Feb 23, 2024 Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
A policy brief is a vital tool used to present research findings and recommendations to an audience with no specialization in the policy matter. Policy briefs offer evidence-based policy recommendations to help legislators make informed decisions (Arnautu & Dagenais, 2021). A strong policy brief incorporates research findings supporting the recommended policy and draws clear connections to policy initiatives. Therefore, it should be clear and concise to ensure the target audience adequately understands the recommendations. This paper presents a policy brief on the recommendation from the Institute of Medicine (IOM) report.
Selected Recommendation
The selected IOM recommendation is: “Nurses should practice to the full extent of their education and training.”
Background
The IOM recommendation emphasizes the need to transform nursing practice. The report encourages lawmakers to be guided by the Nursing Practice Act and Administrative Rules to amend state nurses’ scope-of-practice laws. Advanced Practice Registered Nurses (APRNs) are highly trained and competent to provide a wide range of healthcare services. However, they are limited by barriers, such as federal policies, state laws, obsolete insurance reimbursement models, and organizational practices and culture (Sullivan, 2018).
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State and federal initiatives are needed to update and standardize APRNs’ scope-of-practice regulations to capitalize on their specialized education and full capacity. Furthermore, the IOM report states that APRNs need to be allowed to practice to the full scope of practice. This will ensure that all citizens can access essential healthcare services and that organizations make the best use of the APRNs’ unique contributions to the healthcare team.
Insurance providers and States should create specific policy, regulatory, and financial changes that offer patients the freedom to choose from a range of health providers, including APRNs, to best, meet their healthcare needs (Sullivan, 2018). Eradicating regulatory, policy, and financial barriers to increase patient choices and patient-centered care is critical in creating a reformed health care system.
Current Characteristics
The scope of APRN practice varies with the state. The American Association of Nurse Practitioners (AANP) defines three types of practice authority for APRNs: Full, Reduced, and Restricted practice. APRNs practicing in states with Full practice authority are authorized to practice to their full scope of training, including evaluating, diagnosing, ordering and interpreting diagnostic tests, and prescribing treatments (AANP, n.d.).
The state board of nursing gives them exclusive authority to practice to their full scope. Currently, 24 states in the U.S and its territories have adopted Full practice licensure laws. NPs practicing in states with a reduced practice are allowed to participate in at least one element of the NP practice. However, they are regulated by a collaborative agreement with a physician (AANP, n.d.). Physician oversight is needed for the NP to prescribe treatment. Sixteen states currently have the reduced practice.
There are 11 states with a restricted practice whereby the state board of nursing mandates APRN supervision or delegation of duties such as diagnosing and prescribing by a physician. Texas lies at the lower end of the spectrum with regards to the freedom it offers APRNs. One of the barriers to expanding APRNs’ scope of practice has been opposed by some physicians and physician organizations. Some physicians argue that APRNs are less competent to provide the services outlined in their scope of practice since they do not undergo rigorous training like physicians (Sofer, 2018).
The Impact of the Recommendation
Patients perceive that the recommendation on the full scope for APRNs will increase their access to essential health services, especially in rural areas where there are few physicians and APRNs are usually the primary care providers. Currently, the country faces a shortage of primary care physicians, especially in rural and underserved areas (Ortiz et al., 2018). However, there is also an ample supply of specialists, which increase health care expenditures since specialist charge more expensively than primary care physicians. In addition, healthcare consumers perceive that the recommendation will lower the cost of healthcare. This is because full practice authority lowers duplication of services and billing costs caused by the outdated physician oversight (Ortiz et al., 2018). Besides, full practice decreases the unnecessary office visits, repetition of orders, and treatment services.
Nurses and professional nursing organizations argue that if all states allowed APRNs to practice to the full scope of their education and training, it could increase the workforce needed to meet the country’s primary care needs. APRNs would also contribute their specialized knowledge and skills to delivering person-centered, community-based health care (DePriest et al., 2020). Physicians believe that granting APRNs full practice will reduce their workload and increase access to care for patients living in underserved urban and rural areas. This is because states with full practice authority have many NPs working in the rural and underserved areas, which increases access to healthcare.
Nevertheless, some physicians perceive that the recommendation will negatively impact patient care due to the lack of rigorous medical training for APRNs (Sofer, 2018). Various organizations, such as the Kaiser Family Foundation, argue that APRNs could help meet the demand for primary care. They argue that APRNs’ full practice can help meet the demand for primary health care, which is increasing due to a growing aging population (DePriest et al., 2020). Besides, increased access to health care through the Affordable Care Act increases the population in demand for care, and APRNs can help bridge the gap.
Current Solutions
The current solution to having nurses to their full extent is advocacy. Many professional organizations are lobbying to remove barriers that limit APRNs from working to the full extent of their education and training (Peterson, 2018). NP organizations in various states have engaged lobbyists to help bring the advocacy efforts to the front line of policymakers. The lobbyists are educating policymakers on what APRN full practice entails.
They clarify that it is not a policy against physicians but rather one that seeks to provide patients with access to quality care (Peterson, 2018). The Campaign by the Future of Nursing is one approach taken to lobby for APRNs to practice to their full scope in states with reduced and restricted practice. Furthermore, the National Council of State Boards of Nursing (NCSBN) monitors the practice roles and bills related to APRN practice to keep APRNs informed of their lobbying efforts.
Current Status in the Health Policy Arena
A report from The Campaign shows that APRN practice authority has expanded significantly since the release of the IOM recommendation report. After the release of the IOM report, 44 state Action Coalitions worked on the recommendation to get rid of barriers in the APRN scope of practice. Besides, 13 states have passed laws granting APRNs full practice authority (Sullivan, 2018).
Since the Campaign’s commencement, eight states amended their laws to grant APRNs full practice and prescriptive authority. Furthermore, some states with reduced and restrictive practices have improved their laws to be less restrictive (Sullivan, 2018). For instance, Florida (reduced practice) passed a bill that requires PMHNPs to practice for the first two years with supervision and then practice to the full scope of their licensure.
Conclusion
The IOM recommendation on allowing APRNs to practice to the full scope of their education and training will increase accessibility to healthcare and lower costs. The health care environment is continuously evolving with an increasing demand for healthcare services from the aging population. Thus APRNs’ full contribution to the health care team is essential. Tremendous progress has been made toward decreasing restrictions on the APRN scope of practice across the U.S. States. The states with restrictive and reduced APRN practice are increasing APRNs’ potential to contribute fully to health care. However, more efforts are needed to hasten the amendments of the obsolete policies. We need more states to grant full practice authority to APRNs as primary care providers.
References
AANP. (n.d.). Issues at a glance: Full practice authority. American Association of Nurse Practitioners. https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
Arnautu, D., & Dagenais, C. (2021). Use and effectiveness of policy briefs as a knowledge transfer tool: a scoping review. Humanities and Social Sciences Communications, 8(1), 1-14. https://doi.org/10.1057/s41599-021-00885-9
DePriest, K., D’Aoust, R., Samuel, L., Commodore-Mensah, Y., Hanson, G., & Slade, E. P. (2020). Nurse practitioners’ workforce outcomes under the implementation of full practice authority. Nursing Outlook, 68(4), 459–467. https://doi.org/10.1016/j.outlook.2020.05.008
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/healthcare6020065
Peterson, M. E. (2018). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.
Sofer, D. (2018). AMA Resolution Opposes Independent Practice by APRNs. AJN The American Journal of Nursing, 118(3), 12. doi: 10.1097/01.NAJ.0000530922.33715.46
Sullivan, T. (2018). Institute of Medicine Report, The future of nursing: leading change, advancing health. Policy and Medicine.
Nurses engaged in the policy arena often are asked to provide information on a healthcare topic of interest to policy makers. This is frequently accomplished throughdeveloping a policy brief. A policy brief advocates for a particular recommendation (priorto the enactment of a policy). Learning how to write a policy brief in a clear, succinct,scholarly, and professional manner is an essential skill for advanced practice nurses.
This paper looks into an accountable care organization (ACO) in California and ways that it impacts population health. Accountable health care organizations play vital roles in promoting coordinated efforts between clinicians and medical practitioners while at the same time reducing costs and unnecessary treatments (McWilliams, 2016). Accountable care organizations are a representation of changing health dynamics in the American care system. Accountable care organizations are formed when medical providers, for instance, doctors, nurses, health organizations and non-physician providers collectively agree to be responsible for financial and quality of care in a defined population.
Accountable Care Organization
In California, one of the common ACOs is the Shared Savings Programs (SSP) which is a voluntary program that is formed to encourage hospitals, doctors and other health providers in the country to come together as accountable care organizations. The organization gives coordinated and high-quality care to members who are beneficiaries of Medicare. The SSP was formed wit the intention of moving the payment system of Medicare from a volume perspective to outcome and value-based (Lipa, 2020).
SSP has significantly impacted population health in California. By coming together, SSP has improved the quality of care to patients who could not have afforded such care. The SSP ensures that patients from different areas in the state get the correct care at the right time. Quality care also means that patients do not go for unnecessary tests. Another way that SSP has impacted population health in California is by focusing on preventative care through coordination of services across the different levels of care (Milwee, 2020).
The concept of bundled care.
Bundled care is a concept that entails Medicare implementing voluntary episode of payment models. Medicare used to make individual payments to individual services offered to patients. In Bundled care, all payments are combined in a single payment for physicians and hospital facilities. Bundled care increases the incentives for providers to work together to deliver patient care. Bundled care exposes healthcare facilities to certain risks and challenges.
Some of the risks of bundled care include the fact that patients may have comorbidities (Agrwal, 2020). This is where some patients might require expensive treatment procedures that are uncontrollable by the provider. Another risk of bundled care in handling cases of uncompliant patients. When patients fail to comply with their care plan such as the medication regimen, health care providers will have difficulties in managing the costs.
For this Assignment, you will assess one of the recommendations from the Institute ofMedicine’s The Future of Nursing: Leading Change, Advancing Health: ReportRecommendations. You will then develop a policy brief to advocate for thisrecommendation (the written policy brief is due in Week 7).To prepare, read the Lavis et al. article in the Learning Resources on drafting and producing policy papers.Choosing one of the IOM’s recommendations The Future of Nursing: Advancing Health by Leading Change: This assignment requires you to focus on report recommendations.Investigate the history of the problem that is the basis for the advice, as well as what has been done to try to remedy the problem. What is suggested in the recommendation? Are there any nursing or other organizations now supporting initiatives to execute the suggestion (e.g., Kaiser Family Foundation, professional organizations)? Is the recommendation specific about which groups should be involved in the implementation? Consider how the advice should be implemented critically – did the IOM get it right? What other options are there to consider?
https://www.onlinenursingessays.com/nurs-8100-week-2-discussion-unintended-consequences-of-health-care-reform/
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
By Day 7 of Week 7
To finish:
Create a scholarly and professionally written 2- to 3-page single-spaced policy brief based on the IOM report recommendation you chose, using the structure outlined in the Lavis et al. article. Include the following items:o A brief introduction followed by a summary of the problem.o The chosen recommendation (from the IOM Report)o Historical context o Current characteristicso The recommendation’s impact from the standpoint of consumers, nurses, other health professionals, and other stakeholders o Current solutionso Current state of health policy o Final conclusionso The resources that were used to develop the policy briefDue by Week 7’s Day 7.The Week 7 Assignment area has detailed directions for submitting your Assignment.Please keep in mind that you will post a summary of your policy brief in the Week 7 Discussion.
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
Week in Review
This week, you developed strategies for raising clinical practice issues to anorganizations agenda and also developed a scholarly and professionally written policy
brief. You also analyzed a health policy proposal from the perspective of consumers,nurses, and other health professionals and stakeholders.Next week, you will examine policy process and discover how frameworks from nursingand other disciplines can work together to inform policy analysis.
https://onlinenursingessays.com/assignment-2-health-policy-proposal-analysis-policy-brief-nurs-8100/Rubric Detail
Select Grid View or List View to change the rubric's layout.Name: NURS_8100_Week3_Discussion_Rubric
Assignment 2: Health Policy Proposal Analysis (Policy Brief) NURS 8100
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Grid View List ViewExcellent Good Fair PoorRESPONSIVENESS TODISCUSSION QUESTIONDiscussion post minimumrequirements:*The original posting must becompleted by Wednesday, Day 3,
8 (26.67%) – 8 (26.67%)Discussion postings and responsesexceed the requirements of theDiscussion instructions. They:Respond to the question beingasked or the prompt provided; – Gobeyond what is required in somemeaningful way (e.g., the post
7 (23.33%) – 7 (23.33%)Discussion postings and responsesmeet the requirements of theDiscussion instructions. They: –Respond to the question beingasked or the prompt provided; -Aresubstantive, reflective, with criticalanalysis and synthesis
6 (20%) – 6 (20%)Discussion postings and responsesare minimally responsive to therequirements of the Discussioninstructions. They: – do not clearlyaddress the objectives of thediscussion or the question orprompt; and/or -May (lack) lack in
0 (0%) – 5 (16.67%)Discussion postings and responsesare unresponsive to therequirements of the Discussioninstructions. They: – do not clearlyaddress the objectives of thediscussion or the question orprompt; and/or – Lack in substance,
at 11:59pm MST. Two responsepostings to two different peeroriginal posts, on two differentdays, are required by Saturday,Day 6, at 11:59pm MST. Facultymember inquiries requireresponses, which are notincluded in the minimum numberof posts. Your Discussion Boardpostings should be written instandard edited English andfollow APA style for format andgrammar as closely as possiblegiven the constraints of theonline platform. Be sure tosupport the postings with specificcitations from this week'sLearning Resources as well asresources available through theWalden University onlinedatabases. Refer to the EssentialGuide to APA Style for WaldenStudents to ensure your in-textcitations and reference list arecorrect.
contributes a new dimension,unearths something unanticipated);-Are substantive, reflective, withcritical analysis and synthesisrepresentative of knowledge gainedfrom the course readings andcurrent credible evidence. –Demonstrate significant ability togeneralize and extend thinking andevaluate theories or concepts withinthe topic or context of thediscussion. -Demonstrate that thestudent has read, viewed, andconsidered the Learning -Resourcesas well as additional resources andhas read, viewed, or considered asampling of colleagues' postings; –Exceed the minimum requirementsfor discussion posts*.
representative of knowledge gainedfrom the course readings andcurrent credible evidence.re –Demonstrate ability to generalizeand extend thinking and evaluatetheories or concepts within the topicor context of the discussion. –Demonstrate that the student hasread, viewed, and considered theLearning Resources and has read,viewed, or considered a sampling ofcolleagues' postings -Meet theminimum requirements fordiscussion posts*.
depth, reflection, analysis, orsynthesis but rely more onanecdotal than scholarly evidence;and/or -Do not adequatelydemonstrate that the student hasread, viewed, and considered theLearning -Resources and/or asampling of colleagues' postings;and/or has posted by the due dateat least in part. – Lack ability togeneralize and extend thinking andevaluate theories or concepts withinthe topic or context of thediscussion. -Do not meet theminimum requirements fordiscussion posts*.
reflection, analysis, or synthesis butrely more on anecdotal thanscholarly evidence. – Lack ability togeneralize and extend thinking andevaluate theories or concepts withinthe topic or context of thediscussion. -Do not demonstratethat the student has read, viewed,and considered the LearningResources and/or a sampling ofcolleagues’ postings; and/or doesnot meet the minimum requirementsfor discussion posts*.
CONTENT KNOWLEDGE 8 (26.67%) – 8 (26.67%)
Discussion postings and responses:-demonstrate in-depthunderstanding and application ofconcepts and issues presented inthe course (e.g., insightfulinterpretations including analysis,synthesis and/or evaluation of topic;– are well supported by pertinentresearch/evidence from a variety ofand multiple peer- reviewed booksand journals, where appropriate; –Demonstrate significant masteryand thoughtful/accurate applicationof content, applicable skills orstrategies presented in the course.
7 (23.33%) – 7 (23.33%)Discussion postings and responses:-demonstrate understanding andapplication of the concepts andissues presented in the course,presented with some understandingand application of concepts andissues presented in the course (e.g.,insightful interpretations includinganalysis, synthesis and/orevaluation of topic; -are supportedby research/evidence from peer-reviewed books and journals, whereappropriate; and · demonstratesome mastery and application ofcontent, applicable skills, orstrategies presented in the course.
6 (20%) – 6 (20%)Discussion postings and responses:– demonstrate minimalunderstanding of concepts andissues presented in the course, and,although generally accurate, displaysome omissions and/or errors; –lacksupport by research/evidenceand/or the research/evidence isinappropriate or marginal in quality;and/or lack of analysis, synthesis orevaluation of topic – demonstrateminimal content, skills or strategiespresented in the course. ——-Contain numerous errors whenusing the skills or strategiespresented in the course
0 (0%) – 5 (16.67%)Discussion postings and responsesdemonstrate: -A lack ofunderstanding of the concepts andissues presented in the course;and/or are inaccurate, contain manyomissions and/or errors; and/or arenot supported byresearch/evidence; and/or lack ofanalysis, synthesis or evaluation oftopic -Many critical errors whendiscussing content, applicable skillsor strategies presented in thecourse.
CONTRIBUTION TO THE 8 (26.67%) – 8 (26.67%) 7 (23.33%) – 7 (23.33%) 6 (20%) – 6 (20%) 0 (0%) – 5 (16.67%)
DISCUSSION Discussion postings and responsessignificantly contribute to the qualityof the discussion/interaction andthinking and learning by: -providingRich and relevant examples;discerning and thought-provokingideas; and stimulating thoughts andprobes; – -demonstrating originalthinking, new perspectives, andextensive synthesis of ideassupported by the literature.
Discussion postings and responsescontribute to the quality of thediscussion/interaction and thinkingand learning by -providing relevantexamples; thought-provoking ideas –Demonstrating synthesis of ideassupported by the literature
Discussion postings and responsesminimally contribute to the quality ofdiscussion/interaction and thinkingand learning by: – providing fewand/or irrelevant examples; and/or –providing few if any thought-provoking ideas; and/or -.Information that is restated from theliterature with no/little demonstrationof critical thinking or synthesis ofideas.
Discussion postings and responsesdo not contribute to the quality ofinteraction/discussion and thinkingand learning as they do not: –Provide examples (or examples areirrelevant); and/or -Includeinteresting thoughts or ideas; and/or– Demonstrate of critical thinking orsynthesis of ideas
QUALITY OF WRITING 6 (20%) – 6 (20%)
Discussion postings and responsesexceed doctoral -level writingexpectations. They: · Use grammarand syntax that is clear, concise,and appropriate to doctoral levelwriting; · Make few if any errors inspelling, grammar, and syntax; ·Use original language and refrainfrom directly quoting original sourcematerials; -provide correct APA ·Are positive, courteous, andrespectful when offeringsuggestions, constructive feedback,or opposing viewpoints.
5 (16.67%) – 5 (16.67%)Discussion postings and responsesmeet doctoral -level writingexpectations. They: ·Use grammarand syntax that is clear andappropriate to doctoral level writing;; · Make a few errors in spelling,grammar, and syntax; · paraphrasebut refrain from directly quotingoriginal source materials; Providecorrect APA format · Are courteousand respectful when offeringsuggestions, constructive feedback,or opposing viewpoints;.
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Learning Resources
Note: To access this week’s required library resources, please click on the link to theCourse Readings List, found in the Course Materials section of your Syllabus.Required ReadingsHyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., …Peters, D. (2010). Stakeholder analysis for health research: case studies from low- andmiddle-income countries. Public Health, 124(3), 159–166.Note: You will access this article from the Walden Library databases.
This study demonstrates how the engagement of stakeholders in research and policymaking can assist in the successful implementation of policy proposals. The authorspropose that by engaging stakeholders, researchers and policy makers are providedwith multiple perspectives on proposed policies, which can lead to greater success withpolicy adoption and implementation.Lavis, J. N., Perman
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