Feb 23, 2024 NURS 8100 Health Policy Proposal Analysis (Policy Brief)
A Sample Answer For the Assignment: NURS 8100 Health Policy Proposal Analysis (Policy Brief)
Communities live in different geographical locations with varying health resources, lifestyles, and sociopolitical factors. Jointly and independently, these factors affect public health outcomes since they determine the type and scope of public health issues. As public health nurses and other professionals continue improving health, an in-depth understanding of complex public health concerns is vital. Such knowledge enables them to design and implement effective interventions through health policies. The purpose of this paper is to discuss a public health issue related to the environment and the purpose of policy in addressing the problem.
Public Health Issue Description
Communities require safe and adequately resourced environments to live healthily. Such environments should be pollution-free and provide people with food, water, and other essentials for a quality life. Unfortunately, climate change threatens the environment and health of all populations. Children, youth, and adults are all affected by climate change irrespective of their location, race, and other factors.
According to the American Public Health Association (2023), climate change creates new risks
NURS 8100 Health Policy Proposal Analysis (Policy Brief)
among children and young people, inhibiting their capacity to shape their future. Older adults, pregnant women, and indigenous communities experience more environmental dangers as climate change intensifies. Since all populations are affected, and collaborative interventions are required, it is right to deduce that climate change occurs at all levels.
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The effects of climate change illustrate its severity as an environmental threat and the risk it poses to all populations. Di Napoli et al. (2022) suggested that climate change hampers public health success via direct and indirect pathways.
Direct pathways include health dangers caused by significant changes in temperature, such as cardiovascular disease and kidney problems. Indirect pathways include crop failure, reduced labor capacity, and expansion of disease vectors. Besides, climate change hampers mental health and widens health equity gaps since susceptible groups experience its impact the most (American Public Health Association, 2023; Aylward et al., 2022).
Solutions, including policies, disaster response services, and mental health support, should be problem-centered and specific to issues facing a particular group. The impacts show that no particular community group or age is immune to climate change dangers. Therefore, local, state, and nationwide interventions should be combined to address the severe public health concern.
Impact of the Current Policies
Policies include integrated interventions, such as laws and regulations, implemented to promote society’s health and wellness. President Biden’s administration has embraced various policies to prevent environmental degradation by controlling climate change. They include rejoining the Paris Climate Agreement and the infrastructure bill to fund renewable energy programs (Kennedy et al., 2022).
The Paris Climate Agreement requires member states to pursue efforts to limit global warming to 1.50C. Renewable energy technologies include biofuels for transport to reduce the increased reliance on fossil fuels, mitigating climate change dangers by reducing carbon emissions (White, 2021; Perera & Nadeau, 2022). If successfully implemented, the policies will reduce health concerns stemming from extreme temperatures and other effects of climate change.
Changes to the Current Policies and Steps for Initiating Policy Change
Policies implemented to reduce carbon emissions are vital for a healthy nation presently and in the future. However, achieving the desired outcomes could be challenging if laws hindering policy implementation are not abolished. For instance, the Supreme Court recently limited Environmental Protection Agency’s authority to regulate emissions from power plants (Kennedy et al., 2022).
Such laws should be reviewed or prevented to encourage companies to use renewable energy sources. Commonly, policy change requires political willingness, where policymakers collaborate with politicians to propose and support policy change. Proposals can be reviewed and passed by Congress and other organs involved in policy formulation and implementation.
Stakeholders and their Importance
Policy change is an intensive process with different stakeholders depending on the type and scope of change. Policy changes involving health laws can be initiated by government officials at the state and federal levels. Their primary role is to design appropriate interventions for health problems, search for government funding, and be directly involved in policy implementation. During implementation, government officials such as politicians can mobilize human, material, and financial resources necessary for successful policy change.
Impact on the Health Care Delivery System
Health-related policies are crucial in creating healthy populations hence reducing the illness burden in the health care delivery system. According to the World Bank (2022), global food insecurity has increased progressively due to global warming and other adverse effects of climate change.
Climate control interventions can prevent such an increase and reduce the number of people with health conditions stemming from food insecurity. The mental health burden would also reduce, considering climate change is linked with hopelessness, anxiety, and depression (American Public Health Association, 2023). Addressing these issues through policy implies reducing health care spending while improving public health through illness prevention in the community.
Conclusion
Clean and safe environments are crucial for high-quality public health. Since climate change causes global warming, food insecurity and other health dangers, preventing it should be prioritized by health care providers and governments at all levels. Health policies can effectively address climate change by preventing emissions and obligating organizations to implement measures for preventing global warming. Among others, such interventions can reduce the national disease burden and enable communities to live healthily.
References
American Public Health Association. (2023). How climate change impacts health. https://www.apha.org/Topics-and-Issues/Climate-Change/Health-Impacts
Aylward, B., Cunsolo, A., Vriezen, R., & Harper, S. L. (2022). Climate change is impacting mental health in North America: A systematic scoping review of the hazards, exposures, vulnerabilities, risks and responses. International Review of Psychiatry, 34(1), 34-50. https://doi.org/10.1080/09540261.2022.2029368
Di Napoli, C., McGushin, A., Romanello, M., Ayeb-Karlsson, S., Cai, W., Chambers, J., … & Robinson, E. J. (2022). Tracking the impacts of climate change on human health via indicators: Lessons from the Lancet Countdown. BMC Public Health, 22(1), 1-8. https://doi.org/10.1186/s12889-022-13055-6
Kennedy, B., Tyson, A., & Funk, C. (2022). Americans divided over direction of Biden’s climate change policies. Pew Research Center. https://www.pewresearch.org/science/2022/07/14/americans-divided-over-direction-of-bidens-climate-change-policies/
Perera, F., & Nadeau, K. (2022). Climate change, fossil-fuel pollution, and children’s health. New England Journal of Medicine, 386(24), 2303-2314. https://www.nejm.org/doi/full/10.1056/NEJMra2117706
The World Bank. (2022). What you need to know about food security and climate change. https://www.worldbank.org/en/news/feature/2022/10/17/what-you-need-to-know-about-food-security-and-climate-change
White, T. (2021). Countering climate change with renewable energy technologies. Federation of American Scientists. https://fas.org/publication/countering-climate-change-with-renewable-energy-technologies/
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).
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 health care topic of interest to policy makers. This is frequently accomplished through developing a policy brief. A policy brief advocates for a particular recommendation (prior to 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.
For this Assignment, you will assess one of the recommendations from the Institute of Medicine’s The Future of Nursing: Leading Change, Advancing Health: Report Recommendations. You will then develop a policy brief to advocate for this recommendation (the written policy brief is due in Week 7).
I love your “distraction” strategy and the “Do Not Disturb” sign! I believe that is a wonderful strategy. Thank you for sharing.
I always found that visualizing my was goals helpful, especially when I became discouraged. When I was doing my doctoral studies I would make a simple pie graph and fill it in as I completed my assignments and written work. It really helped me to see how much closer I was to finishing my studies and kept me on track.
I do not know how anyone can be successful in this program without being able to manage their time and having at least fundamental ability to create a Excel spreadsheet, etc.. I think one strategy that has empowered me is the ability to use and understand technology. During my doctoral studies, I learned how technology can improve and challenge one at the same time.
A strategy that I feel is one of the most important is that of effective communication, also. Reading writings a loud prior to posting, is something I utilized even when no one was listening to me. When I could snag someone to hearing me reading aloud, I would read some paragraphs aloud and then try to summarize what I had read aloud, as though I was teaching the content. I found this useful. Perhaps it would work for some of you, too.
References
Laureate Education (Producer). (2012a). Effective online communication: Scholarly writing in online discussion [Video file]. Retrieved from https://class.waldenu.edu
Laureate Education (Producer). (2012f). Tips for effective online composition and communication [Video file]. Retrieved from https://class.waldenu.edu
To prepare:
Review the Lavis et al. article on preparing and writing policy briefs provided in the Learning Resources.
Select one of the recommendations within the IOM The Future of Nursing: Leading Change, Advancing Health: Report Recommendations to focus on for this assignment.
Research the history of the problem behind the recommendation and what has been done to try to solve the problem.
What does the recommendation say should be done? Are there any groups, nursing and others, currently supporting work to implement the recommendation (e.g., Kaiser Family Foundation, professional organizations)? Does the recommendation suggest specific groups that should be involved in the implementation? Think critically about how the recommendation should be implemented – did the IOM get it right? What other strategies are possible to consider?
By Day 7 of Week 7
To complete:
Develop a scholarly and professionally written 2- to 3-page single-spaced policy brief on the recommendation you selected from the IOM report following the format presented in the Lavis et al. article. Include the following:
Short introduction with statement of the problem.
The selected recommendation (from the IOM Report)
Background
Current characteristics
The impact of the recommendation from the perspective of consumers, nurses, other health professionals, and additional stakeholders
Current solutions
Current status in the health policy arena
Final conclusions
Resources used to create the policy brief
Due by Day 7 of Week 7. Complete instructions for submitting your Assignment are provided in the Week 7 Assignment area.
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Note: You will post a summary of your policy brief in the Week 7 Discussion.
Assignment 2: Health Policy Proposal Analysis (Policy Brief)
Program LOs: 4, 5
4: Professions/Collaborators
5: Effective Communicators
DNP Essentials: 5, 6
5: Healthcare Policy for Advocacy in Healthcare
6: Interprofessional collaboration for Improving Patient and Population Health Outcomes (Scroll down for table)
ASSIGNMENT PROMPT
Policy Brief Paper
Target
5 points
Acceptable
3 points
Unacceptable
1 point
Score/Level
Part 1:2- to 3-page single-spaced policy brief on the recommendation you selected from the IOM report following the format presented in the Lavis et al. article. Include the following:
Short introduction with statement of the problem.
The selected recommendation (from the IOM Report)
Background
Current characteristics
The impact of the recommendation from the perspective of consumers, nurses, other health professionals, and additional stakeholders
Current solutions
Current status in the health policy arena
Final conclusions
Resources used to create the policy brief
Program LO: 4, 5
DNP Essential: 5, 6 Exemplary quality.
Content is of a professional portfolio quality; addresses questions/issues discussed in the interview; Applies advanced critical thinking skills; does not summarize or paraphrase the content of the literature review; instead, demonstrates content mastery using examples of and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about Excels in meeting expectations for graduate level work.
Fully meets expectations for LOs 4 and 5.
Fully meets expectations for Essentials 5 and 6.Well-developed good quality work.
Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; includes some summarizing or paraphrasing of literature review; demonstration of content mastery using examples of and/or personalized reflections about the content of the literature review; demonstration of an applied level of understanding through personalized reflections about the content area. It fully meets expectations for graduate level work.
Meets expectations for LOs 4, 5.
Meets expectations for Essentials 5, 6.Superficially developed, unacceptable quality.
Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Does not meet expectations for graduate level work.
Insufficient to meet expectations for graduate work for LOs 4, 5.
Insufficient Essentials 5, 6.
Part 2: Ref
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