Discussion: The Role of the RN/APRN in Policy Evaluation
Merrian-Webster (n.d.) explains evaluation is “to determine the significance, worth, or condition of usually by careful appraisal and study” (p.1). Policy review or evaluation is an essential step when implementing a policy or program. A policy review does not start after a program is implemented but is vital to designing a policy (Laureate Education [Producer], 2018). This discussion focuses on registered nurses (RNs) and advanced practice registered nurses (APRNS) role in policy review, the challenges presented and ways to overcome them, and strategies to advocate for or communicate the existence of these policies.
RNs and APRNs in Role in Policy Review
Registered nurses and advanced practiced registered nurses are encouraged to participate in policy-making and the crucial step in the policy review. RNs and APRNs have the opportunity to make a difference and stamp their mark on the improvement of the healthcare system and delivery of care through the evaluation of policies. Milstead and Short (2019) noted being an active participant of professional organizations such as “the American Nurses Association (ANA), the National League of Nursing (NLN), the American Association of College of Nurses (AACN), and the American Association of Nurse Practitioners (AANP)” is one way to participate in policy review (p. 121). The authors used the Affordable Care Act (ACA) to portray how nurses were involved in the “evaluation process and dissemination of accurate evaluation results” and why the nurses were engaged in the process. They participated because the ACA “advocated for cost transparency and campaign for patient education regarding enrollment in subsidized health insurance plans” (Mistead & Short, 2019, p. 121).
Another opportunity for nurses to review policy is within their organization. Nurses are the largest workforce that spends most of the time providing care to patients. Therefore, they are the experts on the efficiency and effectiveness of a nurse-driven policy. For example, the unit has implemented a policy trying to prevent skin breakdown. Nurses are essential in evaluating the program effectiveness because they are the person that implements the steps of said policy. The nurses are the ones that perform every 2 hour turns, cleans up incontinent patients, so they do not sit in their filth, and mobilize patients as soon as they safely can after procedures. By documenting the skin assessments, the information helps review and evaluate this policy to determine if it is effective or needs to be reshaped (Milstead & Short, 2019, Laureate Education [Producer], 2018).
Challenges and Solutions
The nursing profession holds very high standards built on respect and trust. There are challenges that the RNs and APRNs may face during policy reviews. Milstead and Short (2019) stated that other professionals and legislators might view the policy differently than nurses because of their backgrounds, which can pose a challenge. For example, nurses’ primary focus is patient-centered care, and other’s perceptions of nurses may undervalue a nurses’ expertise. To overcome these oppositions, nurses need to build trusting relationships with interprofessional teams, legislators, community leaders, and the public to gather support. RNs and APRNs may encounter challenges within their unit are fear of new policies, opposition, and resistance to change. To overcome these challenges, the lead nurse needs to educate nurses about the new approach, the cost, and expected outcomes to gather support.
Strategies
Seminars and social media are a couple of strategies to bring awareness to these opportunities for policy review. The nursing organizations hold seminars monthly, quarterly, and annually that keep the nursing world up to date on all of the policy changes that affect the nursing profession (National League for Nursing, n.d.). This concept can also work on the hospital units. Social media is the biggest platform that can reach millions of people in a short period. Many hospitals have their social media account on platforms such as Facebook, Twitter, and Instagram, which through discussion boards, can reach employees, keeping them abreast of policy changes and how they can be involved in policy-making and policy review.
Conclusion
In conclusion, it is crucial to perform policy reviews because policies affect lives. Evidence-based practices change, and policies need to be updated to adapt to the new methods. Technology is advancing exponentially, and policies need to grow with it. Finally, policy review is vital because it impacts public safety, healthcare cost and delivery, and healthcare outcomes and efficacies.
References
Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
Merrian-Webster (n.d.). Merrian-Webster.com dictionary. Retrieved April 25, 2021, from https://www.merriam-webster.com/dictionary/evaluate
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
National League for Nursing. (n.d.) Professional development programs. Retrieved April 25, 2021, from http://www.nln.org/professional-development-programs/c
response
I enjoyed reading about your strategies to overcome policy-review challenges for nurses. Social media is an effective outlet to raise awareness of policy-review opportunities. These platforms are becoming increasingly popular to reach and engage nurses on a variety of topics (O’Conner, 2017). Health systems should share policy changes and the opportunities to participate in leadership groups on their social media pages. Most often, nurses will follow the health system they are employed by.
I believe health systems should also post more about professional nursing organizations. If employees are aware these opportunities exist, they are more likely to engage. Joining a professional nursing organization may be one of the last things on a nurse’s mind at the end of the day, but if a nurse has downtime and sees an advertisement for a professional nursing organization, they may make the choice to join. For the best engagement, health systems should push this information out through all channels including social media and company email (Coray, 2019).
References
Coray, T. (2019). Why marketing to nurses is a smart customer acquisition strategy. Sheer ID. https://www.sheerid.com/blog/why-marketing-to-nurses-is-a-smart-customer-acquisition-strategy/
O’Conner, S. (2017). Using social media to engage nurses in health policy development. Journal of Nursing Management, 25(8), 632-639. https://doi.org/10.1111/jonm.12501
response 2
I read through you post and you made a very good point stating the different ways nurses can participate in policy review. I would like to add my own contribution that there are different ways nurses can participate in policy review. The two most common areas are through professional organizations such as the American Nurses Association and the second one is through their place of work. These are the two easiest ways for nurses to get involved in policy review but there are other ones as well. When policy is being created, it required different viewpoints to put it in order before it becomes law or regulation, when nurses are actively involved in either any professional organization or at their place of work, it will enable them the opportunity to be able to review the policy when it is first developed because if the review is not done, both the RN/APRN and patient will also be affected by whatever policy that is made.
The RN/APRN involvement in the policy review will give them the opportunity to give their recommendation/input to the policy after their review and since the RN/APRN are part of the healthcare system, they have a good understanding of the problem, and will be able to give a potential solution to the problem. Professional organizations such as American Nurses Association believe that “Advocacy is the pillar of nursing” and so we need to advocate not only for ourselves nut also for our patients.
Thank you
References
McCleery, E., Christensen, V., Peterson, K., Humphrey, L., & Helfand, M. (2014). Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses. In VA Evidence Synthesis Program Evidence Briefs. Department of Veterans Affairs (US)
Discussion: The Role of the RN/APRN in Policy Evaluation
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
To Prepare:
- In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
- Review the Resources and reflect on the role of professional nurses in policy evaluation.
By Day 3 of Week 9
Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.
Nurses are the largest sector in healthcare professionals and have a duty to ensure the safety of patients. Nurses need to have the same access as physicians and other healthcare providers in shaping healthcare policy (Milstead and Short, 2019). Nurses and APRNs can take an active role in policy review by evaluating policies and implementation of policies.
One of the essential parts of policymaking is evaluation. Nurses evaluate policies by judging the efficiency and effectiveness of the program or policy (Laureate Education, 2018a). An example of this would be the cost of implementation and the benefits to people. Nurses have a professional obligation to ensure that policies promote access through cost and healthcare quality (Laureate Education, 2018b). Policymaking evaluations challenge examples: public opinions and lack of resources to complete the evaluation (Milstead and Short, 2019). A strategy to overcome this challenge is using social media and education to help sway the opinions of the public and call on other nurses to help you with the evaluation process.
Once a policy has been evaluated, the next thing is to implement the policy. Once the policy is implemented, it will still need evaluation to ensure that it is achieving its goals. Policies must meet the quadruple aim, which is to improve the quality of patient care, lower costs for healthcare, improve population health, and not negatively affect the job satisfaction of healthcare workers (Milstead and Short, 2019). The challenges to the implementation of policies are not enough information and evidence-based research. The strategy to avoid these challenges to ensure the policy reviews are formal versus informal. In the end, the nurse is instrumental in all stages of policymaking.
Laureate Education (Producer). (2018a). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018b). Program Policy and Evaluation [Video file]. Baltimore, MD: Author.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
By Day 6 of Week 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
Thank you for your post. I agree with you having a seat in an organization like the Boards of Nursing (BONs) enables nurses to have a voice in decisions regarding policy-making and policy review that impacts the nursing profession. The National Council of State Boards of Nursing (2014) states that the BONs are a valuable resource for legislators and their staff regarding policy involving all things related to nursing and nursing practices.
Nurses can find an opportunity to be effective in policy review through an internship in a legislator’s office. Milstead and Short (2019) state that nurses can be involved in policy-making, working alongside policymakers, and reviewing healthcare policies enacted to evaluate their efficiency and effectiveness. According to the NCSBN (2014), they suggest government entities at local, state, and federal levels to make nurses a part of their regulatory committee regarding policy discussions referring to healthcare. This opportunity opens a doorway for nurses to positively impact the nursing profession, the delivery, education, and cost of healthcare. Burke (2016) voiced that nurses involved in policy-making and policy review can and will be influential to legislators in bringing about change and improving the quality and delivery of healthcare.
References
Burke, S. A. (2016, June 2). Influence through policy: Nurses have a unique role. Retrieved April 26, 2021, from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning
National Council of State Boards of Nursing (NCSBN). (2014). Public Policy Agenda: 2014 – 2016 Edition. Retrieved April 26, 2021, from https://www.ncsbn.org/PublicPolicyAgenda-2014-2016.pdf
