NURS 8100: Week 11 – Discussion

Week 11: Policy and Practice 

As noted in Understanding Health Policy, “policies tend to evolve in a cyclical process of finding solutions that create new problems that require new solutions,” (p. 205). The tensions created by the pulls between quality care and cost 

containment, for instance, or between caring for the individual and concern with the common good, arise as new policies are introduced at all levels: national, state, local, and institutional. When this occurs, new procedures may need to be implemented in the practice setting. 

This week, you will reflect on the implications of health care policies for consumers and health care providers. You will also consider the reciprocal relationship between policy and practice as you explore how policy influences nursing practice and how evidence-based nursing practice influences policy. Additionally, you will propose a strategy for how nurses can advocate for themselves, their patients, and the profession through involvement in health care policy. 

Note: This week you will complete the Discussion in a small group. Your instructor will notify you of your group assignment by Day 1 of this week. 

Learning Objectives 

Students will: 

Assess the implications of various policy options and solutions to consumers of health care and nursing practice Outline current evidence that supports suggested options and solutions to a policy issue 

Propose an advocacy strategy nurses may employ to address a practice issue through the policy process 

Learning Resources 

Required Readings 

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill. 

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. 

e 

d 

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. 

v 

@ 

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 

e 

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), 10-13. 

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 

Walden University, LLC. (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. 

00 

Kathleen M. White, PhD, RN, NEA–BC, FAAN 

0:00 / 7:14 

Accessible player 

–Downloads– 

Optional Resources 

Birnbaum, D. (2009). North American perspectives: POA, HAC and never events. Clinical Governance: An International Journal, 14(3), 242-244. 

To prepare:

• Briefly summarize your policy analysis, focusing on the implications for clinical practice that may be most relevant or interesting for your colleagues. Include how evidence-based practice influenced the policy, policy options, or solutions.

By Day 3

Post a 1- to 2-paragraph succinct summary of your policy analysis paper. Include at least two of the options or solutions for addressing the policy and the resulting implications for nursing practice and health care consumers.