NURS 8100 Week 4: Policy Analysis Frameworks

NURS 8100 Week 4: Policy Analysis Frameworks

NURS 8100 Week 4 Policy Analysis Frameworks

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Consider the social contract between the nursing profession and consumers of health care. This social contract has long been demonstrated by nurses. For example, recall the nursing pioneer Lillian Wald who in the late 1800s worked to improve the health and welfare of the immigrant population in New York. How does engaging in the policy process assist nurses with fulfilling this social contract today? To better influence health and nursing policy, which seeks to improve health and quality outcomes, nurses need to develop their policy acumen. Utilizing a policy analysis framework can assist in this process.

This week continues the examination of the policy process addressed in Week 3. You will examine how frameworks from nursing and other disciplines can work together to inform policy analysis.

Learning Objectives

Students will:

  • Propose a policy analysis framework for a specific policy issue
  • Conduct a comprehensive policy analysis critically analyzing a health policy from multiple contexts

Photo Credit: [alphaspirit]/[iStock / Getty Images Plus]/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

Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148–155. doi: 10.1177/1527154405276289

Note: You will access this article from the Walden Library databases.

 

In this article, the author applies Kingdon’s multiple streams theory to agenda setting and the public policy issue of tobacco use. In addition, the author points out two limitations of Kingdon’s model—the need to build alliances and the varying power levels among stakeholders.

Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience. American Journal of Public Health, 100(11), 2047–2052.

Note: You will access this article from the Walden Library databases.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108–116. doi: 10.1177/152715440100200205

Note: You will access this article from the Walden Library databases.

 

Fawcett and Russell provide a five-level conceptual model of nursing and health policy, and diagram the relationship between the model and new health policies. Guidelines for health policy analysis and evaluation are also provided.

Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693–6 99. doi: 10.1111/j.1365-2934.2006.00731.x

Initially, this article presents a broad analysis of policy making and then provides a specific framework of policy analysis for nurse managers. The author focuses on the necessity for nurses to become involved in health care policy making

 

Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7) by Hewison, A. Copyright 2007 by BLACKWELL PUBLISHING – JOURNALS. Reprinted by permission of BLACKWELL PUBLISHING – JOURNALS via the Copyright Clearance Center.

Howie, W. O. (2009). Mandatory reporting of medical errors: Crafting policy and integrating it into practice. Journal for Nurse Practitioners, 5(9), 649–654. doi:10.1016/j.nurpra.2009.07.012

Note: You will access this article from the Walden Library databases.

John, P. (2003). Is there life after policy streams, advocacy coalitions, and punctuations: Using evolutionary theory to explain policy change? Policy Studies Journal, 31(4), 481–4 98. doi: 10.1111/1541-0072.00039

Note: You will access this article from the Walden Library databases.

NURS 8100 Week 4 Policy Analysis Frameworks
NURS 8100 Week 4 Policy Analysis Frameworks

This article advances the use of evolutionary theory as policy theory. The author proposes that aspects of evolutionary theory such as randomness, competition, and selection be applied to policy theory but cautions that more research regarding its applicability is needed.

Rawat, P., & Morris, J. C. (2016). Kingdon’s “Streams” model at thirty: Still relevant in the 21st century? Politics & Policy, 44(4), 608-638. doi: 10.1111/polp.12168

Note: You will access this article from the Walden Library databases.

Russell, G., & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108–116. doi: 10.1177/1527154405283304

Note: You will access this article from the Walden Library databases.

 

In this article, Russell and Fawcett revise their 2001 conceptual model of nursing and health policy and provide guidelines for nursing-specific research.

Optional Resources

Bardach, E. (2004). Presidential address—The extrapolation problem: How can we learn from the experience of others? Journal of Policy Analysis and Management, 23(2), 205. doi: 613545361

Discussion: Selecting a Policy Analysis Framework

The goal of policy analysis is to provide in-depth, relevant, and evaluative information about a policy. Using a framework as a guideline for the analysis provides scaffolding for logically and carefully considering the policy issue. To select a framework, one should consider the focus of the policy being analyzed and whether the policy is intended to be predictive or prescriptive. For this Discussion, you will choose a policy issue that is important to you and after evaluating the frameworks described in the Learning Resources, select the framework most appropriate for analyzing the issue.

To prepare:

  • Reflect on your understanding of the policy process: how policy is formulated, adopted, implemented, and evaluated.
  • Review the various frameworks presented in this week’s Learning Resources and consider how they are applied to nursing and health policies. How do they assist you in understanding and shaping policy?
  • Brainstorm a list of the issues that are most important to your practice (these can be issues at the institutional, local, state, national, or international level). Then identify a specific nursing or health care policy related to one key issue, and consider which of the frameworks you would use to examine the issue.

Note: You may not select the Patient Protection and Affordable Care Act for this analysis.

By Day 3

Post a cohesive response that addresses the following:

  • Identify the policy you have selected.
  • Describe the framework that you would use for this particular issue, and provide your rationale.
  • At what other stages in the policy process might an analysis framework provide guidance?

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues selecting postings for which you have an alternative framework suggestion and explain how that framework might affect the analysis.

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.

 

Assignment 3: Policy Analysis Paper
[Major Assessment 2]

In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience.

For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week’s Discussion), and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due the end of Week 11. This paper will also serve as your Major Assessment for this course.

To prepare:

Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.

To complete:

Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:

  • Part 1: Define the policy issue.
    • How is the issue affecting the policy arena?
    • What are the current politics of the issue?
    • At what level in the policy making process is the issue?
  • Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
    • Social
    • Ethical
    • Legal
    • Historical
    • Financial/economic
    • Theoretical underpinnings of the policy
  • Include in this section:
    • Who are the stakeholders of interest?
    • Is there a nursing policy/position statement on this health care issue? If so, who developed it?
  • Part 3: Policy options/solutions
    • What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
    • What are the theoretical underpinnings of the policy options/solutions?
    • What are the health advocacy aspects and leadership requirements of each option?
    • How does each option/solution provide an opportunity or need for inter-professional collaboration?
    • What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
  • Part 4: Building Consensus
    • Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
  • Part 5: References
    • Limit your references so this section is no more than 2 pages.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct.

By Day 7 of Week 11

This Assignment is due.

Week in Review

This week, you proposed a policy analysis framework for a specific policy issue and conducted a comprehensive policy analysis that analyzed a health policy from multiple contexts.

Next week, you will review the four principles of medical ethics and examine these principles in the light of current health care policy.

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The selected policy is the implementation of state agency worksite wellness programs, as directed by Texas Government Code, Section 664.053. The health of state employees affects the state’s healthcare expenditures and the productivity of state agencies. For example, obese individuals cost employers an average of $5,555 per year in covered medical, sick days, short-term disability, and workers’ compensation claims combined, whereas the average cost for an employee of recommended weight is $3,839 per year (Texas Department of State Health Services, 2020). Texas Government Code, Section 664.053 requires the Texas Department of State Health Services (DSHS) to designate a statewide wellness coordinator to create and promote a model wellness program for state agencies. The statute also directs DSHS to study the implementation and participation rates of state agency worksite wellness programs and report the findings to the Legislature biennially.

In 2020, DSHS conducted two surveys, one asking agency wellness liaisons from across Texas state agencies about wellness programs at their respective worksites, and a second asking state employees about their use of wellness-related resources. Of the wellness liaisons surveyed, 65 out of 188 responded to the survey (a 35 percent response rate). Of the responding wellness liaisons, 99 percent reported that their agency has a wellness policy and 55 percent reported a wellness plan that involved implementing activities. However, 46 percent of liaisons reported their agency did not have a wellness budget. Most wellness activities implemented among state agencies required minimal resources so as to work within limited funds, time, agency size, and space. A total of 5,840 state employees out of 145,645 responded to the survey (a 4 percent response rate). A majority of respondents found wellness services and benefits useful but are not aware of the breadth of opportunities available. This indicates more work is needed to raise awareness of these benefits. DSHS leadership and the Statewide Wellness Coordinator will continue to provide technical assistance to wellness liaisons as they implement wellness programs at their agencies. They will also carry out statewide initiatives that align with the objectives of the model wellness program, Work Well Texas (Texas Department of State Health Services, 2020).

The framework is John Kingdon’s multiple streams theory. John Kingdon’s Agendas, Alternatives, and Public Policies advance theoretically by proposing a differentiation between the concepts of governmental agendas and decision agendas. The agenda is the list of subjects or problems to which governmental officials, and people outside of government closely associated with those officials, are paying some serious attention at any given time. For the author, an issue is placed on the governmental agenda when it catches the attention and the interest of policymakers. Kingdon expands the set of actors related to agenda-setting, considering not only decision-makers within the state but also individuals and groups related to them. In addition, given the complexity and the volume of questions facing policymakers, Kingdon reminds us that only a few issues are seriously considered within the governmental agenda at any given time. These issues correspond to the decision agenda: a subset of the governmental agenda where issues are ready for an active decision (Capella, 2020). In the highly competitive agenda-setting process, few issues move from the government agenda to the decision agenda. In his words, we should also distinguish the governmental agenda, the list of subjects that are getting attention, and the decision agenda, or the list of subjects within the governmental agenda that are up for an active decision. Kingdon explains how agendas change from time to time, proposing an explanatory model organized around three streams, the problems stream, the policy stream, and the political stream. The multiple streams model proposed by the author seeks to analyze the pre-decisional stages of the policy process by explaining policy formulation through three streams connected by a public policy entrepreneur who plays an important role when windows of opportunity make changes possible (Capella, 2020).

The policy is in the implementation stage. DSHS will focus on implementing statewide initiatives that align with the objectives of the model wellness program and will continue to support wellness liaisons as they implement related activities in their agencies. Additionally, DSHS plans to initiate demonstration projects at state agencies that currently do not participate in wellness programming. Such projects may include promoting lactation support policies, partnering with cafeteria/vending operators to increase healthy food options in state buildings, and maintaining annual initiatives such as the fitness challenge and wellness conference. Evidence-based, ready-to-implement activities will decrease the time and effort other agencies need to spend developing their own activities. State agencies would only need to make minor logistical changes to integrate activities into their system. Finally, through ongoing collaboration with the Employees Retirement System of Texas (ERS), DSHS will continue to address state-level issues related to improving employee health, raising awareness of available benefits, building wellness infrastructure across all agencies, and providing resources and technical assistance.

References

Capella, A. C. N. (2020). Policy agenda-setting studies: an overview of Brazilian research. Revista de Administração Pública54, 1498-1512.

Texas Department of State Health Services (2020). Implementation and Participation in State Agency Worksite Wellness

NURS 8100 Week 4: Policy Analysis Frameworks Grading Rubric

Performance Category 100% or highest level of performance

100%

16 points

Very good or high level of performance

88%

14 points

Acceptable level of performance

81%

13 points

Inadequate demonstration of expectations

68%

11 points

Deficient level of performance

56%

9 points

 

Failing level

of performance

55% or less

0 points

 Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

Presentation of information was exceptional and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in one of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in two of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
 16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
Application of Course Knowledge

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

Presentation of information was exceptional and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements

  • Applies principles, knowledge and information and scholarly resources to the required topic.
  • Applies facts, principles or concepts learned scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
   10 Points 9 Points  6 Points  0 Points
Interactive Dialogue

Initial post should be a minimum of 300 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated all of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 3 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 2 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
  8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
Grammar, Syntax, APA

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

  • 0-3 errors in APA format

AND

  • Responses have 0-3 grammatical, spelling or punctuation errors

AND

  • Writing style is generally clear, focused on topic,and facilitates communication.
The following was present:

  • 4-6 errors in APA format.

AND/OR

  • Responses have 4-5 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is somewhat focused on topic.
The following was present:

  • 7-9 errors in APA format.

AND/OR

  • Responses have 6-7 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is slightly focused on topic making discussion difficult to understand.
 

The following was present:

  • 10- 12 errors in APA format

AND/OR

  • Responses have 8-9 grammatical, spelling and punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.
 

The following was present:

  • 13 – 15 errors in APA format

AND/OR

  • Responses have 8-10 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.

AND/OR

  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
The following was present:

  • 16 to greater errors in APA format.

AND/OR

  • Responses have more than 10 grammatical, spelling or punctuation errors.

AND/OR

  • Writing style does not facilitate communication
  0 Points Deducted 5 Points Lost
Participation

Requirements

Demonstrated the following:

  • Initial, peer, and faculty postings were made on 3 separate days
Failed to demonstrate the following:

  • Initial, peer, and faculty postings were made on 3 separate days
  0 Points Lost 5 Points Lost
Due Date Requirements Demonstrated all of the following:

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

Demonstrates one or less of the following.

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

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