NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

Walden University NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief) 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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

Whether one passes or fails an academic assignment such as the Walden University NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief) 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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

The introduction for the Walden University NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief) 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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

After the introduction, move into the main part of the NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief) 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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

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 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

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. 

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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. 

Sample Answer 2 for NURS 8100 WEEK 7 Assignment 2 Health Policy Proposal Analysis (Policy Brief)

The policy proposal the Institute of Medicine (IOM) recommends for furthering healthcare is “Nurses should practice to the full extent of their education and training.” Licensing and practice rules for Advanced Practice Registered Nurses (APRNs) scope of practice varies in each state and is determined not by their education and training but by the state laws. APRNs are essential in today’s healthcare system to solve the increasing shortages of primary care providers in rural and urban areas. Therefore, policy and regulatory changes recommend that all states allow APRNs to practice to the full extent of their education and license with full practice authority. According to the article written by Hudspeth and Klein (2019), IOM got it right in proposing that state legislators, Centers for Medicare & Medicaid Services, and Congress allow APRNs can practice to the full extent of their education and training; therefore,, decreasing the primary care provider shortage.

 One of the IOM report messages is that “nurses should practice to the full extent of their education and training.” This message is driven by the need for nurses to transform practice to ensure that all Americans receive healthcare services ( Kershaw, 2019). In addition, nurses should maximize their contribution to the healthcare team. Also, insurance companies and federals should ensure they follow regulations and policies that protect patients’ rights. Several barriers prevent nurses from practicing to the full extent of their education and training. Some obstacles include state laws, federal policies, out-of-date insurance models, and institutional practices and cultures. The healthcare system is evolving. Between the years 1750 and 2000, there have been drastic changes in healthcare. There has been a shift from simple home remedies to complex technological systems. There are actions that the federal state should undertake to ensure the promotion of patient safety and the implementation of nursing recommendations. It provides provision of healthcare services to vulnerable populations. It should ensure the regulation of healthcare markets and support the acquisition of knowledge by nurses(Kershaw, 2019).

References

Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: Regulatory, practice, and employment perspectives now and for the future. Journal of the American Association of Nurse Practitioners, 31(8), 468-473.

Kershaw, B. (2011). The future of nursing – leading change, advancing Health. The future of  nursing – Leading change, advancing health. Nursing Standard, 26(7), 31- 31. https://doi.org/10.7748/ns2011.10.26.7.31.b1274

NURS 8100 Week 8 Discussion Policy and State Boards of Nursing

Regulations Promulgated through Maryland Board of Nursing. 

In the state of Maryland some of the advanced practice registered nurses (APRNs) include certified midwives, nurse anesthetist, certified nurse practioner (NP) and a clinical nurse specialist. This should be similar to other states too. At a minimum and from personal experience Maryland board of nursing has to give permission to practice as an NP and there are basic requirements that have to be met to qualify to be certified. Not all the regulations that are set forth by the state of Maryland for APRN to practice are recent, but they are however all currently used. 

Code of Maryland regulations (COMAR) are the compilation of the state of Maryland regulations that help govern the state, (Maryland.org, n.d). Health care is not an exception and APRNP have to abide by the COMAR regulations. According to COMAR, (2020), APRNs can perform multiple functions independently. These include comprehensive assessments, complete a death certificate, do not resuscitate orders, interpret diagnostic and laboratory tests, prescribe medications, provide care and give referrals to other providers. An NP can also practice as a registered nurse and for those who have certifications for mental health, they can admit a client on an involuntary basis for treatment. 

How State Regulations Are Supported within Place of Employment 

The place of employment has set standards at the same level of practice as expected by the state but for some treatment approaches the expectation is to defer to the primary physician or the medical director.  Establishing this baseline helps achieve the expected standards and also remain in compliance with the COMAR and federal regulations. The place is very supportive that when the NP completes an admission assessment, the doctor does not have to double check unless there is a concern. 

As a nurse practioner, at the place of work there are multiple activities that can be performed independently. These tasks include but not limited to giving orders for medications and treatment, reviewing diagnostic tests, and responding to families as required. One task that is permitted by the state of Maryland but not encouraged at the place of work is signing of certificates of incapacity. (A. Speer, personal communication, July 26, 2021). The primary physician and the psychiatrist sign the Maryland order for life sustaining treatment (MOLST) also and only encourage the NP to sign it if they are not available. This is a task that is authorized by COMAR regulations. 

How States Differ in Terms of Scope of Practice 

Different states have different prescriptive authorities and conditions that they give to their APRNs. There are those states that are referred to as independent states which allow APRN independent prescribing and there are those which do not, (Schirle & McCabe, 2016).  Barriers to practice are not uncommon even when the states are flexible, health care settings can still impose different strict policies and procedures. This leads to restriction of some aspects of patient care and limited access to providers despite the states having full practice authority, (Schorn, Myers, Barroso, Hande, Hudson, Kim & Kleinpell 2022). 

Impact on Professional Nurses across the United States. 

Some nurses have opted to relocate or work where there is more prescriptive authority. Some nurses also have opted not to relocate but get licensures in neighboring states that can give them more autonomy. There are also nurses who have opted to work in other areas where they are needed. These areas include working as lobbyists, researchers, nurse educators and consultants. In this aspect their full potential is more effectively utilized. 

References 

COMAR 10.27.07.00 (2020) Practice of the Nurse Practitioner​ , http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm 

Maryland.org (n.d), Division of state documents. http://www.dsd.state.md.us/COMAR/ComarHome.html 

Schirle, L., & McCabe, B. E. (2016). State variation in opioid and benzodiazepine prescriptions between independent and nonindependent advanced practice registered nurse prescribing states. Nursing Outlook, 64(1), 86–93. https://doi.org/10.1016/j.outlook.2015.10.003 

Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy, Politics & Nursing Practice, 23(2), 118–129. https://doi.org/10.1177/15271544221076524