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NURS 8100 Week 11: Policy and Practice

As noted in Understanding Health Policy, “policies tend to evolve in a cyclical process of
finding solutions that create new problems that require new solutions,” (p. 205). The
tensions created by the pulls between quality care and cost containment, for instance,
or between caring for the individual and concern with the common good, arise as new
policies are introduced at all levels: national, state, local, and institutional. When this
occurs, new procedures may need to be implemented in the practice setting.
This week, you will reflect on the implications of health care policies for consumers and
health care providers. You will also consider the reciprocal relationship between policy
and practice as you explore how policy influences nursing practice and how evidence-
based nursing practice influences policy. Additionally, you will propose a strategy for
how nurses can advocate for themselves, their patients, and the profession through
involvement in health care policy.
Note: This week you will complete the Discussion in a small group. Your instructor will
notify you of your group assignment by Day 1 of this week.
Learning Objectives
Students will:
 Assess the implications of various policy options and solutions to consumers of health
care and nursing practice
 Outline current evidence that supports suggested options and solutions to a policy issue
 Propose an advocacy strategy nurses may employ to address a practice issue through
the policy process
Photo Credit: [Ariel Skelley]/[Blend Images]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical
approach (7th ed.). New York, NY: McGraw-Hill Medical.
 Chapter 17, “Conclusion: Tensions and Challenges”
This chapter concludes with final thoughts on the challenge of providing quality
health care and controlling health care costs. The solution is likely to be resolved
only by a collaborative approach, involving all health care stakeholders, and by
health professionals taking the lead.
Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson,
Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient
Safety and Quality Improvement Act: A review of the medical literature and
analysis. Journal of Patient Safety, 6(3), 147-152.
Note: You will access this article from the Walden Library databases.
The authors studied the dissemination of information on the Patient Safety and Quality
Improvement Act (PSQIA), a federal act that affords protection to those reporting
medical errors. They found medical literature to be inadequate in this regard, and as a
result, medical personnel were uninformed on their legal protections. This lack of
information has become a barrier to policy implementation.
Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for
knowledge translation: Understanding user context. Journal of Health Services
Research & Policy, 8(2), 94–99.
Note: You will access this article from the Walden Library databases.
Lau, B., San Miguel, S., & Chow, J. (2010). Policy and clinical practice: Audit tools to
measure adherence. Renal Society of Australasia Journal, 6(1), 36–40.
Note: You will access this article from the Walden Library databases.

The authors study the compliance to renal-care policies by health care professionals.
They conclude with the necessity for nurses to support evidence-based protocols as
well as to obtain continuing education on new protocols.
McCracken, A. (2010). Advocacy: It is time to be the change. Journal of Gerontological
Nursing, 36(3), 15-17.
Note: You will access this article from the Walden Library databases.

The author proposes that nurses, as patient advocates, need to be more involved in the
making of health care policy instead of reacting to policies that are constantly changing.
The article provides a guide to help organize initial policy efforts.
Nannini, A., & Houde, S. C. (2010). Translating evidence from systematic reviews for
policy makers. Journal of Gerontological Nursing, 36(6), 22–26.
Note: You will access this article from the Walden Library databases.

The article cites geronotological nurses as examples of those who are able to translate
research into policy briefs that can be clearly understood by policy makers.
Geronotological nurses are in this unique position because of their clinical experience
and educational background.
Paterson, B. L., Duffet-Leger, L., & Cuttenden, K. (2009). Contextual factors influencing
the evolution of nurses' roles in a primary health care clinic. Public Health Nursing,
26(5), 421-429.
Note: You will access this article from the Walden Library databases.

This article provides details on a study conducted in a nurse-managed clinic related to
the changing roles of nurses. The authors found that nurses, in response to social,
political, and economic forces, became involved in advocacy for the clinic through
political action, government funding issues, and media relations roles.
Sistrom, M. (2010). Oregon's Senate bill 560: Practical policy lessons for nurse
advocates. Policy, Politics, & Nursing Practice, 11(1), 29-35. doi:
10.1177/1527154410370786
Note: You will access this article from the Walden Library databases.

The author uses the efforts by a nurse advocate in lobbying for an Oregon bill related to
healthy food in public schools to illustrate nurse advocacy and policy making. The bill,
developed in response to childhood obesity, did not immediately become law. The
author concludes with the importance of considering the political environment when
creating successful policy.
Spenceley, S. M., Reutter, L., & Allen, M. N. (2006). The road less traveled: Nursing
advocacy at the policy level. Policy, Politics, & Nursing Practice, 7(3), 180-194. doi:
10.1177/1527154410370786
Note: You will access this article from the Walden Library databases.

Nurses have always been advocates at the patient-level of care, but the authors of this
article promote the need for all nurses to become advocates at the policy level as well.
They discuss factors that have kept nurses from getting involved with policy making and
they provide strategies to resolve these challenges.
Wyatt, E. (2009). Health policy advocacy: Oncology nurses make a difference. ONS
Connect, 24(10), 12-15.
Note: You will access this article from the Walden Library databases.

The author presents information on two nurses who have become health care policy
advocates—one as a policy maker and one as an elected legislator. Both have been
able to use their perspectives from their nursing careers to affect health policy.
Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing:
Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746-1752.
Note: You will access this article from the Walden Library databases.

The authors attempt to distinguish the concepts of advocating for a patient and
paternalism, or overriding a patient’s wishes. They provide clinical examples to illustrate
the differences between these concepts, and they conclude with strategies to use in
practice.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy:
Advocating through policy. Baltimore: Author.

Note: The approximate length of this media piece is 7 minutes.

In this media presentation, Dr. Joan Stanley and Dr. Kathleen White discuss how
nurses can influence practice and engage in advocacy through the policy process.

Accessible player
Optional Resources
Birnbaum, D. (2009). North American perspectives: POA, HAC and never
events. Clinical Governance: An International Journal, 14(3), 242–244.

Discussion 1: Policy Analysis Summary
Health care policy can facilitate or impede the delivery of services. For the past several
weeks, you have been engaging in an authentic activity by critically analyzing a specific
health care policy and various aspects of the impact associated with its implementation.
A critical step in the policy process is communicating your findings with others. This
week, you will share information from your policy analysis and its implications.
To prepare:
 Briefly summarize your policy analysis, focusing on the implications for clinical practice
that may be most relevant or interesting for your colleagues. Include how evidence-
based practice influenced the policy, policy options, or solutions.
By Day 3
Post a 1- to 2-paragraph succinct summary of your policy analysis paper. Include at
least two of the options or solutions for addressing the policy and the resulting
implications for nursing practice and health care consumers.
Read a selection of your colleagues’ postings.
By Day 5
Respond to at least two of your colleagues sharing insights or contrasting perspectives
based on readings and evidence, and the practice implications of the policy.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question
posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
Week 11 Discussion 1 Rubric
Post by Day 3 and Respond by Day 5
To participate in this Discussion:
Week 11 Discussion 1

Discussion 2: Advocating Through Policy
As noted by Dr. Stanley and Dr. White in this week’s media presentation, professional
nurses should be engaging in advocacy efforts to improve health and nursing practice
through involvement in the policy process at the institutional, local, state, or federal
levels. This array of possibilities for involvement provides opportunities for all nurses,
regardless of time, or other possible constraints. Successful policy making is a
collaborative effort, and one that commands mutual respect from all involved. Your

involvement in policy making can lead to expanded opportunities as both a nurse leader
and as a respected member of an interprofessional health care team.
Note: This Discussion provides a forum for discussing advocacy opportunities and
honing your presentation skills in a small group setting.
To prepare:
 Reflect on the insights offered by Dr. Stanley and Dr. White on engaging in advocacy
through the policy process.
 Identify a practice issue that is of interest to you and that could benefit from advocacy
efforts through the policy process.
 Consider the stakeholders and any special interest or professional organizations that
would support your issue.
 Develop a short, yet persuasive PowerPoint (up to 3 slides) as follows:
o Identify the practice issue that would benefit from being addressed through the policy
process
o Represent the key stakeholders (i.e. use graphical images when possible)
o Propose one strategy for how a nurse could advocate for this issue
The PowerPoint should be succinct, visually appealing, and effective.
By Day 4
Post your PowerPoint presentation.
Read a selection of your colleagues’ postings.
By Day 6
Review each group member’s PowerPoint presentation and offer constructive
feedback on:
 Style and quality of the PowerPoint
 Persuasiveness
 Clarity
 Representation of stakeholders, such as additional individuals/groups that could be
included
 Strategy proposal
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
Week 11 Discussion 2 Rubric
Post by Day 4 and Respond by Day 6
To participate in this Discussion:
Week 11 Discussion 2

Assignment 3: Policy Analysis Paper

[Major Assessment 2]

Continue to work on this Assignment, assigned in Week 4. You will need to incorporate
any related topics addressed this week. Your policy analysis paper is due by Day 7 of
this week.
By Day 7
Submit this Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
 Please save your Assignment using the naming convention “WK11Assgn3+last
name+first initial.(extension)” as the name.
 Click the Week 11 Assignment 3 Rubric to review the Grading Criteria for the
Assignment.
 Click the Week 11 Assignment 3 link. You will also be able to “View Rubric” for grading
criteria from this area.
 Next, from the Attach File area, click on the Browse My Computer button. Find the
document you saved as “WK11Assgn3+last name+first initial.(extension)” and
click Open.
 If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit
my paper(s) to the Global Reference Database.
 Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 11 Assignment 3 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 11 Assignment 3 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 11 Assignment 3

Week in Review

In this final week, you assessed implications of various policy options and solutions of
health care and nursing practice and outlined evidence that supports suggested options
and solutions to a policy issue. You also proposed and advocacy strategy that nurses
may employ to address a practice issue through the policy process.

Congratulations! After you have finished all of the assignments for this week, you have
completed the course. Please submit your Course Evaluation by Day 7.
Rubric Detail

Select Grid View or List View to change the rubric's layout.
Name: NURS_8100_Week11_Discussion1_Rubric

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Excellent Good Fair Poor
RESPONSIVENESS TO
DISCUSSION QUESTION
Discussion post minimum
requirements:
*The original posting must be
completed by Wednesday, Day 3,
at 11:59pm MST. Two response
postings to two different peer
original posts, on two different
days, are required by Saturday,
Day 6, at 11:59pm MST. Faculty
member inquiries require
responses, which are not
included in the minimum number
of posts. Your Discussion Board
postings should be written in
standard edited English and
follow APA style for format and
grammar as closely as possible
given the constraints of the online
platform. Be sure to support the
postings with specific citations
from this week's Learning
Resources as well as resources
available through the Walden
University online databases. Refer
to the Essential Guide to APA
Style for Walden Students to
ensure your in-text citations and
reference list are correct.

8 (26.67%) – 8 (26.67%)
Discussion postings and responses
exceed the requirements of the
Discussion instructions. They:
Respond to the question being
asked or the prompt provided; – Go
beyond what is required in some
meaningful way (e.g., the post
contributes a new dimension,
unearths something unanticipated);
-Are substantive, reflective, with
critical analysis and synthesis
representative of knowledge gained
from the course readings and
current credible evidence. –
Demonstrate significant ability to
generalize and extend thinking and
evaluate theories or concepts within
the topic or context of the
discussion. -Demonstrate that the
student has read, viewed, and
considered the Learning –
Resources as well as additional
resources and has read, viewed, or
considered a sampling of
colleagues' postings; -Exceed the
minimum requirements for
discussion posts*.

7 (23.33%) – 7 (23.33%)
Discussion postings and responses
meet the requirements of the
Discussion instructions. They: –
Respond to the question being
asked or the prompt provided; -Are
substantive, reflective, with critical
analysis and synthesis
representative of knowledge gained
from the course readings and
current credible evidence.re –
Demonstrate ability to generalize
and extend thinking and evaluate
theories or concepts within the topic
or context of the discussion. –
Demonstrate that the student has
read, viewed, and considered the
Learning Resources and has read,
viewed, or considered a sampling of
colleagues' postings -Meet the
minimum requirements for
discussion posts*.

6 (20%) – 6 (20%)
Discussion postings and responses
are minimally responsive to the
requirements of the Discussion
instructions. They: – do not clearly
address the objectives of the
discussion or the question or
prompt; and/or -May (lack) lack in
depth, reflection, analysis, or
synthesis but rely more on
anecdotal than scholarly evidence;
and/or -Do not adequately
demonstrate that the student has
read, viewed, and considered the
Learning -Resources and/or a
sampling of colleagues' postings;
and/or has posted by the due date
at least in part. – Lack ability to
generalize and extend thinking and
evaluate theories or concepts within
the topic or context of the
discussion. -Do not meet the
minimum requirements for
discussion posts*.

0 (0%) – 5 (16.67%)
Discussion postings and responses
are unresponsive to the
requirements of the Discussion
instructions. They: – do not clearly
address the objectives of the
discussion or the question or
prompt; and/or – Lack in substance,
reflection, analysis, or synthesis but
rely more on anecdotal than
scholarly evidence. – Lack ability to
generalize and extend thinking and
evaluate theories or concepts within
the topic or context of the
discussion. -Do not demonstrate
that the student has read, viewed,
and considered the Learning
Resources and/or a sampling of
colleagues’ postings; and/or does
not meet the minimum requirements
for discussion posts*.

CONTENT KNOWLEDGE 8 (26.67%) – 8 (26.67%)

Discussion postings and responses:
-demonstrate in-depth
understanding and application of
concepts and issues presented in
the course (e.g., insightful
interpretations including analysis,
synthesis and/or evaluation of topic;
– are well supported by pertinent
research/evidence from a variety of
and multiple peer- reviewed books
and journals, where appropriate; –
Demonstrate significant mastery
and thoughtful/accurate application
of content, applicable skills or
strategies presented in the course.

7 (23.33%) – 7 (23.33%)
Discussion postings and responses:
-demonstrate understanding and
application of the concepts and
issues presented in the course,
presented with some understanding
and application of concepts and
issues presented in the course
(e.g., insightful interpretations
including analysis, synthesis and/or
evaluation of topic; -are supported
by research/evidence from peer-
reviewed books and journals, where
appropriate; and · demonstrate
some mastery and application of
content, applicable skills, or
strategies presented in the course.

6 (20%) – 6 (20%)
Discussion postings and responses:
– demonstrate minimal
understanding of concepts and
issues presented in the course, and,
although generally accurate, display
some omissions and/or errors; –lack
support by research/evidence
and/or the research/evidence is
inappropriate or marginal in quality;
and/or lack of analysis, synthesis or
evaluation of topic – demonstrate
minimal content, skills or strategies
presented in the course. ——-
Contain numerous errors when
using the skills or strategies
presented in the course

0 (0%) – 5 (16.67%)
Discussion postings and responses
demonstrate: -A lack of
understanding of the concepts and
issues presented in the course;
and/or are inaccurate, contain many
omissions and/or errors; and/or are
not supported by
research/evidence; and/or lack of
analysis, synthesis or evaluation of
topic -Many critical errors when
discussing content, applicable skills
or strategies presented in the
course.

CONTRIBUTION TO THE
DISCUSSION

8 (26.67%) – 8 (26.67%)
Discussion postings and responses
significantly contribute to the quality
of the discussion/interaction and
thinking and learning by: -providing
Rich and relevant examples;
discerning and thought-provoking
ideas; and stimulating thoughts and
probes; – -demonstrating original
thinking, new perspectives, and
extensive synthesis of ideas
supported by the literature.

7 (23.33%) – 7 (23.33%)
Discussion postings and responses
contribute to the quality of the
discussion/interaction and thinking
and learning by -providing relevant
examples; thought-provoking ideas
– Demonstrating synthesis of ideas
supported by the literature

6 (20%) – 6 (20%)
Discussion postings and responses
minimally contribute to the quality of
discussion/interaction and thinking
and learning by: – providing few
and/or irrelevant examples; and/or –
providing few if any thought-
provoking ideas; and/or -.
Information that is restated from the
literature with no/little demonstration
of critical thinking or synthesis of
ideas.

0 (0%) – 5 (16.67%)
Discussion postings and responses
do not contribute to the quality of
interaction/discussion and thinking
and learning as they do not: –
Provide examples (or examples are
irrelevant); and/or -Include
interesting thoughts or ideas; and/or
– Demonstrate of critical thinking or
synthesis of ideas

QUALITY OF WRITING 6 (20%) – 6 (20%)

Discussion postings and responses
exceed doctoral -level writing
expectations. They: · Use grammar
and syntax that is clear, concise,
and appropriate to doctoral level
writing; · Make few if any errors in
spelling, grammar, and syntax; ·
Use original language and refrain
from directly quoting original source
materials; -provide correct APA ·
Are positive, courteous, and
respectful when offering

5 (16.67%) – 5 (16.67%)
Discussion postings and responses
meet doctoral -level writing
expectations. They: ·Use grammar
and syntax that is clear and
appropriate to doctoral level writing;
; · Make a few errors in spelling,
grammar, and syntax; · paraphrase
but refrain from directly quoting
original source materials; Provide
correct APA format · Are courteous
and respectful when offering
suggestions, constructive feedback,

4 (13.33%) – 4 (13.33%)
Discussion postings and responses
are minimally below doctoral-level
writing expectations. They: · Make
more than occasional errors in
spelling, grammar, and syntax; ·
Directly quote from original source
materials and/or paraphrase rather
than use original language; lack
correct APA format; and/or · Are
less than courteous and respectful
when offering suggestions,
feedback, or opposing viewpoints.

0 (0%) – 3 (10%)
Discussion postings and responses
are well below doctoral -level writing
expectations. They: · Use grammar
and syntax that is that is unclear ·
Make many errors in spelling,
grammar, and syntax; and –use
incorrect APA format · Are
discourteous and disrespectful
when offering suggestions,
feedback, or opposing viewpoints.

suggestions, constructive feedback,
or opposing viewpoints.

or opposing viewpoints;.

Total Points: 30
Name: NURS_8100_Week11_Discussion1_Rubric

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