NURS 6050: Policy and Advocacy for Improving Population Health

NURS 6050: Policy and Advocacy for Improving Population Health

“Welcome to NURS 6050: Policy and Advocacy for Improving Population Health“

At first glance, it may seem that the realms of politics and nursing exist on somewhat opposite ends of a spectrum. But a closer examination reveals quite a connection between the two.

Nurses occupy a unique and powerful position in the healthcare system. They spend more time than other health professionals in direct patient care. They interact with patients and families, often during times of great need and distress. Because of this, nurses are often among the first to know when the healthcare system does not meet patient needs, and they have a deep understanding of how it might succeed or fail to provide access to safe, affordable care.

In addition to identifying problems with healthcare, nurses are in an equally unique position to improve it. As experts in the delivery of healthcare, nurses can participate in regulatory and legislative processes and can directly impact the laws and rules that govern their practice.

This important course in the MSN program, Policy and Advocacy for Improving Population Health, examines this impact and explores how nurses can make it a reality. You will examine sources of regulatory and legislative information, and how best to apply this information to analyzing current and future policy. You will consider the role that nurses can play in healthcare program design, implementation, and evaluation. Additionally, you will examine the impact that nurses have on addressing not only local and domestic healthcare issues but global issues as well.

Welcome to Policy and Advocacy for Improving Population Health!

Course Description

In today’s rapidly changing healthcare delivery system, decisions made within the political arena impact the future of health delivery systems, healthcare professionals, and the populations they serve. In this course, students examine the policy process and its impact on healthcare delivery, cost, quality, and access. Students examine the importance of getting healthcare issues on federal and state agenda, investigate governmental response through legislation and regulation, and identify where they can advocate for positive outcomes in program/policy design, implementation, and evaluation. Global health issues are examined for their relevance and impact on the development of the nurse advocate. Through discussions, reflection, case studies, and the application of professional communications techniques as political tactics to influence policy outcomes, students demonstrate integration of policy decision-making into professional nurse practice for the benefit of individuals and populations.

Course Learning Outcomes

By the conclusion of this course, you should be able to:

• Evaluate factors that affect nursing practice (such as socioeconomic, political, legal/regulatory, ethical, and global factors).
• Evaluate factors that affect healthcare delivery systems (such as socioeconomic, political, legal/regulatory, ethical, and global factors).
• Evaluate factors that affect population health (such as socioeconomic, political, legal/regulatory, ethical, and global factors).
• Analyze the influence of policy and politics on the cost, quality, and access to healthcare delivery systems.
• Apply policy processes including political advocacy skills into professional nursing practice.
• Assess tradeoffs between cost, quality, and access inherent in a complex healthcare delivery system.
• Analyze global policies for health and healthcare issues.

Course Summary:

Welcome to class. This is actually a very interesting class, and one where you are expected to learn many NEW things. To make it easier for my students I always post helpful hints prior to all assignments. These hints are designed to help you not make the most common student errors I have seen in the past. My goal is to help you earn the highest score possible. But if you do not regularly check and follow the advice I provide, then my posts will not be very useful. 

Remember that APA 7th edition is a course and school requirement. No exceptions, this includes discussion. The things I am most interested in seeing, is that you can correctly format a citation and a reference. In discussion do not try hanging indents, as our system does not know how to do that. Do not cite anything you do not reference, and do not reference anything you do not cite. Finally, never use blogs, magazines, random websites, or newspaper articles as cited sources for discussion or papers. Only use peer reviewed articles found in your library. 

Also check you email frequently as I will send emails, if I see you are having any classroom issues. 

Students are expected to have read the syllabus and handbook and to understand how papers and assignments are graded (rubric). Deadlines are important and you cannot earn points when you do not submit papers or try to submit late. Remember, you must ask for permission to submit late, and this may or may not be approved, depending upon the circumstances.

If you need to speak with me, send me a text. I try to get back to my students quickly. 

According to Montero et al. (2022), about half of adults in the U.S. expressed that they have difficulty affording health care costs. Many Americans are struggling to get affordable insurance that provides good health coverage. Economic stability, one of the social determinants of health, plays a significant role in this topic. After dealing with the pandemic, many people suffered from the loss of jobs and medical insurance coverage from their employers.

During President Trump’s administration, he planned to make prescription drugs less expensive, allow people to choose their insurance, and provide transparency in hospital and insurer prices (Trump White House, 2020). His first strategy was to eliminate the Affordable Care Act and focus on giving people more power to choose their healthcare insurance. As a result, several individual insurance markets became available for Americans to choose from.

Unfortunately, after his term, more Americans were left without any insurance. The population of Americans without insurance increased by 2.3 million before and during the pandemic (Gee, 2020). Individual insurance became too expensive for people to afford. Although President Trump’s plan was promising, it failed to achieve its goals.

President Biden aims to build on the Affordable Care Act to address health care issues related to the pandemic, minimize health care costs, and improve how people navigate the American health care system (The White House, 2021). Just recently, President Biden announced new programs focusing on lowering healthcare costs and eliminating hidden medical charges. New regulations will prevent private insurance companies from offering deceiving coverages for those with underlying conditions.

In a recent survey by the U.S. Census Bureau, more people have health insurance coverage in 2022 than in 2021 (U.S. Census Bureau, 2023). According to the bureau, many factors contributed to the increase in insurance coverage, such as an increase in public coverage that compensated for the lack of private insurance coverage. With all the new programs the Biden administration is implementing, we have yet to see the effect of all these changes in the coming years.

One thing that the presidents could have focused more on is expanding insurance coverage. According to University of Southern California (n.d.), the expansion in Medicaid coverage significantly impacted access to healthcare in the U.S. The expanded Medicaid insurance coverage made it feasible for adults between 18 and 64 to get insured. It makes it possible for them to go to medical facilities to seek help.

Another program that they could’ve implemented is educating people about the many different healthcare sites that are available for us to use. For example, in Home Health, more than half of our patients go directly to the emergency room if they feel ill. We, as clinicians, would educate them that if they experience mild symptoms such as possible UTI, fever, ear or eye infection, or cuts that need stitches, we have access to urgent care that do not only cater to their needs, but also cost them significantly less.

Sample Answer for NURS 6050: Policy and Advocacy for Improving Population Health

Presentation Overview

Welcome to this presentation on policy and advocacy for improving population health. In the evolving nursing practice, health outcomes depend on the state-based and nationwide measures that leaders, policymakers, and healthcare professionals use to promote and sustain health. Some of these measures include regulations, laws, and policies to improve healthcare access and reduce costs. In this presentation, the central focus is the difference between a board of nursing and a professional nurse association in their efforts to improve nursing. The other area is state-level regulations affecting the general scope of practice for nurses and the practice of advanced registered practice nurses (APRNs).

Board of Nursing vs. Professional Nurse Association

Nursing is a highly-regulated practice. Regulation helps to maintain high standards, helping patients to receive healthcare services that meet their expectations. A board of nursing is a state-level licensing and regulatory body mandated to establish and update standards for safe nursing care. Hence, its scope of practice is within the state to ensure high-quality care and safety of the population through safe nursing practices. A board of nursing has four broad functions. The first function is to evaluate licensure applications to ensure nursing applicants have the necessary educational qualifications. Other functions include issuing and renewing licenses and taking disciplinary actions (NurseJournal Staff, 2023). Discipline could be in the form of reprimand, loss of license, and other measures depending on the violations.

Nurses require progressive growth and development to work competently. A professional nurse association is a national organization committed to the personal and professional development of nurses (Gaines, 2019). Instrumental in helping nurses attain their career goals, professional nursing organizations ensure nurses are up-to-date on current practices, including regulations, laws, and ethical standards. Besides, a professional nurse association provides nurses with ample networking opportunities with other professionals within and outside their practice area. This improves their perspectives, beliefs, values, and other critical aspects of patient care. Importantly, professional associations provide their members with adequate resources and information on practice issues and lifelong mentorship to effectively cope with nursing changes and emerging practice concerns.

State-Specific Board of Nursing

Examining the Pennsylvania State Board of Nursing can improve knowledge of how boards of nursing function and their structure. Like other state boards, Pennsylvania State Board of Nursing is responsible for health and safety protection in the state (Penn State College of Medicine, 2023). Board members vary with skills and obligations. Board members include nine professional members, three public members, and one commissioner. Among the nine professional members include six registered nurses, two licensed practical nurses, and one licensed dietitian-nutritionist (Commonwealth of Pennsylvania, 2023). The appointed members are appointed by the state’s Senator, which indicates the continued influence of politics on health.

State Regulation Related to General Nurse Scope of Practice

A nurse’s scope of practice defines the extent to which a nurse can practice in a particular state. Regarding practice authority, Pennsylvania is a reduced practice state, implying that nurses do not practice independently to the full extent of their education and training. Accordingly, nurse practitioners in Pennsylvania require a collaborative agreement with a licensed physician (Pennsylvania Coalition of Nurse Practitioners). In particular, the agreement addresses the physician’s ability to the nurse practitioner through communication, review of patients’ charts and records under the nurse’s care, and a plan for emergency care. Pennsylvania recognizes nurse practitioners as primary care providers. As a result, they can prescribe medications, formulate treatment plans, recommend devices, and prescribe Schedule II-V controlled substances as detailed in the collaborative agreement.

Reduced practice has profound implications on critical care aspects, including delivery, access, and costs. Indeed, this justifies the continued efforts for states to acquire full practice authority (FPA) status. Under FPA, patients are guaranteed full and direct access to nursing services in care facilities (American Nurses Association, 2023). Therefore, this approach prevents potential care delays experienced in states that require nurses to collaborate with a physician as a practicing condition. FPA also provides nurses with more autonomy, which increases their availability in rural and underserved areas; this improves access to care (American Nurses Association, 2023). Physician oversight also leads to duplication of services, which increases billing costs. Under FPA, patients can see their preferred care providers. This implies that the model does not interfere with patient-centered care, which may be encountered under collaborative agreements.

State Regulation Related to Advanced Practice Registered Nurses

Nursing Licensure Compact (NLC) represents an agreement between states allowing nurses to practice in other member states using one compact nursing license. The eNLC was implemented in 2018 to improve the original NLC conditions, such as requiring nurse practitioners to undergo finger print-based criminal background checks. Since it eases the movement of nurses and promotes availability, eNLC is pivotal in increased access to healthcare services, reduced costs to hospitals and patients, and continued support for efficient care delivery (Gaines, 2023). By further allowing members to practice without delay, eNLC will ensure prevent delays for practicing in Pennsylvania which nurses encounter between contracts.

Concerning recent changes, registered nurses under NLC started to provide in-person care and telehealth services to patients in Pennsylvania on September 5, 2023 (Pennsylvania Department of State, 2023). This demonstrates intensified efforts in the past five years to acquire the licensure to improve health outcomes in the state. With these changes, PA patients have an opportunity to benefit from expanded workforce and additional healthcare resources associated with NLC. The expanded workforce will further help to ease the nursing shortage, which significantly hampers access to care. Although nurses from other states will be able to practice here, PA nurses must apply for a multistate license to enjoy the full benefits of the compact.

Summary

In conclusion, it is crucial to reflect on the major points of this presentation. As noted in the beginning, a board of nursing is a state-based licensing and regulatory body. Therefore, it regulates nursing practice within the state. On the other hand, a professional nurse association brings together nurses at the national level to support personal and professional development. It provides nurses with resources, networking opportunities, and mentorship, essential for progressive career development. As a reduced practice state, PA requires nurses and physicians to have a collaborative agreement. The other important development in PA is belongingness to NLC, which allows nurses in member states to serve in all states using one compact license.

References

• American Nurses Association. (2023). Issues at a glance: Full practice authority. https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
• Commonwealth of Pennsylvania. (2023). Board member list. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Board-Member-List.aspx
• Gaines, K. (2019). You should join a nursing organization. Here’s why. nurse.org. https://nurse.org/articles/benefits-of-nursing-organizations
• NurseJournal Staff. (2023). What is the role of the state board of nursing? NurseJournal. https://nursejournal.org/resources/what-is-the-role-of-the-state-board-of-nursing/
• Pennsylvania Coalition of Nurse Practitioners. (2023). Scope of practice. https://www.pacnp.org/page/ScopeofPractice
• Pennsylvania Department of State. (2023). Nurse Licensure Compact. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/NLC.aspx
• Penn State College of Medicine. (2023). Bucher joins state board of nursing. https://pennstatehealthnews.org/topics/bucher-joins-state-board-nursing/