NURS 6050 Policy & Advocacy for Improving Population Health
In today’s rapidly changing healthcare delivery system, decisions made within the political arena impact the future of healthcare systems and the populations that healthcare professionals serve. In this course, students examine healthcare reform and its impact on healthcare delivery, population health, and nursing practice. They evaluate policies that influence the structure, financing, and quality in healthcare and examine healthcare delivery from a global perspective. Through discussions, case studies, and other activities, students examine the effects of legal and regulatory processes on nursing practice, healthcare delivery, and population health outcomes. Students also examine ways to advocate for promotion and preservation of population health and gain the necessary skills to influence policy and support changes effected by the passing of new healthcare reform legislation.
This course aims to equip students with the knowledge and skills necessary to navigate the complex and ever-changing landscape of healthcare policy and advocacy. Students will gain a deeper understanding of how healthcare reform and political decisions impact healthcare delivery and population health outcomes. They will also learn how to evaluate policies and regulations that influence healthcare financing, structure, and quality, and explore healthcare delivery from a global perspective. Through case studies and other activities, students will learn how to advocate for the promotion and preservation of population health and gain the skills to influence policy and support changes brought about by new healthcare reform legislation. Overall, this course aims to empower students to be active and informed participants in shaping the future of healthcare and improving the health of the populations they serve.
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’ Assessment and accreditation processes is provided. Asynchronous discussions and collaborative learning activities will facilitate dialogue about curriculum development and Assessment. This course was
NURS 6050 – Policy and Advocacy for Improving Population Health
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
State boards of nursing have the authority to implement regulatory measures to protect the public. I recently returned to school for an advanced practice degree and found it interesting to research the regulations in different states. For example, I live in rural Northwest Missouri, which is close to the Iowa border. Both states are part of the nurse licensure compact, which allows RNs to practice in multiple states. However, after obtaining my PMHNP, I discovered that the regulations in Missouri and Iowa differ significantly.
In Iowa, APRNs have full-scope practice within their degree specialty, which means they can practice independently. APRNs in Iowa can prescribe medications and controlled substances up to level two as long as they have a current license and are registered with the controlled substance acts. In contrast, APRNs in Missouri need a collaborative practice agreement with a physician to see patients. Additionally, APRNs are not permitted to prescribe controlled substances unless it is stated explicitly in the joint practice agreement. They also need prescription authority, proof of 300 hours of precepted pharmacological experience, and 1,000 practice hours if specified.
Another difference between Iowa and Missouri is the authorization signature required for a patient to obtain a medical marijuana identification card. While the medical diagnosis requirements are consistent across states, in Missouri, a nurse practitioner cannot sign the authorization form. However, Iowa law permits nurse practitioners, physician Helpants, MD/DOs, and podiatrists to sign the health care practitioner attestation.
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
Advanced practice registered nurses (APRNs) in Michigan have been advocating for full prescribing authority for a long time. 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. In 2017, Michigan APRNs celebrated a victory with the passage of MI HB 5400 which empowers them 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. However, they still require collaboration from a physician to prescribe controlled substances in schedules two through five. In contrast, Minnesota APRNs have full prescribing authority and 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.
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. APRNs must continue to participate in the political process to ensure continued progress towards their goal of full prescribing authority. APRNs in Michigan can comply with MI HB 5400 by understanding the specific changes to the regulations, renewing their collaborating agreement on an annual basis and understanding which medications are considered controlled and uncontrolled and the schedules.
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/
NURS 6050 Policy & Advocacy for Improving Population Health Required Course Readings
The links are for required readings found in the Walden databases ONLY. For all other readings, see your course resources.
Enter your myWalden user name and password at the prompt.
ANA’s Foundation of Nursing Package:
Fowler, M. D., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association.
American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Silver Spring, MD: American Nurses Association.
American Nurses Association. (2010). Nursing: Scope & standards of practice. Silver Spring, MD: American Nurses Association.
Backer, E. L., Geske, J. A., McIlvain, H. E., Dodendorf, D. M., & Minier, W. C. (2005). Improving female preventive health care delivery through practice change: An Every Woman Matters study. Journal of the American Board of Family Practice, 18(5), 401–408.
Bainbridge, D., Brazil, K., Krueger, P., Ploeg, J., & Taniguchi, A. (2010). A proposed ystems approach to the Assessment of integrated palliative care. BMC Palliative Care, 9, 8-19. doi: 10.1186/1472-684X-9-8
Begley, A. (2010). On being a good nurse: Reflections on the past and preparing for the future. International Journal of Nursing Practice, 16(6), 525-532. doi: 10.1111/j.1440-172X.2010.01878.x
Berwick, D. (2005). My right knee. Annals of Internal Medicine, 142(2), 121–125.
Bloch, G., Rozmovits, L., & Giambrone, B. (2011). Barriers to primary care responsiveness to poverty as a risk factor for health.BMC Family Practice, 12, 62. doi: 10.1186/1471-2296-12-62
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients. International Journal for Human Caring, 14(4), 27-30.
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions. Journal of Law, Medicine & Ethics, 39(2), 121-129. doi: 10.1111/j.1748-720X.2011.00582.
Davis-Alldritt, L. (2011). Presidential inaugural address: Advocacy, access, and achievement. Journal of School Nursing, 27(4), 249-251.
Deyton, L., Hess, W. J., & Jackonis, M. J. (2008, Winter). War, its aftermath, and U.S. health policy: Toward a comprehensive health program for America’s military personnel, veterans, and their families. Journal of Law, Medicine, & Ethics, 36(4), 677-689.
Erlen, J. (2010). Informed consent: Revisiting the issues. Orthopaedic Nursing, 29(4), 276-80. doi:10.1097/NOR.0b013e3181e517f1
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Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery: Review of medical error. JAMA: Journal of the American Medical Association, 302(6), 669–677. doi: 10.1001/jama.2009.1011
Gardner, D. (2010). Health policy and politics. Expanding scope of practice: Inter-professional collaboration or conflict? Nursing Economic$, 28(4), 264-266.
Goethals, S., Gastmans, C., & Dierckx de Casterle, B. (2010). Nurses’ ethical reasoning and behaviour: A literature review.International Journal of Nursing Studies, 47(5), 635-650. doi: 10.1016/j.ijnurstu.2009.12.010
Hancock, C., & Cooper, K. (2011). A global initiative to tackle chronic disease by changing lifestyles. Primary Health Care, 21(4), 24-26.
Harrowing, J. (2009). The impact of HIV education on the lives of Ugandan nurses and nurse-midwives. Advances in Nursing Science, 32(2), E94-E108. doi: 10.1097/ANS.0b013e3181a3d754
Halpern, S. D., Truog, R. D., & Miller, F. G. (2020). Cognitive bias and public health policy during the COVID-19 pandemic. Jama, 324(4), 337-338.
Karpf, T., Ferguson., & Swift, R. (2010). Light still shines in the darkness: Decent care for all. Journal of Holistic Nursing, 28(4), 266-274. doi: 10.1177/0898010109359310
Kindig, D. (2007). Understanding population health terminology. The Milbank Quarterly, 85(1), 139-61. doi: 10.1111/j.1468-0009.2007.00479.x
Kindig, D., Asada, Y., & Booske, B. (2008). A population health framework for setting national and state health goals. JAMA, 299(17), 2081-2083. doi: 10.1001/jama.299.17.2081
Koplan, J. P., Bond, C., Merson, M. H., Reddy, K. S., Rodriquez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (2009). Towards a common definition of global health. The Lancet, 373, 1993–1995.
Mantzari, E., Reynolds, J. P., Jebb, S. A., Hollands, G. J., Pilling, M. A., & Marteau, T. M. (2022). Public support for policies to improve population and planetary health: A population-based online experiment assessing impact of communicating evidence of multiple versus single benefits. Social Science & Medicine, 296, 114726.
Mullinix, C., & Bucholtz, D. (2009). Role and quality of nurse practitioner practice: A policy issue. Nursing Outlook, 57(2), 93-8. doi:10.1016/j.outlook.2008.07.006
Paquin, S. (2011). Social justice advocacy in nursing: What is it? How do we get there?. Creative Nursing, 17(2), 63-67. doi: 10.1891/1078-4535.17.2.63
Pavlish, C., Brown-Saltzman, K., Hersh, M., Shirk, M., & Rounkle, A. (2011). Nursing priorities, actions, and regrets for ethical situations in clinical practice. Journal of Nursing Scholarship, 43(4), 385-395. doi: 10.1111/j.1547-5069.2011.01422.x
Reinhardt, U. E. (2010, Jan 20). State of the nation (a special report): Voices—A good start. The Wall Street Journal, p. R5.
Reinhardt, U. E. (2010, Jan 30). Repercussions of simplicity. New York Times p. A14.
Schwartz, S., Ireland, C., Strecher, V., Nakao, D., Wang, C., and Juarez, D. (2010). The economic value of a wellness and disease prevention program. Population Health Management, 13(6), 309-317. doi: 10.1089/pop.2009.0070
Soloman, P. (2010). Inter-professional collaboration: Passing fad or way of the future? Physiotherapy Canada, 62(1), 47-55. doi: 10.3138/physio.62.1.47
Stein, R. (2010, Nov 08). Medicare renews debate on health costs. The Washington Post, pp. A.1-A.1.
Stein, R. (2010, Nov 08). Review of prostate cancer drugs Provenge renews medical cost-benefit debate. The Washington Post.
Tan, R. K. J., Tang, W., & Tucker, J. D. (2023). Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery. Current Opinion in HIV and AIDS, 18(1), 18-26.
Tengland, P. (2010). Health promotion and disease prevention: Logically different conceptions? Health Care Analysis, 18(4), 323-341.doi: 10.1007/s10728-009-0125-0
Zomorodi, M., & Foley, B. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746–1752. doi: 10.1111/j.1365-2648.2009.05023.x
