Feb 23, 2024 NURS 8100 Discussion Federalism’s Impact on Policy
A Sample Answer For the Assignment: NURS 8100 Discussion Federalism’s Impact on Policy
Introduction
The Board of Nursing in Miami, Florida, is a regulatory body whose functions include ensuring that nurses are fully qualified to conduct their activities within the state in various ways. The board is mandated to monitor, discipline, educate, license, and rehabilitate nurses. In Miami, nurses are mandated to ensure that they are capable of delivering quality care to all patients in various healthcare environments (Fraser & Melillo, 2018). However, failure to abide by the stated board’s standards results in forfeiting nurses’ licenses and disabling them from practicing within the state.
The Nurse Practice Act enacted by the State’s legislature provides a framework for enhancing safe and professional nursing services and offers nurses with an environment of protection to all patients. Other responsibilities of nurses in Miami under the Florida Board of Nursing include determining the health status of patients concerning risk principles and nursing leadership of patients through the performance of general duties.
Based on additional laboratory outcomes of patients, physical evaluation and background, APNs should recognize and determine with the approval of the suitable physician, appropriate types of disease in the context of the specified processes (Kung, & Rudner, 2015). They should also conduct procedures frequently accepted via the established protocols to provide patients with insensitivity to pain during diagnostic, surgical, or obstetric clinical processes (Fraser & Melillo, 2018).
These processes include ordering and the delivery of spinal, regional and general anesthesia; inhalation methods and agents; intravenous methods and agents; and methods of hypnosis. Also, Advanced Practice Nurses (APNs) in Miami, Florida, are authorized to sustain life functions all through the anaesthesia healthcare process and to use adequate mechanical support devices (Joel, 2017).
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Moreover, APNs should always be accountable for all patients during practice and identify the appropriate delegation of responsibilities about their obligation to render quality care to all patients (Holly, Salmond &Saimbert, 2016). APNs owe similar duties to self as to others, including the liability to enhance safety and integrity, maintain competence, and to create room for personal and professional growth and development.
Advanced Practice Nurses in Miami, Florida are also required to participate in identifying, maintaining and enhancing the healthcare environments as well as conditions of recruiting conducive to the provision of appropriate and quality healthcare services about the values of the profession through collective and individual action (Fraser &Melillo, 2018).
Finally, a licensed nurse is required to participate in the advancement of the nursing profession through contribution to education, practice, knowledge development, and administration. As a result, APNs should work cordially with other health specialist and the public in enhancing the national, community, and global attempts to achieve healthcare needs (Kung, & Rudner, 2015).
Although the functions of APNs in Miami, Florida are well updated, I was not aware that APNs have emerged to be a major force in evidence-based practice as a result of their increased knowledge of the relevance and immunology to emerging therapies such as utilization of published standards of care and establishment of rules and procedures common to the current world of nursing practice (Holly, Salmond & Saimbert, 2016).
APNs are tasked with the role of being principal investigators in clinical trials through coordination of research efforts, conducting physical assessments as well as ensuring patients adhere to the set health protocols. Additionally, I realized that APNs are patient’s advocates as they are involved in negotiations on behalf of patients with insurance agencies, employers as well as other external agencies (Joel, 2017).
NURS 8100 Discussion Federalism’s Impact on Policy
As a result, APNs provide patients with situational and emotional support as advocates for nursing and other medical staff. Finally, in Miami, Florida, APNs are mandated to prescribe medications and are also tasked with the role of assessing, diagnosing, evaluating and following-up patients. Therefore, APNs are required to demonstrate a high level of understanding of multiple sclerosis, its course, management, disease treatment and modification as well as conducting diagnostic tests.
References
Fraser, M. A., & Melillo, C. (2018).Expanding the Scope of Practice of APRNs: A Systematic Review of the Cost Analyses Used. Nursing Economics, 36(1), 23-29.
Holly, C., Salmond, S., & Saimbert, M. (Eds.).(2016). Comprehensive Systematic Review for Advanced Practice Nursing.Springer Publishing Company.
Joel, L. A. (2017). Advanced Practice Nursing: Essentials for Role Development.FA Davis.
Kung, Y. M., & Rudner Lugo, N. (2015). Political Advocacy and Practice Barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151.
For many years, as advanced as the State of Massachusetts was on many fronts, the profession of nursing was not one of them. Up until January 6, 2021, ARNP’s we had be given temporary (full) practice authority due to the Covid Pandemic. When signed in January 2021, we were the last New England State to give ARNP’s full practice authority, and the 23rd State to pass this regulation across the United States (Health Leaders, 2021).
The Health System I work for is woefully behind adjusting policies and procedures to reflect this new amendment to ARNP’s practice authority within the state. We have a significant need for primary care providers within the Commonwealth and with this change, ARNP’s can practice independently and as primary care providers with their own panel of patients (AANP, 2021, Mass.gov, 2021).
Up until a few months ago, I had to have the physician I work with listed as my supervising provider. Other policies came to question as they were completely unnecessary. According to the medical groups administrative leadership, primary care panels by APRN’s is in the works, but likely won’t occur system wide for 18-24 months (Personal Communication, April 24, 2022).
There is significant variability across the United States regarding practice Authority. According to AANP (2021), 29* states (*including Guam, Northern Marina Islands and Washington, DC) have full practice authority, 16* states (*including American Samoa, Puerto Rico and US Virgin Islands) have reduced practice authority and 11 have restricted practice authority (Nurse Journal, 2022.
Full practice authority is defined as an NP practicing to the full scope of licensure without a supervising physician. Reduced practice authority means NP’s can perform parts of their scope independently and parts with supervision. Rarely does this include diagnostic testing and diagnosis and treatment but more often medication oversight. Restricted practice authority states require NP’s to work solely under the supervision of a physician (AANP, 2021, Nurse Journal, 2022).
Professional nurses, regardless of area of practice, have demonstrated competencies to be able to practice in a full scope capacity without supervision. By minimizing scope across the United States, we are ultimately denying access to healthcare by a qualified provider (AANP, 2021). Most advanced practice nurses, especially if they have Doctorate level education, have more years of school and clinical than that of their physician colleagues (Nurse Journal, 2022). Lack of recognition and utilization of our extensive capabilities, may undermine the professions’ ability for growth and respect.
References
American Academy of Nurse Practitioners (AANP). (2021). Information and resources for Massachusetts NPs. https://www.aanp.org/advocacy/massachusetts
Health Leaders (2021). Massachusetts is the 23rd state to allow NPs to practice independently. https://www.healthleadersmedia.com/nursing/nurse-practitioners-massachusetts-granted-full-practice-authority
Mass.gov. (2022). 244 CMR 4.00: Advanced practice registered nursing. https://www.mass.gov/doc/244-cmr-4-advanced-practice-registered-nursing/download
Nurse Journal. (2022). Nurse practitioner practice authority: A state-by-state guide. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/
NURS 8100 Discussion Federalism’s Impact on Policy
RE: Discussion – Week 8
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Federalism’s Impact on Policy
The overall division of the US health care system is something that must be discussed. There are different models of financing and services that are presented within the US health care system. Policy making is something that is done within the US health care system but done on many different levels of the government. This is a shared responsibility. When you have many different hands in the process of policy making then it does take time. This process can be perceived as slow. People have to meet, make choices, need to time to respond in able to make the best choices for policy making. The purpose of this discussion is to discuss the role of the federal government in health care policy making.
On a federal level the law that comes to mind is the Affordable Care Act of 2010. The law stated that each state needed to expand eligibility for Medicaid. “The lay also required insurers to cover healthcare services within a standard set of benefits and prohibited coverage denials based on preexisting conditions” (Public policy in Michigan, n.d.). Even though the Affordable Care Act is a federal policy its very individual on a state level. As far as Michigan goes there has been positive shift. “Between 2013 and 2016 the number of uninsured individuals in Michigan declined by 50.8%. About 284,000 individuals in Michigan were enrolled in health plans offered through the health insurance exchange in 2017. Enrollment in Medicaid amounted to about 2.4 million in May 2017” (Public policy in Michigan, n.d.). On a state level the program that will be discussed is the Michigan’s Medicaid program. This program allows individuals with low incomes to have access to health insurance. This is an example of how Medicaid is a nationwide program but it’s jointly funded by the federal government and the states. Medicaid is a separate program from Medicare.
The advantages of both programs are the increase amount of insured people and additional funding at both levels. “Federalism, mode of political organization that unites separate states or other polities within an overarching political system in a way that allows each to maintain its own integrity. Federal systems do this by requiring that basic policies be made and implemented through negotiation in some form, so that all the members can share in making and executing decisions” (Britannica, T. Editors of Encyclopedia, 2020). Therefore, the Affordable Care Act and Michigan’s Medicaid Program are a good example of the implications of federalism. The federal government’s involvement on health care policy should be mostly financial and insurance basis. What works in healthcare in some places would not work for others, therefore it is not feasible to make healthcare policies at a federal level for more individual issues. “The question of financial accessibility in the comparator federations is somewhat more complicated to treat, and all three perform less well here than on the other HCF performance criteria” (France, 2008).
Reference:
Britannica, T. Editors of Encyclopedia (2020, May 14). federalism. Encyclopedia Britannica. https://www.britannica.com/topic/federalism
France, C. (2008). The form and context of federalism: Meaning for health care financing. Journal of Health Politics, Policy & Law, 33(4), 649-705.doi: 10.1215/03616878-2008-012
Public policy in Michigan. Ballotpedia. (n.d.). Retrieved April 23, 2022, from https://ballotpedia.org/Public_policy_in_Michigan#Healthcare_information
More than a million referrals are made to child protection agencies involving child abuse every year. The United States loses five children every day to child abuse and neglect. At the same time, state agencies found over 656,000 victims of child maltreatment in 2019 (Child abuse statistics, 2021). It requires all levels of government involvement to combat this concern.
The Federal legislation, the Child Abuse Prevention and Treatment Act (CAPTA), was vital in addressing child abuse and neglect in 1974. CAPTA provides Federal funding and guidance to States in support of prevention, assessment, investigation, prosecution, and treatment activities (Petersen, Joseph, & Feit, 2014). Education leaders can promote awareness of Texas laws by developing effective reporting policies, programs, and employee training to piggy on the federal policy.
Texas Education Code (TEC) §38.0041 requires school districts to participate in an activity on prevention techniques and recognition of sexual abuse (Texas Education Agency, 2021). Each school district and open-enrollment charter school must also maintain records that include the name of each school staff member who participates in the training.
Both policies can combat abuse in children at different government levels. Each state must branch off federal policies to maintain consistency in the overall goal. A disadvantage may include that Federalism is a system in which “sovereigntist is constitutionally split between at least two territorial levels so that units at each level have final authority and can act interdependently” (France, 2008). Each state can set its policies and therefore differ from another state.
For example, the professionals most mandated to report across the States include teachers and healthcare workers. Unlike Texas, other states may require additional professionals to report child abuse. For example, volunteers at entities that provide organized activities for children, such as camps, are required to report abuse. These states include California, Hawaii, Illinois, Louisiana, etc. (Mandatory reporters of child abuse and Neglect – Child Welfare, n.d.).
The degree of the federal government’s involvement in health care policymaking should benefit the country. One of the responsibilities of the federal government is to oversee employment insurance and regulation of trade and commerce. Intense federal action is crucial to assembling the resources and political will to end minority health disparities (Kennedy, 2005).
The acquirement of COVID-19 vaccine from other countries and regulating the disbursement were essential to ensuring that every citizen received their doses. In addition, levels of health insurance coverage are lower among minority populations. Child abuse that occurs in minority families may not be able to seek medical care for wounds after an altercation or gain access to post-abuse treatment such as therapy. The degree of the federal government’s involvement in health care policymaking should benefit the country.
Reference
Child abuse statistics. Childhelp. (2021, October 25). Retrieved April 17, 2022, from https://www.childhelp.org/child-abuse-statistics/
France, G. (2008). The form and context of federalism: meanings for health care financing. Journal of Health Politics, Policy and Law, 33(4), 649–705. https://doi.org/10.1215/03616878-2008-012
Kennedy, E. M. (2005). The Role Of The Federal Government In Eliminating Health Disparities. Health Affairs, 24(2), 452-8. http://dx.doi.org/10.1377/hlthaff.24.2.452
Mandatory reporters of child abuse and Neglect – Child Welfare. (n.d.). Retrieved April 20, 2022, from https://www.childwelfare.gov/pubPDFs/manda.pdf
Petersen, A. C., Joseph, J., & Feit, M. N. (2014). New directions in child abuse and neglect research. National Academies Press.
Texas Education Agency. (2021, October 26). Child abuse prevention an overview. Texas Education Agency. Retrieved April 20, 2022, from https://tea.texas.gov/texas-schools/health-safety-discipline/child-abuse-prevention/child-abuse-prevention-an-overview
The fragmentation of the U.S. health care system, with its differing modes of financing and service delivery, is a reflection of a dispersed government structure. Policy making is shared and distributed across various branches and levels of government. As a result, policy making processes can be slow to respond, manipulated towards personal interests, and often redundant. Consider, for example, the public entitlement programs such as Medicaid, Medicare, the State Children’s Health Insurance Program (SCHIPS), and the PPACA of 2010. Where is there overlap between these policies? How do they demonstrate a dispersed government structure?
This week, you will examine the federal government’s role in health-care policymaking.
To get ready:
Examine this week’s Learning Resources, with a focus on the France article and textbook readings.Determine two nursing or health care policies that meet similar needs, one at the federal level and the other at a lower level of government (state or local).
By Day 3
Post a unified response that addresses the following points:
Give an example of two policies that meet comparable needs and were enacted at different levels of government (i.e., federal, state, or local).
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NURS 8100 Discussion Federalism’s Impact on Policy
What are the benefits and/or drawbacks of this duplication? What are the implications of federalism in this example? Provide literature backing for your stance.How much involvement should the federal government have in health-care policymaking? Give specific examples to back up your claim.
Read a few of your coworkers’ postings.
By Day 6
Respond in one or more of the following ways to at least two of your colleagues:
Pose a probing question that is supported by further background information, facts, or research.Share an insight gained from reading your coworkers’ postings, synthesizing the information to bring fresh viewpoints.Use readings from the classroom or your own Walden Library research to offer and defend an opposing viewpoint.Use your own experience and further research to validate a notion.Make a recommendation based on further evidence gathered from readings or after synthesizing multiple postings.Expand on your colleagues’ posts by offering new insights or opposing viewpoints based on readings and evidence.
Note: For formal Discussion question posting and response grading requirements, please consult the Syllabus and Discussion Rubric.
Return to this Discussion in a few days to read the replies to your first post. Take note of what you learned and/or any insights you acquired as a result of your colleagues’ comments.
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NURS 8100 Discussion Federalism’s Impact on Policy
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Submission and Grading InformationGrading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 8 Discussion]
Name: NURS_8100_Week8_Discussion_Rubric Grid ViewList View
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RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements:
*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.
Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
Points Range: 6 (20%) – 6 (20%)
Discuss
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