In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

• In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
• Review the Resources and reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

Instructions

Week 3 Project

In a Microsoft Word document of 2-3 pages formatted in APA style, you will describe the final proposal for your capstone project using the format below. Please note that the title and reference pages should not be included in the total page count of your paper.

Introduction

The introduction establishes the scope, context, and significance of the research being conducted by summarizing current understanding and background information (literature) about the topic, stating the purpose of the work in the form of the research problem and research question(s), explaining briefly the methodological approach used to examine the research problem, and highlights the potential outcomes your study may reveal.

Problem Statement

A problem statement is the description of a currently existing issue which needs to be addressed with evidence-based interventions. The statement of the problem is the focal point of the research. Be sure to back up the noted issue/problem with evidence. Must include citations of evidence.

Research Questions

To help you formulate your research question or questions the following website may be useful: https://researchrundowns.com/intro/writing-research-questions/

One or two research questions for your capstone project are suggested. Based on the constraint of project length of 10 weeks you may not have time to address a multitude of questions. One research question may be sufficient for your project and will make your life a lot easier.

Methodology

The methodology section of a research paper answers two main questions: How were the data collected or generated? You must include when and how you will collect the pre-intervention data, what the intervention(s) is and when/how the intervention(s) will be implemented then how and when you will perform your post-intervention data measurement. Lastly, how the data will be analyzed. A friendly reminder that unless your project has gone through the IRB process you will not be allowed to collect data on more than 3 people. For data collection, you will choose 3 people from your aggregate.

Timetable

Develop a timetable considering the following questions:

• When will your research start and finish?
• Are there particular stages to the research – e.g. piloting, then main research? Screening interviews, then a main study? If there are stages, what are they?
• What objectives have you set for this investigation? Are they addressed in the timeline?
• Is the timetable realistic?
• Is it influenced by external constraints or deadlines?
• How will you provide regular updates and progress reports and to whom will you provide them? How will you demonstrate progress?

On a separate references page, cite all sources using APA format.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
•  This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

To support your work, use your course and text readings and also use resources from the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA Style website through the APA icon below.

TASK

Post your initial response to one of the two topics below

The ACA or the AHCA: Imperfect Solutions to Increasing Access to Health Care?

This week’s discussion focuses on the federal government’s role in protecting the public’s health using the ACA and current efforts to “repeal and replace” the ACA. Please note that the government’s role in protecting the public’s health did not begin with the ACA. In the late 1800s, Lilian Wald brought health care to the community. And in 1965, Congress passed bills authorizing Medicare and Medicaid. Since 1965, Congress has expanded government-sponsored health care to pregnant women and children.

Topic 1

• Compare the current provisions in the ACA with those in the failed first version of the AHCA. 
• Share your opinions about why the AHCA failed in the first attempt at passage.

APA format. MUST BE  1 SEPERATE RESPONSE TO EACH QUESTION. 1 paragraph per response. Use only scholar authors only. References needed

Discussion 1:

According to Spath (2018), FOCUS PDCA is a frequently used quality improvement model used to improve processes. This change model has two phases. The first phase, FOCUS, consists of finding a process needing improvement, organizing a team, clarifying the current process and areas needing change, understanding why improvement is needed, and selecting actions to adjust the process (Spath, 2018). The second phase, PDCA, includes planning through investigation, identification, and brainstorming ways to improve the measure, do or incorporate the process improvement on one unit, check the process to make sure changes are improving the measure, and acting to maintain improvements (Spath, 2018).  This model provides the structure through analysis, planning, outcomes, and feedback.

          FOCUS PDCA is a change model that can be used to decrease falls. Falls during toileting is one safety concern that needs improvement. The quality team, along with other care team members, were organized to clarify current practices and policies and noted care team members are not staying within arms-reach of patients that trigger high fall risk. It is imperative to keep an open line of communication between the team and frontline staff (Godlock, Christiansen, & Feider, 2016).  Understanding the policy deviations and brainstorm to select appropriate interventions to decrease falls during toileting. Interventions that need to be changed requires education to all care team members about the falls policy and how important it is to stay within arms-reach of patients that trigger high fall risk. Education also needs to be provided to CNA’s on certain medications that would make patients higher risk like blood pressure-lowering medications, and diuretics. These interventions will be rolled out to one unit to determine the efficacy of changes. These interventions need to be reviewed for improvement and modified if necessary. Once improvement has been met, it is crucial to maintain these improvements. Maintaining improvements can be accomplished through monthly quality improvement meetings.

Discussion 2:

I selected the quality improvement model of FOCUS-PDCA. This model is split up into two separate phases the FOCUS phase and the PDCA phase. F is for finding a problem that need improvement. Falls can be a detrimental occurrence than can affect patients and staff that is involved. Nursing times stated that as many as 20% of hospitalized patients experience a fall at some point during their stay (Grant, 2013).  Even though falls are not always preventable they can be decreased with proper staff and patient education. If one fall can be prevented by a changed policy that can be one less patient that avoids an extended hospitalization or additional injury. O if for organizing a team. The team I have selected for the improvement project is my nurse manager and mentor as well as some floor nurses from both shifts and our patient care techs. C is to clarify the current policy and changes that need to be made. Our current policy is a yellow falling star sign that can sometimes be confusing to patients and family members. U is for understanding the causes of variation. Variations from standard fall precautions could be patient confusion or patient noncompliance. Another variation could be that staff coming in to assist your patient may not be aware they are on fall precautions if the proper prevention measures are not in place. S is for selecting the actions needed to improve the process. There needs to be something more in depth for each patient not just something generic. In the next phase, P is for plan to change the process. In a study by Lipsett patients falls were decreased by color coded mobility cards being placed in each patient room depending on how they required assistance (Lipsett, 2019). This would be much easier to see and associate with then just a generic fall risk or no fall risk. D is to do the change on a small scale. We will pilot the fall risk mobility cards on our unit. We have a mix of post op, post-partum, and medical surgical patients. C for checking the data to determine its effectiveness. We will compare the falls for the next months after the implementation with the fall rate prior to implementation. Lastly is A to act to maintain the gains.  Randomly compliance should be monitored to make sure that falls risk mobility cards are being used. With this model we will put plans into place and follow up to make sure the best plan possible is put into place.

Assignment:

Healthcare Coverage Gap

The  ACA was meant to provide quality health care coverage for all yet a  coverage gap for some populations especially in states that oppose  Medicaid expansion. Based on what you have learned so far in this  course, create a PowerPoint presentation that addresses the coverage gap  problem, who is impacted by the coverage gap, the role the ACA plays in  the coverage gap, why the coverage gap should be closed, and solutions/  recommendations for closing the gap. Address the following in your  PowerPoint: 

• Select  one state opposed to Medicaid expansion and describe why. Then,  consider your own state. What are the benefits and drawbacks to Medicaid  expansion in your state?
• Define what the coverage gap is (problem/issue)
• Discuss how the coverage gap impact low income healthcare consumers population.
• What role does the ACA have in widening or closing the coverage gap?
• Why is it important to close the gap (implications for positive social change)?
• What  are some solutions to closing the coverage gap and how can healthcare  equity help close the gap? Include recommendations and/or solutions.

Your PowerPoint presentation should include/address:

• Title Slide (1 slide)
• Objectives Slide (1 slide)
• Medicaid expansion (1-2 slides)
• Coverage gap – define/problem/issue (1-2 slides)
• Coverage gap impact on low income healthcare consumers (2-3 slides)
• Role ACA has in widening or closing the coverage gap (1-2 slides)
• Close the gap (1-2 slides)
• Solutions to closing the coverage gap and how can healthcare equity help close the gap? (2-3 slides)
• Reference slide (1-2 slides).

Assignment Expectations

Length: 9-14 slides (in addition to the title slide and reference slides) 

Structure:  Include a title slide and reference slide in APA format.  These do not  count towards the minimum slide count for this assignment.  Your  presentation must include an objectives slide.  Be sure to fully explain  all slides in the Speaker Notes.

References:  Use the appropriate APA style in-text citations and references for all  resources utilized to answer the questions. A minimum of three (3)  scholarly sources are required for this assignment. 

Format: Save your assignment as a Microsoft PowerPoint document (.pptx) or a PDF document (.pdf).