NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

Walden University NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER  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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

 

Whether one passes or fails an academic assignment such as the Walden University   NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER 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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

 

The introduction for the Walden University   NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER 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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER 

 

After the introduction, move into the main part of the  NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER 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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

 

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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

 

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 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

Obesity is a critical public health crisis in the U.S. and despite policy interventions in the last two decades, more and more Americans are becoming overweight, threatening to increase their exposure and susceptibility to chronic health conditions like diabetes and hypertension. The increased prevalence of obesity is a concern not just in the U.S. but across the world with estimates from the World Health Organization showing that close to 1.9 billion individuals suffer from the condition. Obesity augments the risk for a host of lifestyle-related non-communicable diseases that include diabetes, cardiovascular ailments, stroke and hypertension as well as different types of cancers (CDC, 2022). Policy interventions are necessary in addressing the issue and generating possible solutions. The purpose of this paper is analyze existing policies on obesity prevention and reduction in the U.S. and their effectiveness using a policy analysis framework.

Part 1: Policy Definition & Description Analysis

i). Defining the Policy Issue

The Centers for Disease Control and Prevention (CDC) (2021) asserts that obesity prevalence in 2018 was 42% among the adult population. CDC notes that the obesity rates have been increasing since 2000 through 2018 from 30% to 42%. The rise also corresponds with the increase in the prevalence of severe obesity from 4.7% to over 9%. The implication is that about 100 million Americans, both adults and children, suffer from obesity, a situation that exacerbates the problem of healthcare cost burden. In her article, Newman (2019) observes that obesity entails increased financial cost with estimates from CDC showing that in 2008 alone, the country spent over $147 billion on the condition. In their study, Perez-Escamilla et al. (2021) examine the implementation of different policies aimed at preventing and controlling obesity in the United States and Latin America and the vital lesion for research and practice. The authors observe that while efforts and successes exist in addressing the issue of obesity across different areas of the Americas, many policy interv

entions like food-package labeling, and having open streets for play can have positive effects on the issue and allow communities to reduce the astronomical rates of obesity.

ii). Impacts on Policy Arena

Multiple stakeholders are making efforts to develop the most appropriate and effective models to controlling and preventing obesity. Currently, studies show that the use of multiple policy interventions could reverse the higher rates of obesity. In their study, Wang et al. (2020) note that despite different policy interventions and actions, the rates, trends and patterns of overweight, obesity, and severe obesity have been increasing and causing increased concerns among stakeholders. The authors also observe that wide disparities exist across groups as well as geographical areas. The study recommends the implementation of effective, sustainable and culturally-customized interventions to address the problem.

Policy considerations to reduce obesity include effective food-labeling and packaging requirements, regulations on food advertising, creation of public awareness and information provision about the risks and dangers of obesity, and innovative community-based programs like open streets to develop an environment that encourages outdoor activities for children and even adults. The implication is that policymakers will need to decide on effective approaches to reduce obesity across the health continuum and realization of the cultural aspects that can impact their effectiveness (CDC, 2022). Today, a majority of policy efforts focus on creation of public awareness through research evidence about the effects of overweight and obesity. These approaches define the current policy approaches in public health sector in the country at both state and federal levels.

Sample Answer 2 for NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

The provision of quality healthcare is the aim of the American government. Achieving this objective entails a consideration of a number of issues. One of them is increasing the number of people who are covered by the medical insurance schemes. The other one is increasing the affordability, availability, and accessibility of high quality care. There is also a need to improve the cost efficiency of healthcare services. Accordingly, the best available care should be provided with a focus on the optimization of the healthcare resources. In a bid to achieve these objectives, the Affordable Care Act was adopted in the US in 2010. The policy has been effective in delivering the objectives. The success can be seen from evidences such as increased insurance coverage for citizens, expanded accessibility of care, and reduction in costs of healthcare over time in the state (Morrison & Furlong, 2019). Despite these improvements, there have been policy recommendations to either repeal or replace the Affordable Care Act. Consequently, there is an increased need for the investigation of the effects, politics, and options associated with this policy. Therefore, this research paper explores the proposed policy to repeal or replace the Affordable Care Act. It explores aspects that include the definition of the policy issue, application of policy analysis framework, policy options, and building consensus on it.

Definition of Policy

The Affordable Care Act is perceived as one of the policies that have significantly shaped the healthcare system in America. The policy has expanded alongside improved insurance coverage in the U.S. in two mechanisms. Firstly, it has expanded the total number of citizens covered by the medical insurance. This has been achieved using Medicaid expansion and the provision of cost subsidies to those purchasing private insurance exchanges. The second way entails the fact that the policy has upgraded the scope of the coverage through its enhancement of benefit design (Willison & Singer, 2017). Despite these benefits, there have been policy initiatives aiming at the repeal or replacement of the Affordable Care Act. The first attempt to repeal the policy was between 2011 and 2012 where the Republicans and Democrats voted for the repealing of the Job-Killing Health Care Law act. However, the Democrats voted it down in the house of Senate, thereby, prompting Obama not to adopt the policy recommendations. The proposal was also unsuccessful despite the pressure from President Trump (Béland, Rocco & Waddan, 2016). Therefore, repealing or replacing the affordable Care act remains a hotly debated policy initiative for the Americans in the modern era.

The Effect of the Policy on the Policy Arena

The proposed policy on whether the Affordable Care Act should be repealed or replaced has significant effect on the policy arena. One of the health policy stakeholders that have been keen on the proposed policy is the American Association of Family Practitioners. According to a statement from the organization, it does not support the proposal since it violates the fundamental right to access to quality healthcare by the citizens. According to them, their organization strongly advocates patient access to primary medical care and healthcare coverage. It also strives to ensure that the high costs of healthcare are managed to increase the access of patients to their needed care (AAFP, n.d.). Therefore, they anticipate that repeal or replacement of the Affordable Care Act will worsen the existing disparities in access to healthcare.

The American Nurses Association has also provided their insights into the proposed policy. According to association, the Affordable Care Act should not be replaced or repealed. As cited in their response, the proposal would affect adversely the universal access to care by the citizens through high costs of healthcare (ANA, 2017). It will also hinder the optimization of the primary as well as community-based interventions that are utilized to promote health care access with cost-efficient innovative and value driven models of care.

It can be seen from the responses from the above organizations that the proposal to repeal or replace the Affordable Care Act has significant effects on the policy arena. Firstly, it increases the need for the exploration of alternative and sustainable models of improving access, coverage, and cost of healthcare in the US. Secondly, it raises the need for the policy makers to explore the ways in which the current provisions of the Affordable Care Act can be improved to achieve its goals. Lastly, it increases the relevance on the need for active stakeholder engagement in the exploration of the need to repeal or replace the Affordable Care Act.

Current Politics of the Issue

Currently, the status of the proposed policy to repeal or replace the Affordable Care Act is uncertain. The uncertainty arises from three main challenges that face its implementation. They include the issues that must be addressed in the regulatory implementation of the essential health benefits, barriers facing small group markets and individuals in most of the insurance exchanges, and the push for selling health insurance by the Trump administration across states. Generally, the Republicans support the initiatives that aim at repealing or replacing the Affordable Care Act. Their support can be seen from 2011-2012 where their proposal to repeal the Job-Killing Healthcare Law. In 2013-2014, they proposed an act that aimed at repealing the Patient Protection and Affordable Care Act. However, it was unsuccessful.

However, the Democrats have constantly opposed the move by the Republicans. According to the Democrats, repealing or replacing the act will result in significant adverse outcomes. One of them entails increasing the cost of care to the low-income earners in the country. They also argue that it will result in the potential collapse of the health insurance market in the U.S. Lastly, the proposal will lead to the elimination of the protections provided to the vulnerable in the country such as the mentally ill and elderly (Aron-Dine & Broaddus, 2018). Health organizations such as the American Nurses association and American Association of Family Practitioners have supported the bases of opposition by the Democrats. Consequently, it remains evident that replacing or repealing the act is only possible if sustainable, practical, and all-inclusive plan is introduced in the state.

Level of the Policy in the Policy Making Process

The establishment of a policy in any state undergoes several steps. They include policy building, formulation, adoption, policy implementation, evaluation of its effectiveness, and termination. The proposed policy to repeal or replace the Affordable Care Act has passed the building phase and is now at the formulation and adoption stage. The policy formulation and adoption stage is characterized by the policy makers coming up with an approach that can be utilized to solve a problem. There is active involvement of different stakeholders that include the executive branch of the government, interest groups, and the courts. Often, parties are invited to provide their views concerning the proposal. There is also the involvement of the president in the process. The Congress and the Senate are required to vote as a way of determining whether it should be adopted or not. The majority of the voters in both houses win and the proposal is either rejected or embraced. The proposal to repeal or replace the Affordable Care Act is at this stage. Different stakeholders have been invited to provide their views concerning it. The Senate and Congress have also voted to express their views on the issue. The president is also involved in determining the effectiveness and appropriateness of the policy.

Policy Analysis Framework

The framework for policy analysis by Morestin (2012) will be used in this research. According to the framework, policy analysis is done with a consideration of dimensions that include effects and implementation. The analysis of the effects of the policy focuses on aspects that include effectiveness, unintended effects, and equity. On the other hand, implementation focuses on aspects that include the cost, feasibility, and acceptability of the policy. Therefore, the aspects are evaluated in considering the policy in terms of social, ethical, legal, historical, and financial contexts.

Social

The adoption of any policy should promote social good. In relation to the model, the social effectiveness, unintended effects, equity, cost, feasibility, and acceptability of the proposed policy should be explored. The effectiveness of the policy mainly focuses on its effects on the health issue being explored. Repealing or replacing the Affordable Care Act is likely to increase the social costs of health. It will widen the existing inequalities in healthcare due to social determinants of health. It is also likely to increase the misrepresentation of the minority groups such as people of color in healthcare (Béland et al., 2016). Therefore, it is anticipated that the technical feasibility of the proposed policy is low due to it being socially unacceptable.

Ethical

Ethics mainly focuses on ensuring that one does what is considered socially and morally right. It encompasses the consideration of ethical principles such as justice, veracity, non-beneficence and maleficence, and informed consent. The proposed policy changes will promote a reduction in the spending of the state agencies on health. However, there are unintended consequences associated with the decision such as increase in the costs of healthcare, widening of disparities in healthcare, and limiting the availability, access, and affordability of primary care (Morrison & Furlong, 2019). The cost, feasibility, acceptability, and equity impacts of the proposal imply that it will be violating the fundamental rights of the American citizens to affordable, available, accessible, and quality healthcare.

Historical

The historical facet of the policy analysis explores the developments that have influenced the need for policy change. As shown earlier, the adoption of the Affordable Care Act has resulted in significant benefits that include increase in the populations covered by the medical insurance and elimination of barriers to healthcare. The policy has however experienced some challenges. They include the rising costs of healthcare incurred by the state despite the projections of reducing them with its use. Scholars are also concerned that the policy will not have the desired sustainability in the long-term. As a result, there is a need for either repealing or replacing the act. According to the framework by Morestin (2012), the weaknesses identified in the current policy should be considered in exploring the possibilities of policy changes in the future.

Financial Context

The financial context of policy analysis focuses on the cost efficiency and effectiveness of a policy. There is a need to focus on whether the policy has positive socioeconomic and political impacts. The earlier analysis has revealed that the proposed policy changes will increase the social costs of healthcare. There is anticipated rise in the spending incurred by the citizens in seeking the care they need. The financial feasibility and acceptance of the policy are also low (Glassman, 2017). Therefore, there is a need to consider these financial implications when embracing the policy.

Theoretical Underpinnings of the Proposed Policy

There exist theoretical underpinnings for the repealing or replacing the Affordable Care Act. One of them is the assertion that the act is increasing the cost incurred in healthcare rather than reducing it. For instance, it is projected that the cost of healthcare spending is expected to increase more than $1.8 trillion in the next decade (Senger, 2015). The act also has limiting payment reductions in its long-term projections. For instance, cutting the Medicare benefits by up to $700 billion by 2022 will affect adversely the ability of the elderly to access the care they need. There is also the assertion that the current policy has reduced the significance of the private insurance schemes. The introduction of benefit mandates in the new coverage schemes have led to health insurance cancellations for individuals who were privately insured. Lastly, the policy has not met its exchange enrollment targets. The policy was expected to cause a significant rise in the original projections in the enrollment rate to the medical insurance cover. However, this has not been the case since the enrollment has been below the projected targets (Senger, 2017). Therefore, it raises the concerns on the long-term sustainability of the policy in the state. The stakeholders of interest that have been actively involved in exploring the proposed policy change include the healthcare providers, health organizations, politicians, government, and non-governmental organizations. As shown earlier, the American Nurses Association has given its statement concerning the proposed policy change. Accordingly, it argues that the proposed policy changes limit equity in access to healthcare by increasing the costs of healthcare (ANA, 2017).

Policy Solutions

Three policy solutions can be embraced in relation to either repealing or replacing the Affordable Care Act. The first approach is not embracing any change on the current policy. This policy option assumes that the current state of the act should not be altered. It also assumes that the policy is effective in delivering its objectives. It therefore implies that there should be minimal advocacy efforts and leadership requirements in implementing the needed change. The focus should be on maintaining the existing state. The need for inter-professional collaboration is minimal since the stakeholders are satisfied with the policy. The benefits associated with this solution include minimal costs incurred in policy change, maintenance of status quo, and increased possibilities for the projected objectives of the policy being achieved (Glassman, 2017). However, it is associated with disadvantages that include the increased risk for continued rise in costs of healthcare, uncertainty in the future of the policy, and minimal or lack of inter-professional collaboration in analyzing the effectiveness of the policy.

The second option that can be considered is taking partial change. Here, some sections of the act can be repealed. A focus should be placed on improving the areas of the act that are prone to weaknesses and can undermine the sustenance of the policy. The assumptions in this decision are that some weaknesses exist in the policy that can affect its effectiveness. It also assumes that some components of the policy are likely to threaten the realization of the long-term goals of the policy. Therefore, there is a need for the adoption of transformative leadership approaches in implementing this decision. The focus should be on ensuring active stakeholder participation in the policy analysis. There is also a need for active inter-professional collaboration to ensure that the different views are taken into consideration in the policy making process. The benefit of this option is that the current policy will be strengthened by the elimination of its evident areas of weakness. It also empowers different professionals due to their active participation. However, the option is associated with the disadvantage of high costs and too much time needed for dialogue (Cohen et al., 2015). Despite these weaknesses, this option remains the most feasible intervention that can be used to improve the Affordable Care Act.

The last level of policy solution that can be embraced is radical change. The most effective option in this case would be replacing the Affordable Care Act with a new policy. The assumption in this option is that the act is ineffective. There exist alternative pathways that can be explored to increase health-related metrics in the US. The decision also assumes that the act is not sustainable in the long-term. This option requires significant advocacy interventions from the different stakeholders affected by it. There should be active stakeholder engagement to ensure that the new policy incorporates their diverse views. The leadership should also focus on ensuring sustainability of the new policy. It should be cost effective and practical in solving the issues in the current policy. This decision is associated with the benefit of possibly transforming healthcare positively by introducing new policies. However, it is expensive and requires more time for inter-professional collaboration. The decision also fails to improve on the weaknesses of the current policy. Therefore, rather than solving the uncertainty in some provisions, it is transferred to the new act (Cohen et al., 2015). This policy option is the least feasible among the three since radical policy change are difficult to be implemented in use.

Building Consensus

My recommended solution is the adoption of partial change. It is true that despite the affordable Care act being effective; it has some weaknesses that threaten its sustenance. The weaknesses can only be solved by repealing some of the sections and not replacing the act or taking no action. It is therefore recommended that two interventions that include use of open channels of communication and active stakeholder participation be utilized to build consensus. There should be open communication on the changes that should be made on the policy. The different views should be incorporated into the process of changing the current policy. There should also be active stakeholder engagement. The different stakeholders should be involved in exploring the most effective options that can be adopted to improve the policy. Active stakeholder participation will also promote their empowerment and ownership of the policy alongside the sustainability of the policy provisions.

Conclusion

In sum, the Affordable Care Act has brought significant transformations to the US healthcare system. Similar to other policies, it is prone to some weaknesses that might threaten its effectiveness. As a result, a focus should be placed on improving its areas of weaknesses rather than replacing it. The whole process can be a success if active stakeholder engagement and open communication systems are embraced.

 

References

AAFP. (n.d.). aCa Repeal/Replace. Retrieved on 9^th Feb. 2020 from https://www.aafp.org/media-center/kits/aca-repeal-replace.html

ANA. (2017). ANA Principles and Policy Priorities for Affordable Care Act, Replacement or Repair. Retrieved on 9^th Feb. 2020 from https://www.nursingworld.org/~4afd6b/globalassets/practiceandpolicy/health-policy/repair-repeal-positions-comments_2017mar.pdf

Aron-Dine, A. & Broaddus, M. (2018). Latest Republican ACA repeal plan would have similar harmful impacts on coverage and health as all the others. Retrieved on 9^th Feb. 2020 from https://www.cbpp.org/research/health/latest-republican-aca-repeal-plan-would-have-similar-harmful-impacts-on-coverage-and

Béland, D., Rocco, P., & Waddan, A. (2016). Obamacare wars: Federalism, state politics, and the Affordable Care Act. Kansas: University Press of Kansas.

Cohen, A. B., Colby, D. C., Wailoo, K., & Zelizer, J. E. (2015). Medicare and Medicaid at 50: America’s entitlement programs in the age of affordable care. Oxford: Oxford University Press.

Glassman, A. (2017). What’s In. Washington, DC: Brookings Institution Press.

Morestin, F. (2012). A framework for analyzing public policies: Practical guide. Centre de collaboration nationale sur les politiques publiques et la santé, Institut national de santé publique Québec.

Morrison, E. E., & In Furlong, E. (2019). Health care ethics: Critical issues for the 21st century. Burlington, Massachusetts, MA: Jones & Bartlett Learning.

Senger, A. (2017). 8 Reasons why Obamacare should be repealed. Retrieved on 9^th Feb. 2020 from https://www.heritage.org/health-care-reform/commentary/8-reasons-why-obamacare-should-be-repealed

Senger, A. (2015). Five reasons to repeal Obamacare. Retrieved on 9^th Feb. 2020 from https://www.heritage.org/health-care-reform/commentary/five-reasons-repeal-obamacare

Willison, C. E., & Singer, P. M. (2017). Repealing the affordable care act essential health benefits: Threats and obstacles. American journal of public health, 107(8), 1225.

Sample Answer for  NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

Policy analysis involves identifying possible policy options that can address a particular problem and then comparing the available options to select the most effective, efficient, and feasible. Performing the policy analysis ensures one has completed a systematic process to select the policy option that best applies to the specific situation. The first step in policy analysis is to research and identify potential policy options through literature review, environmental scan, and surveying best practices. The second step is to outline possible policy options, and the third is to rank the identified options and select the one that best suits the situation. The purpose of this paper is to analyze a specific policy of interest and utilize a policy analysis framework to identify the impact associated with implementing the policy.

Part 1: The Policy Issue

The policy issue of interest is Illinois HB3871 which creates the Safe Patient Limits Act. The proposed policy sets out the maximum number of patients allocated to a registered nurse (RN) in specific situations. It stipulates that nothing shall prevent a facility from assigning fewer patients to an RN than the limits stated in the Act (IL General Assembly, 2022). Besides, it lays down that nothing in the Act hinders the implementation of patient acuity systems that align with the nurse staffing by the Patient Acuity Act. Nevertheless, the maximum number of patients assigned to a nurse in the Act may not be surpassed, despite the use and implementation of any patient acuity system. Furthermore, the policy proposes that the Department of Public Health should create rules directing the execution and operation of the Act (IL General Assembly, 2022). The policy has as a condition that all healthcare organizations shall develop written policies and procedures that direct the training and orientation of nurses. Besides, no RN shall be designated to a nursing unit or clinical area unless the nurse has exhibited competence in providing nursing care in that area.

How the Issue Is Affecting the Policy Arena

The policy issue on mandate staffing ratios has dramatically affected the policy arena in Illinois. Nurses and professional nursing organizations are pushing state legislators to pass House Bill 3871. The proposed legislation will address the patient-nurse ratios, which have been a major concern in nursing practice, by setting a state-mandated maximum number of patients per nurse (Bartmess et al., 2021). Nurses believe that the Nurse Staffing Improvement Act of 2021 will foster solutions to staffing issues facing hospitals in Illinois. However, The Illinois Health and Hospital Association (IHA) mentioned that it does not champion the one-size-fits-all mandated nurse staffing ratios (Bartmess et al., 2021). This is because acute nursing shortages would make it challenging to adhere to the mandated ratios without risking a decrease in healthcare services.

The Current Politics of the Issue

The proposed policy has triggered heated political debates in Illinois, especially among proponents of the Bill. The Safe Patient Limits Act proponents have urged state legislators not to enact the Bill since it would impose needless and unworkable mandatory nurse staffing ratios at hospitals. Besides, they make a case that the nurse leaders and bedside nurses in hospitals, who have extensive training, knowledge, and experience, should be the individuals making staffing decisions for their facilities on how best to provide high-quality nursing care to patients. The crucial staffing decisions made every day at the hospital are best addressed at the local rather than the state level. Proponents further argue that healthcare facilities should be given the flexibility to establish appropriate staffing levels to meet patient needs. They should regularly track patient acuity and needs and act accordingly in the most clinically relevant approach. Besides, hospitals must be financially prudent, especially during the COVID-19 pandemic.

Level in the Policy-Making Process Is the Issue

The Safe Patient Limits Act was introduced in the House on February-19-2021, by Representative Fred Crespo [D]. It has a 25% progression. The Bill is currently pending in the Illinois House Rules Committee. Its last action was on 2022-03-16, whereby a Co-Sponsor, Rep. Delia C. Ramirez, was added.

Part 2: Application of a Policy Analysis Framework

A policy analysis framework is applied to identify possible policy options that can address a problem. This section will analyze the policy issue in the social, ethical, legal, historical, economic, and theoretical contexts. It will include stakeholders of interest and explore if there is a nursing policy/position statement on the health care issue.

Social

Nurse staffing is one of the crucial activities that occur in hospitals. The policy will positively affect patient care quality, patient satisfaction, patient outcomes, nurses’ satisfaction, and organizational well-being. However, mandate nurse staffing ratios may force hospitals to decrease or eliminate health services offered, like behavioral health (McHugh et al., 2021). Eliminating some of the services provided will affect individuals’ access, fostering their social well-being. Hospitals may also be forced to go on the emergency bypass when they do not have adequate nursing staff to meet the ratios, such as when there is an abrupt influx of patients in the Emergency Department or a particular unit.

 Ethical

The policy will ensure that a nurse attends to a specific number of patients and that nurses are not overworked. This will ensure the delivery of high-quality nursing care and promote patient safety by reducing missed nursing care and medication errors associated with high nursing workload and fatigue (McHugh et al., 2021). Therefore, the policy upholds the ethical principles of beneficence and nonmaleficence by promoting better patient care and reducing the risks of compromised patient safety. Nonetheless, Illinois faces a regional nursing shortage and will lose about one-third of the nursing workforce to retirement in the next ten years. The state does not have enough nurses to meet the nurse-patient ratio mandates. Thus, staffing ratios might only worsen the existing nursing shortage.

Legal

The proposed nurse staffing policy will help lower the lawsuits filed by patients against hospitals due to medication errors that cause adverse health outcomes. It will significantly improve nurse staffing in facilities and likely prevent thousands of medication errors, hospital-acquired infections, and mortalities (McHugh et al., 2021). These are the most causes of lawsuits against hospitals filed by patients when they feel that they were neglected.

Historical

The Safe Patient Limits Act is the same as the mandatory nurse staffing ratios proposal blocked in the 2019 and 2020 legislative sessions. Thus, if similar legislation has previously failed, there is a probability that this Act may not be enacted considering the heated political debates by proponents of the Bill.

Financial/economic

The policy will promote a high quality of nursing care and increased patient safety, which reduces the healthcare costs associated with treating complications and morbidities. The reduced healthcare costs will positively impact patients, healthcare organizations, and the Illinois healthcare system. However, mandate nurse staffing ratios will drive up healthcare costs in Illinois by approximately $2 billion per year for patients, families, employers, and healthcare organizations. This is because hospitals cannot absorb the substantial additional costs from nurse staffing ratios (McHugh et al., 2021). Besides, hospitals will be required to hire many more RNs to meet the ratios, which will result in staffing and financial cuts in other crucial areas such as hiring support staff.

Theoretical Underpinnings of the Policy

California is the only state that has enacted a mandate on nurse-to-patient ratios. There is a significant level of compliance with the standard staffing levels mandated by the California legislation for the nurses in the state. The lower patient-to-nurse ratios have been associated with significantly reduced patient mortality. Studies have found that California nurses report improved job satisfaction, reduced burnout, and a better ability to provide nursing care (Dierkes et al., 2022). However, there is no convincing evidence that enforcing mandatory nurse staffing ratios will enhance the quality of care or patient outcomes. Furthermore, Illinois excels better than California in various quality metrics.

Stakeholders of Interest and Nursing Position Statement

The stakeholders of interest in this policy include nurses, patients, nurse managers, healthcare leaders, professional nursing organizations, and the Illinois public health department. The Illinois Organization of Nurse Leaders (IONL) has released a position statement regarding the Safe Patient Limits Act. IONL states that it does not support a policy that mandates specific nurse-to-patient ratios for all healthcare organizations (IONL, 2019). IONL explained that, although many of the nurses’ staffing ratios seem appropriate on the surface, there is limited flexibility in their application based on staff, patient, and organizational factors (IONL, 2019). Ratios are illogical since they focus on the numbers of RNs and patients instead of patient needs, staff skills and experience, and the desired patient outcomes.

Part 3: Policy Options/Solutions

The policy issue can be addressed by partially changing the Bill to promote safe nurse-to-patient ratios but does not impose legislation mandating hospitals to have specific ratios. This is because staffing mandates come with a hefty cost of complying with the standards (Han et al., 2021). The policy options available to address this issue include mandating a staffing committee largely made up of RNs, mandating public reporting of nurse staffing levels, and enacting a Patient Acuity Act. The staffing committee option entails hospitals establishing a committee composed of at least 50% direct care RNs (Han et al., 2021). It also includes creating a nurse staffing plan that comprises a skill mix (customarily measured as the ratio of RNs to total licensed nurse staffing) per the patients’ needs. Unlike the approach to staffing ratios legislation that presumes all healthcare settings are the same, the staffing committee option addresses staffing levels more properly(Blankenhorn, 2018). It has frontline RNs engaged in planning and considering skill mix and patients’ needs in various settings.

Public reporting provides transparency on nurse staffing to the public. This allows healthcare consumers to choose hospitals with adequate staffing. Besides, it puts market pressure on hospitals with understaffing to improve their nurse staffing ratios. The basis of this method is that healthcare consumers will look for information on nurse staffing and utilize it when making decisions about the facilities to seek healthcare services (de Cordova et al., 2019). In states with public reporting, the law requires hospitals to report LPN staffing, though the public may not know the differences between RNs and LPNs.

Enacting the Patient Acuity Act entails mandating a staffing plan accessible by the public for each patient care area. A committee should create a plan that comprises at least 50% of bedside nurses (Meaghan, 2018). The committee should meet at least biannually to achieve the following: assess, review, modify, and develop the staffing plan for each unit as per the usual patient population, staff factors, and unit and organizational factors. The staffing plan entails modifying staffing by shift, depending on patient acuity and other factors, to meet patients’ needs and expected outcomes (Juvé-Udina et al., 2020). Unlike the Safe Patient Limits Act, the control for the staffing decisions in the Patient Acuity Act is at the facility unit level, with input from staff and leaders to provide optimal and safe patient care.

Health Advocacy Aspects and Leadership Requirements

Each proposed option will need advocacy strategies to push state legislators to include it in the Safe Patient Limits Act to change it partially. The advocacy aspects of each of the three options will include providing professional and clinical education to nurses and other healthcare professionals on how the approaches should be implemented and the pros and cons of implementing each (Han et al., 2021). Furthermore, advocacy will involve educating state legislators about these solutions since they will be key entities in enacting the policy. Advocacy can be taken up by individual nurses, nursing organizations, and healthcare organizations. Additionally, strong leadership will be required to steer the options during the legislation. Leaders will need to be transparent when providing public reports and staffing plans.

How Each Option Provides an Opportunity or Need For Inter-Professional Collaboration

The staffing committee allows inter-professional collaboration since direct care nurses will collaborate with nurse managers and healthcare leaders when developing staffing plans in the nursing care committees (Blankenhorn, 2018). Besides, public reporting avails an opportunity for inter-professional collaboration since healthcare professionals from different cadres will collaborate in identifying ideas on how to improve staffing and the quality of patient care (de Cordova et al., 2019). Nurses can also team up to identify approaches to improve staff nursing levels in the different hospital units. Furthermore, enacting a Patient Acuity Act will promote interprofessional collaboration through the committee that includes bedside nurses and other professionals involved in creating staff plans (Meaghan, 2018).

The Pros and Cons of Each Suggested Change

The advantage of mandating a staffing committee is that it considers skill mix and patient needs in different healthcare settings. Besides, the staffing committees advocate for patients’ rights by demanding safe staffing from hospitals’ leadership. However, the staffing committee laws may not contribute to higher RN staffing since this depends on the nurses’ power within a facility (Blankenhorn, 2018). In addition, this option does not give the staffing committee control over the organization’s budget. Therefore, if there are inadequate resources, committees may be compelled to plan cuts instead of increases. The pros of mandate public reporting are that it positively impacts the quality of care and costs. However, the impact on nurse staffing is less clear (de Cordova et al., 2019). Besides, there is no standardization on public reporting requirements, nor where individuals can access the information.

The advantage of acuity-based staffing is that it maximizes patient and nursing outcomes through improved decision making, enhances operational outcomes and improves nurse and patient satisfaction while improving financial performance through reduced healthcare costs (Juvé-Udina et al., 2020). Nevertheless, it can create a data-entry burden if there is no link to monitor data entry and storage, meaning that data must be collected manually.

Part 4: Building Consensus

The recommended option to address the policy issue of the Safe Patient Limits Act is through staffing committees. The plan for consensus-building includes having informal, face-to-face interactions with state legislators. The plan will take five steps. The first step will involve initiating a consensus-building process using stakeholder assessment. The assessment findings will guide on whether to proceed or not. If the option is to proceed, the next step will be to begin a joint-fact finding process to address complex scientific and technical questions about implementing staffing committees (Choi et al., 2020). The next step will involve the legislator and me making major contributions to attaining agreed goals. This will be by preparing adequately, focusing on interests, exploring other options without committing, and coming up with shared criteria to guide decision-making (Choi et al., 2020). The last step will be to reach an agreement after joint fact-finding, clarifying interests, brainstorming to identify other options, and creating multiple proposals for each possible option.

Conclusion

When conducting policy analysis, one should consider feasible policy options and establish if they will work effectively in the situation. The policy issue of interest is the Safe Patient Limits Act which sets out the maximum number of patients designated to an RN in specific situations. Political proponents of the Bill argue that a one-size-fits-all numerical method to nurse staffing takes away decision-making autonomy and flexibility from healthcare professionals. The identified policy options available to address the policy issue include mandating a staffing committee, public reporting of nurse staffing levels, and enacting a Patient Acuity Act.

References

Bartmess, M., Myers, C. R., & Thomas, S. P. (2021, July). Nurse staffing legislation: Empirical evidence and policy analysis. In Nursing Forum (Vol. 56, No. 3, pp. 660-675). John Wiley & Sons, Ltd. https://doi.org/10.1111/nuf.12594

Blankenhorn, A. (2018). Staffing committees: A safe staffing solution that includes engagement: With nurse input, this hospital strives for staffing satisfaction. American Nurse Today, 13(3), 56-58.

Choi, M., Kim, M., Kim, J. A., & Chang, H. (2020). Building Consensus on the Priority-Setting for National Policies in Health Information Technology: A Delphi Survey. Healthcare informatics research, 26(3), 229–237. https://doi.org/10.4258/hir.2020.26.3.229

de Cordova, P. B., Pogorzelska-Maziarz, M., Eckenhoff, M. E., & McHugh, M. D. (2019). Public Reporting of Nurse Staffing in the United States. Journal of nursing regulation, 10(3), 14–20. https://doi.org/10.1016/S2155-8256(19)30143-7

Dierkes, A., Do, D., Morin, H., Rochman, M., Sloane, D., & McHugh, M. (2022). The impact of California’s staffing mandate and the economic recession on registered nurse staffing levels: A longitudinal analysis. Nursing Outlook, 70(2), 219–227. https://doi.org/10.1016/j.outlook.2021.09.007

Han, X., Pittman, P., & Barnow, B. (2021). Alternative Approaches to Ensuring Adequate Nurse Staffing: The Effect of State Legislation on Hospital Nurse Staffing. Medical care, 59(Suppl 5), S463–S470. https://doi.org/10.1097/MLR.0000000000001614

Juvé-Udina, M. E., González-Samartino, M., López-Jiménez, M. M., Planas-Canals, M., Rodríguez-Fernández, H., Batuecas Duelt, I. J., Tapia-Pérez, M., Pons Prats, M., Jiménez-Martínez, E., Barberà Llorca, M. À., Asensio-Flores, S., Berbis-Morelló, C., Zuriguel-Pérez, E., Delgado-Hito, P., Rey Luque, Ó., Zabalegui, A., Fabrellas, N., & Adamuz, J. (2020). Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison. Journal of nursing management, 28(8), 2216–2229. https://doi.org/10.1111/jonm.13040

IL HB3871 | 2021-2022 | 102^nd General Assembly. (2022, March 16). LegiScan. Retrieved May 14, 2022, from https://legiscan.com/IL/bill/HB3871/2021

IONL. (2019). IONL Position Statement Nurse Staffing/Ratio – Matching Nursing Resources with Inpatient Needs. https://cdn.ymaws.com/www.ionl.org/resource/resmgr/policy_and_advocacy/

McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet, 397(10288), 1905-1913. https://doi.org/10.1016/S0140-6736(21)00768-6

Meaghan, O. K. (2018). Practical steps for applying acuity-based staffing. American Nurse Today, 11(9).

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 8100 Assignment 3: Policy Analysis Paper [Major Assessment] ANSWER

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Important information for writing discussion questions and participation

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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource