NURS 6050 EVIDENCE BASE IN DESIGN

Walden University NURS 6050 EVIDENCE BASE IN DESIGN – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6050 EVIDENCE BASE IN DESIGN assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6050 EVIDENCE BASE IN DESIGN

Whether one passes or fails an academic assignment such as the Walden University NURS 6050 EVIDENCE BASE IN DESIGN depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6050 EVIDENCE BASE IN DESIGN

The introduction for the Walden University NURS 6050 EVIDENCE BASE IN DESIGN is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6050 EVIDENCE BASE IN DESIGN

After the introduction, move into the main part of the NURS 6050 EVIDENCE BASE IN DESIGN assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6050 EVIDENCE BASE IN DESIGN

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6050 EVIDENCE BASE IN DESIGN

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6050 EVIDENCE BASE IN DESIGN

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. 

Also Read:

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ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN AND IMPLEMENTATION

THE ROLE OF THE RN/APRN IN POLICY EVALUATION

ASSESSING A HEALTHCARE PROGRAM/POLICY EVALUATION

GLOBAL HEALTHCARE COMPARISON MATRIX AND NARRATIVE STATEMENT

Sample Answer 2 for NURS 6050 EVIDENCE BASE IN DESIGN

Lower Health Care Costs Act of 2019 

Introduction 

            One of the major concerns of every American is healthcare. Healthcare is a complex, multifaceted issue, and voter concerns include the cost, quality, and availability of care as well as the availability of insurance and coverage of pre-existing conditions. Out of the many healthcare bills in the Congress, few will receive the bipartisan support necessary to move them through Congress, and it’s likely that fewer will be signed into law by the president. Currently, one of the healthcare issues pending in Congress is S 1895, the Lower Health Care Costs Act of 2019. This bill was introduced by Senators Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington (U.S. Congress, n.d.). If the bill is eventually passed into law, it will help in lowering some healthcare costs. 

            This legislation will reduce what Americans pay out of their pockets for health care in three major ways: 

Eliminate Surprise Medical Bills 

• First, the legislation will end “surprise” medical bills. A surprise medical bill is a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient. This, in turn, leads to extraordinarily high healthcare costs. Chartock et al. (2019) found that 11% of mothers experienced a surprise out-of-network bill with their first delivery, and this was associated with an increase of 13% in the odds of switching hospitals for the second delivery, compared to mothers who did not experience a surprise bill. The bill will also require health insurers to make certain information, including estimated out-of-pocket costs, accessible to enrollees through specified technology such as mobile applications (U.S. Congress, n.d.).  

Transparency in Services Offered 

• Second, it creates more transparency. You can’t lower your health care costs until you know what your health care actually costs. The bill applies to in-network cost-sharing requirements to certain emergency and related non-emergency services that are provided out-of-network and requires health care facilities and practitioners to give patients a list of provided services upon discharge and to bill for such services within 45 days (U.S. Congress, n.d.).  

Address Drug Price Increase 

• This bill will attempt to address rapid and significant drug price increases that have occurred in the last few years, with drug companies often raising prices significantly, especially when the drug is unavailable from other drug companies. According to Deb & Curfman (2020), the 2018 price increase alone was estimated to have added $1 billion to US health care costs. The authors cite the price of the world’s best-selling drug, adalimumab (Humira), which was increased by 7.4% for 2020. Also of concern is drug companies’ practice of paying generic drug makers to keep generic versions off the market so prices can remain high (Evans & Fleming, 2019). The bill will revise certain requirements to expedite generics and biosimilars’ approval, including requirements relating to citizen petitions, application effective dates, and labeling (U.S. Congress, n.d.).  

            This bill means a lot to healthcare consumers. The bill’s passage will reduce or eliminate “surprise” medical bills, create transparency in the healthcare industry, and finally alleviate financial burdens on the patients.   

References 

Chartock, B., Garmon, C., & Schutz, S. (2019). Consumers’ Responses To Surprise Medical Bills In Elective Situations. Health Affairs, 38(3), 425–430. https://doi-org.ezp.waldenulibrary.org/10.1377/hlthaff.2018.05399 

Deb, C., & Curfman, G. (2020). Relentless Prescription Drug Price Increases. JAMA: Journal of the American Medical Association, 323(9), 826–828.https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2020.0359 

Evans E. & Fleming K. ( 2019). 5 Key Healthcare Issues Pending In Congress: ‘New Rules’ That Could Change How You Get Healthcare. Retrieved January 10, 2021 from https://www.forbes.com/sites/allbusiness/2019/07/07/5-key-healthcare-issues-pending-in-congress-new-rules-that-could-change-how-you-get-healthcare/?sh=679db6451ed9 

U.S. Congress. (n.d.). S.1895 – Lower Health Care Costs Act. Retrieved January 10, 2021 from https://www.congress.gov/bill/116th-congress/senate-bill/1895 

Sample Answer 3 for NURS 6050 EVIDENCE BASE IN DESIGN

I choose bill S. 201.  This is a bill to ensure continuing education from accredited sources is available for health care providers at federally qualified and rural health care clinics.  This aims to improve access in these underserved areas.  The idea is to improve access to rural and underserved areas. (2021) 

The Health and Human Services Administration is to establish a program to award no more than 100 grants to ensure access to accredited medical education.  This will ensure the providers in these underserved areas are practicing within their full scope, capacity and knowledge.  To be eligible for the grant you must submit an application, ensure the training is provided to physicians and primary care providers, show how participation with meet patient needs, patient target groups and supporting data.  (2021) 

This ensures people in these underserved areas are receiving appropriate cares, provided by medical professionals who are up to date with the latest, evidence based practices and skills.  This increases provider retention and brings in revenue to these small rural clinics and hospitals.  Having financial assistance to continuing and furthering education brings a higher level of care to individuals who previously would have had to travel to receive.  Using these federal dollars ensures that providers stay in these areas or be responsible to pay back the monies out of their own pockets.  This reduces turn over. 

I think this bill is a great step into bringing rural and underserved Americans state of the art, cutting edge health care options and treatments.  This would also ensure CMS funding remains in these rural areas.  This bill would cost about 20 million for about 5 years. (2021)  In return it would bring rural and underserved Americans the health care they deserve.   

(2021). Retrieved 11 October 2021, from https://www.congress.gov/bill/117th-congress/senate-bill/201?q=%7B%22search%22%3A%5B%22health+care%22%2C%22health%22%2C%22care%22%5D%7D&s=7&r=19. 

Sample Answer 4 for NURS 6050 EVIDENCE BASE IN DESIGN

 The health policy I chose to write about pertains to the continuation of telehealth treatment of patients with the limitations established during the COVID19 pandemic. With this legislation, patients that relied on telehealth during the pandemic could continue to receive telehealth care in future years. These patients that telehealth most benefitted were those that were limited in their ability to attain in-person healthcare due to health status or transportation limitations.

Social determinants that affect this include health care access and economic stability. Health care access can be very limiting for some patients, especially those who are in rural areas. For those people, they may have to drive a significant distance to access healthcare, especially if they need to see a specialist. Specialists can be few and far between in healthcare, especially for those who treat rare and unique diseases. Telehealth helps connect people to specialists, who would normally be a great distance away. The financial burden of traveling a great distance, could be enough to deter a patient from seeking the treatment they need. Economic stability ties into the financial burden of travel. If a patient needs to travel a long way to see a specialist, they may not be able to. Additionally, the cost of gas or not having access to a vehicle, can hold patients back from getting treatment.

            Arnaert et al. described a study in which Chronic Obstructive Pulmonary Disease (COPD) patients were given a pulse oximeter to measure their oxygenation status and access to a telehealth RN during the COVID19 pandemic. The study found that these patients felt less anxiety during the study due to the daily availability of a healthcare provider to assess their status (2022). COPD patients were some of the most at-risk people during the pandemic, with already compromised respiratory function, leading to increased anxiety during the time of isolation. This improvement of care is not limited to the pandemic. COPD patients can face daily trials due to their conditions, the ease of access to healthcare cannot be understated in this case. Also, these patients are often elderly patients who cannot easily access healthcare, due to restrictions financially or due to access to transportation.

            In a study, Lindberg et al. describes the increased use of telehealth for contraceptive care during the COVID19 pandemic. The study showed an increase of usage in rural and urban areas with a greater increase in urban areas (2022). This could be due to increased rates of COVID19 in urban areas. While the increase in rural areas could be due to the distance, they would have to travel to receive quality care. This study showed the efficacy of telehealth by bringing more patients in to the office to receive quality care, where they may not have had before telehealth care was available. Overall, the benefits that this policy would keep cannot be overlooked. With the policies that came into effect during the pandemic, more people had more convenient access to quality healthcare that they did not have before. With this policy continuing measure put into place during the pandemic, quality healthcare would reach more people.

References

Arnaert, A., Ahmad, H., Mohamed, S., Hudson, E., Craciunas, S., Girard, A., Debe, Z., Dantica,  J. L., Denoncourt, C., & Côté-Leblanc, G. (2022).             Experiences of patients with chronic obstructive pulmonary disease receiving integrated telehealth nursing services during COVID-19                       lockdown. BMC Nursing, 21(1), 1–13. https://doi.org/10.1186/s12912-022-00967-2

Lindberg, L. D., Mueller, J., Haas, M., & Jones, R. K. (2022). Telehealth for Contraceptive Care During the COVID-19 Pandemic: Results of a                     2021 National Survey. American Journal of Public Health, 112(Sup5), S545–S554. https://doi.org/10.2105/ajph.2022.306886

Test – H.R.341 – 117th Congress (2021-2022): Ensuring Telehealth Expansion Act of 2021. (2021, February 2). http://www.congress.gov/

Sample Response for NURS 6050 EVIDENCE BASE IN DESIGN

Hello Joseph, great post I definitely benefitted from telehealth during the pandemic also. Yes some people may not have access to certain health benefits due to transportation like you mentioned and that could definitely lead to lower health outcomes in underserved communities. You mentioned patients with COPD during the pandemic and I thought this was a great example. Yes these patients have an increased risk of severe pneumonia and poor outcomes when they develop COVID-19. (Leung et al., 2020). While there are a lot of benefits to Telehealth, we cannot overlook the downsides because not every visit can be done remotely. You still have to go into the office for things like imaging tests and blood work, as well as for diagnoses that require a more hands-on approach. (Watson, 2020). 

References 

Leung, J. M., Niikura, M., Yang, C. W. T., & Sin, D. D. (2020, August 13). Covid-19 and COPD. The European respiratory journal. Retrieved October 10, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424116/  

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard Health. Retrieved October 10, 2022, from https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages  

Sample Response for NURS 6050 EVIDENCE BASE IN DESIGN

This bill was introduced on 06/23/2023 to the House Committee Energy and Commerce, sponsored by Davids Sharice (Rep-D-KS-3). The bill seeks funding through FY2033 for family planning services and clinics, covering grants, contracts, and clinic infrastructure. According to the bill, funded clinics must offer nondirective counseling to pregnant patients, including options for prenatal care, infant care, foster care, adoption, and pregnancy termination, with referrals upon request. Additionally, entities receiving sub-awards for family planning services cannot be excluded for reasons other than their inability to provide such services.

This bill directly promotes abortion rights policies, which refer to the legal and social rules that govern the availability and ease of access to abortion services. Abortion has been a highly debated matter for many years, involving multiple factors such as women’s rights, public health, ethical issues, and religious convictions. Throughout history, the legal status of abortion has oscillated between stringent bans and more permissive measures. The crux of the argument revolves around the ethical and legal standing of the fetus, women’s autonomy regarding their bodies, and the government’s role in overseeing personal healthcare choices.

 Primary Social Determinant Influencing the Policy:

Gender inequality significantly impacts abortion rights policies among the different social determinants. The level of women’s autonomy and decision-making authority in countries has a direct influence on their ability to obtain safe and lawful abortion services. Women in areas with heightened gender inequality frequently encounter substantial obstacles while seeking abortion services, resulting in an increased prevalence of unsafe operations (Jones & Jerman, 2017).

Evidence Base for the Policy: The evidence supporting abortion rights policies is substantial, derived from viewpoints in public health, law, and human rights. Studies indicate that implementing restrictions on abortion does not reduce its occurrence but instead results in a rise in hazardous procedures, which in turn leads to elevated rates of illness and death. The World Health Organization (WHO) conducted a study that indicates that in countries with stringent abortion regulations, there is a higher incidence of unsafe abortions (WHO, 2020).

The legal justification for abortion rights is based on the fundamental principles of autonomy and privacy. The Roe v. Wade case in the United States determined that the choice to undergo an abortion is encompassed by the constitutional protection of the right to privacy (Roe v. Wade, 410 US 113, 1973).

Gender Equality: Research indicates that the availability of secure and lawful abortion services is crucial for the well-being and equal treatment of women. According to the UN WOMEN (2022), Reproductive rights are essential to the rights of women, as recognized by international accords and enshrined in legislation throughout various regions. It is important to note also, that President Barack Obama stood firmly in promoting healthcare autonomy regardless of gender and guaranteeing women’s availability to a diverse array of healthcare interventions. He has consistently championed the right to access abortion during his tenure. The policies of his government mostly favored the preservation and expansion of access to abortion services. The Affordable Care Act (ACA) implemented a requirement for most commercial health insurance plans to cover contraceptive procedures, including those considered abortifacients by many opponents (Guttmacher Institute, 2016)

Conclusion: The evidence in favor of abortion rights policies is significant since it addresses public health issues, legal rights, and gender equality. Although the ethical aspects of the abortion issue are intricate, the policy consequences are unambiguous: limiting abortion access does not decrease its frequency but instead worsens public health emergencies and violates women’s rights.

Sample Response for NURS 6050 EVIDENCE BASE IN DESIGN

The Health Equity and Accountability Act of 2022 is a recently proposed health policy that requires more support for adequate actualization. This Act, introduced in the House on April 26, 2022, mandates Health and Human Services (HHS) and other pertinent agencies to engage in comprehensive initiatives against health inequalities (Kelly, 2022). These new provisions enable agencies to transform the healthcare system and guarantee everyone access to reasonably priced treatment. Socioeconomic status is a major social factor impacting the policy (Schrempft & Stringhini, 2023). Kim et al. (2023) found a direct correlation between access to higher quality healthcare, preventative services, and health information and increased income and education. Along these lines of logic, the Act strives to break this cycle of health disparities through evidence-based therapies and structural change.

The base of supporting evidence for this Act is comprehensive. Williamson et al. (2023) demonstrate several inequalities in health outcomes within racial and ethnic groupings. As such, these findings indicate that the goals set by the Act to reduce these health inequities are well-founded. Moreover, Wypych-Ślusarska et al. (2022) highlight that the rampant health inequality issues may significantly be reduced by proper evidence-based interventions, such as community health workers’ programs and culturally-based health education. Other researchers further illustrate discourses on how the services provided in the Act are in tandem with the broader reforming efforts in the health system. According to Wilson and Jones (2022), Medicaid coverage extension and boosting investment in community health centers enhance access to healthcare and reduce inequity. These studies add to a consistent body of evidence supporting the comprehensive strategy elaborated by the Health Equality and Accountability Act through targeted, evidence-based therapies and structural reforms in the quest for health equity.

References

Kelly, R. L. (2022, June 29). H.R.7585 – 117th Congress (2021-2022): Health Equity and Accountability Act of 2022. Www.congress.gov. https://www.congress.gov/bill/117th-congress/house-bill/7585

Kim, Y., Vazquez, C., & Cubbin, C. (2023). Socioeconomic disparities in health outcomes in the United States in the late 2010s: results from four national population-based studies. Archives of Public Health, 81(1), NA–NA. https://doi.org/10.1186/s13690-023-01026-1

Schrempft, S., & Stringhini, S. (2023). Socioeconomic inequalities in the Pace of Aging. Aging. https://doi.org/10.18632/aging.204595

Williamson, C. G., Richardson, S., Ebrahimian, S., Kronen, E., Verma, A., & Benharash, P. (2023). Identifying the origin of socioeconomic disparities in outcomes of major elective operations. Surgery Open Science, 13, 66–70. https://doi.org/10.1016/j.sopen.2023.04.001

Wilson, B. G., & Jones, E. (2022). Lessons on increasing racial and health equity from accountable health communities. Journal for Healthcare Quality, 44(5), 276–285. https://doi.org/10.1097/jhq.0000000000000356

Wypych-Ślusarska, A., Krupa-Kotara, K., & Niewiadomska, E. (2022). Social inequalities: Do they matter in asthma, bronchitis, and respiratory symptoms in children? International Journal of Environmental Research and Public Health, 19(22), 15366. https://doi.org/10.3390/ijerph192215366

H.R.3165 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021

In the United States and across the world, we are experiencing nursing shortages in all patient care settings. This has been detrimental to the patients as well as the nursing workforce (Bartmess et al., 2021). Without the right amount of nurse-to-patient ratio, patients go without care and nurses go without the proper tools and experience to provide care. As a nation we have been facing this issue for many years and since COVID-19 nurse-to-patient ratios have progressively worsened. It is not a surprise to me that policies are being presented to congress to set regulations that require hospitals and other patient care facilities to take action. Patient safety is our top priority in health care. We care for people in their weakest moments which makes them incredibly vulnerable.

The policy “Nurse Staffing Shortages for Hospital Patient Safety and Quality Care Act of 2021”, was presented to congress on May 12, 2021 (Congress.gov, 2021). This policy states that regulations need to be put on hospitals when assigning staff and providing care for patients. This policy outlines what an appropriate nurse-to-patient ratio is in different units of the hospital, and sets a time limit in which hospitals need to be compliant with the policy if passed. One other important area this policy covers is nurse competence (Congress.gov, 2021). It states that nurses need to be educated and competent in the unit they are being assigned. The policy prohibits hospitals from assigning nurses to units they were not orientated to and have enough education to effectively care for the patients within that unit.

The social determinant that this policy most affects is the health care system and the quality of care they provide to patients. There has been a lot of research done on this subject because adverse patient outcomes have been linked to staffing shortages (Bartmess et al., 2021). Often times staffing issues are linked to cost, patients are left without the care they need because hospital administration disregard what is happening within the units (Bartmess et al., 2021). Staffing shortages have also been correlated with nurse burnout, which leads to higher turnover rates for hospitals (Chen et al., 2019). In the study done by Chen et al. (2019), they found that burnout, dissatisfaction, and nurses leaving their job were directly related to patient-to-nurse ratios (Chen et al.,2019). Providing quality care to patients is the standard for any healthcare organization. Quality care is provided to patients via the nurses working within an organization. If we have high levels of burnout and dissatisfaction nursing shortages will continue throughout the world. Setting standards for hospitals to follow would be just the beginning of fighting this battle. As nurses, we have the right to stand up for ourselves and our patients in order to deliver quality care.

References

Bartmess, M., Myers, C. R., & Thomas, S. P. (2021). Nurse staffing legislation: Empirical evidence and policy analysis. Nursing Forum, 56(3), 660–675. https://doi.org/10.1111/nuf.12594Links to an external site.

Chen, Y.-C., Guo, Y.-L. L., Chin, W.-S., Cheng, N.-Y., Ho, J.-J., & Shiao, J. S.-C. (2019). Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction. International Journal of Environmental Research and Public Health, 16(23), 4801. https://doi.org/10.3390/ijerph16234801Links to an external site.

H.R.3165 – 117th Congress (2021-2022): Nurse Staffing Standards for … Congress.gov. (2021, May 12). Retrieved January 12, 2023, from https://www.congress.gov/bill/117th-congress/house-bill/3165Links to an external site.

NURS 6050 Week 5 Professional Nursing and State-Level Regulations

The healthcare team must work collaboratively to accomplish high-quality care and positive outcomes. Each role in the healthcare team has a specific scope of practice and is based on their educational preparation and triaging, allowing them to contribute to primary care (Bosse et al., 2017). APRNs will focus on bringing a holistic, patient-centered, and family-centered approach to prevent and manage complex health and behavioral issues (Bosse et al., 2017). 

           Some examples of APRNs are nurse practitioners (NP) and certified nurse-midwife (CNM). Nurse practitioners provide comprehensive care services to address physical and mental health needs. While CNMs offer services focusing on primary sexual and reproductive health services and postpartum care, childbirth, and care of newborns (Bosse et al., 2017). 

           Healthcare professionals must practice within their scope of practice, or consequences could follow. Living in Pennsylvania, in 2004, Governor Rendell introduced the proposed legislation known as Prescription of Pennsylvania (Rx4PA), which sought to increase access to health care, control spiraling state healthcare costs, and improve quality (Carthon et al., 2016)—allowing for APRNs to order medical equipment, signing disability forms, and prescriptive authorities (Carthon et al., 2016). Pennsylvanians were 11% more likely to use the emergency room than all other Americans (Carthon et al., 2016). 

           State to state regulations varies regarding the prescriptive authority. Revealing in 2017 Florida legislature expanded APRN prescribing controlled substances, such as opioids and stimulants, reported earlier that Florida physicians were dispensing oxycodone five times more than the national average (Reynolds, Reynolds, & Craig-Rodriguez, 2021). Comparing to Pennsylvania, the Governor allowed APRNs to prescribe medications in 2004. Florida was the last state to rant controlled substances prescriptive authority (Reynolds, Reynolds, & Craig-Rodriguez, 2021). 

           In 1985, The Medical Practice Act imposed strict requirements on CNMs to legally practice in Pennsylvania (Levinson, 2018). Pennsylvania legislators made unsuccessful attempts in the early 1990s to legalize non-nurse midwifery practice. Pennsylvania has a high home birth rate, and non-nurse midwives attend (Levinson, 2018). Their attempts were supported by the Amish community and opposed by CNMs and medical groups (Levinson, 2018). The non-nurse midwives practiced illegally because the Midwife regulation Law proscribes midwifery practice without a license, and Pennsylvania currently provides no path to licensure for non-nurse midwives (Levinson, 2018). In Pennsylvania, to certify, the individual must be licensed by the board, have the minimum education requirements, can practice without a physician, and lastly be required to carry malpractice insurance (Levinson, 2018). 

           According to the Florida state website, the requirements need to practice midwifery are they must have a high school diploma, 21 years of age, completion of an approved midwifery program for a minimum of 3 years, if an RN or LPN a reduction in clinical training if qualified (2021). Students must observe additional 25 women before allowing for a license. Once completed, the student will test their proficiency in core competencies that are required (Statutes &Constitution). The difference between the states is Pennsylvania allows for non-nurse midwives due to the Amish community. 

           In conclusion, regulations apply to APRNs and must be followed to practice within the scope of practice. The rules set guidelines and standards for professionals. APRNs must continue to meet the credited education required to keep their license up to date to ensure safety and competence in their chosen practice. 

References: 

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

Carthon, J. M. B., Wiltse Nicely, K., Altares Sarik, D., & Fairman, J. (2016). Effective Strategies for Achieving Scope of Practice Reform in Pennsylvania. Policy, Politics & Nursing Practice, 17(2), 99–109. https://doi-org.ezp.waldenulibrary.org/10.1177/1527154416660700 

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