The Role of the APRN in Policy Evaluation

The Role of the APRN in Policy Evaluation

The Role of the APRN in Policy Evaluation

Question Description

Help me study for my Health & Medical class. I’m stuck and don’t understand.

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.

To Prepare:

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.
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.

Required resources:

https://class.waldenu.edu/bbcswebdav/institution/USW1/202050_27/MS_NURS/NURS_6050/artifacts/USW1_NURS_6050_Shiramizu_et_al._2016.pdf

Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386–393. doi:10.1016/j.outlook.2018.05.003

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
Discussion rubric:

MAIN POSTING–

Excellent 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Good 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.Supported by at least three credible sources.Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Fair 35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.Is somewhat lacking reflection and critical analysis and synthesis.Somewhat represents knowledge gained from the course readings for the module.Post is cited with two credible sources.Written somewhat concisely; may contain more than two spelling or grammatical errors.Contains some APA formatting errors.
Poor 0 (0%) – 34 (34%)

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT:   The Role of the APRN in Policy Evaluation 

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.Lacks reflection and critical analysis and synthesis.Does not represent knowledge gained from the course readings for the module.Contains only one or no credible sources.Not written clearly or concisely.Contains more than two spelling or grammatical errors.Does not adhere to current APA manual writing rules and style.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Nurses are the backbones of the medical system.  The nursing profession is the largest in the U.S. healthcare industry.  For seventeen consecutive years, nursing ranked the most trusted job in Gallop’s ethic survey (For the 17th Year in a Row, Nurses Top Gallup’s Poll of Most Trusted Profession | AHA News, 2019). With so many responsibilities in nursing, it is an obligation that nurses actively participate in the policy review. By involving in policy review, nurses draft and analyze policies to be in a better position to advocate for their patients. This post will discuss the opportunities that currently exist for RNs and APRNs to actively participate in policymaking.

One opportunity for RNs and APRNs to actively participate in policymaking is policy draft.  Through policy drafts, nurses will be able to identify topics that will be critical for the next few years in healthcare. For example, Covid-19 pandemic really took a toll in U.S. healthcare industry.  As of date, over 700,000 people have died from Covid-19 infection in America (CDC, 2020).  Nurses played a significant role in the fight against Covid-19 and continue in the path to defeat this deadly virus.  Professional experiences of the nurses who worked with Covid-19 infected patients speak volumes about how exhausted the healthcare system is.  During the rollout of the Covid-19 vaccines, professional nurses were argued to engage in the vaccine advocacy campaign. Advocacy is a skill that nurses often use in their career; therefore, pairing that skill with a policy draft will enable nurses to organize the policy document with operational benefits properly. A well-drafted document will be easier to administer, maintain and enforce.  Likewise, Rasheed et al. (2020, P 447, Para 2) stress the importance that “due to their close interactions with individuals and communities across the healthcare system, nurses can offer greater direct insights concerning the effect of healthcare policies on individuals and communities.”   So, nurses need to be the drafters of the policies because it will reduce the overall amount of time an organization needs to spend on those activities, for example, vaccine advocacy programs. Appropriate content and specific knowledge and skills are essential in the policy document to avoid valuable time being wasted editing, discussing, and rewording statements that do not belong in the policy in the first place.

After completing a well-drafted policy document, nurses can participate in policy analysis and evaluate the current policy.  They can make a judgment about what went well and what did not, “whom to involve in future efforts, whom to trust, what the most effective timing is, how to create more powerful coalitions, and so forth” (Yoder‐Wise, 2019, p 52). The evaluation step is crucial because it allows the group to determine how to protect the current success and strategies needed to succeed.  However, there are challenges to these opportunities.

Policy drafting and analysis opportunities may present challenges because of poor technical knowledge and clinical skills and a lack of exposure to federal and state government involvement (Scott and Scott, 2020).  These current opportunities present challenges that can be overcome by proper training regarding policy draft and analysis during undergraduate nursing level and, of course, at the graduate level, encouraging students and faculty to participate in politics for policymaking and visiting the state and federal policy places. Scott and Scott (2020) argue that establishing relationships with policymakers is one of the best methods to get your issue on their agenda; it is about who you know and how you can influence them to listen to you.  Therefore, nurses must visit their local representatives to understand their stand on specific issues.  For example, if the nurse advocates for Covid-19 vaccines, they need to know how their local representative feels about the mass vaccination because if the representative does not fully support the vaccines, then the nurses will lose the support for publicizing the importance of the vaccines.  The representative can lobby against it because it is not profitable for them, challenging the nurses to prove their support and decisions.  If that becomes the case, nurses can use irrefutable evidence and knowledge more clearly and justifiably to publicize their support for the policy.

The strategies for better advocating are training and education programs for the nurses. Nurses already understand that they are the largest number of healthcare professionals in the healthcare industry, and therefore, their voices and suggestions are essential.  Advocating for patients at the bedside is as important as advocating for them at the state or federal government.  Nurses must understand that what they want for their patients, only they can deliver, and so, therefore, no one else can provide that on their behalf (Scott and Scott 2020). Suggestions from nurses will ensure safe and quality care through policymaking.

References

CDC. (2020, March 28). COVID Data Tracker. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#datatracker-home

For the 17th year in a row, nurses top Gallup’s poll of most trusted profession | AHA News. (2019, January 9). American Hospital Association | AHA News. https://www.aha.org/news/insights-and-analysis/2019-01-09-17th-year-row-nurses-top-gallups-poll-most-trusted-profession

Rasheed, S. P., Younas, A., & Mehdi, F. (2020). Challenges, Extent of Involvement, and the Impact of Nurses’ Involvement in Politics and Policy Making in in Last Two Decades: An Integrative Review. Journal of Nursing Scholarship, 52(4), 446–455. https://doi.org/10.1111/jnu.12567

Scott, S. M., & Scott, P. A. (2020). Nursing, advocacy and public policy. Nursing Ethics, 28(5), 723–733. https://doi.org/10.1177/0969733020961823

Yoder‐Wise, P. S. (2019). A framework for planned policy change. Nursing Forum, 55(1), 45–53. https://doi.org/10.1111/nuf.12381

            Tax-payer dollars are a conundrum of sorts but not to mention always a hot topic of debates at the capital, city halls, and local towns. After all, the publics’ voting is reflective of what each candidate will be doing with taxpayers’ dollars. Program and policy in nursing are no different. For example, money, in the form of tax-payer dollars, is being requested to be allocated to either reshape, support a bill, or research and not personal monies Laureate Education (2018b). A great majority of decisions and programs at the federal, state, and local levels, involve the health status of the population Milstead and Short (2019). One must be engaged in continuous evaluation at every level of program planning related to the economic impact as tax-payer dollars Milstead and Short (2019). Nurses impact policy through evaluation are poised to measure what the impact is likely to be and the effectiveness of the implemented program, outcomes, or policy Laureate Education (2018b). Furthermore, nurses can review current policy, like at their place of employment or within their practicing state, and engage in evaluation to see why a process did not work Milstead and Short (2019).  According to Milstead and Short (2019), nurses must be in the hierarchy of those in attendance having a pivotal voice at meetings for the redesign of healthcare systems. This includes being engaged from the beginning of policy planning with key participants, to program evaluation of healthcare policies within facilities Milstead and Short (2019). Also, the bill could also come from congress that a nurse may evaluate Laureate Education (2018b). Nurses should utilize the “five-step” framework from the Center for Disease Control and Prevention (CDC) for the evaluation in public health CDC (n.d.).  Nurses must promote cost clarity, patient education, and assist with the dispersion of accurate evaluation results Milstead and Short (2019). Leadership roles, like that of nurses, at times are met with adversity.

Challenges

There can be several challenges during program planning more so if the program is not completed in a tried format. This can be burdensome on program planning; however, most can be alleviated. Some of these challenges are out of the hands of the researcher and others are more apparent. For example, at times, the new policy may go through congress quickly or too slow with the respective audience, either the branch of government or the public, requesting the evaluation results quicker than anticipated Milstead and Short (2019).  Also, when comparing the context of other policies, deficiency of suitable data results may exhibit making it difficult to determine the effect Milstead and Short (2019). Some evaluation results can be unexpected and can divide communities creating a new focus regarding social or health policies Milstead and Short (2019).  Take COVID-19 for example, where some regions were being hit much harder than others and that required refocus and replanning for the safety of everyone. Limited resources or not having the appropriate person to complete the evaluation could also jeopardize program evaluations Milstead and Short (2019). According to Laureate Education (2018b), while measuring the efficiency or effectiveness of a program that did not yield expected results can result in inaccurate results. Fortunately, there are available steps nursing and other vital personal can integrate to decrease or alleviate the above-listed challenges.

How to Overcome Challenges

For program planning, one can be proactive to prevent problems that occur during the program evaluation from a nursing standpoint. Assigning a “point person” to the program is instrumental for the success of a program for they are a professional analyst who is accountable for compiling and creating the evaluation (Milstead & Short, 2019, p. 122). Other strategies available to nurses to guide effective evaluation and overcome challenges include the following. Implementing and applying a series of predetermined questions to the research program will address some challenges before they occur Agency for Healthcare Research and Quality (AHRQ, 2021). For example, is the bill or program doing what it is intended to do? How was the data collected and analyzed? Was the data reviewed by a trustworthy research team? Is it unbiased and complete Laureate Education (2018b)? Furthermore, AHRQ (2021) has compiled several questions to answer during the development of the plan. Some of these include “Who needs to act on the results and who will make decisions based on the results?” (AHRQ, 2021). Ethical issues need to be addressed and governed during the program building to ensure reliability and effectiveness.

Laureate Education (2018a) discusses ethics and advocacy and a point addressed is when a program is implemented, the creation of another implication can be created to address the ethics component of it.  For example, it could have been argued that when the needle exchange program went into effect that there would be more drug users. Instead, to address the ethics component, this program had a triple purpose with two ultimately addressing the risk of increased drug users. These included addressing the overdose with drug treatment options, needle exchange, and training addicts to revive those that have overdoses Laureate Education (2018a). In addition, available to nurses is the “Five-step framework” to guide policies and programs with guidelines regarding public health actions (Centers for Disease Control and Prevention, n.d.).

Strategies to Advocate or Communicate the Existence of these Opportunities

            To any plan, or project created or altered, strategies are available to communicate the existence of the prior discussed opportunities. To address ethical issues, there is professional organizations that provide ethical guidelines for evaluation CDC (n.d.).  For example, American Counseling Association, the American Psychological Association, and other professional organizations have available a series of ethical principles questions and principles that nurses should utilize while implementing and creating their planning Milstead and Short (2019). Milstead and Short (2019) have a list of strategies that can be used during the project planning that are directly related to communication approaches. These include using the most suitable methods during the evaluation, such as the CDC framework for program evaluation. Also, to identify key participants and multiple other vital members with the overall aim, and address conflicts rapidly. Lastly, habitually connecting with members throughout the execution and evaluation cycle of the project is critical Milstead and Short (2019). These strategies when combined with other beneficial theories and guidelines can have a positive effect on the entire process of project planning from beginning to end Milstead and Short (2019).

 

 

 

References

Agency for Healthcare Research and Quality. (2021). Elements of an Evaluation Plan. Retrieved from ahrq.gov

Centers for Disease Control and Prevention. (n.d.). Program Performance and Evaluation Office (PPEO). Retrieved from cdc.gov

Laureate Education (Producer). (2018a). Peter Beilenson: Ethics and advocacy [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018b). The Importance of Program 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.