The Role of the RN/APRN in Policy Evaluation
Sample Answer for The Role of the RN/APRN in Policy Evaluation 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.
A Sample Answer For the Assignment: The Role of the RN/APRN in Policy Evaluation
Title: The Role of the RN/APRN in Policy Evaluation
The first opportunity that exists for RNs and APRNs to actively participate in policy review is the workplace. These professionals have the ability to influence the available and prospective health care delivery initiatives. The fundamental role of RNs and APRNs is to facilitate quality health. Therefore, they have a good opportunity to influence policy review in their workplaces by ensuring promotion of effective policies that enhances quality care. However, if a given policy fails to promote quality care, RNs and APRNs may decline the policy and request for its review. The other opportunity is through professional organizations such as the American Nurses Association and the American Academy of Nursing. These professional organizations can be used by the RNs and APRNs to review some policies. Professional organizations play crucial roles in ensuring that effective policies are adopted by the organizations (Miyamoto & Cook, 2019).
There are challenges associated with opportunity at the workplace. The first challenge is poor leadership, which does not provide
opportunity for nurses to develop their leadership skills. This challenge can be addressed by enabling all RNs and APRNs opportunity to expand their leadership aptitude and inspire confidence in them to query policies adopted (Brunt & Bogdan, 2018). Another challenge is failure to update all nurses on the proposed policies and the need for their review. This can be addressed by informing all nurses on the policy changes and the need to review them before implementation. There is also a challenge of disunity among nurses, which can be addressed uniting nurses to focus on a common goal. Concerning the opportunity in relation to professional organizations, the major challenge is intricate process of membership. This challenge can be overcome by creating a straightforward and clearly understood process that nurses should follow to join the professional organizations.
The strategies to advocate for the existence of these opportunities include provision of training to equip them in understanding their work environment and roles. The other strategy is ensuring good leadership that can provide opportunity for nurses to voice their perceptions about a given policy (Bleich et al., 2020). These two strategies are crucial tools of informed nursing team.
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The Role of the RN/APRN in Policy Evaluation References
Bleich, M. R., Smith, S., & McDougle, R. (2020). Public policy in a pandemic: a call for leadership action. The Journal of Continuing Education in Nursing, 51(6), 250-252. https://doi.org/10.3928/00220124-20200514-03
Brunt, B. A., & Bogdan, B. A. (2018). Nursing Professional Development (NPD) Leadership. Treasure Island, FL: StatPearls Publishing.
Miyamoto, S., & Cook, E. (2019). The procurement of the UN sustainable development goals and the American national policy agenda of nurses. Nursing outlook, 67(6), 658-663. https://doi.org/10.1016/j.outlook.2019.09.004
A Sample Answer 2 For the Assignment: The Role of the RN/APRN in Policy Evaluation
Title: The Role of the RN/APRN in Policy Evaluation
Policy evaluation uses a range of research methods to systematically investigate the effectiveness of policy interventions, implementation and processes, and to determine their merit, worth or value in terms of improving the social and economic conditions of different stakeholders.
It is important to understand how policy evaluation fits into the larger policy process. Understanding this context provides an increased understanding of why policy evaluation is critical to advancing the field of policy. Although there are many theories regarding the policy process and mechanisms of policy change, the policy change process is often conceptualized in several key stages. Evaluation is an integral part of each step in the policy process. Although these steps are laid out in a row, in reality, the steps are circular in nature.
The three types of evaluation:
Evaluating Policy Content: Does the content clearly articulate the goals of the policy, its implementation and the underlying logic for why the policy will produce intended change? Evaluating the development of a policy helps to understand the context, content, and implementation.
Evaluating Policy Implementation: Was the policy implemented as intended? The implementation of a policy is a critical component in understanding its effectiveness. Evaluation of policy implementation can provide important information about the barriers to and facilitators of implementation and a comparison between different components or intensities of implementation.
Evaluating Policy Impact: Did the policy produce the intended outcomes and impact? Within injury prevention, the intended impact may be a reduction in injuries or severity of injuries. However, it is important to evaluate short-term and intermediate outcomes as well.
The type of evaluation selected depends on many factors and often more than one type of evaluation will be needed. Each type of evaluation can provide valuable information for the planning and interpretation of the other types of evaluation (content, implementation, and impact) in addition to uncovering unintentional consequences. However, it is critical for each evaluation to be focused so the most appropriate design and methodology is selected. The team can develop an all-encompassing set of evaluation questions and then select specific evaluation questions and methods for each particular phase.
While all evaluations encounter challenges particularly relevant to policy evaluation and many of these challenges can be easily addressed by using an appropriate design, indicators, and methods. The challenges when conducting policy evaluation are:
- Lack of resources or clear responsibility for evaluation
- Lack of strong evidence base to support policy
- Fear of evaluation and lack of familiarity with policy evaluation methods
- External and contextual factors such as economic conditions or public awareness
- Rapid pace of policy
- Lack of appropriate measures
- Political scrutiny and desire for quick production of results
- Difficulty in identifying appropriate comparison communities
References
Brownson, R. C., Royer, C., Chriqui, J. F., & Stamatakis, K. A. (2009). Understanding evidence-based public health policy. American Journal of Public Health, 99, 1576–1583.
MacDonald, G., Starr, G., Schooley, M., Yee, S. L., Klimowksi, K., & Turner, K. (2001). Introduction to program evaluation for comprehensive tobacco control programs. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/tobacco/tobacco_ control_programs/surveillance_evaluation/evaluation_manual/pdfs/evaluation.pdf
A Sample Answer 3 For the Assignment: The Role of the RN/APRN in Policy Evaluation
Title: The Role of the RN/APRN in Policy Evaluation
Hospital readmission is a current issue in our healthcare due to a lack of access to health insurance and long wait times to see providers. Medicare created a program called the Hospital Readmission Reduction Program (HRRP) that encourages hospitals to improve communication and care coordination to reduce and avoid the need for readmissions (Hospital, n.d.). Within this, hospitals will be financially penalized instead of the patients if they need to be re-hospitalized for an acute myocardial infarction, pneumonia, heart failure, or COPD (McIlvennan et al., 2015). This puts a tremendous financial burden on patients since readmissions are associated with unfavorable patient outcomes and high financial costs (McIlvennan et al., 2015). The criteria used to measure the effectiveness of this program was the data from Health and Human Services from 2007-2011 that show a 30-day readmission rate among Medicare beneficiaries held relatively constant at 19.0-19.5%; in 2012 and 2013, this rate fell to 18.5% and 17.5%, which translates to an estimated 150,000 fewer hospital readmissions between January 2012 and December 2013 (McIlvennan et al., 2015). Although this program has reduced hospital readmissions and increased the quality of care for patients, it has also received criticism. In the original risk-adjustment models, socioeconomic status was not adjusted for, nor was the preexisting measure a preventable event such as repeated MI for drug use history. Overall, the program was a great move in the right direction with reducing healthcare costs for patients and improving quality care for patients, but the social determinants that impact it are a cause for concern. Once a program has been rolled out and surveyed, the evaluation results can polarize communities and lead to a new focus on social or health policies that were unexpected and must be addressed by governmental and healthcare professionals (Milstead & Short., 2019, p.124). For the success in the ongoing progression of this program, further inquiry must be made into the nuanced relationship between readmission rates and socioeconomic factors, which still needs to be included in the risk adjustment methodology (MCIlvennan et al., 2015).
References
Hospital readmissions reduction program (HRRP). CMS.gov. (n.d.). https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1796–1803. https://doi.org/10.1161/CIRCULATIONAHA.114.010270Links to an external site.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.