NURS 8100 Discussion: Policy Brief
By Day 3
Post in your small group thread a cohesive response that addresses the following:
- Briefly summarize the policy proposal you selected from the IOM Future of Nursing Practice Report Brief (Application 2). Based on your analysis of the policy proposal, did the IOM get it right?
- Identify any professional organizations dealing with the issue/recommendation and provide at least two specific ways in which the professional organizations have supported or could support the policy proposal/recommendation.
Read a selection of your colleagues’ postings.
Hello group
The Institute of Medicine (IOM) recommendations asserted the need to transform the work environment, the scope of practice, education, and numbers of America’s nurses by creating a health care system that delivers the right care quality care, patient-centered, accessible, evidence-based, and sustainable at the right time (Peterson, 2017). The IOM noted that even though the APRNS possessed higher and improved levels of education and training, the healthcare industry was not tapping into their total capacity, education, and immense potential to lead innovative strategies. Despite meeting these national standards, the APRNS were denied full practice authority for reasons unrelated to their ability, education or training, or safety concerns, but due to political decisions, and inconsistencies in different state laws (AANP, 2021). The States and insurance companies were to follow through with specific regulatory, policy, and financial changes, to provide patients with the right providers, including APRNs who best meet their health needs. The removal of the regulatory policies and financial barriers with the goal to promote patient choice, and patient-centered care, was recommended as the needed base in the building of a reformed health care system (Stevens, 2013). In response to these recommendations, the Robert Wood Johnson Foundation, AARP, and the AARP Foundation all joined forces and created the Future of Nursing, a group, the Campaign for Action. The group worked in each state to catalyze nurses, health providers, consumers, educators, and businesses, to strengthen nursing in a variety of areas (Altman et al., 2016). The World Health Organization (WHO) also impacted the IOM recommendations in March 2020 when it declared COVID 19 a pandemic, for which the entire world was unprepared. This disease disrupted organizations and systems worldwide, but caused the most rapid delivery system redesign and health policy implementation ever in American history, as twenty-two state governors temporarily waived the physician supervision of the NPs. This allowed them to practice to their fullest extent, to expand much-needed care access. “a multi-pronged liberalization of nurse practitioner scope of practice, ever unprecedented in the United States” (O’Reilly-Jacob, et al., 2022).
References:
Altman, S. H., Butler, A. S., & Shern, L, (2016). Assessing Progress on the Institute of Medicine Report The Future of Nursing. Washington (DC): National Academies Press (US); 22. 2, Removing Barriers to Practice and Care. Available https://www.ncbi.nlm.nih.gov/books/NBK350160/
American Association of Nurse Practitioners (2021). Issues at a glance: Full practice authority. https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
O’Reilly-Jacob, M., Perloff, J., Sherafat-Kazemzadeh, R., & Flanagan, J. (2022). Nurse practitioners’ perception of temporary full practice authority during a COVID-19 surge: A qualitative study. International Journal of Nursing Studies, 126, 104141. https://doi.org/10.1016/j.ijnurstu.2021.10414
Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.
Stevens, K., (May 31, 2013) “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas” OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 4.
The Institute of Medicine (IOM) Future of Nursing Report Brief addresses four very important elements of nursing practice that are in need of change. According to Kershaw (2011), the four areas of needed change include nurses practicing to the fullest scope of their license, nurses engaging in seeking and attaining higher levels of education, nurses being considered as equals with their physician colleagues when taking the initiative to redesign health care, and nurses creating a foundation of data through research and evidence-based practice to support policies and procedures in nursing practice.
The area of specific interest to me is item number three. This initiative focuses on nurses becoming full partners with physicians when redesigning healthcare in the United States (Kershawm 2011). The reason this initiative is important to me is that I work in an acute care setting where physicians are still revered as gods by the hospital leadership and nurses are considered the handmaiden to the physician. It is a large hospital but set in a rural community and the founding fathers who opened the community hospital 16 years ago (Now part of a larger system) were very physician-focused. The bylaws do not promote employing mid-level practitioners, they do not recognize that certified nurse-midwives can practice independently, and have a strong working relationship with a Kaiser Permanente group that feels very threatened by the thought of utilizing mid-level providers and advance practice nurses (APNs). According to Abraham et al. (2019), APNs are far more cost-effective than physicians, and they increase patient experience scores and clinical outcomes. Constable et al. (2022) describe an increase in provider communications scores from 69% to 85% when APRNs were used in the acute care setting. This specific article also outlined a reduction in endotracheal tube-associated pressure injuries by 50% because of the care the APN provided to this population. The reason for this is that APNs are trained to treat patients holistically and not be solely focused on a diagnosis or disease. Physicians are trained with a primary focus on disease. Collaboration between these two groups is essential when health care reform is being considered.
The IOM report brief nailed this issue on the head. There is a need to include APNs in health care reform and the recommendation in the article suggests this will happen through leadership training and the attainment of leadership competencies by all APNs. The American Organization of Nurse Executives (AONE) offers leadership training for all levels of nurse leaders. The sole focus of the AONE is to promote leadership excellence among nurses, advance the practice, increase the engagement of research by nurses, and facilitate the preparation of nurses who will influence legislation and public policy (www.aha.org). For far too long the shape of health care has been formed by only a select portion of the population who provides it. Now is the time to think globally about healthcare reform and invite all of the contributors to the table.
References:
Abraham, C. M., Norful, A. A., Stone, P. W., &Poghosyan, L. (2019). Cost-Effectiveness of Advanced Practice Nurses Compared to Physician-Led Care for Chronic Diseases: A Systematic Review. Nursing Economic$, 37(6), 293–305.
American Organization of Nurse Executives. (February, 2022). AHA releases 2022-2024 strategic plan and updates to vision and mission statements. Retrieved: https://www.aha.org/special-bulletin/2022-02-08-aha-releases-2022-2024-strategic-plan-and-updates-vision-and-mission
Constable, M., Mulkey, M., &Aucoin, J. (2022). Hospital value–based purchasing: How acute care advanced practice nurses demonstrate value. Journal of the American Association of Nurse Practitioners, 34(1), 12–17. https://doi.org/10.1097/JXX.0000000000000606
Kershaw, B. (2011). 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
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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
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Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
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