Feb 23, 2024 NRSE 6050 Week 7 Discussion 1: Evidence Base in Design
NRSE 6050 Week 7 Discussion 1: Evidence Base in Design NRSE 6050 Week 7 Discussion 1: Evidence Base in Design I am glad that you are discussing this topic and policy. I have experienced this issue firsthand while working in a critical care environment. There were many times that I felt unsafe as did my patients. You stated from another source, “If the determined ratios listed in the bill are not met and or there is a safety concern related to the expertise of nurse and patient care, a nurse is allowed to refuse an assignment without any repercussions” This is very important in the safety of patients and the safety and license of health care provider and worker. Every nurse’s ability to provide safe, high-quality care in all practice settings is impacted by staffing. We can improve healthcare for all by doing away with risky nurse staffing practices and policies. (nurse staffing, 2022) There is broad agreement that nurses are an essential part of the health care delivery system and that nurse staffing affects safety, but there is very little agreement regarding the specifics of what research data have and have not established, and there is active disagreement regarding the best course of action to ensure public safety. Nurse staffing is a crucial health policy issue. (Clarke & Donaldson, 2008) Resources: https://www.nursingworld.org/practice-policy/nurse-staffing/. (2022). Nurse Staffing. Clarke, S. P., & Donaldson, N. E. (2008, April 1). Nurse Staffing and Patient Care Quality and Safety – Patient Safety and Quality – NCBI Bookshelf. Nurse Staffing and Patient Care Quality and Safety – Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2676/ When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety. Struggling to Meet Your Deadline? Get your assignment on NRSE 6050 Week 7 Discussion 1: Evidence Base in Design done on time by medical experts. Don’t wait – ORDER NOW! Meet my deadline Click here to ORDER NOW FOR AN ORIGINAL PAPER!!! NRSE 6050 Week 7 Discussion 1: Evidence Base in Design Main Post Nursing is a profession where the care that is provided should be evidence base, and as we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became the culture of care. As our profession is and should be practiced based from evidence we must venture away from those practices and adhere with the evidence base practices. The health policy that I selected is Bill H.R.4647, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act. This bill sponsors are Rep. Schneider, Bradley Scott [D-IL-10], was introduced on 10/15/2019. The background for this proposed bill/problem goes way back before the Affordable Care Act (ACA), whereas people that had pre-existing health conditions were denied health insurance or their prices were way higher to the point where they could not affordable to pay and went uninsured for decades (Giled & Jackson, 2017). President Franklin D Roosevelt introduced the Social Security Act, President Lyndon Johnson made an amendment to the Social Security Act with the passage of Title1X where the Medicare Act was introduced under Title V111. Prior to the ACA, health insurance was obtained medically, meaning insurance companies were privy to an individual health record and other risks factors which they use to determined eligibility and applicants had to fill out a lengthy form with their medical history (Claxton et al., 2016). Medicare Act was introduced at the federal state level to provide coverage to the poorest citizens (Auerbach, 2019). The Patient Protection Affordable Care Act (PPACA) was passed in to law 2010 which protects people with pre-existing health condition against insurance companies that would deny them health insurance coverage (Auerbach, 2019). There is enough evidence to support the fact that people with pre-existing conditions were denied health insurance because before the passage of the PPACA insurance companies were not held accountable. According to Claxton et al. (2016) more than 18% of applicants were denied health insurance before the ACA act and many more people that had pre-existing condition did not apply because they were already informed that they would be denied. PPACA has extended coverage and hold insurance accountable, no preexisting inclusion and now more than 32 million more people have gain access to insurance coverage including people with pre-existing conditions such as patients with cancer (Plaxe & Nagle, 2014). References Auerbach, M. P. (2019). Patient Protection and Affordable Care Act: Overview. Salem Press Encyclopedia. Claxton, G., Cox, C., Damico, A., Levitt, L., Pollitz, K & Kaiser Family Foundation. (2016). Pre-existing conditions and medical underwriting in the individual insurance market prior to the ACA. Montana, 25, 152-000. Glied, S., & Jackson, A. (2017). Access to Coverage and Care for People with Preexisting Conditions: How Has it Changed Under the ACA? Issue Brief (Commonwealth Fund), 18, 1–12. Plaxe, S., & Nagle, V. L. J. (2014). Patient Protection and Affordable Care Act (“Obama Care”). Journal of Gynecologic Oncology Nursing, 24(1), 25–26. NRSE 6050 Week 7 Discussion 1: Evidence Base in Design In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy. To Prepare: Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy. Review the health policy you identified and reflect on the background and development of this health policy. By Day 3 of Week 7 Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples. RE: Discussion – Week 7 Collapse The recent law to ban abortion in Texas sent shock waves across the state and outside, bringing fear of the repo effect as policymakers interfered with a human right. The right to women’s health services. The law put forth restrictions on abortion as early as six weeks and even gave the power for ordinary citizens to sue health care providers found to break this law in the state (Najmabadi, 2021). To prevent the passing of the outrageous law in California, Rep. Chu, Judy (D-CA-27) introduced the bill H.R.3755- Women’s Health Protection Act of 2021. The bill persuaded Congress to protect the right of individuals, in this case, women, when it is time to make an informed decision to terminate the unwanted pregnancy and the protection of providers involved in performing abortion procedures under standardized protocols (Congress.gov, 2021). The Women’s Health Protection Act bill is currently under the Senate review, and it has been used to bring public awareness and to the legislatures on the impact of anti-abortion rules, which through informed evidence, its consequences have been found to perpetuate decreased access to safe abortions, as evidenced by a review of the literature completed by Espinoza et al. (2020), which showed an increased rate of infection and mortality amongst 22 million adolescent girls globally. Also, increased service cost has hindered women from participating in economic and social developments, leaving women vulnerable to socio-economic exploitations from the opposite sex. Last, the sharp increase in mental health disorders and health disparities in minority ethnics have been associated with limited access to women health services and has continued to affect other preventative vital health services that include screenings, contraceptive services, sexually transmitted disease services, prenatal care, and adaptation services (Congress.gov). The fourteenth amendment of the U.S. Constitution gives rights to all American citizens, thus protecting a woman’s right to make adequately informed and educated health decisions and abortion being part of them. References Congress.gov. (2021). H.R.3755 – Women’s Health Protection Act of 2021 . Retrieved from CONGRESS.GOV: https://www.congress.gov/bill/117th-congress/house-bill/3755/text Espinoza, C., Samandari, G., & Andersen, K. (2020, April). Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature. Sexual and Reproductive Health Matters, 28(1); PMC7888105. doi: 10.1080/26410397.2020.1744225. Najmabadi, S. (2021). Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy. THE TEXAS TRIBUNE. By Day 6 of Week 7 Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described. Description of the Health Policy H.R.6637, or the Health Fairness and Accountability Act of 2020, seeks to do two things: decrease health inequalities and increase healthcare fairness. Increased access to culturally and linguistically appropriate healthcare, a higher reporting of demographic and health disparities data, and adjustments to eligibility and conditions for Medicaid, Medicare, private medical coverage, and various other initiatives are all included in the bill’s suite of solutions (Congress.gov, 2020). Some forms of cancer, HIV/AIDS, renal disease, and diabetes disproportionately impact people of color, and this legislation seeks to address these issues. It also stresses the need to ensure environmental and social justice. Background of the Problem or Issue The United States has long struggled with health disparities or systematic variations in health outcomes across various groups. Racial and ethnic minorities, the economically disadvantaged, and foreign nationals are among the groups most likely to have poor health outcomes and the most difficult time gaining access to adequate medical treatment (Schwartz et al., 2019). Unequal distribution of resources, prejudice, socioeconomic position, educational gaps, and cultural differences are all possible causes of such gaps. Social Determinant Most Affecting the Policy The suggested approach is heavily influenced by socioeconomic status, one of the social determinants of health. A person’s access to medical care, health outcomes, and quality of life are heavily influenced by socioeconomic status (Tzenios, 2019). Lower-income people sometimes encounter monetary hurdles to healthcare services, insufficient health awareness, and fewer preventative care options. This factor may exacerbate existing health inequalities. Evidence Base to Support the Proposed Policy The Health Equity and Accountability Act of 2020’s suggested policy has strong empirical backing. The presence of health inequalities and the need for tailored treatments to overcome them have been repeatedly shown by research. For instance, studies have shown that those from impoverished backgrounds, including racial and ethnic minorities, and those with shorter life expectancies and inferior health outcomes overall (Razai et al., 2021). Moreover, efforts aimed at reducing health inequalities have had encouraging outcomes. According to Tzenios (2019), health outcomes and inequalities have improved thanks to efforts to expand access to primary care, increase healthcare practitioners’ cultural competence, and spread health awareness. Aligning with the current research base and addressing the deficiencies discovered in healthcare equity and quality, the Act incorporates evidence-based measures like workforce diversity support, improved data collection, and targeted interventions for particular illnesses. Conclusion The Health Equity and Accountability Act of 2020 implements research-based policies to lessen healthcare access and outcome gaps. The strategy seeks to address the underlying causes of inequities by focusing on social determinants of health, notably socioeconomic status. The proposed law builds on existing research and best practices to ensure its provisions foster health equality and enhance health outcomes for disadvantaged groups. References Congress. Gov. (2020). Health Equity and Accountability Act of 2020. Congress.gov. Retrieved from https://www.congress.gov/bill/116th-congress/house-bill/6637 Links to an external site. Razai, M. S., Majeed, A., & Esmail, A. (2021). Structural racism is a fundamental cause and driver of ethnic disparities in health. BMJ, p. 373. https://doi.org/10.1136/bmj.n938 Links to an external site. Schwartz, S. B., Sanders, A. E., Lee, J. Y., & Divaris, K. (2019). Sexual orientation‐related oral health disparities in the United States. Journal of public health dentistry, 79(1), 18-24. https://doi.org/10.1111/jphd.12290 Links to an external site. Tzenios, N. (2019). The Determinants of Access to Healthcare: A Review of Individual, Structural, and Systemic Factors. Journal of Humanities and Applied Science Research, 2(1), 1–14. https://journals.sagescience.org/index.php/JHASR/article/view/23 *Note: Throughout this program, your fellow students are referred to as colleagues. Submission and Grading Information Grading Criteria To access your rubric: Week 7 Discussion Rubric Post by Day 3 and Respond by Day 6 of Week 7 To participate in this Discussion: Week 7 Discussion Also Read: NURS 6050 Discussion: Presidential Agendas NURS 6050 Assignment: Agenda Comparison Grid and Fact NURS 6050 Discussion: Politics and the Patient Protection and Affordable Care Act NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement RE: Main Question Post Collapse I noted that your health policy you have chosen was The Families First Coronavirus Response Act 2020. I found your chosen health policy interesting in reading seeing the public is in a current pandemic related to this novel virus as in the coronavirus. It was interesting to see what The Families First Coronavirus Response Act 2020 was focusing on. You stated in your paper that The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak, and its focus was on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment. I found it partially as in The Families First Coronavirus Response Act 2020 to be a bit biased. There is so much about this virus that is unfolding before our eyes. We are learning more and each day something new about this virus (Coronavirus). According to the Washington Post in the United States, the Coronavirus appears to be infecting and killing African Americans at a disproportionately high rate (Thebault, Ba William, 2020).). This emerging stark racial disparity led the Surgeon General to acknowledge in personal terms the increased risk for African Americans amid growing demands that the public-health officials release more data on the race of those who are sick, hospitalized and dying of a contagion that has killed more than 12,000 people in the United States (Thebault et al., 2020). It was stated in the Washing Post that the reason for African Americans being affected at a disproportionate rate had to with African Americans having higher rates of diabetes, heart disease, and lung disease are well documented, and noted by Louisiana Governor John Bel Edwards that health problems make people more vulnerable to the new respiratory disease, but there has never has been a pandemic that brought the disparities so vividly into focus (Thebault et al., 2020). Because of this crisis, the Lawyers’ Committee for Civil Rights Under Law and hundreds of doctors joined a group of Democratic lawmakers, including Senators Elizabeth Warren (Mass.), Cory Booker (N.J), and Kamal D. Harris (Calif), in demanding the federal government to release daily race and ethnicity data on coronavirus testing, patients and their health outcomes, seeing that the data for the Centers for Disease Control and Prevention has only released figures by age and gender (Thebault et al., 2020). The data being reported by the Centers for Disease Control and Prevention is only including age and gender and leaving out racial or ethnic data. I find this data to be disturbing and biased. Civil rights law prohibit federally funded health care providers from administering services in a discriminatory manner, said Kristen Clarke, president and executive director of the Lawyers’ Committee of Civil Rights Under Law, which joined with medical professionals to call for the immediate release of racial and ethnic data on coronavirus infections, testing, and deaths (Wambsgans, 2020) According to the Washington Post article, 2020, even though some activists argued African Americans have been more exposed because many held low-wage or essential jobs, such as food service, public transit, and health care, that required African Americans to interact with the public, I find this to be a poor argument in that is still does not address data on race and ethnicity not being reported, as being left out of data for the Center for Disease Control and Prevention. According to the Center for Disease and Prevention Control (CDC), guidelines in every state is legally required to track data on testing and treatment by race, as it has done during other outbreaks. Fewer than a dozen have released that data so far (Evelyn, 2020). According to what is being found, African Americans are particularly more vulnerable. According to Kristen Clarke president and executive director of the Lawyers’ Committee of Civil Rights, this is a social, economic and racial justice issue (Evelyn, 2020). I feel that the Families First Coronavirus Response Act 2020, needs to be re-assessed, in that health care officials need to consider different factors that should be included for this health care policy to be justifiable (unbiased). References Reise Thebault, Andrew Ba Tran, & Vanessa Williams (2020). Washington Post. The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved April 09, 2020, from Https://www.washingtonpost.com/archive Jason E. Wambsgans (2020). National Broadcasting Company news. African Americans may be dying from COVID 19 at a higher rate. Better data is essential, experts say. Retrieved April 10, 2020, from Https://nbcnews.com Kenya Evelyn (2020). The Guardian. It’s a racial justice issue: Black Americans are dying in greater numbers from COVID-19. Retrieved April 10, 2020, from Https://www.theguardian.com Read Also: NURS 6050 Discussion: Professional Nursing and State-Level Regulations NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making NURS 6050 Assignment: Advocating for the Nursing Role in Program Design and Implementation NRSE 6050 Week 7 Discussion 1: Evidence Base in Design The recent health policy I chose is H.R. 8542 which is the Mental Health Justice Act of 2022. This policy will create a grant for each state to train and send mental health professionals to respond to calls that involve a person with behavioral health issues, instead of law enforcement (Congress.gov, 2022). More than 1 in 5 people who are fatally shot by police officers suffered from mental illness which is more than 1,400 people since 2015 (Burke, 2021). I would say safety would be the social determinant that most affects this policy. Safety for both those with mental illness and law enforcement officers. This bill will hopefully put trained mental health professionals out in the field to help deescalate the crisis before any force is used that could cause major injury or even worse death. Currently there are no evidence-based studies to support this topic on whether sending out mental health professionals in a mental health crisis call first will reduce injury/death, but I believe there can be taking into consideration the amount of people who have mental health issues that go untreated and can pose as a threat which puts them in danger without being aware of what is happening. In Rhode Island, they have what they call a co-response team so there are three full time social workers that ride along with an officer during the day and evening shifts to respond to calls as well as two mental health clinicians (Greider, 2022). Although there is no data to support efficacy, it is clear that having co-response teams helps improve safety and resolve incidents for Rhode Island. References Burke, M. (2021). Policing mental health: Recent deaths highlight concerns over officer response. NBCNews.com. Retrieved October 12, 2022, from https://www.nbcnews.com/news/us-news/policing-mental-health-recent-deaths-highlight-concerns-over-officer-response-n1266935 Congress.gov. (2022). H.R.8542 – 117th Congress (2021-2022): Mental Hea
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