NURS 6050 Discussion 1: Evidence Base in Design 

Sample Answer for NURS 6050 Discussion 1: Evidence Base in Design  Included After Question

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

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

NURS 6050 Discussion 1: Evidence Base in Design 
NURS 6050 Discussion 1: Evidence Base in Design

To Prepare: 

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

By Day 3 of Week 7 

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

By Day 6 of Week 7 

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

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. 

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

A Sample Answer For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design 

Title: NURS 6050 Discussion 1: Evidence Base in Design 

The health policy I chose to write about pertains to the continuation of telehealth treatment of patients with the limitations established during the COVID19 pandemic. With this legislation, patients that relied on telehealth during the pandemic could continue to receive telehealth care in future years. These patients that telehealth most benefitted were those that were limited in their ability to attain in-person healthcare due to health status or transportation limitations. 

Social determinants that affect this include health care access and economic stability. Health care access can be very limiting for some patients, especially those who are in rural areas. For those people, they may have to drive a significant distance to access healthcare, especially if they need to see a specialist. Specialists can be few and far between in healthcare, especially for those who treat rare and unique diseases. Telehealth helps connect people to specialists, who would normally be a great distance away. The financial burden of traveling a great distance, could be enough to deter a patient from seeking the treatment they need. Economic stability ties into the financial burden of travel. If a patient needs to travel a long way to see a specialist, they may not be able to. Additionally, the cost of gas or not having access to a vehicle, can hold patients back from getting treatment. 

Arnaert et al. described a study in which Chronic Obstructive Pulmonary Disease (COPD) patients were given a pulse oximeter to measure their oxygenation status and access to a telehealth RN during the COVID19 pandemic. The study found that these patients felt less anxiety during the study due to the daily availability of a healthcare provider to assess their status (2022). COPD patients were some of the most at-risk people during the pandemic, with already compromised respiratory function, leading to increased anxiety during the time of isolation. This improvement of care is not limited to the pandemic. COPD patients can face daily trials due to their conditions, the ease of access to healthcare cannot be understated in this case. Also, these patients are often elderly patients who cannot easily access healthcare, due to restrictions financially or due to access to transportation. 

In a study, Lindberg et al. describes the increased use of telehealth for contraceptive care during the COVID19 pandemic. The study showed an increase of usage in rural and urban areas with a greater increase in urban areas (2022). This could be due to increased rates of COVID19 in urban areas. While the increase in rural areas could be due to the distance, they would have to travel to receive quality care. This study showed the efficacy of telehealth by bringing more patients in to the office to receive quality care, where they may not have had before telehealth care was available. Overall, the benefits that this policy would keep cannot be overlooked. With the policies that came into effect during the pandemic, more people had more convenient access to quality healthcare that they did not have before. With this policy continuing measure put into place during the pandemic, quality healthcare would reach more people. 

References 

Arnaert, A., Ahmad, H., Mohamed, S., Hudson, E., Craciunas, S., Girard, A., Debe, Z., Dantica,  J. L., Denoncourt, C., & Côté-Leblanc, G. (2022).             Experiences of patients with chronic obstructive pulmonary disease receiving integrated telehealth nursing services during COVID-19   lockdown. BMC Nursing, 21(1), 1–13. https://doi.org/10.1186/s12912-022-00967-2 

Lindberg, L. D., Mueller, J., Haas, M., & Jones, R. K. (2022). Telehealth for Contraceptive Care During the COVID-19 Pandemic: Results of a                     2021 National Survey. American Journal of Public Health, 112(Sup5), S545–S554. https://doi.org/10.2105/ajph.2022.306886 

Test – H.R.341 – 117th Congress (2021-2022): Ensuring Telehealth Expansion Act of 2021. (2021, February 2). http://www.congress.gov/ 

A Sample Answer 2 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design 

Title: NURS 6050 Discussion 1: Evidence Base in Design 

Hello Joseph, great post I definitely benefitted from telehealth during the pandemic also. Yes some people may not have access to certain health benefits due to transportation like you mentioned and that could definitely lead to lower health outcomes in underserved communities. You mentioned patients with COPD during the pandemic and I thought this was a great example. Yes these patients have an increased risk of severe pneumonia and poor outcomes when they develop COVID-19. (Leung et al., 2020). While there are a lot of benefits to Telehealth, we cannot overlook the downsides because not every visit can be done remotely. You still have to go into the office for things like imaging tests and blood work, as well as for diagnoses that require a more hands-on approach. (Watson, 2020). 

 

References 

Leung, J. M., Niikura, M., Yang, C. W. T., & Sin, D. D. (2020, August 13). Covid-19 and COPD. The European respiratory journal. Retrieved October 10, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424116/ 

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard Health. Retrieved October 10, 2022, from https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages 

A Sample Answer 3 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design 

Title: NURS 6050 Discussion 1: Evidence Base in Design 

I enjoyed reading your post and analyzing your work. Telehealth significantly improves the health outcomes for patients with chronic diseases and those with difficulty accessing care due to challenges of geographical location (Dinesen & Nonnecke, 2019). When you are ill, you can use telemedicine to avoid driving to the doctor’s office or clinic or waiting in a waiting room. Additionally, virtual visits can often be easily accommodated into a busy schedule, eliminating using gas that some may not have. Some patients live far from hospitals or doctor’s offices, which can be a significant challenge for some. 

While Telehealth has many benefits, it also has challenges. Some patients have less access to care since half of the senior citizens in the US lack internet connectivity and the knowledge to access and use telemedicine. Older adults are not the only ones affected; low-income families may also not have access to the internet. It also poses limitations, as a doctor cannot do a physical exam, leading to the wrong diagnosis. Additionally, while insurance companies are increasingly covering the cost of telehealth visits, some services might not be covered, leading to out-of-pocket costs (Watson,2020). I do think there is a good evidence base to support this policy. Telehealth has brought more accessible access to healthcare for many people. As you said, more people have convenient access to quality healthcare that they did not have before, and I think that is the focus we need. Although some have connectivity issues and technological disadvantages, I think the benefits outweighs the alternative, and doctor offices will still be available for patients. If legislation wants results, moderating factors that limit robustness across settings, populations, and interventions need to be addressed to see these results (Glasgow et al.,2003). 

Dinesen, B., & Nonnecke, B. (2019). Personalized telehealth in the future: A global                      

research agenda. Journal of Medical Internet Research. Retrieved October 9, 2022, from       

         https://www.jmir.org/2016/3/e53/ 

 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://doi.org/10.2105/AJPH.93.8.1261 

 Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard Health.   

Retrieved October 11, 2022, from https://www.health.harvard.edu/staying- healthy/telehealth-the-advantages-and-disadvantages  

 

A Sample Answer 4 For the Assignment: NURS 6050 Discussion 1: Evidence Base in Design 

Title: NURS 6050 Discussion 1: Evidence Base in Design 

Proposed Health Policy

The United States is an outlier in maternal medicine. We are one of the wealthiest countries and yet we have one of the worst maternal mortality rates, and it keeps rising. One of the reasons for this high statistic is the lack in maternal medicine equality in the U.S. “Differences in health insurance coverage and access to care play a role in driving worse maternal and infant health outcomes for people of color” (Hill et al., 2022). We as a nation do not provide adequate maternal care to all citizens. Impoverished and minority groups often have the worst maternal outcomes. “Pregnancy-related mortality rates among Black and ASIAN women are over three and two times higher, respectively, compared to the rate for White women” (Hill et al., 2022). This comes back to the lack of health insurance and access to care. Minorities in AMerica tend to seek less pregnancy care and when sought it is usually toward the end of a pregnancy.

Fetal Maternal medicine is a topic that is talked about often, but the disparities are often left behind. Many states look to change this by instituting review committees however their review process for causes is not consistent as seen in the fact that “49 states have formal maternal mortality review committees (MMRC) to investigate pregnancy-associated deaths, only nine states, Washington, D.C., and New York City consider racial disparities and equity in their assessments” (Tu, 2023). This is an issue as majority of maternal deaths are in the minority communities. Also, there are no regulations on these committees having to report their finding as noted that, “reviews are not consistently delivered by all committees. For instance, MMRCs in only 36 states reported their findings to the CDC between 2017 and 2019” (Tu, 2023). The means that 13 committees chose to not report their findings. This is a concern of great magnitude. How can we seek to fix the issue if we cannot see the disparities or the reviews of cases from committees who look into them across the United States.

This is where H.R. 4605 Healthy Moms and Babies Act proposal comes in. This act seeks to narrow the gap in healthcare disparities and provide new ways of access and guidance in the maternal health arena. They seek to establish programs and require maternal health services to those on Medicaid and enrolled in the CHIP program. They seek to expand access to telehealth services for prenatal and postpartum women on Medicaid. The act will establish an advisement group on the birthing process for healthcare professionals, requiring study on Medicaid coverage of doula services as well.  In addition, one of the biggest things they are seeking through this Act is to require the Conters for Medicare and Medicaid services to develop guidance on ways to address social determinants of health for pregnancy and postpartum women to reduce maternal mortality for Medicaid and CHIP beneficiaries.

The Healthy Moms and Babies Act seeks to address one of the biggest reasons for the high rate of maternal fetal deaths in this Country. Medicaid deals with some of the most impoverished communities and if we can, through legislation, guarantee that we are providing access to care and narrowing the gap of inequality in healthcare then we as a nation must work to do so. It is a travesty that we as a country can be one of the wealthiest in the world, but we cannot protect our mothers and babies because we have not made the cause of mortality rate a priority.

 

References

Congress.gov | library of Congress. (2023). Congress.gov. https://www.congress.gov/

Hill, L., Artiga, S., & Ranji, U. (2022, November 1). Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/

Tu, L. (2023, July 25). Why Maternal Mortality Rates Are Getting Worse Across the U.S. Scientific American. https://www.scientificamerican.com/article/why-maternal-mortality-rates-are-getting-worse-across-the-u-s/