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NURS 8100/8100F/8100M/8100A: Healthcare Policy and Advocacy
NURS 8100 Entire Course Weekly Discussions And Assignments
NURS 8100/8100F/8100M/8100A Week 1: The Health Care System, Part 1
The evolution of health care in the United States has been a roller-coaster story of good intentions that were often buffeted by economic and social change, compromised by special interests, and beset by passionate differences of opinion. The primary goals of health care reform have been fairly consistent: to increase access, lower costs, and improve quality. Many efforts to bring about change, however, have not resulted in policy. Why has this been such a challenge? What barriers have prevented reform efforts from being successful? Exactly how to fix the weaknesses of the current health care system continues to be an issue of public and political debate, and one which continues to be played out in the policy arena.
This week, you will examine the history and evolution of health care and consider how health care financing has been central in shaping the current system. You also will examine provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA)—a groundbreaking attempt at reforming the U.S. health care system by the enactment of new policy.
Looking Ahead
In Week 2, you will begin an assignment that requires you to interview a policy maker. Due to the time-sensitive nature of getting on the desired individual’s schedule, you may wish to review this assignment now to begin thinking about who you might like to contact. |
Objectives
Students will:
- Analyze principal features of the U.S. health care system
- Evaluate the policy process in relation to challenges for health care reform
- Access online learning resources for professional growth and development
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Discussion: Health Care Reform
After much public and political debate, in March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. The PPACA is one of many health care reform efforts that have sought to correct key features of the U.S. health care system such as financing, service delivery, and care coordination. This week, you will examine the passage of PPACA as a milestone along the historical continuum of health care reform in the United States.
To prepare:
- Review this week’s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public’s response to health care reform efforts historically and currently.
- Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?
- How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?
By Day 3
Post a cohesive response that addresses the following:
- Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.
- Describe one or more conditions or challenges specifically related to the passing of the PPACA. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8100/8100F/8100M/8100A Week 2: The Health Care System, Part 2
As addressed in Week 1, many different policies and reform efforts have influenced health care delivery over the past century. Consider for a moment the health care reform efforts during the 1960s and the implementation of Medicare and Medicaid. How did these reform initiatives become policy? What challenges do these programs face today? What problems did they solve, and what new problems have arisen?
The Centers for Medicare & Medicaid Services (CMS) continue to have a strong influence on the health care system and health care policy through financial incentives and reimbursement policies. For example, to improve continuity of care, Medicare is offering financial incentives to health care providers that become accountable care organizations.
This week, you will have an opportunity for an authentic experience as you bring a health care issue of concern to the attention of your state or national politician. You will also consider the unintended consequences that may arise as a result of reform policy, such as the individual mandate.
Learning Objectives
Students will:
- Analyze key health care reform legislation to determine positive results and potential unintended consequences
- Assess reform-related issues for health care
Discussion: Unintended Consequences of Health Care Reform
The PPACA of 2010 fostered new provisions for health care and the structure of health care delivery. The individual mandate to obtain insurance is one provocative provision. While this provision attempts to increase access to health care, it raises questions on how the existing system could sustain the potentially large influx of newly insured individuals.
Another provision calls for new models of health care provider organizations to ensure delivery efficiency and continuity of care. In this week’s media presentation, Dr. Kathleen White discusses the accountable care organization, which comprises a group of providers coordinating care across a variety of institutional settings. Yet becoming an accountable care organization may present a number of challenges.
This week’s Discussion builds on Week 1, continuing the examination of those societal and organizational contexts that influence health care reform. The unintended consequences of reform policy on the health care system are also considered.
To prepare:
- Review this week’s media presentation and the other Learning Resources focusing on how reform may lead to improved quality, greater access, and reduced cost of care. Also think about the unintended consequences that may arise as a result.
- Consider the information presented about the individual mandate and accountable care organizations. What are some questions or concerns you might have regarding the individual mandate? What are the pros and cons associated with becoming an accountable care organization?
- With posting instructions in mind, select either the individual mandate or accountable care organizations as the focus of your Discussion this week.
By Day 3
Post a cohesive response that addresses the following:
- In the first line of your posting, identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience.
- Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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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NURS 8100/8100F/8100M/8100A Week 3: The Policy Process
This week, you will investigate the process of creating health care policy beginning with agenda setting and the policy proposal. How does an issue move along the continuum from simple discussion to policy development? How do you identify key stakeholders and enlist their support in moving a health care issue forward?
To gain experience in the policy process, you will critically analyze recommendations from the Institute of Medicine’s The Future of Nursing report brief and create a policy brief based on your analysis. These are skills that advanced nursing practice requires, and which support your ability to participate in public policy making at all levels: institutional, local, state, national, and international.
Learning Objectives
Students will:
- Develop strategies for raising clinical practice issues to an organization’s systematic agenda
- Critically analyze a health policy proposal from the perspective of consumers, nurses, other health professionals, and additional stakeholders
- Develop a scholarly and professionally written policy brief
Discussion: Agenda Setting
A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level.
To prepare:
- Review this week’s media presentation, focusing on the insights shared by Dr. White and Dr. Stanley on agenda setting and identification of stakeholders.
- Brainstorm clinical practice issues that you believe are worthy of being on your organization’s systematic agenda.
- Who are the stakeholders who would be interested in this clinical practice issue?
By Day 3
Post a cohesive response that addresses the following:
- In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.
- What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues providing additional strategies for informing and persuading stakeholders. Include additional research evidence that supports the importance of their identified clinical practice issue.
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.
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NURS 8100/8100F/8100M/8100A Week 4: Policy Analysis Frameworks
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
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.
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NURS 8100/8100F/8100M/8100A Week 5: Economic and Technological Influences on Policy
Economic factors have long been a key driver of health care policy and reform efforts. As noted in previous weeks, for instance, health policies have attempted to improve the situation for millions of uninsured or underinsured individuals and to address the barriers to health care access that have arisen as a result of the high costs associated with insurance and health service delivery.
This week, you will examine how economics influences health policy and health care reform efforts. You will explore cost containment strategies from increasing administrative efficiency to health care rationing and the role of technology in health care reform and cost control efforts.
Learning Objectives
Students will:
- Evaluate the use of technology to achieve health care reform and cost containment goals
- Analyze the economic consequences of a health care policy
Discussion: Technology and Cost Containment
In response to continually rising health care costs, the Health Information Technology for Economic and Clinical Health (HITECH) provision was created to promote the meaningful use of health care information technology through numerous incentive programs for health care providers. By enhancing data collection, streamlining electronic medical records, and increasing transparency, it is believed that significant cost savings can be realized as well as other positive outcomes. What are some of the tradeoffs involved in this type of policy?
To prepare:
- Reflect on the challenges of containing health care costs in the U.S. presented in the Learning Resources and discussed by Dr. Kominski and Dr. Zelman in the media.
- Consider how information technology may be used to address health care issues related to cost.
- Examine the Health Information Technology for Economic and Clinical Health (HITECH) provision and its goals.
By Day 3
Post a cohesive response that addresses the following:
- Briefly summarize a significant challenge to containing health care costs.
- How do policy makers envision technology could be utilized to address this challenge (above)? Provide at least one example to support your response.
- Do you agree or disagree with the policy makers? Describe why you agree or disagree and include one or more insights from this analysis that relate to the question of how information technology could, or could not, help contain costs while supporting health care reform initiatives.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8100/8100F/8100M/8100A Week 6: Ethical and Legal Implications of Policy
Nurses frequently encounter ethical and legal dilemmas that shape their practice. Likewise, those who are responsible for formulating policy and ensuring effective implementation also encounter critical dilemmas related to health law and ethics. For example, how should decisions involving individual rights versus the collective good be made? What other policy-related issues have ethical and legal implications?
This week you review the four principles of medical ethics—beneficence, malfeasance, autonomy, and justice. You will examine these principles in the light of current health care policy.
Learning Objectives
Students will:
- Analyze a health care policy in terms of the tension between individual rights and the collective good
- Evaluate the ethical and legal considerations of a health care policy
Discussion: Individual Right Versus the Collective Good
Most of the recent successes in improving the public’4 s health have had to address the tension of individual rights versus the collective good. Anti-smoking campaigns and laws banning smoking in public places protect people from the negative health effects of second-hand smoke, yet some believe that they infringe on the individual rights of those who choose to smoke. Requiring childhood immunizations has helped prevent diseases such as polio and measles, but some parents assert that they have the right to decide if being immunized is in the best interest of their children.
This tension also exists in the allocation of scarce resources, from providing adequate staff coverage to making decisions about the amount of health care to provide. Given the nurse’s involvement in policy and health care delivery, it is important to understand the dynamics of this tension, as well as the legal and ethical implications.
To prepare:
- When have you encountered a tension between the individual right and the collective good in your nursing practice?
- With information from the Learning Resources in mind, consider relatively recent examples of health care policy that demonstrate this tension. For this Discussion, select one example of timely health care policy that allows you to evaluate the tension between individual rights and the collective good. Conduct additional research as necessary using credible websites and the Walden Library.
By Day 3
Post a cohesive response that addresses the following:
- In the first line of your posting, identify a health care policy.
- Explain the tension between individual rights and the collective good.
- Analyze the ethical and legal considerations of the policy.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues posting adding to the discussion of the tension and legal and ethical considerations (beneficence, malfeasance, autonomy, and justice).
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
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NURS 8100/8100F/8100M/8100A Week 7: Professional Organizations’ Role in Health Care Policy
Professional organizations play an important role in the development of health care policy. For example, with questions looming about the quality of health care, the aging of the population, the increase in patient acuity, and the rapid growth of knowledge, in 2002 the American Association of Colleges of Nursing (AACN) and other professional organizations began investigating the need for a nursing practice doctorate. In 2004, the AACN membership embraced the DNP degree and this pivotal policy development has had positive implications for the funding of nursing education and practice standards.
In 1999, while working in the emergency department, Karen Daley, a clinical practice nurse of 27 years, received a needle stick injury and contracted HIV/AIDS as a result. As President of the Massachusetts Nursing Association at that time, Ms. Daley spearheaded needle stick legislation that still protects health care providers today.
As these examples demonstrate, nursing’s professional organizations have been guiding and promoting nurse involvement in U.S. health care policy making for decades. This week, you will examine various professional organizations and evaluate their role in nursing, education, and 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:
- Evaluate the involvement of professional nursing organizations in health policy
- Explain how professional organizations could support a policy proposal/recommendation
Discussion: Policy Brief
Professional nursing organizations have influenced the policy agenda by identifying needs, generating ideas, and bringing them into the policy arena; they have had a positive impact on the profession of nursing as well as nursing practice. This week’s Discussion asks you to consider the policy proposal you examined for the policy brief (Assignment 2, assigned in Week 3) and reflect on the opportunities a professional nursing organization might have to further the issue.
To prepare:
- Review this week’s media presentation focusing on Dr. White and Dr. Stanley’s comments on the role of professional organizations in the policy process.
- Consider the policy brief you developed for Application Assignment 2 (due this week), and evaluate how a professional nursing organization might provide additional support or influence.
By Day 3
Post in your small group thread a cohesive response that addresses the following:
- Briefly summarize the policy proposal you selected from the IOM Future of Nursing Practice Report Brief (Application 2). Based on your analysis of the policy proposal, did the IOM get it right?
- Identify any professional organizations dealing with the issue/recommendation and provide at least two specific ways in which the professional organizations have supported or could support the policy proposal/recommendation.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
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NURS 8100/8100F/8100M/8100A Week 8: Federal Role in Health Care Policy
How does the organization and structure of government, including the existence of multiple levels (federal, state, local), promote or hamper effective policy making and implementation? What role does the federal government, in particular, play in the development of policies that affect nursing practice in today’s health care organizations? This week, you will examine how federalism has influenced the current health care system. You will consider the positive, or negative, implications of redundancy in health policy resulting from different levels of government.
Learning Objectives
Students will:
- Assess the implications of federalism in health care policy making
- Analyze the politics and issues surrounding a current health care policy
Discussion: Federalism’s Impact on Policy
The fragmentation of the U.S. health care system, with its differing modes of financing and service delivery, is a reflection of a dispersed government structure. Policy making is shared and distributed across various branches and levels of government. As a result, policy making processes can be slow to respond, manipulated towards personal interests, and often redundant. Consider, for example, the public entitlement programs such as Medicaid, Medicare, the State Children’s Health Insurance Program (SCHIPS), and the PPACA of 2010. Where is there overlap between these policies? How do they demonstrate a dispersed government structure?
This week, you will analyze the role of the federal government in health care policy making.
To prepare:
- Review this week’s Learning Resources focusing on the France article and the textbook readings.
- Identify two nursing or health care policies that address similar needs, one passed at the federal level and the other at another level of government (state or local).
By Day 3
Post a cohesive response that addresses the following:
- Provide an example of two policies that address similar needs, passed at two levels of government (i.e., federal, state, or local).
- What are the advantages and/or disadvantages of this duplication? How does this example reflect the implications of federalism? Provide support from the literature for your position.
- To what degree should the federal government get involved in health care policy making? Provide concrete examples to support your position.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8100/8100F/8100M/8100A Week 9: State and Local Role in Health Care Policy
As noted previously, policy is enacted and carried out through multiple levels of government. This week, the focus turns to the role of state and local government in policy making, with particular attention to the function of state boards of nursing in the regulation of practice. In light of health care reform efforts, scope of practice issues are of central importance and this falls under the purview of state boards of nursing. How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?
Learning Objectives
Students will:
- Analyze the role of state boards of nursing in the regulation of nursing practice
- Assess state and local politics and issues surrounding a current health care policy
Discussion: Policy and State Boards of Nursing
Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing.
To prepare:
- Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article focusing on how states regulate advanced nursing practice and how legislative changes are impacting scope of practice.
- Visit your state board of nursing website and/or contact the board to determine how the state board controls advanced practice through regulations.
- Determine if your state board has created any new policies or regulations that address changes to scope of practice in response to legislative changes.
By Day 3
Post a cohesive response that addresses the following:
- What are the most recent regulations promulgated through your state board of nursing for advanced practice?
- How are the state regulations supported within your place of employment?
- How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues selecting someone from a different state and comparing your state’s scope of practice with your colleague’s. Share any insights and implications for practice.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
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NURS 8100/8100F/8100M/8100A Week 10: Nursing and Health Policy: The International Perspective
To be a professional nurse today means having a world view. With the internationalization of health care issues, it is important to broaden your perspective and explore international health policy and nursing practice.
This week, you will focus on global health care policy. You will examine the nursing profession through an international lens, as well as investigate global efforts to promote health policies and improve health care delivery around the world.
Learning Objectives
Students will:
- Compare and contrast U.S. nursing or health-related policies with those of another country
- Evaluate the role of international nursing or health organizations in developing or supporting nursing policy
Discussion: Nursing and Health Policy in Other Nations
Think for a moment about nurses who relocate because of professional opportunities. How could such a seemingly personal decision have a detrimental impact on global health care? As presented in this week’s Learning Resources, nurse migration is of global concern. In response to this issue, international health care organizations such as the World Health Organization (WHO) and the International Council of Nurses (ICN) have positioned themselves to craft related policy as a solution. This is just one example of a global nursing policy effort.
To prepare:
- With information from the Learning Resources in mind, select a U.S. nursing- or health-related policy.
- Search the web and locate a similar policy in another country.
- Consider how the two policies are similar and dissimilar.
- Was an international organization involved in promoting the policies? If not, should they have been?
By Day 3
Post a cohesive response that addresses the following:
- Post information on the nursing or health-related policies you located including a reference to the source.
- Indicate the country you are comparing to the U.S.
- Compare and contrast the two policies. What insights did you gain as a result of this comparison?
- What is the role of international organizations in developing policy? Provide a specific example.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8100/8100F/8100M/8100A 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
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.
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
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