underlying causes of inequities by focusing on social determinants of health, notably socioeconomic status. The proposed law builds on existing research and best practices to ensure its provisions foster health equality and enhance health outcomes for disadvantaged groups.

References

Congress. Gov. (2020). Health Equity and Accountability Act of 2020. Congress.gov. Retrieved from https://www.congress.gov/bill/116th-congress/house-bill/6637

Links to an external site.

Razai, M. S., Majeed, A., & Esmail, A. (2021). Structural racism is a fundamental cause and driver of ethnic disparities in health. BMJ, p. 373. https://doi.org/10.1136/bmj.n938

Links to an external site.

Schwartz, S. B., Sanders, A. E., Lee, J. Y., & Divaris, K. (2019). Sexual orientation‐related oral health disparities in the United States. Journal of public health dentistry79(1), 18-24. https://doi.org/10.1111/jphd.12290

Links to an external site.

Tzenios, N. (2019). The Determinants of Access to Healthcare: A Review of Individual, Structural, and Systemic Factors. Journal of Humanities and Applied Science Research2(1), 1–14. https://journals.sagescience.org/index.php/JHASR/article/view/23

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

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

 

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RE: Main Question Post

 

I noted that your health policy you have chosen was The Families First Coronavirus Response Act 2020. I found your chosen health policy interesting in reading seeing the public is in a current pandemic related to this novel virus as in the coronavirus. It was interesting to see what The Families First Coronavirus Response Act 2020 was focusing on.

You stated in your paper that The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak, and its focus was on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment. I found it partially as in The Families First Coronavirus Response Act 2020 to be a bit biased.

There is so much about this virus that is unfolding before our eyes. We are learning more and each day something new about this virus (Coronavirus).

According to the Washington Post in the United States, the Coronavirus appears to be infecting and killing African Americans at a disproportionately high rate (Thebault, Ba William, 2020).). This emerging stark racial disparity led the Surgeon General to acknowledge in personal terms the increased risk for African Americans amid growing demands that the public-health officials release more data on the race of those who are sick, hospitalized and dying of a contagion that has killed more than 12,000 people in the United States (Thebault et al., 2020).

It was stated in the Washing Post that the reason for African Americans being affected at a disproportionate rate had to with African Americans having higher rates of diabetes, heart disease, and lung disease are well documented, and noted by  Louisiana Governor John Bel Edwards that health problems make people more vulnerable to the new respiratory disease, but there has never has been a pandemic that brought the disparities so vividly into focus (Thebault et al., 2020).

Because of this crisis, the Lawyers’ Committee for Civil Rights Under Law and hundreds of doctors joined a group of Democratic lawmakers, including Senators Elizabeth Warren (Mass.), Cory Booker (N.J), and Kamal D. Harris (Calif), in demanding the federal government to release daily race and ethnicity data on coronavirus testing, patients and their health outcomes, seeing that the data for the Centers for Disease Control and Prevention has only released figures by age and gender (Thebault et al., 2020).

The data being reported by the Centers for Disease Control and Prevention is only including age and gender and leaving out racial or ethnic data. I find this data to be disturbing and biased. Civil rights law prohibit federally funded health care providers from administering services in a discriminatory manner, said Kristen Clarke, president and executive director of the Lawyers’ Committee of Civil Rights Under Law, which joined with medical professionals to call for the immediate release of racial and ethnic data on coronavirus infections, testing, and deaths (Wambsgans, 2020)

According to the Washington Post article, 2020, even though some activists argued African Americans have been more exposed because many held low-wage or essential jobs, such as food service, public transit, and health care, that required African Americans to interact with the public, I find this to be a poor argument in that is still does not address data on race and ethnicity not being reported, as being left out of data for the Center for Disease Control and Prevention.

According to the Center for Disease and Prevention Control (CDC), guidelines in every state is legally required to track data on testing and treatment by race, as it has done during other outbreaks. Fewer than a dozen have released that data so far (Evelyn, 2020). According to what is being found, African Americans are particularly more vulnerable. According to Kristen Clarke president and executive director of the Lawyers’ Committee of Civil Rights, this is a social, economic and racial justice issue (Evelyn, 2020).

I feel that the Families First Coronavirus Response Act 2020, needs to be re-assessed, in that health care officials need to consider different factors that should be included for this health care policy to be justifiable (unbiased).

References

  • Reise Thebault, Andrew Ba Tran, & Vanessa Williams (2020). Washington Post. The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved April 09, 2020, from Https://www.washingtonpost.com/archive
  • Jason E. Wambsgans (2020). National Broadcasting Company news. African Americans may be dying from COVID 19 at a higher rate. Better data is essential, experts say. Retrieved April 10, 2020, from Https://nbcnews.com
  • Kenya Evelyn (2020). The Guardian. It’s a racial justice issue: Black Americans are dying in greater numbers from COVID-19. Retrieved April 10, 2020, from Https://www.theguardian.com
    •  

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NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

The recent health policy I chose is H.R. 8542 which is the Mental Health Justice Act of 2022. This policy will create a grant for each state to train and send mental health professionals to respond to calls that involve a person with behavioral health issues, instead of law enforcement (Congress.gov, 2022). More than 1 in 5 people who are fatally shot by police officers suffered from mental illness which is more than 1,400 people since 2015 (Burke, 2021).

I would say safety would be the social determinant that most affects this policy. Safety for both those with mental illness and law enforcement officers. This bill will hopefully put trained mental health professionals out in the field to help deescalate the crisis before any force is used that could cause major injury or even worse death.

Currently there are no evidence-based studies to support this topic on whether sending out mental health professionals in a mental health crisis call first will reduce injury/death, but I believe there can be taking into consideration the amount of people who have mental health issues that go untreated and can pose as a threat which puts them in danger without being aware of what is happening.

In Rhode Island, they have what they call a co-response team so there are three full time social workers that ride along with an officer during the day and evening shifts to respond to calls as well as two mental health clinicians (Greider, 2022). Although there is no data to support efficacy, it is clear that having co-response teams helps improve safety and resolve incidents for Rhode Island.

References

Improving Our Health

“You have to take care of yourself before you are able to take care of others,” is a great quote by Dr Phil. This is so true even for health care professionals. As health care workers we are trained to put patients first. Self-care is not a priority among clinicians as it can make them feel selfish. Bill S.610 was introduced to the Senate in March 4, 2021 to allow health care providers access to suicide prevention and mental health resources.

These last years, the mental health needs of healthcare professionals have been gaining attention as a major public health concern and threat to quality care delivery (Sovold, 2021). The global pandemic was declared in March of 2020, and for an already strained system where this additional pressure has caused significant stress and burn out. In a recent study conducted by Li et al. revealed that 21.7% of clinicians have moderate depression and 22.1% have anxiety since the COVID-19 pandemic. (Sovold, 2021).

Dr. Lorna Breen Health Care Provider Protection Act was put into place to alleviate the strains our health care workers have been experiencing. It unanimously passed the Senate on August 6, 2021. This Act has allowed the following:

  • Grants for training health profession students, residents and professionals in evidence-informed strategies to reduce and prevent suicide, burnout and mental health conditions.
  • Identification of evidence-informed best practice for reducing and preventing mental health conditions.
  • Establishment of a national evidence-based education and awareness campaign.
  • Establishment of peer-support programming and treatment
  • Establishment of a comprehensive study on health care professionals

The wonderful features of this Act will allow many health care workers to receive the support they need as they continue to work in a strained environment and the hope is that as students emerge in their desired feels that they come prepared to handle the mental strain with evidenced-informed strategies for adaptation.

References

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

The prevalence of burnout and stress among are healthcare professionals date way before the COVID-19 pandemic. The reality of the US health care environment before the arrival of COVID-19 was already concerning due to shortages of nurses, doctors, respiratory therapists, and other healthcare workers (Ross, 2020). Most healthcare providers are working very long hours with less staffing. The media focus at the beginning of the pandemic was mainly on the number of ventilators and hospital beds, and completely lacking in those discussions was the question of available qualified, healthy healthcare professionals to care for the rest of the population (Ross, 2020).

According to Shah et al. (2021), the covid 19 pandemic worsened burnout by worsening the already existing healthcare worker shortages in facilities and hospitals. The lack of nurses and other healthcare providers put so much pressure on the remaining few professionals to shoulder all the responsibility of providing care. The Covid 19 pandemic exacerbated the burnout rates in the healthcare workforce to the extent of suicide for some (Kaine, 2021).

This discussion will review a policy that can affect all of us directly or indirectly as healthcare providers, the Dr. Lorna Breen Health Care Provider Protection Act. The Dr. Lorna Breen Health Care Provider Protection Act addresses behavioral health and well-being among health care professionals (congrsss.gov, 2021). Healthcare professionals’ stress and burnout have been studied throughout the nation, especially with the pandemic exacerbating the problem. (Kaine 2021).

Description of the health policy

The Dr. Lorna Breen Health Care Provider Protection Act was introduced in 2020 by Senator Kaine, who has been leading the talks on the mental health impact of the pandemic on health care workers (congesss.gov, 2021). This policy aims to provide the resources for healthcare providers to get the needed care now during the pandemic and in the future (Kaine 2021).

The policy calls for the Department of Health and Human Services (HHS) to award grants to hospitals, medical professional associations, and other healthcare facilities for programs to promote mental health and resiliency among health care professionals (congesss.gov, 2021). It is also calling for the Centers for Disease Control and Prevention (CDC) to launch a campaign encouraging health care workers to seek support and treatment for mental and behavioral health concerns without consequence (Congress. Gov, 2021).

As Kaine (2021) stated, the trauma that most healthcare workers are subjected to through the pandemic will leave lifelong emotional and physical damage. Thus, the need for setting this resource for the healthcare workers who risked their lives daily to save others. The grants from HHS are to provide relevant mental and behavioral health training of health care students, residents, or professionals with evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders (Kaine, 2021).

In summary, the policy will focus on removing barriers to accessing care and treatment and identifying strategies to promote resiliency, thereby improving mental and behavioral health amongst healthcare providers (Congress.gov, 2021).

Evidence bases to support the proposed policy

The U.S. Senate Passage of the Dr. Lorna Breen Health Care Provider Protection Act has been praised by many organizations, including the American Medical Association (AMA), American College of Emergency Physicians (ACEP), Association of American Medical Colleges (AAMC), the American Foundation for Suicide Prevention (AFSP), the American Hospital Association (AHA), the American Psychiatric Association (APA), American Nurses Association (ANA), and The Physicians Foundation (THE LEGISLATION, n.d.). American Nurses Association (ANA) (2021) applauded the timely and unanimous passage of the Dr. Lorna Breen Health Care Provider Protection Act by the United States Senate on August 6th, 2021. ANA (2021) states that this critical legislation will help reduce and prevent mental and behavioral health conditions, suicide, and burnout among health care professionals who continue to be overwhelmed by the COVID-19 response and recovery efforts. The bipartisan sponsorship of this policy is evidence base to support its proposal. Given the information above, this bill is a national plea for all healthcare workers to get the resources needed to manage mental health and burnout.

References

The Legislation

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The policy in focus is the Protecting America’s First Responders Act (PAFRA) of 2020 that was introduced by U.S. Representative Bill Pascrell, Jr. and U.S. Senator Charles Grassley. This bill sought to provide payment of death or disability benefits to the first responders who gets injured or seriously disabled in the line of duty (Congress.gov, 2021). This bill is a continuation of the Public Safety Officers Benefits Program (PSOB) of 1976 that was established by the Congress to provide death benefits to the survivors of the officers who perished in line of duty. This law was continuously amended over the years to provide education and disability benefits and to increase the pool of officers who are qualified for these benefits.  However, the initiative has been characterized by the delays in settling of the disability and adjudication claims. Moreover, lack of clear guidelines from the department of justice to adjudicate these disability claims has led to inconsistent results (Pascrell, 2021).

            Essentially, there is scanty evidence base to support the proposed policy since many studies only focus on the general public and hardly subpopulation such as police officers or firefighters. However, this policy is critical in ensuring that officers who cannot permanently secure significant gainful employment after a disastrous injury in the line of duty remain qualified for benefits to avoid living a desperate life. According to GovTrack (2021), the bill is also critical in the present times characterized by devastating Covid-19 strike by enabling the families of the first responders who are permanently disabled or die as a result of Covid-19 to get the similar federal benefits extended to the first responders injured or killed in the line of duty.

References

Congress.gov. (2021). S.3607 – 116th Congress (2019-2020): Safeguarding America’s First Responders Act of 2020. https://www.congress.gov/bill/116th-congress/senate-bill/3607

GovTrack. (2021). Safeguarding America’s First Responders Act of 2020 (2020 – H.R. 7031).https://www.govtrack.us/congress/bills/116/hr7031

Pascrell, B. (2021). Pascrell, Grassley Introduce Bipartisan Legislation for First Responders. https://pascrell.house.gov/news/documentsingle.aspx?DocumentID=4734

RE: Discussion – Week 7

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Top of Form

The recent law to ban abortion in Texas sent shock waves across the state and outside, bringing fear of the repo effect as policymakers interfered with a human right. The right to women’s health services. The law put forth restrictions on abortion as early as six weeks and even gave the power for ordinary citizens to sue health care providers found to break this law in the state (Najmabadi, 2021). 

To prevent the passing of the outrageous law in California, Rep. Chu, Judy (D-CA-27) introduced the bill H.R.3755- Women’s Health Protection Act of 2021. The bill persuaded Congress to protect the right of individuals, in this case, women, when it is time to make an informed decision to terminate the unwanted pregnancy and the protection of providers involved in performing abortion procedures under standardized protocols (Congress.gov, 2021). The Women’s Health Protection Act bill is currently under the Senate review, and it has been used to bring public awareness and to the legislatures on the impact of anti-abortion rules, which through informed evidence, its consequences have been found to perpetuate decreased access to safe abortions, as evidenced by a review of the literature completed by Espinoza et al. (2020), which showed an increased rate of infection and mortality amongst 22 million adolescent girls globally. 

Also, increased service cost has hindered women from participating in economic and social developments, leaving women vulnerable to socio-economic exploitations from the opposite sex. Last, the sharp increase in mental health disorders and health disparities in minority ethnics have been associated with limited access to women health services and has continued to affect other preventative vital health services that include screenings, contraceptive services, sexually transmitted disease services, prenatal care, and adaptation services (Congress.gov). 

The fourteenth amendment of the U.S. Constitution gives rights to all American citizens, thus protecting a woman’s right to make adequately informed and educated health decisions and abortion being part of them. 

References

Congress.gov. (2021). H.R.3755 – Women’s Health Protection Act of 2021 . Retrieved from CONGRESS.GOV: https://www.congress.gov/bill/117th-congress/house-bill/3755/text

Espinoza, C., Samandari, G., & Andersen, K. (2020, April). Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature. Sexual and Reproductive Health Matters, 28(1); PMC7888105. doi: 10.1080/26410397.2020.1744225.

Najmabadi, S. (2021). Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy. THE TEXAS TRIBUNE.

 

Great post. The bill would require targeted testing, contract tracing, public awareness campaigns and outreach efforts specifically directed at racial and ethnic minority communities and other populations that have been made vulnerable to the COVID-19 pandemic. COVID-19 has disproportionately impacted communities of colour and the Trump administration’s response has failed to address the needs of these vulnerable populations. Health disparities for people of colour is rooted in systemic racism, racial discrimination, and record-high levels of income inequality (Benfer et al., 2021). The COVID-19 Health Disparities Action Act ensure that future public health response efforts, including testing, contact tracing, and potential vaccine distributions are tailored for diverse communities. The bill will help racial and ethnic minorities in the ongoing fight against this pandemic, and will help inform future reform efforts to reverse long-standing systemic racism in medical research, testing and delivery of care (Benfer et al., 2021).

The fact is black and brown Americans suffer higher rates of chronic disease, inequitable access to health care, fewer economic opportunities, and in some cases real language barriers (Benfer et al., 2021). The COVID-19 Health Disparities Action Act would create a much-needed plan of action specifically designed to address this issue at the federal, state and local levels. According to the COVID Racial Data Tracker, the pandemic has a disproportionate impact on communities of colour. Nationwide, African Americans are dying from COVID-19 at approximately 2.5 times the rate of white people. American Indian, Alaska Native, Hispanic, and Asian American communities are also facing disproportionate rates of COVID-19. The bill is supported by Families USA, the National Hispanic Medical Association (NHMA), the National Alliance against Disparities in Patient Health (NADPH) the Friends of the National Institute on Minority Health and Health Disparities (NIMHD), the National Council of Urban Indian Health (NCUIH) and UnidosUS (Benfer et al., 2021).

This bill addresses the need for complete and accurate data collection on COVID-19 health outcomes, to better inform and tailor testing and contact tracing efforts, and eventually equitable distribution of a COVID-19 vaccine, which will be dependent upon culturally and linguistically appropriate messaging (Davies et al., 2021). This pandemic has not only exacerbated disparities in health and health care outcomes, but also health inequities, which are unjust and avoidable. Latino communities continue to have high rates of infections, hospitalizations, and deaths from COVID-19. NHMA strongly supports the COVID-19 Health Disparities Action Act because it will support targeted strategies to reduce health disparities for COVID-19 and future public health emergencies (Davies et al., 2021). Thank you!

The H. RES. 590 recognizes the month of August as the “National Healthcare Awareness Month” that was introduced to the Congress on August 21st of this year. It is an essential policy, especially this time of the pandemic. People globally have become more health-conscious since the pandemic comes. Health care is not a priority in most of the countries around the globe before the pandemic. However, due to the pandemic, people recognize the importance of eating healthy and staying fit thru exercise.

Although the United States has a better healthcare system than other nations, Americans are still considered unhealthy. According to a new study, few Americans have a lifestyle that is deemed to be healthy. According to new research published in the journal Mayo Clinic Proceedings, less than 3 percent of Americans meet the measurable characteristics that reduce a person’s risks for heart disease (Krans, 2016). Researchers found that only 2.7 percent of the 4,745 participants ages 20 to 85 met all four criteria to be considered for living a healthy lifestyle. Those included: not smoking, eating a diet that aligns with nutritional guidelines, exercising at least 150 minutes a week, or 30 minutes five times a week, keeping a BMI below 20 percent for men and 30 percent for women (Krans, 2016).

Health literacy is defined as “the capacity of individuals to obtain, interpret and understand basic health information and service, and the competence to use such information and services in ways that enhance health” (Vermont, n.d.).The lack of health awareness is a key component to declining health care. People are unaware of the use of their health insurance in the prevention of illnesses. Furthermore, mental health issues are avoided, and people refuse to acknowledge them.

In evidence-based practice, health education interventions effectively affect culturally and linguistically diverse populations, particularly at improving objective, distal outcomes. These interventions may be equally effective in enhancing proximal patient-reported outcomes (Elsevier, 2021).

If the H. RES. 590 will be passed, it will be a massive help for the government to improve health promotion. Some of the essential highlights from the policy are: to educate Americans on ways health care affects the national community and individual life,  to be more cognizant due to covid 19 pandemic, inform the Americans on the work of their elected representatives in protecting and expanding healthcare and every person should have access to education around health care literacy, be empowered to advocate for health care, and use their voice to make a difference (Congress, n.d.). These are only a few of the advocacy of the said policy.

References

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Krans, B. (2016). Less Than 3 Percent of Americans Have Healthy Lifestyle. Healthline. Retrived from https://www.healthline.com/health-news/less-than-three-percent-of-americans-have-healthy-lifestyle

Elsevier. (2021). Patient Education and Counseling. Retrieved from https://www.sciencedirect.com/science/article/pii/S0738399121000501

Vermont. (n.d.). Health Education. Retrieved from https://www.education.vermont.gov/student-learning/content-areas/health-education

Description of the health policy

The health policy bill I selected is “S.2467 – Public Health Emergency Response and Accountability Act,” a proposed health policy in the United States that aims to improve the country’s public health emergency response and preparedness capabilities To provide for a Public Health Emergency Fund, and other purposes; Senator Cassidy introduced the following bill, which was read twice and referred to the Committee on Health, Education, Labor, and Pensions to provide for a Public Health Emergency Fund, and other purposes. According to Congress.gov. (n.d.), this bill modifies funding mechanisms and establishes reporting requirements for public health emergencies, infectious disease outbreaks, bioterrorist attacks, or disasters. Specifically, the bill establishes a formula-based funding mechanism for the Public Health Emergency Fund to automatically provide funding in the event of these types of emergencies. The amounts provided by the bill are designated as an emergency requirement under the Statutory Pay-As-You-Go Act of 2010 (PAYGO) and the Senate PAYGO rule Congress.gov. (n.d.). 

Brief background for the problem or issue

The need for this policy has been highlighted by the COVID-19 pandemic, which exposed significant shortcomings in the country’s public health emergency response infrastructure. The United States faced challenges in rapidly detecting, containing, and mitigating the spread of the virus due to inadequate public health funding, inadequate coordination between federal and state agencies, and shortages of critical medical supplies such as personal protective equipment (PPE) (United States, 2021).

Social determinant most affects this policy.

Socioeconomic status is one of the social determinants of health that most affect this policy. Socioeconomic status has been shown to influence access to healthcare services, which is critical during a public health emergency. Low-income individuals and communities, for instance, are less likely to have health insurance or access to quality healthcare services, making them more vulnerable to the impacts of a public health emergency. This policy addresses this issue by improving access to healthcare services and ensuring equitable distribution of essential medical supplies during public health emergencies (Levine & Jansson, 2021).

 The evidence base supports the proposed policy. 

The evidence base supporting the proposed policy is drawn from numerous studies and reports on the country’s public health emergency response capabilities. For example, a report by the National Academies of Sciences, Engineering, and Medicine (NASEM,2020) highlights the need for a comprehensive and coordinated approach to public health emergency response, citing deficiencies in the current system that compromise the country’s ability to respond effectively to public health emergencies. With the increasing complexity of both public health emergencies and the public health emergency preparedness and response (PHEPR) system, policymakers and practitioners have a crucial need for access to guidance based on robust evidence to support their decisions on practices, policies, and programs for saving lives during future public health emergencies (NASEM,2020)

Another study by the Centers for Disease Control and Prevention (CDC) underscores the importance of adequate funding for public health emergency preparedness, stating that underfunding of public health emergency preparedness activities has led to a lack of readiness, insufficient infrastructure, and delayed response during public health emergencies. (CDC. n.d.).

In conclusion, S.2467 – Public Health Emergency Response and Accountability Act is a proposed health policy that addresses deficiencies in the United States public health emergency response capabilities. The policy seeks to enhance the healthcare system’s capacity, improve access to essential medical supplies, and strengthen accountability measures for government agencies and private entities involved in emergency response. The policy is grounded in evidence-based research highlighting the need for a comprehensive and coordinated approach to public health emergency response and adequate funding for preparedness activities. Socioeconomic status is the social determinant of health that most affects this policy, which influences access to healthcare services during public health emergencies.

References:

Centers for Disease Control and Prevention (CDC). (n.d.). Public Health Emergency Response Guide. https://emergency.cdc.gov/planning/responseguide.aspLinks to an external site.

Congress.gov. (n.d.). https://www.congress.gov/Links to an external site.

Levine, C. A., & Jansson, D. R. (2021). Concepts and Terms for Addressing Disparities in Public Health Emergencies: Accounting for the COVID-19 Pandemic and the Social Determinants of Health in the United States. Disaster medicine and public health preparedness, 1–7. Advance online publication. https://doi.org/10.1017/dmp.2021.181Links to an external site.

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Board on Health Sciences Policy; Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response; Downey A, Brown L, Calonge N, editors. (2020). Evidence-Based Practice for Public Health Emergency Preparedness and Response (8th ed.). National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK564000/Links to an external site.

United States : Cassidy, Schatz Introduce the Public Health Emergency Response and Accountability Act. (2021, July 28). Mena Reporthttps://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edsgea&AN=edsgcl.669898738&site=eds-live&scope=siteLinks to an external site.

I appreciate you taking the time to comment on H.R. 3165, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021. In order to improve patient outcomes and nurse job satisfaction, I think your idea to regulate nurse-to-patient ratios in hospitals is a crucial first step (Twigg et al., 2020).

The premise that healthcare access and quality are crucial socioeconomic determinants of health is in line with your suggested policy. As you noted, Driscoll et al.’s (2018) systematic review and meta-analysis demonstrated that higher staffing ratios were linked to improved patient outcomes, such as lower mortality rates, fewer prescription errors, and lower infection rates. These results support the notion that to deliver high-quality care, there must be a sufficient number of nurses.

As you also pointed out, there is proof that California’s nursing job satisfaction and retention rates have increased as a result of statutory staffing ratios (Van den Heede et al., 2020). This discovery is crucial since there are currently nursing shortages, and keeping experienced nurses on staff is key to providing high-quality patient care.

You noted in your post that hospitals would have to submit staffing plans to the Department of Health and Human Services under the proposed law and that those who didn’t reach minimal ratios would see Medicare payment modifications. I think this system would work well to ensure adherence to staffing levels and enhance patient outcomes.

Finally, I concur that the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021, H.R. 3165, is backed by data and has the potential to enhance nurse job satisfaction as well as patient outcomes. The suggested legislation would be a positive step in addressing healthcare disparities since it is consistent with the notion that healthcare access and quality are social determinants of health.

References

Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12), 4599-4611.

https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14909Links to an external site.

Van den Heede, K., Cornelis, J., Bouckaert, N., Bruyneel, L., Van de Voorde, C., & Sermeus, W. (2020). Safe nurse staffing policies for hospitals in England, Ireland, California, Victoria and Queensland: a discussion paper. Health Policy, 124(10), 1064-1073.

https://www.sciencedirect.com/science/article/pii/S0168851020302037Links to an external site.

Evidence Base in Design 

In searching through the congress website provided, I came across several health policy bills.  One that caught my eye was a policy introduced on May 28th, 2021, to the House of Representatives, H.R.3572 Increasing Access to Mental Health in Schools Act (Congress, n.d).  This bill was directed to the Department of Education to establish a grant program and student loan forgiveness program to increase the number of school-based mental health service providers in elementary and secondary schools (Congress, n.d.).  The proposed bill would help establish a relationship between mental health providers and school systems.  A deal would be worked out were the mental health service provider would be paid by the grant money as well as an incentive to pay off student loans if working at the school for a certain amount of time.  Low-income areas would be one of the targeted populations.  

Mental health awareness has become an increasingly popular topic in healthcare.  Not only are professionals becoming more aware of the issue, but society of all ages are also recognizing mental health needs as well.  Studies have shown that mental illness is hidden frequently in childhood, later manifesting into adult mental illness.  Sadly, childhood suicide levels are on the rise.  Mental illness has a stigma behind it causing so many to hide their illness and not seek help.  Mental illness is one of the major social determinates society faces.  According to a study done to research mental health awareness in children, studies have shown as children get older their opinions of mental illness become more negative (Fox, 2020).  The theory behind the study is that if children are made aware of mental illness and the importance of mental health early on, they may be less likely to fear those with mental illness and more likely to seek treatment if they are troubled with a mental health issue (Fox, 2020).  Another study done by Ferrie et al. (2020) states that twenty percent of children are troubled with some sort of mental illness, yet children underutilize mental health services. These studies reveal there is a definite evidence base to support the need for this program.  Many of schools lack mental health professional due to funding and budgets, therefore the children are not guided in the right direction when needing help.  Also, schools lack individuals trained in recognizing mental health issues, this would put more mental health professionals in direct contact with students as well as a private place for them to turn to when in need.  Plenty of money goes towards athletic programs in schools, it’s time to start showing up for children with real disparities and mental health needs so they can have the best future they deserve.   

References 

Congress. (n.d.). H.R.3572-Increasing access to mental health in schools act. https://www. www.congress.gov/bill/117th-congress/house-bill/3572?q=%7B”search”%3A%5B”addressing+mental+health+youth”%2C”addressing”%2C”mental”%2C”health”%2C”youth”%5D%7D&s=1&r=16 

Ferrie, J., Miller, H., & Hunter, S.C. (2020). Psychosocial outcomes of mental illness stigma in children and adolescents: A mixed-methods systemic review. https://doi.org/10.1016/j.childyouth.2020.104961 

Fox, C. (2020). Children’s attitudes to people with mental illness. Journal of Applied Developmental Psychology, 67. https://www.sciencedirect.com/science/article/pii/S0193397320300691 

 The Fair Care Act of 2020 introduced by the Republican party would initiate affordable healthcare to all Americans without increasing federal spending. The Fair Care Act is an attempt to create a bipartisan agreement for a healthcare system that provides for all Americans, without taking unnecessary hard-earned tax dollars from those already paying for insurance. “The bill also takes significant steps to reduce the underlying cost of health insurance, by reforming insurance regulations, supporting innovative technologies, and increasing price competition for hospital care and prescription drugs (Roy, 2020).”

 This bill focuses on the external factors of the policy implementation; those that live in poverty and or have unequal access to healthcare. However, there are still citizens who decline healthcare, about three-fourths of the total uninsured, even though they are eligible for Medicaid or the ACA. This bill would seek to negate these social determinants by lowering healthcare costs in hospitals and with prescription drugs, reforming the ACA marketplace, and filling the coverage gaps that create Medicaid expansion “by expanding eligibility for advance premium tax credits to those below 100% FPL (Roy, 2020).”

 As for an evidence base that supports this policy, the evident cost of healthcare is what drives the change for healthcare affordability. According to the World Index of Healthcare Innovation, the United States ranks 29 out of the 31 wealthiest countries in finding ways to decrease healthcare costs. Only estimations and projections can be made at this time based off the Congressional Budget analysis of past, present and future costs of healthcare to support why the Fair Care Act (FCA) would be more beneficial to Americans than that Affordable Care Act (ACT). Deficit reduction is the driving force of trying to find ways to decrease healthcare costs. However, in doing so, the reductions must be made with considerable thought. With cuts to social security and Medicare currently off the table, cuts to Medicaid and premiums from the ACA will be targeted next, Bubanksi, Biniek, & Neuman (2023).

Cubanksi, J., Biniek, J., & Neuman, J. (2023). FAQs on Health Spending, the Federal Budget and Budget Enforcement Tools. KFF.   Retrieved April 10, 2023, from, https://www.kff.org/medicare/issue-brief/faqs-on-health-spending-the-federal-budget-and-budget-enforcement-tools/

Links to an external site.

Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4:   Evaluating policy. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf

Roy, A., (2020). Market-Based Universal Coverage. FREOPP.org. Retrieved from April, 10, 2023, from, https://freopp.org/the-fair-care-   act-of-2020-market-based-universal-coverage-cc4caa4125ae

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