Assignment: Advocating for The Nursing Role in Program Design and Implementation Questions

Questions

Osteoporosis and low bone density affect approximately 54 million Americans making it a growing health issue in the United States. Osteoporosis affects a significant proportion of the aged American population, according to statistics. The implication is that a sizable proportion of the population is predisposed to increased rate of bone fractures and breakage that might not be easy to heal. Osteoporosis prevention and reduction programs have been implemented in the United States (Lieberman et al., n.d.). This paper aims at looking in nursing role in osteoporosis reduction program implemented in my practice.

What is the Cost and Projected Outcome of the Program?

The Osteoporosis Prevention Program is a program that has been implemented in my practice to address high incidences of post knee and hip bone surgeries. The Texas government created the OPP program with the goal of preventing and reducing osteoporosis rates in the state. Implementation of the OPP program was necessitated by the fact that close to one-third of the population in Texas was suffering from recurrent bone fractures in 2015. This program is guided by a number of principles. They include addressing the social determinants of health that contribute to osteoporosis, increasing resource availability, and transforming environments to promote physical activity and healthy eating.

In order to meet the program’s objectives, a number of activities have been implemented.

They include expanding possibilities for healthy eating, encouraging active living through the construction of healthy settings, and providing community and clinical preventive interventions for people who are at risk of becoming bone fractures. The initiative also improves the chances of children and elderly populations at risk having a healthy lifestyle, as well as public health efforts aimed at preventing osteoporosis (Osteoporosis Treatment & Prevention in Houston, Texas, n.d.). The program’s implementation costs are paid for with public funds. Projected outcomes include a decrease in the state’s bone fracture rate, a decrease in morbidity and mortality rates, and increased access to healthy foods and environments for the population (des Bordes et al., 2020). It is also expected to improve Texans’ health and well-being, as evidenced by increased awareness, lifestyle, and behavioral changes on health-related issues.

Who exactly is your target market?

As previously stated, the community surrounding the college is the program’s target market, which is primarily Hispanic and African American and has a big education gap in terms of high blood pressure. I have high blood pressure, but I haven’t started taking the medication that was prescribed to me the last time because I know it’s impossible to stop once you start. This case exemplifies the community’s widespread lack of knowledge about healthcare, particularly HTN. Statements like these highlight the importance of an outreach effort to address the educational and medical deficiencies associated with HTN.

What role does the nurse have in developing design concepts for this healthcare program?

Reviewing the blood pressures of patients seen in this emergency room and keeping track of the following: whether the patient was aware they had high blood pressure; whether they are taking medication; and, if not, why not. The nursing team made the first contribution to the development of the community outreach program. Auditing patient records for these markers demonstrated that the community in which we live need screening, education, dietary and lifestyle modifications, as well as accessible, high-quality treatment. Despite the fact that the internet contains a lot of information on healthy eating and ingredient substitution, many people are still unwilling to modify classic recipes (Maintain a Healthy Weight, n.d.).

What is your role as a representative of the people who will benefit from this

As a patient advocate and emergency department nurse, I may travel to various venues in the area, such as churches and schools, to explain the protocol for screening for HTN. Along with the screening instructions, patients will receive recommendations for free or low-cost clinics as well as a list of pharmaceuticals that are available at discounted prices at various pharmacies. It is critical for the nurses working in this program to interact with community leaders, school officials, and church pastors in order to secure a screening site and attract members of the neighborhood to attend screenings.

Do you have any influence over design choices?

Yes, there was a fantastic team of nurses who recognized a need in the community, worked together with our emergency room doctors and other nurses, and discussed strategies for addressing the high occurrence of HTN. In addition to finding and analyzing traditional meal recipes, this group of healthcare specialists also looked for and evaluated components that are healthy alternatives. As a result of extensive networking among team members and with pharmacies, medical practices, and clinics, a wealth of resources for patients were gathered, and the community outreach program also received support.

Tell us about a within your practice.

The healthcare problem being addressed by my facility by the nurses is hypertension (HTN) awareness, education, nutrition, medication, and exercise. The community surrounding the facility has a large Hispanic and African American population which are more predisposed to develop HTN due to risk

NURS 6050 Assignment Advocating for The Nursing Role in Program Design and Implementation Questions

factors like ethnicity, traditional foods within those communities. Acc

 

ording to various studies and trends of HTN diagnoses, statically African American men and women have a greater disposition to have HTN than Caucasian men and women within the same . (Lackland, 2014). This community outreach is done twice a month for two to four hours at a time and will be held at various locations within the community (churches, schools, etc.) to screen citizens for HTN and refer them to a free or low-cost clinic for management of HTN

Also Read:

Nurses at all stages of their careers should commit to ongoing professional development. As a result, national nursing associations offer unique opportunities for career advancement, networking, and the provision and promotion of best practice guidelines. National nursing associations provide access to leadership development and mentoring that are not always available to professionals within their workplace. National nursing associations offer general membership and may occasionally target specific roles, such as critical care nurses and student nurses (Alotaibi, 2017). National nursing associations frequently gain strength through broad collaboration and the exchange of ideas. Members of national nurse associations frequently benefit from the foundation established through shared professional experiences. Boards of Nursing are organizations that promote and protect the general public’s health and welfare by ensuring and supervising the involvement of licensed nurses in the provision of competent and safe healthcare services. The elected Board of Directors leads the Board of Nurses and oversees various activities to ensure efficient operational processes.

How else do you impact design?

Design is also impacted by specifying which department or individual is responsible for implementation and program evaluation. The design of the program should also have protocols in place that have been agreed upon by nursing and the medical director in the event one of the community members has a medical emergency.

Nurses fill many roles, but the nursing role of the implementation of this HTN screenings program is to actually take vital signs and educate the community about the importance of good blood pressure control to decrease the risk of complications later in their lifetime, such as stroke, congestive heart failure, myocardial infarction, renal damage requiring dialysis, edema in the lower extremities, diabetes and other comorbidities that often occur was a result of long term, sustained, and untreated high blood pressure.

Can you provide examples?

During the design phase to this healthcare program, there was a large amount of research conducted on the topic and program collaborators shared ideas and suggestions as to what information was going to be printed on flyers, and in booklets. It was also during the design phase that it was decided there should be two nurses, protocols, and that relationships should be sought between the community leaders and the facility to encourage participation and increase awareness.

Who are the members of a that you believe are most needed to implement a program? Can you explain why?

Nurses, because nurses can interpret the patient’s blood pressure, provide education about risks of uncontrolled HTN, and educate and encourage patients to make healthy lifestyle changes. Nurses also possess the critical thinking skills needed to identify medical emergencies when running these types of screening clinics, as to where a layperson may not. It was the nurses that were able to compile resources for members of the community, so they have access to affordable quality healthcare and medications. Anyone can go buy an automatic blood pressure cuff from a store, or even us the one in the pharmacy, but many citizens would not know to interpret the plod pressure because the lack the medical background a nurse possesses.

References

Ferdinand, K. C., Patterson, K. P., Taylor, C., Fergus, I. V., Nasser, S. A., & Ferdinand, D. P. (2012). Community-based approaches to prevention and management of hypertension and cardiovascular disease. Journal of Clinical Hypertension (Greenwich, Conn.), 14(5), 336–343.

Lackland D. T. (2014). Racial differences in hypertension: implications for high blood pressure management. The American Journal of The Medical Sciences, 348(2), 135–138. doi:10.1097/MAJ.0000000000000308

Maintain a Healthy Weight. (n.d.). Retrieved July 22, 2019, from

Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?

Interviewee

The program is an integrated weight loss and management initiative in my practice. The program was initiated based on the identification of obesity as a public health concern that continues to impact millions of Americans. The program seeks expansion and promotion of weight loss management to support a spectrum of population needs of people of across all ages who need help to overcome obesity and being overweight. A component of the program is the “Individual Nutrition Model” that mainly focuses on incorporating a healthier lifestyle. Through the program, individuals commit to a three months’ initiative to enhance their nutritional inputs and change their diets at the personal level (Agha & Agha, 2017). The main program is a six-month initiative where patients commit fully to attending forty in-person sessions with the facility’s team that include nurses, dieticians and nutrition counselors to address obesity problem.

At each visit, the patient and the inter-professional collaboration team set goals to attain on weight management issues.  Patients are encouraged to commit to ensuring that they have record of food intake, physical activity and behavioral change goals. At the end of the period, the team evaluates the patient’s progress based on their individualized plan to ascertain if they need more therapies, referrals or are not set to contain their weight. The program charges $100 for each session which a patient’s health insurance can reimburse. Through the program, patients will have enhanced lifestyle and be productive members of society by addressing health challenges associated with obesity.

Challenges Within Policy-Making

As we have discussed before, nurses have the ability to get involved with politics and policy-making by joining a professional nursing organization such as American Nurses Association (ANA) or American Association for Critical Care Nurses (AACN) for RNs and American Association of Nurse Practitioners for APRNs and so many others for every specialty within the nursing profession. RNs and APRNs also have the opportunity to run for office, whether it is for the local board, state legislation or being present at a federal level. “Nurses’ policy influence is nurses’ ability in the influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurses’ job environment and increases patient outcomes” (Arabi et al., 2014).

With presenting new policies there will always be challenges needing to be overcome in order to implement the proposition at hand. One of those challenges seem to be within the first step of introducing the bill to the House of Representatives and Senate for it to be passed on to the appropriate committee. In order to avoid this challenge, getting involved with lobbyists and constituents to obtain endorsements from legislators, influential community leaders and professional associations allows the presenting individuals to go in with support of those who are more familiar with congress (Milstead & Short, 2019). Another challenge may be in the verbiage of the presented policy, which is why it is important that it is “drafted into the proper legislative language” (Milstead & Short, 2019).

Nurses at all levels deserve to know that their voice matters, and their voice can make a difference. The importance of ANA relative to policies needs to be expressed more intensely so nurses can see the hard work being done “behind the scenes” when it comes to policies. “ANA believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care” (ANA, n.d.). Another strategy I would implement would be starting a policy making team or suggestion box within my hospital organization so that those who have concerns or suggestions to better the work environment and patient care can truly feel like the propositions they are presenting are being considered instead of feeling like they are falling on the deaf ears of administration. Nurses need to feel that they are appreciated and in order for that to happen, changes need to be made to improve the issues they are presenting.

References

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from 

 

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315–322.

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

Two Opportunities for Nurses to Participate in Policy-making

There are a number of ways for a nurse to become involved in politics and policy-making. Two of these ways to get involved are by joining a professional nursing organization and to get involved at the state level. It is important for nurses to participate in policy-making, as many policies directly affect the nurse’s scope of practice and evidence-based care. Milstead & Short (2019) explain how nurse leaders are becoming more involved in this process.

One way for a nurse to become involved in policy-making is to join a professional nursing organization. Morin (2021) highlights how professional nurse organizations “play a critical role influencing policy by having their representatives provide testimony on health-related issues to national government leaders.” One specialized nursing organization that is relevant to my own practice is the American Psychiatric Nurses Association (APNA). According to Tierney (2021), as nurses, our “strengths and abilities of our profession empower us to steward health care transformation and revolutionize access to care.” The APNA is a well trusted organization that has the ability to influence policy-making decisions. Becoming a member of most nursing organizations is as simple as logging on and signing up. This will often include annual dues. A barrier may be the cost to join the organization, but the benefits of being a member are worth the cost and contribution. Joining a professional nursing organization like the APNA is a great way for nurses to get involved in policy.

Nurses can get involved in policy-making at the state level to help influence regulations that pertain to their interests and needs as a practitioner. It was found that many nurses do not participate in policy-making because of insufficient resources and policy-making knowledge (Hajizadeh et al., 2021). Many policies that directly effect a nurse’s scope of practice and abilities to practice are made at the state level. It can be intimidating for a nurse to try and get involved at a state level, it is important for institutions to provide information and resources. For instance, an APRN will have different abilities for independent practice in different states. This is why it is vital for nurses to become involved in policy-making at a state level.

References

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R.

(2021). Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing20(1), 128. https://doi.org/10.1186/s12912-021-00648-6

Milstead, J.A., & Short, N.M. (2019). Health Policy and politics: A nurse’s guide (6th ed).

Burlington, MA: Jones & Bartlett Learning

Morin, K. H. (2021). Editorial: contributions of professional nursing

organizations. Journal of Advanced Nursing (John Wiley & Sons, Inc.)77(6), e1–e3. https://doi.org/10.1111/jan.14808

Tierney, M. (2021). Stewarding Access to Care: Where We’ve Been and Where We’re

Going. Journal of the American Psychiatric Nurses Association27(5), 415–417. https://doi.org/10.1177/10783903211038221

   Thank you for sharing your experience and knowledge regarding policy making and the challenges nurses may face. I was always aware of professional nurse organizations (PNOs), but did not know how important and beneficial they are for nurses to join. An article by Crumley (2020) pointed out that “e individual nurses may be constrained by politics within their individual institutions, PNOs provide a collective voice committed to the interests of their members.” I found that to be a powerful statement. PNOs are a great way for nurses to find their voice, participate in policy discussions, and expand their networks.

A study by Rasheed, Younas, & Mehdi (2020) found that nurses were more likely to implement policies and follow them rather than influence policy. They also call upon nurse leaders to actively encourage all nurses to become involved in policy-making opportunities, even if it’s just an online discussion. I feel like the curriculum at Walden University is doing a wonderful job of emphasizing the importance of nurses to get involved in policies!

References

Crumley, Carolyn. (2020). The Benefits of Active Engagement in Nursing Professional

Organizations: A View From Here. Journal of Wound, Ostomy & Continence Nursing47, 547. 

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 Scholarship52(4), 446. 

Hi Jacqueline,

It is almost impossible to hear a lone voice in a multitude of voices.  Nurses mostly have the opportunity to participate in the legislative process through professional nursing organizations. This is because Nursing organizations continue to challenge their energy to maintain nursing’s policy influence for the good of our societies and healthcare systems. In a lot of ways, nursing organizations seek to influence the decision-making processes of key decision makers. As a result, understanding how they are perceived in the eyes of external stakeholders can inform the advocacy strategies that are taken up (Chiu, 2021). Professional nursing organizations also conduct public policy advocacy programs to educate, engage, and improve nurses’ impact in this hard, yet rewarding, area of their profession.

References

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy Advocacy and Nursing Organizations: A Scoping Review. Policy, Politics, & Nursing

Practice, 22(4), 276–296. 

Hi Jacqueline Keener

As you have correctly noted, nurses can participate in policy evaluation through professional nursing organizations. You have said that one of the barriers to entering these organizations is the high registration costs. Can you think of strategies that professional nursing organizations can do to solve this challenge? Nurses should have political competency to advocate for healthcare policies (Clarke et al., 2021). You have stated that they can be involved in policy evaluation at the state level. Can you discuss any specific ways in which they can influence policy evaluation at the state level? 

References

Clarke, J. M., Waring, J., Bishop, S., Hartley, J., Exworthy, M., Fulop, N. J., Ramsay, A., & Roe, B. (2021). The contribution of political skill to the implementation of health services change: A systematic review and narrative synthesis. BMC Health Services Research21(1).  

Name: NURS_6050_Module04_Week08_Assignment_Rubric

Excellent Good Fair Poor
Program Design

In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions.
·   Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?

·   Who is your target population?

·   What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

·   What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

·   What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

Points Range: 41 (41%) – 45 (45%)

Response provides a clear and complete summary of the healthcare program, including an accurate and detailed description of the costs and projected outcomes of the program.

Response provides a clear and accurate description that fully describes the target population.

Response provides a clear and accurate explanation of the role of the nurse in providing input for the design of the program, including specific examples.

Response provides an accurate and detailed description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate and detailed explanation of how the advocate’s role influences design decisions as well as fully explaining impacts to program design.

Points Range: 36 (36%) – 40 (40%)

Response provides a summary of the healthcare program, including a description of the costs and project outcomes of the program.

Response provides an accurate description of the target population.

Response provides an accurate explanation of the role of the nurse in providing input for the design of the program, including some examples.

Response provides an accurate description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate explanation of how the advocate’s role influences design decisions and somewhat explains impacts to program design.

Points Range: 31 (31%) – 35 (35%)

Response provides a summary of the healthcare program that is vague or incomplete or does not include costs or projected outcomes of the program.

Description of the target population is vague or inaccurate.

Explanation of the role of the nurse in providing input for the design of the program is vague, inaccurate, or does not include specific examples.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague or inaccurate.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague or inaccurate.

Points Range: 0 (0%) – 30 (30%)

Response provides a summary of the healthcare program that is vague and inaccurate, does not include costs or projected outcomes of the program, or is missing.

Description of the target population is vague and inaccurate, or is missing.

Explanation of the role of the nurse in providing input for the design of the program, and specific examples is vague and inaccurate, or is missing.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague and inaccurate, or is missing.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague and inaccurate, or is missing.

Program Implementation
·  What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
·   Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why you think this?
Points Range: 36 (36%) – 40 (40%)

Response provides a clear, accurate, and complete explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate and detailed explanation of how the role of the nurse is different between design and implementation of healthcare programs, including specific examples.

Response provides an accurate and detailed description of the members of a healthcare team needed to implement the program selected.

The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.

Points Range: 32 (32%) – 35 (35%)

Response provides an accurate explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate explanation of how the role of the nurse is different between design and implementation of healthcare programs, and may include some specific examples.

Response provides and accurate description of the members of a healthcare team needed to implement the program selected.

The response integrates at least 1 outside resource and 2-3 course specific resources that may support the summary provided.

Points Range: 28 (28%) – 31 (31%)

Explanation of the role of the nurse in healthcare program implementation is vague, inaccurate, and/or incomplete.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague or inaccurate and/or does not include specific examples.

Description of the members of a healthcare team needed to implement the program selected is inaccurate or incomplete.

The response minimally integrates resources that may support the summary provided.

Points Range: 0 (0%) – 27 (27%)

Explanation of the role of the nurse in healthcare program implementation is vague and inaccurate, or is missing.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague and inaccurate, or is missing.

Description of the members of a healthcare team needed to implement the program selected is vague and inaccurate, incomplete, or is missing.

The response fails to integrate any resources to support the summary provided.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

Points Range: 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Points Range: 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Points Range: 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100
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