Discussion 1: Policy Analysis Summary
Discussion 1: Policy Analysis Summary
The selected policy is HB3871 Safe Patient Limits Act, which is currently pending action in the Illinois Legislature. The proposed policy sets a minimum nurse staffing requirement for all hospitals in Illinois. It states the maximum number of patients assigned to a registered nurse in specific situations. It also provides that nothing shall bar a healthcare facility from assigning fewer patients to a registered nurse than the limits stated in Act (Illinois General Assembly, n.d.). Besides, it provides that nothing in the Act stops the use of patient acuity systems consistent with the Nurse Staffing by Patient Acuity Act. Nonetheless, the maximum patient assignments in the Act may not be exceeded, despite using and applying any patient acuity system.
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The policy can be addressed by having each hospital’s clinical team make staffing decisions for their hospitals depending on the unique circumstances at the specific hospital at any given time (Han et al., 2021). The policy can also be addressed by having professional nursing organizations advocate the implementation of the mandated staffing ratios in all hospitals to promote better working conditions for nurses and improve patient safety and quality of care. Implementing the policy can reduce nurse burnout and low job satisfaction associated with high workloads and physical and emotional fatigue (Lasater et al., 2021). In addition, it can improve the safety of patient care and patient outcomes and reduce healthcare costs.
References
Han, X., Pittman, P., & Barnow, B. (2021). Alternative Approaches to Ensuring Adequate Nurse Staffing: The Effect of State Legislation on Hospital Nurse Staffing. Medical care, 59(10 Suppl 5), S463. doi: 10.1097/MLR.0000000000001614
Illinois General Assembly. (n.d.). Bill status for HB2604. https://www.ilga.gov/legislation/BillStatus.asp?DocTypeID=HB&DocNum=2604&GAID=15&SessionID=108&LegID=118738
Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ open, 11(12), e052899. doi:10.1136/bmjopen-2021-052899
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
Learning Resources
Required Readings
Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.
- 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.
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.
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.
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.
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.
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.
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.
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.
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.
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
Walden University, LLC. (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.
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.
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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:
- Identify the practice issue that would benefit from being addressed through the policy process
- Represent the key stakeholders (i.e. use graphical images when possible)
- 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]
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
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.
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