Tag: Clinical-Nursing

Professional Nursing and State-Level Regulations Discussion Essay

Board of Nursing (BON) are government agencies in every state in the US responsible for overseeing all nurses’ activities (Cassiani et al., 2020). They are the organizations in charge of regulating nursing practice in each of the fifty states of the US, and each board of nursing is a member of the National Council of State Boards of Nursing (NCSBN). Each BON’s role is to regulate all nurses’ activities in the particular state using clearly defined standards and practice regulations. However, the version of practice standards differs in every state. Some states permitting advanced practice nurses (APNs) full practice authority in primary settings while others only allow APNs full practice authority under a professional’s supervision Professional Nursing and State-Level Regulations Discussion Essay.

Comparison of Two APRN Board of Nursing Regulations

The activities of nurses are regulated in Arizona by the Arizona State Board of Nursing, which is the state’s licensing and regulatory body in charge of setting standards and scope of practice for nurses in Arizona (Cassiani et al., 2020). Some of the practice regulations put in place by this organization are similar to the regulations in other states in ensuring nurses provide patients with quality medical care. For instance, the regulations guiding a nurse’s requirements to qualify as an APRN are similar in Arizona and New Jersey. To practice as an APRN in both states, a nurse must hold a bachelor’s degree in nursing and acquire certification as a registered nurse from the state’s licensing organ. They must advance their role from an accredited master’s program that met the state’s advanced clinical education standards and passed the national APRN board certification exam. In addition to the graduate degree or master’s program, the person must be licensed as a qualified nurse by the Arizona State Board of Nursing Professional Nursing and State-Level Regulations Discussion Essay.

Difference

Despite sharing many standard nursing practice regulations, the two states differ regarding authorization of full practice authority. Nurse practitioners in Arizona are permitted full practice authority (Bosse et al., 2017)) by the state board of nursing, unlike in New Jersey, where the state board of nursing prohibits the same category of nurses from carrying out some roles unless under the direct supervision of a physician. For example, nurse practitioners in Arizona practice independently in the primary setting. They can prescribe medications to patients and treat basic mild and severe illnesses without signing any supervision contracts with a physician. On the other hand, nurse practitioners in New Jersey are not authorized to prescribe medications independently but under the supervision of a physician with whom they have to sign a practice contract Professional Nursing and State-Level Regulations Discussion Essay.

Application of the Regulations to APRN

Regulations are critical in every area of nursing discipline and any other professional field. Rules ensure only qualified people practice in their different professional roles (Peterson and Morris, 2019). In the nursing domain, regulations guiding the nursing practice are enforced by various professional organizations like ANA and several state-based organizations like ABON. In Arizona, such regulations enforced by the ABON include full practice authority to nurse practitioners. This regulation applies to the APRNs role by enabling the nurse to fully utilize her skills in her position without relying on any physician supervision, thus improving the quality of care provided. Professional independence allows the NP to improve healthcare accessibility at an affordable cost, especially in underserved rural areas (Peterson and Morris, 2019). Career advancement also endows the nurse with the needed competency to fully discharge her role with confidence and make meaningful, informed medical decisions concerning her patients. For example, APRNs with full practice authority adhere to practice regulations by ensuring they consult with other healthcare providers and transfer patients outside their scope of practice to physicians.

References

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. 
Nursing Outlook
, 
65
(6), 761-765.

Cassiani, S. H. D. B., Lecorps, K., Cañaveral, L. K. R., da Silva, F. A. M., & Fitzgerald, J. (2020). Regulation of nursing practice in the Region of the Americas. 
Revista Panamericana de Salud Pública
, 
44
.

Peterson, K. S., & Morris, B. C. (2019). Creating synergy between academia and practice: the Arizona State University and Mayo Clinic Arizona model. 
Journal of Professional Nursing
, 
35
(4), 305-313 Professional Nursing and State-Level Regulations Discussion Essay.

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response

I agree that the Board of Nursing (BON) in each state varies tremendously, which can be very confusing. There should be standardization to the regulations and practice of advanced practice nurses (APN). Presently there are only 21 states that allow APNs to practice independently without physician oversight (Cabbabe, 2016).

One of the barriers that the BON faces is pushback from physicians. Dr. Gary Pigman, an emergency room physician and lawmaker for Florida, states he presented 18 bills on the topic related to APNs becoming primary care providers dating back to 2014 (Jordan, 2019). Many physicians are opposed to the idea and argue that the care provided by APNs is not as comparable to those provided by a physician, even though research has proven this is a false claim. In actuality, physicians are afraid that the increase of APNs as primary care providers and exclusion of physicians from the healthcare team would become a danger to their practice becoming extent (Jordan, 2019).

An APN’s ability to practice independently without physician oversight should not be restricted to state government. Hopefully, with increased lobbying, it will reach the federal level. Therefore, giving all APNs in every state a standardized level as a primary provider Professional Nursing and State-Level Regulations Discussion Essay.

References

Cabbabe, S. (2016, Nov – Dec). Should Nurse Practitioners Be Allowed to Practice Independently? 
Missouri Medicine, 113
(6), 436-437. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139780/

Jordan, G. (2019, December 13). 
WFSU Public Media
. Retrieved from Florida Doctor Groups Push Back Against Giving Advanced Nurses Their Independence: https://news.wfsu.org/state-news/2019-12-13/florida-doctor-groups-push-back-against-giving-advanced-nurses-their-independence Professional Nursing and State-Level Regulations Discussion Essay

Discussion: Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.

To Prepare:

Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

Consider how key regulations may impact nursing practice.

Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

By Day 3 of Week 5

Post
a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected Professional Nursing and State-Level Regulations Discussion Essay.

By Day 6 of Week 5

Respond
 to at least 
two
 of your colleagues
* on two different days
 and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

 

Advanced Practice Registered Nurses (APRNs) have regulations they must follow once they are licensed practitioners. According to NCSBN,
 
Nursing Regulatory Bodies (NRBs) are jurisdictional governmental agencies in the 50 states, the District of Columbia and four US territories that are responsible for the regulation of nursing practice (n.d). One regulation the state of South Carolina has is that APRNs require an approved written protocol with a collaborating physician (Staff Writers, 2020).
 
 One state that has a regulation that differs from South Carolina is Oregon. The regulation for prescribing authority in this state is that APRNs have full prescriptive authority (Staff Writers, 2020). Regulations differ state to state, therefore it is important for APRNs to be familiar with the regulations if they decide to work in a different state. Another regulation that differ in these two states is the requirements for continuing education. According to NCSBN, in South Carolina, APRNs require 20 hours of which 2 much consist of controlled substance. Oregon continuing education requirements consists of APRNs having 45 hours in which 15 are pharmatherapeutic content (n.d). Some states are considered compact which eliminates having regulations being different in all 50 states individually.
 

In states such as South Carolina, APRNs struggle with practicing to their full potential because of what is considered being within their scope of practice. For example, the regulation of prescribing authority explained above limits what the APRN can prescribe to a person without the approval of a MD first. Whereas in states such as Oregon, the APRN can prescribe without consulting a MD or having an approval first.
 
 According to Neff et. al,
 
in states with restrictive NP practice, NPs are geographically collocated with supervising MDs, restricted NP practice limits their ability to provide care in areas that lack access to primary health-care providers, and NPs are not practicing to their full scope of practice (2018). APRNs in some states are further along in autonomy and practicing to their full ability. Someday all 50 states may align with regulations, which will make things simpler rofessional Nursing and State-Level Regulations Discussion Essay.

References

National Council of State Boards of Nursing (NCSBN). (n.d). Retrieved March 29, 2021, from https.//www/ncsbn.org/index.htm

Neff, D.F, Yoon, S.H., Steiner, R.L., Bumbach, M.D., Everhrt, D., & Harman J.S. (2018). The impact of nurse practitioner regulations on population access to care.
 
Nursing Outlook, 66
(4), 379-385. doi: 10.1016/j.outlook.208.03.001

Staff Writers. (2020, October). How does nurse practitioner authority vary by state?. https://www.nursepractitionerschools.com/faq/how-does-np-practice-authority-vary-by-state/

response post

Advanced Practice Registered Nurses (APRNs) have been a great asset for communities, especially rural ones. As a Registered Nurse (RN) in the state of Michigan I can relate to your state, South Carolina, where it can be difficult for APRNs to practice to their full potential due to state board of nursing (BON) difference across all states (Milstead & Short, 2019) Professional Nursing and State-Level Regulations Discussion Essay. Michigan is comparable to South Carolina for we also require an overseeing Physician to delegate the prescription of certain medications, we require a Physician to delegate the prescription of scheduled II-V controlled substances (NCSLSOP, n.d.). With limitations as such, rural areas that have difficulties to hire physicians will continue to struggle because APRNS cannot work there without a delegating/overseeing Physician, which is really unfortunate in my opinion.

Regarding the continuing education (CE) hours, Michigan is also different. According to NursingCE (n.d.) Michigan APRNS are required to complete 25 hours between each licensure renewal. Similarly, we must complete certain number of hours to particular topics. While Michigan’s BON requires at least 2 hours in pain and symptom management and a one-time human trafficking CE (NursingCE, n.d.). Something to consider and to watch out for in some states such as Michigan is a limited amount of CE credits that can be completed in a day. So, do not binge all of the CE credits required for licensure renewal in one day.

Thank you for sharing information about your state, I am glad to see that my state is not the only one that has some ‘stricter’ rules and regulations compared to others like Oregon as you stated Professional Nursing and State-Level Regulations Discussion Essay.

References

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

NCSLSOP. (n.d.). Nurse Practitioners
. Scope of practice policy. 
Retrieved March 30, 2021, from https://scopeofpracticepolicy.org/practitioners/nurse-practitioners/?fbclid=IwAR0xWHuSPdq8iCfp0dAnEfL-tXd6M0vdq6MY9_Aunw54FsUC5fcXW_a1g3A

NursingCE. (n.d.). 
Requirements specific to Nurse Practitioners in Michigan.
NursingCE by ati. Retrieved March 31, 2021 from https://www.nursingce.com/ceu-requirements/michigan/np#requirements Professional Nursing and State-Level Regulations Discussion Essay.

Healthcare Program/Policy Evaluation Analysis

Health programs help improve engagement and empower people to adopt quality behaviors to enhance individual and communal welfare. It targets behaviors that reduce wellness, but which can be modified through education and mentorships. Health programs reduce disease incidence, and therefore, healthcare costs. Sexual and reproductive health continues to draw the attention of medical practitioners because of the negative effects they introduce across populations. The purpose of this health program is to educate and empower young and older adults into making quality decisions that will promote their sexual and reproductive health Assessing a Healthcare Program Essay.

Healthcare Program/Policy Evaluation

 

Planned Parenthood

Description

Planned Parenthood program intends to educate young and old people men and women on sexual and reproductive health. Topics that will be handled in the program are family planning, contraception, abstinence, sexual orientation, safe sex, family life, parent-child communication, sexuality, teenage pregnancy, and women’s health education (Primrose, 2012).

How was the success of the program or policy measured?

The program’s success was measured using the following indicators

The ability of team members to provide high-quality, non-judgmental, and affordable care to all clients.

Ability to provide facts-based and dependable health information

Reduction in barriers that limited people’s access to quality reproductive and sexual health education.

Increased number of people who enrolled for reproductive and sexual health care education.

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

 

 

The program reached 125,000 people living within and outside the country.

This program’s impacts include engagement in responsible sexual behaviors, reduced premarital sex, reduced cases of teen pregnancies and STIs, improved communication between families, improved women’s health, and better familial relationships.

 

What data was used to conduct the program or policy evaluation?

 

 

The program team used the following data to evaluate the program’s success: the number of people educated on sexual and reproductive health, percentage of teens engaging in risky sexual behaviors, the number of teen pregnancies, number of couples who benefited from the family programs, women who accessed contraception and other health services, and participant attitudes towards the experts and quality of services offered. Data on the program’s sustainability (in terms of costs) and effectiveness of the outcomes was also used in the evaluations.

What specific information on unintended consequences were identified?

 

 Implementing the program might have increased the percentage of people seeking abortion services.

Cases of individuals using emergency contraceptives (morning-after pills) increased as more people tried to reduce the chances of getting pregnant after having unprotected sex

What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

 

 

The stakeholders in the program are the patients, medical service providers (doctors and nurses), youth leaders, public health experts, and local advocates (Harris, 2016).

Members of the community are the program’s biggest beneficiaries since it was introduced and designed purposefully to cater to their needs (Harris, 2016).

 

 

 

Did the program or policy meet the original intent and objectives? Why or why not?

The program met its objectives. However, it can still be modified to yield better results in the future. It was able to improve the health status of vulnerable communities and young people. The number of people who received an education, and therefore, became more conversant with sexual and reproductive health increased. More people could access information on family planning, comprehensive sexuality education, child protection education, HIV/AIDS and other STIs, safe and unsafe abortion, and stigma reduction.

Young people were empowered to make quality decisions regarding their sexual health. The abstinence and comprehensive sexual education programs yielded desirable outcomes. These were evidenced with the following results.

The percentage of teens who admitted to engaging in risk-taking behaviors after exposure to the training was reduced.

Teen pregnancies reduced as young people took precautions and protected themselves. However, these changes were slightly low.

More young people admitted to learning and understanding the value of abstinence, although a few found it very difficult to stop such behaviors. Specifically, they became conversant with the social, psychological, and physical impacts of premarital and unprotected sexual activities Assessing a Healthcare Program Essay.

Young people who took advantage of the program and its services were willing to seek treatment according to specialist recommendations. They pledged to share the information acquired from the education program with other people to improve the communities’ overall health.

The adults who participated in the program enrolled in multiple educational services.

The number of women who accessed contraceptives changed.

Most married couples enrolled in family programs. A good percentage reported having better conversations with their loved ones leading to improved sexual health and other forms of relationships.

The program implementers built networks of technical experts who delivered the services promised to stakeholders.

The program implementers partnered with other community-based organizations to make the services affordable and accessible to everyone irrespective of their backgrounds.

The program implementers hired professionals with high levels of knowledge, expertise, and good personal skills to formulate quality interpersonal relationships. These people delivered the services genuinely, honestly, and with excellent efficiency. They were also committed to the provision of quality services.

Would you recommend implementing this program or policy in your place of work? Why or why not?

 I would recommend the program in my workplace because the facility handles clients with diverse needs. The program will help young people who want to learn about their sexual health. It is also valuable for pregnant women and women in general. Families experiencing relationship challenges can also benefit from the program’s educational content.

The organization can introduce the program as part of its diversification plan. More people accessing these healthcare services leads to improved community wellbeing.

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

Nurse advocates can champion for better services and solve persistent problems by testifying issues they observed during the program implementation process, but which limited the program’s success. These testimonies will help decision-makers make sense of the statistics and other outcomes and emphasize critical areas that need to be empowered.

Nurse advocates can also provide recommendations on how the program should be improved (Lewinski & Simmons, 2018).  For example, their contributions will help the implementation team allocate existing resources to encourage better decisions and help resolve the current problems.

General Notes/Comments

The planned parenthood program was successful because of good planning and adoption of effective management strategies.

 

Conclusion

The program was able to achieve its purpose since it empowered the target population to make better decisions. More people became conversant with sexual and reproductive health. Improved choices led to behaviors that enhanced the health status of those who participated in the program. Some of the program’s benefits include reduced risk-taking behaviors and teen pregnancies, the increased value of abstinence, and a higher number of people receiving appropriate treatment. Those who enrolled in family programs reported positive outcomes too. The program’s improvement will lead to better results in the future.

References

Lewinski, A. A., & Simmons, L. A. (2018). Nurse knowledge and engagement in health policy making: Findings from a pilot study.
The Journal of Continuing Education in Nursing, 49
(9), 407-415.

Primrose, S. (2012). The attack on planned parenthood: A historical analysis.
UCLA Women’s LJ, 19
, 165.

Harris, M. J. (2016). Evaluating public and community health programs. Hoboken: John Wiley & Sons Assessing a Healthcare Program Essay.

Assignment: Assessing a Healthcare Program/Policy Evaluation

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.

Select an existing healthcare program or policy evaluation or choose one of interest to you.

Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described Assessing a Healthcare Program Essay.

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The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

Describe the healthcare program or policy outcomes.

How was the success of the program or policy measured?

How many people were reached by the program or policy selected?

How much of an impact was realized with the program or policy selected?

At what point in program implementation was the program or policy evaluation conducted?

What data was used to conduct the program or policy evaluation?

What specific information on unintended consequences was identified?

What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

Did the program or policy meet the original intent and objectives? Why or why not?

Would you recommend implementing this program or policy in your place of work? Why or why not?

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation Assessing a Healthcare Program Essay.

NURS_6050_Module05_Week10_Assignment_Rubric

Excellent

Good

Fair

Poor

Program/Policy Evaluation

Based on the program or policy evaluation you seelcted, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

·   Describe the healthcare program or policy outcomes.

·   How was the success of the program or policy measured?

·   How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

·   At what point in time in program implementation was the program or policy evaluation conducted?

32 
(32%)
 – 35 
(35%)

Response clearly and accurately describes in detail the healthcare program or policy outcomes.

Response accurately and thoroughly explains in detail how the success of the program or policy was measured.

Response clearly and accurately describes in detail how many people were reached by the program or policy and fully describes the impact of the program or policy.

Response clearly and accurately indicates the point at which time the program or policy evaluation was conducted.

28 
(28%)
 – 31 
(31%)

Response accurately describes the healthcare program or policy outcomes.

Response accurately explains how the success of the program or policy was measured.

Response accurately describes how many people were reached by the program or policy and accurately describes the impact of the program or policy.

Response accurately indicates the point at which time the program or policy evaluation was conducted.

25 
(25%)
 – 27 
(27%)

Description of the healthcare program or policy outcomes is inaccurate or incomplete.

Explanation of how the success of the program or policy was measured is inaccurate or incomplete.

Description of how many people were reached by the program or policy and the impact is vague or inaccurate.

Response vaguely describes the point at which the program or policy evaluation was conducted.

0 
(0%)
 – 24 
(24%)

Description of the healthcare program or policy outcomes is inaccurate and incomplete, or is missing.

Explanation of how the success of the program or policy was measured is inaccurate and incomplete, or is missing.

Description of how many people were reached by the program or policy and the associated impacts is vague and inaccurate, or is missing.

Response of the point at which time the program or policy was conducted is missing.

Reporting of Program/Policy Evaluations

·   What data was used to conduct the program or policy evaluation?

·   What specific information on unintended consequences was identified?

·   What stakeholders were identified in the evaluation of the program or policy? Who would benefit the most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

·   Did the program or policy meet the original intent and objectives? Why or why not?

·   Would you recommend implementing this program or policy in your place of work? Why or why not?

·   Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

45 
(45%)
 – 50 
(50%)

Response clearly and accurately identifies the data used to conduct the program or policy evaluation Assessing a Healthcare Program Essay.

Response clearly and thoroughly explains in detail specific information on outcomes and unintended consequences identified through the program or policy evaluation.

Response clearly and accurately explains in detail the stakeholders involved in the program or policy evaluation.

Response clearly and accurately explains in detail who would benefit most from the results and reporting of the program or policy evaluation.

Response includes a thorough and accurate explanation of whether the program met the original intent and outcomes, including an accurate and detailed explanation of the reasons supporting why or why not.

Response includes a thorough and accurate explanation of whether the program should be implemented, including an accurate and detailed explanation of the reasons supporting why or why not.

40 
(40%)
 – 44 
(44%)

Response accurately identifies the data used to conduct the program or policy evaluation.

Response explains in detail specific information on outcomes and unintended consequences identified through the program or policy evaluation.

Response explains in detail the stakeholders involved in the program or policy evaluation.

Response explains who would benefit most from the results and reporting of the program or policy evaluation.

Response includes an accurate explanation of whether the program met the original intent and outcomes, including an accurate explanation of the reasons supporting why or why not.

Response includes an accurate explanation of whether the program should be implemented, including an accurate explanation of the reasons supporting why or why not.

35 
(35%)
 – 39 
(39%)

Response vaguely or inaccurately identifies the data used to conduct the program or policy evaluation.

Explanation of specific information on outcomes and unintended consequences identified through the program or policy evaluation is vague or incomplete.

Explanation of the stakeholders involved in the program or policy evaluation is vague or inaccurate.

Explanation of who would benefit most from the results and reporting of the program or policy evaluation is vague or inaccurate.

Explanation of whether the program/policy met the original intent and outcomes and the reasons why or why not is incomplete or inaccurate.

Explanation of whether the program or policy should be implemented, and the reasons why or why not, is incomplete or inaccurate.

0 
(0%)
 – 34 
(34%)

Identification of the data used to conduct the program or policy evaluation is vague and inaccurate, or is missing.

Explanation of specific information on outcomes and unitended consequences identified through the program or policy evaluation is vague and incomplete, or is missing.

Explanation of the stakeholders involved in the program or policy evaluation is vague and inaccurate, or is missing.

Explanation of who would benefit most from the results and reporting of the program or policy evaluation is vague and inaccurate, or is missing.

Explanation of whether the program or policy met the original intent and outcomes and the reasons why or why not is incomplete and inaccurate, or is missing.

Explanation of whether the program or policy should be implemented, and the reasons why or why not, is incomplete and inaccurate, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive Assessing a Healthcare Program Essay.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6050_Module05_Week10_Assignment_Rubric Assessing a Healthcare Program Essay

NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations

Each state has different regulations, titles, scopes of practice, and regulatory standards (Milstead & Short, 2019, pp. 65) yet they have similar standards for education requirements. As a registered nurse and future advanced practicing registered nurse (APRN) in the state of Michigan, Nurse Practitioners are not recognized as a primary care provider as an individual (NCSLSOP, n.d.).  This means as an APRN I would require a Physician to overlook or delegate ‘tasks’ to maintain care for patients in the state of Michigan. That being stated, Michigan APRNs may prescribe nonscheduled drugs without a delegated physician (NCSLSOP, n.d.), but can prescribe schedules II-V controlled substances if a physician where to delegate the task to an APRN (NCSLSOP, n.d.). Schedules II-V controlled substances would include but not limited to Dilaudid, Methadone, Ketamine, Xanax, Ativan, Phenergan with Codeine, and more (Diversion Control Division, 2021) NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

Comparing Michigan, a single licensure state, to a state included in the Nurse Licensure Compact (NCL) is slightly different for APRNS. Arizona for an example allows APRNs to practice independently without the licensure of a physician compared to Michigan and they are recognized as primary care providers (NCSLSOP, n.d.). That being said, APRNs must work within the guideline and regulations of the state board of nursing, BON, (Milstead & Short, 2019) and they must practice within their scope as well as population focus (NCSLSOP, n.d.). As an RN we are licensed and regulated by our BON and must continuously monitor for changes to verify that we are adhering our care within our scope of practice, especially if one is a travel nurse or if you have recently moved to a different state since state specific practices can vary (Milstead & Short, 2019). To adhere to the regulations as an APRN one should research the states BON for their regulations as well as monitoring the jobs you apply for as an APRN. Some states, such as Arizona, allows APRNs to work without a delegating physician as I stated earlier, but that APRN has to apply for positions within their population focus, such as a Psychiatric mental health NP should not apply for a Pediatric primary care position in Arizona. Although, Arizona allows APRNs to work within their full scope of their education and experience, does not mean every state allows that and research should be done to validate proper and safe care is provided for communities. With the proper education and training, APRNs should be able to work within their scope and practice, as long as the care they are providing are within the guidelines of their BON or delegated from their overseeing Physician NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

References

Diversion Control Division. (2021, March). 
Scheduling actions controlled substances regulated chemicals.
 U.S. Department of Justice. https://www.deadiversion.usdoj.gov/schedules/orangebook/orangebook.pdf

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

Milstead, J. A., & Short, N.M. (2019). 
Health policy and politics: A nurse’s guide 
(6
th
 ed., pp 57-84). Burlington, MA: Jones Bartlett Learning.

NCSLSOP. (n.d.). Nurse Practitioners
. Scope of practice policy. 
Retrieved March 30, 2021, from https://scopeofpracticepolicy.org/practitioners/nurse-practitioners/?fbclid=IwAR0xWHuSPdq8iCfp0dAnEfL-tXd6M0vdq6MY9_Aunw54FsUC5fcXW_a1g3A NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations

response

I was surprised to learn from your post that Michigan remains a single licensure state, so I looked around and found on the Michigan Health and Hospital Association (2020) that the Michigan House Bill 4042 passed both chambers but was vetoed by the governor December 30
th
. Representative Mary Whiteford did reintroduce the legislation as HB 4046 for the 2021-2022 legislative session and hopefully it will pass and continue all the way through.

It is important to note that the Enhanced Nursing Licensure Compact (eNLC) was implemented in 2018 to include new standards like state and federal fingerprint based criminal background checks that the original Nursing Licensure Compact (NLC) did not have (Gaines, 2021). The eNLC will allow practitioners who travel to practice in multiple states without delay, and this is especially important when examining the current pandemic and the increased importance of advanced practice registered nurses. There are continued concerns that do need to be addressed in the eNLC as it moves forward like how to properly discipline, loss of state revenue, and how to work with the increase need for telehealth NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

References

Gaines, K. (2021, March 7). Compact nursing states list 2021. 
Nurse.
 Retrieved from https://nurse.org/articles/enhanced-compact-multi-state-license-eNLC/

Michigan Health and Hospital Association. (2020). 
Nurse Licensure Compact passes the house. 
Retrieved from https://mha.org/Newsroom/ID/2351/Nurse-Licensure-Compact-Passes-the-House

Discussion: Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.

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To Prepare:

Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

Consider how key regulations may impact nursing practice.

Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

By Day 3 of Week 5

Post
 a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

By Day 6 of Week 5

Respond
 to at least 
two
 of your colleagues
* on two different days
and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

Professional Nursing and State-Level Regulations

Throughout the years, the evolution of Advanced Practice Registered Nurses (APRN) has been inconsistent due to the U.S. Constitution giving states the right to establish laws governing professions and occupations. Thus, each state has unique titles, scopes of practice, and regulatory standards (Milstead & Short, 2019). According to the American Nurses Association (ANA) (n.d.), “APRN practice is typically defined by the Nurse Practice Act and governed by the Board of Nursing, but other laws and regulations may impact practice, and other boards may play a role”. APRNs who have legal authority to practice within the full scope of their education and experience, the state permits those NPs to evaluate patients; initiate and manage treatments; diagnose, order, and interpret diagnostic tests; and prescribe medications and controlled substances (State Practice Environment, 2021).

Currently in my state of practice, Virginia, a Nurse Practitioner (NP) with a current license may qualify for autonomous practice after the completion of having five years of full-time clinical experience, a total of 9,000 hours, under a patient care team physician. An NP that has been authorized to practice autonomously can only practice within the scope of the NP’s clinical and professional training and limits of the NP’s knowledge and experience, consult and collaborate with other health care providers based on a patient’s clinical condition, and establish a plan for referral of complex medical cases and emergencies to other health care providers. Another regulation that Virginia has is that unless an NP has been authorized for autonomous practice, the NP may only prescribe Schedule II-VI drugs after meeting certain criteria, having authorization from the Boards of Nursing and Medicine, and obtaining registration from the U.S. Drug Enforcement Administration (DEA). An example of one of these criteria includes having authorization to prescribe medications through a practice agreement with a
collaborating physician
(Laws and Regulations, 2018).

In the state of North Carolina, NPs are not allowed to practice autonomously at any given time and must have a collaborative practice agreement with a primary supervising physician. For an NP to prescribe medications in North Carolina, the NP has to have authorization by the physician approved by the boards as the NP’s supervisor and the supervising physician has stated the drugs that the NP may prescribe in the collaborative practice agreement. In order to prescribe controlled substances, the NP must have an assigned DEA number that is entered on each prescription. This is similar to the regulation stated by Virginia; however, in North Carolina, NPs can prescribe Schedule II-IV drugs with the additional ability to prescribe Schedule V drugs. (Nurse Practitioner Laws & Rules: North Carolina Board of Nursing, 2021) NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.

References

APRN state law and regulation
. American Nurses Association. (n.d.).

https://www.nursingworld.org/practice-policy/advocacy/state/aprn-state-law-and-

regulation/

Laws and regulations
. Virginia Board of Nursing. (2018, July 6).

http://www.dhp.virginia.gov/Boards/Nursing/PractitionerResources/LawsRegulations/

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

Burlington, MA: Jones & Bartlett Learning.

Nurse practitioner laws & rules: North carolina board of nursing
. North Carolina Board of

Nursing. (2021).

https://www.ncbon.com/practice-nurse-practitioner-nurse-practitioner-laws-rules

State practice environment
. American Association of Nurse Practitioners. (2021, January 1).

https://www.aanp.org/advocacy/state/state-practice-environment NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations

Role of the RN/APRN in Policy Evaluation Essay

Two opportunities in which nurses or APRNs can become involved in policy review are getting to know your elected officials and attending meetings for the board of nursing.  Your elected official represents you and the community.  The hospital I worked for had a nurse’s union.  Issues within the hospital 
directly affecting the community
, and neither side would give in,
 and the union discussed it with the then-elected mayor at the time.  These constant visits to the mayor’s office evolved into a relationship between the union and the mayor.  After merging with another hospital system, the hospital I worked for wanted to terminate their pediatrics department and transfer it to the other hospital.  
 The union informed the mayor of the hospital’s intention, town hall meetings were held, and it was also found to be a violation of a treaty between the city and the hospital. As nurses, we have a strong influence 
on policy
 (Brokaw, 2016).  The mayor that my union formulated a relationship with is now a senator
, and he continues to advocate for changes in healthcare Role of the RN/APRN in Policy Evaluation Essay.
 

Attending state board of nursing meetings 
is important if you are interested in the policy review.  The board of nursing has a lawyer that lobbies for changes.  
Nurses are not familiar with legality.  Hence the reason a lawyer is a part of the board of nursing.  Issues are introduced at the board meeting, discussed, and then voted on whether to present to the constituent.   These meetings are very intense because many lobbyists are present, and according to which policy is being discussed, they know which senator to approach.  At one of the meetings I attended, the subject was the legalization of marijuana and how it will affect the APRN’s ability to prescribe?   Removing marijuana from the drug screen toxicology was also brought up.  If someone smoked in a state where marijuana is legal and travel to another state where marijuana is illegal, have they committed a crime.  Another topic discussed was the impaired nurses.  Penalties and years of suspension, working back towards license redemption, and should they go back to the bedside.  There is a log keeping track of the impaired nurses and their progress Role of the RN/APRN in Policy Evaluation Essay.  
 

Challenges to policy review are convincing nurses to get involved, lack communication, collaboration, and information sharing among nurses, and change t
he nurse-physician role (Rasheed, Younas, & Mehdi , 2020).  Nurses feel as though they are subordinates to physicians, and the gender role of men being in the position of authority are other challenges that nurses face (Rasheed, Younas, & Mehdi , 2020).  Nurses fail to realize that they do have an excessive influence concerning policy changes as the largest profession in size and direct interaction with the patient gives nurses a more powerful and louder voice.

Two strategies that may help bridge the gap and get more nurses involved are networking.  My union president took advantage of any opportunity she had to get more nurses involved.  There were chain text messages of upcoming meetings, and in the breakroom, many flyers were posted.  When attending the board meetings, we went in groups.  Groups held more accountability for each other Role of the RN/APRN in Policy Evaluation Essay.
 
 

References

Brokaw, J. J. (2016, September 22). 
The nursing profession’s potential impact on policy and politics
. Retrieved from American Nurses: https://www.myamericannurse.com/nursing-professions-potential-impact-policy-politics

Rasheed, S. P., Younas, A., & Mehdi , F. (2020, May 25). 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. Retrieved from https://doi.org/10.1111/jnu.12567

Shethna, J. (n.d.). 
13 Basic benefits of joining a professional organization
. Retrieved April 11, 2021, from EDUCBA: https://www.educba.com/joining-a-professional-organization/ Role of the RN/APRN in Policy Evaluation Essay

 response 1

 Registered Nurses (RNs) and Advanced Practicing Registered Nurses (APRNs) have several ways and opportunities to be involved with policy review. I was recently affiliated with a hospitals nursing union where we went on strike due to inappropriate nursing staffing ratios, health care plans, wages, and much more. I can attest that getting your local mayor and local representatives on your side is very beneficial and can aide in making changes. After creating a relationship with several local community members, several doors of opportunities can open, such as becoming a board member of other groups and actively participating within the union to review policies and to make changes happen. Even if that means a strike is necessarily. Just as you stated and Milstead and Short (2019) has mentioned, we can make change with numbers especially with nurses being one of the largest healthcare group.

Regarding the portion where you mention the policy changes in your area regarding marijuana use in legal states and then traveling to other states where it is illegal. I live in a state where recreational marijuana use is legal, except several employers in my area will not tolerate it. Employers have found it difficult to validate when the use occurred, so they do hold the right to fire employees for testing positive if positive for marijuana on a drug test (Barreiro, n.d.). So, it is interesting how some employers do not mind, as long as it is legal, while others can and will fire you if a drug screen is positive. As a nurse, we can advocate and change policy if we bring our concerns to the table. I am not saying it is right, but I am not saying it is wrong either. There is definitely a gray area in this subject, especially in this day and age Role of the RN/APRN in Policy Evaluation Essay.

Nursing is all about networking and making connections and it will continue to be that way. Nurses create a strong influence on people since we are always meeting and taking care of new people. Not only will these connections help make change, but they will always help us become more well-rounded and educate of us, nurses, on other topics that may influence our care and policies. Especially, if some of our connections are individuals that are elected officials, for they have the ability to make changes higher up, which is why we should continue to monitor congress.gov (n.d.) and reach out to governors’ regarding their ideas and plans. Especially because we have a professional obligation to involve ourselves with finding new solutions in health care (Laureate Education, 2018) Role of the RN/APRN in Policy Evaluation Essay.

Reference

Barreiro, S. (n.d.). 
State laws on off-duty marijuana use. 
NOLO. Retrieved April 27, 2021, from https://www.nolo.com/legal-encyclopedia/state-laws-on-off-duty-marijuana-use.html#michigan

Congress.gov. (n.d.). Retrieved April 27, 2021 from https://www.congress.gov/

Laureate Education (Producer). (2018). 
Program policy and evaluation
 [Video file]. Baltimore, MD: Author.

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

 

response 2

Nurses spend more time with their patients and are ready to stand up for important issues to their patients. Nurses are taught to be caregivers and advocates, and they are never quiet when it comes to advocacy. However, nurse’s involvement in politics is usually not evidence.

I do agree with you on your recommendations. Nurses need to start from the basics by voting and getting to know their elected officials and calling the offices of these officers to advocate for policies they support Role of the RN/APRN in Policy Evaluation Essay. The nurse can develop and established contacts with legislators and forge relationships with elected officials (Milstead & Short, 2019).

Participating in a professional organization is also recommended; nurses can go the extra mile by seeking experienced nurse advocate for mentorship. There are still challenges nurses to face concerning impacting politics in total, and one of them is the view of the publics of nurses. A research poll of the public opinion of nurses showed that nurses are perceived as caregivers and not as decision-makers (Nitzky, 2018). suppose the workplace provides support and avenue for nurses to participate in their workplace policy, and employers respect and promote the nurses’ contributions. In that case, the public will start to view nurses differently.

Reference

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

Jones & Bartlett Learning.

NItzky, A. (2018). How to lead change in nursing through political action. 
Oncology Nursing News Role of the RN/APRN in Policy Evaluation Essay
.

https://www.oncnursingnews.com/view/how-to-lead-change-in-nursing-through-political-
action

sample response 3

I support the fact that nurses should attend meetings conducted by the board of nursing. They have first to join professional nursing organizations before they can get the opportunity to participate in the meetings. While at the meetings, they can raise policy issues they have seen affecting healthcare delivery at their facilities and propose changes (Matthew, 2012). Through professional organizations, nurses can gain access to politicians who have a strong influence on decision-making. Therefore, nurses can participate indirectly in policy review by joining professional organizations, allowing them to interact with policymakers and give them ideas (Matthew, 2012).

Nurses need to become more involved in policy review by collaborating with other healthcare providers. Physicians should allow nurses to pursue leadership positions instead of having them working under them all the time. Some nurses are afraid to speak up before physicians and other healthcare personnel because they have not been allowed to do so. I think that nurses should not be intimidated by their positions as they strongly influence policymaking and review. Physicians need to provide nurses with training and mentorship to take up active advocacy roles (Turale & Kunaviktikul, 2019). Their voices need to be heard, and they should advocate for their best interests and that of their clients Role of the RN/APRN in Policy Evaluation Essay.

References

Matthews, J. (2012). Role of professional organizations in advocating for the nursing profession. 
Online J Issues Nurs
, 
17
(3).

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. 
International nursing review
, 
66
(3), 302-304 Role of the RN/APRN in Policy Evaluation Essay.

Discussion: The Role of the RN/APRN in Policy Evaluation

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 Role of the RN/APRN in Policy Evaluation Essay.

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.

By Day 3 of Week 9

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.

By Day 6 of Week 9

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.

As members of the largest segment of the healthcare workforce, nurses have an important role in policy and program evaluation” (Milstead & Short, 2019, p. 117). Nurses have a huge role in patient care and advocacy.  They are, in most cases, the last line of defense for the patient. Therefore, a nurse’s role in policy and program change are the most important part of the team Role of the RN/APRN in Policy Evaluation Essay.

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The first opportunity to participate through the workplace, as part of a committee. “Working on organizational boards or involvement in shared governance offers firsthand knowledge” (Jurns, 2019). Most facilities offer committees to assist and get people involved in policy making and leadership. Take advantage and ask your leadership how to get involved. The second opportunity is to work with local politicians on policy that could be part of the legislative process. Politicians look for expert advice from healthcare professionals to implement change in healthcare policy. This would be an excellent way to give input into policy or programs.

 

One challenge for these opportunities is finding a point champion with the knowledge and skills necessary to lead a team for a change of policy. “Having a skilled and knowledgeable point champion and adequate resources are key to a successful evaluation” (Milstead & Short, 2019, p. 122). This person not only should be knowledgeable on the subject but be able to lead and communicate with his/her team. Another challenge would be any ethical dilemmas that may arise from changes in policy. Many organizations, including the CDC has ethical guidelines that you can follow to make sure any policy changes are ethically correct, so its important to review some of these guidelines before making any important decisions Role of the RN/APRN in Policy Evaluation Essay.

“When implementing policies or programs designed to improve the health of populations and communities, professional nurses must adopt strategies to minimize evaluation challenges” (Milstead & Short, 2019, p. 122). The first strategy I would recommend is to contact your local politician and ask how you could get involved. Every state website has the email and phone numbers of all the local politicians and how you may contact them regarding policy and legislation. The second strategy I would use would be recognizing any possible conflicts that may arise between the members of your team.  Remember that nothing will ever get final if there is conflict and indecisiveness amongst the team.  Negotiate and compromise as much as you can and listen to one another’s concerns.

 
References

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

Jurns, C. (2019). Policy Advocacy Motivators and Barriers: Research Results and Applications Role of the RN/APRN in Policy Evaluation Essay. 
Online Journal of Issues in Nursing
, 
24
(3), N.PAG. 
https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol24No03PPT63

response

As you and Milstead & Short (2019) has stated, nurses are one of the largest healthcare workforces and we supply an exponential amount of money for healthcare policies, lobbyists, and more. That being said, we should be a large sum of the individuals that participate within health care policy making and evaluation. Being an advocate and actively participating in your community I think is very important. Those are the people that know you and should know you and will speak highly of you. As we all know, word of mouth travels fast, positively and negatively, especially within the healthcare field. Somehow a patient will know someone, who knows someone, that is related to a politician Role of the RN/APRN in Policy Evaluation Essay.

Hopefully, at this point in time in our career, that is a good thing. At least for myself, I want to advocate for my community members and if that means I can speak directly to a politician regarding a health care concern, I would be ecstatic. Nurses are great at communicating concerns, identifying issues, and of course providing recommendations (Olson, 2020). The whole ISBAR (identify, situation, background, assessment, and recommendation) is a great tool to utilize not only when speaking to healthcare providers, but also politicians, making it easy and relatable for non-healthcare providers to relate to situations and influence their decisions (Milstead & Short 2019).

As we know, there are always challenges, even with the best communications skills. You mentioned that having the skills and knowledge are keys to success, which I could not agree more with. Knowing how to approach issues appropriately can be difficult if you do not have to proper tools or any for that matter. Although, finding a mentor or a reputable resources or organization to aid in yourself growth is important, especially if you want to begin your adventure with policy review Role of the RN/APRN in Policy Evaluation Essay. Knowing where to start and how to find it is only the beginning and sometimes, we may not be aware of an issue until is it in legislation (Laureate Education, 2018). So, finding an organization or induvial to walk you through the steps and assist you to speak up when the time is right (Milstead & Short, 2019) is very important and something we are learning, especially in this course.

Resources

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

Laureate Education (Producer). (2018) 
Program policy and evaluation 
[Video file]. Baltimore, MD: Author.

Olson, K. (2020). 
Influence through policy: four steps YOU can take
. Nursing Centered. Retrieved April 28, 2021, from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_influence-through-policy-four-steps-you-can-take Role of the RN/APRN in Policy Evaluation Essay

NURS 6050 Discussion: Professional Nursing and State-Level Regulations

APRN Prescriptive Authority for Arkansas and Texas

Prescriptive authority in the state of Arkansas for APRNs requires that the APRN be licensed in the state of Arkansas with prescribing practices within the scope of practice per the practitioner’s certification category. Within one year of beginning an APRN level pharmacology course, the practitioner must complete 300 hours of experience with a qualified preceptor and submit a collaborative practice agreement with an Arkansas licensed physician who has an unrestricted DEA registration number. After meeting these requirements, only then can an APRN prescribe legend drugs and medicines or therapeutic devices specific to the practitioner’s area of practice. For controlled drugs, only Schedule III through V may be prescribed by an APRN. With the exception of hydrocodone combination products, an APRN may not prescribe Schedule I and II controlled substances (
Arkansas Department of Health
2018) NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

In the state of Texas, prescriptive authority for APRNs requires the practitioner have successful completion of graduate level pharmacotherapeutics, advanced pathophysiology, and advanced health assessment. The practitioner must also complete 45 hours per course of preceptor experience with a qualified preceptor. If an APRN has prescriptive authority in another state, the practitioner must meet the education requirements of Texas before being able to have
prescriptive authority
. The practitioner also has the ability to authorize or prevent the use of generic substitutions on prescription drugs. Unlike Arkansas, APRNs in Texas are allowed to prescribe Schedule II controlled substances, but only in the hospital setting (
Practice – APRN Scope of Practice
2019) NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

APRN Delegation Regulations for Arkansas and Texas

In the state of Arkansas, an APRN may delegate certain tasks to nurses and/or unlicensed staff. The task may include noninvasive treatments, collection and documentation of data, ambulation, positioning, or turning, and personal hygiene. Tasks that should not be delegated include physical assessments, formulation of the patient’s plan of care, transmitting verbal or telephone orders, and an APRN cannot delegate to unlicensed staff the calling in of prescriptions to the pharmacy (
Arkansas Department of Health
 2018).

One of the major differences in delegation for the state of Texas is that unlike Arkansas, administration of medication to a patient may be delegated to a medication aide in correctional health, long term care facilities, and home health agencies. All other general criteria for delegation apply for the state of Texas as well, with the responsibility of determining competence of the delegate resting on the delegating APRN (
Practice – APRN Scope of Practice
 2019).

Prescriptive Authority and Delegation for APRNs with Full Practice Authority

Prescriptive authority and delegation regulations for APRNs with full practice authority may be affected by the continuous state and national barriers that prevent qualifying practitioners from practicing to their full extent. If allowed to work to their full extent of education and training, APRNs will be able to provide services to vulnerable populations, such as minorities and the uninsured (Bosse et al., 2017) NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

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References

Arkansas Department of Health. (2018, December 29). https://www.healthy.arkansas.gov/programs-services/topics/arsbn-adv.-practice.

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. 
Nursing Outlook
, 
65
(6), 761–765. https://doi.org/10.1016/j.outlook.2017.10.002

Practice – APRN Scope of Practice
. Texas Board of Nursing – Practice – APRN Scope of Practice. (2019). https://www.bon.texas.gov/practice_scope_of_practice_aprn.asp.

Discussion: Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

To Prepare:

Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

Consider how key regulations may impact nursing practice.

Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

By Day 3 of Week 5

Post
a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

By Day 6 of Week 5

Respond
 to at least 
two
 of your colleagues
* on two different days
 and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

In New Jersey, while an advanced practice nurse (APN) or nurse practitioner (NP) cannot practice independently, they are recognized as primary care providers.  Otherwise known as a joint protocol, they require “collaboration, and a written protocol with a physician is required when prescribing medications” (NCSLSOP Scope of Practice Policy, 2021).  This collaboration also extends to prescription writing for all medications (The State of New Jersey, n.d.).    The APNs that I have worked with, prescription pads have a medical doctor’s name and NPI number written on them.  When the APNs introduce themselves, they inform the staff of the name of which doctor they are collaborating with.

In comparison, all advanced practice nurses in Florida do not require collaboration.  HB 607 (Autonomous Practice) is a bill that was passed on March 11, 2020, allowing APNs to be autonomous (FLANP).  They can practice independently, including prescription writing of any drug (NCSLSOP Scope of Practice Policy, 2021). Every nurse practitioner does not have to be autonomous, as it is a choice to be independent or collaborate.   Those who choose to practice autonomously will require additional continuing education hours that include “three graduate-level semester classes in differential diagnosis, three graduate-level semester classes in pharmacology” (FLANP)
, 
and 3,000 hours of supervision.
  
 
The APNs 
who 
choose to continue to collaborate will do so under the supervision of a doctor and cannot prescribe control substances NURS 6050 Discussion: Professional Nursing and State-Level Regulations.

While I agree that APNs should practice independently, I agree with the mandatory supervision hours.  Even though nurses are encouraged to advance their education, the balance requires hands-on care and practice.  We do not want book competent nurses that are deficient in critical thinking due to a lack of clinical exposure. The job of the state board of nursing and as a regulatory body is to protect the public from harm.  Florida’s board of nursing made great strife in going from a restricted status of APN licensure to independent status, yet put the correct stipulations in place to protect the public.

References

FLANP.
 (n.d.). Retrieved from Florida Association of Nurse Practitioners: https://www.flanp.org/page/AutonomousPractice

NCSLSOP Scope of Practice Policy
. (2021). Retrieved from National Organizations for State and Local Officials: https://scopeofpracticepolicy.org/states/nj/

The State of New Jersey
. (n.d.). Retrieved from New Jersey Division of Consumer Affairs: https://www.njconsumeraffairs.gov/nur/Pages/APN-Certification NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Role of the RN/APRN in Policy Evaluation Essay Example

Nurses are very familiar with the evaluation process, as it is the last stage of the nursing process. However, the process of evaluating policy implementation is different from evaluating nursing interventions. During and after policy implementation, policies must be evaluated to determine their effectiveness and observe any unintended consequences (Milstead & Short, 2019). Evaluation can occur either formally or informally, but a formal review is the gold standard, as informal reviews may lead to skewed and inaccurate findings (Milstead & Short, 2019). Evaluation can also occur on an ongoing basis or as a final analysis, but doing both allows a better view of the whole picture (Yoder-Wise, 2019). Data can be collected during review or evaluation in various ways, such as interviews, focus groups, questionnaires, and literature reviews (Moule et al., 2017) Role of the RN/APRN in Policy Evaluation Essay Example.
 

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review.

One way that nurses can be involved in policy review is to join a committee within their organization. The hospital that I work at has numerous committees that implement small changes regularly. One of the changes recently implemented by a unit council (a council specific to each unit) was that nursing assistants would not be assigned patients. Before, nursing assistants were not assigned to patients. Instead, they just helped out where it was needed. Nursing assistants have tasks they need to take ownership of, but sometimes these tasks were not done, and patients’ needs were going unmet. An example of this is that foley catheter care was to be done twice daily by nursing assistants, but audits showed that it was not being done. Subsequently, patients were at increased risk for developing catheter-associated urinary tract infections (CAUTIs). The unit council voted to start assigning nursing assistants to specific patients. Our evaluation shows that foley care is being done more effectively now, and patients receive higher quality care Role of the RN/APRN in Policy Evaluation Essay Example.

Another way to participate in policy review is to join a professional nursing organization (Williams, Phillips, & Koyoma, 2018). Professional nursing associations advocate for causes on many different topics such as reducing gun violence, improving nurses’ health, safe staffing, and much more (American Nurses Association, n.d.).
 

Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges.

Many challenges may be faced through policy review or evaluation. One possibility is that during evaluation, nurses or other staff may feel that their work (or the quality of their work) is being evaluated as opposed to the policy itself (Moule et al., 2017). One way to overcome this is to engage a partnership with staff, ensure them of the policy’s purpose, and, therefore, the evaluation’s purpose (Moule et al., 2017) Role of the RN/APRN in Policy Evaluation Essay Example.

Other challenges include ethical dilemmas (Milstead & Short, 2019). Many professional organizations have created ethical guidelines for evaluation processes. Key considerations include beneficence, safety, autonomy, and justice, according to the ANA code of ethics (Milstead & Short, 2019). If patient data is involved, privacy should always be maintained per The Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Milstead & Short, 2019). Most challenges can be avoided through thoughtful planning and implementation (Milstead & Short, 2019).

Recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

One of the great things about working at a magnet hospital is that the hospital encourages shared governance, a practice that empowers nurses to improve work experiences and patient outcomes (Joseph & Bogue, 2016). One way the hospital promotes shared governance is through committees. The hospital and committee members encourage other members of the hospital, especially nurses, to join these committees. One way my nurse manager advocates for these opportunities is through quarterly emails. She sends out emails asking if any staff members would like to join any hospital committees to make a difference Role of the RN/APRN in Policy Evaluation Essay Example.

Ways to advocate for joining a professional nurse organization include communicating the benefits of joining an association. These benefits include continuing education, networking opportunities, and improvement of the profession.

References

American Nurses Association. (n.d.). Advocacy. Retrieved April 23, 2021, from 
https://www.nursingworld.org/practice-policy/advocacy/

Crumley, C. (2020). The Benefits of Active Engagement in Nursing Professional Organizations: A View From Here. Journal of Wound, Ostomy and Continence Nursing. https://doi-org.ezp.waldenulibrary.org/10.1097/WON.0000000000000700

Joseph, M. L., & Bogue, R. J. (2016). A theory-based approach to nursing shared governance. Nursing Outlook, 64(4), 339–351. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2016.01.004

Moule, P., Armoogum, J., Douglass, E., & Taylor, D. J. (2017). Evaluation and its importance for nursing practice. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 31(35), 55–63. https://doi-org.ezp.waldenulibrary.org/10.7748/ns.2017.e10782

Williams, S.D., Phillips, J.M., & Koyoma, K. (2018). Nurse advocacy: Adopting a health in all policies approach. OJIN: The Online Journal of Issues in Nursing 23(1). DOI: 10.3912/OJIN.Vol23No03Man01 Role of the RN/APRN in Policy Evaluation Essay Example.

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

Discussion: The Role of the RN/APRN in Policy Evaluation

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 Role of the RN/APRN in Policy Evaluation Essay Example.

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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.

By Day 3 of Week 9

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.

By Day 6 of Week 9

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.

I agree with you that nurses can take advantage of the opportunities in their facilities by joining organizational committees. Change starts within the facility as it progresses upwards in the healthcare organizational ladder. Nurses can work together towards advocating for improvement in healthcare policies (Tomajan, 2012). Apart from joining committees, nurses can take up leadership positions to put them at the forefront of policy decision-making and review. Nurses should not shy away from seeking leadership positions, exceptionally if they are qualified Role of the RN/APRN in Policy Evaluation Essay Example. I am currently pursuing my Master’s program at Walden to increase my eligibility for an administrative position in the future. Furthermore, becoming a member of a professional organization is another way that nurses can get opportunities to participate in the policy review. Frequent policy evaluation is necessary to facilitate their amendment or elimination.

I also think the hospital leadership must encourage nurses to seek leadership positions (Arab et al., 2014). Nurses are motivated by the effective leadership of others to pursue administrative positions as well. On the other hand, if the current leadership is not good, nurses are likely to be discouraged from seeking committee membership and leadership Role of the RN/APRN in Policy Evaluation Essay Example.

References

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. 
Iranian journal of nursing and midwifery research
, 
19
(3), 315.

Tomajan, K. (2012). Advocating for nurses and nursing. 
OJIN: The Online Journal of Issues in Nursing
, 
17
(1), 4.

 

response 2

Unit councils are a great way for nurses to start the process of being involved in policy review. My neonatal intensive care unit has a unit based council (UBC) consisting of bedside nurses, nurse leaders, physicians and more that meets regularly to discuss issues affecting the unit and possible solutions. “Health policy can be used as an instrument to incentivize collaboration and teamwork where none previously existed” (Milstead & Short, 2019). Within your facility an issue presented itself that had the potential for patient harm and through interprofessional collaboration and policy review, your team was able to find a solution that was proven to be implementable and effective.  Your mention of nurses feeling their work is being evaluated instead of the policy was something I had not considered. I believe that if establishments provided nurses with the appropriate policy training, then there may be a decrease in those feelings. Turale and & Kunaviktikul (2019) discuss the importance of educating nurses about the policy process by providing them with policy training programs so nurses can confidently collaborate with other healthcare providers to help shape policies. In 
Health policy and politics 
(Laureate, 2018) it is discussed how important it is to be involved in a national association because they exert tremendous influence on the process, and how important it is to be an active member on boards and committees to become an expert in nursing. Being involved in facility committees can provide nurses the opportunity to help important stakeholders understand the issues being presented and what their impact would be Role of the RN/APRN in Policy Evaluation Essay Example.

References

Laureate Education (Producer). (2018). 
Health policy and politics
 [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.

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. 
International Nursing Review, 66
(3), 302-304. https://doi.org/10.1111/inr.12550

 

sample response 3

I enjoyed your post! The section that stood out to me the most was discussing ethical dilemmas in policy making. It is important when developing policies that ethical considerations are taken into account. Is the policy change going to promote the four areas of nursing ethics: autonomy, beneficence, justice and non maleficence (Knight et al., 2020)? Ethical considerations are important today regarding COVID vaccinations in particular. The United States is divided on this issue and there is a sample of the population to expects everyone to be vaccinated and a sample of the population who wants to have the choice to be vaccinated or not. Colleges are beginning to consider requiring students be vaccinated in order to attend their schools for example (Durand, 2021). Parents are upset by this as the vaccine has only been approved for emergency use and is not fully FDA approved at this time. The question then is…can a college require someone to get a vaccine that is not fully approved by the FDA? They understand that vaccines are normally required to attend schools but those vaccines have FDA approval. As a nurse I can see both sides of this coin and it is definitely a dilemma. One good thing (in my opinion) that has come out of the COVID lockdowns is that I feel we have realized that there is so much technology can do for us and it has opened the doors for many different platforms for learning and working Role of the RN/APRN in Policy Evaluation Essay Example.

References

Durand, L. (2021, April 16). Debate over universities mandating COVID-19 vaccination for students in the fall. 
UWIRE Text
.

Knight, S., Hayhoe, B. W., Frith, L., Ashworth, M., Sajid, I., & Papanikitas, A. (2020). Ethics education and moral decision-making in clinical commissioning: an interview study. 
British Journal of General Practice
, 
70
(690), e45–e54. https://doi-org.ezp.waldenulibrary.org/10.3399/bjgp19X707129

 

sample response 4

Thank you for the in-depth discussion post this week! I enjoyed reading your thoughts on barriers and solutions in regards to nurses in the policy-making arena. I think all of us in the class agree that the two most effective methods for nurses to enter the policymaking world of healthcare is by joining nursing organizations and becoming more active within the company they work for. “Nursing organizations with legislative departments provide analysis on current issues in health policy and tips on how to communicate with legislators. Many also offer workshops on nursing advocacy, or legislative days at the state house, both excellent places to begin an advocacy career” (Oestberg, 2013). The groups or members within nursing organizations who are dedicated to policy change can provide a mentor for learning how the legislative aspect of healthcare works. Often a barrier to participation is the lack of understanding of how the process works Role of the RN/APRN in Policy Evaluation Essay Example.

I appreciate how you explained how working within a magnet status hospital changes a lot for nurses in policymaking. In my area of Hampton Roads, VA the major hospital system, Sentara, is working towards achieving magnet status at all of their hospitals. “A fundamental requirement of hospitals applying for Magnet status is that they must demonstrate an effective shared governance structure. Shared governance is a decision-making model focused on empowering the people who care for the patients” (Collins, 2017). As you stated, magnet status hospitals develop committees with all healthcare provider members, dedicated to reviewing, changing, and developing new healthcare policies within the hospital Role of the RN/APRN in Policy Evaluation Essay Example.

References
 

Collins, R. (2017, October). Magnet hospitals and shared governance: Empowering frontline nurses. Vocera. https://www.vocera.com/blog/magnet-hospitals-and-shared-governance-empowering-frontline-nurses

Oestberg, F. (2013, May). Getting involved in policy and politics. Nursing 2020 Critical Care. https://journals.lww.com/nursingcriticalcare/fulltext/2013/05000/getting_involved_in_policy_and_politics.10.aspx Role of the RN/APRN in Policy Evaluation Essay Example

Discussion: Professional Nursing and State-Level Regulations

In Pennsylvania, nurse practitioners are considered primary care providers. They can diagnose, treat, order, and perform tests and prescribe medications. However, they must have a written collaboration with a physician (Pennsylvania Coalition of Nurse Practitioners, n.d.). A federal waiver to dispense buprenorphine-containing products is obtainable through proper training and physician oversight (Pennsylvania Coalition of Nurse Practitioners, n.d.) Discussion: Professional Nursing and State-Level Regulations.

In contrast, Washington D.C. allows nurse practitioners to function independently without physician oversight, including prescribing controlled substances under the state board of nursing authority (American Association of Nurse Practitioners, n.d.). Allowing nurse practitioners to practice within their education’s full scope helps expand the community’s medical resources. Every state should implement this idea to provide greater access to primary care.

For nurse practitioners in Pennsylvania to adhere to these regulations, they can not open a primary care practice. Instead, they must join a team that operates with a physician at the team’s head. The physician provides oversight of the nurse practitioner and their practice. If the physician manages those with opioid addictions, the nurse practitioner working with them can become trained and eligible to prescribe buprenorphine under the physician’s guidance. To do so, a nurse practitioner must complete 24 hours of training, demonstrate the ability to treat and manage opiate use disorder, and be licensed to prescribe Schedule III, IV, or V medications for pain (American Society of Addiction Medicine, n.d.) Discussion: Professional Nursing and State-Level Regulations.

References

American Association of Nurse Practitioners. (n.d.).  State practice environment.  https://www.aanp.org/advocacy/state/state-practice-environment

American Society of Addiction Medicine. (n.d.).  Buprenorphine waiver management.  https://www.asam.org/advocacy/practice-resources/buprenorphine-waiver-management

Pennsylvania Coalition of Nurse Practitioners. (n.d.).  Scope of practice.  https://www.pacnp.org/page/ScopeofPractic e

sample response

I agree with your statement on all states needing to allow APRNs to practice without a collaborating physician. As you stated above , it will provide greater access to health care. According to 
Neff
 et. 
al
, a
llowing
 
NPs
 full autonomy to practice may be a relatively simple policy mechanism for states to improve access to p
rimary
care (2018). This statement shows that research has been done and studies have shown this to be factual. In Pennsylvania , APRNs practice regulations are much like those of South Carolina. The scope of practice in South Carolina is delegated and APRNs can prescribe legend drugs and schedule II controlled substances by a certain amount and time frame (NCSBN,n.d) Discussion: Professional Nursing and State-Level Regulations. Overall, I believe states should look into how to align the regulations and scopes of practices to be alike,hence; APRNs could easily practice in any state and it will help to improve access to health care. Thank you for the knowledge of what regulations are for Pennsylvania and Washington, DC.

References

National Council of State Boards of Nursing (NCSBN). (n.d). Retrieved April 2, 2021, from https.//www/ncsbn.org/index.htm

Neff, D.F, Yoon, S.H., Steiner, R.L., Bumbach, M.D., Everhrt, D., & Harman J.S. (2018). The impact of nurse practitioner regulations on population access to care.
Nursing Outlook, 66
(4), 379-385. doi: 10.1016/j.outlook.208.03.001

response 2

I agree that nurse practitioners should be given the opportunity to practice independently if they choose. Many states have placed restriction on NP in there prescriptive authority and practice. The medical associations are the leading proponents of restricting NP prescriptive and practice, they believe the NP and physician should work together to provide safe and quality healthcare (Park et al., 2018) Discussion: Professional Nursing and State-Level Regulations. Many physicians I have spoken too have said they are not comfortable with all NP practicing independently. The other side of the coin is that there are many NP that do not want to work independent and feel more comfortable with assistance from a physician. Primary care providers are in demand as many physicians have chosen other career pathways. Nurse practitioners have been shown to have less malpractice lawsuits and improved patient satisfaction (Kraus and DuBois, 2016). At the end of the day it really depends on the nurse practitioners comfort level to work independently.

Kraus, E. & DuBois, J.M. (2016). Knowing your limits: A qualitative study of physicians and nurse practitioner perspectives on NP independence in primary care. 
Journal of General Internal Medicine
, 32(3), 284-290. 
https://doi-org.ezp.waldenulibrary.org/10.1007/s11606-016-3896-7

Park, J., Athey, E., Pericak, A., Pulcini, J. & Greene, J. (2018). To what extent are state scopr of practice laws related to nurse practitioners’ day-to-day practice autonomy. 
Medical Care Research and Review,
 75(1), 66-87. 
https://doi-org.ezp.waldenulibrary.org/10.1177%2F1077558716677826

Discussion: Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions Discussion: Professional Nursing and State-Level Regulations.

To Prepare:

Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

Consider how key regulations may impact nursing practice.

Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

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By Day 3 of Week 5

Post
 a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

By Day 6 of Week 5

Respond
 to at least 
two
 of your colleagues
* on two different days
and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples Discussion: Professional Nursing and State-Level Regulations.

Initial Discussion post

The mission of all boards of nursing (BON) is to protect the public. The BONs protect the public through regulatory processes. One regulatory practice used to ensure competency in a nurse is setting specific criteria to sit for a licensure examination (Milstead and Short, 2019). All BONs require new nurses to pass the National Council Licensure Examination (NCLEX) before they are given state licensure as a registered nurse. The BONs use Nurse Practice Acts to provide specific details of what a nurse can do or not do (Milstead and Short, 2019). Some nursing practice acts that the BON may provide requirements for licensure, educational standards, and scopes of practice (Milstead and Short, 2019). There are different regulations in each state, so it is essential to know the state regulations where you practice.

There are regulations in the state board of nursing that may affect the way nurses practice. The nurse practice acts that may restrict nurses from specific procedures are one-way BONs influence nurses’ care. Compact nursing licensure in several states helps nurses make smooth transitions from one state to another to provide care to patients. Sometimes the BONs’ repeal of regulations may also affect nurses’ care (Laureate Education, 2018). It is important to know current regulations and get involved in the regulatory process when it may affect our practice negatively Discussion: Professional Nursing and State-Level Regulations.

The states of Wyoming and Soth Carolina were used to compare Advanced Practice Registered Nurses (APRN) practice acts. In Wyoming, APRNs are allowed to function independently and, in South Carolina, must practice under a physician (AANP, n.d.). Nurse practitioners should have the right to practice independently and without oversite by physicians. Nurse practitioners provide care to underserved populations and rural areas (Bosse et al., 2017). The other regulation that affects APRN’s care is that they are not compensated 100% for Medicaid and Medicare patients. APRNs receive between 80% to 85% of the payment a physician would receive for the same care (Bosse et al., 2017). APRNs have made progress but still, need to be able to practice at the full scope of their education.

American Association of Nurse Practitioners. (n.d.). 
State practice environment
. https://www.aanp.org/advocacy/state/state-practice-environment

Bosse, J., Simmonds, K., Hansen, C., Pulcini, J., Dunphy, L. & Vanhook, P. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. 
Nursing Outlook
, 65, 761-765. 
https://www.nursingoutlook.org/action/showPdf?pii=S0029-6554%2817%2930558-4

Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.

Milstead, J.A. & Short, N.M. (2019). 
Health policy and politics: A nurse’s guide
(6th ed.). Jones & Bartlett Learning Discussion: Professional Nursing and State-Level Regulations.

response

Travel nursing seems to be the popular choice lately. I never thought about how this would impact an advanced practice registered nurse (APRN) crossing state boundaries when each state has particular practice restrictions. Varying regulations make it nearly impossible for APRNs to practice in other states (Milstead & Short, 2019).

Pennsylvania is similar to South Carolina when it comes to APRN practice. All nurse practitioners must operate under a
physician’s guidance,
limiting access to quality healthcare for many Americans. I agree that nurse practitioners should be able to function as independent providers.

After reading your post, I did more research on Medicare payment policies and found some interesting facts. You describe an “incident to” billing, which leaves nurse practitioners’ quality care unrecognized (MedPAC, 2019). This issue occurs when patient care is billed under a supervising physician, even though a nurse practitioner managed the care. I would like to see all 50 states recognize nurse practitioners as independent providers and reimburse them accordingly.

References

MedPAC. (2019). 
Improving Medicare’s payment policies for advanced practice registered nurses and physician assistants. 
http://www.medpac.gov/-blog-/the-commission-recommends-aprns-and-pas-bill-medicare-directly-/2019/02/15/improving-medicare%27s-payment-policies-for-aprns-and-pas

Milstead, J., & Short, N. (2019). 
Health policy and politics: A nurse’s guide. 
Jones & Bartlett Discussion: Professional Nursing and State-Level Regulations.

Discussion: The Role of the RN/APRN in Policy Evaluation

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 Discussion: The Role of the RN/APRN 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.

By Day 3 of Week 9

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.

Opportunity for Policy Review

Nursing is a profession where employees must provide hands-on care while obeying ever-changing healthcare policies. Nurses are built to adapt to anything thrown their way. Each hospital system has a unique set of healthcare policies that work in conjunction with national and state policies. Registered nurses (RN) work within these set healthcare policies each day with their patients. Due to the hands-on utilization of each policy, they are the perfect candidate for the review of old and new policies Discussion: The Role of the RN/APRN in Policy Evaluation.

A second opportunity for registered nurses and advanced practice registered nurses (APRN) to participate in policy review is by actively joining nursing organizations. These organizations often have members who are solely dedicated to healthcare legislation and lobbying. “Groups such as the Association of Public Health Nurses encourage RNs to advocate for health care policies and provide resources on how to do so. The APHN breaks advocacy into three components: ‘creating policies where they are needed when none exist, reforming harmful or ineffective policies, [and] ensuring good policies are implemented and enforced’” (Regis College, n.d.).

 

Challenges and Overcoming Challenges

Challenges that arise for registered nurses and advanced practice registered nurses when participating in policy review include a lack of understanding of the specifics of policy writing. It can become an intimidating task to review or challenge an enacted policy when nurses or APRNs do not feel they have a full grasp of the policy making process (Safari et al., 2020) Discussion: The Role of the RN/APRN in Policy Evaluation.

A second challenge nurses and APRNs face when participating in health care policy review is a sense of lack of influence over policy change (Jurnes, 2019). When part of a large hospital system, it can be easy to feel as if one voice is not heard. This can deter RNs and APRNs from voicing their thoughts of necessary change to policy.

 

Strategies for Advocacy and Opportunities

An easy and effective strategy for advocating for nurses in the healthcare policy review arena is by increasing the amount of nurses or advanced practice registered nurses in the spotlight of change. “Although nurses do receive public accolades as the “most trusted” profession, they tend to be less visible than physicians in media coverage, public policy, and political communities” (Florida Center for Nursing, 2014). Increasing the awareness to the public that nurses play a vital role in policy making and policy review can encourage other nurses to become active participants in change Discussion: The Role of the RN/APRN in Policy Evaluation.

A second strategy to communicate the opportunity for RNs and APRNs to participate in healthcare policy review is by holding seminars within each hospital system. These educational seminars can provide information to nurses regarding their options for involvement. Members from local, regional and national nursing organizations active in policy review may also be present at these seminars to discuss opportunities and get nurses active Discussion: The Role of the RN/APRN in Policy Evaluation.

References
 

Florida Center for Nurses. (2014). Addressing barriers in leadership for nurses. Florida Center for Nursing. 
https://campaignforaction.org/wp-content/uploads/2016/04/Addressing-Barriers-in-Leadership-for-Nurses-FL.pdf

Jurnes, C. (2019, September 6). Policy advocacy motivators and barriers: Research results and applications. The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No3-Sept-2019/Articles-Previous-Topics/Policy-Advocacy-Motivators-Barriers.html

Regis College. (n.d.). How does nursing influence health care policy? Retrieved April 26, 2021, from https://online.regiscollege.edu/blog/how-does-nursing-influence-health-care-policy/

Safari B., Masoumeh, Bahadori, Mohammadkarim, Alimohammadzadeh, Khalil. (2020, August). The related factors of nurses’ participation and perceived benefits and barriers in health policy making. Wolters Kluwer. https://journals.lww.com/jnr-twna/fulltext/2020/08000/the_related_factors_of_nurses__participation_and.6.aspx

By Day 6 of Week 9

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 Discussion: The Role of the RN/APRN in Policy Evaluation.

    I definitely agree that nurses at “the bedside” are the most suitable for collaboration in policy design, implementation, and evaluation. In 
The Importance of program evaluation 
(Laureate, 2018), the importance of effective versus efficiency is discussed, because nurses are the ones that have to adhere to the policies so they see first-hand if the new policy is effective or not. Without nurse’s inclusion and support on a new policy, the likelihood of it being implemented properly is low. In my original post I also touch on education and collaboration being challenges for nurses in the policy process. Not all nurses have the ability to obtain higher education to learn about the policy process through their school, so offering something internally by nurse leaders at an institution would provide nurses an opportunity to gain more insight and feel more empowered to be involved. Turale and & Kunaviktikul (2019) discuss the importance of educating nurses about the policy process by providing them with policy training programs so nurses can confidently collaborate with other healthcare providers to help shape policies Discussion: The Role of the RN/APRN in Policy Evaluation.

References

Laureate Education (Producer). (2018). 
The Importance of program evaluation
 [Video file]. Baltimore, MD: Author.

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. 
International Nursing Review, 66
(3), 302-304. https://doi.org/10.1111/inr.12550

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response 2

I agree that nurses have little influence over policy changes. I have noticed throughout my time working in hospitals that management tends to make decisions with very little input from the nurses and their support staff. Often times my experience has been that changes are implemented with very little notice that the change is going into effect. Without nursing’s input to policy development sometimes these policies end up being ineffective or ignored at times (Bowers, 2020). It is important to ensure that policy changes are based on the latest evidence based research and nurses need to be educated on the policy change why the evidence indicates this is an effective change (Villumsen et al., 2019).

References

Bowers, B. (2020). Improving practice and informing policy development: The impact of gerontological nursing research. 
Geriatric Nursing
, 
41
(1), 32–37. https://doi-org.ezp.waldenulibrary.org/10.1016/j.gerinurse.2020.01.010

Villumsen, S., Faxvaag, A., & Nøhr, C. (2019). Development and Progression in Danish eHealth Policies: Towards Evidence-Based Policy Making. 
Studies in Health Technology and Informatics
, 
264
, 1075–1079. https://doi-org.ezp.waldenulibrary.org/10.3233/SHTI190390

 

sample response 3

Nurses are caregivers and advocates for their patients; they are not scared to voice and stand for the rights of their patients. Nurses are implementors of policies and are not policymakers.

Nurses are strong in numbers as there are over 4 million nurses in the USA (ANA, n.d.).  Therefore, nurses should be encouraged to participate in politics to create change as there is power in number.

Some of the challenges nurses face are lack of political knowledge, time to participate in politics, support and respect from the workplace or other healthcare professionals, i.e., physicians, and motivation. In addition, to overcome these challenges, I agree with you. Nurses need to be respected and supported by other healthcare professionals in other for the public to have a different perception of nurses. Nurses should not only be viewed as caregivers but also as equal contributors to the healthcare profession. Nurses spend more time at work, and so they should be given opportunities to participate in the policy-making process of the organization where they work Discussion: The Role of the RN/APRN in Policy Evaluation.

In addition to your strategies, mentorship of nurses in policy making process should also be encouraged. Research has shown a strong correlation between increased political knowledge and mentorship (Montalvo & Byrne, 2016).

References

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved April 26, 2021,

from 
https://www.nursingworld.org/practice-policy/advocacy/

Montalvo, W., & Byrne, M. W. (2016). Mentoring nurses in political skill to navigate organizational

politics. 
Nursing Research and Practice
. https://doi.org/10.1155/2016/3975634 Discussion: The Role of the RN/APRN in Policy Evaluation

NURS 6050 Discussion Essay

Program/Policy Evaluation

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.

References

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 (6
th
 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.

response

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.

References

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

response 2

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.

                                                               References                                               

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

Discussion: The Role of the RN/APRN in Policy Evaluation

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.

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.

By Day 3 of Week 9

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.

By Day 6 of Week 9

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.

References

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

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sample response

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.
 

References

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.

 

References

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

Assignment: Advocating for the Nursing Role in Program Design and Implementation

Planned Parenthood

The goal of healthcare facilities, healthcare providers, and the healthcare sector, as a while, is to improve the health and wellbeing of the populations they are serving by reducing disease incidences. These systems are often guided with health programs, consisting of well-coordinated and comprehensive procedures, processes, and actions designed to achieve specific targeted outcomes within a given field. Newly developed healthcare programs often seek to solve persistent issues that reduce the quality of life within the community. The purpose of this paper is to summarize the design and implementation actions of a planned parenthood program within a healthcare facility Assignment: Advocating for the Nursing Role in Program Design and Implementation.

Planned parenthood is a healthcare program that focuses on providing sex and reproductive health education. Patients can receive education and other healthcare services covered with the program. This program focuses on family planning, contraception, and sexually transmitted diseases like HIV/AIDS.  Therefore, topics covered range from family life and parent-child communication to abstinence, safe sex, sexuality, puberty, sexual orientation, teenage pregnancy, and women’s health education. Staff members and trained volunteers often offer these services. The primary objective of the planned parenthood program is to equip members of society with the knowledge they need to make decisions on matters related to sexual health and reproduction. The outcomes of the programs are listed as follows. To reduce the percentage of young people making irresponsible sex-related choices by reducing their tendencies to engage in careless and life-threatening behaviors.

The target population for the planned parenthood healthcare program is young and older men and women. Teenagers can also benefit from the services.

Nurses tend to play an important role in the implementation of healthcare programs. However, they can also provide input in the design processes, although only advanced practice nurses are often allowed to participate. Their contributions will inform the creation of staff training procedures since they are conversant with the challenges faced when delivering services. Nurses also contribute to designing quality assurance programs and compliance systems to be applied when implementing the program across the facility (Wilson, 2015). They can contribute to discussions related to the proper and effective implementation of the program. Their involvement also increases their dedication to providing the best possible services upon implementing the program to spearhead the attainment of structured objectives and goals Assignment: Advocating for the Nursing Role in Program Design and Implementation.

As an advocate for the target population, it is imperative to be included in the design process because someone must represent patients’ interests and ensure the organization has equally represented their needs adequately. I will provide input on matters relating to the quality of care and adherence to ethical standards. My role as an advocate will also encompass the need to make user adopted medical systems are simple and easy to use (Tomaschewski-Barleme et al., 2017). For example, healthcare facilities must define and integrate methods to ensure both English and non-English speakers receive good services. They must also ensure care provision strategies and systems uphold the highest standards of ethics. Such measures will allow patients to navigate effortlessly when seeking medical intervention.

I will ensure the screening, diagnosis, treatment, and follow-up processes are satisfactory and well-designed to tackle and ensure quality outcomes. I will link patients with service providers to improve communication. I will work with patients to organize appointments with physicians under special circumstances (Tomaschewski-Barleme et al., 2017). My role will extend to making sure patients who cannot afford to pay for services rendered, for one reason or another, get the financial help they need. Similarly, I will work on getting patients the necessary social and legal support if the need arises. For example, I will speak when I believe a facility is offering unfair treatment and conduct follow-ups to ensure the organization adopts the best strategies all the time. I will also offer advocacy services for cases involving families. For example, I will intervene when the decisions of family members are likely to compromise the overall health and wellbeing of the patient. Here, I will make sure only quality decisions are adopted Assignment: Advocating for the Nursing Role in Program Design and Implementation.

Nurses perform the following responsibilities during healthcare program implementation. Firstly, they will meet and talk to patients, identify their problems, and establish their treatment needs to improve quality and patient satisfaction.  Secondly, they will work closely with other healthcare service providers to ensure clients receive the best care during their visits, guarantee positive experiences and exceptional outcomes. Thirdly, nurses will provide patient-centered primary care by considering the needs and interests of each client. Treatment recommendations will be based on these factors (Milstead & Short, 2019). Therefore, all factors affecting the quality of patient health must be considered during program designing, and reasonable accommodations introduced to smoothen and improve the efficacy of measures implemented in the future. Nurses will also make follow-up calls after patient discharge to monitor their recovery trajectories and tackle any difficulties they might be experiencing. Fourthly, they will uphold convenience by offering quick and speedy services (Milstead & Short, 2019). Lastly, they will reduce unnecessary treatments to prevent errors and extra costs, making these services affordable.

Healthcare facilities have different professionals who work in various capacities to solve emerging problems, which means formulated teams must be interdisciplinary. A healthcare team pulled together to oversee the successful implementation of a planned parenthood health program should consist of physicians, nurses, physician assistants, pharmacists, therapists, rehabilitation specialists, emotional and social support providers, medical directors, and hospital boards (Milstead & Short, 2019). Physicians and their assistants are responsible for diagnosing patients based on their symptoms and needs and recommending evidence-based treatments and care. Nurses monitor patient health and wellbeing. They also follow recommended treatment plans to ensure patient recovery. Board members and medical directors are the highest decision-makers, and therefore, will be responsible for making decisions with complex outcomes. Medical directors will also work closely with the nurses and physicians to assist them in decision-making. For example, sometimes, patients may have to be transferred to newer facilities to receive appropriate care. Such decisions must be made jointly with professionals authorized to make such decisions Assignment: Advocating for the Nursing Role in Program Design and Implementation.

Developing and implementing a planned parenthood program within healthcare facilities would increase the number of services offered, improve organizational financial performances, and enhance health outcomes for societal members. The planned parenthood health program focuses on providing sexual and reproductive care. To design and implement a robust program, the facility must formulate an interdisciplinary team to tap and take advantage of different professionals’ knowledge, skills, and experiences. These activities will guarantee quality service provision while safeguarding the interests of the organization.

 

References

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

Tomaschewski-Barlem, J. G., Lunardi, V. L., Barlem, E. L. D., Silveira, R. S., Ramos, A. M., & Piexak, D. R. (2017). Patient advocacy in nursing: Barriers, facilitators, and potential implications.
Texto Contexto-Enfermagem, 26
(3), e0100014.

Wilson, C. (2015). The role of nursing professional development in the future of nursing.
Journal for Nurses in Professional Development, 31
(1), 56-57 Assignment: Advocating for the Nursing Role in Program Design and Implementation.

Assignment: Advocating for the Nursing Role in Program Design and Implementation

As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.

Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.

In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.

To Prepare:

Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.

Select a healthcare program within your practice and consider the design and implementation of this program.

Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.

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The Assignment: (2–4 pages)

In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions:

Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?

Who is your target population? Assignment: Advocating for the Nursing Role in Program Design and Implementation

What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

 NURS_6050_Module04_Week08_Assignment_Rubric

Excellent

Good

Fair

Poor

Program Design

In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions.

·   Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?

·   Who is your target population?

·   What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

·   What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

·   What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

41 
(41%)
 – 45 
(45%)

Response provides a clear and complete summary of the healthcare program, including an accurate and detailed description of the costs and projected outcomes of the program.

Response provides a clear and accurate description that fully describes the target population.

Response provides a clear and accurate explanation of the role of the nurse in providing input for the design of the program, including specific examples.

Response provides an accurate and detailed description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate and detailed explanation of how the advocate’s role influences design decisions as well as fully explaining impacts to program design.

36 
(36%)
 – 40 
(40%)

Response provides a summary of the healthcare program, including a description of the costs and project outcomes of the program.

Response provides an accurate description of the target population.

Response provides an accurate explanation of the role of the nurse in providing input for the design of the program, including some examples.

Response provides an accurate description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate explanation of how the advocate’s role influences design decisions and somewhat explains impacts to program design.

31 
(31%)
 – 35 
(35%)

Response provides a summary of the healthcare program that is vague or incomplete or does not include costs or projected outcomes of the program.

Description of the target population is vague or inaccurate.

Explanation of the role of the nurse in providing input for the design of the program is vague, inaccurate, or does not include specific examples.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague or inaccurate.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague or inaccurate.

0 
(0%)
 – 30 
(30%)

Response provides a summary of the healthcare program that is vague and inaccurate, does not include costs or projected outcomes of the program, or is missing.

Description of the target population is vague and inaccurate, or is missing.

Explanation of the role of the nurse in providing input for the design of the program, and specific examples is vague and inaccurate, or is missing.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague and inaccurate, or is missing.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague and inaccurate, or is missing.

Program Implementation

·  What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

·   Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why you think this?

36 
(36%)
 – 40 
(40%)

Response provides a clear, accurate, and complete explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate and detailed explanation of how the role of the nurse is different between design and implementation of healthcare programs, including specific examples.

Response provides an accurate and detailed description of the members of a healthcare team needed to implement the program selected Assignment: Advocating for the Nursing Role in Program Design and Implementation.

The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.

32 
(32%)
 – 35 
(35%)

Response provides an accurate explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate explanation of how the role of the nurse is different between design and implementation of healthcare programs, and may include some specific examples.

Response provides and accurate description of the members of a healthcare team needed to implement the program selected.

The response integrates at least 1 outside resource and 2-3 course specific resources that may support the summary provided.

28 
(28%)
 – 31 
(31%)

Explanation of the role of the nurse in healthcare program implementation is vague, inaccurate, and/or incomplete.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague or inaccurate and/or does not include specific examples.

Description of the members of a healthcare team needed to implement the program selected is inaccurate or incomplete.

The response minimally integrates resources that may support the summary provided.

0 
(0%)
 – 27 
(27%)

Explanation of the role of the nurse in healthcare program implementation is vague and inaccurate, or is missing.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague and inaccurate, or is missing.

Description of the members of a healthcare team needed to implement the program selected is vague and inaccurate, incomplete, or is missing Assignment: Advocating for the Nursing Role in Program Design and Implementation.

The response fails to integrate any resources to support the summary provided.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list Assignment: Advocating for the Nursing Role in Program Design and Implementation. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors.   Total Points: 100 Name: NURS_6050_Module04_Week08_Assignment_Rubric  Assignment: Advocating for the Nursing Role in Program Design and Implementation