Discussion: Agenda Setting NURS 8100

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A Sample Answer For the Assignment: Discussion: Agenda Setting NURS 8100

Within every organization, employee satisfaction is a largely contributing factor the success or failure of a healthcare system. What is the organization without its employees? Right now, within the world of nursing, many are searching for opportunities at other organizations. Looking for increased pay, work life balance, flexibility and safe ratios of care. Health care systems are losing nurses in mass numbers with the demand for the profession continuing to grow.

Currently, the national average for turnover rates is 8.8 % to 37.0% varying on location. According to The American Nurses Association (ANA), more registered nurse jobs will be available through 2022 than any other profession in the United States. According to an article in the Nursing Times, The US Bureau of Labor Statistics projects that more than 275,000 additional nurses are needed from 2020 to 2030 (Haddad, et al., 2022).

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Dr. Kathleen White and Dr. Joan Stanley discuss the original theory of agenda setting. These discussions and implementation of formal policies to address important issues (Laureate Education, 2011). Dr. Kathleen also discusses the importance of taking certain steps to get a policy adopted while taking into consideration feasibility, cost, and involvement of stakeholders prior to implementation (Laureate Education, 2011). Collaboration is key to creating change. Policy change cannot occur without the input from frontline members.

In this scenario the staff are the stakeholders. Stakeholders can be defined as “Organizations and individuals that are involved in a specific activity because they participate in producing, consuming, managing, regulating, or evaluating the activity” (Hyder, et. alt. 2010). Hyder describes the importance of stakeholders and their perceptions. The perspective of decision makers is important as it provides insight to areas of policy making.

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The voice of the employee is invaluable to the success and longevity of an organization. At my current organization, every year a survey is administered to each and every nurse to have a better understand of what is important and needed at an employee level. Many policy changes have occurred from the results of this survey. Last year, nurses and patient care technicians spoke to the importance of flexible scheduling related to the wellbeing of their roles. Many described how they were unable to leave from their scheduled shifts in a timely fashion or arrange their lives to meet the needs of the unit.

Hospital leadership met to discuss how to make the voices of the employees heard. Scheduling needs were adjusted to be in 4 hour increments, which increased the workforce. The view from staff was that wellness and work life balance was more achievable with the flexible scheduling. This made happier, healthier employees. This simple change cost nothing but increased retention and was viewed as a recruitment tool as well. Allowing employees to be viewed as individuals not just a body to fill a staffing need.

References

 Haddad LM, Annamaraju P, Toney-Butler TJ. Nursing Shortage. [Updated 2022 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK4931

Hyder, S. Syed, P. Puvanachandra, G. Bloom, S. Sundaram, S. Mahmood, M. Iqbal, Z. Hongwen, N. Ravichandran, O. Oladepo, G. Pariyo, D. Peters, Stakeholder analysis for health research: Case studies from low- and middle-income countries, Public Health, 124 (3), 159-166

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda      setting and the policy process. Baltimore: Author.

Identify the clinical practice issue you would like to see on your organization’s systematic agenda.

Clinical Practice Issue: Frequent Admissions due to Poor Discharge Nursing Education. Reducing hospital readmissions is a national focus for healthcare reform. Consequently, patient discharge education is increasingly important for improving clinical outcomes and reducing hospital costs (Polster, 2015). According to the Centers for Medicare and Medicaid Services (CMS), nearly 20% of all Medicare patients are readmitted to the hospital within 30 days of discharge; 34% are readmitted within 90 days of discharge (Polster, 2015)

The quality of discharge teaching is statistically linked to decreased readmission rates. Nursing most often bears the major responsibility of patient and caregiver teaching (Luther, et al., 2019). Currently, discharge teaching is complicated by problems including time constraints, patient and caregiver overload, and coexisting comorbidities that add complexity to the patient’s care needs at home. (Luther, et al., 2019). A structured discharge process with tools to help healthcare organizations improve their discharge process to decrease readmission rates need to be considered (Luther, et al., 2019).

The CMS expects nurses and other healthcare team members to address modifiable factors that can increase the chance of rehospitalization, such as (1) unplanned and early discharge or insufficient post-discharge support, (2) inadequate follow-up, (3) therapeutic mistakes, (4) adverse drug events, and (5) failed handoffs (Polster, 2015). The policy of interest will focus on failed handoffs or poor discharge education.

Ineffective discharge is related to factors at the level of the individual care provider, the patient, the relationship between providers, and the organizational and technical support for care providers. Providers can reduce hospital readmission rates and adverse events by focusing on high-quality discharge information, well-coordinated care, and direct and timely communication with their counterpart colleagues (Hesselink, et al., 2015)

What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?

There are several strategies that can be used to inform stakeholders while persuading them on the importance of a new policy (Hydera, et al., 2010). For example, the policy of interest must be established and stakeholders to be included.  The stakeholders will entail clinical nursing, physicians, patient experiences, pharmacy, quality and safety, nursing managers and directors. Once a policy of interest and stakeholders have been established, accepting of the stakeholder’s perspective on the issue would be first taken into consideration.

discussion agenda setting nurs 8100
Discussion Agenda Setting NURS 8100

Expectations related to interventions can predict the likelihood of successful intervention implementation through intervention refinement and incorporation of innovative ideas, sharing perspectives with key stakeholders will enhance solidarity around interventions for improving discharge education and reduction of frequent admits (Hydera, et al., 2010). Stakeholder engagement throughout research generation and policymaking becomes critical to strengthening the research–policy interface.

Fostering such linkages between mediators, individuals or institutions with different stakeholders will encourage strong research-policy linkages (Hydera, et al., 2010). Another strategy that can be used to persuade stakeholders on the importance of improving discharge education to decrease frequent admissions is to use policy briefing, a new approach to packaging research evidence for policymakers (Lavis, et al., 2009). The first step in a policy brief is to prioritize a policy issue, followed by use of systematic reviews to mobilize full range research evidence to the various features of the issue.

Hesselink, G., Zegers, M., MyVernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., Ön, G., Olsson, M., Bergenbrant, S., Orrego, C., Suñol, R., Toccafondi, G., Venneri, F., Dudzik-Urbaniak, E., Kutryba, B., Schoonhoven, L., & Wollersheim, H. (2014). Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC Health Services Research. 14: 389.

Hydera, A., Syeda, S., Puvanachandraa, P., Bloomb, G., Sundarama, S., Mahmoodc, S., Iqbalc, M., Hongwend, A., Ravichandrane, N., Oladepof, O., Pariyog, D., & Petersa, D. (2010). Stakeholder analysis for health research: Case studies from low- and middle-income countries. Public Health, 124(3): 159-166

Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy & Systems, 71–79.

Luther, B., Wilson, R. D., Kranz, C., & Krahulec, M. (2019). Discharge processes: what evidence tells us I most effective. Review Orthopedic Nurse; 38(5): 328-333.

Polster, D. (2015). Preventing readmissions with discharge education. Nursing Management, 46(10):  30-37.

Agenda setting is a critical component of the public policy process. The agenda is the set of issues that policymakers or others with influence (direct or indirect) on decision-making consider important at any given time (Kingdon, 2003). Healthcare organizations have recently become interested in the safety culture. Given the significance of nurses’ roles in patient safety, their knowledge and experiences with the challenges that influence patient safety culture can aid in the development and implementation of better strategies. The clinical practice issues that I believe should be on the systematic agenda of my organization will be to investigate nurses’ experiences with the challenges influencing the implementation and integration of safety culture in healthcare (Farokhzadian, Dehghan Nayeri, & Borhani, 2018). Nurses and nursing management are the stakeholders who would be interested in this clinical practice issue. Although patient safety is a new and emerging phenomenon, historical evidence suggests that concerns about patient safety existed long before modern healthcare. Florence Nightingale stated more than 150 years ago that “the very first requirement in a hospital is to do no harm to patients” (Friesen, Farquhar, & Hughes, 2016). In 2001, the Institute of Medicine (IOM) issued a report titled “Crossing the Quality Chasm: A New Health System for the Twenty-First Century.” The IOM emphasized the importance of healthcare safety and the need for patients to be free of danger or risk caused by the healthcare system (Farokhzadian, Dehghan Nayeri, & Borhani, 2018). Modern advances and the complexity of healthcare have resulted in serious deficiencies in care quality and patient safety. The high prevalence of clinical risks and safety incidents has increased healthcare systems’ concerns and challenges (Farokhzadian, Nayeri, & Borhani 2015). Although estimates of the size of the problem are imprecise, millions of people are likely to suffer from disabling injuries or death as a result of clinical risk and safety incidents. It is estimated that one out of every ten patients in developed-country hospitals is harmed while receiving unsafe care. Furthermore, the risk of damage is far greater in developing countries than in developed countries. For example, in some developing countries, the risk of healthcare-associated infection is twenty times higher than in developed countries (Farokhzadian, Dehghan Nayeri, & Borhani, 2018).

Patient Safety Indicators will be used by me as a patient safety advocate. This will include data on the quality of inpatient care, as well as information on avoidable complications and adverse events. After an extensive literature review, analysis of the International Classification of Diseases, Ninth Revision, Clinical Modification medical coding system codes (e.g., rates of death, pressure injury, surgical infection, retained surgical items), expert panel review, risk adjustment, and empirical analyses, Patient Safety Indicators were identified and developed (Agency for Healthcare Research and Quality, 2016). Through routinely gathered point prevalence and administrative data, Patient Safety Indicators assist in the detection of probable adverse events (e.g., inpatient problems) that require further investigation. PSIs have been used by clinical researchers to better understand adverse occurrences and highlight potential areas for practice improvement in the health-care system. Pressure injury prevention, clinical handover, pharmaceutical safety, falls prevention, nutrition services, and venous thromboembolism prophylaxis are the six areas where the PSIs will be concentrated in the facility. Research and quality improvement (QI) efforts in the hospital usually require collaboration across multiple systems and disciplines. Historically, the PSIs have been driven by an emphasis on quality improvement. The desire to engage clinical researchers with experience in the creation and implementation of practice-based interventions has grown as a result of the need to establish robust evidence-based interventions that underpin QI projects and have long-term impacts.

Discussion: Agenda Setting NURS 8100

References

Agency for Healthcare Research and Quality. (2016). Patient Safety Indicators overview. http://www.qualityindicators.ahrq.gov/modules/psi_overview.aspx

Farokhzadian, J., Dehghan Nayeri, N., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 654. https://doi.org/10.1186/s12913-018-3467-1

Farokhzadian J, Nayeri ND, Borhani F. (2015). Rocky milieu: challenges of effective integration of clinical risk management into hospitals in Iran. Int J Qual Stud Health Well-being; 10(1):27040. doi: 10.3402/qhw.v10.27040

Friesen MA, Farquhar MB, & Hughes R. (2016). The nurse’s role in promoting a culture of patient safety: Center for American Nurses. ana.nursingworld.org/mods/archive/mod780/cerole full.htm

Gillespie, B. M. (2016). Setting a Quality Improvement and Research Agenda for Patient Safety in a Tertiary Hospital in Australia: Global perspectives. AORN Journal, 103(6), 632-635. http://dx.doi.org/10.1016/j.aorn.2016.04.007

Kingdon, J. (2003). Agendas, Alternatives, and Public Policies (3a. Ed.) New York, NY: Harper Collins.

Discussion: Agenda Setting

Within every organization, employee satisfaction is a largely contributing factor the success or failure of a healthcare system. What is the organization without its employees? Right now, within the world of nursing, many are searching for opportunities at other organizations. Looking for increased pay, work life balance, flexibility and safe ratios of care. Health care systems are losing nurses in mass numbers with the demand for the profession continuing to grow.

Currently, the national average for turnover rates is 8.8 % to 37.0% varying on location. According to The American Nurses Association (ANA), more registered nurse jobs will be available through 2022 than any other profession in the United States. According to an article in the Nursing Times, The US Bureau of Labor Statistics projects that more than 275,000 additional nurses are needed from 2020 to 2030 (Haddad, et al., 2022).

Dr. Kathleen White and Dr. Joan Stanley discuss the original theory of agenda setting. These discussions and implementation of formal policies to address important issues (Laureate Education, 2011). Dr. Kathleen also discusses the importance of taking certain steps to get a policy adopted while taking into consideration feasibility, cost, and involvement of stakeholders prior to implementation (Laureate Education, 2011).

Collaboration is key to creating change. Policy change cannot occur without the input from frontline members. In this scenario the staff are the stakeholders. Stakeholders can be defined as “Organizations and individuals that are involved in a specific activity because they participate in producing, consuming, managing, regulating, or evaluating the activity” (Hyder, et. alt. 2010). Hyder describes the importance of stakeholders and their perceptions. The perspective of decision makers is important as it provides insight to areas of policy making.

The voice of the employee is invaluable to the success and longevity of an organization. At my current organization, every year a survey is administered to each and every nurse to have a better understand of what is important and needed at an employee level. Many policy changes have occurred from the results of this survey. Last year, nurses and patient care technicians spoke to the importance of flexible scheduling related to the wellbeing of their roles.

Many described how they were unable to leave from their scheduled shifts in a timely fashion or arrange their lives to meet the needs of the unit. Hospital leadership met to discuss how to make the voices of the employees heard. Scheduling needs were adjusted to be in 4 hour increments, which increased the workforce.

The view from staff was that wellness and work life balance was more achievable with the flexible scheduling. This made happier, healthier employees. This simple change cost nothing but increased retention and was viewed as a recruitment tool as well. Allowing employees to be viewed as individuals not just a body to fill a staffing need.

References

Haddad LM, Annamaraju P, Toney-Butler TJ. Nursing Shortage. [Updated 2022 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK4931

Hyder, S. Syed, P. Puvanachandra, G. Bloom, S. Sundaram, S. Mahmood, M. Iqbal, Z. Hongwen, N. Ravichandran, O. Oladepo, G. Pariyo, D. Peters, Stakeholder analysis for health research: Case studies from low- and middle-income countries, Public Health, 124 (3), 159-166

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda      setting and the policy process. Baltimore: Author.

A key aspect of the policy process is agenda setting. How do topics get on that agenda?
Agenda setting requires the support of stakeholders to move the issue forward. In this
week's media presentation, Dr. Kathleen White outlines the policy process and
discusses how to move issues into the policy arena through agenda setting. The
ultimate goal is to gain the attention of leadership whether at the organizational, local,
state, national, or international level.
To get ready: Examine this week’s media presentation, paying special attention to the ideas offered by Dr. White and Dr. Stanley on agenda setting and stakeholder identification.
 Consider clinical practice challenges that you believe should be on your organization’s systematic agenda.
Who are the potential stakeholders in this clinical practice issue?

By Day 3

Post a unified response that addresses the following points:
 Identify the clinical practice issue you want to see on your organization’s systematic agenda in the first line of your posting.
What techniques would you employ to inform and persuade stakeholders of the significance of your identified clinical practice issue?
Read a few of your coworkers’ postings.

By Day 6

Respond to at least two of your coworkers with further informing strategies.

and persuading stakeholders. Include additional research evidence that supports the
importance of their identified clinical practice issue.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question
posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 3 Discussion

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: Agenda Setting NURS 8100

nd yes, discharge planning not only improves the quality of life of patients but also their families. I am not sure if clinical nurses realize the impact of their discharge instructions. Several years ago, I had the opportunity to observe a staff nurse provide education to the patient and his family regarding his CHF admission.

The staff nurse did an awful job in educating the patient and family. The nurse was pull to the side to discuss the observation made. Instead of the nurse listening to the feedback given, she stated, “I am not a teacher, I have too many patients to take care of.” I was truly speechless and just did know how to respond at the time.

Clinical staff need to understand that effective discharge planning promotes safety and quality care and that gaps in discharge planning can lead to increase expenses, life-threatening scenarios, and unnecessary readmissions (Gholizadeh, et al., 2016). It is essential for health mangers and policy makers to pay attention to barrier s of effective discharge planning, for successful implementation of discharge planning (Gholizadeh, et al., 2016).

To maximize organizational effectiveness, senior managers are needed in policy planning and providing concrete services for discharge planning to maximize organizational effectiveness (Wong et al., 2011). Staff need to understand that the patient’s perception and written documentation does not always reflect understanding of discharge care.

Gholizadeh, M., Delgoshaei, B., Gorji, H. A., Torani S., & Janati, A. (2016). Challenges in          patient discharge planning in the health system of Iran: A qualitative study. Global Journal of Health Science; 8(6): 168-178.

Wong, E. L., Yam, C. H., Cheung, A. W., Leung, M. C., Chan, F. W., Wong, F. Y., Yeoh, E. K. (2011). Barriers to effective discharge planning: A qualitative study investigating the perspectives of frontline healthcare professionals. BMC Health Services Research, 11(1):     242.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., …
Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and
middle-income countries. Public Health, 124(3), 159–166.
Note: You will access this article from the Walden Library databases.

This study demonstrates how the engagement of stakeholders in research and policy
making can assist in the successful implementation of policy proposals. The authors
propose that by engaging stakeholders, researchers and policy makers are provided
with multiple perspectives on proposed policies, which can lead to greater success with
policy adoption and implementation.
Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009).
SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and
using policy briefs to support evidence-informed policymaking. Health Research Policy
& Systems, 71–79. doi: 10.1186/1478-4505-7-S1-S13
Note: You will access this article from the Walden Library databases.

The purpose of a policy brief is to communicate an issue clearly and definitively to policy
makers. The authors of this article propose an outline for policy briefs and also stress
the importance of using research when creating a policy brief.

Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting
points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133–138.
Note: You will access this article from the Walden Library databases.

This article provides an example of nurse involvement in policy making by examining a
bariatric nursing issue. The author stresses that nurses, in their patient-advocacy role,
have a responsibility to be involved in the health care policy process.
Moore, K. (2006). How can basic research on children and families be useful for the
policy process? Merrill-Palmer Quarterly, 52(2), 365–375.
Note: You will access this article from the Walden Library databases.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health:
Report recommendations. Retrieved
from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-
Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Introduced in Week 2, this IOM report highlights four k

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