Assignment: Advocating Through Policy
As noted by Dr. Stanley and Dr. White in this week's media presentation, professional nurses should be engaging in advocacy efforts to improve health and nursing practice through involvement in the policy process at the institutional, local, state, or federal levels. This array of possibilities for involvement provides opportunities for all nurses, regardless of time, or other possible constraints. Successful policy making is a collaborative effort, and one that commands mutual respect from all involved. Your involvement in policy making can lead to expanded opportunities as both a nurse leader and as a respected member of an interprofessional health care team.
Note: This Discussion provides a forum for discussing advocacy opportunities and honing your presentation skills in a small group setting.
To prepare:
• Reflect on the insights offered by Dr. Stanley and Dr. White on engaging in advocacy through the policy process.
• Identify a practice issue that is of interest to you and that could benefit from advocacy efforts through the policy process.
• Consider the stakeholders and any special interest or professional organizations that would support your issue.
• Develop a short, yet persuasive PowerPoint (up to 3 slides IN APA FORMAT) as follows:
1) Identify the practice issue that would benefit from being addressed through the policy process
2) Represent the key stakeholders (i.e. use graphical images when possible)
3) Propose one strategy for how a nurse could advocate for this issue
The PowerPoint should be succinct, visually appealing, and effective.
Post your PowerPoint presentation.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
• Chapter 17, "Conclusion: Tensions and Challenges"
This chapter concludes with final thoughts on the challenge of providing quality health care and controlling health care costs. The solution is likely to be resolved only by a collaborative approach, involving all health care stakeholders, and by health professionals taking the lead.
Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis. Journal of Patient Safety, 6(3), 147-152.
The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.
Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94-99.
Lau, B., San Miguel, S., & Chow, J. (2010). Policy and clinical practice: Audit tools to measure adherence. Renal Society of Australasia Journal, 6(1), 36-40.
The authors study the compliance to renal-care policies by health care professionals. They conclude with the necessity for nurses to support evidence-based protocols as well as to obtain continuing education on new protocols.
McCracken, A. (2010). Advocacy: It is time to be the change. Journal of Gerontological Nursing, 36(3), 15-17.
The author proposes that nurses, as patient advocates, need to be more involved in the making of health care policy instead of reacting to policies that are constantly changing. The article provides a guide to help organize initial policy efforts.
Nannini, A., & Houde, S. C. (2010). Translating evidence from systematic reviews for policy makers. Journal of Gerontological Nursing, 36(6), 22-26.
The article cites geronotological nurses as examples of those who are able to translate research into policy briefs that can be clearly understood by policy makers. Geronotological nurses are in this unique position because of their clinical experience and educational background.
Paterson, B. L., Duffet-Leger, L., & Cuttenden, K. (2009). Contextual factors influencing the evolution of nurses' roles in a primary health care clinic. Public Health Nursing, 26(5), 421-429.
This article provides details on a study conducted in a nurse-managed clinic related to the changing roles of nurses. The authors found that nurses, in response to social, political, and economic forces, became involved in advocacy for the clinic through political action, government funding issues, and media relations roles.
Sistrom, M. (2010). Oregon's Senate bill 560: Practical policy lessons for nurse advocates. Policy, Politics, & Nursing Practice, 11(1), 29-35. doi: 10.1177/1527154410370786
The author uses the efforts by a nurse advocate in lobbying for an Oregon bill related to healthy food in public schools to illustrate nurse advocacy and policy making. The bill, developed in response to childhood obesity, did not immediately become law. The author concludes with the importance of considering the political environment when creating successful policy.
Spenceley, S. M., Reutter, L., & Allen, M. N. (2006). The road less traveled: Nursing advocacy at the policy level. Policy, Politics, & Nursing Practice, 7(3), 180-194. doi: 10.1177/1527154410370786
Nurses have always been advocates at the patient-level of care, but the authors of this article promote the need for all nurses to become advocates at the policy level as well. They discuss factors that have kept nurses from getting involved with policy making and they provide strategies to resolve these challenges.
Wyatt, E. (2009). Health policy advocacy: Oncology nurses make a difference. ONS Connect, 24(10), 12-15.
The author presents information on two nurses who have become health care policy advocates-one as a policy maker and one as an elected legislator. Both have been able to use their perspectives from their nursing careers to affect health policy.
Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.' Journal of Advanced Nursing, 65(8), 1746-1752.
The authors attempt to distinguish the concepts of advocating for a patient and paternalism, or overriding a patient's wishes. They provide clinical examples to illustrate the differences between these concepts, and they conclude with strategies to use in practice.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Advocating through policy. Baltimore: Author.
Note: The approximate length of this media piece is 7 minutes.
In this media presentation, Dr. Joan Stanley and Dr. Kathleen White discuss how nurses can influence practice and engage in advocacy through the policy process.
Optional Resources
Birnbaum, D. (2009). North American perspectives: POA, HAC and never events. Clinical Governance: An International Journal, 14(3), 242-244.