In today’s rapidly changing healthcare system, political decisions affect the future of health delivery systems, healthcare professionals, and the populations they serve. Students will examine the policy-making process and its effect on healthcare delivery, cost, quality, and access. Students consider the importance of bringing healthcare issues to the forefront of the federal and state agendas, the governmental response through legislation and regulation, and the areas in which they can advocate for positive outcomes in program/policy design, implementation, and evaluation. Global health issues are analyzed for their relevance and impact on the nurse advocate’s development. Students demonstrate the integration of policy decision-making into professional nurse practice for the benefit of individuals and populations through discussions, reflection, case studies, and professional communications techniques as political tactics to influence policy outcomes.
Prerequisites
MSN Nurse Practitioner Specializations
- NURS 6002N or NURS 6003N
MSN Other Specializations
- NURS 6002 or NURS 6003
NURS 6050 Curriculum & Program Development (3 Credits)
Curriculum development and program development in nursing are dynamic and ever-changing processes. Individual courses in a nursing program of study represent a whole integrative curriculum responsive to internal and external stakeholders. This graduate-level course examines the history, development, and future trends in the nursing education curriculum. The course focuses on curriculum development, which includes the creation of an undergraduate or graduate nursing program of study. An in-depth examination of professional nurses’ evaluation and accreditation processes is provided. Asynchronous discussions and collaborative learning activities will facilitate dialogue about curriculum development and evaluation. This course was previously NUR-560000
Policy and Advocacy for Improving Population Health Care (NURS 6050)
To Get Ready:
- Examine the resources and consider the mission of state/regional boards of nursing, which is to protect the public through the regulation of the nursing practice.
- Consider how essential regulations may affect nursing practice.
- Examine key nursing practice regulations from your state’s/board region’s of nursing and those from at least one other state/region, and choose at least two APRN regulations to focus on for this Discussion.
Compare at least two APRN boards of nursing regulations in your state/region to those in at least one other state/region. Explain how they may differ. Provide specifics and examples. Then, please explain how the regulations you chose might apply to Advanced Practice Registered Nurses (APRNs) who have the legal authority to practice within their education and experience. Give at least one example of how APRNs can follow the two regulations you chose. Policy and Advocacy for Improving Population Health Care (NURS 6050)
NURS – 6050N Policy and Advocacy for Improving Population Health
Each state board of nursing has the authority to impose regulatory restrictions to protect the public. It was interesting to look through the state regulations and how they differed while deciding to return to school for an advanced practice degree. I live in rural Northwest Missouri, about thirty minutes from the Iowa border. The nurse licensure compact, which all states surrounding Missouri are a part of, allows nurses to practice in multiple states as an RN (Nurse Licensure Compact, 2020). Unfortunately, after obtaining my PMHNP, I discovered that the regulations in Missouri and Iowa differ quite a bit.
To begin, Iowa allows nurse practitioners to practice independently within the scope of their degree specialty, which is known as full-scope practice. In Iowa, an APRN may prescribe medications to patients with the nurses’ specialty and independently prescribe controlled substances up to level two as long as they have a current license and are registered with the controlled substance acts (Iowa Board of Nursing, 2020). The APRN must have a collaborative practice agreement with a physician to see patients in Missouri. Furthermore, unless stated explicitly in the joint practice agreement, nurse practitioners are not permitted to prescribe controlled substances. The APRN must have prescription authority, proof of 300 hours of precepted pharmacological experience, and 1,000 practice hours if specified (Board of Nursing, 2020).
Another distinction between Iowa and Missouri is the authorization signature required for a patient to obtain a medical marijuana identification card. The medical diagnosis requirements for the use of medical marijuana remain consistent across states. However, in Missouri, a nurse practitioner cannot sign the authorization form (Board of Nursing, 2020). Nurse practitioners, physician assistants, MD/DOs, and podiatrists are permitted by Iowa law to sign the health care practitioner attestation (Iowa Board of Nursing, 2020).
References
(2020). Retrieved from Iowa Board of Nursing : https://nursing.iowa.gov/
Board of Nursing . (2020). Retrieved from Missouri Division of Professional Registration: https://www.pr.mo.gov/nursing.asp
Nurse Licensure Compact. (2020). Retrieved from NCSBN: https://www.ncsbn.org/nurse-licensure-compact.htm.
NURS 6050: Improving Population Health Through Policy and Advocacy
Regulations of the Board of Nursing
For a long time, advanced practice registered nurses (APRNs) in Michigan have been fighting for full prescribing authority. The state of Michigan does not have a nursing practice act. Instead, APRNs are governed by the Public Health Code 1978, which also governs 25 other health professions (Nurse Practitioner Schools, 2020). With the passage of MI HB 5400 in 2017, Michigan nurses celebrated a victory. This bill empowers Michigan APRNs to prescribe non-scheduled medications, perform hospital rounds, make independent house calls, and order speech and physical therapy without the involvement of a collaborating physician. They still require the collaboration of a collaborating physician to prescribe controlled substances in schedules two through five. As a delegated act, controlled prescriptions require the physician’s and APRN’s names and their DEA registration numbers (Michigan Legislature, 2017). On the other hand, Minnesota’s APRNs have full prescribing authority (Minnesota Board of Nursing, n.d.). They can prescribe any medication, controlled or not, without the involvement of a collaborating physician. They also have complete freedom to practice without the supervision of a collaborating physician. A collaborating practice agreement is not required.
Giving APRNs the legal authority to practice within their education and experience will help alleviate the healthcare provider shortage, lower healthcare costs, increase patient access to care, and allow APRNs to fully utilize their knowledge and skills (Nurse Practitioner Schools, 2020). As members of the collaborative healthcare team, APRNs must continue to fight for their rights. To ensure continued progress toward this goal, APRNs must participate in the political process (Milstead & Short, 2019).
APRNs in Michigan can comply with MI HB 5400 by learning about the specific changes to the regulations. They must renew their collaborating agreement on an annual basis or whenever there are changes to the agreement. It is critical to understand which medications are considered controlled and uncontrolled and the schedules. To combat the opioid epidemic, Michigan, for example, made gabapentin a schedule five controlled substance in 2019. (Department of Licensing and Regulatory Affairs, 2019).
References
Department of Licensing and Regulatory Affairs. (2019, January 9). Gabapentin scheduled as
controlled substance to help with state’s opioid epidemic. https://michigan.gov/lara/
4601,7-154-11472-487050-00.html
Michigan Legislature. (2017, April 9). Public Health Code Act 368 of 1978: 333.17211a
Advanced practice registered nurse; authority to prescribe nonscheduled prescription
drug or controlled substance. https://legislature.mi.gov/(S(au34kb10nbx0fbhmhac50qc))/
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning
Minnesota Board of Nursing. (n.d.). Advanced practice registered nurse (APRN) licensed
general information. https://mn.gov/boards/nursing/advanced-practice/-practice-registered-nurse-(aprn)-licensure-general-information/
Nurse Practitioner Schools. (2020, October 26). Michigan nurse practitioners: The fight for full
practice authority. https://nursepractitionerschools.com/blog/michigan-np-practice-
authority/
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NURSING 6051:
To Get Ready:
- Examine the resources and think about the web article Big Data Means Big Potential, Big Challenges for Nurse Executives.
- Consider your own experience with complex health information access and management and potential challenges and risks you may have encountered or witnessed.
BY DAY 3 OF WEEK 5
Post an explanation of at least one potential benefit of using big data as part of a clinical system. Then, explain why you believe at least one potential challenge or risk of using big data as part of a clinical system exists. Propose at least one strategy that you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using the big data you described. Provide specifics and examples.
RE: Discussion – Week 5
Big Data Risks and Rewards
Data interpretation occurs at all times of the day, whether a person is aware of it or not. If a large pool of data is integrated in a meaningful way, it can be extremely useful. According to Wang et al. (2018), Pooling big data can “improve the quality and accuracy of clinical decisions.” Profit is always the goal where I work, and probably in any healthcare facility. When our chief financial officer (CFO) and admissions team send out their weekly forecast, I see data that they use. This chart displays how many patients are being discharged, how many new patients are expected, and our current census. Having the data organized is critical because it shows the admission coordinator if more outreach is needed to bring in new patients. It also shows them whether we have enough beds to accommodate the influx of new patients. It is directly relevant to me because it is used for staffing requirements. This data is critical to the operation, but it wouldn’t be as useful if it hadn’t been aggregated into a concise template for quick access to the information (Thew, 2016).
However, there are risks to combining large amounts of data. As more data is collected, the organization’s storage requirements will grow. Storage has a cost, and lowering those costs may jeopardize patient privacy (Wang et al., 2018). Our company’s computer system was recently infected with ransomware. Having all of our data in one place turned out to be a bad idea. The confidentiality of our patients’ and employees’ information had been jeopardized. It is critical to have proper IT security in place when dealing with large amounts of data. An intriguing idea for reducing the risk of ransomware recurrence is to divide data into blocks that are distributed across multiple virtual servers (Levitin, 2019). By hacking into a single database or server, the attacker would not have access to the data. In addition to dividing the data, an early warning detection system would be helpful in detecting a breach (Levitin, 2019).
The risks and benefits of big data aggregation are well documented. Data can be collected and stored securely, ensuring patient and user confidentiality by mitigating some risks by increasing security protocols.
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References
Levitin, G., Xing, L., & Huang, H.-Z. (2019). Security of Separated Data in Cloud Systems with Competing Attack Detection and Data Theft Processes. Risk Analysis : An Official Publication of the Society for Risk Analysis, 39(4), 846–858. https://doi-org.ezp.waldenulibrary.org/10.1111/ris…
Thew, J. (2016). Big data means big potential, challenges for nurse execs. Retrieved December 27, 2020 from https://www.healthleadersmedia.com/nursing/big-dat…
Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3-13.
RE: Discussion – Week 5
Big data sets are examined by information professionals, particularly in the hospital setting, for budgeting, staffing, patient admissions and discharges, etc. Data can be computed for all areas that aid inefficient operation. According to Tishgart (2012), more data means more knowledge and opportunities for organizations to use and benefit from that data. McGonigle and Mastrian (2018) This is partially true because the goal of storing this data is to learn and improve, but there are always risks when dealing with technology and large amounts of data.
Some advantages of using big data in a clinical system include improved patient outcomes, as big data allows us to see what is working well for our patients and where we are falling short. If med errors or patient incidents occur frequently, big data sets can help see a bigger picture of what is causing these issues, such as noticing that these incidents occur on days when the floor is understaffed. Another advantage of big data is that it helps with budgeting because even though we are there to care for patients, we are still a business that needs to profit. Big data sets can show where budget cuts are required and which departments require more funding to run efficiently.
Errors and setbacks are possible whenever technology is involved. One disadvantage of big data sets is the possibility of a security breach. In 2016, my workplace was the victim of a cyber attack in which patient and employee information was compromised. In exchange for the computer system, the hackers demanded a ransom. We operated under the Emergency Operations Plan during this time, and paper charting was used. Since then, the organization has upgraded security measures and made changes to email and internet access to accommodate the transition. All employees received training on how to avoid phishing and ransomware and how to identify potential threats. Homomorphic encryption can be used to prevent third parties from accessing data and storing data across multiple servers to make sensitive information more difficult to access. Policy and Advocacy for Improving Population Health Care (NURS 6050)
References
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-dat…
Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understand its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3-13.
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