NURS 8100 Policy Brief

The professional nursing organization that I will be discussing is Michigan Nurses Association (MNA). MNA has influenced the policy agenda on “Safe Patient Care Act”. This bipartisan plan includes RN-to-patient ratios, limits on forced RN overtime, and hospital transparency. During this week’s Discussion, as a doctoral student, the writer is considering the policy proposal on safe staffing.

Brief Summary of Policy Proposal and IOM

The bipartisan Safe Patient Care Act is a plan to increase the safety of patients in Michigan hospitals and retain our nurses in an already stressful environment. The issue at hand is that there is no law that limits the number of patients a registered nurse can be assigned to take care of in the hospital. This is not only alarming nut is very unsafe for both the patient and nurse. There is also no law to prevent hospitals from making nurses work unlimited hours (leading to shifts of 14, 16 or even 20 hours). Nurses are becoming exhausted and stressed which increases the risk of mistakes and errors which is a very dangerous situation.

Quality care and patient advocacy is a priority of the registered nurse. Understaffing and being overworked leads to unplanned events such as falls, infections, medication errors and deaths. There is a solution to lowering these risks and making a safer environment for our patients and registered nurses. “The Michigan Safe Patient Care Act is a 3-part bipartisan package in the state House and Senate that addresses rampant RN understaffing and excessive forced RN overtime. It will force administrators to make decisions based on patients’ needs, rather than misguided cost-cutting in the hospital industry” (MI Nurse Association, 2021).

Ways MNA Support the Safe Staffing Act

MI Nurse Association is a voice by nurses for nurses who carefully evaluate candidates for elective office and make recommendations of which candidates have earned the endorsement for Michigan nurses. This endorsement is specifically around healthcare issues that affect nurses and patient’s direction and not based on political parties. MNA is always working to add leaders that are on that positively affect our profession, practice and patients.

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References:

MI Nurse Association. (2021). The bipartisan Safe Patient Care Act. https://www.misaferhospitals.org/uploads/7/7/1/1/7711851/with_bill_numbers_2021_spca_bills_cheat_sheet.pdf

Response

Hello Randi! This is an outstanding post on the policy brief. Although nurses can greatly influence policy on a global scale, professional nursing organizations play a big role in the realization of this nursing policy influence (Williams et al., 2018). As such, when nurses advance policy agendas such as the Safe Patient Care Act, professional nursing organizations such as the Michigan Nurses Association (MNA) are crucial in realizing the success of the agenda. Organizations such as MNA have various opportunities for their members to shape the influence of nurses on healthcare policy (Lewinski & Simmons, 2018).

Professional nursing organizations can engage in various activities to advance the policy agenda including writing letters to push their state representatives to pass this healthcare policy, deploying lobbyists that can take nursing issues to Capitol Hill, participating in political action committees, and meeting with legislators (Chiu et al., 2021). Through these organizations, nurses can also interact with colleagues from various regions, share insights, and bring together their empirical evidence to generate a watertight, collective argument for the proposed policy.

References

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics, & Nursing Practice, 22(4), 276-296. https://doi.org/10.1177/15271544211050611

Lewinski, A. A., & Simmons, L. A. (2018). Nurse knowledge and engagement in health policymaking: Findings from a pilot study. The Journal of Continuing Education in Nursing, 49(9), 407-415. https://doi.org/10.3928/00220124-20180813-06

Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse Advocacy: Adopting health in all policies approach. Online Journal of Issues in Nursing, 23(3). https://doi.org/10.3912/OJIN.Vol23No03Man01

The Institute of Medicine (IOM) Future of Nursing Report Brief addresses four very important elements of nursing practice that are in need of change. According to Kershaw (2011), the four areas of needed change include nurses practicing to the fullest scope of their license, nurses engaging in seeking and attaining higher levels of education, nurses being considered as equals with their physician colleagues when taking the initiative to redesign health care, and nurses creating a foundation of data through research and evidence-based practice to support policies and procedures in nursing practice.

The area of specific interest to me is item number three. This initiative focuses on nurses becoming full partners with physicians when redesigning healthcare in the United States (Kershawm 2011). The reason this initiative is important to me is that I work in an acute care setting where physicians are still revered as gods by the hospital leadership and nurses are considered the handmaiden to the physician. It is a large hospital but set in a rural community and the founding fathers who opened the community hospital 16 years ago (Now part of a larger system) were very physician-focused.

The bylaws do not promote employing mid-level practitioners, they do not recognize that certified nurse-midwives can practice independently, and have a strong working relationship with a Kaiser Permanente group that feels very threatened by the thought of utilizing mid-level providers and advance practice nurses (APNs). According to Abraham et al. (2019), APNs are far more cost-effective than physicians, and they increase patient experience scores and clinical outcomes. Constable et al. (2022) describe an increase in provider communications scores from 69% to 85% when APRNs were used in the acute care setting.

This specific article also outlined a reduction in endotracheal tube-associated pressure injuries by 50% because of the care the APN provided to this population. The reason for this is that APNs are trained to treat patients holistically and not be solely focused on a diagnosis or disease. Physicians are trained with a primary focus on disease. Collaboration between these two groups is essential when health care reform is being considered. NURS 8100 Policy Brief

The IOM report brief nailed this issue on the head. There is a need to include APNs in health care reform and the recommendation in the article suggests this will happen through leadership training and the attainment of leadership competencies by all APNs. The American Organization of Nurse Executives (AONE) offers leadership training for all levels of nurse leaders. The sole focus of the AONE is to promote leadership excellence among nurses, advance the practice, increase the engagement of research by nurses, and facilitate the preparation of nurses who will influence legislation and public policy (www.aha.org). For far too long the shape of health care has been formed by only a select portion of the population who provides it. Now is the time to think globally about healthcare reform and invite all of the contributors to the table.

References:

Abraham, C. M., Norful, A. A., Stone, P. W., &Poghosyan, L. (2019). Cost-Effectiveness of Advanced Practice Nurses Compared to Physician-Led Care for Chronic Diseases: A Systematic Review. Nursing Economic$, 37(6), 293–305.

American Organization of Nurse Executives. (February, 2022). AHA releases 2022-2024 strategic plan and updates to vision and mission statements. Retrieved: https://www.aha.org/special-bulletin/2022-02-08-aha-releases-2022-2024-strategic-plan-and-updates-vision-and-mission

Constable, M., Mulkey, M., &Aucoin, J. (2022). Hospital value–based purchasing: How acute care advanced practice nurses demonstrate value. Journal of the American Association of Nurse Practitioners, 34(1), 12–17. https://doi.org/10.1097/JXX.0000000000000606

Kershaw, B. (2011). The future of nursing – leading change, advancing health. Nursing Standard, 26(7), 31–31. https://doi.org/10.7748/ns2011.10.26.7.31.b1274