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

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

Sample Answer for NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample Included After Question

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

  • In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
  • Review the Resources and reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Select an existing healthcare program or policy evaluation or choose one of interest to you.

Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.

By Day 6 of Week 9

Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

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

A Sample Answer For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

Evaluation of California’s Whole Person Care(WPC) Program

The Whole Person Care (WPC) is a pilot program under the “Medi-Cal 2020,” a Section 1115 Medicaid Waiver from January 1, 2016 to December 31, 2021. WPC was designed to improve the health of high-risk, high-utilizing enrollees with multiple service needs.

There were 25 pilots representing the majority of counties in California who participated in the WPC and started enrollment in January 2017.  These pilots were required to identify and enroll eligible Medi-cal beneficiaries, coordinate care across health, behavioral health, and social services; involve relevant stakeholders; and share data in real-time with goals of improved care delivery, better health, and lower costs (DHCS.n.d).

Pilots were to target one or more of the following six populations: (1) high utilizers of avoidable emergency departments, hospitals, or nursing facilities (high utilizers); (2) individuals with two or more chronic physical conditions (chronic physical conditions); (3) individuals with severe mental illness and/or substance use disorders; (4) individuals experiencing homelessness; (5) individuals at-risk-of-homelessness; (6) individuals recently released from institutions, including jail or prison (justice-involved); (7) individuals affected or at risk of COVID-19 (Pourat et al, 2022.

The findings of the evaluation showed that the WPC pilots were able to develop appropriate infrastructure like staffing, and standardized protocols to support effective care coordination. In addition, there was a decrease in ED visits and hospitalizations and an increase in long-term stays relative to the control group; a reduction in overall estimated Medi-Cal costs, and enrollees had a reduction in primary care; decline in mental health care and an increase in substance use treatment.

Lack of accessibility to health care services was the most common problem identified by the target population. Lack of economic stability, education access, neighborhood, and community support  along with safe housing, transportation, and exposure to discrimination or violence contribute to a person’s ability to experience high-quality life (Bitfocus. 2021). Focusing on providing shelter and housing first WPC can now better address the challenges that these social health determinants bring.

Bitfocus. 2021. Whole Person Care part 2:Evaluating Social Determinants of Health Crucial to Providing Improved Patient Care. https://www.bitfocus.com/blog/whole-person-care-evaluating-social-determinants-of-health

Links to an external site.

DHCS. n.d. Whole Person Care Pilots. https://www.dhcs.ca.gov/services/Pages/WholePersonCarePilots.aspx

Links to an external site.

Pourat, N., Chuang, E., O’Masta, B., Haly, L., Chen, X., Haile, M. 2022. Final Evaluation of California’s Whole Person Care (WPC) Program. https://healthpolicy.ucla.edu/publications/Documents/PDF/2023/Final-Evaluation-of-CA-Whole-Person-Care-Report.pdf

Links to an external site.

A Sample Answer 2 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

Evaluation is a term that is well-known in the nursing profession. The nursing process, which includes assessment, planning, implementation, and evaluation, is one of the first things that a nurse is taught. Evaluation of programs or policies is no different; the same theory is used to determine the effectiveness of a particular program or policy (Milstead & Short, 2019). This evaluation is critical for policy development because it identifies the long-term effects of policies on populations, but it is frequently overlooked (Laureate Education, 2018).

RNs and APRNs have a professional obligation to advocate for health policy (Laureate Education, 2018). They can get involved in health policy evaluation by developing relationships with and educating political leaders about the wealth of knowledge that an RN or APRN possesses regarding health policy. “The difficult task of the NP political advocate is to educate and convince powerful policymakers that supporting and advancing policies that promote improved health and health care is in the larger community’s best interest” (Kostas-Polston, Thanavaro, Arvidson, & Taub, 2015). Acquiring the trust of a political leader enables one to gain access to policy evaluation. As the nurse advocate’s relationship with the political leader develops, the nurse will be recognized as a reliable source of objective information and evaluation (Kostas-Polston et al., 2015).

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

Another way to get involved in policy evaluation is to join a professional organization like the American Nurses Association (ANA). Numerous professional organizations, such as the ANA, are involved in providing data to legislators during the process of policy evaluation (Milstead & Short, 2019). Nurse advocates frequently serve as the spokesperson for these healthcare reforms. Maintaining current knowledge of health care policies and issues enables the nurse to advocate for the nursing profession, as well as patient safety and access to care. Discussion of NURS 6050 The RN APRN’s Role in Policy Evaluation

Nurses must be prepared for challenges that exist with policy evaluation. One challenge could be gaining access to political leaders, as they have busy schedules. When requesting to meet with a legislator, it is possible that the nurse would be meeting with the legislative staff member. However, the legislative staff member is still influential and their job is to advise the legislator on research and issues (Kostas-Polston et al., 2015). The nurse should present her evaluation of the health policy to the legislative staff member and have a written evaluation to leave with them. An additional challenge to policy evaluation is sparking community comment on the results of the evaluation. Sometimes evaluations can bring to light other issues that will need to be addressed, changing the direction of the political agenda.

One strategy that I would recommend is incorporating health policy into all nursing education. Currently health policy is not part of

the ADN curricula, however I believe that the foundation should be started here. Another strategy to enlighten nurses on involvement in health policy would be for nursing leaders to take initiative with their employees and teach them about health policy and advocacy. Health care organizations could make it part of a clinical ladder program or a yearly education requirement. Knowledgeable nurses need to promote the existence of political advocacy. Nurses should be involved in all stages of health care policy and are urged to use their expertise and their critical thinking to evaluate health policy for the betterment of society. NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample.

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References

Kostas-Polston, E. A., Thanavaro, J., Arvidson, C., & Taub, L.-F. M. (2015). Advanced practice nursing: shaping health through policy. Journal of the American Association of Nurse Practitioners27(1), 11–20. https://doi-org.ezp.waldenulibrary.org/10.1002/2327-6924.12192

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

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

A Sample Answer 3 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

Good job on your post. Being a member of a professional organization is a great place to have a voice in policy making and evaluation since there is strength in number. This means that from now on, we must strive to be voices that will be counted in and join as dues paying members of these organizations. The evaluation process begins as the policy is been crafted as the efficiency and effectiveness of the policy must be measured (Laureate education, 2018). NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

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

References

Abood, S. (2007, Jan. 31). “Influencing Health Care in the Legislative Arena”. OJIN: The Online Journal of Issues in Nursing. 12(1), Manuscript 2. https://doi.org/10.3912/OJIN.Vol12No01Man02

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

A Sample Answer 4 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

I agree nurses must be prepared for challenges that exist with policy evaluation. That is why I feel it is important for nurses to understand how the policy process works first in order to be effective in the political arena.

To influence health care policy, we must start with a basic understanding of the legislative process. How can one play a part in any process without understanding how the process works?

Before introducing a bill, a member of Congress will do research to collect facts and send draft versions to different organizations for their input on how it will affect their members (AACN, 2003). This is the first opportunity for citizens as well as nurses to influence a bill (AACN, 2003).  Members of nursing organizations will be called upon to provide feedback. This is a nursing organization’s advantage and opportunity to influence a bill at this stage of development. Bills start with ideas. The best bills are the ones that are easy to explain and positively affect many people (AACN, 2003).  One best way to get involved in the process of policy making is through nursing organizations. NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

Nursing organizations can be beneficial to all nurses. The American Nurse Association (ANA, 2020). Advocates on the nurse’s behalf, educating and forging relationships with members of the Congress and congressional staff on both sides of the aisle and lobbying to advance ANA’s policy agenda in support of nurses and patients (ANA, 2020).

When Congress passes laws, they rarely contain enough specific language to guide their implementation completely (ANA, 2020). It is the responsibility of the federal administrative agencies to fill in the details of new or amended laws with rules and regulations and it is important that the voice of United States nurses is heard during this process (ANA, 2020).

I feel getting involved in a Nursing organization at a state and federal level is a great opportunity for nurses to get involved in the political arena. Nurses cannot afford to remain in the background or added as an afterthought to the policy and legislative arenas. As the single largest single group of health care providers, nurses have the potential to successfully advocate from a diverse power base; and they have a unique perspective on health care policies and expertise to share with power brokers (Abood, 2007).

Nurses need to be a strong voice actively advocating for positive change. Nurses strengthen their power base when they network with nursing colleagues and other supporters to build consensus on important issues, and a Nursing organization is one excellent way to network with other professionals and to become involved in the politics of health care.

REFERENCES

Sheila Abood, S. (January 32, 2007). Influencing Health Care in the Legislative Arena. OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2.  Retrieved April 25, 2020, from

https://NursingWorld.org>ojin

American Nurses Association (ANA, 2020).  Health Policy. Retrieved April 25, 2020, from

https://NursingWorld>practice-policy>health

American Academy of Ambulatory Care Nursing. How a bill becomes a law. Retrieved April 22, 2020, fro

https://www.aaacn.org>legislative

A Sample Answer 5 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

RNs and APRNs play essential roles in health care that influence policy decisions. There are numerous chances for nurses and nurse practitioners to get involved in policy-making. House policy-making and evaluation are essential, but legislative and political advocacy is no less critical to advancing the profession and patient care (ANA,2020). Participating in creating these policies establishes and incorporates relevant criteria for providing care. 

The first opportunity for APRNs to actively participate in policy-making is becoming a member of a professional nursing organization. Doing so allows an NP to gain access to the tools it might take to get involved with groups of others participating in policy-making. Although some may feel hesitant about joining a professional organization, induction is primarily expected in the nursing community (Echevarria, 2018). An example of a professional organization is the American Association of Nurse Practitioners. Being a part of the American Association of Nurse Practitioners (AANP) is more than just a membership; it is a real opportunity to make a measurable difference in the strength of your profession and the health of this country (American Association of Nurse Practitioners, 2022). This organization offers much insight into the education, advocacy, and practice. Being a member of the AANP will allow individuals to be educated and aware and allows RNs and APRNS to make a difference in patient care. 

 The second opportunity for APRNs and registered nurses to actively participate in policy-making is to continue education. While nurses can participate in policy-making at any educational level, pursuing an advanced degree is an effective way to get a seat at the nursing policy table. Earning a DNP demonstrates nurses’ expertise at the highest level of practice, represents their commitment to advancing health outcomes, and distinguishes them as a thought leader. The DNP has been recognized by the American Association of Colleges of Nursing as the most appropriate degree for advanced-practice registered nurses to enter practice (Marymount University,2021). 

   APRNs might face a challenge in policy-making is the lack of available resources and knowledge.   Some nurses felt as though they did not possess the right resources to be able to mobilize policy-making actions. Reviewing and developing policies can become overwhelming and intimidating. APRNs also felt they had a lack of knowledge pertaining to health policy development, thus making it difficult to move forward in the process. Nurses and nurse practitioners found that influencing policy development and the course of the health policy is mainly about securing resources for health care (Shariff,2014). To overcome this challenge, I recommend becoming a professional nursing organization member. Nursing organizations give nurses the tools they need to stay current on best practices, read the opinions of industry leaders, and get a peek at what other hospitals throughout the nation are doing to change patient care. 

The second challenge nurses and APRNs might face is a feeling of powerlessness to affect policy change. It is not uncommon to feel as though your voice is being ignored when you are a part of a significant movement. Front‐line nurses may believe it is impossible to create policy change at the national or even local level; many may think their role is too small to make a difference in health policy. However, the front-line engagement nurses have with patients, and other healthcare professionals, make them ideal healthcare policy advocates (Rafferty,2018). When decision-makers hear from nurses and practitioners, it will improve decisions on care coordination, regulatory changes, and health information technology. Knowledge is power in these situations. 

One of the strategies I may implement is educating other nurses so they can be a part of policy-making. Until this class, I had no idea that I could affect policy-making. I would share facts, get people involved in a nursing organization that suits them, and increase awareness that we can make a change as nurses or APRNs. A second strategy I would use is to get the hospital I work at involved in policy reviews and nurse advocacy. I would create an in-house organization that makes nurses aware of their power to make change happen. I would collect a list of hospital issues we experience, see what we can do to change them, and collaborate with other hospitals to see if the issue is happening elsewhere. 

American Association of Nurse Practitioners. (2022). Clinical Resources for Nurse Practitioners (NPS). American Association of Nurse Practitioners. Retrieved October 12, 2022, from https://www.aanp.org/practice/clinical-resources-for-nps 

ANA. (2020, April 27). Advocacy. Practice Advocacy . Retrieved October 12, 2022, from https://www.nursingworld.org/practice-policy/advocacy/ 

Echevarria, I.  (2018).  Make connections by joining a professional nursing 

organization.  Nursing,  48 (12),  35-38.  doi: 10.1097/01.NURSE.0000547721.84857.cb. 

 

Marymount University.(2021, November 11). 5 ways nurses can shape policy. Marymount University Online. Retrieved October 12, 2022, from https://online.marymount.edu/blog/nursing-influence-on-health-care-policy 

Rafferty A. M. (2018). Nurses as change agents for a better future in health care: the politics of drift and dilution.Health economics, policy, and law, 13(3-4), 475–491. https://doi.org/10.1017/S1744133117000482 

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 

A Sample Answer 6 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

There has been increasing growth toward nurses’ presence, role and influence in health policies during recent years as the health systems are rapidly developing and changing. Nurses (RN/APRN), as part of the healthcare delivery system should move forward along with these changes that for this reason, nurses need to influence the formulation of health policies rather than just mere implementation of these policies. They need to be active in the development of health policies to be better able to control their practice and they need to acquire policy-making skills in order to address professional challenges. By virtue of their values, professional ethics, advocacy skills and experiences, nurses have unique and valuable views toward health policies.

Nurses are expected to identify the issues deliberately and work with other decision makers to advance health care policies. Therefore, we can say that nurses have to be involved in policies which affect patients, families, themselves and the whole health care system. Nurses’ influence in health polices protects patient safety, increases quality of care and facilitates their access to the required resources and promotes quality health care. By knowing how the political system works and which strategies can effectively influence policy, any nurse can become an advocate at the local, state or federal level. Accordingly, the concept of policy influence in nursing is a new and important concept. Health systems policies settle within three levels: micro, macro and meso. In the micro level, policies are just for specific parts, fields, or groups, and have not been made essentially by the government, whereas in the macro level, policies are for the whole country and have been made essentially by the government. The meso level policies settle between micro and macro levels and have usually been made by official organizations.

Nurses have the ability to affect health policies. This effect is impossible without the required knowledge of health care system as a whole. Nurses need to be aware of policy agenda, policy makers and political backgrounds. They are advocates for improvement of the quality of care, but many of them do not have adequate organizational and personal power for advocating patients’ rights. In fact, for nurses to be in a state of empowering patients, it is first essential for them to be empowered. Their expertise, judgment and policy influence, all together help them to achieve their goals and to facilitate the professional process and the efficacy of health care system.

Professional nursing organizations and other healthcare leaders from government and healthcare organizations call for nurses to engage in health policy leadership and advocacy to fulfill the social and ethical responsibilities of the profession. For example, the American Association of Colleges of Nursing (AACN, 2008) asserts that nurses have a moral and ethical responsibility to participate in the political process and advocate for patients, families, communities, the nursing profession and changes in the health care system as needed. The National League of Nursing (NLN, 2014) asserts that nurses have a role in shaping policy to assure patient access to safe, high-quality health care. The American Organization of Nurse Executives (AONE, 2014) encourages nurses to be active in national policies on health and patient care issues due to the most recent developments in national health policy. The American Nurses Association (ANA) Code of Ethics (ANA, 2015) and the Social Policy Statement (ANA, 2010) explicitly articulate nurses’ social and ethical roles and responsibilities pertaining to health policy. Three provisions from the Code of Ethics relate to the professional nurse’s involvement in health policy formation, implementation and modification. The Social Policy Statement describes nursing’s leadership role in public and political determinations about the health care resources, planning and regulations. Finally, the Institute of Medicine’s (IOM, 2011) report, The Future or Nursing, calls on nurses to be full partners, with physicians and other health care professionals in redesigning health care in the United States.

Many reasons for nurses’ lack of involvement in policy making have been identified, such as lack of awareness, inadequate skills  and little involvement  due to the fact that as direct caregivers, nurses spend more time with patients at the bedside  than any other healthcare providers in other disciplines. Another challenge or barrier is the limited formal health care policy education in nursing.

As early as the 1980s, majority of schools of nursing had incorporated health policy content into the curriculum, and nursing leaders stressed the importance of including health policy in nursing curricula (Andreoli et al.,1987). They argued that education was needed to increase nurses’ political skills, involvement and competence of nursing’s future leaders. (Rains & Carroll, 2000), to socialize students to think and act from the perspective of health policy and understand how they fit in the larger scheme of things (Choudhry & Callahan, 1993) and to provide nurses with a working knowledge of the process of health policy formulation, implementation, and modification. Recommendations for health policy curriculum content are readily available in nursing publications and from professional nursing accrediting organizations. The AACN has played a major role in ensuring that health policy is included in nursing curriculum. The AACN Essentials documents (AACN, 2006, 2008, 2011) call for nurses to achieve 12 health policy competencies at the baccalaureate level, 5 competencies at the master’s level, and 7 competencies at the DNP level. The AACN Essentials documents contain a broad over- view and comprehensive list of health policy competencies, content and activities to be included at every stage of nursing education.

By knowing how the system works and which opportunities or strategies can effectively influence policy, nurses (RN/ APRN) can actively participate in policy making  at the local, state, or federal level.  They can make phone calls to elected representatives about bills under consideration, testify before committees, become involved in practice councils or boards at the workplace and even run for elected office. There is strong consensus that nurses need to be more actively engaged in the health policy process. Although nurses’ contributions to health policy have steadily increased over time and currently receive greater recognition by the general public, far too many health policies are developed without sufficient input by nurses (Richter et al., 2013).

I propose an approach to health policy education in nursing based on stages of nursing professions political development (Cohen et al., 1996). With a staged approach to education, each level of education builds a foundation for the next. Content is introduced appropriate to the nurse’s role at each level of education and begins with what is familiar and most accessible to the student. Beginning at the baccalaureate level, the focus of education is on organizational and local policies, progressing to state and regional policies at the master’s level and culminating with federal health policies at the doctoral level. Aligning health policy content with clearly identified role expectations makes the content relevant. Also the skills gained at each level of education reinforce and are consistent with skills needed to participate in policy at that level. Staged curriculum content that is consistent with the roles for which nurses are educationally prepared expands expectations for students’ participation in health policy at each level of governance. These stages reinforce the notion that political development, like other areas of development, is a process achieved over time. I propose also that health policy be a stand-alone course at each level of education and that it should be reinforced by integrating aspects of policy into other courses in the curriculum.

Finally, I suggest that nursing faculty serve as role models based on their knowledge of and active engagement in health policies. Nursing faculty have a responsibility to facilitate students’ political development by providing the content and learning activities to support student progress through the various stages of development, including political and policy knowledge acquisition and progressive development of skills in communication, advocacy, analysis, and research. Dr. Fauci is our professor this course, Policy and Advocacy for Improving Population Health, he brings his expertise about health policies. I learned so much from him especially when he reflects to my discussions. He helped his students understand the complicated process of health policies and  building on the students’ research skills, writing assignments based on research helps students bring together the key components of health policy making.

With the master’s degree in nursing program, we are encouraged to become active participants in the policy process, bringing issues to policymakers’ attention and recommending alternate or amended policies to improve care to various state populations. Active participation in health policy involves legislative advocacy such as collaborating with policy makers or policy making bodies to gather support or influence the policy development process (Porche, 2012). Thus, graduates of master’s degree nursing programs are able to influence the policy process and its development, implementation and evaluation (AACN, 2011).

References

Cohen SS, Milone-Nuzzo P. Advancing health policy in nursing education through service learning. ANS Adv Nurs Sci. 2001;23:28–4.

Ferguson LS. An activist looks at nursing’s role in health policy development. J Obstet Gynecol Neonatal Nurs. 2001;30:546–51.

Taft SH, Nanna KM. What are the sources of health policy that influence nursing practice? Policy Polit Nurs Pract. 2008;9:274–87.

Nembhard IM, Edmondson AC. Making it safe: The effects of leader inclusiveness and professional status on psychological safety in health teams. J Organ Behav. 2006;27:941–66.

Robert, Wood, Johnson How nurse leaders in policy making positions are transforming public health, charting nursing future. 2008. [Last accessed on 2013 Jul 4]. Available from: http://www.astdn.org/partnershipproject-new-1,htm

Hewison A. Evidence-Based policy, implications for nursing and policy involvement. Policy Polit Nurs Pract. 2008;9:288–98

A Sample Answer 7 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

I believe that nurses can be involved in policy-making and policy evaluation because they spend the most time with patients. Therefore, they can be advocates with governments and regulatory agencies. Myers (2020) notes that “Nurses need to advocate for systematic change, inclusive of the many factors that interact to determine health” (p. 14). Additionally, if we speak about the policy process, nurses should also be involved with its evaluation to see the direct effect on patients.

The adopted program evaluation is a fourth step of the whole policy-making cycle. It ends “after the policy is evaluated to determine to what extent it has been implemented and whether it has achieved the desired outcome” (Clifton et al., p. 25). Nurses have an essential role here as, for example, they can watch the patients’ health state during a new program of cancer or diabetes treatment. That is why it is crucial to get them involved in the policy-making cycle.

There are at least two opportunities for RNs and APRNs to participate in a policy review actively. First of all, it is a policy draft that is necessary because it presents the effect of the policy on social and individual levels. Whitehead et al. (2017) note that “it is a nurse’s professional and societal responsibility to answer the call and provide a voice for the voiceless” (p. 73). Nurses can do it by making and publishing the policy draft. Secondly, policy analysis is another opportunity that follows the previous one more deeply evaluating the significance of a proposed program; it includes the introduction, process definition, analysis, and critical policy events. However, there are challenges in using these opportunities, for example, if nurses emphasize the necessity of implementing new technologies to treat coronavirus patients. Economically vested lobbies may interfere because it is unprofitable for them. In this case, nurses need to prove the validity of their decision more clearly and justifiably, publicizing its importance widely at the same time.

The first strategy to communicate opportunities to participate in a policy review is teaching writing policy drafts during education. The second one is making the ability to write these drafts a prerequisite for employment. Therefore, nurses must know how to participate in a policy review as an essential part of their profession. This knowledge and skill should become usual for them as professionals. They may practice making policy drafts and analyses during education and prove the skill in employment.

References

Clifton, A., Felton, A., Stacey, G., Hemingway, S. (Eds.). (2017). Fundamentals of Mental Health Nursing. An Essential Guide for Nursing and Healthcare Students. Wiley.

Myers, C. R. (2020). Promoting Health: Nurse Advocacy, Policy Making, and Use of Media. In a K. A. Wolgast (Ed.), Building Innovative Nurse Leaders at the Point of Care, An Issue of Nursing Clinics (pp. 11-20). Elsevier Health Sciences.

Whitehead, D. K., Dittman, P. W., McNulty, D. (2017). Leadership and the Advanced Practice Nurse. The Future of a Changing Health-Care Environment. F.A. Davis Company.

A Sample Answer 8 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

There are many ways that APRNs and RNs can get involved in policy making. One way would be to join a nurse’s association. These associations working with and as lobbyists to influence policy makers to produce favorable changes for healthcare. Once a person is in a group like this, they have a voice and a vote as to what the association is lobbying for. Another way to influence policy would be to take your experience right to your local or state policy maker and state the problem you have noticed. Healthcare workers are on the frontline of these issues and can help the policy maker address the problem. That policy maker may not have a lot of healthcare knowledge, this is where the experience of the healthcare workers is crucial.  Being a resource to that policy maker who may not be surrounded by enough expertise on the matter to decide can be crucial in establishing open communication so that policy can be made. Healthcare workers can aid in agenda setting, as well as aiding in policy formation once you have attracted enough attention.

Challenges that one may encounter with being in a nurse’s association could be that your voice gets lost in the crowd. These organizations can be very large, and it may seem like one voice won’t make too much of a difference. To combat this, you could go to one of the leaders in the organization directly or, you could speak to other members of the organization to band together to make your voice louder. With going to your local or state policy maker, a problem may be the time commitment. If you decide to be an asset to this person and provide expertise, this may come with a lot of time committed with potentially no pay. With this, you will need to find a work life balance, which will change person to person. And with both methods there will no doubt be people who oppose your ideology or your proposed change. For this, you must do your research and back up your claims to be able to defend your argument.

One potential strategy could be to identify the proper climate for the introduction of policy development. Make sure that this change would be identified as an issue by the healthcare workers it would affect as well as the policy makers. For example, if there is a rural clinic that would need better funding or continued funding so that a certain area has that resource. The healthcare workers may recognize that there is a significant need in that are which does not have access to other places of healthcare. Some of these rural areas may not have multiple hospitals or clinics within an acceptable range. Another strategy would be to get frontline workers to join you in your policy making process. Frontline workers are greatly affected by policy change. And in today’s society, since the pandemic, they are regarded as heroes by many. Having their voice supporting you may be the difference in whether or not your proposed change is met with open ears by policy makers.

In 2011 the Centers for Medicare & Medicaid Services (CMS) announced incentives to promote the use of EHR (AMA, n.d.).  Physicians were informed they must use a certified EHR system and follow the three stages of meaningful use or they will receive less reimbursement from medicare. The MU incentive program is a branch of the HITECH act to improve patient safety, create less paper work, and decrease practice costs, and increase provider productivity and revenue (Chin & Sakuda, 2012).  Physicians were required to meet these 3 stage requirement by 2017 to avoid penalty.  The program has been evaluated by CMS through deadlines over the years since implementation to make sure physicians were compliant.  At the local hospital I work at, which is a 229 bed facility, resistance was shown in the beginning phase of implementation.  The physicians who were older in age fought the implementation of EHR due to not having a broad knowledge of technology.  Once money is dangled over anyone’s head, participation usually becomes easier.  The MU incentive hit our hospital in 2013, with only a small percentage using EHR for CPOE and documentation to now all physicians using the CPOE and EHR.  Our hospital has a team of nurses that evaluate physician’s useage of CPOE and EHR usage.  This department is called Clinial Information Services (CIS).

In terms of soical determinants, as mentioned before, age of providers is one determinant that played a huge factor in MU cooperation.  Once providers were informed they would receive less payment from CMS they decided to jump on board and learn the technology.  Many providers of older age hired scribes to do their CPOE for them.  The hospital realized that these providers were taking advantage of the scribes and this went against stage 2 of MU implementation.  Safety was a and continues to be a social determinant.  The biggest reason the push was started for the shift to EHR was to decrease the number of injury and death by medical errors.  Not only is it safer, but EHR also allows for patients to take an active role in their own healthcare and enhances provider-patient communication.  Taking that into consideration, edcuation level is a social determinant that plays into EHR systems and MU.  Those with lower levels of education are at a disadvantage of knowing how to use EHR patient portals and systems.  Not only is edcuation level a social determinant for patients but also for physicians who are not educated in the field of technology.  The CMS continues to evaluate meaningul use of providers and facilities that receive payments from medicaid and/or medicare.  Two concepts are looked at when evaluating a program or policy, efficiency and effectiveness (Walden University, 2018).  The CMS continues to evaluate and monitor participation by collecting data from providers and facilities on the efficiency of MU and the effectiveness the incentive has had on pushing providers to use EHR and CPOE for safer practice and increase productivity.

Over the years, nursing has seen significant growth and has undoubtedly become one of the most trusted professions in the US and around the world. Because of this recognition, nurses have a more substantial influence that, when utilized appropriately – may significantly affect policies and politics internally and across artificial boundaries. Nurses are known to be ardent patient advocates and fight for policies that will ultimately improve healthcare delivery to our patients. While some nurses are interested in affecting healthcare policy decisions, it is essential to note that most nurses do not find the world of politics enticing enough and do not participate in healthcare decisions making. However, nurses are increasingly becoming interested in making decisions affecting their patients and the nursing profession as they perceive a professional and moral need to partake in health legislation. Nursing constitutes the most significant part of the healthcare system in the US, and it rapidly continues to grow. Another opportunity that RNs and APRNs can participate in policymaking is by taking up roles in lobbying for their interest and directly lobbying for policies affecting their patients to enhance and improve healthcare delivery rather than just being satisfied with working as bedside caregivers who are ignorant of policies affecting their trade. Over the years, more and more nurses are taking part in decisions affecting healthcare policies, and many nurses view this growing role as a professional and moral responsibility to contribute to healthcare legislation.

Most of the nurses that are venturing into this relatively new area of policy decision-making are often nurses that are frustrated by healthcare policies affecting the overall nursing practice, especially knowing that individuals that are writing up those policies have little or no experience and knowledge in the field of healthcare, and this leads to bitterness, negativity, burnout, and disappointment towards policymakers. Nurses should not just look at healthcare policy as something that happens to them but rather as something they can collectively influence positively – especially when channeling frustrations into positive change that will improve the nursing experience. All nurses can influence policy-making decisions and politics in one way or the other, being at state, federal, and local levels. At local levels, there are increasing number of nurses that are becoming politically active in different ways, some by contacting the elected legislature directly to discuss their stance about legislation affecting the nursing industry and taking part in healthcare leadership positions. With formal and sometimes informal political training, nurses can run for office and be leaders in their local political offices, taking part in committees and city councils, and in some cases, can affect policy decisions by simply exercising their right to vote (Welliver, 2023).

A Sample Answer 9 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

Another opportunity that exists for nurses is to endeavor to be a part of a professional nursing organization like the American Nursing Association and to become active in decisions surrounding policy making and to be a part of those nursing leaders at the forefront advocating for policies change at the legislative level to improve the conditions at which nurses work. We all know that most nursing organizations undoubtedly focus on policy advocacy for nurses. One way nurses can employ an effective method to better advocate for their needs is to organize peaceful rallies to push for the needed changes in their areas of concern. These rallies will raise public awareness, prompting the political elite and other decision-makers to at least listen to the policy change demands by nurses and take the necessary actions. For RNs and APRNs to further the influence nursing has globally for the advancement of the systems of healthcare and our societies, nurses must expand their focus beyond not only the advocacy role of individual nurses but also to ensure that the capacity of nursing organizations is effectively organized for optimal impact on the society, practice, and policy (Chiu et al., 2021).

In addition, nurses have an extended spectrum of areas to advocate for. As part of the numerous responsibilities of nurses, they lobby for safe staffing standards affecting nurse-to-patient ratios at the hospital level and other clinical settings to protect nurses from being overworked and from working in stressful working conditions. At the same time, nurses ensure their patients receive quality care regardless of the challenges. Another opportunity is for nurses to participate in state committees, defend the need for increased appropriation of funding for nurses – including investing in policies that will lead to better patient care experience, and push for legislation requiring states to allow RNs and APRNs to work with complete autonomy to practice at total capacity proportional to the extent of their education, experience, and training. Unfortunately, due to bureaucracy, a list of permissions and steps is needed for an intended policy change bill to be voted upon and ultimately implemented, which may discourage many nurses. However, both RNs and APRNs have unique skills, knowledge, and experiences essential for creating health policy. For APRNs, policy creation is a fundamental part of the degree curriculum; however, only a few APRNs are involved in this crucial nursing role of policy advocacy and policy decision-making (Hajizadeh et al., 2021).

 The Co-occurring Disorders Program at CAMH: A Holistic Approach to Addiction and Mental Health

The Co-occurring Disorders Program at the Center for Addiction and Mental Health (CAMH) in Toronto, Canada, is an exemplary healthcare program that has been evaluated for its integrated holistic approach to addiction and mental health. Below I will discuss  the evaluation of this program and the criteria used to measure its effectiveness. Additionally, it will explore the impact of social determinants on addiction and mental health.

Evaluation Topic

The Co-occurring Disorders Program at CAMH is designed to address the complex needs of individuals with both addiction and mental health disorders. The program integrates various treatment modalities, including pharmacotherapy, psychotherapy, and social support, to provide comprehensive care. The evaluation of this program focuses on its effectiveness in improving patient outcomes, reducing relapse rates, and enhancing overall quality of life. (Skinner et all, n.d.).

Description of the Evaluation

The evaluation of the C0-occuring Disorders Program at CAMH assesses the efficacy of its treatments interventions in achieving positive outcomes. For instance, the program uses evidence-based practices such as cognitive-behavioral therapy (CBT) and motivational interviewing to address the underlying causes of addiction and mental health disorders (SAMHSA, 2019).  Studies have shown that CBT can significantly reduce substance abuse and improve mental health outcomes( Irani et all., 2022).  By incorporating such interventions, the program aims to enhance treatment efficacy and promote long-term recovery (Skinner et all, n.d).Another criterion used to evaluate the program is its success in preventing relapse. The Co-occurring Disorders Program at CAMH recognizes that relapse is a common challenge in addiction and mental health recovery. Therefore, it emphasizes the development of relapse prevention strategies, including ongoing support groups, aftercare programs, and individualized relapse prevention plans. By addressing the triggers and risk factors associated with relapse, the program aims to reduce relapse rates and promote sustained recovery ( Margolis & Zweben, 2011).

The evaluation of the program also considers its impact on improving the overall quality of life for individuals with co-occurring disorders. CAMH recognizes that addiction and mental health disorders can significantly impair various aspects of an individual’s life, including relationships, employment, and housing stability. Therefore, the program provides comprehensive support services, such as vocational training, housing assistance, and family therapy, to address these social determinants of health. By addressing these factors, the program aims to enhance the overall well-being and functioning of its participants. (Skinner et all, n.d.)

Impact of Social Determinants

Social determinants of health, such as socioeconomic status, education, and access to healthcare, play a crucial role in addiction and mental health outcomes. Individuals from disadvantaged backgrounds may face barriers in accessing appropriate treatment and support services, leading to poorer outcomes. The Co-occurring Disorders Program at CAMH recognizes the impact of social determinants and strives to address them through its comprehensive approach. By providing accessible and culturally sensitive care, the program aims to reduce disparities and improve outcomes for all individuals, regardless of their social circumstances.

Conclusion

The Co-occurring Disorders Program at CAMH exemplifies an integrated holistic approach to addiction and mental health. Through its evaluation, the program has been assessed for its effectiveness in improving treatment outcomes, preventing relapse, and enhancing the overall quality of life for individuals with co-occurring disorders. Moreover, the program acknowledges the impact of social determinants on addiction and mental health and strives to address them through comprehensive support services. By considering these factors, the program aims to provide equitable and effective care to all individuals seeking treatment for addiction and mental health disorders.

References

Irani, R. D., Ahmadi, R., Norouzi, S., & Ghazanfari, A. (2022). Comparing the Effectiveness of Cognitive-Behavioral Therapy and Brief Intervention on Relapse Prevention among Drug Users. Addiction & Health, 14(4), 263–267. https://doi.org/10.34172/ahj.2022.1342

Margolis, R. D., & Zweben, J. E. (2011). Relapse prevention. In Treating patients with alcohol and other drug problems: An integrated approach., 2nd ed. (pp. 199–224). American Psychological Association. https://doi.org/10.1037/12312-008

SAMHSA. (2019). Enhancing Motivation for Change in Substance Use Disorder Treatment. https://store.samhsa.gov/sites/default/files/d7/priv/tip35_final_508_compliant_-_02252020_0.pdf

Links to an external site.

Skinner, W., O’grady, C., Bartha, C., & Parker, C. (n.d.). Concurrent substance use and mental health disorders An information guide. https://www.camh.ca/-/media/files/guides-and-publications/concurrent-disorders-guide-en.pdf

A Sample Answer 10 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

When the affordable care act was first introduced in (2020) it was absolute game changing policy for consumeres.Then congressional republicans tries to repeal and replace through AHCA but was not successful in doing so (Willson, C.,& Singer, P. M., 2017, Aug).  Repealing and replacing  ACA was one of the most important policy to revise in the list of President Trump. As revising this pilocy he can attrract voters and make his point that this is good for American economy. Though after the debates republicans were well aware that they will lose voters in the process of replacing the ACA (Willson, C.,& Singer, P. M., 2017, Aug).

“The House Republican plan, “A Better Way,” introduced by Speaker Ryan in June 2016, proposed to repeal some, but not all, of the ACA’s Medicare provisions” (Cubanski J., elt all, Dec 13, 2016). According to this new policy, payments to medicare providers will increase, approximately , $350 billion of the total $802 billion will increase expenses over 10 yeras. But, it will cut the out of pocket deductible to Medicare Advantage plus plan holder (Cubanski, J et all, Dec,13 2016). Addionally, it will covers the coot for preventive services by providing free services (Cubanski, J., et all, Dec13, 2016).

According to ACA repeal (Buettgens, M et all, 2016, June), “congress passed a bill for the firts time, without a replacement of ACA “. The purpose behind this bill was to cut the cost as they purposed it will cut cost by” 90.9 billion by 2021 and $927 billion between 2017 and 2026″ (Buettgens, M et all, 2016, June). And that way legislators will convince the voter that how economically sound their policies are and benefical for people.

But actually, people will pay its price in other ways. Like, number of uninsured peoble will be increased by 24 million by 2021 (81% increase), 14.5 million less people with Medicaid coverage in 2021, State has to inctrease as in terms of expenditure by $68.5 billion between 2017 and 2026  (Buettgens, M et all., 2016, June).

Any policies when introduced or something passed as bill it costs everyone in some way.. According to Short, N. M. (2016), “There is no such thing as a free lunch: for every opportunity taken and for evry option discarded there are trade offs”. So when we talk about the benefits of policies it can benefit the consumers and effects them most. Some get benefitted because of free sevices or cost cuting plans and some can pay more because of their income status. For example, Medical program is beneficial to low socio economic status and on other hand some people hab eto pay for the insurance. Addionally, policymakers also get benefitted in terms of getting more voytes beause of the people favourable policies. Like free money to the people in the Covid period but  it cost the goverment and governement put this burden on the people by increasing taxes and prices on everything. So, its like you get something in one hand and either you or someone else for you pays with other hand.

As you mentioned, a lot of nurses don’t realize the importance of being involved in policy making. I for one can admit to the lack of involvement and interest when it comes to policy, news and law making. Not many individuals carry interest in policy making, but with education and awareness a lot of changes and nursing involvement can be in the rise.

Joining in a Unit Practice Council is one great way staffed nurses can utilize their voices and skills in advocating for changes to be made within patient care and floor nursing. Effective staff councils also serve to develop leadership skills in frontline staff and to inspire commitment and ownership in their departments’ outcomes (Wessel, S, 2012). UPCs achieve a remarkable amount of outcomes.  According to Wessel 2012,  improvements  in  Hospital  Consumer  Assessment  of  Healthcare  Providers  and  Systems (HCAHPS)  scores,  National  Database  of  Nursing  Quality  Indicators  (NDNQI) and  other  employee surveys,  retention  and  other  nurse-sensitive  indicators,  and other measurable clinical outcomes can be seen.  . Executives report stronger interdepartmental cooperation and (ultimately) improved financial results as staffing stabilizes and patient care is better managed and coordinated. Just imagine if nurses all came as one and more involved in policy making.

A number of factors can encourage and support nurses to actively participate in the design and creation of health policy such as having positive role models, personal connections, undertaking research or further education, or gaining direct experience in strategy development. Information technology has been noted as another potential avenue to encourage nurses to participate in policy design, by enabling them to network and communicate with senior leaders and legislators.

References

O’Connor, S. (n.d.). Using social media to engage nurses in health policy development. JOURNAL OF NURSING MANAGEMENT, 25(8), 632–639. https://doi- org.ezp.waldenulibrary.org/10.1111/jonm.12501

Wessel, S. (2012). Impact of Unit Practice Councils on Culture and Outcomes. Creative Nursing, (4), 187. https://doi-org.ezp.waldenulibrary.org/10.1891/1078-4535.18.4.187

A Sample Answer 11 For the Assignment: NURS 6050 Discussion The Role of the RN APRN in Policy Evaluation Sample

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

Thank you for an excellent post. Advanced practice registered nurses is on the front lines of disseminating information to patients that directly affect their outcomes to treatments and medications. We constantly assess, administer treatment and medications and then evaluate that treatment, but seldom do we use those skills to evaluate the policies that have been enacted governing the treatments or medications we administer. Many healthcare policies and programs have been established, but it is critical to determine whether they have been efficient and effective. Efficiency details the number of patients helped, and effectiveness speaks to the quality of care. Evaluation reports are provided by the programs to share specific information that aids members of the legislature, community, and others in understanding how the program works and its impact on the targeted recipients (Walden University, LLC, 2018). Since 1992, more than $8 billion have been delivered for over 360,000 Virginians, almost 150,000 Virginians have received state-sponsored health insurance, almost 4 million patient visits have happened, and more than $16 million in grants given to expanding the state’s medical safety (Foundation, n.d.). The VHCF is very efficient with the number of Virginians it has supported in its 30-year presence. The program’s efficacy is evident by the evidence of expanded health care services to areas of the state that were previously under or not served. In 2021, the priority was on developing mental health care services for those without access to counseling services.

In your response to Dr. Falci’s question, you said that physicians who are not educated in the field of technology are at a disadvantage in knowing how to use Electronic Health Records (EHR) patient portals and systems.

I spoke to several old doctors about how they think of the EHR, and they all said that computerized records aren’t as user-friendly as traditional, handwritten notes. In one study conducted by Rand and financed by the American Medical Association (AMA), 30 physicians were interviewed, and the study found the majority of physicians approve of the EHR in principle. However, they also said that EHR technology appeared to significantly worsen professional dissatisfaction and the reasons they gave were: poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, and inability to exchange information between EHR and the paper chart system. What some doctors have done is have scribes to help with some EHR data entry aspects. This, however, has a disadvantage in that it adds to the overall EHR cost (Rimmer, 2014).

Despite the results of the Rand study, most healthcare companies are resorting to new technology. One young doctor said,“ for a paper hater like me, it’s a dream”. He went on to say“ you can email your doctor or nurse, get medical records released by simply filling out a short online form, and schedule an appointment or renew a prescription with an iPhone app”.