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?<\/p>\n
Some nurses may be hesitant to get involved with policy evaluation<\/a>. 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?<\/p>\n In this Discussion, you will reflect on the role of professional nurses in policy evaluation.<\/p>\n Post<\/strong>\u00a0an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in\u00a0policy review.<\/u><\/strong>\u00a0Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.<\/p>\n Respond<\/strong>\u00a0to at least\u00a0two<\/strong>\u00a0of your colleagues* on two different days<\/strong>\u00a0by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.<\/p>\n Click on the\u00a0Reply<\/strong>\u00a0button below to reveal the textbox for entering your message. Then click on the\u00a0Submit<\/strong>\u00a0button to post your message.<\/p>\n *Note:<\/strong>\u00a0Throughout this program, your fellow students are referred to as colleagues.<\/p>\n 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.<\/span>\u00a0<\/span><\/p>\n The first opportunity for APRNs to actively participate in policy-making is becoming a member of a professional nursing organization<\/a>. 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.<\/span>\u00a0<\/span><\/p>\n \u202fThe 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\u2019 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).<\/span>\u00a0<\/span><\/p>\n \u202f \u202fAPRNs might face a challenge in policy-making is the lack of available resources and knowledge.\u202f\u202f\u202fSome 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.<\/span>\u00a0<\/span><\/p>\n 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\u2010line 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.<\/span>\u00a0<\/span><\/p>\n 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.<\/span>\u00a0<\/span><\/p>\n American Association of Nurse Practitioners. (2022).\u202f<\/span>Clinical Resources for Nurse Practitioners (NPS)<\/span><\/i>. American Association of Nurse Practitioners. Retrieved October 12, 2022, from https:\/\/www.aanp.org\/practice\/clinical-resources-for-nps<\/a><\/span>\u00a0<\/span><\/p>\n ANA. (2020, April 27).\u202f<\/span>Advocacy<\/span><\/i>. Practice Advocacy . Retrieved October 12, 2022, from https:\/\/www.nursingworld.org\/practice-policy\/advocacy\/<\/a><\/span>\u00a0<\/span><\/p>\n Echevarria, I.<\/span>\u202f\u202f<\/span>(2018).<\/span>\u202f\u202f<\/span>Make connections by joining a professional nursing<\/span>\u00a0<\/span><\/p>\n organization.<\/span>\u202f\u202f<\/span>Nursing,\u202f\u202f48\u202f<\/span><\/i>(12),<\/span>\u202f\u202f<\/span>35-38.<\/span>\u202f\u202f<\/span>doi: 10.1097\/01.NURSE.0000547721.84857.cb.<\/span>\u00a0<\/span><\/p>\n \u202f<\/span><\/p>\n Marymount University.(2021, November 11).\u202f<\/span>5 ways nurses can shape policy<\/span><\/i>. Marymount University Online. Retrieved October 12, 2022, from https:\/\/online.marymount.edu\/blog\/nursing-influence-on-health-care-policy<\/a><\/span>\u00a0<\/span><\/p>\n Rafferty A. M. (2018). Nurses as change agents for a better future in health care: the politics of drift and dilution.<\/span>\u202f<\/span>Health economics, policy, and law<\/span><\/i>,\u202f<\/span>13<\/span><\/i>(3-4), 475\u2013491. https:\/\/doi.org\/10.1017\/S1744133117000482<\/a><\/span>\u00a0<\/span><\/p>\n Shariff N. (2014). Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development.\u202f<\/span>BMC nursing<\/span><\/i>,\u202f<\/span>13<\/span><\/i>, 20. https:\/\/doi.org\/10.1186\/1472-6955-13-20<\/a><\/span>\u00a0<\/span><\/p>\n There are many ways in which nurses can be involved in policy evaluation. The two ways are collaborating with elected officials and joining professional associations. Nurses can gather data and information that can help policy evaluation (Milstead & Short, 2017). Nurses can reach out to local and federal legislators. They can work with their elected representatives to advocate for a review of policies that will help better the nursing profession and patient care. They can share their experiences and evidence, assisting in policy evaluation by checking impact and effectiveness (Scott & Scott, 2020). Challenges that nurses may meet may be their inability to contact legislators and different opinions that may arise. If they cannot contact their elected representatives, nurses can form a relationship with policymakers who can help set up meetings.<\/p>\n Nurses also have opportunities for policy evaluation by joining professional nursing associations at the state and national levels. By joining professional associations, nurses can have the opportunity to learn policy making and evaluation. They can attend conferences, network with other members and lobby on behalf of nurses (Morin, 2021). Even though professional nursing associations have benefits, they also present challenges. One challenge of this route is the complex registration process and high membership fees required to join these organizations.<\/p>\n There are several strategies to communicate these opportunities for nurses. The first strategy is to have meetings with healthcare professionals and educate them on the importance of nurses in policy advocacy and policy review. Nurses can also be educated that joining professional organizations may have additional benefits. They can also be taught how they can be involved in these organizations.<\/p>\n <\/p>\n Milstead,\u00a0J.\u00a0A., & Short,\u00a0N.\u00a0M. (2017).\u00a0Health policy and politics<\/em>. Jones & Bartlett Learning.<\/p>\n Morin,\u00a0K.\u00a0H. (2021). Editorial: Contributions of professional nursing organizations.\u00a0Journal of Advanced Nursing<\/em>,\u00a077<\/em>(6).<\/p>\n Scott,\u00a0S.\u00a0M., & Scott,\u00a0P.\u00a0A. (2020). Nursing, advocacy and public policy.\u00a0Nursing Ethics<\/em>,\u00a028<\/em>(5), 723-733.<\/p>\n The community of nurses is so vast and powerful we as nurses can do a lot when it comes to policy making. Nurses can participate in policy reviews by attending policy conferences, and organized policy meetings. Nurses can also attend meetings specifically for policy change directed at health care. Nurses can also plan and organize their own meetings and rallies and open invite members of policy boards to get the purpose of policy change and agenda heard. Joining professional organization would be a good start to a nurse that is new to the idea of policy making. Nursing organizations can provide insight and direction and help improve idea outcomes of nursing policy change. According to Myers (2020) Nurses need to actively embrace strategies to improve population health outcomes and reduce health and other disparities. As a main component in health care, nurses provide the most direct level of care. Nurses are able to see the patient whole level of care therefore are the best advocates for the patient. As stated by Wichaikhum et al. (2020) Nurses\u2019 participation in public health policy development is essential to developing and maintain an efficient, high-quality healthcare system.<\/p>\n Myers, R.C. (2020). Promoting population health: nurse advocacy, policy making, and use<\/p>\n of media.\u00a0Pub Med.Gov, 55(1),\u00a0<\/em>11-20. http:\/\/doi.org\u00a010.1016\/j.cnur.2019.11.001<\/a><\/p>\n Wichaikhum, O., Abhicharttiburta, K., Nantsupawat, A., Kowitlawakul, Y., & Kunavikitkul, W.<\/p>\n (2020). Dweveloping a strategic model of participation in policy development for nurses.<\/p>\n Pub Med. Gov, 67(1),\u00a0<\/em>11-18. http:\/\/doi.org10.1111\/inr.12571<\/a><\/p>\n Your post clearly describes numerous ways that the professional nurse can engage in policy evaluation.\u00a0It is important to note that when policies are designed,\u00a0mechanisms for evaluating the efficacy of the policy should be in place.<\/p>\n Hi Sasha,\u00a0it was great reading your discussion post this week.<\/p>\n Reaching out to local representatives can be the first step in changing, improving, or creating new initiatives in the workplace. Nurses have a unique place in doing this because all of our ideas and initiatives should be evidence-based. We are able to go in and speak from experience, even if it might be a small sample size. This could be a way to start the ball rolling with our local representatives.<\/p>\n Being part of an association of nurses offers all of the previously mentioned benefits, but it now gives a larger voice. One nurse with a list of problems, or even solutions or ideas may not get a chance to present them to their state representatives. These representatives rely on votes. Having a large group that supports them could be important come election time. There is power in numbers. It is important for us to be heard and key for these representatives to continue their work. Therefore, it is vital for us to work for hand and hand in order to accomplish both our goals.<\/p>\n I am in agreement that there has to be an educational component provided, so everyone knows the importance of joining these associations. It should be taught and stressed throughout nursing school. Maybe there could be CE hours credited for membership. Nurses could also have things like bake sales and craft sales in order to cover the cost of yearly memberships. If cost is still an issue, maybe people can still contribute ideas and thoughts for improvement, without being a member. Better and more ways to communicate membership vitality should also be present in the workplace. This could be a constant reminder of our collective voice and its power.<\/p>\n Milstead,\u00a0J.\u00a0A., & Short,\u00a0N.\u00a0M. (2017).\u00a0Health policy and politics<\/em>. Jones & Bartlett Learning.<\/p>\n Thank you for sharing your two ideas for opportunities to participate in policy review. I feel I would be more comfortable participating in policy review by joining a professional nurse organization (PNO) than collaborating with elected officials. Milstead & Short (2017) describe how vital policy evaluation is for transforming and evolving our current healthcare system. Walden has done a great job expressing the importance of policy. I imagine many nurses stop at an associate or bachelor degree and never learn about policy review and how to get involved. Gazarian et al. (2020) noted that nurses are well qualified to \u201cidentify health problems that can be addressed through health policies and to evaluate the effects of those policies.\u201d Essentially, we are in the middle of healthcare and can assess the need for change or evaluate the effect a policy or policy change could have. There is a need for adding more policy education at every level of nursing. It would also be helpful for information to be provided regarding how to get involved with local elected<\/p>\n officials. I also believe that a PNO would be a great means of learning how to get involved. Thank you for another great week of discussion!<\/p>\n Gazarian, P., Ballout, S., Heelan-Fancher, L., & Sundean, L. J. (2020). Theories,<\/p>\n models, and frameworks used in nursing health policy dissertations: A scoping review. Applied Nursing Research.\u00a0https:\/\/doi.org\/10.1016\/j.apnr.2020.151234<\/a><\/p>\n Milstead, J.A., & Short, N.M. (2019).\u00a0Health Policy and politics: A nurse\u2019s guide\u00a0<\/em>(6th<\/sup>\u00a0ed).<\/p>\n Burlington, MA: Jones & Bartlett Learning<\/p>\n 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.<\/p>\n 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.<\/p>\n 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.<\/p>\n 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.<\/p>\n Clifton, A., Felton, A., Stacey, G., Hemingway, S. (Eds.). (2017).\u00a0Fundamentals of Mental Health Nursing. An Essential Guide for Nursing and Healthcare Students.\u00a0<\/em>Wiley.<\/p>\n Myers, C. R. (2020). Promoting Health: Nurse Advocacy, Policy Making, and Use of Media. In a K. A. Wolgast (Ed.),\u00a0Building Innovative Nurse Leaders at the Point of Care, An Issue of Nursing Clinics\u00a0<\/em>(pp. 11-20).\u00a0Elsevier Health Sciences.<\/p>\n Whitehead, D. K., Dittman, P. W., McNulty, D. (2017).\u00a0Leadership and the Advanced Practice Nurse. The Future of a Changing Health-Care Environment.\u00a0<\/em>F.A. Davis Company.<\/p>\n In 2011 the Centers for Medicare & Medicaid Services (CMS) announced incentives to promote the use of EHR (AMA, n.d.).\u00a0 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).\u00a0 Physicians were required to meet these 3 stage requirement by 2017 to avoid penalty.\u00a0 The program has been evaluated by CMS through deadlines over the years since implementation to make sure physicians were compliant.\u00a0 At the local hospital I work at, which is a 229 bed facility, resistance was shown in the beginning phase of implementation.\u00a0 The physicians who were older in age fought the implementation of EHR due to not having a broad knowledge of technology.\u00a0 Once money is dangled over anyone’s head, participation usually becomes easier.\u00a0 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.\u00a0 Our hospital has a team of nurses that evaluate physician’s useage of CPOE and EHR usage.\u00a0 This department is called Clinial Information Services (CIS).<\/p>\n In terms of soical determinants, as mentioned before, age of providers is one determinant that played a huge factor in MU cooperation.\u00a0 Once providers were informed they would receive less payment from CMS they decided to jump on board and learn the technology.\u00a0 Many providers of older age hired scribes to do their CPOE for them.\u00a0 The hospital realized that these providers were taking advantage of the scribes and this went against stage 2 of MU implementation.\u00a0 Safety was a and continues to be a social determinant.\u00a0 The biggest reason the push was started for the shift to EHR was to decrease the number of injury and death by medical errors.\u00a0 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.\u00a0 Taking that into consideration, edcuation level is a social determinant that plays into EHR systems and MU.\u00a0 Those with lower levels of education are at a disadvantage of knowing how to use EHR patient portals and systems.\u00a0 Not only is edcuation level a social determinant for patients but also for physicians who are not educated in the field of technology.\u00a0 The CMS continues to evaluate meaningul use of providers and facilities that receive payments from medicaid and\/or medicare.\u00a0 Two concepts are looked at when evaluating a program or policy, efficiency and effectiveness (Walden University, 2018).\u00a0 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.<\/p>\n American Medical Association. (n.d.). Meaningful use: Electronic health record (EHR) incentive programs. https:\/\/www.ama-assn.org\/practice-management\/medicare-medicaid\/meaningful-use-electronic-health-record-ehr-incentive<\/a><\/p>\nTo Prepare:<\/strong><\/h2>\n
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