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.BELOW IS THE QUESTIONPost 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.BELOW IS THE REQUIRED READINGLearning ResourcesRequired ReadingsMilstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116-124 only)Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261-1267.Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities. Journal of Racial and Ethnic Health Disparities, 4(5), 983-991.Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386-393. doi:10.1016/j.outlook.2018.05.003Document: Healthcare Program/Policy Evaluation Template (Word document):PLEASE DONT FORGET TO ADD 4 REFERENCES NOT MORE THAN 5 YEARS OLD:please refer to the rubic. CORE SKILL: distinguishing POLICY EVALUATION from policy-MAKING, and identifying the specific, non-substitutable contribution nurses make to the evaluation stage.
THE DISTINCTION: policy-making DESIGNS and ENACTS; policy evaluation asks WHETHER IT WORKED, FOR WHOM, AND AT WHAT COST. Evaluation is the feedback loop of the policy cycle (agenda-setting → formulation → adoption → implementation → EVALUATION → and back to agenda-setting, because evaluation findings are what reopen the agenda). Without evaluation, policy is faith-based. Nurses are frequently invited to help implement and almost never invited to help evaluate — which is a strange omission, because they hold the information the evaluation most needs.
WHAT NURSES UNIQUELY CONTRIBUTE TO EVALUATION — this is the heart of the discussion:
— They know whether the policy is actually being IMPLEMENTED AS WRITTEN. A policy evaluated on paper compliance while nurses are working around it every shift will be evaluated as a success and will be a failure. Nurses see the WORKAROUNDS, and workarounds are the single richest source of evaluation data available — they are the system telling you exactly where the design is wrong.
— They see the UNINTENDED CONSEQUENCES and the BALANCING HARMS first — a discharge-throughput policy that improves length-of-stay metrics while increasing readmissions and unsafe discharges; a staffing model that meets ratio on paper while ignoring acuity; a metric that gets GAMED (cream-skimming the easiest patients to hit a target) because it was measured without being understood.
— They can speak to whether the OUTCOME MEASURED is the outcome that MATTERS. What gets measured gets managed — so the CHOICE of measure is a VALUE JUDGMENT disguised as a technical one. Nurses can advocate for patient-centered outcomes over merely countable ones. This is the strongest point available in the whole discussion.
— They hold the data (clinical documentation, incident reports, patient-reported experience) and, crucially, the CLINICAL CONTEXT to interpret it. An analyst can tell you the rate changed; a nurse can tell you why.
OPPORTUNITIES TO PARTICIPATE: quality and safety committees; institutional review and QI boards; professional organization policy committees; public comment on proposed rules; research and evaluation teams; state health department advisory panels; hospital board membership.
THE BARRIERS: time and shift work; lack of formal training in evaluation methods; not being invited (evaluation is often outsourced to consultants or handled by finance); and organizational discomfort with findings that are inconvenient.
TWE STRATEGIES TO INCREASE ENGAGEMENT (most versions ask for two): (1) embed nurses formally on evaluation and QI committees with PROTECTED TIME — not as volunteers on top of a full assignment, because unprotected participation is participation that decays; (2) build evaluation literacy into nursing education and professional development, so that nurses can engage with logic models, process vs. outcome measures, and balancing measures on equal terms rather than as guests in someone else’s methodology.
FRAMEWORKS TO CITE: the logic model (inputs → activities → outputs → outcomes → impact); formative vs. summative evaluation; process vs. outcome vs. balancing measures; and the caution that OUTPUTS ARE NOT OUTCOMES (“we screened 400 patients” says nothing about whether anyone got better).
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
