Posted: January 21st, 2023
RNs and APRNs need to be involved in the evaluation process of policies and programs to ensure they are functioning and accomplishing the intended goals. This practice is an essential piece of the policy implementation process that nurses and even policymakers forget (Laureate Education, 2018b). The Patient Protection and Affordable Care Act (ACA) passed in 2010 required healthcare facilities to evaluate and plan their programs and policies. Part of this requirement focuses on the leadership roles of nurses and meeting what is considered the quadruple aim (Milstead & Short, 2019). The quadruple aim consists of improved quality of care, reduced costs, improved population health, and job satisfaction of the healthcare employees (Milstead & Short, 2019) NURS 6050 Discussion Essay.
RNs and APRNs should look to actively participate in policy reviews to assess how and if the quadruple aim is meeting expectations. Nurses use assessment and evaluation skills in their day-to-day practice. There are informal and formal evaluation processes. Informal evaluation occurred in small groups and is more gossip than an evaluation. This informal evaluation can cause information gathered to be inaccurate (Milstead & Short, 2019). Formal evaluations involve standardized processes that keep all stakeholders involved in the process and assess the effectiveness of the program or policy overall (Milstead & Short, 2019). An ongoing evaluation must begin during the planning stage of the policy change (Laureate Education, 2018a). Nurses should be consistently assessed for improvement and challenges while planning and implementing policy and program changes (Milstead & Short, 2019) NURS 6050 Discussion Essay.
Policy evaluation does not come without its challenges. Sometimes policy changes can happen too quickly or too slowly. Policy changes may be rushed due to pressure from the government. It is essential to be aware of the economic conditions of a sample population, public awareness of the policy change, and the influence of social media outlets and ongoing political campaigns (Milstead & Short, 2019). Nurses must ensure that evaluation reports contain carefully collected data, analyzed, and released by reputable sources and if the answer regarding the desired outcomes is clear (Milstead & Short, 2019).
Nurses can be involved with policy evaluation by being active in professional nursing organizations such as the American Nurses Association (ANA). The ANA is active in the policy-making process by lobbying for improvements to the nursing profession. They are involved in ongoing data collection and disseminating the results to the public and interprofessional networks (Milstead & Short, 2019). As stated above, nurses are constantly assessing and re-assessing the effectiveness of nursing interventions, and the same process is used for policy evaluation (Milstead & Short, 2019). During the entire process of policy planning, implementation, and evaluation, nurses should monitor and gather data and present it to and educate stakeholders on whether the data shows the policy is working or not working (Yoder-Wise, 2020) NURS 6050 Discussion Essay.
Laureate Education (Producer). (2018a). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018b). Program Policy and Evaluation [Video file]. Baltimore, MD: Author.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Yoder-Wise, P. S. (2020). A framework for planned policy change. Nursing Forum, 55(1), 45-53 NURS 6050 Discussion Essay.
I agree with your statements of nurses needing to be a part of policy review since they are mainly the personnel implementing policies. it is simpler for nurses to implement policies because of their lifelong learning, development of their knowledge, and skills and competency throughout their professional lives (Hlongwa et. al, 2019). As you stated, nurses use assessment and evaluation skills in their day-to-day practice that can help them be good addition in policy review. Policy review can be more beneficial and have better outcomes when different individuals are helping to make a decision. According to Clifford et. al, policy process theory can usefully articulate the complexity of working with multiple policy actors in differing contexts (2019). Every individual has their own input and role in policy review. Nurses have an important role in policy review because of the responsibilities they have in patient care. Nurses assess, evaluate, and carry out decisions and policies daily. With that being said, nurses are key people in policy review because they can see first-hand the effectiveness of policies. As you stated, policy review is not simple and can have challenges. When it comes to nurse’s input in policy review; nurses may have challenges in ensuring feedback and data is collected carefully and presented appropriately. According to Glasgow et. al, greater attention needs to be paid to documenting intervention reach, adoption, implementation, and maintenance. Recommendations are offered to help close the gap between efficacy and effectiveness research and to guide evaluation and possible adoption of new programs (2003) NURS 6050 Discussion Essay.
Clifford, B., Wilson, A., & Harris, P. (2019). Homelessness, health and the policy process: a literature review. Health Policy, 123(11), 1125–1132. https://doi-org.ezp.waldenulibrary.org/10.1016/j.healthpol.2019.08.011
Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.
Hlongwa, E. N., & Sibiya, M. N. (2019). Challenges affecting the implementation of the policy on integration of mental health care into primary healthcare in KwaZulu-Natal province. Curationis, 42(1), 1–9. https://doi-org.ezp.waldenulibrary.org/10.4102/curationis.v42i1.1847 NURS 6050 Discussion Essay
Hello, xx. The policy evaluation process is essential because there are chances of omitting fundamental aspects of the health care system during the policymaking process (Scott et al., 2020). Health care policy evaluation involves a systematic approach of gathering and analyzing the vital information in the policy to enhance the policy’s ability to promote public health. The nurses’ involvement in the evaluation process of the health care policies is essential because it results in improved service delivery and performance in the health care system. According to Poorchangizi et al. (2017), crucial patients’ needs that were omitted during policy making will be added during policy review. The importance of involving the nurses in health care policy evaluation is because they are always involved in most of the activities in the system to ensure that therefore knowledgeable about the challenges and the areas the policy will affect. Thus, the nurses will point out the areas of the policy that need an adjustment NURS 6050 Discussion Essay.
Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M., & Borhani, F. (2017). The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC medical ethics, 18(1), 1-7. https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-017-0178-9
Scott, J. W., Schwartz, T. A., & Dimick, J. B. (2020). Practical guide to health policy evaluation using observational data. JAMA Surgery, 155(4), 353-354. doi:10.1001/jamasurg.2019.4398 NURS 6050 Discussion Essay
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 NURS 6050 Discussion Essay.
Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain 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.
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.
Policy Review Opportunities
There are numerous opportunities for registered nurses (RNs) and advanced practice registered nurses (APRNs) to participate in policy review. First, nurses can participate in a program evaluation design within their organization (Milstead & Short, 2019). During a program evaluation meeting, the team can discuss organizational policies, expected outcomes of the policies, data collection methods, and final result planning (Milstead & Short, 2019). To illustrate this, let us say that a hospital decides to implement mandatory influenza vaccines yearly for all employees. If an employee is non-compliant with the vaccine, they must wear a mask on the property from the start to end of flu season NURS 6050 Discussion Essay. The expected outcome would be that most hospital employees would be compliant in receiving the influenza vaccine. Data collection would consist of tracking the number of employees who received the vaccine versus the number of employees who declined to receive the vaccine. Based on the results, the program evaluation team may choose to implement additional restrictive measures for employees who decline the vaccine or offer incentives for employees who receive the vaccine to increase hospital-wide compliance. Second, as with aiding in policy-making, nurses can join a professional nursing organization to assist with policy review. Nurses played a significant role in implementing the Affordable Care Act by reviewing processes and supplying data to lawmakers (Milstead & Short, 2019).
Challenges and Strategies
When reviewing policies, nurses are bound to face challenges. Very few prevention and health promotion interventions are applied in healthcare settings (Glasgow et al., 2003). Two challenges may arise in social media and public awareness, or lack thereof (Milstead & Short, 2019). Let us take the policy discussed above regarding compliance with the influenza vaccine within a hospital system. As we have seen with COVID-19, many individuals refuse the vaccine due to a lack of education and social media’s strong influence. Education of hospital employees should include facts and efficacy statistics of the vaccine to combat false information seen on the internet NURS 6050 Discussion Essay. To advocate for policy-review opportunities, nurses must know the positive impact they make at the state and national levels. In Hawaii, policy teams have worked together to reduce health disparities for state citizens (Shiramizu et al., 2018). Word of mouth is the best advocate in this scenario. Nurses should also be encouraged to participate on local nursing boards and with national nursing organizations. Being involved with nursing groups provides strength in numbers when it comes to policymaking and review.
Glasgow, R., Lichtenstein, E., & Marcus, A. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261-1267.
Milstead, J., & Short, N. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett.
Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T., Ho, T., Mokuau, N., & Hedges, J. (2018). Leading by success: Impact of a clinical & translational research infrastructure program to address health inequities. NCBI. https://doi.org/10.1007/s40615-016-0302-4
You provide an excellent example about vaccine education and the importance of being able to dispel rumors regarding illnesses and vaccines. The hospital I work at has said that employees will likely have to wear barrier masks during cold and flu seasons in the future, regardless of vaccination status. After reading your discussion, I wonder if this will affect the influenza vaccine rate of employees at UW Hospital. UW has sent out numerous emails to staff about how to have conversations with patients and family members about conspiracy theories and misinformation surrounding Covid-19. I am grateful that my hospital supports us to have these conversations thoughtfully, but as a nurse, I am frustrated that these conversations even exist NURS 6050 Discussion Essay.
Nurses often discuss vaccines with patients and family members (Navin, Kozak, & Deem, 2020). Nurses need to develop a positive rapport and gain the trust of the individual before discussing the importance of vaccination, as this is a topic that some individuals do not take lightly. Education can occur through more than just discussion, though. As you pointed out, social media can be very polarizing and often supports the spread of vaccine misinformation. Enhanced vaccine education can occur through social media, virtual reality, cartoons, smartphone apps, and more. People are entitled to their own beliefs, but hopefully, people who have false beliefs about Covid-19 and vaccines have good opportunities for education during the pandemic.
Kashangura, C. (2020). Enhanced education on vaccines can reduce the scourge of vaccine rejection and hesitation. South African Journal of Science, 116(9/10). https://doi-org.ezp.waldenulibrary.org/10.17159/sajs.2020/8143
Navin, M. C., Kozak, A. T., & Deem, M. J. (2020). Perspectives of public health nurses on the ethics of mandated vaccine education. Nursing Outlook, 68(1), 62–72. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2019.06.014 NURS 6050 Discussion Essay
sample response 2
There are indeed many opportunities for the nurses to participate in the health care policy evaluation. They can participate through the nurses’ professional organizations such as the American Nursing Association, The National League for Nursing (NLN), The American Board of Nursing Specialties (ABNS), Sigma Theta Tau International Honor Society of Nursing (Sigma), and The National Student Nurses Association (NSNA) (Lake et al., 2019). These organizations participate actively in politics during elections, creating a political environment that will enable them to be considered by Congress during the policy evaluation process. They have advocates who will efficiently evaluate the policies to ensure the policies meet the healthcare system’s needs (O’Rourke et al., 2017). The organizations also influence the members to vote for several professional nurses to Congress during the elections. When they are elected, they can represent the nurses in evaluating the health care policies that might not be forwarded to the organizations for evaluation. The representatives will also influence the other legislatures in Congress to support their recommendations to solve the challenges in the health care system.
Lake, E. T., Sanders, J., Duan, R., Riman, K. A., Schoenauer, K. M., & Chen, Y. (2019). A meta-analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes. Medical care, 57(5), 353. https://dx.doi.org/10.1097%2FMLR.0000000000001109
O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political efficacy and participation of nurse practitioners. Policy, Politics, & Nursing Practice, 18(3), 135-148. https://doi.org/10.1177%2F1527154417728514 NURS 6050 Discussion Essay
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