NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation

Similarly to how we have previously discussed RNs and APRNs involvement in policy making, these nurses are in the position to also have the opportunities to actively participate in policy-review. Nurses have more of a voice than some may believe. Having the most face to face interaction with patients gives them the leverage to be familiar with patients and are able to give their input of knowledge, experience, and skill set. There are different ways that nurses may actively participate in policy review at any level. Joining professional nursing organizations will boost the nurses credibility and give them more of an opportunity to be part of policy review. There are hundreds of professional nursing organizations ranging from state to federal levels (nurse.org, 2021) NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. Within these nursing organizations, the goal is to ensure that any policies that are going to be implemented will be beneficial for nurses. To ensure that new policies are favorable for nurses, a review process or policy-review must take place within the organizations giving nurses the chance to participate in such matters. The professional nursing organizations are important for generating new ideas and proactive work needed to maintain a health profession that advocate the needs for patients and nurses (Matthews, 2012). With the collaboration of the organization, reviewing the policy as a team will ensure that only the best and most beneficial policies are implemented. 

NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation Regardless of a nurses ranking within their workplace, taking part of policy-review is an obtainable goal. As stated above, nurses have a much larger voice than some think. Within the workplace is a fantastic way for nurses to get their feet wet in policy-review I order to gain experience in this realm and be able to take it to much higher levels like federal policies. Nurses are the most familiar faces to patients within the healthcare system and therefore should be the biggest advocate for these patients. Being able to be part of the policy-review process within the workplace is crucial to the best patient outcomes and care. Although the final decision will come from those holding a higher position, this does not mean that nurses are not a critical piece to this team. Nurses are able to request a review of a policy that they don’t deem to promote quality care, thus preventing such policy from being implemented at that time. This gives the nurse a chance to add input as to how this policy could be improved or changed. With the hands on experience that nurses possess and the amount of face to face interaction with patients they have, nurses are able to determine what will work and what will not NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. 

With the great opportunities to participate in policy-review also comes challenges nurses may face. When it comes to professional nursing organizations, joining the organization may be the biggest challenge. Some organizations require an extensive process and review in order to accept new nurses into their program thus deterring many nurses away from joining. This obstacle could be overcome by creating an easy to join process with workers whom help with the onboarding process. Nurses have enough stress on their plate, so joining a nursing organization for the benefit of their career should not add to this. Making it easy to join with the appropriate credentials and experience would surely help. Being part of policy-review in the workplace faces its own challenges as well. An obstacle that a nurse could face is not being entirely familiar with the updated set of policies and rules within their own workplace. This must be firmly understood as a baseline before you can think of beginning new policy changes and reviews. Within the workplace, no matter what career path you are in, you may experience poor leadership. If this is the case, a major obstacle may stand in your way from being part of policy-review. A good leader would promote team input for decisions to be made. This is not always the case with every leader. Poor management may cause a blockade when it comes nurses having a voice NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. 

 Now making these opportunities known to more nurses may be difficult. Ways that I believe could promote nurses to participate in policy review is by providing training classes or in services within their facilities to provide the knowledge necessary about what goes on beyond the bedside. Educating nurses within facilities about the policies and regulations already in place will give the nurses a better understanding while simultaneously cause better patient care within the regulations per that facility. Another way for better communication of these opportunities for nurses is to climb the ranks of these professional nursing organizations or have a good rapport with those in leadership positions so you can actively advocate the nurses role in policy-review. Contrary to what I stated earlier, good leadership will be extremely beneficial for everything within the workplace including the ability for communication to employees and the joint efforts in policy-review NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. 

References 

Matthews, J., (2012, January 31). Role of professional organizations in advocating for the nursing profession. https://pubmed.ncbi.nlm.nih.gov/22320879/

Nurse.org.(2021). List of Nursing Organizations. https://nurse.org/orgs.shtml

Michael

Good point when listing off various nursing organizations NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. They can be extremely helpful when it comes to nurses interacting in the political sphere and in policy review. Many of the websites of these nursing organizations also describe how nurses can specifically get involved in policy review through those organizations. For example, the AANP allows nurses to communicate with policymakers through their AANP Advocacy Center on their website (American Association of Nurse Practitioners [AANP], n.d.). This can add valuable information to the nurses’ knowledge on policies and evaluation. Nurses who may not be aware about how to get involved in policy evaluation can get information through these various nursing organizations. As you said, there is the issue of planning when it comes to proper healthcare policy evaluations. In fact, time constraints are actually included in some of the main difficulties that nurses have when it comes to joining nursing organizations (Walton, 2017). I believe that with the proper knowledge and if nurses understand that they can devote whatever time they can, they can be successful. Another way around the timing and planning issues when it comes to policies is in some cases, participation in policy review can actually be included in CEUs. That way, nurses can both participate in policies and policy review and also get credits that they must get every year to keep their licenses and add on to their nursing lifelong knowledge NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. For example, one way that nurses can participate in policy analysis and review is through the annual Policy Summit that is held annually by the American Association of Colleges of Nursing (AACN). The AACN allows nurses to have direct contact with congressional offices and be involved in the policy process, whilst also obtaining CEUs (AACN, 2019).

References

American Association of Colleges of Nursing. (2019). Policy and advocacy. American Association of Colleges of Nursing: The Voice of Academic Nursing. https://www.aacnnursing.org/Policy-Advocacy/Get-Involved/Student-Policy-Summit

American Association of Nurse Practitioners. (n.d.). AANP federal Policy Priorities. https://www.aanp.org/advocacy/federal/federal-issue-briefs/aanp-federal-policy-priorities

Walton, K. R. (2017). Barriers to membership in a professional organization for advanced practice nurses. Walden University. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=5287&context=dissertations#:~:text=For%20example%2C%20most%20of%20the,Rapp%20%26%20Collins%2C%201999)

 Nurses need to be aware of the current health policy issues, the process necessary to make change happen. They also need advocacy groups for nursing and advanced practice nursing to remove barriers and support policies that will allow them to provide the best care to their patients. Evaluation of service delivery is an essential aspect of nursing practice. Service evaluation is increasingly used and led by nurses, who are well placed to evaluate service and practice delivery. ( Moule, P et al. 2017). Evidence-based practice promotes the quality and cost-effectiveness of healthcare and should be based on the best available evidence and patient preference and take account of clinical judgment ( Schmidt and Brown 2011 ). Evaluation is essential in healthcare because it supports an evidence-based approach to practice delivery ( Moule et al., 2017 ). It is used to assist in judging how well something is working. Nurses are positioned to evaluate their services and practice to develop an evidence base for effective care delivery. Nurses work with patients; they know the specific needs of the communities they serve, making them great advocates for them. Another way nurses and ARNP can participate in policy evaluation is through their place of employment NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation.

The Journal for Nurse Practitioners indicates that nurses play an integral role in changing health policy on multiple levels. However, there are several reasons for the limited nursing participation and challenges in policy and politics. Lack of education, inadequate skills, and little opportunity for involvement are just a few factors. In addition, resources are further obstacles to the nursing profession’s participation in politics because studies show that nurses do not have sufficient support to generate the evidence needed to influence healthcare policy. Another challenge would be workplace kickback during a policy review/evaluation and going to several administrations to make effective change, hence making the process complex.

Moreover, nurses need support to make changes, and this support starts at home. Families and friends of nurses need to encourage political activism. Nursing schools need to include healthcare policy education as part of the curriculum and promote some level of political involvement from nursing students. Furthermore, the faculty of nursing schools should also participate in policy changes, thereby acting as role models for their students. Finally, employers need to provide staff nurses with training programs, resources, and opportunities to influence policy involvement because healthcare legislation affects us. Something as simple as exercising the right to vote can impact healthcare policy NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation.

Reference;

Moule, P., Armoogum, J., Douglass, E., & Taylor, D. J. (2017). Evaluation and its importance for nursing practice. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 31(35), 55–63. https://doi-org.ezp.waldenulibrary.org/10.7748/ns.2017.e10782

ANA. (n.d.). Health Policy – American Nurses Association (ANA). Retrieved April 22, 2020, from https://www.nursingworld.org/practice-policy/health-policy/

Chilton, L. (2015). Nurse Practitioners Have an Essential Role in Health Policy. The Journal for Nurse Practitioners, 11(2), A19. https://doi.org/10.1016/j.nurpra.2014.10.009

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Participation in Policy Review

Advanced Practice Registered Nurses (APRN) and Registered Nurses (RN) should participate in policy review since they are directly and indirectly affected by resulting health policies. RNs and APRNs can take advantage of the opportunity of the increased nurse shortage to gain a foothold in greater participation in the policy review (Alhassan et al., 2019

The first opportunity that exists for RNs and APRNs in Policy Evaluation is through their professional organizations. The professional nursing organizations that can assist the RNs and APRNs in getting their voices heard in policy review are the American Academy of Nursing, Emergency Nurses Association, and American Nurses Association (Williams et al., 2018). During policy planning, implementation, and evaluation, the professional nursing organization ensures that the nurses’ needs and interests are properly understood and incorporated.

The second opportunity for RNs and APRNs is through their workplaces (Alhassan et al., 2019. Through the workplaces, the nursing professionals can evaluate the policies as they are implemented in practice.

NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation It is the nurses – at their workplaces – that know what will work and what will fail regarding the proposed healthcare policies (Williams et al., 2018). The RNs and APRNs may also take leadership positions at the workplace to influence these policy reviews and evaluation processes.

The main challenges associated with the first opportunity – professional organizations – include the complex processes involved in becoming members. In addition, these organizations are often characterized by unclear and disjointed leadership processes. Alhassan et al. (2017) claim that the leadership processes of these organizations need to be reformed to stay responsive to the participatory needs of the members. The challenges may be overcome by creating well-understood and straightforward strategies for joining and remaining active in the professional bodies. For the workplaces opportunity for RNs and APRNs, the main challenge revolves around the nurses’ poor training and experimental knowledge repository, especially concerning the policies (Williams et al., 2018). These nurses are often poorly equipped with knowledge regarding the newly emerging policies and changes in their practice. Nurses are, furthermore, often disunited and unaware of the goals and values of their organization and their nursing practice. These challenges at the workplace may be overcome through proper leadership and the promotion of continuous learning processes in practice.

The two strategies that may assist in promoting and leveraging these opportunities to address policy review are training of the nurses and good leadership. Effective leadership should be employed within healthcare organizational structures to alleviate practitioners’ challenges from actively participating in the policy review. The top management should encourage education, knowledge, and understanding of policy processes and the importance of incorporating RNs and APRNs into the policy development processes (Shariff, 2014). Using information gathered first-hand and policy review, they are better poised to improve the overall healthcare position.

Effective and efficient training processes within the nursing environments are also crucial in improving the nurses’ participation in the policy review. For instance, these nurses may be encouraged to attend nursing workshops and share their nursing experiences with fellow practitioners from other centers (Shariff, 2014). Such co-sharing of nursing knowledge may assist in understanding the policy recommendations and the gaps and evaluation strategies of such knowledge. In addition, RNs and APRNs are involved in a profession that requires continuous and purposeful learning while actively engaging with policy and practice-based experiences. Nursing leaders must therefore create platforms to onboard nurses into leadership roles. Within these roles, nurses will become knowledgeable in organizations’ managerial and strategic objectives to better inform opinions on what improvements could improve policy outcomes (Williams et al., 2018).

References

Alhassan, A., Kumi-Kyereme, A., Wombeogo, M., & Fuseini, A. (2019). Nurse Participation in Political Activities: Level and Practices of Registered Nurses in Tamale, Ghana. OJIN: The Online Journal Of Issues In Nursing, 24(2). https://doi.org/10.3912/ojin.vol24no02ppt63

Shariff, N. (2014). Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development. BMC Nursing, 13(1). https://doi.org/10.1186/1472-6955-13-20

Williams, S., Phillips, J., & Koyama, K. (2018). Nurse Advocacy: Adopting a Health in All Policies Approach. OJIN: The Online Journal of Issues In Nursing, 23(3). https://doi.org/10.3912/ojin.vol23no03man01

Hi Lucy

Good post

That was informative post. Also, many of the leading nursing organizations promote active participation by nurses in policy formulation. Many of the nursing organizations state wide promote nursing education and help nurses in the process of attaining higher educational standards. Education and knowledge help nurses to become aware of existing healthcare policies and understand what needs to be amended for better treatment and patient outcomes. Nurses are also invited to leadership positions as they work alongside with healthcare institutions or organizations (Milstead & Short,2019).

This gives nurses the opportunity to become knowledgeable about health care policies at the national and global level and contribute to policy making and evaluations more effectively. Nurses are encouraged to obtain leadership training and interprofessional learning which can contribute to advance nurses in roles of advocacy and quality improvement, it also provides an opportunity to healthcare programming and policy reviewing (IOM,2010) NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation.

Reference

Institute of Medicine (IOM). (2010). Future of nursing 2010 report. Retrieved from, https://campaignforaction.org/resource/future-nursing-iom- report/

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Healthcare policy evaluation, or policy review, has become more critical as policymakers have realized that decisions and proposals have consequences that affect the health status of citizens (Milstead & Short, 2019).  For this reason, healthcare providers must take an active role in developing, implementing, and reviewing healthcare policy to evaluate the impact of the policy.

There is a vast amount of opportunities for registered nurses (RNs) and advanced practice registered nurses (APRNs) to become involved in healthcare policy review.  It is recommended that nurses are introduced to healthcare policy review and development at the organizational level (Ellenbecker et al., 2017).  By staging the nurse’s involvement in policy development, including review, they are better able to comprehend the policy process and are better prepared to influence policy.  Policy review at the organizational-level can be as simple as taking an active role on a policy review committee, or even starting policy change on a departmental level through staff meetings (Ellenbecker et al., 2017).

Another opportunity for nurses to influence policy through review and development is through a professional organization.  Professional organizations have strong financial backing, existing resources, and can complete much of the research to make a positive change in healthcare policy.  By joining a professional organization, nurses can be well educated on healthcare policy and may receive updates regarding important policy issues (Hader, 2012).

There are challenges in policy review in any setting.  One of the more common problems is the method for review.  According to Milstead and Short (2019), many organizational policy discussions are word of mouth or “water cooler” talks.  Policy review in such an informal setting is usually negative and not successful.  It’s important to develop an organized review plan to remedy this problem.  Structuring the review committee with a chairperson, or team leader, and operating the review sessions as an organized group can lead to a productive review session.

Another area where nurses may encounter challenges in reviewing policy is related to accurate data.  As with any other profession, nursing requires data to make appropriate decisions.  Collecting and gathering this data requires time, effort, and in some instances, money.  These resources may prove challenging to obtain, which can hinder policy efforts.  To remedy this, it is crucial that the committee fairly delegates many of these tasks and maintain reasonable expectations.

To advertise or communicate these opportunities, nurses hoping to influence policy can write to their local professional organization with information regarding the proposed review group, providing contact information to allow contact with other individuals interested in the policy review.  Another method of communicating the availability of a review group is through an organizational newsletter.  Most facilities provide a periodical newsletter or email memo.  Providing information about this proposal and review groups mission through the memo or newsletter may influence others to become involved in the group NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation.

References:

Ellenbecker, C., Fawcett, J., Jones, E., Mahoney, D., Rowlands, B., & Waddell, A. (2017). A Staged Approach to Educating Nurses in Health Policy. Policy, Politics, & Nursing Practice, 18(1), 44-56. doi:10.1177/1527154417709254

Hader, A. (2012). Advocating through Nursing Specialty Organizations. Perioperative Nursing Clinics, 7(4), 433-436. doi:10.1016/j.cpen.2012.08.003

Milstead, J., & Short, N (2019). Health policy and politics (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Opportunities to participate in policy and practice legislation may seem foreign to many bedside practicing nurses.  Availability for nurses have the opportunity to lend expertise to the nursing scope of practice when participating in educational policy exist in many forms (Jurns, 2019). Reviewing educational and practice policy’s assist with creating and enhancing nursing practice (Beasley, Farmer & Nunn-Ellison, 2019). Nurse education legislation is critical to shaping the future of the nursing profession. Nurses must self-educate on policy process to understand how to participate. Nurses also must priorities making time to make change in healthcare by participating in policy practices.

References

Beasley, S. F., Farmer, S., Ard, N., & Nunn-Ellison, K. (2019). A Voice in the Accreditation Process: The Role of the Peer Evaluator. Teaching & Learning in Nursing, 14(4), A3–A5. https://doi-org.ezp.waldenulibrary.org/10.1016/j.teln.2019.06.001

Jurns, C. (2019). Policy Advocacy Motivators and Barriers: Research Results and Applications. Online Journal of Issues in Nursing, 24(3), N.PAG. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol24No03PPT63

I agree, most nurses are already pulled in too many directions at baseline. We need to incorporate legislative participation in our work schedule.

               Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) play an integral part of policy forming and implementation in the hospital setting. Nurses are typically well versed in the evaluation phase of their assessment. Regardless of their expertise and experience they usually understand this phase well. This is a task that is highlighted in nursing school as one of the major pieces of the nursing process along with assessment, planning and implementation (Millstead & Short, 2019).  Two opportunities that exist currently for nurses to participate in policy review is by joining a committee at their organization that is based around policy forming and review. Another opportunity that exists is advocating for policy review within a nursing organization and using the resources they have available (ANA, n.d.).

Challenges exist for RNs and APRNs during the review process of policies.  Many organizations have a standard procedure that is to be followed when forming and putting new policies into place. This can be a lengthy process as well as a forced process due to the pressure from some stakeholders (Millstead & Short, 2019). Often, policies are formed under pressure due to an error that has happened that did not have a policy in place to support it. It is important to slow down and for every key member to understand that policy forming and implementation do not happen overnight. There must be a systematic approach to forming a policy. Something that can help with this is to have a “champion” or lead in the policy group. They should keep the group focused and have an outlined timeline of steps to complete prior to implementation.

Another challenge the evaluation phase can bring to light is ethical considerations. To avoid these types of challenges, nurses can use resources from organizations like the American Nurses Organization and the Center for Disease Control (CDC) who have published guidelines and programs that target overcoming ethical challenges (Millstead & Short, 2019). Thoughtful preparation of policies can help with the complexity of policy review.

References:

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved October 27, 2021, from https://www.nursingworld.org/practice-policy/advocacy/.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Hi there Betsy! Thank you for the great post!

I very much agree with you that RNs and APRNs are integral to policy formation and implementation in the hospital setting, and that policy evaluation is similar to the nursing process.

Milstead and Short (2017) describe how policy review is,

Like the nursing process, which is intended to ensure safe and effective patient care, create and facilitate excellent health professional academic and training programs, and ensure reliable research data and dissemination, qualitative and quantitative program evaluations are integral to effective policy and programming. (p. 117).

The first opportunity you mentioned for RNs and APRNs to participate in policy review at their workplace organization, is something that I don’t really feel is promoted at my workplace. It would make sense for hospital facilities to promote nursing participation in policy review, but hospital facility administrators seem to be perhaps more focused on evidence-based research review on focused hospital-acquired conditions such as VAPs, CLABSIs, and CAUTIs.

I do also concur with your suggestion of RNs/APRNs participating in policy review, by joining a professional organization such as the American Nurses Association (ANA). The ANA has a political action team that meets with legislators with whom they can collaborate on healthcare-related issues. (ANA, n.d.).

ANA leadership, its members, and staff continuously develop new and evolving legislative priorities while ANA’s federal lobbyists work in a bipartisan fashion to educate lawmakers and develop legislation on these priorities. The RN Action team alerts ANA members and nurse advocates across the country on important legislative developments such as a new bill on a nursing issue being introduced or voted out of committee. The RNAction team will call on ANA members and concerned nurse-advocates to take action and help amplify the work ANA is doing on Capitol Hill. ANA maintains constant contact, coordination, and amplification to ensure any state legislative priority has the full backing of ANA. (ANA, n.d.)

I also agree with your statement that joining a nursing organization like the ANA can have challenges, that you mentioned, such as lengthy policy review processes in part due to stakeholders, time constraints, and perhaps forced errors resulting. You further described the importance of RNs and APRNs in understanding the systematic process of policy formation and implementation. I found that the Centers for Disease Control and Prevention (CDC) (2015) describes policy review as an overarching domain, applicable to each step (domain) of the policy process: Problem identification; Policy analysis; Strategy and policy development; Policy enactment; And Policy Implementation. The process could potentially aid in nursing member education on policy review. You also made an enlightening suggestion for RNs and APRNs to anoint a champion amongst a policy review group, to assist with the timeliness and perhaps knowledge guidance with a group’s review process.

I also agreed with your statement of ethical considerations can be a challenge to policy evaluation, with your reference to utilize resources from the ANA and CDC to overcome ethical challenges. Boston et al. (n.d.) affirm that government agencies such as the ANA and CDC can assist with the ethical review process and that   ethical policy analysis includes the five components of, “integrity, competence, responsibility, respect, and concern”.

Boston et al. (n.d.) states that there are,

At least two important lessons concerning the relationship between ethics and public policy. First, being able to justify policies on multiple ethical grounds has significant potential benefits: not merely does it strengthen the moral case for governmental action and increase the likely level of public support, but it also helps to ensure policies are appropriately crafted to take into account the full range of relevant ethical values. Second, the means and the ends of public policy are closely coupled. They both have ethical dimensions, and these need to be considered simultaneously rather than sequentially.

References

American Nurses Association. (n.d.). ANA advocacy toolkit. Retrieved October 22, 2021, from

https://ana.aristotle.com/SitePages/toolkit.aspx

Boston, J., Bradstock, A., & Eng. (n.d.). Public policy: Why ethics matters. Retrieved October 30, 2021, from

https://press-files.anu.edu.au/downloads/press/p80991/html/ch01_intro.xhtml?referer=&page=3#toc-anchor

Centers for Disease Control and Prevention. (2015, May 29). Cdc policy process. Retrieved October 24,

2021, from https://www.cdc.gov/policy/analysis/process/index.html

Milstead, J. A., & Short, N. M. (2017). Health Policy and Politics (6th Ed). [[VitalSource Bookshelf

version]] NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation.

Nurses may not be aware of available opportunities to participate in the legislative process. Nurses have value to add to the process due to hands on patient experience and field expertise (Jurns, 2019). Participating in the process adds value to the field of nursing from education to hands on patient care practices (Beasley, Farmer & Nunn-Ellison, 2019). Nurse participation in the legislative process is critical to the field of nursing. Although nurses are very busy, it’s essential for nurses to lend time to the legislative process.

References

Beasley, S. F., Farmer, S., Ard, N., & Nunn-Ellison, K. (2019). A Voice in the Accreditation Process: The Role of the Peer Evaluator. Teaching & Learning in Nursing, 14(4), A3–A5. https://doi-org.ezp.waldenulibrary.org/10.1016/j.teln.2019.06.001

Jurns, C. (2019). Policy Advocacy Motivators and Barriers: Research Results and Applications. Online Journal of Issues in Nursing, 24(3), N.PAG. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol24No03PPT63

Excellent article. Annisha, I believe that policy evaluation is vital to determine the success of existing policies and those drafted bills. Comparative effectiveness research gathers and assesses evidence-based research that compares the benefits and challenges of various policies to prevent, diagnose, treat, and monitor a clinical condition or improve care delivery. CERs; is designed to enable consumers, medical practitioners, and policymakers to make educated decisions to enhance healthcare at individual and population levels (Translation Research in Practice: An Introduction, n.d.).

The American Nurses Association advocated for its member when the pandemic hit by lobbying Congress and other regulatory agencies to provide frontline liners with the proper protective personal equipment, wellness, and educational resources to combat the pandemic. The Association was able to lobby for this response from Congress with the help of its over 350,000 nurse members voicing their concerns (Brusie, 2021). It shows us that nurses can influence legislation about policymaking for the benefit of the community.

Reference

Translation Research in Practice: An Introduction. (n.d.). Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Translational-Research-in-Practice.html

Brusie, C. (2021, January 18). ANA President Encourages Nurses To Get Into Politics and Advocacy. Nurse.org. https://nurse.org/articles/american-nurses-association-politics-advocacy/

Hello Annisha, 

 Thank you for the information in your post. I strongly agree with you idea of the importance of policy review and how it is used to determined the effectiveness of a policy and if any changes need to be made. This is crucial in the healthcare setting with new advances in practice, laws, and regulations almost daily. Without a policy review, there will be no way to tell if the implemented policy is even working. Both of your strategies for giving nurses a role in the participation of policy review sync up with mine. The first one you mentioned was joining a professional nursing organization. With hundreds of organizations to choose from in any medical field ranging from state to federal level (nurse.org, 2021), there is a spot for everyone out there to climb the ranks in their nursing career and begin to participate in every step of the policy process NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation. Furthermore, when you are in an organization like these, you have an an entire team and collaborative effort to work together and back each other for common goals. The professional nursing organizations are important for generating new ideas and proactive work needed to maintain a health profession that advocate the needs for patients and nurses (Matthews, 2012). Your second strategy is also very effective. Becoming part of a policy review within your workplace could be much easier but also share its challenges depending on the environment. Becoming educated on your specific policies and rules within your workplace will add value and credibility to your opinions and input and make you a greater asset to the review of policies. As you stated as well, any path you take to participate in policy review can have its own set of obstacles. Education is crucial in any field of practice, but within the healthcare system where things are changing constantly, staying educated on the newest information and policies is vital. Thank you for sharing your ideas.

References

Matthews, J., (2012, January 31). Role of professional organizations in advocating for the nursing profession. https://pubmed.ncbi.nlm.nih.gov/22320879/

https://nurse.org/orgs.shtml List of Nursing Organizations. Nurse.org.(2021).

Two opportunities that currently exist for RNs and APRNs to actively participate in policy review.

The RNs and APRNs can actively participate in policy review by joining a professional organization. This will help them to voice out their concerns regarding health care issues. In the professional organization there are many people from different areas in the health care sector where they discuss about issues which affects their profession. Nursing policies needs to be reviewed before implemented. If it is not reviewed, it will be difficult to change it, that is why it is good to review it with policy makers. Nurses should participate in policy making by joining an organization (Rasheed et al., 2020).  Another way is for the APRNs or RNs  is  to collaborate with other members of the health care team who are directly involved in reviewing policies.

Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges

Some of the challenges might include lack of knowledge about policy review, lack of resources, members in a group  might not able to meet people in charge of policy review, lack of clear define goals and objectives., lack of training. To overcome these challenges, we need to meet the right people involved to review the policy and come to an agreement with them. We need to work together as a team because if not, it will be difficult for anything to move on smoothly.  Good communication skills are also required among team members. Some of the challenges might also be overcome by measuring the effectiveness and efficiency of the policy (Laureate Education, 2018).

Recommend two strategies you might make to better advocate for or communicate the existence of these opportunities.

Educating nurses on the opportunities available and directing them how they can acquire more knowledge for example attending nursing conferences, registering in health care and professional platforms.  Through these platforms they will be current and know what is happening in the community, examples include the American nurse association, American association of nurse practitioners etc.  Nurses should advocate for their patients in the community, providing them with high quality care, this will improve their health and wellbeing (Stodart, 2017).

References

Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.

Rasheed, S. P., Younas, A., & Mehdi, F. (2020). Challenges, Extent of Involvement, and the Impact of Nurses’ Involvement in Politics and Policy Making in in Last Two Decades: An Integrative Review. Journal of Nursing Scholarship, 52(4), 446–455. https://doi-org /10.1111/jnu.12567

Stodart, K. (2017). Advocating for patients and communities. Kai Tiaki Nursing New Zealand, 23(9), 11–12.

            I enjoyed your post, Faith! I researched stakeholders to understand their role more in the policy review process. I found an article that discussed their role in depth and the challenges that comes with identifying stakeholders. For example, involving stakeholders in the review identifies areas of agreement and disagreement, allowing discussions of why they feel differently (Lemke & Harris-Wai, 2015). Utilizing stakeholders also gives the community a voice and promote transparency (Lemke & Harris-Wai, 2015).

I agree nurses need to be educated to understand the policy development process. This includes the policy-making, review, and evaluation. Jurns (2019) discussed that nurses can become involved in shared governance to learn about organizational policy. In addition to working on organizational boards or joining a shared governance committee, nurses can also search for workshops and webinars on the topic of policy (Jurns, 2019). I feel this class has helped me understand the process and avenues tremendously, so as you stated continuing education is a great way to better understand policy review.

References

Jurns, C. (2019). Policy Advocacy Motivators and Barriers: Research Results and      Applications. Online Journal of Issues in Nursing, 24(3), N.PAG. https://doi-            org.ezp.waldenulibrary.org/10.3912/OJIN.Vol24No03PPT63

Lemke, A. A., & Harris-Wai, J. N. (2015). Stakeholder engagement in policy development: challenges and opportunities for human genomics. Genetics in medicine : official journal of the American College of Medical Genetics, 17(12), 949–957. https://doi.org/10.1038/gim.2015.8

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review.

Nurses can participate in policy review by joining a professional nurses organization. Some examples of professional nurses organizations include Academy of Medical-Surgical Nurses, Academy of Neonatal Nursing, ACNP-American College, College of Nurse Practitioners, American Association of Nurse Anesthetists, American Association of Nurse Practitioners, and many more! When joining these organizations, nurses can get to know one another and learn about different opportunities and networking to branch out and support other nurses. Through these networking events, they can expand on their education and even career opportunities as well! They can also review different policies and even come up with new ideas based on different shared experiences throughout the members of the organizations.

Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges.

Some challenges that nurses or advanced nurses can face when it comes to policy review can be, the review being passed. If nurses best interest are to keep the patient’s safe, and they notice something that is happening that is putting the patient not in the patient’s best interest, then they should speak up. For example, if they are short staffed and they are forced to have 7 patients per 1 nurse. They could technically put that against policy review. If the facility is not unionized or protected in their favor, then the policy review may not go anywhere. This may present as an ongoing challenge for the health care workers and may cause a lot of stress and frustration.

Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities.

One strategy I would recommend to better advocate for myself and the other nurses would be to communicate with clear and set boundaries. It is important to always communicate with your manager and HR if you feel that you are being treated unfair and that if the treatment is causing your patients to be put in unsafe situations. Secondly, always communicate with respect. It is very easy to speak out of line when getting upset. On the other hand, when speaking from a place of respect, it is easier to be heard. Always remember to keep it professional and speak to others how you would like to be spoken to!

https://nurse.org/orgs.shtml

American Nurses Association (ANA).

Nurses can become informed of such opportunities via independent research, employer presented opportunities and or professional organizations. Scoping reviews are an important component of the research process provides educators and clinicians opportunity to thoroughly review evidenced based data to assure accuracy (Pollock et al., 2021).  Nurses have the opportunity to participate in such review process in research during policy or scope of practice legislative considerations. Participation in professional organizations provide opportunities for nurses to get involved in the legislative process.

Participating as a per evaluator, reviewing nursing scope of practice is an example of participating in the legislative review process. Opportunities exist for nurses to lend expertise to the nursing scope of practice (Jurns, 2019). Reviewing educational and practice policy’s assist with creating and enhancing nursing practice (Beasley, Farmer & Nunn-Ellison, 2019). Nurse education legislation is critical to shaping the future of the nursing profession.

Barriers preventing nurse participation in the policy review process include lack legislation education. Nursing policy while built into nursing education is not required during practice. Nurses unaware of legislative practice may lack participation awareness. Nurses may lack understanding of the importance of legislative participation. Nurses may also lack awareness of how to participate in the legislative process.

Independent research and education are methods for nurses to overcome barriers causing lack of participation in the legislative review process. Nurses desire advocating beyond the bedside. Lack of education prevents policy review participation. Individual research provides process and participation guideline education. Once nurses are empowered with knowledge of process, legislative participation opportunities appear as a more practical option. Education is the key to access, including legislative participation.

Identify mentors to assist with introducing participation opportunities. Connecting with Individuals who currently participate in the legislative process could be beneficial to gain participation access. Lack of process understanding creates participation barriers. Mentors will provide introduction to process guidance, building confidence and potentially encouraging legislative process participation.

References

Beasley, S. F., Farmer, S., Ard, N., & Nunn-Ellison, K. (2019). A Voice in the Accreditation Process: The Role of the Peer Evaluator. Teaching & Learning in Nursing, 14(4), A3–A5. https://doi-org.ezp.waldenulibrary.org/10.1016/j.teln.2019.06.001

Jurns, C. (2019). Policy Advocacy Motivators and Barriers: Research Results and Applications. Online Journal of Issues in Nursing, 24(3), N.PAG. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol24No03PPT63

Pollock, D., Davies, E. L., Peters, M. D. J., Tricco, A. C., Alexander, L., McInerney, P., Godfrey, C. M., Khalil, H., & Munn, Z. (2021). Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics. Journal of Advanced Nursing, 77(4), 2102–2113. https://doi-org.ezp.waldenulibrary.org/10.1111/jan.14743 NURS – 6050 Discussion: The Role of the RN/APRN in Policy Evaluation

“Given its proven ability to greatly improve the quality of care while simultaneously reducing costs, it is critical to advance the adoption of EBP. Armed with the necessary knowledge and skills, nurses can be an integral part of EBP implementation as members of interdisciplinary teams and healthcare systems” (UMFK, 2020).

Another area where nurses can promote change is through shared governance. ‘Shared governance is a model of nursing practice designed to integrate core values and beliefs that professional practice embraces, as a means of achieving quality care. Shared governance models were introduced to improve nurses’ work environment, satisfaction, and retention”(Anthony, 2004).

It  may have been in my initial discussion this week or in our last week’s assignment, but I had mentioned maybe bringing the idea of shared governance to my current workplace. Just the other day, my DON approached me about leading up a shared governance committee. I just had to laugh and told her why. Now I’m presented with the task of developing and recruiting for the committee a multidisciplinary approach for problem solving and retention. I’m hoping with the collaborative work we are able to make some positive changes when right now the moral of certain staff members is toxic which is causing some newer staff to leave the company.

Anthony, M. (2004, January). Shared Governance Models: The Theory, Practice, and Evidence. Shared governance models: The theory, practice, and evidence. Retrieved October 30, 2021, from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No1Jan04/SharedGovernanceModels.aspx.

What is evidence-based practice in nursing? University of Maine Fort Kent Online. (2020, September 2). Retrieved October 30, 2021, from https://online.umfk.edu/articles/rnbsn/evidence-based-practice-nursing.aspx.