Health Issue and Advocacy Essay Paper

Health policies are intended to address population disadvantages. In fact, economically and socially disadvantaged populations rely on policies to improve the conditions that impact their health. Having the right policies can help interrupt their cycle of health disparities and disadvantages by addressing material and social resources inadequacies that are typically referred to as the determinants of health. These determinants of health are necessary for longer life and better health, and firm the nexus between shorter livers, poor health, inequalities and social injustice. Towards this end, nursing advocacy helps to intervene by influencing policy development and framing to result in better policies that address the existing concerns. The foundation of nursing is rooted on the fundamental concern for physical, emotional and social needs of the whole society, and it is for this reason that nurses engage in advocacy to improve the social conditions that shape wellbeing (Black, 2016). Disadvantaged populations are unlikely to be in good health, and less likely to access quality medical services, and more unlikely to live longer when compared to advantaged populations. The appropriate interventions and right policies can interrupt this cycle of poor health, limited access to medical services and shorter lives by preventing the precursors. Effective and evidence-based policies can ensure good public health and address the lack of access to material and social resources that form the root of the disadvantages and disparities. Nurses can advocate for the right policies to promote health equity, fairness and justice, and adequately address the social determinants of health (Porter-O’Grady & Malloch, 2016). The present article discusses opioid epidemic as a population health issue of concern among disadvantaged societies and proposes a policy change to address the issue.

Health issue and significance to nursing

About 80 people die every day in the USA from an opioid overdose. Although the majority of these deaths are associated with unauthorized narcotics, these illegal substances are not the only culprits.  Health Issue and Advocacy Essay Paper In addition, prescription opioids are playing a significant role in the increasing frequency of abuse and death linked to opioids. Because some of the persons abusing opioids either received them from someone with a prescription, or were prescribed the drugs, nursing professionals must be involved in fighting the opioid epidemic. As the largest group of health care professionals whose presence is felt in virtually every medical scenario, it is important to involve nurses in addressing the opioid epidemic as a health issue (Macy, 2019).

ORDER A PLAGIARISM-FREE PAPER HERE

Opioids are typically prescribed as medication for relieving pain. They work by inhibiting the pain signals sent to the brain and simultaneously reducing the pain stimulus effect. Although typically prescribed to relieve pain, some opioids are prescribed for severe coughs and diarrhea. Some of the commonly prescribed opioids include oxycodone, hydrocodone, morphine and codeine. For persons dealing with chronic persistent pain, common over the counter medication may not be enough. In such cases, opioids are typically prescribed as a beneficial medication. However, these opioids present an addiction concern. Opioids are highly addictive substances that can lead to dependence if used without supervision or over a long period. In fact, some of the patients do not use the medication as prescribed thus resulting in opioid addiction (Graeme, 2017).

The use of opioids to manage severe pain within the medical setting is becoming increasingly common. The opioid epidemic is an unfortunate result. Although pain levels have not necessarily risen within the population, the sale of prescription opioids have multiplied. From 1999 to 2014, the sale of opioids quadrupled. Additional review of the associated figures reveals that about 50% of opioid related overdoses involve prescription medication. However, illegal narcotics also contribute to the opioid epidemic with heroin being the largest contribute with the number of deaths tripling over the last decade. Still, the tie to prescription opioids cannot be overlooked since individuals typically start by abusing prescription opioids before moving on to abuse heroin and other illegal narcotics. This awareness identifies the need for a policy intervention to control and monitor the use of prescription opioids as well as involve nurses in applying other intervention strategies (Lembke, 2016).

Stakeholders analysis

Four stakeholders have been identified as being concerned with opioid epidemic as a health issue. Firstly, policymakers are responsible for establishing the framework within which medical care (opioid prescription) is provided to the population and managed. The term policymaker is synonymous with jurisdictional entities that are responsible for public health to include legislators, government departments and health care regulators. They have a relationship with other stakeholders by regulating health care coverage (payors), regulate service providers (providers), and maximize health (patients). Policymakers aggregate health data from other stakeholders (patients, providers and payors) to develop metrics that inform policies at the level of the population. In this context, they answer the questions of: who should receive prescription opioids; what medication should be provided; how, where and by whom the medication should be prescribed; are the prescription services well managed and are they accessible; are disadvantaged populations adequately served and are the services accessible; and what medical concerns should be planned for next (Geyman, 2018).

Secondly, patients who include all members of the population since they receive medical care and are patients at one time or another. All taxpayers, voters and citizens are included in the patients’ category. They have a relationship with other stakeholders as care seekers and recipients (providers), influence policy as taxpayers and voters (policymakers), and pay for insurance (payors). The policymakers have a fiduciary duty to the patients, and the policy framework that they establish is targeted at benefiting the patients. Patients receive medical services from the providers and are the payors beneficiary customers. Their interest is in managing their pain while avoiding the dependence and addiction associated with opioid use (Geyman, 2018).

Thirdly, providers (who include all medical personnel, organizations and facilities) are responsible for operationalizing care delivery within the policy framework presented by the policymakers. They provide medical care to the patients and manage their access to prescription opioids as well as use. They have a relationship with other stakeholders by meeting the reporting and invoicing needs of the suppliers (payors), provide care as members of the care team (patients), and conform to applicable policy and legislation as regulated professionals (policymakers). Providers form care teams that monitor the patient through the continuum of care to determine when prescriptions opioids are needs, the appropriate dose, when to discontinue use, and when to use alternative pain management strategies (Geyman, 2018).

Finally, payors (who include health insurers) are responsible for operationalizing the financial elements of the policy framework. They enroll patients as beneficiaries, and procure health care services from the providers on behalf of the beneficiaries. Their focus is on the financial sustainability of the health care policy and its actuarial results. They have a relationship with other stakeholders by conforming to the regulated service in terms of policy and legislation (policymakers), procure and pay for cost-effective, high quality and effective services for their beneficiaries (providers), and minimize the costs while ensuring financial sustainability for the benefits package they offers (patients) (Geyman, 2018).

Advocacy plan

The opioid epidemic has turned into a public health crisis receiving much attention from the media. This is not unusual as pain is perhaps the most common occurrence among patients (whether chronic or acute) with prescription opioids being the most effective pain management strategy available to the health care industry. About 25 million adult Americans suffer from chronic pain and about 126 million experience recurring pain, all on a daily basis. This is a significant number of Americans who require pain medication on a daily basis. Approximately 2 million adult Americans suffer from opioid misuse or use disorder. A review of the figures shows an upward trend and the figures are alarming (St. Marie, Arnstein, & Zimmer, 2018). The opioid epidemic issue has received much political and policy attention although tangible policy interventions are slow to be implemented owing to effectiveness and cost concerns. This identified opioid users as a disadvantaged population since their pain forces them to use opioids even when faced with the risk of addiction and dependence (Lembke, 2019).

The reality is that despite the risks associated with opioid use, they are perhaps the best available pain management medication. Prescribing opioids is an important component of health care. As such, any policy to address the opioid epidemic must keep away from deterring opioid prescription. The present advocacy plan proposes that nurses’ qualifications for administering, dispensing and prescribing opioid medication be revised. Nurses are at the forefront of health care delivery, and have the unique capacity to assist in addressing the opioid epidemic and improving patient outcomes. Pain management is an essential component of health care, and nurse professionals should be educated on all aspects of pain management so that their qualifications for administering, dispensing and prescribing opioid medication can be revised (Lembke, 2019). Opposition to the policy would argue that nurses are not equipped to manage opioid medication. However, a comprehensive education plan that includes pain assessment and prescription monitoring can address this concern by ensuring that nurses are competent enough to manage opioid medication (Black, 2016).

Conclusion

One must accept that health policies present an opportunity for addressing population disadvantages. In addition, one must acknowledge that opioids use in pain management presents a population disadvantage to the American public since they are forced to use opioids as the more effective pain management strategy and yet it presents addiction and dependence concerns. In fact, about 80 people die every day from opioid overdose in the USA with 50% of the deaths resultant from prescription opioids. Given this awareness, the policy proposal is presented that that nurses’ qualifications for administering, dispensing and prescribing opioid medication be revised to enable their greater involvement.

References

Black, B. (2016). Professional nursing: concepts & challenges. Elsevier Health Sciences.

Geyman, J. (2018). Crisis in U.S. health care: corporate power vs. the common good. Copernicus Healthcare.

Graeme, D. (2017). The Opioid Epidemic of America. CreateSpace Independent Publishing Platform.

Lembke, A. (2016). Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop. Johns Hopkins University Press.

Macy, B. (2019). Dopesick: Dealers, Doctors, and the Drug Company That Addicted America. Head of Zeus.

Porter-O’Grady, T. & Malloch, K. (2016). Leadership in nursing practice: changing the landscape of healthcare (2^nd ed.). Jones & Bartlett Learning.

St. Marie, B., Arnstein, P., & Zimmer, P. (2018). Pain and opioids: Call for policy action. The Journal for Nurse Practitioners, 14(1), 40-44. https://doi.org/10.1016/j.nurpra.2017.10.002

The purpose of this assignment is to identify a health issue requiring advocacy from the nursing profession on a local, regional, state, national, or international level. This topic can be related to health promotion, population health, disease management, or patient safety in the community or other healthcare setting. You are assuming the role of advocate in various capacities. The topic you select for this paper will be the subject of your Policy Brief and Advocacy Letter Assignment. Therefore, research thoroughly your topic of interest to ensure that it can be applied across both assignments.

In this paper you will identify a health issue which may or may not already be represented in the form of legislation or health policy. Individuals may just take a position on an issue affecting local policy with decision makers.

An example of this with legislation includes:

• Health issue: primary care access for patients
• Health policy: increasing primary care providers using nurse practitioners; support of PA HB 765 for CRNP independent practice An example of this without legislation includes:

• Health issue: increased chronic back pain from integration of technology in healthcare
• Health policy: ergonomic evaluation of work environments for all employees; letter of support to employers for new healthcare organization policy

Health Issue and Advocacy Essay Paper