NUR 8100 Discussion: Selecting a Policy Analysis Framework

A Sample Answer For the Assignment: NUR 8100 Discussion: Selecting a Policy Analysis Framework

Policies form a critical part of any professional body as they have a substantial influence on how the activities are run and the directions which the operations take. One such area is nursing. Policy making is an area of interest in nursing as it influences the nature of care offered to patients and how the nurse professionals operate within the care settings (Rasheed et al., 2020). The implication is that nurses should be up to date with current policies that directly impact or affect patient care, the nursing profession, and nursing activities.

Nurses can ensure this by participating in various policy issues and advocacy processes. Therefore, the purpose of this assignment is to analyze a policy issue. Various aspects will be discussed, including the policy definition, application of a policy analysis framework in exploring the issue, policy options or solutions, and building a consensus.

Part One: The Policy Issue

Currently, there are various policy issues in the area of nursing which directly impact patient outcomes and the nurses’ working environment. One of them is the nursing shortage. The issue of nursing shortage has existed for years and, surprisingly, is still a policy issue to date.

A nursing shortage is a case where the available nursing professionals like registered nurses can not adequately fill the available professional slots implying that the demand has exceeded the supply (Haddad et al., 2022). The nursing shortage has been shown to lead to various undesirable impacts such as increased rates of mortality and morbidity as well as higher cases of medical errors.

This issue has affected the policy arena for decades, with legislators participating in the law-making processes geared toward reducing nursing shortages (Haddad et al., 2022). In addition, various lobby groups and nursing professional organizations have been advocating for an increased number of nursing staff for better nurse-to-patient ratios. Currently, there are politics surrounding the issue.

For example, one of the major discussions has been expanding the expansion of nursing roles to reduce nursing shortage (Marć et al.,2019). While some argue that expansion of the nursing roles would be key to reducing nursing shortage, others argue that such expansion may put the patients at risk since nurses are not well equipped or trained to handle some patient care services.

As earlier discussed, the nursing shortage has been a policy issue for some time now and has attracted various stakeholders such as healthcare professionals and legislators. The latest attempt to solve the problem through policy-making and process came recently when the legislation titled the build back better act which was an initiative by President Biden.

As part of this legislation, there was a provision for the nursing workforce (Peter, 2022). The proposal was to invest about $5 billion in nursing care and the nursing workforce in the next decade.

Specifically, $500 was proposed to be used in the expansion of the nurse corps program, which offers scholarships and also helps in repaying student loads for APRNs and RNs to encourage more to go for the nursing course. Another $170 million would be used to grow and diversify the perinatal nursing workforce.

Other funds would go to schools of nursing to help them in developing, disseminating, reviewing, and evaluating health professional training and increasing the staffing levels for the nursing homes (Peter, 2022). This policy proposal recently received a major obstacle when Senator Joe Manchin stopped supporting the bill alleging failure to match the preferred cost, hence retracting his support. Such opposition halted the bill, but President Biden indicated that the government would continue deliberating on how the bill could be brought back to ensure its implementation.

Part 2: Analysis Using a Policy Analysis Framework

Policy frameworks are key in analyzing policies in several contexts. One of the most common policies is the centers for disease control’s policy analytical framework. According to this theory, analysis of an issue can be done using four major steps.

The steps include problem or issue identification, identification of a suitable policy solution, identification and description of policy options, and formulating a strategy that can be applied to fully adopt the policy solution (“CDC,” 2020). Therefore, this framework can be used in the analysis of the policy in various contexts such as social, ethical, legal, historical, and economic/or financial. The first and the second steps in the framework are key in analyzing the policy issue.

The social context of the issue is that the nursing shortage is closely connected to various social issues. For example, an inadequate number of nurses potentially lead to poor rehabilitation of individuals such as those who have been impacted by drug and substance abuse, nursing services to individuals who have faced violence, and even survivors of natural calamities.

Nursing shortage as a policy issue also has an ethical context. For example, it is ethical that patients access equitable patient care and get appropriate nursing services. However, an inadequate number of nurses negatively impact access and the nursing services, an indication that appropriate strategies should be used towards solving the problem (Marć et al.,2019).

One of the adverse impacts of nursing shortage is medical errors; the medical errors can be deadly to patients and also increase healthcare costs. When medical errors occur, a possibility is that patients may sue the healthcare institution hence damaging the institution’s image.

The historical context of the policy issue. As earlier indicated, the nursing shortage has been an issue for years and has been caused by factors such as perceived poor working conditions, the desire by nurses to move on and seek greener pastures, nurse burnout, and an increase in the number of the aging population which needs more care.

Therefore, there have been attempts to formulate legislation with the major aim of fighting it. It is worth noting that, from a historical point of view, it is not possible to narrow down on a single causative factor since the problem of nursing shortage is complex.

The problem of nursing shortage also has a financial or economic context. As earlier discussed, nursing shortage results in various undesirable impacts (Marć et al.,2019). For instance, medical errors have been associated with a nursing shortage as nurses have to attend to more patients within a time schedule. Such a requirement leads to fatigue and burnout, which offers a ground for medical errors.

These errors are costly. For instance, the errors cost up to $20 billion every year in the USA, showing how expensive it is. Correcting the problem attracts a lot of money, as revealed in the recent bill, the build back better bill. It is evident that more funds are needed for training nurses, offering nursing scholarships, and developing nursing programs that align with the current market demands to help ease the problem.

The policy also has theoretical underpinnings. While the policy had several aspects included, a huge part of it was focused on nursing care and the nursing workforce. This aspect majorly aimed to improve the patient-nurse ratio by using various initiatives and increasing funding that can then be used to implement these programs.

One of the theoretical underpinnings of the policy is that an increase in the number of the nursing workforce would improve the nature of patient care services, especially after the Covid-19 pandemic, which saw the need for nursing services substantially rise. Another underpinning has been drawn from Jean Watson’s theory, especially offering patient care through a holistic approach (Watson & Woodward, 2020).

It is important that nurse offer affection and cares to patients, and these are only possible if the management ensures that there is appropriate staffing. Adequate staffing ensures that the nurses are able to offer holistic care to patients without burnout, hence appropriate patient outcomes.

There are various stakeholders of interest in this policy. Among them are nurses who are directly affected as an increase in funding for scholarship and training would improve the nursing workforce hence better outcomes. The other stakeholders include patients who would have improved access to care (Jarrar et al., 2018).

The next stakeholders include legislators, both democrats and republicans, nursing training institution leaders, and other healthcare professionals. The importance of the issue means that there are nursing position statements regarding the issue.

For example, during the covid-19 pandemic, the American Nurses Association indicated that they are the severe nursing shortage is of deep concern and is likely to have considerable impacts on the nursing profession and the healthcare delivery system. These will eventually impact negatively on the nation’s health. They, therefore, called for it to be called a national crisis.

Part 3: Policy Options/Solutions

The issue of nursing shortage can be solved through various levels, including no change, partial change, and maximum change. It is evident that the first level is not a good option for this issue as adjustments are needed to ensure that the problem of nursing shortage is solved. As such, partial changes can be made to the existing strategies.

One of the possible solutions is to establish more nurse training institutions to ensure that more individuals enroll in the course. This will go all the way toward reducing the shortage. Another solution is increasing funding and scholarship opportunities for nursing, which would encourage more to register for the course (Harris, 2019).

This problem can also be solved using radical change. This radical change may come in the form of developing a new curriculum for the nursing course (Chan et al.,2019). This may involve integrating course content that focuses on offering care to a particular group of patients, such as the older population and the children.

This will call for specialization when the nurses train. Specialization can be a major step to ensuring that nurse training registration goes up. Specializing from the first year of training can be key in encouraging more nurses to register for training hence helping to solve the problem of nursing shortage. The theoretical underpinnings of the policy options or solutions are those of the system theory.

Open systems theory suggests that organizations are ordered in nature, and every part of the system is correlated to the other, and they work to achieve common goals. Therefore, the suggested solutions mean that nurses, as part of the healthcare organizations, are a critical part, and so increasing their number will help improve patient outcomes by improving patient to nurse ratio.

The proposed solutions have leadership and health advocacy requirements. Establishing more nurse training institutions means that more nurse leaders have to be trained to take leadership at the new training institutions. Again more nurse educators have to be trained to ensure there is enough personnel to train the nurses.

Health advocacy for this solution would involve influencing nurse legislators to formulate and support legislation that would support the establishment of new institutions to improve the nurse staff numbers (Turale & Kunaviktikul, 2019). Increasing funding and scholarship opportunities also require advocacy in terms of suggesting policies that would help ensure that every state has a structure that offers more funding and scholarship for nurses.

Formulating and establishing a new curriculum for nurse training is a radical change that requires more leadership requirements. For example, leaders have to put in place a framework for identifying individuals that can lead in the curriculum change; such individuals need to have appropriate leadership qualities, nursing knowledge, and knowledge regarding current trends in nursing.

In terms of health advocacy, nurse organizations will have to take an active part in ensuring that the new curriculum has appropriate content (Chan et al.,2019). Therefore, they will have to propose the content they feel should be part of the new curriculum and forward that to the new committee. They can then try to present their case in a bid to influence the outcomes and implementation process.

The options also offer opportunities for patient inter-professional collaboration. For example, establishing new nursing institutions would call for collaboration between the nursing profession and educators who would help in offering educational leadership. Again, financial experts will be brought on board to help advise on the financial viability of establishing each institution.

Offering more funding and scholarship to nurses would mean more would be registered for nurse training. Therefore, other healthcare professionals can be brought in to help train the nurses in specific areas. Establishing a new curriculum will also offer an opportunity for inter-professional collaboration with curriculum development experts (Chan et al.,2019). Doctors may also be brought along to suggest possible courses which can help improve the nursing profession in a bid to reduce the nursing shortage.

Each of the suggested options has pros and cons. Establishing new nursing institutions can have the advantage of improving nurse trainees’ registration. However, the cost could be high due to the need to build new structures and acquire new equipment. However, it will be effective and efficient in increasing the number of nurses hence lowering the shortage.

The option is feasible since the funding can be sourced. Increasing funding and scholarship for nurses may also be costly, but it will be effective and efficient in improving nurse enrolment hence lowering nurse shortage (Marć et al., 2019). This option is less feasible due to the fact that the healthcare system cost is already high, and it would only stretch it more.

Curriculum change may have the advantage of aligning the nurse skills with the current and emerging patient requirements. It may be less costly. However, it will take a long time to implement. This option will also be effective and efficient. In addition, it will be feasible through a curriculum development committee.

Part 4: Building Consensus

Consensus building is key in reaching an agreement on a particular issue as appropriate. Therefore, in implementing the solutions, various steps will be taken to build consensus. The stages will entail problem definition, which in this case, in nursing shortage in the context of patient care, participant identification, and recruitment then follow (Ball, & Griffiths, 2021).

This will involve bringing in interest groups, nurse organizations, and other professional bodies. The convening will then follow, which involves securing funds as the main aspect. Process design will then follow, which involves consideration of the proposed three solutions and evaluating them. Agreement approval and implementation eventually follow.

Conclusion

Policy issues exist in every society and may involve several steps that need to be considered for better solutions. This write-up has considered nursing shortage as a policy issue, and various considerations have been studied. Establishing more nurse training institutions and securing more funding for nurse scholarships and new curricula can be key to solving this problem.

References

Ball, J. E., & Griffiths, P. (2022). Consensus Development Project (CDP): An overview of staffing for safe and effective nursing care. Nursing Open, 9(2), 872-879. https://doi.org/10.1002/nop2.989

CDC (2020).policy analytical framework. https://www.cdc.gov/policy/analysis/process/analysis.html#:~:text=The%20policy%20analytical%20framework%20(Figure,policies%20that%20can%20improve%20health

Chan, Z. C., Cheng, W. Y., Fong, M. K., Fung, Y. S., Ki, Y. M., Li, Y. L., … & Tsoi, W. F. (2019). Curriculum design and attrition among undergraduate nursing students: A systematic review. Nurse education today, 74, 41-53. https://doi.org/10.1016/j.nedt.2018.11.024

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/

Harris, J. (2019). Challenges of nursing faculty retention. The Midwest Quarterly, 60(3), 251-270. http://www.pittstate.edu/engl/midwest.html

Jarrar, M. T., Rahman, H. A., Minai, M. S., AbuMadini, M. S., & Larbi, M. (2018). The function of patient‐centered care in mitigating the effect of nursing shortage on the outcomes of care. The International journal of health planning and management, 33(2), e464-e473. https://doi.org/10.1002/hpm.2491

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International nursing review, 66(1), 9-16. https://doi.org/10.1111/inr.12473

Rasheed, S. P., Younas, A., & Mehdi, F. (2020). Challenges, extent of involvement, and the impact of nurses’ involvement in politics and policy making in in last two decades: an integrative review. Journal of Nursing Scholarship, 52(4), 446-455. https://doi.org/10.1111/jnu.12567

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International nursing review, 66(3), 302-304. https://doi.org/10.1111/inr.12550

Peter R. (2022) Proposed federal policy changes related to nursing. https://campaignforaction.org/resource/2021-22-federal-policy-changes-related-to-nursing/

Watson, J., & Woodward, T. (2020). Jean Watson’s theory of human caring. SAGE Publications Limited.

Discussion: Selecting a Policy Analysis Framework

The goal of policy analysis is to provide in-depth, relevant, and evaluative information about a policy. Using a framework as a guideline for the analysis provides scaffolding for logically and carefully considering the policy issue.

To select a framework, one should consider the focus of the policy being analyzed and whether the policy is intended to be predictive or prescriptive. For this Discussion, you will choose a policy issue that is important to you and after evaluating the frameworks described in the Learning Resources, select the framework most appropriate for analyzing the issue.

To get ready:

Consider your understanding of the policy process, including how policy is developed, adopted, implemented, and assessed.
Consider how the various frameworks offered in this week’s Learning Resources apply to nursing and health policies. How do they help you understand and shape policy?
Make a list of the most essential concerns in your profession (these can be issues at the institutional, local, state, national, or international level). Then, choose a specific nursing or health care policy relating to one significant issue and explore which of the frameworks you would use to investigate it.

Please keep in mind that you cannot use the Patient Protection and Affordable Care Act for this analysis.

By Day 3

Post a unified response that addresses the following points:

Determine the policy you’ve chosen.
Describe and justify the structure you would use to address this specific issue.
What other stages of the policy process would an analysis framework be useful for?

Read a few of your coworkers’ postings.

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By Day 6

Respond to at least two of your colleagues’ postings for which you have an alternate framework option and explain your reasoning.

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how that framework might affect the analysis.

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 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.