Discuss the impact the doctoral prepared APRN on the legislative process and health care policy|My homework helper

Posted: February 12th, 2023

DNP Peers’ Posts Needing Responses

QUESTION: Discuss two (2) of the following areas this week in the discussion board:

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1. Discuss the impact the doctoral prepared APRN on the legislative process and health care policy?

2.  Identify an area of policy that you find interesting.  How will you work to get involved to show leadership and affect change in this area?

3. Describe effective communication techniques and how do you employ effective communication and collaborative skills?

4. What are the challenges and opportunities in forming a healthcare coalition?

5. Discuss workforce and regulatory issues that affect interprofessional collaboration in the clinical setting.

6. In what ways can you improve interprofessional collaboration in your setting?

7. How can your experience with a mentor improve your ability to mentor others?

 

Aimee Fahey

1. Discuss the impact the doctoral prepared APRN on the legislative process and health care policy?

APRNs can and must have influence on the complex system that produces legislation and policy.  We can’t assume that legislators know what RNs and APRNs do and should build relationships with them when they are out of session and aren’t distracted by competing priorities (Schaeffer & Habler, 2019). According to Mund (2021), prescriptive authority, the right to use the word diagnose, and the right for APRNs to directly bill Medicare for anesthesia services were all topics battelled over during the 1970’s. She goes on to say that it was 1989 when APRNs could directly receive reimbursement for anesthesia services from Medicare.  None of this advancement would have been possible without APRN involvement in the legislative process.

ARPNs can be involved in the legislative process by authoring policy briefs, partnering with legislators to draft legislation, ensuring the right stakeholders are brought to the discussion, and serving as content experts through their relationship with the legislators and/or through testimony.  They should also build coalitions with other professional associations and be involved from inception to implementation, not just when proposed legislation is coming to a vote (Mund, 2021). Nurses can also be impactful by holding legislative offices.  They are well prepared by their professional experience which gives them public trust and scientific knowledge and has helped them learn how to communicate, partner, and to find the win/win in situations (Schaeffer & Habler, 2019).

2. In what ways can you improve interprofessional collaboration in your setting? 

Mund (2021) describes a practice model implemented by Essential Health which assigns patients to a MD/NP or a MD/PA duo.  Patients who are high-risk or coming in for post-hospitalization follow-up see the MD while those coming in for chronic disease management or well-visit see the NP or PA. She points out key parts to interprofessional collaboration are members valuing their different perspectives and valuing the parts of their roles that overlap. In the practice model described, collaboration and role clarity led to improved access and improved satisfaction of the providers. Role clarity is an important part of the collaboration process.

Recently in my practice setting, I as a nursing leader, was working with two physician leaders and three other nursing leaders to discuss what patient diagnoses currently required an intermediate level of care at our hospital and to discuss any changes we wanted to make. The conversation was going well, and we were easily able to agree on patient care designations. Then there was a sudden fear and concern from one of the physicians that were going to try to increase the nurse-to-patient ratio. The intention of the meeting was to make sure the higher-acuity patients were in the right level-of-care and not in med-surg level patient ratios. It was important to quickly reaffirm that we were there to collaborate, with our patients at the center of our conversation, and to ensure we had the right resources, not fewer resources, available for the patients. At that moment, it felt as if the physician was suddenly wanting to exert control over nursing ratio decisions which is something that the multidisciplinary team should discuss and understand but is important to define as a nursing decision versus a medical decision. Continuing to work on flattening the power hierarchy, working to ensure open and respectful conversations amongst the different disciplines, and to clearly define roles and how they interplay both independently and together will help improve interprofessional collaboration (Mund, 2021).

References

Mund, A. (2021). Healthcare policy for advocacy in health care. In M. Zaccagnini, & J. M. Pechacek (Eds.),  The doctor of nursing practice essentials. (4th ed., pp. 131-161). Jones & Bartlett Learning.

Schaeffer, R., & Haebler, J. (2019). Nurse leaders: Extending your policy influence.  Nurse Leader17(4), 340–343. https://doi.org/10.1016/j.mnl.2019.05.010

 

Edith Gyan

1. In what ways can you improve interprofessional collaboration in your setting? 

Interprofessional Collaboration

Collaboration is when two or more professionals work together to solve problems about health and improve quality of life with a common goal. Gone are the days when there was an insufficient team approach to solving health issues. Nursing and medicine have created organizational environments that promote interprofessional collaboration to promote continuity of care and quality of health outcomes (O’Brien et al., 2009). Working as a team will achieve the

maximum results for patient functional status and care adherence. Having interprofessional collaboration helps control healthcare expenditures by reducing different appointments schedule. It enhances access to care and improves patient care delivery. The ever-changing healthcare system with evolving technology and complexity demands improved patient safety and interprofessional collaboration to relieve patients from stress. There is a need to improve health outcomes to safeguard patients from preventable medical errors through interprofessional cooperation (Zaccagnini & Pechacek, 2021). The interdisciplinary team includes nurses, nurse practitioners, physicians, pharmacists, social workers, occupational therapists, dieticians, and other allied health professionals. These teams provide coordinated, integrated, and evidence-based care to patients and families in this complex healthcare system. Without collaboration, there will be challenges in achieving the best outcome for the patients.  

Ways to improve interprofessional collaboration. 

Training professionals to improve interprofessional collaboration.

First, there is a need for professional training to increase interprofessional collaboration by educating doctors, nurses, and other health professionals to work together as a team for better health outcomes (O’Brien et al., 2009). Everyone must bury their differences and focus on achieving the highest quality care for the patients and their families. For example, training will enhance collaboration by improving referrals and using practice‐based interventions.

Using a current approach to care delivery using Research

Also, the mindset of providers needs to change from the traditional way of thinking and focus on new delivery approaches. Because every professional brings specialized skills and abilities, functioning together as a team will enable the team to provide high-quality, safer, cost-effective, and patient-centered care (Ash, Miller, & Zaccagnini, 2021). Gone are the days when doctors make decisions without patients. The current approach is that patients are involved in every step of their treatment plan and decision-making. Currently, things have changed because of research and evidence-based practice.

Open Communication

Interprofessional collaboration is achieved by encouraging open communication and creativity with the technological platform (Ash, Miller, & Zaccagnini, 2021). For example, in veteran affairs, we utilize the teams in communicating with dieticians, pharmacists, and even the engineers when there are issues to be communicated to the department. It has reduced delays in

caring for patients, especially if pharmacists need to release medication for patients. Interprofessional collaboration and open communication ensure a clear understanding of roles and responsibilities to make an informed decision. The healthcare team must be involved to achieve the best outcome of care.

Technology

It helps professionals to transfer information from one department to another. Collaboration lets the healthcare team view patient records and make necessary recommendations for care improvement and better outcomes. Also, technology can simulate interprofessional collaboration and improve models before implementation (O’Brien et al., 2009).

Overall, improving interprofessional collaboration is about the patient and the quality of care they will receive. Hence, improving interprofessional collaboration enhances patient and population health outcomes. Healthcare coalition enhances chronic disease management. Collaboration ensures that all appointments are scheduled within the time frame to reduce relapse. It makes patients complain about care, leading to job satisfaction and better care outcomes.

# 4 What are the challenges and opportunities in forming a healthcare coalition.

A Healthcare coalition is a collaborative network of healthcare organizations from the public and private sectors that serve as a multiagency with other groups to assist in preparing, responding, recovering, and mitigating activities related to healthcare organization disaster operations (Kansas Department of Health and Environment, 2021).     The healthcare coalition’s purpose is to prepare healthcare workers during emergencies and respond to unexpected occurrences like COVID-19. Coalitions enable healthcare workers to help during incidents to serve public health and impact the population in the short and long term. The healthcare coalition exists as emergency preparedness activities involving the health and medical members. The healthcare coalition requires planning, organizing, equipping, training, exercises, and evaluating duty demands (Kansas Department of Health and Environment, 2021).

Challenges of Healthcare Coalition

First, the healthcare coalition (HCC) is faced with sustainability and supporting the growth of the healthcare coalition. With so many different HCCs and approaches to handling finances within the alliance, it can be challenging to know which model to choose or which project to initiate first. Forming a coalition can bring tension between the amount of work that needs to be done and the availability of resources. Hence, delaying projects due to indecisiveness and bureaucracies (Kansas Department of Health and Environment, 2021).

Another challenge is bringing multiple stakeholders with diverse expertise and perspectives to agree upon set goals and targets. Diverse expertise leads to bureaucracies resulting in low creativity and lagging adaptation. The team may find it challenging to actualize personal initiative (Kansas Department of Health and Environment, 2021).

Another challenge is that different organizations will have varying perspectives, which could delay decision-making and hinder the coalition’s progress. Hence, members must agree to disagree and work with diverse opinions to fulfill the organization’s goals (Kansas Department of Health and Environment, 2021).

Opportunities for Healthcare Coalition

Healthcare Coalition facilitates information sharing among participating healthcare organizations and jurisdictional authorities in promoting everyday situational awareness (U.S. Department of Health and Human Services, 2012).

Also, HCC allocates resources fairly to support and expedite the mutual aid process and resource-sharing arrangements among Coalition members, supporting the request and receiving assistance from local, State, and Federal authorities (U.S. Department of Health and Human Services, 2012).

HCC ensures care coordination when there are incidences and responds accordingly to coalition members. Hence, HCC has consistent ways, objectives, and strategies when responding to emergencies (U.S. Department of Health and Human Services, 2012).

HCC facilitates an interface between the Healthcare Coalition and relevant jurisdictional authorities to establish adequate healthcare system resilience and medical surge support (U.S. Department of Health and Human Services, 2012).

References

Ash, L., Miller, C., & Zaccagnini, M. (2021). Interprofessional Collaboration for Improving Patient and Population Health. In M. Zaccagnini & J. Pechacek (Eds.),  The doctor of   nursing practice essentials: A new model for advanced practice nursing (4th ed., pp. 163-191). Jones & Bartlett Learning.

Kansas Department of Health and Environment (2021). Healthcare Coalitions. Retrieved from Kansas Department of Health and Environment: Preparedness – Healthcare Coalitions (kdheks.gov)

Mund, A. (2021). Healthcare Policy for Advocacy in Health Care. In M. Zaccagnini & J. Pechacek (Eds.),  The doctor of nursing practice essentials: A new model for advanced practice nursing (4th ed., pp. 131–158). Jones & Bartlett Learning.

O’Brien, J. L., Martin, D. R., Heyworth, J. A., & Meyer, N. R. (2009). A phenomenological perspective on advanced practice nurse-physician collaboration within an interdisciplinary healthcare team. Journal of the American Academy of Nurse Practitioners, 21(8), 444–453. https://doi.org/10.1111/j.1745-7599.2009.00428.x

U.S. Department of Health and Human Services (2012). The Healthcare Coalition Overview. Retrieved from https://www.phe.gov/Preparedness/planning/mscc/healthcarecoalition/chapter2/Pages/overeview.aspx

 

Garry Thompson

3. Describe effective communication techniques and how do you employ effective communication and collaborative skills?

For a team to have good collaboration and accomplish their goals, it is important for them to have a shared vision and team values. Communication competencies need to top the list for each member so the team can be successful. It is critical for each team member to feel that they have equal standing within the team and be able to openly share their ideas. One must also remember that nonverbal communication is sometimes more important than what you say. Maintaining good eye contact displays interest in what someone is communicating and being aware of your facial expressions and body posture can also assist in showing receptiveness. Smiling and leaning forward shows approachability. Once the non-verbal are appreciated then the team needs to be aware of how they respond to each other. It is vital to team collaboration to avoid responding by using qualifiers or being defensive. Team communication works better when emotion is eliminated from the dynamic and the focus is on how each member can contribute to the solution. In that case it is important that each member can function at their highest level, and everyone is providing their best effort as this will build trust and develop the best results (Ash et al., 2017, pp.233-274). To complete these tasks, the team lead needs to provide these expectations of team dynamic in their initial meeting. I have seen this occur as part of the charter of the team’s project which is reviewed within the first team meeting. It is also important to note that team member selection is vital if the team is made up of staff as the leaders can be selective as to which of their staff is skillful in each of these domains.

7. How can your experience with a mentor improve your ability to mentor others?

Throughout my nursing leadership career, I have been involved in several programs where I was paired with designated mentors. Those opportunities, although invaluable, I feel lacked some of the most important fundamentals for mentorship. I would classify those mandatory mentors as more of advisors, sponsors, or coaches.  They really assisted with my professional development and provided me with advice on job-related activities as they were an informative resource for my development. Although these formalized developmental processes expected me to identify a mentor, they instead failed to provide me that level of support and the central reason I feel that occurred was the inability to develop trust with the designated mentor. To me, the people I consider to be mentors in my career development are ones that I feel conformable enough to discuss my doubts and failures. Trust to me is a major component for development of mentorship and that leads to relationships that are lifelong and enriching for both involved.  I can truly only identify a few people in my life that I would consider as a mentor and me as a mentee and I consistently will draw upon the lessons they have provided me to support my decision making and even leadership activities. I find these lessons I have learned about mentorship is important as I have been asked to be involved in the same type of courses. I believe that for the designated person to be more successful, I will often start by explaining how I view our relationship will be and even explain what they can expect of me.  I will provide them with personal experiences of decisions I have made and be fully transparent as I will give examples of success and failures.  Ideally, one wants to accomplish some designated goals and provide insight into be mentee’s strength and weakness/opportunities. I will say from my personal experience mentorships are cultured by trust and continuous relationship building where people view vulnerability as a strength and an opportunity to learn (Newsome et al., 2021).

 

SOLUTION

  • The impact of a doctoral prepared APRN (Advanced Practice Registered Nurse) on the legislative process and healthcare policy is significant. APRNs who hold a Doctor of Nursing Practice (DNP) degree are equipped with advanced knowledge, skills, and expertise in patient care and healthcare delivery. They play a crucial role in advocating for patient-centered care, promoting quality and safety, and improving healthcare outcomes. As a result, they are in a prime position to influence and shape healthcare policy through the legislative process. APRNs can use their knowledge and expertise to educate policymakers and advocate for policies that support quality patient care, nursing practice, and the role of APRNs in the healthcare system.
  • I find the area of telehealth policy to be particularly interesting. Telehealth has the potential to transform the way healthcare is delivered, especially in rural and underserved communities. To get involved and show leadership in this area, I would engage in ongoing education and research about telehealth policy and its impact on healthcare delivery. I would also seek out opportunities to participate in relevant stakeholder groups and coalitions, such as telehealth advocacy organizations and professional associations. Additionally, I would engage in grassroots advocacy efforts, such as meeting with policymakers, submitting public comments on proposed policies, and speaking out in support of telehealth at public forums.
  • Effective communication is essential for successful collaboration and advocacy efforts. To employ effective communication and collaborative skills, it is important to be clear, concise, and respectful in all interactions. This includes active listening, being open to different perspectives, and seeking common ground. Other effective communication techniques include using visual aids, using plain language, and avoiding technical jargon. Additionally, it is important to establish clear expectations and to engage in ongoing, open communication with partners and stakeholders.

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